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PURPOSE: The purpose of this study was to examine tooth-brushing frequency in 575 urban and nearby suburban African American children as part of a comprehensive risk-reduction study for students at high risk for violence, drugs, school delinquency, and unsafe sexual behaviors to determine which covariates predicted tooth-brushing frequency. METHODS: Students were surveyed 5 times, from the beginning of grade 5 and the end of each year through grade 8, and parents were surveyed at the beginning of grade 5. Peer influence, importance of being liked, self-esteem, attitudes towards tooth-brushing, oral health knowledge, self-efficacy, parental attitudes, and other covariates were examined for the ability to predict self-reporting of tooth-brushing frequency. RESULTS: In the fifth grade, peer influence, the importance of being liked, and physical self-esteem were the significant predictors, and peer influence continued to predict tooth-brushing in the eighth grade. Oral health knowledge and parental influence were not significant. CONCLUSION: Peer influence is an important factor in tooth-brushing behavior in metropolitan African American preadolescent children.

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PURPOSE: Pediatric oral rehabilitation patients who receive presedation with oral Versed and general anesthesia (GA) occasionally experience prolonged sedation and delayed discharge. The Bispectral Index System (BIS) is an EEG monitor that measures the anesthesia level. The purpose of this study was to compare the effects of monitoring the BIS to not monitoring the BIS on time from discontinuation of GA to extubation and to discharge. METHODS: Twenty-nine children were enrolled. BIS was monitored from admission until discharge. Each child received 0.7 mg/kg of oral Versed. In the operating room, GA with sevoflurane (IH), rocuronium 1 mg/kg (IV), fentanyl 1 microg/kg (IV), and ondansetron 0.15 mg/kg (IV) was administered. Randomly, in half the patients, the anesthesiologist maintained the level of anesthesia and BIS by adjusting sevoflurane. In the rest, the anesthesiologist did not know BIS. The time from turning off sevoflurane to discharge was compared. RESULTS: Group 1 patients were extubated 5+/-2 minutes sooner than group 2 patients (P=.04). The post-anesthesia care unit stay for group 1 patients was 47+/-17 minutes compared to 63+/-17 minutes in group 2. (p=0.02). CONCLUSIONS: Monitoring anesthesia with BIS promotes earlier extubation and discharge for pediatric dental patients who receive oral Versed and sevoflurane GA.

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PURPOSE: Pediatric patients who receive both intramuscular (i.m.) sedation and general anesthesia (GA) for oral rehabilitation occasionally experience prolonged sedation and delayed discharge. The Bispectral Index System (BIS) is an EEG monitor that measures the level of sedation. The authors compared discharge times of patients who had BIS monitoring to those who did not to determine if the use of BIS speeded discharge. METHODS: After IRB approval, 20 children were enrolled. BIS was monitored continuously from admission until discharge. Each child received ketamine, midazolam, and glycopyrrolate i.m. Once sedated, the patient was transferred to the operating room, monitored, and i.v. access was established. GA proceeded with sevoflurane, rocuronium, and fentanyl. Randomly, in half the patients, the anesthesiologist knew and maintained the BIS at GA level of sedation by adjusting sevoflurane. In the rest, the anesthesiologist did not know BIS. Time from turning of sevoflurane to discharge was noted and compared. RESULTS: Patients where the BIS was known and used were discharged 60+/-13 minutes after the end of GA. Patients where BIS was unknown were discharged 90+/-11 minutes after the end of GA (P<.001). CONCLUSIONS: Based on the data, the authors recommend the use of BIS to facilitate faster discharge of pediatric patients who require i.m. sedation and GA for oral rehabilitation.

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BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate sealant shear bond strength on bovine enamel with standard acid etching compared with CO(2) laser etching. STUDY DESIGN/MATERIALS AND METHODS: Bovine enamel was prepared either by acid or laser etching and divided into four experimental groups, either acid or laser-etched teeth with or without a primer. A gelatin capsule was used to place the sealant on the prepared enamel surface and the bond tested in shear. Also surface roughness was evaluated by using a surface analyzer and an atomic force microscope. RESULTS: Shear bond strength results were the following: acid etch = 8.8 +/- 3.8 MPa, acid etch with primer = 10.3 +/- 5.5 MPa, laser etch = 4.0 +/- 1.1 MPa, and laser etch with primer = 6.2 +/- 2.3 MPa. Analysis of variance statistical analysis found no significant difference in bond strength between the acid-etched groups. However, the laser-etched groups had significantly lower bond strengths from the acid-etched teeth. In addition, a significant difference was observed between the laser-etched groups, where the use of the primer helped to increase the bond strength of the sealants. The surface roughness was significantly greater on the laser-etched teeth at the microm level (by using a surface analyzer) from the acid-etched and the control specimens. No difference in roughness (by using an atomic force microscope) was observed at the nanometer level between the laser and acid-etched teeth. CONCLUSION: For these particular settings, the laser-etched teeth resulted in lower bond strengths to enamel and the use of a primer increased the bond strength for laser-etched teeth only.

