RESUMEN

Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received. This was to overcome the sequence effect. Group I received oral midazolam (0.4 mg/kg/chloral hydrate (50 mg/kg) at the first visit while they received midazolam (0.4 mg/kg)/promethazine (5 mg/kg) in their second visit. Group II received the premedication in the opposite sequence. The operator and child were blinded to the medication administered. Sedative efficacy of the two combinations were assessed and judged by two independent pediatric dentists based on the Wilson scale. Data were analyzed with ANOVA and paired t-test. Results. Only 10% of children who received chloral hydrate with midazolam exhibited high improvement in their behavior while 53% showed reasonable positive changes and 12% had no change or even deterioration of behavior. The difference between the effect of the two combination drugs was statistically significant (P<0.05) in favor of the chloral hydrate group. Conclusion. The results showed a significant difference in the sedation level induced between the two groups. Midazolam/chloral hydrate combination more effectively improved the co-operation for dental treatment.

RESUMEN

BACKGROUND: Early childhood caries (ECC) is a severe type of dental caries affecting infants and pre-school children. Because of the infectious nature of the disease, the immunologic response by the host plays an essential role in its development. OBJECTIVE: This study investigated the association between the presence of salivary sCD14 and ECC. METHODS: This study was carried out on 40 healthy children, of whom 20 were caries-free (CF) and 20 had ECC, within the ages of 36 to 71 months. Unstimulated saliva of the children was collected with disposable needle-less syringe from buccal and labial vestibules. Seven children with ECC received complete treatments. Saliva was collected for a second time after 3 months from this group. The sCD14 levels in salivary samples were analyzed by ELISA method. RESULTS: Mean concentrations of sCD14 in ECC and CF groups were 57.82 and 31.92 ng/ml respectively (p=0.008). After three months, the mean concentration of sCD14 among the treated children decreased to 11.38 ng/ml, which was significantly lower compared to that of ECC children before intervention (p<0.001), and also CF children (p<0.05). CONCLUSION: The increased levels of sCD14 can be considered as a marker of inflammation and innate immune response during ECC.

Asunto(s)

Caries Dental/metabolismo , Receptores de Lipopolisacáridos/metabolismo , Saliva/metabolismo , Biomarcadores/metabolismo , Estudios de Casos y Controles , Preescolar , Estudios Transversales , Caries Dental/inmunología , Caries Dental/terapia , Femenino , Humanos , Estudios Longitudinales , Masculino

RESUMEN

BACKGROUND: Toothbrushing twice daily is a recommended component of oral self-care soon after the eruption of primary dentition. Aim. This study aims to investigate oral hygiene and frequency of oral cleaning in children up to 3 years, in relation to mother-related factors. DESIGN: A cross-sectional study of 504 children aged 12-36 months in Tehran, Iran was implemented. Mothers answered questions about their own oral self-care and their activity in their children's oral hygiene. The child's oral hygiene was assessed on the basis of visible dental plaque on the labial surfaces of the upper central incisors. Data analysis included chi-square test, analysis of variance (anova) and logistic regression. RESULTS: Twice daily oral cleaning was reported for 5% of all children and once daily cleaning for 19% of the 12- to 15-month-old children, 18% of the 16- to 23-month-old children, and 48% of the 24- to 36-month-old children. Of the mothers, 59% stated that they lacked the skill to clean their children's teeth. Dental plaque was observed in 65-76% of the children. Clean teeth were more likely (OR = 1.7, 95% CI 1.3-2.3) in children of mothers who themselves have a higher toothbrushing frequency. CONCLUSIONS: To improve oral hygiene in early childhood, more emphasis should be placed on mothers' own toothbrushing and their skills in their children's oral cleaning.

Asunto(s)

Placa Dental/epidemiología , Madres , Higiene Bucal/métodos , Actitud Frente a la Salud , Preescolar , Métodos Epidemiológicos , Femenino , Humanos , Lactante , Masculino , Conducta Materna , Higiene Bucal/instrumentación , Cepillado Dental

RESUMEN

The association between plaque and caries in older children and adults has been poor, however, some studies show that there may be a relationship in younger children. The aim was to study the relationships between dental caries and dental plaque among 12-36-month-olds in Tehran, Iran. A cross-sectional study among a stratified random sample of 504 children aged one to three years from 18 public health centres in Tehran. Mothers were interviewed about their child's date and order of birth, gender, primary caregiver, the mother's age and the educational level of both parents. Dental examination was carried out according to the WHO criteria. Early childhood caries (ECC) was defined as the presence of any dmf teeth. Dental plaque was visually inspected on the labial surfaces of upper central incisors. Data analysis included Chi-square test, t -test, anova and logistic regression modelling. The prevalence of ECC ranged from 3 to 33% depending on age group, with a mean dt of 1.1 for 26- to 36-month-olds. No gender-differences existed in ECC prevalence and mean dt. Dental plaque was visible on at least one index tooth for 65-75% of the children. Presence of ECC was related to the presence of dental plaque (OR = 1.5; 95% CI 1.0-2.3) when controlling for background factors by means of logistic regression. The high occurrence of visible plaque and rather high ECC prevalence call for improvement in oral health promotion programs of the children.

Asunto(s)

Caries Dental/epidemiología , Placa Dental/epidemiología , Adolescente , Adulto , Factores de Edad , Preescolar , Estudios Transversales , Índice CPO , Escolaridad , Femenino , Humanos , Incisivo , Lactante , Irán/epidemiología , Masculino , Edad Materna , Persona de Mediana Edad , Padres/educación , Prevalencia

RESUMEN

This report presents a case of 10 years old girl who was referred to the pediatric dentistry clinic sustaining a sever trauma led to crown fracture and intrusive luxation of immature maxillary incisors. Antibiotic therapies were initiated at first visit, and after surgical exposure both intruded and extruded teeth were endodontically treated by calcium hydroxide. Orthodontic repositioning was performed and root canal filling with gutta-percha was accomplished. Six years after orthodontic repositioning, clinical and radiographical examinations revealed satisfactory apical and periodontal conditions.