Abstract: The aim of this in vitro study was to determine and compare the erosive potentials of red and white wines, exerted on enamel surfaces prepared from extracted human permanent teeth. European wines (50 red, 50 white wines) from different regions were purchased, and the pH values were measured. Eight wines with different pH values were selected. Enamel samples with an average surface area of 25 mm(2) were prepared from 25 extracted permanent teeth from male and female patients aged 40 to 65 years and incubated with wines for up to 24 hours; the amounts of released calcium were determined colorimetrically, and mean surface roughness was measured with a profilometer. A quantitative elemental analysis for Ca was carried out in various depths (5-50 microm), using an electron probe microanalyzer. Incubation of the enamel surfaces with different wines caused a time-dependent release of calcium. After 24 hours, white wines caused a significantly higher (P = .003) Ca release (range: 8.74-28.56 mg dL(-1) 25 mm(-2)) than red wines (range: 4.85-19.43 mg dL(-1) 25 mm(-2)), whereas the values for surface roughness were similar (white wines: 2.67 +/- 0.92 microm; red wines: 2.64 +/- 0.66 mum). Incubation with white wines resulted in a higher loss of Ca down to a depth of 60 microm. In this study, it was demonstrated that white wines have higher erosive potentials than red wines. Within the limits of this in vitro study, it can be predicted that a frequent consumption of white wines might lead to severe dental erosion.
Abstract: PURPOSE: The aim of this study was to compare the results of a new method, measurement of lactic-acid production on the tongue (LAP), with established methods of caries risk assessment in children. METHODS: One hundred nineteen children (6-10 years old) participated in the study. Data collection included number of carious lesions (D-T) and filled teeth (F-T), approximal plaque index (API), LAP, buffering capacity (BC), counts of mutans streptococci (MS) and lactobacilli (LB) in stimulated saliva. According to caries presence, the children were divided into low risk (LR group; D-T = 0) and high risk (HR group; D-T > or = 1) groups. Statistical analysis was performed using Chi-square test, Spearman's test for nonparametric correlations, uni- and multivariate regression analysis. RESULTS: Seventy-two children (F-T = 0.4 +/- 1.4) were in the LR and 47 (D-T = 2.5 +/- 2.7; F-T = 1.5 +/- 1.9) in the HR group. The correlation analysis verified statistically significant correlations between D-T and the salivary counts of MS/LB and between D-T and F-T. API correlated with F-T and LB, while F-T and LB also correlated with each other significantly. The counts of MS and LB showed also a significant correlation. The LAP showed a significant correlation only to F-T. Significances in univariate regression analysis were found for F-T, counts of LB and MS in saliva, and for LAP. The multivariate regression analysis indicated significances only for F-T and LB in saliva, but not for LAP. CONCLUSION: LAP might be useful only as a supplementary screening tool for caries risk assessment, but not as a sole predictor.
Abstract: Dental erosion caused by acidic beverages is common and occurs with increasing tendency. The aim of this in vitro study was to analyse the erosive potential of apple juice on human enamel samples from the first and second dentition. Apple-juice-containing beverages (n = 23) were selected, and pH and buffering capacity were determined. Enamel samples were prepared from impacted, surgically removed wisdom teeth (20 mm superset2) and from deciduous teeth (16 mm superset2). Prepared enamel slices were incubated with a selected apple juice (pH = 3.5) for up to 24 h; the amounts of released calcium were determined colorimetrically, and mean surface roughness (Ra) of the enamel was measured using an optical profilometric device (perthometer, Mahr, Göttingen, Germany). Controls were incubated with a 0.9 % sodium chloride solution under the same conditions (37 degrees C, humidified atmosphere of 5% CO subset2 and 95 % air). The surfaces of the enamel samples were visually examined by CLSM (Leica TCS SP2). The pH-values of the apple juices ranged from 3.3 to 4.2. Incubating the enamel slices (from both dentitions) with a selected apple juice caused a time dependent release of calcium. After 24 h, the primary dentition showed Ca-release values of 0.61 +/- 0.035 mg/ 20 mm superset2 and the second dentition of 0.41 +/- 0.085 mg/ 20 mm superset2; the surface roughness for the primary teeth was 6.8 +/- 1.09 microm and for the second dentition 6.2 +/- 0.41 microm. CLSM show structural changes on all surfaces when compared to the controls. In this in vitro study, the erosive potential of apple juice on teeth of the first and second dentition could be demonstrated. However, it must be considered that numerous modifying factors influence the human enamel surface in vivo; therefore, a direct translation from in-vitro conditions can only be done with caution.
