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BACKGROUND AND OBJECTIVES: The primary objective of the undertaken study was to determine the morphological changes that occur within the oral epithelium in children undergoing chemotherapy following a diagnosis of hematological malignancies. MATERIALS AND METHODS: The study group consisted of 18 patients diagnosed with leukemia or lymphoma undergoing treatment with chemotherapy. Swabs (liquid-based cytology) were collected from the oral cavity for microscopic evaluation at baseline, during the chemotherapy cycle with oral mucositis symptoms present, and upon completion of the cycle. Both the neutrophil count and oral mucositis (OM) were registered using the WHO (World Health Organization) scale. The control group included 41 children who were generally healthy. All samples underwent microscopical analyses at the Department of Pathology, Medical University of Gdansk, Poland. RESULTS: A total of 190 cytological preparations were evaluated. The baseline preparations revealed similar cytological images, and the superficial cells of the epithelial layers were seen. A significant (p < 0.01) increase in the number of cells in the intermediate layer of the oral epithelium, as well as a decrease (p < 0.01) in the volume of cells in the superficial layers, was observed in further stages of cytostatic treatment. CONCLUSIONS: A decrease in the percentage of superficial epithelial cells with a corresponding increase in the number of intermediate epithelial cells is considered to be a result of toxic damage to the oral mucosa during chemotherapy.
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Background and Objectives: One of the most debilitating side effects of chemotherapy is oral mucositis (OM). Photobiomodulation (PBM) demonstrates high efficacy in the management of OM. The aim of the study was to investigate the incidence of oral mucositis and evaluation of the effectiveness of PBM therapy. Materials and Methods: A total of 23 children diagnosed with leukaemia or lymphoma affected by chemotherapy-induced OM were enrolled in the study. OM grade was assessed with the World Health Organization (WHO) scale. Patients completed an approved questionnaire, and blood cell counts were read every 2 days. OM lesions were treated with class IV laser therapy with a frequency of every 48 h and density of 2, 4, 8, 16 or 30 J/cm2. The level of pain was measured with VAS scale. Results: The 23 patients developed a total of 41 OM episodes with a mean duration of 7.61 days ± 4.70. Laser therapy showed a great reduction regarding pain and a better function of patients even with neutropenia. Conclusions: Oral mucositis represents a significant burden to children. PBM brings positive aspects for patients; however, the optimal treatment parameters require further study.
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Antineoplásicos , Terapia por Luz de Baja Intensidad , Estomatitis , Antineoplásicos/efectos adversos , Niño , Humanos , Dolor , Proyectos Piloto , Estomatitis/inducido químicamenteRESUMEN
The objective of this manuscript was to review the literature on dental trauma splints and discuss materials used for splinting injured teeth in terms of their properties and conditions that are required for optimal stabilization. A literature search was conducted in the PubMed database with the keywords: "trauma splints", "dental trauma" and "traumatic dental injuries". The search was limited to English language publications. 42 publications fulfilled the inclusion criteria and were in accordance with the current recommendations. Optimal splinting of the teeth after trauma is one of the main predictors for pulpal and periodontal healing. The splints stabilize and protect the teeth, creating favorable conditions for the regeneration of the supporting tissues. Their application and removal should be easy and fast without any additional irritating of the surrounding tissues. The materials used to stabilize the injured teeth should keep the tooth in the original position, allowing for its physiological mobility.
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Férulas (Fijadores) , Movilidad Dentaria , Pulpa DentalRESUMEN
BACKGROUND: Molar incisor hypomineralization (MIH) is a common condition that causes considerable pain to children and distress to their parents. Clinically it is manifested by demarcated opacities of tooth enamel with reduced mineralization. The mean global incidence of this disorder has been estimated at around 13-14%. Environmental pollution is one of the suspected etiological factors, but the impact of air pollutant components on MIH has yet to be studied. OBJECTIVES: To assess whether the level of air pollution components has an impact on the prevalence of MIH. MATERIAL AND METHODS: This cross-sectional study included 2354 children, aged 6-12 years, attending schools in 2 voivodeships (regions) of Poland with best and worst air quality. Smog alarms are announced more than 50 times a year in the Silesian voivodeship, while in the Pomeranian voivodeship, consistently low levels of air pollution are observed. Our air quality assessment was carried out on the basis of average annual results from measuring stations located in the 2 voivodeships. Dental examinations of teeth were conducted using the European Academy of Paediatric Dentistry (EAPD) criteria for the diagnosis of MIH. RESULTS: Levels of air pollution components over time were notably higher in the Silesian voivodeship, especially sulfur dioxide (SO2), particulate matter (PM10) and polycyclic aromatic hydrocarbons (PAH). The MIH was diagnosed more often in children in the Silesian voivodeship (13.7%) than in the Pomeranian (6.4%). In the Pomeranian voivodeship, MIH was most often diagnosed in children aged 6 (14.53%). CONCLUSIONS: This study shows a correlation between higher concentrations of air pollutants and the occurrence of enamel developmental disorder in the form of MIH. Future research is required to assess whether this is related to the presence of a specific component or to the more frequent occurrence and treatment of air pollution-related general diseases, such as respiratory illnesses.
