2015-IAPD Glasgow Poster Abstracts PDF

Poster sessions
British Society of Paediatric Dentistry Poster Prize Session – PZ01
Poster sessions
British Society of Paediatric Dentistry Poster
Prize Session – PZ01
PZ01.01 G3), or 5000 ppm NaF (groups: G4–G6). The seventh group
(G7) was control (no treatment). Then, the slabs were deminera-
Investigation of care staff attitudes regarding oral lised by stirring for 10 s five separate times in fresh 200 mL
care provision for dependent children and young aliquots of citric acid, 0.3% w/v, pH3.20. A 60-min gap was left
people prior to implementation of a toothbrushing between demineralisations/treatment as well as rinsed where slabs
programme incubated into artificial saliva. Then, samples were treated as fol-
E. COLE1,2,3, R. EMANUEL1 & J. PARRY1,3 low (slurries): 1450 ppm NaF toothpaste (G1), 1450 ppm NaF
1 toothpaste with casein phosphopeptide-amorphous calcium phos-
Special Care Dentistry, Sussex Community Trust, West Sussex,
UK; 2Paediatric Dentistry, Kings College Hospital, London, UK; phate fluoride (CPP-ACPF) gel (G2), 1450 ppm NaF toothpaste
3 with CPP-ACPF gel and 22,500 ppm NaF varnish (G3);
Royal Alex Children’s Hospital, Brighton, UK
5000 ppm NaF toothpaste (G4), 5000 ppm NaF toothpaste with
Background: Chailey Heritage Foundation (CHF) is a pioneering CPP-ACPF gel (G5), 5000 ppm NaF toothpaste with CPP-ACPF
UK charity which educates and cares for children and young gel and 22,500 ppm NaF varnish (G6). Nanohardness of enamel
adults with complex physical disabilities and health needs. Chai- was measured at baseline and after cycling using atomic force
ley Heritage Residential offers flexible care packages for children microscopy.
and young people aged 3–19 years old. Futures@Chailey Heri- Results: All specimens showed reduction in enamel hardness after
tage, for 19–25 year olds, is where young disabled adults are cycling. The percentage of enamel hardness reduction (%
helped to develop life skills. change SD) was G1: 30.11 18.28, G2: 19.18 10.19, G3:
Aim: To investigate care staff attitudes regarding oral care provi- 9.71 23.13, G4: 18.20 21.54, G5: 4.08 19.95, G6:
sion and to introduce a new tooth brushing programme using 6.80 23.67, G7: 34.45 16.63 (ANOVA, P < 0.05).
non-foaming toothpaste and suction for patients with severe eat- Conclusion: The groups with highest fluoride exposure (G3, G5,
ing and drinking difficulties (Eating and Drinking Ability Classi- G6) exhibited less demineralisation of hypomineralised enamel
fication System Level V). than other treatments. No treatment regime was able to inhibit
Design: Assessment of attitudes towards oral care provision was demineralisation completely.
gathered from staff involved in caring for children and young
people at CHF. The brushing programme was introduced to
develop a standardised programme of oral care for patients
PZ01.03
with swallowing difficulties (EDACS V), using non foaming Lifecourse determinants of dental caries in three year
toothpaste and a protocol which encourages suction during old children: a feasibility data linkage study
brushing. J. OWEN1, P. F. DAY1,2, E. PETHERICK3, J. GODSON4 &
Results: 82% of staff felt that oral care was a high priority and G. DOUGLAS5
the majority did not find toothbrushing unpleasant A number of 1
Department of Paediatric Dentistry, University of Leeds, Leeds,
challenges were identified including lack of time (50%), lack of UK; 2Salaried Dental Service, Bradford District Care Trust,
child co-operation (94%) and in some cases lack of training and Bradford, UK; 3Bradford Institute for Health Research, Bradford,
confidence. Over 66% felt that the use of non-foaming toothpaste UK; 4Public Health England, North of England, UK; 5Dental
and suction would be useful. Public Health, University of Leeds, Leeds, UK
Conclusions: Staff at CHF face a number of challenges in deliver-
ing good oral care. It is likely that a programme utilising Background: Birth cohorts, such as Born in Bradford (BiB), pro-
improved training, non-foaming toothpaste, suction and an indi- vide an opportunity to study the influence of environmental fac-
vidual oral care plan would benefit the children at CHF. tors acting in pregnancy, birth and infancy on the development
of caries in later years. Dental epidemiology surveys (DES) are
undertaken annually in Bradford for different age groups using a
PZ01.02 standardised and robust methodology as part of the national
The effect of different oral care treatments on the dental epidemiology programme.
demineralisation of hypomineralised enamel Aim: To explore through data linkage whether caries at 3 years
A. Z. ABDULLAH, A. J. IRELAND, J. R. SANDY & M. E. old is associated with birthweight in a cohort of Bradford chil-
BARBOUR dren.
University of Bristol, Bristol, UK Design: Parents of children consented to participate in DES had
the additional option of consenting for data linkage where their
Objectives: The objective of this study was to investigate the child was also part of BiB. Data linkage, following establish pro-
effect of six different putative protective treatments on the inhibi- tocols, was undertaken using each child’s unique NHS number.
tion of demineralisation of hypomineralised enamel in vitro. Associations between caries (dmft) and the following variables
Methods: 126 enamel specimens measuring 2 9 2 9 3 mm were were investigated: birthweight, ethnicity, gestation, gender, parity,
prepared from human first molars exhibiting MIH (seven groups, maternal education, deprivation and maternal language. Simple
n = 18). The samples were initially immersed in a slurry (1 : 3 descriptive and exploratory statistical analysis was undertaken.
toothpaste : deionised water) of 1450 ppm NaF (groups: G1–
46 © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd, 25 (Suppl. 1): 1–251
Poster sessions
British Society of Paediatric Dentistry Poster Prize Session – PZ01
Results: From the sample of 152 children examined for the DES Aim: To observe and experience the management of dental caries
in Bradford, 69 parents consented for data linkage. Only 36 chil- in paediatric patients at Angkor Hospital for Children in Cambo-
dren had actually participated in BiB as well. Six children had dia and to report on the materials and operative techniques used.
caries (dmft >0). There were no statistical associations between Design: A 2 week volunteer placement took place at AHC dental
any variable and caries. department. Paediatric patients were seen by undergraduate den-
Conclusions: Data linkage and analysis was successfully under- tal students and treated under the supervision of hospital den-
taken between the DES and BiB data sets, with data safely trans- tists.
ferred. Almost half the parents who consented for data linkage, Results: Knowledge and language barriers led to difficulties
inaccurately thought their child was also part of BiB. Alternative obtaining a history. Carious teeth were restored using the limited
approaches need to be explored to accurately recruit children materials available at AHC and restorative treatment was largely
participating in both annual DES and BiB. restricted to hand-mixed GIC filings. Restorative techniques were
kept very quick and simple, as recommended by the hospital den-
PZ01.04 tists. A large proportion of carious teeth, both deciduous and
permanent, were unrestorable and were extracted under local
Customised soft bite guards for paediatric special anaesthetic.
care patients Conclusions: A lack of acclimatisation and a non-existent referral
D. SISSON, D. SHELAT & K. COOMARASWAMY system makes management of pre-cooperative paediatric patients
Department of Paediatric Dentistry, Birmingham Dental Hospital, in Cambodia extremely difficult. The absence of a state-funded
Birmingham, UK healthcare system in Cambodia combined with a high level of
poverty results in a large proportion of patients presenting in
Introduction: Cohorts and individuals within the special care pop-
pain with an immediate need for dental treatment.
ulation can often suffer considerable self-inflicted trauma to oral
hard and soft tissues. Conditions such as Lesch-Nyhan syndrome
and Congenital insensitivity to pain have been implicated, PZ01.06
amongst others. It is the responsibility of the Dental team to Pre-operative documentation of sleep disordered
limit oral trauma and damage caused by the dentition for these breathing (SDB) status for children undergoing
patients. One method commonly employed is the use of a soft
bite guard. No gold standard design has yet been recognised,
dental general anaesthesia (DGA)
with various constructions advocated in the literature. M. C. DE SOUZA & M. HARRISON
Case reports: We present two designs commonly used at Birming- Department of Paediatric Dentistry, Guy’s & St Thomas’s NHS
ham Dental Hospital. The appliance designs were derived from Trust, London, UK
input from both clinicians and dental technicians. Our first design Background: Sleep disordered breathing (SDB) affects up to 20%
was made to provide protection to the peri-oral and oral soft tis- of children and includes snoring, obstructive hypo-ventilation
sues. Our second design intended to limit the effect of severe and obstructive sleep apnoea. Associations with adeno-tonsillar
bruxism and resultant attrition. Conventional splint designs are hypertrophy, obesity and increased GA risk are known. This
generally not adequate as in many special care patients they can may necessitate inpatient management and close monitoring in
pose a choking or ingestion risk. The two designs presented have the post-operative period. SDB status enquiry was not routine in
been found to be well tolerated, safe and can be fabricated with our pre-operative assessment for day case DGA, sometimes
standard materials with only minimal modifications to conven- resulting in cancellation of procedures on the day of admission.
tional methods. Aim: To assess whether dentists are routinely enquiring about the
Comments: Dentists may be called upon to advise on or manage presence of SDB pre-operatively for children planned for DGA.
special care patients with self inflicted trauma of the oral tissues, Method: The dental records of 50 child patients attending for
or elsewhere, caused by the dentition. The two designs specified DGA were selected and assessed for evidence of enquiry regard-
have proven to be both safe and well tolerated by special care ing SDB.
patients in our hospital. Results: 90% of the sample were healthy children (10% asth-
matic). No documentation of active enquiry regarding SDB was
PZ01.05 found in 95% of the sample. Only 1 child had documented evi-
dence of being asked about sleep apnoea and adeno-tonsillar
Management of dental caries in children in an NGO- problems. One child had undergone tonsillectomy previously with
run hospital in Cambodia a history of ‘breathing problems’ prior to this. One child0 s proce-
D. BAILEY dure was cancelled on the day by the anaesthetist due to tonsilli-
University of Bristol Dental School, Bristol, UK tis. Interestingly, this child had suffered multiple previous bouts
Background: Angkor Hospital for Children (AHC) is an NGO- of tonsillitis and was pending tonsillectomy procedure - neither
run hospital in Siem Reap, Cambodia with a dental department of which had been documented in the original medical history.
that runs 5 days per week and provides dental treatment to over Conclusions: The majority of dentists failed to document SDB en-
70 children per day. With the average Cambodian child surviving quiries during assessment for DGA. This led to alteration of the
on less than US$1 per day and with no state-funded healthcare medical history form to include SDB to help identify potentially
system, the need for dental treatment is very high. high risk patients, maximise safe delivery of DGA and prevent
unnecessary short-notice cancellation of procedures.
© 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd, 25 (Suppl. 1): 1–251 47
British Society of Paediatric Dentistry Dental Care Professional Poster Prize Session – PZ02
British Society of Paediatric Dentistry Dental

Care Professional Poster Prize Session – PZ02
PZ02.01 Results: During 2013, 2326 children attended dental examinations
which represents 65.9% of children enrolled at these settings.
Audit of frequency and type of splints already placed During Visit 1, DuraphatÒ was applied to the teeth of 723 Kin-
on patients that attend with a dental trauma to dergarten children. Two-hundred and fifty eight referrals were
paediatric dentistry casualty made at Visit 1 and 28% of these patients attended their appoint-
L. ARCHER & L. A. L. BURBRIDGE ments. A further 147 were referred for dental appointments at
Child Dental Health, Newcastle Dental Hospital, Newcastle, UK Visit 2 with 14% attending appointments. Preliminary analysis of
tooth surfaces shows that timely intervention resulted in 98.9%
Background: Within our department the preferred splinting
of surfaces remaining constant or improved (Visits 1–3).
approach for trauma patients is the use of orthodontic brackets
Conclusions: The program has been extended to school aged chil-
and wire. Local teaching is provided for regional Max Fax DCT
dren (5–6 years) in the Barwon Region of Victoria, Australia in
3 but it is unclear if the teaching is being put into practice in the
2014 and 2015.
clinical setting.
Aim: To find out if orthodontic splints were being placed for
patients with dental trauma outside of the department. Gold PZ02.03
standard: 100% of cases should have orthodontic brackets and Dental morbidity among early childhood children left
wire splints. without parents’ care and children living with parents
Design: Data were collected for 4 months, August - November
2014. Data included the injury sustained; date of trauma;
in Moscow
whether the patient attended somewhere else prior to our depart- K. MILOSERDOVA, L. KISELNIKOVA, O. ZAYTSEVA & E.
ment and the type of splint placed if applicable. KIRILLOVA
Results: Fifty-three patients attended our children’s casualty MSUMD, Moscow, Russian Federation
clinic with a dental trauma over the audit period. Of those, 35 Against the background of significant success in learning etiol-
had attended somewhere else for initial management and 10 had ogy, pathogenesis and treatment early childhood caries remains a
a splint in place. All of the splints were composite and wire and complex problem. Medical care of children left without parents
seven of the patients had their splints removed and replaced with care requires special attention of society and state. That’s why
an orthodontic splint on our casualty clinic. dental assistance is one of important medical and social problems
Conclusions: In the audit period, despite training being given to in dentistry.
Max Fax staff, the gold standard was not met. The impact of Aim: To evaluate dynamics of caries affection among the children
this is that patients attending our department are frequently hav- who left without parents’ care and among the children living with
ing their splints removed and replaced within days of their parents.
trauma which can often be traumatic for them. A re-audit is Methods: Clinical investigation of 133 children who live without
planned for February - May 2015 to assess whether intensive parents care in special institutions was carried out in Moscow.
training has resulted in a change in practice. And 478 children living with parents. Decayed, missing and fill-
ing (DMFT) were employed. Criteria for caries recording fol-
PZ02.02 lowed WHO standarts. Groups of children aged 1, 2, 3 year
respectively were investigated.
Kinder wide smiles Results: The prevalence of dental caries among children aged
A. MASON, L. MAYZE, E. VO, S. SHARP & M. SMITH
2 year was 23.8%; among children aged 3 year 51.3%; among
Oral Health Services, Barwon Health, Newcomb, Vic., Australia
children aged 4 year 39%; among children aged 5 year 25%.
Background: The Barwon Region is a large diverse regional/rural And among children living with parents aged 1 year was 7.07%;
area of Victoria, Australia. Some areas are situated approxi- among children aged 2 year was 26.63%; among children aged
mately 100 km or more from the nearest public or private dental 3 year was 53.33%. The average DMFT index among children
clinic and include many low socioeconomic areas. Many Kinder- aged 2 year was 0.7; among children aged 3 year 2.6. And among
garten children in the Barwon region of Victoria have required children living with parents aged 1 year was 0.32; among children
emergency dental appointments or treatment under general aged 2 year was 1.25; among children aged 3 year was 2.83.
anaesthesia. Conclusion: The prevalence of dental caries and the average
Aim: Our aim was to improve access to dental services for chil- DMFT index among children who live without parents care and
dren in the region by utilising a preventive dental approach. children living with parents shows necessity of dental treatment.
Design: An outreach service was developed for children (aged 3–
5 years) in early learning centres named Kinder Wide Smiles dur-
ing 2013. Sixty centres throughout the Geelong (44) and Colac-
Otway (16) region were visited. Participant Information and Con-
sent forms for dental examinations and fluoride application were
distributed to parents/guardians. Children received three dental
check-ups during the year and fluoride application (0.25 mL/
tooth) with DuraphatÒ (Colgate-Palmolive Pty. Ltd.) for white
spot lesions.
PZ02.04 Results: 2009 data revealed an overall high rate of tooth decay
and poor oral hygiene with 83% of 5–6 year old children requir-
Preventive care offered to an adolescent accessing
ing some form of dental treatment. The total number of assess-
public oral health services in NSW Australia ments to date is 1078. Of significance is the increase in children
A. V. MASOE1, A. S. BLINKHORN2, J. TAYLOR1 & F. A. assessed as plaque free, from 3% (n = 215) in 2009 to 60% in
BLINKHORN1 2013 (n = 324).
1
Faculty of Health and Medicine, School of Health Sciences, Oral Conclusions: Initial results demonstrate the oral health benefits of
Health Discipline, The University of Newcastle, Ourimbah, NSW, an ongoing preventive program. Further studies will determine
Australia; 2Faculty of Dentistry, University of Sydney, Sydney, the long term impact of the project.
NSW, Australia
Background: Adolescents are at risk of dental caries and peri- PZ02.06
odontal disease due to poor toothbrushing and dietary behav- Topical fluoride postcode lottery; who’s the winner?
iour. These oral health problems may be moderated by providing
C. BOWER1, V. WILSON1, L. MCCLEAN1, T. BROOMHEAD2,
individuals with preventive care and advice. In New South Wales
Z. MARSHMAN2 & H. ZAITOUN1
(NSW) Dental Therapists and Oral Health Therapists (Thera- 1
Paediatric Dentistry, Charles Clifford Dental Services, Sheffield,
pists) working in the public health system may assist this vulnera-
UK; 2School of Clinical Dentistry, University of Sheffield,
ble group by offering free dental care and advice on preventing
Sheffield, UK
oral diseases.
Aim: To investigate factors that influence Therapists plan preven- Background: Topical fluoride is an evidence-based preventive
tive oral health care for adolescents attending NSW Public Oral measure which should be applied regularly as per national guide-
Health Services. lines. Children in areas of high deprivation are in greatest need
Design: A cross-sectional postal survey using two clinical vign- of this simple intervention.
ettes were used to record the preventive care treatment plans Aim: This service evaluation determined the proportion of chil-
offered by Therapists working across all 16 NSW Local Health dren, referred for a hospital new patient assessment, who have
Districts. Data were tabulated and Chi square statistics were used had topical fluoride applied by their general dental practitioner.
in the analysis. The deprivation scores of the referring practice locations were
Results: 117 Therapists returned questionnaires giving a 64.6% also analysed.
response rate. The participants highlighted the importance of Design: A piloted data collection tool was used to capture data
offering oral hygiene instruction (97.0%); dietary advice (95.0%) from 100 consecutive new patients. Parents were questioned
and topical fluoride applications (74.0%). Recommended home regarding their child’s attendance history and how often topical
use products included fluoride toothpaste 5000 ppmF (59.0%) fluoride had been applied. Referral letters were reviewed to deter-
and casein phosphopeptide amorphous phosphates plus fluoride mine whether the dentist had previously applied topical fluoride.
(CPP-ACPF) paste (57%). Over 50% offered fissure sealants. Practice postcodes were recorded to determine the corresponding
Most respondents (88%) would utilise Motivational Interviewing Index of Multiple Deprivation.
strategies for a patient with dental caries concerns, however, only Results: Of the 100 participants, aged 2–17 (mean = 7.6 years),
63% would use this technique for a patient in pain (P < 0.001). 92% were regular attenders. 56% (n = 56/100) reported having
Conclusion: Considerable variations were noted in Therapists rec- topical fluoride applied. This was only applied 6-monthly in 25%
ommendations for stabilising and managing oral disease, suggest- (n = 14/56) and 3-monthly in 17.5% (n = 10/56). 19% (n = 11/
ing a need for Clinical Directors to consider providing additional 56) had reportedly had more than one application but 37.5%
professional education to Therapists on the scientific basis and (n = 21/56) only recalled one previous application. 81% of
clinical prevention techniques for preventing dental diseases. patients were deemed high caries risk. Nearly half (46%) were
from the most deprived areas of England.
PZ02.05 Conclusion: While some dental practices are providing fluoride
varnish for their young patients, this does not appear to be as
Overview of a volunteer student placement oral frequently as indicated by national guidelines and the caries risk
health promotion project: saving smiles in Soe, status of the child. Practices in areas of high deprivation should
Australia be further supported to increase the frequency of application.
L. WALLACE & J. TAYLOR
Oral Health, University of Newcastle, Ourimbah, NSW, Australia PZ02.07
Background: Volunteering in professions has increased markedly Children’s views on fluoride varnish application by
over the last few years, both for health graduates and as part of extended-duty dental nurses in a non-dental setting
undergraduate training programs. Since 2009 final year Bachelor A. L. WICKENS1, A. ALJAFARI2 & M. T. HOSEY2
of Oral Health students from the University of Newcastle have 1
Paediatric Dentistry, King’s College Hospital, London, UK;
volunteered as part of an annual medical and dental visit to Soe, 2
Paediatric Dentistry, King’s College London, London, UK
West Timor, Indonesia. The proposal was presented as a valu-
able learning experience for the students and the opportunity to Background: Fluoride varnish application outside the dental clinic
provide a much needed service to the local community. has become an established part of many oral-health promotion
Aim: To develop and implement an ongoing health promotion programmes. Evidence on various aspects of its use is abundant.
project that improved the oral health outcomes for school age However, very few investigated the children0 s perspective.
children in Soe. Aim: to assess satisfaction of high caries-risk children with Fluo-
Design: A local primary school in Soe was selected as the local ride varnish application by Extended-Duty Dental Nurses in
partner school. Baseline data was collected in 2009, and updated non-dental setting.
each year. After discussion with several stakeholders it was Methods: A cross-sectional study involving 4–10 year-old children
decided that the project would include a fluoride varnish program attending a medical pre-assessment clinic prior to dental extrac-
and development of ‘key’ oral health messages and resources. tions under General Anaesthesia (GA). The primary outcome
The first student placement commenced in 2010. measure was child’s satisfaction with Fluoride varnish on a
100 mm Visual Analogue Scale (VAS). The Secondary outcome Risk factors for caries progression were other carious teeth
measures were: 1) Child’s qualitative feedback. 2) Parent’s famil- within the dentition and continued night-time feeding
iarity with fluoride varnish at baseline and 3 months after. Conclusion: ICCMS was a useful tool for a tooth preserving
Results: 105 children received Fluoride varnish application, approach to the management of carious primary incisors in chil-
including 59 boys and 46 girls from various ethnicities. Their dren with limited co-operation who may otherwise require GA
average age was 6.5 years [Range = 4–10]. Children gave the extractions.
treatment an average rating of 62 out of a 100 [Range = 0–100,
SD = 40]. They described the process as ‘easy’, however, some PZ02.09
said that they found it ‘disgusting’ or ‘sticky’ and suggested dif-
ferent flavours. Only 39% of parents were familiar with the treat- Paediatric dentistry oral and intravenous sedation
ment before the study. Fifty nine parents were available after service evaluation: how are we doing?
3 months and 78% of them indicated they are now familiar with A. BORKOWSKA, R. BARNARD, A.WICKENS, F. ROBERTS
Fluoride varnish. & L. LOURENC ß O-MATHARU
Conclusion: Children find fluoride varnish application marginally Paediatric Dentistry, Dental Institute, King’s College London,
acceptable. However, new flavours and changes in texture might London, UK
improve the experience. In addition, high caries-risk families were
Introduction: At King0 s College Hospital both intravenous (IV)
not familiar with Fluoride varnish despite being already referred
and oral (OS) midazolam sedation have been used in the Paediat-
for GA. Efforts to educate parents and achieve wider treatment
ric Department since 2006/7.
delivery are needed.
The aim is to provide a high quality, efficient, specialised service
of conscious dental sedation to alleviate anxiety. This should also
PZ02.08 reduce dental treatment under general anaesthetic.
Management of carious primary incisors in preschool A retrospective Service Evaluation was carried out to improve
children based on ICCMS philosophy the quality of services and safeguarding high standards of care in
L. D. BASSI & J. M. FEARNE accordance with the Standardise Quality Assurance Assessment
Document, 2011.
Paediatric Dentistry, Bart’s Health NHS Trust, Royal London
Aim: To evaluate sedation service to children receiving dental
Dental Institute, London, UK
treatment under OS and IV sedation and assess parent0 s satisfac-
Background: ICCMS (international caries classification and man- tion.
agement system) is a health outcomes focused system that aims Methods: The records of all patients having received midazolam
to maintain health and preserve tooth structure. It involves stag- sedation in 2014 were examined. Data collected included age,
ing the carious lesion and assessing the caries risk to provide per- gender, type of sedation, dental treatment, waiting time for
sonalised patient management. Early childhood caries usually appointments from assessment and number of completed/
affects the primary incisors. Limited patient co-operation and repeated. Details of significant events, untoward incidents and
aesthetic concerns can complicate treatment planning-often complaints were explored.
requiring general anesthetic extractions A questionnaire was sent to estimate parent0 s overall experience
Aim: To follow the outcome of caries progression in primary and satisfaction.
incisors managed using the ICCMS philosophy Results: In 2014, 308 patients were booked, but 136 girls and 124
Design: 41 children under the age of 5 with asymptomatic caries boys had dental treatment with sedation (IV / OS). Mean ages
in upper primary incisors under the care of dental therapist (LB) 3.7 (OS) and 13.2 years (IV). Mean waiting time, 4.5 weeks (OS)
were planned for follow up. Teeth scored as initial or moderate and 5.7 weeks (IV). Twenty five children were emergencies seen
active carious lesions were included. Caries risk was scored as on the same day. In only six children sedation failed. No unto-
low moderate or high based on other carious teeth within the ward incidents or complaints were reported. Overall, most par-
dentition, continued use of a nighttime bottle/breast feeding. All ents were satisfied with the service provided, some found
received fluoride varnish application and preventive advice at information unclear, areas which need improvement.
visit 1 and followed every 3 months. Conclusions: Oral and IV sedation are safe methods of conscious
Results: 41 children with 144 carious teeth were included. All 41 sedation and parents were pleased with the service.
were reviewed at 3 months, 24 at 6 months, and 16 at 1 year. 7
teeth progressed from initial to moderate active carious lesions.
20 teeth were restored and two children required GA extractions.
Dental Anomalies Poster Session – PR02
PR02.19 PR02.21
Dens invaginatus in an immature permanent tooth Dental anomalies associated with agenesis of
combined with chronic periapical periodontitis mandibular second premolars in Turkish population
X. CHEN & S. ZHU M. ZIYA, T. BEZGIN, B. MEMISß OZG € € & S. SARI
UL
Department of Paediatric Dentistry, School of Stomatology, China Paediatric Dentistry, Ankara University, Ankara, Turkey
Medical University, Shenyang, China
Background: It has been proven that genetic factors are effective
Introduction: Dens invaginatus is a congenital tooth developmen- in etiology of tooth agenesis. A single genetic damage might
tal deformity caused by over folding or local proliferation of cause different phenotypes such as tooth agenesis, microdontia or
enamel organ to dental papilla before dens calcification. Dens in- ectopic tooth position.
vaginatus is the weakest anatomy part, prone to food accumula- Aim: The aim of the study was to evaluate the prevalance of
tion and bacterial reproduction, which will further trigger other dental anomalies found in patients with 1 or more congeni-
pulpitis, pulp necrosis and periapical periodontitis. Here we have tal agenesis of mandibular 2nd premolar teeth.
described a case of dens invaginatus combined with chronic peri- Design: 87 patients applying to Ankara University Faculty of
apical periodontitis in an immature permanent tooth. Dentistry Department of Pedodontics between the years 2012–
Case reports: A 12-year-old patient with repeated suppuration of 2014, with 1 or more agenesis of mandibular 2nd premolar teeth
the right side of the maxillary anterior labial gingiva over were inclueded in the study. Clinical and radiographic examina-
3 years. Clinical examination revealed dens invaginatus and tions were carried out to detect other dental anomalies such as;
abnormal tongue ditch of the maxillary right permanent central agenesis or microdontia of maxillary lateral teeth, infraocclusion
incisor (tooth 11), with alveolar pyorrhea adjacent to the labial of persistent decidiuous molars and other form anomalies (talon
frenum. Periapical and CBCT radiographs showed high density cusp, taurodontism, supernumerary teeth). Data were evaluated
image in the neck of 11, wide space in the root canal, open apical with Chi-square and Mann-Whitney U tests.
foramen and radiolucency image in the periapical area. Apexifica- Results: Out of 87 patient, 64.4% were girls and 35.6% were
tion was performed and the tongue ditch was restored with com- boys aged between 7–15 (mean age 10.3). Microdontia (14.9%)
posite resin. The labial gingival fistula healed in 2 weeks. After and agenesis (%6.9) of maxillary lateral teeth were the most com-
4 months, the radiolucency around periapical tissue disappeared. mon dental anomalies associated with mandibular 2nd premolar
8 months later, both the periapical and CBCT examinations agenesis. 19.5% of the persistent molars exhibited infraocclusion.
revealed an image of hard tissue deposition in the periapical area Conclusion: The results of the study showed that microdontia
with the apex closed. Permanent root canal filling was finally per- and agenesis of maxillary laterals and decidiuous molars’ infraoc-
formed. clusion were related with the agenesis of mandibular 2nd premo-
Comments: It’s critical to control the infection in a necrotic lar teeth in Turkish population.
immature tooth, which can recover the vitality of the root sheath
and dental papilla, thus to induce cell differentiation of dental
papilla and deposition of hard tissue at the apex.
PR02.22
A case report: multiple un-erupted teeth and other
PR02.20 dental anomalies in a non- syndrome patient
J. D. EDWARDS & T. PERCIVAL
Mutation in WNT10A and MSX1 genes associated Paediatric Department, Child Dental Health Unit, School of
with oligodontia – a case report Dentistry, University of the West Indies, Champs Fleurs, Trinidad
E. RONKAINEN, S. ALALUUSUA & P. NIEMINEN and Tobago
Institute of Dentistry, University of Helsinki, Helsinki, Finland
Introduction: Delay or failure of eruption of teeth can occur in
Introduction: Wnt10A is strongly expressed in the epithelium and association with other dental anomalies and early diagnosis is
MSX1 in the mesenchyme of the developing teeth. Mutations in critical in effective patient management. The following is a male
WNT10A and MSX1 can cause tooth agenesis. WNT10A muta- patient with multiple causes of failure of permanent tooth erup-
tions affect all tooth types, with considerable variation. Muta- tion with other dental anomalies.
tions in MSX1 are associated with oligodontia typically involving Case reports: A 13 year old Afro-Caribbean male was referred
third molars and second premolars. WNT10A and MSX1 muta- for management of unerupted incisors and canines. His medical
tions are also responsible for some rare syndromes exhibiting and family history revealed nothing of significance and there was
tooth agenesis as a prominent feature. no report of previous dental trauma.
Case report: The proband, originally from Thailand, was a 10- Examination revealed retained 53, 55, 65 and 73, unerupted 21,
year-old boy. He was referred to the Unit of Specialized Oral 22, 23, 33, 15, 25, impacted 37, 47 and ectopic 34 and 35. There
Care, Metropolitan Area in Helsinki for diagnosis and treatment was transposition of 12 and 13, dilaceration of 22 and unilocular
of oligodontia. In addition to third molars, 10 permanent teeth radiolucent lesions encircling the crowns of 15 and 25 and some
(seven premolars, mandibular central incisors and a mandibular decayed teeth.
second molar) were missing. His maxillary lateral incisors were Consultation was undertaken with the departments of paediatric
conical. He had grade III microtia and atresia of the right ear. dentistry, orthodontics and oral surgery. Premolar impaction was
He had also cafe au lait skin lesions. His 11-year-old brother had ascribed to over-retained primary teeth and dentigerous cysts and
seven missing premolars and agenesis of third molars. Both the aetiology of the other multiple unerupted teeth was deemed
brothers had normal hair, nails and function of sweat glands. idiopathic as there was neither family/dental trauma history nor
Their mother and 9-year-old sister had no missing teeth. Mother evidence of a syndrome, supernumerary teeth or ankyloses.
reported that the father of the children and his mother had some The proposed treatment under general anaesthesia included resto-
teeth and nails missing. Genetic analysis revealed that the broth- ration of carious permanent teeth, extraction of all retained pri-
ers had a homozygous missense mutation in WNT10A, mary teeth, surgical removal of 22, 34, 35, exposure and bonding
c.637G>A (p.G213S). Mother was heterozygous. All three had of 21 and 23 and marsupialization of dentigerous cysts associated
also a heterozygous mutation in MSX1, c.818G>C (p.G273A). with 15 and 25.
Comments: We conclude that tooth agenesis is caused by the
homozygosity of the WNT10A mutation.
Morita Prize Entries (Research Posters) – PZ–03
Methods: We developed a two-tailed questionnaire addressing PZ03.06

1) parents of children/ young adults up to the age of 21 years
Induced artificial bone marrow cells from dental pulp
with questions concerning experiences with dentists and
dental clinics and cells of primary tooth using a natural compound
2) children and/or their parents (depending on the patient0 s A. YAMADA, T. NAKAMURA, M. ARAKAKI, Y.
age) to gather information of oral life quality (adapted SUGAWARA, K. SAITO & S. FUKUMOTO
versions of CPQ-G11-14, ECOHIS and OHIP). Division of Pediatric Dentistry, Department of Oral Health and
Results: The application to the target group was feasible. Limita- Development Sciences, Tohoku University Graduate School of
tions were the responsiveness of parents in a proxy situation of Dentistry, Sendai, Japan
intellectually disabled children and young adults and the hetero- Background: Tissue stem cells including dental pulp stem cells are
geneity of the small rare diseases groups. A consolidation with useful for regenerative medicine. However, the number of cells is
larger study groups is necessary. limited.
Aim: The aim of this study was to identify the compound to
PZ03.05 induce dental pulp stem cells from differentiated cells, and to
Association between maternal psychosocial factor and examine the multipotency of induced dental pulp stem cells.
Design: A total of 12,000 compunds approved by Food and Drug
early childhood caries (ECC) among preschool Administration (FDA) were added into the culture of dental pulp
children of Bangalore city cells from human primary tooth. After 2 days culture, stem cell
A. SHAKIR1, M. MOHAN2 & K. PUSHPANJALI3 marker Oct3/4 expression were examined. A compound induced
1
Department of Pedodontics and Preventive Dentistry, Faculty of Oct3/4 was one of the candidates to induced artificial dental pulp
Dental Sciences, M S Ramaiah University of Applied Sciences, stem cells. To examine the multipotency, compound treated cells
Bangalore, India; 2Achutha Menon Centre for Health Science were transplanted into immunodecifient mouse to investigate
Studies, Sree Chitra Tirunal Institute for Medical Sciences and bone formation.
Technology, Trivandrum, India; 3Department of Public Health Results: A compound from edible conch induced Oct3/4 positive
Dentistry, Faculty of Dental Sciences, M S Ramaiah University of dental pulp cells from differentiated cells of human primary
Applied Sciences, Bangalore, India tooth. After transplantation of the compound induced Oct3/4
positive dental pulp cells with hydroxyapatite (HA) into immun-
Background: The relationship between psychosocial factors and
odecifient mouse, cells absorbed HA and formed bone tissue with
ECC might be influenced by stress which can be defined as adjus-
bone marrow. Further, hCD11b positive monocyte and granulo-
tive demands placed on the individual or their internal biological
cyte were observed in the mouse peripheral blood indicating that
responses. It is likely that maternal psychological stress and
functional peripheral cells from human dental pulp cells were
related conditions affect parenting behaviours which in turn can
formed using a natural compound treatment.
increase a childs risk to ECC.
Conclusions: We established the method to form artificial dental
Aim: The aim of this case control study was to determine the
pulp cells and bone marrow cells using a single natrural com-
association between maternal stress levels and ECC.
pound. It may have a possibility of application for not only bone
Design: 121 cases and 121 controls were selected from various
regeneration but also hematopoietic stem cell transplantation for
child care facilities across Bangalore. Cases were defined as the
leukemia patients without any immune-suppresing drug and a
mothers of those preschool children who satisfied the clinical
risk of graft vs host disease.
diagnostic criteria of severe ECC. Mothers of completely caries
free children were selected as controls. The cases and controls
were matched according to the age and gender. The stress level PZ03.07
of the mother was assessed using Parenting Stress Index. This Prevalence of molar-incisor hypomineralization
index depicts mean parental distress, parent-child dysfunctional
(MIH) in groups of children in national schools in
interaction and mean difficult child scores between cases and con-
trols. Selangor, Malaysia
Results: Parenting stress index comparison between cases and B. SOOVULAMAH1, T. VIJAYAKUMAR1, M. MAHADI2, D. J.
controls showed that mean scores were found to be slightly MANTON3 & A. GHANIM3
1
higher among cases in all the three parameters. However the Department of Paediatric Dentistry, Kajang Hospital, Kajang,
mean parental distress scores were significant. This index showed Malaysia; 2Hulu Langat Dental Division, Kajang, Malaysia;
3
the risk of ECC associated with increased 1.64 times with mater- University of Melbourne, Melbourne Dental School, Vic.,
nal stress levels. Though the association was statistically signifi- Australia
cant (P < 0.05), but the odds ratio was not found to be Aim: To investigate the prevalence of MIH in 7–9 year old chil-
significant. dren in three national schools in Hulu Langat, Selangor in terms
Conclusions: It can be concluded maternal stress levels do have a of socio-demographic factors such as age, gender as well as sever-
significant association with early childhood caries. ity and extent of lesion.
Methods: A cross-sectional study with a representative sample
was used. Schoolchildren ranging from 7–9 years-of-age were
examined by a single calibrated investigator using the 2003 criteria
by the European Academy of Paediatric Dentistry. Data analysis
was performed with the P-value set at 0.05 using SPSS version 22.
Results: A total of 483 children participated in this study and 27
(5.6%) were diagnosed with MIH. Males (N = 15; 51.6%) were
affected more than females (N = 12; 48.4%). All of the lesions
were mild in severity and demarcated creamy white opacities
were the most frequent. The 9 year old age group had the great-
est number of cases diagnosed (N = 15; 39.1%). A large number
of Malays (89.4%) were diagnosed but comparisons between the
ethnic groups could be made accurately as Malay students Results: One-hundred and forty five children (22.7%), with a
formed the majority in the included schools. mean age of 10.4 years, DNA their appointment. Of the 120
Conclusion: The prevalence of MIH in this study was found to be available case-notes, one child was recorded as being at ‘high
lower than other studies done in the region such as India (9.2%) risk’ of neglect and was managed fully in accordance with the
and Singapore (12.5%). This study can be used as a basis for process. The majority of the remaining non-attending children
other MIH prevalence studies in other states in Malaysia and be (n = 119) were correctly reappointed (87.7%) or discharged
tailored to represent the population ethnic ratio in the country. (83.7%). An information-sharing letter was appropriately sent in
85% of; with GDPs (85%) and parents (58%) being most com-
PZ03.08 monly informed. However, contrary to the process, information
was only shared with GMPs in 15% of cases and attempts to dis-
Cytotoxicity of accelerated mineral trioxide cuss attendance with parents by telephone were recorded.
aggregate on stem cells from human dental pulp Conclusions: Although the majority of non-attending children
B. KARGUL1, P. KULAN2, O. KARABIYIK3 & G. TORUN were managed in accordance with the process, there were omis-
KOSE4 sions mainly in copying the GMP. The action plan included fur-
1
Pediatric Dentistry, Marmara University, Istanbul, Turkey; ther staff training and automatically copying GMPs into all
2
Marmara University, Istanbul, Turkey; 3Department of Genetics paediatric correspondence which have been implemented.
and Bioengineering, Faculty of Engineering, Yeditepe University,
Istanbul, Turkey; 4Faculty of Engineering, Yeditepe University, PZ03.10
Istanbul, Turkey
Cost-Effectiveness of fluoride varnish in the
Aim: MTA is used widely in endodontic therapy as a pulp-capping prevention of early childhood caries in non-fluoridated
material, root-end filling material and perforation-repair material.
Although MTA has many favorable properties, it has some disad-
areas
C. ZAROR1, G. ESPINOZA2, P. MUNOZ ~ 1
, C. VERGARA3 & S.
vantages. One of the major disadvantages of the material is its ~ 2
long setting time, which, in turn, necessitates multiple visits by the MUNOZ
1
patients. The aim of this study was to evaluate the cytotoxicity of Paediatric Dentistry and Orthodontic Department, Faculty of
accelerated-set MTA on stem cells from human dental pulp. Dentistry, Universidad de La Frontera, Temuco, Chile; 2Public
Methods: MTA was prepared by mixing MTA with various addi- Health Department, Faculty of Medicine, Universidad de La
tives which tested include distilled water, 15 wt% disodium hydro- Frontera, Temuco, Chile; 3Health Service Araucanıa Sur, Temuco,
gen phosphate (Na2HPO4), K-Y Jelly, 5 wt% and 10 wt% calcium Chile
chloride (CaCl2). Human dental pulp stem cells were seeded into Background: Early childhood caries (ECC) is very prevalent in
96-well plates at 2 9 103 cells per well and incubated with MTA Chile, especially in communities without water fluoridation. The
for 24 h, 3 and 7 days. Cell viability was evaluated by MTS assay. use of a 5% sodium fluoride varnish has been shown to be effec-
Results: According to MTS results on the 1st, 3rd and 7th days, tive in the prevention of ECC.
statistically significant difference was found (P < 0.05) between Aim: To assess the incremental cost-effectiveness ratio (ICER) of
the experimental materials and the control group. MTA mixed the fluoride varnish in the prevention of early childhood caries in
with K-Y Jelly in all groups showed the lowest cell viability at non-fluoridated areas of Chile.
all-time points (P < 0.05). The cell viability of MTA mixed with Design: We performed a cost-effectiveness analysis from the
distilled water, 5 wt% CaCl2, 10 wt% CaCl2 and Na2HPO4 payer perspective. Therefore a tree of clinical decisions was made.
increased significantly through time. The effectiveness and the cost of the varnish were determined
Conclusions: This in vitro study, distilled water mixed MTA, 5 wt from a randomized controlled clinical trial with triple blind in
% and 10 wt% CaCl2 mixed MTA and Na2HPO4 mixed MTA 277 caries-free children between 24 and 47 months. The children
were biocompatible with dental pulp stem cells. Further in vitro were randomly allocated in two groups: an experimental group
and in vivo investigations are required to prove the clinical appli- (n = 133) who received a preventive protocol, which included
cations of MTA mixed with the various additives. fluoride varnish every 6 months and a control group (n = 144)
with a placebo varnish. The costs were expressed in Chilean
PZ03.09 pesos (CLP) as of 2014.
Results: Incidence of ECC was 46.79% for the experimental
DNAs (did not attend) in the dental paediatric clinic: group and 60.5% for the control group with a 2-year follow-up
how are they managed and can we improve? (P = 0.038). The weighted cost to intervene and treat the conse-
B. BUAHIN, K. LEE, S. WALLEY & S. ALBADRI quences of ECC was CLP 65,493 for the fluoride varnish and for
Paediatric Dentistry, Liverpool University Dental Hospital, the control group was CLP 67,956. The ICER was -CLP 17,965
Liverpool, UK for each extra healthy child in favour of fluoride varnish.
Background: A previous service evaluation revealed inconsisten- Conclusions: The protocol that included fluoride varnish has
cies in the management of paediatric DNAs at Liverpool Univer- turned out to be a dominant treatment, more effective and less
sity Dental Hospital (LUDH). Hence, in order to improve and costly in the prevention of ECC in non-fluoridated areas, when
standardise the management of non-attendance, a local DNA compared with placebo.
process was developed in association with the hospital Safeguard-
ing team.
Aim: To identify if non-attending children are managed in accor-
dance with the DNA process.
Design: A retrospective audit of children who DNA their dental
appointment at LUDH in October 2013 was carried out. A data col-
lection sheet was used to collect information relating to the DNA
process, including follow-up, parental contact and information
sharing. A locally agreed standard of 100% compliance was agreed.
PZ03.11 Demineralisation in dentin: 1: 144.2 [20.9], 2: 150.3 [37.0], 3:

157.7 [28.0], 4: 134.9 [30.6], 5: 134.4 [39.2],
Prevalence of Talon cusp and its genetic link between
And at 500 lm away from the margins: demineralisation in
ethnic groups and the autosomal dorminant trait in enamel: 1: 53.4 [12.6], 2: 54.2 [24.9], 3: 62.2 [19.1], 4: 64.7 [22.6],
recent mixing 5: 50.4 [31.6].
C. V. A. WITT, P. KERSCHOT & M. LUTHI € Demineralisation in dentin: 1: 103.8 [20.7], 2: 113.6 [62.5], 3:
Paediatric Dentistry, School Dental Clinic, Schaffhausen, 118.7 [25.3], 4: 65.7 [52.8], 5: 100.5 [50.4]. No significant differ-
Switzerland ence was exhibited in demineralisation within the groups
(P > 0.05, Bonferroni). Dentine exhibited significantly greater
Introduction: Talon cusp is a rarely reported developmental
demineralisation values at margins in comparison to enamel and
anomaly. The prevalence rates of Talon cusp in the modern pop-
compared to 500 lm for groups 1–4 (P < 0.05, ANOVA, mod.
ulations ranges from 0.06–7.7% with higher frequencies reported
LSD).
among Asian populations. Mitocondrial DNA confirms the rela-
Conclusions: The findings of the study highlight the positive
tionship between the ethnic groups and recent mixing can still
effect[N3] of CHX addition in the adhesive procedure for con-
express itself as an autosomal dorminant trait.
trolling the extent of demineralisation.
Case report: An 8.5 year old girl of German and Asian origin
was referred for a routine dental check up. Family history
revealed that the mother is of Malaysian, Indian and Portuguese PZ03.13
origin. Clinical examination revealed a unilateral presence of a ORAI1/2 and STIM1 protein expression patterns
Talon cusp on the palatal surface of upper left lateral incisor. and potential functions during tooth development
The talon cusp came in contact with occlusion and since the girl
D. DIMITRAKI1, A. LEFKELIDOU1, N. KOTSANOS1 & P.
was scheduled for an orthodontic removable appliance due to
PAPAGERAKIS2
crowding, X-rays were done to assess pulpal involvement. The 1
Pediatric Dentistry, Aristotle University of Thessaloniki,
accessory cusp was relieved from occlusion by grinding 1 mm of
Thessaloniki, Greece; 2Orthodontics and Pediatric Dentistry,
the enamel surface and flouride was applied. Patient is undergo-
University of Michigan, Ann Arbor, MI, USA
ing orthodontic treatment without complications.
Comments: The knowledge of dental anomalies with prevalence Background: The Store Operated Ca2+ Entry (SOCE) pathway
in ethnic groups is important for a paediatric dentist. Though plays a key role in Ca2+ homeostasis in cells, via CRAC chan-
Talon cusp is a trait seen in people of Asian descent with preva- nels. Main representative of the SOCE system is STIM1 which
lence rate in Asian Indians 7.7%, Portuguese 6.3%, Malaysians interacts with ORAI family proteins. Mutations of the genes
5.2%, Southern Chinese 2.5%, Hungarians 2.5%, Keewatin Eski- encoding these proteins have been linked with various clinical
mos 1–2%, Mexicans 0.06%. Due to recent migration and mix- conditions such as immunodeficiency, ectodermal dysplasia, sali-
ing these anomalies do present themselves outside the known vary and sweat glands malfunctions, myopathy, thrombocytope-
regions. The world spread of the Mitocondrial DNA lineage nia, cancer and amelogenesis imperfecta. The protein expression
gives a better inside to how these archeological and modern popl- patterns and potential roles of STIM1 and ORAI1/2 in tooth
uations share a common trait. development remain unknown.
Aim: To characterize the localization of ORAI1/2 and STIM1
PZ03.12 during tooth formation stages.
Design: ORAI1/2 and STIM1 proteins localization was examined
Evaluation of secondary caries in a microbial caries with immunohistochemistry. Sections of mice developing molars
model after the addition of chlorhexidine in the and incisors were immuno-stained using antibodies against
adhesive procedure ORAI1, ORAI2, and STIM1.
C. BOUTSIOUKI1,2, S. LUECKER2, S. AMEND2, K. TOLIDIS1, Results: All three proteins are differentially expressed in dental
P. GERASIMOU1 & N. KRAEMER2 tissues. The strongest expression is found in odontoblasts and a-
1 meloblasts at different stages of dental development, thus, sug-
Operative Dentistry, Aristotle University of Thessaloniki,
Thessaloniki, Greece; 2Paediatric Dentistry, University of Giessen, gesting potential roles of SOCE system at the regulation of Ca2+
Giessen, Germany homeostasis during the deposition and mineralization of dentin
and enamel.
Background: The antimicrobial activity of chlorhexidine (CHX) Conclusion: Our results provide new insights on the expression
against S. Mutans, decreases caries, while its anti-MMP effect patterns of CRAC channels during tooth development. These
against endogenous matrix metalloproteinases increases the long- data provide foundation for follow up studies to examine the role
term stability of the adhesive bond. of SOCE in different dental tissues and to evaluate their potential
Aim: To investigate the caries inhibition effect after dentine pre- role as therapeutic targets. This new pathway could possibly
treatment with CHX and addition of CHX to a 3-step bonding explain developmental abnormalities in dental tissues at the
system. absence/modification of the expression of the above proteins.
Design: A total of 62 Class V cavities were divided according to
the adhesive protocol: 1) Control, Adper-Scotchbond-Multipur-
pose (3M-ESPE), 2) CHX as dentine pre-treatment, 3) CHX in
primer, 4) CHX in bonding agent, 5) Peak Universal Bonding
Agent (Ultradent).
Specimens were thermocycled (10.000 cycles) and inserted into
the S. Mutans caries model. The 10-day biological protocol con-
sisted of consecutive phases of demineralisation (1 h) and remin-
eralisation (3 h). Evaluation under fluorescence microscope
followed.
Results: Margins (in lm [SD]): demineralisation in enamel: 1:
60.8 [19.9], 2: 72.8 [22.5], 3: 81.5 15.9], 4: 78.0 [13.9], 5: 82.3
[18.9].
PZ03.14 1.20 g/L) solutions randomly and asked for their taste percep-
tion. They cleaned with tap-water between solutions and the
Efficacy of probiotics in plaque reduction and
same procedure was followed next week. All data were processed
gingival health maintenance among children under with the NCSS Software.
orthodontic treatment: a pilot study Results: Mean DMFT, DMFS, dft and dfs were 1.74 1.90,
D. KOLIP1, N. YILMAZ1, P. KULAN2, B. GOKKAYA€ 2
& B. 2.14 2.67, 2.82 3.23, 5.26 6.49 respectively. %20 of the
KARGUL2 children were caries-free. The mean age of children who per-
1
Department of Orthodontics, Marmara University, Istanbul, ceived salt was found significantly higher. No significant differ-
Turkey; 2Pediatric Dentistry, Marmara University, Istanbul, ence was found between any taste perception and caries risk
Turkey factors.
Conclusion: Our study showed that school children0 s caries pre-
Background: Probiotics represent a breakthrough approach to
diction results weren’t correlated with sweet, salty, bitter and
maintaining oral health by utilizing natural beneficial bacteria
sour taste perceptions.
found in healthy mouths to provide defense against bacteria
harmful to teeth and gums.
Aim: The aim of this study was to clinically evaluate the effects PZ03.16
of probiotics on plaque and gingival accumulation in subjects Factors predicting the success of pre-formed metal
with fixed orthodontics. crowns: a retrospective study
Design: The study was comprised of 15 healthy patients aged 11–
E. GUPTA1, J. COWLAM2 & H. RODD1
18 undergoing fixed orthodontic treatment. Patients used 1
Oral Health and Development, University of Sheffield, Sheffield,
‘LORODENTÒ’(a complex of six probiotic strains; Streptococcus
UK; 2Paediatric Dentistry, University of Sheffield, Sheffield, UK
salivarius K12 and five strains of the genus Lactobacillus) for
28 days. Gingival Index (GI) according to L€ oe-Silness, and Pla- Background: There is a good evidence-base to support excellent
que Index (PI) according to Quigley-Hain for all teeth were mea- outcomes for pre-formed metal crowns (PMCs) for managing
sured at baseline (Day 0), and at the end of probiotic regimen carious primary molars in young children. There are, however,
(Day 28). Entire dentition GI and PI scores for all patients com- numerous clinical factors that may interact to influence overall
bined were compared between baseline and endpoint using a Wil- success rates.
coxon signed rank test. Aim: To identify what variables predict the success or failure of
Results: Significant reductions in both mean GI and PI scores PMCs.
(P < 0.01) were seen at Day 28 for all patients combined. The Design: Retrospective data were obtained for children who had
mean baseline GI score for all participants was 1.05 0.24 SD, received one or more PMCs in a hospital setting, including the
reducing to 0.79 0.43 SD at 28 days, with an average reduc- following variables: tooth type; availability of pre-operative
tion within each patient of 28.4%. The mean baseline PI score radiographs; experience of operator; provision under GA; use of
was 1.31 0.67 SD, falling to 0.97 0.98 SD at 28 days, with separators; placement of adjacent crowns; site and extent of car-
an average reduction within each patient of 35.8%. ies; technique used (Hall vs conventional) and total number of
Conclusions: In this study, the probiotic complex LORODENTÒ PMCs placed per child. The primary outcome measure was over-
was found to be effective in reducing plaque accumulation and all success of the PMC. The survival probability was assessed
gingival inflammation, demonstrating its potential therapeutic using Kaplan-Meyer analysis. Cox regression was used to assess
value. Our encouraging results warrant future investigation of the risk of failure and to identify possible clinical predictors.
LORODENTÒ in long-term clinical studies. Results: Data were obtained for 177 children, with a mean age of
5.8 years (range-2–15 years) who had a total of 577 PMCs
PZ03.15 placed. Each child had received an average of 3 crowns
(range = 1–8). The mean follow-up period was 26 months. The
Sweet, salty, bitter and sour taste perceptions of only significant predictors of PMC success were: caries depth
school children and relationship with caries-risk being less than half way through dentine (P = 0.003) and the
factors number of crowns (≤3) placed per child (P = 0.04).
E. EGIL & A. MENTES Conclusions: PMCs have good success rates irrespective of the
Pediatric Dentistry, Marmara University, Istanbul, Turkey techniques used and the experience of the operator. However,
teeth with deep caries, and children receiving multiple PMCs may
Background: Four basic taste perceptions and relationship with have less favourable outcomes.
caries are poorly investigated in children as compared to adults.
Aim: The aim of this study was to evaluate salty, sweet, bitter
and sour taste perceptions of school children and compare them PZ03.17
with demographic, clinical, microbiologic and biochemical caries- An unusual and severe sequela following trauma to
risk factors. the primary incisors
Design: Two-hundred children (99 boys, 101 girls, and age 6–13) E. HADJIANTONIS & M. DUGGAL
who attended to Paediatric Dentistry Department of Marmara Paediatric Department, University of Leeds/Leeds Dental School,
University were included in the study. Informed consent was Leeds, UK
obtained from parents. Questionnaires were presented to parents
to record, the socioeconomic and education levels, oral health Introduction: Traumatic injury to primary teeth has the potential
knowledge, their child’s general health, habits, diet contents and to damage the underlying permanent tooth germ which may dis-
frequency, fluoride exposure. The dental examination was per- turb its development. The extent of the malformation depends on
formed using DMFT, DMFS, dft and dfs indices according to the developmental stage of the permanent tooth and the severity
WHO. The oral hygiene was assessed with Sillness&L€ oe Index. of the trauma. Odontoma-like malformation is a rare conse-
Salivary flow rate, buffer capacity, mutans streptococci and lacto- quence following trauma.
bacilli counts were estimated using CRT chairside kits. Children Case report: We report a case of an 8 year old girl who was
rinsed twice sodium chloride (2 mg/L; 4 mg/L), sucrose (12 g/L; referred for management of the delayed eruption of upper central
24 g/L), caffeine (0.27 g/L; 0.54 g/L) and citric acid (0.6 g/L; incisors and history of constant sensitivity associated with par-
tially erupted UR2. She had previously suffered severe traumatic PZ03.19
extrusion of upper primary central incisors at the age of one with
Prevalence of enamel defects and dental caries in
subsequent extractions of both upper primary centrals. At the
age of 8 years she presented with an erupting upper right lateral patients with diamond blackfan anaemia
incisor (UR2) which was hypomineralised. There were no signs F. BAHARIN1, M. KABBAN2, J. DE LA FUENTE3 & M.
of eruption of UR1, UL1 or UL2. Radiographic examination AHLUWALIA2
1
revealed gross abnormality in formation of all upper anterior Paediatric Dentistry, King’s College London, London, UK;
2
teeth, following which a small volume CBCT was carried out. Paediatric Dentistry, King’s College London Dental Institute,
This revealed gross defects in crown and root morphology of London, UK; 3Paediatric Haematology, St Mary’s Hospital,
UR1, UL1, UL2 and UR2. These defects were so severe that London, UK
they also give the appearance of possibly being compound odon- Background: Diamond Blackfan Anaemia (DBA) is a rare genetic
tome. The prognosis of all the four upper anterior teeth was con- disorder. The majority of cases are sporadic but 10–25% are
sidered to be extremely poor. It is expected that these will need familial with autosomal dominant inheritance. The incidence is
to be surgically removed at which time a histological examination reported to be 5 per million live births in the UK. DBA is associ-
will be carried out. ated with multiple craniofacial anomalies such as hypertelorism
Comments: Trauma to the primary incisors at a very young age and broad flat nasal bridge. To date, there are only two case
can cause serious and irreversible consequences for the develop- reports of dental findings in DBA patients in the literature.
ing permanent tooth germs. Aim: To determine the prevalence of enamel defects and dental
caries in patients with DBA attending the paediatric haematology
PZ03.18 unit at St. Mary’s Hospital in London, and to report any other
Different phenotypes of Amelogenesis Imperfecta presenting oral anomalies.
Design: In this prospective observational cohort study a total of
presenting in two siblings 48 children with DBA (mean age: 7 years and 5 months; SD
E. H. ALNUAIMI, M. KOWASH, M. ALHALABI & I. 4 years) were seen for clinical dental examination as part of their
HUSSEIN haematology outpatient visit. Caries experience was recorded
Paediatric Dentistry, Hamdan Bin Mohammed College of Dental using the International Caries Detection System (ICDAS) and
Medicine (Previously Dubai College of Dental Medicine), Dubai, enamel defects using the modified developmental defects of
United Arab Emirates enamel (DDE) index.
Introduction: Amelogenesis Imperfecta (AI) is an inherited disor- Results: Twenty nine children (60.4%) had evidence of enamel
der of dental enamel affecting all the primary and permanent defects most commonly affecting second primary molars. The
dentition. AI prevalence ranges from 1 : 2000 to 1 : 18,000 and defects presenting most often were hypoplasia and diffuse opaci-
is classified into three main categories: hypoplastic, hypocalcified, ties. Thirteen children (27.1%) had dental caries.
and hypomatured. In this case report, we describe variations in Conclusion: The prevalence of enamel defects in children with
the phenotype of two siblings with AI and their management. DBA is high with most defects observed in primary second
Case report: Two siblings, a 15-year-old girl (Patient A) and a 7- molars. These children require targeted prevention as they are at
year-old girl (Patient B), were referred by their general dental increased risk of developing systemic complications from dental
practitioner for the management of what was initially thought to pathology. Paediatric dentists play a key role in the multidisci-
be chronological hypoplasia. No relevant maternal or early life plinary management of these patients.
medical factors were found. A family history showed parental
consanguinity and a positive history of AI (maternal aunt). Clini- PZ03.20
cal examination revealed different clinical features between both
A report of inverted primary maxillary central
siblings. Patient A, in the permanent dentition stage, had partial
expression of AI. She had hypocalcified features affecting all her incisors
permanent teeth and hypoplastic lower incisors and canines. The G. H. M. LEE
maxillary central incisors were unaffected. She also had micr- Paediatric Dentistry, Faculty of Dentistry, University of Hong
odontia of 12 & 22 and taurodontism. Patient B, in her mixed Kong, Hong Kong, Hong Kong
dentition stage, had complete expression of AI with severely hyp- Introduction: Tooth impaction in primary dentition is a rare phe-
ocalcified first permanent molars, second primary molars and nomenon. Among the few reported cases, primary second molars
lower permanent incisors. She also had hypoplastic maxillary are most frequently involved, followed by primary central inci-
incisors, bilateral posterior crossbite and an anterior open bite. sors and first molars. Reported contributing factors include:
Comprehensive treatment plans to suit their individual needs, mechanical obstruction in the path of eruption, like odontomes
were arranged. and ameloblastic fibroma, ectopic position of tooth germ due to
Comments: This case report represents a diagnostic dilemma as trauma or other reasons, primary failure of eruption, ankylosis,
AI may express itself differently even in siblings. Differential infection and interferences of tooth development.
diagnosis includes chronological hypoplasia. A multidisciplinary Case report: A 5-year-old Chinese girl visited with a complaint of
comprehensive long term approach should be considered in the missing bilateral primary maxillary central incisors. Medical his-
management of these cases. tory was non-contributory, and there was no known history of
intra-oral infection or trauma. Pregnancy and delivery were nor-
mal. Patient had finger-sucking habit since birth. There were cal-
lus and peeling on her fingers. Clinical examination identified
moderate enlargement in the buccal aspect of the alveolus in the
missing teeth 51 and 61 region with no pain in palpation. Teeth
72 and 82 were in crossbite. Radiographic examination revealed
that teeth 51 and 61 were inverted with open apexes and incom-
plete root formation. The inverted teeth were near to the dis-
placed permanent tooth germs of 11 and 21. The inverted teeth
51 and 61 were then surgically removed under general anaesthe-
sia. The patient was regularly reviewed. Permanent teeth 11 and cavitated or non-cavitated lesion. Further, among these 604 chil-
21 in good condition erupted in a displaced position 2 years dren with caries, 50.3% had non-cavitated surfaces (ICDAS
after. codes 1 and 2) and 49.7% had cavitated surfaces (ICDAS codes
Comments: Finger-sucking habit may be the contributing factor 3-6). An incidental finding was that enamel lesions were present
to the impaction. Primary teeth impaction could affect the erup- particularly on labial surface of mandibular canines only, in 27
tion and development of their permanent successors. Early diag- children with otherwise sound dentition.
nosis and intervention are necessary. Conclusions: While the prevalence of ECC in rural areas of South
India is high (40%), concerns regarding the greater prevalence
PZ03.21 towards pre-cavitated lesions, underscore the need for prevention.
Regional odontodysplasia. A report of two cases

G. KOTANTOULA, M. S. DUGGAL & S. A. FAYLE
PZ03.23
Paediatric Dentistry, Leeds Dental School of Dentistry, Leeds, UK Perceptions of school teacher’s towards oral health
Introduction: Regional odontodysplasia (RO) is a rare develop-
and school dental health programmes- a qualitative
mental anomaly of the teeth were enamel, dentine and pulp is study
abnormal. In the majority of cases in the literature RO are pre- J. A. THOMAS1, L. ANANDAKRISHNA1 & K. M.
sents in the maxilla affecting usually one quadrant of the jaw. SHWETHA2
1
We describe two cases of RO in mandible with different presenta- Department of Pedodontics & Preventive Dentistry, Faculty of
tions. Dental Sciences, M S Ramaiah University of Applied Sciences,
Case reports: Case 1: 7-year-old girl referred with a heavily bro- Bangalore, India; 2Department of Public Health Dentistry, Faculty
ken down LR6 and a history of pain. There was facial swelling of Dental Sciences, M S Ramaiah University of Applied Sciences,
and buccal abscess associated with LR6 which was partially Bangalore, India
erupted. Radiographs revealed LR6 to have a ‘ghost-like’ appear- Background: School teachers form an effective workforce towards
ance with a large pulp-chamber and thin enamel walls. There was health promotion. Although their knowledge has been gauged by
also possibly a delay in formation of LR7. Acute management
many quantitative studies but their perceptions and opinions still
with antibiotics followed by surgical extraction of LR6 under remain beyond the scope of professionally designed question-
general anaesthesia was performed. naires.
Case 2: A 2-year-old boy was referred for management of hypo- Aim: To assess the perceptions of school teachers towards oral
plastic lower teeth. Teeth were subsequently extracted secondary
health and school dental health programmes.
to infections on three occasions before a diagnosis of RO that Design: A qualitative research using focus group discussion
symmetrically affected the lower teeth from LR5 to LL5 was (FGD) was planned and a focus group discussion guide was
made. Subsequent progress and management to age of 13 year is
designed for this purpose. The FGD guide comprised of a list of
presented. questions designed keeping in mind the research question. The
Comments: While the first case is a typical example of RO the discussion was carried out on two groups of teachers comprising
second has an unusual presentation with symmetrical presenta- of six members each. Their responses were recorded following
tion in the anterior region of the mandible. This case is distinc-
informed consent. The data collected was transcribed and analy-
tive as majority of the cases that report defect in only one sed using QDA Miner 4.0 qualitative data analysis software.
quadrant of the posterior teeth and usually not crossing of the Results: The teachers had a fairly good idea about the oral
midline. hygiene practices regarding both themselves & children. Good
awareness about school dental health programmes was also per-
PZ03.22 ceived. They felt that children from higher socioeconomic status
Prevalence of early childhood caries in 0–3 year old were more prone to dental decay due to their dietary habits.
They were of the opinion that repetition was the key to instilling
children from rural areas of South India, using good oral hygiene habits among children.
ICDAS Conclusion: Teachers are instrumental in creating oral health
J. A. HENRY, M. S. MUTHU, A. SAIKIA & M. BALA awareness among students and are very effective in making a
Pedodontics and Preventive Dentistry, Sri Ramachandra school oral health programme successful. However, further rein-
University, Chennai, India forcement of the knowledge and training sessions are required to
Background: Early childhood caries (ECC) is considered to be use this manpower in order to impact the oral health status of
the most widespread unmet health need among children. Epide- children.
miological surveys play a significant role in monitoring the drifts
in dental caries and for assessing the dental needs in a commu- PZ03.24
nity. Autophagy in odontogenesis and pulp regeneration/
Aim: To investigate the prevalence of Early Childhood Caries
(ECC) in 0–3 year old children from rural areas of South India
revascularisation
using the ICDAS II index. J. YANG1,2, G. SONG2, Y. ZHANG1 & Z. CHEN1
1
Design: Representative samples of 1711 children (0–3 years) were State Key Laboratory Breeding Base of Basic Science of
recruited from Anganwadi centers in rural areas of Lalgudi taluk Stomatology (Hubei-MOST) & Key Laboratory of Oral
of Trichy district in India. Intraoral examinations were per- Biomedicine Ministry of Education, School & Hospital of
formed by 2 calibrated examiners. The International Caries Stomatology, Wuhan University, Wuhan, China; 2Pediatric
Detection and Assessment System was used to measure caries. Dentistry Department, School & Hospital of Stomatology, Wuhan
Data entry was done using the ICDAS epidemiological software University, Wuhan, China
tool and then exported for statistical analysis. Background: Autophagy, a lysosome or endosome-mediated self-
Results: The proportion of children with healthy teeth and ECC degradation process, participates in embryogenesis and tissue
was 59.4% (882) and 40.6% (604), respectively. Screening morphogenesis, including angiogenesis, neurogenesis and osteo-
revealed that 604 children (Males-317, Females-287) had either a genesis.
Education, Service Evaluation and Audit Poster Session – PR11
understanding of the reasons why children 0 did not attend0 PR11.09

(DNA) is essential if service improvements are to be made.
Patient and parents/carers satisfaction on the joint
Aim: To establish the reasons given by parents for non-atten-
dance and elicit their opinions regarding strategies to reduce orthodontic-paediatric clinic (JOP)
DNAs. R. ALSOURANI1, P. KANDIAH2 & H. DHALIWAL3
1
Design: After project registration with the clinical effectiveness Paediatric Dentistry, University of Leeds, Leeds, UK; 2Paediatric
unit, all children (n = 145) who DNA their dental appointment Dentistry, Leeds Dental Institute, Leeds, UK; 3Orthodontic
at Liverpool University Dental Hospital in October 2013 were Deaprtment, Leeds Dental Institute, Leeds, UK
identified (DNA rate: 22.7%). Parents with available telephone Aims: The aim was to determine if patients and parents were sat-
numbers (n = 113) were contacted, on two occasions, and permis- isfied following their appointment on the JOP clinic. The stan-
sion requested to participate in a structured interview. Questions dard set was 90% satisfaction from parents & patients following
elicited reasons for non-attendance, preferred method(s) of the JOP appointment.
appointment communication and strategies to reduce DNAs. Design: All patients and parents attending the monthly JOP clinic
Results: Forty parents agreed to take part, giving an overall were asked to complete the questionnaires after their appoint-
response rate of 35%. The profile of participants was representa- ment. The questionnaires were given out by the nursing staff.
tive of the non-attending cohort (P < 0.05) in relation to; reason Results: The data collected from Aug 2014-Jan 2015 was analysed
for referral, age and clinic non-attended. Reasons for non-atten- as interim results. There were 6 clinics during this time period
dance included forgetfulness (20%), unaware of appointment with 42 complete and 3 incomplete questionnaires.
(18%) and illness (10%). Text messages were the preferred In terms of the patients, majority seemed to know why they had
method of appointment reminder (50%). Seventy-six percent of been referred (86%). Most of the patients had not been worried
parents suggested strategies to reduce DNAs, from which two about their appointment (62%) and felt that their concerns had
major categories emerged; communication and appointment been listened to by the JOP team (83%) and knew what was hap-
times. pening at the next visit (83%).
A new hospital booking system is being implemented and the In terms of the parents, they too understood why their child had
DNA rate will be monitored. been referred (86%) and the length of time for the appointment
Conclusion: The low response rate appears to be similar to other was acceptable (90%). All parents felt that the JOP team was
surveys of hospital non-attendance. Findings indicate a need to polite and informative.
develop innovative strategies designed to reduce non-attendance Conclusion: The feedback from the initial analysis seemed to sug-
at paediatric dental appointments. gest both patients and parents were happy with the care given on
the JOP clinic. The plan for this review is to continue with the
PR11.08 data collection to gain further feedback.
An audit of complete documentation of allergy status
in the Paediatric Dentistry Department, King’s PR11.10
College Hospital Reasons for and sources of referral to paediatric
A. PATEL1, M. YASIN2, A. LIM2, T. ATIEA2, J. MITCHELL1 & dentistry
M. KABBAN1 M. G. BROSNAN & B. K. DRUMMOND
1
Paediatric Dentistry, King’s College London, London, UK; Oral Sciences, University of Otago School of Dentistry, Dunedin,
2
King’s College London, London, UK New Zealand
Background: Assess whether allergies are accurately documented Background: The University of Otago Paediatric Dentistry service
in dental records for children attending the department. provides contracted care for children referred from throughout
Aim: All children with allergies will have appropriate documenta- Otago and Southland in the South Island of New Zealand.
tion completed in dental records. Therefore it is important to have an accurate understanding of
Design: Retrospective sample: Children with an allergy attending the numbers of referrals and care being requested.
a new patient consultation February 2013 (first cycle) and July Aim: To determine the reasons for and source of referrals to the
2014 (second cycle). A proforma was completed using patient discipline of Paediatric Dentistry at the University of Otago
records to determine documentation of allergies. School of Dentistry.
Results: First cycle: 161 records were assessed, 11 children (7%) Design: Consecutive referral letters for children and adolescents
had known allergies. Second cycle: 251 records were reviewed, 35 were reviewed over a six-month period. The reasons for referral,
children (14%) had known allergies. To facilitate improvement source of referral, age and gender of the child and medical status
results and recommendations from the first cycle were dissemi- were recorded. The children were placed in three different clinics
nated via staff meetings, hand-outs and e-mail. Whether the aller- - undergraduate, postgraduate and staff.
gic substance was written in clinical records on the alerts table Results: Over the six-month period 163 children and adolescents
showed a significant improvement from 15% (first cycle) to 56% attending the Dental School for the first time were reviewed
(second cycle). The orange alert sticker was placed on the front before placement in the different clinics. The majority of children
cover of the clinical records in 31% cases (first cycle) and were referred by Dental Therapists (55%), dentists (19%), emer-
improved to 63% (second cycle). gency (18%). The main reason for referral was for management
Conclusions: The second cycle of this audit highlighted there had of caries including early childhood caries early (50%), challenging
been a marked improvement in the departments’ allergy docu- behaviour (12%), dental anomaly (15%) or medical reasons
mentation particularly placing alert stickers on records and (13%). 81% recorded the medical status. 67% were referred to
recording allergies in the folder cover. Further improvement is the undergraduate clinic and 33% to staff and postgraduates.
necessary to reduce the risk of allergic reactions occurring and Conclusion: This clinical audit highlighted the significant reasons
improved patient safety due to poor record keeping. A third cycle for children and adolescents attending the clinics. It also identi-
is planned following dissemination of recent findings. fied the sources of referral and is allowing us to communicate
more efficiently with the referrers.
audit the documentation in patient records. There were 24 and

PR11.25
30 items to be recorded for inhalation sedation (IS) and intrave-
Audit of 0 Did Not Attend0 (DNA) appointments for nous sedation (IV) respectively. The data for Round 1 was col-
0–16 year old children across Leeds Community lected retrospectively, for about 20 cases per dentist. A meeting
Dental Service (CDS) was held to discuss the findings of Round 1 and to identify areas
M. KALKANI1 & S. KINDELAN2 of improvement in record keeping. Second round data were then
1
Paediatric Dentistry, University of Leeds, Leeds Dental Institute, collected prospectively. A target of 80% compliance was set for
Leeds, UK; 2Paediatric Dentistry, Leeds Community Dental both rounds.
Service, Leeds, UK Results: A total of 12 dentists took part in Round 1; while one
dentist withdrew in Round 2. Round 1: 99 IS and 140 IV records
Background: There are many reasons for a child not to be were audited. Percentage of items which achieved 80% compli-
brought to a dental appointment. In some cases, failure to attend ance was 37%. Round 2: 55 IS and 118 IV records were audited.
raises concerns about safeguarding. Repeated non-attendance for Percentage of items which achieved 80% compliance increased to
health appointments should be seen as an alert for possible child 100%.
neglect. Leeds CDS treats a very vulnerable patient group, Conclusions: The audit was successful in improving the documen-
including children with medical comorbidities, learning disabili- tation of conscious sedation in primary dental care.
ties and children with pre-existing safeguarding concerns.
In 2013, Leeds Community Healthcare Trust (LCHT) produced
a DNA protocol, which described clinicians’ responsibilities fol-
PR11.27
lowing individual patient risk assessment. An audit comparing record keeping in electronic and
Aim: Identify children who were not brought to dental appoint- paper formats on a paediatric dentistry student
ments and ensure LCHT protocol is followed. teaching clinic
Design: 1st cycle: Computer records of all children who had K. L. O’DONNELL1, A. MAXWELL2, W. ANDERSON3, V.
failed to attend in May 2014 were reviewed and evidence of the SHADRICK3, G. L. RICHARDSON4 & J. I. FOLEY5
following was recorded: 1
2
Risk assessment and action plan by the dentist Charles Clifford Dental Hospital, Sheffield, UK; 3University of
Documented discussions with parents/carers/other profes- Aberdeen, Aberdeen, UK; 4Glasgow Dental Hospital, Glasgow,
sionals UK; 5Edinburgh Dental Institute, Edinburgh, UK
Administrative staff action Background: At completion of undergraduate training, dental stu-
Actions: dents are expected to fulfil criteria laid out by the General Dental
Meeting with the LCHT safeguarding team regarding DNA Council(GDC) in the “Standards for Dental Professionals” docu-
letters ment. This includes guidance regarding record keeping. As
Training to the dental team regarding the protocol increasing numbers of dental practices move to electronic patient
2nd cycle (March 2015): Re-audit, using the same inclusion crite- records(EPR), it is essential that an equal standard of record keep-
ria, and comparison with previous results. ing is maintained when compared to paper-based records(PBR).
Results: 1st cycle: 108 children failed to attend their dental Aim: To compare the quality of record keeping in the Depart-
appointments across Leeds CDS during May 2014. 54% did not ment of Paediatric Dentistry at the University of Aberdeen Den-
have a risk assessment recorded and 41% did not have a docu- tal School and Hospital prior to and following the introduction
mented action plan. 50% of “high-risk” DNAs were not ade- of EPR on the undergraduate student clinic.
quately followed-up. Design: In Round 1, 150 patient records were examined retro-
2nd cycle: results will be presented and further action plan deter- spectively (50PBR and 100EPR) from patients who had attended
mined. the department for an examination with a fourth year dental stu-
Conclusions: Successful implementation of LCHT protocol will dent. Data were collected for various demographic and clinical
enable dealing with DNAs consistently, promote attendance and criteria and added to a Microsoft Excel spreadsheet. Six months
safeguard vulnerable children. elapsed, and data collection for Round 2 (100 EPR) was com-
pleted as in the first round.
PR11.26 Results: Recording of patient demographics was maintained at
>95% throughout round 1 and 2. Medical history recording
An audit of documentation of conscious sedation in decreased in EPR in Round 1 and 2 when compared to PBR.
primary dental care Improvements were noted in recording of dental charting in EPR
C. A. YEUNG1 & S. A. KHAN2 round 1, while recording of treatment plan and diagnosis
1
Public Health, NHS Lanarkshire, Bothwell, UK; 2Hamilton decreased in EPR round 1 and 2.
Dental Centre, Hamilton, UK Conclusions: The quality of record keeping obtained with the
Background: In June 2012, the Dental Clinical Effectiveness Pro- EPR appeared to be inferior in some areas compared to the
gramme (SDCEP) published the second edition of the dental clin- PBR. Feedback on the EPR has been provided to staff- and stu-
ical guidance on Conscious Sedation in Dentistry dent groups and re-audit is recommended.
(www.sdcep.org.uk/?o=2331). It recommends the documentation
for each patient includes details of pre-sedation assessment, the
visit for dental treatment under conscious sedation, the treatment
procedure and the recovery.
Aim: To audit the documentation of conscious sedation in pri-
mary dental care.
Design: All dentists in Lanarkshire Health Board who conducted
conscious sedation were invited to participate in this audit. Based
on the recommendations of the SDCEP guidance on conscious
sedation in dentistry, a data collection form was developed to
congruous with the concept of minimally invasive dentistry. Alu- Conclusions: Preliminary results demonstrated a success rate of
mina, while currently the most common abrasive used for cut- 100% for MedCem-MTAÒwhile that of Formocresol was 94%,
ting, has controversial health and safety issues and no similar to that described in the literature.
remineralisation properties. The alternative, original bioactive
glass 45S5, has the advantage of potentially inducing reminerali- PZ03.33
sation within hard tissue. However, 45S5 is slower as a cutting
abrasive and lacks fluoride in its formulation. In this study, a Oral rehabilitation of two cases with ectodermal
customised composition of fluoride-containing bioactive glass dysplasia and their long-term follow-up
named Na0SR was fabricated to compare its cutting efficacy O. P. SALAMARA1, R. PITROU1, O. PANAGOPOULOU1, A.
against alumina on dentine. LAUD1, N. POLYCHRONAKIS2 & D. EMMANOUIL1
1
Aim: To compare the cutting efficacy of dentine using a fluoride- Pediatric Dentistry, National and Kapodistrian University of
containing bioactive glass vs the conventional alumina abrasive Athens, Athens, Greece; 2Prosthodontics, National and
in an air abrasion set up. Kapodistrian University of Athens, Athens, Greece
Design: Two abrasives, in-house fabricated bioactive glass Na0SR
Introduction: Ectodermal dysplasia (ED) is a congenital disorder
(38–80 lm) and commercial alumina abrasive (29 lm), were com-
characterized by abnormal development in two or more ectoder-
pared using an air abrasion set up. Fluoride was incorporated
mal structures (skin, nails, hair and teeth).
into Na0SR to enhance remineralisation properties while stron-
There are more than 100 ED types. Two cases of X-linked inher-
tium was included to increase its radiopacity. Powder outflow
ited hypohidrotic (HED) type, treated at the Postgraduate
rate was recorded prior to the cutting tests. Principal air abrasion
Department of Paediatric Dentistry, are presented.
cutting tests were carried out on pristine ivory dentine. Finally,
Case reports: Two 4 year-old children, one male and one female,
the abrasion depths were quantified and compared using X-ray
came to the postgraduate Department of Paediatric Dentistry,
microtomography.
University of Athens for dental rehabilitation. Clinical and radio-
Results: Na0SR bioactive glass was found to create statistically
graphic examination revealed abnormalities in teeth concerning
deeper cavities in dentine than alumina, despite its lower powder
size and shape, congenital absence of several primary and perma-
outflow rate and predictably reduced hardness.
nent teeth consistent with a previous diagnosis of ED. No caries
Conclusion: Na0SR, a fluoride-containing bioactive glass, appear
were detected. Treatment plan included behaviour modification,
to be more efficacious at cutting dentine as compared to alu-
application of a preventive program, prosthetic rehabilitation
mina.
with dentures and over-dentures, that were replaced when
needed, and orthodontic treatment. The follow-up period for the
PZ03.32 first child was 5 years and for the second 10 years.
Effectiveness of MedCem-MTAâ vs formocresol as Comments: Any prosthesis made for a young patient with ED
dressing agents in pulpotomized primary molars: must be closely monitored for needed adjustments or replace-
ments due to the child’s growth and development. The effect of
preliminary results removable dentures in children affected by ED is extremely
N. BERNFELD1, R. PETEL2, K. ZISKIND1 & M. MOSKOVITZ1 important for their oral function, aesthetics and quality of life.
1
Hebrew University – Hadassah School of Dental Medicine,
Jerusalem, Israel; 2Dental Volunteers for Israel (DVI), Jerusalem,
Israel PZ03.34
Background: Devitalization approach using formocresol is nowa-
Indirect pulp treatment with incomplete removal of
days replaced with a verified successful regeneration approach carious dentine in primary teeth: a case report after
using MTA. Lately, great attention has been focused on the evo- 24 months
lution of Portland Cement (PC) as an alternative to MTA. Both P. MUÑOZ1, Y. MOYANO2 & S. S. ROJAS2
1
materials have comparable antibacterial activity and similar Pediatric Dentistry, University of Chile, Santiago, Chile;
2
chemical properties. The difference between MTA and PC is the University of Chile, Santiago, Chile
absence of bismuth ions and presence of potassium ions in PC,
Introduction: Indirect pulp treatment (IPT) is a conservative vital
thus being more biocompatible. A disadvantage of PC is lower
pulp procedure that is performed in teeth presenting deep carious
radio-opacity than MTA, however, MedCem-MTAÒ is a second
lesions with reversible pulp status. IPT technique involves partial
generation PC which consist of a radio-opaque substance to
caries removal in affected teeth leaving the dentin that is poten-
overcome this problem The major advantage of this product is
tially remineralisable, which is covered by different biocompatible
its lower cost compared to MTA.
materials (e.g. calcium hydroxide and calcium silicate).
Aim: The objective of this prospective randomised clinical trial is
Case reports: Five caries-affected children aged 4-to-8 years old
to assess, clinically and radiographically, the effect of MedCem-
were selected for this case report. They presented 10 primary
MTAÒ as a pulp medicament following coronal pulp amputation
molars affected by deep dentinal cavities (adjacent to the pulp),
in human primary molars with carious pulp exposure in compari-
without any clinical manifestation of irreversible pulp pathology
son to Formocresol.
(e.g. prolonged sensitivity to cold and/or heat and some time
Design: Following standard pulpotomy procedure, the pulp
to sweets). IPT was undertaken by a postgraduate student in
stumps of 66 primary molars in 66 healthy children were ran-
paediatric dentistry, the procedure included complete caries
domly covered either with MedCem-MTAÒ or Formocresol.
removal from the cavosurface margin of each cavity prepara-
The pulp chambers were filled with Intermediate Restorative
tion, reportedly a key element to clinical success. Calcium
Material (IRMÒ) and teeth were restored with stainless steel
hydroxide (DycalÒ; from Denstply) or calcium silicate (Bioden-
crowns. At 6 and 12 months follow-up appointments, the clini-
tineÒ; from Septodont) were used to induce pulp protection
cal status of the treated teeth was assessed and radiographs were
and dentin remineralisation. Dental cavities were restored by
taken.
using resin-based composite (Z350; from 3M). Follow-up after
Results (preliminary): After 6 months: 25/25 success of Med-
24-month showed that both materials were successful in main-
CemMTA and 25/7 success of Formocresol.
taining pulp vitality as no children presented clinical or radio-
After 12 months: 8/8 success of MedCemMTA and 6/6 success
graphic pathology.
of Formocresol.
Comments: IPT with incomplete removal of caries-affected den- tion of secondary dentine for pulp protection and allows for
tine looks to be a successful approach in primary teeth when cal- gradual reduction of talon size while maintaining pulp vitality.
cium hydroxide or calcium silicate is used as restorative material Case reports: This case series of children with talon cusps reviews
at least for 24 months. Accurate diagnosis of pulp health status, talon type, associated anomalies, treatments, outcomes and dura-
proper restoration sealing and long-term clinical/radiographic fol- tion of follow up. The rationale and technique of selective reduc-
low-up also play key roles in the success of IPT that need consid- tion for talon cusp management is presented.
eration. Comments: Treatment of talon cusps in the growing patient using
selective reduction is a simple and conservative treatment
PZ03.35 approach which encourages biological healing. It is an effective
treatment for the young patient as it is minimally invasive and
Oral health behaviours and barriers to dental care predictably maintains pulpal vitality.
among preschool children with autism spectrum
disorders PZ03.37
R. Y. DU1, C. YIU2, N. KING3 & C. MCGRATH4
1
Faculty of Dentistry, University of Hong Kong, Hong Kong,
The relationship between radiographic depth and
Hong Kong; 2Paediatric Dentistry and Orthodontics, Faculty of clinical cavitation of proximal lesions in primary
Dentistry, University of Hong Kong, Hong Kong, Hong Kong; teeth
3
Faculty of Medicine, School of Dentistry, The University of S. SUBKA, H. RODD & C. DEERY
Western Australia, Perth, WA, Australia; 4Periodontology and Academic Unit of Oral Health and Development, University of
Public Health, University of Hong Kong, Hong Kong, Hong Kong Sheffield, Sheffield, UK
Background: Autism Spectrum Disorders (ASD) is a spectrum of Background: The presence of a radiographic radiolucency pene-
developmental disorders characterized by impairments in commu- trating into dentine is generally taken to indicate cavitation and
nication and social skills. Children with ASD have difficulties in the need for restoration placement.
oral health care. Aim: The aim of this in-vivo/in-vitro study was to find the rela-
Aim: The aims of this study were to (1) compare the oral health tionship between the radiographic depth of proximal lesions and
behaviours of preschool children with and without ASD, and (2) clinical cavitation, in primary teeth.
identify the main barriers to oral self-care and dental services Design: 356 primary molars comprising 213 (60%) first molars
experienced by children with ASD and their parents. and 143 (40%) second primary molars were collected from 78
Design: Two hundred and fifty-seven preschool children with children aged 5–10 years who required extractions in a hospital
ASD were recruited from 17 Special Child Care Centres in Hong setting. All children had bitewing radiographs taken prior to
Kong. An age- and gender-matched sample of children from tooth removal. The proximal surfaces of the collected teeth were
mainstream preschools was recruited as control group. The chil- visually examined in-vitro using the ICDAS criteria. Radiographs
dren’s oral health behaviours and their main barriers to oral self- were scored according to Ekstrand0 s modified classification. The
care and dental services were assessed. relationship between the radiographic depth of the lesion and the
Results: Preschool children with and without ASD had similar presence of cavitation was examined by cross tabulating the IC-
dental attendance, in terms of time since last dental visit and DAS scores and the radiographic scores of the proximal surfaces.
experience of dental treatment under general anaesthesia Results: Examination showed that 55% of surfaces with a radio-
(P > 0.05). Compared to children without ASD, children with graphic radiolucency reaching the outer third of dentine were
ASD were reported to have performed tooth-brushing and used cavitated, whilst 98% of surfaces showing a radiolucency extend-
toothpaste less frequently, but more frequently required parental ing into middle of dentine were cavitated. Less than 17% of sur-
assistance in tooth-brushing (P < 0.05). Similar frequency of faces with a radiolucency in enamel showed cavitation. Intra-
snacking was reported among children with and without ASD examiner reproducibility for the radiographic examination was
(P = 0.05). Barriers to oral self-care and use of dental services excellent (K = 0.95), at the caries in to dentine threshold.
were more frequently reported for children with ASD compared Conclusions: Almost half the proximal surfaces of primary teeth
to children without ASD (P < 0.001). with a radiolucency extending into the outer third of dentine
Conclusions: Differences in oral health behaviours existed were not cavitated, indicating that many of these lesions may be
between preschool children with and without ASD, particularly amenable to preventive management. Conversely, radiolucencies
with respect to tooth-brushing habits. Barriers to oral self-care into the middle third of dentine or beyond almost always require
and access to dental services among children with ASD existed restorative management.
and warrant consideration.
PZ03.38
PZ03.36 Selective stripping in 1st permanent molars affected
Selective reduction of talon cusps; a biological by MIH prior its extraction
treatment approach S. DYCHTER, A. M. SILVA & R. M. VALENCIA
R. LEITH & A. C. O’CONNELL Pediatric Dentistry, Universidad Tecnol
ogica de M
exico, Mexico
Dublin Dental University Hospital, Dublin, Ireland City, Mexico
Introduction: Talon cusps associated with permanent incisors are Introduction: Molar incisor hypomineralization (MIH) represents
a rare occurrence but can cause numerous complications includ- a major concern in the actual minimal invasive dentistry world.
ing malocclusion, occlusal interferences, poor aesthetics and car- It‘s tendency is to preserve these teeth with minimal intervention.
ies susceptibility. Treatment options for true talon cusps in the Severely affected 1st permanent molars are difficult to treat and
growing patient include complete or stepwise removal of the often the treatment is a challenge. When indicated, a treatment
accessory cusp. Early treatment is often warranted to normalise option is the extraction of the 1st permanent molar and it‘s
the appearance for psychological reasons. However, the benefit replacement by a second permanent molar. In young patients
of early intervention must be weighed up with the risk of devital- around 9 years of age, when the 2nd permanent molar is behind
ising the pulp. Selective tooth reduction aims to promote deposi- or in the limit of the alveolar bone, and the root development of
the furcation is starting, a mesial drift of this molar may be PZ03.40

expected, allowing a better eruption pattern. Late extractions of
A calibration technique to improve the accuracy of
1st permanent molars result in mesial inclination and lingual
rotation movement of 2nd permanent molars. This case report working length determination in immature permanent
shows a progressive way to control mesial drift and a new treat- incisors
ment alternative by selective stripping that preserves alveolar S. SIMPSON1, S. CONROY1, B. PHILPOTT2, J. KIRBY3 &
width. E. M. ROEBUCK1
1
Case report: A 9-year-old boy was referred to our clinic with Paediatric Department, Edinburgh Dental Institute, Edinburgh,
MIH. Clinical and Radiographic examination show a failure of a UK; 2Restorative Department, Edinburgh Dental Institute,
previous root canal treatment in 36 and 46. The treatment Edinburgh, UK; 3Paediatric Dental Department, Sheffield
options for this patient. Teaching Hospital, Sheffield, UK
1) Root canal retreatment and extensive rehabilitation,
Background: Determination of working length (WL) in teeth with
2) Extraction of both teeth and implant placement, and
open apices is challenging. Apex locators can be unreliable resulting
3) Selective stripping of the 1st permanent molar to be
in repeat radiographic examination. Estimated WL measurement
replaced by the 2nd permanent molar.
on a calibrated digital radiograph may allow for more accurate file
The third option exchanges a severely compromised 1st perma-
placement prior to intra-operative radiographic confirmation.
nent molar by a healthy 2nd permanent molar, and the third
Aim: To assess the accuracy of radiographic calibration in WL
molar, in time takes the place of the 2nd permanent molar.
estimation in teeth with open apices.
Design: Retrospective analysis of WL radiographs of teeth with
PZ03.39 open apices was carried out by two independent examiners. Each
Evaluation and comparison of salivary ions and oral radiograph was calibrated using the length of the digital sensor.
manifestations in children with autism spectrum Using the software’s linear measurement function, the Calibrated
Digital Length (CDL) of the file was calculated by measuring the
disorders to children without autism spectrum distance between a reference point to the file tip and the mean
disorders (ASD) value calculated. The CDL for each radiograph was then com-
S. I. KUMAR1, V. KRISHNAPRIYA2, G. SHILPA3, S. KUMAR4 pared with the Confirmed File Length (CFL) clinically and Cali-
& P. SEHRAWAT5 bration Factor (CF) for each radiograph calculated. Number of
1
Department of Pedodontics and Preventive Dentistry, Army EWLR was recorded.
College of Dental Sciences, Secunderabad, India; 2Pedodontics, Results: In 19/20 cases, the mean CDL was within 2 mm of the
Army College of Dental Sciences, Secunderabad, India; 3Army CFL, with 45% (9) being within 1 mm. 40% of patients had 2
College of Dental Sciences, Secunderabad, India; 4NTRUHS EWLR taken.
Vijayawada AP India, Secunderabad, India; 5PDM College of Calibrated working lengths were on average 0.66 times the uncal-
Dental Sciences Bahadurgarh, Secunderabad, India ibrated. CDL corresponded to actual file lengths in 95% of cases.
An average of 1.4 CWL radiographs were taken per case.
Background: Autism Spectrum Disorders (ASD) has become a
Conclusions: Calibration resulted in digital measurements of
frequently observed clinical disorder in children with special
within 2 mm of the actual WL in the majority of cases.
health care needs. Although recent studies have compared the
Further work is required to assess the accuracy of determining a
effect of salivary ions on oral diseases with individuals suffering
digital measurement of the WL from a calibrated pre-operative
from various genetic disorders, children with Autism are often
radiograph.
neglected.
Aim: The Aim of present study was to investigate the effect of
variations in salivary ions on oral diseases in children suffering PZ03.41
with ASD. Timing for surgical removal of mesiodens
Design: The study consisted of a sample size of 100 children suf- C. Y. HSIEH, T. P. TSAI & W. Y. SHIH
fering with ASD in various special schools in Hyderabad city, Division of Pedodontics, Department of Stomatology, Taipei
India and a control group of 100 children without ASD. Chil- Veterans General Hospital, Taipei, Taiwan
dren of age group 4–18 years were included in the study. Unstim-
ulated salivary samples were collected after a specific time Background: Mesiodens were defined as supernumerary teeth
interval after rinsing with deionised water. Cations were evalu- located at maxillary central incisor region. Timing for surgical
ated using Inductively Coupled Plasma Atomic Emission Spec- removal of mesiodens has been controversial. Early intervention
trophotometry (ICPAES). Anions were evaluated using Ion instead of delaying treatment till root complete of adjacent per-
Chromatography, Ion Selective Electrode, and Colorimetric manent teeth although was stated to increase risk of harming
method. adjacent tooth germs, it could lower the possibility and difficulty
Results: In the present study it was found that levels of sodium, of the treatment afterward.
calcium and fluoride ions were significantly higher, whereas levels Aim: This retrospective study was to investigate if timing for
of potassium, magnesium and phosphorous were less and not sig- removal of mesiodens has relation with harm to adjacent perma-
nificant statistically, in children with ASD. clinical examination nent teeth during operation.
showed that bruxism, malocclusion and poor brushing habits Design: A total of 118 Taiwanese children, who received surgical
were significantly higher, among children with ASD whereas odontectomy of unerupted mesiodens during 2005 to 2012 and
results of dental caries and gingivitis were not significant statisti- had records of longitudinal follow-up, were included. Grouped
cally. by different dental stages of permanent central incisors with No-
Conclusion: The neurological imbalance in children with ASD lla’s classification, comparison about the surgical complications
may be the reason for variation in salivary ions which in turn to associated permanent incisors was carried out using Fisher’s
has its effect on the oral environment leading to oral and dental exact test between groups with a P-level of 0.05 for statistical sig-
diseases in children with ASD. nificance.
Results: 105 patients with 145 mesiodens were in the final analy-
sis. The mean dental developmental stage of the permanent cen-
tral incisors at the time of surgery was 7.7 1.2, about one-third
to two-third of root complete. No significant difference was 48 h, for adequate demineralisation. The demineralised samples
noted between groups about the surgical complications to nearby in each group were treated with the respective remineralizing
permanent teeth at follow-up records. agents. Evaluation was done for mineral content and lesion pro-
Conclusions: The findings from the present study show that tim- gression using SEM-EDAX and Diagnodent, respectively post
ing for surgical removal of mesiodens has no relation with the remineralization. Statistical Analysis was done using the appro-
possible harm to adjacent permanent teeth. Therefore, a clinical priate tests of significance.
implication rises up that mesiodens could be removed as soon to Results: Exposure to the novel agents like Theobromine reduces
avoid possible complications and early removal would not make the lesion formation (P < 0.01) and caries progression.
the possibility of surgical complications to adjacent teeth greater. Conclusions: In conclusion, the present study demonstrated that
Theobromine acts in a medium that can enhance the remineral-
PZ03.42 ization potential of enamel as determined by using an established
in vitro caries cycling model, and may be a viable alternative to
Regression of data and invention of moyers roulette fluoride additives in commercial dentifrices.
analysis

S. M. BRAVO JAIMES, L. TORRES AREVALO, G. A. PZ03.44
CALAMPA SOPLA, Y. A. CASTRO RODRIGUEZ &
H. A. MARENGO CASTILLO How to cure black stains: an innovative study
Universidad Nacional Mayor de San Marcos, Lima, Peru S. CARUSO1, S. BERNARDI1, M. R. GIUCA2, G. MARZO1,
R. DOCIMO3 & R. GATTO1
Background: To date, one of the most common analysis of mixta 1
Department of Health, Life and Environmental Sciences,
dentition is Moyers analysis. This analysis is based on tables of University of L’Aquila, L’Aquila, Italy; 2Department of Surgical,
probability. This values has been determined in US population, Medical, Molecular and Critical Area Pathology, University of
unfortunately in most of the cases the values do not apply in our Pisa, Pisa, Italy; 3Department of Experimental Medicine and
population because peruvian people have higher values than we Surgery, University of Rome, Torvergata, Roma, Italy
find in the tables.
Aim: This study aimed to project the data Moyers tables through Background: The black stains are linear black spots that affect the
linear regression equations and invent a new material that facili- depression of the surface of the tooth crown, whose microbiologi-
tates the analysis of Moyers in mixed dentition. cal origin has been attributed to Negative Actinomyces Catalase,
Design: The classical tables of Moyers and through four linear Positive Actinomyces Catalase, Corynebacterium, Streptococci,
equations projected data for both values of men and women were Neisseria, Prevotella melaninogenica. These spots are mainly
used, roulette was created from a new table with values projected found in patients from countries on the Mediterranean Sea.
from the measured 25.5 mm. Linear regression and linear equa- Aim: The aim of the study is to develop a professional oral
tions was used to project values for both, the maxilla and mandi- hygiene protocol that will allow us to evaluate possible predispos-
ble. Roulette model was created on the model of the ort ometro ing factors.
of Korkhaus and emulating the classic gestation tables. Designs: The study aims at recruiting 150 children suffering of
Results: Two tables were created with new data values from 25.5 black stains on the tooth surface.
to 30.5 mm measurement, measures which correspond to the sum The following therapeutic protocol will be used:
of the mesiodistal distance of the lower incisors. The new values 1) One ablation every week for 3 weeks; a different mouth-
include projections for both, the maxilla and the mandible. wash will be used every week.
Conclusions: The new roulette has projected values above normal 2) Microbiological analysis every week before salivary collec-
in addition to facilitating the analysis of Moyers in a more enter- tion.
taining way data. 3) This study will last 12 months.
4) Obtained data will be evaluated by statistical means
(mean, ds and t student test).
PZ03.43 Results: This study involves the recruitment of 150 children, by
Remineralizing potential of theobromine on artificial now 50 children have already been visited. Among these ones, 30
enamel carious lesions of them have successfully completed the therapy course, 10 chil-
S. NEKKANTI dren have completed treatment with positive results and 10 have
Peddontics & Preventive Dentistry, College of Dental Sciences, not finished the therapy course. We expect a positive microbio-
Manipal University, Manipal, India logical confirmation, which is still ongoing.
Conclusions: New data are being collected and we are improving
Background: The consumption of chocolate, as a sugar-contain- the microbiological part regarding the origin of the disease, but
ing confectionery, has been associated with dental caries. How- further researches are needed to confirm this study.
ever, series of studies suggested that cocoa powder and chocolate
might contain some caries-inhibitory substances [Stralfors, 1966].
Studies in hamsters showed that pure cocoa powder inhibited
PZ03.45
dental caries by 84% with cocoa percentage of 20% [Stralfors, Caries preventive effect of a chlorhexidine/thymol
1967]. These reports suggest that cocoa extract, the main compo- varnish and a fluoride one in erupting permanent
nent of chocolate, could contain an agent (Theobromine) which molars: a comparative study
has caries inhibitory action.
S. FLAMEE1, S. GIZANI1, C. CARONI2, L.
Aim: The aim of present study is to evaluate the remineralisation PAPAGIANNOULIS1 & S. TWETMAN3
potential of Theobromine (100 mg/L, 200 mg/L) when compared 1
Pediatric Dentistry, University of Athens, Athens, Greece;
to Hydroxyapatite (ReminPro, VOCOTM), Novamine toothpaste 2
Mathematics, University of Athens, Athens, Greece; 3Odontology,
(SHY-NMTM) and Fluoridated dentifrice (ColgateTM) (1000 ppm
University of Copenhagen, Copenhagen, Denmark
F) on artificial enamel carious lesions.
Design: 150 extracted primary teeth (30 per sample) were col- Background: To combat early fissure caries development, until
lected and stored in 0.01% Thymol at room temperature. The the occlusal surface is fully erupted, topical interventions based
specimens were allowed to stay in the demineralising solution for on antibacterial agents and fluoride have been suggested.
Aim: The aim of the study was to compare the caries preventive PZ03.47
effect of a chlorhexidine/thymol-containing antibacterial varnish
Establishment of SspB peptide binding assay for
to that of a fluoride varnish applied topically during the eruption
of permanent molars. Porphyromonas gingivalis colonization processes
Design: The study group consisted of 183 patients 5–14 years old T. ITO, T. ICHINOSAWA, N. IKEMATSU-ITO & T. SHIMIZU
with at least one sound erupting permanent molar, either first Department of Pediatric Dentistry, Nihon University School of
(1st, n = 110) or second (2nd, n = 73). After stratification by Dentistry at Matsudo, Matsudo, Japan
molar and stage of eruption, the patients were randomized to Background: Porphyromonas gingivalis is a major periodontal
either quarterly topical applications to all present teeth of anti- pathogen that binds efficiently to Streptococcus gordonii, which
bacterial varnish (CervitecÒ Plus; CV group) or biannual applica- in turn binds to salivary agglutinin (gp340). The SspB of S.
tions of fluoride varnish plus biannual treatments with placebo gordonii appears to mediate this association.
varnish (Fluor Protector; FV group) for 2 years. The primary Aim: We previously reported that the streptococcal SspB peptide
endpoint was caries incidence. analog, designated SspB (390-T400K-402), showed high binding
Results: After 2 years, 11 new caries lesions were found on the activity with saliva. To understand the three-way interaction
1st (4 in the CV group and 7 in FV one, P > 0.05) and 2 in the among S. gordonii, P. gingivalis and salivary gp340 as a unit, we
2nd (1 in CV and 1 in FV group). Salivary mutans streptococci established a peptide binding assay using the analogous SspB
was significantly lower in the CV group after 2 years (P < 0.05) peptide.
for both 1st and 2nd molars. Design: The binding activity of the SspB (390-T400K-402) to P.
Conclusions: Quarterly topical applications of chlorhexidine/thy- gingivalis was detected by ELISA. Ninety-six well plates were
mol varnish were as effective as the bi-annual applications of coated with whole bacterial cell (P. gingivalis strains ATCC
fluoride varnish in preventing caries development during the 33277, and W83; S. gordonii DL1) in Na2CO3 coating buffer.
eruption of permanent molars. Both professional regimes may be After blocking, bacterial cells were incubated with saliva or sali-
considered alternatives for children during this period. vary agglutinin peptide (SRCRP2). Biotinylated SspB (390-
T400K-402) was applied and incubated with 1 : 1000 streptoavi-
PZ03.46 din-conjugated alkaline phosphatase. After development, A405
Emergence time and sequence of permanent teeth in was recorded.
Results: P. gingivalis 33277 showed the highest binding activity of
children of Kavre district, Nepal the tested bacteria, whereas P. gingivalis W83, which is deficient
S. UPADHYAY1, R. SHRESTHA2, D. SHRESTHA2, S. in Mfa1 fimbriae, exhibited poor binding activity, as did S.
POUDYAL3 & D. D. BARAL4 gordonii. The binding of SspB (390-T400K-402) in saliva- or
1
Pedodontics and Preventive Dentistry, Dhulikhel Hospital, SRCRP2-treated P. gingivalis was significantly higher than that
Kathmandu University Hospital, Dhulikhel, Nepal; 2Conservative in non-treated cells.
Dentistry and Endodontics, Dhulikhel Hospital, Kathmandu Conclusion: SspB peptide binding assay revealed that initial
University Hospital, Dhulikhel, Nepal; 3Department of Community attachment of P. gingivalis to the substrata of S. gordonii may
and Public Health Dentistry, Kist Medical College and Hospital, require salivary gp340-mediated SspB-Mfa1 interactions. The
Gwarko, Nepal; 4School of Public Health and Community assay is available to assess the relationships among SspB, Mfa1
Medicine, B. P. Koirala Institute of Health Sciences, Dharan, and salivary gp340 as a unit.
Nepal
Background: To date permanent teeth emergence in Nepalese PZ03.48
population has not been investigated. The reference for the tooth
Knowledge of preschool teachers on early childhood
emergence age needed for clinical and academic situations is
based on American and European standards. But population spe- oral health. Association with their demographic and
cific standards on emergence time and sequence of teeth are personal characteristics
essential in planning dental care for children. V. LIONTOU, A. AGOUROPOULOS, S. GIZANI & L.
Aim: To determine the standards for permanent teeth emergence PAPAGIANNOULIS
time and sequence in children of Kavre district, Nepal. Department of Paediatric Dentistry, School of Health Sciences,
Design: A descriptive cross sectional study was conducted in 623 Faculty of Dentistry, University of Athens, Athens, Greece
children of age 5–14 years from schools of Kavre district. The
Background: In the literature there is little evidence of the knowl-
number of permanent tooth erupted except third molar was
edge of preschool teachers regarding oral health issues, at that
recorded along with age and gender. Data were analysed using
age, leading to implementation of relevant education programs.
SPSS 11.5. Student0 s ‘t’ test was used to detect the inter-jaw and
Aim: To investigate oral health knowledge of preschool teachers
inter-gender differences.
and its association with demographic, educational and personal
Results: The study population constituted 50.7% boys and 49.3%
characteristics.
girls of the total sample. The first tooth to emerge was the first
Design: The teachers (N = 594) of the largest preschool institu-
molar, whereas the second molar tended to be the last to emerge
tion in Greece participated in this cross-sectional study. They
in both the genders. Mandibular teeth tended to precede the cor-
completed a self-administered questionnaire with 40 questions on
responding maxillary teeth in emergence. Right and left sided
demographic data, childhood oral health knowledge, personal
teeth emerged almost at the same time in both the arches.
habits and attitudes and on implementation of oral health educa-
Though not significant, girls showed early tooth emergence than
tional programs.
boys.
Statistical analysis included bivariate correlations and multiple
Conclusion: This is the first study for permanent teeth emergence
linear regression modelling (P ≤ 0.05).
age in Nepal. So, the result can be used as a reference data for
Results: The response rate was 85%, participants’ mean age was
clinical and academic purpose especially for the children of Ka-
41 years (SD: 7.5), 68% were parents, mean number of correct
vre district, Nepal.
answers was 7 (out of 13) and 1% answered all questions cor-
rectly. From the participants, 74% had not attended oral health
educational courses, their major source of information was the
dentist alone (40%) or in combination with other sources (52%), These new techniques however give no visible pictures. Recently,
70% believed that their oral health knowledge was insufficient and KaVo DIAGNOcam was introduced. It is a near infrared low
only 45% had implemented oral health educational programs. power laser system (wavelength 780 nm) with corresponding
Significant factors that influenced the overall knowledge were actual digital video camera and project live captured pictures
implementation of oral health educational programs (P < 0.001), direct onto the computer screen for lesion analysis and detection.
the belief that oral health courses during basic studies are neces- It was the aim to present first findings and recommendations
sary (P = 0.01), confidence on personal knowledge (P = 0.03) using KaVo DIAGNOcam in children and to find out if bite-
and parenthood (P = 0.05). wing radiographs can be avoided.
Conclusions: The results of this study showed that knowledge on Case reports: During recall visits a series of permanent teeth with
basic oral health issues is poor among preschool teachers and rel- discolored fissures were assessed for occlusal and interproximal
evant education is necessary during their studies or later on. caries visually, radiographically and with DIAGNOcam.
Comments, It became clear that DIAGNOcam can provide satis-
factory information for the diagnosis of occlusal caries. The deci-
PZ03.49 sion making for necessary therapy either cavity preparation or
The use of DIAGNOcam in children: preventive treatment (including fissure sealant) can be well-
planned. Interproximal lesion can also be visualised but give lim-
recommendations and limitations
ited information about the extension of the caries in the direction
I. WAN MOKHTAR1,2, L. MARTENS1 & J.
of the pulp. Further, it also became clear that the device is not
VANDENBULCKE1
1 eligible for use in patients with orthodontic appliances, on erupt-
Department of Paediatric Dentistry, PAECOMEDIS Research
ing teeth or in very young children.
Cluster, Ghent University, Gent, Belgium; 2Faculty of Dentistry,
Conclusion: From a series of cases, it can be concluded that the
Mara University of Technology, Shah Alam, Malaysia
use of DIAGNOcam in daily practice for the diagnosing of
Introduction: For caries diagnosis, new digitial-fiber-optic-illumi- ‘occlusal caries’ can certainly have an added value. Moreover
nation (DIFOTI) techniques became well studied and have bitewing radiographs can be avoided thus exposing children to
shown to be very sensitive in occlusal and interproximale caries. less radiation chances.
Morita Prize Entries (Case Reports Posters) – PZ03 Case Report Posters
Morita Prize Entries (Case Reports Posters) –

