-
[show abstract]
[hide abstract]
ABSTRACT: Severely hypomineralised first permanent molars (FPMs) in children with molar incisor hypomineralisation (MIH) often require comprehensive restorative treatment. Different types of treatment have been described in the literature, including conservative treatment and use of various types of crowns.
To describe a gentle and minimally invasive method for restoration of severely hypomineralised FPMs and to perform an initial, practice-based evaluation of the outcome for up to a 10-year follow-up period.
Thirty-three children (mean age 12.1 years, SD 2.6) were treated with 57 minimally invasive cast adhesive gold copings (CAC). Sedation, local analgesia using a computer-controlled injection device, and behaviour management techniques were used to secure gentle care of the child. In cases with need for treatment of several teeth, the teeth not under treatment were covered by splints. The preparation border was placed in sound enamel, allowing 1/2-2 mm space to secure sufficient strength of the final restoration, which was cemented with dual composite cement. Follow-up examinations were performed by the dentists referring the children.
All the children referred for treatment could be treated using this procedure, and of the 57 CAC, 56 (98.2 %) were still functioning after a mean observation period of 38.6 months (SD 28.9).
In addition to existing types of treatment, minimally invasive CAC seems to be a feasible and useful method for restoration of FPMs with demarcated opacities and post-eruptive surface loss in children with MIH.
European Archives of Paediatric Dentistry. Official Journal of the European Academy of Paediatric Dentistry. 02/2013; 14(1):35-9.
-
[show abstract]
[hide abstract]
ABSTRACT: Hypophosphatemic rickets (HR) is a rare hereditary disease in which dental problems in terms of spontaneous periapical infections are frequently reported. Most previous reports have been based on a small number of HR patients and have been published before the disease could be confirmed genetically. The aim of the present study was to describe the periapical and endodontic status of permanent teeth in patients with genetically and/or biochemically confirmed HR. The patients were recruited from a medical study on HR patients. The patients underwent a dental examination including a digital panoramic radiograph, which was scored for endodontically affected teeth (i.e. teeth with periapical radiolucencies and/or endodontically treated teeth). A total of 52 patients (age range: 5·7-74·5 years; 17 males and 35 females) were included. HR patients were characterised by a high number of endodontically affected teeth (mean: 4·2; s.d.: 5·0). The number of affected teeth rose significantly with age (P < 0·01), and no statistically significant gender difference was found. The relative distribution of endodontically affected teeth in the three tooth groups (incisors and canines, premolars, and molars) varied according to age. In the youngest age group, only incisors and canines were affected, while the relative proportion of affected premolars and molars increased with age. Endodontically affected teeth are common in HR patients, and the number of affected teeth increased significantly with age. Hence, the need for endodontic treatment among HR patients is comprehensive.
Journal of Oral Rehabilitation 09/2011; 39(2):144-50. · 1.53 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Demarcated opacities in permanent first molars are common developmental tooth defects, characterized by areas with insufficient mineralization of the enamel. The defects present clinically as a continuum from creamy-white demarcated opacities, yellowish-brown demarcated opacities to macroscopic loss of tooth substance. The etiology is sparsely elucidated, but asthma drugs have been suspected to increase the prevalence. The aim of this study was to examine the prevalence of demarcated opacities in permanent first molars among 6-to-8-year-old children with prescriptions and without prescriptions for asthma drugs.
In a cross-sectional study in two Danish municipalities, all children aged 6-8 years (n = 891) were included. A total of 745 (83.6%) went through a dental examination during which demarcated opacities and tooth substance loss due to these were recorded. The analyses were restricted to 647 children in whom all four permanent first molars had erupted. Data on use of asthma drugs from birth until the time of the dental examination were obtained from a population-based pharmaco-epidemiological prescription database.
Among 47 children with prescriptions for both inhaled beta(2)-agonists and inhaled corticosteroids before the age of 3 years, 15 (31.9%) had demarcated opacities of any type, and six children (12.8%) had opacity-related loss of tooth substance. Among 264 children with no prescriptions for either inhaled or oral asthma drugs from birth until the date of the dental examination, 96 (36.4%) had demarcated opacities of any type, and 13 (4.9%) had opacity-related loss of tooth substance. The odds ratio (OR) of any demarcated opacity, and of opacity-related loss of tooth substance in children with prescriptions for both inhaled beta(2)-agonists and inhaled corticosteroids before the age of 3 years was 0.82 (95% CI: 0.39-1.65), and 2.42 (95% CI: 0.70-7.43).