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Contaminación del Aire , Hipoplasia del Esmalte Dental , Contaminación del Aire/efectos adversos , Niño , Estudios Transversales , Hipoplasia del Esmalte Dental/epidemiología , Hipoplasia del Esmalte Dental/etiología , Humanos , Incisivo , Diente Molar , Polonia/epidemiología , PrevalenciaRESUMEN
Idiopathic solitary cysts have a predilection for long bones and the mandible. Although the origin of these cysts is unclear, the prognosis seems to be good, given proper diagnosis and surgical treatment. A 14-year-old female patient with a bone lesion in the right mandibular ramus was referred to the Department of Pediatric Dentistry at the Medical University of Gdansk, Poland. Due to severe headache lasting two days, the patient had previously undergone magnetic resonance imaging (MRI) examination of the head. A unilocular bone cyst in the mandible was discovered incidentally. Comparison with a previous orthopantomogram (OPG) taken two years earlier for routine dental treatment revealed a clearly visible but smaller bone lesion at the same location. Surgery was carried out in order to achieve bone regeneration. This report documents the importance of careful evaluation and assessment of all radiographs taken, as the lesion could have been diagnosed and treated much earlier, thus lowering the risk of complications.
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Quistes Óseos , Quistes Maxilomandibulares , Enfermedades Mandibulares , Adolescente , Quistes Óseos/diagnóstico por imagen , Femenino , Humanos , Quistes Maxilomandibulares/diagnóstico por imagen , Mandíbula , Enfermedades Mandibulares/diagnóstico por imagen , RadiografíaRESUMEN
OBJECTIVES: A significant increase in individuals participating in contact sports has been noticed. Boxing is one of the most traumatic of such sports. In spite of this, the level of awareness among young boxers as to prevention and dental first aid is very poor. The aim of this study was to evaluate the frequency of dental injuries during trainings and competitions, the habit of wearing mouthguards, and the general level of awareness regarding prevention and first aid after tooth avulsion. DESIGN: Cross-sectional survey. METHODS: Our research was based on questionnaires given to 338 amateur boxers in Poland (divided into age groups: schoolboys, juniors, youth and seniors). Chi-square tests were used for the comparison of groups of respondents and relevant variables. RESULTS: The survey showed that 35.9% of the participants had suffered some kind of dental trauma. A similar number of 36.5% had witnessed some kind of dental injury during training and 26.1% during tournaments. The survey showed that only 15.8% of all participants knew that immediate replantation was the best way of treating an avulsed tooth. Also, 93.7% of all those interviewed reported that they had worn mouth-formed mouthguards and only 5.7% custom-made mouthguards. Of all the survey's participants, 41.1% were definitely satisfied with their mouthguards. CONCLUSIONS: To improve knowledge regarding dental trauma in the boxing environment it is essential to emphasize the need for an extensive educational campaign. Preventive measures, especially in the form of good custom-made mouthguards, should be mandatory for all active individuals participating in contact sports.
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Boxeo/lesiones , Primeros Auxilios , Conocimientos, Actitudes y Práctica en Salud , Protectores Bucales/estadística & datos numéricos , Avulsión de Diente/terapia , Adolescente , Adulto , Estudios Transversales , Humanos , Masculino , Polonia/epidemiología , Avulsión de Diente/prevención & control , Traumatismos de los Dientes/epidemiología , Traumatismos de los Dientes/prevención & control , Adulto JovenRESUMEN
BACKGROUND: Approximately 50% of children under the age of 15 years are subjected to various kinds of injuries in the orofacial region. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and leads to loss of the tooth. The current literature emphasizes that the awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. RESULTS: This case report presents the immediate self-replantation of a right lateral mandibular incisor of a 12-year-old male patient following a traumatic avulsion. The same patient had earlier, aged 10 years, experienced a trauma leading to the loss of all four maxillary incisors. The missing incisors were replaced by a removable acrylic denture. Having the requisite experience from the earlier accident, the child performed on himself an immediate replantation of the tooth at the site of the accident. After avulsion, the tooth was not splinted timely nor was an endodontic procedure carried out and no antibiotics were prescribed. The first dental examination after the trauma was performed 6 months later and since then, radiographic follow-up has been introduced. One year after the trauma, following the late endodontic treatment performed 6 months after reimplantation, the tooth is asymptomatic and stable. CONCLUSIONS: Immediate self-replantation of an avulsed tooth is the best treatment choice, even without any other proceeding treatment. However, the healing process should be followed up to allow for the treatment of the early signs of pulpal necrosis and/or root resorption.