PZ03 Case Report Posters
PZ03.50 reached its normal occlusal level within 6 months. At the end of the
postoperative 15 months follow up, the lower left first permanent
Premature primary incisor exfoliation in a child with molar erupt normally without alternation in alveolar bone level.
Kabuki syndrome Comments: Luxation is a simple treatment option for ankylosed
Y. K. LOO & J. MITCHELL primary molar, no coronal build-up or space maintainer is
Paediatric Dentistry, King’s Dental Institute, London, UK needed when the response to treatment is favorable.
Introduction: Kabuki syndrome is characterised by distinctive
facial features and an array of congenital abnormalities, develop- PZ03.52
mental delay and intellectual disability. It is caused by mutations Primary failure of tooth eruption: a case report
in the KMT2D (MLL2) or KDM6A genes. Oral features include
Y. M. ZHAO & L. H. GE
cleft lip and/or palate, a high arched palate, micrognathia, hyp-
Pediatric Dentistry, Peking University School and Hospital of
odontia and microdontia. The aim of this report was to present a Stomatology, Beijing, China
case of premature exfoliation of primary teeth in a child with
Kabuki syndrome, previously unreported. Introduction: Primary failure of eruption (PFE) is a rare condi-
Case reports: A 2-year-old girl presented to Casualty Clinic hav- tion where there is tooth eruption failure without obvious local
ing lost her primary maxillary left central incisor whilst having or systemic causes, otherwise, due to a disturbance of the erup-
her teeth brushed. There was no history of dental trauma. tion mechanism. It often affects permanent molars, and causes a
On clinical examination, the primary mandibular right incisors severe posterior open bite. The condition tends to occur in isola-
and primary mandibular left incisors were fused. The primary tion, and application of orthodontic force often leads to ankylo-
maxillary right central incisor displayed grade 1 mobility. Gingi- sis rather than normal tooth movement. Here we describe a
val tissues displayed no evidence of trauma, ulceration or bleed- female with most permanent teeth failed to erupt.
ing. Histopathological examination of the exfoliated tooth Case reports: A 10 years old girl came to the Department of
revealed resorption lacunae indicative of premature tooth resorp- Pediatric Dentistry Hospital of Stomatology, PKU with the main
tion. The primary maxillary right central incisor exfoliated simi- complaint of no tooth replacement. The patient showed normal
larly 4 months later. Spontaneous permanent maxillary central physical growth and development, and denied a family history.
incisor and molar resorption have been reported in Kabuki syn- Clinical examination showed early mixed dentition with 31 and
drome however primary tooth resorption has not. 41 erupted. Panoramic examination showed no obvious develop-
Comments: Dentists should be aware of the possibility of external mental defect of permanent tooth germs except 43 missing. No
root resorption causing mobility and premature loss of primary root resorption of primary teeth was observed, and the develop-
maxillary central incisors in children with Kabuki syndrome. This ing roots of permanent teeth were closed to the inferior border of
is important, as Kabuki syndrome is associated with respiratory the mandible. The patient underwent five operations under gen-
infections, seizures and patients commonly present with hypoto- eral anesthesia including serial extraction of primary teeth and
nia resulting in swallowing difficulties. surgical exposure of permanent teeth. At age 15, most of the per-
manent teeth erupted with normal occlusion.
PZ03.51 Comments: The diagnosis and treatment of PFE are difficult. Early
detection and appropriate treatment such as surgery may lead to good
Luxation as a treatment option for ankylosed results. Further studies are required to determine the etiology of PFE.
primary molar: a case report
H. YU-SHENG & H. CHIEN-CHIAO PZ03.53
Department of Pediatric Dentistry, Changhua Christian Hospital,
Changhua, Taiwan Prosthetic rehabilitation in a medically compromised
pediatric patient: a case report
Introduction: Ankylosis of primary molar is a common clinical
I. CARDOSO MARTINS, J. MARINHAS, A. COELHO, S.
finding. The incidence reported varies between 1.5% and 9.9%. MAGALHAES, ~ A. ALVES & P. MARQUES
Its diagnosis is usually made base on the clinical detection of dif-
Paediatric Dentistry, Faculty of Dental Medicine, University of
ference in occlusal planes of adjacent molars and immobility of
Lisbon, Lisbon, Portugal
the affected tooth. Although many of the ankylosed molars do
exfoliate naturally, severe complications such as impaction of Introduction: Infective endocarditis is an uncommon life-threaten-
succeeding premolar has been reported. Treatment strategies usu- ing complication resulting from bacteremia. Dental practitioners
ally include monitoring, prosthetic build-up, extraction with and should consider prophylactic measures to minimize the risk of IE
without space maintainer, or orthodontic traction. Luxation has in patients with underlying cardiac conditions associated with the
been suggested to break the ankylosed parts and correct the highest risk of adverse outcome from endocarditis.
infra-occlusion. We report a boy with an ankylosed primary In high risk cardiac patients, antibiotics are recommended for all
second molar, which were successfully treated by luxation. dental procedures that involve manipulation of gingival tissue,
Case report: A 3 years 8 months boy was diagnosed of presenting the periapical region of teeth or perforation of the oral mucosa.
an ankylosis of lower left primary second molar. Six months moni- Thus, extractions are recommended instead of pulp treatment,
toring showed sign of caries and progressive submergence of the creating the need for prosthetic rehabilitation.
tooth into gingiva. After consulting with his parents, interceptive Case reports: A 4-year-old boy was referred for management of
treatment with gingivectomy and luxation of the primary molar was dental decays. Clinical and radiographic examination revealed
performed. Eruption of the ankylosed molar was soon noted after multiple caries lesions in the deciduous dentition. The patient has
the treatment. The affected tooth received a restorative filling and indication for prophylaxis of bacterial endocarditis due to surgi-
cal VSD correction, with prosthetic material and residual flow. ment, enamel hypoplasia, gingival hyperplasia and increased sus-
Several anterior and posterior teeth with extensive decay and ceptibility to caries.
pulp involvement were extracted under general anesthesia. Case report: Female, 6.3 years, Transplanted Liver, BDA, celiac,
A fixed upper acrylic prosthesis and an inferior removable acrylic mixed dentition, mild gingivitis, decay associated with poor oral
prosthesis were performed. Follow-up visits were performed at hygiene, generalized intrinsic greenish brown stains in primary
short intervals to make prosthetic adjustments and oral hygiene. and permanent dentition, right canine mesioclusion, left distoclu-
Comments: Treatment planning of pediatric patients with cardiac sion, left posterior crossbite, anterior open bite, altered tongue
conditions associated with high risk of IE, includes antibiotic position. Comprehensive multidisciplinary rehabilitation treat-
prophylaxis for invasive dental procedures. Tooth extraction is ment was performed with a minimally invasive approach. Extrac-
preferred to invasive pulp therapy increasing the need for pros- tions of decayed primary teeth with pulp engagement, composite
thetic rehabilitation. resin fillings in front teeth, interceptive orthodontic treatment
with bimaxillary functional appliances and physiotherapeutic
PZ03.54 treatment to retrain tongue position were conducted.
Comments: The Role of the Pedodontist is essential, the clinical
Novel approach for esthetic rehabilitation of primary evaluation in the etiology of tooth staining as a manifestation of
anterior teeth using temporization material: a case series systemic diseases, and also in the performance of adequate restor-
N. GUGNANI1, I. PANDIT1, M. GUPTA1, S. GUGNANI2, ative treatment to reduce family anxiety and self-esteem problems
J. SHARMA1 & J. NAGPAL1 that affect the quality of life in these patients.
1
Department of Pediatric and Preventive Dentistry, DAV (C) In transplant patients the dental management is multidisciplinary
Dental College, Yamunanagar, India; 2DAV (C) Dental College, and complex due to side effects of immunosuppressive drugs and
Yamunanagar, India the difficulty of masking the color of teeth with restorative
materials.
Introduction: Carious primary teeth are usually restored using in-
tracoronal/ full-coronal restorations. Intra-coronal restorations are
for single surface caries and include tooth-colored materials like PZ03.56
Composites, GIC etc. Strip crowns with composites are frequently Maxillary cyst associated with tooth-eruption
used to restore teeth with multiple-carious surfaces, but moisture con-
disturbance in a child: a case report with 4-year
trol in children is a frequent challenge compromising their retention.
Full-coronal restorations like prefabricated zirconia/ pre-veneered follow-up
Crowns (indicated to restore traumatized/ grossly carious teeth) S. ROSA, J. C. RAMOS, J. P. MARCELINO, M. T. XAVIER,
exhibit better esthetics and retention but higher cost and difficult A. D. SOARES & A. L. COSTA
adaptation are their limitations. Dentistry Department, Faculty of Medicine, University of
Hence, an alternative would be to fabricate chair-side, customized full- Coimbra, Coimbra, Portugal
coronal restoration, which should also be esthetic, durable and cheap. Introduction: Deciduous, permanent or supernumerary teeth for-
Case-series depicts novel application of temporization material mation and its potential ectopic eruption outside the dental
(Luxatemp, DMG-Germany) for full-coronal restoration(s) in arches is a rare entity. Its occurrence has been reported in the
primary anterior teeth. chin, maxillary sinus, palate, nasal and orbital cavities, with max-
Case report: Patients aged 4–5 years with grossly carious/ trau- illary canine and mandibular third molar representing the most
matized anterior teeth requiring full-coronal restoration were commonly affected teeth. Although its pathogenesis remains
selected from department of Pediatric dentistry, DAV Dental unknown, development disturbances including cleft palate,
College Yamunanagar. Informed consent was sought from par- trauma, infections, genetic factors and dentigerous cysts follow-
ents after explaining the technique. ing impaction, have been suggested as etiological factors.
Following caries excavation/ pulpal therapy, tooth preparation was Case report: 4-year follow-up case report of a 9-year old child
done, reducing the tooth ~1.5 mm from all surfaces and ensuring who attended to our department due to persistent infection in the
removal of undercuts. Suitably sized strip crowns were selected, and upper left quadrant with recurrent exacerbations in the previous
loaded with Luxatemp using Automix syringe. Loaded strip crown 6 months, not apparently related to erupted teeth pathology. In-
were then placed on prepared tooth and were removed when the traoral examination revealed normal eruption chronology and a
temporization material was still in elastic stage. Material was then marked purulent drainage on distal and vestibular surfaces of the
allowed to set extra-orally. Strip crowns were then peeled-off, fol- upper left first molar. Computerized tomography disclosed the
lowed by finishing and cementation of custom-fabricated crowns. presence of two ectopic molars on the left maxillary sinus, adja-
Comments: Excellent aesthetic results were achieved. Randomized cent to the orbital floor, associated with large cyst. Surgical inter-
clinical trials are required to evaluate color stability and longevity vention under general anesthesia was performed according to the
of such custom-fabricated crowns in primary anterior teeth. Caldwell-Luc procedure. Histological analysis revealed a dentiger-
ous cyst, with complete symptoms resolution following surgery.
PZ03.55 Comments: Facial pain, headache, epistaxis, purulent rhinorrhea,
Biliary ducts atresia: oral manifestations. A case nasal deformity and lacrimal duct obstruction may occur in max-
illary cysts associated with eruption disturbances. Differential
report diagnosis should include foreign body, infections, benign and
S. S. ROJAS, C. ANDREUCIC, S. A. ECHEVERRIA & A. VERA malignant lesions. An exploration of etiology could become criti-
University of Chile, Santiago, Chile cal to exclude concomitant conditions and potential complica-
Introduction: The biliary ducts atresia (BDA) is an uncommon tions. Standard treatment is extraction, which should be
obstructive cholangiopathy, affecting 1 in every 9000 to 12,000 particularly urgent in clinical exacerbations.
live births, of unclear etiology, it occurs in neonatal stage, with
jaundice after 2 weeks. It is the main cause of extra hepatic
origin jaundice in neonatal period and of liver transplantation.
Bilirubin is distributed in the body during the period of hyperbi-
lirubinemia. It is permanently deposited in dental tissue causing
green pigmentation of teeth, delayed tooth and bone develop-
PZ03.57 PZ03.58
Differential diagnosis of Amelogenesis imperfecta in Erupting compound odontome presenting in a
primary dentition – a case report newborn: a case report
S. T. CHENG1, Y. H. CHEN2 & C. C. HUNG1 S. C. CONROY1, G. WRIGHT1, N. MALDEN2, B. CONN3 &
1
Department of Pediatric Dentistry, Changhua Christian Hospital, J. FOLEY1
Changhua, Taiwan; 2Changhua Christian Hospital, Changhua, 1
Paediatric Department, Edinburgh Dental Institute, Edinburgh,
Taiwan UK; 2Oral Surgery Department, Edinburgh Dental Institute,
Edinburgh, UK; 3Royal Infirmary of Edinburgh, Edinburgh, UK
Introduction: Amelogensis imperfecta (A.I.) is a disorder of
enamel development, genomic in origin with large variation in Introduction: Developmental oral conditions not uncommonly
epidemiology. It was typically affected in both primary and per- present at birth include natal teeth, Bohn’s nodules and Epstein
manent dentitions. A.I. has very strong genetic association with pearls. Less common are epulises, malignancies and odontomes
present proven genes of AI1, AI2, AI3, AIH1, AIGFS, etc. There (a type of hamartoma), the latter of which, arise from epithelial
are also multiple routes of inheritance including autosomal domi- and mesenchymal cells, consist primarily of enamel and dentine,
nant, autosomal recessive and X-linked. We hereby present a case often in a disordered pattern. Odontomes are classified as com-
of possible A.I. in primary dentition. pound, where enamel and dentine deposition is anatomically sim-
Case reports: A 3 year old Taiwanese girl with medical history of ilar to normal teeth, or complex, where enamel and dentine form
prematurity and necrotizing enterocolitis came to our hospital irregular masses with a haphazard pattern. Odontomes are
for her unusual appearance of primary teeth. There is no family benign malformations and when fully calcified do not undergo
history of A.I. The followings were noted after examination. further development, however may erupt intra-orally. Occurrence
1) Generalized enamel hypoplasia with yellowish discolor- within gingival soft tissues has been reported, however odonto-
ation in primary teeth. mes are predominantly intraosseous lesions.
2) Cavitation and pitting with roughness over occlusal sur- Case reports: A 12 day old Caucasian female newborn was referred
faces of primary molars and buccal/lingual surfaces of pri- by her midwife regarding what was described as an asymptomatic
mary incisors. but mobile back tooth present from birth with concern of potential
3) Anterior open bite. dislodgement during feeding. Examination revealed a mobile calci-
4) Radiographically, the enamel contrasts normally from den- fied mass surrounded by erythematous and oedematous soft tissue
tine, but the thickness of enamel is thinner than usual. (10 mm 9 10 mm) overlying the left posterior maxillary alveolar
Based on the clinical and radiographic findings, the etiology for ridge with the appearance of an erupting upper deciduous molar.
this generalized presentation of enamel hypoplasia cannot be Excisional biopsy of hard and soft tissue lesions was performed
solely attributed to her perinatal sickness. The diagnosis of A.I. under general anaesthesia at age 19 days, and histological analysis
was made. Full mouth rehabilitation including stainless crowns confirmed the diagnosis of compound odontome. Pre-and post-
and full coverage composite crowns was performed. The perma- operative clinical and histopathological images are presented.
nent lower central incisors appear normal after eruption. Comments: This case supports the inclusion of odontomes in dif-
Comments: Amelogesis Imperfecta in primary dentition can very ferential diagnoses of oral developmental calcified anomalies in
easily be overlooked. Systematic approach with careful evalua- newborns. It also highlights the advantage of general anaesthesia
tion of the clinical and radiographic presentations will facilitate when performing an excisional biopsy as regards access and hae-
differential diagnosis of the disorder. Genetic analysis may be mostatic control in a newborn.
indicated to support the clinical judgment.
NuSmile Restorative Case Report Poster Prize Entries – PZ04
NuSmile Restorative Case Report Poster

Prize Entries – PZ04
PZ04.01 of permanent molar. After partial caries removal, the dentin was
pre-treated with polyacrylic acid for 10 s, followed by rinsing
A novel approach for building-up ankylosed primary and removing water excess with cotton balls, maintaining the
molars in cases of missing permanent premolars. A dentin moist. The GIC (Fuji-IX – GC Corp.) was mixed accord-
case report ing to manufacturer0 s instructions and inserted in the cavity with
K. CHATZIDIMITRIOU, N. N. LYGIDAKIS & N. A. insertion spatula. The tip of vibratory sonic device (Smart Sonic
LYGIDAKIS Device – FGM) was inserted into the cavity and activated for
Private Paediatric Dental Clinic, Athens, Greece 15 s in medium power. The tip was immediately removed from
the cavity and the restoration received a layer of petroleum jelly
Introduction: Aplasia of second premolars might be found in
under finger press for 60 s. The material began to lose the shiny
17–24% of cases of ankylosed primary molar teeth. Occasion-
appearance after 15 s after application of sonic device. After
ally, there are such cases where treatment plan includes reten-
6 months of follow-up, the restoration showed a good marginal
tion of the infra-occluded primary molars for space preservation
integrity.
and future implant placement. In these cases crown built up to
Comentaries: It was concluded that the use of vibrating sonic
the occlusal line is necessary to prevent various clinical prob-
device is a useful tool to optimize the clinical chair time in
lems.
Pediatric Dentistry when using high viscous glass ionomer
Case report: The technique is presented in a 12 year old girl,
cement.
with nine missing permanent teeth. Orthodontic evaluation
indicated space closure for five teeth and space maintenance
for the remaining 4 second primary molars. The technique PZ04.03
includes the following clinical steps: a) Elastic separators Dental management of a patient with tricho-dento-
placed proximally to the primary molars for few days for cre- osseous (TDO) syndrome: a case report
ating space. b) Proximal reduction of the crown width is per-
S. NTAOUTIDOU1, A. ARGIROPOULOU1, K.
formed; a composite core is used to increase crown height
ARAPOSTATHIS1, E. KOTSIOMITI2 & N. KOTSANOS1
facilitating the selection of a preformed metal crown (PMC). 1
Paediatric Dentistry, Aristotle University of Thessaloniki,
The selected PMC fitting perfectly the crown width is filled up
Thessaloniki, Greece; 2Prosthodontics Department, Aristotle
with self-cured composite and placed on the primary tooth fol-
University of Thessaloniki, Thessaloniki, Greece
lowing acid etch and adhesive procedure. Excess cervical com-
posite is removed. c) A week later PMC is carefully removed Introduction: Tricho-dento-osseous (TDO) syndrome is an auto-
using cutting instruments and the revealed composite built-up somal dominant disorder characterized by curly hair at birth,
is polished and occlusally adjusted. Radiographic evaluation enamel hypoplasia, taurodontism, dysplastic nails and general-
confirms the successful result. ized osseous dysplasia involving the long bones and calvar-
Comments: The above described method using conventional ium. Genetic studies have identified a 4 bp deletion in the DLX3
instruments and materials appears a valuable clinical tool in the gene.
hands of the paediatric dentists who frequently find themselves Case reports: An 11-year-old patient was referred to the Paediat-
dealing with infra-occluded ankylosed primary molars that need ric Dental Clinic for management of dental trauma of #21. The
to be retained and can produce serious clinical problems if left medical history was clear and no abnormalities during preg-
untreated. nancy were reported. The extra-oral examination revealed nor-
mal body growth with blonde curly hair and splitting of
fingernail edges. The intra-oral examination revealed the remain-
ing root of #21 covered by gingiva, tooth shape and size anoma-
PZ04.02 lies and enamel hypoplasia/hypomineralization. Reduced
Sonic vibration device to accelerate glass occlusal vertical dimension was also noted due to severe attrition
ionomer cement setting in ART technique: a case of posterior teeth, as well as dentoalveolar abscesses and mobil-
ity of the mandibular lateral incisors. Additional radiographic
report findings were taurodontism of the permanent molars, wide pulp
L. YOSHIOKA, T. K. TEDESCO, A. F. B. CALVO & D. P.
chambers of anterior teeth and periapical lesions of the mandib-
RAGGIO
ular lateral incisors. The family history revealed that patient’s
Department of Orthodontics and Pediatric Dentistry, School of
mother, mother’s father, sister and her son had similar dental
Dentistry, University of Sao Paulo, Sao Paulo, Brazil
defects and hair appearance. The treatment plan included end-
Introduction: Recently, there are efforts to optimize the required- odontic treatment of the mandibular lateral incisors, preformed
time of clinical treatment in Pediatric Dentistry. An alternative is metal crowns of first permanent molars, direct composite resto-
to reduce the setting reaction time of high-viscosity glass ionomer rations of anterior teeth, extraction of #21 with semi-permanent
cements (GIC) used for Atraumatic Restorative Treatment prosthetic rehabilitation (Maryland bridge) to improve function
(ART). and aesthetics.
Case report: After clinical examination in one 6-year-old boy, it Comments: The dental management of TDO syndrome should be
was detected active caries lesion ICDAS score 5 (International undertaken by a team approach at an early age. Definitive dental
Caries Detection and Assessment System) on the occlusal surface treatment should be completed entering adulthood.
NuSmile Restorative Research Poster Prize Entries – PZ04
NuSmile Restorative Research Poster Prize

Entries – PZ04
PZ04.04 Design: Eighteen-freshly extracted sound human deciduous
molars were used. The teeth were embedded in acrylic blocks,
Decellularisation of dental pulp for use as a scaffold such that their buccal surfaces were shown and aligned with the
in regenerative endodontics acrylic surfaces. The teeth were randomly divided into three
M. MATOUG-ELWERFELLI1, H. NAZZAL2, J. GRAHAM3, M. groups.
DUGGAL2 & E. M. RAIF1
1
Department of Oral Biology, University of Leeds, Leeds, UK; Group I: enamel surfaces without any intervention (Uncut
2
Paediatric Dentistry, University of Leeds, Leeds, UK; Enamel),
3
Department of Histopathology, St James University Hospital, Group II: enamel surfaces with minimal grinding (Cut
University of Leeds, Leeds, UK Enamel), and
Background: Current regenerative endodontic techniques of non– Group III: dentin surfaces.
vital immature teeth offer less than an ideal approach, with For all groups, self-adhering flowable composite-resin (DyadTM-
unpredictable results especially with regards to continuation of flow, Kerr, USA); was applied. Specially designed holed-split Tef-
root development and increase dentine thickness. The use of scaf- lon mould was used for constructing composite-resin cylinders
folds and signalling molecules might guide stem cells into regen- (3 9 3 mm) over the buccal surfaces of the mounted teeth. The
eration of pulp tissues rather than revascularisation or healing. DyadTM-flow was applied in a central hole of the mould upon
With greater knowledge and improvements within the fields of tooth surface, and then light cured for 20 s. The teeth were
tissue engineering, novel approaches to produce a biocompatible stored in distillate water at 37°C for 24 h. The bond strength was
acellular extracellular matrix through decellularisation process recorded blindly by a different assessor using universal testing
could be developed. machine and statistically analyzed. Modes of failure were studied
Aim: To assess the scientific feasibility of decellularising the using digital microscope.
human dental pulp tissue to produce a biologically compatible Results: Mean values of shear bond strength for groups I, II and
scaffold. III were 9.6, 5 and 3.6 MPa respectively, with statistically insig-
Design: Two human dental pulp tissues were extracted. The test tis- nificant difference P = 0.09 (P value 0.05). Some specimens
sue was decellularised using a well–established decellularisation showed spontaneous de-bonding after water storage [groups I
protocol (Wilshaw et al, 2006), while the control tissue was left (33.33%) and III (83.33%)]. Failure mode was 100% adhesive
untreated. Histological sections were then prepared and stained failure in all groups.
using hematoxylin and eosin, alcian blue, picrosirius red and 40 ,6- Conclusions: Bonding of DyadTM-flow was highest in uncut
diamidino-2-phenylindole (DAPI) stain in order to assess tissue enamel however further material improvement may be required.
histological architecture, glycoaminoglycans content, collagen dis-
tribution, DNA detection respectively. PZ04.06
Results: The decellularised sections showed an acellular collage- Detection of noncavitated occlusal caries with a novel
nous matrix with no evidence of whole cell nuclei. Histological
analysis also revealed consistency of collagen morphology with
impedance spectroscopy
no apparent structural change of the decellularised scaffold when S. ADIGUZEL, B. KARGUL, S. PEKER & F. YANIKOGLU
compared to the control tissue. Marmara University, School of Dentistry, Istanbul, Turkey
Conclusion: The decellularisation technique used showed promis- Aim: The aim of this study was to investigate the validity of an
ing results with regards to eliminating cellular materials while impedance spectroscopy technology in the detection and assess-
maintaining the extracellular matrix needed for stem cell growth ment of occlusal caries in primary and permanent teeth. To eval-
and differentiation. uate the performance of CarieScan PRO, the method was
compared with a commonly used laser fluorescence device (DI-
PZ04.05 AGNOdent pen, KaVo) and International Caries Detection and
Assessment System (ICDAS II).
Bonding performance of a self-adhering flowable Design: 83 teeths were assessed using all three systems under
composite-resin to different deciduous surfaces standardised in vivo conditions. A non-cavitated sample of 83
F. K. ABDEL GAWAD1, M. A. RASHED1, R. M. posterior teeth (21 primary; 62 permanent) was selected and
ABDELRAOUF2 & M. A. MOHAMMED3 assessed for caries on enamel and dentin level with the aid of
1
Pediatric Dentistry and Dental Public Health, Faculty of Oral CarioScan PRO and DIAGNOdent pen by two examiners.
and Dental Medicine, Cairo University, Giza, Egypt; 2Biomaterial, Results: ICDAS showed the highest validity and repeatability.
Faculty of Oral and Dental Medicine, Cairo University, Giza, The DIAGNOdent pen0 s overall clinical validity was relatively
Egypt; 3Pediatric and Community Dentistry, Faculty of Oral and more comparable to that of ICDAS for one examiner while it
Dental Medicine, October 6 University, Giza, Egypt was CarieScan PRO for the other examiner. The inter-examiner
Background: Self-adhering flowable composite-resin was intro- performance of DIAGNOdent is better than CarieScan PRO
duced to the market; they bond to enamel and dentin without since correlation coefficient of the former is 0.51 while it is 0.43
etching or bonding. for the latter. However, the inter-examiner performance of IC-
Aim: Evaluation of the shear bond strength of self-adhering flow- DAS is the best among all since the correlation coefficient turned
able composite-resin to different surfaces of deciduous molars. out to be 0.75.
NuSmile Restorative Research Poster Prize Entries – PZ04
Conclusions: Overall performances of DIAGNOdent and Carie- dentin replacement materials: (i) SDRTM; (ii) BiodentineTM and
Scan PRO changed according to the examiners suggesting that it (iii) Conventional Glass Ionomer Cement.
depends on the examiners themselves. Material handling characteristics and modes of fracture were also
analyzed.
PZ04.07 Design: 60 acrylic blocks, each with a central hole were prepared.
These were randomly distributed into three equal groups, each
Shear bond strength of two novel dentin replacement corresponding to one of three dentin replacement materials-
materials and glass ionomer cement bonded to two SDR, Biodentine and GIC. The central holes were filled with
resin composites these materials. After setting and application of the respective
W. R. CHOUDHURY & N. SRIDHAR adhesive system, the specimens were further divided into two
Department of Pedodontics & Preventive Dentistry, Manipal sub-groups each, of Nano-filled or Micro-hybrid Composite
College of Dental Sciences, Manipal University, Manipal, India Resin. The respective composite material was then applied onto
the dentin replacement materials using a cylindrical plastic
Background: The unique anatomic and behavioral considerations matrix. Shear bond strength was tested on a Universal Testing
in pediatric patients has made necessary the search for newer Machine (Instron-3366), at a crosshead speed of 1.0 mm/min.
materials with improved biological, mechanical and handling Results: Amongst the dentin replacement materials, SDR showed
properties for replacement of lost dentinal structure. Two exam- superior handling characteristics and significantly higher bond
ples are Flowable Bulk Fill Composite Resin (Smart Dentin strengths (P < 0.01) to overlying composite in comparison to
ReplacementTM, Dentsply Inc.) (SDR), and Tricalcium-silicate GIC and Biodentin.
based cement (BiodentineTM, Septodont, France). Conclusion: The superior handling and bonding characteristics
Aim: The aim of this study was to evaluate the shear bond shown by SDR indicate its usefulness in the unique setting of
strength of Nanofilled and Micro-hybrid composite resin (Filtek- Pediatric dentistry, in lesions with significant loss of dentin.
Z350-XT and Filtek-Esthet-X-Flow-XTTM), to three different
Jens Andreasen Poster Prize Entries – PZ05

PZ05.01 level, with overlapping fragments on an oblique fracture plane.
The root canals were medicated with calcium hydroxide paste for
Abstract withdrawn
2 weeks, after which the coronal root fragment was obturated
with MTA. 4 weeks later, surgical intervention was made under
local anaesthesia for the removal of periradicular granulation tis-
PZ05.02 sue and management of apical fenestration. The tooth was
Combined surgical and restorative management of splinted immediately after surgery for 4 months. The patient has
invasive cervical resorption: a case report been attending regular control visits for 24 months which
B. OZGUR & Z. C. CEHRELI revealed gradual improvements in periradicular bone healing and
Paediatric Department, Hacettepe University Faculty of Dentistry, mobility as well as the aesthetic appearance.
Ankara, Turkey Comments: The multidisciplinary treatment approach presented
herein not only provided improved healing and aesthetics, but
Invasive cervical resorption (ICR) is a relatively uncommon and also favoured continued growth of the anterior maxilla with
often aggressive resorptive process that may occur in the perma- proper gingival contours.
nent dentition. The exact cause of this condition remains unclear
but is potentially predisposed by trauma, orthodontic treatment,
PZ05.04
dento-alveolar surgery, periodontal treatment and bleaching. The
present report describes the combined surgical-restorative treat- Clinical evaluation of composite restorations of
ment approach in an advanced case of invasive cervical resorption. traumatized anterior teeth in children: a four-year
A 15-year-old male patient was referred to the Paediatric Den- prospective longitudinal study
tistry Department for diagnosis of pink discolouration at the cer- C. SAKKAS1, L. KHOMENKO2, N. BIDENKO2 & I.
vical labial region of a maxillary left central incisor. Clinical and TRACHUK3
radiographic examination revealed a lesion extending from the 1
Private Paediatric Dental Practice, Nicosia, Cyprus; 2Paediatric
cervical level of crown to the coronal third of the root, which and Preventive Dentistry, Bogomolets National Medical University,
strongly indicated diagnosis of invasive cervical resorption. The Kiev, Ukraine; 3Private General Dental Practice, Nicosia, Cyprus
tooth responded positively to electric pulp testing. A surgical flap
was raised to expose the resorption site. Following curettage of Background: Only a few clinical studies have been published on
the lesion, a large cavity without pulpal involvement was long-term prognosis of composite restorations of traumatized
observed. The defect was restored with a glass ionomer cement anterior teeth in children.
and composite resin. At 18-month follow up, the patient recalled Aim: The aim of this prospective longitudinal clinical study was
with pulpal symptoms that led to root canal treatment. At to evaluate the clinical performance of fractured anterior teeth
24 months, the patient was still attending uneventful recalls, as restored with a composite resin in children.
confirmed clinically and radiographically. Design: Seventy-eight fractured anterior teeth in 54 children (8–
Due to the aggressive nature of ICR, early diagnosis can help pre- 11 years) were restored with a composite resin (Gradia Direct,
vent the consequences of the resorptive process. Advanced cases, GC, Japan) using the etch-and-rinse technique (Prime and Bond
however, may require surgical intervention combined with restor- NT, Dentsply, U.S.A). The restorations were placed by two oper-
ative treatment. In the present case, restorative management under ators. The restorations were evaluated according to the modified-
surgical exposure of the resorption site provided good aesthetic USPHS criteria at baseline and every year for 4 years follow up.
and functional results during the 24-month follow-up period. Statistical analyses included the McNemar and the Mann-Whit-
ney non-parametric tests (P < 0.05).
Results: Nine children (16.6%) were lost to dropout throughout
PZ05.03 the 4-year follow-up period. The complete replacement rate was
Multidisciplinary management of a late-referred root 18% (12.8% due to the secondary trauma, 3.9% due to the
fracture insufficient anatomical form and 1.3% due to loss of pulp vital-
C. OZSIN OZLER1, M. AKKOCAOGLU2 & Z. CEHRELI1 ity). The partial replacement rate was 28.3% (20.6% due to the
1 slight marginal staining and 7.7% due to the mismatch in colour
Department of Paediatric Dentistry, Hacettepe University Faculty
of Dentistry, Ankara, Turkey; 2Department of Oral Maxillofacial or shade). At the end of follow-up period only 53.7% restora-
Surgery, Hacettepe University Faculty of Dentistry, Ankara, tions totally fulfilled the score ‘Alfa’ of the modified-USPHS cri-
Turkey teria.
Conclusions: Despite improvements in mechanical properties of
Introduction: Postponed or late intervention in root fractures may dental composite materials, the composite restorations of frac-
present with various functional and aesthetic consequences that tured anterior teeth should be considered as semi-permanent res-
require multidisciplinary treatment. This report presents a com- torations.
bined endodontic and surgical treatment approach in a root-frac-
tured permanent incisor whose complaints surfaced 5 years after
trauma.
Case reports: A 12-year-old boy was referred to the Paediatric
Dentistry Department with chief complaint of unpleasant aeshtet-
ics and intraorally-exposed root tip of a displaced left maxillary
central incisor that was traumatized 5 years earlier. Clinical and
radiographic examination revealed a root fracture at the apical
PZ05.05 ment was continued with gingivectomy and restoration of the

tooth with etch-and-rinse adhesive and composite resin. The
A clinical audit of avulsion injuries to permanent
patient has been attending regular visits and the tooth has been
dentition at School Dental Service, Health Promotion in function for 4 years.
Board Comments: Orthodontic extrusion is a viable treatment option to
C. K. J. LEE1, S. K. X. CHUA1, L. Y. H. LEE1, A. X. E. LIM1, restore function and esthetics of teeth with complicated crown-
W. LIM2 & H. J. TONG1,2 root fracture.
1
Faculty of Dentistry, National University of Singapore,
Singapore, Singapore; 2School Dental Service, Health Promotion
PZ05.07
Board, Singapore, Singapore
A prospective clinical study of regenerative
Background: Avulsion is a serious dental emergency which endodontic treatment of traumatised non-vital
demands prompt and appropriate management for favourable
outcomes, and good documentation for medicolegal reasons.
immature teeth
Aims: This retrospective study aimed to investigate the appropri- H. NAZZAL1, K. KENNY2, J. KANG3 & M. S. DUGGAL2
1
ateness of clinical documentation, compliance to IADT guide- Paediatric Dentistry, University of Leeds, Leeds, UK; 2University
lines, and the success of treatment rendered for patients of Leeds, Leeds, UK; 3Oral Biology, University of Leeds, Leeds,
presenting with avulsion injuries at the School Dental Service, UK
Health Promotion Board (SDS-HPB), Singapore. Background: Currently there is no consensus with regards to the
Design: Clinical records of 87 patients (109 teeth) who presented use of regenerative endodontic technique (RET) in promoting
with avulsion injuries at SDS-HPB between January 2006 and root development in immature non-vital permanent teeth. Most
July 2013 were reviewed. Radiographic and clinical information of the available data is of low quality and conflicting results. It
relating to the injuries were retrieved from the electronic dental has been suggested that damage to the Hertwig’s epithelial root
records system and analysed. The quality of operators’ records sheath during trauma to some of these teeth could be a potential
and compliance of treatment to IADT guidelines, as well as the reason for these conflicting results hence the need for further
outcome of each case were evaluated. assessment of the success of this technique in traumatised teeth.
Results: The quality of clinical records was generally poor, with Aim: The aim of our study was to evaluate the treatment out-
information that was deemed essential at the presentation visit comes of RET in the management of traumatised non-vital
and subsequent appointments recorded only 48.3% and 63.1% of immature teeth.
the time respectively. Adherence to IADT guidelines with regards Design: Following ethical approval, 15 healthy children (age
to splinting duration, time to pulp extirpation, and follow-up was range = 7–11 years, mean = 8.7 years) with traumatised non-vital
fairly low. Treatment was successful in 45.0% of teeth, while the immature upper incisors consented to take part in this study.
rest demonstrated signs of initial or definitive failure. Treatment Regenerative endodontic technique, using two antibiotics (cipro-
outcome was significantly associated with storage medium floxacin and metronidazole), was used in treating these teeth with
(P = 0.034), and appropriateness of time of pulp extirpation an average follow up of 9.9 months (range = 7–13 months). One
(P = 0.037). In addition, ankylosis was significantly associated operator undertook all treatments, clinical reviews and standar-
with increased EODT>30 min (P = 0.005). dised radiographic exposures. Radiographs were analysed by two
Conclusion: The findings of this study underscore the need for experienced clinicians.
better clinical documentation. Furthermore, re-training of den- Results: Inter-operator measurement reliability was excellent
tists and dental therapists on the IADT guidelines is imperative (overall intra-class correlation = 0.974 (95% CI 0.955–0.986)).
to ensure better compliance and improved outcomes. Wilcoxon signed ranks test found no statistical significant differ-
ence in root length, root dentinal wall thickness or apical fora-
PZ05.06 men width between pre and post-operative radiographs
(P = 0.735, 1.000, 0.310 respectively). Clinically 100% resolution
Multidisciplinary treatment approach in a
of clinical signs and symptoms was found.
complicated crown-root fracture Conclusions: Our data showed that teeth treated with RET did
G. ERBAS UNVERDI & C. H. GUNGOR not demonstrate any continuation of root development, but com-
Pediatric Dentistry, Hacettepe University Faculty of Dentistry, plete healing was evident in all non-vital immature traumatised
Ankara, Turkey incisors.
Introduction: A complicated crown-root fracture involves enamel,
dentin, cementum and results in pulp exposure. Depending on PZ05.08
the severity of the injury, different treatment options can be A case of invasion of alveolar bone into the root
applied.
Case report: An 8 year-6-month old girl was referred to the Pedi-
canal of an avulsed and replanted permanent incisor
atric Dentistry clinic after a fall accident. The injury had resulted H. AL-BAHAR & M. DUGGAL
in crown fracture of maxillary right central incisor and also obli- Department of Paediatric Dentistry, University of Leeds, Leeds, UK
que crown-root fracture of maxillary left central incisor. The Introduction: An avulsed and replanted immature permanent
fracture line was extending subgingivally at the palatal aspect. tooth can undergo several healing responses. A rare one can be
The right central incisor was restored with composite resin at the bony infill in the root canal of the immature tooth.
same appointment. The coronal fragment was reattached to the Case reports: A 9-year-old boy sustained an avulsion injury to
left central incisor after completion of root canal treatment. the UR1. The tooth was replanted and splinted after 2 ½ h with
Eight months later, the patient suffered another fall accident EADT of 30 min plus 2 h in milk. Four years later, further den-
which lead to the fracture of her maxillary left central incisor to-alveolar trauma resulted in severe intrusion of UL1, which
and loss of the coronal fragment. Orthodontic root extrusion was surgically-repositioned and splinted.
was initiated with a modified Hawley appliance which also com- Radiographic examination showed evidence of infection-related
prised elastic strings placed and tied around orthodontic buttons resorption of the UL1, which was anticipated. However, an inci-
bonded to the labial surface of the fractured incisor. The treat- dental radiographic finding revealed the UR1 to have undergone
a rare type of pulpal healing, causing invasion of the alveolar researchers to compare, contrast and combine outcomes from dif-
bone into the immature root canal. This was characterised radio- ferent studies.
graphically as an immature root with incomplete root develop- Aim: To develop a core outcome set for traumatic dental injuries
ment and an ingrowth of bone into the root canal, with presence (TDI) in children and adults.
of a lamina-dura and PDL space within the root canal. This find- Design: The project was registered with the COMET initiative. A
ing was also captured clinically during a planned premolar auto- web-based survey was developed to capture the opinions of den-
transplant procedure, where a thin bony protrusion of bone was tists from around the world. Through multiple dental organisa-
present in the UR2 socket, as well as in the extracted tooth’s root tions, dentists were asked to complete the survey and identify
canal. what outcomes should be recorded. From this list, duplicates and
Comments: Bony ingrowth into the pulp space has been reported those not meeting the criteria of an outcome were removed. This
rarely. This finding would first be diagnosed radiographically. list was scored by an Expert Working Group (EWG), according
Here we present both radiographic findings and the clinical find- to the GRADE method of achieving consensus. The scoring was
ings on extraction of this tooth to confirm that the growth is undertaken twice, followed by conference calls to discuss and
indeed bone like tissue. finalise the COS.
Results: 1476 dentists completed the online questionnaire. 1144
PZ05.09 outcomes were identified; this was reduced to 287 following
removal of duplicates and non outcomes. In keeping with COS
Clinical outcomes and survival rates of transplanted best practice, outcomes were organised into six domains. The
permanent teeth in children EWG then scored the outcomes twice. The scores were collated
J. DÍAZ, C. ZAROR & J. ALEJANDRA and discussed by the EWG via conference calls. Nine core out-
Paediatric Dentistry & Orthodontic Department, Universidad de comes to be recorded for all traumatic dental injuries were identi-
La Frontera, Temuco, Chile fied. An additional 17 outcomes specific to each injury type were
identified.
Background: Congenital absence and loss of maxillary permanent
Conclusions: A Core Outcome Set has been identified for Trau-
incisors due to trauma in children is a clinical challenge concern-
matic Dental Injuries. Further work is ongoing to detail how to
ing to the most appropriate treatment and prognosis. Literature
measure these outcomes and when to measure them.
has shown that tooth autotransplantation is a biologically
accepted alternative treatment.
Aim: Assess the clinical and radiographic outcomes in terms of PZ05.11
pulp - periodontal healing and root development in 43 trans- Cone beam computed tomography assisted
planted permanent teeth. management of intruded maxillary primary incisors
Design: In a sample of 20 males and 11 females
M. S. MUTHU1,2, L. SUNDERRAJAN2, C.
(11.51 years 2.59 SD), 43 dental transplants were performed THAMOTHARAMPILLAI2 & F. J. MOHAMMED2
within 2004–2014. These were assessed through clinical and 1
Department of Pediatric Dentistry, Faculty of Dental Sciences,
radiographic examination to verify pulp-periodontal healing and
Sri Ramachandra University, Chennai, India; 2Pedo Planet,
root development. Success criteria are pulp survival, pulp obliter- Pediatric Dental Centre, Chennai, India
ation and normal periodontal healing. Failures corresponded to
cases that developed replacement resorption or severe invasive Introduction: The incidence of traumatic injuries to primary teeth
cervical resorption. Fisher Exact Test and Kaplan-Meier analyses varies from 11% to 30%; luxation constitutes 21% of such inju-
were performed to determine the association between the vari- ries (Senda et al Ref No 1&2). Intrusive luxation, one of the
ables and estimation of survival rates, respectively. types of luxation injuries, is defined as dislocation of a tooth in
Results: Thirty seven (86.0%) transplanted teeth were recorded an axial direction into the alveolar bone (Megha et al Ref no 5).
as successful and six as unsuccessful (13.9%). During 10 years It damages the periodontal ligament and fibres of the neurovas-
of follow-up (64.4 months 43.3 SD), survival and success cular bundle.
rates reached 97.6% and 83.9% respectively. Only one tooth Case reports: A 4 year and1 month old boy, with no health prob-
was extracted and four teeth developed replacement resorption lems was referred to the Pediatric Dental Centre with the chief
(9.3%). 79.1% of the teeth had incomplete root formation, complaint of intruded upper front teeth. History revealed that he
which proved to be a significant variable in the success. The had a fall from the table and hit the floor. After the injury, he
majority of immature transplanted teeth developed pulp obliter- visited a nearby dentist who had advised an OPG and referred
ation (56%). for the specialist opinion. The parents were concerned about the
Conclusions: The findings from this study highlights the high suc- potential injury to the unerupted permanent incisors. Since all
cess and survival rates of tooth transplantation. The low preva- the four maxillary primary incisors were intruded, a Cone Beam
lence of complications confirm that tooth transplantation is a Computed Tomography (CBCT) was advised to definitively rule
therapeutic option in growing patients. out the possibility of permanent teeth injury. The CBCT images
revealed the non involvement and absence of injury to the devel-
PZ05.10 oping permanent incisors. Hence, parents were advised to wait
for spontaneous re-eruption. The patient was followed up until
Development of a core outcome set for traumatic the eruption of permanent incisors.
dental injuries Comments: CBCT helped to definitively rule out the possibility of
K. P. KENNY1, M. O. SHARIF2 & P. F. DAY1 permanent teeth injury. Patient had uneventful eruption of per-
1
Department of Paediatric Dentistry, School of Dentistry, manent incisors after 27 months.
University of Leeds, Leeds, UK; 2Department of Orthodontics,
Eastman Dental Institute, London, UK
Background: Core Outcome Sets (COS) are agreed and standar-
dised collections of outcomes for use in clinical studies and trials.
The reporting of core outcomes in published studies allows
PZ05.12 Comments: So far, no consensus or conclusive evidence on the

most appropriate treatment for crown-root fracture has been
Tales of a tooth monster
established. Further investigation with more cases is required to
N. TEWARI, N. SINGH, S. SINGH & S. GUPTA
serve for clinical practice.
Pedodontics and Preventive Dentistry, BABU Banarasi Das
College of Dental Sciences, BBD University, Lucknow, India
PZ05.14
Introduction: Traumatic dental injuries affecting the primary den-
tition are associated with unusual, diverse and severe conse-
Legal aspect updates in traumatology: an Italian
quences in the permanent dentition. These sequelae are almost overview
unpredictable and depend upon type & severity of trauma, direc- S. BERNARDI1, S. CARUSO1, L. DI FABIO1, M. A.
tion of force and stage of development of the succedaneous CONTINENZA1, R. GATTO1 & R. DOCIMO2
1
tooth. Department of Life, Health and Environmental Sciences,
Case report: An 11 year old girl reported to out patient depart- University of L’Aquila, L’Aquila, Italy; 2Department of
ment with a chief complaint of swelling in upper front region of Experimental Medicine and Surgery, University of Rome ‘Tor
oral cavity. The medical history was non contributory with a Vergata’, Rome, Italy
reported trauma by tricycle handle at 2.5 years, leading to
Background: Dental traumatic injuries affect in most of the cases
avulsed 51 and intruded 61 & 62. Clinical examination revealed
pediatric patients. This implies long terms consequences.
an enlargement with palpable anomalous erupting 11. Radio-
Aim: The aim is to evaluate the Italian legal aspect about these
graphs exhibited an odontoma like malformation in 11 alongwith
issues, which can considerably affect young patients.
root dilaceration. Treatment plan comprising of surgical exposure
Design: Italian legal recommendations have been examined
and shaping of 11 with orthodontic alignment was formulated.
(information among Italian National Denstists Association -
However, she didn’t report after initial preventive protocol, to
INDA-, IADT, Italian National Health Department- INHD)
turn up 2 years later with pain and swelling in the region. The
from 2009 to 2014.
radiographs now showed a periapical radiolucency in 11. A con-
Results: The used protocols are those provided from the IADT,
servative endodontic management was done followed by diode
updated at 2012. In 2009, in a manual edited by INDA, Monta-
Laser gingivoplasty
gna et al. stated that tables and methods, which were used to
(Zolar 3W, Canada). Exposed monster tooth was 10 mm mesio-
quantify the damages in terms of money compensation, are not
distally with an unusual Talon cusp. It was esthetically recon-
suitable. The submitted estimate should include therapies and
toured using diamond burs and composite (Z250, 3M, USA).
future restorations needed to complete damages restorations.
Patient is presently undergoing an orthodontic treatment.
Anomalies, enamel defects, endodontic therapies are coefficients,
Comments: Knowledge about its etiopatgogenesis and outcomes
which low the refunding. In special cases such as the damages to
is essential to design an effective treatment plan often requiring
the permanent teeth, authors recommend to highlight the connec-
multi disciplinary interventions and a long term follow up. The
tion between the injury and the future damages and a timeesti-
use of newer technologies as Laser are highly beneficial for avoid-
mation for long-term distance damage refund. In 2012, INHD
ing complex surgical procedures and motivating the patients.
published guidelines about dental traumatology, considering it a
minor abuse sign. In 2014, in the new update guidelines, it is sta-
PZ05.13 ted that the medical certificate used for refunding must be written
Management of crown-root-fractured permanent during dental check-up, clearly and provided with all the neces-
sary documentations.
incisors by multidisciplinary approaches: a case series
Conclusions: Forensic dentistry plays an important role in dental
L. WUN, R. FANG, S. LI, L. GAO, J. LI & X. WANG
trauma in young patients in order to obtain a good compensa-
School of Stomatology, Fourth Military Medical University, Xi’
tion as the burden of proof meets to the patients.
an, China
Introduction: Crown-root fractures can be grouped into uncom- PZ05.15
plicated and complicated according to pulp involvement. The lat-
ter challenges dentists as different treatment options can be
Intentional implantation with 180 degrees rotation of
chosen, but with uncertain outcome. We present three cases of complicated crown-root fractured incisor in an
complicated crown-root-fractured teeth managed by different anxious child: a case report
multidisciplinary approaches. S. GALLAGHER & P. FLEMING
Cases reports: Case 1: A 10-year-old boy who suffered from Dental Department, Our Lady’s Children’s Hospital, Crumlin,
crown-root fracture on right maxillary incisor was treated conser- Dublin, Ireland
vatively with stainless steel wire splinting for 3 months and then
splinting ribbon was applied as alternative in the lingual side Introduction: Complicated crown-root fractures are complex den-
after removal of the stainless steel one. tal injuries which affect enamel, dentine, cementum and pulp.
Case 2: The crown fragment of a 12-year-old boy’s incisor was They typically present with an oblique fracture line which is su-
fixed with semi-rigid splint and temporarily reattached with glass- pragingival on the facial aspect and subgingival on the palatal
ionomer cement. Endodontic therapy was performed through lin- aspect. Treatment often involves multiple dental visits and multi-
gual access followed with a fiber post cementing. disciplinary care. Treatment may not be achievable for patients
Case 3: A 10-year-old boy was prescribed the same treatment with learning impairments or extreme dental anxiety. We describe
protocol as case 2 at first, but periodontal tissue bleeding was a case of an anxious child with a complicated crown-root frac-
uncontrollable when root canal preparation was carried out. ture who had comprehensive care under general anaesthetic by a
So we extracted both the coronal and the apical fragments and paediatric dental team.
completed the endodontic therapy in vitro. The coronal fragment Case reports: An anxious, 8 year-old girl was referred for man-
with a fiber post was bonded to the apical one, and then agement of dental trauma. Clinical examination revealed a com-
replanted to its original position and splinted for 1 month. Up to plicated crown-root fracture of tooth 11 with the coronal
now, all the three cases work well for more than 2 years with no fragment in multiple parts. Treatment options included extrac-
clinical symptoms and signs of foci radiographically. tion, vital root submergence, exposure of fracture line by ortho-
dontic repositioning or periodontal surgery and surgical reposi- The proceeding is the conservative management of a male who
tioning with or without rotation. The first treatment phase under suffered severe intrusion and dislocation injuries to the 11 and
general anaesthetic involved removal of the fractured coronal 21.
fragments revealing a palatal fracture extending 4 mm subgingin- Case report: An 8 year old male patient was referred from hospi-
givally. The tooth was removed, the root inspected for fractures, tal Emergency for management of dentoalveolar trauma follow-
rotated 180 degrees and implanted, resulting in the fracture being ing a fall at school.
1 mm supragingival on the facial aspect. Splint application, pulp Clinical examination revealed barely visible 11 and 21 and soft
extirpation, placement of non-setting calcium hydroxide root tissue trauma. Radiographs revealed open apices of upper central
canal dressing and glass ionomer restoration were completed. At incisors with no root fractures. Fracture of the labial alveolar
a subsequent general anaesthetic 3 weeks later, the splint was plate was noted.
removed, endodontics completed and the tooth restored with full After consultation with the Orthodontic and Oral Surgery
coverage composite strip crown. departments, consideration was given to patient age, severity of
Comments: This approach has avoided extraction in an anxious the injury and the increased risks of ankylosis and loss of vitality
child and resulted in an aesthetic, functional outcome which is with surgical repositioning. A very conservative treatment
maintaining bone and space. approach was taken with reduction of the fractured alveolar plate
and monitoring for spontaneous re-eruption. Orthodontic inter-
PZ05.16 vention would be done if required.
At the 3, 6 month and 1 year reviews, re-eruption of 11 and 21,
Conservative management of severely intruded maintenance of vitality and continued root development were
permanent central incisors in an 8 year old patient recorded. Unaided full re-eruption was observed after 2 years
T. PERCIVAL & J. D. EDWARDS however radiographic pathology and inconsistent sensibility tests
Paediatric Department, Child Dental Health Unit, School of in the asymptomatic 11, 21 were found.
Dentistry, University of the West Indies, Champs Fleurs, Trinidad Comments: The eruptive potential of the immature permanent
and Tobago incisors and conservative approach resulted in a favourable aes-
thetic outcome for this patient. Nevertheless, loss of vitality albeit
Introduction: The current recommendation in the management of
delayed still remains a risk in dental injuries of this nature.
severely intruded permanent incisors i.e. >7 mm is surgical repo-
sitioning. In a young patient more conservative approaches with
orthodontics may also be considered.
Preventive Dentistry Poster Session – PR01

PR01.01 PR01.03
Infant oral health: the voice of the future Investigation and analysis of malocclusionin in
L. R. F. MUGAYAR primary dentition of Shanghai
Pediatric Dentistry, University of Florida, Gainesville, FL, USA J. FENG1,2 & J. MI2
1
Background: Early Childhood Caries has been found as one of Shanghai Stomatological Disease Center, Shanghai, China;
2
the most common contagious disease in young children in the Shanghai Tongji Hospital, Shanghai, China
United States, and affects children Worldwide. Aim: The purpose of this study was to investigate and analyse
Prevention and early intervention combined with parental educa- the prevalence of malocclusion among children in primary denti-
tion has been shown to be a successful avenue to promote Oral tion in the area of Shanghai. To provide theoretical basis for the
health, especially in the early stages of life. establishment of children0 s oral health care measures.
Design: A model of a successful integrated Infant Oral Health Design: The investigation of occlusion in primary dentition on
Clinic addressed for children aged 0–3 years old will be pre- 2744 cases of children aged 3–6 of Shanghai was carried out by
sented. The Academic componenent will also be discussed, as pediatric specialists.
part of the Undergraduate and Graduate training programs, as Results: The prevalence of malocclusion in primary dentition in
well the Inter and Multidisciplinary approaches. Shanghai was 69.64%, no significant difference was found in gen-
der. All types of malocclusion symptoms were analysed, Deep
PR01.02 overbite prevalence rate is highest (55.39%), followed by deep
overjet (24.31%), dental crowding (21.25%), cross-bite (12.03%)
Is a caries risk assessment (CRA) protocol necessary and open-bite (7.22%). 35 percent of the patients with more than
to provide an effective caries preventive regime? two kinds of malocclusion.
C. AFUAKWAH1, F. STOOPS1 & R. R. WELBURY2 Conclusions: The prevalence of malocclusion in primary dentition
1
Crosshill Dental Practice, Port Glasgow, UK; 2Paediatric and types of malocclusion symptoms in the area of Shanghai
Department, Glasgow Dental Hospital and School, Glasgow, UK were obviously changed than before. A series of secorresponding
Background: Clinical guidelines recommend an individual is given preventive measures needs to formulate to prevent the occurrence
a caries risk status based on analysis of defined clinical and social and development of malocclusion in primary dentition.
criteria before implementing a tailored preventive plan.
Aims: PR01.04
1) Improve documentation of CRA by a systems based approach Comparison of Mineral density in molar incisor
to quality improvement methods.
2) Investigate the impact of quality improvement efforts on sub-
hypomineralisation applying fluoride varnishes and
sequent design and delivery of preventive care. casein phosphopeptide-amorphous calcium phosphate
3) Identify barriers to delivery of CRA and provision of preven- (CPP-ACP)
tive care. A. M. BIONDI, D. E. FRIDMAN & S. G. CORTESE
Design: Data for patients aged 0–16 years was collected over 2 Pediatric Dentistry, University of Buenos Aires, Buenos Aires,
cycles using standard audit methodology. The first cycle was a Argentina
retrospective analysis (n = 400) using random sampling. The sec-
Background: Previous studies suggested a relationship between
ond cycle a prospective analysis (n = 513) using consecutive sam-
pling over a 15 week period. Five staff meetings with feedback visual detection of defects and mineral density (MD) recorded
occurred between cycles. with Laser Fluorescence (LF).
Results: In cycle 1 no specific CRA system was identified. CRA Aim: Compare MD subsequent to application of fluoride var-
nishes (FV) and CPP-ACP in hypomineralised teeth.
wasn’t stated widely, risk factors weren’t analysed and there was
variation with respect to the prescription and delivery of preven- Design: 45 children aged 6–16 years seeking attention from 2013
tive strategies. These discrepancies were demonstrable for all the to 2014 were evaluated. Subjects were divided into two groups
according to year of attendance. G1 (2013) was comprised of 37
four participating dentists and at all ages. In cycle 2 100%
recorded CRA. All risk factors were analysed and individual car- teeth clinically diagnosed as mild (A) and moderate (B) lesions
ies risk was correctly annotated. There was 100% compliance with no structural loss and G2 (2014) of 33 teeth. They were
with the protocol for preventive plans. assessed by DIAGNOdent (KaVo) by an operator. MD was
measured on enamel surfaces with simultaneously creamy-white
Conclusions: and yellow-brown opacities. Then, teeth received three applica-
1) The use of CRA improved documentation of caries risk tions of DuraphatÒ in G1 and of MI PasteTM in G2 and assessed
status. with LF at 15, 30 and 45 days. Percentage differences in both
2) This has improved subsequent prescription of age specific groups were calculated for each observation with respect to the
evidence based preventive care appropriate to the risk sta- basal and compared using ANOVA.
tus of that individual. Results: Mean value of MD in G1 and G2 in A was 18.57 5.88
3) Barriers were identified to the delivery of CRA and the and 17.37 7.22 and in B 56.88 15.71 and 29.53 17.85. At
provision of comprehensive preventive care by the dentists 15 days for A: 7.09 2.34 and 3.76 2.41 and for B:
and other health care professionals. 2.43 2.94 and 1.87 3.02; 30 days: A: 15.75 2.74 and
7.86 2.82 and B: 31.2 3.18 and 7.56 3.27; and
45 days: A: 18.91 3.11 and 9.12 3.2 and B: 36.17 3.21
and 4.72 3.31 in G1 and G2 respectively. Comparison of esti- Group B (experimental) was given 0.5% epigallocatechin-3-
mated marginal means showed that the effect Time and Enamel gallate (EGCG) mouthwash.
was greater than with FV than with CPP-ACP (P < 0.001). Children rinsed for 1 min, under supervision, during 2 weeks of
Conclusion: In this sample, loss of mineral density after the appli- school based rinsing program. Plaque accumulation and gingival
cation of CPP-ACP showed a smaller reduction in the magnitude condition were recorded using Turesky modification of the Quig-
of the effect than that revealed by fluoride varnishes. ley-Hein plaque index and Gingival index. Plaque and gingival
scores were recorded at baseline and after 2 weeks period.
PR01.05 Results: Plaque scores were compared and the difference between
epigallocatechin gallate and chlorhexidine mouthwash was deter-
The prevalence and risk factors of tooth wear in mined by t-test. Plaque and gingival scores were significantly
Chinese adolescents reduced (P < 0.05) in both groups after 2 weeks period. No sig-
H. JIANG, M. Q. DU & B. J. TAI nificant difference in plaque and gingival score between the
Department of Preventive Dentistry, School of Stomatology, groups were obtained. Mothwash containing 0.5% epigallocate-
Wuhan University, Wuhan, China chin gallate had similar efficacy compared to 0.12% chlorhexi-
dine.
Background: Tooth wear has been investigated in numerous
Conclusions: This study supports the effectiveness of mouthwash
countries and the prevalence is various. But the data of tooth
containing green tea epigallocatechin gallate in plaque reduction
wear in China is scarce.
and control of gingival infalammation. It should be explored as a
Aim: The aim of this study was to describe the prevalence of
natural, long-term antiplaque rinse, suitable for school based
tooth wear and to investigate the relative factors associated with
rinsing programs.
tooth wear in Chinese adolescents.
Methods: A cross-sectional descriptive study was done among
720 adolescents in Hubei Province, Central China. The age PR01.07
groups of this study were 12 and 15 years old, each group includ- ‘In vitro’ dissolution of tooth enamel due to
ing 360 participants, of whom the female and the male was 50% frequently consumed beverages: preliminary study
respectively. A modified version of the tooth wear index BEWE
A. B. ARGENTIERI, L. E. PASSARINI, M. CASTRO, P.
was recorded on buccal, cervical, occlusal/incisal and lingual
SALGADO & A. L. SORAZABAL
faces of all the teeth on the 720 adolescents. Every participant
Department of Preventive and Community Dentistry, School of
was asked to answer a questionnaire containing 32 questions Dentistry, University of Buenos Aires, Buenos Aires, Argentina
about their current and historical dietary habits and oral hygiene.
Results: The prevalence of tooth wear was 18.6% and 89.4% Aim: To evaluate ‘in vitro’ enamel dissolution with regular and
respectively in 12 and 15 years old adolescents. The prevalence diet non-alcoholic beverages.
rates of dentine exposure were 1.94% and 5.56% respectively. Sev- Design: Twenty-four healthy premolars were used. They were sec-
eral factors such as drinking soft drinks and fruit juices immedi- tioned into two blocks (buccal and lingual) using a high speed
ately after sport, taking aspirin, reflux, unilateral chewing, tooth steel under constant cooling. Each block was weighed using a
brushing once or less daily, duration of brushing <2 min and Model A5200 OHAUS. Regular Coca ColaÒ, light Coca ColaÒ,
swimming in summer were found to be associated with tooth wear. GatoradeÒ, CepitaÒ orange juice were used. Following determi-
Conclusions: Tooth wear in Chinese adolescents is a significant nation of beverage pH, 10 blocks were exposed to each beverage.
problem and should receive more attention. The prevalence of Control blocks (8) were exposed to distilled water. The blocks
tooth wear is associated with socio-behavioral risk factors. were weighed at 1, 8 and 15 days post-exposure, and were
immersed in a fresh sample of the corresponding beverage after
PR01.06 each determination. Statistical analysis: Results were analyzed
using repeated measures ANOVA and Dunnetts’s post hoc test.
Effectiveness of 0.5% epigallocatechin gallate in Results: No differences were observed between baseline weight
comparison to 0.12% chlorhexidine mouthwash in and weight at the first determination. The difference between the
reduction of plaque and gingivitis in children second and third determination was recorded as mg of weight
K. PERISIC1, M. LALIC1, N. BOROTIC2, M. GAJIC1 & E. loss and compared to that of blocks exposed to water. Significant
ALEKSIC3 differences were observed between sections immersed in water
1
Department of Preventive and Paediatric Dentistry, Faculty of and those exposed to GatoradeÒ (29 mg difference) (P < 0.001),
Dentistry Pancevo, University Business Academy Novi Sad, and to CepitaÒ (26 mg difference) (P < 0.001). No significant dif-
Pancevo, Serbia; 2Department of Prosthodontics, Faculty of ferences were found between blocks exposed to water and those
Dentistry Pancevo, University Business Academy Novi Sad, immersed in regular Coca ColaÒ (14 mg) or light Coca ColaÒ
Pancevo, Serbia; 3Department of Orthodontics, Faculty of (11 mg) (P < 0.001).
Dentistry Pancevo, University Business Academy Novi Sad, Conclusions: At similar time points and pH, the beverages
Pancevo, Serbia showed different behavior; this may be attributed to the composi-
tion of each drink. The data presented here indicate that the ana-
Background: There is an increased public attention for use of nat- lyzed beverages may cause enamel dissolution in the long term.
ural products in daily oral care. Epigallocatechin gallate from
green tea was reported to be effective in treatment of gingival
inflammation.
PR01.08
Aim of this study was to compare effectiveness of epigallocate- Monitoring levels of preventive care: 7 year results
chin gallate and chlorhexidine gluconate mouthwash in reduction F. E. HOGG1, S. HUDDA2, J. HASHIM2 & C. CAMPBELL1
1
of plaque and gingivitis. Paediatric Dental, Glasgow Dental Hospital and School, Glasgow,
Design: A randomized blinded controlled trial with 50 healthy UK; 2Undergraduate, Glasgow Dental Hospital and School,
12 years old children was carried out. The subjects were ran- Glasgow, UK
domly assigned to two groups of 25 subjects per group.
Group A (control) was given 0.12% chlorhexidine gluconate Background: Dental caries continues to affect 32% of 5 year-olds
and in Scotland.1 The caries assessment risk evaluation (CARE) pro-
ject started in the paediatric department in Glasgow Dental Hos-
pital & School in 2008.2 Clinical audit was used to monitor the PR01.10
impact of CARE on prevention delivered. Cycle 1 in 2007, Cycle
Oral health preventive program for visually impaired
2 in 2010 and the 3rd cycle using this audit project in 2014.3
Aim: 1. Determine the current rates of caries risk assessment children: Indian experience
(CRA) documentation. K. GAUBA1, D. SARDANA1,2, A. GOYAL1 & A. KAPUR1
1
2. Compare current standards of prevention packages with 2007 Oral Health Sciences Centre, Postgraduate Institute of Medical
and 2010 audit cycles. Education & Research, Chandigarh, India; 2Centre for Dental
Standards: 80% of records to have CRA documented within past Education, All India Institute of Medical Sciences, New Delhi,
12 months and preventive plans documented and undertaken India
according to CRA. Background: Visually impaired children have been reported to
Design: Random selection of 100 records from all children/clinics have a high prevalence of gingival diseases, dental caries and den-
within the department at GDH & S from March 2013 to March tal trauma. Conventional methods of teaching oral hygiene for
2014. A data collection spreadsheet (Excel) was used to record removal of dental plaque involves use of visual perception by
CRA documentation and Prevention plan documentation (as per using disclosing agents which is not practically feasible for visu-
standards). The results were compared with previous cycles. ally impaired children, who depend mostly on their tactile and
Results: From 2007 (92 case records) 2010 (94 case records) and hearing sensations for learning.
2013/14 (100 case records) the following results were found Aim: This Study was carried out to compare and evaluate two
(respectively):- CRA 0%, 66%, 50%, toothbrushing instruction specially designed educational and motivational techniques of
9%,48%, 54%, toothpaste strength advice 10%, 52%, 53%, die- implementing oral health education program in visually impaired
tary advice 10%, 54%, 55%, fluoride varnish application (FVA) children.
3%, 44%, 59%, fissure sealants 94%, 86%, 84%. Design: The study was carried out on 148 institutionalised visu-
Conclusion: CRA recording and prevention packages do not yet ally impaired children wherein the efficacy of specially designed
meet the set standards. Further action is required to ensure ALL oral health education program using two different motivational
children attending receive targeted preventive care. The FVA techniques was evaluated utilizing their tactile (Braille + plastic
project presently in use GDH & S continues to improve applica- models) and audio sensations (Audio story + JAWS -Job Access
tion rates. With Speech), over a period of 6 months by evaluating the
change in KAP regarding oral health practices, dental plaque
PR01.09 and gingival scores.
Er:YAG laser-A magical wand for cavity free Results: Brushing frequency of twice daily increased in both the
groups (Group I 35% to 87.8%, Group II 47.3% to 98.6%,
childhood P = 0.02). Significant improvement in mean plaque scores
S. SINGH & M. SRIVASTAVA (Group I = 1.34 0.29 to1.04 0.31, P = 0.00, Group
Pedodontics & Preventive Dentistry, Babu Banarasi Das College of II = 1.24 0.47 to1.10 0.17, P = 0.01) was evident at
Dental Sciences, Lucknow, India 6 months evaluation in both the groups. Similar significant
Background: Laser irradiation and fluoride has been used as a improvement was evident in gingival scores thus demonstrating
preventive measure to combat dental caries both in permanent the effectiveness of the two motivational techniques.
and primary teeth but little has been done to compare their effect Conclusions: The study emphasizes the need and importance of
among both the dentition. implementing specially framed oral health education program in
Aim: The aim of this study was to evaluate the effect of Er:YAG institutes for visually impaired.
laser application with and without fluoride on the acid resistance
of primary and permanent tooth enamel. PR01.11
Study design: An in-vitro randomized-controlled trial was carried
Impact of Nigerian parents / caregivers oral health
out in 80 enamel blocks of sound teeth and were allocated to
four groups of 20 teeth (10 primary and 10 permanent teeth) knowledge, attitude and practices on the oral health
each - Group 1 (No treatment), Group 2 (Laser only), Group 3 of their children
(Fluoride only) and Group 4 (Laser + Fluoride). Thereafter, pH C. A. ADEKOYA-SOFOWORA1 & F. O. FANIRAN2
1
cycling was done for 9 days and the enamel blocks were sec- Child Dental Health, Obafemi Awolowo University, Ile-Ife,
tioned. The samples were subjected to assessment of surface mi- Nigeria; 2Preventive Dentistry, Obafemi Awolowo University, Ile-
crohardness in terms of Vickers Hardness and surface Ife, Nigeria
morphological changes were observed using SEM. Data obtained
Aim: To investigate whether the oral health knowledge, attitude
was analyzed using ANOVA.
and practices of Nigerian parents/ caregivers, had influence on
Results: SEM for primary teeth showed higher proportion of
the oral health status of their children.
melting without any crater formation and surface irregularities
Study design: An analytical cross sectional study was used.
thereby significant increase in microhardness with the maximum
Methods: Parents/caregiver of children aged 1–12 years, in Ife
VHN of 372.40 while permanent teeth showed marked deminer-
central Local Government Osun State, Nigeria with different
alization with crater and crack formation and reduced microh-
occupation, and educational level participated in the study. A 27
ardness with the minimum VHN of 187.
stem questionnaire on socio -demographic, knowledge, attitude
Conclusion: Er:YAG laser irradiation combined with APF treat-
and practices regarding oral health were administered.
ment of the primary tooth enamel gave morphologically hard-
Result: A total of 113 parents/caregivers participated in this study.
ened enamel surface than the permanent teeth which can be a
About 79 (69.9%) of the participants had never attended the den-
protective barrier against a cariogenic attack.
tist while 34 (30.1%) gave a positive response, with toothache 10
(8.8%) being the major complaint followed by routine check-up 8
(7.1%). Sixty five (57.5%) reported once daily brushing, and 66
(58.4%) used soft bristled textured tooth brush with fluoridated
tooth paste. Fifty five (48.7%) reported they change their tooth-
brush once the bristles worn out, with more significant values
(v2 = 0.027, P = 0.01) found in adults above 30 year old. Many examined by calibrated examiners. Dental caries was assessed
parents (4 4.2%) with tertiary level of education did not know using diagnostic criteria recommended by WHO. Inclusion crite-
the ideal age for a child’s first dental visit and this was statisti- ria was presence of completed primary dentition. Treatment need
cally significant (P = 0.04). was assessed using RI index (d/dft ratio) that shows how many
Conclusion: The knowledge of Nigerian parents / caregivers on of all teeth that require treatment were treated.
oral health were inadequate, and this had negative impact on the Results: The dft scores (mean) were 0.84 (2.18); 2.42 (3.59);
oral health status of their children. There is need for dental 3.01 (3.67); 3.34 (3.93) and 4.37 (4.13); for 3, 4, 5, 6 and
health education amongst Nigerian parents to update their 7 years old respectively. RI index scores were: 0.04; 0.17; 0.19
knowledge and promote oral health in the community. and 0.23; 0.25 for 3, 4, 5, 6 and 7 years old respectively.
Conclusions: The mean dft value and the treatment needs increase
PR01.12 with age. The conclusion that the dental care for primary teeth is
neglected it can be drawn from this results. It also can be con-
Factors associated with prevalence of the recurrent cluded that in our region, which is currently without adequate
dental caries after 12 months treatment under general prevention program for preschool children, exist conditions in
anesthesia which child has a good chance to develop more and more carious
Y. T. LIN1, C. Y. S. HSU2 & Y. T. J. LIN1 lesions over the years.
1 Thus, implementation of quality prevention program and motiva-
Pediatric Dentistry, Kaohsiung Chang Gung Memorial Hospital,
Kaohsiung, Taiwan; 2Department of Preventive Dentistry, Faculty tion for dental care through it is a high priority.
of Dentistry – National, Singapore, Singapore
Background: There is no data in the dental literature concerning
PR01.14
the risk factors of the recurrent dental caries performed in young Assessment of an oral health education programme
children with early childhood caries under general anesthesia (OHEP) for pregnant women attending at St.
(GA). Thomas’ Hospital
Aim: The aim of this cross-sectional study was to determine the
A. ALRAJAHI1, P. CORREIA1, C. WILLIAMS2, D.
risk factors associated with the prevalence of the recurrent dental SYMINGTON3 & M. T. HOSEY1
caries in Taiwan pre-schoolchildren after 12-months treatment 1
Paediatric Dentistry, King’s College London Dental Institute,
under G.A.
London, UK; 2Children’s Dentistry, St Thomas’ Hospital, London,
Design: Eighty-three children, mean age 48.80 months were trea-
UK; 3Antenatal Education Unit, St Thomas’ Hospital, London,
ted under GA and re-examined 12 months after completion of UK
treatment. A 1-year prospective study on 83 schoolchildren, smal-
ler than 6 years old, was conducted. At baseline, data on general Background: Promoting oral health is important for the wellbeing
health, diet, oral hygiene and salivary analyses were obtained. of pregnant women and it appears to benefit the oral health of
Deft and defs were calculated from records. Re-examination for their expected child. In some instances, Dentists have consoli-
caries was done after 1 year. The children were divided into four dated teams with Midwifes to reach for this population, but none
groups according to the assessed caries risk at baseline. The cor- in the UK.
relation between associated factors and dental caries prevalence Aim: To find out the acceptability of an OHEP and its improve-
was analyzed using chi-square test and multiple logistic regression ment on the oral health knowledge of pregnant women.
analysis. Design: An educational programme was developed for pregnant
Results: The percentage of recurrent dental caries schoolchildren women attending an antenatal workshop at St Thomas’ Hospital
was 80% and the mean deft was 2.54 2.53 (mean SD). The focusing on preventing early childhood caries of their expected
caregivers thought that the main reason for tooth decay was child. It consisted of questionnaires, a short presentation, and a
brush, the MS count and CRA were strongly associated with car- telephone interview. A trial of this programme was carried out
ies experience (P < 0.05). involving Community Midwives and pregnant women attending
Conclusions: This study indicated that these variables are risk fac- the workshop to assess the design and acceptability of the study,
tors associated with recurrent dental caries experience in a com- via a self-reported questionnaire. Demographic and qualitative
munity of Taiwan pre-schoolchildren after 12-months treatment data were obtained.
under G.A. The Cariogram predicted caries increment in this Results: The trial involved 30 participants. The majority of which
particular population accurately than any included single-factor were satisfied with all the proposed intervention elements: 71.4%
model. of Midwives and 92.9% of pregnant women reported that the
questionnaires were relevant and easy to understand; 81.8% of
PR01.13 Midwives and 92.3% of pregnant women agreed that the presen-
tation was informative; 90% of Midwives and 84.6% of pregnant
What are the chances for the development of caries women agreed with the follow-up of pregnant women’s knowl-
without prevention programs? edge. Research Ethics Committee approval was granted (REC
D. BAKARCIC1, J. N. IVANCIC1 & R. GRZIC2 reference: 14/YH/1239).
1
Department of Paediatric Dentistry, University of Rijeka, Rijeka, Conclusions: Based on the feedback received from the partici-
Croatia; 2Department of Prosthetic Dentistry, University of pants, improvements were made on the OHEP. The educational
Rijeka, Rijeka, Croatia programme is ready to be delivered to pregnant women attending
an antenatal workshop at St Thomas’ Hospital.
Aim: The aim of this study was to obtain information on increase
of: number of caries lesions and treatment needs of children with
primary dentition due to lack of preventive program for pre-
school children. This results will be used as start point for plan-
ing future preventive measures in Primorsko - Goranska County,
Croatia.
Methods: Total of 2934 preschool children (1502 boys and 1432
girls) aged 3–7 years were surveyed. Each child was clinically
PR01.15 difference was found in incidence of caries between two groups,

but incidence of dentine caries of CMT-3G was significant less
Early childhood caries prevention: a survey on
than CG (P < 0.01). Mean Keyes score of enamel was
knowledge, attitude and practices among 3.67 3.11 and 5.75 4.65 in CMT-3G and CG respectively.
pediatricians, general and pediatric dentists in There was no significant difference between two groups. Mean
Taiwan Keyes score of dentine was 1.25 2.31 and 3.08 3.75 in
S. DIMA & N. C. TENG CMT-3G and CG respectivel, CMT-3G was great lower than
Department of Pediatric Dentistry, School of Dentistry, Taipei CG (P < 0.05).
Medical University, Taipei, Taiwan Conclusion: MMPs inhibitor CMT-3 has no effect on incidence
of caries, but might inhibit the progress of dentine caries.
Background: To date, there has been increasing interest to incor-
porate physicians in preventing early childhood caries, consider-
ing young children0 s better access to medical care in their first PR01.17
years of lives. Comparison of the newer preventive therapies on
Aim: To evaluate physicians’ and dentists’ knowledge and prac- remineralisation of enamel in vitro
tices on children’s oral health and attitudes towards implantation M. BATAINEH, M. MALINOWSKI, J. TAHMASSEBI & M.
of medical setting based prevention in Taiwan. DUGGAL
Design: A cross-sectional, self-administered survey was conducted Paediatric Dentistry, University of Leeds/Leeds Dental School,
among 194 dentists and 31 pediatricians currently practicing in Leeds, UK
Taiwan.
Results: The mean knowledge score of pediatric dentists were Background: A range of new agents based on milk products have
higher than those of general dentists and pediatricians (P < 0.05). been developed to enhance the remineralisation of early enamel
More than 80% of the respondents agreed that physicians can carious lesions such as CPP-ACP.
play important role in preventing dental caries in children. For Aim: To investigate in vitro the effect of CPP-ACP containing
the medical setting based preventive intervention, the proportion products (Tooth Mousse (TM), MI Paste Plus (MIplus)) in the
of dentists who agreed physicians can apply fluoride varnish was remineralisation of enamel subsurface lesions when used supple-
significantly lower: 16.4% of pediatric and 34.3% of general den- mentary to fluoridated toothpastes (FTP) and to compare these
tists despite of 54.8% of pediatricians who agreed to perform the to the effect of 0 ppm, 1450 ppm and 2800 ppm FTP.
task. Potential barriers affecting this opinion of dentists include, Design: Enamel subsurface lesions were created in bovine enamel
physicians are not confident to identify dental caries, patients are slabs (N = 120) which were assigned randomly to five groups;
too young and uncooperative in medical office, physicians may 0 ppm FTP, 1450 ppm FTP, 2800 ppm FTP, 1450 ppm FTP +
not have time for oral screening and caries risk assessment TM and 1450 ppm FTP + MIplus. The enamel slabs were sub-
(P < 0.05). 90% of the pediatricians were strongly willing to jected to a pH cycling regimen for 21 days. QLF images were
inquire about bottle usage, tooth brushing and referral to dentist taken before and after treatment and were analysed. Data analy-
during children’s visits. Pediatricians with higher knowledge score sis was carried out using one way ANOVA.
were significantly more willing to carry out oral health-related Results: In all groups, both DF and DQ values improved signifi-
practices. cantly within the same group after the treatment. In addition,
Conclusion: Although the majority of pediatricians reported will- the mean difference in DF of 0 ppm FTP was significantly
ingness to include preventive interventions in children’s visits, a lower than the mean difference in DF of 1450 ppm FTP,
lack of dental knowledge and confidence appear to pose barriers. 1450 ppm FTP + TM and 1450 ppm FTP + MIplus but not
2800 ppm FTP. Also, the mean difference in DQ of 0 ppm
FTP was significantly lower when compared with all other
PR01.16 groups (P < 0.05).
The effect of matrix metalloproteinases (MMPs) Conclusions: The use of TM and MIplus in conjunction with
inhibitor on caries progression in rats 1450 ppm FTP showed some increased efficacy in the reminerali-
D. YANG1, J. XUN2, C. MIAO2, J. LI2 & L. GE2 sation of enamel subsurface lesions; however this did not reach a
1 significant level.
Department of Pediatric Dentistry, Capital Medical University
School of Stomatology, Beijing, China; 2Capital Medical
University School of Stomatology, Beijing, China PR01.18
Background: The process of caries involves demineralization and Children0 s access to oral health care in Nigeria: the
degradation of organic matrix. Studies revealed that matrix me- role of paediatricians
talloproteinases(MMPs) may cause the degradation of organic O. O. ORENUGA1,2, O. O. SOFOLA3,4, E. N. EKURE5,6 & C. I.
matrix in caries. ESEZOBOR5,6
Aim: Observe the effect of MMPs inhibitor on caries progression 1
Child Dental Health, University of Lagos, Lagos, Nigeria; 2Child
in rats. Dental Health, Lagos University Teaching Hospital, Lagos,
Design: Sixty-five SD rats were divided into three groups. Experi- Nigeria; 3Preventive Dentistry, University of Lagos, Lagos,
mental group (CMT-3G, 25 rats) was inoculated with Streptococ- Nigeria; 4Preventive Dentistry, Lagos University Teaching
cus mutans, fed with keys 2000 and applied MMPs inhibitor Hospital, Lagos, Nigeria; 5Paediatrics, University of Lagos,
CMT-3 on surface of mandibular molars. Positive control group Lagos, Nigeria; 6Paediatrics, Lagos University Teaching Hospital,
(C Group, 25 rats) were inoculated with Streptococcus mutans Lagos, Nigeria
and fed with keys 2000. Blank control group (BG, 15 rats) were
fed with standard rats diet. Rats were put to death after Background: Access to professional oral health care in Nigeria as
10 weeks. Caries decay and Keyes score of mandibular molars of in most underserved populations in developing countries is poor.
each rat was detected and calculated . This may be attributed to various reasons:low professional man-
Results: No caries was detected in BG. Incidence of caries were power and inequitable distribution of oral health facilities.
75.0% and 83.3%, while incidence of dentine caries were 33.3% Aim: Assessment of the knowledge and practices of paediatricians
and 70.8% in CMT-3G and CG respectively. There no significant regarding oral health screening and counselling and to determine
their willingness to incorporate preventive oral health care in excessively demineralize tooth structure while exhibiting excellent
their routine well child visit. bonding durability. The combined use of the novel conditioner
Design: Cross sectional self-administered questionnaire survey of and the standard BeautiSealant method was expected to stabilize
doctors attending an annual paediatric conference in Nigeria was bonding ability.
conducted to assess their knowledge of dental caries and gingivi-
tis as well as their current experiences with oral diseases in their PR01.20
practice. The questionnaire also assessed their current practice of
and willingness to include oral disease screening in their consulta- Motivational interview, a useful strategy in preventive
tion. dentistry when used with mapuche paediatric patients
Results: One hundred and sixteen questionnaires were distributed, P. JUNOD
71 responded (61.2% response rate). Respondents were spread Universidad Mayor, Temuco, Chile
through 19 of 36 states in Nigeria giving coverage of 52.8%.
Introduction: Prevention is key in paediatric dentistry, but it often
More than half (56.6%) reported seeing dental complaints at
becomes a small complement of the clinical treatment and a
least once a month in their practice. Forty-seven (66.2%) cur-
peace-of-mind exercise for the practitioner. One of the reasons
rently carry out ‘well child care’ however this does not involve
for this is the difficulty for changing the lifestyle of the patients,
anticipatory guidance and counselling on oral health. Nearly all
since many of the good habits on oral health promoted by the
respondents were willing to screen for oral diseases but a busy
dentist implicate changing routines at home. To reduce the caries
practice and lack of knowledge of what to look for were identi-
risk, the practitioner needs to communicate/interact with the
fied as obstacles. A short rotation in child oral health would also
patient with the objective of encouraging the patient to engage in
be beneficial.
self-care behaviours. Motivational Interviewing (MI) is an indi-
Conclusion: Paediatricians in Nigeria have a huge potential to
vidual-centred counselling method that uses an empathic, collab-
improve preventive oral health of Nigerian children with a reori-
orative style to build on patients’ own reasons for change.
entation of their services if properly harnessed.
Case reports: Five patients aged 5–9 from mapuche ethnicity
attending the clinics of Universidad Mayor in Temuco, Chile,
PR01.19 were chosen to be interviewed by a trained 5th year student using
Bonding ability of novel pit and fissure sealant system MI concepts. Four principles of the MI technique were preserved
containing S-PRG filler during the first two visits, before the beginning of the clinical
K. SHINNO1, T. NAKATSUKA1, A. NAGAFUJI1, S. treatment:
1) expression of empathy,
TATEISHI1, A. YAMADA2 & S. FUKUMOTO2
1 2) facilitation of the individual’s formulation of arguments
SHOFU INC.R&D, Kyoto, Japan; 2Division of Pediatric
for changing
Dentistry, Department of Oral Health and Development Sciences,
Tohoku University Graduate School of Dentistry, Sendai, Japan 3) progressing through the resistance and
4) supporting self-efficacy.
Background: Fissure sealant has been widely used as an effective Compliance with dental treatment, reduction of plaque indexes,
method to prevent occlusal surface caries in primary and imma- reported satisfaction and reported change in high-caries-risk hab-
ture permanent teeth. However, pretreatment with phosphoric its were improved when compared to similar patients undergoing
acid etchant demineralizes sound enamel, which becomes suscep- normal protocol interviewing. Two of the five patients did not
tible to caries. attend to the first clinical control.
Aim: This study aimed to evaluate bonding ability to enamel Comments: MI technique can be used by dentists, improving the
using a novel S-PRG filler containing pit&fissure sealant system risk factors associated with lifestyle and, as in these cases, con-
combined with a novel non-phosphoric acid conditioner, com- tribute to a better practitioner/patient understanding.
pared to a phosphoric acid etchant.
Design: Materials used were a novel conditioner, a 33%phospho- PR01.21
ric acid etchant, and a novel sealant system (BeautiSealant) con-
sisting of self-etching primer and ion-releasing S-PRG filler Effect of short-term probiotic yogurt consumption on
containing sealant. Bovine enamel surfaces polished with 600-grit caries risk factors in infants
paper were treated with E. EDEN1, A. TOPALOGLU-AK1, E. ERGIN1, F. OZGENC2 &
1) Primer, G. AKSU2
1
2) Conditioner, Ege University School of Dentistry, Izmir, Turkey; 2Department
3) Etchant, or of Pediatric Gastroenterology, Ege University, Izmir, Turkey
4) Conditioner+primer.
Background: Probiotics provide several advantages to both gen-
A mold (diameter: 4 mm) was fitted onto each treated surface,
eral and oral health.
filled with sealant, and light-cured to obtain specimens. After
Aim: To evaluate the effect of short-term probiotic yogurt con-
2000 thermal cycles (5°C/60°C), specimens were subjected to
sumption on buffering capacity and Streptococcus mutans, Lac-
shear bond strength (Initial SBS = i, Durable SBS = d) testing.
tobacilli, secretory IgA levels of saliva in 6–8 months old infants.
The data were analysed using ANOVA, Tukey test (P < 0.05).
Design: Twenty healthy 6–8 month old infants and their mothers
Results: Self-etching method ((1) primer-treatment i: 17.7 MPa,
were enrolled in the study. They were randomly allocated into
d: 18.6 MPa) showed higher SBS than Total-etching method ((2)
two groups as study and control. In the study group, probiotic
conditioner-treatment i: 12.8 MPa, d: 12.0 MPa (3) etchant-treat-
yoghurt (Bifidobacterium Longum BB536, Bifidobacterium Bifi-
ment i: 16.7 MPa, d: 14.9 MPa). (3) Etchant-treatment showed
dum Bb12, Lactobacillus RhamnosusHN001) was given to
higher SBS than (2) Conditioner-treatment. However, (2) condi-
infants as morning snack for 3 weeks whereas in the control
tioner-treatment showed little SBS decrease after thermal-cycling,
group home made yoghurt was consumed.
suggesting good bonding durability. (4) Combined method (i:
Saliva samples were collected by the help of sterile cotton rolls at
20.1 MPa, d: 23.6 MPa) using (2) Conditioner followed by (1)
baseline and at the end of 3 weeks.
Primer exhibited the highest increase in SBS.
A dental saliva pH-Indicator strip (GC, Japan) was used for sali-
Conclusions: Unlike the conventional surface treatment with
vary pH measurements. CRT Buffer (Ivoclar, Vivadent) strips
phosphoric acid etchant, the method using conditioner did not
were used for obtaining buffering capacity of saliva. CRT Bacte- Design: In this study, a total of 166 children (89 boys,77 girls)
ria (Ivoclar-Vivadent) kit was used for bacteriological examina- with sound mandibular first permanent molars, aged 9–12 years,
tion. Enzyme-Linked Immuno-Sorbent Assay (ELISA) (IBL were selected and divided into three groups. In Group-1 (52 chil-
International GMBH, Hamburg, Germany) was used for the dren), either ClinproTMSealant or Teethmate F-1 were applied
measurement of salivary secretory IgA. Scores at baseline and randomly to 104 first permanent molars. In Group-2 (56 chil-
3 weeks after were statistically evaluated by Wilcoxon test. dren), ClinproTMSealant was applied to 122 teeth with or without
Results: Salivary pH, Ig A, Streptococcus mutans and lactobacilli ozone therapy. In Group-3 (58 children), Teethmate F-1 was
values showed no significant change after 3 weeks of probiotic applied to 116 first permanent molars with or without ozone
yogurt consumption however there was a statistically significant therapy. The children were recalled for clinical examinations at 3,
increase in the buffering capacity of saliva (P = 0.04). 6, 12 and 18 month. USPHS criteria were used for follow up
Conclusion: Within the limitations of this study, improvement in examinations. Statistical analysis was performed by using Chi-
buffering capacity is worth gaining attention and the role of pro- square and Fisher’s exact tests.
biotic consumption on oral health will be of interest for future Results: In Group-1, there was a significant difference between
research. ClinproTMSealant with 82.7% success and Teethmate F-1 show-
ing 63.4% success at the end of18-month follow-up (P < 0.05).
PR01.22 In group-2 and group-3, although there was no significant differ-
ence (P > 0.05), general success was higher in the ozone sub-
Can a pacifier act as a reservoir for bacterial groups (Group-2: 83.9%, Group-3: 70.7%).
contamination of teeth in young children? A pilot Conclusions: The results of this study indicated that Clin-
study proTMSealant0 s clinical success rate was higher compared to
D. STERCKX1, D. DECLERCK1 & W. TEUGHELS2 Teethmate F-1, on the other hand it was observed that ozone
1 therapy did not show a statistically significant difference
Unit of Pediatric Dentistry and Special Dental Care, Department
of Oral Health Sciences and Department of Dentistry, KU Leuven, (P < 0.05).
Leuven, Belgium; 2Periodontology, Department of Oral Health
Sciences and Department of Dentistry, KU Leuven, Leuven, PR01.24
Belgium
The survey on deciduous dental caries for young
Introduction: Extent and type of bacterial colonization of primary children in Nanjing
teeth are important factors associated with caries experience in J. WU1 & W. ZHU2
young children. The work presented here aimed to evaluate 1
Department of Oral Health Care, Affiliated Maternity and Child
microbial load and composition on a pacifier used by a young Health Hospital, Nanjing Medical University, Nanjing, China;
child and to compare this with that retrieved in different oral 2
Department of Pediatric & Preventive Dentistry, Nanjing Yuhua
niches in both child and parent. Dental Hospital, Nanjing, China
Case reports: In a 3-year old boy attending the pediatric dental
clinic of the University Hospitals Leuven, microbial samples were Background: Deciduous dental caries not only affected children0 s
taken from both outer and inner surface (after cutting with sterile oral health but also detrimental to the systemic health. Recent
bistouri) of his pacifier. In addition, samples were taken from sal- years pediatric dental patients in the hospital increased more and
iva, plaque and tongue coating using standardized procedures in more.
both the child and his parent. Samples were plated on blood agar Aim: The purpose of this report was to obtain data about the
(aerobic and anaerobic conditions), TYCSB (S. mutans, SM) and prevalence of deciduous dental caries of young children in Nanj-
Rogosa agar (lactobacilli, LB). ing city.
Results: The outer surface of the pacifier was colonized by aero- Design: According to the criteria by WHO’s ‘Oral Health Surveys
bic and anaerobic species (5.96E+03 and 6.56E+03) and SM Basic Methods’, 4th. A sample of 612 young children 3 and 5-
(1.24E+03). A similar pattern was seen at the inner surface, but years-old who were from eight kindergartens in Nanjing, China,
with lower counts (3.20E+02, 3.20E+02 and 2.00E+01). The sal- which were sampled with a stratified cluster sampling procedure
iva, plaque and tongue showed high numbers of bacteria, with and divided to four equal groups by the gender and the age.
massive counts of SM in plaque. The parent showed a compara- Between the prevalence of different gender groups used by
ble picture but with lower SM counts in plaque (3.62E+04). Chi-square and dmft, dmfs score by T-test with SPSS 11.5 for
Comment: Analyses presented here demonstrate the presence of a windows.
considerable microbial load on the pacifier, reflecting the micro- Results: The trends of deciduous teeth caries increased signifi-
bial composition in other oral niches. The fact that bacteria were cantly with the growing of age, at the age of 3 and 5-year groups
also present on the inner surface might indicate that the pacifier were 33.33% in girls, 30.72% in boys and 66.45% in girls,
can act as a reservoir for continuous (re)contamination possibly 68.42% in boys respectively. The mean number score of dmft, at
withstanding standard hygiene protocols. the age of 3 and 5-years-old groups were 1.46 2.52 in girls,
1.18 2.11 in boys and 3.03 5.70 in girls, 2.84 5.18 in boys
respectively. When compared between boys and girls, the preva-
PR01.23 lence of deciduous dental caries and the mean number score of
The effects of ozone therapy on clinical success of dmft in each group, there were no significant differences
fissure sealant application P > 0.05.
F. KÜÇÜK, M. C
ß ETINKAYA & F. TULGAOZ € Conclusions: The survey data show that should arouse dentists,
Paediatric Dentistry, Ankara University, Ankara, Turkey parents of children more attention, therefore it is very necessary
that early detect deciduous dental caries and take effective
Background: Ozone therapy can be used due to its oxidative and measures of preventive and treatments.
antimicrobial effect in fissure sealant applications in pediatric
dentistry.
Aim: The aim of this study was to evaluate the effects of ozone
therapy on clinical success of ClinproTMSealant and Teethmate
F-1 fissure sealants.
PR01.25 but unaware of the long term oral health risks of consuming
these beverages.
The rate of retention of fissure sealants in the
paediatric dentistry clinic
H. M. ALHASHMI & M. ALHALABI PR01.27
Paediatric Dentistry, Dubai College of Dental Medicine, Dubai, Mother’s knowledge about early childhood caries in
United Arab Emirates Chilean children from low socioeconomic status
Background: Pits and fissures are generally recognized as highly R. R. SEPÚLVEDA1, S. L. ECHEVERRIA1, E. D.
HENRIQUEZ1, M. E. RIOS2 & C. D. PENA ~ 1
susceptible for caries and least likely to benefit from systemic or 1
topical fluoride. Fissure sealant (FS) is a material that is placed Paediatric Dentistry, University of Chile, Santiago, Chile; 2Public
in the pits and fissures and early (non-cavitated) carious lesions Health, University of Chile, Santiago, Chile
of teeth in order to prevent or arrest the development of dental Background: Early childhood caries (ECC) is a major public
caries by providing a physical barrier that inhibits microorgan- health problem, being the most common chronic infectious child-
isms and food particles from collecting in pits and fissures. Indi- hood disease. It is difficult to control due to the complex interac-
cations for the placement of FS are documented in the literature. tion of many risk factors (behavioral, biological and social)
Aim: The aim of this audit was to identify the rate of sealant associated with their onset and progression. Oral Health Educa-
retention in the paediatric dentistry clinic in an effort to improve tion (OHE) is one of the most important strategies to prevent
the quality of preventive and therapeutic oral health care pro- and control the Early Childhood Caries. Parents are the primary
vided in the clinic. educators in the early years of life. Therefore, it is necessary to
Design: Random retrospective case note study for sealants placed measure their knowledge about this topic and recognize strengths
in the clinic for a period of 6 months or longer using the elec- and weaknesses.
tronic patient file. The results were analysed using Simple Aim: To assess the mother0 s knowledge about ECC in a popula-
descriptive statistic. tion of Chilean children of low-income status in Santiago, Chile.
Results: In the 49 teeth selected: 93.4% of the FS were retained, Design: A Descriptive study was conducted. The sample consisted
96% of the FS were performed in the clinic, 98% of the FS were of 114 mothers from preschool children that answered a self-
performed under isolation of cotton rolls and 6.6% of the FS administered questionnaire that inquire about primary risk fac-
were partially or totally lost. The patients with partially or totally tors, eating habits, oral hygiene and visits to the dentist by yes or
lost FS were not regular clinic attendees. not answers and results were expressed in frequency. Data were
Conclusions: The findings from the audit highlighted the high analyzed using Chi square test.
quality standards of practice in the paediatric clinic. A second Results: Mean average knowledge for all dimensions was 63.7%.
cycle of the audit will be conducted with new residents to assure More positive answers were obtained in eating habits and dentist
maintenance of these standards. visits. Knowledge related to hygienic habits and primary risk fac-
tors were insufficient. Mother0 s knowledge was related to their
PR01.26 access to OHE and not to age or educational level.
Conclusions: For our study population, the global knowledge
Assessment of acidic beverages consumption habits in
about ECC is sufficient, but far from optimal. The results
sports children strengthen the fact that mother0 s access to Oral Health Education
U. BHUSHAN & M. GOSWAMI is of high relevance for the children0 s oral health.
Pedodontics and Preventive Dentistry, Maulana Azad Insitute of
Dental Sciences, Delhi, India
PR01.28
Background: In recent times the popularity and ease of availabil- The effect of computer-based intervention programme
ity of sports and other soft drinks among young children has
raised many questions over their health impact. There is limited
on adolescents
data on their consumption and effect on oral health in India. A. TORATTI1, M. L. LAITALA1, A. KEMPPAINEN1, P.
Aim: To assess consumption pattern of sports drinks, sugar PESONEN2 & V. ANTTONEN1,3
1
sweetened beverages and aerated soft drinks and assess the preva- Department of Paedodontics, Institute of Dentistry, University of
lence of dental erosion among sports children in New Delhi, Oulu, Oulu, Finland; 2Medical Research Center Oulu, Oulu,
India. Finland; 3Oulu University Hospital, Oulu, Finland
Design: A cross-sectional study was carried out to assess the Background: Effect of different types of interventions on oral
prevalence of sports drinks and soft drinks consumption habits health has been studied in the past. Hardly any studies have
among children playing organized sports in New Delhi. This investigated the effect of computer-based feedback systems on
study included 300 children aged 6–18 years attending various person’s oral health behaviour.
sports training programs in New Delhi. A close-ended structured Aim: The main aim of this study was to investigate how com-
questionnaire was exclusively developed to evaluate consumption puter-based feedback affected oral health behaviour of adoles-
patterns of sports drinks and soft drinks and attitude among cents. Another aim was to question the opinion of adolescents on
young athletes with intraoral examination. this type of feedback. Additionally, sources of oral health infor-
Results: Prevalence of dental erosion was high among children mation for secondary school pupils were analysed.
who consumed sports drinks and soft drinks and was statistically Design: A total of 66 pupils in two secondary schools in Oulu,
significant (P < 0.05). Significant number of children involved in Finland responded a computer-based questionnaire regarding
sports thought that sports drinks are good for oral health, and their oral health behaviours, sources of health information and
also, consumed it at least once a day. opinion on the programme. According to their responses, the
Conclusions: The findings from the present study highlight that programme gave pupils feed-back or advice towards better oral
knowledge about sports drinks is inadequate, emphasizing urgent health. The same questionnaire was repeated 4 weeks later. The
need for preventive and promotive programs for children, coa- pupils were then, additionally, asked to evaluate the effect of the
ches and parents in New Delhi, India. Acidic sports and soft programme on health behaviours.
drinks can cause dental erosion and young athletes are prone,
Results: The pupils found this kind of oral health promotion indicated by LF value >10 in their second molars. At baseline, all
both useful (51%) and easy-to-use (79%). They gained new infor- participants got individual instructions concerning targeted tooth
mation on all issues, especially the harmful effects of beverages brushing of their second molars and were randomly provided
on dentition (21% of all pupils). Boys received oral health infor- tooth paste containing 0 or 1500 ppm fluoride. After 1 month’s
mation from their parents (86% vs girls 72%), whereas girls intervention period, remineralisation was evaluated by the change
learnt most from magazines (63% vs 38%) and friends (37% vs in LF values. The change in LF values was compared between
18%). Internet was a common source for both genders (about 1/ non-fluoride and fluoride groups, considering i.e. the tooth
3). After 1 month 22% reported improvement in the quality of (upper/lower; left/right), brushing frequency and depth of the
meals, and 15% decrease in snacking. lesion at baseline (LF 11-20/21-30/>30). For statistical analyses,
Conclusions: Computer-based oral health promotion is modern chi-square test and t-test were used.
and useful way of delivering information for adolescents. Results: There was no significant difference in remineralisation
between non-fluoride and fluoride groups. In both groups, LF val-
PR01.29 ues decreased in upper molars, the decrease being most distinct in
the upper right molars in lesions with LF values 11–20 at baseline.
The effectiveness of fissure sealing permanent molars Conclusions: Surprisingly, targeted tooth brushing of newly
of 8 year old children erupted molars seems to be effective in remineralisation of initial
L. LIKAR OSTRC, L. HOCEVAR, T. LEBAN & A. PAVLIC caries lesions even without fluoride. This effect can be detected
Department of Paediatric and Preventive Dentistry, Faculty of using LF.
Medicine, University of Ljubljana, Ljubljana, Slovenia
Background: Occlusal caries represents a significant proportion of PR01.31
all caries. Re-mineralising effect of CPP-ACP (Recaldent) and
Aim of the study was to determine the morbidity of caries in 8- b-tricalcium phosphate varnishes on dental enamel
year-old children, the proportion of children with at least one
Y. MARTÍNEZ1, C. MARTINEZ1, P. GATON 2, C. SERNA1, A.
FPM sealed, and to compare morbidity of caries in a group with VICENTE1 & A. ORTIZ1
at least one FPM sealed and a group without sealed FPM. 1
University of Murcia, Murcia, Spain; 2University of Barcelona,
Design: Dentitions of 478 children, aged 8 years, were examined
Barcelona, Spain
according to ICDAS recommendation and results converted to
DMFT. Background: The Minimally Invasive Dentistry development has
Results: Of all children 325 (67.99%) had caries-free permanent fostered remineralizing treatments of demineralised enamel.
teeth (DMFT = 0) and 67 (14.02%) caries-free deciduous teeth Development of remineralizing agents based on casein phospho-
(dmft = 0). The mean DMFT and dmft were 0.64 and 4.45, peptide-amorphous calcium phosphate (CPP-ACP), b-Tricalcium
respectively. 378 children (79.08%) had at least one sealed FPM. Phosphate in combination with sodium fluoride have been shown
The mean number of sealed FPM were 2.52 and 3.19 of all chil- effective in the enamel remineralization and can be used both as
dren and in the group with sealed FPM, respectively. Of all 1906 enamel defects and incipient carious lesions (white spots).
FPM there were 1207 (63.33%) sealed, 99 (5.19%) decayed Aim: The aim of this study is to compare the remineralizing
unsealed, 189 (9.92%) filled unsealed and 411 (21.56%) healthy capacity of two varnishes composed of casein phosphopeptide-
unsealed. In the group of children with sealed and in the group amorphous calcium phosphate (CPP-ACP) (Recaldent 1–5%)
with unsealed FPM number of children with DMFT = 0 were and b-TCP both combined with 900 ppm of sodium.
268 (70.9%) and 58 children (58.59%), respectively. In these two Design: A total of 28 bovine lower incisors were used. The basal
groups in the same order the mean DMFT were 0.48 and 1.27. level of enamel mineralization, demineralization produced by an
Conclusions: FPM are most caries-susceptible teeth in the young acid solution, and remineralization at 14 and 28 days was deter-
permanent dentition (Skeie et al., 2006). Fissure sealing effec- mined, after a single treatment with MI VarnishÒ (Recaldent)
tively prevents the development of fissure caries (Ahovuo-Salo- and ClinproTM White Varnish (b-TCP). To measure (% weight)
ranta et al., 2008). In the study, a higher DMFT was estimated SEM-EDX was used.
in 8 year olds with unsealed FPM comparing to their peers with Results: The results of EDX analysis no showed significant differ-
sealed FPM. ences in the elements Ca, F, P, with the different varnishes. For
Calcium and Phosphorous concentrations, the highest values (%
PR01.30 weight) were found for MI Varnish at 28th day.
Conclusions: In both study groups, the varnishes remained on the
Influence of targeted tooth brushing on enamel surface hindering mineral content measurement after
remineralisation of initial caries lesions in newly 28 days of study, but with no statistical significant differences
erupted second molars between the groups. The use of a varnish comprising Recaldent mol-
M. L. LAITALA1, E. JAANTI1, H. VAH € ANIKKIL
€ € 1, T.
A ecule and with 900 ppm sodium fluoride, allows a highest increase
MA € ATT
€ A € 1 & V. ANTTONEN1,2 in the concentration by weight of calcium and phosphorus after
1 28 days of employment, with no statistical significant differences.
Department of Paedodontics, Institute of Dentistry, University of
Oulu, Oulu, Finland; 2Medical Research Center, University
Hospital and University of Oulu, Oulu, Finland PR01.32
Background: Targeted brushing of erupting teeth has been shown Effect of fluoride varnishes on surface microhardness
to effectively decrease the occurrence of dental caries. Remineral- of enamel – an in-vitro study
isation of initial caries lesions after regular use of fluoride tooth G. BABU KADAKAGERE LAKSHMANA, T. SANGEETA & P.
paste is detected by laser fluorescence (LF) even in weeks. SUBRAMANIAM
Aim: This study aimed to investigate the effect of targeted tooth Department of Pedodontics and Preventive Dentistry, The Oxford
brushing with fluoride or non-fluoride tooth paste on reminerali- Dental College and Hospital, Bangalore, India
sation of initial caries lesions in newly erupted second molars.
Design: The study group comprised 13–14-year-old school-chil- Background: The ease of application of fluoride varnishes has led
dren (n = 51) who at baseline had at least one initial caries lesion to its popularity in pediatric dentistry. Precipitation and hyper-
saturation of fluoride ions into hydroxyapatite crystals restores PR01.34

the lattice structure of superficial layer of enamel and increases
The relationship between mothers’ attitudes to diet
its surface microhardness (SMH).
Aim: To evaluate and compare the SMH of enamel following and oral hygiene and caries risk in infants
application of three commercially available fluoride varnishes. M. BARTOSOVA1,2, M. SVETLAK3, M. KUKLETOVA1 & L.
Design: One hundred and twenty premolar teeth indicated for IZAKOVICOVA HOLLA1,4
1
orthodontic extraction were collected and divided into four St. Anne’s Faculty Hospital and Faculty of Medicine, Clinic of
groups, group A, B, C and D, consisting of 30 teeth each. For Stomatology, Masaryk University, Brno, Czech Republic;
2
evaluating surface microhardness, samples of group A, B and C Research Centre for Toxic Compounds in the Environment
were coated with MI varnishÒ, FluorprotectorÒ and BiflouridÒ, (RECETOX), Chemistry Section, Masaryk University, Faculty of
respectively. Samples of group D formed the control group. Fol- Science, Brno, Czech Republic; 3Department of Psychology and
lowing application of varnish, these samples were subjected to a Psychosomatics, Faculty of Medicine, Masaryk University, Brno,
demineralization-remineralization cycle for 7 days. The surface Czech Republic; 4Department of Pathophysiology, Faculty of
microhardness of all the samples were assessed using surface mi- Medicine, Masaryk University, Brno, Czech Republic
crohardness tester machine. Data obtained was subjected to sta- Background: Early childhood caries prevalence in the Czech
tistical analysis using one way ANOVA and Tukey multiple post Republic is reported to be about 20%.
hoc test. Aim: The aim of the study was to associate mothers’ attitudes to
Results: The mean SMH of Group A, B and C were found to be diet, oral hygiene, possible transfer of microbes and knowledge
488.68 5.54 KHN, 487.84 6.16 KHN and 449.47 7.37 of caries preventive measures in relation to early childhood car-
KHN, respectively. All the three study groups showed a signifi- ies.
cant increase in SMH as compared to that of the control group Design: A total of 127 pairs of mother/child were invited to par-
(P ≤ 0.05). SMH of group A and group B were significantly ticipate in the study. After filling in the questionnaire, 94 children
higher than that of group C (P ≤ 0.05). (mean age 11.15 months, SD = 2.724) were orally examined and
Conclusion: MI varnishÒ was as effective as FluorprotectorÒ in their dental status (dmft) was recorded. Saliva and dental plaque
increasing surface microhardness of enamel. samples were taken both from children and their mothers and
assessed for the presence of mutans streptococci (DentocultÒ SM
PR01.33 Strip mutans). SPSS Statistics 21, IBM Corporation, 2011 was
The prevalence of S-ECC and related factors in 3- used.
Results: The analysis of questionnaire responses showed that
year old children in middle of Taiwan sugar intake was not a risk factor for the development of dental
H. H. CHIANG1, K. T. SUN2, Y. H. HSUEH1, C. J. HUNG1 & caries in most of the infants involved in this study (77.2% of
Y. C. CHANG1 mothers did not sweeten beverages). A more significant risk fac-
1
China Medical University Hospital, Taichung, Taiwan; 2Pediatric tor was the absence of oral hygiene (21% of mothers did not
Dentistry, China Medical University Hospital, Taichung, Taiwan clean infants’ teeth) and bacterial transmission from mother’s
Background: The prevalence of severe early childhood caries (S- mouth to infants. Our results demonstrated a significant relation-
ECC) was 80% for Taiwanese children in 1997. S-ECC could ship between the presence of microbes in mothers and children
induce many problems including infection, pain, esthetics, unbal- (P < 0.05). In addition, children with higher amounts of microbes
anced nutrition, and bad life quality. Oral health policy were showed higher dmft index. Decayed teeth in 1-year-old infants
implemented to reduce the high prevalence of S-ECC. However, were identified in 2.4%.
the prevalence of S-ECC was very high in Taiwan. Conclusions: Mothers’ attitudes towards dietary habits were gen-
Aim: This study was to investigate the prevalence of S-ECC and erally at a high level in our cohort, nevertheless, more profound
related factors in middle of Taiwan. education focused on further caries preventive measures is recom-
Design: A total of 836 children, 3-year-old children and under mended.
were examined in our department of Pediatric Dentistry from
June to December in 2014. The caries numbers of primary denti- PR01.35
tion was recorded. Fluoride application and oral health instruc-
A new toothpaste effectiveness at reducing gingival
tion were performed. Questionnaires were delivered to mothers
of the children with S-ECC and caries-free children. The ques- inflammation and preventing gingival bleeding: a
tions were related to the children0 s dietary habits, oral hygiene, double blind randomized controlled clinical trial
and the use of fluoride toothpaste. D. NEGOVETIC VRANIC1, M. MAJSTOROVIC1 & T.
Results: The prevalence of S-ECC is 53%, and is higher than KATANEC2
1
other countries. The most common factor is bottle feeding with- Department of Paediatric Dentistry, School of Dental Medicine,
out cleaning before and during sleep. The second is insufficient University of Zagreb, Zagreb, Croatia; 2Community Dental
cleaning. The third is incorrect cleaning method, many parents Centar, Zagreb, Croatia
didn’t use toothbrush. The fourth is lack of regular check up,
Objective: A combined effect of a new toothpaste containing
most of parents bring their children to visit dentist until the den-
active ingredients potassium nitrate (5.00%) and zinc citrate
tal caries have existed. The fifth is insufficient fluoride supple-
(0.50%) was tested among a randomly selected group of 80 par-
ment, many children didn’t use fluoride dentifrice until 3 years
ticipants who attended the dental clinic of the School of Dental
old.
Medicine in Zagreb (Croatia).
Conclusions: S-ECC could induce many problems and waste
Materials and methods: Participants were aged 16–55 years and
resources, and it could be effectively prevent by correct eating
equally divided by genders. Inclusion criteria were: hypersensitiv-
habit, fluoride, correct cleaning method, and regular check up.
ity to thermal, chemical and mechanical stimulations due to accu-
mulated plaque and gingival retraction. The toothpaste had
previously been clinically tested and had been produced accord-
ing to ISO 9001/14001 integrated quality normatives. Soft tooth-
brushes were used and provided by the same supplier. Plaque
index (Aproximal Silness & L€ oe Index) and gingival bleeding PR01.37