Children with prescriptions for inhaled asthma drugs before the age of 3 years did not have an overall increased risk of demarcated opacities in first permanent molar but they seemed to have an increased risk of the severe demarcated opacities, i.e. opacities resulting in macroscopic loss of tooth substance, and possibly a need for restorative care.
Community Dentistry And Oral Epidemiology 04/2010; 38(2):145-51. · 1.89 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The JP2 clone of Aggregatibacter actinomycetemcomitans is strongly associated with aggressive periodontitis. To obtain information about colonization dynamics of the JP2 clone, we used PCR to examine its presence in 365 Moroccan juveniles from whom periodontal plaque samples were collected at baseline and after one and two years. Periodontal attachment loss was measured at baseline and at the two-year follow-up. At baseline, 43 (12%) carriers of the JP2 clone were found. Nearly half (44 %) of these were persistently colonized with the clone. The relative risk for the development of aggressive periodontitis, adjusted for the concomitant presence of other genotypes of A. actinomycetemcomitans, was highest for individuals continuously infected by the JP2 clone (RR = 13.9; 95% CI, 9.0 to 21.4), indicating a relationship between infectious dose and disease, which further substantiates the evidence for the JP2 clone as a causal factor in aggressive periodontitis.
Journal of dental research 09/2009; 88(9):856-60. · 3.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The highly leukotoxic JP2 clone of Actinobacillus actinomycetemcomitans is strongly associated with periodontitis in adolescents. Availability of the DNA sequence of the complete genome of A. actinomycetemcomitans strain HK1651, a representative strain of the JP2 clone (http://www.genome.ou.edu/act.html), has provided new possibilities in basic research regarding the understanding of the pathogenesis of A. actinomycetemcomitans in periodontitis. This case report describes the periodontal treatment of the original source of A. actinomycetemcomitans HK1651, a 16-year-old Ghanaian adolescent girl with aggressive periodontitis. The bacterial examination involved polymerase chain reaction analysis for presence of JP2 and non-JP2 types of A. actinomycetemcomitans. The treatment, including periodontal surgery supplemented by antibiotics, arrested the progression of periodontitis for more than 10 years. Initially, infection by A. actinomycetemcomitans, including the JP2 clone, was detected at various locations in the oral cavity and was not limited to the periodontal pockets. Post-therapy, the JP2 clone of A. actinomycetemcomitans disappeared, while the non-JP2 types of A. actinomycetemcomitans remained a part of the oral microflora.
International Journal of Paediatric Dentistry 10/2006; 16(5):370-5. · 1.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A small proportion of children and adolescents need dental treatment with general anaesthesia (DGA). The aim of this retrospective cross-sectional study was to analyse how country of origin and medical status were related to age at treatment, waiting times in the system, and dental treatment provided in general anaesthesia.
A total of 786 patients received DGA at the University Hospital of Aarhus, Denmark in the period from 1990 to 2001. Information on the date of referral, the date of examination, the date of treatment, country of origin (Danish or non-Danish), medical status (non-special needs or special needs), and dental treatment performed was collected from patient records.
Patients with special needs were older when treated than non-special needs patients, whereas patients with a non-Danish origin were younger than those with a Danish origin when treated. There were no differences between non-special needs and special needs patients in waiting times from referral to examination and from examination to dental treatment. In contrast, patients from a non-Danish origin waited longer from examination to treatment than patients of Danish origin, whereas no difference was found in waiting time from referral to examination. Patients with special needs had fewer teeth treated than non-special needs patients, whereas patients with non-Danish origin had more teeth treated than those of a Danish origin.
Age at treatment, waiting times in the system, and dental treatment received under general anaesthesia vary according to medical status and country of origin of the patients in Denmark. These findings should be considered in the organization and the funding of this type of service.