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Incisivo/lesiones , Tratamiento del Conducto Radicular/métodos , Autocuidado , Avulsión de Diente/cirugía , Reimplante Dental/métodos , Niño , Humanos , Masculino , MandíbulaRESUMEN
BACKGROUND: To be able to help at the site of the oro-facial injury, the majority of persons would turn to medical books and first-aid books to extend their knowledge. Proper information in first-aid textbooks and manuals should be the best way to present necessary procedures on how to act at the site of injury. The objective of this review is to report the quality of the knowledge presented in first-aid books and manuals. METHODS: We carried out a review of first-aid international textbooks and manuals available in Medical University Libraries in Poland. The inclusion criteria were all manuals on first-aid that were written for medical staff and lay persons, and were published between 1969 and 2007. All texts were screened for dental trauma treatment recommendations. RESULTS: Our literature review has shown that among 45 first-aid textbooks and manuals only 19 mention procedures for use in case of dental trauma. Of those texts, only 13 detail the storage media for an avulsed tooth until replantation. CONCLUSIONS: Current, evidence-based, recommendations concerning first-aid procedures after dental trauma should be incorporated in forthcoming editions of first-aid textbooks and manuals. The guidance on procedures contained in reviewed texts is misleading.
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Primeros Auxilios , Manuales como Asunto , Libros de Texto como Asunto , Traumatismos de los Dientes/terapia , Primeros Auxilios/normas , Humanos , Manuales como Asunto/normas , Derivación y Consulta , Libros de Texto como Asunto/normas , Avulsión de Diente/terapia , Fracturas de los Dientes/terapiaRESUMEN
In view of the widespread lack of knowledge of first aid procedures in cases of dental trauma, this article describes the current state of knowledge and highlights the need for education of those likely to witness or be victims of dental trauma while practising sports. Dental and oral injuries, the commonest type of orofacial injuries, are often sustained by athletes playing contact sports; indeed, they represent the most frequent type of sporting injury. Studies of a large group of children and adults have shown that as many as 31% of all orofacial injuries are caused by sporting activities. Furthermore, current literature on the subject emphasizes that awareness of appropriate triage procedures following dental trauma is unsatisfactory. Delay in treatment is the single most influential factor affecting prognosis. What should we know and, more importantly, what should we do? Immediate replantation of an avulsed tooth is the best treatment option at the site of the accident. If replantation is impossible, milk is the preferred transport medium for the avulsed tooth. There is a general low level of awareness about the need for prompt triage of traumatic dental injuries sustained in sports, despite their relative frequency. When a cohort of Swiss basketball players was interviewed, only half were aware that an avulsed tooth could be replanted. Cheap, commercially available tooth storage devices containing an isotonic transport medium (so-called 'Save-a-Tooth boxes'), can maintain the viability of an avulsed tooth for up to 72 hours, prior to replantation. More readily available storage media such as milk, sterile saline or even saliva may be used, but knowledge of this information is rare among sports participants. For example, just 6.6% of the Swiss basketball players interviewed were aware of the 'Tooth Rescue box' products. Sporting organizations seem to offer very little information about sports-related risks or preventive strategies for orodental trauma. Having an attending dentist at sports events - amateur or professional - is clearly a luxury that is neither practical nor affordable. The solution must lie in extending the knowledge of management of orodental trauma beyond the dental profession. Educational posters, when displayed prominently in sports clubs, gym halls and dressing rooms of swimming pools, are a clear, accessible and low cost method of presenting the appropriate procedures to follow after orodental injury. When the potentially avoidable financial burden and discomfort of protracted restorative or cosmetic dentistry are taken into account, rarely can such significant morbidity be so easily prevented.