(Probing Bleeding Index after Saxer & Muhlemann) were clini-
Habit changes in infants under four years of age,
cally evaluated at the initial visit and again at 2 and 4 week
check-up intervals. with systemic pathology attending the oral health
Statistical analysis: Data was analyzed by using analysis of vari- program at Luis Calvo Mackenna Hospital
ance (ANOVA), t-test and the Mann-Whitney U test. (HLCM), Chile
Results: Plaque index significantly decreased among participants M. A. LIPARI1,2,3, G. DE LA FUENTE1, A. VERA2, A.
who used the toothpaste with active ingredients potassium nitrate MUNOZ~ 1
& G. SILVANA1
and zinc citrate (15.4%) vs participants who used the toothpaste 1
Facultad Odontologıa Universidad de Chile, Santiago, Chile;
2
without active ingredients (5.8%). Gingival bleeding significantly Hospital Luis Calvo Mackenna, Santiago, Chile; 3Sociedad
reduced among participants who used the toothpaste with active Chilena de Odontopediatria, Santiago, Chile
ingredients potassium nitrate and zinc citrate (10.9%) vs partici-
pants who used the toothpaste without active ingredients (2.5%). Introduction: The importance of optimal oral health in infants
Conclusion: This 4-week clinical trial sustains a combined effect with systemic pathologies is well recognized. Evidence shows pro-
of active ingredients potassium nitrate and zinc citrate contained fessional preventive measures are effective at reducing oral
in the new toothpaste on reducing gingival bledding and inflam- pathologies. The Oral Health Program accomplished in 2–4 visits
mation due to accumulated plaque and can be recommended in to the specialist, includes providing anticipatory guidance regard-
preventing periodontal diseases. ing dental and oral development, healthy oral habits, and oral
preventive measures.
Aim: To describe the habit changes in infants <4 years presenting
PR01.36 systemic pathologies and who are attending the Oral Health Pro-
The effect of different fluoridated toothpastes and gram at HLCM.
fresh orange juice on enamel surface microhardness Methods: In a descriptive cross sectional study, medical records
in vitro of 195 patients, cared by professors and students from the Spe-
cialization Program of Pediatric Dentistry, University of Chile,
S. SELVI-KUVVETLI1, S. KAVALOGLU CILDIR2, N.
registered between 2011 and 2014, were analyzed assessing
SANDALLI1, M. BAS2 & A. AYKOR3
1 changes in oral hygiene, nutritive and nonnutritive habits.
Department of Pediatric Dentistry, Yeditepe University, Faculty
Results: At baseline, 50% of patients who presented poor hygiene
of Dentistry, Istanbul, Turkey; 2Private Paediatric Dental Clinic,
_ habits, showed a significant decrease to a 24% (P = 0.00001). In
Istanbul, Turkey; 3Department of Operative Dentistry, Okan
relation to infants using bottle feeding, its use showed a signifi-
University, Faculty of Dentistry, Istanbul, Turkey
cant decrease from an 80% to a 53% (P = 0.00001). On the
Aim: The aim of this study was to compare the rehardening other hand, pacifier sucking showed an only 6% reduction, which
effect of three different fluoridated toothpastes on bovine enamel is statistically non-significant (P = 0.9496).
softened with fresh orange juice. Conclusions: A Preventive Oral Health Program produces sub-
Design: The crowns of 16 bovine incisors were cut longitudinally stantial improvements in hygiene changes and nutritive habits,
and embedded in acrylic resin blocks. 32 enamel specimens were but not in pacifier sucking use. Therefore, it is necessary to con-
softened via immersing in fresh orange juice for 15 min. The tinue working on preventive programs, in order to pay special
specimens were divided into four groups and brushing was per- attention to infants’ oral care, particularly those with systemic
formed using ColgateÒ Maximum Protection Caries (Group A), diseases.
Crest Pro-Health (Group B), Sonsodyne Pronamel (Group C)
and untreated samples served as control group (Group D). The PR01.38
toothpastes were applied via brushing the samples at 0, 8, 24 and
32 h. The Vickers surface microhardness measurements were per- Early childhood caries: protective and determinant
formed at baseline, after immersion in orange juice and 48 h factors correlated with disease manifestation in
after the rehardening procedures. Friedman, Kruskal Wallis and children up to 4 years old
Dunn’s Multiple Comparison tests were used for the statistical L. V. F. M. LEMOS1,2, M. A. REGO1, A. C. C. ZUANON3, S. I.
analysis. MYAKI2 & L. R. F. WALTER4
Results: Enamel surface microhardness was decreased signifi- 1
Paediatric Dentistry Department, Universidade do Vale do
cantly after immersion in fresh orange juice. The three different Paraıba – UNIVAP, School of Dentistry, S~ ao Jos
e dos Campos,
toothpastes significantly increased the hardness of softened Brazil; 2Department of Social Dentistry and Paediatric Dentistry,
enamel compared to the control group (P < 0.05) and there was Universidade Estadual Paulista – UNESP, School of Dentistry,
no statistically significant difference between the groups S~ e dos Campos, Brazil; 3Department of Paediatric Dentistry
ao Jos
(P > 0.05). and Orthodontics, Universidade Estadual Paulista – UNESP,
Conclusion: Although the microhardness values after rehardening School of Dentistry, Araraquara, Brazil; 4Department of
could not reach the baseline values in all groups, three different Paediatric Dentistry, Universidade Estadual de Londrina – UEL,
fluoridated toothpastes significantly increased the microhardness School of Dentistry, Londrina, Brazil
of enamel in vitro.
Background: There are few studies in the literature about behav-
ioral aspects of early childhood caries.
Aim: The aim of this study is to correlate and evaluate the dental
caries experience (0–48 months), behavioral and clinical aspects
of dental care, who attended a preventive government program
in the State of S~ao Paulo, Brazil.
Design: 465 participants on a dental care preventive government
programs were assigned: G0 – babies whose mothers joined the
program when still pregnant (n = 50); G1 – babies that joined
the program during the first year of life (n = 230); and G2 – chil-
dren that joined the program between 13 and 18 months
(n = 185). Parents also answered a questionnaire including ques- PR01.40

tions about the children’s diet habits, day and night hygienic
Development of an evidence based oral care protocol
habits, night feeding habits, parents’ education level, social eco-
nomical condition, and children’s behavior during home and pro- for the prevention and management of oral mucositis
fessional treatment. Dental caries experience/children’s age were for paediatric patients on chemotherapy
correlated with variables. Chi-Square test and the Mann-Whitney V. GÓMEZ CLEMENTE1, A. ADANERO VELASCO1, E. M.
test was used, the gross odds ratio was calculated and adjusted MARTINEZ PEREZ 1
, C. MATA FERNANDEZ 2
& P.
1
by the Logistic regression (CI 95%). PLANELLS DEL POZO
1
Results: Assiduity, night oral hygiene presence and parents’ level Paediatric Dentistry, Complutense University of Madrid, Madrid,
of education variables were protection factors for dental caries. Spain; 2Paediatric Oncohematology, Hospital General
Cariogenic diet and night feeding were determinant factors for Universitario Gregorio Mara~ non de Madrid, Madrid, Spain
dental caries. Children’s behavior throughout the treatment, at
Background: Oral mucositis (OM) is a term that describes the
home or at the office, was associated with dental caries
inflammatory response of ephitelial cells of the oral mucosa to
(P < 0.05).
the cytotoxic effects of oncology treatment. Its high incidence
Conclusions: We concluded that positive behavioral, assiduity and
and impact on patients’ quality of life and prognosis have led to
the children’s age when joining the program that represent dental
numerous studies and interventions for prevention and treatment,
caries protection factors, are essential to promote oral health and
complicating the lack of uniform standards.
the prevention of dental caries.
Aim: The aim of this study was to develop a protocol for outpa-
tient applicability and possible application in hospitals, made by
PR01.39 the assessment of dental health of the entire sample of paediatric
In-vivo evaluation of acidogenic proprieties of Stevia oncohematologic patients.
rebaudiana extracts on human saliva: a pilot study Design: A sample of 36 patients of the Oncohematology Paediat-
ric Department of the General Academic Hospital Gregorio
B. ALCIDI1, T. CANTILE1, M. CODA1, A. POLLIO2, A.
Mara~ non of Madrid, is analyzed in order to describe the oral
INGENITO1 & G. F. FERRAZZANO1
1 health status (descriptive study). Moreover, a cross-sectional
Department of Paediatric Dentistry, University of Naples
study is performed to determine whether oral hygiene recommen-
Federico 2, Naples, Italy; 2Department of Biology, University of
dations that follow in the Service Oncohematology, are effective
Naples Federico 2, Naples, Italy
against the presence of mucositis and to determine the impor-
Background: There is a definite relationship between dietary con- tance of oral health in the prevention of mucositis.
sumption of sucrose and incidence of dental caries. Recent Results: 67% of the patients had not received prior dental board.
researches are oriented towards the discovery and evaluation of 72% did not receive oral hygiene tips. 17 patients had mucositis
novel potentially non cariogenic sweeteners from plants, as the at the time of evaluation, 11 of them had high levels of the
diterpene glycoside Rebaudoside A: a steviol glycoside extracted entity. After analyzing the data and valuation analysis between
from Stevia rebaudiana Bertoni plant. variables, according to the results of our study, patients who
Aim: This preliminary study evaluated the effect of Stevia received hygiene tips, presented higher degree of mucositis values.
extracts oral assumption on salivary pH value in pediatric peo- Conclusions: It is necessary to unify criteria and therapeutic pro-
ple. tocols for clinical applicability, as proposed in the present study.
Design: 30 volunteer children between 12 to 16 years old, free of
oral disease were included in this pilot study. Each subject was PR01.41
casually included into the two different treatment groups: Group
1 subjects rinsed the mouth with 10 mL of a solution made of pH measurement, flow rate calculation, salivary
water and 10% of sucrose for 1 min. Group 2 subjects rinsed for concentration of CPP-ACP and Quercetin after
1 min with 10 mL of a solution made of water and 0.5% of Re- medicated chewing gum oral delivery
baudoside A. The different concentrations in solution of the two G. F. FERRAZZANO1, T. CANTILE1, B. ALCIDI1, M. CODA1,
molecules are due to their different sweetener power. Salivary pH M. G. VOLPE2 & A. INGENITO1
value was measured for each subject before rinsing (t0), at the 1
Department of Paediatric Dentistry, University of Naples
end of rinsing (ti), 10 min (t1), 20 min (t2), 30 min (t3) and Federico 2, Naples, Italy; 2National Research Council, Institute of
60 min (t4) after rinsing. Food Science, Avellino, Italy
Results: After 10 and 20 min, the in vivo sucrose rinse produced
a statistical significant lower pH value compared to the Stevia Background: Casein phosphopeptides (CPPs) are phosphorylated
extract. casein-derived peptides that prevent demineralization and
Conclusions: Despite the limitations of a preliminary in vivo eval- enhance remineralization of enamel caries by stabilizing high lev-
uation, Rebaudoside A can be considered non-acidogenic: it is els of amorphous calcium phosphate (ACP) on the tooth surface;
possible to suppose that steviol glycosides could not be metabo- Quercetin is a flavonoid active against gram-positive and gram
lized by oral bacterial flora to produce cariogenic acids, obtaining negative bacteria. Chewing gum can be considered a suitable
a stable non-acidic salivary pH value. drug delivery system for dental prevention.
Aim: The objective of this study was to evaluate the salivary
release of both Casein-Phosphopeptides-Amorphous-Calcium-
Phosphate (CPP-ACP) and Quercetin (Qt) in a novel experimen-
tal gum using an in vivo experiment; to assess pH changes and
flow rate in salivary samples.
Design: The release of CPP-ACP and Qt from the gums was
assessed in vivo by a chew-out method: 10 subjects were recruited
to chew for 30 min 1 g of gum and separate samples of whole
saliva over the 0—5, 5—10, 10—20, 20—30 min periods were
collected. Salivary pH was measured with a glass electrode and
flow rate was calculate; the amount of Ca and QT were analyzed effect of cornflakes when consumed with milk has an acidogenic
for all saliva samples. potential.
Results: The results showed that there were no significant differ- Aim: Study was done to assess the acidogenic potential of milk
ences in flow rate and in pH and demonstrated that both CPP- and cornflakes and also compare the acidogenic of Plain milk,
ACP0 Ca and Qt were released during chewing and decreased pro- Milk with Sugar, Cornflakes with Milk and Cornflakes, Milk
gressively as a function of the chewing time. with Sugar.
Conclusions: The study suggests that CPP-ACP0 Ca and Qt in a Study design: 24 h prior to the conduct of the study Oral prophy-
gum formulation are efficiently released during the chewing process laxis was done in all 40 children. Baseline unstimulated saliva
and both the drugs can serve their role as a novel anti caries agent. was collected and salivary pH recorded with salivary ph meter
among all. The saliva samples from respective groups were
PR01.42 obtained 5, 10, 30 min and 2 h after breakfast and the pH of sal-
iva were recorded again.
Audit of compliance with Scottish Dental Clinical Results: Baseline pH was an average of 7.26. All the groups
Effectiveness Programme (SDCEP) guidelines on showed a fall in pH at 5 and 10 min duration except milk group.
provision of topical fluoride and fissure sealants in a
general dental practice setting PR01.44
E. L. MCCRORY A phase II randomised controlled trial of an oral
NHS Lanarkshire, Edinburgh, UK
health education video game for high caries risk
Background: All children are at risk of dental caries. A caries risk children
assessment will determine the appropriate level of prevention rel- A. ALJAFARI, J. GALLAGHER & M. T. HOSEY
ative to their needs. Division of Population and Patient Health, King’s College London,
Aim: Identify compliance with SDCEP guidelines on provision of London, UK
topical fluoride and fissure sealants as part of a dental caries pre-
vention strategy within general dental practice. Background: A quarter of children undergoing general anaesthe-
Design: Two cycles of retrospective data collection using a ran- sia (GA) for caries treatment end up needing more treatment,
dom sample of 50 patients were completed using computerised indicating failure in reducing caries risk. Families have requested
clinical notes of patients aged 2–16 years, in November 2013 and support and suggested video games as an education method.
again in March 2014. Gold standard is SDCEP guidance docu- Aim: to compare an oral health education video-game to verbal
ment 0 Prevention and Management of Dental Caries in Children0 : education in terms of family satisfaction and ability to improve
1) Biannual fluoride varnish application to children over dietary knowledge and habits.
2 years of age, with additional two applications for those Methods: A two-armed randomised controlled trial involving 4–
at increased caries risk. 10 year-old children undergoing carious teeth extractions under
2) Fissure sealants placed on permanent teeth if the child or GA. The primary outcome measures were:
particular tooth has an increased caries risk. 1) Parent and child satisfaction measured by a Visual Ana-
Results: The first audit cycle demonstrated 44% of patients were logue Scale,
classified as 0 moderate-high caries risk0 . 14% had topical fluoride 2) improvement in child’s dietary knowledge measured by a
placed at their last recall and 50% had fissure sealants. After the quiz, and
cycle, staff were educated on identifying the caries risk of each 3) Change in child’s diet and oral hygiene habits as reported
child and providing appropriate prevention therapies. The second by parent and child.
audit cycle showed 44% of patients were classified as 0 moderate- Measures were taken at baseline, post intervention, and 3 months
high caries risk0 . 91% had topical fluoride applied at their last later.
recall. 100% of these patients had sealants. Results: 109 children were recruited. Average age was 6.5 years
Conclusions: It is imperative to identify the caries risk of each and 56% were male. Groups were well matched in age, gender and
child and implement a prevention strategy specific to their needs. ethnicity. Children and parents found both methods of education
Dental caries prevention strategies should be evidence-based, with satisfactory, although parents seemed to slightly favour verbal
the opportunity to re-audit and continuously improve. delivery [P = 0.003]. Both groups showed significant improvement
in recognition of healthy foods following the intervention
[P < 0.001]. 55% of parents completed phone follow-up after
PR01.43 3 months and reported changes in dietary practices, including less
Acidogenic potential of plain milk, milk with sugar, sweet drinks [P = 0.019] and non-core foods consumption [P0.046].
cornflakes with milk, and cornflakes, milk with sugar Attendance for a 3 month follow-up visit was poor (11%).
– In vivo comparison Conclusion: Video-games can be as acceptable and effective as
S. S. BHAT1, V. S. BHAT2 & R. KANAMATH1 verbal oral health education. Application in high caries risk fami-
1
Pedodontics, Yenepoya University, Mangaluru, India; lies should be part of a wider oral health promotion programme.
2
Prosthodontics, Yenepoya University, Mangaluru, India
PR01.45
Introduction: Dental caries is an infectious and a nutritious
related disease. There is sufficient evidence regarding the effect of Effect of probiotic bacterium Lactobacillus reuteri on
saliva in controlling plaque pH and stimulation of saliva by white spot lesion development in orthodontic patients
foods is an important factor in determining their acidogenic S. GIZANI1, G. PETSI1, S. TWETMAN2, C. CARONI3 & L.
potential. The introduction of fermentable carbohydrates into the PAPAGIANNOULIS1
1
modern diet has been associated with the increase in the preva- Pediatric Dentistry, University of Athens, Athens, Greece;
2
lence of dental caries. Milk is universally considered as the ideal Odontology, University of Copenhagen, Copenhagen, Denmark;
3
food for the growing child. Milk products and cornflakes etc Mathematics, University of Athens, Athens, Greece
which consumed for a breakfast are prone to risk for excess
sugar consumption which appears to be a reasonable component Background: Since mutans streptococci accumulation is thought
in the carious process yet there is no evidence demonstrating the to be a primary ecological factor in WSL-development, the con-
cept of probiotics may be beneficial also for orthodontic patients. PR01.47

To our knowledge, there are no long-term orthodontic studies
Preventive effect of CPP-ACP/NaF and NaF
available with WSL formation as endpoint.
Aim: The aim of the study was to evaluate the effect of daily varnishes on dental erosion associated with abrasion,
intake of probiotic bacteria on salivary lactobacilli (LB) and mu- and on dental caries
tans streptococci (MS) counts, as well as white spot lesion forma- L. C. MAIA1, A. K. ALEXANDRIA1, T. I. VIEIRA1, T. K. S.
tion (WSL) in patients undergoing orthodontic treatment with FIDALGO1, M. M. PITHON2 & A. M. G. VALENC ß A3
1
fixed appliances. Paediatric Dentistry and Orthodontics, Federal University of Rio
Design: A randomised double-blind placebo-controlled study de Janeiro, Rio de Janeiro, Brazil; 2Department of Health,
design with two parallel arms was employed. Patients (n = 85, Southwest Bahia State University, Jequi e, Brazil; 3Department of
mean age 15.9 year) with maxillary braces on at least eight teeth Clinical and Social Dentistry, Federal University of Paraıba, Jo~
ao
and a remaining treatment period of 7–24 months were enrolled Pessoa, Brazil
and randomly allocated to a test (intake of one probiotic lozenge
Aim: Evaluate the preventive effect of CPP-ACP/NaF and NaF
containing Lactobacillus reuteri once daily) or placebo group
varnishes on dental erosion associated with abrasion, and on
(one identical lozenge without active bacteria once daily). Dental
dental caries.
plaque, WSL and salivary MS and LB levels were recorded at
Design: Enamel specimens were pre-treated and divided in two
baseline and at debonding.
parts, also called erosive and abrasive experiment (EAE) and car-
Results: There were no differences in the incidence of WSL
ies experiment (CE). In EAE – the challenge was 4 times/day,
between the groups at debonding. The patients had generally a
5 min in acid soft drink+2times/day for 15 s of abrasion, during
neglected oral hygiene, both at baseline and at the follow-up.
3 days. In the EAE, treatments were: G1 = CPP-ACP/NaF var-
The levels of salivary LB were significantly reduced in both
nish (V1), G2 = NaF varnish (V2) or G3 = Mili-Q water. Enamel
groups (P < 0.05) at the time of debonding compared with base-
loss (Gap) and roughness (linear-Ra and volumetric-Sa) were
line, while no alterations of the MS counts were unveiled.
measured using the 3D non-contact profilometry. In CE, the cari-
Conclusions: Daily intake of probiotic lozenges did not seem to
ogenic challenge was made with a mixed bacterial biofilm grow-
affect the development of WSL during orthodontic treatment
ing. The treatments were G4 = V1, G5 = V2, G6 = culture
with fixed appliances.
medium with biofilm) and G7 = culture medium without bio-
film). The inoculum of 1.5 9 106 CFU/mL of microorganisms
PR01.46 was placed on treated enamel blocks (microaerophilic environ-
Oral health, vitamin and trace element status in child ment, 24 h, 37°C). The percentage of surface microhardness loss
with ASD (% SML) was evaluated. Photomicrographs were obtained in
scanning electron microscopy for both EAE and CE.
B. LEIVA1, J. MOLINA2, E. PLANELLS2 & P. PLANELLS1
1 Results: Anova⁄Tukey tests showed that in EAE both G1 and G2
Prophylaxis, Paediatric Dentistry and Orthodontics Department
were able to significantly reduce Gap, Ra and Sa when compared
IV, Complutense University of Madrid, Madrid, Spain;
2 with G3 (P < 0.0001). G1 present better results than G2
Physiology Department, Faculty of Pharmacy, Granada
(P < 0.05). In CE, although G4 and G5 did not differ (P > 0.05),
University, Granada, Spain
G4 differ from G6 (P < 0.05) and G5 did not (P > 0.05). The
Background: Children with autism spectrum disorder (ASD) have photomicrographs revealed worst structural loss in G3. G4 and
problems of food selectivity, implying risks of nutritional defi- G5 presented small areas of demineralization, compared with
ciencies. Bad feeding habits have a direct effect causing dental their controls.
malocclusions and bruxism, as well as other dental disorders. Conclusion: The best performance from prevent erosion plus
Aim: To assess the nutritional status and oral health in a popula- abrasion as well as dental caries was observed with CPP-ACP/
tion of children with ASD in Madrid (Spain), and correlate with NaF varnish.
associated anthropometric parameters.
Design: A survey consisting of 17 children (aged 5–19 years) from PR01.48
ASD centre in Madrid, approved by the ethic committee. The in-
traoral examination was carried out under OMS criteria. Anthro- The prevalence of enamel demineralization of
pometric parameters were recorded by bioelectrical impedance primary teeth in children 12 to 48 months old
(TANITA) and nutritional intake was analysed by 72 h food W. ZHU1 & J. WU2
1
diary, obtaining the quantitative amount consumed, and percent- Department of Pediatric & Preventive Dentistry, Nanjing Yuhua
age values for each nutrient in accordance to Recommended Die- Dental Hospital, Nanjing, China; 2Department of Oral Health
tary Allowance (DRA) with Nutriber program. Care, Affiliated Maternity and Child Health Hospital, Nanjing
Results: 47% of the patients in this study had mixed dentition Medical University, Nanjing, China
and 52.9% had permanent dentition. 41.1% had dental malocclu-
Background: The enamel demineralization of deciduous teeth
sions, 23.4% bruxism. 100% of gingivitis was observed and poor
were very popularly in the children, but to the present so far
hygiene habits were shown in 35.3%. 29.4% presented caries.
failed to arouse people0 s enough attention.
41.2% of children had low-weight compared to 17.6% who were
Aim: The purpose of this investigation is to detect the status of
overweight. 41.9%, 48.4%, 12.9% and 19.4% of children showed
enamel demineralization of deciduous teeth in children, in order
an insufficient intake of minerals (<75% RDA) as Zn, I, Mg and
to find and prevent to it early.
Fe respectively. The intake of vitamins showed as 29.0% and
Design: Total 600 children from 12 to 48 months old were from
22.6% of children had a lower intake to 75% of the RDA for
our dental health care clinic with six anterior teeth of the maxil-
retinol and pantothenic acid respectively.
lary were erupted, and were divided into three groups (each
Conclusions: Children with ASD require more oral prevention,
group n = 200). Children in A group was 12–23 months old, chil-
due to a higher propensity to suffer nutritional problems.
doldren in group B was 24–35 months old, children in group C
was 36–48 months old. The detection on smooth surface of the
teeth (51, 52, 53, 61, 62, 63 FDI) was using visual diagnosis. Cri-
teria for DEDT-P (Deciduous Tooth Early Demineralization
Prevalence), DTED-I (DTED Index) the basis of the white or Results: The prevalence of non-invasive sealings was 75% and
chalky spot or with brown stain covered the surface of enamel for minimally invasive tehnique 25%. The main cause of failure
by the scope of size was scored from DTED-I = 0 to 4. The data for both materials was retention loss. At 6 months the complete
analysis of DEDT-P and DTED-I used chi-square and ANOV loss of sealings was higher: 40% for Alphaseal and 20% for
test with SPSS 11.5 for windows. N‘Durance for non-invasive procedures and lower 16% for Al-
Results: DEDT-P and DEDT-I at three groups were 23.50%, phaseal and 11% for N‘Durance for minimally invasive proce-
49.00%, 64.50% and 0.48 0.96, 0.87 1.25, 1.60 1.38 dures. At 12 months unchanged clinical evaluations. At
respectively. when compared among three groups which there 18 months 30% Alphaseal non-invasive sealings were lost but
were significant difference (P = 0.000). only 5% N‘Durance; 16% for Alphaseal and 11% for N‘Durance
Conclusion: The data show that both DEDT-P and DEDT-I were sealed restorations were lost. At the end only 21% Alphaseal and
were increased in children with growing of age. So preventing it 57% N‘Durance non -invasive sealings were intact; 66% Alpha-
further develop into to ECC that seeks to eliminate related risk seal and 78% N‘Durance were there.
factors, and detecting early is all-important. Conclusions: The retention of minimally restorations with both
materials was better compared with non-invasive sealings; but
PR01.49 between them N‘Durance was more performant.
A retrospective longevity study of occlusal sealants

R. S. VIEIRA1, C. PEREIRA1, M. CARDOSO1, A. KONRATH2,
PR01.51
A. BORGATTO2 & L. R. REGATTIERI3 Oral microbiota of children in public and private
1
Pediatric Dentistry, Santa Catarina Federal University, school and their relationship with food and oral
Florianopolis, Brazil; 2Informatic and Statistic Department, Santa habits
Catarina Federal University, Florianopolis, Brazil; 3Private M. P. GUERRERO, N. M. JIMENEZ, C. AMARO, S.
Practice, Curitiba, Brazil AGUILAR, I. OLIVEROS & E. AGUIAR
Background: Dental sealants have been considered as an impor- Pediatric Dentistry Posgraduate Program, Universidad Aut
onoma
tant adjunct to caries prevention in occlusal surfaces. de Nayarit, Tepic, Mexico
Aim: The aim of this retrospective longitudinal study was to eval- Background: The interaction between acid producing bacteria
uate the clinical performance and effectiveness of occlusal seal- such as S. mutans organized in the plaque, the presence of fer-
ants in first and second permanent molars. mentable carbohydrates, poor eating habits and lack of oral
Design: Dental records of 206 patients were analyzed totaling 954
hygiene, associated with parental education, are considerate at
teeth, being 544 first molars and 410 second molars. Data high risk for caries. In children attending different social eco-
included: gender, date of birth, previous caries experience, tooth nomic school areas, has been observed that S. mutans quantity is
sealed and date of placement, repair/replacement date and proxi-
different.
mal caries. At a second stage, dental examination was done by Aim: Determinate the association between the S. mutans, eating
one calibrated examiner considering the retention, marginal integ- habits and oral hygiene in 6 year old children in a public school
rity and the incidence of carious lesions. and a private in Tepic, Nayarit, Mexico.
Results: for the first molars, the follow up time varied from
Design: Explanatory, transversal, in 125 children of 6 years old,
4.9 to 26.3 years (average 15.1 years). The retention was 100% of a private and public school, mother’s scholarship was identi-
and marginal integrity rated 96.3%. 3.7% were repaired and fied, as well as oral and eating habits and caries risk. Plaque sam-
6.06% were decayed. For second molars, the follow up varied ple was taken and the amount of S. mutans was identified in
from 0.6 to 22 years (average 8 years) and had 100% of reten-
laboratory.
tion and marginal integrity was 98.5% and the incidence of Results: 40 children in a public school in 38 in private met inclu-
sealant repair was 1.5%. Caries were detected in 0.73% of the sion criteria. Pearson v2 showed a significant relationship
cases.
between S. mutans and hygiene habits in both schools. Mother
Conclusions: Occlusal sealants of permanent molars present an professional scholarship was 30% public school and 68% private
excellent clinical performance under the prism of the retention, was found a high caries risk by S. mutans in the public school.
marginal integrity, and marginal carious lesions in patients regu- Conclusions: There is a significant relationship between oral
larly followed up at the private practice.
hygiene with the number of S. mutans bacterial colonies, not
being significant to the eating habits. Because of the mother low
PR01.50 scholarship, in public school the S. mutans caries risk was high.
A retrospective study of the retention rate of non-
invasive vs minimally invasive fissure sealants- 2 ys PR01.52
follow-up To compare the remineralization potential of milk,
M. TANASE, A. M. RADUCANU & I. V. FERARU cheese and GC tooth mousse on demineralized human
Paediatric Dentistry, UMF Carol Davila, Bucharest, Romania enamel
Introduction: There are many discussions about the poor reten- I. K. VAKIL, V. SHETTY & A. HEGDE
tion of non-invasive sealants but few about the retention of Nitte University, Mangalore, India
sealed restorations. Background: Caries initiation is associated with demineralization
Aim: To evaluate the rate of retentionof sealings applied by two of the subsurface tooth enamel. Today bioactive agents based on
tehniques and with two materials (Alphaseal, N‘Durance Dimer
milk products have been developed to enhance remineralization
Flow). of the enamel and dentine under cariogenic conditions. However,
Material and methods: The study was carried out on 264 first per- there is limited information on the remineralization potential of
manent molars sealed by students in the Paedodontic Depart- milk and milk products.
ment. Modified UPHS criteria for the direct clinical evaluation
Aim: To assess and compare the remineralization potential poten-
adapted for sealing were used to asses the status of each sealing. tial of milk, cheese and GC tooth mousse on demineralized
Data were analyzed using SPSS for Windows. human enamel.
Design: 70 enamel specimens were prepared from sound human PR01.55

premolars. All enamel specimens were then placed in demineraliz-
Powered vs manual tooth brush in children oral
ing solution for 4 days at 37°C to produce artificial carious
lesion. Enamel specimens were then randomly divided into four health
groups. Group 1 specimens were kept in artificial saliva whereas M. A. DURHAN, B. KARGUL & M. ULUAKAY
group 2, 3 and 4 enamel specimens were treated with milk, cheese Pediatric Dentistry, Marmara University, School of Dentistry,
and GC tooth mousse respectively for 5 min twice daily for Istanbul, Turkey
21 days. Pre and Post treatment surface microhardness (SMH) Aim: Good plaque control facilitates good gingival and periodon-
measurements of all specimens were evaluated on the 1st, 7th, tal health, prevents tooth decay and preserves oral health for a
14th and 21st day. Data was statistically analyzed using One-way lifetime. The purpose of this study was to compare and determine
Anova test. the plaque-reducing effectiveness of powered and manual tooth
Results: The mean baseline SMH value of enamel specimen was brushing method in a small group of children.
314.4 15.3 VHN which reduced to 127.9 16.8 VHN after Design: 10 children aged ranged between 7 to 10 years old were
demineralization. There were statistically significant increases in included the study. Each child firstly used manual tooth brush
the post SMH values in milk 211.2 16.9 VHN, cheese (ORAL B Stages for children). After 2 weeks children were asked
198.04 10.3 VHN and GC tooth mousse- 228.4 12.9 VHN to use powered tooth brush (ORAL-B TRIUMPH 5000 SMART
[P < 0.001] at the end of 21st day of remineralization. GUIDE) for 2 weeks. as well. Buccal surface plaque was
Conclusion: Milk and GC tooth mousse showed better remineral- recorded according to TQHPI every 2 weeks. Data were statisti-
ization potential followed by cheese on demineralized human cally analyzed by using IBM SPSS Statistics 22 (IBM SPSS, Tur-
enamel. key). Mann-Whitney U test and Wilcoxon signed rank test were
used. for comparison the jaws and automatic brush /manual
PR01.53 brush. Significance at P < 0.05 were considered.
Results: Both brushes significantly reduced the plaque accumula-
Withdrawn abstract tion, though to different degrees. Powered brushes showed signif-
icant plaque reduction as compared to the manual brushes.
PR01.54 Conclusions: Moderate quality evidence finds statistical benefit in
Dental caries recurrence after treatment for severe oral health for powered over manual toothbrushes. Therefore,
powered tooth brush can be recommended for children to
early childhood caries under general anesthesia: a 1- increase the oral health.
year follow-up
J. TIAN
Peking University, Beijing, China
PR01.56
The influence of ozone, sealants and fluoride varnish
Background: severe early childhood caries has high prevalence in
on occlusal caries development in 24 months period
china (66% for 5 years old) and is difficult to treat successfully,
J. KALNINA & R. CARE
up to 50% of children have new caries lesions after therapy, but
Riga Stradins University, Riga, Latvia
the reasons is not clear.
Aim: the aim of this study was trying to characterize factors asso- Background: Application of fissure sealants and fluoride varnishes
ciated with new lesions post-treatment. are two preventive procedures for dental caries developed since
Design: A total of 70 children accept caries treatment under gen- 1960’s. The application of ozone on dental hard tissues is a novel
eral anesthesia participate this study. Questionnaires and treat- preventive and therapeutic approach.
ment records including basic information, feeding and oral habit Aim: To detect influence of ozone, fissure sealants and fluoride
and treatment informations were collected. Opaque spot didn0 t varnish on occlusal caries development in permanent premolars
include in dt was treated with apply fluoride only. Children back of children.
to hospital for recall examination on 3, 6 and 12 month after Design: A clinical trial was conducted on four groups of 10 years
treatment, their feeding and oral habit and new lesions occur- old children:
rence information were collected. For children with new lesions a group 1 (n = 19) in which fluoride varnish (Fluocal solute,
post-treatment, apply treatment and fluoride; for children with- Septodont, France) was applied and re-applied up to
out new lesions, apply fluoride. All the informations were statisti- 24 months; and
cally evaluated. a group 2 (n = 17) in which fissure sealant (ClinproTM Seal-
Results: The caries recurrence rate after 1 year was 42.1%. On ant, 3M ESPE, USA) was applied and re-applied up to
3 months after treatment, children with new lesions compared 24 months,
with without new lesions has significant differences on age, dt group 3 (n = 17) in which ozone (Prozone, W&H, Austria)
and ft (P = 0.048; P = 0.026; P = 0.042 respectively). There are was applied and re-applied up to 24 months, and
no significant differences between with new lesions and without control group 4 (n = 44). Percent of caries reduction was
new lesions group on 6 and 12 months after treatment on all the studied in these initially healthy premolars: 90 (fluoride var-
observed factors. nish), 78 (fissure sealants), 95 (ozone) and 144 (control) pre-
Conclusions: On the time of treatment children in young age are molars met inclusion criteria.
more likely to develop new lesions short-term after treatment Results: Occlusal caries was developed in: group 1 – 2.2%
than elder children. Children with opaque spot before treatment (n = 2), group 2 – 5.1% (n = 4), group 3 – 3.2% (n = 3) and
are likely to develop into cavity short-term after treatment even group 4 – 9.7% (n = 14). The changes in occlusal caries incidence
applied with fluoride. between fluoride varnish, fissure sealants and ozone groups were
not statistically significant. Caries increment was significantly less
in preventive groups as compared to control at 24 months.
Conclusions: The results suggested that for occlusal caries preven-
tion all these preventive procedures could be recommended at
individual and also at community level.
PR01.57 nance of localization in the premolar/molar segment and in

patients with poor oral hygiene.
The effect of MI paste plus on initial caries lesion Conclusion: Poor oral and dental hygiene was identified as the
using focus ion beam/scanning electron microscopy most important risk factor for the development of white spots
(FIB/SEM) during multibracket orthodontic treatment.
B. KITIKI1, M. SEZEN2 & B. KARGUL € 1 Orthodontists should be proactive and take active responsibility to
1 prevent the development of WSL by educating their patients about
Department of Pediatric Dentistry, Marmara University Faculty
of Dentistry, Istanbul, Turkey; 2Nanotechnology Research and the importance of maintaining an excellent dietary compliance and
Application Center, Sabancı University, Istanbul, Turkey oral hygiene regime. In front of the appearance of the white spots,
several preserving palliative treatments can be suggested.
Background: Caries process is not a static one, but is dynamic
with interspersed periods of demineralization and remineraliza-
tion of enamel. Novel caries preventive dental materials are now PR01.59
incorporating CPP-ACP in the composition of their products for Application of ICDAS and CAMBRA protocols in
the prevention of caries. patients with cerebral shunt valves. A case report
Aim: This study was designed to evaluate the effectiveness of MI A. HERNANDEZ FERNANDEZ1,2, E. FERNANDEZ-
Paste plus in inhibition of enamel demineralization using focus ~
MINANO 1
, Y. MARTINEZ-BENEYTO1, A. J. ORTIZ-RUIZ1, A.
ion beam/scanning electron microscopy examination. M. ALCAINA-LORENTE1 & S. NAVARRO-GARRIDO1
Design: Two freshly extracted human molars were collected and 1
University of Murcia, Murcia, Spain; 2Clinica Dental, Murcia,
pumiced by using rubber cups with fluoride-free paste, washed, Spain
and dried. The specimens were immersed in the demineralizing
solution for 48 h. In pH cycling method, samples were subjected Introduction: The lack of drainage of cerebrospinal fluid (CSF)
to pH cycling for 7 days. FIB-SEM tomography studies were produced in the cerebral ventricles causes a condition called
performed using ‘slice and view’ technique at the JEOL JIB hydrocephalus. The treatment chosen for these patients is surgi-
4601F MultiBeam platform. FIB milling was carried out on the cal placement of a by-pass valve to decrease intracranial pressure
sample at the conventional angle of 53° such that the ion beam and thus avoid CNS lesions.
impacted perpendicular to the sample surface and was able to The oral cavity is a source of pathogens, and after dental proce-
sequentially ‘slice’ surfaces away from the volume of interest, dures these pathogens can pass into the bloodstream, causing
while electron beam was used to image the cross-sectional sur- bacterial endocarditis that may be present in patients with car-
faces simultaneously. The enamel surfaces with magnification of diac devices
5000, 10,000, 20,000 taken by FIB/SEM. Case reports: 6-year-old child came to the clinic for an oral cavity
Results: The FIB/SEM observation showed that demineralized review. The patient suffered a severe brain hemorrhage encepha-
enamel surface and subsurface was disorganized, with variable lopathy secondary to arteriovenous malformation that fell into a
rod widths and a smaller number of enamel rods. After reminer- coma for 6 months. She was treated with drainage and ventricu-
alition enamel rods and prismatic substance are not discernable, loperitoneal by-pass valve.
at a higher magnifications the areas of calcified deposits are more ICDAS: The patient had three teeth with severe decay (codes 5
evident. and 6) as well as three pieces with established decay (code 3 and
Conclusions: Detailed morphological analysis is critical to under- 4). Likewise three teeth with early stage decay (Code 2)
standing the structural features of enamel and designing preven- CAMBRA: the girl showed a high caries risk. There were four
tive strategies. interproximal lesions and five tooth with enamel defects. Besides
the child required special needs. The only protective factor was
brushing daily fluoridated with toothpaste.
PR01.58
The treatment plan consisted in restoring advanced lesions, pit
White spot lesions and orthodontics: a clinical study and fissure sealants, topical fluoride application, monitoring of
and proposed preventive protocol early lesions and diet tips.
W. RERHRHAYE, A. BENKADDOUR, A. BAHOUM, L. All procedures were performed with bacterial endocarditis pro-
BAHIJE & F. ZAOUI phylaxis.
Department of Orthodontics, Faculty of Dental Medecine, Comments: Patients with valves must be introduced into a proto-
University Mohammed V, Rabat, Morocco col that includes prophylaxis of bacterial endocarditis and into a
preventive program against caries, to decrease the risk of infec-
Introduction: The enamel demineralizations, more commonly tion. We propose the use of Cambra index.
known as ‘white spot lesions’ (WSL), lead in some rare cases to
the creation of true cavities, causing both esthetic and functional
problems. The aim of our retrospective clinical study was to eval- PR01.60
uate the incidence of the appearance of these WSL in a Moroc- Improving integration of dental and medical oral
can orthodontic population and to determinate possible health services for young children
associations with a number of risk factors. J. J. CRALL1,2
Patients and methods: The study was based on intraoral photo- 1
Public Health & Community Dentistry, UCLA, Los Angeles, CA,
graphs of a pool of 69 patients who underwent orthodontic treat- USA; 2UCLA-First 5 LA Oral Health Program, Los Angeles, CA,
ment with or without extractions. Patients with prostheses or USA
WSL before the beginning of the study were excluded. Digital
pre and posttreatment photos for each patient were compared Background: Early childhood caries (ECC) is a persistent com-
looking for the appearance of WSL on the vestibular surfaces. mon chronic disease. Efforts to increase access and utilization of
WSL were classed according to three degrees of severity: slight, dental services for U.S. preschoolers at elevated risk for ECC
severe and cavitation. Data were processed using SPSS 13.0 soft- have yielded some success, but new approaches are needed. One
ware. such strategy involves engagement of primary medical care pro-
Results: The results of the study showed that the prevalence of viders (PCP) who generally have more encounters with infants
WSL in the sample was 66.7%, with a highly significant predomi- and young children.
Aim: To develop and test interventions to increase PCP involve- PR01.62

ment in oral health care and improve integration of oral health/
Treatment of immature permanent teeth with
dental care delivery for young children.
Design: A multi-faceted intervention comprised of infrastructure periapical lesions
enhancements, training and technical assistance, and implementa- S. GROMOVA1 & O. KOVYLINA2
1
tion of a quality improvement learning collaborative (QILC) was Kirov State Medical Academy, Kirov, Russian Federation;
2
developed and implemented in partnership with six community Paediatric Dentistry Dept, Moscow State University of Medicine
clinics that provide primary medical and dental care to high-risk and Dentistry named after A.I. Evdokimov, Moscow, Russian
population groups in Los Angeles. Six additional clinics partici- Federation
pated, but were not involved in the QILC. Background: Mineral trioxide aggregate (MTA)-it is the first bio-
Results: Baseline assessments identified several factors associated compatible with periradicular tissues material, of which surface
which limited participation of PCP and dental personnel in oral can cementum growing. It is non cytotoxic to fibroblasts, but
health care for young children – including lack of professional antimicrobial to bacteria.
training in contemporary caries prevention and disease manage- Bioactive calcium silicate-based materials BiodentineTM (Septo-
ment, limited inter-professional collaboration, and information dont) have recently been developed with the aim of improving
system barriers which limited sharing of information collected clinical use and overcoming MTA limitations.
during medical and dental care delivery. Evaluation of the impact Aim: To compare two biocompatible and bioactive materials.
of various intervention components demonstrated improvements Design: Study has included two groups of 10-years old children
in oral health care service delivery and clinic system capacity to (nine of them were treated with using MTA (Dentsply), other
serve young children, and underscored the importance of coordi- eight with using BiodentineTM (Septodont). All those children
nated and sustained efforts to address system barriers that limit have diagnoses Acute apical periodontitis of pulpal origin or
capacity, effectiveness and efficiency. K04.5 Chronic apical periodontitis of immature permanent teeth,
Conclusions: Integration of medical and dental services can be which were complications of unsuccessful of previous treatment.
achieved through sustained systematic efforts. X-Ray examination and clinical observations were performed at
interval of 3, 6, 12, 18, 24 month.
PR01.61 Results: Both teeth have similar instrumentation and irrigation
Contributions of caregiver’s social support to protocol (order). In first case apical 1/3 of root canal was obtu-
rate with MTA (Dentsply). In second case root canal was obtu-
children’s dental caries in Guangzhou: a structural rate to the working lang with bioaktiv calcium silicate-based
equation model materials Biodentine (Septodont). The two cases were considered
R. QIU1,2, E. C. M. LO3 & H. LIN2 completely healed and were followed for 2.5 more year. The 2-
1
Department of Pediatric Dentistry, College of Stomatology, year follow-up consolidated the previous observation with
Guangxi Medical University, Nanning, China; 2Department of absence of clinical symptoms and radiographic evidence of regen-
Preventive Dentistry, Guanghua School of Stomatology, Sun Yat- eration of the periapical tissues and revealed toothroot develop-
sen University, Guangzhou, China; 3Dental Public Health, Faculty ment and formation, and as result apexification.
of Dentistry, University of Hong Kong, Hong Kong, China Conclusions: Both clinical cases showed reduction of root-canal
space and forming of apical part and apexification was achieved.
Background: Caries of preschool children still remains highly pre-
That means both biocompatible and bioactive materials MTA
valent in China. Psychological factors can increase an individual’s
(Dentsply) and Biodentine (Septodont) can be used with expecta-
engagement in health-promoting behaviors, and finally influence
tions of success.
the oral health.
Aim: To explore the contributions of caregiver’s social support to
children’s caries in Guangzhou, China. PR01.63
Design: A structure model which explored the contributions of Management of white spot lesions before and during
social support to children’s dental caries in Guangzhou was
orthodontic treatment
tested by structural equation modeling. Information on social
M. VELISSARIOU, M. CHAROPEME, N. CHANDWANI & K.
support and oral health knowledge, attitudes and practices of the
KAVVADIA
caregivers of children aged 5 years, and information on the chil-
Pediatric Dentistry, European University College, Dubai, United
dren’s oral health practices was collected by a questionnaire.
Arab Emirates
Examination of the children’s dental caries was conducted.
Results: Caregiver’s social support influenced the children’s caries Introduction: White spot lesions (WSLs) occur as early as 4 weeks
indirectly by the children’s oral health practice. Meanwhile, Care- after placement of fixed appliances and if not managed properly
giver’s social support influenced children’s oral health practices can progress into a cavity. IconÒ is a low viscosity resin infiltra-
indirectly by caregiver’s oral health knowledge, attitudes and tion technique used to manage WSLs in orthodontic patients.
practices, and caregiver’s oral health knowledge affected chil- The aim is to present two WSLs management cases, before and
dren’s oral health practices indirectly by caregiver’s oral health during orthodontic treatment, as well as their follow up.
attitudes and practices. Case reports: Case 1: A 12 years old female with multiple cervical
Conclusions: Caregiver’s social support could be an important WSLs on upper incisors and generalized gingivitis was referred
predictor for the children’s caries. from the orthodontist. Prevention prescribed was: 5000 ppmF
toothpaste, flossing, 0.12%, chlorhexidine mouth-rinse, 2.26%
topical fluoride varnish in office application. IconÒ was used over
the WSLs to halt their advancement. After bonding the fixed
appliances and for the 1.5 years follow up, the progression of the
WSLs was halted.
Case 2: A 12 years old male under orthodontic treatment was
referred due to severe WSLs on all upper incisors, caries, heavy
plaque deposits and generalized gingivitis. Fixed appliances were
removed and preventive treatment plan was prescribed (v2 daily
MI plus toothpaste (900 ppmF), v2 daily 0.12% chlorhexidine Design: The initial surface microhardness of the restorative mate-
mouth-rinse, 2.26% NaF in office varnish). WSLs were managed rials GC Fuji IX, Nano Glass ionomer (KetacTM N100), FiltekTM
with IconÒ. In the 6 months follow up, patient’s oral health has Z350 Composite and Ceram XTM Nano ceramic restorative was
improved and his fixed appliances were bonded back. recorded in Knoop hardness number (KHN). These materials
Comments: WSLs in orthodontic patients can be managed suc- were studied under three experimental categories that included
cessfully with IconÒ before and during the orthodontic treat- those exposed to a Coca ColaÒ and SpriteÒ group daily for a
ment. week, once a week, and with no exposures at all and the final
surface microhardness was recorded. The Institutional ethical
PR01.64 clearance was obtained for this experimentation.
Results: KHN data were subjected to statistical analysis using
Effect of carbonated beverages on aesthetic paired t-test and one-way ANOVA at 5% significance level. The
restorative materials – an in-vitro surface t-test comparisons showed a high statistical significance on com-
microhardness study parison of the surface microhardness changes among all the four
A. M. XAVIER1, S. M. SUNNY2 & A. M. HEGDE3 restorative materials exposed to both the beverages on a daily
1
Department of Pediatric Dentistry, Amrita School of Dentistry, basis for a week (P < 0.0005). Inter-comparisons among the
Aluva, India; 2Dental Surgeon, Smile ‘n Care Multispecialty & restorative materials exposed to both the beverages displayed a
Pediatric Dental Home Aluva, Ernakulam, India; 3Pedodontics and varying response, however showing the maximum surface mi-
Preventive Children Dentistry, A.B. Shetty Memorial Institute of crohardness reduction with KetacTM N100 and Nano ceramic
Dental Sciences, Mangalore, India restorative (P < 0.0005).
Conclusions: Repeated exposure of carbonated beverages on
Background: The consumption of carbonated beverages over the restorative materials markedly reduced its surface microhardness;
years by all age groups, especially children has increased at large, Coca ColaÒ producing the maximum effect.
thereby causing a rise in tooth wear and a subsequent demand
for aesthetic restorative materials.
Aim: This in-vitro study assesses the surface microhardness
changes of four aesthetic restorative materials following exposure
to two commonly consumed acidic beverages.

PR02.01 Stainless steel crowns for deciduous molars and final impression
of upper and lower ridges were performed under general anesthe-
Phenotypic and genotypic profile of a child with a sia due to uncooperative behavior. Fixed-type partial dentures
unique pattern of molar teeth agenesis with band-retained on primary molars were inserted at subse-
B. AHMED quent appointment. The results showed a significant improve-
Prosthodontics, National University of Science & Technology ment in the esthetics, chewing and phonetic function of the
(NUST), Islamabad, Pakistan patients. The dentures became unfitted due to continued alveolar
Tooth Agenesis is the congenital absence of one or more of the arch development 3 years later. New removable partial dentures
normal complement of teeth, and is one of the most frequent were fabricated when they were 6-year-old.
alterations of the human dentition. The etiology of Tooth Agene- Comments: Early prosthodontic treatment for ectodermal dyspla-
sis is still unknown. However, different studies show distinct phe- sia cases is usually difficult because of their oligodontia, undevel-
notypic and genotypic heterogenious patterns affecting different oped alveolar ridges and very young age. In our cases, early
demographic and geographic profiles. Tooth Agenesis either prosthodontic intervention established the function and improved
alone or associated with craniofacial developmental disorders can the social living and life quality of the patients. The proper age
pose speech and masticatory dysfunctions as well as aesthetic and for implants insertion should be considered in the future.
functional problems thus significantly affecting the oral health
related quality of life. PR02.03
Objectives: To describe the pattern of clinical presentation of Treatment for a patient with molar-incisor
molar teeth agenesis in this patient.
To describe the mode of inheritance of molar tooth agenesis in
hypomineralization
this family. S. H. YU1, H. H. CHANG1, Y. L. WANG1, G. F. HUANG1 &
To establish the mutations in candidate genes responsible for M. K. GUO2
1
tooth agenesis in this pattern. Pediatric Dentistry, National Taiwan University Children
It was a descriptive study. Hospital, Taipei City, Taiwan; 2Graduate Institute of Clinical
Setting: The clinical examination of the affected individual, Oral Dentistry, National Taiwan University, Taipei City, Taiwan
Stereognostic (OSA), Oral Motor ability (OMA) testing and Introduction: Molar incisor hypomineralization (MIH) could be
genetic assessment was conducted in the Department of Prostho- recognized as hypomineralized dental enamel of idiopathic etiol-
dontics, National University of science & Technology Pakistan. ogy of systemic origin affecting permanent first molars (PFMs)
Demographic data like age, gender, number and pattern of miss- and permanent incisors. Patients with MIH often suffered from
ing teeth was recorded on the prescribed proforma. hypersensitivity and unacceptable esthetic. Rapid development of
Clinical pattern was established using history, examination and caries, repeated marginal breakdown of restorations in affected
radiographic evaluation of the affected subjects. Family pedigree teeth are frequently occurred. We describe a clinical case and its
was drawn and the mode of inheritance was established. management.
This study added to the knowledge about the clinical presenta- Case report: A 7-year-old girl was referred from local dentist to
tion and pathogenesis of tooth agenesis in the studied popula- treat the newly erupted PFMs. Clinical examination revealed
tion. This in turn assisted in establishing clinico pathological and demarcated opacities on tooth 11, 32, 31, 41, 42, 46, post erup-
molecular diagnosis and genetic counseling facilities for the tion breakdown of 16 and 26 with hypersensitivity, atypical resto-
affected patients and families. ration of 36 and dental caries of 64, 65, 75, 85. All major
systemic diseases and prolonged antibiotics therapy since birth
PR02.02 were denied by the parents. The girl received SSC restoration on
16, 26 and 36, composite resin restoration on 64, 65, 75, 85, 11
Early prosthodontic intervention in children with and 21. Fluoride varnish was applied thereafter. The girl was
ectodermal dysplasia at age three scheduled for regular 3-month-follow-up.
L. W. OU-YANG & A. I. TSAI Comments: MIH can be associated with alteration of permanent
Department of Paediatric Dentistry, Chang-Gung University, teeth development during the same formative period. The diagno-
Chang-Gung Memorial Hospital, Taoyuan county, Taiwan sis depends on a thorough history taking. Early detection and
Introduction: Ectodermal dysplasia is characterized by the abnor- diagnosis are essential. Preventive measures such as frequent topi-
mal development of embryonic ectoderm derivatives. This triad is cal fluoride application and dietary adjustment should be taken
usually accompanied by partial or complete absence of the pri- after the affected tooth is detected. When defect demarcates with
mary and permanent dentition. The objectives of prosthesis fabri- supragingival margin, composite resin is the material of choice.
cation in the early childhood period include the improvement of However, in moderate to severe cases, full coverage SSC restora-
masticatory and speaking function; the establishment of better tion is the choice of treatment. For anterior teeth, esthetic is con-
facial appearance; and the development of self-esteem during the cerned, composite resin veneer with minimal tooth preparation is
pre-school period. suggested.
Case report: Severe oligodontia were noted in two 3-year, 4-
month-old twin girls who suffered from ectodermal dysplasia. In
their deciduous dentition, only few primary molars were present.
It is difficult to gain adequate retention and support for conven-
tional dentures because of their underdeveloped alveolar ridges.
PR02.04 Comments: Patient reported improvement in appearance and

function. She will have further clinical reviews for future plan-
Dental treatment consideration in a child with Pompe
ning.
disease
K. Y. CHU1,2, Y. L. WANG1,2, H. H. CHANG1,2, G. F.
HUANG1,2 & M. K. GUO1,2 PR02.06
1
National Taiwan University Hospital, Taipei, Taiwan; 2National Prevalence of hyperdontia and hypodontia in a
Taiwan University, Taipei, Taiwan Turkish pediatric patient population
Introduction: Pompe disease is a rare genetic disorder caused by M. ULUAKAY, B. PEKEL & A. MENTES
mutations in the gene that encodes for a-glucosidase, which Pediatric Dentistry, Marmara University, Istanbul, Turkey
leads to accumulation of glycogen in cells throughout the body. Background: Hyperdontia and hypodontia are the most widely
The most severe form, infantile Pompe disease, historically reported and significant anomalies in children affecting the pri-
resulted in early mortality within the first year of life. Now mary and mixed dentition.
treatment with enzyme replacement therapy (ERT) has extended Aim: The aim of this study was to determine the prevalence of
the life span of individuals with this disease. As living longer hyperdontia and hypodontia in patients referred to Marmara
due to ERT, the need of dental treatment for children with University, Pediatric Dentistry Department.
infantile Pompe disease is encountered clinically to pediatric Design: A retrospective study was performed using patient
dentist nowadays. records aged between 6 and 12. In total 1008 patients included to
Case reports: A 5-year-old boy was referred to the pediatric den- the study whom radiographs had been taken for routine dental
tistry department for dental examination from pediatrics depart- treatments. All radiographs were examined by two researchers
ment. He is a patient with the history of Pompe disease, classical and the anomalies including supernumerary tooth and tooth
infantile-onset type, under ERT. agenesis were noted for each patient.
The facial appearance showed long face appearance, mouth Results: In 1008 patients, 13 hyperdontia (1.29%) and 74 hyp-
opening posture, mid-face ditch-in, and mandible prognathism. odontia (7.34%) cases were detected. In 13 hyperdontia patients
After an intra-oral examination which revealed poor oral 9 were boys (69.23%) and 3 were girls (23.07%). Only one
hygiene, multiple caries, and class III malocclusion. The most sig- patient had two supernumerary teeth. According to morphology,
nificant radiographic finding was consistent pulp chamber mor- the most common supernumerary teeth were conical (57.14%),
phology alternation of both permanent first molar. The following tuberculate (21.42%), supplemental (14.30%) and pa-
developing of tooth germ and dentition was in normal range and ramolar types (7.14%). In 74 hypodontia patients 48 were girls
comparable to his calendrical age. (64.86%) and 26 were boys (35.14%). Only one patient had oli-
He received full mouth dental treatment and oral hygiene instruc- godontia. In 74 hypodontia patients 131 germ agenesis were diag-
tion was also provided to his primary caregiver. nosed; 85 premolars (64.89%), 45 laterals (34.35%), one second
Comments: As children with infantile Pompe disease are now liv- molar (0.76%).
ing longer due to ERT. Therefore, pediatric dentists are more Conclusions: The prevalence of hypodontia and hyperdontia in
likely to provide dental treatment to those children. Through this this study were within the range as reported in the literature.
case, we identify special characters that we must pay attention in Those cases are often diagnosed in paediatric patients during
the process of dental treatment. mixed dentition. Females were affected mostly from hypodontia
whereas males were affected mostly from hyperdontia. Pediatric
PR02.05 dentists have the essential role in the initial diagnosis of hyper-
dontia and hypodontia. Early detection of these anomalies leads
Dental management of a patient presenting with
to interceptive treatment modalities within a multidisciplinary
incontinentia pigmenti (IP) team for better esthetics and function.
L. DAKKOURI, P. ASHLEY & S. PAREKH
Paediatric Department, Eastman Dental Institute, London, UK
Introduction: Incontinentia pigmenti (IP) is a rare X-linked domi- PR02.07
nant multi-systemic ectodermal disease that principally occurs in
Abstract withdrawn
females. A bullous rash along Blashko0 s lines (BL) followed by
verrucous plaques, evolving over time to hyperpigmented swirling
patterns is one main manifestation. It is characterised by teeth
abnormalities, alopecia, nails dystrophy and occasionally affects
PR02.08
the retina and the central nervous system (CNS). Majority of IP Supernumerary teeth: prevalence in a dental hospital
cases are caused by mutations in the NEMO gene located in sample
Xq28 locus that are responsible for 80% of new mutations. As E. J. L. BAVA, M. GARCIA, V. PAVAN, G. ARREBOLA, M.
this mutation causes variable characteristics and expressions, PANTYRER & L. MENDEZ
cutaneous findings that follow a chronological sequence are the Department of Pediatric Dentistry, University of Buenos Aires,
main symptoms of the disease. Four clear stages of IP can occur: Buenos Aires, Argentina
inflammatory or vesicular stage, verrucous stage, hyperpigmented
stage, and hypopigmented stage. Supernumerary teeth are those in addition to the normal series
Case report: A 10-year-old young girl was referred to the East- that can affect both dentitions and cause complications in adja-
man Dental Hospital. Upon intra oral examination, she pre- cent teeth.
sented with missing permanent teeth and retained primary teeth. Objective: Analyze the characteristics of supernumerary teeth and
Dental anomalies related to her medical condition were; mal- the clinical-eruptive complications associated with adjacent teeth,
formed shape and form of the dentition, hypodontia, impacted in non-syndromic patients.
teeth and under-developed alveolar bone. Treatment provided Method: Retrospective observational study. Medical records of
was to restore the dentition and to provide partial dentures to patients with erupted or retained supernumerary teeth who were
restore occlusion and aesthetics. derivate for their attention to the Department of Pediatric Den-
tistry FOUBA in the period 1999–2013 were evaluated. The study PR02.10
included all the complete medical records that presented periapi-
Solitary median maxillary central incisor (SMMCI)
cal, panoramic and/or occlusal radiographs. 4 calibrated opera-
tors (Kappa 0.97 0.95–0.99) recorded: age, sex, number, type, syndrome – a variant with a supplemental median
orientation, position, erupted or retained supernumerary and the maxillary central incisor
relationship with adjacent teeth, on specially designed forms. E. DUNBAR & R. R. WELBURY
Results were statistically analyzed with percentages (confidence Glasgow Dental Hospital and School, Glasgow, UK
intervals 95%) and Chi square.
Introduction: Solitary median maxillary central incisor (SMMCI)
Results: 159 patients (9.47 + 2.47 years) were evaluated (37.21%
syndrome affects approximately 1 in 50,000 live births with
females P = 0.2). 232 supernumeraries, 83.62% (78.20–88.15)
unknown aetiology. Developing midline structures in utero are
remained retained (P 0.00). Quantity of supernumerary for
affected including the cranium, nasal structures, facial bones,
patient: 64.78% presented one, 28.30% two, 4.40% three, 1.88%
dentition and other midline structures. We describe a case of
four and 0.62% over 5. In relation to the orientation: 73.70%,
SMMCI syndrome with dental features not previously described.
18.96%, and 7.32% were normal, inverted and transversal respec-
Case reports: A 5 year old female diagnosed with SMMCI syn-
tively. 47.84% (41.24–54.49) were located horizontally over the
drome at age 2 after surgical removal of a midline dermoid cyst
central incisor. In relation to the form: 63.4% were conical. Sig-
and extraction of a maxillary midline tooth was examined. There
nificant differences between the type and orientation, horizontal
was a complete deciduous dentition with a midline diastema and
position, anteroposterior position and no eruption of permanent
radiography showed an unerupted supernumerary midline central
teeth were found (P < 0.05). The 56.46% of supernumerary
incisor together with a normal complement of permanent teeth.
caused retention in permanent teeth.
Her 2 year old brother had a normal deciduous dentition with an
Conclusions: In this study, supernumeraries were mostly pre-
additional maxillary supplemental central incisor. Anterior radio-
sented retained causing complications in the eruption of perma-
graphic examination revealed that he too had a permanent super-
nent teeth.
numerary midline central incisor as well as normal central and
lateral incisors.
PR02.09 Comments: Recognition of classical SMMCI syndrome is critical
Attitudes towards genetic testing for dental disorders as it can be a predicting sign for the serious developmental
in children anomaly holoprosencephaly (HPE). Less severely affected babies
have normal or near normal cerebral development but may pres-
C. J. BUSHELL1 & M. HARRISON1,2
1 ent with eye, nose and lip deformities as well as cognitive impair-
Paediatric Dentistry, King’s College London Dental Institute,
ments and developmental delay.
London, UK; 2Consultant Paediatric Dentist, Guy’s and
A positive family history of SMMCI or any of the other men-
St.Thomas’ NHS Trust, London, UK
tioned associated features is seen in 25% of cases.
Background: Specialist Paediatric Dentists often see children with The dental practitioner may be the first healthcare professionals
rare dental disorders of genetic origin. With the declining cost to recognise SMMCI and medical liaison is essential.
associated with whole genome sequencing it is now possible to
offer this as a diagnostic service for a small number of conditions PR02.11
seen on the dental clinic. It is important to know families’ views
on this and there are no studies in the UK highlighting attitudes Non-syndromic hypo-hyperdontia in the mandibular
towards genetic testing for dental disorders. anterior region
Aims: To ascertain what families think about the possibilities of S. S. HUANG1,2, M. H. SHEEN2, S. T. HUANG2,3 & S. Y.
genetic testing being offered, to find out what participants wish HSIAO2
1
to do with the information resulting from genetic testing and Department of Dentistry, College of Dental Medicine, Kaohsiung
who they think should disseminate such information, and to Medical University, Kaohsiung, Taiwan; 2Department of Pediatric
ascertain if there is any difference in opinions among the public Dentistry, Kaohsiung Medical University Hospital, Kaohsiung,
and professionals (qualified dentists and research scientists). Taiwan; 3Department of Oral Hygiene, College of Dental
Design: Prospective study of a convenience sample of 51 families Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
and 23 dentists and researchers at Guys and St. Thomas’ NHS
Introduction: Hypodontia and hyperdontia are two developmental
Trust completed either paper based or online questionnaires.
dental anomalies and are more frequently seen in permanent den-
Results: Seventy-three (99%) of the participants agreed that peo-
tition. The most common site for hyperdontia is the upper pre-
ple have a right to know about their own genes, forty-seven
maxillary area. And as for hypodontia, the teeth most often
(92%) of the public and twenty (87%) of the professionals agreed
missing are upper lateral incisors and second premolars besides
that genetic testing should be available in the dental clinic as a
third molars. There are few published cases having both hyp-
diagnostic tool. Sixty-one (82%) of the participants agreed that
odontia and hyperdontia in the same arch.
incidental findings should be made available to them.
Case reports: A 7-year old boy came to our department of pedi-
Conclusions: The results of this study provide evidence of an
atric dentistry with his parents asking for extraction of retained
overwhelming positive attitude towards genetic testing for dental
lower primary incisors. After the radiographic examination, two
disorders in children. How dental genetic information is commu-
missing permanent lower lateral incisors and a partial erupted
nicated needs to be explored further.
conical shape supernumerary tooth between the two lower central
incisors were found.
Comments: Hypodontia and hyperdontia are of great concern to
the dentists due to associated malocclusion and esthetic prob-
lems. However, the etiology of non-syndromic hypohyperdontia
still remains unclear and the diagnosis relies on both clinical and
radiographic examinations. Management of the dentition during
early mixed dentition may lead to a better outcome in the long
run.
PR02.12 first clue. This case highlight the importance of the complete
investigation to guide the patient. Patients with oligodontia
Regional odontodysplasia: the report of two unusual should be examined for symptoms of systemic disorders,
cases involved cross-region and over-region although association does not have to be present.
G. SONG, S. ZHANG & M. M. OMAR
Pediatric Dentistry, School & Hospital of Stomatology, Wuhan
University, Wuhan, China
PR02.14
Comprehensive care of a young child diagnosed with
Introduction: Regional odontodysplasia is a rare and nonheredi-
tary developmental disorder in tooth formation and involves
a de novo mutation of osteogenesis imperfecta type
both primary and permanent dentitions. On radiographs, affected IV and dentinogenesis imperfecta with 4 year follow
teeth have an abnormal morphology, a hypoplastic crown, and up
only a faint outline of hard tissue, a condition termed ‘ghost P. SCHOGGER & L. GARTSHORE
teeth.’ The affected teeth display a grooved and brownish surface Paediatric Dentistry Department, University of Liverpool,
with swelling gingiva or periapical abscess without caries. Liverpool, UK
According to previous cases, this condition mostly affects teeth
Introduction: Dentinogenesis imperfecta (DI) is a hereditary con-
in one quadrant. In this article, we will present two unusual gen-
eral involved cases which weren ‘t confined to only one quadrant. dition affecting dentine formation with variable expressivity.
Case reports: A 4-year-old boy was referred for the swelling of Osteogenesis imperfecta (OI) is an autosomal dominant disorder
left side. Intra-oral examination revealed the lower left quadrant characterised by abnormal collagen, repeated fractures and skele-
and the upper left molars and canine were affected with swelled tal deformities. De novo mutations may arise. We describe the
gingiva. comprehensive management of a young child with OI type IVB
2. A 6-year-old girl came for the complaint of uneruption of per- who had a tumultuous start to life, leading to complexities in
manent teeth and yellow discoloration of the teeth in the right management and late diagnosis.
lower quadrant. Intra-oral examination revealed right mandibular Case reports: A 6-year-old boy was referred by his endocrinolo-
first molar to left mandibular canine crossing the mid-line. The gist regarding sensitive teeth. Multiple fractures occurred during
Histopathology examination showed inflammed gingival tissue the first year of life, before being diagnosed with OI. The presen-
tation of a rare subtype of OI, and lack of family history, raised
and hypocalcification with areas of cleft within dentin
The Panoramic radiograph of two cases showed the both the pri- safeguarding concerns. He was fostered for 11 months until a de
mary and peemanent teeth were affected with the ‘ghost novo mutation of the COLIA2 gene was discovered. He experi-
teeth’appearance. However, the etiology is still unknown. ences bone pain, frequent fractures and receives bisphosphonates.
Comments: Because of the over-reginal and cross-reginal involved Examination revealed DI, caries, pulpal pathology and tooth
condition, dentists should consider the number of involved teeth wear. Management included placement of preformed metal
and the patient’s stage of growth to make a long-term therapy crowns and extractions under general anaesthetic, without com-
for function and appearance. plication. 4 years following completion of treatment the patient
attends for regular review and maintains excellent oral hygiene.
Comments: This patient was referred late as a result of stressful
PR02.13 family experiences of hospital care. Optimal communication with
Oligodontia in a pediatric patient with systemic medical colleagues was imperative, particularly regarding preop-
disease erative planning. Patients with OI are susceptible to bone frac-
Z. A. GÜÇLÜ1 & A. ALAC ß AM2 tures during manual handling, hyperthermia and secondary
1
Erciyes University, Faculty of Dentistry, Pediatric Dentistry bleeding. There are no reported cases of osteonecrosis-bisphosph-
Department, Kayseri, Turkey; 2Pediatric Dentistry, Faculty of onate related in children and no antibiotic prophylaxis was pre-
Dentistry, Gazi University, Ankara, Turkey scribed. The OVD is maintained despite delayed intervention.
The patient and his family became motivated attenders who pri-
Introduction: Oligodontia is defined as congenital absence of oritise dental care.
more than six teeth in permanent or both dentitions. The inci-
dence of oligodontia is very rare, the prevalence ranges from PR02.15
0.08% to 0.16%. Oligodontia can occur in association with vari-
ous syndromes and systemic disorders. In this case report an oli- Primary failure of eruption presenting in a patient to
godontia case with hypothyroidzm was presented. varying degrees in all four quadrants
Case reports: A 9-year old boy complained for pain, was referred P. ASHLEY1, C. CLAYTON2, J. NOAR2, A. SHARMA2 & L.
to the Gazi University Pediatric Dentistry Department. His past KNEAFSEY2
1
medical history revealed no systemic disease. There was no con- Paediatric, Eastman Dental Institute, University College London
genitally missing teeth in family history. Mother had hyperthy- (UCL), London, UK; 2Orthodontics, Eastman Dental Institute,
roidism. Extra oral examination was normal. Clinical University College London (UCL), London, UK
examination, revealed deep caries lesions in primary teeth. The
upper and mandibular right first molars were missing. The Introduction: Primary failure of eruption (PFE) is an isolated
patient had no extraction history. Mandibular deciduous central condition causing failure of tooth eruption with no other identifi-
able local or systemic involvement.
incisors were retained, lateral incisors were new erupting. Pano-
ramic radiography showed all four first and second premolars, We describe the long-term follow up of an 8-year-old female with
permanent right mandibular and maxillary molars, permanent PFE in all four quadrants.
mandibular central incisors were missing. The germ of all four Case report: An 8-year-old was referred for the management of
third molar teeth were absent. Patient was referred to pediatric delayed dental development. Clinical and radiographic examina-
endocrinology for investigation. High TSH value was detected. tion revealed infraocclusion of LRD, delayed eruption of LR4,
He is still under control of pediatric endocrinology department impacted UR6 and UL6. LL6 was vertically delayed in its devel-
with hypothyroidism diagnosis. opment, LR6 was partially erupted, there was no evidence of
Comments: Dentists may be the first clinicians whom suspect a hard tissue obstruction. Treatment carried out included extrac-
child with systemic disease and oral conditions could present the tion upper E’s and LRD, soft tissue exposure of LL6.
Ten-year follow-up showed failure of eruption of varying degrees these, a systemic cause should be considered. The literature
in all quadrants. On the right side there was partial eruption of describes several conditions presenting with premature tooth loss,
6’s and no eruption of 7’s. In the upper left quadrant there was such as Coffin-Lowry syndrome, precocious puberty and hypo-
eruption of UL6 but no eruption of UL7. In the lower left quad- phosphatasia.
rant LL6 showed further infraocclusion, with soft tissue exposure Case report: A 4-year-old boy without medical antecedents was
having no effect on its position. referred to the pediatric dentistry clinic of the University Hospi-
As the patient had no functional problems due to the missing pos- tals of Leuven for advice after spontaneous exfoliation of tooth
terior teeth and it was felt the destructive nature of removal of the 73 while toothbrushing. Clinical examination showed increased
teeth would outweigh any benefit, no treatment was carried out. mobility of all remaining front teeth, both in upper and lower
Long-term follow up is required to assess LL6 for cystic change jaw. Dental history revealed a traumatic insult, 1.5 years earlier,
and there is the need for excellent oral hygiene around partially resulting in avulsion of the left upper central incisor. Both right
erupted teeth to minimize risk of caries or periodontal problems. upper incisors were lost spontaneously shortly afterwards. A pan-
Comments: This case shows PFE having different manifestations oramic X-ray revealed the absence of the roots of all primary
in different quadrants in the same patient and the importance of front teeth and reduced roots on primary first molars. Family
monitoring dental development. history was negative and a general check-up did not reveal any
dimorphism, showing normal bone age and absence of arguments
PR02.16 for an underlying endocrinopathy. Chemical blood analysis pre-
sented an aberrant (low) value of alkaline phosphatase activity.
Regional odontodysplasia: an unusual case report and Despite matching clinical symptoms, no mutation of the alkaline
two years follow up hypophosphatase liver-type-gene (ALPL) could be detected.
C. DUMAN1, I. KALYONCU1, G. OLUS2 & A. R. MENTESß 1 Comments: This case report describes a 4-year old boy presenting
1
Paediatric Dentistry, Marmara University, Istanbul, Turkey; with unexplained premature tooth loss in the primary dentition.
2
Oral and Maxillofacial Surgery, Marmara University, Istanbul, Without an accurate diagnosis, there is no guidance for an
Turkey appropriate prognosis and treatment.
Introduction: Regional odontodysplasia (RO) is an uncommon,
nonhereditary developmental anomaly affecting dental tissues PR02.18
derived from mesoderm and ectoderm. The aetiology is A case report of pre-mature eruption of an upper left
unknown. The criteria for diagnosis are based on clinical, radio- first permanent premolar in a 5 year old patient
graphic, and histologic findings. This report describes a child
G. CHU1 & E. RAVICHANDRAN2
patient with RO affecting both sides of midline. 1
Public Dental Services, NHS Greater Glasgow & Clyde, Glasgow,
Case report: An 8 year-old boy referred to the Paediatric Den-
UK; 2NHS Greater Glasgow & Clyde, Glasgow, UK
tistry Department of Marmara University with complaint of
delayed eruption of 21. Clinical examination showed that an api- Introduction: The normal eruption date expected from an upper
cal abscess existed on 36. All teeth of lower left quadrant had first permanent premolar is around the 10–11 year old period for
abnormal crown, with a yellowish discoloured hypoplastic most individuals. Certain factors may influence teeth to experi-
enamel. 41 was also affected. Panoramic radiography showed ence delayed or pre-mature eruption. In this case report I
impacted 21, 34, 35 had delayed and misshaped development and describe a 5 year old female who attends with a erupted 24
erupted 41, 31, 32, 36, 73 and 74 showed typical ‘ghost-like’ tooth.
appearance. Diagnosis of RO was achieved and a treatment plan Case reports: A 5 year old girl attended for a routine exam with
was initiated with a goal to preserve all affected teeth. Endodon- concerns from their mother regarding a tooth which appeared
tic treatments of 31 and 36 has completed with MTA. Diode carious. The patient had previous extractions under GA of the
laser was used for crown lengthening of 36 and teeth was 54, 52, 51, 61, 62, 64, 74 and 84 2 years previously. There was no
restored with SSC. An apical abscess progressed on 31 at the end mention of carious lesions in the previous exam appointment
of 1 year and apical resection was done and restored by strip 5 months prior. On examination the oral hygiene was good. A
crown. Eruption of hypoplastic 21 was observed at the end of tooth was observed anterior to the 65 which was hypoplastic and
first year. The patient is still in our routine follow up. similarly shaped like a premolar. No pain was reported from this
Comments: RO is usually unilateral. Our case showed bilateral tooth and was grade 2 mobile. A OPT confirmed this was the 24
abnormality and conservative approach to those patients is rec- which had pre-maturely erupted by 5 years and it was seen that
ommended in order to preserve the bone tissue surrounding the the 14 was near to eruption also. Following consultant advice, 24
affected teeth. This approach also eliminate the need for prosth- was temporarily restored with glass ionomer to be retained in the
odontic treatment in a growing child. short term for space maintenance.
Comments: This case demonstrates that pre-mature eruption of a
PR02.17 permanent premolar can occur by as much as 5 years. It is
important to exclude the presence of supernumerary teeth and
Premature tooth loss in a 4-year old healthy boy, a although the long term prognosis of such teeth are poor, it is still
diagnostic challenge of benefit to consider preserving and maintaining these teeth in
H. BACKAERT1, T. DE RAVEL2, I. BAILLEUL-FORESTIER3 & the short term.
D. DECLERCK1
1
Department of Oral Health Sciences and Department of
Dentistry, Unit of Pediatric Dentistry and Special Dental Care,
University Hospital Leuven, KU Leuven, Leuven, Belgium; 2Centre
for Human Genetics, University Hospital Leuven, KU Leuven,
Leuven, Belgium; 3Paediatric Dentistry, Dental Faculty, CHU
Toulouse, Toulouse, France
Introduction: Premature tooth loss in the primary dentition can
occur locally, triggered by trauma or infection. In absence of
PR02.19 PR02.21
Dens invaginatus in an immature permanent tooth Dental anomalies associated with agenesis of
combined with chronic periapical periodontitis mandibular second premolars in Turkish population
X. CHEN & S. ZHU M. ZIYA, T. BEZGIN, B. MEMISß OZG € € & S. SARI
UL
Department of Paediatric Dentistry, School of Stomatology, China Paediatric Dentistry, Ankara University, Ankara, Turkey
Medical University, Shenyang, China
Background: It has been proven that genetic factors are effective
Introduction: Dens invaginatus is a congenital tooth developmen- in etiology of tooth agenesis. A single genetic damage might
tal deformity caused by over folding or local proliferation of cause different phenotypes such as tooth agenesis, microdontia or
enamel organ to dental papilla before dens calcification. Dens in- ectopic tooth position.
vaginatus is the weakest anatomy part, prone to food accumula- Aim: The aim of the study was to evaluate the prevalance of
tion and bacterial reproduction, which will further trigger other dental anomalies found in patients with 1 or more congeni-
pulpitis, pulp necrosis and periapical periodontitis. Here we have tal agenesis of mandibular 2nd premolar teeth.
described a case of dens invaginatus combined with chronic peri- Design: 87 patients applying to Ankara University Faculty of
apical periodontitis in an immature permanent tooth. Dentistry Department of Pedodontics between the years 2012–
Case reports: A 12-year-old patient with repeated suppuration of 2014, with 1 or more agenesis of mandibular 2nd premolar teeth
the right side of the maxillary anterior labial gingiva over were inclueded in the study. Clinical and radiographic examina-
3 years. Clinical examination revealed dens invaginatus and tions were carried out to detect other dental anomalies such as;
abnormal tongue ditch of the maxillary right permanent central agenesis or microdontia of maxillary lateral teeth, infraocclusion
incisor (tooth 11), with alveolar pyorrhea adjacent to the labial of persistent decidiuous molars and other form anomalies (talon
frenum. Periapical and CBCT radiographs showed high density cusp, taurodontism, supernumerary teeth). Data were evaluated
image in the neck of 11, wide space in the root canal, open apical with Chi-square and Mann-Whitney U tests.
foramen and radiolucency image in the periapical area. Apexifica- Results: Out of 87 patient, 64.4% were girls and 35.6% were
tion was performed and the tongue ditch was restored with com- boys aged between 7–15 (mean age 10.3). Microdontia (14.9%)
posite resin. The labial gingival fistula healed in 2 weeks. After and agenesis (%6.9) of maxillary lateral teeth were the most com-
4 months, the radiolucency around periapical tissue disappeared. mon dental anomalies associated with mandibular 2nd premolar
8 months later, both the periapical and CBCT examinations agenesis. 19.5% of the persistent molars exhibited infraocclusion.
revealed an image of hard tissue deposition in the periapical area Conclusion: The results of the study showed that microdontia
with the apex closed. Permanent root canal filling was finally per- and agenesis of maxillary laterals and decidiuous molars’ infraoc-
formed. clusion were related with the agenesis of mandibular 2nd premo-
Comments: It’s critical to control the infection in a necrotic lar teeth in Turkish population.
immature tooth, which can recover the vitality of the root sheath
and dental papilla, thus to induce cell differentiation of dental
papilla and deposition of hard tissue at the apex.
PR02.22
A case report: multiple un-erupted teeth and other
PR02.20 dental anomalies in a non- syndrome patient
J. D. EDWARDS & T. PERCIVAL
Mutation in WNT10A and MSX1 genes associated Paediatric Department, Child Dental Health Unit, School of
with oligodontia – a case report Dentistry, University of the West Indies, Champs Fleurs, Trinidad
E. RONKAINEN, S. ALALUUSUA & P. NIEMINEN and Tobago
Institute of Dentistry, University of Helsinki, Helsinki, Finland
Introduction: Delay or failure of eruption of teeth can occur in
Introduction: Wnt10A is strongly expressed in the epithelium and association with other dental anomalies and early diagnosis is
MSX1 in the mesenchyme of the developing teeth. Mutations in critical in effective patient management. The following is a male
WNT10A and MSX1 can cause tooth agenesis. WNT10A muta- patient with multiple causes of failure of permanent tooth erup-
tions affect all tooth types, with considerable variation. Muta- tion with other dental anomalies.
tions in MSX1 are associated with oligodontia typically involving Case reports: A 13 year old Afro-Caribbean male was referred
third molars and second premolars. WNT10A and MSX1 muta- for management of unerupted incisors and canines. His medical
tions are also responsible for some rare syndromes exhibiting and family history revealed nothing of significance and there was
tooth agenesis as a prominent feature. no report of previous dental trauma.
Case report: The proband, originally from Thailand, was a 10- Examination revealed retained 53, 55, 65 and 73, unerupted 21,
year-old boy. He was referred to the Unit of Specialized Oral 22, 23, 33, 15, 25, impacted 37, 47 and ectopic 34 and 35. There
Care, Metropolitan Area in Helsinki for diagnosis and treatment was transposition of 12 and 13, dilaceration of 22 and unilocular
of oligodontia. In addition to third molars, 10 permanent teeth radiolucent lesions encircling the crowns of 15 and 25 and some
(seven premolars, mandibular central incisors and a mandibular decayed teeth.
second molar) were missing. His maxillary lateral incisors were Consultation was undertaken with the departments of paediatric
conical. He had grade III microtia and atresia of the right ear. dentistry, orthodontics and oral surgery. Premolar impaction was
He had also cafe au lait skin lesions. His 11-year-old brother had ascribed to over-retained primary teeth and dentigerous cysts and
seven missing premolars and agenesis of third molars. Both the aetiology of the other multiple unerupted teeth was deemed
brothers had normal hair, nails and function of sweat glands. idiopathic as there was neither family/dental trauma history nor
Their mother and 9-year-old sister had no missing teeth. Mother evidence of a syndrome, supernumerary teeth or ankyloses.
reported that the father of the children and his mother had some The proposed treatment under general anaesthesia included resto-
teeth and nails missing. Genetic analysis revealed that the broth- ration of carious permanent teeth, extraction of all retained pri-
ers had a homozygous missense mutation in WNT10A, mary teeth, surgical removal of 22, 34, 35, exposure and bonding
c.637G>A (p.G213S). Mother was heterozygous. All three had of 21 and 23 and marsupialization of dentigerous cysts associated
also a heterozygous mutation in MSX1, c.818G>C (p.G273A). with 15 and 25.
Comments: We conclude that tooth agenesis is caused by the
homozygosity of the WNT10A mutation.
Comments: Recommended treatment was not obtained and the curly scalp hair, scarce eyebrows and eyelashes, dry anhidrotic
patient presented 5 years later interestingly with continued erup- skin. Intraoral examination at the initial visit revealed that the
tion of teeth 15 and 35 that were not thought to have eruptive soft tissue was normal and 15 primary teeth and nine permanent
potential. teeth had been presented. No microdontia or hypoplasia were
seen on the teeth. The radiograph revealed no congenitally miss-
PR02.23 ing permanent teeth were seen.
Comments: For the appropriate prevention and treatment of
Management and follow up of an erupting mesiodens EDA-ID, the dentists should be well aware of the broad spec-
in a four year old patient trum of its clinical phenotypes. Since patients with EDA-ID have
J. B. AMMARI immunodeficiency, careful follow-up including effective caries
Private Paediatric Dental Clinic, Amman, Jordan preventive measures and dental therapy is important in order to
manage their systemic condition.
Introduction: Supernumerary teeth, a developmental problem in
children, can be supplementary or accessory, single or multiple;
mainly occur in the maxilla. Mesiodens is the most common PR02.25
supernumerary tooth that occurs in the premaxilla, with a preva- Developmental enamel defects in 1-year-old infants
lence of 0.09–2.05%. Only 25% of mesiodens erupt; their pres- delivered with low and extremely low birthweights
ence can cause failure of eruption of the permanent successor V. MERGLOVA1, R. KOBEROVA2, Z. BROUKAL3, J. DORT4 &
and malocclusion.
H. TOBRMANOVA4
Case reports: A 4.5 -year-old healthy boy attended a paediatric 1
Dentistry Department, Faculty of Medicine in Pilsen, Charles
dental clinic following the loss of his upper right primary incisor,
University in Prague, Pilsen, Czech Republic; 2Dentistry
with no history of trauma or underlying cause. Clinical examina- Department, Faculty of Medicine in Hradec Kralove, Charles
tion showed no abnormalities. However, radiographic examina-
University in Prague, Hradec Kralove, Czech Republic; 3Dentistry
tion (periapical and panoramic) revealed a mesiodens in the
Department, 1st Faculty of Medicine, Charles University in
upper right primary incisor site. No further treatment was carried Prague, Prague, Czech Republic; 4Department of Neonatology,
out at that stage due to the good position of the mesiodens and
Faculty Hospital in Pilsen, Pilsen, Czech Republic
the age of the patient. At 6 months follow up, the mesiodens
erupted in place of the upper right incisor improving aesthetics Background: Preterm infants with very low birthweights (VLBW)
and compensating for the early loss of the primary incisor. At and extremely low birthweights (ELBW) suffer from several neo-
the age of 6.5 the upper left primary incisor exfoliated, further natal complications and morbidity that may affect mineralisation
imaging revealed no resorption of the mesiodens with displace- of primary teeth and occurrence of enamel hypoplasia and hypo-
ment and rotation of the upper right central incisor. The mesio- mineralisation.
dens was extracted under local anaesthesia. Nine months later Aim: The aim of the study was to evaluate the prevalence and
both upper right and left permanent incisors erupted normally. possible risk factors of enamel defects in primary dentition of
Comments: Proper diagnosis and management of supernumerary infants delivered prematurely with VLBW and ELBW.
teeth is essential, the timing of extraction of the supernumerary is Design: A cross-sectional study was carried out with 132 1-year
of utmost importance, early surgical extraction can cause iatro- old infants. The perinatal (gestational age, birthweight) and post-
genic damage to the adjacent structure and teeth, and requires a natal variables (frequency of orotracheal intubation, number of
general anaesthesia. teeth with enamel defects) were collected through hospital records
and clinical examination. The obtained data were statistically
PR02.24 evaluated using chi-squared test.
Results: The research cohort consists of 62 boys (47%) and 70
Dental findings in the diagnosis of ectodermal (53%) girls with mean gestational age 28.8 weeks, mean birth-
dysplasia with immunodeficiency: a case report weight 1119.7 g and mean number of erupted teeth 5.6. The
T. KAWAKAMI1, Y. HAGIWARA1, H. YONEYAMA1, M. prevalence of enamel developmental defects was 34.1% and the
MAEDA2, Y. ITO2 & H. KARIBE1 teeth most affected were maxillary central incisors in 52.2%. The
1
Pediatric Dentistry, School of Life Dentistry, The Nippon Dental gestational age (P = 0.22), gender (P = 0.054) and frequency of
University, Tokyo, Japan; 2Pediatrics, Nippon Medical School, orotracheal intubation (P = 0.053) correlated negatively to the
Tokyo, Japan number of primary teeth with enamel defects. The significant sta-
tistical relationship was between ELBW and the number of teeth
Introduction: Ectodermal dysplasia (ED) syndrome is a group of
with developmental defects (P = 0.009).
genetic disorders identified by lack or dysgenesis of at least two
Conclusion: The prevalence of developmental enamel defects of pri-
ectodermal derivatives such as hair, nails, teeth, or sweat glands.
mary incisors was 34.1%. ELBW represents statistically significant
More than 150 different variants of ED have been described. An-
risk factor for development of enamel defects in primary teeth.
hidrotic /Hypohidrotic ectodermal dysplasia with immunodefi-
ciency (EDA-ID) is characterized according to its various
manifestations, which include ectodermal dysplasia, vascular PR02.26
anomalies, and diverse immunological abnormalities. Two genes Management of pre-eruptive intra-coronal
responsible for EDA-ID have been identified: nuclear factor-jB radiolucency in a maxillary canine: a rare case report
(NF-jB) essential modulator (NEMO) for X-linked EDA-ID
A. ALKADHIMI, J. HENNESSY, E. AL-AWADHI & T.
(XL-EDA-ID) and IjBa for autosomal-dominant EDA-ID. GARVEY
NEMO mutations are scattered across the entire NEMO gene in
Department of Public and Child Dental Health, Dublin Dental
XL-EDA-ID patients, which explains the broad spectrum of clin-
University Hospital, Dublin, Ireland
ical manifestations. We report here the dental findings in a male
patient with XL-EDA-ID. Introduction: Pre-eruptive intra-coronal radiolucency (PEIR) is a
Case reports: An 8-year-old boy was referred to our department rare but significant radiographic finding. It has been described as a
with the chief complaint of delayed eruption of the permanent lesion in the coronal dentine, adjacent to the dentine-enamel junc-
teeth. The patient presented with several abnormalities including tion of an unerupted tooth. There are very few cases in the litera-
ture describing PEIR. Only four studies have reported on the prev- PR02.28
alence of this condition. It ranges from 0.85% to 6%. The aetiology
Idiopathic pre-eruptive coronal resorption of four
is not fully understood, however four aetiologies have been pro-
posed to explain these radiolucent lesions. Currently, the most impacted mandibular premolars in a child with
widely accepted theory is idiopathic external dentine resorption. STIM-1 deficiency
The prognosis for the affected tooth will depend on the lesion size, M. LAMBRECHTS1, I. MEYTS2, M. PEUMANS1 & G.
pulpal involvement and timing of intervention. At the moment VANSTEENKISTE1
1
there is a lack of consensus in the management of these lesions. Department of Oral Health Sciences and Department of
Case reports: A 12-year-old boy was referred to the orthodontic Dentistry, Unit of Paediatric Dentistry and Special Dental Care,
unit in St James’s Hospital, Dublin, for treatment of a posterior University Hospitals Leuven and University of Leuven, Leuven,
crossbite. Clinical examinations revealed a class I incisor relation- Belgium; 2Department of Immunology and Microbiology,
ship on a class I skeletal base, with overjet of 2 mm, overbite Childhood Immunology and Department of Pediatrics, University
50%, complicated by a unilateral crossbite on the right side asso- Hospitals Leuven and University of Leuven, Leuven, Belgium
ciated with 2 mm displacement. There was an incidental finding
Introduction: STIM-1 or oral interaction molecule 1 plays a cru-
of PEIR on the unerupted maxillary left permanent canine on
cial role in store-operated calcium entry (SOCE), an important
the pre-treatment radiographs. The crossbite was corrected ortho-
calcium influx pathway in many non-excitable and some excitable
dontically. The tooth was then root canal treated and restored
cells. STIM-1 deficiency leads to primary immunodeficiency, mus-
with glassfibre post and indirect composite resin crown.
cular hypotonia, anhidrotic ectodermal dysplasia with amelogene-
Comments: The difficulty in terms of management is whether to
sis imperfecta, autoimmunity and lymphoproliferative disease.
intervene surgically or monitor the tooth until it has erupted. Thus,
Here we describe a case with resorption of impacted teeth, not
it is important to determine whether or not the lesion is progressive.
yet described in association with STIM-1 deficiency.
Case reports: A 7-year-old boy from consanguineous Turkish
PR02.27 parents was referred to the paediatric dental department for the
Minimally invasive rehabilitation of a case with management of amelogenesis imperfecta. Between 2000 and 2009,
amelogenesis imperfecta permanent teeth needed extensive restorative treatment. A pano-
ramic radiograph at the age of 13, led to the presumption that
M. A. CHAUDHARY & F. S. L WONG
all four mandibular premolars were impacted, which was con-
Paediatric Dentistry, Barts and the London School of Medicine
firmed 2 years later. Surgical extraction was suggested as treat-
and Dentistry, Queen Mary University of London, London, UK
ment option, but because of noncompliance never executed. At
Introduction: Amelogenesis imperfecta (AI) is a hereditary devel- the age of 20, continued resorption of the crowns of the impacted
opmental condition that effects the dental enamel. premolars was seen. A radiograph taken 2 years later showed
Patients with AI have weak enamel and therefore present with progression, with almost complete resorption of the crowns,
dental sensitivity and breakdown of hard tissues. This has a extending to the roots. Considering the medical condition of the
marked impact on the child and adolescent patients aesthetics patient, further follow-up without intervention was suggested.
and function, leading to psycho-social issues. In light of this the Comments: Impaired SOCE is known to interfere with hard tissue
paediatric dentists have a vital role in the treatment of AI for formation, leading to amelogenesis imperfecta. The exact mecha-
immediate and long term benefits. nism of action is not yet understood. Inadequate SOCE leads to
Case report: A 14-year-old boy with AI presented with unsatis- impaired mineral deposition by osteoblasts. Osteoclasts will still
factory aesthetics and dental hypersensitivity. The intraoral show resorption activity, but resorption pits are smaller. Current
examination revealed the patient to be in a permanent dentition knowledge regarding STIM-1 deficiency does not provide an
phase. A decrease in the vertical dimension with a resultant trau- explanation for the unusual resorption pattern of impacted pre-
matic deep bite leading to structural loss of the labial aspects of molars seen in this case.
the mandibular incisors was observed. A hypoplastic smooth and
thin form of AI was diagnosed. A treatment plan was formulated PR02.29
with focus on prevention and rehabilitation. Initially, preventive
treatment was implemented, with fluoride varnish and tooth Microscopic analysis of new dental anomaly: molar-
mousse. In the second stage rehabilitation treatment was exe- incisor malformation (MIM)
cuted. Face bow records were taken. Gold onlays were provided J. M. JANG, H. S. LEE, J. S. SONG & J. H. LEE
with minimally invasive dental preparation on the posterior teeth Department of Pediatric Dentistry, College of Dentistry, Yonsei
whereas direct composite resin restorations were used to improve University, Seoul, Korea
the appearance of anterior teeth. The treatment resulted in estab-
Background: Molar-incisor malformation (MIM) is a newly dis-
lishing the vertical dimension, reduction of the dental hypersensi-
covered type of dental anomaly that involves a characteristic root
tivity and improvement of the aesthetic and function, along with
malformation of the permanent first molars. A MIM tooth has a
the quality of life.
thin, narrow, or short root and a normal crown. Although the
Comment: Paediatric dentist have a pivotal role in improving the
first permanent molar is most commonly affected, occasionally
quality of life by protecting the enamel along with dealing with
the second deciduous tooth can exhibit these characteristics along
the psychosocial issues related to AI.
with cervical malformation of the upper incisors.
Aim: The aim of this study was to reveal the microstructure of
MIM teeth.
Design: Two MIM teeth were extracted from a 9-year-old girl
due to severe mobility. The detailed microstructure of the teeth
was determined by examinations using microcomputed tomogra-
phy (micro-CT), hematoxylin-eosin (HE) staining, immunohisto-
chemical staining with antibodies raised against osteocalcin (OC),
dentin sialoprotein (DSP), and collagen XII, and scanning elec-
tron microscopy (SEM) to reveal the detailed microstructure.
Results: Micro-CT and HE staining revealed the presence of a tooth decay. A multi-disciplinary approach to management is
normal crown, malformed root, and thick pulpal floor. The pul- therefore essential. This case presents the dental care for a Turner
pal floor comprised three layers: upper, middle, and lower. syndrome patient.
Amorphous hard tissues and hyperactive cells were observed in Case reports: A 14Y11M girl with Turner syndrome came to our
the middle layer of the pulpal clinic for dental treatment. Her clinical features showed some
floor, and the cells stained positively for DSP and OC, but not typical characteristics of Turner syndrome such as: short stature,
for collagen XII. SEM revealed the presence of crystal-like struc- low hairline, low-set ears, obesity, small feet and typical facial
tures and a reduction in the number of dentinal tubules at the features like down-slanting eyes and hypertelorism. Dental exam
boundary between the upper and middle layers of the pulpal showed high palatal vault, spaced dentition and some caries as
floor. well as poor periodontal health. Mental retardation was also
Conclusions: MIM-affected molars have a normal crown and a present. Due to her mental retardation and inability to cooperate,
malformed root, and appear to result from inappropriate differ- dental treatment under GA was suggested. Full mouth rehabilita-
entiation of the apical pulp. tion was done under GA followed by periodic check-ups and pre-
ventive dental care in 3-month intervals.
PR02.30 Comments: Early diagnosis of oral anomalies and timely treat-
ment of dental problems is important for patients with Turner
Children with deciduous-molar-hypomineralisation are syndrome. Effective patient assessment and regular dental check-
at higher risk of developing molar-hypomineralisation ups are advised to manage problems with tooth abnormalities
P. F. JIMENEZ1, D. M. PEREIRA1, J. N. VIVES1 & V. A. thus improving their quality of life.
PEREZ1,2
1
Department of Pediatric Stomatology, University of Talca, Talca, PR02.32
Chile; 2Department of Pharmacology and Therapeutics, The
University of Melbourne, Melbourne, Vic., Australia Multiple anomalies in the mixed dentition: a case
report
Background: Deciduous-Molar-Hypomineralisation (DMH) is R. INDRIYANTI
defined as demarcated opacities affecting second primary molars.
Pediatric Dentistry, Padjadjaran University, Bandung, Indonesia
Due to anatomical co-localisation and overlapping development,
it has been suggested that DMH might be used as a predictor of Introductions: Impaired tooth development (Anomaly) may occur
Molar Hypomineralisation (MH), a prevalent enamel defect of 6- due to the presence of abnormalities at the time of differentiation
year-old molars that causes increased caries risk for affected chil- of dental lamina and tooth germ, as well as abnormalities at the
dren. As MH aetiology remains unknown, clinical detection of time of the formation of dental hard tissues. Tooth development
risk factors of MH is needed to establish early dental-care mea- disorder can occur because inherited, congenital, or idiopathic.
sures, in an effort to prevent and limit pathological sequelae. Case reports: A 10-year-old girl came with complains of the max-
Aim: To determine the prevalence of DMH and its relationship illary anterior teeth has the shape and arrangement of irregular
with MH in 6-to-9-year-old children. that it interferes with the aesthetic and often wound on the inner
Design: This cross-sectional study with appropriate ethical lips because of sharp teeth. Intraoral examination and radio-
approval included 207 children who received dental care at the graphs showed excessive number of teeth on the upper jaw,
Dental Clinics Centre of the University of Talca, Chile. Clinical reduced the number of teeth on the lower jaw, as well as the
check-up was undertaken by a DMH/MH-calibrated examiner anomalous shape of deciduous teeth and permanent teeth in the
(Kappa = 0.865/0.855). Exact Binominal Test was used to deter- maxilla and mandible. The treatment was supernumerer tooth
mine prevalence and relative risk (RR) between DMH and MH. extraction which causes sores on the lips and the inside of the
Results: The prevalence of DMH and MH was 28% and 32.3% tooth that has undergone unsteadiness persistence. For preventive
at child level and 13.4% and 20.4% at molar level, respectively. action performed fissure sealant on the teeth with a deep fissure
The risk for MH based on DMH presence was statistically signif- in the teeth as well as fusion, geminasi, and spoon-shaped teeth.
icant at child (RR 2.21, CI 1.52–3.21) and molar levels per quad- Comments: It takes a long-term care plans include revocation,
rant (Molar 1.6/RR 3.64 CI 2.18–6.07; 2.6/RR 3.06 CI 1.89–4.95; aesthetic restoration, creation of permanent and temporary den-
3.6/RR 2.65 CI 1.46–4.80; 4.6/RR 2.54 CI 1.45–4.46). tures, and orthodontic treatment. Provide clear information to
Conclusion: DMH-affected children are at higher risk of develop- patients and their parents with regard to the treatment to be per-
ing MH. Thus, DMH presence may be used as a clinical predic- formed and counseling inheritance pattern.
tor of MH in the studied population. The validation of these Keywords: Dental anomalies, developmental anomaly, pattern of
findings in a larger population need further research. inheritance
PR02.31 PR02.33
Dental management of a patient with Turner Effect of analgesics in mineralization degree of
syndrome – a case report molars and incisors of mice
J. M. SU
C. SERNA, A. PEREZ, Y. MARTINEZ, A. VICENTE & A. J.
Dental Department, Show-Chwan Memorial Hospital, Chang-Hua, ORTIZ
Taiwan University of Murcia, Murcia, Spain
Introduction: Turner syndrome is a common genetic disorder Background: To date, molar incisor hypomineralization has been
associated with a 45X karyotype, many of which involve mosai- associated to several factors, including prenatal, perinatal and
cism. It only affects girls and the prevalence is around one in postnatal ones. Within the latest, the use of analgesics has been
2500 female live births. The most characteristic features of this proposed as a possible etiological factor.
syndrome are growth failure, congenital heart disease, gonadal Aim: To determinate mineralization degree of molar and incisor
failure, and learning disabilities. Dental manifestations include enamel of just weaned mice medicated during 30 days with ibu-
high arched palate, poor or abnormal tooth development that profen and acetaminophen.
may lead to a greater risk of tooth loss, periodontic disease and
Design: A total of six mice were included in each group (acetami- instances, AI can be linked with delayed eruption. I will describe
nophen n = 6, ibuprofen n = 6 and control group with no medi- a child with Enamel Agenesis Amelogenesis Imperfecta.
cation n = 6). Medication were administered during 30 days. Case report: A 8-year-old girl was initially referred for tooth sur-
Samples were fixed in 10% buffered formalin (1 week), dehy- face loss and delayed eruption. There was no reports of any dis-
drated 24 h and sputter coated with carbon and examined by comfort, but parents and the patient were worried about the
EDX (JSM-6100 JEOL SEM). The counting was conducted on appearance Clinical examination revealed severe tooth loss in the
all cusps of molars, and the incisal, middle and cervical third of primary dentition with no permanent teeth clinically present.
incisors. Interproximal caries were noticed in the upper primary molars.
Results: With the anova one way test the results were as follow: There was an anterior openbite present. Radiographic assessment
Calcium: control 47.72 0.89; Acetaminophen 39.55 0.94; showed that all permanent successors are visible, with a thin
Ibuprofen 42.58 1.44. Phosphate control 22.02 0.46; Acet- layer of enamel. The immediate plan involves a comprehensive
aminophen 19.18 0.42; Ibuprofen 19.11 0.47 prevention plan with high fluoride toothpaste and regular fluo-
Ratio Ca/P: control 1.67; Acetaminophen 1.59; Ibuprofen 1.72. ride applications. Restorative plan involved full coverage restora-
There were statistical difference between control group compared tions on the primary second molars and a denture replacing
with both study groups (P < 0.05). upper primary anterior teeth for aesthetic reasons. Long term
Conclusion: Ibuprofen and acetaminophen produced a decrease in plan includes 3-months reviews and full coverage restorations of
mineralization degree of molar and incisor enamel of mice. permanent teeth following eruption.
Comments: As paediatric dentists, we may be the first to diagnose
PR02.34 this dental anomaly. Early identification and comprehensive plan-
ning is essential to improve the long term prognosis.
Tricho-Dento-Osseous syndrome and its phenotypic
aspect: a case report PR02.36
V. SIURBLYTE, G. REKEVICIUTE, E. SLABSINSKIENE & B.
JANKAUSKIENE Case report: pre-eruptive coronal resorption of
Lithuanian University of Health Sciences, Kaunas, Lithuania mandibular canine
G. DILER & H. C. BODUR
Background: Tricho-Dento-Osseous syndrome is a rare autosomal
Gazi University, Ankara, Turkey
dominant disorder which belongs to the group of ectodermal dys-
plasias, which usually affects hair, teeth, bones, nails and/or skin. Introduction: Pre-eruptive coronal resorption appears as a radio-
It is difficult to recognize and name the diagnosis of Tricho-den- lucent lesion in the coronal dentine of an unerupted tooth. These
to-osseous sindrome (TDO) because of its various possible phe- lesions are usually detected with routine dental radiographs.
notypic aspects, as not always all triad of the clinical features are However the aetiology of resorption remains unclear.
evident, some defects are not visible namely the defects of hair, Case report: A 11 years 5 months old boy was refferred to Gazi
nail and bones. The purpose of this case report case is to help to University Faculty of Dentistry Department of Paediatric Den-
detect general and intraoral features which are meant to be con- tistry for restorative management of tooth #43. Intraoral exami-
sistent in this TDO syndrome, which would help to make diagno- nation revealed only the cusp of the tooth was visible in the
sis quickly and precisely and start the treatment as soon as mouth and the tooth was asymptomatic. There was an irregular
possible. radiolucent area within the crown involving both enamel and
Case presentation: An 8.5 year-old boy together with his mother dentine. The demineralized tooth structures were excavated and
addressed to our Clinic for Preventive and Paediatric Dentistry, temporary restoration was performed with glass ionomer cement.
in Kaunas. The patient was diagnosed with the main clinical fea- At the end of 3 months, the tooth was erupted and following fur-
tures of TDO sindrome: severe generalized enamel hypoplasia, ther excavation of remaining demineralized tooth structures, the
kinky, uncombable hair and nail or skin defects, but taurodontia tooth was restored with composite resin.
and bone density deffects are not identified in our clincal case. Comments: In this case, eruption process of a tooth with intraco-
Conclusion: According to clinical and radiological data, the TDO ronal resorption was followed up for 13 months, where as the
syndrome with attenuated phenotypic expression was diagnosed lesion of tooth was treated gradually.
to our clinical case. If we want to prove our diagnosis, we need a
molecular genetic investigation of DLX3 gene. This article reveals PR02.37
the variety of phenotypic expressions of TDO syndrome, and
shows that its explanation requires further studies, which would Pre- eruptive intra-coronal resorption in a maxillary
help to better understand the genetic-phenotypic correlation. canine tooth
Z. HATIPOĞLU & N. AKAL
PR02.35 Gazi University Faculty of Dentisrty, Ankara, Turkey
Enamel agenesis amelogenesis imperfecta in a 8-year Introduction: Eruption of the teeth with coronal resorption could
old patient be challenging to diagnose for clinicians. Pre- eruptive intra-coro-
A. S. ALTIMIMI nal resorption is a defect located in the dentin of an unerupted
tooth, just beneath the dentin-enamel junction. The depth of the
Paediatric Dentistry, Leeds Dental Institute, Leeds, West
lesion is variable and may also reach the pulp. A more common
Yorkshire, UK
view that these lesions are sourced from resorption, however
Introduction: Amelogenesis imperfecta (AI) is a hereditary dental there might be many reasons about the etiology. The report
disorder affecting the formation of enamel. The prevalence describes the clinical management of a case of a pre-eruptive
ranges from 1 : 700 to 1 : 14,000, depending on the population. intra-coronal resorption.
Various classifications are available with Witkop’s classification Case reports: 13 year old girl was referred to Gazi University
being mostly used. This is based on the phenotype, which are Faculty of Paediatric Dentistry for restorative management of
divided into four groups; hypoplastic, hypomature, hypocalcified, tooth # 23. The patient claimed that tooth erupted with caries
and hypomature hypoplastic with taurodontism. In some and there was no tooth structure in appearance. Intraoral exami-
nation revealed soft tissue like caries intracoronally in tooth #
23. Based on the lack of symptoms, the soft tissue was excavated No root pathology was discovered.
and apexogenesis was started. However, in the next control Dental examination of the other family members was performed
appointment, the treatment was shifted to apexification due to and the family dental history was constructed.
the tooth mobility and the patient suffering from pain. After root On the basis of the clinical and radiographic appearance, Amelo-
canal treatment, the restoration was completed with composite genesis Imperfecta Type I was suspected.
(Tetric N- Ceram Ivoclar Vivadent, Asia). Esthetics and function The treatment plan included adherence to oral hygiene rules,
were recorded with a 2-year follow-up period. 30 months after remineralizing therapy, restoration of molars with standard
the restoration, because of coming with missing filling it was crowns, restoration of anterior teeth with non-invasive veneers.
decided to make the crown restoration to the patient. Comments: The treatment of AI depends on age at which the
Comments: According to the 3 years radiographic and clinical diagnosis was established.
follow-ups, the teeth were asymptomatic and esthetic was main- The main aims of the therapeutic treatment are: to prevent early
tained during this time. pathological abrasion of patient’s teeth and prepare the patient
for orthodontic treatment.
PR02.38
Regional odontodysplasia: report of a case PR02.40
N. GÜNGÖRDÜ & D. ATABEK Early loss of primary incisors: a suspected case of
Gazi University, Ankara, Turkey hypophosphatasia
Introduction: Regional odontodysplasia (RO) is a rare develop- C. M. FEENEY1, Z. J. GREENWOOD2 & S. LEE2,3
1
mental odontogenic anomaly that affects the enamel, dentin, den- Community Dental Services, Betsi Cadwaladr University Health
tal pulp and dental follicle of both primary and permanent Board, Liverpool, UK; 2Community Dental Services, Betsi
dentitions. The affected teeth are described as ‘ghost teeth’. The Cadwaladr University Health Board, Rhyl, UK; 3Paediatric Dental
maxilla is typically affected twice as often as the mandibula. The Department, Liverpool Dental Hospital, Liverpool, UK
clinical and radiographic findings of a case with RO on the right Introduction: Hypophosphatasia (HPP) is a rare metabolic bone
mandibula and treatment objectives are presented. disease where oral symptoms are often the first clinical signs of
Case reports: A 10 year-old male came to Gazi University, Fac- the disease and can provide the key to its diagnosis. HPP is char-
ulty of Dentistry, Pedodontics, with lack of teeth on the right acterised by low or zero levels of tissue-non-specific-alkaline-
mandibula. The patient had neither other local abnormalities nor phosphatase (ALP).
any relevant medical history. Clinical examination revealed that Severe forms of HPP have a prevalence of 1 : 100,000 live births;
permanent incisors and canine tooth on the right side of the however it is speculated that the milder forms have a higher prev-
mandibula were affected. At the affected area, the gingiva was alence as they tend to go undiagnosed for a number of years[i].
enlarged, fibrous, and tense. Radiographically, the affected teeth Early loss of teeth is characteristic of all forms of HPP, in partic-
showed abnormal morphology and hypoplastic crowns. The pulp ular early exfoliation and periodontal changes in the primary
chambers were wide and the roots were short with wide and open dentition. These signs, along with low ALP levels are often diag-
apices. The gingivectomy and aesthetics composite restoration nostic of HPP. We describe the initial diagnosis and investigation
were planned in order to resolve the sensitivity and aesthetics of a boy with suspected HPP
problems of the patient. Case reports: A 4-year-old boy attended the community dental
Comments: Treatment of RO is controversial and no consensus services for routine care. An examination revealed that the upper
has yet been raeched. The dentist should take into consideration incisors were splayed and mobile. His mother reported loss of
factors such as the medical history, the age, the number of the lower incisors at age two. Medical history included annual
affected teeth, the presence of any pathology. The conservative radiographic review of the long bones in the first 2 years of life
treatment of these patients is preferable to extraction due to pre- due to concerns regarding bowing of the legs.
serve optimum oral function and aesthetics until the end of the A radiograph of the upper incisors showed funnel-shaped bony
growth period. defects. Shortly afterwards the upper left central incisor exfoli-
ated with the root intact. Blood tests revealed very low levels of
PR02.39 alkaline phosphatase. A diagnosis of suspected HPP, pending
review by the paediatrician was made.
Amelogenesis imperfecta type I. Hypoplastic: a case Comments: Dentists are often the first clinicians to recognise
report (therapeutic treatment) HPP, particularly in its childhood form and vigilance is essential
O. I. KHAKHALINA, A. G. SEDOYKIN & L. N. DROBOTKO in identifying atypical exfoliation patterns of primary teeth.
Paediatric Dentistry Department, Moscow State University of
Medicine and Dentistry named after A.I. Evdokimov (MSUMD),
Moscow, Russian Federation
PR02.41
Non-syndromic supernumerary teeth in maxillary and
Introduction: Amelogenesis imperfecta (AI) is a genetically deter-
mined disease affecting primary and permanent teeth.
mandibular region
Children are worried about aesthetic aspect of their teeth (discol- M. F. VALENZUELA-SAENZ, J. E. AYON-JAIME, M. A.
orations, destruction of enamel structure, hypersensitivity, ZAMUDIO-GOMEZ, C. A. FREGOSO-GUEVARA & I. A.
pathology of occlusion. VERDUGO-VALENZUELA
Case report: A 9-year-old girl patient was referred to the Pediat- Pediatric Dentistry Posgraduate Program, Universidad Aut
onoma
ric Dentistry Department of Moscow State University of Medi- de Baja California, Tijuana, Mexico
cine and Dentistry due to discoloration of her teeth (dark-yellow Introduction: Supernumerary teeth or hyperdontia are abnormal
color), hypersensitivity, having difficulty chewing food. teeth development that may or may not be associated with a syn-
The patient’s medical history revealed allergy to penicillins, drome. Hyperdontia is defined as teeth that exceed the normal
severe toxicosis in the mother during the first trimester of preg- dental formula. According to the literature, the reported preva-
nancy. lence is 0.1–3.8% in permanent dentition. Males are affected
Radiographic examination revealed that enamel was located only twice as frequently when compared to females. The presence of
in the cervical part of the crowns of the teeth.
multiple supernumerary teeth associated with non- syndrome PR02.44