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OBJECTIVE: Previous studies demonstrated that the use of a custom-made intraoral acrylic appliance, known as a palatal stabilizing device, prevents palatal groove formation and reduces the frequency rate of accidental extubations in premature, intubated babies. In this study, we compared the effectiveness of a prefabricated palatal device with an acrylic custom-made palatal stabilizing device. Specifically, we compared the stability, fit, and retention of these two devices. DESIGN: Randomized comparative study. SETTING: Clincal trial. PATIENTS: A total of 70 medically stable, premature, intubated babies. INTERVENTIONS: A total of 70 medically stable, premature, intubated babies randomly received Pala-nate (experimental group, n = 34) or palatal stabilizing device (control group, n = 36). MEASUREMENTS AND MAIN RESULTS: Differences among birth weight, gestational age, and period of intubation of the two groups were statistically nonsignificant at p

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The aim of the study was to determine the bond strength of glass ionomer and resin-modified glass ionomer sealants compared to Bis-GMA sealants using both static and cyclic fatigue shear testing. Four materials were evaluated: D, a Bis-GMA sealant with 10% phosphoric acid etchant; FC, a resin-modified glass ionomer sealant with 20% polyacrylic acid etchant; FD, a resin-modified glass ionomer sealant with 10% polyacrylic acid etchant; and FSC, a self-cured glass ionomer sealant with no etchant. Gelatin capsules filled with the sealant material were bonded to the enamel surfaces of bovine teeth after appropriate surface conditioning and then tested in shear static and cyclic fatigue. Static and cyclic shear bond strengths, respectively, for each group were (MPa): FC: 21.1+/-2.8 and 17.1+/-3.1; FD: 14.6+/-5.9 and 8.5+/-3.1; D: 10.8+/-4.9 and 4.7+/-2.6; FSC: 8.7 (1.0 and 2.9+/-0.6. The resin-modified glass ionomer sealants had better fatigue bond strength than both Bis-GMA and self-cured glass ionomer sealants with the surface conditioning affecting the bond strength of the resin-modified glass ionomer sealants.

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The purpose of this study was to compare the mechanics of sucking for 48 term infants with four different nipple units: Gerber Newborn (Gerber Products Company, Fremont, Mich.), Playtex (Playtex Products, Westport, Conn.), Evenflo (Evenflo Products Co., Canton, Ga.), and Gerber NUK. At 24 hours after birth, infants were assigned randomly to one of the nipple units and were studied twice with that nipple unit. A customized data acquisition system was used to measure and record the following variables: intraoral suction, sucking frequency, work, power, milk flow, milk volume per suck, and oxygen saturation. Although no statistically significant differences among the nipple units were noted for intraoral suction, sucking frequency, power, and oxygen saturation, the data revealed that the Playtex nipple unit was accompanied by higher peak milk flow and greater volume of milk per suck (p < 0.05). Infants fed differently with the Playtex nipple than they did with the other nipples. Our findings indicate that the Playtex nipple permits a greater milk flow in response to similar amounts of suction, work, and power when compared with others. The mean total work per such was significantly lower in the Gerber NUK group compared with the Playtex group. In addition, the total number of sucks per volume ingested was higher, and the total time to ingest a specific quantity of milk was longer for the Gerber NUK nipple.

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Recent technological advances in materials have changed the face of restorative dentistry. But, as these experts note, some things remain the same.

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Larsen's syndrome is a genetic disorder of connective tissue characterized by multiple large-joint dislocations, abnormalities of hands and feet, and anomalous facial features. Although findings involving multiple systems have been added to its clinical and pathological entity, oral pathology besides cleft palate has not been reported. We report here advanced periodontitis with severe gingival inflammation in a 29-year-old Larsen's syndrome patient. Bacterial culture of subgingival plaque identified the periodontal pathogens that were present in numbers above the normal range. We speculate that the underlying defect in connective tissue may predispose Larsen's syndrome patients to periodontal destruction provoked by microbiological factors.

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This cross-sectional study of fifty-two prematurely-born children, ages two to five years, evaluated the long-term effects of oral intubation at birth on palatal architecture, crossbite malocclusion, and enamel structure. Seventy percent showed a high palatal vault, with palatal grooving in 25 percent; 36 percent had enamel defects in the maxillary primary incisors; and 17 percent had posterior crossbites. The mean palatal depth was 12.9 mm, as compared to 11.4 mm for a group of 45 nonintubated, normal healthy children (the difference was significant at alpha = 0.05). There are significant iatrogenic defects from prolonged neonatal intubation with this sample of preschoolers.