International Journal of Paediatric Dentistry 08/2006; 16(4):239-46. · 1.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of the present study was to provide further data for comparison of retention and caries-preventive effect of a resin-based sealant (Delton, and a glass-ionomer sealant (Fuji III).
The study was conducted in the municipality of Vaerløse located 15 km north of Copenhagen, Denmark in the period 1996-2001. The study comprised 153 children aged 8-13 years with a total of 364 site-pairs. Caries was diagnosed both clinically and radiographically, and sealant retention was diagnosed clinically. Sealants were placed either by one of four dentists, who had the responsibility for the children's dental care, by a dental hygienist or a dental assistant. Mean follow-up time was 38-39 months for sites on first permanent molars and 28-29 months for sites on second permanent molars.
The retention rates were consistently, and considerably lower for Fuji III than for Delton. Relative risks of caries in Delton-sealed teeth over Fuji III-sealed teeth was 0.435 (95% CI 0.150-0.846) based on the clinical diagnosis, and 0.559 (95% CI 0.342-0.905) based on the radiographic diagnosis. The ratio of the relative risks (clinical over radiographic diagnosis) was close to 1 (0.778; 95% CI 0.272-1.481).
In the present study, Delton-sealed teeth had a lower risk than Fuji III-sealed teeth of developing caries, independent of the caries diagnostic method used.
Community Dentistry And Oral Epidemiology 03/2006; 34(1):36-40. · 1.89 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Actinobacillus actinomycetemcomitans is frequently detected in dental plaque collected from Moroccan adolescents, and has been shown to be associated with clinical attachment loss in this population. The aim of this study was to assess whether behaviors such as the sharing of toothbrushes, and eating and drinking habits were associated with the presence of A. actinomycetemcomitans in Moroccan adolescents.
A total of 121 adolescents were clinically examined. Interviews regarding sharing of toothbrushes, eating and drinking habits were performed, and plaque samples were collected and analyzed for A. actinomycetemcomitans with different leukotoxin promoter types by polymerase chain reaction. Based on eating and drinking habits, the study population was divided in a low risk behavior group (LRB) and a high risk behavior group (HRB).
No association was found between the sharing of toothbrushes and the presence of A. actinomycetemcomitans. The odds ratios between the HRB and LRB group for being positive for the JP2 type, for non-JP2 types, and for any type of A. actinomycetemcomitans were 4.74 (95% CI 0.55; 40.71), 2.49 (95% CI 1.03; 5.97), and 2.97 (95% CI 1.28; 6.91), respectively. The difference in the mean number of teeth with a clinical attachment loss of > or = 3 mm between the HRB and the LRB group was 0.91(95% CI 0.09; 1.72).
Sharing of toothbrushes does not seem to be associated with the presence of A. actinomycetemcomitans in young Moroccans. Eating and drinking habits conducive to exchange of saliva are positively associated with presence of A. actinomycetemcomitans, and with a higher level of clinical attachment loss.
Oral Microbiology and Immunology 09/2005; 20(4):195-8. · 2.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The JP2 clone of Actinobacillus actinomycetemcomitans has been implicated in the etiology of periodontitis in adolescents. The aim of this two-year longitudinal study was to describe clinical attachment loss (CAL) progression and to assess its association with baseline occurrence of the JP2 and non-JP2 types of A. actinomycetemcomitans. Clinical re-examination of 121 adolescents in Morocco was performed. Progression of CAL > or = 1 mm, > or = 2 mm, > or = 3 mm, and > or = 4 mm on at least one site was found in 58%, 48%, 22%, and 6% of the subjects, respectively. Subjects who, at baseline, harbored the JP2 clone had a significantly higher progression of CAL than did subjects harboring non-JP2 types of A. actinomycetemcomitans. Subjects harboring non-JP2 types displayed a marginally higher CAL progression than did subjects who were culture-negative for A. actinomycetemcomitans.