occurs in <1% of cases.
Dental care for a Cornelia de Lange syndrome child
Case reports: An 11.1 year old male patient was presented to the
I. C TIEN1,2 & S. T. HUANG2,3
clinic for a routine check. The patient gave familial history of 1
Guan-Jie Dental Clinic, Hsing-Chu, Taiwan; 2Department of
extra teeth in his father. At clinical examination we observed
Dentistry, Division of Special Care Dentistry, Kaohsiung Medical
Class I molar relationship type 2 Deway-Anderson with signs of
University Hospital, Kaohsiung, Taiwan; 3Department of Oral
hypomineralization in second premolars, root fragments left
Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan
upper second primary molar and the presence of upper canine
left of the first dentition, an erupted supernumerary in the pala- Introduction: Cornelia De Lange Syndrome (CdLS) is a rare con-
tine area and the upper left permanent canine eruption in pro- genital disease which affects the physical and psychological devel-
cess. In the panoramic radiograph a total of six supernumerary opment of the child. It is characterized by craniofacial, skeletal,
teeth were observed, five of them unerupted, two in the right jaw gastrointestinal and cardiac deformities or malformations. The
and two in the left jaw with a normal crown form in the premo- incidence is estimated at 1 in 30,000~50,000 neonates. Diagnosis
lar region, the other one between the right upper canine and pre- of this disease is difficult, to date is mainly based on clinical find-
molar with undefined crown form. ings.
Comments: The pediatric dentist should be aware of this condi- Case report: Here, we want to present a case of a 12 y/o girl who
tion; the presence of multiple supernumerary teeth can interfere were diagnosed as Cornelia De Lange syndrome. The poor func-
in the normal occlusal development and aesthetic so it’s essential tion of mastication, malnutrition, severe delayed physical devel-
to diagnose them as soon as possible to give prevention and opment, loss of facial muscle tone and being long-term bedridden
management of complications. was noticed, and the episode of dysphagia and esophageal reflux
was appealed frequently. She also suffers from epilepsy and was
PR02.42 hospitalized for aspirational pneumonia several times.
She visited our dental department due to full mouth gum bleed-
Developmental defects of enamel in first permanent ing and severe gingival inflammation. In the oral examination,
molars associated with use of asthma drugs at she had full mouth severe calculus deposition, delayed exfoliation
preschool age in Greek children. A retrospective case- of deciduous teeth and class II malocclusion was noticed.
control study In the treatment planning, we conducted oral hygiene instruction
A. MASTORA1, G. VADIAKAS1, A. AGOUROPOULOS1 & P. to her parents, performed full mouth scaling using manual instru-
GARTAGANI-PANAGIOTOPOULOU2 ments due to her choking tendency, extract the retained decidu-
1
Faculty of Dentistry, Department of Paediatric Dentistry, School ous teeth #51, 61, 71 and fluoride application for caries
of Health Sciences, University of Athens, Athens, Greece; 2First prevention were arranged. The 3 months interval check-up sche-
University Department of Pediatrics, Pediatric Pulmonology dule was set for her to promote her oral health and hygiene.
Clinic, University of Athens School of Medicine, Aghia Sophia Comments: In this case of Cornelia De Lange Syndrome, who
Children’s Hospital, Athens, Greece always suffered of physical, psychological and intellectual disabil-
ity, may need of intensive dental care from dental professional,
Background: Asthma and drugs used for treatment have been parents and caregivers to enhance their oral and dental health.
studied as potential risk factors for Developmental Defects of
Enamel (DDE) in a few studies.
Aim: To investigate the association between the occurrence of
PR02.45
DDE, in first permanent molars, and bronchodilators and/or cor- Dens invaginatus, hypodontia and taurodontism in the
ticosteroids intake for asthma like episodes treatment at pre- permanent dentition of a healthy child
school age, in 6–12 year old children. C. MATSIOULA1, H. VASTARDIS2, Y. GYFTODIMOU3 & L.
Design: Children of study group (n = 70) were followed in the PAPAGIANNOULIS1
Pulmonary Clinic of ‘Aghia Sofia’ Children’s Hospital, Athens 1
Paediatric Dentistry, Dental School, Αthens, Greece; 2Oral
and had used asthma drugs (0–4 y.o) Control group (n = 70) Biology, Dental School, Athens, Greece; 3Department of Genetics
consisted of healthy children who visited the Postgraduate Paedi- Institute of Child Health, Athens, Greece
atric Dental Clinic, University of Athens. Information regarding
demographic data, medical history, pregnancy, birth weight, Introduction: Dens invaginatus occurs as a result of the invagina-
duration of breastfeeding, mother’s smoking habits and antibiotic tion of the enamel organ. Hypodontia is characterized by the
use, at preschool age were obtained through questionnaire. Data developmental absence of one to six teeth excepting third molars.
for asthma drugs were extracted from medical records. Modified Taurodontism is another dental anomaly where involved teeth
DDE Index was used. Chi square statistics, Spearman correlation have enlarged and elongated bodies and pulp chambers with api-
and logistic regression analysis were conducted (P ≤ 0.05). cal displacement of the pulpal floor. A rare case of a healthy
Results: DDE were present in 24 children (34.3%) in the study male with these concurrent dental anomalies in his permanent
group and only in 6 (8.6%) in the control. Difference between dentition is presented.
the two groups was statistically significant (OR = 5.56). 41.6% of Case report: A healthy 8-year-old boy was referred for the man-
the children with DDE presented hypoplastic molars with loss of agement of a dental abscess in the maxillary left permanent lat-
enamel. Type of asthma drug, age at treatment onset and dura- eral incisor (22). Clinical examination revealed abnormal size and
tion of drug use were not significantly associated with the sever- shape of 22, a fistula in the area, malocclusion (class II, deep
ity and extent of DDE. Gender was the only statistical significant overbite) and a missing incisor in the mandible. The radiographic
factor. examination showed dens invaginatus type III with open apex
Conclusions: The use of asthma drugs in preschool age was asso- and periapical lesion in 22, hypodontia involving bilateral agene-
ciated with DDE occurrence. Severe hypoplastic lesions with loss sis of maxillary canines, agenesis of a maxillary lateral incisor, an
of enamel was a frequent finding among affected molars. ipsilateral premolar and a mandibular incisor. Finally, taurodon-
tism of primary and permanent molars in maxilla and mandible
was observed. Comprehensive dental care was undertaken con-
PR02.43 sisting of the application of a preventive program, endodontic
Abstract withdrawn treatment and restoration of 22 and orthodontic treatment. Dur-
ing the 1 year recall the clinical and radiographic examination affected. The lower left molar was severely affected, with brown-
revealed no pathological signs and symptoms. Due to the fact ish discoloration and partial enamel breakdown, cavitation
that taurodontism has been associated with chromosomal aneu- extending into dentin. Both upper molars presented discolor-
ploidy, karyotype analysis has been scheduled. ations, but no hard tissue loss was recorded: 1.6 showed mild
Comments: The triad of dens invaginatus, hypodontia and taur- defects with demarcated opacities, on 2.6 the yellow-brownish
odontism is very rare. Dentists should investigate the correlation area reached into the occlusal half of the smooth surfaces. After
of dental disorders to the underlying genetic alterations. gently cleaning and polishing, the soft parts of the occlusal
enamel of 3.6 were carefully removed under pain-free conditions,
PR02.46 and occlusal filling with fluoride-releasing glass ionomer cement
(Fuji Triaje, GC) was applied. The upper molars were treated
Prevalence of dental developmental anomalies: a with fissuresealant (Clean Pro, 3M). Additional preventive home-
radiographic study care was administered using amorphous calcium phosphate
€
Ö. A. ÖGE, L. OZKAN, S. KORUN, A. ISLAM, H. TUNC ß & S. (Tooth Mousse, CG) on a weekly basis. The 6 month, 1 year
C
ß ETINER and the 2 year follow-up showed arrested defects.
Pediatric Dentistry, Near East Univesity Faculty of Dentistry, Comments: For MIH patients, early diagnosis and treatment is of
Nicosia, Cyprus essential importance. The applied methods should follow the
principles of minimal invasive dentistry with highlights on pre-
Background: The study of developmental dental anomalies is
ventive measures.
important as it generates information that is important for both
anthropological and clinical management of patients. Addition-
ally developmental dental anomalies are rarely observed by den- PR02.48
tal practitioners. Minimal invasive treatment protocol for young
Aim: The aim of the study was to determine the prevalence of patients with enamel hypoplasia. A report of 2
developmental dental anomalies and the gender difference related
to these anomalies in patients attending Near East University,
clinical cases
paediatric department of school of dentistry. M. KUKURBA-SETKOWICZ
Design: This retrospective study was based on the panoramic Private Dental Office, Krakow, Poland
radiographs of 2784 patients (1429 female, 1355 male) attending Introduction: Enamel hypoplasia is a developmental defect of the
the Near East University, paediatric department of school of den- enamel that is caused by initial failure of the deposition of enamel
tistry between the dates of January 2008 to January 2015. The protein, clinically visible as enamel defects. Disorders that occur
radiographic investigation included one panoramic radiograph during the stages of enamel development and maturation reduce
from each individual. The ages of the patients examined ranged the amount or thickness of the enamel, resulting in white spots,
from 3 to 18 years. These patients were examined for the following tiny grooves, depressions and fissures in the enamel surface.
developmental dental anomalies: hypodontia, supernumerary Case reports: This paper based on two cases presents treatment
teeth, microdontia, infra occlusion of deciduous teeth, impacted protocol for patient with EH. Case 1: Seven year- old female
teeth, taurodontism, fusion and germination. Additionally pres- patient with localized enamel hypoplasia on teeth 11 and 21 due
ence of systemic diseases and history of trauma was also recorded. to trauma of primary predecessor, Case 2: Sixteen-year old
Results: Of the 2784 patients, 433 patients had one or more female patient with generalized enamel hypoplasia. In both cases
developmental dental anomalies (15.6%). The percentage of minimal invasive approach was applied after initial examination,
anomalies was 7.4% for boys and 8.1% for girls. P values indi- using CPP-ACP daily in order to obtain a remineralization of the
cated that the dental anomalies were statistically independent of enamel opacities. Enamel defects were restored with composite
gender (P > 0.05). Anomalies seen frequently were hypodontia resin to improve aesthetic appearance. In case 2 microabrasion
(7.9%), impacted teeth (1.7%) and taurodontism (1.2%). with 18% hydrochloric acid was used to reduce discoloration and
Conclusions: The most common developmental dental anomaly preparing enamel surface. All restoration were re-evaluated after
was hypodontia and mandibular left second premolar teeth was 6 and 12 months – aesthetic appearance were satisfactory, and
frequently the missing teeth. the restorations were intact and functional. In order to decrease
the risk of recurrence of the defects patients were asked to main-
PR02.47 tenance therapy with CPP-ACP.
Comments: The presented protocols based on the combined use
Arresting progression of molar-incisor of CPP-ACP and low-invasive treatment options have shown to
hypomineralisation (MIH) syndrome on permanent be effective and safe, with a good clinical outcome.
first molars – a case presentation
E. MLINKÓ, I. TARJAN, AN
D. Z. NAGY, G. FABI & N.
PR02.49
ROZSA
Department of Paedodontics and Orthodontics, Semmelweis Chronology of developmental defects of enamel and
University, Budapest, Hungary its relation to systemic disturbances – a case series
R. M. MALLIKARJUNA
Introduction: The molar-incisor hypomineralisation (MIH) syn- Paediatric Dentistry, Oman Dental College, Muscat, Oman
drome is an enamel matrix formation disturbance of the first
molars and incisors with multicausal aetiology. Following tooth Introduction: Local and systemic factors can interfere in forma-
eruption, hypomineralised dental hard tissues with high porosity tion of tooth. Interfering with the normal matrix formation leads
are lost rapidly with subsequent caries development. Hypersensi- to enamel hypoplasia and factors interfering calcification and
tivity of the affected teeth and the decreased adheration capacity maturation produces enamel hypocalcification. Developmental
to dental materials make the clinical management more difficult. defects in tooth can be correlated chronologically to the time of
Case report: A 7-year-old girl was referred for treatment accusing systemic disturbances.
persisting hypersensitivity and irregular pain on tooth 3.6. Clini- Case reports:
cal examination revealed hypomineralized enamel defects on all Case 1: An 8-year-old girl with complaint of sensitivity on drink-
four fully erupted first permanent molars. The incisors were not ing water was referred for management of enamel hypoplasia in
relation to 11, 12, 21, 22, 16, 26, 36, and 46. On interviewing PR02.51
mother revealed history of severe calcium deficiency at birth and
Amelogenesis imperfecta: a report of 4 cases with
pregnancy.
Case 2: A 7-year-old girl with complaint of sensitivity on eating long term management and 7 years follow-up
food was referred for management of fluorosis in relation to 11, E. PANAGIOTOU1, A. BABATZIA1, S. PAPANAKOU1, O.
21, 16, 26, 36, and 46. On interviewing parents revealed history SAKELLAROPOULOS2, M. ANGELOPOULOU1 & G.
of staying in a place with high fluoride content in water during VADIAKAS1
1
the first year of child. Paediatric Dentistry, National and Kapodistrian University of
Case 3: A 9-year-old boy with complaint of discoloured teeth Athens, Athens, Greece; 2Operative Dentistry, National and
was referred for management of enamel hypoplasia in relation to Kapodistrian University of Athens, Athens, Greece
11, 21, 16, 26, 36, and 46. On interviewing parents revealed his- Introduction: Amelogenesis Imperfecta (AI) is a heritable enamel
tory of episode of high fever and hospital admission at the age of defect with many classifications depending on the quality and/or
8 months. the quantity of dental enamel. AI can affect both the primary
Case 4: A 10-year-old boy with complaint of discoloured teeth and the permanent dentition and is inherited with multiple pat-
was referred for management of tetracycline stain in relation to terns. Severe sensitivity of teeth, unsatisfactory esthetics and poor
anterior teeth. On interviewing parents revealed history of admin- mechanicals properties of dental tissues are the most common
istration of tetracycline during first year of life. problems which finally result in reduced oral health and related
Comments: Identifying the factor responsible developmental quality of life. The aim of this case series is to present the differ-
defects in enamel will help dentist to do a comprehensive treat- ent treatment approaches of the AI patients in different ages dur-
ment plan for discolouration, tooth sensitivity, susceptibility to ing a period of at least 5 years.
caries, wear and erosion. Case reports: Four children (two boys and two girls) aged 6–
11 years old, referred to the Postgraduate Paediatric Dental
PR02.50 Clinic. Their chief complaint was the unsatisfactory appearance
Syndromic amelogenesis imperfecta in Morocco: a and the high sensitivity of their teeth. An individualized treat-
ment plan was performed for each patient including, detailed pre-
cohort study ventive program and restorations mostly with stainless steel
M. EL ALLOUSSI1, S. LAOUINA2, I. CHERKAUI3, A. crowns and composite resins. During the long follow up of those
SEFIANI3, R. AMEZIAN4 & A. BLOSCH ZUPPON5 patients (4–7 years) they presented new therapeutic needs in the
1
Pediatric Dentistry, Dental School University Mohamed V, permanent dentition. Some of these problems were associated
Rabat, Morocco; 2University Mohamed V Rabat, Rabat, with old restorations and others with newly erupted teeth. More
Morocco; 3Department of Medical Genetics, National Institute of complex techniques were then used such as composite resins
Hygiene, University Mohammed V – Souissi (UM5S), Rabat, build-ups and direct composite on lays.
Morocco; 4Pediatric Dentistry, Dental School University Comments: AI is a defect that requires interdisciplinary treatment
Mohammed V – Souissi (UM5S), Rabat, Morocco; 5Sciences and close monitoring during the development of the dentition.
Biologiques, Faculte de Chirurgie Dentaire de Strasbourg The restorative treatment should be suitable to the child’s age,
Universite de Strasbourg, Strasbourg, France needs and type of the defect and should ensure function and aes-
Background: Amelogenesis imperfecta (AI) is a group of heredi- thetics.
tary disorders that affect the quality and/or quantity of dental
enamel. The clinical data are whose manifestations are very PR02.52
diverse, which makes nosological classifications very difficult
Fluorosis of the primary teeth
(classification of Witkop, 1988). Few studies (case reports or
O. KOVYLINA, T. RZAEVA, I. MALANCHUK & T. PIKILIDI
descriptive cases) were reported in Morocco with syndromic
Paediatric Dentistry, Moscow State University of Medicine and
amelogenesis imperfecta.
Dentistry named after A.I. Evdokimov (MSUMD), Moscow,
Aim: To analyse the distribution of syndromic amelogenesis
Russian Federation
imperfect in respect to gender and sex, and to study the correla-
tion between this different forms and the dental abnormalities. Introduction: Fluorosis – a disease that occurs in regions with
Design: We collected 10 cases of syndromic amelogenesis imper- high concentration of fluorides in drinking water – endemic
fecta among 40 cases of amelogenesis imperfecta, four cases of areas, and in the case of increased individual susceptibility child0 s
Jalili syndrome, three cases of AI associated with gingival hyper- organism to fluorine. The optimum concentration of fluorides in
trophy, two cases of Heimler syndrome and one case of orofacio- water is 0.7–1 mg/L. In case of a higher concentration various
digital syndrome. The criteria of selection of these patients was forms of dental fluorosis can develop. A fluorosis in permanent
made based on age, sex, clinical appearance, family history, diag- teeth were described earlier. It is now believed that the placenta
nosis examination (calcified dental plaque Agenesis, gingival does not delay fluorides that come into the organism before
hyperplasia, absence of rash or retention dental root, resorption birth.
orthodontic). Case reports: A 4-year-old girl with discoloration in temporary
Results: The syndromic amelogenesis imperfecta is more common teeth. History: mother lived in the village during pregnancy and
in the female patient, the hypoplastic type is the most dominant, used water from a well. Breastfeeding continued up to
and the familial form is more dominant compared to sporadic 10 months. In the first year girl also lived in the village, and
cases. The form of AIH is frequently associated with failure of received food and drinks prepared on the well-water.
tooth eruption. On examination: grooves on the labial surface of the front teeth.
Conclusions: In Morocco, the AIH syndromic amelogenesis im- White spots and light brown stripes on the molars. Enamel of
perfecta is more frequent in patients with consanguineous parents temporary teeth hard, without shine. Spots on the teeth are not
and the characteristics of AIH are: hereditary disorders, severe colored by caries indicator.
forme is the hypoplastic type and failure of tooth eruption. The Diagnosis: Fluorosis in temporary teeth. The tooth surface was
disease is associated with dermatologic manifestations, otorhino- cleaned and dried. The Tooth Mousse pasta was applied. Using
laryngol and ophthalmic problems. of water without fluoride, and milk, juices, foods high in calcium
is recommended. Parents should hold regular remineralizing den-
tal care for child. The dentist should examine the child 3–4 times PR02.55
a year.
Comments: Pregnant women, living in the local centers of high Clinical and radiographic delineation of Goldblatt
fluoride content, should receive defluorinated water and food. syndrome
Children with fluorosis in temporary teeth must be carried out A. HALIMI1, A. SEFIANI2, M. DARBI3 & M. EL ALLOUSSI4
1
remineralizes therapy. Orthodontics, Dental School University Mohamed V Rabat,
Rabat, Morocco; 2Department of Medical Genetics, University
Mohammed V – Souissi (UM5S), National Institute of Hygiene,
PR02.53
Department of Medical Genetics, Rabat, Morocco; 3Radiology,
Management of dens evaginatus in a pre-adolescent University Mohamed V Rabat, Rabat, Morocco; 4Dental School
child University Mohamed V Rabat, Rabat, Morocco
S. MUNSIE & E. BARRETT
Introduction: The association of dentinogenesis imperfecta (DI)
The Hospital for Sick Children, Toronto, ON, Canada
with a distinct form of chondrodysplasia in a boy was reported
Introduction: Dens evaginatus is a dental anomaly that can result by Goldblatt et al. [1991; and has been given the name of Gold-
in complications such as pulp necrosis and infection. The man- blatt syndrome or odontochondrodysplasia (ODCD;
agement of dens evaginatus in children is often complicated by OMIM#184260). Since the original description, only 11th further
incomplete root development and orthodontic considerations. individuals have been reported (one sib pair and two unrelated
Case report: A 10 year-old male with a repaired unilateral cleft cases). We report on an additional one, with clinical and radio-
lip and palate and unremarkable medical history presented com- graphic features that confirm the nosologic status of this entity.
plaining of pain and swelling on the lower left side of his face of The main radiographic features are Metaphyseal irregularities
2 days duration. He presented with an indurated, painful swelling affecting all long bones with severe metaphyseal changes particu-
of the left mandibular region. Intra-orally, he had a minimally larly of the hands, wrists, and knees, mesomelic limb shortening,
restored caries-free permanent dentition and a Class III malocclu- and coxa valga. The main physical signs are short stature, joint
sion. Dens evaginatus were observed on 34, 35, 44, 45. The pulp laxity, narrow chest, and DI. This combination of clinical and
was exposed on 35, the tooth was mobile and pus was present at radiographic findings allows clear recognition of this syndrome in
the buccal gingiva. Radiographic examination revealed a radiolu- early childhood. Of note, t
cency associated with the immature apex of 35. Case report: This girl was originally given a diagnosis of chondro-
Diagnosis was cellulitis of the left submandibular and buccal plasia schmids type. She had surgical procedure and orthopedic
spaces and symptomatic apical periodontitis secondary to pulp treatment by armed splints in the lower limbs. Dental examina-
exposure of 35. tion performed several years after the medical diagnosis showed
Following resolution of infection with oral antibiotics (clindamy- that this girl is also suffering from dentinogenesis imperfecta (DI).
cin), treatment options included extraction or pulp treatment and DI is also seen in the permanent teeth of Patient. But mutation
restoration of 35. Endodontic treatment was performed with min- analysis of COL2A1 gene on chromosome 6q21-q22 has given
eral trioxide aggregate (MTA). Enameloplasty was performed on negative results, and the molecular etiology is as yet unknown.
34, 44, 45 with the aim of promoting tertiary dentin formation. Comments: This observation shows the role of dentists in the
Comments: Identification of dens evaginatus soon after eruption diagnosis and treatment of this genetic disease and It is therefore
of an affected tooth is important to prevent pulp exposure. Col- possible that ODCD is more common than the reported case
laboration with orthodontics is advised if the extraction of numbers would suggest.
affected teeth is being considered. Management of the immature
apex is a consideration in endodontic management. PR02.56
Molar incisor hypomineralization: a survey of
PR02.54
dentists in Morocco
Oral rehabilitation with implants and dentures in N. OUATIK1, S. EL MANDILI2, R. AMEZIANE3 & M. EL
child with ectodermal dysplasia ALLOUSSI3
1
M. BOLAN, T. C. TRICHES, M. XIMENES, J. G. S. OLIVEIRA, Division of Pediatric Dentistry, Faculty of Dentistry, McGill
A. R. L. PEREIRA & A. C. CARDOSO University, Montr eal, QC, Canada; 2Facult e de M edecine
Pediatric Dentistry, Santa Catarina Federal University, Dentaire, Universite Mohamed V, Rabat, Morocco; 3Service
Florianopolis, Brazil d’Odontologie P ediatrique – Prevention, Facult
e de Medecine
Dentaire, Universite Mohamed V, Rabat, Morocco
Introduction: Ectodermal dysplasia is an anomaly determined by
genetic factors that alters ectodermal structures, such as the skin, Background: Molar-incisor hypomineralisation (MIH) is a quali-
hair, nails, glands and teeth. Children affected by this condition tative defect of enamel, affecting the first permanent molars and
require extensive, comprehensive and multidisciplinary treatment. frequently associated with lesions of one or more incisors. Very
To present a case of oral rehabilitation with a complete upper little data exists about this condition in countries south of the
denture and mandibular fixed implant-supported denture in an Mediterranean.
eight-year-old female with ectodermal dysplasia. Aim: To assess the knowledge and awareness of Moroccan den-
Case reports: An 8 years old female patient, sought the Dentistry tists concerning MIH. To describe current management strategies
Clinic, with the chief complaint of ‘multiple dental absences’. The used in Morocco.
mother reported that she was a carrier of ED. In the clinical and Design: A sample consisting of 300 Moroccans dentists was sur-
radiographic examination, there was congenital absence of sev- veyed. A 24-item questionnaire based on a previous European
eral deciduous and permanent teeth and tooth germs. The child study, which included clinical photographs of MIH, was distrib-
has been oral rehabilitated with maxillary complete denture and uted to dentists at national and international meetings, and in
mandibular implant-supported fixed denture. dental offices in different regions of Morocco.
Comments: This type of rehabilitation proved to be a satisfactory Results: In the studied sample, 88% knew about MIH and had
treatment option able to restore the functions and esthetics as noticed it at least once on their patients, while 12% were una-
well as to improve the patient’s self-esteem and social wellbeing. ware of this condition.
A percentage of 95% of dentists surveyed found it relevant to PR02.59

study MIH, while 84% noted that it was a clinical problem.
The most common clinical difficulties were in relation to achieving
The management of spontaneously erupted
profound anesthesia and placing an adequate restoration. Regard- supernumerary teeth: three case reports
ing the etiology of MIH, 62% of surveyed practitioners believed A. OZTURK, S. GUNER & N. SANDALLI
that environmental pollutants were a predominant factor. Paediatric Dentistry, Yeditepe University Faculty of Dentistry,
Composite resins were the most commonly used material in the Istanbul, Turkey
restoration of teeth affected by MIH. Introduction: Supernumerary teeth are extra teeth which may
Conclusions: This study finds that MIH is present in the Moroc- have either erupted or unerupted. The etiology behind it is still
can population and that dentists in Morocco are aware of this unclear although proliferation of dental lamina and genetic fac-
clinical condition. tors have been implicated. Mesiodens is the most common type
of supernumerary teeth which is located in the central incisor
PR02.57 region. It may present in both the primary and permanent denti-
Teeth in a newborn – treat or leave! tion. If it is not managed, It can result in malocclusion and poor
N. K. VELLORE LOGANATHAN aesthetics. The extraction is the mostly preferred treatment
Paediatric Dentistry, Westmead Centre of Oral Health, Sydney, option of spontaneously erupted mesiodens. We present the man-
NSW, Australia agement of three cases diagnosed with mesiodens.
Cases: A 7 year old girl and two 6 year old boys were refered to
Introduction: Presence of teeth in a new born may affect the baby Yeditepe University Faculty of Dentistry Department of Pediat-
and the mother either physically or psychologically. The teeth ric Dentistry with the presence of supernumerary teeth. Clinical
which are present in mouth at birth are referred to as ‘natal and radiographic examination revealed spontaneously erupted
teeth’ and those which erupt within the first 30 days are ‘neona- mesiodens. In the first two cases supernumerary teeth were pala-
tal teeth’. Natal teeth are a rare phenomenon occurring most fre- tally positioned and in the third case mesiodens was located
quently as pairs in the anterior mandible and are more frequent between cental incisors. All the supernumerary teeth were
than neonatal teeth. 90% of the natal teeth belong to primary extracted as precautionary measure for malocclusion.
dentition. Comments: The diagnosis and management of mesiodens by pae-
Case report: In this report we present six new born kids with dif- diatric dentist is important to prevent any further complications
ferent presentations of natal tooth/teeth. The appearance were like malocclusion and esthetic problems.
dependent on the degree of maturity, but most of the time they
were small, loose, covered by gums, discoloured, and hypoplastic. PR02.60
Some of the natal teeth exhibited a brown-yellowish or whitish-
opaque colour, attached only to the oral mucosa in many Dental abnormalities in a patient with microcephalic
instances as the root development is incomplete or defective. osteodysplastic primordial dwarfism Type II
Dentists are often consulted when teeth are present in the new- N. GHOUTH1,2 & M. S. DUGGAL1
1
born. Common issues arising from natal tooth relate to poor Peadiatric Dentistry, Leeds Dental Institute, Leeds, UK; 2Taibah
attachment while feeding, ulcerations on the ventral surface of University, Madinah, Saudi Arabia
tongue or mother’s breast, risk of aspiration and diverse supersti-
Introduction: Microcephalic Osteodysplastic Primordial Dwarfism
tions among the different ethnic groups.
II (MOPD2) is a rare condition of an autosomal recessive inheri-
Comments: Natal teeth should ideally be managed conservatively
tance defined by severe intrauterine and postnatal growth retar-
and be extracted only if indicated clinically. Negative cultural
dation, short stature of the affected individual and skeletal
attitudes towards natal teeth if seen will demand proper parental
abnormalities. After birth, the final adult height ranges from 20
counselling and guidance. It must be considered that these teeth
inches to 40 inches. Many patients are also affected with cerebro-
are conditions of fundamental importance not only for dentists
vascular abnormalities. Mental delay if present is usually mild or
but also for paediatricians since their presence may lead to
absent.
numerous problems.
Case report: A 11 year old boy with MOPD II and narrowing
cerebral vessels showing the onset of Moya Moya disease was
PR02.58 referred from the community dentist to our clinics for the extrac-
Unique dental features in Allgrove syndrome tion of the left mandibular permanent second molar. The patient
I. YAVUZ1, E. G. MANCINI2, C. E. WILLOUGHBY3, G. had two previous dental treatments under general anaesthesia.
CLARICH4, A. B. GIANNI2 & M. CALLEA4 Examination revealed hypodontia with congenitally missing per-
1
Department of Pediatric Dentistry, University of Dicle, manent canines, generalised severe microdontia, spacing, hypo-
Diyarbakir, Turkey; 2Department of Maxillo Facial Suegery, plasia, small pulp spaces and under developed root formation.
Postgraduate School of Maxillofacial Surgery and Orthodontics, Due to the risk of the patient having a cerebral stroke with either
University of Milan, Milan, Italy; 3Department of Eye and Vision another GA or under stress of a difficult procedure, the patient
Science, Institute of Ageing and Chronic Disease, University of was managed conservatively. As a result, a preformed metal
Liverpool, Liverpool, UK; 4Institute for Maternal and Child crown (SSC) using Hall technique was decided to be placed on
Health – IRCCS ‘Burlo Garofolo’, Trieste, Italy the left mandibular permanent second molar. Follow up and rig-
orous prevention is planned.
Introduction: Allgrove syndrome is a rare autosomal recessive dis- Comments: Dental abnormalities in children with MOPD II have
order. The syndrome has been mapped to chromosome 12q13 seldom been reported in the dental literature. The management
and is characterized by alacrima, acha-lasia, and adrenal insuffi- of such patients requires the appropriate liaison with the medi-
ciency and often amyotrophy. cal team taking into consideration a full detailed and updated
Case report: We report on a case of Allgrove Syndrome (AAA medical history. Conservative approaches are indicated in these
syndrome) presenting peculiar dental findings; such as anomalies situations where radical interventions might be a contraindica-
in number and shape of the teeth. tion.
Comments: These dental features resemble those of Ectodermal
Dysplasia (EDs).
PR02.61 PR02.62
Molar-Incisor-Hypomineralization (HIM) in a group Premature exfoliation of primary teeth – a case
of Brazilian preterm children: preliminary findings report
S. M. PINTO ALVES CAMPOS VIEIRA1, M. FAUSTO2, L. M. YASIN1, J. C. MITCHELL1, D. AGERHOLM2 & M.
TAKAOKA1, A. L. GOULART1 & B. KOPELMAN1 WACKS3
1
Federal University of S~ ao Paulo, Brazil; 2Univerity of
ao Paulo, S~ 1
Paediatric Dentistry, Dental Institute, King’s College London,
S~ao Paulo, S~
ao Paulo, Brazil London, UK; 2Periodontology, Dental Institute, King’s College
London, London, UK; 3General Paediatrics, King’s College
Background: The definition of preterm birth is children who born
Hospital, London, UK
alive before 37 weeks of pregnancy. In Brazil, the population-
based data showed 10.7% of preterm birth prevalence in 2011. Introduction: Non-traumatic, early exfoliation of primary teeth
Because of the infection morbidities, poor feeding and lack of can be a daunting experience for children and their parents. Hyp-
optimal nutrition, preterm children may have a higher risk of ophosphatasia is a rare condition causing pre mature exfoliation
developing hypomineralized teeth. of teeth due to defective mineralization secondary to reduced
Aim: The aim of this descriptive study is to investigate the occur- alkaline phosphatase activity. The symptoms are highly variable
rence of hypomineralization permanent incisor and molar teeth and severity of disease is not directly related to serum alkaline
(HMI) in children born prematurity. phosphatase levels.
Design: Total of 24 preterm patients (29–35 weeks pregnancy- Case report: A 4 year old boy was referred from the community
age, 15 males, 9 females, 10–14 years old) were attending at pre- dental services regarding premature exfoliation of primary teeth
mature dental service (Federal University of S~ao Paulo) in order in spite of good oral hygiene. Following minor dental trauma 71,
to diagnosing and classifying molar-incisor hypomineralization 72 and 81 were lost starting at 11 months of age. Increasing dia-
(MIH index) according to European Academy of Paediatric Den- stema between 51 and 61 was a further concern reported by the
tistry criteria. The dental examination was performed after pro- patient’s mother. Pocketing of 4 mm was detected around 51 in
fessional cleaning and a numeric score was record for each tooth: the absence of other periodontal pathology. Dental radiographic
no defect (0); demarcared opacities (1), pos-eruptive enamel loss examination revealed bony support at the apical one third of 51
(2), atypical restaurations replacing the affect dental hard tissue and 61 roots and up to apical half of 82 root. Subsequently, in
(3), molar extraction because of pronounced hypomineralization spite of maintaining excellent oral hygiene, 51 and 61 were lost.
(4) and uneruption molar or incisor (5). Histopathological examination of one exfoliated tooth revealed
Results: 284 teeth were evaluated in 24 children. 76 (26.8%) were the cementum layer was atrophic except near the apex. Blood
no rated HMI index, 181 (63.7%) had rating score 1, and 27 tests confirmed reduced alkaline phosphatase level and radio-
(9.5%) were classified by score 2. No teeth were rated with 3 or graphic assessment identified serious irregularity and sclerosis of
4 score. distal metaphysis, features consistent with hypophosphatasia.
Conclusions: The finding of this preliminary study is a high num- Genetic studies are under way.
ber of affect teeth in demarcaded opacity (score 1) in premature Comments: In some children premature loss of primary teeth may
children. Pre and perinatal factors might influence in the develop- be the initial presenting complaint of hypophosphatasia. It is
ment of the permanent teeth. important for paediatric dentists to identify this condition and
initiate an appropriate referral for medical management.
Dental Anxiety and Behavioural Management Poster Session – PR03
Dental Anxiety and Behavioural

Management Poster Session – PR03
PR03.01 Review summary: The link between the hospital environment and
patients’ anxiety is well established; however with regards to chil-
Pulpal laser anaesthesia vs local anaesthetic injection dren the literature remains scarce. Environmental factors affect-
A. V. K. EFTHYMIOU
ing children’s anxiety include elements of: the physical
Paediatric Department, Private Dental Office, University of
environment (space, interior decor, colours), the sensory environ-
Athens, Aigaleo, Greece
ment (artwork, music, scents), the social environment, noise lev-
Aim: To evaluate the acceptance and efficiency of laser induced els, waiting times and others. Alleviating children’s anxiety and
pulpal anaesthesia, during conventional cavity preparation in pri- enhancing patients’ satisfaction is now widely recognized as inte-
mary and permanent teeth. gral to the provision of high quality care ‘patient centered care’.
Design: It is a randomised cross-over clinical study. The study Conclusion: Environmental factors play a significant role in mod-
includes 14 children of 5–9 years old for primary teeth and 24 ulating the child’s anxiety and coping with DGA. Future studies
patients of 10–25 years old for permanent teeth. ICDAS: 4 or of high quality are needed in that area.
5. Two conventional cavities treatments were made at each sub-
ject, one under local anaesthesia by injection, 20 mg lidocaine PR03.03
hydrochloride (2%) with epinephrine 0.0125 mg (1 : 80,000) and
one under pulpal anaesthesia by low level laser irradiation,
Managing patients with special health care needs –
810 nm, 600 lm, spot size 6 mm, 250 mW, 120 s. The sequence are we there yet?
of the two treatments was random. Wong Baker faces pain M. GUELMANN MARCIO & L. R. F MUGAYAR
scale was used for self-reporting of pain felt during cavity prep- Pediatric Dentistry, University of Florida, Gainesville, FL, USA
aration. Background: Special Care in Dentistry has been a controversial
All persons gave their informed consent prior to their inclusion segment of Dentistry especially when focusing on the patient
study.
behaviour management and treatment planning in a clinical seti-
Results: Mean value for primary teeth: 0.71. Permanent teeth:
ing. Various techniques contemplating behaviour management
mean value was 1.37 for laser anaesthesia and 1.25 for conven- and desensitisation have been proposed and practiced all over the
tional anaesthesia. A comparison of quantitative variables years. Nevertheless, when it comes to exercising them in our daily
between the two different methods of anaesthesia was performed
clinical practice it seems to become not a feaseable easy option.
(Wilcoxon test) resulting that there were no statistical significant Hospital Dentistry has been showing to be a valuable resource;
differences in the pain level between them. however, often it is not a possible choice for a large number of
Conclusions: It was possible to provide painless cavity prepara- patients, neither the various levels of Sedation – Conscious or
tions after laser anaesthesia in permanent and primary teeth. It is
Intravenous – especially when taking into consideration the vari-
an important method of behavioural management of dental ables regarding the health systems in place in each Country,
patients and conduces in the reduction of the pharmacological around the World.
agents overuse. Aim: The aim of this presentation is to review and discuss the
different approaches regarding the behaviour management and
PR03.02 oral care of the patients with Special Health Care Needs, and
Environmental factors affecting children’s anxiety & consequently of their families and caregivers.
Conclusions: Summarizing the possible factors for a successful
coping with dental general anaesthesia and not as successful use of such techniques, daring to bring out
A. S. ZAHER, M. T. HOSEY & S. SOOD
a new perspective into the ‘Dentistry for Patients with Special
Paediatric Dentistry, King’s College London, London, UK
Health Care Needs’.
Background: In paediatric dentistry there is still a high need for
dental general anaesthesia (DGA). Ensuring a positive hospital PR03.04
experience for those children is thus regarded of high importance,
as it will influence their future dental attitudes. The ability of a
Attitude towards oral health and prevalence of caries
child to cope with the hospital experience is determined by a in school children in Tijuana, BC Mexico
variety of factors; both genetic and environmental. P. A. GALVAN CARRILLO, M. A. ZAMUDIO GOMEZ, M. E.
Aim: To detail the literature related to the impact of the hospital TORRES ARELLANO, A. CAMPOS FRIAS, C. A. FREGOSO
environment on children’s anxiety and coping with DGA via a GUEVARA & J. L. BUSTAMANTE REYNOSO
systematic/narrative review. Especialidad Odontologıa Pediatrica, Universidad Aut
onoma de
Design: An electronic search of the literature was carried out Baja California, Tijuana, Mexico
from 1985 to the present, using terms related to the hospital Aim: Identify the attitude towards oral health and caries preva-
environment, children’s anxiety and general anaesthesia (GA). lence in school children in Tijuana, Baja California.
Results: A total of 113 papers were identified that dealt with chil-
Design: For this study, 560 children from 13 primary schools and
dren’s anxiety or coping with GA one way or another. There one secondary school were reviewed in the city of Tijuana, Baja
were no studies identified in the literature directly related to California, whom they observe the presence or absence of caries
DGA. by the epidemiological index Knutson and we applied the survey
in attitude Likert scale.
Results: A total of 562 children distributed in 13 primary schools PR03.06

and one secondary school in the city of Tijuana were reviewed,
Comparison of oral and intramuscular ketamine,
Baja California. The results of attitude increased frequency of
response according to the Jose de Jesus Lopez Elementary School midazolam, atropine for sedation of 1–4 year old
with 94.4%, primary school Otto Murillo in response hesitant uncooperative pediatric dental patients
50.6% and school reform laws with 14.7% in disagreement G. ANSARI1, N. PASDAR2, M. VAHID GOLPAYEGANI1, S.
response was observed and In the lower frequency response was SHAYEGHI3 & A. MAHDAVI3
1
observed according to the Lazaro Cardenas elementary school Pediatric Dentistry, Shahid Beheshti Medical University, Tehran,
with 47.9% undecided response in the Jose de Jes us L
opez pri- Iran; 2Pediatric Dentistry, Mazandaran University of Medical
mary school with 5.4% and response also disagree primary Sciences, Babol, Iran; 3Anesthesiology, Shahid Beheshti Medical
school Jose de Jes us L opez. Results caries prevalence was University, Tehran, Iran
observed more frequently in the prevalence of caries in primary
Aim: The purpose of this study was to evaluate the efficacy and
school Lazaro Cardenas 91% and a lower prevalence of caries in
safety of a mixture of ketamine, midazolam and atropine and
primary school Emma A Bustamante.
compare oral and intramuscular routes for sedation of pediatric
Conclusions: It was concluded that 66.6% of schoolchildren,
uncooperative dental patients
agreed with the survey but alarming is the data observed among
Design: This crossover clinical trial included 31 1–4 year old
26.9% undecided well as those who had to be disagreement with
pediatric patients who were definitely negative (Frankl behavioral
6.5%. The rlation of attitude and caries that 66.6% who agreed
scale), randomly received Oral ketamine (10 mg/kg), midazolam
and healthy patients with 55%.
(0.2 mg/kg) and atropine (0.02 mg/kg) in one session while keta-
mine (6 mg/kg), midazolam (0.05 mg/kg) and atropine (0.02 mg/
PR03.05 kg) through the IM route. Sedation scores, were recorded as well
Evaluation of the effect of general anaesthesia and as behavior ratings (Houpt scale), physiological parameters. Each
restraint during dental treatment on dental anxiety case was selected and assigned for two groups based on two simi-
lar size Dental treatment needs.
and behavior in children Results: A significantly deeper sedation was noted in patients at
H. ZHANG1, B. XIA2, J. WANG2, X. CHEN1 & L. GE2 their IM session than their Oral (P < 0.035). There were no sig-
1
Pediatric Dentistry, Clinic of Peking University School and nificant differences in sleeping, movement, crying and overall
Hospital of Stomatology, Beijing, China; 2Pediatric Dentistry, behavior scores and physiological parameters in two treatment
Peking University School and Hospital of Stomatology, Beijing, groups (P > 0.05). Success rate at the first 15 min was 80.7% in
China the oral route and 87.1% in the intramuscular. Nausea, vomiting,
Background: The impact of restraint and general anaesthesia visual disturbances and hallucination were reported. Practitioner
(GA) on the level of children’s dental anxiety and behavior are and parent0 s satisfaction of the oral and intramuscular routes did
very concerned by pediatric dentist and parents. not differ significantly (P > 0.05).
Aim: To compare the level of dental anxiety and behavior Conclusion: This cocktail provides sedation similar to that pro-
between dental fear (DF) children with dental treatment under duced by the same drugs given IM. Because of children0 s prefer-
general anaesthesia and those under restraint. ence for oral medications, it can be used in limited and
Design: The GA group and restraint group both included 31 4– emergency dental treatments in uncooperative patients.
6 years old DF children. Age, gender, DMFT and MCDASf
score before treatment were matched. The Chinese version of PR03.07
MCDASf was used to evaluate the level of dental anxiety in each
Efficacy and outcome assessment of a specially
child before treatment, right after treatment and before examina-
tion at recall visit. The Chinese version of Venham clinical anxi- designed augmentative communication program for
ety and cooperative behavior scale was used to evaluate managing children with special health care needs in a
children’s dental behavior in each child before treatment and pediatric dental set-up
before examination at recall visit. N. GREWAL1, S. GREWAL2 & T. SETHI1
Results: The average scores of MCDASf in GA group right after 1
Pedodontics & Preventive Dentistry, Government Dental College,
treatment and before recall were significantly lower than that Amritsar, India; 2Pediatric Dentistry, Tufts University Dental
before treatment (P < 0.05). Furthermore, the average score of School, Boston, MA, USA
MCDASf before recall was lower than that after treatment
(P < 0.05); The average scores of MCDASf in restraint group Background: Dental care is the most prevalent unmet health care
right after treatment and 2–3 weeks after the treatment were for special children affecting substantially more children than any
higher than that before treatment (P > 0.05). Children’s dental other health care need category in India. The most common rea-
behavior was significantly improved at recall visit in both groups son given by caretakers and practicing dentists is lack of educa-
(P < 0.01). tion about managing them in the dental set-up.
Conclusion: Dental fear could be reduced by treatment under Aim: To evaluate the efficacy of a specially designed AAC system
GA. And children’s dental behavior was improved after GA. software in improving: >communication skills of children and
Restraint did not result in the significant elevation of dental anxi- their caretakers/special educators with the dentist.
ety level, but dental behavior was improved after restrain during >specific Behaviour towards specific dental procedures.
short-term recall. Design: A longitudinal study wherein 590 SHCN subjects aged 7–
16 years with none to moderate difficulty (Capacity and Perfor-
mance qualifiers for Activities and Participation as per (ICF)
were subjected to a specially designed software program named
‘Special smiles for special child’ in english and spoken regional
language after baseline assessment of knowledge of caretakers/
special educators as well as special children through a pre- assess-
ment questionnaire scored on a three point likert scale. Dental
behaviour of the subjects was assessed by pre-calibrated clinicians
through two behaviour rating scales before subjecting them to of sessions were recorded. All the recorded data were statistically
the program. Evaluation and reinforcement sessions were carried analysed by SPSS 15.0 programme and chi-square tests.
out at equal intervals of time for a total of 24 months. Results: FIS scores of children who were younger than 9 years
Results: Wilcoxon Signed Ranks Test was applied to non-paramet- old were 2, and older children’s scores were 3. FIS scores of boys
ric data to study the change in behaviour before and after training. were 3 and girls were 2. According to FIS scores, age was a sta-
The results were evaluated with P value <0.001 level of significance tistically significant criteria, but gender was not. Children pre-
and found to be highly significant for all dental procedures. ferred water48.7%, pink 27.2%, green liquid 17.4% and only 18
Conclusion: This training method proved to be beneficial to treat- children tried all of the cups in one DTS. Children who preferred
ing dentists in improving behaviour issues of special children in a more than one cup had significantly (P: 0.021) higher FIS scores.
dental set up. Conclusion: Water was the mostly chosen rinsing liquid. Children
whose FIS scores were 3, may be curious about trying different
PR03.08 colours of rinsing liquids.
The effectiveness of using visual pedagogy in dental

PR03.10
checkups and preventive dentistry for children with
autism: a randomized clinical trial Considering two scales for behaviour assessment
F. NILCHIAN1 & Z. TAGHIJARAH2 during paediatric dental sedation
1
Dental Public Health, Esfahan Medical University, Esfahan, Iran; L. R. COSTA1, A. DAHER1, H. S. GOMES2, K. A. VIANA2, G.
2
Esfahan University of Medical Sciences, Esfahan, Iran C. M. MACHADO1 & P. S. S. COSTA3
1
Paediatric Dentistry, Federal University of Goias, Goiania, Brazil;
Background: Autism is a pervasive neuro-developmental disorder. 2
Dentistry Graduate Program, Federal University of Goias,
The purpose of this study was the evaluation of using visual ped- Goiania, Brazil; 3Paediatrics, Federal University of Goias, Goiania,
agogy in dental check up and preventive dentistry for children Brazil
with autism.
Material and methods: In this Randomized clinical trial study Background: There are several scales but little information on
(IRCT2014102519665N1), the level of cooperation for 4 purposes their ability to properly assess children’s behaviour during dental
including: Entering the dental surgery and sitting in the dental sedation procedure.
chair, opening the mouth and showing the teeth, examining with Aim: To evaluate the characteristics of two scales, Houpt scale
mirror and fluoride therapy, has been evaluated. Forty children and the Ohio State University Behavioral Rating Scale (OS-
with autism aged 6–12 years, in Autism Charity Center recruited. UBRS) in assessing the behaviour of preschool children during
Children in the test group were trained by center trainers to get sedation for dental procedures.
familiar to dental visit by the use of visual pedagogy method, Design: This observational study nested to a randomised clinical
step by step. Finally the data was analyzed using statistics test trial (NCT02284204) included 27 children, 4–6 years old, with
such as Cochran test, chi square test and fisher test. early childhood caries. They were rendered dental treatment
Result: Cochran test proved that the level of cooperation only in under moderate sedation with oral midazolam and ketamine.
fluoridtherapy was significantly increased in test group with the Dental appointments were video recorded; four trained and cali-
repetition of dental visit and training (P ≤ 0.001), but the level of brated observers assessed video files to score children’s behaviour
cooperation with the repetition of dental visit and training had according to the Houpt scale and OSUBRS. Data were analysed
no difference in control group (P = 0.41). by descriptive, correlation and survival tests
Conclusion: The result of this study proved that the visual peda- (P < 0.05).
gogy method in fluorid therapy has been effective significantly in Results: Based on 1209 min of observation, Houpt scores indi-
the test group. The results showed that the repetition of dental cated that children were mostly awaken (median 1.0, minimum
visits was more effective to increase the level of cooperation in 1.0 – maximum 2.0), with controllable movement (3.5, 2.8–4.0)
purposes such as entering the dental surgery, opening the mouth and mild crying (3.4, 2.4–4.0), and very good overall behaviour
and showing the teeth and examining with mirror. (5.0, 2.0–6.0). OSUBRS scores in a session were: quiet (54.4%,
23.3–100%), crying/no movement (6.4%, 0–38.5%), movement/
no crying
PR03.09 (0%, 0–23.3%), struggling (22.2%, 0–61.1%). Houpt and OS-
Degree of anxiety and colour priority of child in a UBRS scores significantly correlated (rho< 0.8, P < 0.001).
dental session Favourable behaviour was maintained for a median of 24 min
D. ONER OZDAS (Houpt-movement), 23 min (Houpt-crying) and 22 min (OS-
Pediatric Dentistry Department, Istanbul Aydin University/ UBRS). Procedures more frequently associated with switching into
Dentistry Faculty, Istanbul, Turkey less favourable behaviour were the insertion of rubber dam/clamp
for absolute isolation and the administration of local anaesthesia.
Introduction: Anxiety and fear are present in minds of many Conclusions: Houpt scale and OSUBRS were strongly correlated
patients during dental procedures. Being able to prefer provides and adequate to measure children’s behaviour, mainly movement
more positive interaction and cooperation between patient and and crying.
dentist.
Aim: To determine the degree of anxiety and choice priorities of
children in between the coloured mouth rinsing liquids during a
PR03.11
dental treatment session (DTS). The use of relaxation and needle desensitisation to
Methods: Totally 222 children (ages 3–15 year old; mean age: treat and resolve dental phobia
8.70 2.40; 112 female, 110 male) assessed in this study. Begin- C. M. CAMPBELL, C. SIMPSON & G. D. TAYLOR
ning of DTS, child’s anxiety scored by using FIS (Facial Image Department of Paediatric Dentistry, Glasgow Dental Hospital and
Scale). Three transparent cups filled with water, green and pink School, Glasgow, UK
rinsing solutions and aligned near dental unit. During DTS, child
was told to rinse his/her mouth with one of the cups whichever Introduction: Phobia is a clinical mental disorder where subjects
he wanted. The preferred colour of cups, gender, age and number display persistent and extreme fear of objects or situations with
avoidance behaviour and interference of daily life. Assessment PR03.13

with an appropriate clinical history and assessment tool (eg faces
Comparison between two types of video eyeglasses in
version of the Modified Child Dental Anxiety Scale – MCDASf),
is recommended. Treatment success is based on dental treatment management of pediatric dental patients
completion and resolution of the phobia. G. M. MAHMOUD
Case report: An 8-year-old boy was referred for restoration of Pediatric Dentistry, 6th October University for Modern Science
permanent molars. He was needle phobic with a 2 year history of and Arts, Cairo, Egypt
attendances at general dental practitioner (GDP) and public den- Background: Distraction is one of the most popular techniques
tal service (PDS). Assessment history revealed a palatal injection for behavior management of child dental patients. Ideal distrac-
(GDP) triggered his dental phobia, inhalation sedation was not tion should isolate the child from the dental environment, and
successful (PDS). His MCDASf score was 31/45 indicating both wireless video eyeglasses is able to do so by replacing the signals
dental and medical needle phobia. He was an information seeker from the environment by a pleasant movie.
and happy for relaxation exercises and needle desensitisation Aim: This study compared the use of 3-D vs 2-D audiovisual dis-
(ND). Clinical examination revealed caries in 16, 26, 36, 75 and traction in management of child dental patient, using video eye-
46, the OPT radiograph confirmed these teeth restorable. Relaxa- glasses.
tion was taught at his assessment visit. He completed the seven Design: A total of 60 children, 4–8 years, requiring restorative
stage needle desensitisation over two visits, with L.A. adminis- dental treatment were recruited for this study. They were ran-
tered and restoration of 16. All carious teeth were subsequently domly assigned for one of three groups; using either 2D video
restored and at his review appointment he remains caries free eyeglasses (group A), 3D video eyeglasses (group B), or tradi-
both clinically and radiographically. His MCDASf is now 15/45. tional audiovisual distraction (group C). Anxiety level was
Comments: A comprehensive assessment is essential in under- assessed using Venham0 s scale. Behavior was assessed using Mod-
standing the best treatment for dentally phobic children. An ified Houpt Scale, and pulse rate was monitored using pulse oxi-
information seeker, taught to cope and understand (relaxation meter.
and ND) was the key to ensuring this patient’s dental phobia Results: There was a significant decrease in anxiety between both
resolved with discharge and care with GDP now possible. group ‘A’ and ‘B’ in comparison to group ‘C’. Behavior was sig-
nificantly improved in both groups in comparison to group ‘C’,
PR03.12 while intergroup comparison showed insignificant difference
Parent, dentist, and independent rater assessment of between group ‘A’ and ‘B’ regarding anxiety level and behavior
ratings. Pulse rate showed significant lower levels in both group
child distress during preventive dental visits ‘A’ and ‘B’ in comparison to ‘C’, with insignificant difference
T. M. NELSON1, C. E. HUEBNER1,2 & J. A. M. SCOTT1 between ‘A’ and ‘B’.
1
Department of Pediatric Dentistry, University of Washington, Conclusions: The use of both types of eyewear is more effective in
Seattle, WA, USA; 2School of Public Health, University of distracting children in the dental office, in comparison to tradi-
Washington, Seattle, WA, USA tional audiovisual method. The use of 3d is of comparable effect
Background: Clinicians, parents, and independent observers have to the use of 2d video eyewear.
varying interpretations of patients’ stress behaviors. Some studies
found medical and dental healthcare providers can underestimate PR03.14
children’s pain while focusing on clinical procedures, a concept
Children’s intelligence quotient following dental
known as ‘pain blindness.’ Although typically not painful, pre-
ventive dental care may be difficult for preverbal children. Learn- general anesthesia: clinical observation
ing how parents, dentists, and independent observers perceive B. XIA, Y. XIAO, J. WANG & L. GE
child distress facilitates better understanding of clinical interac- Department of Pediatric Dentistry, Peking University School and
tions during pediatric preventive care. Hospital of Stomatology, Beijing, China
Aim: This study examined the concordance between parent and Background: It has been demonstrated that anesthetics exposure
dentist ratings of child distress during preventive dental proce- may lead to neurocognitive impairment in developing brain of
dures and compared each with the assessment of an independent animal models. However, for the limitation that the animal mod-
observer. els cannot fully mimic the dose and duration in clinical settings,
Design: 65 children under 3 years of age enrolled in a govern- the clinical significance of anesthetics exposure on developing
ment insurance program for low-income children were seen for central nervous system remains undetermined.
preventive dental care at a university-based dental clinic. Parents, Aim: We conducted the current study in order to observe the
dentists, and an independent observer rated intensity of child dis- fluctuation of intelligence quotient (IQ) after the administration
tress on a 5-point scale (0 = none; 5 = extreme) during 4 phases of dental general anesthesia comparing to that before surgery.
of the dental visit: pre-examination, positioning, visual examina- Design: Thirty three patients who were exposed to dental general
tion, cleaning and fluoride application, and after examination. anesthesia, aged 4–6.5 years, were enrolled in this prospective
Results: The average age of the children was 24.4 months (SD study. Intelligence quotient was evaluated with the Chinese
7.2). The visual exam with cleaning and fluoride was judged to Wechsler Young Children scale of Intelligence (Urban version)
be most distress inducing. Mean distress ratings for this phase before and 2 weeks after dental anesthesia.
were: 2.30 (parents), 2.47 (dentists), and 3.08 (independent obser- Results: The results of intelligent assessment from 28 subjects
ver). Scores given by all three raters were highly correlated and were collected. The postoperative Full IQ (128.46 10.85) was
ranged from a correlation of 0.76 (parent and dentists) to 0.85 higher than that before surgery (124.64 11.46) (P = 0.017). We
(dentists and independent observer). found that the elevation of Performance IQ, from a large extent,
Conclusions: Our findings suggest that dentists do not have ‘pain contributed to this changes in Full IQ (P = 0.007). Correspond-
blindness’ in judging young children’s distress during preventive ingly, there was no statistical difference in the Verbal IQ
dental procedures. (P = 0.854).
Conclusion: Dental general anesthesia has no negative effect on
preschool children’s intelligence. The Full IQ and Performance
IQ were slightly enhanced after treatment which can be explained respondingly. Minor adverse events, such a vomiting, hiccup and
by the memory effect. hyperexcitability occurred in 14% of sessions.
Conclusions: Midazolam sedation administered orally or intra-
PR03.15 muscularly and performed with anesthesiologists is a safe and
effective method for dental treatment in very young children, on
An integrated care approach in the management of the condition of an appropriate selection of the patients.
small children requiring dental treatment under
general anaesthesia (GA) PR03.17
L. DROBOTKO, A. SEDOYKIN & K. FEDOTOV
Paediatric Dentistry Department, Moscow State University of
Comparative study of articaine vs lidocaine for
Medicine and Dentistry named after A.I. Evdokimov (MSUMD), extraction of primary molars
Moscow, Russian Federation S. BADR1,2 & M. EL-SHIEKH3
1
Pediatric and Community Dentistry Department, Beirut Arab
Background: Dental treatment under GA of small children leads University, Beirut, Lebanon; 2On Secondment from Faculty of
to the improvement of quality of life of the children themselves Oral and Dental Medicine, Cairo University, Cairo, Egypt;
and their parents. 3
Pediatric Dentistry Department, Faculty of Oral and Dental
Aim: At MSUMD a multidisciplinary team provides holistic Medicine, Cairo University, Cairo, Egypt
treatment planning for uncooperative children. The objective of
the study was to assess the medical status, nature and extent of Background: Surgical procedures are quite challenging in children
treatment and outcome for patients treated in an integrated care especially when cooperation is questionable. Thus the replace-
pathway in 2012. ment of poorly tolerated inferior alveolar nerve block (IANB)
Design: The study group comprised of 97 children (43 boys and and palatal injections by buccal infiltration of articaine required
54 girls; aged 1–3 years – 18 patients, 3–4 years – 42 patients, 5– to be tested.
6 years 18 patients). Dental caries was the most common diagno- Aim: The objective of this study is to compare the clinical effec-
sis 90%. All the children were uncooperative and the cases were tiveness of 4% articaine vs 2% lidocaine buccal infiltration anes-
selected only those where intervention was justified. thesia during extraction of mandibular and maxillary posterior
Results: Comprehensive dental care undertaken under GA, teeth in children above 6 years.
administered in a specially designed room by anesthesiologists, Design: This prospective, randomized, split-mouth comparative
included preventive measures (70/78), dental extraction (30/78), study was conducted on 60 children (6–10 years old) requiring
adhesive resin restorations (70/78) and performed metal crowns extraction of unrestorable primary teeth or remaining roots for
(SSC) (23/78). All the patients entered a regular review pro- bilateral mandibular or maxillary primary molars. Children were
gramme at MSUMD. To date, none of the study group has randomly assigned to receive buccal infiltrations of 4% articaine
required repeat GA. on one side and 2% lidocaine on the other side, at two separate
Conclusions: An integrated care pathway minimizes the need for dental visits. Child pain and behaviour was assessed using face,
repeat GA and reduces morbidity in small children. Multidisci- leg, activity, cry and consolability (FLACC) Behavioral Pain
plinary planning, intra-operative assessment, strict treatment cri- Assessment Scale. Child overall experience and postoperative
teria and follow-up are integral parts of this approach. self-report of pain was also assessed using the Wong-Baker
FACES pain rating scale.
Results: Articaine buccal infiltration anaesthesia showed signifi-
PR03.16 cantly higher clinical effectiveness than lidocane in extraction of
Midazolam sedation for young children primary maxillary and mandibular teeth in children. Concerning
L. KISELNIKOVA, A. ZOLOTUSSKY, L. DROBOTKO, A. the FLACC behavioral pain scale and self-report of pain using
SEDOYKIN & K. FEDOTOV Wong-Baker FACES scale articaine infiltration showed signifi-
Paediatric Dentistry Department, Moscow State University of cantly lower scores over lidocaine.
Medicine and Dentistry named after A.I. Evdokimov (MSUMD), Conclusion: Under the conditions of this study, articaine buccal
Moscow, Russian Federation infiltration anaesthesia provide an effective, deep and less painful
alternative to anasethize primary molars and related lingual and
Background: midazolam sedation makes dental treatment in
palatal gingival tissues utilizing less anaesthetic dose.
young children less traumatically from psychological point of
view.
Aim: The objective was to determine the safety and efficacy of PR03.18
midazolam (orally or intramuscularly) for conscious sedation, Acceptance of child behavior management techniques
when administered by anesthesiologists in a dental out-patient’s by a group of Cambodian mothers
clinic. C. YOS1,2
Design: 1116 teeth that should be treated in 132 children aged 1
Pediatric Dentistry, Mahidol University, Faculty of Dentistry,
between 1 and 5 years were under study. The selection criterion
Bangkok, Thailand; 2Dentistry, Faculty of Dentistry, University of
was Frank LS et al II- III. Exclusion criteria were any conditions Puthisatra, Phnom Penh, Cambodia
that predispose to airway difficulties and the use of medications
interfering with pharmacokinetics of midazolam. All the children Introduction: Success of child management in dentistry does not
were previously examined by the anesthetist. Informed consent solely depend on expertise of clinicians to use techniques but also
was obtained. The patients received 0.005–0.15 mg/kg of midazo- on parental acceptance toward those techniques which varies
lam as injections or 0.5–0.75 mg/kg per os as cherry syrup. among population. In Cambodia, mothers play an important
Results: 605 teeth with caries were treated – 54.2%; 355 teeth roles in child cares and their attitudes toward the techniques have
with chronic pulpitis were treated – 31.8%; 156 cases of peri- not yet been explored.
odontal disease were treated – 14%; 114 teeth (1, 3%) were Aim: To evaluate Cambodian mothers’ acceptance toward differ-
extracted under sedation. All the manipulations were performed ent behavioral management techniques effectively used in den-
for one visit or for two visits – 94 (71, 2%) and 38 (28, 8%) cor- tistry.
Design: There were 417 mothers of preschoolers in Phnom-Penh Conclusion: Vibraject was able to alleviate pain of needle admin-
participated. Background information of the mothers and chil- istration significantly better than benzocaine and control.
dren including child oral care were recorded. Mothers were asked
to watch video tape showing seven behavior management tech- PR03.20
niques utilizing on a preschooler, Passive Restraint, Parent Pres-
ent/Absent, Oral Sedation, Active Restraint, Tell-Show-Do, The application of video glasses to manage
Voice Control and General Anesthesia in random order and challenging paediatric dental situations
rated the technique in Likert Scale from strongly disagree (1) to P. J. HARIA, A. CASAUS & K. COOMARASWAMY
strongly agree (5) at each technique ended. Wilcoxon signed Paediatric Dentistry, Birmingham Dental Hospital, Birmingham,
Ranks Test was used to determine if there were significant differ- UK
ences among the mean scores of each technique.
Introduction: Dental fear in the paediatric population can be a
Results: Ranking from the most acceptable to the least acceptable
significant barrier resulting in failure of treatment delivery. Phar-
were: Tell-Show-Do (4.58), Parent Present/Absent (3.60), Passive
macological management techniques utilised to tackle this prob-
Restraint (3.62), Active Restraint (3.36), Voice Control (3.18),
lem require specialised equipment, staff training and are
Oral Sedation (2.76) and General Anesthesia (2.50). The mean
expensive. With recent advances in technology, video glasses are
Likert score for Parent Present/Absent was not different from
an economic and novel distraction technique that can overcome
Passive Restraint, whereas other techniques were significant dif-
this barrier.
ferences from each other (P = 0.001).
Case reports: A healthy 5 year old boy was referred for a general
Conclusion: Cambodian-mothers prefer communicative and non-
anaesthetic to extract carious primary teeth due to anxiety. Inha-
pharmacological techniques to pharmacological ones. Voice con-
lational sedation was contra-indicated as he was a mouth
trol is the least accepted in communicative techniques. The two
breather. Using video glasses, we were able to stabilise his denti-
least accepted techniques are oral sedation and general anesthe-
tion by carrying out vital pulpotomies and stainless steel crowns,
sia.
thus avoiding the need for a general anaesthetic.
An immature and non-vital UR1 in a 7 year old girl was being
PR03.19 managed under inhalational sedation. It was difficult to provide
Comparative evaluation of clinical effectiveness of a a hermetic seal with the rubber dam due to the nasal hood. The
vibrating device (Vibraject) and surface anesthetic video glasses engaged her attention and allowed root canal treat-
ment to be undertaken comfortably.
agent in reducing pain during local anesthesia A 15 year old Aspergers syndrome girl with hypodontia was
injection under fixed appliance therapy to correct her malocclusion. A
I. K. PANDIT1, N. GUGNANI1, M. GUPTA1, N. PANDIT2 & heavily restored lower left first permanent molar devitalised and
H. MALHAN1 was unable to be managed by her local dentist. The ability to
1
Paediatric and Preventive Dentistry, DAV(C) Dental College, choose and watch her favourite movie in the dental surgery
Yamunanagar, India; 2DAV(C) Dental College, Yamunanagar, allowed root canal treatment to be undertaken successfully.
India Comments: There is a paucity of data for dental treatment facili-
tated by video glasses. It has been shown however to be an alter-
Background: Local anaesthesia (LA) administration commonly
native cost-effective method in improving a child’s dental
used in paediatric dentistry to avoid pain requires needle injec-
tion which itself is accompanied with significant pain. We fre- experience.
quently use surface-anaesthetics (SA) to avoid pain but with
varying success. ‘Vibraject’ has recently been introduced that PR03.21
claims to alleviate pain significantly. Computer capillaroscopy assisted assessment of stress
Aim: Randomized-clinical study was undertaken to comparatively
evaluate clinical effectiveness of ‘VIBRAJECT’ and SA agent in
level in children undergoing dental treatment under
reducing/alleviating pain during intra-oral LA injection. conscious sedation
Design: 120 participants of age group 5–12 (ASA grade-I) requir- E. SHAVLOKHOVA1, M. KOROLENKOVA1, F. MUTAFINA2
ing administration of intra-oral LA were selected and randomly & I. F. OSTREIKOV3
1
divided into 3 equal (n = 40) groups using three-different inter- Pediatric Dentistry, Central Research Institute of Dentistry and
vention strategies; Vibraject, 20% Benzocaine gel and Normal Maxillofacial Surgery, Moscow, Russian Federation; 2Functional
Saline (Control-NS) respectively. ‘Vibraject’ (vibrating motor) Diagnostics, Central Research Institute of Dentistry and
was attached to dental syringe through its autoclavable attach- Maxillofacial Surgery, Moscow, Russian Federation; 3Russian
ment and kept-on during administration of LA injection. In Medical Academy of Postgraduate Education, Moscow, Russian
Group-2 and 3, Benzoaine and Normal Saline (NS) were applied Federation
topically for 1-min prior to LA injection. Pain perception using Background: Dental treatment of infants and pre-school children
Sound-Eye-Motor (SEM) and Wong-Baker FACES (FS) pain is challenging with general anesthesia and conscious sedation
rating scale during and after LA administration was assessed and (MCS) being the most popular options for behavioral control.
videotaped later seen by Observer-2 who also gave SEM scores Standard techniques of monitoring do not always provide accu-
independently. Mean score of Observer-1 and 2 was considered. rate determination of stress level in children.
Results: For both SEM and FS parameters, Vibraject showed Design: The research involved 298 children. 256 of them were
minimum mean pain scores (MeanSEM = 3.70 0.99, MeanFS = treated under MCS (intramuscular injection of midazolam in dos-
0.95 1.28) followed by Benzocaine (MeanSEM = 6.08 1.79, ages of 0.1, 0.15, and 0.2 mg per kg) and 42 constituted reference
MeanFS = 3.90 1.50) and NS (MeanSEM = 7.13 1.71, group treated without MCS. Following microcirculation parame-
MeanFS = 4.70 1.40). Kruskall Wallis-H test for intergroup ters were recorded by capillaroscopy (CC): density of capillary
comparison showed highly significant result (PSEM < 0.001, net, size of arterial, venous and transitional microcirculation links
PFS < 0.001). Mann-Whitney U-test, where Benzocaine and NS (ML), linear and volume blood flow velocity, perfusion balance.
were compared with Vibraject also showed significant results Results: Statistically significant difference especially prominent in
(PSEM < 0.001, PFS < 0.001). children underoing oral surgery procedures was obtained in
parameters when comparing midazolam group with reference dental treatments, but in vain, the patient was whining and trem-
group (P < 0.05). Midazolam group demonstrated the reduction bling during treatments. Hence we arranged comprehensive den-
of blood pressure and heart rate, the raise of SpO2, the increase tal treatment under general anaesthesia, which included
of capillary net density and of the transitional ML size. The composite resin filling, endodontic treatment following by direct
dynamics of physiological parameters did not show any notable resin restoration, extraction of unrestorable teeth, and full mouth
differences. Likewise, no influence of the anesthetic dosage or scaling. After the full mouth dental treatment, the patient’s den-
child age was noted for both groups. tal fear had lessen and was finally able to receive simple dental
Conclusions: Children undergoing dental treatment without MCS treatments. Consequently, she was referred to our Prosthodontics
are affected by stress. The degree of stress in surgical patients department for the fabrication of removable partial denture in
was noted to be significantly higher. The absence of physiological the upper jaw. Now, she visits our department for a regular den-
parameters changes in children treated without MSC does not tal check-up every 3 months.
prove the absence of stress. The increase of midazolam dose over Comments: Dental phobia is a huge barrier of dental care and
0.15 mg per kg is not associated with further reduction of stress. could have a severe impact on patient’s social life. Therefore,
comprehensive treatment under pharmacologic management is an
PR03.22 effective and a worthy regimen for regaining their good oral
hygiene, confidence, and normal social life.
Dental treatment in a patient with Ullrich congenital
muscular dystrophy under total intravenous PR03.24
anesthesia
M. K. BAIK, T. J. SHIN, K. T. JANG, S. H. LEE & C. C. KIM
To compare the efficacy of various sedative agents -
Department of Pediatric Dentistry, School of Dentistry, Seoul oral, inhalational and intravenous, in children for
National University, Seoul, Korea minor dental procedures
A. B. JOSHI1, A. M. HEGDE1, M. GOPAKUMAR1 & U. S.
Introduction: Ullrich congenital muscular dystrophy (UCMD) is
RAVEENDRA2
characterized by early-onset, generalized and slowly progressive 1
Pedodontics and Preventive Dentistry, A B Shetty Memorial
muscle weakness, multiple proximal joint contractures, marked Institute of Dental Sciences, Nitte University, Mangalore, India;
hypermobility of the distal joints and normal intelligence. Weak- 2
Aneasthesiology and Critical Care, K S Hegde Medical Academy,
ness of the facial muscles, a high-arched palate, congenital hip
Nitte University, Mangalore, India
dislocation, protrusion of the calcaneus, torticollis, contractures,
and distal laxity may be the neonatal findings. Motor milestones Background: Behaviour management is of paramount importance
are delayed. Muscular dystrophy patients appear abnormal reac- in the field of pediatric dentistry. When non-pharmacological
tions to several drugs. Especially, the development of malignant techniques fail sedation remains the next choice for the control
hyperthermia during inhalation anesthesia for patients with mus- of pain and anxiety, where there is always a need for newer com-
cular dystrophy is a concern. binations of sedatives agents.
Case reports: A 8-year-1-month old, 27 kg girl with Ullrich con- Aim: To compare the efficacy between the five groups, nitrous
genital muscular dystrophy was scheduled for dental treatment of oxide (NO), nitrous oxide with midazolam premedication (NM),
multiple caries. She was poorly cooperative for treatment due to oral combination of midazolam and ketamine (KM), intravenous
developmental delay and movement disorder, so general anesthe- combination ketamine and propofol (KP) and intravenous com-
sia was considered. Dental treatment - resin restoration, pulpoto- bination of ketamine and dexmedetomidine (KD) for sedation in
my, and stainless steel crown restoration - was successfully children undergoing minor dental procedures.
performed under total intravenous anesthesia (TIVA). There were Design: 75 Patients were selected, evaluated according to the cri-
no airway complications and sings of hyperthermia during anes- teria decided and divided in equal numbers of 15 amongst five
thesia. groups NO, NM, KM, KP and KD. Informed consent was
Comments: In conclusion, our cases suggest that TIVA may be a taken, NPO (Nil per Oral) guidelines were followed and the
safe strategy for dental treatment in uncooperative patients with study drug was delivered. The heart rate (HR), blood pressure
progressive muscular dystrophy considering the possibility of (BP) and oxygen saturation (SPO2) were monitored continuously
sedation - related airway problems. throughout the procedure. The Modified Ramsay sedation
(MRS) score was recorded along with Houpt and later recovery
PR03.23 status was accessed by Modified Aldrete’s recovery scale. The
results were statistically analyzed by one way anova, posthoc
Dental phobia with anxiety in adults who needs assessment tukey test and chi square test.
comprehensive dental treatment: a case report Results: The sedation achieved with Ketamine-Dexmedetomidine
Y. H. HSUEH, K. T. SUN, H. H. CHIANG, Y. C. CHANG & was adequate and highly significant (P values for MRS = <0.001,
C. J. HUNG Houpt = <0.001) compared to all other groups, but the postoper-
China Medical University Hospital, Taichung City, Taiwan ative recovery was fastest and highly significant with Nitrous-
oxide group (Recovery scale: P value = <0.001) followed by
Introduction: Dental phobia is the severe fear of dentistry and
Nitrous-Midazolam, Ketamine-Midazolam, Ketamine-propofol
dental treatment. It may not only affect patient’s healthiness, but
and Ketamine-Dexmedetomidine respectively.
also affect their social life. We describe a 32-year-old female who
Conclusion:
had suffered from dental phobia since childhood and asked for
1) Ketamine-Dexmeditomidine intravenous combination has the
comprehensive dental treatment.
best efficacy.
Case reports: A 32-year-old female had suffered from fear of vis-
2) Nitrous-oxide had the fastest recovery and ease of delivery.
iting the dentist, and severe dental problems made her depressed
and affected her social life for years. She was diagnosed as dental
phobia with anxiety by her psychiatrist, hence Lorazepam was
prescribed. The clinical examination revealed multiple tooth cavi-
ties, full mouth heavy calculus accumulation, and multiple unre-
storable teeth. We tried behavior management and some simple
PR03.25 (P = 0.05). 239 patients out of 610 visited the clinic again with
the need of dental treatment (% 34.6) (P = 0.05). 142 of those
Dental treatment under general anesthesia (DGA)
239 patients required sedation for the second time (% 59.4),
among healthy and medically compromised children whereas 97 (% 40.6) patients were treated without sedation
V. ANTTONEN1,2, S. RANKINEN1, H. VAH € ANIKKIL
€ € 1, S.
A (P = 0.05). There were no statistical difference between the ages
KOSKINEN3 & M. L. LAITALA1 of the patients required sedation for the second time, and the
1
Department of Paedodontics, University of Oulu, Medical patients who were treated without sedation after the first seda-
Faculty, Oulu, Finland; 2Medical Research Center, University tion.
Hospital and University of Oulu, Oulu, Finland; 3Oulu University Conclusions: It can be concluded that, the patients who are in

Hospital, Oulu, Finland need of sedation for dental treatment would possibly require
Background: Dental care in general anesthesia (DGA) is an sedation again for their further visits.
option when normal dental care cannot be accomplished espe-
cially for children. PR03.27
Aim: The aim of this study was to investigate DGAs and causes Child in the dental chair - communicating beyond
for them among healthy and medically compromised children.
Design: Data were collected from the medical records of children
words
under 7 years of age treated under DGA in 2009 and 2010 in the R. NAIR1, S. BRIDGES2 & C. K. Y. YIU3
1
Oulu University Hospital, Finland. Background information (year Paediatric Dentistry and Orthodontics, Faculty of Dentistry,
of DGA, age in months, gender, dental and medical diagnosis, Hong Kong University, Hong Kong, Hong Kong; 2Faculty of
ICD10) as well as DGA procedures were registered. In analyses Education, Hong Kong University, Hong Kong, Hong Kong;
3
Chi-squared test was used; difference was considered significant Paediatric Dentistry, Faculty of Dentistry, Hong Kong University,
with P values < 0.05. Hong Kong, Hong Kong
Results: The number of children treated in DGA was n = 140; Background: Due to anxiety & fear, young children tend to be
mean age was 57.3 months (SD 15.91). Proportion of boys was less co-operative in the dental setting. Even the very sight of the
bigger than that of girls (n = 81; 57.9%). Majority of the study dental chair can frighten some children. It is therefore essential
group were healthy (72.1%). Dental caries and fear were the two for dentists to have good communication skills - both verbal &
main causes for DGA of all children. Procedures under DGA nonverbal; to provide the best possible care for their child
were not associated with general health, rather the age; i. e. chil- patients. Nonverbal communication accounts for majority of
dren 35 months or younger had commonly stainless steel crowns, information transmitted during interpersonal interactions.
whereas extractions were more common among children Aim:
>35 months. Medically compromised children had had more fre- 1) To document through video analysis, nonverbal communi-
quently DGAs (16.2%) in the past compared with healthy chil- cation between the child patient and the dental team dur-
dren (5.2%). ing paediatric dental consultations.
Conclusions: Threshold for treating medically compromised chil- 2) To identify patterns in nonverbal communication during
dren in DGA seems to be lower than treating healthy children. dental consultations with child patient.
To avoid unnecessary DGAs, caries control should be empha- Design: A Pilot study (13 cases of 5–12 years old healthy chil-
sized for all children according to individual needs. Children and dren) was conducted to analyze nonverbal communication
parents need information and continuous support for good self- between the dental team and child patient during dental consulta-
care. tion. Naturally occurring routine clinical dental consultations
were captured using audio-visual recording devices. The data was
PR03.26 stored electronically and accessed for data analysis.
Results: All cases analyzed showed existence of nonverbal com-
Evaluation of pediatric patients0 needs who treated
munication during paediatric dental consultations. The very
with sedation in the first place: a retrospective young children (5–6 years) are almost always subjected to non-
research verbal communication in the form of body language like - hand
€
S. E. YOLDAŞ1, H. M. GORCEK 1
, H. KINACI2, G. KIP1 & H. gestures, body movements, facial expressions & body position.
BODUR1 The frequency of use of body language decreases as the child’s
1
Department of Pediatric Dentistry, Faculty of Dentistry, Gazi age increases.
University, Ankara, Turkey; 2Department of Statistics, Faculty of Conclusions: Using body language to communicate is an integral
Science, Gazi University, Ankara, Turkey part of paediatric dental consultations in gaining the confidence
of a young, anxious child. This phenomenon decreases in older
Background: Treatment of pediatric patients could be challenging.
children, exhibiting physical & intellectual independence.
To treat them effectively, application of various behaviour man-
agement techniques could be required.
Aim: It is widely known that basic behaviour guidance techniques PR03.28
are pretty succesful in managing dental behavioural problems. Diurnal bruxism treatment with behavior
The aim of this research was to investigate if the pediatric management: a case report
patients treated under sedation in the first place require to be
G. INAN & T. ULUSU
treated under sedation again for their further dental treatment
Pediatric Dentistry, Gazi University, Ankara, Turkey
needs.
Design: The data received from the records of 1190 patients who Introduction: Patterns of oral behavior have been suggested as
referred to Gazi University Faculty of Dentistry Department of factors leading to head and facial pain. Bruxism is a habit that
Pediatric Dentistry between 2012–2014 and treated under deep causes significant dental damage such as wear on teeth, damaged
sedation. 499 patients with various systemic diseases and syn- bone structures, craniofacial pain.
dromes excluded from the study. Case report: A 10-year-old girl was referred to the Department of
Results: % 57 of the sedated patients were boys and 43% were Pediatric Dentistry, Gazi University, because of the pain on right
girls (P = 0.05). Mean age of the patients was determined as 3.96 side of her face. Patient and her parents reported that she had
diurnal bruxism. Extraoral examination showed that the patient have been developed to minimize the injection pain of local anes-
was sensitive to palpation on her right cheek. The measurement thesia. A new procedure to reduce the injection pain is DentalV-
results were determined according to limitation in mouth opening ibe Injection Comfort System based on the vibration stimulus.
(24 mm). At first visit the patient was informed about the poten- Aim: The aim of this randomize controlled crossover clinical
tial consequences in case of not quitting her habit. At weekly study was to compare injection pain during palatal infiltration
intervals the extraction of the teeth which are indicated for anesthesia injected by either traditional syringe (TS) or DentalV-
extraction due to exfoliation time arrival had been performed ibe Injection Comfort System (DV) in pediatric patients.
and the level of pain and mouth opening had been checked. In Design: Sixty children who required palatal anesthesia for the
every visit she was motivated to quit her habit and in time she operative procedures on their maxillary molars bilaterally were
reported that the habit reduced gradually. At the end of 5th week selected. One of the teeth was treated with a TS and the contra-
it was found that the patient completely quit her oral habit and lateral tooth was treated with the DV. A total of 120 injections
she wasn’t gnashing her teeth any more. Mouth opening was were applied by using two different anesthesia systems. Subjective
determined as 41 mm which is within the normal range and she evaluations were performed using the Wong-Baker Faces Pain
had no pain. Rating Scale (PRS) and objective evaluations were performed
Comment: This case report describes the relationship between with the Face, Legg, Activity, Cry, Consolability Scale (FLACC
bruxism and pain, limitation in mouth opening. The treatment was Scale) to measure each child0 s pain. Also preference of patient
performed only by providing the patient to quit her oral habit. was determined. The data was evaluated using Mann-Whitney U
and Wilcoxon t tests.
PR03.29 Results: There were no statistically significant differences between
two injection methods for objective pain evaluation. Traditional
Dental anxiety in Czech pre-schoolers syringe injections were detected more painful according to PRS.
J. VASAKOVA1, J. MATOUSKOVA1, L. SEBESTOVA1, L. Most of the patients preferred DentalVibe injection.
NAVAROVA1 & Z. BROUKAL2 Conclusions: The pain during palatal infiltration anesthesia
1
Departement of Paediatric Dentistry, 1st Faculty of Medicine, administered with DentalVibe injection was less painful than tra-
School of Dental Medicine, Charles University, Prague, Czech ditional syringe according to self-report of the children.
Republic; 2Departement of Epidemiology and Preventive Dentistry,
1st Faculty of Medicine, School of Dental Medicine, Charles
University, Prague, Czech Republic
PR03.31
Comparing dental stress in new child patients and
Background: Dental anxiety and uncooperativeness is common
reason of preschool children0 s referral to the clinic. There are
returning patients using salivary cortisol,
many factors connected to the origin of dental anxiety (DA) as Immunoglobulin-A and alpha-amylase
child age, gender on one hand and the preceding experience on A. NADREEN1, S. M. ALAKI2, A. SAFI1 & S. OUDA1
1
the other. King Abdulaziz University, Jeddah, Saudi Arabia; 2Pediatric
Aims: The aim of this preliminary study was to assess preschool Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
children’s level of DA using Venham picture test and to compare Background: Dental treatment can be a major source of anxiety
it to dental status.
and fear for patients, especially children.
Design: Local ethical committee approved the study. The child Aim: This study was aimed at comparing dental stress in children
subjects were recruited in randomly selected public nurseries in having their first dental visit to those returning for dental treat-
the Czech Republic and based on parental informed consent. The ment using salivary stress biomarkers including salivary cortisol
investigators or teachers filled the questionnaire out with the chil-
(s-cortisol), Immunoglobulin-A (s-IgA) and alpha-amylase (s-a-
dren. Oral examination was conducted using head-light, mirror amylase). Additionally, the study was aimed at monitoring the
and probe. Caries status of every tooth surface was recorded change in stress in new patients as they progressed from the wait-
together with child0 s age, gender and place of residence. Statistics
ing to the clinical areas.
- chi square test (P = 0.05) was used for comparison. Design: Salivary samples were collected from 40 children coming
Results: The Venham test was completed by 138 children (64 for their first dental visit and similar samples collected from 40
girls, 74 boys), the dental examination underwent 124 children children who were returning for completion of dental treatment.
(54 girls, 69 boys), response rate 54.7% children within an age
Salivary cortisol, s-IgA and s-a-amylase concentrations were
range of 2–7 years. Lower levels of DA were observed in children obtained by Enzyme-linked Immunosorbent Assay (ELISA).
over 4 years (mean 0.88) and in boys (mean 1.4) compared to Results: s-cortisol levels were higher for new patients at the wait-
younger ones (mean 2.7) and girls (mean 1.9). Higher DA score ing area compared to that while being in the dental chair
correlated significantly with higher means of ds, ms and dmfs
(P = 0.05). Returning patients had higher s-a-amylase
(P < 0.05) in both under and over 4 years of age. (P = 0.001) and s-IgA (P = 0.016) compared to new patients.
Conclusions: The preliminary study confirmed that Czech pre- Conclusions: Children coming in for their first dental visit experi-
schoolers’s dental anxiety level depends on the age, gender and
ence dental stress at the waiting area before being seated for den-
dental status.
tal examination. Returning children experience higher levels of
stress compared to new patients possibly due to previous dental
PR03.30 exposure. We recommend paying special attention to stress
DentalVibe injection comfort system vs traditional reducing techniques to returning children and new patients at the
waiting are.
syringe for palatal local infiltration anesthesia in
children
C. KAYA, U.€ SßERMET ELBAY, M. ELBAY & C. UGURLUEL
Pediatric Dentistry, Kocaeli University Dentistry Faculty, Kocaeli,
Turkey
Background: Palatal local infiltration anesthesia is one of the
painful procedures during dental treatment. Several methods
PR03.32 61.98%, meanwhile more than 33.33% of them considered that

anaesthetics would hurt children’s physical and brain develop-
The increasing rate of autism spectrum disorders and
ment. The income, educational level, and resident place were the
associated factors in Taiwan statistically significant affected factors on parents’ acceptability.
C. H. LI1, S. C. CHEN2, Y. H. HSUEH1, C. J. HUNG1 & K. T. Conclusions: There was a low degree of acceptability among par-
SUN1 ents for DGA. The selection of DGA need informed consent of
1
Pediatric Dentistry, China Medical University Hospital, the parents. We should reinforce health education about behavior
Taichung, Taiwan; 2Department of Endocrinology, Cheng Ching management techniques to the public.
Hospital, Taichung, Taiwan
Background: The prevalence of diagnosed Autism Spectrum Dis- PR03.34
orders (ASD) has increased rapidly over the last several decades Children0 s dental disease treatment effect observed
among U.S. children, the increasing rate was 78% from 2002 to
2011 according to the CDC of America. Due to impaired social
under general anesthesia
relationships, language, and communication, ASD usually needs Y. ZHANG, X. CAO, L. ZHU & W. QIN
pharmacologic management like sedation or general anesthesia Pediatric Dentistry, Dalian Stomatological Hospital, Dalian, China
for dental treatment. Recently, the case numbers of ASD was Background: In recent years, the low age children0 s dental caries
growing. We wonder whether the numbers of ASD was increas- incidence increased gradually. More and more children can0 t
ing in Taiwan. cooperate with the pediatric dentist, and so many children0 s dis-
Aim: To investigate the numbers of ASD, increasing rate, and ease is not treated in time. Present more demand for the treat-
the associated factors in Taiwan. ment of general anesthesia. And treatment of the credibility of
Design: According to the Ministry of Interior and Taipei Autism the general anesthesia is rising.
Children Social Welfare Foundation record, there were statistical Aim: Observed the treatment effect for adopting the method of
data of diagnostic numbers of ASD and the increasing rate from general anesthesia treatment of children0 s dental disease, and they
2006 to 2013 in Taiwan. cannot accept the usual dental treatment
Results: The numbers of ASD was 6185 in 2006, 12,712 in 2011, Design: Through 2003.7~2013.1 statistic 3 ~ 8 years old children0 s
and 13,366 in 2013. The increasing numbers was 1000 ASD per dental patients with 252 cases, by adopting a one-time treatment
year. The increasing rate was 16.52% per year. ASD is the most under general anesthesia and monitoring of caries and pulpitis
rapid increased disorder among the groups of special need. The and apicitis etc. such as caries filling, root canal therapy, metal
associated factors include genetic factors, complications during crown, extraction, space keeping etc. With 2 weeks, 6 months,
labor and delivery, virus infection during pregnancy, metabolic 1 year, 2 years, follow-up the therapeutic effect was observed.
syndromes, and toxic exposure in pregnancy, and environmental Results: 252 cases of children treated with general anesthesia, can
factors. Among the suspected toxins surveyed, some ethers and reach pain relief, occlusal function to recover as much as possi-
aluminum adjuvants have increasing trends that correlate posi- ble, followed by the children0 s growth and development did not
tively to the rise in autism. see abnormalities.
Conclusions: Diagnosed autism prevalence has risen dramatically Conclusions: Treatment of children0 s dental disease under general
in Taiwan and other countries. Prevent infections and exposed to anesthesia effect is reliable.
toxins during pregnancy and early detection are important for
reducing the prevalence of ASD.
PR03.35
PR03.33 Factors correlated with children’s dental anxiety in
Latvia
Acceptability and cognition of dental general L. KRONINA1, R. CARE1 & M. RASCEVSKA2
anesthesia to parents in Xi’an, China 1
Institute of Stomatology, Riga Stradins University, Riga, Latvia;
S. YUAN, F. LIU & X. WANG 2
Faculty of Education, Psychology and Arts, University of Latvia,
Department of Pediatric Dentistry, School of Stomatology, The Riga, Latvia
Fourth Military Medical University, Xi’an, China
Background: Dental anxiety has multifactorial origins and mani-
Background: Researches have demonstrated dental general anes- festation, having remarkable consequences on dental health.
thesia (DGA) to rank the third most acceptable behavior man- Aim: To evaluate relationship between children’s dental anxiety
agement technique among all eight techniques in 2005. However, (CDA), dental health (DMFt) and psychosocial factors.
another survey showed that DGA was the penultimate one to Design: Totally 240 randomly selected children (mean age
accept. Meanwhile, there is no study to claim what the affected M = 7.96, SD = 2.61, range from 4 to 12) and their parents were
factors are. taking part in the study. Parents evaluated their own (MDAS)
Aim: To investigate the acceptability and cognition of DGA to and their children’s anxiety (CFSS-DS). Psychosocial factors
parents and to analyze the possible affected factors. were evaluated by a large, newly developed questionnaire, con-
Design: 1002 parents were included in this investigation. After sisting of seven blocks of independent variables: socio-demo-
explaining the DGA technique, parents filled the questionnaires graphical/ economical, medical experience, dental experience,
which contained the parental age, income, educational level, parental/information, dental habits/behavior, children’s character,
types of medical insurance, and resident place. SPSS 11.0 soft- family stress. Evaluation of children’s dental status was per-
ware was used for statistical analysis. We used the relative num- formed according to WHO ICDAS criteria. Frankl’s scale was
ber to express the level of the acceptability and cognition to used to evaluate child’s behavior in the dental setting. Pearson’s
parents, and used chi-square test to figure out the correlation correlation and stepwise linear regression analysis were per-
between investigatory factors and the acceptability. formed within the blocks of independent variables.
Results: Among all behavior managements in pediatric dentistry, Results: Children’s character (general anxiety and children’s
parents’ familiarity with DGA was lower than others. Only behavior at dentist) gave the most impact on CDA, totally
6.69% of the parents had heard about DGA, and 20.76% of explaining 55.4% of CDA variance. Dental experience (restora-
them would accept the technique when dentists suggested. The tions under GA and negative experience) as well as parental/
percentage of worrying about the side effects of anaesthetic was
information factors (parental anxiety and promising gifts before conduct problems, hyperactivity, peer problems and prosocial
treatment), and medical experience (cautious attitude towards behavior.
doctors) explained 39.0%, 29.7% and 33.8% of CDA variance, Child behaviour in dental clinic was assessed by the investigator
respectively. Socio-economical/demographical factors (number of by using modified Frankl’s Behavior Rating Scale. A total of 175
children and mother0 s age) explained 11.8%, but children’s dental children of 3–14 years of age participated in this study.
habits (brushing as a duty) – 13.3% of variance. Family stress Results:
factors had no correlation with either CDA or DMFt and were 1) 80% of children show abnormal behavior in home whereas
excluded from further analysis. only 8% shows good behavior.
Conclusions: Variables that represented children’s character, med- 2) 83% of child shows positive modified frankl scale in dental
ical experience as well as parental/information factors predicted clinics during treatment followed by 7% of child showed
CDA at the most. definitely positive, 9% child showed negative scale and 1%
constitutes definitely negative behavior.
PR03.36 3) Approximately 75% of child of all age groups, showed
positive behavior in dental clinics. The child with negative
Pharmacological vs physical restraint: a clear and definitely negative behavior scale comes from lower
polarization among Brazilian paediatric dentists age groups of 3–7 years.
G. C. M. MACHADO, A. M. L. S. DAHER, A. P. S. COST & L. 4) 84% male and 82% female child shows positive behavior
R. COSTA in dental clinics. The negative behavior is shown by 7%
Dental School, Federal University of Goias, Goi^
ania, Brazil male and 11% female. The definitive negative behavior is
shown by 1% of male.
Background: In paediatric dentistry, behavioural management
Conclusion: The children behave differently in home environment
techniques aim to guide children to accept dental treatment with
and in dental clinics.
the least possible discomfort. Sometimes, uncooperative children
should be managed with pharmacological methods such as seda-
tion and general anaesthesia, instead of physical restraint, to PR03.38
have their dental treatment accomplished. Prevalence of intra-oral injection fear in children and
Aim: This study aimed to explore the attitudes of Brazilian paedi- adolescents. Preliminary results
atric dentists in regards to pharmacological methods and physical
K. G. BERGE1,2, M. L. AGDAL1,2, M. VIKA1,2 & M. S. SKEIE1
restraint for children0 s dental behaviour management. 1
Department of Clinical Dentistry, University of Bergen, Bergen,
Design: This survey included the attendees of the Brazilian Con-
Norway; 2Specialist Oral Health Centre for Western Norway,
gress on Paediatric Dentistry, who were requested to answer self-
Bergen, Norway
administered questionnaires. The questionnaire covered items
related to dentists’ attitudes on pharmacological methods - rela- Background: Reports on the prevalence of blood-injury-injection
tive analgesia, moderate sedation and general anaesthesia - and phobia (BIIP) are based on different criteria and do most fre-
physical restraint for guiding uncooperative children behaviour. quently not distinguish between the subtypes, fear of intra-oral
Data were analysed through hierarchical cluster analysis. injections are included if at all reported.
Results: 301 questionnaires were analysed (92.0% women; mean Aim: To i) estimate among children and adolescents the prevalence
age of 38.5 years, standard deviation 8.9, range 23.0–66.0). Physi- of BIIP and the prevalence of its subtype intra-oral injection pho-
cal restraint was the most preferred behaviour management bia and ii) explore their possible overlap with dental anxiety.
method; general anaesthesia was the least preferred one, no mat- Design: This was a cross-sectional questionnaire study, performed
ter the child’s age. Respondents showed clear familiarity to physi- in elementary schools in the county of Hordaland, Norway. The
cal restraint method instead of pharmacological methods. schools were randomly selected, and a total of 1400 of 10–
Hierarchical cluster analysis found two-cluster solutions about 16 year-old pupils were invited to participate. The questionnaire
dentists’ attitudes, revealing two clear major groups: on one side consisted of four psychometric instruments; Intra-Oral Injection
those who mostly disagree about physical restraint and on the Phobia Scale (IOIP), Injection Phobia Scale for children (IP-c),
other, those that mostly disagree about pharmacological meth- Mutilation Questionnaire for children (MQ-c) and Children’s
ods. Fear Survey Schedule - Dental Subscale (CFSS-DS). Based on
Conclusions: The majority of paediatric dentists are not familiar- these instruments descriptive statistics were conducted. Cross tab-
ized and do not use pharmacological methods for child behaviour ulation analyses were used to explore the overlap between fear of
management in Brazil. Moreover, there is a clear polarization in injections and dental anxiety.
Brazilian paediatric dentists’ attitudes about physical restraint vs Results: Preliminary results will be presented.
pharmacological methods. Conclusions: Conclusions for the preliminary results will be pre-
sented.
PR03.37
Assess the relation between the behavior of children PR03.39
in home and in dental clinics Dancing tango on teeth and lips - a medical
N. JAYAVEL PANDIYAN anthropological study on oral care for persons with
Dept of Paediatric Dentistry, Penang International Dental College, profound intellectual and multiple disabilities
Penang, Malaysia N. C. CHEN1, Y. C. LEE1, S. T. HUANG2 & Y. Z. WANG3
1
Aims and objective: To check for any association between behav- Kaohsiung Medical University, Kaohsiung, Taiwan; 2Division of
iour of the child in home and their behavior in dental clinics. Special Care Dentistry, Kaohsiung Medical University, Kaohsiung,
Study design: Parents / guardians of newly registered patients and Taiwan; 3Department of Psychology, Kaohsiung Medical
walk-in patients to the Pediatric Dentistry clinic were involved. A University, Kaohsiung, Taiwan
Questionnaire was specifically designed is used to assess the Child Background: We are curious about how dentists understand
behaviour at home and in dental clinics. Child behavior at home, patients’ emotion by their facial expressions or body movements
were assessed under five categories such as emotional symptoms, and release patients’ fear during the oral care.
Aim: The study aims to explore how the patients with profound EDS. These included fragility of the oral mucosa with delayed
intellectual and multiple disabilities (PIMD) transform attitude healing, microdontia, short or malformed roots, large pulp stones
from resisting to accepting, and how the role of dentists shifts and calcification of the pulp, and periodontal disease. Further-
during the process of oral care. more, some study and clinical experience shown that topical local
Design: A qualitative research study was conducted with herme- analgesia or local infiltration anesthesia might be ineffective, due
neutic phenomenological approach to explore the process of den- to tissue scarring for ELS patients. Pain during dental care is
tal care for persons with PIMD. also difficult to manage. In this presentation, we suggest an other
1) This study is taken place at Special dental clinic of Ka- approach, an alternativ technical anesthesia to improve its suc-
ohsiung Medical University Chung-Ho Memorial Hospital cess and the comfort of these patients during dental care.
in Taiwan.
2) Research data are collected by field observation and in- PR03.41
depth interviews with family members of the patients and
dentists. The data are analyzed by hermeneutic phenome- Pre-operative fasting time for chewing gum: a survey
nological research method. of anaesthetists
Results: This qualitative research reveals explicitly that H. TATHAM1 & C. DAVIES2
1
1) The occurrence of fear begins in the waiting time. Department of Paediatric Dentistry, Guy’s and St.Thomas’ NHS
2) The reaction of fear or reject to oral care of patients with Trust, London, UK; 2Department of Anaesthetics, Guy’s and St.
PIMD might be the reflection of dentist internal feeling. Thomas’ NHS Trust, London, UK
3) The approach for facing dental fear in PIMD is better
Background: A child attending for dental treatment under general
with ‘partnership’ method than the dentist single-handedly
anaesthetic at a dental hospital was chewing gum during the pre-
dealing with the dental fear.
operative fasting period. The anaesthetist decided to delay the
Conclusions: This qualitative research reveals explicitly fear has
child0 s general anaesthetic to allow time for gastric emptying.
always existed, fear itself is not eliminated or generated; what
Departmental pre-operative fasting guidance did not state that
changes it the attitudes and reaction toward fear. Physical body
chewing gum is a nil-by-mouth substance. A review of national
is the stage of doctor-patient communication. It’s more than oral
guidelines revealed variation in guidance for fasting times for
care and the whole process of oral care can be described as
chewing gum in the pre-operative period.
‘Dancing Tango on teeth and lips’.
Aim: The aim of this survey was to ask NHS England anaesthe-
tists to report and comment on pre-operative chewing gum fast-
PR03.40 ing time within their trust.
Ehlers-Danlos alternative: a new syndrome for Design: Thirty NHS England acute trusts were randomly
anesthesia? selected. A survey was sent via an online survey tool with seven
A. L. BONNET1, S. BADRAN2 & N. JEGAT3 questions relating to pre-operative chewing gum fasting times.
1 Information was requested about mention of chewing gum in the
EA 2496, Paris Descartes, Montrouge, France; 2Public Health,
trust0 s fasting policy, specific fasting time for chewing gum, per-
Reims Champagne Ardennes, Reims, France; 3Odontologie
Pediatrique, Paris Descartes, Montrouge, France sonal opinion on fasting time for chewing gum and any cancella-
tions or complications due to chewing gum pre-operatively.
Introduction: Ehlers-Danlos syndrome is an inherited disease Results: 163 anaesthetists participated in the survey. 60% of fast-
characterized by an alteration of connective tissue. ELS is due to ing policies mentioned chewing gum. Minimum fasting times var-
mutations in genes encoding various types of collagen or colla- ied: no specific time (17%), 2 h (29%), 4 h (5%) and 6 h (14%).
gen-modifying enzymes (collagen I, III, and V; tenascin-X 43% thought chewing gum fasting time should be 2 h. 23% had
(TNX); or lysyl hydroxylase-1) and leads an abnormal procolla- cancelled GA due to chewing gum pre-operatively. 3% experiend-
gen production by fibroblast. The prevalence of Ehlers-Danlos ed chewing gum related complications.
syndrome is estimated between 1 in 5000 and 1 in 10,000. Conclusions: Pre-operative fasting time for chewing gum varies
Clinical manifestations of the syndrome are joint hypermobility, across the trusts surveyed. Similarly, anaesthetists0 personal opin-
skin hyperextensibility, and tissue fragility. The different types of ion varies. This poses a challenge for surgical departments to
EDS are classified into six types according to clinical signs: classi- provide accurate pre-operative fasting guidance for their patients.
cal, hypermobility, vascular, Kyphoscoliosis, Arthrochalasia and
dermatosparaxis types.
Because collagen is present throughout the oral and maxillofacial
area, specialists in dentistry are made aware of the complications
Epidemiology and Dental Public Health Poster Session – PR04
Epidemiology and Dental Public Health

Poster Session – PR04
PR04.01 Design: A retrospective review of dental records from dental out-
reach programs in 2013 and 2014.
Gutkha and paan - a threat to our youth Results: Dental examinations were conducted for 211 (2013) and
N. MAJEED1 & A. M. HEGDE2
1 230 (2014) children. Caries prevalence decreased significantly
Middle East Specialised Medical Centre, Abu Dhabi, United Arab
from 83% at baseline to 73%. Caries prevalence among day
Emirates; 2AB Shetty Memorial Institute of Dental Sciences,
scholars was 13% higher than among boarders (87.3% vs 74.2%;
Mangalore, India
P < 0.05) at baseline. In 2014, there was no significant difference
Background: Gutkha use among teens is becoming serious prob- in caries prevalence based on boarding status. There was no sig-
lem in developing countries. The early age of initiation under- nificant difference in dmfs scores between day scholars and
scores the urgent need to intervene and protect this vunerable boarders in 2013 or 2014. The inability to match individual
group from falling prey to this addiction. 40% of the tobacco patient records from 2013 to 2014 prohibited analysis of caries
consumed in India is in the smokeless form. The last two decades incidence.
have seen a phenomenal growth in the smokeless tobacco indus- Conclusion: At baseline, boarders had better oral health than day
try. scholars, but these differences did not persist after 1 year of
Aim: To determine the prevalence of gutkha and paan chewing intervention. The high caries prevalence indicates a need for com-
among adolescent of lower socio-economic class prehensive intervention techniques.
To identify reasons for indulging in chewing habits.
To access knowledge about ingredients, benefits and harmful PR04.03
health effects.
To investigate the oral mucosal disorders associated with habit-
Changes in caries prevalence of Isle-of-Islay children
ual paan consumption in the above mentioned population. 1999–2014
Design: A cross-sectional community-based survey and examina- M. FORMBY1 & R. R. WELBURY2
1
tion of oral cavity was done by amongst 144 adolescents ofAge Remote and Rural Fellow, NHS Education for Scotland, Isle-of-
between 12–17 years belonging to lower socio-economic class in Islay, UK; 2Paediatric Dentistry, University of Glasgow, Glasgow,
Kerala, India. UK
Results: Results show 26.4% of the population used paan with
Background: The Isle-of-Islay has a remote-rural population.
arecenut and tobacco and 13% were meeta paan users. The rea- Two dentists have been responsible for the care of the majority
sons stated are use of these substances by family members and of the school-age children for 15 years. The island affords a
friends, low cost and easy availability. unique situation to measure caries prevalence in a relatively static
91% of users were aware of the harmful effects of paan chew-
population.
ing.47% of users had white lesions and mucosal burns. Paan Aim: This study measures the changes in the dental caries experi-
users had poorer oral hygiene, stains on teeth and higher preva- ence of 5 and 12-year olds exposed to a preventive based
lence of localized periodontitis. approach to improving dental health which included a school-
Conclusions: The findings from the present study highlight the
based toothbrushing programme (4–12 years).
need of eliminating the use of paan and gutkha control pro- Design: Data from the practice based records were collected for
grammes and public education. children aged 5 and 12 in the years 1999–2003 and 2012–2014.
Indices including percentage of children with no obvious caries,
PR04.02 dmft/DMFT and care index were calculated, translated into
Children’s oral health outcomes after school-based graphs and compared to Scotland’s National Dental Inspection
Programme data.
oral health program in Nepal Results: 478 children were included in the study. The mean num-
R. M. HILL, C. TUN & S. M. HIRSCH
ber in each year group for 5 year olds was 28 (SD 5.65) and
Global Outreach and International Initiatives, New York
for 12 year olds was 31.75 (SD 8.30). The percentage of chil-
University College of Dentistry, New York, NY, USA
dren caries free increased from 39% to 85% (5 year-olds) and
Background: NYU College of Dentistry (NYUCD) introduced a 31% to 97% (12 year-olds). dmft/DMFT decreased from 3.04 to
dental outreach program at the Srongtsen Bhrikuti Boarding 0.30 (5 year-olds) and 3.74 to 0.03 (12 year-olds). Figures for
High School in Kathmandu in 2013. Of 680 pupils, 40% lived at care index and percentage of first permanent molars fissure sealed
the school (‘boarders’), while the rest commuted to school daily were higher than national data averages.
(‘day scholars’). NYUCD initiated a school-based oral health Conclusion: Caries prevalence decreased in children in Islay aged
intervention consisting of daily toothbrushing with fluoridated 5 and 12 years over the period 1999–2014. There was no control
toothpaste and quarterly fluoride varnish applications performed group but the differences described above can be associated with
by the school nurse and teachers. Follow-up examinations were the introduction of a preventive approach, however they cannot
conducted in 2014. be assumed to be causative.
Aim: The aim of this study was to review the oral health out-
comes of children who participated in the school-based dental
programs.
PR04.04 need two-surface restorations, 0.441 teeth need more than two-
surface restoration, 2.641 teeth need pulp therapy, 0.547 teeth
Wait times for pediatric dental treatment under
need extraction, 0.153 teeth needs space maintainer and 1.988
general anesthesia at three U.S. Federally qualified teeth needs crown. Only 4 (2.4%) children out of 170 were caries
health centers (FQHCs) free.
D. OKUJI, A. ENGELHARDT, M. GREABELL & J. SIELSKI Conclusions: This study demonstrated that parents most often
Dental Medicine, Lutheran Medical Center, Brooklyn, NY, USA seek dental care for problems like decayed teeth, pain, abscess
and swelling rather than seeking dental assistance at a much ear-
Background: There is inadequate access to care for pediatric
lier stage for preventive measures.
patients requiring dental treatment under general anesthesia. The
mean wait time from consultation to the surgery date is reported
at 71 days. Wait time for treatment impacts the health status for PR04.06
patients requiring general anesthesia. Patients at FQHCs are at Antley-Bixler-syndrome oral findings, a case report
increased risk for dental caries and require greater access to care. M. O. HILLALI1 & A. M. SULIAMAN2
Aim: The aim is to analyze factors related to wait time for dental 1
Pediatric, Khartoum University, Khartoum, Sudan; 2Khartoum
treatment under general anesthesia at FQHCs in Maryland, Mas- University, Khartoum, Sudan
sachusetts, and Missouri. The data describes patient demograph-
ics; wait time; distance from patient home to FQHC; and clinical Background: Antley and Bixler was described an unusual syn-
findings. drome disorder in newborn consisting of complex craniosynosto-
Design: Institutional review board approval was received for a sis with midfacial hypoplasia. The Antley Bixler syndrome is
retrospective dental record review at three FQHCs. Records met complex disturbance of craniofacial growth due to premature
the inclusion requirements if the subject underwent treatment synostoses of the cranial base and the vault. The mode of inheri-
between Jan 9, 2010 and Jul 2, 2014. Data were collected from tance is supposed to be autosomal recessive; however diagnosis is
601 dental records. based on a characteristic craniofacial deformity in association
Results: The results are as follows: with humeroradial synostosis.
1) Race/Ethnicity: 37% Hispanic, 34% Caucasian, and 30% Case report: 11 years old boy complaining of palatal swelling on
African-American, the left side of the maxilla, following examination the child has
2) Payer: 92% government-sponsored Medicaid, typical feature of Antley Bixler Syndrome.
3) Mean age: 3.19 years old, Oral examination revealed that left palatal swelling was associ-
4) Mean distance from residence to FQHC: 43.3 miles, ated with 25 eruption palataly, the 65 is in good occlusion with
5) Mean wait time: 110 days, no signs of mobility and 26 deviated bucally. On the right side
6) Mean average # teeth treated intra-surgically: 11.52, the 55 was lost with no residual space left.
7) Percent subjects with unserviceable restorations at first Oral hygiene is good, caries free, other else shedding and erup-
post-surgical visit: 19.9%. tion are in sequence, angle class III occlusion and upper anterior
Conclusions: The mean wait time of 110 days is greater than the spacing.
71 days reported by other studies. The mean # teeth treated The radiographic examination was revealed 25 eruption in pala-
intra-surgically, 11.52, is lower than other studies. The 19.9% of tal position crowed in area form 56–26 after orthodontic consul-
subjects presenting with unserviceable restorations at the first tation the decision was to extract the 25 to allow good
post-surgical visit is lower than other studies. alignment of the 26, extraction of 25 was done under local
anaesthesia.
Comments: It is important that all clinicians are aware of the
PR04.05 physiopathology and oral manifestations of Antley Bixler syn-
Reasons for seeking dental care, caries profile and drome, so that they can plan any dental treatment such that it is
treatment need of children in Tabuk, KSA appropriate to the patient0 s limitations and needs.
S. A. H. JAFRI & M. AMRI
Dental Department, North West Armed Forces Hospital, Tabuk, PR04.07
Saudi Arabia
The oral health regimes, dental experience and
Background: Dental Caries is the most prevalent dental disease of parental perceptions of oral health care of children
childhood. Despite credible scientific advances and the fact that with special needs
caries is preventable, it continues to be a major public health
N. N. LONGRIDGE1, S. WALLEY1, S. ALBADRI1 & S. J.
problem.
SPILLER2
Aim: The aim of this study were to identify the most common 1
Paediatric Dentistry, University of Liverpool, Liverpool, UK;
reason for seeking dental treatment, to determine caries profile 2
Sutton Dental Practice, Ellesmere Port, UK
and there treatment need in children visiting dental department
of hospital in Tabuk, KSA. Background: Children with special needs are at an increased risk
Design: A total of 170 Saudi children between the age of 1– of dental disease, yet they experience significant barriers to their
5 years, who visited the hospital for treatment were examined by care.
single pedodontist and their chief complaint, caries status and Aim: To investigate the oral health regimes, dental experience
overall treatment needs were recorded. and parental perceptions of oral health care of children with spe-
Results: The most common reason for seeking treatment by the cial needs.
children between age of 1–5 years was decayed teeth (52.4%) fol- Design: Following ethical approval by the University of Liver-
lowed by pain or swelling or abscess (40.6%). The mean dmft/ pool’s committee of research ethics, an anonymous 0 Oral Health
dmfs index was 9.8/22.4. The mean dmft/dmfs was slightly higher Questionnaire0 was designed and distributed via school adminis-
among girls (9.97/22.54) as compared with boys (9.79/22.25). tration teams, to the parents/guardians of children attending
Each child needs different types of dental treatments ranging three special needs schools in Northwest England. Questionnaires
from one surface restoration to pulp treatment and crown. In used visual analog scales, multiple choice and short answer ques-
Each child 3.412 teeth need one-surface restorations, 2.041 teeth tions. Data was analysed using SPSS.
Results: Of the 176 questionnaires distributed 72 (41%) were Design: A total of 293 mothers of 3–6 years old children attend-
returned. The participating children had an average age of ing Pediatric Dental Clinic at Faculty of Dentistry Mahidol Uni-
11.0 years (range 3–18), 57% were male and the majority had a versity participated. Data on controlling children’s sugared
diagnosis of Autistic Spectrum Disorder. The majority reported snack, attitudes, subjective norms, perceptions of behavioral con-
suboptimal dental care regimes; 54% brush once a day or less trol, and self-efficacy were collected by structured questionnaire.
and 38% rinse with water after brushing. Most children receive Both direct measures and belief-based (indirect) measures were
routine dental care in general dental practice (59%) and evaluated. Spearman0 s rank correlation and multiple regression
attend at least twice yearly (83%). Thirty-two percent had were used to analyze the relationship between mother’s behaviors
received dental treatment under general anaesthesia. Many par- and the predicting variables.
ents reported their child’s special needs ‘significantly affects their Results: Factors related to controlling sugar snack were self-effi-
ability to cope with dental treatment’ (74%), that the ‘condition cacy (r = 0.425, P < 0.01), perceived behavioral control
of their child’s mouth/teeth affects their overall life’ (44%) and (r = 0.361, P < 0.01), attitude (r = 0.302, P < 0.01), and subjec-
that they would approve of dental check-ups in a school setting’ tive norm (r = 0.211, P < 0.01), respectively. Control beliefs were
(93%). the most significant factors related with behaviors, followed by
Conclusion: This study reinforces the oral health care needs of normative beliefs, but not the behavioral beliefs. Multiple linear
this high risk group and emphasises the barriers perceived by regression analysis revealed that self-efficacy, attitude, and
parents to oral health care. mother’s age significantly predicted the controlling of sugared
snack behaviors.
PR04.08 Conclusions: To control children’s sugared snack, mothers should
develop their self-efficacy and perception of control, rather than
The burden of oral disease in children with welfare focusing only on the attitude towards caries prevention.
concerns in Glasgow, Scotland: the work continues
C. M. PARK1, L. M. MILLAR2 & A. M. CAIRNS1 PR04.10
1
Paediatric Dentistry, University of Glasgow, Glasgow, UK;
2
Paediatric Dentistry, Glasgow Dental Hospital and School, ECC: a disease that is about more than just baby
Glasgow, UK teeth
L. SMITH
Background: The relationship between oral health and child mal-
Pediatrics, University of Calgary, Calgary, AB, Canada
treatment has been investigated locally and internationally. Many
studies show an increased burden of oral disease in maltreated Background: ECC is a serious public health problem that has
children. thrived in the traditional disciplinary divide between medicine
Aim: To build on previous work by Harris (now Park) et al and dentistry. ECC prevention is simple and inexpensive, yet pre-
describing the demographics and oral health of children with wel- vious efforts to promote it have failed. The solution is a coordi-
fare concerns for whom a comprehensive oral assessment (COA) nated national awareness campaign that engages the public,
was completed in Greater Glasgow and Clyde, Scotland. medical and dental professionals, social workers, the judiciary
Design: Data from oral examinations of 283 children attending and public health authorities and policymakers at all levels of
for a COA was available from a database. Child demographics, government.
dmft/DMFT scores, BPE, tooth wear and presence of tooth This totally preventable disease affects the well being of the
structure defects were recorded. whole child and this is what we need to understand if we are to
Results: Age range was 4 months to 16 years (mean 6.5 years). succeed in our quest to eliminate it.
All resided in areas with SIMD quintiles ≤3. 62% of children Aim: We are on three paths that have this common goal. The
≤9 years and 79% of children ≥10 years had dental caries. Mean first is dealing with the children who currently suffer from ECC.
number of decayed, missing and filled teeth (dmft) was 7.26 for The second is to minimize the occurrence if this disease in infants
those ≤9 years and 3.7 for those ≥10 years. 6.3% had evidence of and young children.
dental hard tissue trauma and 7.1% had enamel defects. The third is to teach these children while they are in elementary
Conclusion: Children in Glasgow who completed a COA continue and middle school the importance of oral health to their overall
to have a high burden of dental caries and evidence of poor oral well being and to the overall health and wellbeing of their future
hygiene which is in keeping with previous research. children.
YEs, it parallels the philosophy that if you give a village fish to
PR04.09 eat, they will eat it and when it runs out they will suffer the
pangs hunger or if you teach them to raise the fish -supplying the
What influence mothers to control children’s sugared knowledge and tools to do so, they will care for themselves.
snack? An application of theory of planned behaviors
T. VICHAYANRAT1, S. SUDHA2, K. KUMTHANOM2, J. PR04.11
APISUDTISIN2, N. UAEWATANASAKUL2 & Y.
ARIYAKIETSAKUL2 Childhood risk factors for the late eruption of
1
Department of Community Dentistry, Mahidol University, Faculty permanent teeth
of Dentistry, Bangkok, Thailand; 2Mahidol University, Faculty of H. M. WONG, S. M. PENG, Y. F. WEN & C. MCGRATH
Dentistry, Bangkok, Thailand University of Hong Kong, Hong Kong, Hong Kong
Background: Theory of Planned Behaviour (TPB) has been suc- Background: Adequate knowledge of tooth emergence assists in
cessfully applied by wide range of behaviors such as smoking diagnosis and treatment planning in pediatric dentistry and
habits, alcohol drinking, health screening and tooth brushing orthodontics; however, reports of perinatal influences on eruption
behaviors. Few studies have been conducted to apply TPB of permanent teeth were limited in the literature.
regarding to sugared snack control especially in Asian culture. Aim: The study aimed to associate potential factors in early life
Aim: The aims of this study were to examine the factors related with eruption status of permanent teeth of 12 years old children.
to children’s controlling of children’s sugared snack among Thai Design: Clinical examination of tooth emergence was conducted
mothers of preschool children based on TPB. on a birth cohort of Hong Kong children from local secondary
schools. Subjects’ background information including birth char- PR04.13