Abstract: PURPOSE: The aim of the study was to determine possible differences in decrease of pH-values of whole saliva, following the intake of different beverages. MATERIALS AND METHODS: Twelve boys and 13 girls (4.9 +/- 0.9 years old) participated in this study. A dental examination was performed (dmft). Orange juice (pH = 3.67), instant fennel tea (pH = 7.38), whole milk (pH = 6.84) and mineral water (pH = 5.88) were tested. All beverages were given at the same time of day. Salivary pH and buffering capacities of the beverages were determined with a portable pH-meter. Immediately after intake of a beverage, and 5, 10, 15 and 25 minutes later, whole saliva was collected, and the pH-value was measured again. The statistical evaluation was performed using the Wilcoxon test for paired samples. RESULTS: Fifteen children had healthy dentitions. Ten subjects had a mean dmft of 1.1 +/- 2.3. The mean base salivary pH was 7.09 +/- 0.07, without differences between the children with and without dental decay. Mineral water led over the whole period of measurements to a significant rise in salivary pH (P < 0.05). Orange juice caused a significant reduction in the salivary pH during the first 10 minutes. After intake of instant tea or milk, significant reductions were found in the period of 5 to 10 minutes. After the intake of instant tea, the reduction was still significant after 15 minutes. During the period of 5 to 10 minutes, the change in pH (deltapH) in whole saliva differed significantly only between consumption of mineral water and other beverages (P < 0.01). CONCLUSION: With regard to dental health, a regular consumption of orange juice or sweetened instant teas should be discouraged.
Abstract: The aim of this study was to establish correlations of clinical and radiological dental findings, alone or in combination, with chronological age in adults. Dental findings and orthopantomograms of 984 patients (aged 20-60 years; 524 females/460 males) were analyzed. DMF-T index and distance (alveolar bone level, ABL) between cemento-enamel junction and alveolar bone margin were recorded. Additionally, clinical and radiological findings at each tooth crown and root were collected according to the actual status of destruction and restoration, and a total score for each dentition (TSD) was calculated. After univariate correlation analysis, correlation coefficients for ABL and TSD were improved by using square root (sqrt). However, the determination accuracy was still not satisfactory; 90% of the residuals were in the range of about +/-10. The present study showed that clinical and radiological dental findings could not be used, not even in combination, for accurate age estimation as a single method, but that they could support other methods.
Abstract: High weight and obesity represent risk factors for numerous diseases. Correlations between body mass index (BMI) and carious lesions have also been described. In the present study, a possible association between caries prevalence and high weight ranges were examined in 2071 primary school pupils (51.8 % girls, 48.2 % boys), aged 6 to 10 years. A dental examination including the assessment of carious lesions (df-t + DF-T) was followed by measurements of height and weight in order to determine the BMI. The evaluation showed that 6.8 % of the elementary school children were underweight, 76.4 % had a normal weight, and 10.5 % were overweight and 6.3 % obese. Underweight children showed healthy teeth in 50 % of the cases, 47.4 % with normal weight showed naturally healthy teeth, while overweight and obese children displayed naturally healthy teeth in 41.5 % and 38.3 % of the cases, respectively. In primary school pupils, a significant association between the caries frequency and the BMI was found. A low BMI showed a correlation with the absence of carious lesions (p < 0.0001), and a high BMI was linked to a high number of caries lesions (df-t + DF-T values; p = 0.0021). However, no gender-related differences, regarding the prevalence rates for high weight and obesity, could be established. The significant correlation between the BMI and caries frequency persisted even after adjustment to the age of the children.
Abstract: Dystrophic epidermolysis bullosa (DEB) is one of the three major types of epidermolysis bullosa (EB), an inherited cutaneous disease with blister formation following minor trauma. A subtype of DEB is recessive dystrophic epidermolysis bullosa, Hallopeau-Siemens type (RDEB-HS), where marked scarring leads to deformities of extremities. In RDEB-HS the mucous membranes may also be involved and form adhesions with ankyloglossia and microstomia. Oral hygiene is difficult. A 7-year-old boy with RDEB-HS was brought to the Johannes Gutenberg University dental clinic with dental pain. He had multiple carious lesions, poor oral hygiene and gingivitis. Because he was noncompliant and had microstomia, he required dental therapy under general anesthesia. The recall visits over the past two years had demonstrated that the dental health of this patient with RDEB-HS could be maintained by means of improved oral home care, using antibacterial agents.
Abstract: PURPOSE: The aim of the study was to compare the effectiveness in plaque removal of a three-headed toothbrush with a conventional toothbrush in pre-school children. MATERIALS AND METHODS: Twenty-nine children (aged 4-5 years) participated in this study. Fourteen children (group A) used a three-headed toothbrush, and 15 children (group B) used a conventional toothbrush for 3 months. At the initial visit, the children brushed their teeth with their regular toothbrush, and at the final visit with the type of toothbrush they had used for the past 3 months. Plaque was recorded at 48 surfaces (molars: vestibular, oral, occlusal; front teeth: vestibular, oral). Plaque reduction was assessed on anterior and posterior areas of the dentition, and on the different tooth surfaces in sextants (I = 55/54; II = 53/63; III = 64/65; IV = 74/75; V = 73/83; VI = 84/85). Statistical evaluation was performed using Wilcoxon signed rank and Mann-Whitney tests. RESULTS: In group A, the median number of surfaces with plaque was reduced significantly after 3 months (p < 0.05). At final examination the number of surfaces with plaque in both groups differed significantly (p < 0.05). Significant decreases in plaque scores were recorded at maxillary and mandibular posterior and mandibular anterior teeth in group A (p < 0.05). The comparison of changes in plaque scores of both groups showed significant differences (p < 0.05) on the occlusal surfaces of molars, except in sextant IV. Significant differences between the groups were also noted on all surfaces of the left side and on the occlusal surfaces of the right side of the mouth (p < 0.05). CONCLUSIONS: This study indicates that the three-headed toothbrush could be an alternative to the conventional toothbrush.