Journal of Dental Research 11/2004; 83(10):767-70. · 3.49 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The JP2 clone of Actinobacillus actinomycetemcomitans, a high-leukotoxin-producing strain, characterized by a 530-basepair (bp) deletion in the promoter region of the leukotoxin gene operon and mainly found among individuals with African origin, is associated with localized aggressive periodontitis. The objective of the study was to examine the occurrence of periodontal disease in a Moroccan immigrant family living in Denmark in which the oldest son (14 year) was referred and treated for localized aggressive periodontitis. Further, the potential occurrence of the JP2 clone of A. actinomycetemcomitans in the family was examined. Here we present the clinical, radiographic, and microbiological findings from the family. Clinical and radiographic examination of the other family members revealed that 3 of 5 younger siblings had localized aggressive periodontitis, one had gingivitis and the mother had chronic periodontitis. Despite scaling followed by intensive maintenance therapy several family members, including the sibling with gingivitis, had further attachment loss at the 1-year examination. The JP2 clone of A. actinomycetemcomitans was isolated from subgingival plaque samples from 4 children with periodontitis. In contrast, it was not detected in plaque from the oldest boy, who had been treated for localized aggressive periodontitis by surgery combined with antibiotic therapy. The 4 children with periodontitis and colonized with the JP2 clone were treated by scaling and antibiotic administration. One month later the JP2 clone could still be detected in plaque samples. In conclusion, it is confirmed that members of immigrant families with African origin are potential carriers of the JP2 clone and that those families often have multiple family members with localized aggressive periodontitis. It is proposed that those families are given periodontal examination frequently to benefit from early diagnosis and treatment of the disease.
International Journal of Paediatric Dentistry 02/2004; 14(1):41-8. · 1.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A particular clone (JP2) of Actinobacillus actinomycetemcomitans with increased leukotoxin production has been isolated from individuals with early-onset periodontitis (EOP). The aim of this study was to determine the frequency of carriers of this clone and its association with EOP in Moroccan schoolchildren. Of 217 plaque samples, 131 (60.4%) were culture-positive for A. actinomycetemcomitans. A total of 19 of these isolates had a 530-bp deletion in the leukotoxin promoter region characteristic of the JP2 clone. A strong association between the presence of A. actinomycetemcomitans with the 530-bp deletion and EOP was found (adjusted OR = 29.4; 95% Cl = 8.3 - 104.4; p < 0.0005), while no association could be demonstrated between the presence of A. actinomycetemcomitans without the deletion and EOP (adjusted OR = 1.3; 95% CI = 0.5 -2.9; p = 0.750). The study demonstrates that the endemic presence, in a human population, of the highly leukotoxic JP2 clone may result in an unusually high prevalence of EOP.
Journal of Dental Research 07/2001; 80(6):1580-3. · 3.49 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Actinobacillus actinomycetemcomitans strains with enhanced levels of production of leukotoxin are characterized by a 530-bp deletion from the promoter region of the leukotoxin gene operon. Previous isolates with this deletion constituted a single clone belonging to serotype b, although they displayed minor differences among each other. We have analyzed the geographic dissemination of this clone by examining 326 A. actinomycetemcomitans isolates from healthy and periodontally diseased individuals as well as from patients with different types of extraoral infections originating from countries worldwide. A total of 38 isolates, all belonging to the same clone, showed the 530-bp deletion. Comparison of a 440-bp sequence from the promoter region of the leukotoxin gene operon from 10 of these strains revealed complete identity, which indicates that the deletion originates from a single mutational event. This particular clone was exclusively associated with localized juvenile periodontitis (LJP). In at least 12 of 28 families from which the clone was isolated, more than one family member had LJP. Notably, all the subjects carrying this clone had a genetic affiliation with the African population. These observations suggest that juvenile periodontitis in some adolescents with an African origin is associated with a disseminating clone of A. actinomycetemcomitans.
Journal of Clinical Microbiology 01/1998; 35(12):3037-42. · 4.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Actinobacillus actinomycetemcomitans has been associated with different forms of periodontitis, particularly with localized juvenile periodontitis (LJP). The bacterium possesses several virulence factors which have been shown to interact with the host immune system. Among these factors, leukotoxin, surface antigens (serotype) and bacteriophages have been suggested directly or indirectly to influence the course of infection. However, few studies have been able to show associations between these factors and periodontal disease, alone or in combination. Thus, the purpose of the present study was to investigate possible correlations between periodontal disease status and selected virulence factors (serotype, presence of bacteriophages, and the presence of a 530 bp deletion in the promoter region of the leukotoxin gene). 36 subjects took part in the study. Serotype c was the most frequently found serotype among periodontally affected subjects, although serotypes a and b were also present. 27 out of 36 strains harbored bacteriophages, and there was strong evidence that some of the bacteriophages were different from the previously characterized phi Aa phage. A. actinomycetemcomitans containing the F-fragment phage were more frequently associated with periodontal disease. Five strains, all serotype b, 3 from LJP patients and 2 from healthy subjects, showed a 530-bp deletion in the promoter region of the leukotoxin gene.