acteristics, prenatal and early childhood exposures, family socio-
Prevalence of oral habits and its related malocclusion
economic status and medical records were prospectively collected.
Children were divided into complete emergence (of 28 permanent among 6–12 years old school children of Lucknow
teeth) and partial emergence groups based on clinical examina- city, India
tions. Bivariate analyses were used to assess the association of N. KHAN1, F. SAMADI1, S. NAVIT2, K. SINGH3, N. SINGH4
tooth emergence status with each potential factor. & N. SHRIVASTAV1
1
Results: Complete background information and clinical data were Pedodontics, Career Post Graduate Institute of Dental Sciences,
available from 514 children. Maxillary central incisors were Lucknow, India; 2Pedodontics, Saraswati Dental College &
found to have emerged in all subjects, followed by first molars Hospital, Lucknow, India; 3Orthodontics, Saraswati Dental
(99.9%), maxillary lateral incisors (99.6%) and mandibular College & Hospital, Lucknow, India; 4Pedodontics, BABU
canines (98.8%). Except for the maxillary (61.8%) and mandibu- Banarasi Das College of Dental Sciences, Lucknow, India
lar second molars (81.8%), over 90% of all other teeth had
Background: Oral Habits are frequent problems encountered in
emerged. Bivariate analyses showed that the average birth weight
children and their importance can be gauged by the number of
in the partial emergence group was significantly lower compared
articles published in various journals for more than half a dec-
to the complete emergence group (mean difference 0.2 kg,
ade. These abnormal oral habits are of interest to general Dental
P = 0.006). Mode of birth delivery was significantly associated
practioners, Pedodontist and also child physician so as to recog-
with tooth emergence status (P = 0.037).
nise in early stage and prevent its deleterious effect on dentition,
Conclusions: Birth weight and mode of delivery were associated
perioral structures and craniofacial complex of developing child.
with emergence of permanent teeth in a group of 12 years old
Aim: The present prevalence study is a part of an epidemiological
children in Hong Kong.
study carried out with an aim to investigate the prevalence of
various oral habits and to correlate their harmful effects on the
PR04.12 developing oro-facial complex of children.
Improvement of oral health conditions of school Design: The study was conducted on 5000 school children of
children in Cambodia by oral health education both the sexes comprising of 2612 (52.24%) boys and 2388
(47.76%) girls, aged 6–12 years in Lucknow city, India.
Y. YUKO1,2, A. IWAMOTO3, N. NIIZATO4, N. GOTO1 & K.
Result: The statistical analysis showed that the prevalence of
KOZAI2,4
1 abnormal oral habits in children of Lucknow city was 19.24%
Department of Pediatric Dentistry, Hiroshima University
with significantly higher in girls (21.61%) than in boys (17.08%).
Hospital, Hiroshima, Japan; 2Center of International
(v2 = 16.21, P < 0.001). Among the habits tongue thrusting was
Collaboration Development for Dentistry, Institute of Biomedical
the most prevalent habit (14.22%),
and Health Sciences, Hiroshima University, Hiroshima, Japan;
3 (v2 = 20.34, P < 0.001) and lip biting the least prevalent (0.10%),
Department of Maxillofacial Functional Development, Institute of
(v2 = 0.03, P = 0.87). Regarding malocclusion, maxiilary procli-
Biomedical and Health Sciences, Hiroshima University, Hiroshima,
nation and posterior crossbite was mostly seen in thumb sucking
Japan; 4Department of Pediatric Dentistry, Institute of Biomedical
cases, openbite and spaced dentition in tongue thrusting cases.
and Health Sciences, Hiroshima University, Hiroshima, Japan
Whereas retroclination was observed in cases of lip biting and
Background: In Cambodia, numerous children have extensive car- thumb sucking habit.
ies but lack opportunities to receive dental treatment or oral Conclusion: Early detection of abnormal oral habits can prevent
health education. and intercept the possible malocclusions or skeletal dysplasia
Aim: We investigated the effect of oral health education by teach- from occurring on developing dentition.
ers on school children’s dental health, in addition to yearly
researcher-led dental education. PR04.14
Design: We examined the oral health conditions of 126, 117, and
164 school children at the primary school in Siem Reap, Cambo- Caries prevalence of 15-year old Greek children using
dia yearly between 2011 and 2013. Furthermore, we educated not the ICDAS. A national pathfinder survey
only the school children but also their teachers about oral health. M. SIFAKAKI1, A. KAVVADIA1, K. TSINIDOU1, E.
Results: After our instructions, teachers taught oral health in BERDOUSIS1, N. DIMOU2 & C. J. OULIS1
1
their daily work, established ‘brushing time,’ and repeated to Paediatric Dentistry, School of Health Sciences, Faculty of
children the importance of oral health. As evidenced by oral Dentistry, Athens, Greece; 2Computer Sciences and Biomedical
examination, prevalence of dental caries in primary and perma- Informatics, University of Thessaly, Thessaly, Greece
nent teeth was very high, over 96.0% each year. Mean number
Background: Epidemiological surveys are conducted in an
of DMFT plus dft is 8.22 in 2011. However, it decreased to 6.58
attempt to develop and propose long-term and effective strategies
in 2012, and 5.73 in 2013. Moreover, prevalence of untreated
for the prevention of oral health diseases of the population.
tooth decay decreased remarkably to 90.5% in 2011, 76.3% in
Aim: To study the caries experience and treatment needs of 15-
2012, and 51.7% in 2013.
year-old children in Greece in correlation to socio-demographic
Conclusion: We have shown the oral health conditions of children
factors and its evolution over the 2004–2014 period.
in this primary school to improve yearly. Consequently, we have
Design: A total of 1131 13-year-old adolescents of Greek nation-
initiated a similar program at the teacher training school in Cam-
ality, randomly selected throughout the country, were examined
bodia, because when these education students learn and utilize
by 10 calibrated examiners under standardized conditions. Caries
the program in primary schools across the country, every child
prevalence was recorded using the ICDAS II criteria combined
benefits. We believe our program will lead to self-supported den-
with the caries experience mft/s component of WHO index. The
tal health in Cambodia.
demographic data collected included gender, county, urban and
rural areas, and parents’ educational status.
Results: Of the participants, 33.2% were caries-free (ICDAS = 0).
The rural areas demonstrated more caries D3–6MFT rural = 2.31
and D3–6MFT urban = 2.89 and the care index was CI = 39.91%
showing that the largest amount of the treatment needs were tions of labial frenum were assessed in both maxillary and
unmet. Parental educational status, residency status, region, oral mandibular arch. A modified Sewerin’s typology of frenum was
hygiene, smoking and alcohol consumption were the risk indica- employed for classification. Data were collected and analysed
tors for caries inequalities. using chi square test.
Conclusions: Despite the decrease in the prevalence of caries in Results: Of 900 children examined, 53% were male, 47% were
Greek adolescents, disparities remain and their dental health female. The ethnic background of the children varied with
problems remain higher than most European countries, with the 56.77% Mongoloid and 43.22% Aryans. 59.1% had simple fre-
adolescents from rural areas with a lower socioeconomic status num, 25.22% had nodular type, 4.6% had appendix type, 7.11%
showing most of the caries. All of the above call for more drastic had persistent type and 3.88% had variation type of frenal
intervention with preventive programs and better geographic tar- attachment in maxilla. In mandible, 95% had simple frenum,
geting of the dental services at a national level. 0.22% had nodular type, and 3.22% had variations type of fre-
num. Frenum was absent among 1.55% of children in mandible.
PR04.15 No statistical difference was found between two ethnic groups in
relation to morphology of frenum.
Temporomandibular disorders (TMD) in children: Conclusion: In this study, simple frenum was found to be the
postural alterations as a risk factor most common morphology in both maxilla and mandible; fol-
S. CORTESE, A. MONDELLO, R. GALARZA, D. FRIDMAN & lowed by nodular type of frenum, among both ethnic groups in
A. BIONDI maxilla. No statistical significant difference was found between
Pediatric Dentistry, School of Dentistry, University of Buenos two ethnic groups with respect to frenum morphology.
Aires, Buenos Aires, Argentina
Background: Studies on the relationships between postural altera- PR04.17
tions and TMD are controversial and inconclusive. Association of temporomandybular dysfunction signs
Aim: To estimate frequency and assess the presence of postural and the different types of malocclusion in children
alterations as a risk factor for TMD in patients aged 10–15 years.
Design: The study comprised patients aged 10–15 years seeking
(6–13 years old)
comprehensive dental care between 2012 and 2013. TMD diagno- G. RUIZ MIRÓN, M. M. GONZALEZ FONSECA, J. M.
sis was made by dentists who were standardized in the use of GUIZAR MENDOZA & I. D. MORENO VELASCO
RDC/TMD (Kappa = 0.88). For static postural assessment, pho- Paediatric Dentistry, Faculty of Odontology, De La Salle Bajio
tographs were taken of patients standing in an upright relaxed University, Leon, Mexico
position in front of a grid, and then analyzed by a physiotherapist Background: Temporomandybular dysfunction (TMD) is a
following Kendall’s model. Patients were divided into three pathology that has been considered unrelated to the children.
groups: A: without TMD (n = 133; 12.56 1.69 years); B: with However, their presence has been more frequent and malocclu-
muscle disorders (n = 61; 12.57 1.90); and C: with disk displace- sions are a very important etiologic factor.
ment (n = 49; 12.65 1.82). Data were statistically analyzed using Aim: The aim of this study was to investigate the association
ANOVA, OR, and percentages with confidence intervals of 95%. between symptoms and signs of TMD with malocclusion in chil-
Results: No differences in age were observed among groups dren.
(P = 0.95). Significant association was observed between the pres- Design: A prospective and descriptive survey was performed in
ence of alterations in spinal curves, head posture, and lower 1521 children with an age average of 8.54 1.9 years (6–
limbs, and muscular TMD: OR: 3.40 (1.73–6.69), 2.44 (1.20– 13 years), from four elementary schools in Le on, Guanajuato.
4.94), 2.22 (1.19–4.15) respectively. All variables in group C had The presence of malocclusion, Angle molar and signs of TMD
an OR <1. The most frequent alterations in A and B were hyper- were evaluated. Also they were evaluated by age groups (6–8, 9–
lordosis 23.30% (16.40–31.44) and 32.78% (21.27–46.03); for- 10 and 11–13 years) and gender.
ward head posture 39.85% (31.44–48.71) and 52.45% (39.23– Results: TMD signs were identified in 801 of the cases (52.7%), it
65.43); and genu valgum 33.08% (25.15–41.78) and 45.90% was more frequent on girls (P < 0.0001) and in children from 11–
(33.03–59.18) respectively. 13 years old. The most frequent molar class was class I (52.5%).
Conclusions: The most frequent postural alterations were lumbar The presence of clicks and grating was higher in children with
hyperlordosis, forward head posture, and genu valgum. Altera- molar Class II and III. The clicks were more common in students
tions in head posture, vertebral curves, and lower limbs could be with posterior crossbite and anterior open bite; grating with
considered risk factors for muscular TMD. crossbite leading edge to edge.
Conclusions: The presence of DTM signs was more frequent in
PR04.16 Molar Class II and III, in more than half of the evaluated children.
Keywords: Articulation, dysfunction temporomandybular, maloc-
Occurrence of variations in morphology of frenum clusion, frequency
among children of different racial groups
N. GHIMIRE
Pedodontics and Preventive Dentistry, Kathmandu University
PR04.18
School of Medical Sciences, Kavre, Dhulikhel, Nepal Prevalence and correlates of halitosis among
Background: The distribution of the variation in morphology of
adolescents in Debrecen, Hungary
J. A. NEMES1, Z. PAPP1, N. RACZ 1
, G. KOVALECZ1, J.
the maxillary and mandibular labial frenum in the children of 2
different ethnic backgrounds of Nepal has not been studied MATH & M. ALBERTH1
1
extensively. Faculty of Dentistry, University of Debrecen, Debrecen, Hungary;
2
Aims: To assess the variation in morphology of maxillary and Institute of Psychology, University of Debrecen, Debrecen,
mandibular labial freum among children of two ethnic groups. Hungary
Design: A cross-sectional epidemiological study was done among Background: Bad breath (halitosis) is a common complaint all
900 children of age (1–14 years) of two ethnic groups (Mongol- over the world, regardless of age and gender.
oids and Aryans) attending the department. Morphological varia-
Aim: The aim of this study was to investigate the prevalence of PR04.20
halitosis among adolescents, and to examine the possible aetio-
Oral conditions in extremely low birth weight
logical factors.
Design: The study group consisted of 120 patients aged 14– children
M. ALBERTH1, K. LAMPE 1, G. KOVALECZ1, J. MATH 2
& J.
18 years, 335 adult subjects belonged to the control group. All
had completed a questionnaire and had undergone a clinical A. NEMES1
1
examination where cariological and periodontal indices were Faculty of Dentistry, University of Debrecen, Debrecen, Hungary;
2
recorded. The extent of tongue coating was also determined. Hal- Institute of Psychology, University of Debrecen, Debrecen,
itosis was measured by organoleptic evaluation and confirmed by Hungary
measuring volatile sulphur compounds (VSCs) using a portable Background: The majority of low birth weight (≥2500 g) is due to
gas chromatograph (OralChroma). preterm birth. These children are at a great risk of medical prob-
Results: Halitosis was found to be present in 43.4% of the ado- lems among them oral and dental problems. Our aim was to
lescent group when using organoleptic testing method, in 38.3% evaluate the oral condition of extremely low birth weight
of subjects when employing gas-chromatography. Significant cor- (ELBW, ≤1000 g) children and compare it to children with nor-
relation was found between organoleptic scores and VSC mea- mal birth weight.
surements. The prevalence of halitosis increased with age. In the Design: Fifty-six ELBW 8- year- old children were evaluated and
adolescent group gender, number of missing teeth and plaque compared with 56 age and sex matched normal birth weight chil-
index positively correlated with the organoleptic scores while the dren. Oral examination were performed according to the WHO
presence of calculus showed a significant, negative (protective) criteria. The parents answered a questionnaire about the child’s
effect against oral malodour. In the adult population halitosis feeding habits, oral hygiene practices, previous medical history
level was significantly related to the tongue coating index, DMFS and the exact birth weight. Data were analysed statistically.
score, plaque and bleeding indices and the presence of prosthetic Results: There were significant association between birth weight
replacements. and the occurring systemic diseases. We found correlation
Conclusion: Halitosis is a significant problem among Hungarian between ELBW and cariological indices (dt P = 0.010, dmft
adolescents. Measuring oral malodour, as an indicator of oral P = 0.040). Higher prevalence of enamel defects (P < 0.001) was
health, may serve as a motivating factor for improving oral found in the ELBW group. We could not found any association
hygiene. between the birth weight and DMF-T or orthodontic anomalies.
Conclusion: ELBW and pre-term labour can be a predisposing
PR04.19 factor for structural diseases and caries in the primary dentition.
Prevalence and associated factors of molar incisor
hypomineralisation among schoolchildren in PR04.21
Debrecen, Hungary The relationship between childhood oral habits, dental
G. KOVALECZ1, J. A. NEMES1, J. MATH 2
& M. ALBERTH1 abnormalities and articulation disorders
1
Faculty of Dentistry, University of Debrecen, Debrecen, Hungary; N. RÁCZ1, B. BAKSA1, I. PONGRACZ 1
, J. MATH2
& M.
2
Institute of Psychology, University of Debrecen, Debrecen, ALBERTH1
Hungary 1
Faculty of Dentistry, University of Debrecen, Debrecen, Hungary;
2
Institute of Psychology, University of Debrecen, Debrecen,
Background: Molar incisor hypomineralisation (MIH), the
Hungary
enamel defect of the first permanent molars and incisors is a
common finding nowadays. The prevalence varies from 5–40% Background: Previous studies revealed a strong correlation
depending on the criteria and population used for the investiga- between orthodontic and speech disorders. Childhood oral habits
tion. As far as we know no Hungarian data were collected yet. significantly influence the development and maintenance of these
Aim: Our aim was to study the prevalence and the possible etio- anomalies.
logical factors of MIH in North-eastern Hungary. Our aim was to analyse of the relationship between malocclusion,
Design: The study group consisted of 505 children aged 11–15. oral habits and the associated articulation disorders in primary
Clinical examination was done by one examiner with dental school age.
probe and mirror, for dental status the WHO and for the MIH Design: The study group consisted of 1364 children aged 6–15. A
IAPD 2003 criteria were used. A questionnaire was used to parental questionnaire was used to gather information about the
gather information about pregnancy, the mother’s and child’s child0 s past and existing oral habits, speech disorders and ortho-
previous medical history. Data were analysed statistically. dontic treatment. The clinical examination consisted of dental
Results: The prevalence of MIH was 16.8%, no gender differ- and orthodontic screening according to the WHO and the Angle
ences were found. The findings showed a significant correlation orthodontic diagnostic system. Local anomalies were also
between MIH and illnesses occurring during the first year of life recorded. Speech therapist examined the articulation distur-
and medicaments used to treat them, especially in the group of bances.
low birth weight children. Certain medicaments enhance the risk Results: According to the parents’ opinion 24.3% of the children
of MIH without low birth weight as well. had oral habits, but the clinical examination found parafunction
Conclusion: The high prevalence of MIH emphasize the impor- in 52.8% of the cases. Although the parents’ attention was called
tance of the collaboration and the discussion between general that the child had malocclusion in 26.5% only 12.2% had past
practitioners and dentist about the used medications during preg- or present orthodontic treatment. Among those children whose
nancy and early childhood. The early recognition of the defect is parents recognised no articulation disorder, the specialist found
very important to avoid late complications and provide a better anomaly in 24.1%. Orthodontic anomalies associated with para-
life to the child. functions were significantly more common (P = 0.000) than
orthodontic problems alone. The co-existence of parafunction
and orthodontic anomaly significantly increased the incidence of
speech disorder (P = 0.000).
Conclusion: The frequent occurrence of parafunction and ortho-
dontic disorder associated speech disorders emphasize the impor-
tance of regular and complex (dental, orthodontic and speech) between children of immigrant mothers and Danish mothers
screening. Early diagnosis can help the effective treatment. It is (P < 0.001). In total, children of immigrant mothers had on aver-
very important to educate the parents as well. age dmfs+DMFS = 3.1 in 2006 compared to 2.2 in 2013. Danish
children had dmfs+DMFS = 1.7 in 2006 compared to 1.1 in 2013.
PR04.22 The multiple regression analysis showed that even when adjusted
for other explanatory variables, children of immigrant mothers
Childsmile National data linkage birth cohort: still suffer from a larger caries experience compared to Danish
Scotland 2003–2012 children illustrated by an incidence rate ratio of 2.1 (P < 0.001).
J. B. R. KIDD, D. I. CONWAY, A. SHERRIFF, F. HODGINS, L. Conclusions: Despite overall reductions in caries prevalence
M. D. MACPHERSON & A. D. MCMAHON among Danish children as well as children of immigrant mothers,
Community Oral Health, Dental School, College of MVLS, immigrant status should still be regarded as a separate risk indi-
University of Glasgow, Glasgow, UK cator for caries, in addition to indicators such as education, fam-
ily income and number of children in the family.
Background: Childsmile, Scotland’s national child oral health
improvement programme, established in 2006, delivers oral health
interventions: fluoride varnish application, toothbrushing instruc- PR04.24
tion and dietary advice from birth in educational and dental ser- Dental caries prevalence using ICDAS - a call for
vices settings via extended duty dental nurses and with additional proper diagnosis
support from Dental Health Support Workers.
O. O. DENLOYE1, O. ALADE2 & B. POPOOLA1
Aim: Identification and linkage of individual Electronic Patient 1
Child Oral Health, University of Ibadan, Ibadan, Nigeria;
Records (EPR) datasets to evaluate the effectiveness of Childs- 2
Periodontology and Community Dentistry, University College
mile interventions. Hospital, Ibadan, Nigeria
Design: We have piloted the Scottish Informatics Programme
(SHIP), a secure research portal that allows researchers to gather, Background: Permanent molars remain highly vulnerable to den-
manage, share and analyse EPR datasets. tal caries due to their susceptible occlusal surfaces. Generally low
Baseline data were children with a Child Health Surveillance 6–8- caries prevalence has been reported in some Nigerian studies
week review record from 2003–2012. These were linked through using the WHO criteria for diagnosis.
the Community Health Index Number (unique NHS ID) to mul- Aim: To assess caries prevalence on the occlusal surfaces of first
tiple national datasets containing individual level data on Childs- permanent molars in some Nigerian children using the icdas
mile interventions, dental registrations and treatments, with scores.
outcome data including hospital inpatient cases, National Dental Design: This was a descriptive study. Children from four public
Inspection Programme (NDIP) and childhood body mass index. junior schools were randomly selected and only children with
Geographical and deprivation data were also included. fully erupted first permanent molars were included in the study.
Results: The initial linked database consists of 482,955 children Ethical considerations were observed. Diagnosis of dental caries
from across Scotland (85% of births due to Health Boards roll- was made using icdas criteria for assessment and scoring after
ing out implementation of the Child Health Surveillance pro- standardization of the researchers. Occlusal surface of each tooth
gramme). A sub-cohort of 177,731 children with NDIP data examined was cleaned to remove food debris using a ball ended
indicates an improvement of 5-year-olds with no obvious dental probe and thoroughly dried with cotton wool. Intraoral source
caries experience (62% in 2009 to 66% in 2013), in keeping with of light was with the aid of a moxie led head lamp.
published NDIP data. Results: 178 children with mean age of 13.2 years mainly from
Conclusions: We have created an invaluable resource for evaluat- middle social class and with a total of 712 first permanent molars
ing the national Childsmile programme. Further analysis will help were examined. 121 teeth (17%) from 57 children had caries.
determine which interventions are more effective and efficient for Using codes 5 and 6 of icdas (cavitation stage), a prevalence of
improving oral health and reducing oral health inequalities. 4.8% (34 teeth) was recorded, while over 50% of the carious
teeth were in the initial stages of the lesion –codes 1 and 2 and
PR04.23 would have responded to remineralization/ inhibition of lesion
progression therapy.
Mother0 s immigrant status as indicator for caries Conclusion: The use of icdas in this study captured the contin-
among 5-, 7-, 12- and 15-year old children in uum of the caries process and emphasizes the need for detection
Denmark: a study based on data from 2006 and 2013 of initial carious lesions for non- invasive intervention.
L. B. CHRISTENSEN1, K. ROSING1,2 & A. SUNDBY2
1
University of Copenhagen, Copenhagen, Denmark; 2The Child PR04.25
and Youth Oral Health Services of Copenhagen, Copenhagen,
Denmark
The perception and practices of nomadic women in a
rural community in South Western Nigeria to their
Background: During the last decade the public dental care service children’s oral health
in Copenhagen has focused on children of mothers with immi-
O. BANKOLE1, F. LAWAL2 & A. BALOGUN3
grant status in relation to caries risk and preventive activities. 1
Child Oral Health, University of Ibadan, Ibadan, Nigeria;
Aim: The aim of the present study was to investigate immigrant sta- 2
Periodontology and Community Dentistry, University of Ibadan,
tus as a risk indicator for caries experience compared to other risk
Ibadan, Nigeria; 3General Dental Practice, University College
indicators among children attending the public dental care service.
Hospital, Ibadan, Nigeria
Design: Caries data were collected among all 5, 7, 12 and 15-
year-olds during their regular dental visit in 2006 (n = 12,706) Background: Nomads move from one settlement to another and
and in 2013 (n = 14,260). Information on mothers’ immigrant it has been difficult to have adequate documentation about their
status, mothers’ education, family income and number of chil- oral health and that of their children.
dren in the family was obtained via public registries. Aim: To investigate the perception and practices of nomadic
Results: A considerable reduction of caries experience was seen in Fulani women towards their children’s oral health.
all age groups, and variations were found within the age groups
Design: A cross sectional study was conducted among 197 Fulani PR04.27
women using a structured interviewer administered questionnaire.
Prevalence and characteristics of supernumerary
Results: Two fifths attributed bleeding gums to worms (40.1%).
Over half (59.4%) cleaned children’s teeth once daily and teeth in Japanese children and the influences on
(14.8%) occasionally. Polyurethane foam (46.7%), toothbrush permanent dentition
(32.0%), finger (18.8%) and wooden twigs (2.5%) were aids used H. HOMMA, M. MIYASHIMA, N. NAGAI, A. TASHIRO, A.
for cleaning children’s teeth. A few used ground ceramics (3.0%) SAKURAI & S. SHINTANI
and sand (1.0%) as cleaning agents while (5.6%) used nothing. Department of Pediatric Dentistry, Tokyo Dental College, Tokyo,
For bleeding gums (45.1%) gave children self medication with Japan
antibiotics, and herbs (10.2%). Perceived causes of tooth decay
Background: Supernumerary teeth (ST) are mostly located in the
include worms (23.9%) and sugar (5.1%). For tooth decay
anterior maxillary region and are often detected by a clinical and
(32.0%), (15.2%) and (5.1%) will give children antibiotics, tradi-
radiographic examination. Although an appropriate approach to
tional concoctions and analgesics respectively. Over two fifths
ST is crucial to make a comprehensive treatment plan, it has not
(43.1%) give their children sugary diet in between their meals.
been provided yet.
Many (68.0%) feed babies with sweetened drinks in bottles, Sip-
Aim: To establish the appropriate approach to ST, radiographs
py cups (82.7%) and (71.6%) give them pacifiers dipped in sweet
were investigated about as follows; the prevalence and the num-
liquids. Majority (88.3%) give children sweets to reduce temper
ber of ST and the influence on permanent dentition.
tantrums. Respondents associated teething with fever (67.0%),
Design: 1251 images at our pediatric dental clinic were examined.
diarrhea (17.8%), and cough /catarrh (18.3%).
For each patient with ST, the demographic variables, number
Conclusions: These mothers have suboptimal oral health knowl-
and location were recorded. In addition, ST were classified
edge, attitudes and practices towards their children’s oral health.
according to the presence or absence of complications (displace-
There is a need for urgent intervention among this group of peo-
ment, root resorption, and eruption disturbance of adjacent
ple.
tooth) and whether any treatments were carried out.
Results: ST were detected from 172 images (13.8%). If children
PR04.26 visited our clinic because of ST-associated chief complaint were
Association between being overweight and caries omitted, we happened to find ST in 2.7% of children and it was
experience among children 5–8 years old likely to be true prevalence rate. Children with ST comprised 136
males and 36 females (P < 0.0001). 55.0% of ST was vertical,
F. C. SOARES1,2, R. A. LIMA3, M. V. G. BARROS4, G.
€ 1 & V. COLARES2 29.2% was inverted and 6.4% was horizontal. ST were usually
DAHLLOF
1 extracted at 5–7 years old in the vertical type and at 7–8 in the
Department of Dental Medicine, Karolinska Institute, Stockholm,
inversed type. 71.4% of children with ST was judged to require
Sweden; 2Department of Pediatric Dentistry, University of
orthodontic treatment after extraction and following observation
Pernambuco, Recife, Brazil; 3Center for Research in Childhood
period.
Health, University of Southern Denmark, Odense, Denmark;
4 Conclusions: There is controversy regarding the appropriate
Department of Physical Education, University of Pernambuco,
extraction time of ST, especially inverted type. From our data,
Recife, Brazil
the extraction of ST at an early stage did not suppress the need
Background: The increase the children with overweight is a of orthodontic treatment.
worldwide serious public health problem. The overweight is asso-
ciated with several health problems. Researchers suggest that PR04.28
overweight children have more dental caries, but the results of
the association between dental caries and body mass index (BMI) Factors influencing prevalence of caries in a Chilean
in children are inconsistent. preschool population: econometric analysis
Aim: To verify the associations between overweight and caries R. A. PALACIO1,2, C. R. VERNAZZA1,2, J. SHEN2, J. G.
experience in children. STEELE1,2 & L. VALE2
1
Design: This is a cross-sectional study conducted with 465 chil- School of Dental Sciences, Newcastle University, Newcastle Upon
dren with 5–8 years old. Children answered a questionnaire and Tyne, UK; 2Institute of Health and Society, Newcastle University,
underwent a clinical examination. Overweight was diagnosed Newcastle Upon Tyne, UK
using age-adjusted BMI and the oral health was evaluated by
Background: Different studies worldwide have highlighted differ-
dmft index. The children with dmft + DMFT = 0 were classified
ent factors influencing caries prevalence and with Chile there
as caries-free. A multivariate binary logistic regression was used
appears to be a difference between regions in prevalence. Why
for the analysis.
this prevalence differs warrants investigation and additional stud-
Results: The dmft mean was 2.11 2.6. Children with over-
ies are required to determinate the factors associated with this
weight have an increased risk (OR = 1.85; 95% CI: 1.14–2.99)
difference.
for dental caries compared to those children with normal weight
Aim: To examine the relationship of several risk indicators with
independent of dental anxiety; frequency of tooth brushing; fam-
the prevalence of caries (dmft >0) in the Chilean preschool popu-
ily income; age of child and gender.
lation.
Conclusions: The result of this study shows that children with
Design: The data used come from a cross-sectional study directed
overweight may be a risk group for dental caries development
by the Chilean Ministry of Health. This dataset is drawn from a
and should be offered additional preventive measures.
clinical examination of 1600 4-year-olds children and a parental
completed questionnaire carried out in 2010. Variables used in
the analysis include socioeconomic status, oral health behaviours,
and coverage of fluoridated water by county. Multivariate logistic
regressions were conducted to investigate the relationship
between these variables and prevalence of caries.
Results: Educational level of head of household and dependency
of school (private, subsidised or public) showed statistically sig-
nificantly relationships indicating that children with a lower risk Results: Children who were from the western part of China were
of caries were those who attend private schools and those with a less likely to have had a dental visit within last 1 year (aOR:
more educated head of house. Other significant variables were 0.79; 95%CLs: 0.72, 0.87), and lower filling rates (aOR: 0.44;
mother’s number of teeth, frequency of toothbrushing, autonomy 95%CLs: 0.37, 0.53) than the children who were from eastern
of toothbrushing, drinking sugary liquids before bed, previous China. The children who were from rural areas were less likely to
dentist experience and perceived need for treatment. The presence have filling services (aOR: 0.43; 95%CLs: 0.29, 0.64) when they
of fluoridated water was highly significant (P < 0.001) and had had caries. The children who were from higher dentist density
an OR of 0.3 (IC95 0.2–0.4). areas (aOR: 1.71; 95%CLs: 1.47, 1.98) and higher disposable
Conclusions: The nonexistence of fluoridated water was the most income areas (aOR: 1.69; 95%CLs: 1.29, 2.22) were more likely
significant predictor of caries prevalence. These findings will to have had a dentist visit within the last year.
allow better targeting of preschool population in future studies. Of the total survey population, 56.8% of children had never vis-
ited a dentist.
PR04.29 Conclusion: The total dental care potential for Chinese children
was underused. The children who were in the 5-year-old group,
Challenges for the management of paediatric dental in western China, rural areas, low dentist density areas and low
emergencies in major metropolitan urban area: Paris income areas were less likely to have had dental care services.
M. NASSERIPOUR1,2 & J. AZERAD2,3
1
University Paris 5, Paris, France; 2Odontology, H^ opital La Piti
e PR04.31
Salp^ ere, Paris, France; 3University Paris 7, Paris, France
etri
Prevalence survey of dental trauma to schoolchildren
Background: A profound reflection on the state of paedodontic in Xi’an, China
care management in Parisian metropolitan area is needed, with R. TENG & Q. GUO
its lack of peadodontic care coverage in general and its sole night
Stomatology Hospital of Xi’an Jiaotong University, Xi’an, China
and weekend dental emergency department.
Aim: Our study highlights the dysfunctions of paedodontic emer- Aim: Dental trauma is a common disease, after the incidence of
gency care management in order to propose appropriate mea- dental caries for schoolchildren. We’re aimed to assess dental
sures for its improvement. trauma injury by questionnaires, with regard to background
Design: This is a retrospective review of the emergency dental ser- information in schoolchildren in Xi’an referred to Stomatology
vice coverage using the La Pitie Salp^etriere Hospital Emergency Hospital of Xi’an Jiaotong University, China, from 2012 to 2013.
services Urquel informatics system to extract the information Design: The study was based on the cluster and simple random
concerning night and weekend dental emergencies. The original sampling survey, 4013 pupils in schools in nine districts and four
data extracted was imported into Excel to obtain the graphics counties in Xi0 an were sampled respectively. The children who
illustrating the results of the study. have a history of dental trauma were examined clinically for
Results: More than 11% of the night and weekend emergency den- traumatic dental injuries by two investigators. The following
tal patients are 16 years and younger, with a majority of males. information was recorded: age, gender, trauma history, teeth
60% of the paedodontic emergencies are of endodontic nature with involved, type of trauma, treatment provided, previous trauma
patients 10 years old and younger. The 93 suburb is ahead with histories, and management technique. Results of the question-
close to 800 consultations out of 3284, Paris intramuros is 2nd. By naire were expressed as frequency distributions in percentages.
adding the results from the 20th, 19th and 18th arrondissements, Results: A total of 4013 survey questionnaires, back 3883, the
the Parisian north-east, which has lower socio-economic profile, response rate was 96.8%, the effective rate was 93.8%. 1882 boys
represents 30% of the patients, socio-economically challenged. and 1759 girls with age of 6–13 years were participated in the
Conclusions: All paedodontic emergency night and weekend care study. The prevalence rate of immature permanent dental trauma
is delivered by La Pitie Salp^etriere Hospital the sole greater Pari- was 10.5%. Dental injuries were frequent in boys, 7–9 years old
sian metropolitan structure covering dental emergencies, ill suited have the highest percentage (75.6%), falls are the most common
to welcome, manage and care for paediatric patients. The regular causes (50.9%), the maxillary central incisors were the most fre-
paedodontic needs are not met due to a serious lack of paed- quently traumatized teeth (75.4%), the most frequent type of
odontists in the greater Parisian metropolitan area, leading to dental injuries recorded was enamel fracture (35.6%). We have
higher numbers of night and weekend emergencies. low level attendance rate for dental injuries (38.2%) and it’s
treatment is not timely.
PR04.30 Conclusions: Public health policies and educational programs
aimed at prevention should be developed and provide more
Regional disparities and resources used in dental continuing education programs for someone who will work to
health care among children in China reduce dental injuries.
X. QU1, S. HOUSER2, J. ZOU3 & X. ZHOU1
1
State Key Laboratory of Oral Diseases, West China Hospital of PR04.32
Stomatology, Sichuan University, Chengdu, China; 2School of
Health Professions, University of Alabama at Birmingham, Caries experience of 12 year-old Greek children
Birminghanm, AL, USA; 3Pediatric Dental Department, State Key using ICDAS II criteria. A national pathfinder survey
Laboratory of Oral Diseases, West China Hospital of O. PANAGOPOULOU1, K. KAVVADIA1, K. TSINIDOU1, E.
Stomatology, Sichuan University, Chengdu, China BERDOUSIS1, N. DIMOU2 & C. OULIS1
1
Department of Paediatric Dentistry, School of Health Sciences,
Aim: This study examined the disparities in dental health and
Faculty of Dentistry, University of Athens, Athens, Greece;
resources used in dental care among children in different eco- 2
Department of Computer Science and Biomedical Informatics,
nomic regions, urban and rural areas of mainland China.
University of Thessaly, Thessaly, Greece
Design: Data used were the Chinese National Third Oral Epide-
miology Survey and dentist density, disposable income data from Background: Epidemiological studies provide information about
Statistics Year Book of Health Ministry of China. Multiple logis- prevention, dental care and treatment in public and private level
tic regression analysis was used to adjust for confounders. and contribute to changes for effective dental care.
Aim: To register caries experience and treatment needs of 5) status of overretained primary teeth: 37.24% had caries
12 year- old Greek children, under standardized criteria with cali- (treated or untreated), 30.34% infra-occlusion; 23.45%
brated examiners and to correlate the above findings with socio- had one-quarter of the root resorbed.
demographic parameters. Conclusion:
Design: A stratified cluster sample of 1102 healthy children with- 1) There are no statistically significant differences between
out fixed orthodontic appliances was randomly selected and sexes/ jaws concerning the frequency of overretained pri-
examined by calibrated examiners. Dental caries was recorded mary teeth.
according to ICDAS II criteria. Data about socio-demographic 2) Congenital absence of permanent successor was most com-
features and the knowledge, attitudes and behaviour related to monly associated with persistent primary teeth, followed
oral health were retrieved though a structured questionnaire, via by abnormal position of successor.
interview. Statistical analysis was performed with SPSS. Uni- and
multi-variable (negative binomial regression models and Logistic PR04.34
regression models) were conducted to investigate potential risk
indicators for the manifestation of dental caries in this age Academic performance and athletic activities of
group. Greek schoolchildren with cleft/lip palate: pilot study
Results: Dental caries varied considerably between the different G. VAGDOUTI1, R. PITROU2, M. NASIKA3 & S. GIZANI2
1
geographic districts, with mean D3–6MFT = 1.26 and IC- Department of Pediatric Dentistry and Orthodontics, University
DAS1+2 = 1.75. Caries free was 28% of the sample, Care Index of Athens, Athens, Greece; 2Department of Pediatric Dentistry,
(CI) was 19.5% and sealants were recorded at 14.7% of the sam- University of Athens, Athens, Greece; 3Department of
ple. Girls had higher D3–6MFT than boys (P = 0.040). Children Orthodontics, University of Athens, Athens, Greece
living in rural areas demonstrated higher D3–6MFT, less sealants
Background: Cleft lip/palate is a craniofacial malformation that
and low CI. Children with highly educated fathers and mothers
has a significant impact in ones quality of life. The literature indi-
showed lower D3–6MFT values (P < 0.001).
cates that these individuals often experience learning difficulties
Conclusions: The mean D3–6MFT was 1.26 and incipient carious
and low school achievements during their childhood/adolescence.
lesions was 1.75 (ICDAS1+2). Gender, mother’s educational sta-
Aim: The aim of the study was to evaluate the academic perfor-
tus and tooth brushing frequency found to be the only statisti-
mance and athletic activities of Greek schoolchildren/adolescents
cally significant risk factors for the development of caries in
with cleft/lip palate.
12 year-old children.
Design: The sample consisted of 38 Greek individuals with cleft
lip/palate, 6–18 years old, who visited university and private
PR04.33 orthodontic clinics. Information was collected using question-
Over retained primary teeth in children attending the naires (modified version of Persson et al. 2012) from the parents
paediatric dentistry clinic - Bucharest, Romania or the patients concerning children’s academic performance and
sports achievements.
R. LUCA1, A. MUNTEANU1, A. M. BRATU2, C. FARCASIU1
Results: 23% of the parents mentioned that their child faced
& T. FARCASIU3
1
Paediatric Dentistry, Carol Davila University, Bucharest, learning difficulties. The majority of the children had high grades
in Mathematics and Greek literature in elementary school
Romania; 2Orthodontics, Carol Davila University, Bucharest,
(>80%) while 65% of them followed a foreign language course.
Romania; 3Prosthetics, Carol Davila University, Bucharest,
In middle school, high scores in Mathematics were achieved by
Romania
38% and in Greek literature by 31%, while in high school this
Background: Overretained primary teeth can be either the cause was the case for 30% and 40%, respectively. Almost 70% of the
or a consequence of a variety of developmental particularities children were involved in sports.
which need to be taken into account and adequately managed in Conclusions: These preliminary results indicate a good perfor-
order to favour evolution towards a harmonious permanent den- mance in school and an increased interest in athletic activities of
tition. Greek children and adolescents with cleft. Further investigation
Aim: To assess the frequency of overretained primary teeth and into the academic and athletic performance as well as the self-
find possible associations between the status of the overretained esteem of a larger number of Greek young persons with cleft lip/
primary tooth and that of the permanent successor. palate, and in comparison with healthy individuals, could reveal
Design: Retrospective study on 847 patients (448 boys) from possible differences in their quality of life.
Paedodontics Department, Carol Davila University Bucharest
aged between 8 and 18 years (mean age = 10.96 2.24 years). PR04.35
Frequency, topographic distribution and status of overretained
primary teeth were recorded, as well as the permanent successor’s Assessing the prevalence of early childhood caries
status. Data was statistically analyzed using SPSS 20.0 and the associated determinants in children: a cross
(P ≤ 0.05). sectional study in Egypt
Results: R. K. ABOU EL FADL1, T. A. EL MOKADEM2, M. A. ABDEL
1) 8.26% of patients (n = 70 patients, 35 boys) had 145 FATTAH2 & M. E. ALLAM3
overretained primary teeth: 48.9% (71 teeth) in boys and 1
Pediatric Dentistry & Dental Public Health Department, Faculty
51.1% (74 teeth) in girls (NS); of Dentistry, Ain Shams University, Cairo, Egypt; 2Dental & Oral
2) topography: 42.75% upper jaw, 57.24% lower jaw (NS); Health Department, Ministry of Health and Population, Cairo,
50.34% right side, 49.66% left side (NS); Egypt; 3Misr International University, Cairo, Egypt
3) most affected teeth: 48.27% second lower primary molars,
17.93% second upper primary molars, 12.41% upper lat- Background: Early childhood caries (ECC) is a public health
eral incisors; problem especially in developing countries. The pattern of ECC
4) permanent successor’s status: 62.07% congenitally absent, reflects a specific risk profile related to socio demographic and
19.31% abnormal position, 14.48% generalized delayed lifestyle factors. Little is known about the prevalence of ECC in
eruption; Egypt and the influence of several determinants on its incidence
and severity among children.
Aim: The aim of this study was to assess the prevalence of early PR04.37
childhood caries among Egyptian children and investigate the
Socioeconomic status and oral conditions related to
potential determinants associated with this condition.
Design: A total of 651 children aged 3–5 years were randomly quality of life
F. D. D. S. FROTA1, M. B. D. GAVIAO ~ 1 & H. LAURENCE2
selected from 160 gathering points located in 26 governorates in 1
Egypt. A cross sectional study was designed and data on oral Peadiatric Dentistry, UNICAMP, Piracicaba, Brazil;
2
hygiene practices, feeding habits and socioeconomic status was Epidemiological, UofT, Toronto, ON, Canada
collected through a questionnaire conducted with the primary Aim: To investigate the influence of socioeconomic status (SES),
caregiver of the enrolled children. Information on dental caries oral conditions, and oral habits on the subjective self-perceptions
was also recorded through dental examination of the teeth fol- about oral health-related quality of life (OHRQoL) using the
lowing a standardized clinical protocol based on World Health Brazilian Portuguese short versions of the Child Perceptions
Organization measures. Questionnaire (CPQ8–10) and (CPQ11–14).
Results: 67.7% of examined children had at least one decayed Design: Data were collected in public (n = 73.5%) and private
tooth in their primary dentition and mean dmf score was 3.3. schools in the city of Fortaleza-Ce, Brazil. Data about oral hab-
Girls had lower mean dmf score than boys. There was a positive its were collected using a structured questionnaire answered by
correlation between dmf scores in children and their mothers the schoolchildren and they were clinically examined for the pres-
having high caries experience (r = 0.130, P < 0.001). Moreover, ence or absence severity of the following conditions, according to
caries risk decreased with tooth brushing (P < 0.01) and the methodology set forth by the World Health Organization.
increased with high sugar intake. The Chi-square test was used to measure the risk estimate
Conclusions: The findings from the current study imply there is between socioeconomic status, self-perceived oral health and
high burden of early childhood caries among children. This high- OHRQoL and logistic multiple regression was performed, consid-
lights the importance of implementing caries preventive programs ering caries prevalence as the dependent variable and gender, age
in Egypt. and type of school (private vs public) as independent ones.
Results: Both age-specific questionnaires detected differences in
PR04.36 the self-perceived impact of gingivitis on quality of life, with the
Prevalence of white spot lesions of teeth in Gifu, greatest scores in the expected direction (P = 0.02; P = 0.01),
respectively. Higher impacts on OHRQoL were observed for chil-
Japan dren 11–14 years of age with untreated dental caries (P = 0.03).
T. OKANO, N. WAKAMATSU, S. KUWABARA, M. ITO, M. The logistic regression model indicated that children in public
IINUMA & Y. TAMURA schools with a low SES were 3.7 times more likely to have caries
Department of Pediatric Dentistry, Division of Oral Structure, than those who studied in private schools and were significantly
Function and Development, Asahi University School of Dentistry, better off economically.
Mizuho, Japan Conclusion: The findings from the present study support the evi-
Background: White spot lesions of teeth (WSLs) are divided into dence that some clinical conditions (caries and gingivitis) and
carious and non-carious lesions. The pre-cavitation carious lesion socioeconomic status had significant impact on schoolchildren’s
is reversible, therefore, early detection and appropriate corre- oral health-related quality of life.
spondence are important to arrest the demineralization process.
Nevertheless, there were few clinical surveys about the prevalence PR04.38
of WSLs in Japanese children.
Relevance of motor function and oral function in
Aim: To evaluate of the prevalence of WSLs on anterior teeth
and canine with deciduous, mixed and permanent dentition in childhood: efficiency of the mouth rinsing function
Japanese children. test
Design: A total of 1130 patients aged 2–18 years attending Asahi T. ASAMI1, A. ISHIZAKI1, H. KWON1, K. MURAKAMI1, A.
University Hospital Pediatric Dentistry for the recalls were exam- TANAKA2 & S. HIRONAKA1
1
ined. The labial surfaces of the anterior teeth and canine were Department of Special Needs Dentistry, Division of Hygiene and
investigated the presence of WSLs by the ocular inspection under Oral Health, Showa University, Tokyo, Japan; 2Tanaka Dental
appropriate illumination. Clinic, Ibaraki, Japan
Results: In deciduous dentition, 12.9% of the subjects had WSLs
Background: Eating behaviors such as quick feeding and picky
and the incidence of maxillary teeth was significantly higher than
eating may be associated with oral function such as biting and
those of mandibular teeth. In mixed dentition, 27.7% of the sub-
gulping down. However, a convenient evaluation of oral function
jects had WSLs and the incidence of 11 and 21 was significantly
in early childhood has not been established.
higher than those of the other teeth. In permanent dentition,
Aim: In our division, we divided gargle development into five
23.9% of the subjects had WSL and the incidence of maxillary
steps and we devised the mouth rinsing function test (MRFT) to
anterior teeth was significantly higher than those of the other
evaluate the oral function. The purpose of this study was to
teeth. The ratios of person with WSL of the cervix increased sig-
examine the usefulness of the MRFT.
nificantly in mixed and permanent dentition as compared with
Design: Subjects were 3 to 5-year-old total of 24 preschool chil-
deciduous dentition. The ratios of person with WSL which has
dren (14 boys, 10 girls; average age, 4Y2M 9M). Age, gender,
history of the traumatic injury of precursor were 14.3% in mixed
height, weight, the eating behavior questionnaire; the Children’s
dentition and 10.0% in permanent dentition.
of Eating Behavior Questionnaire (CEBQ), body composition
Conclusions: Results suggest that the treatment of pre-cavitation
(InBodyÒ), oral examination, oral function evaluation (MRFT,
carious lesions to assist remineralization is necessary from the
DENTAL PRESCALEÒ) were examined. This survey was con-
mixed dentition period.
ducted with the approval of the Ethics Committee of Showa Uni-
versity School of Dentistry (2014-015).
Result: The MRFT scores increased with advancing age. Children
whose parents answered that their child had a problem with eat-
ing based on the eating questionnaire, and low-birth-weight
infants had a low MRFT score with age. The group mouth rinse Results: The average age of the surveyed children was 2.74 years.
completely were more significantly average occlusal pressure. The research has shown surprisingly good level of dental health.
Conclusion: Mouth rinsing in dental clinics is frequent. The The incidence of caries was generally 15%; mean dt 0.67; mean
MRFT may be useful for evaluating infant oral function. dmf/t 0.72. Dental Treatment Index was 0.073.
9.3% of surveyed children has a malocclusion and 7.3% had had
PR04.39 already suffered dental trauma.
Conclusion: The survey has shown satisfying level of oral health
Relevance of motor function and oral function in in the surveyed children. However, there is still a need to con-
childhood: eating behavior and general development tinue with dental hygiene and promote regular check-ups, and
A. OGAWA1, A. ISHIZAKI1, H. KWON1, D. TAKAGI1, A. varnishing.
TANAKA2 & S. HIRONAKA1
1
Department of Special Needs Dentistry, Division of Higiene and PR04.41
Oral Health, Showa University, Tokyo, Japan; 2Tanaka Dental
Clinic, Ibaraki, Japan
Relevance of motor function and oral function in
childhood: association between occlusal force and
Background: Currently, there is a worldwide decline in the inci- triceps surae muscle thickness
dence of dental caries among children, and eating behavior that
K. FUJII1, S. HIRONAKA1, K. ISHIKAWA1, A. UTSUMI1, L.
affects dentition and occlusion has been noted. However, for
OSAKABE1 & A. TANAKA2
pediatric patients, there are very few items of conventional oral 1
Department of Special Needs Dentistry, Division of Hygiene and
functional examination. Reports of safe and highly cooperative
Oral Health, Showa University, Tokyo, Japan; 2Tanaka Dental
methods or items are very few.
Clinic, Ibaraki, Japan
Aim: The purpose of this study was to create safe and highly
cooperative methods through a questionnaire survey. This study Background: Although occlusal force in adults have been
also examined the relationship between eating behavior and oral reported to be associated with size of masseter muscle and limb
function through whole-body function. muscle, there are few reports about muscle thickness and occlusal
Design: Subjects were total of 24 preschool children (14 boys, 10 force in preschool children.
girls). The age, gender, growth, and development of the children Aim: The purpose of this study was to clarify the factors which
were examined. Eating functions were investigated using the Chil- including muscle thickness (triceps surae and masseter) and body
dren0 s of Eating Behavior Questionnaire (CEBQ). Other ques- composition in relation to occlusal force in preschool children.
tionnaires was used to assess the children’s living environment. Design: The subjects were total of 17 preschool children aged 3
The following survey items were assessed: anthroponetric data to 4-year-old (11 boys, 6 girls; mean age 44 7 months) from 24
(InBodyÒ), masseter muscle and triceps surae muscle thickness children aged 3 to 5-year-old. Occlusal force was evaluated by
(Miru-CubeÒ), occlusal force (DENTAL PRESCALEÒ), oral DENTAL PRESCALEÒ, masseter and triceps surae (soleus, gas-
function evaluation (mouth rinsing function). This survey was trocnemius) muscle thickness was measured by Miru-CubeÒ, and
conducted with the approval of the Ethics Committee of Showa Body Composition was examined using InBodyÒ. Age, gender,
University School of Dentistry (2014-015). height, weight, grip strength, calf circumference were also mea-
Result: The average age of the children was 4Y2M 9M (range, sured. This survey was conducted with the approval of the Ethics
3Y0M-5Y7M). The earlier the child began walking, the greater Committee of Showa University School of Dentistry (2014-015).
was the occlusal force. In premature children, the average occlu- Result: The size of the Soleus muscle was significantly related to
sal pressure was high. Food motivation was increased when the occlusal force (P = 0.016). The size of masseter muscle was not
Kaup index was high. significantly related to occlusal force.
Conclusion: Oral function development was correlated with Conclusion: Result of examining the background factors related to
whole-body development. It is important to examine the teeth occlusal force in preschool children showed that the thickness of
and dentition, and to evaluate the development of oral function soleus muscle and occlusal force was associated. Muscle size and
and whole-body power. motor activity is inferred that affect occlusal force in preschool
children. Furthermore, it was considered to be able to infer the
PR04.40 occlusal force from growth condition of the lower extremities.
Dental health of 1 to 3-year old children in a large
PR04.42
city in northern Poland
E. NADOLSKA-GAZDA & K. EMERICH Mothers related risk factors of ECC in very low
Department of Paediatric Dentistry, Medical University of birth weight children
Gdansk, Gdansk, Poland R. KOBEROVA IVANCAKOVA1, J. ZEMANKOVA2, Z.
JANOVSKA3, V. MERGLOVA4 & Z. BROUKAL5
Background: The prevention of caries in early infancy is a deci- 1
Paediatric Dentistry, Faculty of Medicine and University
sive factor which determines future dental health in children and
Hospital, Charles University Prague, Hradec Kralove, Czech
adolescents. Early detection of caries is fundamental to the suc-
Republic; 2Paediatrics, Faculty of Medicine and University
cess of subsequent treatment.
Hospital, Charles University Prague, Hradec Kralove, Czech
Aim: The aim of the study was to assess the condition of dental
Republic; 3Dentistry, Faculty of Medicine and University Hospital,
health of children aged 1–3 years in day nurseries in a large city
Charles University Prague, Hradec Kralove, Czech Republic;
in northern part of Poland (Gdansk). 4
Paediatric Dentistry, Faculty of Medicine Pilsen, Charles
Design: The study was conducted in 7 randomly chosen private
University Prague, Hradec Kralove, Czech Republic; 5Dentistry,
day nurseries in Gdansk in 2015 among a group of 140 children
Faculty of Medicine Prague, Charles University Prague, Hradec
aged 1–3 years.
Kralove, Czech Republic
The research focused on qualitative as well as quantitative assess-
ment of teeth healthy, with caries, filled, filled with caries, post- Background: ECC can be associated with health complications
traumatic, extracted and unerrupted. Dental caries was identified and poorer oral health of pregnant women.
at cavity level. It was carried out in ordinary day light with a Aim: The aim of the study was to identify relevant risk factors of
standard dental examination mirror. early childhood caries in mothers delivered their child pre-
maturely with VLBW in comparison to those delivered eutrophic, Aim: To analyze the status of 5-year-old children’s dental caries
full-term children. The study was approved by the ethical com- in Shanghai from 2008 to 2011.
mittees of University Hospitals in Hradec Kralove and Pilsen. Design: By using equal-sized randomly sampling method, this
Design: Altogether 104 age-matched mothers of 1-year old chil- survey was carried out on the caries status of randomly selected
dren have been included in the study, 56 with VLBW children, 950 children aged 5 years in Shanghai respectively in 2008 and
48 with full-term children (30.9 vs 31 years) based on their 2009, and 900 children respectively in 2010 and 2011. The data
informed consent. Mothers were dentally and periodontally of prevalence of dental caries, dmft, caries filling constituent ratio
examined and basic oral health data were calculated (DMFT, and SiC index were collected.
PBI). Health history was obtained by the questionnaire. Statistics Results: From 2008 to 2011, the prevalence of deciduous tooth
- Fisher exact test, t test (P < 0.05). caries among 5-year-old children was 63.47%, 64.00%, 64.89%
Results: Risk pregnancy was reported more frequently in mothers and 64.44% respectively. The mean dmft score was 2.96, 2.99,
with VLBW children (64.3% vs 16.7% – P < 0.05). Systemic dis- 3.23 and 3.09 respectively. The caries filling constituent ratio was
eases and complications of pregnancy were more frequent in 10.93%, 12.76%, 16.96% and 20.63% respectively. The preva-
women delivering pre-maturely as compared with those with full- lence of caries and mean dmft showed no significant difference in
term deliveries (17.9% vs 4.2% - P < 0.05). The most of mothers 4 years (P > 0.05), and the caries filling constituent ratio was
from both groups were non-smokers (83.9% vs 93.7% - obviously increased (P < 0.01). Each year the prevalence of
P = 0 > 0.05). Oral health was slightly better in mothers deliv- deciduous tooth caries and mean dmft in urban areas were lower
ered full-term compared to pre-term (DMFT 9.5 vs 11.4, PBI than suburban areas (P < 0.01), but the children came from
16.5 vs 29.9 - in both parameters P > 0.05). urban areas showed significant higher filling rate than those from
Conclusion: Risk pregnancy, frequently associated with poorer suburban areas (P < 0.01).
general and oral health may lead to pre-mature delivery and Conclusions: The prevalence of deciduous tooth caries and dmft
VLBW of the child and thus can be taken as a relevant risk fac- of 5-year-old children in Shanghai have changed little, and the
tor of perinatal complications and of the ECC in these children. caries filling constituent ratio has increased year by year. To pro-
mote children’s oral health further, we still need to take more
PR04.43 active preventive measures for high caries risk group.
Caries experience in children with cleft lip and palate

PR04.45
in Latvia
K. KRASONE, R. CARE & I. AKOTA Maternal active smoking and its risk of oral clefts: a
Riga Stradins University, Institute of Stomatology, Riga, Latvia meta-analysis
L. RENKAI, Z. XUAN, P. YIRAN & L. CHENGHAO
Background: Previous epidemiological studies shoved high preva-
West China School of Stomatology, Sichuan University, Chengdu,
lence of caries in Latvian children. The incidence of caries nega- China
tively affects children with clefts because the success of the oral
rehabilitation is related to adequate oral health. Aim: To figure out the association between maternal active ciga-
Aim: to assess if children with clefts have an increased caries rette smoking and the risk of oral clefts in newborns.
experience. Design: The present meta-analysis included 29 case-control and
Design: A total of 171 children with clefts and 196 noncleft con- cohort studies through Cochrane, PubMed and Ovid Medline.
trol were divided into three age groups: 2–3; 6–7; 11–12 year olds Oral clefts are discussed separately as three subgroups: total
and examined for dental caries using the dmf(t)/DMF(T) index clefts, cleft lip with or without cleft palate (CL/P) and cleft palate
for decayed, missing and filled teeth and dmf(s)/DMF(S) for sur- only (CP). Studies involving different levels of smoking informa-
faces. Indices were used according to the WHO criteria (1997). tion were gathered to examine the dose-response effect.
Gained data were registered in clinical evaluation forms. Results: A modest but statistically significant association was
Results: In the cleft group, 74.8% were affected by caries com- found between maternal active smoking and CL/P (odds ratio
pared 86.2% in control group. In the primary dentition, the 1.368, 95% confidence interval 1.259–1.486) and between mater-
mean dmf(t) for the 2–3 year olds was 3.49 (4.70) vs the control nal active smoking and CP (odds ratio 1.241, 95% confidence
group 4.83 (3.83) while that for the 6–7 year olds was 7.7 interval 1.117–1.378). The odds ratio of isolated CL/P decreased
(3.79) vs the control group 5.97 (3.11). In the permanent den- a little while it increased for isolated CP (isolated CL/P:1.324,
tition, the mean DMF(T) for the 6–7 year olds was 0.48 (1.02) isolated CP:1.326). Half of the studies showed positive dose-
vs the control group 0.88 (1.40) and for 11–12 year olds 4.64 response effect for each subgroup (test for linear trend, P value
(3.66) vs the control group 4.48 (2.98). <0.05).
Conclusions: Caries experience in primary dentition is higher in Conclusions: There is a moderate but existent risk for having a
2–3 year olds to noncleft children compare to children with child with a CL/P or CP in smoking women during pregnancy.
clefts. In permanent dentition 6–7 year olds caries experience is We could still not confirm if there is a positive dose-response
higher in noncleft children and 11–12 year olds in cleft children. effect between maternal smoking and clefts.
It is necessary to develop preventive programs for children with
cleft lip and palate according to their needs. PR04.46
Incidence and risk factors of traumatic dental injury
PR04.44
in preschool: a prospective longitudinal study
Analysis of caries status among 5-year old children in ^
S. M. PAIVA1, P. CORREA-FARIA 1
, M. L. RAMOS-JORGE2 &
Shanghai from 2008 to 2011 I. A. PORDEUS1
C. R. LI 1
Federal University of Minas Gerais, Belo Horizonte, Brazil;
2
Shanghai Municipal Hospital of Oral Health, Shanghai, China Federal University of Jequitinhonha and Mucuri Valleys,
Diamantina, Brazil
Background: Dental decay is one of the most common diseases
threatening children’s health. Background: Studies on incidence of traumatic dental injuries
(TDI) in primary dentition are scarce and there is no evidence on
the association between previous episodes of TDI and the occur- PR04.48
rence of new cases of TDI.
Oral health of children with Down syndrome in
Aim: The objectives of this prospective longitudinal study were
estimate the incidence of TDI in primary dentition and test the Bosnia and Herzegovina
H. JURIĆ1, S. POROVIC 2, S. MESIHOVIC-DINAREVI
C 3 & S.
hypothesis that children with previous TDI are more prone to
C
JURISI 4
new cases of TDI. 1
Design: The first TDI exam was carried out with 261 children Department of Preventive and Paediatric Dentistry, School of
aged 1–4 years in Diamantina, Brazil. The second exam was car- Dental Medicine, University of Zagreb, Zagreb, Croatia;
2
ried out 1-year latter with the same participants of the first Paediatric Dental Department, Public Health Centre of Sarajevo
phase. Among 261 children, 194 were reexamined. In the follow- Canton, Sarajevo, Bosnia and Herzegovina; 3Paediatric Clinic,
up exam, the expose group was composed by children with previ- University Clinical Centre Sarajevo, Sarajevo, Bosnia and
ous TDI (n = 65) and a non-exposed group (n = 129) by children Herzegovina; 4Department of Periodontology, Dental Polyclinic
who had no previous TDI. TDI was diagnosed based on the cri- Juri
si
c, Mostar, Bosnia and Herzegovina
teria proposed by Andreasen and Andreasen (2007). During the Background: Oral health in Down syndrome children has some
exam, incisor overjet was measured and lip coverage was evalu- peculiar aspects that must be considered in the follow-up of these
ated. Parents were interviewed about socioeconomic indicators. patients.
Descriptive, bivariate and adjusted Poisson regression model Aim: The aim of this study is to determine the state of the oral
analyses were performed. health of children with Down syndrome aged 6–18 years,
Results: The incidence of TDI in the overall sample was 55.7%: through dental status, plaque and CPI index, and compare it
64.6% in the exposed group and 51.2% in the non-exposed with the oral health of healthy children in Bosnia and Herzegovi-
group. The risk of a new cases of TDI was significantly higher na.
among children with a history of TDI (RR: 1.30; 95%CI: 1.01– Design: This study included 57 Down syndrome children from
1.67), independently of the other variables. Tuzla and Sarajevo Canton, Bosnia and Herzegovina, clinically
Conclusions: The incidence of TDI was high. Previous TDI in pri- examined and established dental status, CPI and plaque index,
mary dentition was associated a new cases of TDI. according to the rules of the WHO. Subjects were divided into
three age groups, for easier data analysis.
PR04.47 Results: The dmft value in respondents aged up to 6 years (group
Oral and dental health status of children with chronic I) is 6.40, DMFT value (first permanent molars) in respondents
aged 7–12 years (group II) is 2.05; DMFT value of respondents
renal failure (CRF) 13–18 years (group III) amounts to 10.30. Values of CPI index
S. A. MOUSSA1 & S. Y. AL-BAUOMY2 for indexed groups were as follow: 0.10 (group I); 0.17 (group
1
Dental Department, Primary Health Care Coopration, Doha, II); 0.40 (group III). There were no statistically significant differ-
Qatar; 2Pedatric Dentistry and Oral Public Health, Al Azhar ences in plaque index subjects with Down syndrome in relation
University, Cairo, Egypt to the set age groups.
Background: Advances in pediatric-nephrology during the last- Conclusions: Tested sample of children with Down syndrome, has
two decades have resulted in a marked increase in the number of shown dmft/DMFT index extremely high in all age groups, with
CRF-children’s survival. Improving their dental hygiene reduces a high proportion of carious teeth in compared to healthy chil-
the risk of infections as oral-cavity is considered as septic-foci. dren, while CPI and plaque index do not differ from healthy
Aim: The aim of this study was evaluating the oral and dental individuals.
health status of children with (CRF), to investigate the cario-
genic-mircoflora. PR04.49
Design: A total of 50-children with CRF were compared with 50-
Parent’s knowledge and attitude towards the
normal children. Salivation of each child was stimulated by chew-
ing a paraffin pellet for 5-min to collect 3 mL of saliva. Salivary importance of primary teeth
levels of urea and pH were measured. Salivary Streptococcus-mu- S. A. HAIDARY1 & A. SALAAH2
1
tans and Lactobacilli were counted by means of selective culture Dentistry, Ajman University of Technology and Sience, Dubai,
media. Oral examination was carried out with criteria of (WHO) United Arab Emirates; 2Dentistry, Ajman University of
for hypoplasia, discolorations, gingival-indices (GI), plaque-indi- Technology and Sience, Ajman, United Arab Emirates
ces (PI) and dmf and DMF-scores. Collected data was statically Background: Parents have a central affect in implementing proper
analyzed by t-test with (P < 0.05). oral hygiene. Poor knowledge about the child’s oral hygiene and
Result: Enamel hypoplasia, discoloration and PI were signifi- primary dentition among parents has a deep implication on the
cantly greater in the CRF-group, but the prevalence of the caries oral health in primary and permanent dentition.
and salivary levels of cariogenic-microorganisms were signifi- Aim: The aim of this study was to evaluate parent’s knowledge
cantly lower than in the control group. However, there wasn’t about the primary dentition of their children and help them
any significant difference in GI in both groups. increase their knowledge to prevent problems that may affect the
Conclusion: In CRF-children the levels of cariogenic-microorgan- child’s permanent dentition in the future.
isms were decreased due to increased concentrations of antibacte- Design: A cross-sectional study, to assess the knowledge of the
rial chemicals as urea in saliva. Also, uremia in CRF children parents regarding the primary teeth care, was conducted in the
during teething might cause Intrinsic-discoloration, as well as, dental clinic of Ajman University of Science and Technology in
the use of ferrous-sulfate syrup for anemia treatment which (U.A.E). One hundred questionnaires were distributed between
caused black-brown extrinsic-staining. Therefore, although the parents who visited the AUST clinics in the year 2014.
need of dental treatment was low, these children should receive Results: One hundred parents (female: 40%; male: 60%), partici-
oral health education and oral hygiene instructions in order to pated in this study. (51 percent) of participant had no knowledge
improve their overall oral health. about the number of primary teeth. Furthermore, about 20 per-
cent had no knowledge around which age, the child starts losing
primary teeth. 23 percent believed that it’s not necessary to visit
a dentist after a trauma to the primary teeth, 24 percent had no
idea that trauma to the primary teeth can affect the permanent used for data collection. Type-III clinical examination was car-
teeth. ried out to all selected children by single dentist to identify the
Conclusion: There is an intensive need to improve the parental presence of dental caries using DMF index. Data were analysed
knowledge regards to the primary teeth. Thus an educational using SPSS version 20. Bivariate and multivariate analyses were
dental health programs for parents of young children, is required employed.
to be established. This step can help in improving the children’s Result: It was observed that children with indigenous practices are
oral hygiene and implementing the importance as well as prevent- having less caries expereince, P = 0.01. 60% of the male and 65%
ing and managing the primary dentition. of the female children were afftected with careis. Children who
reported to have regular oral rinsing habit expreienced less caries.
PR04.50 Conclusion: Information obtained from this study can be kept as
baseline data for planning and developing cost-effective primary
Pattern and prevalence of retained primary teeth at caries preventive stratagies oreinted towards children.
the paediatric dental clinic of the University College
Hospital, Ibadan, Nigeria PR04.52
O. I. IYUN1, O. M. OLANLOYE2, O. AYEBAMERU2 & O.
POPOOLA2
Differentiated approach to preventive dentistry
1
Maxillofacial Unit, Ring Road State Hospital, Ibadan, Nigeria; programs in children with special needs
2
Child Oral Health, University College Hospital, Ibadan, Ibadan, Y. V. PAKHOMOVA1 & O. G. AVRAAMOVA2
1
Nigeria Pediatric Dentistry, Central Research Institute of Dentistry and
Maxillofacial Surgery, Moscow, Russian Federation; 2Preventive
Background: There is a dearth of studies that have investigated Dental Care, Central Research Institute of Dentistry and
the pattern and prevalence of retained deciduous teeth in litera- Maxillofacial Surgery, Moscow, Russian Federation
ture.
Aim: The aim of this retrospective study was to determine the Background: Dental treatment in children with intellectual dis-
pattern of presentation of retained primary teeth at the Paediatric abilitiy (ID) is often impeded because of uncooperative behavior,
Dental Clinic, University College Hospital, Ibadan. so preventive dental care is a must in this pediatric population
Design: Clinical information relating to retained primary denti- group.
tion was collected from the records of patients that attended the Design: To assess the feasibility of oral hygiene education (OHE)
Paediatric dental clinic between November 2012 and October we used a modified living skills diagnostics card, which was used
2014 and analyzed using SPSS 16.0 and descriptive statistics was to analyze 52 15 years-old children (27 (52%) males and 25
applied. The level of significance was taken at P value <0.05. (48%) females) with moderate (40.4%), advanced (44.2%) and
Results: One hundred and fifty seven patients presented with severe (15.4%) ID. Survey score varied from 0 (oral habits train-
retained teeth within the studied period, out which 52.8% was ing impossible) to 32 (normal ability for OHE).
females. Male to female ratio was 1 : 1.1. The mandibular pri- Periodontal disease incidence, OHI-S and PMA index were
mary central incisors were observed to be the most commonly assessed at baseline examination and 6 months after children and
retained (30%) and the first mandibular primary molars were the caregivers received OHE sessions.
least, (4%). The commonest age that presented was 6 years Twenty-five children (48.1%) having survey score 0 to 12 with
(23%) and 2 teeth were retained most commonly (42.7%). Six good hygienic skills had OHE sessions with dental hygienist, 10
teeth were retained in 1.3% of the patients. children with score 13–21 may manage controlled oral hygiene
Conclusions: Retained teeth were observed to be commoner in procedures. In 17 children with score 22–32 OHE in children was
females and the mandibular anterior segment is the commonest impossible and only caregivers were trained.
site. The findings from this study will serve as baseline data for Results: Oral hygiene improved in all study groups. The fact is
future studies on factors associated with retained teeth. confirmed by statistically significant OHI-S reduction (from
3.51 1.09 to 1.87 0.71, from 4.35 1.39 to 2.43 0.96,
from 4.01 1.15 to 2.03 0.90 in groups 1, 2 and 3, corre-
PR04.51 spondingly) (P = 0.01).
Impact of indigenous tooth cleaning and normal tooth In group 1 PMA decreased from 23.80 20.42% to 12.10
brushing habits on caries experience in children 11.81% (P < 0.05), in group 2 - from 50.20 34.94% to 36.52
S. PACHAVA 28.70% (P < 0.05). In group 3 PMA reduction was especially signif-
Public Health Denitstry, Sibar Institute of Dental Sciences, icant: from 48.28 32.13% to 27.54 21.26% (P = 0.01).
Guntur, India Conclusion: In 6 months of differentiated OHE approach satisfac-
tory oral hygiene was observed and statistically significant PMA
Background: There is a paucity of data comparing the effect of reduction was seen in all groups of children with ID.
indigenious and tooth brushing practices among children in
Indian context. The impact of tooth cleaning practices on dental
caries expereince vaires.
PR04.53
Aim: To evaluate dental caries experience in children with Indige- Dental caries in school children at two different
nous tooth cleaning and normal tooth brushing practices. Libyan settings: the effects of fluoride level
Design: A community based cross-sectional study was conducted O. H. RHOUMA & A. M. NASR
in a field practice area of a South Indian State, Andhra Pradesh. Zawia Dental School, University of Zawia, Zawia, Libyan Arab
Children between 7 to 14 years of age were included. By statiri- Jamahiriya
fied cluster sampling technique a desired sample size of 600 was
achieved using single population proportion formula with an Background: Not much attention has been given to study the
assumption of 95% confidence level, 8% degree of precision, pro- prevalence of dental caries and the effect of fluoride level among
portion of dental caries, 70% and design effect of two. Pretested Libyan school children.
and structured questionnaires that included socio-demographic Aim: To assess prevalence and severity of dental caries among 6–
characteristics, dietary habit, health care seeking behaviour 12 years old children in relation to fluoride concentration levels
towards oral health problems and oral hygiene practices were in drinking water.
Design: Cross-sectional observational study, done in two Libyan PR04.55

cities. Recruited 2000 children (6–12 years old, 969 boys, 1031
Caries experience of 5 year-old Greek children using
girls / distributed into three groups according to the age) from
four randomly selected public schools. The WHO diagnostic cri- ICDAS II. A national pathfinder survey
teria was used to measure dental caries. K. KAVVADIA1, C. REPPA1, K. TSINIDOU1, E. BERDOUSIS1,
Results: The overall caries prevalence was 61%. The highest car- N. DEMOU2 & C. OULIS1
1
ies prevalence was in group III (11–12 years). Overall mean Pediatric Dentistry Department, University of Athens, Dental
DMFT, deft and dmft indices were 1.01 (SD 1.48), 1.35 School, Goudi, Athens, Greece; 2Department of Computer Science
(SD 1.84) and 1.45 (SD 2.39) respectively. There was a sta- and Biomedical Informatics, University of Thessaly, Larissa,
tistically significantly negative correlation in overall mean of Greece
DMFT scores at various water fluoride levels (10.73 0.36 ppm) Background: Epidemiological studies provide information about
(P = 0.020). Caries experience was more among girls than boys prevention, dental care and treatment in public and private level
(P = 0.021). and contribute to changes for effective dental care.
Conclusion: The caries prevalence was very high, there was a neg- Aim: To register caries experience and treatment needs of 5 year-
ative correlation between caries experience and fluoride concen- old Greek children, under standardized criteria with calibrated
tration; for the entire study population. However, in high examiners and to correlate the above findings with socio-demo-
fluoride areas, there was a positive correlation between fluoride graphic parameters.
concentration and dental caries. Water de-fluoridation on an Design: A stratified cluster sample of 1222 healthy preschool chil-
urgent basis is a priority here than water fluoridation, because of dren was randomly selected and examined by calibrated examin-
the prevalence and severity of dental fluorosis is very high. ers. Dental caries was recorded according to ICDAS II criteria.
Data about socio-demographic features and the knowledge, atti-
PR04.54 tudes and behaviour related to oral health were retrieved via
The dentition status and treatment needs of children parental completion of a structured questionnaire. Statistical
analysis was performed with SPSS. Uni- and multi-variable (neg-
with developmental delay ative binomial regression models and Logistic regression models)
Y. C. YEH1, H. Y. LIU2, R. S. TANG2, S. Y. HSIAO3 & S. T. were conducted to investigate potential risk indicators for the
HUANG1,3 manifestation of dental caries in this age group.
1
Department of Oral Hygiene, College of Dental Medicine, Results: Dental caries varied considerably between the different
Kaohsiung Medical University, Kaohsiung, Taiwan; 2School of geographic districts, with mean d3–6mft = 1.48 and IC-
Dentistry, College of Dental Medicine, Kaohsiung Medical DAS1+2 = 1.41. Caries free was 42.4% of the sample, Care Index
University, Kaohsiung, Taiwan; 3Division of Paediatric Dentistry, (CI) was 13.23%. Boys had higher d3–6mft than girls (P = 0.042).
Department of Dentistry, Kaohsiung Medical University Hospital, Children living in rural areas demonstrated slightly lower d3–6mft
Kaohsiung, Taiwan (P = 0.434), while children with highly educated fathers and
Background: To date, most government are very concerning mothers showed lower d3–6mft values (P = 0.195 and P = 0.932
about the social welfare of the children with developmental delay respectively). 29% of the children with caries suffer from severe
(CDD), but the dental conditions and treatment needs of CDD ECC.
are not clear. Conclusions: The mean d3–6mft was found to be lower than the
Aim: To evaluate the dentition status and treatment needs among previous Pathfinder Survey. Tooth-brushing frequency and fre-
CDD in Taiwan. quency of sugary snacks consumption found to be the only statis-
Design: 649 CDD were included by purposive sampling, <6 years tical significant risk factors for the development of caries in
old, received dental examination including dentition status, treat- preschool children.
ment needs, debris index, gingival status and calculus index by
four dentists. Informed consent was obtained from the partici- PR04.56
pants’ parents and the study was approved by the Institutional
To assess the level of parent’s satisfaction in a dental
Review Board of Kaohsiung Medical University Hospital. The
descriptive frequencies were used for statistical analysis. setting
Results: The deft index of all children was 2.82 4.26, caries V. GAURAV
prevalence was 38.83%, debris index was 0.65 0.69, gingival Paedodontics and Preventive Dentistry, Seema Dental College and
status was 0.10 0.31, calculus index was 0.0052 0.0510. Hospital, Dehradun, India
Based on the regional analysis, the deft index in Taipei Region Background: Not many studies have been conducted in the past
(2.07 3.51) was lowest, and the deft index in Southern Region to determine parent’s level of satisfaction in academic dental set-
(3.55 4.98) was highest. The caries prevalence in Taipei Region tings. This parent satisfaction study analyzed the level of parent’s
(29.38%) was lowest and the caries prevalence in Southern satisfaction with the dental setting at Seema Dental College and
Region (46.09%) was highest. Although the deft index and caries Hospital, Rishikesh (Uttarakhand).
prevalence in Central Region were not highest, the dt index Aim: The purpose of the study was to determine if there was a
(2.93 4.53) was highest and the ft index (0.20 0.77) was low- statistically significant influence of demographic characteristics of
est. About the treatment needs, 30.97% CDD needed 1-or-more- the parent’s and the affective behavior of the care providers on
surface filling, 11.40% needed pulp treatment and 4.16% needed level of parent’s satisfaction.
tooth extraction. Design: Parent’s in the Paedodontic department at the Seema
Conclusions: The deft index and caries prevalence in CDD were Dental College and Hospital were the target population whose
still high. The treatment needs were mostly about restoration. perceptions and ideas were collected in the form of a parent’s sat-
The rural-urban disparity was still remaining in this study. isfaction survey.
Results: It was found that except for age, other demographic
variables did not have any statistically significant influence on
parent’s satisfaction.
Conclusion: As patient’s needs are prioritized in this customer-dri-
ven industry, such positive parent’s satisfaction data can be used
for the welfare of the patients, the care providers, and the health Aalborg Municipality, were reviewed based on data in their den-
care organization. tal records.
In these 100 children, we identified 128 yellow-brown PFMs and
PR04.57 194 control PFMs, being PFMs without any sign of opacities. Three
years after initial examination, we examined the dental files and
Evaluation of oral health status, practices and recorded whether the PFMs were intact (not filled), filled or missed.
treatment needs of children attending special schools Results: A total of 38 children had one or more filled yellow-
S. N. AMBATI & R. MUPPA brown PMFs, while their control PMFs remained healthy. Two
Department of Pedodontics & Preventive Dentistry, Panineeya children had had their yellow-brown PMFs extracted, while their
Institute of Dental Sciences and Research Center, Hyderabad, control PMFs remained healthy. Six children had had one or
India more filled yellow-brown PMFs, while their control PMFs were
filled as well. One child had an endodontically-treated PMF and
Background: Oral health forms a major determinant and is an
had fillings in the control PMFs as well. Of the 128 yellow-brown
intrinsic part of good health. Children with special care are said
PFMs, 49 (38.3%) were recorded as filled, two as extracted and
to be under high risk in this perspective. Hence, routine dental
one endodontically-treated, whereas among 194 control PMFs,
procedures help to diagnose potential problems at an early stage
16 (8.2%) were recorded as filled.
that could help the Pedodontist to give better services to these
Conclusions: The risk of fillings in PFMs with yellowish-brown
children.
opacities is high, and children with this condition should be sur-
Aim: The aim of the present study is to evaluate the total oral
veyed thoroughly.
health status, prevalence and oral hygiene practices of these chil-
dren.
Design: A total of 682 children have been screened. Consent was PR04.59
taken from the institutional authorities and the parents. The Epidemiological study of extrinsic stain and early
study population comprised of five different categories. childhood caries
They are: S. ANKITA, M. S. MUTHU, A. JEAN & B. MURUGAN
1) Children with a learning disability
Department of Pedodontics and Preventive Dentistry, Faculty of
2) Down’s syndrome children
Dental Sciences, Sri Ramachandra University, Chennai, India
3) Autistic disorder children
4) Cerebral palsy children Background: There is no consensus in the literature concerning
5) children with speech and hearing impairment the prevalence of extrinsic stains and associated caries distribu-
Before the start of the study a questionnaire was given to be tion pattern in children upto 3 years.
filled by the parent/guardian of the child regarding the oral Aim: This study was designed to assess the following:
hygiene practices and term of delivery. 1) prevalence of extrinsic stain in preschool children,
The following aspects of oral health was recorded: 2) correlation between extrinsic stain and incidence of ECC
Dental caries experience and
Oral hygiene status 3) to compare the distribution of caries in fissures, smooth
Molar occlusion surfaces or both among children with and without extrinsic
Other findings regarding malocclusion stain using ICDAS II index.
Cooperation during examination/ Oral defensiveness Design: A cross-sectional study was carried out in a representa-
Results: There was a significant difference in the oral tive sample of 0–3 year-old children in Tamil Nadu, India. Chil-
hygiene practices, oral hygiene status among the disabled children were divided into two groups:
dren. Caries experience was high among these children but there Group I; Children with extrinsic stain,
was no statistical significance. Prevalence of malocclusion was Group II; Children without stain.
high. Both Group I and II were further divided into two subgroups; Ia
Conclusion: Preventive services, regular checkups, oral hygiene and IIa: children with ECC and Ib and IIb: children without
visits along with education and motivation to the parents would ECC. The presence of extrinsic stain and the distribution of car-
be beneficial to these children. ies pattern were assessed by two calibrated examiners.
Results: The overall prevalence of extrinsic stain was 6.2%. There
PR04.58 was no statistical difference observed with regards to caries distri-
bution pattern (P value = 0.568) between Group Ia and Group
Molar incisor hypomineralisation: 3-year follow-up of II a (control group). However, high significant difference of P
filling status in permanent first molars value 0.011 was reported with regards to fissure caries among
P. WOGELIUS1 & D. HAUBEK2 children in both the groups.
1
Aalborg Municipal Dental Service, Aalborg, Denmark; Conclusions: The incidence of fissure caries was found to be high
2
Department of Dentistry, Section for Pediatric Dentistry, Health, in children with extrinsic stain when compared to children with-
Aarhus University, Aarhus, Denmark out stain.
Background: A tooth with yellow-brown opacities is at risk of
post-eruptive breakdown and subsequent need of restorative PR04.60
treatment. Traumatic dental injuries among 3 to 17 year old
Aim: To compare the frequency of dental fillings in permanent school children
first molars (PFMs) with yellow-brown opacities and in PFMs
U. A. NAYAK1 & V. KHANDELWAL2
without opacities in 100 subjects affected by molar incisor hypo- 1
Pedodontics & Preventive Dentistry, NIMS Dental College,
mineralisation (MIH).
NIMS University, Jaipur, India; 2Pedodontics & Preventive
Design: The restorative treatment need of PFMs in a subgroup Dentistry, Sri Aurobindo College of Dentistry, Indore, India
of 100 subjects, being part of a larger epidemiological population
study on MIH originally including 3600 9-year old children from Background: Anterior tooth trauma has been the most tragic
experience for both patient & parents in terms of damage to den-
tition, compromised esthetics, psychological trauma or social PR04.62

stigma.
Children with severe caries may have toothache and
Aim: To assess the prevalence and distribution of traumatic inju-
ries to the anterior teeth among 3–17 years old children. To cor- requirement for dental care
relate the prevalence of the injury to the cause of the trauma and A. DAHER, H. S. G. RODRIGUES, G. C. M. MACHADO, A.
the specific age groups. To ascertain the percentage of those seek- P. MUNDIM, P. S. S. COSTA & L. R. COSTA
ing the treatment. Federal University of Goias, Goiania, Brazil
Design: 5000 school going children aged between 3–17 years of Background: There is current discussion about utility of dental
Indore, India of both sexes and different socioeconomic status interventions in early childhood caries. Toothache can indicate
were divided into three age groups 3–5 years, 6–11 years and 12– dental intervention, but its assessment in young children through
17 years. Traumatic injuries to the anterior teeth were recorded non-validated methods is questionable.
according to Ellis and Davey classification along with sex, age, Aim: To evaluate if toothache assessed with validated tool is
cause of trauma, number of the injured teeth, type of teeth, associated with severe caries and dental treatment needs in pre-
socio-economic status. In addition, the level of unmet treatment school children.
need was also be ascertained. Design: This study observed 56 children (33 girls), mean age of
Results: The overall prevalence of trauma among the boys and 61.9 months, who participated in randomized clinical trial
girls was 23.6% and 15.8%. Class I fracture was the most com- (NCT02284204). Dental caries and treatment needs were assessed
mon followed by class II fracture. Single tooth injury, Upper by dental exam, based on WHO criteria (dmf-t and dental treat-
socio-economic class, children from Private Urban schools were ment needs). Severe caries was categorized as: severe childhood
more commonly associated with trauma and maxillary central caries (‘dmf-t’ index ≥ 6), untreated severe dental decay (‘pufa’
Incisor was most affected tooth. Fall was the most common etio- index>0), and the Significant Caries index (SiC). Dental Discom-
logic factor. Merely 2.5% of children who experienced trauma fort Questionnaire, Brazilian version (DDQ-B) was used to assess
had undergone treatment. caries-related toothache. DDQ-B median score and occurrence of
Conclusions: This study emphasizes the need for education pro- toothache (DDQ-B ≥ 3) were outcome variables (Sample power
grams about traumatic dental injuries that should be directed 95.7% to 99.8%, CI 95%). Data were analyzed by non-paramet-
towards the children, parents and school teachers. ric bivariate tests (P < 0.05).
Results: DDQ-B score correlated with dmf-t (rho = 0.45,
PR04.61 P < 0.001) and pufa (rho = 0.33, P = 0.001) indexes, and with
A health program strategy for improving the oral the number of teeth needing dental procedures (rho = 0.52,
P > 0.001). Median (third-first quartile) of DDQ-B scores were
health of schoolchildren higher in children with pufa > 0 (5.0, 8.0–3.0, P = 0.007), dmf-
A. PITCHON t ≥ 6 (5.0, 8.0–2.0, P = 0.008), and in children included in the
Oral Health Technical Coordination, Municipal Health Agency of SiC index (5.5, 8.0–2.3, P = 0.006), compared with children with-
Belo Horizonte/Minas Gerais, Belo Horizonte, Brazil out those conditions. 68.9% of children presenting dental treat-
Background: In recent decades it has been observed in Brazil a ment needs (P = 0.01) and 78.3% with pufa > 0 needing more
dental carie incidence decline in children, yet about 50% still invasive procedures (P = 0.02) had toothache.
need clinical intervention, with a greater emphasis of caries Conclusions: Caries-related toothache measured by validated
within the population of greater social vulnerability. Given this instrument is associated with severe caries and need of dental
context, we developed a program for prevention and treatment procedures in children.
of oral diseases for children enrolled in the public education sys-
tem (0–14 years) in low-income areas of the city of Belo Horizon- PR04.63
te.
Indicators of dental morbidity of children in
Aim: The goals are: improve oral health in school, promote the
integration of school personnel and health services teams; identify ecologically unfavorable region of Kazakhstan
vulnerable groups with dental diseases; develop prevention activi- G. YERMUKHANOVA1, R. NURLY2 & M. KUAT3
1
ties in order to promote and restore oral health. Pediatric Dentistry, Kazakh Nationa Medical University after S.
Design: The program has been implemented in all health units in Asfendiyarov, Almaty, Kazakhstan; 2Stomatologic Faculty, Kazakh
the city in partnership with each school district. Actions are Nationa Medical University after S. Asfendiyarov, Almaty,
implemented for school personnel, for intance, implementation of Kazakhstan; 3Mangistau Stomatologic Center, Aktau, Kazakhstan
daily brushing with fluoride toothpaste and health education Background: Currently there are no scientific researches on the
activities. An annual epidemiological survey is conducted in hygienic assessment of oil-gas fields in Mangistau region impact
schools, referring each case to treatment in the health services to dental health of children.
system. Aim: The aim of the present research was investigating the state
Results: Some 170,000 students are monitored in this program. of dental health of children in Mangistau region and the develop-
Five years after its implementation there was an increase of 26% ment of ways to improve.
of caries-free children, reaching 44% of the total, of which 24% Design: Examined for the 2012–2014 period in all 880 children of
did not require treatment and 32% required clinical support. three key ages. Inspection of children spent a pediatrician. Spe-
Conclusions: The program has demonstrated its effectiveness in cialist hygienist conducted the investigate of environmental fac-
improving the oral health of schoolchildren. The partnership of tors according to the regional SES.
the education and health systems has been fundamental to the Results: According to the results of the screening of Mangistau
change in the epidemiological scenario, and also to promote and region‘s children dental status prevalence of dental caries – 89.3%,
maintain oral health. the intensity of caries – 3.8. Comparative analysis of the perfor-
mance research of the dental status in children following the results
of work for 2012–2014 showed a decrease in the prevalence of den-
tal caries by 5.9% and amounted 83.4%, and the intensity 3.4.
The survey with pupils revealed that a lot do not possess the fun-
damentals oral hygiene.
Conclusions: pediatric patient is predisposed to various systemic and oral dis-

1) Improvement of the situation with dental disease by mass eases due to mental retardation and morphogenetic properties
organization dental offices in schools. they possess. Saliva is a protective factor in the oral cavity, there-
2) Indicators of dental caries in children is possible to reduce fore, the analysis of this physiological liquid is a relevant diag-
by preparing a dental hygienist and organization of their nostic tool.
work in the pre- and schools. Aim: Determine the flow and salivary pH in a pediatric popula-
3) It is necessary the introduction of a comprehensive pro- tion with DS in Merida.
gram of prevention of dental diseases considering regional Design: A total of 100 pediatric patients with SD (M = 50,
features. F = 50) aged 0–18 years old with 2 h of fasting and/or tooth-
4) Scientists, teachers of dental faculties medical universities brushing, from 3:00 pm to 7:00 pm, the flow rate was obtained
can organize for funding the regions in need research pro- salivary (TFS) using the technique cotton weighing by Strongin,
jects aimed at identifying problems, providing scientific Hinsie and Peck (SHP) values were classified as: Xerostomy, Pro-
and practical assistance to specialists. nounced low, Low, Normal and Hypersalivation. Measurement
of pH was obtained with portable digital pH meter ATSÒ in inti-
PR04.64 mate contact with the ventral side of the tongue.
Results: 83% of cases TFS had pronounced low (0.1–0.7 mL/
Adding xylitol to milk as a pediatric caries min), males had a higher mean TFS 0.458 mL/min, the age range
prevention strategy: factors associated with caries in 0–3 years had the highest average of TFS 0.450 mL/min; Most
a school-based tandomized clinical trial in Peru occurred in acid pH, the highest value was female with 6.9 and
A.R. CABRERA MATTA1, D. L. CHI2, G. ZEGARRA3, E. C. 7.1 was the highest in 16–18 year age range.
VASQUEZ4, M. C. ROBERTS2 & L. MANCL2 Conclusions: The TSF decreases as the age advances; the female
1 is more affected by hyposalivation. The TFS and pH values
Academic Department of Dentistry for Children and Adolescents,
Universidad Peruana Cayetano Heredia, Lima, Peru; 2University change obediently at context of DS pediatric.
of Washington, Seattle, WA, USA; 3Universidad Alas Peruanas,
Arequipa, Peru; 4Universidad Catolica de Santa Maria, Arequipa, PR04.66
Peru
The prevalence of childhood dental fear and dental
Background: Xylitol is known to prevent caries, but no studies to caries in Northern Greece
date have evaluated whether adding xylitol to milk is a feasible V. BOKA1,2, K. ARAPOSTATHIS1, N. KOTSANOS1, V.
school-based caries prevention strategy. To test this hypothesis, KARAGIANNIS1, J. VEERKAMP2 & C. VAN LOVEREN2
we initiated a randomized clinical trial among school-aged chil- 1
Aristotle University of Thessaloniki, Thessaloniki, Greece;
dren in Peru expected to end in December 2014. In this study, 2
ACTA, Amsterdam, Netherlands
our aims are to report baseline characteristics of participants and
to identify factors associated with dental caries. Background: There are no previous epidemiological studies in
Design: We enrolled 161 school-aged children and collected the Greece about the prevalence of childhood dental fear and dental
following baseline data: age, gender, hygiene status, and mutans caries.
streptococci level (log base 10). A pediatric dentist examined each Aim: To present: the normative data on dental fear and the caries
child and collected caries data using the U.S. NIDCR EC4 Pro- status for the children of Thessaloniki, Greece.
tocol. We used linear regression models to examine the relation- Design: 1540 children (48.3% boys and 51.7% girls, 6–13 years
ships between dental caries and the following: age, gender, and old) were selected from 15 public schools, using simple one-stage
hygiene status. We used log-linear regression models to evaluate cluster sampling method on all areas of Thessaloniki. 1484
the association between baseline streptococcus mutans levels and (96.4%) participated the analysis. Multilevel analysis with schools
dental caries. at level 1 and children at level 2 was performed (statistical signifi-
Results: About 50.3% of children were male and the mean age cance level: P < 0.05). Dental examination performed in the
was 7.34 1.99 years. Nearly 80% of children had poor hygiene classroom, with single-use mirrors and a penlight. To assess their
and 13% presented with an intraoral abscess. Over 93% of chil- dental fear all children completed the CFSS-DS.
dren had caries on at least one tooth. The mean proportion of Results: The overall mean CFSS-DS score was 27.1 10.8. Age
carious surfaces was 14.98% (SD = 13.02). Younger age was significantly (P < 0.05) related to CFSS-DS, while after
(P = 0.002), male gender (P = 0.0001), and poor hygiene 9.7 years, dental fear tended to decrease. Mean differences
(P < 0.0001) were significantly associated with dental caries. between boys and girls (P = 0.467) were not significant. 45.4% of
There was a significant positive association between baseline mu- the children were caries-free. The overall mean DMFS and dmfs
tans streptococci level and dental caries (Beta = 0.041; were 0.6 1.5 and 3.4 5.9, respectively. Significant differences
P = 0.0001). were observed between different city parts relating to socioeco-
Conclusion: Demographic, behavioral, and intraoral factors were nomic factors (P > 0.05, sequential Bonferroni method). Boys
significantly associated with dental caries in a population of chil- showed greater dmfs values (mean = 4 6.6) than girls
dren enrolled in a xylitol milk trial. (mean = 2.9 5.1), P = 0.026. Contrary, girls showed greater
DMFS values (mean = 0.75 1.77) than boys
(mean = 0.44 1.15), P < 0.001. Although a positive association
PR04.65 was observed between DMFS and CFSS-DS (P = 0.001), dmfs
Salivary flow and pH in patients with Down and CFSS-DS was not found to be correlated (P = 0.298).
syndrome Conclusions: There is a correlation between age and dental fear.
F. M. ENRIQUEZ RIVERA, A. L. PINZON TE, M. E. REJON Dental fear is related to DMFS but not to dmfs.
PERAZA & F. J. AGUILAR AYALA
Maestrıa en Odontologıa Infantil, Universidad Aut
onoma de
Yucatan, M erida, Mexico
Background: Yucatan is the state with the highest prevalence of
Down syndrome (DS) in Mexico with 1 per 550 live births. DS
PR04.67 by one calibrated paediatric dentist. Mutans Streptococci (MS)

levels and Saliva Buffer Capacity (SBC) were assessed using chair
Oral health status of preschool Greek children with
side tests. Parents completed a questionnaire on demographic,
neurodevelopmental disorders. A preliminary study general and oral health characteristics of their children. Data
A. AGOUROPOULOS1, K. TZOUANAKI1, P. NIKOLAOS2 & were analyzed using cross tabulations Spearman correlation coef-
L. PAPAGIANNOULIS1 ficients and linear regression modeling (P ≤ 0.05).
1
Deparment of Paediatric Dentistry, School of Dentistry, Results: In this sample with mean age 4.3 yo (SD:1.5), 35% of
University of Athens, Athens, Greece; 2Department of the children had caries lesions, mean dmft index was 2.84
Orthodontics and Dentofacial Orthopedics, Dental School, Medical (SD:5.86), VPI was 0.49 (SD:0.25), 14% had detectable levels of
Faculty, University of Bern, Bern, Switzerland MS and 21% had high SBC. Children with inflammatory gingival
Background: Children with neurodevelopmental disorders have hyperplasia were 3.12 times more likely to have dental caries.
been shown to exhibit more oral health problems and receive less Regression analysis (R2 = 0.26, P < 0.001) indicated that factors
treatment. significantly related to the dmft index were VPI (P = 0.02),
Aim: To investigate the oral health status of preschool Greek detectable MS (P = 0.02), maternal education level (P = 0.002)
children with neurodevelopmental disorders and its association to and family income (P = 0.02). Furthermore 63% of the children
personal and family characteristics. had never visited a dentist and 44% of the mothers ignored the
Design: Children attending ELEPAP preschools in Athens, importance of brushing with fluoride toothpaste.
Giannena and Agrino, (N = 102) were examined clinically, after Conclusion: Results of this study confirm that preschool children
written parental informed consent. Dental caries (dmft), visible with neurodevelopmental disorders have impaired oral health,
plaque (VPI) and presence of gingival hyperplasia were recorded, indicating the need for early intervention and parental education.
Dento-Alveolar Trauma Poster Session – PR05

PR05.01 2) To enhance post-operative assessment and record keeping
following tooth auto-transplantation.
Intrusive and lateral luxation injuries to maxillary Design: A retrospective case note audit was undertaken of 57
incisors: a rare combination of dental traumatic review appointments for patients who had undergone tooth auto-
injury transplantation at the LDI. Standards were agreed locally in the
B. D. TRIVEDI absence of published guidelines and the gold standard was 100%
Pediatric and Preventive Dentistry, College of Dental Science and assessment and documentation of appropriate information.
Research Centre, Bopal, Ahmadabad, Surat, India Results: The most commonly recorded information was patient
complaint (70%) and colour of tooth (70%). Sixty percent of cli-
Introduction: Unfortunately, DTIs result in fractured, displaced
nicians took radiographs as appropriate. The most poorly docu-
or lost anterior teeth and this could have significant negative
mented information included the presence/absence of a sinus
functional, esthetic, speech, and psychological effects on children
(10%), percussion tone (10%) and bleeding on probing (10%).
thus affecting their quality of life. The combined occurrence of
Conclusions: This audit highlights inadequacies in post-operative
intrusive luxation and lateral luxation injuries are rare.
assessment and record keeping following tooth auto-transplanta-
Case report: An 11 year old girl met with road accident. Trauma
tion. Action plan: Development of a standardised proforma for
has occurred 1 week before patient 1st visit to our clinic. Imme-
use in auto-transplantation review clinics. This proforma was
diately after trauma patient has visited local dentist. Dentist has
introduced to all clinicians involved in the care of auto-transplan-
done splinting in a wrong manner without reduction and it was
tation patients. Compliance and effectiveness of the review pro-
hurting the child by causing ulcer. On extra oral examinations
forma will be assessed in a second cycle of the audit.
lacerations were seen on upper lip and lower chin. TMJ was nor-
mal. Facial symmetry was maintained. On intra oral examina-
tions 11 and 21 were having rare combination of intrusive and PR05.03
lateral (labially) luxation injuries and grade III mobile. 11 has Management of horizontal root fracture associated
Ellis class III fracture. 12 and 22 have luxation injury and grade with complicated crown fracture using MTA
II mobile. Posteriors were occluding in class 1 relationship. Intra-
A. N. KATRE
oral periapical radiographs and orthopentomogram were advised
Department of Pediatric and Preventive Dentistry, YMT Dental
to rule out roots fracture and bony fracture. Radiographs were
College & Hospital, Navi Mumbai, India
normal. Removal of old splinting, proper reduction and place-
ment of splint in correct manner was done. Regular recall visits, Introduction: The management of a horizontal root fracture is an
vitality tests, radiograophs, early root canal treatment with intra ardous task, especially if there is an associated complicated
canal calcium hydroxide dressing and selection of proper restora- crown fracture. The discovery of MTA has simplified the man-
tion help to bring back the teeth in to aesthetic and normal ana- agement of endodontic complications of traumatic injuries. How-
tomic position. ever, the restoration of these teeth remains a challenge. A case of
Comments: Combinations of intrusive and lateral luxation inju- horizontal root fracture concurrent with complicated crown frac-
ries are rare. Immediate proper treatment, periodic radiographs ture using MTA to endodontically seal the fracture line is pre-
and regular follow ups are necessary to maintain natural denti- sented.
tion. Case report: A 13-year-old girl reported with a traumatic injury
to the maxillary anterior teeth. Clinical and radiographic exami-
PR05.02 nation revealed a complicated crown fracture and grade II mobil-
ity in 21 along with a horizontal root fracture in the middle
An audit of post-operative record keeping following third. There was no evidence of any alveolar damage or bone
tooth auto-transplantation Leeds Dental Institute, loss. Following access opening, cleaning and shaping of the root
Clarendon Way, Leeds, LS2 9LU canal, an intracanal calcium hydroxide dressing was kept for
S. DUGGAL, S. HABIBPOUR, S. BARRY, J. BARBER & M. 7 days. An apical barrier using MTA was created. The canal was
SPENCER obturated with a paste of MTA that was ultrasonically vibrated
Paediatric Department, Leeds University, Leeds, UK so that it may flow in the fracture line. A sterile endodontic
instrument was used as an intra-radicular splint. A core built up
Introduction: Tooth auto-transplantation has gained popularity in was done using composite and the tooth was restored with an
the field of Paediatric Dentistry. The most common complica- acrylic crown. No pathology has been evident ever since.
tions following tooth auto-transplantation include pulpal necro- Comments: The challenges in treating traumatic injuries to ante-
sis, infection-related resorption, ankylosis and replacement rior teeth are unparalleled. The use of MTA has definitely pro-
resorption. These potential problems must be identified as early vided the clinician with more predictable treatment outcomes.
as possible to allow timely management. Therefore a comprehen- However, on occasions, a novel way many have to be considered
sive assessment is necessary at each review appointments and to salvage those teeth which would otherwise have been consid-
results should be accurately recorded. ered for extraction.
Aims:
1) To evaluate whether the current post-operative assessment
and record keeping following tooth auto-transplantation at
the Leeds Dental Institute (LDI) corresponds to best-prac-
tice guidelines.
PR05.04 students and doctors, so they could offer immediate help at the
site of an accident.
Simple and effective protection against dental trauma
with new generation polyolefin material mouthguards
U. TIWARI1, N. GREWAL2 & F. KUMARI2 PR05.06
1
Photonics, Central Scientific Instruments Organization, Healing of horizontal root fracture: a case report
Chandigarh, India; 2Pedodontics & Preventive Dentistry, with 7 years follow-up
Government Dental College, Amritsar, India H. W. CHEN1, K. Y. CHU1, G. F. HUANG1,2 & M. K. GUO1,2
1
Background: Cost and Time prohibit mass production of custom National Taiwan University Hospital, Taipei, Taiwan; 2National
fabricated mouthguards and there are definitely not enough den- Taiwan University, Taipei, Taiwan
tists and labs to meet the needs of millions of mouthguards that Introduction: Horizontal root fracture is relatively less common
would be required. Hence, an over-the-counter true mouth- type of dental injuries, which comprise approximately 0.5~7% of
formed mouthguard with comparable properties to a custom fab- all trauma cases and occur mostly in the root middle third. Since
ricated mouthguard would be a more feasible and user-friendly transverse root fracture affects dentin, pulp, cementum, and peri-
chairside option. odontal ligament, the healing process was complicated and
Aim: The present in-vitro experimental study was carried out to involved varying types of tissues.
compare the shock absorption ability of EVA laminate mouth- Case report: This article reports a clinical case of 13Y4M boy
guards with self adapting polyolefin material mouthguards in with a horizontal root fracture located in the middle third of the
three different anterior teeth alignments. maxillary right central incisor with severe extrusive luxation of
Design: Finite Element Analysis (FEA) was performed to simu- coronal segment. The coronal segment of fractured tooth was
late the stress distribution due to impact on the respective mouth- repositioned and stabilized with resin and wire immediately, and
guards. Customized pendulum device with three interchangeable the splinting period was 1 months. The case was observed under
standard size impact objects was used. Response of grating was a regular follow-up regimen. The healing process and pattern
monitored using a FBG Interrogation system. Shift in wavelength between the coronal and apical segments were concerned. The
for each impact was measured. Three Nissin standardized jaw pulp obliteration of both segments occurred about 1 year later
models were subjected to a total of 72 impact strikes with three by X-ray finding and healing with interposition of connective tis-
different balls on two specified sites by releasing the objects from sue was diagnosed by CBCT. There was no signs or symptoms
two different heights H1 – 24 cm H2 – 48 cm. for over 7 years.
Results: Two way ANOVA test was applied. It was found that Comments: Different factors determine the prognosis and the
the percentage shock absorption ability of polyolefin mouthguard type healing of horizontal root fracture. Proper initial manage-
was highly significant at <0.001 level in both anterior and poster- ment and pulpal/periodontal evaluation are essential for success-
ior regions. The influence of height on the shock absorption abil- ful treatment of a root-fractured tooth. The presented case
ity of both mouthguards was highly significant at P < 0.001. demonstrated that immediate treatment of the transverse root
Conclusion: Self adapting polyolefin mouthguards fulfill similar fracture with a severely displaced coronal segment was important
protection requirement as custom fit mouthguards and can be for good prognosis.
used for millions of athletes if properly fitted chairside by a den-
tist without requiring laboratory fabrication.
PR05.07
PR05.05 Traumatic crown-root fractures in multiple primary
molar teeth: a case report
Polish family doctors’ knowledge concerning first-aid E. P. SYRRAKO, V. LIONTOU, G. VADIAKAS & L.
after dental injuries PAPAGIANNOULIS
K. EMERICH Department of Paediatric Dentistry, School of Dentistry,
Department of Paediatric Dentistry, Medical University of University of Athens, Athens, Greece
Gdansk, Gdansk, Poland
Introduction: In preschool children complicated crown/crown-root
Background: Current literature emphasizes that awareness of fractures of primary molars, though rare, pose a challenge for
appropriate triage procedures following dental trauma is unsatis- the clinician requiring early diagnosis and effective treatment.
factory and that delay in commencing the treatment is the most The objective of this report was to present and discuss the case
influential factor affecting prognosis. Polish data are not avail- of a child who, following a fall, had many of his primary molars
able in this respect. seriously traumatised.
Aim: The aim of this survey was to establish the current state of Case report: A 4-year-old boy was referred to the Department of
knowledge with regard to first-aid procedures in cases of dental Paediatric Dentistry by a general practitioner, complaining for
trauma of family doctors. pain during mastication. Based on history, 2 months before his
Design: In order to assess the knowledge, a self-completed ques- visit, he felt off a bunk-bed. Clinical and intraoral and panoramic
tionnaire addressing definitions and first-aid measures in the case radiographic examination revealed complicated crown-root frac-
of tooth avulsion was developed and distributed. The sample size tures in four primary molars and an uncomplicated crown frac-
consisted of 134 family doctors attending a conference. ture in one primary molar while the mandible was intact.
Results: Results revealed that 53% of all family doctors knew Treatment plan consisted of behavioural guidance, oral hygiene
that in the case of dental avulsion tooth replantation could be instructions, restorative and preventive orthodontic treatment
performed. 55% of doctors were aware, that the time factor after and regular follow-ups. Treatment included an extraction, three
tooth avulsion is the single most influential factor affecting the pulpotomies, placement of four stainless steel crowns, a compos-
prognosis. 56% of family doctors knew the recommended trans- ite resin restoration as well as a band and loop space mainte-
port medium for an avulsed tooth. nance appliance. Patient was re-examined after 3, 6, 12 and
Conclusions: In the face of still poor knowledge regarding dental 18 months both radiographically and clinically.
injuries there is an need for adequate education programs on the Comments: This case confirms the findings of similar cases in the
subject of sport-related orofacial injuries directed at all medical literature that treatment of dental trauma in posterior primary
teeth is neglected and/or misdiagnosed. After a facial trauma There was the lack of equipment to effectively manage acute den-
(especially when it involves the chin area) detailed radiographic tal trauma in A&E.
and clinical examination of the posterior teeth and the mandible Conclusion: A&E staff are expected to diagnose and refer dental
should be made. In preschool children with complicated crown- trauma appropriately, however the majority of them have never
root fractures priority should be given to conservative treatment had any formal training in this field. OMFS SHOs felt competent
and not to extractions. in managing dental trauma although the lack of equipment
affected their ability to treat these injuries adequately in A&E.
PR05.08 As a result further training has been provided to A&E staff and
a patient care leaflet on dental trauma has been recommended.
Effect of different storage media on re-attachment of
incisal fragment: laboratory study PR05.10
A. A. EL-GAMMAL, A. M. ABDELLATIF & I. H. EL-KALLA
Pediatric Dentistry, Mansoura University, Mansoura, Egypt Management of severe extrusive luxation injury
involving segmental cortical bone fracture: 24-month
Background: Tooth fragment re-attachment represents an impor-
tant technique in restoring fractured anterior teeth. The strength
follow-up
of the final restoration is dependent partly on correct hydration E. ATAOL & Z. C. C ß EHRELI
of the fragment. Paediatric Dentistry, Hacettepe University, Ankara, Turkey
Aim: Evaluate and compare the effect of different storage media Introduction: Timely management of luxation injuries is crucial
of the tooth fragments on fracture resistance of re-attached teeth. for favorable treatment outcome. This case report presents the
Design: A total number of 144 permanent incisor teeth freshly treatment and 24-month follow-up of severely extruded immature
extracted were used. A line was traced on the labial surface of maxillary incisors with segmental buccal plate fracture.
each tooth, 3 mm from the incisal edge and parallel to it. Then, Case reports: A 10-year-old boy was referred to the Paediatric
each tooth was embedded in acrylic resin block up to three milli- Dentistry Department 1 h after a fall accident. Clinical and
metres away from the marker. The fracturing procedure was radiographic examination revealed severe extrusive luxation of
done by a blunt chisel and hummer. The fractured fragments maxillary left central and lateral incisors with open apex. A seg-
were stored in appropriate storage media (dry, tap water, milk mental buccal cortical plate fracture was also evident along with
and full humidity) for one day, 1 and 2 weeks. As scheduled, the gingival lacerations. Emergency treatment consisted ofreposition-
fragments were rinsed by water and re-attached using a flowable ing of luxated teeth with minimal pressure, reduction of the corti-
composite. All samples were subjected to fracture resistance test cal bone, placement of a semi-rigid splint, suturing of soft tissue
using a universal testing machine at a speed of 0.5 mm/min. The lacerations and raising the bite using acid-etch resin-based com-
force required to fracture each tooth was recorded in Newton posite on maxillary permanent first molars. The splint was
(N) and the data were collected and statistically analysed. removed 3 weeks later. Clinical and radiographic examinations
Results: One day fragment storing in milk and water was found were performed at 3, 6, 12 and 24 months. Radiographic evi-
to be with significantly higher fracture resistance than 1 and dence of periradicular healing was observed 6 months after the
2 weeks storing (P < 0.001). No significant differences were extrusive injury, followed by progressive thickening of the root
detected between the different media in 1 and 2 weeks storing. walls and apical closure. Positive response to cold test and elec-
Conclusion: Re-attaching the tooth fragment kept wet in milk or tric pulp test were observed at 12 and 24 months, respectively.
water for one day yields the highest fracture resistance. Comments: Early emergency management and adherence to the
IADT guidelines provided a favorable treatment outcome as evi-
PR05.09 denced by continued root development in the absence of pulpal
and periodontal complications.
Management of dental trauma at two Yorkshire,
U.K. hospitals - a survey of staff in A&E and OMFS
PR05.11
SHOs
1 2
A. GALLACHER , H. ATKINS & S. NAYAR 3 Clinical assessment of dental trauma: ensuring
1
Restorative, Leeds Dental Institute, Leeds, UK; 2Hessle Grange completeness to allow correct diagnosis
Dental Practice, Hull, UK; 3Institute for Reconstructive Sciences N. DONALDSON & P. HARRIS
in Medicine, Edmonton, AB, Canada Oral Surgery Department, Birmingham Dental Hospital,
Birmingham, UK
Background: Patients suffering with dental trauma commonly
present to A&E departments where staff are expected to diagnose Background: Patients present with dental trauma to the Emer-
and refer to the appropriate speciality. gency Department (ED) of Birmingham Dental Hospital follow-
Aim: To determine confidence and knowledge of A&E staff and ing referral by their GDP, or indeed having self referred. Our
Oral & Maxillofacial Surgery SHOs in the management of dental role is to establish diagnosis and provide emergency treatment.
trauma presenting to two Yorkshire based hospitals. In cases of trauma a thorough baseline assessment is important
Design: Two questionnaires were prepared, one for A&E staff as it informs diagnosis, provides a reference at review appoint-
which was more general in nature and one more detailed for ments and may form part of a medicolegal case. Staff members
OMFS SHOs. ‘The Dental Trauma Guide 2010’ International in the ED have varied dental backgrounds and experience levels
Association of Dental Traumatology was used as our standard. and hence there is a large disparity in familiarity with dental
Results: It was found that the majority of A&E staff understood trauma, its assessment, diagnosis and management.
the importance of urgent referral of avulsed teeth and an appro- Aim: To audit initial assessment dental trauma within the ED
priate storage medium. Over half of the staff questioned were not against assessment standards agreed locally in the Paediatric
routinely asking or assessing dental trauma in patients with head Department.
and neck trauma. Design: The notes of 50 cases of trauma that had been managed
Amongst the OMFS SHOs, the knowledge base was generally in the ED were retrospectively audited against a set of criteria
good on this topic. There was wide variation in the after-care based on national and international guidelines and agreed locally
advice being given and advice about possible complications. by the Paediatric Department.
Results: This audit showed that the vast majority of histories Case report: A 6-year-old male patient presented having sustained
included the relevant details, the clinical assessment of patients an avulsion injury to 11 without re-implantation and lateral luxa-
was often inadequate. Specifically, sensibility testing, discolour- tion of 21, these injuries happened 8-months prior to attendance
ation, and occlusion were not recorded in the majority of cases. at our hospital. Subsequent radiographic follow-up demonstrated
Conclusions: The recording of trauma in the ED is substandard, continued root development of 21 with formation of a distinct
leaving the potential of incorrect diagnosis or inaccuracy at apical portion of root giving the impression of a root fracture. In
review. By implementing the Pediatric Department standard, as addition, 22 which was unerupted at the time of injury developed
expressed in a trauma assessment pro-forma, these failings will severe disto-angular root dilaceration. Interestingly 62 had not
be rectified and our assessment and diagnosis improved. knowingly been injured and therefore the typical mechanism for
disruption to the succedaneous tooth germ post-trauma was not
PR05.12 present in this case.
Comments: The developing root tip consists of two layers of pro-
The importance of long-term planning in the liferating odontogenic epithelial cells and as such is at risk of
management of the tooth with a hopeless prognosis in damage or disruption from the forces generated during dental
the developing dentition trauma. This case demonstrates two possible manifestations of
S. BARRY & S. E. GRIFFITHS this disruption in neighboring teeth.
Paediatric Department, University Dental Hospital Manchester,
Manchester, UK PR05.14
Introduction: Traumatic injuries to anterior teeth are common Audit of record keeping for trauma cases affecting
presenting injuries to all paediatric dental practices. In addition the permanent dentition in the paediatric patient
to the acute management of trauma, there is a need to consider C. M. SEEBALLUCK1, E. MACKESSACK-LEITCH1, A. J.
long-term outcomes in the developing dentition. When treatment KEIGHTLEY2 & K. BLAIN1
planning for the tooth with a hopeless prognosis, clinicians 1
Paediatric Dentistry, Dundee Dental Hospital, Dundee, UK;
should anticipate the need for both space maintenance and the 2
Dundee Dental Hospital and School, University of Dundee,
preservation of bone. Dundee, UK
Case report: A 10-year-old male attended the paediatric dental
department at the University Dental Hospital, Manchester on an Background: Dental trauma is a common reason for a child to
emergency basis. He reported trauma to his upper permanent attend a paediatric dental department. A number of factors influ-
central incisor teeth. He presented with multiple injuries to UL1 ence the prognosis of an injured tooth. Information must be
and UR1. Clinical examination revealed a severe intrusion UL1 recorded and accessible to guide patient care. A method of achiev-
and uncomplicated enamel dentine fracture UR1 on the back- ing this is a trauma sheet, capturing key information. Historically,
ground of a class II division one malocclusion and dental anxi- there has been no specific trauma sheet in use in the department.
ety. Anterior occlusal and periapical radiographs demonstrated Aim: To assess current departmental record keeping in relation
additionally that UL1 had uncomplicated enamel dentine and to dental trauma.
oblique crown root fractures and a horizontal mid-third root Design: A retrospective review of case notes for patients diag-
fracture. Management included restoration of UR1, removal of nosed with dental trauma. Cases selected during November 2014,
coronal portion UL1 and the fitting of an immediate partial den- either
ture to replace this tooth. Mesial and distal spurs ensured space 1) patients on waiting list for trauma review or
maintenance. The vital root fragment was left in-situ to maintain 2) patients who had previous trauma and were atttending for
bone growth. an appointment.
Comments: Strategies to conserve bone and space in the develop- A data collection sheet was developed to review information
ing dentition need to be considered at the initial treatment visit recorded at patient’s initial trauma presentation, with data analy-
for children presenting with traumatic injuries. Long-term thera- sed using Microsoft Excel. The expected standard was 100%
peutic options may include pre-molar transplantation or implant recording for all items.
placement, both of which require preservation of adequate space Results: 71 case notes were reviewed. Results for information
and bone. We outline a case where a vital root was maintained recorded in the case notes: complete date of trauma 42%, mecha-
in-situ to maximize future treatment options. nism of trauma 83%, venue trauma occurred 51%, service that
provided immediate management 99%, history of prior trauma
11%, comment on any non-dental injuries 37%, sensitivity test
PR05.13 results 69%, full dental charting 77%, radiographic report 94%,
A case demonstrating Hertwig’s root sheath trauma diagnosis 77%.
separation and root dilaceration of atypical aetiology Conclusions: Overall data recording was inconsistent, with scope
A. R. MCKAY & S. ALBADRI for improvement in a number of areas. To address this, a trauma
Liverpool University Dental Hospital, Liverpool, UK sheet is to be introduced, along with staff training on its use. A
second audit cycle will be undertaken to assess its impact.
Introduction: Hertwig’s epithelial root sheath is responsible for
guiding root formation in the developing tooth. It projects api-
cally in advance of hard tissue formation. Trauma to an imma-
PR05.15
ture tooth may result in separation of the root sheath from the Delayed replantation of avulsed incisors:
immature root. If proliferation of the root sheath continues after inflammatory & replacement root resorption - a
separation the apical portion of the root will continue to develop clinical review after 2 years follow up
as a distinct entity.
S. HASANUDDIN & J. S. REDDY
Root dilaceration can occur in an unerupted permanent incisor
Department of Pedodontia, Government Dental College &
following dental trauma to the primary predecessor, especially Hospital, Hyderabad, India
following avulsion and intrusive luxation injuries. Whilst root dil-
aceration has other aetiological factors it is unusual for it to Introduction: Replantation of avulsed incisors is a routine clinical
result from traumatic impact to an adjacent permanent tooth. procedure. Parent compulsion is the reason for delayed replanta-
tion in many cases, even though a poor prognosis is explained to PR05.17