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This study evaluated the eruption pattern of primary teeth in thirty-one prematurely born children with low birth-weight. Compared with the normal development pattern, the prematurely-born children younger than age twenty-four months had 28 percent fewer erupted teeth, on average.

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Stevioside and rebaudioside A, two intense natural sweeteners, that are constituents of the South American plant Stevia rebaudiana, were tested for cariogenicity in albino Sprague-Dawley rats. Sixty rat pups colonized with Streptococcus sobrinus were divided into four groups and fed stevioside, rebaudioside A or sucrose added to basal diet 2000 as follows: group 1, 30% sucrose; group 2, 0.5% stevioside; group 3, 0.5% rebaudioside A, and group 4, no addition. All four groups were sacrificed after 5 weeks. S. sobrinus counts were made and caries was evaluated according to Keyes' technique. There were no differences in food and water intake and weight gains between the four groups. There were significant differences in sulcal caries scores (p < 0.02) and S. sobrinus counts (p < 0.05) between group 1 and the other three groups. There were no significant differences between the stevioside, rebaudioside A and no-addition groups. It was concluded that neither stevioside nor rebaudioside A is cariogenic under the conditions of this study.

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The objectives of this study were to (1) determine chemotaxis (CX) response by neutrophils (PMNs) isolated from patients with the localized form of pre-pubertal periodontitis (L-PP) and compare these responses with those of age-matched and adult controls, (2) determine the level and up-regulation of CD11b expression upon stimulation with fMLP by peripheral blood PMNs (PB-PMNs) isolated from patients with L-PP and compare these levels with those of age-matched and adult controls, and (3) determine whether there is a correlation between CX and CD11b expression (up-regulation) by PB-PMNs. PB-PMNs from a total of seven patients with L-PP, seven age-matched pediatric controls, and 11 adult controls (four adults for both CD11b and CX assays, and seven adults for CX assays only) were analyzed for CX and CD11b expression. Direct immunofluorescence staining of CD11b was performed with FITC-conjugated monoclonal antibody. Flow cytometry was used to analyze stained cells for their fluorescence intensity. Chemotaxis activity in response to 10(-8) mol/L fMLP was examined in micro-well chemotaxis chambers. The results indicated that CX of PMNs from both L-PP patients and pediatric control subjects was significantly decreased, compared with that of normal adult control subjects (p less than 0.001). There was no significant difference between CX of PMNs from L-PP patients and that from normal pediatric controls (p greater than 0.7). CD11b expression did not significantly differ among L-PP patients, normal pediatric controls, and adult controls.(ABSTRACT TRUNCATED AT 250 WORDS)

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A prospective, randomized study using an acrylic palatal stabilizing device (PSD) was conducted to evaluate the effectiveness of this device in preventing disruptions in palatal architecture. A total of 26 premature infants with birth weights of 540 to 1740 g, and intubated orally for a period varying from 7 to 109 days were randomized to control and experimental groups. All neonates in the control group developed palatal grooving ranging from 2 to 5 mm in depth, whereas those in the experimental group (with a PSD) showed no evidence of palatal grooving. We conclude that a PSD is an effective preventive device in premature orally intubated infants.

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Palatal groove is one of the complications of orotracheal intubation in premature infants. Previous reports demonstrated an incidence of 48% of palatal groove formation in premature infants which increased to 88% when the duration of intubation was greater than two weeks. A prosthetic intraoral acrylic appliance which has successfully prevented such a groove formation has been described in this paper.

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The purpose of this study was to evaluate the effect of freeze-dried bone on amputated pulps. Fifteen primary and one permanent monkey teeth were treated with freeze-dried bone. As the control group, another fifteen primary teeth were treated with calcium hydroxide and fifteen primary and one permanent teeth with formocresol. Four other primary teeth pulps were amputated and sealed with tin foil and IRM as controls. Twelve mandibular incisors were left intact. Histologically all but three teeth treated with human freeze-dried bone after three months showed a complete or partial calcific barrier directly below the amputation site. Normal appearing odontoblastic cells were noted below the calcific barrier. The apical third was vital with an occasional chronic inflammatory cell visible. The histological findings of teeth treated with calcium-hydroxide were very similar to freeze-dried bone. All but four teeth showed a complete calcific barrier at the amputation site. The odontoblastic cells were normal in appearance and the inflammatory cell reactions decreased from the middle portion toward the apical region. The histological evaluation of the formocresol-treated teeth was comparable with previously published studies.

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