RESUMEN
PURPOSE: The main purpose was to study young patients' self-reports on dental fear over a 5-year period, prospectively. Also, to compare these to professionals' proxy reports for dental fear during invasive and non-invasive dental visits. The research question was, to what extent the self-reports and dental professionals' proxy reports are congruent, and if there were patient age-dependent differences. METHODS: 3134 patients from 11 public dental clinics, representing urban and rural areas, were invited. Four age cohorts were formed: 3, 7, 11, and 15 years of age and followed between the years 2008 and 2012. Dental examinations (non-invasive) and restorative treatments + extractions (invasive) were registered. During the treatments, self-reports regarding fear and professional proxy reports were registered: Not afraid at all = 0, little nervous = 1, quite afraid = 2, very scared = 3, terrified = 4. RESULTS: 2363 patients completed the cohort periods (51% girls and 49% boys). In all, 9708 dental examinations, restorations and extractions were performed. The fear prevalence increased with the invasiveness of the dental procedure; 7-56%. For dental examinations and restorations, fear declined with ascending age. The highest fear prevalence was reported for dental extractions. Younger children reported fear more frequently than older children, p < 0.001. Frequent inconsistencies between self-reports and proxy reports were observed among the younger children (16%) compared to the older children (8%), p < 0.001. CONCLUSION: Non-congruence was observed for self-reports and proxy reports regarding all age cohorts.
Asunto(s)
Ansiedad al Tratamiento Odontológico , Adolescente , Niño , Ansiedad al Tratamiento Odontológico/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Prevalencia , Estudios Prospectivos , AutoinformeRESUMEN
AIM: This was, firstly, to study the occurrence of oral pain and discomfort, using the Dental Discomfort Questionnaire (DDQ), in children and adolescents with intellectual or physical disabilities, compared with controls. Secondly, was to analyse the relationship between pain and discomfort, as measured by the DDQ, and dental health, as well as oral hygiene habits and dietary habits. METHODS: The study included 135 children and adolescents (12-18 years), registered at the Child and Adolescent Habilitation Unit in Göteborg and Södra Bohuslän, Sweden, and 135 gender- and age-matched controls. The children's legal guardians completed a questionnaire comprising the DDQ and questions on oral hygiene and dietary habits. Data on dental health were retrieved from dental records. RESULTS: The DDQ total mean score was higher for the study group, compared with the control group, 3.2 (SD 2.9) vs. 1.6 (SD 2.0), respectively (p = 0.001). Furthermore, children and adolescents with a severe intellectual disability had higher total mean DDQ scores than children with a mild intellectual disability, 4.8 (SD 4.2) vs. 2.4 (SD 2.9), respectively (p = 0.034), and also higher than children with a physical disability, 2.2 (SD 2.1) (p = 0.012). There were no differences in DMFT between children with disabilities and age-matched controls. There was no relationship between the DDQ scores and oral hygiene/dietary habits in children with disabilities. CONCLUSIONS: Children and adolescents with intellectual or physical disabilities experienced oral discomfort and pain more often than matched controls. Dental health expressed as DMFT could not be related to the DDQ responses.
Asunto(s)
Niños con Discapacidad , Discapacidad Intelectual , Odontalgia/epidemiología , Adolescente , Estudios de Casos y Controles , Niño , Preescolar , Índice CPO , Caries Dental/epidemiología , Conducta Alimentaria , Femenino , Humanos , Tutores Legales , Masculino , Salud Bucal , Higiene Bucal/estadística & datos numéricos , Dimensión del Dolor , Encuestas y Cuestionarios , Suecia/epidemiologíaRESUMEN
The aim of this investigation was to present the 2-year follow-up results of a longitudinal study examining the influence of growth hormone (GH) substitution on dental maturity in healthy children of short stature (height <2 SD). At baseline, the children were divided into a GH-deficient group and a GH non-deficient group, and comparisons were made with healthy controls (height between -2 SD and 2 SD) and between the short stature groups. The GH-substituted group included 24 children (8 F, 16 M) with a mean chronological age of 12.20 +/- 2.40 years, whereas the GH non-substituted group included 19 children (5 F, 14 M) with a mean chronological age of 11.00 +/- 2.40 years. The corresponding age- and sex-matched control groups constituted 48 and 36 children, respectively. The mean dental age in the GH-substituted group was 11.60 +/- 2.70 years, compared to their healthy controls 12.40 +/- 2.60 years (P< 0.05). The dental age for the GH non-substituted children was 10.20 +/- 2.60 years compared to their controls 11.90 +/- 2.60 years (P< 0.001). GH-substituted children show an acceleration in their dental maturity in contrast to controls, whereas in non-substituted children the acceleration is less pronounced.