them. In this paper we have discussed the prognosis of delayed
Intrusive luxation in primary teeth: tooth located in
replantation of avulsed incisors with extended dry extra oral
time, with or without extra-oral endodontic procedures after the base of nostril post intrusive dislocation of
2 years of follow up and the quality of bone formed after primary tooth
replacement resorption. E. G. GONZALEZ MALLEA1, C. VERGARA1 & M.
Case reports: Few cases with delayed extra-oral time more than CAMPODONICO2
1
24 h and no proper storage media were evaluated. In the first Odontopediatria, Universidad Mayor, Santiago, Chile; 2Sociedad
case, a 14 year old boy had reported to the department with Chilena de Odontopediatria, Santiago, Chile
intra-oral sinus opening and grade II mobility in relation to both
Introduction: Intrusion is one of the most severe dental trauma-
central incisors. Both the teeth were replanted 2 years ago and
tisms, very complex to deal with and possessing a negative prog-
splinted with composites, but no endodontic procedure was car-
nosis, involves the complete breakage of periodontal fiber and
ried out. In the second case, a 10 year old boy had reported with
the displacement of the tooth inside the alveolar bone. All trau-
a non vital maxillary right central incisor tooth which was
matic injuries of a deciduous tooth have the potential to damage
replanted 2 years ago after extra-oral endodontic treatment. In
the germ of the permanent underlying tooth and the range of this
the third case, a 12 year old boy reported with non vital maxil-
malformation is going to depend on the stage of development of
lary right central and lateral incisor. The central incisor was
the permanent tooth and the severity of the trauma, being intru-
replanted 2 years ago after extra-oral endodontic treatment. In
sion the one that describes most complications.
all the above cases, the IOPA’s revealed inflammatory and
Case reports: Patient: 4 year-old boy, non-cooperative. The
replacement resorption to such an extent that the entire root was
mother noticed an increase in volume in the base of the right
replaced by bone, which was analysed.
nostril. This is the reason for the medical consultation. The
Comments: The prognosis of a replanted avulsed tooth is often
mother reports that the boy suffered a dento-alveolar traumatism
complicated by ankylosis followed by the process of inflamma-
about 2 years ago with the avulsion of tooth 5.1. When examin-
tory and replacement resorption.
ing the base of the nostril, a foreign body was found, of a whit-
ish color, rigid consistency and the radiological exam shows the
PR05.16 presence of a tooth in the nostril. Exodontia is carried out under
Dental trauma treatment: bio-functional esthetic deep sedation, through nasal route in order to avoid complica-
appliance after an early loss of primary teeth tions.
Comments: Evaluation is essential, clinical as well as using X-
B. L. MORENO1, H. A. RAMIREZ1, R. M. VALENCIA2, M. E.
rays. Differential diagnosis between an intrusion and an avulsion
GARCIA1 & E. E. RANGEL1
1 is required. If the tooth is not to be found, it is the responsibility
Pediatric Dentistry, UANL Universidad Autonoma de Nuevo
of the dentist to seek for the location of the tooth and evaluate
Leon, Monterrey, Mexico; 2Pediatric Dentistry, UNITEC, Distrito
the possibility of an aspiration and to warn the parents about the
Federal, Mexico
possible consequences.
Introduction: Premature loss of primary teeth after dental trauma
is common. Unfortunately, in most of the cases lost teeth cannot PR05.18
be reimplanted due to 1) poor long term results.2) poor patient
and parent behavior for complex treatments (ie. Endodontics). Management of inflammatory root resorption using
The pathological sequelae for the premature loss of primary biodentine as root filling: 1-year follow-up
teeth, affects the quality of life. Disorders such as cosmetic prob- E. ARSLAN1 & Z. CEHRELI2
1
lems, eating, language development, integrity of the dental arch, Paediatric Dentistry, Hacettepe University, Ankara, Turkey;
2
alterations in the development and eruption of permanent teeth Paediatric Dentistry, Hacettepe University Faculty of Dentistry,
and the presence of oral habits have been shown. Ankara, Turkey
The aim of this report is to show a simple, esthetic and func-
Introduction: Inflammatory root resorption is a serious complica-
tional alternative to the loss of primary teeth.
tion of dental trauma which leads to progressive loss of the root
Case reports: A 4 year old boy was referred to the Pediatric Den-
structure. This case report describes the treatment and one-year
tistry Clinic of the Universidad Aut onoma de Nuevo Le on for
follow-up of two previously traumatized central incisors affected
the management of a dental trauma sustained a few hours earlier.
by inflammatory root resorption.
Tooth 61 was avulsed and tooth 51 presented severe mobility,
Case report: A 9-year-old boy was referred to the Paediatric Den-
which was exacerbated by root resorption due to previous dento
tistry Department with a history of fall trauma to the maxillary
alveolar trauma. Radiographic examination, showed the presence
central incisors 1 month earlier. Reportedly, the left central inci-
of a supernumerary tooth between the non-erupted central maxil-
sor had been avulsed in a fall trauma and replanted 75 min after
lary permanent incisors (11 and 21). The treatment consisted in
dry storage. On clinical examination, the maxillary central inci-
removing supernumerary and primary central incisor (51). Two
sors presented with extreme mobility and pain. Radiographic
weeks later a bio-functional esthetic appliance using the extracted
examination of both teeth revealed findings of root resorption
teeth was made giving a greater esthetic and functional appear-
and periapical radiolucency. Following endodontic access under
ance.
rubber dam isolation, calcium hydroxide dressing was placed into
Comments: Fixed appliances to replace missing teeth are made
the root canals, and the teeth were stabilised with a semi-rigid
with acrylic teeth, showing some times a poor aesthetics in pedi-
bonded splint. The calcium hydroxide dressing was removed after
atric patients. This case shows an alternative to re-set primary
4 weeks and the root canals were obturated with tricalcium sili-
teeth and giving a functional with natural appearance.
cate cement (Biodentine). In the same appointment, the coronal
access was restored using acid-etch resin composite, and the
splint was removed. After 3 months, both teeth showed signs of
periradicular healing and decreased mobility in the absence of in-
fraocclusion. The patient has been attending uneventful control
visits for one year.
Comments: Based on short-term clinical and radiographic obser- root canal was temporarily filled with calcium hydroxide paste.
vations, Biodentine performed successfully as a root filling mate- After splint removal at 3 weeks, endodontic treatment was com-
rial after treatment of inflammatory root resorption. pleted with gutta percha and sealer. At 12 months, the tooth
showed mobility within physiological limits. Radiographically, no
PR05.19 signs of root resorption was evident.
Comments: Intentional replantation may be a treatment option
Traumatic dental Injuries in children attending to for severely extruded tooth with delayed treatment.
Yeditepe University Pediatric Dental Clinic, Istanbul
S. GUNER, H. FELLAGH, S. SELVI KUVVETLI & N. PR05.21
SANDALLI
Department of Pediatric Dentistry, Yeditepe University Faculty of Conservative approach of a complex dental and
Dentistry, Istanbul, Turkey mandibular trauma in a 11-years old boy
A.VINEREANU, D. C. CONSTANTINESCU, D. POPESCU &
Background: Traumatic dental injuries can result in a number of D. PETROVSKI
different injury types involving the tooth and the supporting
Carol Davila University, Bucharest, Romania
structures.
Aim: The aim of this study was to report the distribution of trau- Introduction: Trauma is relatively common among paediatric den-
matic dental injuries among children attending to Yeditepe Uni- tistry patients.
versity, Department of Pediatric Dentistry in four year period. Case report: An 11-years old male patient of our office showed
Design: The data were evaluated from the standardized dental 9 days after having experienced a trauma by falling on his chin
trauma examination forms of 442 patients referred to Yeditepe while in a summer camp. He had been taken to a medical office
University, Department of Pediatric Dentistry after a traumatic immediately after the accident. The chin bruise was cleaned. No
dental injury. The etiology of trauma, age, gender, number of symptoms were present and no further examination was per-
injured teeth and type of injury were evaluated. formed then. At the time of the dental visit, the boy complained
Results: Of all 442 patients with traumatic dental injuries 57.69% of pain in mastication (dental and on both vertical ramus of the
were boys and 42.31% were girls. A total of 711 teeth were eval- mandible, especially on the left). Clinical examination revealed
uated. Among all primary teeth 311 (84.29%) had suffered a lux- vertical enamel-dentin crown fractures in 1.6, 2.4 and 4.5 (4.5
ation injury and 58 (15.72%) had suffered fracture whereas 140 with involvement of pulp chamber), asymmetrical mouth opening
permanent teeth (40.94%) had suffered a luxation injury and 196 and slight deviation of lower inter-incisor line to the right. As the
(57.31%) had suffered fracture. The maxillary central incisors patient had undergone orthodontic treatment in our office,
were the most affected teeth. Subluxation (22.49%) and intrusion records of his status right before the trauma were readily avail-
(19.51%) were the most commonly occurring type of injuries in able, so the deviation of the mandible was regarded as a conse-
primary teeth whereas crown fracture with pulp exposure quence of the trauma and triggered further investigation.
(31.87%) and crown fracture without pulp exposure (23.68%) in Panoramic X-ray suggested bilateral condyle neck fracture, con-
permanent teeth. Injuries were found to occur more frequently firmed by CT scan. Treatment: Partial pulpectomy was per-
during the summer and winter seasons. formed on 4.5. Crown fractures were restored with glass-ionomer
Conclusions: Distribution of traumatic dental injuries vary cement, subsequently replaced by composite. Condylar fractures
between primary and permanent teeth. Luxation injuries occur were treated by a conservative orthopedic approach, using a
more frequently in primary teeth whereas fractures occur more functional appliance. After six months, occlusion is corrected, 4.5
common in permanent teeth, which may be due to the chances in continued root development despite some pulp calcification, no
the biological structures associated with age. symptoms persisted and no complications occurred.
Comments: Dental and condylar fractures may sometimes be
PR05.20 overlooked by general examination. Traumatic cranio-facial inju-
ries in children may need complex approaches for diagnostic and
Management of a late-presenting extrusive luxation treatment.
case
S. KOPRULU1 & H. C. GUNGOR2 PR05.22
1
Pediatric Dentistry, Hacettepe University, Ankara, Turkey;
2
Pediatric Dentistry, Hacettepe University Faculty of Dentistry, Conservative approach to intruded immature
Ankara, Turkey permanent teeth: a case report
C. UZUN & H. C. GUNGOR
Introduction: Extrusion is a type of luxation injury in which par-
Paediatric Dentistry, Hacettepe University Faculty of Dentistry,
tial or total separation of the periodontal ligament results in loos-
Ankara, Turkey
ening and displacement of tooth. Delayed treatment of such a
case makes repositioning problematic. Introduction: Intrusive luxation is axial displacement of a tooth
Case report: A 12-year old boy suffered a bicycle accident and into the supporting alveolar bone. The injury results in comminu-
sustained trauma to his face. He received emergency treatment tion or fracture of the socket and causes remarkable damage in
for abrasions in his face and lip laceration in a medical facility. the periodontal ligament (PDL). In immature permanent teeth
A day later, he was presented to pediatric dentistry clinics for with minor or moderate intrusion, waiting for spontaneous erup-
treatment of his displaced front tooth. Intraoral examination tion of the affected teeth is the treatment of choice.
revealed 4 mm extrusion of maxillary right central incisor and Case report: A 7-year old girl was presented to the pediatric den-
laceration in gingival mucosa. Due to delayed referral, tooth tistry department for treatment of her front teeth 2 h after a fall
repositioning was not considered. Instead, an intentional replan- accident. In intraoral examination, lacerations on marginal gin-
tation was planned. giva and bleeding from gingival sulcus of maxillary central inci-
After extraction, the root surface was irrigated copiously with sors were noted. Both teeth were immobile and tender to
saline. Following blood clot removal, the tooth was replanted percussion with metallic sounds. In addition, enamel and dentin
into its socket, positioned and splinted with 0.9 mm monofila- fracture of left maxillary central incisor was observed. Periapical
ment. At first week, endodontic treatment was initiated and the radiographs revealed narrowed PDL space around the still-devel-
oping roots. Enamel and dentin fracture of left central incisor She fell from the stairway at 1.5-year-old, and her mandibular
was restored and the patient was scheduled for follow-up visits. right and left primary central incisors were lost by completely
At 3 weeks, the teeth responded normal to percussion test and dislocation. At first visit to our hospital, incisal edge of left cen-
their mobility were within physiological limits. The patient con- tral incisor had been slightly erupted with exposed yellowish den-
tinued for regular visits to the clinic. After 15 months, uneventful tin and small crypt. In the dental X-ray findings, mandibular
healing was evident, both clinically and radiographically. both central incisors were observed enamel defects of 1/2 of tooth
Conclusion: A conservative treatment plan and appropriate fol- crown, and abnormal incisal edges were close to pulp cavity. She
low-up are essential for optimum healing of slightly intruded showed air pain, abrasion pain with toothbrush, and cold-water
teeth with immature roots. pain. Therefore, we filled in the pit of left central incisor with
surface pre-reacted glass ionomer (S-PRG) filler containing seal-
PR05.23 ant (BeautiSealantÒ) at 6-year-2-month-old. Since 6-year-4-
month-old, we applied S-PRG containing hypersensitivity sup-
Orthodontic and prosthodontic approach to a pression material (PRG Barrier CoatÒ). After the starting of
12 year-old-girl with traffic accident history right central incisor eruption, we covered the region of enamel
A. MISZTALEWSKA-GOZUBUYUK, M. ULUAKAY & A. hypoplasia with S-PRG containing composite resin (BEAUTIFIL
MENTES FlowÒ) at 6-year-8-month-old and now she has not complained
Pediatric Dentistry, Marmara University, School of Dentistry, of pain.
Istanbul, Turkey Conclusion: S-PRG filler containing materials are useful for the
treatment of teeth with enamel hypoplasia, which have problems
Introduction: The most common injuries in the permanent denti-
for hypersensitivity and oral cleaning, attrition and aesthetics.
tions are due to falls, followed by traffic injuries, acts of violence
and sports Its frequency and incidence at a young age, factors
related to costs and treatment may be ongoing for future years. PR05.25
The purpose of this case report was to describe the management Treatment of eruption disturbance of permanent
of dento-alveolar trauma of a child patient who had a traumatic successor after trauma to primary tooth: 2 case
car accident.
Case reports: The 12 year-old-girl was referred to Pediatric Den-
reports
tistry Department, Marmara University, three months after a N. IKEMATSU-ITO, K. SAWAMOTO, R. SHIMADA, T. ITO &
horrendous car accident. She had been hospitalized for multiple T. SHIMIZU
fractures in the lower limbs and maxillofacial area. Intraoral Department of Pediatric Dentistry, Nihon University School of
examination revealed 13, 12, 11, 21 were missing whereas a sig- Dentistry at Matsudo, Matsudo, Japan
nificant amount of bone loss had occurred in the maxilla with a Introduction: Trauma to oral and facial structures is a significant
bilateral cross-bite which made the patient seem as a pseudo-pro- problem that may have serious medial, aesthetic, and psychologi-
truded lower jaw. cal consequences on children and their parents. Trauma to pri-
The first step of treatment involved an upper pediatric partial mary teeth in1–3 years of age which developing permanent tooth
denture with a central screw to expand the maxilla and a bite germ is frequent in patients and can cause problems both to the
plane to disclude the upper anterior teeth for appropriate over-jet primary teeth and permanent successor. In these two cases
for a period of 6 months. A removable Hawley appliance was reports, we describe the permanent successor that was erupting
also given in the lower arch for a period of 5 months to recline disturbance because of trauma to the corresponding primary
the lower anterior teeth. When the proper occlusion was achieved tooth.
the partial upper denture was renewed. Rx time was 8 months Case reports: Case1, A 7-year-old girl was referred to our depart-
with a 1-year follow-up. The patient is still under our continual ment with chief complaint of impaction of the maxillary right
observation. permanent incisor. Reportedly, the girl had suffered trauma to
Comments: Patient0 s face aesthetics, phonetics and function primary tooth at 2 years of age, and had root canal treatment at
improved along with her self-esteem. Final prosthetic rehabilita- her primary-care dentist. Radiography showed the maxillary right
tion will be implants with fixed prosthetics when the appropriate permanent incisor positioned in horizontal and transalveolar as
age is achieved. high as the anterior nasal spin. The treatment was operated twice
surgical fenestration combined with orthodontic traction.
PR05.24 Case2, An 8-year-old boy came to our department for an une-
rupted maximally right permanent incisor. Reportedly, a trauma
Case report: enamel hypoplasia on mandibular occurred about 2 years of age, and follow-up at his primary-care
permanent central incisors by the trauma of primary dentist. Radiography showed that the right incisor positioned as
teeth high as root apical of the completely erupted left incisor. The
M. ARAKAKI, A. YAMADA, K. SAITO, Y. SUGAWARA, R. treatment was to wait for spontaneous re-eruption. 10 months
HINO & S. FUKUMOTO after, the right permanent incisor exhibited labial ectopic erup-
Division of Pediatric Dentistry, Department of Oral Health and tion.
Development Sciences, Tohoku University Graduate School of Comments: Clinical and radiographic follow-up is very important
Dentistry, Sendai, Japan after any dental trauma on primary teeth until the permanent
successor has completely erupted and root is completely formed.
Introduction: Trauma of primary dentition frequently occurs in
1–2 years old. In complete dislocation of primary teeth, there are
reports that some impacts occur to the successor permanent teeth
in more than 80% as colored enamel. Here, we showed that the
treatment for enamel hypoplasia in mandibular permanent cen-
tral incisors caused by the trauma of primary teeth using S-PRG
filler containing materials.
Case reports: 6-year-2-month-old (female), systemic history;
autism.
PR05.26 PR05.28
Management of root fracture in primary dentition A case of eight years follow up of avulsed permanent
M. SENER, M. TEKCICEK & G. UNVERDI central incisors
Peadiatric Dentistry, Hacettepe University Faculty of Dentistry, C. Y. HUANG, M. H. SHEEN, S. T. HUANG, H. S. CHEN &
Ankara, Turkey S. Y. HSIAO
Introduction: Root fractures are rare in the primary dentition as Dentistry, Kaohsiung Medical University Hospital, Kaohsiung,
about %2–4. Due to the elasticity of alveolar bone, luxation inju- Taiwan
ries are more common in the primary dentition. Clinicians usu- Introduction: Dental injuries are most frequent in children from 8
ally prefer not to manage root fracture in primary dentitions due to 9 years of age and most injuries involve the upper incisors.
to non-cooperation Patients with an increased overjet are at a significantly greater
Case report: A 3.5-year-old girl was referred to the Paediatric risk of dental injury. Tooth avulsion, a total displacement of the
Dentistry Department, with the complaint of pain and abnormal tooth out of its socket, ranging from 0.5 to 3% of traumatic inju-
mobility of her maxillary central incisors. Reportedly, the patient ries.
had a fall accident at home about 3 weeks ago. Her maxillary Case report: A 19 year-old boy had dental injury with tooth avul-
right central incisor had displaced palatally and it had been repo- sion of upper central incisors with open apex when he was
sitioned by her mother at that moment. On clinical examination, 10 years old. The avulsed teeth were replanted 3 h later after the
the maxillary primary central incisors were mobile. Radiographi- accident. From his 10–12 year of age, he had routine follow up
cally there were horizontal root fractures on the apical third of every 3 months. Six months after the replantation, radiographic
primary maxillary central incisors. Teeth were fixed with a semi- examination revealed external root resorption of tooth 11, 21
rigid splint for four weeks for patient comfort. The patient was without other clinical symptoms or tooth mobility. However, one
instructed to remain on a soft diet and oral hygiene. At year after the resorption was found, a gumboil over tooth 11 was
16 months recall, the patient had no complaint or discomfort noted, and at the time we performed pulpectomy of tooth 11.
with her teeth. And radiographically connective tissue healing Besides, the patient asked for orthodontic treatment due to Class
was observed. II malocclusion. During the orthodontic treatment, the anylosis
Comment: Maintaining root-fractured primary teeth by splinting of tooth 11, 21 was noted, increasing the difficulty of the
may be regarded as a conservative approach in young children as treatment.
it may eliminate the need for extraction. Comments: Upper incisors were great influence to the esthetics.
However, complications such as external root resorption or anky-
PR05.27 loses following tooth avulsion could compromise the prognosis
of the injured teeth. Management of avulsed permanent incisors
Reposition of a maxillary central incisor due to with immature root formation should be attentive and need a
extrusive luxation long time following up.
€
E. GÜL AYDIN & N. OZALP
Paediatric Dentistry, Ankara University/Faculty of Dentistry,
Ankara, Turkey
PR05.29
Management of severely extruded permanent central
Introduction: Extrusive luxation is one of the most critical injuries
of permanent teeth. Repositioning of the extruded tooth as early
incısors
E. BALLIKAYA, G. ERBAS UNVERDI & C. H. GUNGOR €
as possible is the accepted treatment for extrusive luxation. This
case report presents the treatment of extrusive luxation after Pediatric Dentistry, Hacettepe University Faculty of Dentistry,
6 days of trauma. Ankara, Turkey
Case report: A 13 year-old male patient was referred to our clinic Introduction: Extrusive luxation is partial or total separation of
6 days after having trauma. Intraoral examination revealed a the periodontal ligament (PDL) which results in loosening and
maxillary right central incisor with extrusive luxation and a max- displacement of the tooth in an axial direction.
illary left central incisor with enamel fracture. Radiographical Case report: A 10-year old patient was presented with severe dis-
examination indicated that the tooth had a closed apex and was placement of her front teeth resulting from a traffic accident, oc-
extruded approximately 3 mm relative to the cement-enamel curing one day earlier. Intraoral examination revealed severe
junction of the adjacent tooth. Before the repositioning; under axial displacement of maxillary central incisors (8 mm). In addi-
local anesthesia the gingiva was gently cleaned and irrigated with tion, the retrusion of teeth were very pronounced. They were
saline solution and oxygenated water. Then the right central inci- loosely attached to the palatal gingiva and extremely mobile.
sor was gently pushed back into the socket with finger pressure. Due to late referral, repositioning of teeth was not considered.
Teeth were splinted with semi-rigid 0.5 mm orthodontic wire Instead, an intentional replantation was planned. After extrac-
from maxillary right lateral incisor to left central incisor. Chlorh- tion, the PDL on root surfaces was removed with a periodontal
exidine(0.1%) mouth rinse and antibiotic (tetradox 100 mg) were scaler and teeth were kept in NaF gel for 20 min. Following
prescribed as a prophylactic aim. One week later, root canal ther- coagulum debridement of the alveolar sockets, teeth were
apy was performed and calcium hydroxide based root canal replanted and splinted with 0.9 mm monofilament fishing line. At
dressing was placed for ten days. Two weeks later; root canal this visit, endodontic treatment was initiated for both teeth which
treatment was performed and the splint was removed at the same were temporarily dressed with calcium hydroxide paste. After
appointment. After 6-months follow-up, clinical and radiographi- splint removal at 3 weeks, root canals were obturated with cold
cal examinations showed no pathological signs. lateral compaction using sealer and gutta percha. Clinical exami-
Comments: In this case report a successful treatment after 6 days nation at 24 months showed optimal gingival condition but lim-
of extrusive luxation of a maxillary central incisor was showed, ited physiologic mobility for the traumatized teeth.
despite of the general view that repositioning of extrusive luxa- Radiographically, replacement resorption was evident.
tion injury is not possible after 24 h due to blood clot. Comments: Proper diagnosis, treatment planning and follow-up
care of traumatized teeth in children are critical for a favourable
outcome to ensure.
PR05.30 Conclusions: Our study showed that pro-inflammatory cytokines

such as IL-1b, IL-6 and TNF-a and MMP-3 and -9 were more
Etiology and prevalence of dental trauma in north significantly expressed in the tissues surrounding the replanted
Brazilian preschool children teeth.
A. J. NOGUEIRA1, R. M. NOGUEIRA1, D. B. CORREA2 & M.
C. MARTINS2 PR05.32
1
Pedodontic, Federal University of Par em, Brazil; 2Superior
a, Bel
School of Amazonia, Belem, Brazil Post-operative treatment of severe maxillary
deficiency due to trauma on a 7 year old child: a case
Backgound: The dental trauma represent a public health problem
report
among children and adolescents being studied both nationally
L. PAPAGIANNOULIS1, N. POLYCHRONAKIS2, M.
and internationally by several researchers.
SIFAKAKI1, D. EMMANOUIL1, N. THEOLOGIE-LYGIDAKIS3
Aim: The present study aims to analyze the etiology and preva-
& I. IATROU3
lence of dental injuries in preschool children 0–3 years old in the 1
Department of Paediatric Dentistry, University of Athens, Athens,
city of Belem, Par a, Brazil.
Greece; 2Department of Prosthetics, University of Athens, Athens,
Design: The survey was conducted in 10 public and six private
Greece; 3Department of Oral and Maxillofacial Surgery,
nursery schools of city. A total of 426 boys and girls participated
University of Athens, Athens, Greece
in the study. Children were clinically examined for signs of dental
trauma according to Andreasen & Andreasen (1990) classifica- Introduction: Maxillofacial injuries to children due to traffic acci-
tion, including concussion. It was verified a prevalence of dental dents are a common cause of mid-facial fractures and lacerations
trauma in 29.6% of children. and may influence their life- quality. In the treatment of such
Results: The highest percentage of trauma occurred in children injuries an interdisciplinary team of specialties is involved.
aged 3 years, with no gender difference (P > 0.05). Enamel frac- Case report: A 7 year old boy was referred by the Department of
ture was the most prevalent type of trauma, followed by concus- Oral and Maxillofacial Surgery to the postgraduate clinic of
sion. The most frequent etiological factor was a fall, followed by Pediatric Dentistry for dental care. Six months before the child
collision, there is no such significant statistical association between had suffered a severe traffic accident with a Le-Fort I type maxil-
these and the gender (P > 0.05). The maxillary central incisors lary fracture resulting to a major defect of the anterior maxilla
were the teeth most affected by trauma. A separate analysis for and loss of his primary and permanent teeth. He had been trans-
tooth, shows that enamel fracture are of common occurrence. ferred to the Pediatric Hospital in a life-threatening condition,
Conclusions: Given the traumatic events is important to popular- was operated urgently to fixate fractures. Post-operatively and
ize information about trauma, its consequences and its preven- after stabilization of his condition he developed Post Traumatic
tion. Stress Disorder resulting to loss of speech, problems in swallow-
ing, eating and walking as well as refusal to cooperate with the
PR05.31 health team. The dental treatment plan consisted first of restora-
tion of his multiple carious lesions under general anesthesia and
Expression of inflammatory cytokines and MMPs on then a partial denture to improve function and psychological
the periodontal tissue of replanted rat teeth support. For the next two years two sets of different partial den-
S. C. CHOI1, H. J. AHN1, H. S. LEE1, J. E. YOU1,2 & G. T. tures were fabricated due to the progressive alveolar bone resorp-
KIM3 tion.
1
Department of Pediatric Dentistry, Kyung Hee University, School Comments: The child through a desensitization process that
of Dentistry, Seoul, Korea; 2Seoul Children’s Dental Center, involved the Pediatric Dentist and the Psychologist gradually
Seoul, Korea; 3Department of Oral and Maxillofacial Radiology, regained his speech and gaiety. The multidisciplinary and imme-
Kyung Hee University, School of Dentistry, Seoul, Korea diate approach of these cases is essential in order to eliminate the
impact of the accident in the child0 s quality of life.
Background: Tooth avulsion is a complex traumatic injury char-
acterized by complete displacement of the tooth from its socket.
The preservation of a vital periodontal ligament (PDL) attached PR05.33
to the root is highly correlated with healing of the periodontium. Management of luxation injury and associated
Aim: This study was designed to evaluate the correlation between
impacted mesiodens - a case report with 24 months
different extra-alveolar dry times and inflammatory cytokines
and matrix metalloproteinases (MMPs) as part of the PDL gene follow up
€
P. KINAY & A. OLMEZ
expression on replanted rat teeth.
Design: The first phase of the study aimed testing human PDL Department of Paediatric Dentistry, Gazi University, Ankara,
cells ex-vivo. Extracted teeth were dried for 15 and 30 min. The Turkey
PDL cells were extracted and analyzed by qRT-PCR. The second Introduction: Lateral luxation injuries are characterized by partial
phase was performed in-vivo, thirty-six Sprague Dawley rat first or total separation of the periodontal ligament. In immature
maxillary molars were extracted and replanted after 15, 30 and developing teeth, revascularization can occur after the trauma.
60 min extra-alveolar time. We tested the levels of inflammatory Mesiodens is the most prevalent type of supernumerary tooth.
cytokines and MMPS in periodontal tissue at 3, 7 and 28 days However, as regards surgical removal of mesiodens, ideal timing
after tooth replantation. of intervention remains to be a highly controversial issue.
Results: In ex-vivo study, pro-inflammatory cytokines such as Case report: This report describes a case of a 8-year-old female
TNF- a, IL-1b, and IL-6 showed up-regulated in 30 min dried who had traumatic injuries at his permanent maxillary incisors.
PDL cells and all tested MMPs showed increased levels after Intraoral examination showed lateral luxation of tooth 21.
30 min dry conditions. In in-vivo study, the levels of pro-inflam- Because of the patient’s age, apex of the tooth 21 was opened. In
matory cytokines increased as time increased and it was addition to that presence of an impacted conical shaped mesio-
expressed in different patterns with increased extra-alveolar time. dens was observed. The tooth 21 was gently pushed back into its
Regarding tested specific MMPs, the expression levels of MMP-3 original location and a semi-rigid splint was applied. The patient
and -9 were increased as extra-alveolar time increased. was monitored about symptoms of the tooth for devitalization.
In addition, to eliminate the risk of devitalization and/or root ber 2012. All the data were statistically analyzed using the ANO-
malformation of adjacent tooth and to prevent affecting the VA and chi-square statics.
young child phsycology with surgical procedure, mesiodens was Results: Most of the intrusions occurred in children who were 1–
left without extraction until the root development was completed. 3 years old. Boys were slightly more prone to the tooth injuries
At the one year follow-up, there was no evidence about pulp de- than girls, and the boy/girl ratio was 1.75:1. The most common
vitalization and root development was completed. Surgical proce- cause of intrusion was fall down and collision in both sexes. Pri-
dure was performed by oral surgeons for extraction of the mary teeth were injured most frequently in the home. The major-
mesiodens. At 24th follow up, the tooth was clinically and radi- ity of traumatized teeth are the upper primary central incisors
ograpically asymptomatic. (81.6%). Complications were found in 65 of 84 intruded primary
Comments: In case of lateral luxation assosiated with mesiodens, incisors (52.8%). Complications in the injured primary dentition
to prevent potential damages to adjacent teeth, surgical interven- comprised: pathologic root resorption (25.2%), crown discolor-
tion could delayed until the root formation was completed. ation (20.8%), periapical abscess (13.2%), and ankylosis(6.3%).
PR05.34 importance of the careful attention to children younger than
3 years and the management of childhood dento-alveolar trauma.
Management of intrusive luxation maxillary incisor
by surgical repositioning: a case report PR05.36
A. COŞKUN & T. ULUSU
Gazi University, Ankara, Turkey Posterior crown fractures due to trauma in both
dentitions
Introduction: Tooth intrusion is defined as the displacement of a
H. M. GÖRCEK & A. ALAC ß AM
tooth into alveolar bone. Serious damage to the tooth pulp and Department of Pediatric Dentistry, Gazi University Faculty of
supporting structures occurs because of the dislocation of tooth
Dentistry, Ankara, Turkey
into alveolar process. Pulp necrosis, external-internal root resorp-
tion, loss of marginal bone support, replacement resorption- Introduction: As dental trauma prevalance to anterior teeth is
ankylosis, disturbance in continued root development, partial- high, crown fractures at posterior region are rarely observed.
total pulp canal obliteration and gingival recession may occur as Indirect trauma sustained to the chin increases the risk of poster-
a consequence of intrusive luxation. The management of intruded ior teeth fractures.
permanent tooth may consist of allowing spontaneous re-erup- The purpose of this case report is to describe a series of 3 poster-
tion, surgical repositioning and fixation, orthodontic reposition- ior trauma cases.
ing, and a combination of surgical and orthodontic therapy. Case 1: A 13-year-old boy referred Gazi University Faculty of
Case report: A 9-year-old boy was referred to Gazi University Dentistry Department of Pediatric Dentistry after an accident
Department of Pediatric Dentistry. On examination, there were happened 7 months before. Intraoral examination revealed all
no signs of neurological or extra oral injuries. Intra-orally, he the first permanent molars had uncomplicated crown fractures.
presented with severe intrusive luxation of 22 (more than 6 mm). All traumatized molars restored with composite-resin restoration
The traumatized tooth was treated by surgical repositioning. one of which required Cvek pulpotomy and stainless steel crown
Teeth were splinted with wire-composite for 4 weeks. After 2 weeks after. The patient is followed up for 21 months.
removal of the splint the tooth responded as vital to electric pulp Case 2: A 7-year-old boy was involved in an accident 2 months
vitality test. The patient was recalled for 3–6–9 months controls. prior to attending. Clinically, uncomplicated crown fracture in
The tooth remained symptomless. The patient is still under con- #74 and radiographically an oblique mid-third root fracture were
trol. seen. Root canal treatment and stainless steel crown were
Comments: This case report describes management of a patient applied. The patient is followed up for 9 months.
with severe intrusive luxation by surgical repositioning. Intrusive Case 3: A 9-year-old boy referred after 2 h to posterior trauma.
luxation is a serious injury that can cause many physiologic Clinically, vertical complicated crown fracture in #85, mobility in
problems. Permanent teeth with open apices are more likely to #84 were diagnosed. Treatment planning included root canal
survive even from severe trauma. treatment and stainless steel crown to #85 and extraction #84.
Removable space maintainer was applied to the lower jaw. The
PR05.35 patient was followed up for 10 months.
Comment: The posterior crown fractures caused by indirect
Intrusive luxation of primary incisors: a retrospective trauma rarely observed. Stainless steel crowns and resin restora-
clinical study tions could be used successfully in the management of indirect
W. C. CHO1, Y. K. HAN1, D. KIM2, K. C. KIM1 & S. C. CHOI1 trauma cases.
1
Department of Pediatric Dentistry, Kyung Hee University, School
of Dentistry, Seoul, Korea; 2Center for Disability and Oral PR05.37
Health, Dankook University, Jukjeon Dental Hospital, Kyeonggi-
do, Korea Vitalcem mineral trioxide aggregate (MTA): a new
option for regeneration in odontopediatric pulp
Background: Intrusive luxation is the displacement of the tooth
into the alveolar bone along the axis of the tooth and is accom-
treatment
panied by comminution or fracture of the alveolar socket. R. A. R. FIGUEROA BANDA
Aim: The purpose of this study was to research about traumatic Arequipa - Peru, Universidad Catolica de Santa Maria, Arequipa,
intrusive luxation of children in aspects of gender difference, age, Peru
cause, place of trauma, and severity of injuries, and to evaluate Introduction: The VITALCEM MTA is an odontopediatric and
complications to the primary and permanent dentition. endodontic sealer consisting of mineral oxides, calcium sulphate
Design: This study involves 176 preschoolers aged 8 months to as hydrophilic particles that stimulate tissue regeneration. Very
7 years and 3 months (mean age: 3.0 1.6), who attended the similar to the MTA Angelus “Brazilian”. Chemical composition:
Department of Pediatric Dentistry, Kyung Hee Dental Hospital SiO2, Al2O3, Fe2O3, SO3, CaO, MgO, Na2O, ZrO2
for intrusive luxation injuries between January 2003 and Decem-
Properties: PR05.40
Alkalinity above 12 (pH values). por encima de 12
Demographics, management and long term outcomes
Radiopacity similar as gutta percha
Resistance to compression suitable for use. for a group of children experiencing permanent tooth
Texture of matter after gritty setting, light gray, odorless avulsions at Glasgow Dental Hospital and School
Case Report: Apexification Using Vitalcem MTA. Prior permis- R. MCGOWAN1, R. WHITELAW1, A. MCCANN1 & A.
sion of the Ethics Committee. One patient reported (female, born CAIRNS2
1
2004) Undergraduate, University of Glasgow, Glasgow, UK;
2
Tooth fracture is observed in superior central incisors. On radio- Department of Paediatric Dentistry, University of Glasgow,
graph it was noted that on right superior central incisor (11) the Glasgow, UK
apical root has not been formed.
Background: Avulsion of a permanent tooth affects between 1
Diagnoses:
and 16% of children. Extra oral time (EAT), extra oral dry time
Coronary trauma fracture for 1.1 and 2.1
(EADT) and storage medium play a crucial role in the success of
Apex has not been formed.
re-implantation.
Treatment:
Aims: To investigate the management and outcomes of avulsion
Aperture and antibiotics for 72 h.
injuries presenting to the Paediatric Department of Glasgow
VITALCEM MTA placed in apex.
Dental Hospital and School.
Endodontic procedure.
Design: A departmental trauma database identified 203 patients
Rehabilitation.
with avulsion injuries between 2006 and 2014. Approval was
sought from Greater Glasgow and Clyde NHS to conduct a ret-
PR05.38 rospective analysis of case notes.
Prevalence and awareness of sports related dental Results: 119 case notes were available, 68.9% being male. The
trauma amongst children in New Delhi average age at time of injury was 9.41 years. 79.8% occurred
outdoors, 32.6% involved bicycles/scooters. 52% of avulsed teeth
M. GOSWAMI
were stored in milk, 13.4% were left dry. 36.9% of avulsed teeth
Pedodontics and Preventive Dentistry, Maulana Azad Institute of
had an EADT ≤30 min. Of the teeth with an EADT ≤60 min,
Dental Sciences, New Delhi, India
48.3% resulted in pulp death and 31.7% were extracted. In com-
Background: Sports activities have an associated risk of orofacial parison, 71.8% of teeth with an EADT ≥180 min were extracted.
injuries. The prognosis of traumatized teeth depends on prompt There was evidence of antibiotic prescribing in only 29 cases,
and appropriate treatment, which often relies on knowledge of amoxicillin being the most commonly prescribed (75%).
lay people such as the child’s parents, their school teacher and Conclusion: The results show that over half of avulsions were
coaches. Prevention of such injuries has become the main focus stored in milk. Whilst this is encouraging, a proportion of avul-
being included in Preventive Dentistry. Awareness among sports- sions are not being stored appropriately and public awareness
men and various international sports organizations has recog- needs to be raised. To concur with existing evidence a correlation
nized the need of dentistry in sports. was identified between the EADT and the final outcome of the
Aim: To evaluate the occurrence of dental injuries in children tooth resulting in an increased number of extractions. The
involved in organized sports, the level of awareness about preven- department needs to develop a protocol with regard to the pre-
tive measures and management of dental trauma during sports. scription of antibiotics for avulsions.
Design: A cross-sectional study was carried out among 450 chil-
dren aged 6–16 years attending various sports training pro- PR05.41
gramme in summer camps in New Delhi. A structured
interviewer-guided questionnaire containing 20 questions was Auto-extraction of permanent incisors and self-
used to evaluate the prevalence and awareness of oral injuries inflicted orodental trauma in a severly burned child
sustained during sports. €
G. DOĞUSAL, S. KELESß & I. SONMEZ
Results: Mean age of the children participated was 12.6 years. Department of Pedodontics, Adnan Menderes University, Aydin,
20.9% children had injured their orofacial region during sports. Turkey
Maximum type of injury experienced was chipping/fracture of
Introduction: The aim of this report was to describe the case of a
teeth. Awareness about re-implantation of the avulsed tooth was
self-inflicted oral injury and auto-extraction of mandibular per-
significantly high (58.4%). A significant number of children knew
manent incisors in a 7-year-old child that may be related to
about mouthguards (71.3%) but in spite of being aware, were
chronic pain caused by a severely burned body. To do best of
not using them.
our knowledge, there are studies report orodental injuries during
burn treatment but auto-extraction of permanent incisors hasn’t
importance of awareness of preventive aspects of sports related
been reported.
trauma. Parents, Teachers, Athletic personnel, Coaches and
Case reports: A 7-year-old boy was admitted to the Intensive
Health care providers should be educated on all the aspects of
Care Department of Adnan Menderes University in Aydın, Tur-
Prevention of sports-related oro-facial injuries.
key, with a diagnosis of severe burn (67%) due to playing with a
lighter gas. Burns involved almost all body parts, except the head
PR05.39 and face region. Because the patient had tooth clenching, grind-
Abstract withdrawn. ing and autoextraction of mandibular incisors, the pediatrician
called pediatric dentist for a consultation. The dental examina-
tion was performed in the hospital’s burn unit. There were deep
caries and teeth 31, 41, 42, 73 were extracted by patient. His
father reported that he had extracted one or two more teeth
before our examination. Because of severe pain maxillary second
molar was extracted in hospital under local anaesthesia. And
after he was discharged from hospital after five months we notice
that he extracted tooth 42 and 83. After finishing all necessary due to trauma in the upper anterior region and can be a proper
treatments of the teeth a partial removable denture was prepared substitute for removable or fixed appliances used for this reason.
for missing teeth. 2. This method is fast, simple and efficient and therefore meets
Comments: Tooth grinding and autoextraction may be related also the economical considerations.
with the severe pain during burn treatment. In such cases, multi-
disciplinary treatment approaches may be more useful for PR05.44
patients.
Dentofacial injuries in children and adolescents in
PR05.42 relation to symptoms of disruptive disorders
I. G. VASILOUDIS1, G. VADIAKAS1, G. KOLAITIS2,3 & L.
Management of Fractured maxilla due to dog bite in PAPAGIANNOULIS1
1
a 5 year child Department of Paediatric Dentistry, School of Dentistry, National
J. CHANDRA1, V. S. BHAT2 & S. S. BHAT3 and Kapodistrian University of Athens, Athens, Greece;
1 2
Oral and Maxillofacial Surgery, Yenepoya University, Department of Child Psychiatry, Medical School, National and
Mangaluru, India; 2Prosthodontics, Yenepoya University, Kapodistrian University of Athens, Athens, Greece; 3’Aghia
Mangaluru, India; 3Pedodontics, Yenepoya University, Mangaluru, Sophia’ Children’s Hospital, National and Kapodistrian University
India of Athens, Athens, Greece
Introduction: Midface injury is most common in children when Background: Children with disruptive disorders present with signs
animals attack them. The face is the most accessible area for the and symptoms commonly related with attention deficit hyperac-
animals and can result in soft tissue injuries. It is quite rare to tivity (ADHD), oppositional-defiant and /or conduct disorders
have fractures due to animal bite. Children are predisposed to that potentially constitute predisposing factors for injuries.
such injuries due to their short stature, increased head to body Aim: To investigate whether disruptive disorders (ADHD with or
ratio and lack of awareness of the dangers involved. without conduct disorders) are related with an increased risk for
Case report: A five year old boy who was playing in the field was dentofacial injuries.
suddenly encountered by a barking dog. The boy started crying Design: The study sample was selected among children / adoles-
loudly and this made the dog bite him on the face in return. cents of school age that showed up for treatment at the postgrad-
Clinically soft tissue tears were seen on the cheek and lips, and uate pediatric dental clinic, University of Athens. The study
the child was unable to close his mouth properly. group included 202 subjects with a history of dentofacial injuries
X ray investigation confirmed fracture of maxilla. Treatment was and the control group 207 subjects without a history of dental
carried out under General anaesthesia. Open wounds were trauma. Two questionnaires were completed by parents; the first
cleaned and sutured. Fracture of maxilla was managed with cus- for symptoms of general psychopathology (SDQ, Goodman,
tomised cap splint and wiring. 1997) and the second for attention-deficit / hyperactivity symp-
Comments: It is of paramount importance to identify and manage toms (ADHD Rating Scale IV, DuPaul et al., 1998). A detailed
the fractures in children to prevent future complications. It dental trauma record was completed for each patient, followed
requires a team work effort involving pedodontist, oral surgeon, by a complete clinical examination.
prosthodontist to manage such injuries. Results: Children and adolescents of study group showed a signif-
icantly higher expressivity of attention deficit/hyperactivity symp-
PR05.43 toms compared to the control group (P = 0.02). Regarding the
subtype hyperactivity, the study group also showed a higher ex-
Esthetic reconstruction of avulsed incisor pressivity that was borderline non significant (P = 0.068). No sig-
M. TOMA1, A. TATUCU2 & C. MIHAI3 nificant differences were found between the two groups regarding
1
Pediatric Dentistry, University of Medicine and Pharmacy ‘Carol the variables indicative of general psychiatric disorders i.e. hyper-
Davila’ Bucharest, Bucharest, Romania; 2Dent Estet, Timisoara, activity, emotional symptoms, conduct and peer problems as well
Romania; 3Dent Estet, Bucharest, Romania as prosocial behavior (P = 0.11).
Introduction: Trauma in the maxillary central region is very com- Conclusions: The traumatised children / adolescents showed a
mon particularly in boys over 8 years old. Removable appliances tendency for higher hyperactivity without displaying any other
or fixed soldered metal bands and rings remain to date the most symptoms of general psychiatric disorders.
practiced methods for regaining the esthetics and the function
properties of a lost tooth. PR05.45
A simple method in which both esthetic and functional purposes are Dental trauma in patients attending at a county
gained is a paramount goal in cases of trauma in the frontal area.
This case report describes a technique for achieving both pur-
hospital emergency room
poses by using a fiberglass splint. C. D. IONEL1,2 & R. LUCA2
1
Case report: A 9 years old patient came to our dental office with Paediatric Dentistry; Endodontics, Dunarea de Jos University,
a 3 weeks old avulsion of tooth #2.1 and an uncomplicated Faculty of Medicine and Pharmacy, Galati, Romania; 2Paediatric
enamel-dentine crown fracture of tooth #1.1. He has normal Dentistry, Carol Davila University, Bucharest, Romania
occlusal relations with an overjet of 1–2 mm. Sensitivity tests Background: Romanian medical emergency services, including
revealed that #1.1 is vital, thus reconstructed using the direct dental care, undertook a remarkable transition in the past
composite restoration technique after an indirect pulp capping. 10 years. After 2007 in most regions UPU-SMURD (Emergency
The missing space of the avulsed tooth #2.1 was restored by Room Unit- Mobile Service for Emergency, Reanimation and
building a composite crown attached to a fiber-glass splint bonded Extrication) services were founded at the county0 s hospitals.
directly on the adjacent teeth. Aim: Dental trauma (DT) addressability for this service profile
Clinical and X-ray and follow-ups at 1 month, 4 months, was evaluated.
7 months and 10 months reveals good clinical results, without Design: A retrospective study was conducted at the Dental
radiological changes. Department of UPU-SMURD service from „Sf. Apostol Andrei”
Conclusions: 1. Fiberglass splinting seems to be a proper substi- emergency hospital, Galatßi. DT records from the registry books
tute for traditional treatment options in cases of missing teeth
were selected for all patients(aged 2–73 years), for the period PR05.48
2008–2011 and then prevalence, DT type, distribution, etiology,
Interdisciplinary management of a crown-root
daytime and season of DT occurrence for patients aged under 25
were analyzed. The statistical analysis was performed in SPSS fracture in a young permanent incisor: a case report
17.0 for Windows(P ≤ 0.05). P. A. PINO1, A. VERA2, D. BRAVO-CAVICCHIOLI3 & M. A.
Results: 1.84% of patients (n = 326) from all age groups suffered ROJAS4
1
DT. DT for the group aged under 25 years (mean Department of Pediatric Stomatology, University of Talca, Talca,
age = 16.92 5.95 y): a) 0.71% of patients (n = 127 patients Chile; 2Department of Pediatric Stomatology and Department of
with 234 DT, 77.1% boys) from all age groups had DT; b) the Oral Rehabilitation, University of Talca, Talca, Chile;
3
prevalence was 38.95% from DT in all age groups; c) distribution Department of Oral Rehabilitation, University of Talca, Talca,
86.61% of DT injured front teeth; d) luxations were more fre- Chile; 4Department of Stomatology, University of Talca, Talca,
quent (41.21%); e) etiology - aggression in 67% of cases, boys Chile
more affected (P = 0.004); f) DT was diagnosed almost in equal Introduction: Emergencies due to dental trauma are highly preva-
variances during night and day (45–55%); g) 28.4% of DT took lent among young Chileans. Traumatic crown-root fractures with
place during the summer months. pulp exposure are often complicated to treat and require an inter-
Conclusion: Luxations injuries suffered during the summer disciplinary management, to provide adequate treatment and
months were the most frequent. Aggression was the main cause improving prognosis.
of DT. Evan if the DT addressability was low, emergency service Case reports: A 7 year-old male patient was evaluated at the
provided continous care even during off hours. Dental Clinical Centre at the University of Talca, 5 days after a
dental trauma, were he had received emergency treatment, con-
PR05.46 sisting of fragment bonding with a Glass-ionomer restorative
Evaluation of dental pulp blood flow in immature cement. No symptoms were present during clinical examination,
but mobility of the fragment was present; periapical X-ray
maxillary incisors with concussion by Laser Doppler showed an open root apex and an oblique crown-root fracture.
Flowmetry Treatment plan was discussed by an interdisciplinary team, which
X. WANG & Z. TIAN performed the clinical procedures. Under local anesthesia, a par-
Department of Pediatric Dentistry, School of Stomatology, The tial pulpotomy and crown reconstruction with Glass Ionomer
Fourth Military Medical University, Xi’an, China was performed by a Pediatric Dentist and Endodontist; the
crown-root fragment was stored in saline solution. Fifty days
Background: Detecting the pulp vitality in traumatic teeth is
later, the Periodontist lifted a gingival flap and the Prosthodon-
important. However, there are many limitations to decide the
tist placed a rubber dam, removed the restorative material and
pulp vitality in immature teeth because of undeveloped root.
bonded the fragment using a total etch technique and composite
Aim: To explore the relationship between pulpal blood flow
resin cement; small missing fragments were restored using a
(PBF) of immature maxillary incisors with concussion and pulp
nanofilled composite. After 6 months, the patient was still symp-
outcomes for 12 months.
tom-free and the tooth and surrounding tissues had achieved
Design: 42 children, aged 7–12 years, were selected randomly
health, function and aesthetics.
from School of Stomatology, Fourth Military Medical Univer-
Comments: All dental practitioners should be familiar with the
sity. We treated 69 central incisors and 46 lateral incisors with
protocols regarding management of emergency dental traumas;
concussion following IADT guidelines and collected the PBF
nonetheless, interdisciplinary approach is often required to pro-
data with Laser Doppler flowmetry (LDF) every 1, 3, 6 and
vide optimal final treatment and to achieve the best possible clini-
12 months. Moreover, we also chose 30 healthy children, aged 7–
cal outcomes.
12 years, to collect the normal PBF data with LDF as control.
Results: We observed the PBF data from the healthy teeth of dif-
ferent ages had no statistics differences. In addition, we observed PR05.49
the PBF data from 61 central incisors and 42 lateral incisors with Delayed permanent tooth eruption due to the previous
concussion were in the normal range for the first visit. After one
trauma and treatment procedure
month, all the PBF data turned into the normal range. After € A. OGE
€
S. KORUN1, A. ISLAM1, G. SAVTEKIN2, O. 1
& S.
three months, the data of 6 central incisors and 2 lateral incisors
ß ETINER1
C
became lower. After six months, only 4 central incisors’ data 1
Pediatric Dentistry, Near East Univesity Faculty of Dentistry,
were lower. After one year, the same 4 central incisors’ data
Nicosia, Cyprus; 2Oral and Maxillofacial Diseases and Surgery,
became especially low, one crown turned grey and the other 3
Near East Univesity Faculty of Dentistry, Nicosia, Cyprus
teeth had fistula, indicating the pulp is necrotic.
Conclusions: PBF data of immature maxillary incisors with con- Introduction: Trauma to the primary dentition is common. It
cussion could help the dentists to give proper treatment and get may cause disorders in the development of permanent successor
better prognosis. teeth. The alterations may either occur at the time of accident or
be caused by post-traumatic consequences.
PR05.47 Case reports: A 6-year-old healthy girl was presented to the
department of pediatric dentistry. Her parents reported that, she
Abstract withdrawn had fallen while running and hit her face. In clinical examination,
mobility of the maxillary left primary central incisor was
observed. After the radiographic examination, root fracture was
diagnosed and the tooth was extracted. Clinical control was per-
formed after a week. The parents were informed regarding possi-
ble further complications and were reminded of the necessity of
clinical controls every year until the permanent tooth erupted.
Two years later, the patient returned with the complaint of a
missing tooth. The radiographic examination revealed a delay in
the eruption of the maxillary left permanent incisor. The patient
was observed monthly for two consecutive months for the erup- trauma, in the emergency dental office, both remnants of the root
tion of tooth and the mucosal incision indicated the necessity for were extracted under local anaesthesia and patient was prescribed
the removal of thick, fibrous gingiva. Infiltrative local anesthesia antibiotics. Four months after the trauma patient presented in
was performed and diode laser was used for the incision. After our Polyclinic. Clinical and radiographic examination revealed
one week, the patient came for a follow-up check and it was empty sockets. The pedodontist constructed a wire-composite
observed that eruption of the tooth had started. splint (from tooth 12 to 22) with two acrylic central maxillary
Comments: The protocol for patients who had experienced dental incisors attached in place of the missing teeth. The orthodontist
trauma is that they must be observed with a systematic clinical made complete orthodontic diagnostics including cephalometric
and radiographic follow-up and options of alternative treatments analysis and diagnosed the patient with skeletal Class III. maloc-
for the primary and permanent teeth involved should also be clusion and skeletal open bite. Since the patient is in a skeletal
considered. growth pattern orthodontist began the therapy with removable
orthodontic appliance-Class III bionator. Future therapy plan
PR05.50 includes orthodontic - surgical treatment, and when the facial
bone growth is completed, the implant surgery associated with
Revascularization of necrotic, immature permanent porcelain crowns.
tooth: a case report Comments: In such cases it0 s necessary to have a multidisciplinary
M. E. GUEVARA VELOSO approach in order to successfully resolve patient0 s aesthetic and
Pediatric Dentistry, Clinique Dentaire Ardentis Vevey, Vevey, functional problems.
Switzerland
Introduction: Standard techniques for apexification involves the PR05.52
use of Ca(OH)2. However,the absence of root walls development Environment of traumatic dental injuries in children
makes the tooth susceptible to fracture. Studies on traumatic and adolescents treated at the University Medical
injuries to immature teeth have shown promising outcomes of re-
vascularized root canal. This report presents a successful case of
Centre Ljubljana, Slovenia
apexification with revascularization technique. V. POLANSEK & R. KOSEM
Case reports: A 7.5-year-old boy presented intrusive luxation of Dept. of Paediatric and Preventive Dentistry, University Medical
tooth 11. The tooth did not respond to cold testing, was sensitive Centre, Ljubljana, Slovenia
to percussion and its mobility was grade 2. Periapical radiograph Background: Prognosis of traumatized teeth depends on appropri-
revealed an incomplete apex. One month later, the cold testing ate emergency treatment, which often relies on lay people, pres-
was negative; the diagnosis was pulpal necrosis. The revasculari- ent at the place of traumatic dental injury (TDI).
zation was undertaken. First, the necrotic tissue was removed; Aim: The aim was to analyze TDIs according to the place where
the canal was disinfected with 3% sodium hypochlorite without they occurred, related activities and persons, who were present at
mechanical preparation and dried with sterile paper points. A the site of trauma.
creamy paste of metronidazole, ciprofloxacin and cefuroxim was Design: Data were collected from TDI-records of children and
applied to the canal and the cavity remained closed with glass-io- adolescents under treatment and/or follow-up at the Department
nomer during one month. At the second appointment, the cavity of Paediatric and Preventive Dentistry, University Medical Cen-
was opened and irrigated with NaCl. An intracanal hemorrhage tre Ljubljana, Slovenia, between 2009 and 2014. Age distribution,
was provoked. Portland cement was placed up to 3-mm cemento- places of trauma, related activities and persons present at the site
enamel junction and the cavity was closed with glass-ionomer of trauma were analyzed.
and composite resin. During the 1-year follow-up the radio- Results: Relevant data on TDI-related places and activities were
graphic evaluation showed a gradual apical development and the available in 543 records. 427 children and adolescents (mean age
tooth was asymptomatic. 10.2 2.8, range 5.8–20.1 years) suffered trauma to their perma-
Comments: This case demonstrates the successful revasculariza- nent teeth. In 116 children (mean age 2.7 1.3, range 0.8–
tion of necrotic root canal system. The use of the revasculariza- 6.9 years) primary dentition was affected; majority of these TDIs
tion technique has permitted the physiological development of occurred at home (78%). Home was also the main place of TDIs
the root walls and apex, improving thus the prognosis of the of permanent teeth (43%), followed by road (22%) and school
tooth. (19%). In general, the most common activities related to TDIs
were playing (56%), walking and running (13%) and riding a bicy-
PR05.51 cle (12%). Persons present at the place of TDIs were mostly parents
(61%) and teachers/educators (21%); in 5% of analyzed records no
Multidisciplinary approach in treatment of avulsion person being present at the site of trauma was identified.
of both maxillary central incisors Conclusions: Domestic and educational environment were the
S. KADIĆ1, M. MAGDALENIC MESTROVI
2 & V. PICEK1
C most common places where TDIs occurred. Instructions for par-
1
Paediatric Dentistry, Dental Polyclinic Zagreb, Zagreb, Croatia; ents and education staff could increase the odds for appropriate
2
Orthodontics, Dental Polyclinic Zagreb, Zagreb, Croatia emergency treatment of TDIs.
Introduction: Tooth avulsion is very rare and represents only 0.5–
3.0% of all dental traumas. In most cases it affects maxillary cen- PR05.53
tral incisors and predominantly only one tooth is avulsed. It rep- Orthodontic management of traumatically intruded
resents a great functional and aesthetic problem and treatment
options are challenging especially in cases when replantation can
immature upper pemanent incisor
not be performed. N. JEGAT1, A. CHOKRON2 & A. KAMOUN2
1
Case reports: A 13-year-old boy was referred to our Dental Poly- Odontologie Pediatrique, Paris Descartes University, Montrouge,
clinic for management of missing both central maxillary incisors, France; 2Orthodontic, Paris Descartes University, Montrouge,
lost due to the bicycle accident. The patient suffered avulsion of France
both maxillary central incisors (11 and 21) with fractured apical Introduction: Dental injuries are probably the most common oro-
third of the roots left in their alveoli. The day following the facial injuries. Intrusion is characterized by the displacement of a
tooth impacted into the alveolus and the alveolar bone by an axi- PR05.55
ally directed impact. This injury is accompanied by comminution
Alveolar trauma with dental replacement and alveolar
or fracture of the alveolar socket.
Case report: Here, we describe the management of an 7.5-year- bone maintenance for dental implant positioning. A
old patient who suffered intrusion of her immature permanent case report with a 7 year follow-up
central incisor following an accident. After 3 months attempt for L. R. ARZAMENDI1, S. AYALA1, H. GOMEZ-LLANOS2, J.
spontaneous re-eruption of this immature tooth, and in the ALVELAIS3 & E. SERENA1
1
absence of any signs of necrosis or resorption of the tooth, we Odonthology, CISALUD UABC, Tijuana, Mexico; 2Odonthology,
opted to facilitate re-emergence. Therefore, we did the choice to UABC, Tijuana, Mexico; 3Medicine, CISALUD UABC, Tijuana,
an orthodontic repositioning combining expansion and extrusion Mexico
of the tooth to her right and ideal position. This management
Introduction: Dental trauma is the second cause of attention in
was decided according to three main goals: aesthetic, endodontic
odontopediatrics; it is not characterized by and only etiologic
and bony. It aims at giving back the patient a nice smile, allow-
mechanism, nor do they follow a predictable pattern towards
ing and facilitating endodontic treatment if needed later one on
extension.
this tooth, keeping satisfactory alveolar bone and periodontal tis-
Studies done by Andreasen and Ravn (1972) informed that about
sues if implant treatment has to be considered in the future.
30% of children minor to 6 years of age have suffered temporal
Comments: The tooth is regularly radiographically and clinically
dental trauma.These lesions in temporal dentition can have
observed to control root development and intercept potential
important long term consequences in a biological and emotional
endodontic complications. The first six months of management
point of view. The prognosis of the lesion will depend on the
are shown in this presentation.
good resolution in the emergency room consultation.
Case reports: This is a case of a 13 year old patient that presents
PR05.54 after alveolar trauma due to a fall. Avulsion of dental piece 21
The role of paediatric dentists in the management of and intrusion of dental piece 11 in alveolar bone was found. The
a complex trauma case avulsion dental piece was stored in milk 12 h prior to medical
attention. Conduct treatment was done on piece 21 and reposi-
S. E. DUMAIS PELLETIER & D. D. VU
tioned in infraocclusion for cast during a 10 week period. End-
Paediatric Dentistry, CHU Ste-Justine/University of Montreal,
odontic treatment was done on both pieces and external
Montreal, QC, Canada
reabsorption was presented, implant replacement was done after
Introduction: Considerations for management of complex oro- bone development. After the placing of bone graft we waited
facial traumas include severity of the injuries, aesthetics and 6 months for its adaption and two dental implants developed the
financial resources. Paediatric cases present additional challenges function and aesthetics of the patient.
due to the on-going growth and development of oro-facial struc- Comments: The adequate management and follow-up of trauma
tures. simplifies future of the patient which is important during the
Case reports: A 15 year old girl with mild attention deficit hyper- development stage. This case presented has a multidisciplinary
activity disorder was referred to us following an oro-facial 7 year follow-up. During the case follow up the patient was sub-
trauma from a scooter accident. Extra-oral examination revealed mitted to conservative treatment achieving a good development,
irregularity of the anterior mandibular border, limited mouth function and aesthetics.
opening and lacerations of the lower lip and chin. Intra-oral
examination revealed gingival lacerations, hematoma of the floor PR05.56
of the mouth, unstable occlusion with an anterior open-bite, deb-
onded lingual retainer and grade III mobility of tooth 42. Multi- The use of regenerative endodontic technique for an
ple dental fractures were observed including eight uncomplicated unusual presentation of non-vital immature permanent
crown fractures, complicated crown fractures of teeth 11/21, incisor
uncomplicated crown-root fractures of 26/27 and a complicated W. ALMUTAIRI & M. DUGGAL
crown-root fracture of 46. Radiographic examination confirmed Paediatric Dentistry, University of Leeds, Leeds, UK
multiple dental fractures and revealed bilateral intra-articular
condylar fractures, right parasymphyseal fracture extending Introduction: A rare sequelae of trauma to primary teeth is par-
through the 42 ligament space. Multidisciplinary emergency man- tial or complete arrest of root formation of the developing per-
agement of the traumatic injuries was undertaken under general manent successor. An immature root development of such a
anaesthesia including reduction of mandibular fractures, pulpoto- tooth is challenging to manage particularly if there is a decreased
mies of exposed pulp tissue with mineral trioxide aggregate and crown/root ratio. Regenerative endodontic therapy can be con-
temporary restorative treatment. Discoloration of 11/21 was sidered as a treatment option for immature non vital permanent
noted at post-operative appointment. Oral rehabilitation with teeth because it could lead to some further root development.
composite restorations done by the paediatric dentistry team pro- Case report: An 8-year-old girl was referred for management of a
vided the patient with an aesthetic interim result whilst awaiting non-vital, immature UL1 with uncomplicated crown fracture and
completion of facial growth and endodontic development. chronic periodontal abscess. History taking revealed a previous
Comments: Although different specialists are involved in the dental traumatic injury to ULA about 10 months ago but the
management of complex trauma cases, paediatric dentists are at history and type of trauma was not clear. Clinical examination
the epicentre of the multidisciplinary team and should oversee revealed partially erupted UL1 with a buccal periodontal abscess
the treatments. and uncomplicated crown fracture. Radiographic examination
revealed arrested root development of UL1 with unfavourable
crown/root ratio and a periradicular radiolucent lesion. Regener-
ative endodontic treatment under local anaesthesia was the most
appropriate treatment option for this patient. This was carried
out with the use of a two antibiotic mixture; ciprfloxicillin and
metronidazole. Bleeding was induced and clot formation was
obtained before coronal seal was placed. Review appointment
has shown resolution of apical radiolucency and bone formation (2) Leaving the tooth for spontaneous re-eruption. Intruded pri-
apical to the tooth. Clinically, there are no signs or symptoms of mary incisors usually re-erupt within 3 weeks, though re-eruption
infection. starting after several months has been reported.
Comments: Further review appointments will be arranged to As yet, the mechanism that allows re-eruption of the intruded
assess changes in root width and length. tooth is unknown. In our experience, there are cases in which the
primary incisor fails to re-erupt even years after the intrusion.
PR05.57 Aim: To present 4 cases in which the intruded tooth had been
extracted shortly close to the eruption of the permanent successor
Molar incisor hypomineralization: two case reports and present the outcomes.
L. P. CHEN & S. J. CHEN Case reports: The characteristics of 4 cases of intruded primary
Gung Memorial Hospital, Taipei, Taiwan incisors are reported which all showed different sequelae as fol-
Introduction: Molar Incisor Hypomineralization (MIH) is a hypo- lows: irregular resorption of the root; irregular resorption of the
mineralization of systemic origin of one to four permanent first root and enamel; complete resorption of the root and partial
molars frequently associated with affected incisors.The etiology resorption of the enamel and irregular resorption of the root and
of MIH is unknown, a number of possible causes, such as envi- enamel.
ronmental changes, exposure to dioxin, respiratory diseases and Comments: We wish to highlight the potential risk of leaving such
oxygen shortage of the ameloblasts. Enamel defects can range intruded teeth until the eruption of the permanent successors.
from mild opacities, white or yellow in color, to severe enamel Extraction at that time may interfere with the development of
involvement which breaks down rapidly after eruption. the labial bone plate.
Case reports:
Case 1 is a 6-year-old healthy boy suffered from pain over lower PR05.59
right posterior tooth. During clinical examination, all first perma- Complete root resorption as a consequence of
nent molars presented with opacities. The radiographs showed
teeth 36 and 46 were affected by deep caries lesions near the
multiple avulsion
N. IVANČIĆ JOKIĆ1, D. BAKARCI C 1 & R. GRZI
C2
pulp. Following removal of carious tissue and porous enamel, all 1
teeth were restored with glass ionomer cement and SSC. Paediatric Dentistry, School of Medicine, University of Rijeka,
Case 2 is a 7-year-old boy referred due to severe caries of perma- Rijeka, Croatia; 2Prosthodontics, School of Medicine, University
nent molar. His medical history was ALL during remission stage. of Rijeka, Rijeka, Croatia
Clinical checkup and radiographs showed large cavity of teeth Introduction: Tooth avulsion is a serious dental injury. The blood
26, 36, 46 with cusp breakdown, and opacity of tooth 16. Try to supply of pulp is interrupted and periodontal ligament cells are
perform indirect pulp capping over teeth 26 and 46, composite exposed to external environment. In this case risk of complica-
resin restoration of tooth 46 and preventive sealant of tooth 16. tions is high. Complications such as pulp necrosis and external
1-year follow up of case 1 and 6-month of case 2 reveal that the root resorption are common. In this case reports we described a
restorations are intact and symptoms free. multiple avulsion of permanent teeth that resulted in complete
Comments: Treatment options of MIH are case dependent, range root resorption.
from preventive fissure sealants, composite restorations, stainless Case reports: A 13-year old female visited a Clinical Hospital
steel crowns, casting restorations, even to extraction. Early inter- Center two day after avulsion of three permanent upper incisors.
vention is important to prevent further undesirable complica- Teeth were replanted and splinted approximately one hour after
tions. injury by oral surgeon in emergency. Splint was rigid and inap-
propriate placed on gingival margin. Gingival and oral mucosa
PR05.58 laceration was present too. In our Clinic first treatment was a
correction of rigid splint. After splinting period of 15 days, on
Consequences of non-eruption of intruded primary teeth 12, 11 and 21 was performed a root canal treatment with
incisors obturation with gutta-percha. A X-ray follow-up examination
A. SHMUELI AVIV & G. HOLAN show a external root resorption on all teeth, four months after
Pediatric Dentistry, Hebrew University-Hadassah School of Dental treatment. Six months later a periradicular surgery was per-
Medicine, Jerusalem, Israel formed. The root resorption was continued and 60 months after
Introduction: Two treatment options for intruded primary incisors injury teeth 12 and 11 was extracted and replacement with space
are suggested: maintainer.
(1) Extraction – when the intruded tooth is pushed against the Comments: Although the teeth was replanted on the time, some-
bud of the permanent successor. times is difficult to prevent a root resorption and loss of teeth.
Orthodontics and Craniofacial Growth and Development Poster Session – PR06
Orthodontics and Craniofacial Growth and

Development Poster Session – PR06
PR06.01 Results: It was found that a short duration of breast-feeding
(never or ≤6 months) was directly associated with posterior cross
The next big thing in clear aligners therapy bite (OR = 3.13; P = 0.031), maxillary atresia (OR = 1.63;
S. KANDIL
P = 0.038) and higher probability of developing pacifier-sucking
K Line Europe GmbH, Dortmund, Germany
habits (OR =4.21; P < 0.001). Children who were bottle-fed for
Background: 3D printing has significantly improved dental indus- over 18 months had a 1.45-fold higher risk of nonmesial step
try by fabricating best-fit oral appliances with wide range of occlusion and a 1.43-fold higher risk of a class II canine relation-
hybrid materials and variable properties. Clear aligners could ship compared with those for 6–18 months. A prolonged digit-
provide proper teeth alignment painlessly, not too lengthy nor sucking habit increased the probability of an anterior open bite,
costly and effortless compared to conventional braces. The use of while a pacifier-sucking habit associated with excessive overjet
3D printing in clear aligners is limited to fabricating supporting and absence of lower arch developmental space.
models on which thermoformable sheets are pressed. This process Conclusions: Breastfeeding duration was shown to be associated
is lengthy and requires human finishing and some material waste. with the prevalence of posterior crossbite, maxillary atresia in the
Aim: To exploit 3D printing technology in producing clear align- deciduous dentition and development of a pacifier-sucking habit.
ers with easier setup and less time and material waste. To intro- Non-nutritive sucking habits were also found to affect occlusion.
duce new aligners with properties of the currently used ones and
with minimum human intervention in their fabrication. PR06.03
Design: Specialized software made the orthodontic tooth move-
ments on digital models. Then, the gross movement was subdi- Abstract withdrawn
vided onto submodels. A splint was designed, virtually
smoothened and finished as a negative replica for each submodel PR06.04
mimicking the fitting surface of the teeth. The splint was 3D Management of multiple supplemental mesiodens - a
printed with plastics in ≤1 mm thickness. multidisciplinary approach
Results: Aligners were fabricated in rigid and soft forms. Rigid S. R. CHERUKU1, D. V. REDDY2 & L. BUNETI3
aligners had reasonable strength but low elasticity, while the soft 1
Department of Pedodontics and Preventive Dentistry, Sri Sai
ones had better adaptation and resistance to fracture but less College of Dental Surgery, Vikarbad, India; 2Department of
strength. The aligners were not clinically tested and still subject Orthodontics, Sri Sai College of Dental Surgery, Vikarbad, India;
to change. 3
Sri Sai College of Dental Surgery, Vikarbad, India
Conclusion: Aligners could be fabricated with direct 3D printing
with little effort, time, material and human intervention. Introduction: Mesiodens is a supernumerary tooth present in the
Together with material and 3D printing technology providers, we mid line between the two central incisors. It usually results in
may improve the overall properties of the aligners and substitute oral problems such as malocclusion, food impaction, poor aes-
the current technique. thetics and cyst formation. Etiology remains unclear and could
be multifactorial. However, excessive proliferation of the dental
PR06.02 lamina, dichotomy of the tooth bud, hereditary and environmen-
tal factors are tested as possible etiology.
Association between feeding duration, non-nutritive Case reports: A 10-year-old boy reported seeking treatment for
sucking habits and occlusal characteristics in Chinese his unesthetic smile. Clinical examination revealed two supple-
children mental supernumerary teeth between maxillary central incisors
C. XIAOXIAN1, G. LIHONG2 & X. BIN2 (Mesiodens). Presence of these mesiodens resulted in facial and
1
Department of Pediatric Dentistry, First Dental Center, Peking distal displacement of teeth #11, 21 and cross bite of tooth #22.
University School and Hospital of Stomatology, Beijing, China; Extraction of supernumerary teeth resulted in 12 mm space
2
Department of Pediatric Dentistry, Peking University School and between maxillary central incisors. Orthodontic treatment was
Hospital of Stomatology, Beijing, China started with a removable appliance containing finger spring for
tooth #11and Z-spring for crossbite correction of tooth #22. The
Background: Both maternal breast-feeding for a short period and teeth were then strapped up with a 0.018 _Roth appliance. Initial
non-nutritive sucking habits may be related to occlusofacial aligning of the incisors was done with a 0.016_ NiTi wire, fol-
abnormalities as environmental factors. lowed by 0.016 Australian arch wire. The teeth were brought to
Aim: The aim of this study was to assess the effects of feeding the occlusal plane and redistribution of the spaces was done with
duration and non-nutritive sucking habits on the occlusal charac- NiTi open coil springs. Retroclination of incisors reduced the
teristics in 3–6-year-old children in Bejing city. interdental spaces.
Design: This cross sectional study was conducted via an examina- Comments: Early diagnosis and prompt treatment for patients
tion of the occlusal characteristics of 734 children combined with with supernumerary teeth is recommended. This would allow suf-
a questionnaire completed by their parents/guardians. The fol- ficient space for the erupting permanent teeth. Influencing factors
lowing variables were evaluated: deep overbite, open bite, ante- are the number, type of supernumerary teeth, amount of dis-
rior cross bite, posterior cross bite, deep overjet, terminal plane placement of adjacent teeth, developmental stages of adjacent
relationship of the second primary molar, primary canine rela- permanent teeth and space available within the dental arch.
tionship, atresia and spacing.
PR06.05 PR06.07
Management of pre-occlusal tooth eruption with Treatment of adolescent patients with missing
short root permanent teeth and multidisciplinary therapy with
I. MERGEN & Z. CEHRELI implants insertion: 5-year prospective study
Paediatric Dentistry, Hacettepe University, Ankara, Turkey T. DOSTALOVA, P. KRIZ, J. PAPEZ, L. STEPANEK, A.
POLASKOVA & J. FEBEROVA
Introduction: Teeth at the phase of pre-occlusal eruption with
Department of Stomatology, Charles University, 2nd Faculty of
inadequate root length may fail to tolerate trauma from normal
Medicine and Motol University Hospital, Prague, Czech Republic
masticatory load. This case report presents the use of a custom
essix appliance to protect mandibular permanent premolars dur- Background: Dental care of adolescent patients without own teeth
ing function and maintain normal root development. is not easy. Anthropological age determination for implant inser-
Case report: A 7-year-old boy with congenital kidney disorder tion is important and prosthodontic methods can be often
was referred to the paediatric dentistry clinic for the management applied only after multidisciplinary therapy.
of carious lesions and orthodontic evaluation. The mandibular Design: Prospective study of 73 implants was prepared. The
premolars were at the stage of preocclusal eruption, with about patients at implants surgery ranged from 16 to 23 years of age.
one-third of their roots developed, as verified by panoramic radi- The aesthetic appearance was checked, loss of bone marginal
ography. A custom essix appliance overlaying the entire mandib- support, patient satisfaction, and quality of life after patient
ular teeth was fabricated to protect the developing roots from rehabilitation. Also, the effect of microthread on the maintenance
possible detrimental effects of masticatory load. Following of marginal bone level was evaluated. No remarkable complica-
6 months of appliance therapy, the root length of premolars tions were found during the observation period.
increased to about one-half of expected final root length without Results: Aesthetic optimum was obtained mainly after trauma.
clinical symptoms. Shape and size compromise was necessary in 18%. The influence
Comments: Occlusal trauma to an erupting permanent tooth may of fixture diameter on marginal bone level ranged from +0.34
affect proper root development. Here, the custom essix appliance (SD 0.40) (3 mm fixture diameter) to +0.40 (SD 0.33) (4.5 mm
provided a practical and cost-effective solution to enable root fixture diameter). The amount of peri-implant bone was signifi-
development uneventfully. cantly lower with the 5 mm diameter fixture 0.10 (SD 0.25).
Marginal bone-level increase for different heights of microthreads
PR06.06 from 0.18 (SD 0.43)-microthread 0.14 mm, 0.34 (SD 0.37) micro-
thread 0.16 mm; 0.04 (SD 0.35) microthread 0.22 mm. All twelve
Impact of three different topical agents on enamel Wilcoxon signed-rank tests show significant differences between
demineralization around orthodontic brackets: a QoL score before and after implantation, namely P < 0.05,
clinical study except for the one comparing difficult taste sensation before and
A.M. ABDELLATIF1, S. M. HAMMAD2 & A. M. FOUDA2 after implants were applied, namely P = 0.389.
1
Pediatric Dentistry, Mansoura University, Mansoura, Egypt; Conclusions: Multidisciplinary treatment planning is directly con-
2
Orthodontics, Mansoura University, Mansoura, Egypt nected with skeletal maturation. More emphasis has to be placed
to CAD CAM techniques. Multidisciplinary therapy with
Background: One of the serious side effects of fixed orthodontic
implants insertion may result in a much better quality of life.
appliances is the development of white spot lesions.
Aim: The aim of this study was to evaluate the in vivo effects of
three topical protecting agents on enamel demineralization PR06.08
around orthodontic brackets at two time intervals. Oral communication disorders and oral health status
Design: Twenty-eight patients, 13–16 years (mean: of children in daycare
14.06 1.73 years), scheduled to have four first premolar teeth L. D. B. C FONTES1, F. C. D. FREITAS2, A. S.
extracted, were divided into four groups: three experimental and NASCIMENTO3, R. B. DA SILVA3, J. B. MARQUES4 & N. S.
one control. SeLECT-DefenseTM, (Lubbock, TX, USA), Clinpro DE LIMA1
fissure sealant (3M ESPE-USA) and White Varnish with TCP 1
Clınica e Odontologia Preventiva, Universidade Federal de
(3M ESPE-USA) were applied to tooth surfaces around brackets Pernambuco, Recife, Brazil; 2Odontologia, Universidade Estadual
in the experimental groups. After one month, two premolars of da Paraıba, Campina Grande, Brazil; 3Faculdade de Odontologia,
each patient; (14 premolars from each group) were extracted. The Universidade de Pernambuco, Camarajibe, Brazil; 4P os Graduacßa~o
teeth were stored in a refrigerator in flasks containing gauze - Mestrado, Universidade Estadual da Paraıba, Campina Grande,
dampened with saline. After two months, the other fourteen pre- Brazil
molars form each group were extracted and treated similarly.
Demineralization of enamel around the brackets was evaluated Background: Communication disorders have a significant detri-
by a cross- sectional microhardness method with an indentation mental effect on a child’s development, affecting educational,
at two positions (occlusal-cervical), 10 lm depth. social and psychological progress.
Results: There was no significant difference between the microh- Aim: Check the possible association between oral communication
ardness of either the occlusal or the cervical halves in the two disorders and oral health status of children linked to daycare in a
times tested. Statistically significant differences were determined city of northeastern Brazil.
between each of the treatment and control groups (P < 0.001). Design: This was a cross sectional study, quantitative and induc-
However, no statistically significant differences were detected tive, with descriptive and inferential analysis of the data, adopt-
between the experimental groups (P < 0.05). ing, for such a CI of 95%.A face to face interview with
Conclusion: The findings from the present study highlight the application form and physical examination intraoral represented
value of the usage of any of the three protecting agents to the instruments used in data collection. The total sample consisted
decrease demineralization around orthodontic brackets. of 374 children aged from two to 5 years, enrolled in five public
day care centers, who met the inclusion and exclusion criteria and
determined by a sample calculation with predefined parameters.
Results: These children had a mean age of 4.1 years, 59.9% male, no apparent facial anomalies with normal-bite, and group B
with a mean dmft of 3.27, 70.1% carriers arch type I Baume for included 20 subjects (13 boys and 7 girls) with anterior crossbite.
the primary dentition and with a history of deleterious oral hab- Three-dimensional facial images were acquired by using the por-
its, 59.9% of carriers anterior open bite, 79.9% no change in table FaceSCAN3D System from each child at the first visit and
labial or lingual frenulum. A significant association 6 months later,and imaged matching point on auricula. During
(P < 0.01) between the anterior open bite and changes in the lin- this period, children in group B completed crossbite correction.
gual frenulum and the phonetic and phonological deviations, for Data were analyzed using Mann-Whitney Test.
individuals assessed. Results: The change of facial morphology was most evident in
Conclusions: There was an association between disorders of the lower third of the face in group B, significant differences
speech and language and some conditions related to oral health. occurred in the area of lip (up lip: 2.75 0.44 mm, z = 3.16,
P < 0.01, low lip: 2.40 0.75 mm, z = 2.17, P< 0.05,) at the
PR06.09 end of observation after crossbite correction, whereas group A
showed no obvious changes in these 6 months.
Displaced permanent canines with associated Conclusions: Early crossbite correction effectively improved chil-
disturbance of primary canines: a case reports with dren’s facial contour. The facial changes occurred mainly in the
CT and literature review area of lip. The three-dimensional facial morphometry allowed
M. C. WANG & W. Y. SHIH noninvasive evaluation of facial changes at any time during and
Taipei Veterans General Hospital, Taipei, Taiwan after orthodontic treatment.
Introduction: The two main theories of canine impaction are the

guidance theory (local environment) and genetic theory. Extrac-
PR06.11
tion of deciduous canines has been proposed as a preventive Development of sucking function of infants with cleft
treatment. The reasons for removing primary canines as an effec- lip and palate
tive option are (1) to remove the inflammatory tissue or primary Y. SANO1, H. OGURA1, T. KONDO1, S. KONDO2, H.
canine and (2) to decompress any cystic lesions. However, few NAKAHARA1 & T. TAMURA1
studies have presented the exact relationship between apical path- 1
Pediatric Dentistry, Asahi University, Mizuho City, Japan;
osis of primary canines and the displaced permanent canines. 2
Clinic of Cleft Lip and Palate, Fujita Health University, Toyoake
Case report: In this report, we provide some CT images of lesions City, Japan
of primary canines hindering permanent canine eruption.
An 11-year-old boy was referred for management of canine impac- Background: Cleft lip and palate (CLP) is the most frequent cleft
tion. He received endodontic treatment of that predecessor malformation seen in maxillofacial region and morphological
4.5 years ago. CT reports showed an enlarged apical lesion of the changes have been observed when evaluating treatment. How-
primary canine hindering the dental follicle of the permanent canine ever, few studies were reported about changes of oral function.
to the palatal side while the root remained over the buccal side. Aim: The aim of the present study was to investigate changes in
Another 11-year-old boy was diagnosed with canine impaction. physiological characteristics of sucking function along with per-
The primary canine was prior-root-canal-filled 3.5 years ago. CT ioral muscles’ activity and sucking pressure in infants with CLP.
examination revealed that the permanent canine root tip was Design: Twelve infants with unilateral CLP underwent to a chei-
located bucally while the crown was pushed palatally by the loplasty procedure at the clinic of cleft lip and palate at Fujita
radiolucency of the primary canine. Health University Hospital. Measurements were performed
Comments: Infection of primary canines should be monitored before, 1 week and 3 months after the cheiloplasty. Electromyo-
carefully. Apical lesions may hinder the eruption process of per- gram (EMG) findings from bilateral temporal (L-R, TM), masse-
manent canines. Thus, extracting infected primary canines can be ter (L-R, MM) muscles, as well as oris (OM) of healthy side and
an effective preventive treatment. Some other etiologies, such as suprahyoid (SM) muscles were recorded. Values for sucking pres-
genetics and other local factors, however, require different inter- sure and EMG findings obtained from healthy infants at the age
ventions. Furthermore, the possible interaction mechanisms of of 3 months were used as a control.
permanent dental follicles and primary apical pathosis are dis- Results: Sucking cycle time and negative pressure duration during
cussed in more detail in this report. sucking were significantly longer following the operation. Activi-
ties on both side of TM, MM, OM and total muscle activities
were significantly increased after operation. Sucking pressure also
PR06.10 significantly increased at 3 months after the cheiloplasty.
Three-dimensional assessment of facial soft-tissue Conclusions: Sucking cycle was increased following the operation,
modification in children with crossbite before and which seemed to be effective for formation of negative intraoral
after early correction pressure. However, as EMG activity of SM for the CLP was still
J. LI, H. LIU, M. QIN, Y. WANG & Y. C. SUN small after the operation, indicating that tongue movements of
School and Hospital of Stomatology, Peking University, Beijing, infants with CLP during sucking was weaker than in full-term
China normal infants.
Background: Three-dimensional computerized system with land-

mark representation of the soft-tissue facial surface allows nonin-
vasive and fast quantitative study of facial change.
Aim: The aim of the present investigation was to quantify
changes in soft-tissue facial morphology of cross-bite children
before and after correction in comparison with children without
any malocclusion.
Design: Thirty four children 3–4 years old treated in pediatric
department of Peking University Hospital of Stomatology from
2013 to 2014 were recruited in this study and divided into two
groups. Group A included 14 subjects (6 boys and 8 girls) had
PR06.12 PR06.14
Using dental age by estimation chronological age in Assessment of functional therapy influence on facial
Czech children aged 3 - 18 years proportions
K. GINZELOVA1, T. DOSTALOVA1 & H. ELIASOVA2 A. MUNTEAN1, A. MESAROS2, C. COSTEA1, D. FESTILA3 &
1
Deparment of Stomatology, Charles University, 2nd Faculty of M. MESAROS1
1
Medicine and Motol University Hospital, Prague, Czech Republic; Paediatric Dentistry, University of Medicine and Pharmacy
2
Institut of Criminalistics Prague, Prague, Czech Republic ‘I.Hatieganu’, Faculty of Dental Medicine, Cluj Napoca, Romania;
2
Dental Propaedeutic and Aesthetics Department, University of
Background: The Demirjian methods to determine the dental age
Medicine and Pharmacy ‘I.Hatieganu’, Faculty of Dental
are based on analysis of the orthopantograms. Dental age estima-
Medicine, Cluj Napoca, Romania; 3Orthodontics, University of
tion is based on the establishment tooth development stages.
Medicine and Pharmacy ‘I.Hatieganu’, Faculty of Dental
Aim: The purpose of this study was to assess the accuracy of estima-
Medicine, Cluj Napoca, Romania
tion the dental age by Demirjian in the use of his all four methods.
Design: 505 Czech healthy boys and girls aged 3–18.99 were Background: Presently facial aesthetics is synonymous with social
radiographic examined at the Charles University, 2nd Medical acceptance and success.
Faculty, Department of Stomatology, Prague. It was mentioned Aim: Aim of this study was to evaluate the effect of functional
the factors influence of underlying diseases on the accuracy of therapy on facial aesthetics, in class II/1 patients, treated in
the estimate dental age. For statistical evaluation used descriptive mixed dentition.
statistics to compare deviations of the mean values chronological Design: Evaluate facial proportions on standard orthodontics pho-
and dental age in each age group. tographs for 60 patients with class II/1 malocclusion, aged between
Results: The results of difference dental age - chronological age 6 and 12 years, treated with functional appliances. We used
are not significant in both genders only by both Demirjian 7 anthropometric index (Farkas and Munro, 1987): F2-Lower face-
teeth methods of 1973 and 1976. Therefore they may be most face height, F3-Mandibulo-face height, F4-Mandibulo-upper face
appropriately used for forensic age estimation. They are shown height, F5-Mandibulo-lower face height. This items were selected
standard deviation difference in different countries. because functional treatment act mainly on lower an in a smaller
Conclusions: Demirjian original method 7 teeth 1973 and Demirj- ration on the middle area of the face. Data were statistically analy-
ian revised method 4 teeth 1976 appear to be the best methods sed and the results were considered significant for P < 0.05.
for calculating the dental age of healthy Czech children of both Results: When the treatment initiate the difference significant
genders. This research was supported by IGA MZCR 13351-4 and between the 2 genders was for F4. The mean value for F4
00064203 (FN Motol). (0.83 0.17) for girls was higher than the value F4 (0.71 0.07)
for boys (P = 0.001). At the end of the treatment the differences
PR06.13 according to gender were not significant related to analysed indi-
ces. For the group 6–9 years the initial and the final values dif-
Maximal interincisal distance in healthy children in fered significantly for F4 (P = 0.001) and F5
Istanbul (P < 0.001). For the group 9–12 years the differences between ini-
F. SEYMEN1, M. KORUYUCU2 & K. GENCAY2 tial and the final values were significant for F4 (P = 0.006) and
1
Department of Pedodontics, Istanbul University, Istanbul, Turkey; F5 (P = 0.005).
2
Istanbul University, Istanbul, Turkey Conclusions: Functional therapy must be used during active
growth period in order to achieve a well-balanced face in har-
Background: Assessment of mandibular function is performed by
mony with muscular complex. Patient compliance is essential in
means of several diagnostic tests. One of the elementary tests to
functional therapy success and for this reason treatment can initi-
evaluate tmj function is measurement of the range of motion of
ate in the second period of mixed dentition.
the joints during maximum mouth opening. A reduced mouth
opening capacity may be one of the first clincal signs of TMJ
involvement. PR06.15
Aim: The purpose of this study was to create age related percen- 3-D image measurements of facial growth in children
tiles for the maximal inter-incisal distance of healthy children. with thalassaemia
Design: Children who fulfilled the following criteria were included
K. ALMUKHTAR1, J. FEARNE1 & L. ZOU2
in this study: sound and immobile primary maxillary and man- 1
Centre Oral Growth and Development/Paediatric Dentistry,
dibular central incisors, no caries, no history of facial and dental
Queen Mary University of London/Barts & The London School of
trauma, no anterior open-bite and no restorative materials that
Medicine and Dentistry, London, UK; 2Clinical Oral Biometric,
influenced the incisal edges, and no orthodontic appliances that
Queen Mary University of London/Barts & The London School of
could influence the position of the central incisors. The interinci-
Medicine and Dentistry, London, UK
sal measurements were performed with metallic caliper and also
malocclusions were recorded for all children. Oneway Anova test, Background: Thalassaemia is a Haematological disorder that
Tukey HDS test, Tamhane’s T2 test and Student t test were used affects the amount of production of the haemoglobin leading to
for statistical analysis. chronic anaemia. This may lead to hyperactivity of the bone
Results: The study population comprised of 1059 (569 M, 490 F), marrow and bone expansion, consequently facial bones grow into
3-to 15-year-old (mean age 8.82 3.06) children. The mean so called thalaseamia faces. These facial features are well recogni-
score of maximal inter-incisal distance was found 33.24 5.54 sed but poorly documented or quantified.
(females); 33.32 5.71(males). The mean score of maximal inter- Aims: This study looked at 3-D facial changes in children with
incisal distance was found 28.63 4.34 for 3–5 years; thalassaemia using a facial scanner based on stereo-photogram-
33.52 4.84 for 6–11 years; 37.35 5.52 for 12–15 years. Sig- metry (3DMD, USA), as a non-invasive method, and to assess
nificant differences were found between age groups and between whether these changes can be used as an indication for further
malocclusion groups (P: 0.001; P < 0.01). medical intervention.
Conclusion: The result of this study indicated that positive rela- Design: A total of 26 children with thalassaemia (14 thal. major
tionship between the maximum mouth opening and age and mal- and 12 thal. intermedia) were included in the study. The ages at
occlusion. the first scan are from 7 months to 15 years 7 months. Scans
were carried out once in every 6 months using the facial scanner. high. Facial neurofibroma is commonly associated with osseous
The consecutive 3-D images were superimposed using software changes and can cause severe disfigurement.
“Cloud” and the differences between the images at three time Case report: An 8 year-old girl was referred into the dental
points were measured on the areas of frontal, nasion, nasal tip, department by the Head and Neck Surgeon. A comprehensive
cheeks, and chin. dental examination was difficult due the presenting enormous left
Results: The initial results of I year from three cases (2 thal cervicofacial neurofibroma and a macroglossic tongue. Asymme-
Major and 1 thal intermidian) showed area growth at frontal: try features was evident on the left side with hemi-facial hyper-
1.7–3.2 mm, nasion: 1.5–2.4 mm, nasal tip: 1.8–2 mm, cheek trophy. A tracheostomy (and gastrostomy) was in situ. Dental
prominence: 0.3–1.7 mm and chin 2.6–4.3 mm. examination was difficult and it was almost impossible to manip-
Conclusions: The 3-D facial scans, as a non-invasive tool, is capa- ulate the left sided soft tissues. Gross calculus deposits were evi-
ble to accurately identify facial growth, further work with a con- dent covering the whole dentition. The OPG showed severe
trol group is underway to assess clinical indications for its use. crowding, impaction and immature roots of the upper left denti-
tion. The maxilla and mandible showed severe hypoplastic intra-
PR06.16 osseous lesions with an increased risk of mandibular fracture.
The aim of our treatment, in this difficult case, was to deliver
The management of a patient with fibrodysplasia intensive oral hygiene and scaling and to ensure the patient is
ossificans progressiva suffering from a dental abscess caries free.
F. E. FLETCHER, S. THILLAINATHAN, S. PAREKH & G. Comments: This case highlights the role of a paediatric dentist in
ABOU-AMEIRA managing the difficulties associated with rare complex medical
Maxillofacial and Dental Department, Great Ormond Street conditions.
Introduction: Fibrodysplasia ossificans progressiva (FOP) is an PR06.18
autosomal dominant genetic disorder which leads to bone defor- The mouth breathing children, their characteristics
mation and heterotrophic ossification of connective tissues. FOP and the possible relation with their academic
affects 1 in 2 million people with the ossification of connective
tissue beginning in the first two decades of life. Anaesthetic man-
performance
agement for FOP patients is challenging. These patients are high R. M. NOGUEIRA1, A. J. NOGUEIRA1, D. B. CORREA2 & M.
risk for general anaesthesia (GA) due to their complicated airway C. MARTINS2
1
management. Flare ups may occur spontaneously but can be Pedodontic, Federal University of Par em, Brazil; 2Superior
a, Bel
precipitated by the injection of local anaesthetic during dental School of Amazonia, Belem, Brazil
procedures. Backgound: The mouth breathing syndrome is an inadequate way
Case report: MB, 4-year-old girl was referred to the department of breathing that leads to a series of changes such as body pos-
for the management of severe dental pain from the lower left ture, respiratory, behavioral and functional changes on the entire
quadrant. MB had an abnormality of the ACVR1 gene, which Stomatognathic System. In students, this inadequate breathing
classically presents in patients suffering with FOP. Clinical exam- this syndrome, acting on the maxillary and dental processes, and
ination revealed a dental abscess associated with the LLE, and their disorders, as well as alerting the childrens’ teachers and par-
caries affecting the LRD secondary to a highly cariogenic diet. A ents about the learning alterations that may occur. The data con-
multi-disciplinary approach was undertaken for MB to have den- tained refer to the research executed in a municipal public school
tal treatment under GA for the extraction of the LLE and resto- from Belem-Brazil.
ration of the LRD. Preformed metal crowns were placed Aim: The research aimed to identify carriers of the Mouth
prophylactically on the remaining deciduous molars. Due to the Breathing Syndrome at the public schools of Belem and the pos-
patient’s complicated medical condition and the risk of surgery, sible influence in their academic performance, it also aimed to
the GA was safely administered by a specialised anaesthetist. Fol- alert their parents about the possible interferences and the ade-
lowing dental treatment, MB will be reviewed annually within quate treatment.
the department to reinforce preventative advice and monitor den- Design: The selection was a visual and clinical examination per-
tal development. formed at the schools. The students data and other alterations
Comments: This case highlights the important role of the paediat- that characterized them as mouth breathers were annotated on
ric dentist in liaising with all multi-disciplinary team members for specific charts. After that, a questionnaire regarding the students
patients with complex medical conditions. Prevention of dental performance and behavior was submitted to the parents and
disease is paramount in such cases. teachers.
Results: Once the syndrome was detected, the parents were
PR06.17 alerted to the problem when 237 students from 4 to 11 years old
were examined. 79 carry the Mouth Breathing Syndrome corre-
An interesting case of an enormous cervicofacial sponding to 33.3% of the examined patients. 29% of the patients
neurofibroma with the syndrome presented a regular academic perfor-
S. THILLAINATHAN, F. FLETCHER & U. DEVALIA mance,62% presented a good academic achievement and 9% pre-
Great Ormond Street Hospital, London, UK sented insufficient academic performance.
Introduction: Neurofibroma is a benign tumour that originates Conclusions: There is a relation between the presence of the Syn-
from either nerve sheath cells or subcutaneous peripheral nerves. drome and the academic performance of the examined children,
Large neurofibromatosis, as in this case, can result in functional when identified, we can intervene early contributing to improve
disfigurement and disability. Usually these tumours are present these students0 performance.
from birth and can often progress slowly during childhood. Com-
plete excision of the tumour is usually not possible due to the
infiltrating nature of the vital structures of these tumours. The
risk of neurological and functional destruction upon resection is
PR06.19 Case 2: A 3 years 2 month old child with anterior crossed bite.
The treatment starts with Trainer (EF Class III petit) and bite
Modification of overjet and overbite in children with
elevation with glass ionomer stops and functional education.
tongue thrusting after cementation of palatal buttons Comments: The early treatment intervention used in these3-year-
for the reeducation of the tongue old patients produced facial and occlusal favorable changes and
G. C. CARVAJAL, M. AGUIRRE & S. S. PARROCHIA fast corrections. These modifications can be seen in the mandibu-
Clınica Indisa, Santiago, Chile lar position and the stimulation of the maxillary development.
Background: Tongue thrusting habit is a condition in which the
tongue makes contact with any teeth anterior to the molars dur- PR06.21
ing swallowing. Tongue thrust seems to affect the soft-tissue and Early orthopedic treatment with fixed appliances
dental characteristics causing lip incompetency, mouth-breathing M. G. CASANOVA MERCADO, C. A. FREGOSO GUEVARA,
habit, hyper-active mentalis muscle activity, open-bite, and pro- I. A. VERDUGO VALENZUELA, M. A. ZAMUDIO GOMEZ,
clination of maxillary incisors. M. E. TORRES & M. SALCEDO
The 38.29% of Chilean children in early mixed dentition have Pediatric Dentistry, Universidad Aut
onoma de Baja California,
dentomaxilar anomalies. In one study, the 66% had disfunctional Tijuana, Mexico
oral habits, of which 15% had tongue thrust. And 16% of dento-
maxillary anomalies that produces this habit were diagnosed with Introduction: Hybrid orthopedics, consists in combining the prin-
anterior open bites. ciples and techniques of mechanical orthopedic therapy utilizing
Aim: The present study aims at finding an alternative interceptive fixed devices with heavy forces and applying the fundamental
treatment easy to apply to patients in early mixed dentition with principles of functional therapy, neural stimulation with chewing
anterior open bite due to tongue thrusting in function and rest. oriented therapies and providing the patient with physical ther-
Design: A group of 20 healthy children between 6 and 9 years apy when needed, this will let us optimize the therapies improv-
were selected. The inclusion criteria was early mixed dentition ing results and shortening times.
with anterior open bite only due to tongue thrusting in function Case reports: Male patient, 5.8 years in apparent good health.
and rest. Has a straight facial profile. Intraoral inspection shows an ante-
An oral exam and a Ricketts cephalometric study were per- rior cross bite, super mesial terminal and lingual inclination of
formed. A metallic button was cemented in teeth 1.1 and 2.1. the lower incisors and tendency toward class III malocclusion.
Patients were controlled every two weeks to check for dislodge- Treatment: upper and lower fixed appliances with buccal arms
ment of the button. Measurements were taken after three for traction elastics up to 500 g, accompanied by planas direct
months. tracks. After improving occlusion relations, selective tooth wear
Results: We observed a statistically significant (P < 0.01) decrease is done and diet changes. It’s maintained until adequate incisal
of overjet but there was no decrease of overbite (P > 0.05). The guide is achieved.
interincisive angle increases significantly (P < 0.01). Male patient, 5.2 years in apparent good health. Has a convex
Conclusion: Metallic buttons in palatine of teeth 1.1 and 2.1 indi- facial profile. Intraoral examination revealed a distal terminal
cate to patients the proper position of the tongue allowing reedu- and a large overjet is observed. Cephalometrically presents class
cation in function and rest, correcting anterior open bite. II values for retrognathism. Treatment: upper fixed appliances
with buccal arms for traction elastics, modified in orden to
slightly touch the upper incisors and align them, the lower fixed
PR06.20 appliances is converted into “lipbumper”. Accompanied by selec-
Early treatment in primary dentition of a class III tive tooth wear and diet changes.
malocclusion with the trainer (EF Class III): a cases Comments: The interceptive treatment by orthopedics in early
report ages is more important because the growth potential is greater,
G. C. PIMENTEL1, R. E. SEPULVEDA1 & F. R. FIGUEROA2 shortening treatment times with stable and lasting results.
1
Paediatric Dentistry, University of Chile, Santiago, Chile;
2
Pontifical Catholic University of Chile, Santiago, Chile PR06.22
Introduction: The prevalence of dentomaxillary anomalies in The effects of rapid palatal expansion with facemask
4 year old children in Chile is 33.3%. This is why an early treat- on permanent successor by finite element analysis
ment is recommended in the primary or mixed dentition. The D. H. KIM1, T. J. SHIN1, H. H. SON2, S. H. LEE1, C. C. KIM1
main objective is to improve the dental and skeletal development & K. T. JANG1
1
before the eruption of the permanent dentition. To achieve this, Department of Pediatric Dentistry, Seoul National University,
one of the therapeutic tools used is the pre-orthodontic appliance Seoul, Korea; 2Department of Conservative Dentistry, Seoul
called “Trainer”, which are low cost, silicon appliances character- National University, Seoul, Korea
ized by their standard dimensions according to the age and
pathology of the child. The Trainer is also complemented with Background: Recently, rapid palatal expansion with facemask is
myofunctional education. widely used for anterior movement of maxilla and mesial move-
Clinical reports: ment of maxillary tooth. There were many studies about cephalo-
Case 1: A 2 year’s 5-month-old child with primary dentition, metric changes of dentoalveolar composition but quantitative
anterior crossed bite and maxillary compression. Class III with studies of permanent successor were small.
family history and atypical swallowing, she uses baby bottle and Aim: The purpose of this study was to evaluate the stress distri-
pacifier. The treatment is initiated with the removal of the suc- bution and displacement patterns of permanent successors at
tion habit, when she is 3-year-old the Trainer is implemented (EF anterior movement of maxilla by orthopedic treatment in patient
Start) accompanied with a bite elevation with glass ionomer stops with class III malocclusion using finite element analysis.
to facilitate normal development and complemented by breathing Design: The subject was consisted of 15 children who had skeletal
a tong positioning exercises. When she is 4-year-old, the treat- class III malocclusion and were taken rapid palatal expansion
ment with the trainer continues (EF Class III standard). with facemask. The controlled group was composed of children
who had no orthopedic treatment. Maxillary dentoalveolar mea-
surements of cephalometric data were analyzed by finite element school for young people with a wide range of special needs and
analysis. specific learning difficulties. She uses speech to communicate; she
Results: When the maxilla moved to anterior, there was more uses lip reading together with her limited hearing to understand
anterior and inferior displacement in the anterior portion of per- what others say to her. She was highly motivated to improve the
manent successor than posterior portion. In successor, the incisal intelligibility of her speech. The first step in treatment was to
edge showed more anterior displacement than the root apex. increase tactile feedback and sensori-motor learning around ton-
Conclusions: It is thought that the results from this finite element gue placement using a palatal training appliance (PTA), which
analysis will help to comprehend the effects to permanent succes- incorporated a small bead on the alveolar ridge to encourage
sor which affected by orthopedic treatment. Georgia to lift her tongue tip to a specific target site on the pal-
ate. After 6 months of PTA use, Georgia was introduced to elec-
PR06.23 tropalatography which provides a visual display of tongue
contact with the roof of the mouth providing Georgia with
Oral manifestrations of twin sisters with speech feedback.
pseudohypoparathyroidism type Ia Comments: Dentists and Speech and Language Therapists work-
N. ISOGAWA & Y. BABA ing together can help children reach their full potential by
Pedodontics and Orthodontics, National Center for Child Health enabling learning of new motor patterns that transfer skills to
and Development, Tokyo, Japan speech.
Introduction: Pseudohypoparathyroidism (PHP) is a rare hetero-
geneous disease with a prevalence of 3–4 per million births. PHP PR06.25
type Ia is characterized by resistance to multiple hormones, Influence of adhesives and different methods of
including parathyroid hormone, and causes hypocalcemia. It is enamel pretreatment on the bond strength of
generally associated with Albright’s heredity osteodystrophy,
which is characterized by a short stature, obesity, round face,
orthodontic brackets
C
H. JURIĆ1, S. JURISI 2, G. JURISI
C 2 & S. POROVIC 3
brachydactyly, brachymetacarpia, subcutaneous ossifications, 1
and, in some cases, mental retardation or developmental delay. Department of Preventive and Paediatric Dentistry, School of
The oral features include enamel hypoplasia, hypodontia, short Dental Medicine, Zagreb, Croatia; 2Dental Polyclinic Juri
si
c,
roots, and delayed eruption. However, the craniodentofacial Mostar, Bosnia and Herzegovina; 3Public Health Centre of
characteristics in patients with a deciduous dentition have not Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
been discussed in detail. Background: Two-component composite resins or glass ionomer
Case report: We describe two cases involving 11-year-old Japa- cements are used for bracket bonding in fixed orthodontics. Glass
nese monozygotic twin sisters with PHP type Ia. Both patients ionomer cements chemically bond to tooth structure, while resins
exhibited a short stature, obesity, brachydactyly, brachymetacar- bond micromechanically. The aim is always to use materials with
pia, basal ganglia calcification, and subcutaneous ossifications. optimal working time, with increased resistance to moisture and
Craniodentofacial findings included a thick cranium, a small cra- sufficient bond strength of brackets to teeth.
nial base angle, an acute posterior cranial base, enamel hypopla- Aim: The objective of this study was to examine bond strength of
sia, short roots, malformed pulp cavities, and submerged brackets to enamel, with respect to the type of adhesive material
deciduous molars. In addition, five premolar tooth germs were and methods of enamel pretreatment.
congenitally missing in both patients. One patient also exhibited Design: The experimental sample consisted of 80 extracted
impaction of the deciduous maxillary left second molar in the human first molars, with intact vestibular surface. The sample
maxillary sinus and mesial and horizontal tipping of the perma- was divided into four groups with the same number of specimens,
nent maxillary left first molar. and the brackets were bonded with different materials, beside
Comment: Both patients showed the typical systemic and oral various enamel pretreatments: group A - GC Ortho LC
features of PHP type Ia. On the other hand, it is suggested that (Ortho Conditioner); group B - GC Ortho LC (37% orthophos-
not only the disease itself but also environmental factors may dis- phoric acid etching); group C - Unitec Trans-bond Plus SEP,
turb the normal growth of the dentition, such as deciduous tooth Trans-bond XT; group D - Unitec MIP, Trans-bond XT. Metal
exfoliation and permanent tooth eruption. brackets were used (Discovery, Edgewise brackets, Dentaurum,
Germany). Bond strength of brackets to enamel and ARI index
PR06.24 were measured.
Results: The highest bond strength was found in groups C and D,
Palatal training therapy - a team approach to and a statistically significant difference (P < 0.05) was found in rela-
management of intractable speech disorders tion to group B. There was no difference in the results of ARI index.
J. PARRY1,2, D. SELLERS3 & C. BIRD3 Conclusions: Transbond XT adhesive systems showed better bond
1
Special Care Dentistry, Sussex Community Trust, West Sussex, strength compared to GC Ortho LC. GC Ortho LC achieved bet-
UK; 2Royal Alex Children’s Hospital, Brighton, UK; 3Speech and ter bond strength in case of enamel pretreatment with Ortho
Language Therapy, Sussex Community Trust, West Sussex, UK Conditioner
Introduction: Sussex Community Trust operates clinics for ENT (10% polyacrylic acid) in relation to 37% orthophosphoric acid.
and Oral difficulties. The aim is to optimise potential for devel-
oping oral skills for speech, eating, drinking and saliva control. PR06.26
Children with intractable speech disorders, unresponsive to con- Occlusal characteristics of primary dentition and the
ventional speech therapy, are commonly referred.
Case report: Georgia, a 14-year-old girl was referred and seen for
prevalence of malocclusion in preschool children
a consultation by paediatric dentistry and speech and language C. BICA1, C. COSMA2, D. ESIAN1, R. GYERGYAY1, A. BUD1

