"Biological responses of two calcium-silicate-based cements on a tissue-engineered 3D organotypic deciduous pulp analogue"

OBJECTIVES

The biological responses of MTA and Biodentine™ has been assessed on a three-dimensional, tissue-engineered organotypic deciduous pulp analogue.

METHODS

Human endothelial (HUVEC) and dental mesenchymal stem cells (SHED) at a ratio of 3:1, were incorporated into a collagen I/fibrin hydrogel; succeeding Biodentine™ and MTA cylindrical specimens were placed in direct contact with the pulp analogue 48 h later. Cell viability/proliferation and morphology were evaluated through live/dead staining, MTT assay and Scanning Electron Microscopy (SEM), and expression of angiogenic, odontogenic markers through real time PCR.

RESULTS

Viable cells dominated at day 3 after treatment presenting typical morphology, firmly attached within the hydrogel structures, as shown by live/dead staining and SEM images. MTT assay at day 1 presented a significant increase of cell proliferation in Biodentine™ group. Real-time PCR showed significant upregulation of odontogenic markers DSPP, BMP-2 (day 3,6), RUNX2, ALP (day 3) in contact with Biodentine™ compared to MTA and the control, whereas MTA promoted significant upregulation of DSPP, BMP-2, RUNX2, Osterix (day 3) and ALP (day 6) compared to the control. MSX1 presented downregulation in both experimental groups. Expression of angiogenic markers VEGFa and ANGPT-1 at day 3 was significantly upregulated in contact with Biodentine™ and MTA respectively, while the receptors VEGFR1, VEGFR2 and Tie-2, as well as PECAM-1 were downregulated.

SIGNIFICANCE

Both calcium silicate-based materials are biocompatible and exert positive angiogenic and odontogenic effects, although Biodentine™ during the first days of culture, seems to induce higher cell proliferation and provoke a more profound odontogenic and angiogenic response from SHED.

Psychometric properties of the Greek version of the Jefferson Scale of Empathy and empathy levels in Greek dental postgraduate students

PURPOSE

The aims of this study were to: (1) examine the psychometric properties of the Greek version of JSE-HP and (2) explore empathy among Greek dental postgraduate students.

METHODS

The JSE-HP scale was translated into Greek using the back translation method. The questionnaire was given to 111 dental postgraduate students between November 2017 and February 2018. A random sample of 25% was retested to assess test-retest reliability. The reliability of the Greek version of JSE-HP was measured with Cronbach's alpha (α) and Discrimination Indices (DIs). Exploratory Factor Analysis, with varimax rotation of the factorial axes, was used to examine the dimensionality and the factorial validity of the Greek version of the JSE-HP. Comparisons between groups of postgraduate students were performed as appropriate with the Kruskal-Wallis or the Mann-Whitney U test.

RESULTS

The response rate was 100%. The mean age was 28.9 years. The reliability, in the sense of internal consistency of the questionnaire was considered satisfactory (Cronbach's alpha: 0.76, average DI: 0.33.) The test-retest reliability was satisfactory (Pearson's r = 0.77, p < 0.001). Factor Analysis revealed 7 significant factors. No statistically significant differences in empathy scores were found among groups of postgraduate students.

CONCLUSIONS

The Greek version of the JSE-HP shows good psychometric properties. Empathy scores do not differ among Greek dental postgraduate students.

Tooth-surface distribution of caries in Greek schoolchildren, using ICDAS-II index. A national pathfinder survey

AIM

The objective of this cross-sectional nationwide study was to assess the caries status of Greek children, in regard to the severity and the distribution pattern of the lesions in the primary and permanent dentition at a tooth-surface level, based on ICDAS-II criteria.

METHODS

Study Design: A national survey was conducted in 15 urban and 9 rural sites and about 50 subjects were examined at each location across the country. Caries data, based on ICDAS-II index, were recorded on 4,410 children aged 5, 12, and 15-years by 10 calibrated dentists. The rankings of the most affected tooth-surfaces, the most vulnerable teeth found cavitated, the right-left symmetry of caries stages and its pattern of distribution shown per jaw or dentition were determined by using descriptive statistics (SPSS v.20).