European Journal Of Oral Sciences 09/1997; 105(4):310-7. · 1.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Several bacteriophages associated with the oral bacterium Actinobacillus actinomycetemcomitans have been identified. Lysogeny might affect the virulence of this bacterium, which has been implicated in the etiology of juvenile and adult periodontitis. We have determined the presence of bacteriophage Aa phi 23-related DNA sequences among 185 A. actinomycetemcomitans strains belonging to 2 well-characterized collections and have related the findings to the population genetic structure of the collections. 2 cloned Aa phi 23-specific DNA probes were used in Southern blot hybridization experiments to detect homologous sequences in whole-cell DNA of the strains. DNA from 65 (35%) of the 185 strains hybridized to either of the DNA probes. The majority (74%) of the hybridizing strains showed an identical hybridization pattern, indicating presence of phage Aa phi 23. Whole-cell DNA from the remaining hybridizing strains hybridized to the probes with different patterns, indicating that DNA sequences related to but different from phage Aa phi 23 occur in these strains. The majority (81%) of the strains which harbored phage Aa phi 23 were of serotype a, whereas serotype d strains appeared to be resistant to infection with this phage. There was a clear correlation between hybridization patterns and genetic subdivisions based on our previous population genetic analyses of A. actinomycetemcomitans. However, there was no significant correlation between occurrence of Aa phi 23 among A. actinomycetemcomitans strains and the periodontal status of the patients from whom the isolates were obtained, suggesting that this bacteriophage does not significantly influence the virulence of A. actinomycetemcomitans.
European Journal Of Oral Sciences 03/1997; 105(1):2-8. · 1.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The bacterium Actinobacillus actinomycetemcomitans has been implicated in the pathogenesis of juvenile periodontitis as the etiologic agent on the basis of several lines of circumstantial evidence. A matter of extensive debate is whether A. actinomycetemcomitans is an exogenous contagious pathogen or an opportunistic pathogen that resides in the normal oral microflora. Here we show evidence of a single clone of A. actinomycetemcomitans isolated from multiple patients with juvenile periodontitis in members of families of African origin living in geographically widespread areas. The clone is characterized by a 530-bp deletion in the leukotoxin gene operon, resulting in a significantly increased production of leukotoxin.
Journal of Clinical Microbiology 07/1996; 34(6):1576-8. · 4.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Genetic analysis of an Actinobacillus actinomycetemcomitans population consisting of 88 clinically well characterized Finnish isolates performed by multilocus enzyme electrophoresis confirmed that the five serotypes divide into two phylogenetic lineages, one comprising serotypes b and c and one comprising serotypes a, d, and e. There was no association between any subpopulation and the periodontal health status of the subject from whom the isolates originated, suggesting that the role of A. actinomycetemcomitans in periodontitis is largely opportunistic in the population examined. Southern blot analyses of genomic DNA digested with each of the restriction endonucleases MspI, RsaI, and TaqI revealed extremely limited genetic polymorphism of the structural leukotoxin gene, ltxA, and its associated promoter. All isolates hybridized to a 530-bp DNA fragment derived from the promoter region of the leukotoxin gene operon of a minimally leukotoxic A. actinomycetemcomitans strain. Deletion of the 530-bp sequence has been associated with significantly increased toxin production detected among isolates from patients with juvenile periodontitis in North America but was detected neither among the 88 isolates in the present collection analyzed nor among more than 60 strains in another population of northern European A. actinomycetemcomitans isolates analyzed previously.
Journal of Clinical Microbiology 03/1995; 33(2):395-401. · 4.15 Impact Factor