& K. MARTHA 3
specialists. Georgia is profoundly deaf from birth and currently 1
aided bilaterally with a hearing aid and radio aid. She presented Paediatric Dentistry Department, University of Medicine and
with chronologically normal dental development, good oral Pharmacy, T^ırgu Muresß, Romania; 2University of Medicine and
hygiene and a caries free dentition. Georgia attends a special Pharmacy, T^ırgu Muresß, Romania; 3Orthodontic Department,
University of Medicine and Pharmacy, T^ırgu Muresß, Romania
Background: The identification and interception of dento-maxil- PR06.28

lary anomalies by simple orthodontic interventions leads to cor-
Accuracy and reliability of tooth size and arch width
recting anomalies or to ensuring a favourable prognosis.
Aim: Clinical evaluation of occlusal relations in a group of pre- measurements using conventional and three-
school children with primary dentition and early diagnosis of dimensional digital models
dento-maxillary anomalies in order to initiate an interceptive T. YONEZU1, A. ARAKAWA2, A. TASHIRO1 & S.
orthodontic treatment. SHINTANI1
1
Design: 372 children, aged 3–6 years, with primary dentition from Pediatric Dentistry, Tokyo Dental College, Chiba, Japan; 23D
Muresß County, were included in the study. Based on clinical and Corporation, Chiba, Japan
photographic examination, we identified the main parameters of
Background: Three-dimensional dental system offers many advan-
development of the dental arches: terminal plane, sagittal relation-
tages, including elimination of storage problems and model
ships in canines, overbite, overjet, the presence or absence of scis-
breakage, instant retrieval of models. However, as with any new
sor bite, crowding or spacing. We highlighted the percentage
method, accuracy must be assessed by comparison with existing
distribution of changes in occlusion and obtained correlation with
gold standard.
aetiological factors, age and gender of the child.
Aim: The aim of this study was to evaluate the accuracy of den-
Results: The ratio of children with terminal plan in a mesial step
tal measurements taken with calipers on plaster dental casts and
is 25% at the age of 3 years, 30% at 4 years, 44.5% at 5 years,
those from digital 3-dimensional models.
and 63.3% at 6 years. Of all children aged 5, 26% had distaliza-
Design: Ten dental casts of primary dentitions were selected.
tion relationships in the canines, 15% had overbite, and 19%
Three-dimensional images were obtained with a surface laser
had an overjet of >5 mm. Scissor bite was identified in 16% of
scanner and analyzed by original software (DORA; Digital Pro-
boys and 14% of girls. In addition, 85% of children aged 4 had
cess, Tokyo, Japan). Measurements, including mesiodistal widths
clinical signs of insufficient transverse development of the upper
of teeth, dental arch widths were made with a caliper directly on
jaw.
the dental casts and also digitally on the digital models. Depen-
Conclusions: The results highlight the importance of early ortho-
dent t tests were used to evaluate measurement accuracy on the
dontic examinations in children and of monitoring risk groups to
digital models.
establish an optimal interceptive treatment.
Results: Tooth-width values obtained from 3-dmensional digital
models were greater than those obtained from the plaster dental
PR06.27 casts. However, the differences never exceeded 0.36 mm and no
Planas direct tracks for early anterior crossbite statistically significant differences were found between the 2
correction methods. Dental arch width measurements on the digital models
did not differ significantly from those on the plaster dental casts.
A. M. P. A. SOUZA
Interexaminer reliability was consistent for both the plaster and
Odontologia, Universidade Regional de Blumenau, Blumenau,
the digital models.
Brazil
Conclusions: Three-dimensional dental measurements are valid,
Introduction: The anterior crossbite is described when the anterior reliable and reproducible method to obtain dental measurements
teeth are in reverse relation occlusion, involving a tooth, several for diagnostic and also research purposes.
teeth or all anterior teeth. Among the various possibilities of
treatment of anterior crossbite is making Planas direct tracks, PR06.29
which is an apparatus made with light-cured composite resin in
the vestibular of deciduous teeth and it is responsible for return- Alternative preventive treatment for high-risk
ing the patient to an occlusal harmony, uncrossing them artifi- maxillary canines impaction
cially and restoring vertical dimension, because it stimulates the S. ZEPEDA, K. N. RAMIREZ, I. A. VERDUGO, M. A.
premaxilla to the vestibular development, and corrects the incli- ZAMUDIO & C. A. FREGOSO
nation of the upper incisors. Postgraduate of Pediatric Dentistry, Universidad Autonoma de
Case reports: An infant girl of two years old was seen in the Baja California, Tijuana, Mexico
extension project “Health Education in Maternal Child Area” of
Introduction: The maxillary canine it’s fundamental for the facial
the Regional University of Blumenau. She was referred to routine
esthetics and occlusion. It’s very important the germ’s early loca-
dental care and clinical examination and it was found that she
tion so a preventive treatment can be performed. Traditional
had anterior crossbite. In anamnesis the mother reported that the
treatments include: serial extractions initiating with the tempo-
father and the eldest brother of the girl had full cross-bite. The
rary canines, eliminate interference, space maintainer, even the
treatment consisted of making Planas direct tracks on teeth 51
extraction of the permanent canine or surgical exposure when
and 61. The girl is currently six years old and carries out regular
impaction is present.
monitoring in the pediatric dentistry clinic University.
Case reports: A Nine-year-old male patient with high-risk diagno-
Comments: The malocclusion when diagnosed early with the col-
sis of impaction of maxillary canines. The treatment of choice was
laboration of the child, should have an intervention as soon as
the extraction of the first temporary molars, selective carving and
possible to obtain a good prognosis. The dentists should use the
functional orthopedic appliance class I. Afterwards, periodical
knowledge of occlusal neuro rehabilitation, preventive orthodon-
appointments for an X-ray following to observe the germ’s erup-
tics, interceptive orthodontics and functional orthopedics, to have
tion and decrease of the angle created by the canine in relation to
more chances of successful treatment.
the middle line, until it’s correct eruption. Unlike common treat-
ments, in the present case keeping the temporary canine for main-
taining a guide for the permanent canine was preferred over
extracting it, and to use methods that promote the transversal
development of maxillaries, mainly on the canine zone, and erup-
tion guides that allow the eruption of the first premolar giving
space for the relocation of the canine’s eruption guide.
Comments: The early diagnosis of the canine’s eruption guide is Design: Panaromic radiographies of 100 healthy patients, aged
imperative to prevent impaction and thus a much more invasive between 6 and 13 were examined and were retrospectively evalu-
treatment. ated. Dental ages of these children were calculated with both,
Demirjian method and OnyxCeph3tm software.
PR06.30 Results: Mean dental ages calculated with Demirjian method and
OnyxCeph3tm software are 9.57 2.28 and 9.56 2.26 respec-
Long-term Space changes after premature loss of a tively. The results are almost matching (P = 0.128).
primary maxillary first molar Conclusion: The outcomes of the software are close to the out-
P. C. TANG, Y-T LIN & Y. T. LIN comes of the conventional Demirjian analysis. So, it can be men-
Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan tioned that OnyxCeph3tm software is reliable as the conventional
Demirjian method and can be employed as a replacement in den-
Background: Many factors may be involved in the consequences
tal age calculations.
of premature extraction of primary maxillary teeth. It appears
that many situations exist clinically, which seems to have differ-
ent conclusions. PR06.32
Aim: The aim of this study was to use established longitudinal data Acute otitis media and the need for myringotomy
to investigate ongoing (81-month) dental-arch space problems aris- tubes among paediatric cleft lip and palate patients
ing as a result of premature loss of a primary maxillary first molar. V. LEHTONEN, R. LITHOVIUS, L. YLIKONTIOLA, V.
Design: Nine children (mean age at time of tooth extraction:
ANTTONEN, T. AUTIO & V. HARILA
6.0 0.74 years) with unilateral premature loss of a primary
Oulu University Hospital and University of Oulu, Oulu, Finland
maxillary first molar were selected. Maxillary dental study casts
were obtained from participants within 3 days after the tooth Background: Cleft lip and palate is the most frequent congenital
was removed, as well as at a follow-up appointment averaging anomaly occurring in the craniofacial region. While acute otitis
81 months later. The contralateral intact primary molar served as media is very common for small children, it is even more com-
a control. Five reference lines were measured: arch width/length, mon in children with clefts.
intercanine width/length, and arch perimeter. A paired t test was Aim: The aim of this study was to investigate the association of
used to compare the cast measurements. cleft lip and palate patients and the development of middle ear
Results: Eight out of nine cases (88.9%) showed no crowded per- diseases and need for myringotomy tubes.
manent successors or canine block-out on the extraction site. A Design: Patient records of 204 cleft patients treated in Oulu Uni-
significantly greater arch width, arch length, and intercanine versity Hospital, Finland during the period 1997–2014 were anal-
width were found after 81 months compared with the initial ysed. The analyses were carried out using cross-tabulation and
parameters. No significant differences were found in intercanine Chi-square testing. Differences between the groups were consid-
length and arch perimeter. ered statistically significant with P values <0.05.
Conclusions: The 81-month space changes in the maxillary dental Results: Almost four in five (79.4%) had excretory products in
arch showed significantly increased arch dimension. It is sug- their middle ear. Purulent secretions referring to acute otitis
gested that there is no need for the use of space maintainers in media was detected in 27.9% of the all cleft lip/and palate
cases of premature loss of a primary first molar around the time patients. Mucous secretion referring to glue ear was detected in
the permanent first molar is about to erupt or has erupted. 92.1% of the cleft lip and palate patients, 73.8% of the cleft pal-
ate patients; and in 18.1% of the cleft lip patients. Almost all
PR06.31 patients in the study group (88.3%) had had one or more my-
ringotomy tubes placed during the follow-up period. There was a
Comparative evaluation of OnyxCeph3tm software difference in the need of tubes according to the cleft type - all
and Demirjian method for estimating dental age of cleft lip and palate patients had had tubes placed (≥1); 95.7% of
6–13 year-old children those with palatal involvement, but only 18.2% of cleft lip
€
N. ÖZVEREN1, S. OZALP 1 €
, T. UNVER 2
& E. AYTUGAR 2 patients.
1 Conclusions: Among other problems cleft patients have frequent
Department of Pediatric Dentistry, Bezmialem Vakif University
Faculty of Dentistry, Istanbul, Turkey; 2Department of Oral and ear infections needed myringotomy tubes; especially the more
Maxillofacial Radiology, Bezmialem Vakif University Faculty of severe clefts are associated with frequent infections.
Dentistry, Istanbul, Turkey
Backround: Dental maturation is the most common used parame-
PR06.33
ter in estimating chronological age. Various methods are devel- To keep or not to keep the space following the
oped to estimate dental age. However, Demirjian method is premature loss of primary molars?
distinguished due to its wide spread use and reliability. C. PUJADE1,2, M. M. LANDRU1,2 & E. DURSUN1,2,3
Demirjian method, requests the evaluation of panaromic radiog- 1
Paediatric Dentistry, Paris Descartes University, Montrouge,
raphy of the first seven mandibular teeth on the left side for cal- France; 2Paediatric Dentistry, Mondor-Chenevier Hospital
cification, maturation, and apex closure stages. Maturity scores Complex, Cr eteil, France; 3Dental Materials Research Unit,
calculated of each teeth are summed to obtain the overall matu- Innovations and Interfaces, Montrouge, France
rity score. Then, this score is converted to dental age using con-
version tables. Background: the premature loss of primary molars can disrupt
Aim: OnyxCeph3tm software is a cephalometric analyze software the eruption of permanent teeth and cause malocclusions. It is
that calculates dental age according to Demirjian method. There common to place space maintainers (SM) to prevent these poten-
are numbers of studies about Demirjian method. On the con- tial consequences. However, their indications vary according to
trary, no or limited research is present on accuracy of dental age the authors and no scientific evidence are available.
calculations by utilizing OnyxCeph3tm. The purpose of this study Aim: To reflect on the need for SM, by an assessment of the loss
is to compare dental age calculations done with the conventional of space (LS) and its consequences (C) in patients, according to
Demirjian method and OnyxCeph3tm and to determine the accu- the clinical context.
racy of the software.
Design: 430 files were collected. Those reporting one or more PR06.35
molar extractions were selected. Before the visit: the gender,
Alternative and simple technique for prosthodontic
birthday, extracted tooth/teeth, 1st permanent molar (1MP) posi-
tion, diastema/crowding, Angle classification, time since the oral rehabilitation of patient with dystrophic
extractions were noted. At the consultation, the LS was measured epidermolysis bullosa: a clinical case report
and the C (presence of malocclusion) registered. Student and J. MORÁN, S. KRAMER & M. VALLE
Anova tests, then logistic and linear regression were performed. University of Chile, Santiago, Chile
Result: 75 extracted teeth in 35 patients were included. The LS et
Introduction: Epidermolysis Bullosa is a rare genetic disease char-
C were more pronounced when the 1MP was in eruption and in
acterized by the formation of blisters and erosions on the skin
cases of crowding, but not correlate with the initial occlusion.
and mucous membranes following minor traction or trauma.
The LS and C remained constant after a few months. The LS
Oral manifestations of the disease include obliteration of the ves-
was more frequent after the extraction of 2nd molar or 1st and
tibule, ankyloglossia and microstomia.
2nd molars, in particular at the mandibule. The quantity of LS
Case reports: An 18-year-old girl diagnosticated with Dystrophic
was not related to the arcade. The higher LS it was, the more
Epidermolysis Bullosa at born, with social risk and geographi-
there was C.
cally isolated, without dental care history; at 16-year-old was
Conclusions: Following the premature loss of primary molars, the
referred to the Special Care Clinic at University of Chile.
SM should be thoughtful and non-systematic. An orthodontic
Due to severity of bucal pathology the first step was erradicate
assessment is essential to adopt the suitable management: moni-
any infection focus with extractions of twelve residual root of
toring, SM placement, orthodontic treatment.
permanent teeth. This consequent partial edentulous condition
with just six remained maxillar teeth present a great challenge
PR06.34 owing to the absence of vestibule, severe microstomia and
Prevalence of and relationship between malocclusion extreme fragility of oral mucous.
and orofacial dysfunction in children and adolescents Second step was design a transitional prosthesis made with vac-
uum forming plate system, tested and use it for six months with-
- an epidemiological study out lesions.
M. B. D. GAVIÃO, M. S. LEME & T. S. BARBOSA Third step was progress treatment making an acrylic prosthesis
Department of Pediatric Dentistry, University of Campinas, with metal retainers, regularly controlled on time and discontinue
Piracicaba, Brazil it use at minimal appear of soft tissue injuries.
Background: Although a close relationship between form and Patient has used it for the last 10 months with no damage at all,
function is recognized, the degree of interplay remains a matter improving oral health, oral functions and self-esteem.
of conjecture. Comments: Oral rehabilitation, and in particular prosthetic rehabil-
Aim: This study aimed to determine the prevalence of and rela- itation is a challenge. This article describes a simple, effective and
tionship between orofacial dysfunction and malocclusions. inexpensive removable prosthetic alternative for a partially edentu-
Design: 1561 (aged 4–14 years) subjects were divided in four lous patient with Recessive Dystrophic Epidermolysis Bullosa.
groups: Primary dentition (PRD, n = 387), Intermediate mixed
dentition (IMD, n = 387), Late mixed dentition (LMD, n = 402) PR06.36
and Permanent dentition (PD, n = 385). The orofacial dysfunc-
Early correction of Classe III malocclusion: a
tion was assessed using the Nordic orofacial test-screening
(NOT-S). Malocclusion was assessed considering morphological systematic review and case reports
occlusal characteristics and Dental Aesthetic Index (DAI). The H. BENYAHIA, W. RERHRHAYE, Y. OUALALOU & F.
sample was subdivided in malocclusion and no malocclusion ZAOUI
groups. Statistical analysis constituted of descriptive analysis, chi- Department of Orthodontics, Faculty of Dental Medecine,
squared partition and independence tests, and Mann-Whitney University Mohammed V, Rabat, Morocco
and Kruskal-Wallis tests. Aim: The purpose of this systematic review was to identify the
Results: Malocclusion prevalence was 64.9% in PRD, 83.2% in appropriate timing for the correction of Class III malocclusion.
IMD, 80.4% in LMD and 90.7% in PD, being increased overjet Design: We searched in the electronic databases Scopus and Med-
the most common malocclusion found. Orofacial dysfunction prev- line. The selection criteria was: French and English language,
alence was 86.6% in PRD, 88.1% in IMD, 91.3% in LMD and children in the primary or mixed dentition with a confirmed skel-
89.6% in PD, being the presence of deleterious oral habits the most etal Class III malocclusion.
frequent one. Malocclusion groups of bilateral class II (in PRD), Clinical trials, systematic reviews, meta-analysis, cohort studies,
frontal open bite (in PRD and PD), unilateral class III and unilat- case-control studies, and cross-sectional studies were included,
eral and bilateral posterior crossbite (in PD) presented significant whereas literature reviews, case reports, case series, symposiums,
more orofacial dysfunction compared to no malocclusion group. compendiums, pilot studies, and expert opinions were excluded.
Conclusions: The prevalence of malocclusion and orofacial dys- Only articles in duplicate by two investigators was checked.
function were high and it was detected a positive interrelation Results: A total of 143 articles were identified following electronic
between higher impacts on orofacial dysfunction and the pres- and hand searching and checking reference lists. Following exam-
ence of malocclusion. ination of titles, abstracts and, where applicable full articles, 4
articles were included. Owing to the low levels of evidence.
Conclusion: This review has established evidence for the efficiency
of Early correction of Class III malocclusion in children. High
level studies are required before definitive conclusions can be
made. Clinical cases will be presented to demonstrate the amelio-
ration of esthetics and function.
PR06.37 can also be used to identify children (<18-year) with high degree
of correct prediction, 100%.
Simultaneous correction of the posterior unilateral
Conclusions: The 18-year threshold is easily identified by attaining
cross bite, anterior open bite and sucking digital specific staging scores of both third molar variables (TMD and
habit using a modified hyrax breaker TME) without complex calculations.
P. JARA1 & H. ORREGO2
1
Ministry of Health, Lima, Peru; 2Universidad Nacional Mayor de
PR06.39
San Marcos, Lima, Peru
Early treatment of anterior crossbite in children
Introduction: The habits and alterations in the transversal plane, under 3 years: clinical cases
establish alterations in the orthodontic clinic with the indication ACIEN1,2, S.
G. REDONDO SANTIAGO1, R. MAYNE
of early treatment if they are not intercepted in the right moment
YUSTE & J. MARISTANY I VILANOVA1
1,3
and with efficacy, this will condition in the patients clinical situa- 1
Dr. Maristany Private Practice, Barcelona, Spain; 2Universidad
tions more serious with no desirables functional and esthetic con-
de Barcelona, Barcelona, Spain; 3Universidad internacional de
sequences. The cross bites with skeletal origin, the ones that
Catalunya, Barcelona, Spain
indicate a transversal deficiency in the superior basal, are treated
by the palatine disjunction procedure. The sucking digital habit Introduction: Anterior crossbite in primary dentition causes
has more relation to the open bite, gap between the anterior adverse growth on the mandible and premaxilla and an altered
superior teeth, high and narrow palate, increased overjet and the function of the masticatory pattern. If this situation is not solved
presence of additional habits. as soon as possible the anteroposterior relationship between the
Case report: A 09-year-old girl with sucking digital habit, at the mandible and maxilla becomes worse and it will make the child a
extra oral clinical examination revealed asymmetric with the jaw candidate for more invasive treatments and prolonged orthodon-
turned to the right, good labial seal, balanced facial thirds and tics.
straight profile. Intraoral examination revealed mixed dentition The lack of cooperation of children as well as the lack of the cli-
with malocclusion class I, unilateral posterior cross bite, anterior nician’s skill to treat infants, is a problem that delays early treat-
open bite and deviation of the lower dental midline. The addition ment.
of a circuit breaker was performed at grid welded so as not to Case reports: Three infants between 21 and 30 months with ante-
interfere in the activation of the apparatus so was possible to rior crossbite are presented.
make the cross correction. Applying this modification the prob- Anterior composite strip-crowns in the central and lateral incisors
lem of sucking habit is blocked and simultaneously open bite is were used in order to correct the anterior crossbite. The corrected
corrected. axial inclination of the composite crowns created a temporary
Comments: The modification of the Hyrax breaker presented in occlusal interference which guided the mandible to adopt a new
this article was able to give a simultaneous therapy blocking the posterior position.
sucking digital habit, correction of the anterior open bite and the In the 2-month follow-up visit the anterior crossbite was cor-
elimination of the posterior cross bite. rected in all three patients.
Comments: Early treatment of the anterior crossbite provides
PR06.38 clear benefits for patients. Correcting advanced mandibular posi-
tion and providing stimulus to premaxila for growth. Masticatory
Stages in third molar development and eruption to function is rehabilitated.
estimate 18-year threshold In all cases the correction of crossbite was very quick and parents
M. Y. P. MOHD YUSOF1,2, R. CAUWELS1 & L. MARTENS1 could see visible changes in the mandibular position and mastica-
1
Department of Pediatric Dentistry and Special Care, tory efficiency, also improving the aesthetics of the patient.
PAECOMEDIS Cluster, Ghent University, Ghent, Belgium; The pediatric dentist has the advantage of seeing children from
2
Centre of Oral & Maxillofacial Diagnostics and Medicine Studies, babies and be the first to diagnose this type of bite. It is also the
Faculty of Dentistry, Universiti Teknologi MARA, Shah Alam, ideal professional for correction, used to treat very young
Malaysia patients and have the confidence of parents.
Background: Age 18 is considered as the age of majority by most
countries. By using the same radiograph of the same individual, PR06.40
both third molar development (TMD) and eruption (TME) stag- A longitudinal radiographic study of tooth eruption
ing scores can be obtained to reach certain age of interest. L. MUSTAFA, F. WONG & H. LIVERSIDGE
Aim: To assess the chronological course of third molars develop- Centre for Oral Growth and Development, Queen Mary University
ment and eruption in a Malay sub-adult population and evaluate of London, London, UK
the prediction when specific stage(s) of TMD and TME has been
attained pertinent to the age group of interest (18 years). Background: The time taken between eruption levels is not well
Design: A sample of 705 digital panoramic radiographs of Malay documented.
sub-adults aged between 14.1 and 23.8 years was collected. The Aim: The aim of this study was to investigate tooth eruption
techniques described by Gleiser and Hunt (modified by Kohler) from archived longitudinal panoramic radiographs.
and Olze were employed to stage the TMD and TME, respec- Design: This was a retrospective study of panoramic radiographs
tively. A binary logistic regression was performed to predict the taken in the course of diagnosis and treatment. The sample was
18-year threshold with staging score as predictors. 426 individuals from London and 12 from Japan aged 4.44 to
Results: Stages 7–10 (TMD) and C-D (TME) in males and stages 14.92 years. Selection criteria were two or more radiographs with
5–10 (TMD) and B-D (TME) in females were found to be corre- erupting permanent mandibular teeth. Left first (M1) and second
lated in discriminating 18-year-and-more group. In both genders, (M2) mandibular molars were scored for eruption level (cusp tips
the stages 9–10 (TMD) and D (TME) are accountable to be used at the alveolar bone level (AE) or partially erupted (PE) halfway
as reference stages to estimate whether the subject is likely to be to the occlusal level). The mean time between AE and PE for M1
equal or above age 18, with 94.74–100% and 85.88–96.38% of and M2 was calculated and compared using a t-test.
correct predictions, respectively. Stage 4 (TMD) and A (TME) Results: The time interval between radiographs ranged from 0.19
to 8.60 years. Five individuals were observed with M1 first at
alveolar eruption and secondly at partial eruption and 18 with was assessed from 225 juvenile skeletal remains from the Natural
M2 at these eruption levels. The mean time between AE and PE History Museum, London. Permanent tooth eruption was
for M1 was 1.08 year (standard deviation 0.58, range 0.50– assessed from 3208 archived panoramic radiographs from dental
2.03 years) and slightly longer for M2 at 1.23 year (standard patients aged 2–25.
deviation 0.67, range 0.22–2.96 years) and these were not statisti- Results: The modal tooth stage for most teeth at alveolar erup-
cally significant (P > 0.05). tion was R1/4 and at partial eruption was R1/2 although there
Conclusions: Time between eruption levels in M1 and M2 showed was some variation of root stage particularly for later erupting
considerable variation in speed of eruption. teeth. The modal root stage for the deciduous teeth and perma-
nent central incisor, first and second molars at alveolar eruption
PR06.41 was R1/4. The permanent lateral incisor, canine, premolars and
third molars reached eruption levels with relatively more root
Defining normal eruption in terms of root stage formed. By root half, most central incisors, first and second
H. LIVERSIDGE molars had reached alveolar eruption. Most other mandibular
Dental Institute, Queen Mary University of London, London, UK teeth reached alveolar eruption when root equalled three quarters
Background: Delayed eruption is usually expressed in terms of length, although some third molars only reached AE at root
age but little is documented in terms of root formation stage. complete. This suggests that mandibular teeth that have failed to
Aim: The aim of this study was to describe root stage of mandib- reach alveolar eruption at these root stages could be considered
ular teeth at alveolar eruption and partial eruption levels. to be delayed.
Design: Root stage of mandibular teeth with cusp tips at the Conclusion: Root stage when cusp tips reach the alveolar bone
alveolar level (AE) and partially erupted (cusp tips half way to level can be used to predict abnormal eruption.
the occlusal level PE) were assessed. Deciduous tooth eruption
Periodontology and Microbiology Poster Session – PR07
Periodontology and Microbiology Poster

Session – PR07
PR07.01 Medical history was significant for three hospital admissions with
unexplained metabolic acidosis. Following these episodes she was
Aggressive periodontitis in a 5-year old child without reviewed by a paediatric metabolic consultant and discharged fol-
any systemic diseases lowing normal investigations.
M. HAGHIFAR There was no known family history of early tooth loss or peri-
Paediatric Dentistry, Zanjan University of Medical Sciences, odontal disease.
Zanjan, Iran Examination revealed a full primary dentition with the exception
Introduction: Aggressive periodontitis comprises a group of rare, of 71 and 81. 51 and 61 were mobile. There was no gingival
often severe, rapidly progressive forms of periodontitis often inflammation and oral hygiene was good.
characterized by an early age of clinical manifestation and a dis- Haematological investigations requested demonstrated reduced
tinctive tendency for cases to aggregate in families. Cases affect- serum alkaline phosphatase. Following referral to the paediatric
ing the primary dentition that leads to tooth exfoliation early in endocrinologist, further haematological, urinary, radiological
life are usually interpreted as periodontal manifestations of sys- and genetic testing confirmed a diagnosis of odontohyposphos-
temic (hematologic) diseases, such as leukocyte adhesion defi- phatasia. Other features of odontohypophosphatasia include
ciency. We describe a child with features of aggressive reduced alveolar bone height, enlarged pulp chambers and root
periodontitis that wasn’t associated with any other systemic dis- canals.
ease. Comments: Early exfoliation or abnormally loose teeth may be
Case reports: A 5-year-old girl presented to dental school of Tab- the first or only presenting feature of hypophosphatasia. Hence
riz University of medical science. Clinical signs was intense gingi- the paediatric dentist plays a vital role in the identification of this
val inflammation, Bone resorption, attachment loss, extreme disease.
mobility of some of the primary teeth. Periodontal probing depth
ranging from 3 to 8 mm. Furcation involvement was seen in PR07.03
mandibular left first molar. Mobility grade II was seen in man- Comparison of Streptococcus mutans in saliva before
dibular incisors and first molars also maxillary incisors. Patient
was reffered to a specialist. Laboratory tests was performed. No
and after dentalcaries filling with resin-based
symptoms of systemic disease was found. Sampling and PCR was composite
performed. Presence of highly leukotoxic strains of A. actinomy- L. FANG, Y. LIU, R. YANG & J. ZOU
cetemcomitans was shown. Loose and painful teeth was West China College of Stomatology, Sichuan University, Chengdu,
extracted. Metronidazole in combination with amoxicillin was China
used as a treatment. After 2 year follow up there was no signs of
Background: It has been proved that dental caries is a bacterial
Aggressive periodontitis in permanent teeth.
infectious disease. Streptococcus mutans (S.mutans) is one of the
Comments: In this case the patient has no systemic disease, but most important cariogenic bacteria in oral cavity. With the devel-
some cases affecting the primary dentition and leading to tooth opment of oral microbiology, there is increasing interest in com-
exfoliation early in life are usually interpreted as periodontal
prehensive approaches to managing caries over the conventional
manifestations of systemic diseases. So we must rule out systemic surgical approaches.
diseases. Aim: This study was undertaken to evaluate the level of S.mutans
in saliva before and after dental caries filling with resin-based
PR07.02 composite without fluoride.
Early loss of primary teeth as the presenting feature Design: In sum, 20 volunteers (19–25 year old; mean
22.3 1.43 year) were enrolled in this study, all caries were
of hypophosphatasia removed and filled with resin-based composite without fluoride.
R. POWER1, R. JOHN2 & C. BURREN3
1 Non-stimulated saliva samples were collected before and 1, 2, 3,
Department of Paediatric Dentistry, Bristol Dental Hospital,
4 weeks after filling. 100 lL saliva sample was transferred, plated
Bristol, UK; 2Department of Paediatric Dentistry, University of
on mitis salivarius with bacitracin agar(MSB) and incubated
Bristol, Bristol, UK; 3Department of Paediatric Endocrinology and
anaerobically at 37°C for 48 h. Treatments were carried out by
Diabetes, Bristol Royal Hospital for Children, Bristol, UK
specialist pediatric dentists.
Introduction: Hypophosphatasia is a disorder of mineralisation Results: The S.mutans level in saliva sample one week after filling
affecting the teeth and bones characterized by low levels of tissue decreased apparently while compared to the level before filling
non-specific alkaline phosphatase. There are six reported types (P < 0.05). However, the level of S.mutans in saliva sample two,
which present with early exfoliation of primary teeth as a result three and four weeks after filling had no significant differences
of defective cementum. Odontohypophosphatasia describes such (P > 0.05).
cases where there is isolated dental involvement. Conclusion: Caries removal and resin-based composite filling
Case report: A two year old girl was referred by her general den- could reduce the level of S.mutans in saliva during a certain per-
tal practitioner to the department of paediatric dentistry follow- iod of time. However, the level of S.mutans in saliva would grad-
ing the premature exfoliation of 71 and 81 at approximately ually regained to the status before treatment as time went by.
12 months of age. Her parents described increased mobility rap- Sole filling of dental caries can not change the level of S.mutans
idly followed by exfoliation without root resorption. in saliva, which is highly stable after colonization in oral cavity.
PR07.04 the difference was 119.55 times and 96.45 times, respectively. The
expressions of AMBN associated with amelogenesis imperfect
Oral microbiome analysis in children with colored were markedly higher in IGF and the difference was 79.32 times.
dental biofilms The results of RT-PCR and IHC staining supported well with
N. NAGAI, A. SAKURAI, H. HOMMA, K. TANAKA, Y. with those of microarray analysis.
ARAI & S. SHINTANI Conclusions: Reduced proteolytic activity by the low expression
Department of Pediatric Dentistry, Tokyo Dental College, Tokyo, of MMP-13 and MMP-12 appeared to be a potential mechanism
Japan to gingival overgrowth. Genetic investigations such as expression
level of MMP-13, MMP-12 and AMBN may clarify the defect
Background: Mature dental biofilms usually show yellow or yel-
behind this new syndrome characterized by gingival enlargement
lowish-brown in adults. Also in children, colored biofilms are
with abnormal root development.
occasionally observed but children with colored biofilms do not
always have poor oral hygiene or dental status. There’s little
knowledge about differences of bacterial composition between PR07.06
white and colored biofilms in children. Generalised aggressive periodontitis in the primary
Aim: We tried to compare the bacterial composition of colored
dentition: a case report
and white biofilms in children.
Q. ZHANG, R. YANG & J. ZOU
Design: Colored and white biofilms were collected from 38 chil-
Department of Pediatric Dentistry, West China School of
dren participated in this study. As a control group, white biofilms
Stomatology, Sichuan University, Chengdu, China
were also collected from children without colored biofilms. Cario-
genic and periodontopathic pathogens were detected by PCR and Introduction: Generalized aggressive periodontitis (GAP) in pre-
real-time PCR. Microbiome analysis by 16S rRNA sequencing schoolers is an exceptionally rare disease in primary dentition.
was also performed. The cause of this disease is not completely understood but seems
Results: By PCR and real-time PCR, S. mutans was most fre- to be associated with a peculiar subgingival microbiota or a man-
quently detected among 11 bacterial species, followed by S. san- ifestation of a systemic disease. This report describes a 4-year fol-
guinis. Although colored biofilms contained slightly more species low-up case of GAP in a 5-year-old girl with lead intoxication.
than white ones, there were no significant differences. Children Case reports: A 5-year-old Chinese girl, without sibling, was
who had decayed or filled teeth had significantly abundant spe- referred to the hospital due to early loss of incisors, gingivitis,
cies than those who were free from dental caries. Bacterial com- tooth mobility in her primary dentition and frequent occurrences
posions had much variety among biofilms from children with of oral ulcer. Intraoral examination revealed GAP involving the
many caries experiences. entire primary dentition. Dental plaque samples from the tooth
Conclusion: In children, there is no significant difference of the surfaces, gingival sulcus, and mucosa were collected. F. nucleatum,
number of detected bacteria between colored and white biofilms. P. intermedia and P. gingivalis were identified as the dominant bac-
It was supposed that colored biofilms did neither have abundant teria through the PCR-DGGE and Sanger’s sequence. Systemic
bacteria nor show their maturity, compared to white biofilms. As examination revealed the content of lead in blood (Pb) reached up
well as matured biofilms in adults, colored biofilms from children to 603 lg/L. No obvious abnormity was detected from her par-
with caries experience might contain complicated microbiome ents. Comprehensive treatment plan were developed, including sys-
including periodontopathic pathogens and these children might temic and oral treatment. The oral treatment plans consisted of the
need long-term and careful oral check-up throughout life. extraction of the severely affected primary teeth, periodontal scal-
ing, caries prevention, dental home, occlusive guidance and follow-
PR07.05 up care. After a 4-year follow-up, the patient’s periodontal status
remains stabilized, facilitating the eruption of permanent teeth.
Potential role of MMP-13, MMP-12 and Comments: Even the etiology of the lead intoxication in this case
ameloblastin in a new type of gingival fibromatosis was still unknown. This case report demonstrated prompt diag-
C. KANG, J. H. LEE, J. S. SONG & S. O. KIM nosis and comprehensive treatment regimen may provide an
Department of Pediatric Dentistry, College of Dentistry, Yonsei effective therapeutic management of GAP.
University, Seoul, Korea
Background: The biochemical events involved in idiotpathic gingi- PR07.07
val fibromatosis (IGF), also known as gingival hyperplasia and Effect of ozone on bacteria related to early childhood
gingival overgrowth, are not well understood and the mRNA
caries
expression in IGF has not been assessed.
M. X. PONTE1, M. CARDOSO1, R. ARNOLD2, L. A.
Aim: The aim of this study was to compare the gene-expression
PIMENTA3 & R. VIEIRA1
profiles between a new type of IGF and normal gingiva in order 1
Pediatric Dentistry, Universidade Federal de Santa Catarina,
to clarify the nature of the gingival overgrowth mechanism and
Florianópolis, Brazil; 2University of North Carolina, Chapel Hill,
related gene expressions that might be responsible for dental
NC, USA; 3Craniofacial, University of North Carolina, Chapel
anomaly.
Hill, NC, USA
Design: Gingival tissue was collected from an IGF patient and
from nine healthy subjects. Gene-expression profiles were com- Background: Currently, there are few studies proposing the use of
pared between normal and IGF gingiva using cDNA microarray ozone gas in pediatric dentistry.
analysis and quantitative real-time reverse transcription-polymer- Aim: Investigate the action of ozone on S. mutans (SM), Lacto-
ase chain reaction (RT-PCR). Histological analysis was carried bacillus (LB), and E. faecalis (EF).
out on hematoxylin-eosin and immunohistochemical (IHC) stain- Design: Three ozone generator were tested: G1-HealOzone X4Ò;
ing. G2-OL8A; G3-OL80W. G1 was only tested in SM suspended in
Results: Microarray analysis revealed that genes related to the liquid. A microtiter plate was used to receive 10 lL of 106 CFU/
regulation of cell proliferation, and resistance to proteolytic deg- mL of SM treated with O3 (2.100 ppm/1–4 min). Then, bacteria
radation were expressed more strongly in IGF. Especially, the were again re-suspended and incubated at 37°C. After 18 h, the
expressions of MMP-13 and MMP-12 were lower in IGF, and optical densities were determined. For G2 and G3, bacteria’s
dilutions ranging of 108–100 CFU/mL were performed. A drop Aim: The aim of this study was to compare the frequency of the
of 10 lL of each concentration of bacteria was applied on the occurrence of oral pathogens in plaque detected by two different
surface of sheep blood agar plates and treated with O3 (2, 20, PCR methods and assess the degree of their mutual agreement.
200 and 2000 ppm/4 min). The plates were incubated at 37°C. Methods: Twenty-five preschool children (mean age 4.06 years,
After 18 h, recovery analysis of colony formatting units verify SD 1.39) were involved into this study. Dental plaque samples
the reduction of bacterial activity using positive control (no treat- were taken from the periodontal region both in localities with
ment) as the standard plate. and without gingival inflammation. These samples were assessed
Results: Data were submitted to Wilcoxon (P < 0.05), ANOVA by the StomaGeneO (Protean s.r.o. Czech Republic) and Paro-
and Tukey’s test (P < 0.05). The optical density (k610 nm) of G1 CheckO 20 (Greiner bio-one GmbH, Germany) systems. The dif-
showed no statistical difference (P = 0.53). G2 e G3 showed ferences in the detection of individual periodontal bacteria
death >3log10 (99.9%) for all bacteria in one application of between inflammatory and healthy sampling sites were tested by
ozone ≥20 ppm. the Pearson’s chi square test. The agreement between results
Conclusion: G1 showed no efficiency in the death of SM, and G2 detected by both PCR methods was tested by kappa statistics.
and G3 showed effective in controlling the bacterial growth of Results: P. gingivalis was revealed only by the StomaGeneO sys-
SM, LB and EF. tem. Both methods detected the presence of other bacteria at
least in the inflammatory areas. The agreement between Stoma-
GeneO and ParoCheckO 20 methods was substantial for A.a.
PR07.08
and F.n. in the samples taken from the inflamed localities. In the
Acute necrotizing ulcerative gingivitis in primary clinically healthy sites the agreement between both methods was
denture: a proposal of treatment substantial only for F.n.
M. MARTY1,2, F. VAYSSE1,2 & I. BAILLEUL-FORESTIER1,2 Conclusions: The results of our study imply that the PCR-based
1
Pediatric Dentistry, Toulouse Dental School, Toulouse, France; techniques using similar but not identical primers bring, at least
2
Toulouse University Hospital, Toulouse, France in some bacterial species, congruent results.
Introduction: Acute Necrotizing ulcerative gingivitis (ANUG) is a
gum disease characterized by the involvement of the interproxi- PR07.10
mal papillae and the presence of a pseudomembranous necrotic The metagenome analysis of salivary microflora in
covering of the marginal tissues. This infectious disease is rare Japanese children with early childhood caries
among preschool, healthy children. There should be no difficulty T. FUJIWARA, K. SATOH & T. HOSHINO
in the diagnosis of ANUG, however, the treatment of very young
Department of Pediatric Dentistry, Nagasaki University Graduate
children is often a challenge for the dental practionner. This pre-
School of Biomedical Sciences, Nagasaki, Japan
sentation aims to describe a treatment fit for preschool children,
through the description of two cases. Background: Recently oral flora was well analyzed by using 16S
Case reports: Two 3 years old children, were referred for manage- rRNA gene probe. However, the metagenome sequencing analysis
ment of a gum disease by their physicians. The oral examination has not yet been employed in children with early childhood caries.
shows a painful, bleeding gingival tissue, fetid odor and pseudo- Aims: The purpose of this study was to investigate oral bacterial
membranous necrotic cover. Those patients do not present any flora of children with early childhood caries.
related general disorder. Design: The whole saliva samples were recovered from three car-
Dues to the difficulty to use mouth rinses on young children, the ies affected children (age range 2–5 years old) and three caries
management include local treatment by parent’s patients, use of non affected children (age range 3–4 years old). Bacterial DNA
antibiotics and professional cleaning of the teeth. After ten days, was extracted and the 16S rRNA gene fragments were amplified
this procedure produced a dramatic recovery from the infection, by PCR using 16S rRNA gene universal primers. The amplicons
and the patients are monitored for several month. were sequenced by Roche 454 GS FLX+ next-generation sequen-
Comments: This presentation aims to propose a simple, policies cer. The obtained data were analyzed by BLAST search and were
based treatment (AAPD guidelines; HAS guidelines) of acute classified in every genus.
necrotizing ulcerative gingivitis on primary denture. Dues to the Results: About lactic acid bacteria, genus Lactococcus was
young age of patients, the procedure should be adapted, and the detected from a caries non affected child. However, other lactic
parents should be involved in the treatment. Further investiga- acid bacteria such as the genus Enterococcus, Lactbacillus, Bifido-
tion is required to determine if it is adaptable to other age condi- bacterium and Pediococcus were not detected. The average detec-
tions, and to validate the better product to use. tion ratio of the genus Streptococcus in caries affected children
was higher than in caries non affected children. On the other
PR07.09 hand, the average detection ratios of the genus Porphyromonas,
Prevotella, Neisseria, Veillonella, Rothia, and Lautropia in caries
Agreement of two molecular methods for the oral non affected children were higher than in caries affected children.
anaerobes detection in children Conclusion: In the microorganism community analysis, the com-
P. PANTUCKOVA1, M. BARTOSOVA1, Z. BROUKAL2, M. position of salivary bacterial flora in caries active children would
KUKLETOVA1 & L. I. HOLLA1,3 differ from that of caries free children.
1
Clinic of Stomatology, St. Anne’s Faculty Hospital, Faculty of
Medicine, Masaryk University, Brno, Czech Republic; 2School of PR07.11
Dental Medicine, Charles University in Prague, the 1st Faculty of
Medicine, Prague, Czech Republic; 3Department of A case of advanced periodontitis with palmo-plantar
Pathophysiology, Faculty of Medicine, Masaryk University, Brno, keratoderma and its 3-year comprehensive
Czech Republic management
Background: Anaerobic bacteria constitute a significant part of M. LIU, Y. CHEN & S. LI
the indigenous oral microflora. However, results obtained with Sichuan University, Chengdu, China
various methods differed between each other. Introduction: Periodontitis with Palmo-plantar keratoderma is a
rare autosomal recessive condition. More than 300 cases have
been reported worldwide. The skin lesions are usually found PR07.13
when the patients are <3 years. The uncontrollable periodontal
Evaluation of effects of four combinations of root
destruction leads to the premature loss of both dentitions and
reduces the quality of life. The functional failure of the cathepsin canal irrigants on microflora in the infected root
C gene might contribute to the clinical manifestation of the disor- canals of primary teeth: an in vivo study
der. R. YANG, L. TANG & J. ZOU
Case reports: A 7-year-old male, mentally and physically normal, Pediatric Dentistry, West China College of Stomatology, Sichuan
complained of toothache upon mastication. White and pinkish University, Chengdu, China
plaques on palms and soles were prominent with a few scatter
Background: Successful root canal treatment partly depends on
lesions on the knees and elbows. No superimposed infection was
thorough root canal irrigation. There is few reports about irri-
found on the defective skin. Finger and toe nails were normal.
gants used in infected primary root canals treatments.
Premature loss of all primary teeth, loose erupted permanent
Aim: Evaluate four combinations of root canal irrigants group
molars, lower incisors with deep pockets and edematous gingivae,
used in canal treatment of infected primary root canal treatment,
traces of calculus and debris on the lingual and labial surfaces of
in order to provide a scientific basis for clinical doctors to choose
the lower incisors were found. Panoramic radiograph revealed
the appropriate irrigants.
alveolar bone loss close to the root apices of the molars and
Design: 25 infected primary teeth were chosen as subjects and
lower central incisors. No intracranial calcification was found.
randomly divided into 5 groups: A 1% NaOCl +17% EDTA; B
Blood tests differential and serum alkaline phosphatase were
1% NaOCl +6% CA; C 1% CHX +17% EDTA; D 1% CHX
within normal range.
+6% CA; E 0.9% NaCl. Root canal fluid and infected dentin
Positive family history and consanguineous marriage was denied.
were collected before and after root canal irrigation. RT-PCR
Non-surgical periodontal scaling and root planing, plus two-week
was applied to determine total number of bacterial cells, quanti-
antibiotic application and three-year traditional medication were
ties and proportions of Porphyromonas gingivalis before and
given to the patient; all the erupted permanent teeth function
after root canal treatment.
normally except for the upper second bicuspids malocclusion.
Results: The quantities of total bacteria and Porphyromonas gin-
Comments: Even advanced periodontitis with Palmo-plantar kera-
givalis were significant lower than used before (P < 0.05) irrigant
toderma is difficult to cure, chances of saving those affected teeth
in all groups. The total bacteria and Porphyromonas gingivalis
are high given active management timely.
reduction(%) in the five group in descending order was B > D,
A > C > E and A = B = C = D > E.
PR07.12 Proportions of Porphyromonas gingivalis showed increasing
Antibacterial effect of ozone water on trend in group A, C, D, E (P < 0.05) after the irrigation, while
periodontopathogens in vitro no obvious change in group B (P > 0.05).
Conclusions: The ability of removing the total bacteria and Por-
Q. SHI1 & G. X. JIA2
1 phyromonas gingivalis in 1% NaOCl + 6% CA group was the
Paediatric Dentistry, Capital Medical University School of
best in this study, which can be used as a recommended combi-
Stomatology, Beijing, China; 2Beijing Childrens Hospital, Beijing,
nation in the endodontic therapy of the infected primary teeth.
China
Background: Bacteria are recognized as key etiologic factors in PR07.14
periodontal diseases. Controlling periodontopathogens is a prere-
quisite for successful treatment of periodontal diseases. Ozone, as Analysis of effectiveness of triterpenoid compounds
a quickly, effectively and broad spectrum antibacterial agent, has for prevention of dental caries
been widely used in the medical field. However, its antibacterial C. MITSUHATA1, N. TATSUKAWA1, Y. OHARA1, Y.
activity on periodontal pathogens has not yet been elucidated. IWAMOTO2 & K. KOZAI1
1
Aim: To investigate the effect of ozone water on four major peri- Pediatric Dentistry, Hiroshima University, Hiroshima, Japan;
2
odontalpathogens and detect the effective concentration. Pediatric Dentistry, Hiroshima University Hospital, Hiroshima,
Design: Four standard periodontalpathogens strains were chosen, Japan
including Porphyromonas gingivalis(P.g), Fusobacterium nuclea-
Background: Oleanoric acid (OA) and ursolic acid (UA) are trit-
tum(F.n), Porphyromonas intermedia(P.i) and Actinomyces visco-
erpenoid compounds. They have many beneficial effects, such as
sus(A.v). Three concentrations (1.02 ppm, 2.03 ppm and
reducing inflammation and inhibiting tumor growth. It was also
3.88 ppm) of ozone water were used, pure water without ozone
reported that they inhibit GTF for Streptococcus mutans, which
as negative control, and 3% H2O2 as positive control. All groups
is the principal causative agent of dental caries.
were treated with 60s. Quantitative suspension method was used
Aim: Our aim of this study is to investigate the effect of OA and
to count the colony of periodontalpathogens.
UA on cariogenic microorganisms with revealing related gene
Results: All three concentrations of ozone water groups have a
control mechanism.
less colony counts of P.g, P.i, F.n, A.v than negative control
Design: We selected 3 different S. mutans strains which are UA
(P < 0.01). 1.02 ppm ozone water group on P.i was no significant
159, MT8148R and NCH105. At first, 3 strains were checked the
difference compared with 3% H2O2 group, and 2.03 ppm ozone
minimum inhibitory concentration (MIC) which was determined
water group on P.g and P.i was also no significant difference
using a microtitre plate dilution assay. Second, the effect of OA
compared with 3% H2O2 group. Otherwise, the colony counts of
and UA on the biofilm formation of strains was evaluated using
3.88 ppm ozone water on four periodontalpathogens were com-
the biofilm assay by Loo et al. At last, RNA expression levels of
parable with those in 3% H2O2 group.
some target genes with MIC of OA or UA were evaluated using
Conclusion: Ozone water has an antibacterial effect on the major
real-time PCR.
periodontalpathogens, and it appears to be an alternative anti-
Results: The MIC of OA and UA against 3 strains was 6.25 and
bacterial agent of treating periodontal disease. 3.88 ppm is the
3.13 lg/mL. Biofilm formations were inhibited with the similar
effective concentration.
concentration as MIC. RNA expression levels of gtfs and enolase
were observed change of two or more times compared with
control.
Conclusion: It was shown that OA and UA inhibited growth and

PR07.16
biofilm formation of S. mutans by changing expression levels of
related several genes. It is possibility that OA and UA contribute Assessment of gingival thickness in children
as antibacterial agents for prevention of dental caries. D. CHACUN1,2, S. M. DRIDI3,4, C. JOSEPH5 & E. DURSUN1,2
1
Paediatric Dentistry, Paris Descartes University, Montrouge,
France; 2Paediatric Dentistry, Mondor-Chenevier Hospital
PR07.15 Complex, Cr eteil, France; 3Periodontology, Paris Descartes
Role of glucan-binding domain of GbpC in biofilm University, Montrouge, France; 4Periodontology, Mondor-
formation by Streptococcus mutans Chenevier Hospital Complex, Cr eteil, France; 5Paediatric
Y. TAKASHIMA, Y. MORIKAWA, K. FUJITA & M. Dentistry, Nice Sophia Antipolis, Nice, France
MATSUMOTO-NAKANO
Background: The gingival biotype (gingival width and thickness)
Department of Pediatric Dentistry, Graduate School of Medicine,
is genetically determined, but changes over time, especially during
Dentistry, and Pharmaceutical Sciences, Okayama University,
growth. Its regular assessment is important to establish preven-
Okayama, Japan
tive measures, in case of unfavorable biotype. The gingival width
Background: Streptococcus mutans implicated as a primary causa- is easy to quantify, but its thickness is more difficult. In adults,
tive agent of dental caries in humans, produces multiple glucan- the probe visibility through the marginal gingiva was considered
binding proteins (Gbps), which presumably promote formation as a reliable criterion to describe a thin gingiva. However, prob-
of biofilm on tooth surfaces. In our previous study, we identified ing may be difficult in children.
the sequence DPTKTIF, located in the middle of the gbpC gene Aim: To test the clinical relevance of the whitening of the
encoding GbpC, as the glucan binding domain. attached gingiva with labial traction in coronal direction and the
Aim: In this study, we examined the role of the DPTKTIF visibility of the gingival blood supply to evaluate gingival thick-
domain of GbpC in S. mutans. ness.
Design: Rabbit anti-DPTKTIF serum (anti-serum) was generated Design: In 69 children and adolescents, gingival thickness of pri-
using a commercially available peptide of the DPTKTIF mary and/or permanent central incisors and lateral incisors, first
sequence. To examine biofilm formation by S. mutans MT8148, primary molars and/or first premolars was assessed with three
staining with SYTOÒ 9 green was performed, then absorbance of tests: the probe visibility through the marginal gingiva, the whit-
the 600 nm was adjusted to 0.1 with chemically defined medium ening of the attached gingiva with labial traction, the gingival
including 1% sucrose. The resulting bacterial solution was mixed blood supply visibility. The odds ratio between the two latter
with dextran labeled with Alexa FluorÒ 647 in the presence or in tests and probing were calculated to determine their correlation,
the absence of anti-serum, then inoculated onto chamber slides their sensitivity and specificity.
and grown under an anaerobic condition at 37°C for 24 h. Results: To view the probe through the gum were 3.05 times
Formed biofilms were observed using a confocal scanning laser more likely when the gingiva whitens and 5.98 in case of gingival
microscope. blood supply visibility. These two tests provided a reliable assess-
Results: Confocal microscopic observations revealed that the ment (specificity respectively 84 and 96%), but a poor screening
thickness of biofilm in the presence of the anti-serum was signifi- test (sensitivity 37 and 19%) of gingival thickness.
cantly lower than that in its absence. Furthermore, the quantity Conclusions: Whitening of the attached gingiva with labial trac-
of glucan bound to bacterial cells in the presence of the anti- tion or gingival blood supply visibility may be useful when clini-
serum was significantly lower than that in its absence. cal examination is limited or to confirm/reverse the probe
Conclusions: Our results suggest that the DPTKTIF domain of visibility.
GbpC may be a crucial factor for biofilm formation by S. mu-
tans, while anti-serum against that sequence may be effective for
inhibiting biofilm formation.
Restorative Dentistry Poster Session One – PR08–1
Restorative Dentistry Poster Session One –

PR08–1
PR08-1.01 Results: Sixty-four cases were examined with a median follow-up
of 7 months (range 2–36). Mean age at treatment was 13.8 years
Patient-reported outcomes for pre-formed metal (range 8–18). Non-vitality predominantly resulted from trauma
crowns: a dental therapist-led audit (93.75%). Survival at most recent follow-up was 100%. Out-
J. COWLAM1, E. GUPTA2, F. GILCHRIST2 & H. RODD2 comes, using ESE guidelines, were predominately ‘successful’
1
Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, (40.6%) or ‘uncertain’ (46.9%), with 12.5% classified as ‘failure’.
UK; 2Oral Health and Development, University of Sheffield, Of the 0 uncertain0 , 66.7% were asymptomatic and demonstrated
Sheffield, UK radiographic healing, giving a short-term success rate of 71.9%.
Background: Preformed metal crowns (PMCs) are part of a den- 57.8% of treatments were technically satisfactory; common issues
tal therapist’s normal scope of practice and have become increas- included obturation voids (25.0%) and incorrect length (10.9%
ing popular since the introduction of the non-invasive Hall extruded, 4.7% >2 mm short). No significant difference was
Technique. found between technical quality and outcome, but apexification
Aim: To assess patient-reported outcomes for PMCs placed by a method (MTA) and lesion size (<5 mm) increased likelihood of
dental therapist in a hospital setting. success (P < 0.05).
Methods: This was part of an on-going prospective study (2009- Conclusions: Short-term outcomes of endodontic treatment in
present). All children who had received a PMC for a carious pri- paediatric patients appear positive. However, results suggest that
mary molar were reviewed at 3–6 monthly recall intervals by a apexification method and lesion size may influence healing. Fur-
dental therapist. ther research is required to assess long-term prognosis in this
Results: Data were obtained for 452 PMCs provided for 173 chil- subpopulation.
dren, whose mean age was 7.5 years (range = 2–12 years). Each
child received an average of 3 crowns (range = 1–8). 74% of PR08-1.03
PMCs were placed on teeth with caries extending less than half Partial pulpotomy of two carious primary molars
way through the dentine. The majority of PMCs (98.2%) were
placed using the Hall Technique, and very few (1.8%) had
using bioactive tricalcium silicates as a pulp dressing
involved conventional tooth preparation Only 256 PMCs had a material. A Case report
follow-up period of ≥6 months or greater (mean = 14 months; M. Z. RADWAN, N. E. METWALLI, N. S. KABIL & R. K.
range = 7–73 months) and of these, no patient complaint was ABU EL FADL
reported for 95.3% (n = 244) of crowns. For the few children Pediatric Dentistry Dept. Faculty of Dentistry, Ainshams
who did say that their PMC was problematic: 1.6% complained University, Cairo, Egypt
of jaw pain; 2.3% complained of difficulty eating; 2.7% said they
Introduction: The classical approach for pulp therapy in primary
had toothache, and 0.8% said they had a gum swelling/bleeding.
molars has been paradoxical in the past decade due to the carcin-
Conclusions: These findings support the growing evidence-base ogenic potential exhibited by formocresol. In this case report its
for the use of PMCs, using the Hall Technique, as they appear to clearly shown that the use of bio-active materials as pulp capping
cause few problems for young children. Therapists clearly have a
agents not only could help in the preserving the pulp vitality but
role in achieving these high quality outcomes. also can conserve the tooth structure in primary molars.
Case report: This report introduces an innovative technique in
PR08-1.02 which Bioactive Tricalcium silicates (BiodentineTM) are used in
Short-term outcome of endodontically treated cariously exposed primary molars as a pulp dressing material.
The teeth were selected according to a settled criterion. Caries
permanent teeth in a paediatric population removal was performed with the implementation of moisture con-
P. T. CLARKE1, N. LONGRIDGE1, A. JONES2 & S. ALBADRI3
1 trol procedures. Pulp exposure was widened to perform slight
Restorative, Liverpool Dental Hospital, Liverpool, UK;
2 pulpal amputation to ensure the removal of the superficially
Maxillofacial Dept, Alder Hey Children’s Hospital, Liverpool,
inflamed tissues. Bioactive tricalcium silicate was applied. Two
UK; 3Paediatrics, Liverpool Dental Hospital, Liverpool, UK
days later final resin restorations were utilized as an emanel sub-
Background: In contrast to adults, data regarding outcomes of stitute above BiodentineTM.
orthograde endodontics performed on children is sparse. That The primary molars have been followed up for a total period of
available focuses on outcomes of trauma, but to date no studies 18 months using periapical radiographs. Neither evidence of pul-
specifically examine endodontic quality and associated clinical pal necrosis nor periapical pathosis has been detected.
outcomes. Comments: In the near future, this technique could replace the
Aim: To investigate endodontic quality and short-term clinical use of formocresol and complete coronal pulp amputation in pri-
outcomes of permanent teeth in a paediatric subpopulation. mary molars. Therefore, direct resin restorations can be used
Design: Radiographs and records of patients undergoing end- instead of nickel chromium crowns to restore the function in
odontic treatment or review between Sept 2013 and July 2014 at addition to the valuable esthetics which is nowadays in growing
a UK dental hospital’s paediatric department, were analysed ret- demand.
rospectively. Apical status, technical quality and clinical out-
comes were graded using the periapical index (Orstavik, 1986)
and the European Society of Endodontology (ESE) Guidelines.
PR08-1.04 3 days for one week. Finally the tooth was restored using com-
posite veneer.
Evaluation of the mechanical properties of a newer Comments: Different treatment options like bleaching, crowns
universal flowable composite for applications in and laminate veneers are used in the treatment of discolored
pediatric restorative dentistry teeth. The major advantage of this approach is, it is a conserva-
R. G. UBEJA & C. BHAT tive and non- invasive method in stain removal. Bleached tooth
Department of Pediatric and Preventive Dentistry, Bharati should be followed for the cervical root resorption.
Vidyapeeth Dental College and Hospital, Pune, India
Background: The choice of material in pediatric restorative den- PR08-1.06
tistry should not be merely based on technical considerations but Color changes of S-PRG tooth-coating material
other factors such as age, cooperation of child and durability of “Barrier Coat” applied on white spot lesion in
material are equally important in choice of material.
primary tooth enamel: in vitro and clinical studies
Aim: Invitro evaluation of flexural strength and wear resistance
Y. HOSOYA1,2, H. OTANI3, M. MIYAZAKI1 & F. GARCIA-
of a universal flowable composite for applications in pediatric
GODOY4
restorative dentistry. 1
Department of Operative Dentistry, Nihon University School of
— To evaluate the flexural strength and wear resistance of two
Dentistry, Tokyo, Japan; 2Division of Pediatric Dentistry,
flowable composites - G-aenial universal flo(GC- Corp.),Tetric-
Department of Oral Health and Development Sciences, Tohoku
N-flow(Ivoclar Vivadent) and resin modified glass ionomer
University Graduate School of Dentistry, Sendai, Japan; 3Otani
cement- GC fuji II LC(GC-Corp).
Dental Clinic, Nayoro, Japan; 4Department of Bioscience
— To compare the flexural strength & wear resistance of these
Research, University of Tennessee Health Science Center, College
flowable composites and — GC fuji II LC.
of Dentistry, Memphis, TN, USA
Design: FOR WEAR RESISTANCE-30 specimens were prepared
using customized mould. 2 body wear test is performed by wear Background: To arrest incipient caries lesion without tooth dis-
testing machine. coloration, esthetic coating materials are recommended.
FOR FLEXURAL STRENGTH- 30 specimens were prepared Aim: This study evaluated the color of S-PRG Barrier Coat
using customized mould.. This test is conducted as per ASTM D (Shofu Co.) applied on white spot lesion in primary tooth
790 standard and is performed in 3 point bending test device. enamel.
Result: By using ANOVA test and Tukey’s test, the mean flexural Design: Artificial white spot lesions were produced in 12
strength of G aenial was found to be highest followed by Tetric extracted sound primary canines. Teeth were divided into PRG
N fow and RMGIC. Final weights between G aenial and GC fuji group (white spot lesion was coated with Barrier Coat) and con-
II LC is nonsignificant. Moreover there is no significant differ- trol group (no coating), and soaked in artificial saliva for
ence in weight loss of tetric n flow group. 12 weeks. Color images with a color-matching sticker were taken
Conclusion: Flexural strength of G-aenial universal flow is high- with a digital camera in each of the 8 stages of before test, after
est, followed by Tetric N Flow and GC fuji II LC.Wear resis- lesion produced, after coating, after 1, 4, 8 and 12 weeks soaking
tance of Tetric N flow was highest, and there was no significant in artificial saliva, and after coat removal. Spectrophotometric
difference between GC fuji II LC and G-aenial universal flow color measurements were also attempted. Barrier Coat was
groups. applied on 30 primary anterior teeth and the color change was
clinically observed.
PR08-1.05 Results: Neither in vitro nor clinical observation, color changes of
Barrier Coat applied to lesions were not different during the
Bleaching of traumatized discolored anterior tooth tested period. The total color difference (DE*ab) of each stages
using walking bleach technique in the PRG group were 6.9, 6.3 5.5 5.0 5.7, 5.9 and 7.0, and
A. ISLAM, S. KORUN, H. TUNC ß & S. C
ß ETINER those in the control group except for after coating and coat
Paediatric Dentistry Department, Dentistry Faculty of Near East removal stages were 4.2, 5.4, 4.1, 6.2 and 4.9. In both groups,
University, Nicosia / Northern Cyprus, Cyprus there was no significant difference of the DE*ab among the mea-
suring stages.
Introduction: Discolored anterior teeth are often perceived as an
Conclusion: The color change of the Barrier Coat applied on
esthetic deformation. Discoloration of endodontically treated
white spot enamel lesion was imperceptible to the naked eye.
teeth after trauma originates from intrinsic discoloration of the
Barrier Coat was color-stable and effective to use for white spot
pulp chamber. Hemorrhage, calcification of the pulp and end-
enamel lesion.
odontic filling materials are the most common causes of internal
discoloration following trauma.
Case report: A 17 years old male patient was referred to the Den- PR08-1.07
tistry Faculty of Near East University with a complaint of a dis- Microleakage and dentine surface after
colored upper front tooth. According to patient0 s history, he had
chemomechanical caries removal versus drilling
a bicycle fall seven years ago. Clinical examination of the teeth
K. KITSAHAWONG1, A. L. SEMINARIO2, P.
revealed severe discoloration in tooth 21. It was non-sensitive to
PUNGCHANCHAIKUL1, A. RATTANACHAROENTHUM1 &
percussion and palpation tests. The radiographic examination
W. PITIPHAT3
showed a complete root canal treatment without periapical 1
Department of Pediatric Dentistry, Khon Kaen University, Khon
pathology. The patient was informed about the bleaching proce-
Kaen, Thailand; 2Department of Pediatric Dentistry, University of
dure. During his first appointment, the root canal filling material
Washington, Seattle, WA, USA; 3Department of Community
was shortened 2 mm sungingivally. Stains in the pulp chamber
Dentistry, Khon Kaen University, Khon Kaen, Thailand
were removed using round bur with minimal invasion. 1 mm
glass ionomer cement was inserted over gutta percha. The pulp Background: Nowadays, various techniques have been used for
space was cleaned with alcohol. Following this, 35% hydrogen dental caries management. PapacarieÒ has been introduced as a
peroxide bleaching gel was placed in the pulp chamber and the new technique for caries removal. However, only a few studies
access cavity was sealed. The bleaching gel was replaced every reported the efficacy of PapacarieÒ on caries removal.
Aim: To compare the performances of a chemo-mechanical were found between the other pairwise comparisons for agents
method of caries removal using PapacarieÒ and conventional and systems (P > 0.05).
drilling on morphological changes of surface dentine and micro- Conclusion: The findings from the present study showed that all
leakage of subsequent restorations. of the tested materials and systems can be used for cavity disin-
Design: Forty-six carious deciduous molars were randomly fection irrespective of their antibacterial contents.
divided into two groups: caries removal using
(1) PapacarieÒ and PR08-1.09
(2) drilling.
After completion of caries removal, 40 teeth were restored with Effectiveness of gingival retraction methods: a
glass-ionomer(GI) and subjected to thermo-cycling. Subsequently, systematic review
teeth were immersed in 0.5% methylene blue dye solution and S. TABASSUM
sectioned through the restoration. Sectioned teeth were examined Dentistry, Aga Khan University Hospital, Karachi, Pakistan
with a light diffraction microscope to evaluate dye penetration.
Background: It is essential to properly manage the gingival tissues
Three unrestored teeth per group were prepared for scanning
for obtaining accurate impressions when fabricating fixed restora-
electron microscopy (SEM) and polarized light microscopic
tions in which the finish line is near the gingival sulcus. The
analysis.
retraction of the gingiva creates sufficient space between the
Results: There was more microleakage in the PapacarieÒ
preparation finish line and the gingiva to allow for the injection
(mean standard deviation, 2.1 0.9 mm) than the drilling
of impression material into the gingival crevice. There are various
(1.2 0.6 mm; mean difference = 0.8 0.2; 95%CI = 0.3–
gingival retraction methods to choose from including mechanical,
1.3 mm; P < 0.001).The morphology of residual dentine in the
chemomechanical and surgical methods.
PapacarieÒ showed a rough and irregular surface with smear
Aim: The purpose of this systematic review was to see which gin-
layer while the drilling showed less irregularity and a thin smear
gival retraction method was most effective in terms of amount of
layer. After restoration, pictures of polarized light microscope
gingival retraction achieved and minimal trauma to the gingiva
showed that GI adapted well to the dentine surfaces in both
as assessed by clinical parameters.
groups and no interfacial gap was observed. However, the den-
Design: PubMed, CINAHL plus (Ebsco), COCHRANE were
tine-GI interfaces in the drilling were smoother when compared
searched along with hand search using the key terms and differ-
to that of the PapacarieÒ.
ent permutations of gingival retraction* AND displacement
Conclusions: Cavity preparation using PapacarieÒ resulted in
method* OR technique* OR agents OR material* OR medica-
more roughened dentine surfaces and more microleakage com-
ment. Our initial search results yielded 142 articles which were
pared to conventional drilling.
narrowed down to final 7 after a strict eligibility of including
clinical trials or experimental studies on gingival retraction meth-
PR08-1.08 ods with the amount of tooth structure gained and assessment of
In vitro evaluation of the antibacterial effects of clinical parameters as the outcomes, conducted on human perma-
various agents and systems used for cavity nent teeth only.
Results: The total number of teeth assessed in all 7 studies were
disinfection 336. Most commonly used gingival retraction method was
O. BAYGIN1, I. ERDEMIR2, G. BAYRAMOGLU3, R. AKYOL3 mechanical. 3/7 studies reported the amount of gingival retrac-
€ UNER
& T. TUZ € 1
1 tion achieved whereas 4/7 studies assessed the clinical parame-
Department of Paediatric Dentistry, Karadeniz Technical ters.
University, Trabzon, Turkey; 2Department of Paediatric Dentistry, Conclusions: There are just seven studies available on the retrac-
RTE University, Rize, Turkey; 3Microbiology, Faculty of tion methods. The studies were heterogeneous in terms of report-
Medicine, Karadeniz Technical University, Trabzon, Turkey ing the outcomes. No single method (mechanical/
Background: Cavity disinfection has been recommended to pre- chemomechanical/surgical) appeared superior to the other. Clini-
vent the occurrence of residual caries, postoperative sensitivity, cal parameters such as PI, GI, PD, AL, BOP etc. were not signif-
and pulp inflammation caused by bacteria. icantly affected with gingival retraction.
Aim: The aim of this study is to evaluate antibacterial effect of
Corsodyl, Cervitec, Cervitec Plus, Flour Protector agents and PR08-1.10
FotoSan, diode and Er,Cr:YSGG laser systems on S.mutans and
Abstract withdrawn
L.acidophilus.
Design: A cavity tooth model test was used to determine antibac-
terial activity. Eight cylindrical cavities were prepared on dentin PR08-1.11
surface of 24 bovine incisors and 12 of them were left in contact
with S.mutans, others were left in contact with L.acidophilus for
The effect of chlorhexidine 2% application on shear
72 h to allow bacterial invasion. Test agents and systems were bond strength of different dentin adhesives in
applied on one of the eight infected cavities, eighth was left deciduous teeth: an in vitro study
untreated for control. Standardized amounts of dentin chips were E. FAROKH GISOURE
obtained from cavity walls, and the number of bacteria recovered Peadiatric Dentistry, Kerman Dental Faculti Iran, Kerman, Iran
was counted. Statistical analysis was carried out using Kruskal
Wallis and Mann-Whitney U test with Bonferroni correction (P Background: Composite restoration materials have gained
< 0.05). increased attention because of the type of cavity preparation and
Results: All of the tested agents and systems showed significantly maintaining healthy dental tissue. The strength of adhesive bond
higher antibacterial effects compared to the control group (P < to dentin is one of the most important parameters for evaluating
0.01) on both of two microorganisms. Cervitec (P < 0.001) and efficacy of bondings.
Fotosan (P < 0.001) showed significantly lower antibacterial Aim: We aimed to evaluate the effect of chlorhexidine 2% on shear
effects compared to Fluor Protector on S.mutans and also Fluor bond strength of different dentin adhesives in primary teeth.
Protector revealed significantly decreased effects compared to the Design: Sixty human primary molars were selected and sectioned
Corsodyl (P < 0.001) on L.acidophilus. No significant differences bucco-lingually (120 cases) and were divided into 12 groups:
(normal and caries affected), bonding,SE Bond(SE),Clearf- tion (ICON) claims to provide full depth protection in vitro, it is
ilS3Bond(S3),SingleBond2(S2) and treatment (with chlorhexidine hard to detect clinically due to its lack of radiopacity.
[CHX 2%],without CHX 2%). In S2 group, after etching, CHX Aim: To develop a smart radiopaque infiltrating resin that has the
were applied for rewetting of dentin and In SE and S3 were potential to re-mineralise the initial carious lesion in full depth.
applied before use of bonding system. The samples were main- Design: Strontium Bioglass (SrBG) and the Strontium hydroxy-
tained in distilled water at 37 ˚c in the incubator for 24 h and apatite (SrHAP) were added to BIS-GMA based resin as radio-
placed under thermocycles in the next stage (500 heat cycles of opaque agents at concentration of 10, 20 and 30 wt%. The mate-
5–55˚c). Shear bond strength was calculated with testometric rials were photo-polymerised to form 6 9 1 mm2 discs using a
machine running at a crosshead speed of 0.5 mm/min, and mode blue LED light. An enamel disk and resin-only disk were used as
of failure was examined with stereomicroscope. standards. Each sample and an aluminium wedge were placed
Results: No significant difference in shear bond strength between side by side on a dental radiographic sensor and digital radio-
the different types of adhesives (P = 0.9), use of chlorhexidin graphs were taken with 0.6 ms exposure at 70 kV and 8 mA.
(P = 0.22) and type of dentin (P = 0.9). the mean shear bond The mean grey values (MGV‘s) of each sample and aluminium
strength of the different groups. the failure distribution percent- (Al) step wedge were measured by using the histogram function
age after shear bond strength test. The dominant fracture pattern of a computer graphics program.
was mixed followed by cohesive. Results: The equivalent Al thickness radiopacities for resin only
Conclusion: This study showed that CHX 2% had no effect on and enamel were 0.7, 2.1 mm respectively, for 10, 20, 30%
the shear bond strength of adhesive systems to normal dentin SrBG-resin were 0.6, 0.9, 1.1 mm respectively, and for 10, 20,
and caries affected dentin in primary molars. 30% SrHAP-resin were 0.7, 0.9, 1.8 mm respectively.
Conclusion: 30% SrBG and 30%SrHAP - resins have radio-opac-
PR08-1.12 ity equivalent to >1 mm which is the ISO standard as a radi-
opaque dental material.
Dental treatment of patients with hemophilia A: a
case report PR08-1.14
T. Z. SUN, H. H. CHANG, Y. L. WANG, G. F. HUANG &
M.K. GUO Comparative clinical of adhesives systems used in
National Taiwan University, Taipei, Taiwan primary teeth
A. M. ORTOLANI, S. G. CORTESE & A. M. BIONDI
Introduction: Hemophilia A is a congenital bleeding disorders Department of Pediatric Dentistry, University of Buenos Aires,
caused by deficiency of factor VIII. The severity of the disease
Buenos Aires, Argentina
depends on the level of clotting factor activity. Patients with fac-
tor levels <1% of normal are classified as severe hemophilia. Background: Previous studies suggested that single component
Some dental treatment may risk prolonged bleeding to these self-etching adhesive systems showed to be a good alternative in
patients; therefore, be attentive to the systemic condition of the Pediatric Dentistry with less operative time than conventional
patients and modify the treatment protocol, would reduce the systems and similar clinical performance but with lower enamel
unfavorable outcomes in practice. bond strength values.
Case report: A 5-year-old boy with severe type of hemophilia Aim: Compare clinical performance of restorations placed in pri-
A visited Pediatric Dental Clinic of NTUH for caries examina- mary dentition using a single component self-etching adhesive
tion and treatment. Previous lab data showed excessively pro- system AdperTM Easy One with and without previous enamel acid
longed aPTT (153.6 s), which was consistent with the conditioning.
extremely deficiency of the factor VIII level (< 1%). He has Design: Experimental Design. Data obtained from 42 patients
been undergoing primary prophylaxis with recombinant factor (5.47 1.67 years.) with one or more small and moderate cari-
VIII 2–3 times a week since he was 1-year-old. Accordingly, ous lesions in vital deciduous teeth were restored using resin
his dental treatment was performed about 1 h after factor composites and AdperTM Easy One previous enamel etching with
replacement. He received composite resin filling on tooth 51, phosphoric acid 37% during 30” (Group AAG n = 67) and com-
61, 64, 65, 84; pulp therapy plus stainless steel crown restora- pared with results obtained in 24 patients (5.16 0.11 a~ nos)
tion were performed on tooth 54, 55, 74, 75, 85. In any way, using the same system without previous conditioning (Group AA
we saved the teeth and avoided dental extraction in such n = 44). 111 composite resin restorations were placed by 3 cali-
patients as possible. Then he was scheduled for periodic fol- brated operators (Kappa: 0.96) and assessed at baseline and after
low-up at 3-months intervals. 6 and 12 months following the modified Ryge criteria.
Comment: Dental treatment of patients with bleeding disorders is Results were statistically analyzed with Fisher’s Exact Test. Pro-
challenging, in that many procedures involving oral soft tissues ject was approved by Ethics Committee.
may lead to unexpected hemorrhage. It is shown that with little Results: Failure rates over 6 month period were 6% in both
more consideration and preparation, even severe hemophilic groups and 7% in AA in 12 month period. No significant differ-
patients can also experience harmless dental treatment at dental ences were found between AAG vs AA P = 0.576 at 6 months
clinic. and 12 months P = 0.058.
Conclusion: In this study clinical performance of restorations
PR08-1.13 using a single component self-etching adhesive system with and
without previous enamel acid conditioning showed similar results
Development of radio-opaque resin for white spot with less need for replacements after 12 months in the group of
lesion selective enamel etching.
M. MOEINIAN1, F. WONGI1, R. HILL1, J. DARR2 & D.
CLEMENT2
1
QMUL, London, UK; 2UCL, London, UK
Background: White spot lesion is an early sign of caries charac-
terised by subsurface demineralisation. Though the lesion could
be remineralised, it is usually found superficially. Resin infiltra-
PR08-1.15 greater MD/BL ratio than girls (1.10) (P < 0.05). The average of
MD distance is near to No.4 SSC in boys and No.3 SSC in girls.
Caries experience and treatment of children with
Conclusions: The crown size of lower D was greater in boys than
special health care needs (CSHCN) that of girls in Taiwan. Understanding the morphologic charac-
K. BÜCHER, K. ROTHMAIER, V. PITCHIKA, R. HICKEL & J. teristics of lower D is important for dentists to prepare the tooth
€
KUHNISCH and apply SSCs.
Kinder- und Jugendbehandlung, Poliklinik f€
ur Zahnerhaltung und
Parodontologie Klinikum der Universit€
at M€unchen, M€unchen,
Germany PR08-1.17
Minimal invasive potential of three caries excavation
Background: CSHCN have an elevated need for preventive and
operative care of caries. For an extensive treatment need, the use
methods in children
of general anaesthesia (GA) is indicated. M. K. ZAYET1, S. B. ELTAWIL2, S. A. MAHMOUD2 & S. A.
Aim: This retrospective study aimed to retrieve information ABDELMONIEM2
1
about the caries experience and treatments performed in a popu- Oral Radiology Department, Faculty of Oral and Dental
lation of CSHCN with regards to invasive and preventive care. Medicine, Cairo University, Cairo, Egypt; 2Pediatric Dentistry and
Design: A total number of 795 patients (m:f = 1.4:1) had been Dental Public Health, Faculty of Oral and Dental Medicine, Cairo
treated at the Paediatric Division of the Department of Operative University, Cairo, Egypt
dentistry from 2004 to 2012. All included children were younger Background: Recently, the concept of minimally invasive (MI)
than 14 years and suffered from at least one ICD-10 relevant dentistry has emerged. MI calls for the selective removal of heav-
medical condition. Statistical analysis was performed with Micro- ily infected and irreversibly denatured dentin caused by carious
soft Excel and “R”. lesions while preserving dentin that is demineralized but not
Results: The mean age of sample patients was 6.8 (3.3) years infected.
with a dmft/DMFT of 5.6/0.9 at the initial visit. The major medi- Aim: To compare the minimal invasive potential (MIP) of fluo-
cal diagnoses were mental/chromosomal malformations (ICD rescence aided caries excavation (FACE), caries detection dye
Q00-09) and mental/behavioural disorders (ICD F00-09). First (CDD) and conventional caries excavation methods in children.
treatment under GA was necessary in 41.6% with a second GA Design: A total of 105 carious primary molars in 43 children were
in 50 cases and third GA in 11 patients with a significantly included in this study. The teeth were randomly divided into
higher dmft than for the remaining population treated chair-side. three groups according to the caries excavation method. Preoper-
Time-span between 1st and 2nd GA was 28.9 13.9 months. At ative evaluation of the carious teeth was performed using digital
the end of the observation period (mean 22.4 months), 45.5% of radiography after sealing the cavities with a radiopaque material.
patients received solely preventive care, 41.5% chair-side treat- Caries excavation was performed using FACE, CDD or conven-
ment and only 6.5% a treatment under GA. tional caries excavation method. The teeth were restored using
Conclusions: CSHCN have a high treatment need that may self-cured resin-reinforced glassionomer. Postoperative radio-
demand for a treatment under GA. With a preventive oriented graphic examination was then performed. Pre and postoperative
recall, the numbers of repeat treatment are relatively low. Minor widths and depths for the cavities were assessed. MIP was deter-
problems may be solved chair-side without GA despite the under- mined by comparing the prepared-cavity width and depth relative
lying medical condition. to the initial width and depth of the caries lesion, respectively.
Results: There was no statistically significant difference between
PR08-1.16 the MIP of examined groups neither after comparing cavity
widths at P = 0.253 nor depths at P = 0.06. FACE showed the
Comparison of morphology of Taiwanese lower
highest mean values of MIP potential for cavity widths
primary molars with related stainless steel crowns (1.41 0.36) and depths (2.04 0.74).
T. T. CHAO1 & H. H. TSAI2 Conclusions: FACE, CDD, and conventional caries excavation
1
Dentistry Department, Mackay Memorial Hospital, Taipei, showed comparable MIP in children.
Taiwan; 2School of Oral Hygiene, Taipei Medical University,
Taipei, Taiwan
PR08-1.18
Aim: The first choice of restoration for a decayed primary molar Shear bond strength and microleakage of a sealant
is a stainless steel crown (SSC). The lower primary first molars
(Palmer notation code D┐ or ┌D) have not only unique shape
containing S-PRG filler (BeautiSealant)
but also more variations in morphology than any other teeth. H. SEO & J. AN
The aim of this study was to examine significant and clinical rele- Department of Pediatric Dentistry, Gangneung-Wonju National
vant aspects of the lower primary first molars in Taiwanese chil- University, Gangneung, Korea
dren and the related SSC (3M ESPE,No.2~No.7). Background: Recently, self-etching fissure sealant containing S-
Design: The materials comprised dental casts of 63 children (33 PRG filler have been introduced to reduce technical sensitivity.
girls, 30 boys) who have intact clinical crowns of all molars. The However, their efficacy should be assessed.
right lower D of dental casts and SSC were scanned by Micro- Aim: The aim of this study was to compare self-etching primer
scribe G2 Digitizers (Immerion Inc., US) to build 3D data set. and conventional acid etching on shear bond strength (SBS) and
Standardized photographs of the occlusal surfaces of dental casts microleakage of fissure sealant containing S-PRG filler in vitro.
and SSCs were obtained. The 3D data sets were translated by Design: Forty-five non-carious premolars were randomly divided
software Graph-R(Graph-R Project,Japan) for 3D drawing and into three groups (N = 15). (Group1) 37% phosphoric acid etch-
calculated by Microsoft Excel 2013 and software Keynote 6.1 ing + ClinproTM sealant (3M ESPE, St.Paul, USA), (Group2)
(Apple Inc., US) for data analysis. 37% phosphoric acid etching + BeautiSealant (Shofu, Kyoto,
Results: The MD distance of lower D showed a statistically sig- Japan), (Group3) self-etching + BeautiSealant.
nificant difference between boys (7.75 mm) and girls (7.41 mm) For the SBS test in each group (N = 10), microcylinders of fis-
(P < 0.01). The BL distance showed no significant difference sure sealant were bonded to prepared buccal and lingual surfaces.
among the genders. Boys (1.17) had statistically significant The samples were subjected to 500 rounds of thermocycling and
shear bond testing using a universal testing machine with a cross- strate the treatment of immature, necrotic, permanent incisor by
head speed of 1 mm/min. using regenerative endodontic therapy.
For the microleakage test in each group (N = 5), sealants were Case report: A 12 year-old boy was referred to the dental pediat-
adjusted on each occlusal fissure of teeth. All teeth surface were ric clinic with a chief complaint of unsuccessful endodontic treat-
coated with nail varnish, with the exception of a 1.0 mm window ment of his upper right incisor. He had a history of trauma from
around the restoration margins. The teeth were immersed in 2% his upper central incisors after a fall of 2 years ago. After several
methylene blue solution for 24 h and then rinsed in water. failed treatments the patient was directed to our dental pediatric
Results: The mean of SBS (MPa) and occurrence of microleakage clinic. In intraoral examination, there was an access cavity related
(score) of the groups were as follows. Group 1:17.08 MPa, 1.2, with oral cavity. The tooth was hypersensitive to percussion. The
Group 2:16.04 MPa, 1.3 and Group 3:12.42 MPa, 1.6. radiographic examination revealed apical radiolucency. Following
Sealant using phosphoric acid etch application prior to Beauti- disinfection of the canal space with calcium hydroxide paste,
Sealant application demonstrated more SBS in comparison with regenerative endodontic treatment was performed. The root canal
that of self-etching primer application. There was no statistically was sealed with mineral trioxide aggregate and the tooth crown
significant difference in occurrence of microleakage among three was restored permanently with composite resin. Clinical examina-
groups. tion at 1, 2, 3, 6 and 9 months revealed an asymptomatic tooth.
Conclusions: In order to obtain adequate bonding strength and Radiographic examination revealed resolution of periapical
lower microleakage, it is recommended to use acid etching prior radiolucency, increased thickening of the canal wall, and length-
to BeautiSealant application. ening of the root, which demonstrated the continual development
of the tooth root at recall appointments.
PR08-1.19 Comments: Regenerative endodontic techniques may enhance
continued root development and, therefore, offer an alternative
Could mini-head hand-piece optimize operator’s approach to the management of traumatized immature perma-
convenience & patients’ behavior in minimally nent teeth with pulp necrosis and periradicular infection.
invasive procedures?
M. RASHED, D. MOHEB & S. AWAD PR08-1.21
Pediatric Dentistry and Dental Public Health Department, Faculty
of Oral and Dental Medicine, Cairo University, Cairo, Egypt
Comparative evaluation of the effect of 10% a-
tocopherol solution and 5% grape seed extract on the
Background: Child behavior in dental clinic remains challenging micro hardness and shear bond strength of bleached
to the pediatric dentist. Efforts should not be spared to reduce
patients’ anxiety and increase their satisfaction. NSK S-Max air-
dentin
turbine Pico Mini-Head was claimed to offer wider visibility and C. SINGH & M. SRIVASTAVA
more convenience -especially when operating in Minimally Inva- Pedodontics and Preventive Dentistry, KD Dental College and
sive (MI) procedures- because of its ultra mini-head and slim Hospital, Mathura, India
body shape. However knowledge gap still exists supporting its Background: The bleaching of nonvital teeth is a minimally inva-
use in everyday pediatric dental practice when compared to the sive intervention conserving tooth structure with side effects like
regular sized hand-piece. alterations in tooth structure, external root resorption and
Aim: To assess the convenience of Pico Mini-Head vs the regular decreased bond strength.
sized hand-piece on the operator and patient levels. Aim: To evaluate the effect of 10% a-tocopherol and 5% grape
Design: Thirty 6–8 years old patients received conservative CP. seed extract on the micro hardness and shear bond strength of
Split-mouth technique was randomly employed where Pico Mini- bleached human dentin.
Head and the regular sized hand-piece were utilized to treat dif- Design: Two hundred extracted premolars decoronated and grin-
ferent quadrants. Bieri-Modified Scale-six cartoon-faces starting ded to get flat dentin surface occlusaly. Twenty samples as con-
from a neutral state to tears/crying- was recruited to assess dental trol and remaining 180 samples were bleached with 35% H2O2
anxiety. Subsequently, the operator’s convenience, patients’ satis- gel. The 180 bleached dentin surfaces were divided into three
faction and behavior were analyzed. groups of 60 each depending upon type of antioxidants used.
Results: On operator level, compared to regular sized hand-piece, Groups were further sub divided into sub groups I & II (n = 30)
Pico Mini-Head showed high dentists’ satisfaction, expanded based on storage period before building with composite. Fifteen
operational visibility, more convenience as well as accessibility in samples from each sub groups were used for determination of mi-
children, less mean operator time (18 compared to 20 min) and crohardness and the remaining 15 samples were stored in distilled
less need for local anesthesia during CP. On patients’ levels less water for 24 h before shear bond strength determination.
discomfort and fear from Mini-Head hand-piece were noted. Results: Study revealed bleaching decreases the microhardness &
Children welcomed its appearance even more. bond strength of the dentin. Shear bond strength was more in all
Conclusion: Mini-Head hand-piece provided greater patient-den- groups after 15 days. Application of 10% alpha-tocopherol and
tist comfort and cooperation. Based on its design, it is well suited 5% grape seed extract was effective in reversing the adverse
to pediatric patients and may open novel horizons in fields of MI effects of bleaching over the dentinal surface microhardness &
and pediatric dentistry. shear bond strength & also 5% grape seed extract proved to be
better than alpha tocopherol.
PR08-1.20 Conclusion: .Adverse effects of bleaching can be reversed with
application of 10% alpha tocopherol & 5% grape seed extract
Revascularisation of immature permanent teeth: 9- over the dentinal surface microhardness & shear bond strength.
month follow-up
E. KARAKAYA, B. N. C €
ß ELIK & H. SONMEZ
Pediatric Dentistry, Ankara University, Ankara, Turkey
Introduction: Regenerative endodontics is a promising alternative
treatment to conventional endodontic therapy for immature teeth
with necrotic pulp. The aim of this case report was to demon-
PR08-1.22 apical closure in one root and thickening of root walls in both
incisors after twenty-four months.
Histologic evaluation of the short term response of
Comments: In previously root-filled, open-apex teeth which
primary dental pulp to a biodegradable propolis require endodontic retreatment, the revitalization procedure may
preparation. An experimental study on dogs facilitate apical closure and to some extent, thickening of root
A. N. ABD EL-LATIF1, M. A. MATAR2, G. M. MAHMOUD3 walls.
& G. F. BALATA4
1
Oral Pathology, Pharos University in Alexandria, Alexandria,
PR08-1.24
Egypt; 2Pediatric Dentistry, Pharos University in Alexandria,
Alexandria, Egypt; 3Pediatric Dentistry, 6th October University Obtaining exfoliated teeth for research purposes: a
for Modern Science and Arts, Cairo, Egypt; 4Department of feasibility study
Pharmaceutics, Faculty of Pharmacy, Zagazig, Egypt C. WARNER, T. BROOMHEAD & H. RODD
School of Clinical Dentistry, University of Sheffield, Sheffield, UK
Background: Recent trends in pulp therapy depend on tissue
regeneration rather than fixation or preservation. Propolis is a Background: Clinical outcomes support the success of preformed
natural nontoxic resinous material collected by Apis mellifera metal crowns (PMCs), using the non-invasive Hall Technique
bees from various plants. It has antimicrobial, anti-inflammatory, (HT), for carious primary molars. However, the underlying pulp-
antioxidant, anesthetic and cytotoxic properties, Ethanol extract dentine responses have not yet been elucidated as tooth samples
of propolis has the ability of inducing hard tissue formation. are difficult to obtain.
Aim: The aim of the present study was to evaluate the effect of a Aim: To determine the feasibility of obtaining naturally exfoli-
resorbable preparation of propolis on primary dental pulp. ated primary molars, previously restored with a HT PMC.
Design: Resorbable propolis was prepared by composing 10% Design: A single-page questionnaire was posted to parents of 100
PE, 1.8% chitosan, 0.2% HPMC, 5% Propylene glycol& 2% children, aged between 8 and 12-years, seeking information about
acetic acid To 100. Vital pulpotomy was performed in 36 primary their child’s exfoliated primary teeth. All children had been previ-
molars of dogs. 18 teeth were treated with a biodegradable prop- ously treated at Sheffield Dental Hospital, UK, and had received
olis preparation (group A), and 18 were treated with formocresol one or more PMCs using the HT.
(group B). Animals were sacrificed after two and six weeks and Results: 24 questionnaires were returned, giving a low response
histologic evaluation were performed for both inflammatory rate of 24%. 58% (n = 14) of respondents stated their child usu-
response and hard tissue formation. ally placed exfoliated teeth under a pillow and the parent kept
Results: Propolis specimens showed significantly less pulpal them indefinitely. 96% (n = 23) gave their child money for exfoli-
inflammation compared to formocresol at two and six weeks. All ated teeth (mean = £1; range = £0.5-£5). Seven parents had saved
specimens of propolis (100%) showed hard tissue formation at an exfoliated tooth with a PMC and 86% (n = 6/7) said that they
six weeks compared to four out of nine specimens (44.4%) in the would be happy to donate it for research purposes. Of those
formocresol group. whose child’s PMC tooth had not yet exfoliated, 77% (n = 10/
Conclusions: A resorbable propolis preparation results in less 13) said they would definitely give the tooth to further research
inflammatory response than formocresol, and is more effective in and 23% (n = 3/13) said they may be prepared to do so.
promoting hard tissue formation when used as a vital pulpotomy Conclusions: Although the response rate was low, parents were
agent in primary dental pulp. found to be very happy to provide their child’s exfoliated teeth for
research purposes. It would therefore be feasible, with forward
PR08-1.23 planning and ethical approval, to collect exfoliated teeth that had
previously received a HT PMC for histological examination.
Revitalisation of previously traumatized root-filled
incisors: 24-month follow-up PR08-1.25
G. ATASEVER & Z. CEHRELI
Department of Pediatric Dentistry, Faculty of Dentistry, Cytotoxicity and regenerative potential of three
Hacettepe University, Ankara, Turkey different tricalcium silicate-based cements
K. C. HUTH, K. BROOS, S. KIST, R. HICKEL & M.
Introduction: Revascularisation/Revitalisation of open-apex inci-
KOLLMUSS
sors has become a viable treatment option, particularly in cases
Department of Restorative Dentistry & Periodontology, University
of traumatic injuries. This case report presents revitalisation of
of Munich, Munich, Germany
previously traumatized and root-filled incisors.
Case reports: A 10-year-old girl was referred to the Paediatric Background: Recently there are an increasing number of indica-
Dentistry Department for retreatment of poorly obturated max- tions for the use of tricalcium silicate-based cements in Dentistry,
illary central incisors that had experienced traumatic injury two most of them in direct contact to oral tissues that should remain
months earlier. Radiographic examination of the clinically intact and in fact regenerate.
asymptomatic incisors revealed root canal fillings of unaccept- Aim: To investigate a possible cytotoxic effect and osteogenic
able quality along with periapical radiolucency. The root fillings regenerative potential of three tricalcium silicate-based cements
were removed under rubber dam isolation with minimal (ProRoot MTA, Dentsply; MedCem MTA, MedCem; Bioden-
debridement, which revealed open apices of approximately tineTM Septodont).
1 mm diameter. The root canals were medicated with triple Design: Cement eluates (cement specimens incubated in medium
antibiotic paste for 3 weeks, after which a revitalisation proce- for 24 h followed by filtration to remove particulates) were pro-
dure involving removal of the antibiotic paste, induction of api- duced. Three cell lines (human gingival fibroblasts HGF-1, pri-
cal bleeding and placement of MTA coronal barrier was mary human osteoblasts HOB, primary human periodontal
performed. Following a two-week temporisation with conven- ligament fibroblasts hPDLF) were exposed to serial eluate dilu-
tional glass ionomer cement, a final restoration was placed tions (undiluted, 1:2, 1:5, 1:10 in medium) over 24 h with med-
using acid-etch resin-based composite. The patient was recalled ium as negative and Triton-X-100 1% as positive controls.
every six months for clinical and radiographic examinations, Cytotoxicity was analysed by WST-8-Assays (n = 3) and survival
which revealed resolution of periapical radiolucency, complete rates given as % of negative control. To assess possible osteo-
genic regenerative potentials, Western blots from nuclear protein of LD (Lesion Depths) and penetration depth of PD (Penetration
cell extracts incubated with undiluted cement extracts for 24 h Depths), calculating penetration percentage of PP (PP = PD/
were performed. A monoclonal antibody was used to show up- LD 9 100%), multisample rank test analyzing of the relationship
regulation of RUNX2 transcription factor responsible for expres- between the penetration depth and time.
sion of important osteogenic proteins like osteocalcin or osteo- Results: Penetration depth of penetrating resin in 1 min was
pontin. <3 min .90% of maximum demineralization depth can be
Results: No significant differences were observed between the achieved when the resin penetrating for 2.5 min; the maximum
three cement types, with none showing any degree of toxicity. demineralization depth can be achieved after 3 min penetration,
RUNX2 Western blots showed higher levels of RUNX2 in trea- but there was no significant effect on penetration depth after
ted cells compared with untreated and no significant differences more time and there was no statistically significant difference.
between cements. Conclusion: 3 min penetration time can basically achieve maxi-
Conclusion: These cements can therefore be used without hesita- mum demineralization depth of early enamel caries.
tion when indicated and when direct contact with oral tissue
occurs, while the exact mechanisms of their osteogenic potential PR08-1.28
need further elucidation.
In-vitro antibacterial activity of innovative endodontic
PR08-1.26 medicaments and different vehicle combinations
T. M. NALAWADE1, K. G. BHAT2, S. H. P. SOGI3 & S.
A comparative study of BiodentineTM and MTA HUGAR1
1
Angelus on adhesion of human periodontal ligament Pedodontics and Preventive Dentistry, KLE University, Belgaum,
fibroblasts India; 2Consultant, Dr Prabhakar Kore Basic Science Research
A. ALCAINA1, O. CORTES 1, M. CATALA 2, S. GUZMAN 1& Center, KLE University, Belgaum, India; 3Pedodontics and
3 Preventive Dentistry, M. M. College of Dental Sciences &
M. D. AUSTRO
1
Pediatric Dentistry, University of Murcia, Murcia, Spain; Research, Ambala, India
2
Pediatric Dentistry, University of Valencia, Valencia, Spain; Background: Dental caries is the most common chronic disease
3
University of Murcia, Murcia, Spain and one of the most expensive diseases to treat. The National
Background: Biocompatibility is the property of a material to Oral Health Survey and Fluoride Mapping 2002–2003 in India,
perform with an appropriate host response to a specific applica- revealed a high proportion of untreated caries. The reasons being
tion. Numerous materials have been used to seal the root-end the cost of treatment, myths about the primary dentition that
cavity during periradicular surgery. A root-end filling material they shed off and do not require treatment. Additional influenc-
functions as a ‘physical seal‘ to prevent microleakage from the ing factors were that dental treatment for children is multi-visit
root canal system into adjacent periradicular tissues. and causes loss of pay on part of the parents to avail treatment
Aim: The aim of this study was to evaluate the cellular adhesion at educational institutions. Hence, Lesion Sterilization and Tissue
potencial as well as in vitro biocompatibility of BiodentineTM Repair with the combination of antibacterial agents for disinfec-
compared to MTA Angelus. tion of pulpal and periapical lesions of primary teeth might be a
Design: Human periodontal ligament fibroblasts (PDL) were pre- simple and economical treatment with more patient acceptance.
pared from the extracted roots of two impacted mandibular third Aim: The aim of this study was to evaluate antibacterial activity
molars. Biocompatibility was assessed by 3-(4,5-dimethylthiazol- of innovative endodontic medicaments and different vehicle com-
2-yl)-2,5-diphenyltetrazolium bromide salt (MTT) assay. Stere- binations using well-plate method.
omicroscopy was used to observe cellular attachment, sprouting, Design: In-vitro study on Streptococcus mutans (ATCC 25175),
and survival. Staphylococcus aureus (ATCC 12598) and Enterococcus facealis
Results: The results of this study are in process of evaluation. (ATCC 35550).
Conclusions: The biocompatibility and adhesion of these materi- Results: 2% Chlorhexidine gluconate was consistently effective of
als is important when considering use for root-end endodontic all endodontic medicaments especially in combination with pro-
microsurgery. Further investigation is required in order to reveal pylene glycol (P < 0.05) amongst all vehicles followed by a mix-
the wound healing capabilities in vivo. ture of propylene glycol and polyethylene glycol.
Conclusions: 2% Chlorhexidine gluconate in combination with
propylene glycol could be also used as an endodontic medica-
PR08-1.27 ment instead of the routinely used antibiotic pastes in Lesion
Effect of penetrating resin on the penetration depth Sterilization and Tissue Repair. Chlorhexidine gluconate is a
of early artificial enamel caries at different safer alternative to the routinely used Triple Antibiotic paste and
penetrating time Double Antibiotic Paste due to its inherent advantage of not
J. LIN1, W. MA2 & X. ZHU2 developing resistance in micro-organisms and low toxicity.
1
The Affiliated Hospital of Stomatology, Chongqing Medical
University, Chongqing, China; 2Chongqing Medical University, PR08-1.29
Chongqing, China Preliminary research of Er:YAG laser used on
Aim: The purpose of this in vitro study is to evaluate the effect of pulpotomy of dogs
different permeating time on enamel permeating depth when Y. GUO1 & S. ZHANG2
1
applied enamel with GermanDMG penetrating resin. Paediatric Dentistry, Peking University School of Stomatology,
Design: 50 healthy premolars without caries extracted for ortho- Beijing, China; 2Peking University School of Stomatology, Beijing,
dontic reason were selected, then artificial enamel caries was pre- China
pared,randomly divided into 5 groups (n = 10).Samples were
penetrated with penetrating resin for 1 min, 2 min, 2.5 min, Background: With many advantages such as painlessness, low
thermal effects and effective cutting of enamel and dentin with-
3 min, 4 min, respectively, then light curing 60s. Specimens were
prepared after the teeth being sliced and polished,observed with out damaging the pulp, Er:YAG laser has gained more and more
inverted fluorescence microscope, measuring caries damage depth attention in handling dental diseases. It will not cause irreversible
damage by virtue of its low thermal effect when used for cavity a fuzzy sillhouette known as “ghost teeth”. This case report pre-
preparation or on pulp directly. Furthermore, the inflammation sents oral and radiographic features of a child patient with ROD
response can be weakened and the formation of reparative dentin and the prosthetic approach utilized to preserve the developing jaw.
accelerated with Er:YAG laser. With all these properties, the Er: Case report: A 12-year-old girl was referred to the Paediatric
YAG laser shows a promising potentials on pulpotomy. But the Dentistry department with a chief complaint of unerupted perma-
studies are limited. nent maxillary left central, lateral and canine teeth. The affected
Aim: Explore the effects of Er:YAG laser used on pulpotomy of region had no visible swelling or fistula. Radiographic examina-
teeth of beagle dogs, observing the clinical and radiological tion revealed hypoplastic crowns with abnormal morphology and
results, as well as the inflammation level of apical area of pulp absence of contrast between enamel and dentin, with a fair
and the formation of dentin bridge. demarcation between enamel and dentin. Owing to the asymp-
Design: 1-year-old Beagle dog premolar teeth were used. The tomatic nature of the condition, a non-surgical conservative
coronal pulp were removed by traditional bur or Er:YAG laser. treatment plan involving fabrication of a custom removable pros-
Then, they were dressed with MTA and sealed with resin. Clini- thetic appliance overlaying the affected area until cessation of
cal, radiological and histological analysis was performed 1 day, jaw development was made. The patient has been attending regu-
2 weeks, 4 weeks and 8 weeks after treatment. The samples were lar control visits for 12 months.
assessed by an independent observer for calcified bridge forma- Comments: In child patients with ROD, the treatment plan
tion and radicular pulp inflammation. should be tailored according to the age of patient; the extent of
Results: The clinical and radiological results show no differences involvement, and the functional and aesthetic needs of each indi-
between laser and control group. The histological examination vidual case.
show no difference of radicular pulp inflammation between laser
and control group. Dentin bridge formation of laser group was PR08-1.32
better than control group in 2 weeks.
Conclusion: The laser pulpotomy show no harm to radicular pulp Hall technique preformed crowns-a survey of
and can promote the formation of dentin bridge. specialist paediatric dentists in the UK
A. ROBERTS, A. MCKAY & S. ALBADRI
PR08-1.30 School of Dentistry, University of Liverpool, Liverpool, UK
Pulp-dentin complex regeneration by using a new Background: The use of Hall technique preformed crowns
modified treated dentin matrix agent (HTPCs) to restore primary teeth has been suggested as an alter-
native to conventional treatments. Little is currently known
W. GUO, L. LI & W. TIAN
about specialist use of this technique.
Sichuan University, Chengdu, China
Aim: To assess the use of HTPCs amongst specialist paediatric
Background: Pulp capping has proven to be more effective than dentists in the UK.
root-canal therapy for pulp-dentin regeneration. Given the low Design: This was a prospective questionnaire-based study. An
success rate of conventional methods, new materials should be online questionnaire was distributed to all specialists registered
developed. Our previous studies suggested treated dentin matrix on the British Society of Paediatric Dentistry email list between
(TDM) could promote the odontogenic differentiation of dental July and September 2014.
stem cells. Results: Ninty four questionnaires were completed. The majority of
Aim: The pulp capping agent derived from TDM would induce respondents work in teaching hospitals, followed by community
pulp stem cells differentiate to odontoblastis and would achieve dental services. Out of the 90 individuals who use HTPCs, 15% use
better dentin bridge and slighter pulp reaction than Dycal in them as treatment of choice for symptomless carious primary
direct pulp capping experiment. molars, with 58% using them as a treatment option, and 23% using
Design: In this study, TDM is treated to powder by two kinds of them only when unable to provide a conventional restoration. 60%
technology then mixed with gelatin (G) and propylene glycol have been using HTPCs for over 5 years. 15% always use separators
(PG) separately to contribute the new bioactive pulp capping prior to fitting HTPCs and 67% sometimes use them.76% will con-
agent (TDMA) that compare with Dycal in vivo and in vitro. sider placing HTPCs under inhalation sedation, and 26% under
Results: TDMA shows good handling properties, as well the non- general anaesthesia- with 46% who would fit HTPCs on a patient
toxicity and dentinogenesis inducibility to human pulp stem cells who is due to have general anaesthesia for extraction of other teeth.
in vitro. Gelatin (G) and propylene glycol (PG) both help Over 90% believe that HTPCs are suitable for: undergraduate
improving the plasticity of pulp capping agent and keep their teaching, general practice, postgraduate training and specialist prac-
characteristic respectively. In the mini swine pulp exposure tice. Reasons given for not using the technique include lack of: train-
model, the quality of TDMA groups’ regenerative pulp-dentine ing, confidence and evidence of their effectiveness.
complex is better than Dycal group. Conclusion: HTPCs are widely used amongst specialist paediatric
Conclusions: TDM is expected to an excellent bioactive materials dentists in the UK, with the vast majority believing they should be
in pulp-dentin complex regeneration. used in all settings.
PR08-1.31 PR08-1.33
Regional odontodysplasia: report of a case Treatment of a large endodontic lesion caused by
Ö GÜNEŞ1 & Z. CEHRELI2 chronic mechanical trauma due to the unusual
1
Paediatric Dentistry, Hacettepe University, Ankara, Turkey; habitual behavior
2
Paediatric Dentistry, Hacettepe University Faculty of Dentistry, Y. AYIK1, K. N. KOSE2 & S. AKYÜZ1
Ankara, Turkey 1
Deparment of Pedodontics, Marmara University, School of
Introduction: Regional Odontodysplasia (ROD) is a rare develop- Dentistry, Istanbul, Turkey; 2Department of Periodontology,
mental anomaly that usually presents as a localized condition Marmara University, School of Dentistry, Istanbul, Turkey
involving a few adjacent teeth in a single maxillary or mandibular Introduction: Harmful parafunctional oral behaviors including
quadrant. Clinical and radiographic findings of ROD include grindings, nail biting, and finger nail scratching may cause serious
delayed or failed eruption, abscess formation, early exfoliation and
problems such as endodontic lesion, tooth wear, occlusal trauma, PR08-1.35

and gingival recession. This case report presents the treatment of
Evaluation of two iodoform-based root canal filling
permanent mandibular molar having severe mobility (grade3) with
diffuse endodontic lesion due to chronic mechanical trauma. materials for pulpectomy of primary molars: an
Case reports: 12-year-old male patient with a chief complaint of in vivo study
swelling in relation to the lower left mandibular first molar was H. M. SABER, S. A. ABDELMONIEUM & S. A. MAHMOUD
referred to the Pedodontics Department. Careful anamnesis Pediatric Dentistry, Cairo University, Cairo, Egypt
revealed that he had been moving his tooth by his fingers for
Background: Pulp therapy aims to maintain the integrity and
2 years to fasten its exfoliation due to his misinterpretation of its
health of teeth and their supporting tissues. Pulpectomy is the tech-
being deciduous tooth. Clinical and radiographical examination
nique of choice for the treatment of primary molars diagnosed with
verified an occlusal decay on #36 without pulpal involvement, a
irreversibly inflamed pulp. Various root canal filling materials for
large and diffuse endodontic lesion with buccal fistula, severe
primary teeth have been used. Unfortunately, the ideal root canal
mobility (grade3), sensitivity on percussion, negative vitality test,
filling material has not yet been identified. The most popular root
and no periodontal involvement. He, primarily, was encouraged
canal filling materials used are zinc oxide eugenol (ZOE), iodoform
to give up this habit. Then, endodontic treatment was initiated
paste, and calcium hydroxide. Iodoform-based pastes fulfill most
without any antibiotic usage including repeated irrigations with
of the requirements of an ideal filling material for primary teeth.
5% NaOCl, intracanal dressings with non-setting CaOH, and
Aim: To evaluate the clinical and radiographic success of two
completed with Gutta Percha and sealer (AH Plus) after four
iodoform-based pastes for pulpectomy of primary molars.
dressing sessions. No periodontal treatment and occlusal adjust-
Design: Thirty carious primary molars in 27 children aged 4–
ment were performed. 18-month of follow up proved complete
7 years, were treated with pulpectomy and were divided ran-
recalcification of the lesion with no complication.
domly into 2 groups according to the root canal filling material;
Comments: It is crucial to use multidisciplinary diagnostic approach
Group A: canals were obturated with Zical and Group B: canals
to determine whether it is originated from pulp or periodontium
were obturated with Metapex. Stainless steel crowns were placed
in the successful treatment of mandibular first molars with large
as a final restoration. Clinical and radiographic evaluations of
and diffuse endodontic lesion caused by chronic mechanical trauma
pulpectomized molars were performed immediately, 3 and
to prevent needless periodontal treatment and antibiotic abuse.
6 months following treatment using specific criteria.
Results: Clinical evaluation showed complete resolution of pre-
PR08-1.34 senting signs and symptoms in both groups. Radiographic evalu-
Bioactive glass versus tri-calcium phosphate in the ation revealed an insignificant difference between tested groups
treatment of dentin hypersensitivity: a short-term for furcation pathology at 3 and 6 months (P = 0.061,
clinical trial P = 0.116) respectively.
B. KARABULUT1 & C. D. CAN-KARABULUT2 Conclusion: Both Zical and Metapex gave encouraging clinical
1
Pedodontics, GMMA Training Hospital, Istanbul, Turkey; and radiographic success rates.
2
Restorative Dentistry, Sancaktepe Dental Health Hospital,
Sancaktepe Istanbul, Istanbul, Turkey PR08-1.36
Aim: The aim of this study was to evaluate the success of two In vitro evaluation of the effect of ozone treatment on
different commercial pastes in the treatment of cervical dentin fissure sealant
hypersensitivity in permanent teeth of children. M. TURGUT, M. C ß ETINKAYA & F. TULGA ÖZ
Design: A randomized controlled clinical trial was conducted Pediatric Dentistry, Ankara University, Ankara, Turkey
with a total of 32 teeth. Nupro sensodyne prophylaxis paste with
Background: Ozone treatment could be used to provide alkalinity
fluoride and novamin (Dentsply DeTrey) and Vanish % 5 sodium
and antimicrobial activity on fissure sealant applications.
fluoride white varnish with tri-calcium phosphate (3M-ESPE)
Aim: The aim of this in vitro study was to evaluate the effect of
were applied onto the cervical dentin surfaces. Distilled water
ozone treatment on micro-leakage, micro-bond strength and
was used as the placebo group. The baseline measurement of
adaptation of ClinproTM Sealant and Teethmate F-1 fissure seal-
hypersensitivity was made by using visual analog scale (VAS).
ants.
Twenty-four hours and 7 days after the application of desensi-
Design: 120 extracted third molar teeth were divided into 4
tizer pastes and the placebo group, a new VAS analysis was con-
groups.In Group-1; ClinproTM Sealant and in
ducted for the patients’ sensitivity level.
Group-2, Teethmate F-1 were applied without ozone treatment.
Results: The mean pain scores of placebo group was significantly
In Groups 3 & 4 ozone treatment was applied before fissure seal-
higher than the desensitizer pastes’ mean scores (ANOVA, P <
ant applications.
0.05). The VAS analysis revealed a significant decrease in dentin
Micro-leakage was scored using a stereomicroscope and micro-
hypersensitivity in 7 days with the use of the desensitizer contain-
bond strength was measured by Universal testing machine. The
ing pastes. No statistically significant difference was observed
adaptation between sealants and enamel was evaluated by SEM.
between these two treatments (P > 0.05). Although novamin and
Student t, Chi Square and Fisher’s Exact Chi Square tests were
tri-calcium phosphate containing desensitizer pastes present dis-
used for statistical analysis.
tinct modes of action, they caused a significant reduction of den-
Results: 63.3% of the teeth in Group-3 showed no micro-leakage.
tin hypersensitivity.
The results of bond strength tests showed that bond strength of
Conclusions: While desensitizer pastes’ ‘action difference’ in
Teethmate F-1 was statistically lower than that of ClinproTM Seal-
tubule occlusion may reflect the differences in the acid resistance
ant (P < 0.05); and that even if the ozone treatment has
of the compounds; their application had displayed similar effec-
decreased the micro-tension bond strength, it had no statistical
tiveness in reducing immediate dentin hypersensitivity.
effect (P > 0.05). The adaptation of the sealant to the enamel
surface was higher in group-3 (100%) and group-4 (100%) than
group-1 (85.7%) and group-2 (85.7%).
Conclusions: Within the limits of this study, ozone treatment
could be used with fissure sealant applications. Even though
ozone treatment had no statistically effect on fissure sealant’s tooth remained asymptomatic, the entire root canal was obliter-
success, its antibacterial efficiency might be beneficial. ated. Follow-up examinations are continuing.
Comments: Pulp canal obliteration is a serious disadvantage of
PR08-1.37 revascularization treatment that can be observed over the long-
term, thus requiring regular follow-up of patients.
The use of PRP in treatment of an immature tooth
with a large periapical lesion: a case report PR08-1.39
N. KAYA1, T. BEZGIN1, B. N. C ß ELIK1 & A. D. YILMAZ2
1
Pediatric Dentistry, Ankara University, Ankara, Turkey; 2Ankara Disinfectant effects of sodium hypochlorite on
University, Ankara, Turkey pulpotomies in primary teeth: clinical, radiological
Introduction: Regenerative endodontics refers to biologically
and histopathological study
based treatment aimed at restoring normal physiologic function A. DEMIREL1, M. AKC ß AY2, Sß . SARI1, B. N. Cß ELIK1 &
3
in necrotic immature permanent teeth. This case report describes Ö. GÜNHAN
1
the use of platelet-rich plasma (PRP) in the treatment of an Pediatric Dentistry, Ankara University, Ankara, Turkey;
immature maxillary lateral incisor with a large periapical lesion
2
Pediatric Dentistry, Izmir Katip C ß elebi University, Izmir, Turkey;
3
over a 24-month clinical and radiographic follow-up period. Pathology Department, Gülhane Military Medical Academy,
Case report: A 14-year-old boy was referred to the pediatric den- Ankara, Turkey
tistry clinic with the chief complaint of pain in the maxillary left Background: Sodium hypochlorite (NaOCl) can be used as an
lateral incisor. The patient had a history of an untreated trau- antibacterial agent to promote pulpal healing in vital pulpotomy
matic injury 4 years prior to presentation. Clinical examination treatment.
showed tenderness to percussion and palpation, and radiographic Aim: The aim of this study was to evaluate the effects of %5
examination revealed an immature root and a large periapical NaOCl as cleansing agent on calcium hydroxide (CH) and min-
lesion. Following disinfection of the canal space with triple anti- eral trioxide aggregate (MTA) pulpotomies for 24 months fol-
biotic paste (1:1:1: ciprofloxacin, metronidazole and cefaclor), low-up.
revascularization treatment was performed using a PRP scaffold. Design: 128 primary molars were divided into 2 main groups
The final restoration was completed with white mineral trioxide according to pulpotomy agents (CH-MTA), into 2 subgroups
aggregate and composite resin. The patient was recalled for clini- according to cleansing agents (NaOCl-Saline) and followed clini-
cal and radiographic evaluation every 6 months. After 24-months cally and radiographically. After 24 months, 20 extracted teeth
of follow-up, complete radiographic healing of the periapical were evaluated histologically for hard tissue bridge formation,
radiolucency was observed; however, apical closure had not been pulpal inflammation, odontoblastic layer continuity, tubular
achieved. Follow-up examinations are continuing. structure and internal resorption. Fisher’s exact, Pearson’s chi-
Comments: PRP was found to be useful in constructing a scaffold square and Mann Whitney U test with Bonferroni correction
for successful regenerative endodontic treatment of a periapical were used for statistical analysis.
lesion; however, a longer follow-up period is needed to observe Results: Clinically and radiographically, no significant differences
apical closure. were observed between the NaOCl and saline subgroups of either
CH or MTA groups (P < 0.0042). However, success rate of
PR08-1.38 MTA subgroups were statistically higher than CH subgroups
independent of the cleansing agent (P < 0.0042). In histological
Pulp canal obliteration after revascularization results, lack of pulpal inflammation, hard tissue bridge formation
treatment: a case report and odontoblastic layer continuity were higher in MTA sub-
E. C. TATLI1, T. BEZGIN1, B. N. C ß ELIK1 & A. D. YILMAZ2 groups compared to CH subgroups.
1
Pediatric Dentistry, Ankara University, Ankara, Turkey; 2Ankara Conclusions: Regardless of cleansing agent, success rate decreased
University, Ankara, Turkey dramatically over time in CH. In both CH and MTA groups,
Introduction: Pulp canal obliteration is an undesirable outcome of NaOCl did not affect clinical, radiographical and histological
revascularization treatment that stems from the osteoinductive success compared to saline. Based on these results obtained in
activity of mineral trioxide aggregate. This case report describes this study, it is confirmed that the pulpotomy material is more
the total obliteration of the canal space over a 3-year follow-up important than the cleansing agent in vital pulpotomy treatment.
period after revascularization of a premolar tooth.
Case report: A 12-year-old boy was referred to the Department PR08-1.40
of Pediatric Dentistry for a routine dental examination. There Polylatic acid absorbable intracanal post and films in
was no significant medical history. Intraoral examination
revealed a deep carious lesion in the maxillary left second premo-
restoring primary anterior residual root of early
lar tooth. The tooth did not respond to electric or cold sensitivity childhood children
testing, and responses to percussion, palpation and probing H. HUANG & Y. HOU
pocket depths were all within normal limits when compared to Dept. of Pediatric Dentistry, The Affiliated Stomatology Hospital,
adjacent and contralateral teeth. Radiographic examination of Guangxi Medical University, Nanning, China
the tooth revealed an immature root and open apex, although no Introduction: Severe early childhood caries can lead to residual
periapical radiolucency, internal/external root resorption or other root, when restored with composite resin, it’s easy to fall off. If
pathosis was found. The tooth was diagnosed with a necrotic using polylatic acid absorbable intracanal post and films can
pulp. The canal space was disinfected with triple antibiotic paste
improve the retention and allow physiological root absorption of
(1:1:1: ciprofloxacin, metronidazole and cefaclor), and revascular- primary teeth. The posts we used were absorbable screw implants
ization treatment was performed usinga PRP scaffold. The final used in bone fractures, produced by Inion Oy. The polylatic acid
restoration was completed with white mineral trioxide aggregate absorbable films were formed by evaporating of polylatic acid
and composite resin. At the end of a 3-year follow-up period,
solution.
complete apical closure was observed; however, although the Case reports: A 4-year-old girl was referred for early childhood
caries. Clinical examination revealed that 51 had caries, 61 was
residual root. X-ray showed that 51, 61 had root inflammation The indications, objectives, and type of pulpal therapy depend on
and there was a high density image in the root canal of 61. Com- whether the pulp is vital or nonvital, Formaldehyde derivates
prehensive dental treatments were finished under general anesthe- have been used as acceptable capping material for the fixation of
sia, 51, 61 were treated with root canal therapy, and then 51 was the pulp for many years. Success rate of pulpotomy with formoc-
restored with composite resin. The post-space of 61 was prepared resol has been comprised with electrosurgery, glutaraldehyde,
by special equipment, then absorbable screw post was enwound mineral trioxide aggregate and vitapex .Pulpotec obturating paste
by absorbable films and screwed into the root canal. Finally the (Produits Dentaires S.A., Switzerland) is radiopaque, non resorb-
crown was formed using composite resin. After that, every able paste for the treatment of pulpitis by pulpotomy in vital
3 months the patient was called back to give an examination, molars, both permanent and deciduous.
including clinical and periapical radiograph examination to eval- Aim: The aim of this study was to compare the clinical and
uate clinical effects. Meanwhile, to detect the absorption of the radiographic success of pulpotec and Mitapex for root canal
residual root and the development of 21. After 3 years’ follow treatment of pulpally involved primary anterior teeth.
up, 21 was found to have erupted normally. Design: Thirty teeth from 20 healthy children aged 3–4 years with
Comments: The short - term effects of the residual root restored pulpally involved primary anterior 10 child were treated with
by polylatic acid absorbable post and films were favorable, but pulpotec (group A) and 10 child were treated with Mitapex
long - term effects need further research. (metabiodent) (group B) The subjects were followed up clinically
and Radiographically at 3 and 6 months, respectively.
PR08-1.41 Results: Clinical and radiographical examinations carried out on
follow up visits revealed that all cases showed considerable clini-
Biological response of dental pulp cells derived from cal and radiographic success. There was no significant difference
human deciduous teeth for PRG cement (The second between grup A and B. However, group A rapid relief of pain
report) and infection in comparison with group B.
M. FUJITA, K. OKUBO, R. KOMORI, M. MATSUZAWA & S. Conclusion: Simplicity in use, absence of pain symptoms during
KIMOTO the treatment, minimal instrumentation are positive outcome of
Department of Dentistry for Growth and Development of Oral clinical trials of ‘Pulpotec’ preparation enable to recommend it
Function, Kanagawa Dental University, Yokosuka-shi, Japan for use in extensive clinical practice.
Background: PRG cement contains S-PRG filler, has fluoride

release and recharge ability as well as the ability to release vari-
PR08-1.43
ous ion species. A randomized controlled trial of ProRoot MTATM,
Aim: The purpose of this study is to investigate the biological OrthoMTATM, and RetroMTATM for pulpotomy in
response of dental pulp cells derived from human deciduous teeth primary molars
(HDPC-D) to evaluate the possibility, that PRG cement can be Y. SUN, C. KANG, H. J. CHOI & J. S. SONG
used for pulp capping.
Department of Pediatric Dentistry, College of Dentistry, Yonsei
Design: We studied four materials: two kinds of PRG cement,
University, Seoul, Korea
PRG(1) and PRG(2) (Shofu, Kyoto, Japan),　Dycal (Dentsply
Sankin, Tokyo, Japan), and Fuji Ionomer Cement Type II (GC, Background: Mineral trioxide aggregate (MTA) pulpotomy of
Tokyo, Japan). After each materials were mixed according to the primary teeth has been conducted successfully for decades.
manufacturer’s instruction. Each cement were hardened, then Despite several clinical studies measuring the effects of MTA, as
placed in medium. Each material extracts were assessed ICP ion yet there has been no comparison of the clinical applicability of
analysis and ion meter measured fluoride. We adjusted to the RetroMTA and OrthoMTA.
medium, which contained fluoride (F) ion or aluminum (Al) ion Aim: The aim of this study was to determine the clinical efficacy
or F + Al ion. HDPC-D were cultured the medium, and we per- of the newly developed OrthoMTA and RetroMTA compared to
formed MTT assay and ALP assay. conventionally used ProRoot MTA for pulpotomy in primary
Results: Ion analysis showed PRG cement multiply released F teeth.
and Al ion compared with sample. MTT assay showed F ion and Design: In this randomized clinical trial, 143 teeth were deemed
Al ion has no cytotoxicity compared with control. Both ions suitable for pulpotomy, having met the tooth inclusion criteria,
simultaneous were added in medium, both ions promoted cell and were divided in a randomized, double-blind manner into
proliferation. All sample increased ALP activity. In particular three groups according to the planned treatment: RetroMTA
PRG (1) and (2), Both ions showed more increased compared (n = 49 teeth), OrthoMTA (n = 47 teeth), and ProRoot MTA
with respective ion added. (n = 47 teeth). Clinical and radiographic follow-up examinations
Conclusions: Al ion and F ion in PRG extract may have stimu- were conducted at 3, 6, and 12 months postoperatively.
lated proliferation of HDPC-D. We found out that PRG cement Results: By the end of the study period, 34 teeth had been lost to
promotes proliferation of HDPC-D and dentin formation. We follow-up, so that 109 teeth were evaluated at 12 months (n = 33,
suggest that PRG cement has a good potential as pulp capping 38, and 38 teeth in the ProRoot MTA, OrthoMTA, and Retro-
material. MTA groups, respectively). The radiographic success rates in
these three groups were 100% (33/33), 94.7% (36/38), and 94.7%
PR08-1.42 (36/38), respectively; the corresponding clinical success rates were
100% (33/33), 97.4% (37/38), and 100% (38/38). The Kaplan-
Clinical evaluation of pulpotec as treatment options Meier survival function curves relative to clinical and radio-
for pulpally involved primary anterior teeth graphic cumulative survival rates did not differ significantly
N. R. KABEL1 & M. M. ELSHIEKH2 between the three groups.
1
Pediatric Dentistry, Misr University for Science and Technology, Conclusions: The success rates of RetroMTA, OrthoMTA, and
Cairo, Egypt; 2Pediatric Dentistry, Cairo University, Cairo, ProRoot MTA are indistinguishable, indicating that pulpotomy
Egypt can be carried out successfully in primary molars with the newly
developed materials.
Background: The primary objective of pulp therapy is to maintain
the integrity and health of the teeth and their supporting tissues.
PR08-1.44 Wallis H nonparametric test was used to determine intergroup

difference.
Comparison of cytotoxicity between resin infiltrant,
Results: A statistically significant difference of microleakage was
Icon and novel radiopaque resin infiltrant observed among the three tested groups (P = 0.002). Group B
A. S. I. ZAKARIA, F. S. L. WONG, M. P. PATEL & S. C. F was the lowest (0.50 0.45) mm, followed by Group A
RAWLINSON (1.30 0.77) mm and Group C (1.47 0.41) mm. But no signif-
Centre for Oral Growth and Development, Bart’s and the London icant difference was observed between Group A and Group C
School of Medicine and Dentistry, Queen Mary University of (P = 0.246).
London, London, UK Conclusions: The sealing capability of polylatic acid absorbable
Background: Resin infiltrant, IconÒ is not radiopaque on radio- film is as better as glass ionomer cement, it can be used to restore
graph. The radiopacity has improved after addition of tin meth- primary teeth with screw post.
acrylate, SnM which blends well with the resin monomer.
However, there is cytotoxic concern regarding the usage of SnM. PR08-1.46
Aim: The aim of this study is to compare the cytotoxic effect Microtensile bond strength between polylactic acid
between resin infiltrant, IconÒ and the novel radiopaque resin in-
filtrant.
absorbable post and composite resin core
Design: Three mixture of resin infiltrant, IconÒ and SnM were S. LI & H. HUANG
prepared by weight, by the ratio of IconÒ: SnM of 4:1, 2:1 and Dept. of Pediatric Dentistry, The Affiliated Stomatology Hospital,
1:1. The three mixtures of radiopaque resins and IconÒ only Guangxi Medical University, Nanning, China
underwent three cytotoxic tests, the MTT, Neutral Red (NR) Background: Polylactic acid(PLA)has been proved to be a good
uptake and DNA fluorometric assay. Degree of conversion (DC) material as the post for the restoration of residual root and
of the materials was also determined, using Fourier Transform crown of the primary teeth.
Infrared (FTIR) spectrometry. T-test was performed to test the Aim: To evaluate the effect of different surface treatments on the
null hypothesis that there is no statistically significant difference microtensile bond strength between PLA post and the composite
between IconÒ and radiopaque resin infiltrant for all the tests resin core.
performed. Design: Twenty-five PLA posts were randomly divided into 5
Results: All three cytotoxic tests showed that all the resin materi- groups based on the surface treatments. Group A was coated
als were cytotoxic to the cell lines. The mixture of IconÒ: with total-etch adhesive Prime&Bond NT (PB). Group B was
SnM = 1:1 was the most toxic, followed by 4:1, 2:1 and IconÒ coated with chloroform and then with PB. Groups C, D and E
respectively. IconÒ has the highest DC, followed by IconÒ: were coated with the mixture of chloroform and PB in propor-
SnM = 4:1, 2:1 and 1:1 respectively. No significant difference tion as 1:1, 1:2, 2:1, respectively. Group F with five quartz fiber
was noted when compared the cytotoxicity and DC of radiopaque posts was set as the control group, and was coated with PB. All
resin infiltrant to IconÒ, except for IconÒ: SnM = 1:1 (P < 0.05). treated posts were cemented with composite resin cores and
Conclusion: The IconÒ-SnM compound did not have significant shaped as rod-like bonding specimens and subjected to the micro-
increase in cytotoxicity in concentration lower than 50%. Further tensile bonding strength test. Failure modes of specimens were
research is needed to explore the potential usage of SnM as a evaluated under a stereomicroscope (940). Surface morphologies
radiopaque material. of two fractured specimens from each group were assessed by
scanning electron microscopy.
PR08-1.45 Results: The microtensile bond strength of the five groups was
(5.03 1.48) MPa, (10.91 1.61) MPa, (20.58 3.35) MPa,
Microleakage of endodontically treated teeth restored
(12.80 2.77) MPa, (13.35 3.21) MPa, (12.24 1.40) MPa,
with polylatic acid absorbable screw post and film respectively. The microtensile bond strength differed significantly
Y. HOU & H. HUANG among all the groups (P = 0.000), and was highest in group C.
Dept. of Pediatric Dentistry, The Affiliated Stomatology Hospital, The fracture mode showed differences among all the groups
Guangxi Medical University, Nanning, China (P = 0.000).
Background: To date, all of the luting cement materials are not Conclusions: Coating the surface with the mixture of chloroform
absorbable. When used to restore primary teeth, it may not allow and PB in proportion as 1:1 showed better effect on improving
subsequent smooth transition to permanent teeth. the adhesive strength between resin core and PLA post.
Aim: To assess the sealing capability of polylatic acid absorbable
posts and films in restoring primary teeth, using the method of PR08-1.47
microleakage. Effect of calcium hydroxide medicaments on the anti-
Design: Fifty extracted maxillary central incisor were chemome-
chanically prepared, filled with gutta-percha and sealer. Then
fracture strength of immature permanent teeth
randomly divided into five groups, in vitro
group A: restored with polylatic acid absorbable posts and films. Y. ZHAO, C. LI, L. JIN & Z. WANG
The posts were absorbable screw implants used in bone fractures, Pediatric Dentistry, School of Stomatology, Tongji University,
produced by Inion Oy. The absorbable films were formed by Shanghai, China
evaporating solvent of chloroform;
Background: According to some researches, the possibility of
group B: using fiber posts cemented with ResiLute;
fracture on tooth cervical raises long after root canal filled with
group C: using metal screw posts cemented with glass ionomer
calcium hydroxide. Recently, researches into its influence on the
cemen;
intensity of dentin mostly focus on long-term root effects, but
group D and E were positive and negative controls.
not short-term effects.
After that, the teeth were immersed in Indian ink for 72 h
Aim: To compare the short-term effect of three different root
separately. A buccolingual section was made through the verti-
canal filling medicaments with Ca(OH)2 on the anti-fracture
cal axis of specimens and a stereomicroscope was used to
strength of immature permanent teeth.
evaluate the deepest length of dye penetration. The Kruskal-
Design: This study included 140 human premolars extracted for PR08-1.49
orthodontic reasons, who were equally randomized to four
Dental attendance of patients after treatment under
groups: three trial and one control. The premolars in trial groups
were respectively filled with mixture of Ca(OH)2 and distilled general anaesthesia (DGA) - a data-based follow-up
water, Metapex and Vitapex as designed, those in the control study
were used to be blank.The anti-fracture strength of the teeth in M. TILJA1, M. L. LAITALA1, P. PESONEN2 & V.
experimental groups was tested at the time of 14 days, 1 month ANTTONEN1,3
1
and 3 months, while the control group was tested at the 3rd Department of Paedodontics, Institute of Dentistry, University of
month. Data were analyzed by S-N-K test. Oulu, Oulu, Finland; 2Medical Recearch Center Oulu, Oulu,
Results: At the time of 14 days, the change of the anti-fracture Finland; 3Oulu University Hospital, University of Oulu, Oulu,
strength of the teeth in experimental groups was not obvious. Finland
But it decreased statistically after the teeth filled with the three
Background: Most common self-reported causes for DGA are
calcium hydroxide products for more than 1 month. After
dental fear and dental caries - which both are associated with
3 months, the anti-fracture strength decreased 32.20%, 35.75%
poor dental attendance.
and 33.42% respectively.
Aim: The aim of this study was to monitor dental attendance of
Conclusions: The anti-fracture strength of immature permanent
patients treated under DGA as well as procedures at follow-up
teeth decreased statistically after the treatment with calcium
visits.
hydroxide-distilled water, Metapex or Vitapex for more than
Design: The study population comprised 66 patients, who
1 month. It seemed that using of calcium hydroxide products
received DGA during September 2010 - May 2011. The data
should be limited in 2 weeks when they were used clinically.
were collected from electronic patient files covering the follow-up
period September 2010 until June 2013. The data comprised the
PR08-1.48 participants’ age (years) and gender, number of appointments,
Functional and aesthetic oral rehabilitation of type of the procedures (prevention/restoration/endodontic treat-
hypohydrotic ectodermal dysplasia with severe ment/extraction) and missed/cancelled appointments. Associa-
tions of the variables were analysed using cross tabulation and
oligodontia means, frequencies and distributions were calculated; statistical
A. SAHLANAN, B. OZGUR & Z. C. CEHRELI significance between groups was determined by khi square test.
Paediatric Department, Hacettepe University/Faculty of Dentistry, SPSS 20.0 software was used for analyses.
Ankara, Turkey Results: The group was slightly dominated (56.1%) by females.
Hypohydrotic Ectodermal Dysplasia (HED) is a rare inherited The mean age among the participants was 15.7 years SD12.8. On
multisystem disorder that typically affects the skin, hair, nails, average, the participants had 4.4 visits during the follow-up (SD
eccrine glands, and teeth. This case report presents the conserva- 3.21; min 0, n = 3 and max 17, n = 1). The proportion of missed/
tive and prosthetic management in a case of HED with severe cancelled appointments was 14.9%. Missed/cancelled appoint-
oligodontia. ments occurred mostly on appointments 1–3 after DGA
A 4-year-old boy was referred to the Paediatric Dentistry (P = 0.011). Most common procedures were dental restorations
Department for prosthetic management of multiple missing (mean 0.6 SD 1.04), followed by prevention (mean 0.3 SD 0.63)
teeth. The patient had been previously diagnosed for HED and and extractions (mean 0.2 SD 0.58). On average, females had
was followed by several Paediatric departments. Extraoral more preventive procedures (P = 0.012) but also more frequently
examination of the patient revealed typical features of HED sedation compared to the males (15.1% vs 10.9% of appoint-
inclusing: dry, darkly pigmented skin, sparse hair and eyebrows, ments).
low facial height and unusually thick lips. Only two conically- Conclusions: Individuals commonly still need dental treatments
shaped maxillary primary incisors were observed on intraoral after DGA. The proportion of missed/cancelled appointments is
examination. The treatment plan included aesthetic restoration considerable.
of the maxillary primary incisors using monochrome composite
resin, followed by fabrication of removable dentures for both PR08-1.50
dental arches. After 4 years, gingival recession and some mobil-
Oral rehabilitation in pediatric dentistry patient
ity was evident which called for renewal of the dentures as well
F. X. P. C. SIMOES1,2, C. F. BRANDAO1 & F. A. S. NEVES1
as the existing composite restorations using layered nanohybrid 1
Bahia School of Medicine and Public Health, Salvador Bahia,
composite.
Brazil; 2Saude I, University Southwest of Bahia, Jequie, Brazil
Growing HED patients with severe oligodontia cannot benefit
from the advantages of dental implants, which in turn renders Introduction: Dental caries is still one of the most common dis-
prosthetic and conservative treatment extremely difficult for eases that affect people around the world. It’s a multifactorial
both the patient and the clinician. Since natural abutment teeth disease. Biofilm accumulation in contact with the tooth during a
can be exposed to excessive forces by the dentures, these period of time should determinate the white spot. Others factors
patients should be recalled regularly. In the present case, the are responsible to established the severity as modulating factors
treatment provided a good outcome in terms of aesthetics and (biological and social). The International Caries Detection and
function. Assessment System (ICDAS) has been constructed to auxiliary
the dentist to define the correct treatment. Oral health has impact
of quality of life, can affect physical and psychologic the patient,
influencing how speak, chew, taste and socialize. In relation to
the restorative material used in Pediatric Dentistry, composite
resin and glass ionomer cement are the most usually.
Case reports: A 5-year-old boy reported a Pediatric Dentistry
Clinic of Bahia School of Medicine and Public Health with com-
plain of cavity in his anterior and posterior teeth. Clinical and
radiographic examination revealed cavities in 51, 52, 54, 55, 61,
62, 63, 73, 74, 83 and 84. Treatment plan was propose to the
stepmother to authorize it. In every visit oral health orientation previously been audited but there were anecdotal concerns that
and fluoride has been applied. Were used composite Z350 (3M) this had become a problem again.
in 51, 52, 61, 62, 63, 73, 83 and RIVA glass ionomer cement Aim: To determine the proportion of paediatric patients who are
(SDI) in 55, 54, 64, 74 and 84. Patient and stepmother were satis- registered with and continue to see their primary care dentist.
fied with the result. Secondarily, to ascertain if communication between the dental
Comments: Pediatric dentist may evaluate oral conditions to hospital and primary care was adequate.
make correct diagnosis and treatment plan. The professional is Design: A third cycle of an audit was undertaken in 2014 in
co-responsible to the patient quality of life. Newcastle Dental Hospital. The first 2 cycles were in 2006 and
2007. The standards set were for 100% of patients to be regis-
PR08-1.51 tered with/attending a GDP and for 100% of GDPs to have
received a letter. A consecutive sample was taken of all patients
An audit of general dental practitioner registration attending during a two week period. Parents were asked about
for patients in the department of paediatric dentistry GDP registration and other information was derived from retro-
M. GELDENHUYS1 & C. R. VERNAZZA2 spective review of the notes.
1
Oral Surgery, James Cook University Hospital, Middlesbrough, Results: The results showed that 90% of patients were registered
UK; 2School of Dental Sciences, Newcastle University, Newcastle, with a GDP with only 46% being seen regularly. A letter of cor-
UK respondence was found in 80% of cases. Results were always bet-
ter for staff’s patients than students’.
Background: It is important for paediatric patients to continue to
Conclusions: None of the standards were fully met. This aspect of
see their General Dental Practitioner (GDP) whilst receiving sec-
practice should be re-audited in 6 months after all relevant staff
ondary care to ensure appropriate delegation and continuity of
members are made aware of the changes required.
and access to ongoing care. During shared care, good communi-
cation is vital. Registration and communication with GDPs had
Restorative Dentistry Poster Session Two – PR08–2
Restorative Dentistry Poster Session Two –