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Traumatismos en Atletas , Primeros Auxilios/métodos , Conocimientos, Actitudes y Práctica en Salud , Traumatismos de los Dientes , Traumatismos en Atletas/etiología , Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/terapia , Educación en Salud Dental , Humanos , Avulsión de Diente/etiología , Avulsión de Diente/prevención & control , Avulsión de Diente/terapia , Traumatismos de los Dientes/etiología , Traumatismos de los Dientes/prevención & control , Traumatismos de los Dientes/terapia , Reimplante DentalRESUMEN
Approximately 50% of children under the age of 15 are victims of various kinds of injuries in the orofacial region. Post-traumatic complications may occur, including crown discolouration, cervical root fracture, ankylosis, root resorption and tooth loss. The most severe complication after dental injury in primary dentition can affect the developing permanent tooth germ, and various consequences may be seen several years later when the permanent tooth erupts. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and will lead to loss of the tooth. Current literature emphasises that awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. What should a paediatrician know, and more importantly, how should he/she advise parents and caretakers? In an emergency situation such as tooth avulsion, reimplantation within 30 min is the best treatment option at the site of the accident. If reimplantation of the tooth is impossible, milk, saline or even saliva are the preferred transport media. The prognosis for an avulsed tooth depends upon prompt care, which is a determinant factor for successful treatment of the traumatised tooth. In all other dental trauma cases, it is important to refer the child to a paediatric dentist, to follow up the healing process and reduce late post-traumatic complications. With timely interventions and appropriate treatment, the prognosis for healing following most dental injuries is good. In conclusion, it is important that paediatricians are able to inform parents and caretakers about all possible and long-lasting consequences of different dental injuries.
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Educación en Salud Dental , Avulsión de Diente/terapia , Traumatismos de los Dientes/complicaciones , Adolescente , Niño , Preescolar , Humanos , Padres/educación , Guías de Práctica Clínica como Asunto , Pronóstico , Avulsión de Diente/etiología , Avulsión de Diente/cirugía , Traumatismos de los Dientes/terapia , Reimplante Dental/métodosRESUMEN
Primary preventive strategies for oral health are an essential public health priority. Paediatricians have frequent contact with families during routine preventive visits in the child's first few years of life and are in an ideal and unique position, to advise families about the prevention of oral diseases in their children. Primary prevention is always recommended in very young children, to promote positive outcomes during childhood and later adulthood. The knowledge paediatricians acquire about orofacial growth may enhance the implementation and eventual success of a preventive programme. In view of the widespread lack of any orthodontic knowledge amongst paediatricians, this paper describes most common and distinctive symptoms appearing frequently in the early stages of a child's development that are easily detectable by clinicians. It is difficult to define preventive strategies to prevent malocclusion owing to its multifactorial origin. There are some recognised behaviours, however, that should be discouraged to allow for ideal craniofacial development and some that require early referral to the orthodontist. The following disorders are easily diagnosed by the paediatrician or parents and represent conditions in which early intervention might be appropriate to prevent future possible orofacial dysfunction: different sucking habits persisting beyond 3 years of age, mouth breathing and significant deviations from established teeth eruption norms. It is suggested that early referral to a paediatric dentist or orthodontist is indicated when any of these conditions are observed. In general, measures to prevent malocclusion should be based on providing good incentives to promote normal growth and development of the face and the elimination of potential interferences that may harm these processes.
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Maloclusión/prevención & control , Tamizaje Masivo , Derivación y Consulta , Preescolar , Humanos , Lactante , Ortodoncia , Pediatría , Guías de Práctica Clínica como Asunto , Factores de Riesgo , Conducta en la Lactancia , Erupción DentalRESUMEN
PURPOSE: To evaluate histological findings in human immature permanent premolars scheduled for extraction for orthodontic reasons, in which mechanical pulp exposures were capped with white ProRoot Mineral Trioxide Aggregate (WMTA) or calcium hydroxide (CH). METHODS: Forty-eight human immature premolars in 23 patients (age 10-18 years) were randomly treated with WMTA or CH. After rubber dam isolation Cl I cavities were prepared and the pulps exposed. After hemostasis the pulps were capped with either material. The preparations were restored using an acid etch, bonding agent, flowable composite and composite resin technique. The teeth were extracted after 47 to 609 days and processed for routine histological examination, stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria. Statistical analyses of inflammation, bridge formation and bacterial leakage were performed using a Chi-square test and ANOVA. RESULTS: Forty-four of 48 teeth were suitable for microscopic evaluation, 30 with WMTA, 14 with CH. Of the WMTA group, 29 teeth were vital, 28 had formed a bridge, and one specimen had failed. Twelve of 14 teeth with CH were vital, while three teeth failed to form a bridge. No statistically significant differences between WMTA and CH were found, except for superficial and deep inflammatory cell response (P < or = 0.05). Pulp capping of intentionally exposed human immature premolars performed slightly better when using MTA.