Asunto(s)
Enanismo Hipofisario/fisiopatología , Hormona de Crecimiento Humana/deficiencia , Hormona de Crecimiento Humana/farmacología , Diente/crecimiento & desarrollo , Adolescente , Estatura/efectos de los fármacos , Estudios de Casos y Controles , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Odontometría , Valores de Referencia , Reproducibilidad de los Resultados , Diente/efectos de los fármacosRESUMEN
Inflammatory processes occurring in the vicinity of bone tissue often result in stimulation of osteoclast activity and loss of skeletal mass. The aim of the current study was to determine if inflammatory exudates collected from gingival pockets in patients with periodontitis contain factors capable of stimulating resorptive activity. The degree of bone mineral mobilization and bone matrix degradation was assessed by analysis of the release of 45Ca and 3H from bones prelabelled with 45CaCl2 and [3H]proline, respectively. Gingival crevicular washings from six patients with signs of periodontitis stimulated 45Ca or 3H release from the calvarial bones. The stimulatory effect of the gingival crevicular washings on 45Ca release was concentration- and time-dependent, and reduced by calcitonin, a specific osteoclast inhibitor. These data demonstrate that crevicular fluid contains factor(s) which can stimulate osteoclastic degradation of bone in vitro. The bone resorbing activity was partially retained after extensive dialysis. Analysis of the concentrations of prostaglandin E2, interleukin-1alpha and interleukin-1beta in the crevicular fluids, and comparisons of these agents as stimulators of 45Ca release in the mouse calvarial assay, suggest that prostaglandin E2 is not the sole factor responsible for the bone resorbing activity of the exudates. The data indicate that other factors, such as IL-1, may play key roles in the stimulation of osteoclastic activity by gingival crevicular washings.
Asunto(s)
Pérdida de Hueso Alveolar/metabolismo , Líquido del Surco Gingival/química , Periodontitis/metabolismo , Adolescente , Adulto , Animales , Matriz Ósea/metabolismo , Calcitonina/farmacología , Calcio/análisis , Cloruro de Calcio , Radioisótopos de Calcio , Dinoprostona/análisis , Relación Dosis-Respuesta a Droga , Bolsa Gingival/metabolismo , Humanos , Interleucina-1/análisis , Ratones , Persona de Mediana Edad , Minerales/metabolismo , Osteoclastos/metabolismo , Prolina , Radiofármacos , Cráneo/metabolismo , TritioRESUMEN
The levels of prostaglandin E2 (PGE2) and interleukin-1 beta (IL-1 beta) were determined in gingival crevicular fluid (GCF) collected from patients with gingivitis: 15 Down syndrome children and 15 controls. The mean level of PGE2 in GCF was significantly higher (P < 0.05) in the Down syndrome group (10.0 pg/microliters GCF) than in the control group (4.6 pg/microliters GCF). In GCF samples collected from sites characterized as noninflamed, the mean level of PGE2 was significantly higher (P < 0.001) in the Down syndrome group than in the controls. The mean level of PGE2 in samples from inflamed sites, on the other hand, did not differ between the two groups. The mean level of IL-1 beta was not significantly higher in the Down syndrome group than in the controls. This study shows that the level of PGE2 detected in GCF from Down syndrome patients is increased, a fact that may be of importance in the pathogenesis of the periodontal disease frequently seen in these patients.