CONCLUSION

Caries lesions were quite frequent in this school aged child population and the most common code of ICDAS-II observed was that of incipient enamel caries, mainly on the occlusal surfaces, indicative of the need for fissure sealant application. For those surfaces with ICDAS-II=3-6, dental care and intensive prevention programmes, both at home and office based, are needed.

Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points

AIM

To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece.

METHODS

Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children&#x2041;s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale.

STATISTICS

Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05.

RESULTS

First sample: The mean CFSS-DS score was 27.1&#177;10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33).

CONCLUSION

Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

Treatment management of first permanent molars in children with Molar-Incisor Hypomineralisation

AIM

To study the treatment management of first permanent molars in children with Molar-Incisor Hypomineralisation (MIH).

STUDY DESIGN

Retrospective analysis.

METHODS

The records of the clientele of a private paediatric dental practice were scanned. Thirty-six cases of children fulfilling the diagnostic criteria of MIH were retrieved who had been followed for a mean period of 4.5 years, and 36 children of matching age and gender, and with similar follow-up period, were randomly selected from the same clientele to serve as controls.

RESULTS

Children in the MIH group exhibited greater DMFS and smaller dmfs scores. The frequency of restorative intervention was greater in children of the MIH group (OREST=11.00, 95% C.I. 2.85-42.45). Stainless-steel crowns had been placed only on MIH group molars. The follow-up records revealed that only restorations in the MIH group needed retreatment. Fillings and sealants in the MIH group had a greater probability of needing retreatment than in the control group (OREST=3.10, 95% C.I. 1.60-6.01).

CONCLUSIONS

Children affected by MIH may need to undergo a significant amount of restorative treatment at an early age. Moreover, fillings and sealants in MIH affected children have a greater probability of needing retreatment than in control group children.

Supragingival and subgingival microbiota of adult patients with Down's syndrome. Changes after periodontal treatment

In this longitudinal study, five adult Down's syndrome patients with periodontitis were placed on a frequent recall visit schedule (every 6 weeks) after treatment, in order to investigate: 1) the microbiological status, both supragingivally and subgingivally, and the changes that occurred after treatment and 2) the effect of frequent professional supragingival plaque control on the subgingival microbiota and clinical variables in these patients. The clinical variables recorded were probing pocket depth, probing attachment level, bleeding on probing and presence of plaque (full mouth, six surfaces per tooth). Microbiological examination was performed separately for supragingival and subgingival samples from the same site for 14 species, using whole genomic DNA probes and the "checkerboard" DNA-DNA hybridization technique. The findings indicate that, although a reduction of periodontal indices was noticed, plaque levels remained high (60%) even at the end of the experimental period. Periodontal pathogens including Porphyromonas gingivalis, Bacteroides forsythus and Actinobacillus actinomycetemcomitans were frequently detected both supragingivally and subgingivally (>30%). The presence of a species supragingivally and the presence at the same time points subgingivally were correlated. This finding suggested that supragingival plaque acts as a reservoir for reinfection of treated sites. A reduction of the percentages of detection of these species was noticed 1 month after an oral hygiene period as well as at 3 and 6 months after treatment. Inadequate oral hygiene as performed by these patients probably affected supragingival, and consequently subgingival, plaque composition.

Removable prosthodontic treatment for the primary and mixed dentition

Dental prosthetic treatment of children in the primary and mixed dentition years was planned with respect to the special conditions accompanying the absence of teeth. Besides the immediate functional and esthetic benefit of prosthetic therapy, the prosthetic appliance helps to maintain the oral functional status, which is considered necessary for undisturbed lower facial growth. Therefore, careful follow-up and thoughtful treatment decisions should be exercised, especially in cases where impairment of permanent dentition and supportive tissues complicate the prognosis.