Transmission of mutans streptococci in mother-child pairs

BACKGROUND & OBJECTIVES

Dental caries is an infectious, transmissible disease. Maternal transfer of mutans streptococci (MS) has been a subject of research. The aim of this study was to evaluate the transmission of MS from mother to children through genetic analysis.

METHODS

Thirty mother-child pairs were included and divided into three groups according to the age of the children. Saliva samples were collected and MS colonies from each mother-child pair were isolated. After inoculation and incubation, MS colonies were submitted to amplification technique by polymerase chain reaction (PCR) for identification and arbitrarily primed PCRs (AP-PCRs) to determine various MS genotypes.

RESULTS

From birth to six months of age, 30 per cent of children exhibited MS colonization, and by the age of 30 months, 100 per cent harboured the bacteria (P < 0.001). Factors associated with MS colonization were eruption of teeth (P < 0.001), feeding habits with mean colony count being significantly lower in breast-fed as compared to bottle-fed children (P < 0.001) and a significant association between mean MS count of child and mother's practice of sharing spoon with child (P < 0.001). The AP-PCR fingerprinting profile analysis showed 17 MS groups (clusters) containing identical or highly related isolates in mother-child pairs with a high level of similarity (77.27 %).

INTERPRETATION & CONCLUSIONS

The presence of matching MS genotypes suggested vertical transmission from mothers to children. Feeding habits, gum cleaning and number of erupted teeth in children had significant effect on MS colonization. There is a need to develop strategies to present MS colonization in children.

Correlation between dental caries experience and mutans streptococci counts by microbial and molecular (polymerase chain reaction) assay using saliva as microbial risk indicator

Background:

The aim of this study was to assess the relationships of quantitative salivary levels of mutans streptococci (MS) in children, aged 3–6 years and 12–15 years, exhibiting variable patterns of caries activity, and to compare the association of MS in saliva using microbial and molecular (polymerase chain reaction [PCR]) assay.

Materials and Methods:

In this cross-sectional observational study, eighty children were included, forty children each in Group I (3–6 years) and Group II (12–15 years). Children were further divided into two subgroups (Group IC, INC and Group IIC, IINC) based on their dental caries status. Saliva samples were collected and plated onto Mitis Salivarius-Bacitracin agar plates. After detection of MS, DNA was isolated and purified, and MS were evaluated using the PCR and AP-PCR.

Results:

Of the selected 80 children, 42 were male and 38 were female. In Group IC, the mean colony count was 2.27 ± 0.54 × 10⁵ CFU/ml, and in Group INC, the mean colony was found to be 1.61 ± 0.54 × 10⁵ CFU/ml. In Group II, where mean colony count of 3.31 ± 0.85 × 10⁵ CFU/ml and 2.44 ± 0.54 × 10⁵ CFU/ml was observed in Group IIC and Group IINC, respectively.

Conclusion:

The mean colony count increased with increasing age and was also more in children with dental caries. Based on the matrices generated by the PCR analysis using coefficient slipped-strand mispairing, wide range of genetic diversity was seen in cases of children with and without clinically detectable caries.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study

Background:

To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)₂) in inducing root end formation of immature roots of traumatized young permanent anterior teeth.

Materials and Methods:

The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)₂ Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)₂ group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test).

Results:

In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)₂ Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)₂ group.

Conclusion:

MTA and Ca(OH)₂, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste

PURPOSE

This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Trioxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors.

METHODS

Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups--Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months.

RESULTS

The mean time taken for barrier in Group I was 4.50 +/- 1.56 months whereas for Group II was 7.93 +/- 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 +/- 1.49 months whereas the time period for Group II was 6.43 +/- 2.59 months (p value- 0.0067).

CONCLUSION

MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

Comparison of oral ketamine and oral midazolam as sedative agents in pediatric dentistry

The safe and effective treatment of uncooperative or combative preschool children with extensive dental needs is one of pediatric dentist's ongoing challenges. The traditional methods of behavior management are no longer acceptable to parents as they are not ready to spare more time for dental treatment of their children. Keeping this in mind, the present study was designed and carried out to evaluate the sedative effects of oral ketamine and oral midazolam prior to general anesthesia. Twenty uncooperative children in the age-group of 2-6 years were selected after thorough medical examination and investigations. Informed consent was obtained from the parent. This was a randomized double-blind study. An anesthesiologist administered either 0.5 mg/kg midazolam or 5 mg/kg ketamine orally. The heart rate, respiratory rate, and oxygen saturation were recorded at regular intervals. The sedation and anxiolysis scores were also recorded. The parents were asked to answer a questionnaire at the follow-up session the next day on the surgical experience of the parent and the child and side effects experienced, if any. When the data was subjected to statistical analysis, it was observed that both drugs resulted in adequate sedation at the end of 30 min, with oral midazolam providing significantly better anxiolysis. The heart rate and respiratory rate were marginally higher with oral ketamine. The questionnaire revealed a better response with oral midazolam; side effects were more prominent with oral ketamine.