Asunto(s)
Dinoprostona/análisis , Síndrome de Down/metabolismo , Líquido del Surco Gingival/química , Adolescente , Pérdida de Hueso Alveolar/metabolismo , Análisis de Varianza , Estudios de Casos y Controles , Niño , Femenino , Hemorragia Gingival/metabolismo , Gingivitis/metabolismo , Humanos , Interleucina-1/análisis , Masculino , Enfermedades Periodontales/etiología , Bolsa Periodontal/metabolismoRESUMEN
The aim of this investigation was to study dental maturity in healthy prepubertal children of short stature (height<-2 SD), with or without growth hormone (GH) deficiency, compared to healthy controls. The GH-deficient group (GH level<10.0 microg/l) included 29 children (11 female, 18 male) with a mean age of 10.2+/-2.2 years. The GH non-deficient group consisted of 17 children (5 female, 12 male) with a mean age of 8.5+/-2.1 years. All the children were evaluated for serum concentrations of IGF-1, alkaline phosphatase (ALP), triiodthyronin (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and fasting plasma insulin; height and bone age were also recorded. Dental maturity was determined from panoramic radiographs. The mean difference between the dental and chronological ages was -0.67+/-0.89 years in the GH-deficient group compared to 0.23+/-1.07 years in their controls: in the GH non-deficient group the difference was -0.95+/-0.82 years compared to controls 0.16+/-1.06 years in their controls. Compared to chronological age, both bone and dental age were lower in the GH-deficient and GH non-deficient groups. It is concluded that children of short stature, both GH-deficient and GH non-deficient. exhibit a delayed dental age compared to their chronological age- and sex-matched controls. A multiple stepwise regression analysis showed that the sitting height and GH level were the only significant factors associated with dental maturity.
Asunto(s)
Determinación de la Edad por los Dientes , Estatura , Hormona de Crecimiento Humana/deficiencia , Determinación de la Edad por el Esqueleto , Envejecimiento , Fosfatasa Alcalina/sangre , Estudios de Casos y Controles , Niño , Ayuno , Femenino , Trastornos del Crecimiento/sangre , Trastornos del Crecimiento/fisiopatología , Humanos , Insulina/sangre , Factor I del Crecimiento Similar a la Insulina/análisis , Estudios Longitudinales , Masculino , Odontometría , Pubertad , Radiografía Panorámica , Análisis de Regresión , Tirotropina/sangre , Tiroxina/sangre , Triyodotironina/sangreRESUMEN
Oral carriage of Candida albicans was studied in 55 children and adolescents with Down's syndrome (DS), aged between 7 months and 20 years 6 months, and compared with an age- and sex-matched control group of subjects. Twenty-two of the DS subjects were diagnosed as having congenital cardiovascular malformations. Compared to controls, the DS subjects were more prone to infections. The number of subjects colonized with C. albicans in the oral cavity was significantly higher in the DS group (69%) than in the control group (35%). Colonization with C. albicans and simultaneous erythematous or white pseudomembranous lesions of the oral mucosa were diagnosed in 22 (40%) of the DS groups and in only one of the control group. In both the DS and the healthy control subjects the frequency of colonization with C. albicans was positively correlated to age. The DS subjects were significantly more densely colonized by C. albicans than the controls. Abnormalities of the immune response in DS children may contribute to the increased oral carriage of C. albicans.
Asunto(s)
Candida albicans/aislamiento & purificación , Síndrome de Down/microbiología , Mucosa Bucal/microbiología , Adolescente , Adulto , Candida/aislamiento & purificación , Candidiasis Bucal/etiología , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Preescolar , Recuento de Colonia Microbiana , Atención Dental para Niños , Atención Dental para Enfermos Crónicos , Síndrome de Down/complicaciones , Femenino , Humanos , Lactante , Masculino , Infecciones Oportunistas/etiología , Hueso Paladar/microbiología , Lengua/microbiologíaRESUMEN
The prevalence of pain and dysfunction in the stomatognathic system was studied in a group of 19 long-term survivors after pediatric bone marrow transplantation (BMT), conditioned with total-body irradiation (TBI). Compared with the control group, the children and adolescents in the BMT group had a significantly reduced mouth opening capacity. A reduced translation movement of the condyles was diagnosed in 53% of children treated with TBI, compared with 5% in the control group. Signs of craniomandibular dysfunction were found in 84% of children in the BMT group, compared with 58% in the control group. Both irradiation and chemotherapy induce long-term alterations in connective and muscle tissues resulting in inflammation and eventually fibrosis. These changes in tissue homeostasis and concomitant growth retardation may lead to the observed malocclusion and reduced mobility of the temporomandibular joint, with subsequent muscle pain and headaches, which were found in this study.