Abstract: OBJECTIVES: The usage of minimally invasive procedures and attention to patient comfort are of great importance, especially for dental treatment in small children. This has led to the development of chemomechanical methods for caries removal. The aim of this study was to compare the efficacy of chemomechanical caries removal with that of conventional excavation in reducing the count of the cariogenic flora. DESIGN AND SETTING: Subjects for this study were chosen from children admitted to dental clinic for restorative procedures under general anaesthesia. SAMPLES AND METHODS: Twenty-one children (mean age 43.5 +/- 12.0 months) with early childhood caries were included in this study. Two primary teeth with comparable degrees of carious destruction were chosen in each child (n = 42) for caries removal with Carisolv' or by means of rotary instruments. Samples from carious dentine were taken with a sterile scraping instrument, then all softened dentine was removed and a second sample was taken. All samples (n = 84) were serially diluted and plated on two different nutrient agar plates. RESULTS: After 24 h of incubation, colony forming units were determined for total bacterial counts and lactobacilli. Twelve per cent of the samples from carious dentine contained more than 10(6) bacteria, 23.8% contained more than 10(5) lactobacilli. Both methods of caries removal produced a statistically significant reduction in the bacterial counts (P = 0.0001). In at least 90.5% of the samples taken after the removal, the total bacterial count was below 10(2), and in 95.2% lactobacilli fell below 10(2). CONCLUSION: These results indicate that the efficacy of chemomechanical removal of carious dentine in children by means of Carisolv' is comparable to the results obtained by conventional methods, and thus might serve as a suitable alternative.
Abstract: PURPOSE: Psychological stress factors can lead to changes in the immune system, the nervous system, and to psychosomatic diseases, besides releasing typical stress metabolites. This study on hand was to record the reliability of stress self assessment of students in various stress periods, and to be compared with the cortisol value of the saliva. MATERIALS AND METHODS: A total of 38 healthy students (18 women and 20 men), with an average age of 26.9 participated. The saliva of the participants was always tested between 9 AM and 10 AM, and always in various stress periods - during a typical semester internship, and immediately following the oral final examination. This was followed by a questionnaire concerning daily life styles (nutrition, part-time employment, sleeping pattern). The evaluation of the respective cortisol concentration of the total saliva resulted in a statistically high significant difference of values, relevant to stress levels (p = 0.0001). RESULTS: An average value for cortisol of 0.085 microg/dl total saliva was measured in the non-stress period, and in the stress period of 0.315 microg/dl total saliva. The comparison of the questionnaire evaluation to life styles did not show anything significant, the comparison to the cortisol concentration of the saliva showed significant deviations from the individual stress assessments by the participants. CONCLUSION: The results cover a significant correlation of particular stress factors to changes in cortisol values. It is important for dental therapy to use stress reducing measures, or reduce them as much as possible in order to avoid factors that pre-operatively can affect the patient in a stressful way.
Abstract: PURPOSE: The aim of the present study was to compare changes in salivary pH after intake of apple juice and its various dilutions with mineral water, in children and adults. MATERIALS AND METHODS: 15 children (mean age 4.4+/-0.9 years), and 15 adults (mean age 30+/-2.4 years) participated in this study. Carbonated mineral water, apple juice and its various dilutions with carbonated mineral water were tested. The pH-value of unstimulated whole saliva was measured at the same time of day. The pH-value was measured again immediately after intake of a beverage, and 5, 10, 15 and 25 min later. The flow rate and buffering capacity of stimulated saliva, and the buffering capacity, calcium and phosphorus contents of the beverages were measured. The statistical evaluation of the data was performed employing the Wilcoxon test for paired samples. RESULTS: The mean base value of the pH of whole saliva was 7.0+/-0.2 (children), and 6.8+/-0.3 (adults). The differences in the flow rates of stimulated saliva in children and adults were statistically significant (p = 0.0003). The intake of mineral water led to a statistically significant rise in the salivary pH-value (p < 0.05). Undiluted and diluted apple juice caused a reduction in the salivary pH-values. Within the first 10 min the changes of pH in saliva only differed significantly between mineral water and the other beverages (p < 0.01). In the pH range of 5.8 - 7.0, mineral water had a weak buffering capacity, while undiluted apple juice had a high buffering capacity. CONCLUSIONS: With regard to dental and general health, only mineral water can be recommended for children.