PR08–2
PR08-2.01 or any other form patch. It has a long anti-bacterial effect, adhe-
siveness, haemostatic and rapid repair tissue.
Effect of different parameters of Er:YAG laser Aim: To evaluate the response of the pulp in rats’ teeth when N-
irradiations on class V composite restorations: a hexyl Cyanoacrylate is used as an agent for pulpotomies, and to
microleakage study compare its histological effect with histological effect of MTA.
E. B. TUNA1, E. OZEL2 & E. FIRATLI3 Design: 12 female Wister rats with an approximate weight of
1
Department of Pediatric Dentistry, University of Istanbul, Faculty 150 g were used.Two groups were established, MTA and N-hexyl
of Dentistry, Istanbul, Turkey; 2Department of Restorative Cyanoacrylate. Pulpotomies were carried out in the upper first
Dentistry, University of Kocaeli, Faculty of Dentistry, Kocaeli, molars of each rat and the material was applied. After 30 days
Turkey; 3Department of Periodontology, University of Istanbul, the rats were killed and the fragments with teeth were extracted
Faculty of Dentistry, Istanbul, Turkey from the maxilLa. These were decalcified and studied histologi-
cally. The degree of pulp inflammation was studied, any dentinal
Aim: The purpose of this in vitro study was to compare different
bridge and reparative dentin in the root canals, the presence of
parameters of Er:YAG laser irradiations on the marginal micro-
the odontoblastic layer and pulp fibrosis.
leakage of Class V resin composite restorations.
Results: Inflammation was not observed in the groups studied.
Design: Cavities prepared on both buccal and lingual surface of
The MTA group was associated with a greater number of den-
50 premolars by Er:YAG laser or bur and divided into nine
tinal bridge.In the N-hexyl Cyanoacrylate group we found a
groups. The occlusal margins were in enamel and the cervical
irregular odontoblastic layer calcifications in other localization
margins were in cementum.
and absence of pulp fibrosis.
Group 1: bur preparation;
Conclusions: Although the results obtained with N-hexyl Cynao-
Group 2: laser preparation (lp) (600 mJ/5 Hz);
acrylate are acceptable, more studies are required to determine
Group 3: lp (300 mJ/10 Hz);
its behavior regarding dental pulp.
Group 6: lp (200 mJ/20 Hz); PR08-2.03
Group 7: lp (300 mJ/14 Hz); Clinical performance of compomer strip crowns in
Group 8: lp (400 mJ/10 Hz); primary incisors, in children with high risk caries who
Group 9: lp (700 mJ/5 Hz).
All teeth were stored in distilled water at 37°C for 24 h, then
underwent GA
thermocycled 1000 times (5–55°C). Teeth which were prepared S. MICHAL
for the microleakage test, immersed in 0.5% methylene blue dye Specialized Private Dental Practice, Warsaw, Poland
for 24 h. After immersing, the teeth were sectioned and observed Background: Esthetic restoration of primary incisors is challeng-
under a stereomicroscope for dye penetration. Data were ana- ing. Teeth with multiple-surface carious lesions, when pulpal
lyzed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). therapy is indicated usually are extracted in children with high
Results: More microleakage was observed in cervical regions risk caries. In children treated under GA, even when there is
compared to occlusal regions in all groups (P < 0.05) except for inadequate tooth structure, strip crown restorations allowed to
Group 6 (P > 0.05). No significant difference was observed restore esthetic and function.
among all groups in terms of occlusal and cervical surfaces, sepa- Aim: The purpose of this retrospective study was to evaluate the
rately (P > 0.05). longevity of compomer strip crowns restorations placed in pri-
Conclusion: It may be concluded that the cavities prepared by Er: mary incisors after plupectomy in children who underwent GA.
YAG laser showed higher degree of microleakage than bur pre- Design: Dental records of 72 children who underwent GA at a
pared at cervical regions. Different parameters of Er:YAG laser specialized practice during 2010–2014 were studied. Only children
irradiations did not affect microleakage. who report on recall visits were included.
Results: In group of 72 children, who underwent 74 GA, in age
PR08-2.02 from 21 to 152 months (mean 52) 601 teeth were restored, 152
extracted, 96 pulpotomies and 63 pulpectomies were performed.
Response of pulp to MTA and N-hexyl cyanoacrylate In this group 49 primary incisors after pulpectomy were restored
in pulpotomies of rat‘s teeth with full coronal, compomer strip crowns with one step adhesive.
~
A. P. SILVA, C. S. MUNOZ, Y. M. BENEITO, A. V. All procedures were performed by one operator. Mean observa

HERNANDEZ & A. J. O. RUIZ tion period was 30 months. 86% (43) of strip crowns were com-
Stomatology, University of Murcia, Murcia, Spain pletely retained. 6% (3) were partially lost (2 in lateral incisors
Introduction: The treatment chosen for exposed pulp in primary and 1 in central incisor) and 8% (4) were completely lost (3 in
teeth with reversible pulpitis, or after a traumatic injury, is pulp- lateral incisors and 1 in central incisor).
otomy. Numerous agents have been used for pulpotomies. To Conclusions: Full coronal restorations with strip crowns in exten-
date, MTA (mineral trioxide aggregate) is the most used material, sively decayed primary incisors, after pulpectomy were succesfull
but its cost is still high.N-Hexyl Cyanoacrylate is an adhesive treatment. When there is minimal tooth structure remaining after
material used as an alternative during surgery to staples, sutures preparation, especially in lateral primary incisors, there is more
risk of total or partial lost of restoration.
PR08-2.04 Design: Twelve-freshly extracted sound human deciduous molars

were used. The teeth were embedded in acrylic blocks, such that
Bonding of self-adhering flowable composite-resin their buccal surfaces were shown and aligned with the acrylic sur-
versus total-etch to dentin surface of permanent faces. The enamel surfaces were subjected to minimal grinding.
molars The teeth were randomly divided into two groups, Group I: Self-
M. A. RASHED1, F. K. ABDEL GAWAD1, M. A. adhering flowable composite-resin (DyadTM-flow, Kerr, USA);
MOHAMMED2 & R. M. ABDELRAOUF3 Group II: Total-etch flowable composite-resin necessitate etching
1
Pediatric Dentistry and Dental Public Health, Faculty of Oral and bonding (FiltekTMZ350-XT, 3M-ESPE, USA). A specially
and Dental Medicine, Cairo University, Giza, Egypt; 2Pediatric designed holed-split Teflon mould was used for constructing
and Community Dentistry, Faculty of Oral and Dental Medicine, composite-resin cylinders (3 9 3 mm) over the buccal surfaces of
October 6 University, Giza, Egypt; 3Biomaterial, Faculty of Oral the mounted teeth. For group I, composite-resin was applied on
and Dental Medicine, Cairo University, Giza, Egypt tooth surface using the mould and light-cured for 20 s. For
group II, using the mould the following steps were performed:
Background: A unique self-adhering flowable composite-resin
1) acid etching (60 s),
combines resin technology of composites and adhesives, eliminat-
2) bonding agent (light-curing 20 s) and
ing the need for separate etching and bonding steps.
3) composite-resin (light-curing 20 s).
Aim: Evaluation of bond strength of self-adhering flowable
The teeth were stored in 37°C distillate water for 24 h. The shear
composite-resin vs total-etch to dentin surface of permanent
bond strength was recorded blindly by a different assessor using
molars.
universal testing machine and statistically analyzed. Modes of
Design: Twelve-freshly extracted sound human permanent molars
failure were studied using digital microscope.
were used. The teeth were embedded in acrylic blocks, such that
Results: Mean values of bond strength for groups I and II were 5
their buccal surfaces were shown and aligned with the acrylic sur-
and 21.6 MPa respectively with highly significant difference
faces. The teeth surfaces were subjected to grinding till exposing
P = 0.005 (P value ≤0.01). Modes of failure for groups I and II
dentin. The teeth were randomly divided into two groups,
were [100%adhesive] and [16.7%cohesive within tooth +83.33%
Group I: Self-adhering flowable composite-resin (DyadTM-flow,
mixed] respectively.
Kerr, USA);
Conclusions: The bonding performance of DyadTM-flow compos-
Group II: Total-etch flowable composite-resin necessitate etching
ite-resin still needs further enhancement.
and bonding (FiltekTMZ350-XT, 3M-ESPE, USA).
Specially designed holed-split Teflon mould was used for con-
structing composite-resin cylinders (3 9 3 mm) over the buccal PR08-2.06
surfaces of the mounted teeth. Clinical evaluation of microabrasion and resin
For group I, the composite-resin was applied in the mould upon infiltration applications on white spot lesions
tooth surface and light-cured for 20 s.
C. BUYUK & N. AKAL
For group II using the mould the following steps were per-
Pediatric Dentistry, Gazi University Faculty of Dentistry, Ankara,
formed:
Turkey
1) acid etching (30 s),
2) bonding-agent (light-curing 20 s) and Background: White spot lesions (WSLs) are enamel lesions that
3) composite-resin (light-curing 20 s). look white and opaque. Several techniques have been proposed
The teeth were stored in 37°C distillate-water for 72 h. The shear to improve the appearence of arrested WSLs.
bond strength was recorded blindly by a different assessor using Aim: After the application of microabrasion paste (OpalustreÒ)
universal-testing-machine and statistically analyzed. Modes of and resin infiltrant (IconÒ) on WSLs, masking of the lesions,
failure were studied using digital-microscope. changes in their color and structure of the lesions were evaluated
Results: Mean values of shear bond strength for groups I and II clinically.
were 4.3 and 6.7 MPa respectively with significant difference Design: The procedure applied to 68 permanent anterior teeth of
P = 0.03 (P value ≤0.05). Modes of failure for both groups were 13 children with symmetric WSLs on their vestibular surface. IC-
100%adhesive. DAS criteria and L*, a*, b*, DE values were used for evaluation
Conclusions: Bonding to dentin still represents a challenge. How- of performance of the materials on masking WSLs. By using Di-
ever, self-adhering DyadTM-flow needs modifications to be compa- agnoDent PenÒ, structural changes which occur inside the lesions
rable to total-etch FiltekTM Z350-XT. in time were examined. Measurements were performed before
and right after the application, and were repeated at 1st week,
PR08-2.05 3rd month and 6th month after the application.
Results: According to the ICDAS scores, L*, DE values and
Shear bond strength of two different types of VITA scores, after 6 month of the application, findings which
flowable composite-resin to enamel surface of are statistically insignificant (P > 0.05) shows that IconÒ was
deciduous molars more effective in comparison to the other group in masking
M. A. MOHAMMED1, M. A. RASHED2, F. K. ABDEL WSLs. Considering to the Diagnodent PenÒ scores which are sta-
GAWAD2 & R. M. ABDELRAOUF3 tistically insignificant as well (P > 0.05), improvement of the
1
Pediatric and Community Dentistry, Faculty of Oral and Dental WSLs in IconÒ group was appeared to be more distinctive than
Medicine, October 6 University, Giza, Egypt; 2Pediatric Dentistry the other group. As a result, both materials found to have effec-
and Dental Public Health, Faculty of Oral and Dental Medicine, tiveness in masking WSLs, whereas after 6 months later their
Cairo University, Giza, Egypt; 3Biomaterial, Faculty of Oral and effects were diminished.
Dental Medicine, Cairo University, Giza, Egypt Conclusions: IconÒ, which found to be more successful in mask-
ing the WSLs on the children’s permanent teeth, is recommended
Background: Self-adhering flowable composite-resin reduces to be applied in every 6 months repeatedly.
application time, but its bonding is still questionable.
Aim: Evaluation of bond strength of a self-adhering flowable
composite-resin vs total-etch and bond to cut enamel surfaces of
deciduous molars.
PR08-2.07 Although long term follow up, no evidence of root development

was observed.
Pediatric preformed crowns in a dental school clinic:
Comments: In spite of numerous reports of revascularization
parents’ preference and reasons for choice treatment in literature, no incomplete root development was
N. R. CHEDID, J. C. ABOU CHEDID, N. MOUCHAYLEH & reported after long term follow up. The disinfection of root
B. MELKI canals may have provided healing periapical lesion however
Pediatric Dentistry, Saint Joseph University, Beirut, Lebanon incomplete root development may be the reason of insufficient
Background: Optimal restorative treatment for primary molars remaining vital tissue for regeneration. Although incomplete root
following endodontic treatment should fully cover tooth surfaces, development, positive response to the pulp test is controversial.
usually via pediatric preformed crowns. These crowns, initially
available in stainless steel material, exist now as pre-veneered PR08-2.09
stainless steel or zirconia preformed crowns, allowing a choice Regenerative endodontic treatment of an immature
for primary molars. The latter crowns present a more esthetic
alternative but necessitate more tissue removal for preparation
permanent molar with a necrotic pulp: a case report
and are more costly than stainless steel preformed crowns, there- P. ÖNAL & N. ÖZTAŞ
fore parents’ choice may depend on several factors. Gazi University, Ankara, Turkey
Aim: To determine the criteria upon which parents choose pediat- Introduction: Loss of vitality in an immature tooth due to deep
ric preformed crown types as restorations for their children’s end- caries or trauma affects development of the root negatively and
odontically treated primary molars. cause leaving the tooth with thin root canal walls and open apex.
Design: In this prospective study conducted at the Pediatric Den- Case reports: A 7-year-old male patient presented with deep car-
tistry department clinic - Saint Joseph University - School of ies on the mandibular right first molar tooth with a necrotic
Dental Medicine (Beirut, Lebanon) over 24 months, parents of pulp. Radiographic examination revealed that an incompletely
children necessitating endodontic primary molar treatment developed root with an open apex. The tooth was clinically
answered a questionnaire regarding their preference for post- asymptomatic. Under local anaesthesia and rubber dam isolation,
endodontic restoration of treated teeth, before and after an infor- the access cavity was prepared. After the necrotic pulpal rem-
mation session on restorative options types (filling or crown), nants were removed, the canal was irrigated with 5.25% NaOCl
materials (composite, stainless steel, zirconia), and characteristics solution without mechanical instrumentation. A triple antibiotic
(esthetics, durability, type of tooth preparation, cost). mixture (metronidazole, ciprofloxacin and doxycycline) was
Results: Of 1814 crown restorations, 3.74% were esthetic (year 1: packed in the canal and left for 14 days. At the next appoint-
0.22%, year 2: 3.52%), chosen mostly for “pleasant aspect” and ment, after removal of the antibiotic mixture, a blood clot was
“child self-esteem”. Stainless steel (96.26%) was chosen foremost created inside the canal, and then white mineral trioxide aggre-
for “cost”, followed by “expected tooth lifespan” and “less tooth gate was placed into the coronal third of the canal. Two days
structure loss”. Choices were statistically similar before and after later the tooth was restored with stainless steel crown. The
the information session. patient was recalled for further examinations during 1, 3, 6,
Conclusions: Parents’ choice appears financially motivated; how- 12 months of clinical/radiographic follow-up. At 12 month fol-
ever an increased demand for esthetic crowns noted over time low up, the tooth was clinically and radiographically asymptom-
suggests the need for further investigations to ascertain the atic and length of the root had increased.
results. Comments: Regeneration is an effective and viable treatment
method that allows continuous root development of immature
PR08-2.08 teeth with necrotic pulps.
Healing with incomplete root development after
40 months following revascularization: a case report PR08-2.10
M. AKYILDIZ1, M. ERKMEN ALMAZ2 & I. Sß AROGLU Clinical and radiographic evaluation of MedCem
€
SONMEZ 1
Portland Cement in pulpotomies of primary molars: a
1
Pediatric Dentistry, Adnan Menderes University Faculty of pilot study
Dentistry, Aydın, Turkey; 2Pediatric Dentistry, Kırıkkale
M. ARMAS SERRET, C. CUADROS-FERNANDEZ, A. I.
University Faculty of Dentistry, Kırıkkale, Turkey
LORENTE-RODRIGUEZ, S. SAEZ & M. MERCADE-BELLIDO
Introduction: For both patients and dentists, endodontic treat- Universitat Internacional de Catalunya, Sant Cugat del Valles,
ment of an immature permanent tooth with pulp necrosis is very Spain
difficult and time consuming. In recent years, the concept of
Background: An ideal pulpotomy agent for primary molars has
‘Pulp Revascularization’ therapy has been developed that
been sought for many years, but no good alternative to Formoc-
employs the use of a mixture of antibacterial drugs for disinfec-
resol has been identified.
tion of infected root canals.
Aim: To compare the preliminary results of MedCem Portland
Case reports: A 13-year-old girl with an immature permanent
Cement (MedCem PC) and Mineral trioxide aggregate (MTA)
premolar tooth (#35) with pulp necrosis, was referred to our
when used as pulp agents in pulpotomies of primary molars.
clinic. After clinical and radiographic examination it was
Design: The study involved 30 healthy male and female patients
observed that the tooth had a deep carious lesion and had an
from 4 to 9 years of age with at least one or more cavities in
immature apex with periapical radiolucency. According to vital-
their primary teeth that needed pulp treatment. Thirty primary
ity, percussion and palpation exams the tooth was diagnosed
molars that required pulp treatment were allocated randomly to
with pulp necrosis and chronic apical abscess. Revascularization
the MTA and MedCem PC groups. Clinical and radiographic
treatment with triantibiotic mix (including ciprofloxacin, metroni-
evaluations were performed 6 months after treatment. All teeth
dazole, minocycline) was administered for 2 weeks. Then a blood
were restored with a reinforced zinc oxide-eugenol base and
clot was created in the canal, over which mineral trioxide aggre-
stainless steel crowns. Statistical analysis using Fischer’s exact
gate was placed. After 40 months follow up, the tooth was
test was performed to determine significant differences between
asymptomatic, there was radiographic evidence of healing of
the groups.
periapical lesion with a positive response to the pulp test.
Results: Both of the MTA and MedCem PC groups showed 100% of restorative materials (P < 0.05). As restorative materials were
clinical and radiographic success after 6 months of follow- up. compared, there was a significant difference between G2-G5 and
Conclusions: MedCem PC may be a promising alternative for use G9-G12. According to the adhesives, G1-G3, G5-G6, G10-G12
in pulpotomies of primary molars although studies with longer and G11-G12 were significantly different. A significant difference
follow-up times are required to confirm this. was found between G5-G11 and G6-G12 in comparison with
laser and control groups.
PR08-2.11 Conclusions: Bond strength was effected by Er:YAG laser based
on restorative materials and adhesive systems used.
Immature permanent teeth with apical periodontitis
treated with apexogenesis technique: a report of case PR08-2.13
Y. LI, Y. LIN, X. LIANG, Y. JI & Y. ZHANG
Pediatric Dentistry, Dalian Stomatological Hospital, Dalian, China Effect of Er:YAG laser irradiation after silver-
diamine-fluoride and ammonium hexafluorosilicate
Introduction: Most apical periodontitis of immature permanent
premolars are come by deformities secondary pulp infection after
applications on the microtensile-bond-strength in
central cusps broken. This report will introduce a clinically suc- sound and caries-affected-dentin and changes in the
cessful for treatment of immature with apical periodontitis trea- structure of dentin
ted with apexogenesis method. B. BOLUKBASI, E. KUCUKYILMAZ, M. AKCAY & S. SAVAS
Case reports: A healthy 12-year-old boy was referred to our hos- Department of Pediatric Dentistry, Izmir Katip Celebi University,
pital with lingering pain on chewing on the right side of his Faculty of Dentistry, Izmir, Turkey
upper jaw. Clinical examination revealed a broken central tip on
Background: Cariostatic and preventive agents are applied to cre-
the upper right first premolar, with notable localized swelling in
the buccal mucosa and also sensitivity to percussion and palpa- ate caries-resistant dentin surfaces and may affect subsequent
tion. The teeth showed serious mobility. The teeth had immature resin bonding.
Aim: The aim of this study was to investigate the effect of differ-
roots and apical pathosis in the radiographs. Considering our
clinical tests, our treatment plan considering the immaturity of ent agents with/without Er:YAG laser irradiation on the micro-
the tooth was apexogenesis. During recall results, we observed tensile bond strength (lTBS) of resin composite to sound dentin
necrotic immature permanent teeth can achieve continuedbuccal (SD) and caries-affected-dentin (CAD), and to assess morpholog-
ical and chemical changes in the specimens.
and palatal to divide two root structure development after
22 months after treatment. Design: 84 extracted molars were divided into a control (deion-
Comments: Immature permanent teeth as a special stage in the ized water) and two experimental groups [ammonium hexafluo-
process of tooth development, apical Zone dental papilla organi- rosilicate (AHF), silver diamine fluoride (SDF)] that subdivided
according to different conditions (SD, CAD, SD + laser irradia-
zation has a strong ability of anti infectious and tissue repair.
tion, CAD + laser irradiation). After surface treatment proce-
dures, the teeth were restored and the lTBS was tested with a
PR08-2.12 universal testing machine. Moreover, twelve teeth for each group
The effect of Er:YAG laser irradiation on the bond were prepared to analyze the surface morphological changes after
strength of fiber-reinforced composite with various application of preventive agents with/without laser irradiation.
Morphological changes of the surface and elemental analysis
adhesive systems to dentin were investigated using SEM-EDS. The data were analyzed using
S. KELEŞ1, G. DINC €
ß 2, G. GÜZEL1 & I. SONMEZ 1
1 Kruskall-Wallis and Mann Whitney-U tests.
Department of Pedodontics, Adnan Menderes University, Aydin,
Results: SDF and AHF applications reduced the lTBS values in
Turkey; 2Department of Restorative Dentistry, Adnan Menderes
both SD and CAD groups (P < 0.05). Laser irradiation
University, Aydin, Turkey
increased the lTBS values in AHF groups, the values was
Background: Er:YAG lasers have been used for conditioning the adversely affected in SDF groups (P < 0.05). Fluoride content
dentin surface for increasing bond strength of composite to den- of the specimens increased in all of the treatment groups com-
tin. There are many studies evaluated the effect of Er:YAG lasers pared with control group. Silver content was detected only in
on microtensile bond strength of various composites and adhe- SDF groups and silicon was detected only AHF groups.
sive systems to dentin. However, there is no study conducted Conclusions: The lTBS values of resin composite, surface mor-
with fiber-reinforced composites(FRC). phology and chemical characteristics of dentin were affected by
Aim: This study was designed to compare microtensile bond the material type, dentin condition and laser irradiation.
strength of a fiber-reinforced composite to dentin conditioned by
Er:YAG laser and conventional techniques in human molars. PR08-2.14
Design: This in-vitro study was conducted on freshly extracted 48
caries-free human molars. Teeth were divided randomly into 12
Analysis of the composition and maturation of a new
following groups.G1:TE + FRC; G2:SE + FRC; G3: UAS + tricalcium silicate cement - Medcem MTAâ
FRC; G4:TE + UR; G5:SE + UR; G6: UAS + UR; G7: Er:YAG L. C. MARTENS1, C. VERCRUYSSE2, D. SCHAUBROECK3 &
laser + TE + FRC; G8: Er:YAG laser + SE + FRC; G9: Er: S. RAJASEKHARAN1
1
YAG laser + UAS + FRC; G10: Er:YAG laser + TE + UR; G11: Department of Paediatric Dentistry, PAECOMEDIS Research
Er:YAG laser + SE + UR; G12: Er:YAG laser + UAS + UR. Cluster, Ghent University, Gent, Belgium; 2Department of Basic
(TE:Total etch, SE: Self etch adhesive system, UAS:Universal Medical Science - Biomaterials Group, Ghent University, Ghent,
adhesive system, UR: Universal composite, FRC: Fiber-rein- Belgium; 3Centre for Microsystems Technology, Imec, Department
forced composite). of Electronics and Information Systems, Faculty of Engineering
Restorations were thermocycled and samples (1 9 1 mm2) were and Architecture, Ghent University, Ghent, Belgium
tested on universal testing machine. The data was analyzed by Background: Medcem MTAÒ GmbH (Weinfelden, Switzerland) is
three-way ANOVA and Bonferroni tests (P = 0.05).
a second generation MTA consisting of pure Portland cement
Results: There was a significant difference between the groups and zirconium oxide as radiopacifier.
(laser and control) and adhesives and the overall bond strength
Aim: To evaluate the maturation of the setting cement using PR08-2.16

Medcem MTAÒ powder as reference and to monitor the forma-
Fracture resistance of two types of full ceramic
tion of calcium hydroxide at different time intervals.
Design: Energy-dispersive X-ray (EDX), Scanning Electron crowns restoring primary teeth
Microscopy (SEM), X-Ray Diffraction (XRD) and Fourier O. EL SHAHAWY, M. A. EL SAYED & R. A. NASR
Transformation Infrared spectroscopy (FT-IR) analysis was per- Pediatric Dentistry, Cairo University, Cairo, Egypt
formed on Medcem MTAÒ powder for composition analysis and Background: Restoration of mutilated primary teeth has been
baseline reference. The cement was mixed according to manufac- always a challenge. Recently, esthetic crowns have facilitated
turer’s instructions. Samples were randomly divided and stored these restorations to quite an extent. Fracture and dislodgment
in either water or 100% relative humidity (RH). XRD and FT- are the main causes of failure.
IR analysis were performed after 12 min, 3 h, 1, 7, 14, 21 and Aim: To compare fracture resistance of full ceramic restorative
28 days. systems by two manufacturers (NU-Smile and Zirkz crowns) and
Results: Predominantly homogenous distribution of calcium and to determine the maximum load to failure using an in vitro test.
silicon was observed in SEM and EDX analysis of the powder. Design: A total of 24 full ceramic crowns, 12 from each type were
Back scattered analysis highlighted the homogenous repartition used and inspected using light microscopy at 109 to determine
of zirconium oxide over the cement surface. Elemental presence any pre-existing cracks. Natural primary incisors were prepared
of calcium, silicon, zirconium and aluminium were confirmed by and rounded allowing a passive fit of the crowns. Each crown
EDX analysis. XRD analysis of the powder enabled identifica- was individually cemented with glass ionomer to the underlying
tion of all major components mentioned by the manufacturer. abutment. Each crown/abutment system was axially loaded with
XRD and FT-IR analysis at different time intervals of matura- a dynamic load applied at a position one-third of the way down
tion revealed the formation of calcium hydroxide in samples the inciso-palatine surface by mean of a specially designed stain-
stored in water. Calcium hydroxide formation was absent when less steel pointed tip in a universal testing machine. The load at
stored in RH. which failure occurred was recorded in kilograms. The data were
Conclusions: During maturation, Medcem MTAÒ requires mois- analyzed using one-way analysis of variance (ANOVA) and Tu-
ture in the surrounding for the formation of calcium hydroxide. key HSD test (P-value <0.05).
Chemically, Medcem MTAÒ and ProRootÒ white MTA are tri- Results: There was no significant difference in fracture resistance
calcium silicate based hydraulic cements with almost similar con- of both types of crowns. The Mean load in Kg for Nu-Smile was
stituents and setting reaction barring few exceptions. 29.6 5.5 and that for Zirkz was 27.3 18.4 (P = 0.178). How-
ever higher prevalence of cracking occurred within Zirkz crowns
PR08-2.15 (P = 0.016).
Density and tubular diameter in different dentin Conclusion: Both tested types of crown restoration showed almost
comparable fracture resistance values. Nu-Smile crowns showed
depths associated with bond strength better resistance to cracking under load than Zirkz crowns.
A. G. S. SILVA, G. G. DOMINGUES, T. K. TEDESCO, A. F. B. Keywords: Esthetic Primary Crowns, Zirconia Crowns, Fracture
CALVO & D. P. RAGGIO Toughness
Department of Orthodontics and Paediatric Dentistry, University
of Sao Paulo, Sao Paulo, Brazil
PR08-2.17
Background: The influence of the density and diameter of the dif-
Revascularization treatment of necrotic immature
ferent dentin depths has been reported in the dentin bond strength
(BS) related with two high viscosity glass ionomer cement. permanent tooth - a case report
S. HRVATIN1, J. JELICI C
2, L. SKOJO
3
, I. CUKOVI
C-BAGI 4 &
C
Design: 20 permanent molars were divided into 6 groups accord-
H. JURIC 4
ing to the dentin depth and GIC. Slices were obtained from 1
Proximal Dentin (P), occlusal surface (OS) and deep occlusal School of Medicine, University of Rijeka, Rijeka, Croatia;
2
(DO) 1 mm thick each. Then topographic analysis was performed Health Centre Zagreb-East, Zagreb, Croatia; 3Department of
to obtain diameter and density by tubular confocal microscopy Paediatric and Preventive Dentistry, Dental Policlinic of Split,
(1009). Polyethylene cannulae were positioned on the sections Split, Croatia; 4Department of Pediatric and Preventive Dentistry,
pretreated with dentin and filled. The specimens were stored in School of Dental Medicine, University of Zagreb, Zagreb, Croatia
distilled water for 24 h at 37°C and subjected to microshear Test Introduction: Pulp revascularization is a regenerative endodontic
(0.5 mm/min). Data were analyzed by ANOVA and Tukey0 s test procedure which allows continued root development in nonvital
(a = 5%). immature permanent teeth. The ability of residual pulpal, peri-
Results: Significant differences were found between the tubular odontal and apical stem cell to differentiate and growth in the
density at different depths (P: 30036.46 4472.14; OS: canal space with blood clot as a scaffold rich in growth factors,
29665.35 6232.00; OP: 43942.88 10039.69). On the other generate vital tissue and promote root maturation.
hand, there was no difference in relation to tubular diameter (P: Case reports: A 12-years-old boy was referred to our Department
19.6 0.84; OS: 19.1 0.67; OP: 18.8 1.36). It was also ver- for evaluation of the upper right permanent incisor. The patient
ify that OS dentin provided highest bond strenght, regardless of had a tooth avulsion 4 years ago. The tooth was replanted and
the GIC, while the OP caused lower, especially for Ketac Molar splinted within 30 min of trauma. After splint removal the patient
(P - FUJI IX: 3.6 1.0; Ketac Molar: 3, 4 1.6; OS - FUJI was not followed-up. Clinical examination showed discoloration of
IX: 4.7 1.8; Ketac Molar: 5.0 1.2; OP - FUJI IX: 3.2 1.0; the crown, infraocclusion and the presence of sinus tract in the api-
Ketac Molar: 2.8 1.2). cal area. Radiographic examination showed incomplete root devel-
Conclusions: The density of the dentin tubules at different depths opment and a periapical lesion. Revascularization was achieved
is inversely proportional to BS of high viscosity GICs. through multiple procedures. During the first visit the necrotic pulp
tissue was removed, the canal was irrigated with 5.25% NaOCl
and an antiseptic was set in the pulp chamber. Seven days later a
mixture of metronidazol, ciprofloxacin and doxycyclin was placed
into the canal. After 7 days periapical bleeding was induced and
blood clot in the first third of the root canal was stabilised with
paste of Ca(OH)2. Finally, after one week MTA was placed over than females (63%). The mean time carrying the device is
coagulated blood. A 9-month follow-up showed radiographic evi- 2.5 years. The fracture of the weld in the prosthesis was the most
dence of periapical healing and root development. common problem with the devices (31%), followed by the frac-
Comments: Revascularization could be useful procedure in treat- ture of the crowns (25%).
ing immature permanent teeth with necrotic pulp providing fur- Conclusions: We suggest, in the results of this study, that more
ther growth and development of the root. studies of this type of devices should be conducted in order to
evaluate their effectiveness.
PR08-2.18
Fixed aesthetic appliance for replacing lost anterior PR08-2.20
primary teeth: a case series Success rates of pulp protection with either Dycalâ
J. M. FARZAN and VitrebondTM or BiodentineTM in young permanent
Pedo Planet Pediatric Dental Centres, Chennai, India teeth with deep caries of patients 6–18 years old
Introduction: Anterior primary teeth provide aesthetics to a child. S. THEPPIMARN, P. CHOMPU-INWAI & T. SASTRARUJI
They are important part of the oral cavity for providing proper Chiang Mai University, Chiang Mai, Thailand
speech and psychological well being of the child. Early loss of Background: Calcium hydroxide and glass ionomer cement were
these anterior primary teeth can happen due to extensive Early commonly used as a liner and base in deep cavity. New calcium-sil-
Childhood Caries or dental trauma. This loss in turn can affect icate based cement (BiodentineTM) was recently introduced as a
the child’s aesthetics, phonetics and psychological well being. dentin substitute. At present, there have been no studies comparing
This case series describes clinical cases with a fixed aesthetic the success rates of pulp protection with DycalÒ and VitrebondTM
appliance for replacing lost anterior primary teeth. to BiodentineTM in young permanent teeth with deep caries.
Case reports: This case series describes the utilization of a fixed Aim: To compare success rates of pulp protection with either Dy-
aesthetic appliance which incorporates composite resin strip calÒ and VitrebondTM or BiodentineTM in young permanent teeth
crowns attached to a metal framework made of 0.032 round with deep caries.
stainless steel wire soldered together with preformed metal bands Design: Nineteen teeth with deep caries diagnosed with normal pulp
over the posterior primary teeth. The appliance is cemented on or reversible pulpitis from 19 subjects (mean age 9.5 years old) were
the primary molars utilizing a glass ionomer luting cement. All available for 6 months follow up. Four percent articaine with
the children were followed up for review at frequent intervals 1:100,000 epinephrine was administered and rubber dam was
during which they showed excellent gingival health and gingival placed. Dental caries was removed until the hardness of dentin was
adaptation. The regenerated gingiva and interdental papilla in felt. The cavity was irrigated with 2% Chlorhexidine. Then, the
between and around the composite resin strip crowns attached to teeth were randomly assigned into 2 groups of pulp protection:
the appliance showed natural aesthetics of the children. Group DycalÒ and VitrebondTM and Group BiodentineTM. The
Comments: The case series described provide a simple and easy tooth was finally restored with composite resin or stainless steel
design for fixed replacement of lost anterior primary teeth in chil- crown. After 6 months, all teeth received the clinical and radio-
dren. The utilization of composite resin strip crowns and the graphic evaluations.
excellent gingival health and adaptation further increases the nat- Results: The overall success rates of pulp protection with DycalÒ
ural aesthetics of the children. and VitrebondTM was 100% (8/8 teeth) and was 90% (10/11
teeth) in BiodentineTM (mean follow up 9.7 months). There was
PR08-2.19 no statistically significant difference between the success rates of
both groups (P = 0.38).
Treating early loss of primary teeth: effectiveness of Conclusions: DycalÒ and VitrebondTM or BiodentineTM can be
fixed prosthesis appropriately used as pulp protection in young permanent teeth.

A. ADANERO, V. GOMEZ,
B. GOMEZ, E. M. MARTINEZ & However, more samples and follow up are needed.
P. PLANELLS
Department IV-Pediatric Dentistry, Faculty of Dentistry,
Universidad Complutense de Madrid, Madrid, Spain
PR08-2.21
Effect of nitrous oxide/oxygen inhalation sedation on
Background: The early loss of primary teeth is not only a functional
problem for children, we have to face psychosocial problems. There
the success rate of pulpal anesthesia in subjects with
are many solutions to restore dental function, but there are not irreversible pulpitis premedicated with ibuprofen
many studies that investigate the effectiveness of these devices. S. SIMPRASERT, P. CHOMPU-INWAI & T. SASTRARUJI
Aim: The aim of this retrospective, longitudinal study is to evalu- Chiang Mai University, Muang Chiang Mai, Thailand
ate the effectiveness of fixed prosthesis with metallic crowns in Background: To increase success rates of pulpal anesthesia in irre-
temporary molars, used to restore teeth that were early lost. To
versible pulpitis teeth, several methods have been reported with
evaluate this we studied: wide range of success. However, there have been no studies that
-Etiology of the loss. evaluate the success of the combination of pre-emptive NSAIDS
-Time that the device was carried.
and nitrous oxide sedation.
-Problems with the device, and other variables. Aim: To compare the success rates of pulpal anesthesia between
Design: A total of 83 children attending a private dentist consult the groups using either nitrous oxide or oxygen in subjects with
in Madrid were invited to enter the study. Clinical information irreversible pulpitis premedicated with ibuprofen.
relating to the child’s dental information was collected from
Design: Forty seven asymptomatic and symptomatic irreversible
patient records. This includes radiographic and photographic pulpitis teeth from 39 subjects (mean age 10.4 years old) were
images during and after treatment. A descriptive analysis was included into the study. All subjects were premedicated with ibu-
conducted and a cross sectional analysis was made in order to profen. Subjects in both groups were randomly assigned to either
evaluate the relation between the variables.
the nitrous oxide or oxygen group. Four percent articaine with
Results: The most common reason of the early tooth loss was a epinephrine 1:100,000 were administered and treatment was per-
traumatic cause (93%), being more common this loss in males formed. Participants used Wong Baker Faces Pain Rating Scale
(WBFPS) to self-report their pain during the procedure. WBFPS Aim: The purpose of the present study was to investigate the
score higher than 4 indicated the failure of pulpal anesthesia. degree of polymerization with respect to specimen thickness to
Results: In all studied teeth, the success rate of pulpal anesthesia understand the effect of exponentially attenuating incident light
were 68% (17/25) and 45% (10/22) in the in the nitrous oxide within specimens.
and oxygen groups respectively and there was no statistically sig- Design: Ten differently classified (flowable, microhybrid, and
nificant difference between them (P = 0.119). However, in the nanohybrid) composite resins were chosen and specimens of three
group of symptomatic irreversible teeth, the success rates of pul- different thicknesses (1, 2, and 3 mm) were made. Numbers of
pal anesthesia were 63% (10/16) and 18% (2/11) in the nitrous photons passing through specimens, microhardness, refractive
oxide and oxygen groups respectively. There was statistically sig- index, and color of specimens for different backgrounds were
nificant difference between them (P = 0.047). measured at different thicknesses.
Conclusions: Nitrous oxide can increase the success rate of pulpal Results: Within specimens, numbers of photons exponentially
anesthesia in subjects with symptomatic irreversible pulpitis pre- decreased with different attenuation coefficients for each resin
medicated with ibuprofen. products. Filler content was high linearly correlated with microh-
ardness, but poorly correlated with refractive index and the
PR08-2.22 translucency parameter (TP). Microhardness and refractive index,
microhardness and TP, and refractive index and TP were found
Smile for life: management of dental anomalies in a to be linearly correlated. Microhardness, refractive index, and TP
child with acute myeloid leukemia in Sri Lanka values were inversely related to specimen thickness.
P. W. N. WICKRAMARATNE, S. S. SIRIWARDANA & I. R. Conclusions: The linear correlations found in the present study
PERERA for the resin products tested can be applied to other resin prod-
Ministry of Health, Dental Institute Colombo, Sri Lanka, ucts to estimating these properties regardless of filler content.
Colombo, Sri Lanka
Introduction: Acute myeloid leukaemia is a genetically heteroge- PR08-2.24
neous group of malignant bone marrow neoplasms of myeloid pre- Microleakage of newly developed glass carbomer
cursors of white blood cells. It is rare and presents approximately cement in primary teeth
5% of all childhood leukaemias with an incidence of 1.6–2.2 per
K. G. ULU GUZEL, S. KELES, M. AKYILDIZ, G. DOGUSAL,
million per year. The treatment modalities involve chemotherapy,
M. DALOGLU & I. SONMEZ
radiotherapy, and/or bone marrow transplant contributing to sig- Department of Pediatric Dentistry, Adnan Menderes University
nificant improvement in survival of children with an overall sur-
Faculty of Dentistry, Aydin, Turkey
vival rate of 60–70%. However, there is a considerable impact on
quality of life of affected children compounded by oral health Background: Glass Carbomer is a new generation restorative
problems and dental anomalies such as enamel hypoplasia, micr- material developed from glass-ionomer cements with possibility
odontia and dental agenesis. We describe dental management in a of gradual mineralization into fluorapatite.
12-year-old girl presented at the age of 6-years from Sri Lanka. Aim: The aim of this study was to compare the microleakage of
Case reports: A 6-year- old girl presented to the Restorative a newly developed glass carbomer cement with a compomer and
Clinic with brownish, hypoplastic permanent teeth with the diag- a resin modified GIC in primary molars.
nosis of acute myeloid leukaemia -N7. She was on chemotherapy Design: Standardized cavities were prepared on extracted human
from the age of 10 months to 4 years. Her oral hygiene was primary molars, and the teeth were randomly assigned into the
improved and stainless steel crowns were placed on four first per- following groups (n = 15/each): (1) Dyract XP (LD Caulk/Dents-
manent molars. Enamel hypoplasia was present in 11, 21, 26, 36, ply, USA); (2) resin modified GIC (RMGIC) (R&D series Nova
32 and 31, 41, 42 and 46. They were treated with composite fill- Glass LC Imicryl), Konya, Turkey]); (3) glass carbomer cement
ings over a period of 6 years as intermediate management; the (GCP); (Glass Carbomer Products, Leiden, Netherlands). The
definitive treatment would be porcelain veneers. She has been restored teeth were then stored in distilled water at 37°C for
referred for orthodontic treatment for anterior open bite. 24 h, Following thermocycling at 5–55°C for 1000 cycles, the
Comments: Long term, interdisciplinary management of dental specimens were immersed in 0.5% basic fuchsin solution, sec-
anomalies involving restorative and orthodontic care is essential to tioned, and microleakage was evaluated with a magnification of
ensure smile for life of a surviving adolescent of acute myeloid leu- 309. For comparative evaluation of microleakage scores between
kaemia. This case-report highlights the context in a developing the groups, Kruskal-Wallis statistical analysis was done.
country. Results: The greatest amount of dye leakage was observed in the
glass carbomer specimens, followed by the RMGIS. However;
PR08-2.23 there was no significant difference between the microleakage val-
ues of GCP and RMGIC (P > 0.05).
Effect of curing depth on polymerization of light- Conclusion: Within the limitations of this in vitro study, new glass
cured composite resins carbomer cement restorations did not perform better than com-
E. SONG1,2, Y. KIM1, Y. BAE1, S. SHIN3, Y. KWON3 & T. pomer material in class V cavities in terms of microleakage
JEONG1 assessment.
1
Pediatric Dentistry, Pusan National University School of
Dentistry, Yangsan, Korea; 2Goodwill Junior Dental Clinic,
Busan, Korea; 3Pusan National University School of Dentistry,
Yangsan, Korea
Background: All resin constituents hinder the passage of incident
light through uncured resin. As a result, incident light does not
reach the bottom surface uniformly and then, polymerization dif-
fers through resins. Furthermore, these different degrees of poly-
merization affect the densities of cured resins.
PR08-2.25 Results: 182 restorations were assessed. 76 amalgam restorations

and 106 steel crown restorations. Clinically successful amalgam
Success of sodium hypochlorite versus formocresol
fillings were 56.57% (n = 43/76) and failure 43.42% (n = 33/76).
pulpotomy: a 30-month study Successful restorations with steel crowns were 48.11% (n = 51/
P. CHOMPU-INWAI1 & S. CHAOWARAT2 106) and failure 51.88% (n = 55/106).
1
Orthodontics and Pediatric Dentistry, Chiang Mai University, Conclusion: There is no significant difference between amalgam
Chiang Mai, Thailand; 2Sappasittiprsong Hospital, and steel crowns restorations for tooth with pulpitis (P < 0.05).
Ubonratchathanee, Thailand
Background: Formocresol (FMC) has been one of the most popu- PR08-2.27
lar medicaments for pulpotomy in primary molars. However, the A study on the penetration ability of early deciduous
continued searching for alternatives is growing due to its toxicity
concerns. Sodium hypochlorite (NaOCl) has several interesting
teeth caries with resin infiltration
characteristics to be used as pulpotomy medicament and only L. YINGQUN, X. XIN & Z. YIXIN
few short-term studies of NaOCl pulpotomy have been reported. The Affiliated Stomatology Hospital of Harbin Medical
Aim: To compare long-term success of pulpotomy in primary University, Harbin Medical University, Harbin, China
molars between using 5.25%NaOCl and 20% FMC. Aim: To determine the effects of different resin infiltration, of dif-
Design: Sixty four primary molars that met the inclusion criteria ferent sorts of acid etching, of different etching time, and of dif-
were randomized into 2 treatment groups. There were 33 and 31 ferent penetration time on the penetration ability of resin
teeth in the NaOCl and FMC groups respectively. After 30 s of infiltration.
NaOCl and 5 min of FMC cotton pellet applications in each Design: A total of 48 extracted deciduous lower incisors were
group, IRM base and stainless steel crowns were used as final immersed in a demeneralized solution for 45 d to form the early
restorations in both groups. Clinical and radiographic results artificial caries and then were randomly divided into 16 3-teeth
were evaluated at 6 and 30 month-periods. Chi square test was groups. Infiltration treatment with different resin infiltration, acid
used to compare their successes. etching, etching time and penetration time, then making speci-
Results: At 6 month-periods, there were 61 teeth remaining for mens. Penetration ability was examined after sectioning speci-
recall. The clinical success rates were 100% in both groups and mens were observed under CLSM, measuring the depth of
the radiographic success rates were 90.3% and 86.7% in the penetration of the resin (PD) and the depth of lesion (LD) and
NaOCl and FMC group respectively. At 30 month-periods, there calculating the percentage penetration (PP).
were 39 teeth remained for recall. The clinical success rates were Result: There was no statistically significant differences between
100% in both groups and the radiographic success rates were treatment groups (P > 0.05). But the difference of comparison of
77.8% and 76.2% in the NaOCl and FMC group respectively. own different levels of two factors, namely resin infiltration and
There were no statistically significant differences in the success penetration time were statistically significant respectively (P <
rates between the two treatment groups at both 6 and 30 month- 0.05). Penetrating materials main effect is greater than the infil-
periods. tration time main effect.
Conclusion: NaOCl may be recommended as an alternative pulp- Conclusion: Combination of resin infiltration and penetration
otomy medicament. time of 3 min has proved to be a better solution.
PR08-2.26 PR08-2.28
Treatment outcome of primary molars0 restorations Prefabricated composite veneers: an interesting
placed under general anesthesia: long-term result treatment option for the pediatric dentist
A. CIGANOVICA, I. VIDUSKALNE & I. MALDUPA S. LOPEZ CAZAUX1,2, T. PRUD’HOMME1,2, C. LUSSON1, I.
Riga Stradins University, Institute of Stomatology, Riga, Latvia HYON2 & S. DAJEAN TRUTAUD1,2
1
Background: General anesthesia (GA) allows dental treatment to Pediatric Dentistry, Faculty of Dentistry, Nantes University,
be rendered under optimal conditions, theoretically ensuring ideal Nantes, France; 2Nantes Hospital, Nantes, France
outcomes. The most common restorations in primary molars Introduction: Restoration of anterior permanent teeth in young
placed under GA are amalgam fillings and stainless steel crowns. patients could be a challenge in different situation. The presence
Aim: The aim of this study is to appreciate the lifetime and qual- of a dental anomaly or extensive caries could complicate our
ity of restoration and compare stainless steel crowns and amal- treatment. When the patient is a child or an adolescent we must
gam fillings for primary molars with diagnosis pulpitis. restore the function and the esthetic using conservative
Design: 52 patients attending Institut of Stomatology of Riga approaches. Preservation of tooth structure must be considered
Stradins University for dental treatment under GA in 2010. - when selecting a restorative material or technique. Direct com-
2012. were invited to participate in the study. Mean age at the posite resin restorations are mostly used, even in case of exten-
time of GA were 31.8 months and mean age at the follow up vis- sive defect or destruction, waiting full coverage restorations
its were 71.4 months. Treatment information was collected from when the patient becomes an adult. Prefabricated composite
patient notes. New dental status, radiographics and intraoral veneer systems have been recently developed. They are not
photos were made in follow up visit. The restorations were evalu- widely used but they provide an alternative therapeutic option.
ated using radiographics and intraoral photos. Outcome mea- Case report: Trough 4 case reports we will develop the clinical
sures were clinically rated in two groups, minor failure and procedure and present a long time follow up during at least
major failure were merged into one group. The other group was 2 years. Prefabricated composite veneers restore esthetic and
successful restorations. function.
Comments: This technique can be used to restore anterior perma-
nent teeth in case of amelogenesis imperfecta, dentinogenesis im-
perfecta and extensive caries. This new treatment option may
open new opportunities for pediatric dentist.
PR08-2.29 Treatments resulting in pain complaints, apical problems, fistulae,

resorption or fracture are considered as failure of treatment.
Treatment of infected primary molars with lesion
Results: A total of 37 teeth were treated between January 2009
sterilization and tissue repair: a case series and December 2014. We excluded 7 teeth, one because no bleed-
A. AKBAY OBA1, S. ALP1, I. SßAROGLU €
SONMEZ 2
& L. ing could be achieved and 6 because the follow-up time was <
ÖZER3 6 months. The mean follow-up time of the remaining teeth was
1
Pediatric Dentistry, Kırıkkale University Faculty of Dentistry, almost 24 months. No failures were reported. Everyone adhered
Kırıkkale, Turkey; 2Pediatric Dentistry, Adnan Menderes to the protocol and the collaboration between the dentists was
University Faculty of Dentistry, Aydın, Turkey; 3Pediatric good. The data are considered comparable and reliable.
Dentistry, Ankara University Faculty of Dentistry, Ankara, Conclusions: RET seems to be a promising treatment method for
Turkey teeth with wide open apex. Well documented case series, as
Introduction: In primary dentition, the tooth with infected root described here, contribute to the development and improvement
canals and periradicular lesion is a common problem. In recent of the clinical procedure.
years, the Cariology Research Unit of the School of Dentistry
Niigata University has developed the concept of ‘‘lesion sterilisa- PR08-2.31
tion and tissue repair’’ (LSTR) therapy. A mixture of antibacte- Changes in dental rehabilitation treatment options for
rial drugs are used in this technique to disinfect the dentinal,
pulpal and periradicular infections by non-instrumentation end-
children with disabilities
MLINKÓ, K. DERI
N. RÓZSA, E. & G. FABI AN

odontic treatment. In this case report, LSTR therapy was used
for treating infected primary molar teeth with periradicular Paediatric Dentistry and Orthodontics, Semmelweis University
lesions. Budapest, Budapest, Hungary
Case reports: After dental examinations with appropriate radio- Background: Dental rehabilitation performed under general
graphs were completed, the clinical diagnosis were determined anaesthesia has become an important alternative for treating dis-
and three primary molar teeth with pulpal infections and perira- abled children. This young patient group with special-needs
dicular lesions were chosen for treatment. The teeth were treated requires not only up to date dental skills and empathy, but also
with 3Mix-MP paste which contains Metranidazole, Minocycline special medication for pain and anxiety control such as inhala-
and Ciproflaxacin without enstrumantation (LSTR therapy). All tion and intravenous sedation agents.
teeth were restored with resin-modified glass ionomer cement. Aim: The purpose of the present study was to present changes in
After the restorative treatment, Stainless Steel Crowns were the dental treatment needs of young patients with disabilities trea-
applied. Patients were recalled periodically and success of the ted at the Department for Paediatric Dentistry and Orthodontics,
treatments were considered clinically and radiographically. The Semmelweis University Budapest, for the period 2005–2014.
teeth were asymptomatic, the periradicular lesions have become Design: 451 Special-needs patients, aged 2–18 years, (male/female
smaller in size after 12 months. ratio = 1.37; P = 0.03), undergoing paedodontic treatment under
Comments: Compared to traditional root canal therapy, taking general anaesthesia were analysed. The changes in in the basic
less treatment time is the main advantage of LSTR therapy. This diagnosis of the disorders and the treatment needs presented by
advantage makes LSTR therapy more comfortable for both these patients between January 2005 and December 2014 were
patients and dentists. Further clinical research is needed in order evaluated. Chi-Quadrate-Test, Graph Pad PrismÒ 2014 was used
to evaluate the success of LSTR therapy in infected primary teeth. for statistical analysis.
PR08-2.30 Results: A total of 29 diseases and syndromes were recorded, the
Regenerative endodontic therapy most frequent were mental (93.15%), autistic (51.3%), emotional
J. S. C. HEIJDRA1,2, M. E. C. ELFRINK3,4, J. B. KRIKKEN5,6, and behavioral disorders (14.4%), epilepsy (12.6%) and Down
W. H. KOUWENBERG-BRURING7,8, H. C. KOUWENBERG7,8 syndrome (7.65%). For primary dentition extractions (68%) and
& K. L. WEERHEIJM6,9 glass ionomer fillings (20%) were the most preferred treatment
1
Tandartspraktijk Puntgaaf, Barneveld, Netherlands; 2Paediatric options (P < 0.0001, df = 3). Permanent teeth (P < 0.0001,
Research Project (PREP), Barneveld, Netherlands; df = 9) required frequently extractions (30%), composite fillings
3
Mondzorgcentrum Nijverdal, Nijverdal, Netherlands; 4Paediatric (30%) and calculus removals (22%).
Research Project (PREP), Nijverdal, Netherlands; 5Kindertand- Conclusions: The number of disabled children requiring dental
West, Amsterdam, Netherlands; 6Paediatric Research Project rehabilitation under special conditions is increasing. Considering
(PREP), Amsterdam, Netherlands; 7Mondmaatjes & Dental Care treatment options, the continuous increase of the conservative
Clinic Kouwenberg-Bruring, Doetinchem, Netherlands; 8Paediatric approach is important for the improvement life quality, even if
Research Project (PREP), Doetinchem, Netherlands; 9Kindertand, extractions are still predominant.
Amsterdam, Netherlands
PR08-2.32
Background: Treatment of teeth with wide open apex is challeng-
ing. Treatment mainly focuses on stabilization of the largely Treatment outcomes for direct pulp capping
weakened tooth. These teeth easily show early root fractures or procedures with calcium hydroxide and MTA:
possible apical inflammation. Since 2004 the Regenerative End- 12 months evaluation period
odontic Therapy (RET), (Leeds University), is a promising treat- V. TUPČIJENKO & I. VIDUSKALNE
ment-method. It focuses on continuation of the root growth by Department of Conservative Dentistry, Riga Stadins University,
revitalization of the pulp tissue. Riga, Latvia
Aim: The aim was to collect series of cases treated with RET in
different practices, according to the same protocol. Background: Without pulp inflamation signs, the pulp capping
Design: The seven dentists from PREP meet 2–3 times per year procedure may provide protection for the pulp, continued pulp
and additionally discuss cases and problems by e-mail (e.g. treat- vitality and apexogenesis.
ment protocol and strategy of data collection). RET treatments Aim: Of the study was to verify the long-term results after pulp
started and cases were collected by the PREP dentists in their five capping procedure in deep carious teeth using calcium hydroxide
different secondary dental care clinics in the Netherlands. and MTA, compare clinical outcomes.
Design: In prospective clinical study participated 53 children 7– PR08-2.34

17 years old with deep carious lesions, showed no history of pain
Treatment of special patient with Opitz Frias
in response to temperature or biting. Children were divided ran-
domly into two groups. Control group treated with calcium syndrome
hydroxide; research group - with MTA. Clinical and radiographic V. KOUTSI1, M. SIFAKAKI1, R. GKOUGIOUMTZAN2, I.
outcomes were evaluated. Success rates were accepted when tooth SIFAKAKIS3, G. VADIAKAS1 & N. THEOLOGIE-LYGIDAKIS2
1
was asymptomatic, with positive response to sensitivity testing. Department of Paediatric Dentistry, University of Athens, Athens,
Criteria for lack of healing included: tooth pain or necrotic pulp Greece; 2Department of Oral and Maxillofacial Surgery,
as indicated by clinical and radiographic observations. University of Athens, Athens, Greece; 3Department of
Results: 53 children participate in the study. Mean age was 12.8 Orthodontics, University of Athens, Athens, Greece
(4.5) years. Over the observation period 48 of 53 teeth were fol- Introduction: Opitz Frias syndrome is a genetic condition that
lowed. 89.58% was success rate for all followed teeth. For con- affects several structures along the midline of the body. The most
trol group - 88.00% (n = 22/25), for research group - 91.30% common features of this condition are wide-spaced eyes, defects
(n = 21/23). There were 9/16 oclussal/aproximal cavities for con- of the larynx, trachea, and/or esophagus causing breathing prob-
trol group, and 13/10 - for MTA group. Only approximal resto- lems, dysphagia, intellectual disability and structural defects in
rations had failures (3 for calcium hydroxide; 2 for MTA). There the brain. Maxillofacial abnormalities that may be seen in this
were 10 immature teeth. One tooth from research group with disorder include a flat nasal bridge, thin upper lip, low set ears,
immature root development had failure, no apexogenesis and cleft lip with or without a cleft palate. Opitz Frias syndrome is
endodontic treatment needed. thought to affect 1 in 100,000 males.
Conclusion: Both materials could be used for direct pulp capping Case report: An 8 year old boy was referred by the Department
procedures, with better results using MTA. of Genetics to the postgraduate clinic of Paediatric Dentistry for
Only pulp capping’s in occlusoproximal cavites failed. dental care. He presented with multiple occlusal and interproxi-
Teeth with open apices continue root formation. mal carious lesions, two supernumerary teeth in the area of the
upper left central incisor and an impacted left central incisor.
PR08-2.33 Treatment plan consisted of restoration of his multiple carious
Following the aesthetic pediatric crowns: the CAD/ lesions and the surgical removal of the supernumerary teeth as
well as the surgical exposure of the tooth #21 under general anes-
CAM composite resins for primary teeth thesia. Brackets were bonded on the anterior teeth as soon as it
E. DURSUN1,2,3, A. MONNIER-DA COSTA1,3 & C. was possible, and the traction of the impacted central incisor
MOUSSALY2 started.
1
Paediatric Dentistry, Paris Descartes University, Montrouge, Comments: Two years later, the central incisor has fully erupted
France; 2Dental Materials Research Unit, Innovations and with no signs of clinical pathology. Interdisciplinary care among
Interfaces, Montrouge, France; 3Paediatric Dentistry, Mondor- health providers in a patient with Opitz Frias syndrome is essen-
Chenevier Hospital Complex, Cr eteil, France tial for a succesful outcome.
Introduction: In cases of multi-surface caries and/or following
pulpotomy/pulpectomy on primary teeth, a full coronal coverage PR08-2.35
restoration is conventionally performed to ensure a sustainable
A retrospective longevity private practice-based study
survival. Stainless steel crowns are a simple and reliable option,
but unsightly. Zirconia crowns or others veneered with tooth-col- of the posterior composite resin restorations
ored material constitute more aesthetic alternatives. However, all M. CARDOSO1, C. PEREIRA2, C. M. VELHO2, L. R.
these techniques remain substantially invasive. The aim of this REGATTIERI3, A. KONRATH2 & A. BORGATTO2
1
communication is to present a new management, using CAD/ Pediatric Dentistry, Federal University of Santa Catarina,
CAM technology and composite blocks. Florianópolis, Brazil; 2Federal University of Santa Catarina,
Case reports: Four primary molars with deep caries (on three Florianópolis, Brazil; 3Private Paediatric Dental Practice,
patients) were treated by pulpotomy. Occlusoproximal composite Curituba, Brazil
onlays were performed. The material used was a CEREC Omni- Aim: The aim of this retrospective longitudinal study was to eval-
Cam (without powder) (Sirona) and LAVA Ultimate composite uate the clinical performance of 562 composite resin posterior
blocks (3M ESPE). The tooth preparation consisted: in supra- restorations placed on 1st and 2nd permanent molars in patients
gingival margins (if possible) at the proximal area; and, in an with a regularly follow up in a private dental practice.
occlusal reduction of buccal and lingual walls, over a length of Design: Dental records of 206 patients, totaling 562 teeth. Clini-
3 mm, until a flat surface of 2 mm. The proximal finitions were cal examination was done by a calibrated examiner, accessing the
made with a diamond insert. Then, the optical impression was restoration retention, marginal integrity, and presence of second-
taken, the virtual restorations were designed and manufactured ary caries. Including selection criteria were patients who received
in the session. A self-etching resin cement was selected for bond- class I restorations, returned semiannually for clinical exam and
ing the restorations (the rubber dam is not mandatory). annually for radiographic exams, and who were inserted on a
Comments: The use of CAD/CAM technology to restore health program. The excluded criteria were patients who received
extended caries on primary teeth is a very interesting and promis- other kind of material and who had their teeth treated by other
ing technique. The latter combines: high strength, excellent aes- professional.
thetic and good biocompatibility; minimally invasive technique; Results: According to the multivariate regression analysis, consid-
strengthening of dental tissues; respect of surrounding tissues; ering both 1st and 2nd permanent molars and repair as a depen-
rapid implementation; patient and parent satisfaction. However, dent variable, the study did not show any variables statistical
the acquisition of equipment is fairly expensive. significantly associated with the repair cases (P < 0.05). At the
patient’s records analysis, proximal caries lesions were reported
in 4.64% on the first molars and 12% on the second molars; the
presence of restoration repair was 6% for 1st molars and 1.6%
for the 2nd molars. At the clinical exam, the restoration’s reten-
tion was 100% for the 1st molars and 2nd molars. Concerning
longevity, each year of follow-up the chance of a patient to have invagination (Ohlers IIIA) and periapical radiolucency were diag-
repair increases 1.05%. nosed in the upper lateral incisor of a 12-year-old girl.
Conclusions: Occlusal restorations of permanent molars present The endodontic treatment of the teeth were carried out under
an excellent clinical performance especially when patients are dental operating microscope aided by ultrasonic cleaning and
inserted in a health promotion program by means of a regular preparation. Different obturation techniques were used during
follow up. management. The root canal in Oehlers IIIB malformation was
filled with thermoplasticized, injectable guttapercha after obtura-
PR08-2.36 tion of the apical foramen with glass ionomer cement. The lateral
incisor was obturated with warm lateral compaction technique.
Resin infiltration of mild to moderate idiopathic white Comments: Three-year radiographic follow up of these cases
spot lesions - a case presentation show normal periapical morphology, suggesting that teeth with
D. Z. NAGY, I. TARJAN, AN
I. SIMON, G. FABI & N. RÓZSA severe morphologic abnormalities can be treated successfully with
Department of Paediatric Dentistry and Orthodontics, Semmelweis proper treatment planning and technique.
University, Budapest, Hungary
Introduction: Resin infiltration is a relatively new method for PR08-2.38
arresting non-cavitated proximal caries and for improving aes- Dental laser applications for children: which
thetics of white spot lesions (WSL), occurring after fixed ortho- wavelength for which tissue?
dontic appliance removal. Based on the capillary effect, a low
S. PEKER
viscosity light-curing resin penetrates the affected enamel area
Pediatric Dentistry Department, Marmara University Faculty of
until the outer ⅓ of the dentin. Previously, the surface is condi-
Dentistry, Istanbul, Turkey
tioned with a 15% HCL etching agent. This diffusion barrier
arrests the incipient caries and, due to light refraction properties Introduction: Dental lasers are widely used in many areas in pedi-
the tooth surface regains its initial colour. Initially resin infiltra- atric dentistry from prevention to diagnosis, from cavity prepara-
tion indications did not include idiopathic WSL. tion to pulp vitality tests and from endodontics to trauma cases
Case report: A 12-year-old boy was referred for treatment of idi- and even apnea reduction. Laser technology and different wave-
opathic WSL localized on the vestibular surfaces of the perma- lengths can be used as an alternative instrument that sometimes
nent upper incisors and canines. On the right upper incisors the completes and at other times substitutes and assists for the tradi-
alteration was mild to moderate, with white-yellowish linear dis- tional techniques.
colorations. On the left side clinical examination showed moder- Case reports: In this presentation the dental lasers with different
ate to severe alterations, with deeper brownish, minimally wavelengths, soft and hard tisssue aplications in our clinic and
cavitated defects. As first treatment step teeth 1.1 and 1.2 were acceptance of dental lasers both for children and parents and advan-
chosen for treatment. ICONÒ (DMG) infiltrant was applied tages and laser safety subjects will be reviewed with many cases.
respecting the manufacturer’s recommendations. Due to the nat- Comments: Reduction in the use of anaesthetics, analgesics and
ure of the treated alterations, it was decided to repeat the etching antibiotics, and in intra-operative and post-operative bleeding,
procedure for another 2 and resin application for 1 min. After elimination the need sutures and producing faster wound healing
light-curing, and polishing, a picture was taken for cosmetic and less scar tissue are some advantages of dental lasers in pedi-
result follow-up. After 6 months no alteration was observed. atric dentistry. With the developing technology dental lasers are
Comments: Resin infiltration significantly improved the clinical becoming more important in pediatric dentistry and children
appearance of WSLs of unknown aetiology. Despite aesthetic should be considered as the foremost patients for having laser-
results were not perfect, patient and relatives were extremely sat- assisted dentistry.
isfied with the improvement and decided for further treatment.
PR08-2.39
PR08-2.37 Mesenchymal stem cells homing to the root canal of
Management and three-year follow up of dens immature permanent teeth during apical periodontitis
invaginatus. A report of two cases and regenerative endodontic treatment
B. SANDOR, K. KRAJCZAR, A. NAGY & I. SZANTO M. CHEN, X. CHEN, Y. LIU & Z. F. BAO
Dentistry, Oral and Maxillofacial Surgery, University of Pecs, Department of Paediatric Dentistry, School of Stomatology, China
Pecs, Hungary Medical University, Shenyang, China
Background: Dens invaginatus is a rare morphologic developmen- Background: Regenerative endodontic treatment (RET) or revas-
tal disorder characterized by the infolding of the enamel organ cularization is a new option for treating immature permanent
into the dental papilla. The etiology is still controversial. Diagno- teeth that have infected or necrotic pulps. During RET, induced
sis is based on radiographic examination. Teeth may exhibit bleeding introduces mesenchymal stem cells (MSCs) into the root
many variations in size and form. Oehlers-classification is used canal for tissue repair; however, it is unclear whether stem cells
commonly to describe the type of invagination. Until the 1970’s can arise from other sources.
extraction was suggested. Since then other treatment options Aim: This animal study aimed to explore whether stem cells can
have been proposed depending on the type of invagination. arise from other sources and what the important role of induced
Proper preparation and cleaning of root canals during endodon- bleeding was in tissue regeneration.
tic treatment of these teeth are challenging for the dental profes- Design: Eighteen immature premolars from three 6-month-old
sional. Occasionally apexification may be indicated due to early Beagle dogs were randomly assigned to normal control (NC),
pulp infection and necrosis, or because of the malformation itself apical periodontitis (AP), RET-baseline, 1 week, and 2 weeks
(Oehlers class IIIB). (RET-0, RET-1, RET-2), and gelfoam-1 week and 2 weeks
Case reports: In the first case we present the treatment of an (GE-1, GE-2) groups (3 teeth/group). Root canal contents were
invaginated upper central incisor (Oehlers IIIB) with symptom- collected by irrigation for a cytospin smear after teeth were
atic irreversible pulpitis in a 14-year-old girl. In our second case extracted and split, and MSCs were identified by immunocyto-
chemistry using antibodies against STRO-1 and CD 105.
Results: The number of MSCs was higher in the AP than in the Conclusions: According to these data, diode laser pulpotomy had
NC group. MSC markers were detected in both RET and GE similar success rates to FC pulpotomy. It may consider that
groups. diode laser could become an appropriate substitute for FC. How-
Conclusions: Endogenous stem cells that home to the root canal ever, long-term follow-up study with histologic findings of diode
after blood clot formation are involved in RET. laser pulpotomy will be expected in the futures.
PR08-2.40 PR08-2.42
A simple technique modification to prepare zirconia Demineralized bone matrix(DBM) used for direct
crowns on primary teeth pulp capping in rats
E. B. ACOSTA1, H. A. RAMIREZ1, R. M. VALENCIA2, M. E. Y. F. MEI1,2, X. ZHU2 & Q. LIU1
GARCIA1 & E. E. RANGEL1 1
Nanjing Medical University, Nanjing, China; 2
Jiangsu Key
1
Pediatric Dentistry, UANL Universidad Autonoma de Nuevo Laboratory of Oral Disease, Nanjing, China
Leon, Monterrey, Mexico; 2Pediatric Dentistry, UNITEC,
Introduction: Demineralized bone matrix (DBM) is mainly com-
Distrito Federal, Mexico
prised of collagen and bone morphogenetic proteins (BMPs). The
Introduction: Stainless steel crowns (SSCs) in primary teeth have two main component are favorable for the formation of dentin,
been historically used to restore anterior primary teeth. Unfortu- it suggests the possibility of its application as a pulp capping
nately, these restorations fail to meet the esthetic demand of material compared with calcium hydroxide(Ca(OH)2).
patients ‘parents. Recent developments in restorative materials Design: Pulpotomy was performed on maxillary first molars of
with zirconia crowns in primary teeth have been introduced for one side in each rat, and left another side as the blank control.
anterior and posterior teeth. Tooth preparation is technique sen- After 1, 3, 7, 14 and 28 days, HE and Immunohistochemical
sitive and needs excessive tooth reduction, increasing possibility stained for observing the changes of pulp tissue after capped with
of pulp exposures and damaging the adjacent teeth. the two materials.
Aim: Propose a more conservative tooth preparation for poster- Results: DBM could induce reparative dentin formation,
ior teeth for zirconia crowns. although the pulp tissue below the calcified dentin bridge exists
Design: Evaluation of a conventional SSCs preparation technique inflammatory reaction, the pulp tissue necrosis and pathological
was conducted and modified for zirconia crowns. The recom- calcification were fewer than Ca(OH)2 group. Generally, the
mend modifications included an occlusal reduction of 2 mm, sub- expressions of relate factors during the dentine forming in DBM
gingival depth of 1–1.5 mm, no retentions and labial-lingual group are higher than the same time in Ca(OH)2 group.
reduction of 1.5–2 mm. We also recommend a wooden wedges Conclusions: DBM could start the physiology wound healing in
(2 mm wide) in the proximal mesial and distal surfaces to prevent pulp, the pulp tissue below the calcified dentin bridge was well-
possible damage the adjacent teeth. preserved. At the early stage of reparative dentiogenesis, DBM
Conclusions: Prefabricated zirconia crowns could be a promising have the ability to induce odontoblasts differentiation and to
replacement of the conventional SSCs, working time and tech- promote reparative dentin formation. Therefore, DBM can be
nique must be the main considerations to choose this aesthetic used for direct pulp capping as a biological material.
alternative. PR08-2.43
PR08-2.41 An audit of the materials used to restore the primary
Application and comparison of diode laser pulpotomy molars of children at Barts Health NHS Trust
and formocresol pulpotomy Community Dental Service
S.-L. PEI1,2, M.-H. CHEN1,2 & J.-F. LIU3,4 J. DOUGHTY1, K. ALMUKHTAR2 & N. PEARSON1
1
Graduate Institute of Clinical Dentistry, School of Dentistry, 1
Community Dental Service, Barts Health NHS Trust, London,
National Taiwan University, Taipei, Taiwan; 2Dental Department, UK; 2Barts and The London School of Medicine and Dentistry,
National Taiwan University Hospital, Taipei, Taiwan; 3Graduate Queen Mary University of London, London, UK
Institute of Dentistry, School of Dentistry, National Yang-Ming
University, Taipei, Taiwan; 4Department of Pediatric Dentistry, Background: The Scottish Dental Clinical Effectiveness Pro-
Taichung Veterans General Hospital, Taichung, Taiwan gramme (SDCEP) suggests that glass ionomer cements (GIC)
should not be used in class II cavities; stainless steel crowns
Introduction: Formocresol (FC) is considered the risk of its toxic (SSC) are recommended as “gold standard” in this clinical situa-
effect and carcinogenic effect. The application of this material in tion. A baseline audit conducted in 2010 identified that GIC was
pediatric dentistry was worried by the dentists. Recently, the the restorative material of choice for class II cavities in deciduous
researchers found many different methods to perform primary molars.
tooth pulpotomy with less complication, such as laser pulpoto- Aim: To assess compliance with best practice guidance for the
my. restoration of Class II cavities in deciduous teeth and identify
Aim: The aim of this study was to determine whether diode laser barriers that prevent the use of SSCs.
is a suitable alternative for FC in the pulpotomy treatment. Design: Retrospective audits were carried out in 2010 and 2013
Design: This study included 70 children from 2 to 8 year-old. to compare the materials used to restore primary molars against
The boys were slightly more than girls. There are 90 primary those recommended by the SCDEP guidelines. Additionally,
molars in diode laser group (2W; 915 nm) and FC group. These open-ended questions were used in a semi-structured interview
teeth were calculated success rates and radiographic images from process to establish what clinicians felt about the use of SSCs.
3 to 12 months follow-up X-rays. Results: The baseline audit found that GIC was used for 73% of
Results: The radiographic success rates were slightly higher in class II restorations; very few SSCs were placed (5.0%). The cor-
diode laser group than in FC group, but there were no statisti- responding figures for the re-audit were 72.4% for GIC and
cally significant differences. Both groups had the teeth with canal 21.1% for SSCs. Clinicians were reluctant to use SSCs, predomi-
calcification. In radiographic failure, the highest proportion of nantly due to greater familiarity and confidence with conven-
diode laser group was periradicular lesion and the highest pro- tional restorative techniques.
portion of FC was internal root resorption. But it’s still no sig-
nificant difference between these two groups.
Conclusions: Although there has been a significant increase in teeth. It is considered an option between preventive and invasive
SSCs placed to restore deciduous molars, GICs are frequently approaches to treat these lesions.
being placed inappropriately. Clinicians requested further hands- Case report: The aim of this case report is to present the clinical
on training in the placement of SSCs. and radiograph follow-up of a primary molar treated with caries
infiltration. A girl, 7 years old, was referred to the Pediatric Den-
PR08-2.44 tal Clinic at the Federal University of Rio de Janeiro for dental
treatment. Clinical examination did not reveal cavitated lesions.
Effect of additional acid etching for single-step self- The radiographic examination showed a non-cavitated proximal
etch adhesives on dentin bond strength in primary lesion on the distal surface of the tooth 74, reaching the outer
teeth third of dentin. Caries risk was achieved by the Cariogram and
J. KIM, Y. KIM & T. JEONG was considered high. The treatment plan included dietary and
Pediatric Dentistry, School of Dentistry, Pusan National oral hygiene instructions and caries infiltration using IconÒ
University, Yangsan, Korea (DMG, Hamburg, Germany) on the primary molar. Treatment
time was suitable; the child did not report pain and no short-
Background: Little information is available regarding bonding term side effects were observed. This patient was recalled 6/
characteristics of the newly developed single-step self-etch adhe- 6 months for evaluations. After 2 years of follow-up, no caries
sives to primary dentin. progression was observed either by radiographic or clinical exam-
Aim: The aim of this study was to evaluate bond strength of sin- inations. In the present case, the caries infiltration showed to be
gle-step self-etch adhesives to primary dentin with and without a feasible, effective and safety technique to control proximal car-
acid etching, by means of microtensile bond strength tests. ies in a primary molar.
Design: Total 154 specimens were prepared on extracted primary Comments: The infiltration of proximal caries lesions seems to be
molars. Four commercial single-step self-etch adhesives (Scotch- a promising non-invasive approach to treat carious lesions and
bondTM Universal, All-bond UniversalÒ, AdperTM PromptTM L- so, it should be considered an effective alternative to invasive res-
popTM, ClearfilTM S3 Bond) were used in this study. Two etch- torations.
and-rinse adhesives (Prime & Bond NT, ScotchbondTM Multipur-
pose) served as controls. Microtensile bond strength tests have
done to single-step self-etch adhesives with and without addi-
PR08-2.46
tional acid etching and two etch-and-rinse adhesives. Microbial evaluation of immature permament teeth
Results: All single-step self-etch adhesives except for AdperTM with necrotic pulp with triple antibiotic paste or
PromptTM L-popTM exhibited increased microtensile bond strength calcium hidroxyde with 2% Chlorhexidine gel in pulp
values (P < .05) under additional acid etching condition and
there was no statistically significant interaction between the type
revascularization
of adhesive system and subjection of prior acid etching S. GUZMAN1, O. CORTES2, M. A. ALCAYNA2 & J. BOJ3
1
(P = 0.056). Pediatric Dentistry, Universidad de Murcia, Universidad de
Comparison of microtensile bond strength of single-step self-etch Murcia Murcia, Spain; 2Universidad de Murcia, Murcia, Spain;
3
adhesive groups without additional acid etching and etch-and- Universidad de Barcelona, Barcelona, Spain
rinse adhesive groups, Prime & Bond NT gave higher values than Background: The treatment of immature permanent teeth with
All-bond UniversalÒ (P < .05). Meanwhile, comparison of micro- necrotic pulp constitutes a challenging situation for pediatric den-
tensile bond strength of single-step self-etch adhesive groups tists. Regenerative endodontics is a promising alternative treat-
under prior acid etching and etch-and-rinse adhesive groups, ment for immature teeth with necrotic pulps. Revascularization
ClearfilTM S3 Bond obtained higher values than AdperTM outcome depends on microbial elimination because apical repair
PromptTM L-popTM. will not happen in the presence of infected tissues.
Conclusions: Additional acid etching can increase bond strength Aim: The aim of this study is to investigate how two different
of most single-step self-etch adhesives to primary dentin, except types of antiseptical solutions work against the main strict and
for the adhesive with very acidic property. facultative anaerobic microorganisms in deciduous teeth with
necrotic pulps. The two types of medical antibacterial activity
PR08-2.45 were Calcium Hydroxide with 2% chlorexidine gel and modified
antibiotic paste of antibiotic (Ciprofloxacine, Metronidazole,
Infiltration of proximal caries in a primary molar: Clindamycin).
two years clinical and radiographic follow-up Design: The study is carried out with a plantation of E. Coli in
M. M. AMMARI1,2, A. S. LETIERI1, R. C. JORGE1, I. P. R. petri plates with their anaerobic environment and conditions. At
SOUZA1 & V. SOVIERO3 the same time a susceptibility exam was done with the antibiotic
1
Pediatric Dentistry and Orthodontics, Federal University of Rio paste and Calcium Hydroxide with 2% chlorexidine gel by the
de Janeiro, Rio de Janeiro, Brazil; 2Specific Trainning, Agar diffusion method.
Fluminense Federal University, Nova Friburgo, Brazil; 3Preventive Results: The results of this study are in process of evaluation.
and Community Dentistry, State University of Rio de Janeiro, Rio Conclusions: The findings from the present study highlight the
de Janeiro, Brazil importance of eradication of bacteria from the canal space for
Introduction: Caries infiltration is an alternative of minimum successful regenerative endodontic procedures.
intervention technique that uses a low viscosity resin for non-cav-
itated lesions on proximal surfaces of primary and permanent
Social Science Research Poster Session – PR09
Social Science Research Poster Session –

PR09
PR09.01 Results: Autistic children showed significantly more mean number
of symptoms (P = 0.041), daily life problems and parental con-
Impact of dental caries and its treatment on the cerns (P = 0.000). They also exhibited higher mean summary
quality of life of 12–15-year old adolescents in Benin, scores for sections II and III (P = 0.004 and 0.008, respectively).
Nigeria In section IV, children with autism had lower scores for oral
N. M. CHUKWUMAH1, M. O. FOLAYAN2, E. O. OZIEGBE2 well-being (P = 0.000–0.001). These children had higher caries
& A. A. UMWENI3 prevalence (P = 0.013) and severity (P = 0.003).
1
Department of Preventive Dentistry, University of Benin Teaching Conclusions: Children with autism have significantly lower OHR-
Hospital, Benin City, Nigeria; 2Child Dental Health, Obafemi QOL and more caries prevalence and severity than healthy chil-
Awolowo University, Ile- Ife, Nigeria; 3Department of Preventive dren.
Dentistry, University of Benin, Benin City, Nigeria
Aim: To assess the impact of caries and its treatment on quality PR09.03
of life (QoL) in 12–15-year-old children in Benin, Nigeria. Can mHealth dental 0 Apps0 help disadvantaged
Design: This was a cross-sectional study involving 1790 children. parents establish children’s oral hygiene routines?
Clinical examinations were conducted using the WHO criteria for L. M. JONES & K. PRESTON
diagnosis and coding of caries. The Decayed Missing Filled Teeth
Psychology, Massey University, Wellington, New Zealand
(DMFT/dmft) score of each child was calculated. The child Oral
Impact on Daily Performance questionnaire was used to assess the Background: There are regions in New Zealand where there is a
QoL of children with caries pre- and post-treatment. Associations poor uptake of fully funded children’s oral health services; and
between age, sex and socioeconomic status and caries were analy- an unsurprising relationship between parents not being engaged
sed using bivariate and multivariate logistic regression analysis. with these services and children’s oral health.
Results: The prevalence of caries in the study population was Aim: To explore the efficacy of a mobile health (mHealth) oral
21.9%. Approximately 57% of children with caries reported neg- hygiene App in a disadvantaged area, for teaching and establish-
ative impact on their QoL pre-treatment. Eating (47.6%), was ing children’s tooth brushing routines.
the most affected domain. The mean pre-treatment QoL score Design: A quasi-experimental design included pre intervention
was 8.40 10.34. Four weeks post-treatment, only 1.12% of individual interviews with seven mothers and three fathers, who,
participants reported negative impact of caries treatment on their between them, had 14 children (1–11 years old). Following the
QoL. The mean post-treatment QoL score was 0.22 0.91. interview the (MacLean’s) Nurdle Time App was downloaded
There was a significant difference between pre- and post-treat- and demonstrated a mobile device that the participant owned.
ment QoL scores They were to try to use the App to establish a recommended
(P = 0.0001). Age, sex and socioeconomic status had no signifi- tooth brushing routine with their children, over a three week trial
cant impact on QoL pre and post-treatment. period. Following the intervention the mothers met as two focus
Conclusions: Caries had a significant impact on the QoL of ado- groups to discuss their experiences. Interview and focus group
lescents. Its treatment resulted in marked improvement in QoL. data were subjected to thematic analysis.
Results: None of the parents had heard of or used any mHealth
PR09.02 Apps, although they all had devices that could run them. They
confirmed various difficulties accessing oral health information.
A comparative study of oral health status and oral All participants reported that their families were motivated to
health related quality of life in children with autism work on oral health because the fun educational component was
S. ALAKI1, J. KHAN2 & E. AL-ASHIRY1 reinforced via a virtual token economy. Parents suggested ways
1
Pediatric Dentistry, King Abdulaziz University, Jeddah, Saudi to improve the programme especially for older children, and to
Arabia; 2King Abdulaziz University, Jeddah, Saudi Arabia include parents “in finishing the job off”.
Conclusions: Classic behaviour modification principles did elicit
Background: The risk for oral disease is known to increase in
and strengthen children’s tooth brushing behaviour. Parents sug-
individuals with special health care needs. Studies in Saudi Ara-
gested using oral health Apps in early childhood centres.
bia on oral health related quality of life (OHRQOL) in children
with autism are lacking.
Aim: This study assessed the parental perception of OHRQOL
and oral health status of children with autism in Jeddah, Saudi
Arabia.
Design: The study included 75 autistic and 99 healthy children,
ages 6–12 years. Parents filled out a questionnaire including per-
sonal data and the Franciscan Hospital for children Oral Health-
related Quality of Life (FHC-OHRQOL) instrument including
four sections: I-child’s oral symptoms, II-daily life problems, III-
parental concerns, and IV- oral well-being. Oral examinations of
children were done to assess caries, oral hygiene, gingival health
and extra- and intra-oral abnormalities.
PR09.04 that declined from 17.4 to 1.6 (P < 0.0001), as well as for individ-
ual domains scores (P < 0.0001). Mean change scores showed a
Pain behaviour among children with juvenile idiopatic
gradient in the expected direction across categories of the global
arthritis (JIA) and orofacial pain transition judgment. There were significant differences in the pre-
E. LEKSELL1,2, M. ERNBERG3, B. HEDENBERG- and post-treatment scores of those who reported improving a little
MAGNUSSON4, B. MAGNUSSON5 & U. HALLBERG6 (P < 0.0001) and those who reported improving a lot
1
Pediatric Dentistry, Umea University Hospital, Ume
a, Sweden; (P < 0.0001). The ES and SRM based on change scores mean for
2
Pediatric Dentistry, Blekinge Centre of Competence, Karlskrona, total scores and for global transitions judgments were large.
Sweden; 3Dental Medicine, Karolinska Institutet, Stockholm, Conclusions: The B-ECOHIS is responsive to dental treatment
Sweden; 4Oral Physiology, Folktandv arden, Stockholm, Sweden; and can be used as an outcome indicator in clinical trials.
5
Paediatric Rheumatology Unit, Karolinska University Hospital,
Stockholm, Sweden; 6Nordic School of Public Health, G€ oteborg,
Sweden PR09.06
They care, cause we treasured - multi-win pattern of
Background: Orofacial pain among children with juvenile idio-
pathic arthritis (JIA) are frequent, mostly of moderate character
oral care of Aboriginal children in remote area
but severe among some. The pain takes a fluctuating course and R. S. TANG1,2, Y. T. LIN1,2 & H. SHUN-TE1
1
can sometimes be linked to increased disease activity. As it was Kaohsiung Medical University, College of Dentistry, Kaohsiung,
found that children endure their symptoms in silence, expecting Taiwan; 2Baby Tooth Family Dental Clinic, Kaohsiung, Taiwan
adults to understand their needs, children’s pain behaviour is Aim: The aim of this study was to evaluate the oral care and the
important to learn more about. relationship establishment with children effect of oral health sta-
Aim: To investigate children’s behaviour when they have orofa- tus of aboriginal children in remote area in Taiwan.
cial pain and dysfunction. Design: This was a 2-year longitudinal study. We collected oral
Design: Fifteen children aged 6–16 years with JIA and 15 parents health data of children from 2 elementary schools and 4 kinder-
to children with JIA attending the department for paediatric den- gartens in remote area of Kaohsiung in Taiwan for 2 years. Oral
tistry were interviewed. The children were asked to describe in care of children include preventive and dental carious treatment
their own words their symptoms and how they act when in pain. and routine oral hygiene instructions. Data were analysed by t-
The parents were asked to describe how they find their children’s test and ANOVA (P < 0.05 was statistically significant).
behaviour when in orofacial pain. Results: The average DMFT index improved from 3.59 to 1.82
Results: Children described that the orofacial pain made them and deft index improved from 4.74 to 2.11. No caries was noted
avoid to eat and chew, meet friends and that it made them strug- over the first permanent molar in children from kindergarten to
gle with sleeping problems. (They used their occlusal appliance, 1st grade and 2nd grade elementary school. Extra finding was
made jaw exercises, used a hot pillow at the cheek or contacted that children were more likely to keep oral hygiene habits when
the dental care providers.) we established a good relationship with them. Lower grade stu-
For the parents the orofacial pain behaviour was not so easy to dent showed better performance than higher grade students.
differ from the general pain behaviour. Parents found their child Conclusion: Children care their teeth, because we treasure them.
in a bad mood, avoiding social contacts or in need of analgesics Dentists, children, schools, and caregivers were benefit from our
and avoiding ordinary food. care in the process.
Conclusion: Orofacial pain affected the behaviour for the child, it
was often difficult for parents to recognise and differ from pain
in general.
PR09.07
Oral health condition of preschool children liver
PR09.05 transplant candidates and its impact on oral health
Responsiveness of the Brazilian early childhood oral related quality of life (OHRQoL) - a pilot study
E. A. VIDIGAL, J. ABANTO, F. A. ALVES & M. BONECKER €
health impact scale (B-ECOHIS) to dental treatment Paediatric Dentistry, University of Sao Paulo, Sao Paulo, Brazil
1 2 1
J. ABANTO , S. M. PAIVA , F. M. MENDES , T.
CORDESCHI1, E. A. VIDIGAL1 & M. BONECKER € 1
Background: Preschool children liver transplant candidates tend
1
University of Sao Paulo, Sao Paulo, Brazil; 2Federal University to suffer from dental problems, which can negatively impact their
of Minas Gerais, Minas Gerais, Brazil oral health-related quality of life (OHRQoL).
Aim: The purpose of this study was to assess the prevalence of
Background: To test oral health-related quality of life measures as
oral diseases and their impact on OHRQoL in preschool children
outcomes in clinical trials, the instrument must to be responsive.
candidates for liver transplant.
Aim: To assess the responsiveness of the Brazilian ECOHIS (B-
Design: Oral examinations were conducted on 17 preschool chil-
ECOHIS) to dental treatment for dental caries.
dren with biliary liver atresia aged 12–36 months. Presence of gin-
Design: One hundred parents of 3–5-year-old children completed
givitis, dental plaque (OHI-S), dental caries (dmf-t), dental
the B-ECOHIS prior to their children’s treatment and 7–14 days
hypoplasia (DED-Index) and hyperbilirrubinemic stain of teeth
after the completion of treatment. The post-treatment question-
were evaluated by one trained and calibrated examiner. Parents
naire also included a global transition judgment that assessed
answered the Brazilian version of the Early Childhood Oral Health
parent’s perceptions of change in their children’s oral health fol-
Impact Scale (B-ECOHIS). Descriptive analyses were performed.
lowing treatment. Change scores were calculated by subtracting
Results: Hyperbilirrubinemic stain (70.6%), presence of dental
post-treatment scores from pre-treatment scores. Longitudinal
plaque (47.1%) and dental caries (41.2%) were the most preva-
construct validity was assessed by using one-way analysis of vari-
lent dental problems. The mean (standard deviation) B-ECOHIS
ance to examine the association between change scores and the
score was 6.52(4.74). Parent’s distress domain showed the highest
global transition judgments. Measures of responsiveness included
mean score (3.41(2.26)).
standardized effect sizes (ES) and standardized response mean
Conclusion: Hyperbilirrubinemic stain was the most frequent oral
(SRM).
problem in preschool children liver transplant candidate and may
Results: The improvement of children’s oral health after treatment
be responsible for a negative impact on the OHRQoL.
are reflected in mean pre- and post-treatment B-ECOHIS scores
PR09.08 4 children, whereas 20% had ≥5 children. For three in four

(76%) of the children, DGA was the first one. In 8% of the cases
Interprofessional study of oral health in primary care also siblings had been treated under DGA. More than half
A. NOWAK1, J. SILVERMAN2 & L. MITCHELL-ROTSTON1 (64%) of the parents did not report dental fear; while 28%
1
AAPD Policy and Research Center Oral Health Policy Center, reported fear; 16% of the parents had had DGA themselves. For
Chicago, IL, USA; 2AAPD Policy and Research Center, Chicago, 48% of the families DGA was a good experience, 74% reported
IL, USA it as a relief. For 13% of the cases the experience was frighten-
Background: Caries is the most common chronic condition of ing, but not a bad one for anyone.
childhood. Primary care providers are well positioned to support Conclusions: The findings highlight the importance of the entire
dental preventive care in their practices/clinics. family in association with children’s DGA. The influence of the
Aims: 1. Identify drivers of oral health services in primary care family-size and parents’ experiences on children’s need for DGA
settings requires further investigation.
2. Determine which caries-risk assessment tools are being used in
primary care PR09.10
Design: Utilizing membership rosters, selection criteria identified
The contribution for life quality of a social-educative
potential participants. Surveys were sent electronically requesting
specific information on practices and procedures. Six focus programme
groups were conducted by following a structured guide related to J. S. MOREIRA JR1, L. V. S. MARTINO1 & E. MICHEL-
oral health promotion Twelve practice observations were con- CROSATO2
1
ducted in primary care facilities providing oral health promotion Health, Social Service of the Commerce, Sao Paulo, Brazil;
2
for children 0–6 years old. Odontologia Social, Universidade de S~
ao Paulo, S~
ao Paulo,
Results: The focus groups participants: Brazil
Mostly female (68%); mean age of 50; Background: The understanding of social determinants of health,
71% pediatricians; 29% family medicine physicians. and not only biological conditions, is fundamental to achieve
66% practiced in urban areas. health promotion. Assuming that the scholar environment is
71% of all participants had been in practice more than 10 years; appropriate to health promotion, offering a more supportive struc-
44% in private practice. ture, a social-educative program, thought having a broader scope,
40% of the practices saw 26–75 children under age 3 per week; may contribute to growth of children within a life quality context.
32% saw <25 children under age 3.The practice observation sites: Aim: The goal of this work is to analyze the contribution of this
66% urban pediatric private practices social-educative program undertaken in a few Social Service of
42% included an oral health program for more than one year; the Commerce units of the Sao Paulo State aiming the oral
42% over 5 years. health of the participating children.
Conclusion: • Incorporating oral health activities into existing pri- Design: For the analysis of oral impact on daily activities of the
mary care workflows is difficult. children, an adapted index (Child-OIDP), that considers life qual-
• Visual inspection was the most commonly identified caries-risk ity as a variable of clinic indicators, was applied. A questionnaire
assessment tool by primary care providers. was also directed to the educators that followed the program to
• Caries-risk assessment tools not utilized in their original ver- verify the behavior and oral health knowledge level. The researcher
sions. visited company operational units and applied the questionnaires
• Integration of caries-risk assessment tools and preventive strate- to persons involved in the study (620 children and 60 educators).
gies into the electronic health record makes implementation much Results: The results show that the more prevailing oral impacts
easier; is an essential step for consistency, implementation, qual- on daily activities were observed during feeding, oral hygiene and
ity assurance and documentation. emotional state (P = 0.05).
Conclusions: The importance of children’s participation acknowl-
PR09.09 edgement during their development, within a structure that pro-
vides an adequate support, followed by capable educators,
Family related factors of children treated under
reinforces this kind of approach. Nevertheless, initiatives aiming
dental general anesthesia (DGA) - a pilot survey at an increase of knowledge in oral health, including this subject
P. RAJAVAARA1,2, M. L. LAITALA1 & V. ANTTONEN1,3 in the program curriculum, may contribute to reinforce an effec-
1
Department of Paedodontics, University of Oulu, Institute of tive partnership, enabling a healthy development with enhanced
Dentistry, Oulu, Finland; 2Municipal Health Center, Oulu, life quality for the participating children.
Finland; 3Medical Research Center, Oulu University Hospital and
University of Oulu, Oulu, Finland
PR09.11
Background: About 5–10% of children in Finland have serious
Patient with ectodermal dysplasia: how to improve
caries problems occasionally requiring DGA.
Aim: The aim was to investigate associated factors leading their quality of life from childhood to adolescence?
healthy children to DGA. A. J. LÓPEZ, M. PADILLA, A. ADANERO, V. GÓMEZ & P.
Design: Guardians escorting their children to DGA (n = 25) were PLANELLS
asked to answer a structured questionnaire given to them after Deparment IV-Paediatric Dentistry, Faculty of Dentistry,
DGA in the recovery room, while they waited for their child to Complutense University of Madrid, Madrid, Spain
be released from the clinic. Material of this pilot study was col- Introduction: Hypohidrotic ectodermal dysplasia is a genetic dis-
lected between Nov/2014 and Jan/2015. All the children were ease that affects the development of the ectoderm and presents
≤12 years. Outcome was analysed and presented in frequencies, with the classic triad of hipohidrosis, hypotrichosis and dental
proportions and means. anomalies.
Results: The majority (16/23) of the respondents were children’s Survival in childhood and adolescence is associated with dental
biological mothers. Families were mostly two-parented (76%). alterations in number and shape and with total anodontia in
The mean age of the respondents was 38.5 years (SD 6.21). extreme cases. This implies the presence of problems in chewing,
Almost half (4%) of the families had only one child, 76% had 2–
swallowing and phonation that influence the development of the Parents/caregivers are the main decision makers regarding adoles-
child, as well as psychological problems due to unfavorable aes- cents0 health and their perceptions exert a major influence on
thetics. Therapeutically, there are different types of prosthetic treatment choices.
treatments that allow early oral rehabilitation, in order to ensure Aim: To evaluate parents0 /caregivers0 views of the impact of mal-
the function during growth. occlusion on the OHRQoL of Brazilian adolescents using the
Case report: We present a case report of follow-up of a 15 years Parental-Caregiver Perceptions Questionnaire (P-CPQ).
old teenage girl, which was referred by her paediatrician to our Design: A sample of 280 parents/caregivers of adolescents, aged
department at the age of two and a half years due to lack of 11 and 12 years, was selected for this study. Participants
eruption of some deciduous teeth. After clinical and radiological answered the Brazilian version of the P-CPQ. Malocclusion was
examination of the paediatric dentist, we established a suspicion evaluated using the Dental Aesthetic Index. Adolescents0 gender
diagnosis of Hidrotic Ectodermal Dysplasia that we confirmed and age as well as family monthly income were also recorded
after genetic testing profile. and considered as confounding variables. Data handling con-
We started an early oral therapy with the main purpose of recov- sisted of descriptive statistics, Mann-Whitney test, and multiple
ering functionality and improving her quality of life, based on regression analysis.
space maintenance, control of tooth eruption and maintenance of Results: A total of 262 individuals completed the P-CPQ provid-
oral health. ing a response-rate of 93.5%. The multivariate model demon-
Currently the patient carries on treatment with the goal of final strated that parents/caregivers of adolescents diagnosed with
rehabilitation with dental implants. malocclusion were more likely to report a negative impact on the
Comments: Dental anomalies can alert of systemic disorders with overall P-CPQ score [rate ratio (RR) = 1.21; 95% confidence
a genetic basis. interval (CI) = 1.14 - 1.29] as well as on the functional limitations
Early diagnosis, proper treatment and early multidisciplinary oral [RR = 1.19; CI = 1.06 - 1.34], emotional well-being [RR = 1.28;
rehabilitation are keys to improving the quality of life in these CI = 1.14 - 1.44] and social well-being [RR = 1.36; CI = 1.21 -
patients and the restoration of oral functions. 1.52] subscales compared to those parents/caregivers of adoles-
cents with no malocclusion.
PR09.12 Conclusions: Parents/caregivers of adolescents with malocclusion
were more likely to report a negative impact on the OHRQoL
Quality of life of Brazilian children with cleft lip and with significant repercussions on the functional limitations, emo-
palate tional well-being, and social well-being subscales.
A. F. F. PEREIRA1, M. FALZONI2, T. C. SILVA2, D. RIOS2, M.
A. A. M. MACHADO2 & T. M. OLIVEIRA1,2 PR09.14
1
Hospital for Rehabilitation of Craniofacial Anomalies, University
ao Paulo, Bauru, Brazil; 2Department of Pediatric Dentistry,
of S~ Psychosocial impacts on children following dental
Orthodontics and Public Health, University of S~ ao Paulo/Bauru injury: a systematic review
School of Dentistry, Bauru, Brazil A. SINGH1, H. ZAITOUN2, H. RODD1, F. GILCHRIST1 & Z.
MARSHMAN3
Background: The use of quality of life assessment in routine of clin- 1
Unit of Oral Health and Development, University of Sheffield,
ical practice might contribute to the communication with patients
Sheffield, UK; 2Department of Paediatric Dentistry, Charles
and the identification of oral problems that affect patients.
Clifford Dental Hospital, Sheffield, UK; 3Academic Unit of Dental
Aim: The aim of this study was to evaluate the oral health-
Public Health, University of Sheffield, Sheffield, UK
related quality of life and malocclusion of Brazilian children with
cleft lip and palate. Background: Traumatic dental injuries (TDIs) are common in
Design: Sixty-nine children, aged 8–10 years, were selected and childhood and may be associated with numerous impacts, mostly
divided into groups according to the cleft type: unfavorable, on young people’s daily lives.
Group I - cleft lip and alveolus; Aim: To determine the psychosocial impacts associated with
Group II - cleft lip and palate; untreated and treated TDIs in children.
Group III - cleft palate. Design: A systematic review, using six electronic databases, was
Each child filled in a questionnaire comprising 29 multiple-choice conducted on the dental literature (2004–2014) to identify any
questions on the impact of oral diseases on the quality of life studies which had recorded patient-reported outcomes following
(Child Perceptions Questionnaire8-10). Then, a visual examination TDIs, including Oral Health-Related Quality of Life (OHRQoL).
of dental occlusion was carried out. Kruskal-Wallis and Mann- Four calibrated reviewers independently examined selected papers
Whitney tests were used to statistical analysis (P < 0.05). to extract the following data: population studied; setting; study
Results: The results did not show statistically significant differ- design; nature of the TDI or related treatment, and any reported
ences in the impact of oral health-related quality of life for cleft impacts.
lip and palate and malocclusion. Results: The initial search found 231 papers but only 35 met the
Conclusions: In conclusion for this study, at this age range, the inclusion criteria. Inter-examiner agreement was good
cleft lip and palate and malocclusion had no influence on the (kappa = 0.81–1.0). 69% of studies (n = 24) took place in school
impact of oral health-related quality of life. settings, and the majority were cross-sectional (71%; n = 25).
Only two investigations sought longitudinal data. In 49%
PR09.13 (n = 17) cases, impacts were actually sought from a proxy not
children themselves. Only one paper involved a qualitative
Parents/caregivers perceptions of the impact of approach, the remaining 34 studies (97%) employed OHRQoL
malocclusion on adolescents0 quality of life questionnaires. Key findings were that untreated TDIs in children
L. G. ABREU, C. A. MELGAC ß O, M. H. ABREU, E. B. LAGES resulted in significant negative impacts, mainly relating to daily
& S. M. PAIVA function and psychosocial well-being. OHRQoL was found to
Federal University of Minas Gerais, Belo Horizonte, Brazil improve following clinical interventions.
Conclusions: The use of existing OHRQoL measures has revealed
Background: Oral health-related quality of life (OHRQoL) mea-
significant negative impacts on children, and their families, fol-
sures the impact of oral outcomes on individuals0 quality of life.
lowing TDIs, especially where they remain untreated. However,
it is recommended that future studies also employ qualitative Design: It was a prospective interventional study carried out on
approaches to gain more meaningful insights into the short and children aged 2–5 years and their parents in two hospitals in La-
long term impacts of sustaining TDIs during childhood. gos. Information was obtained from parents/caregivers by means
of interviewer administered Early Childhood Oral Health Impact
PR09.15 Scale (ECOHIS) questionnaire.
Results: A total of 208 children with a mean age of 4.14 (0.99)
Does obesity increase risk of dental caries? Cross- years; 100 (48.1%) males and 108 (51.9%) females participated in
sectional study at Taif University the study. One hundred and eighty-eight (90.4%) parents/caregiv-
M. ABDEL WAHAB ers reported one form of impact on their children’s oral health
Taif University, Taif, Saudi Arabia related quality of life. Acute herpetic gingivostomatitis and
chronic marginal gingivitis had the greatest and the least negative
Background: Obesity is a growing health problem internationally.
impact, respectively on the quality of life of children although
Dental caries and obesity are multifactorial diseases and are asso-
55% of the study population presented with one or more carious
ciated with dietary and lifestyle habits. Few data showed associa-
lesions. There was a reduction in the subjects’ total ECOHIS
tion between BMI and caries in children/adolescence but limited
scores after related treatment of their oral conditions.
data about such association in adult.
Conclusion: Dental caries was the commonest oral condition;
Design: We conducted a cross-sectional study at Taif University
however, acute herpetic gingivostomatitis and chronic marginal
outpatient clinic, Taif, Saudi Arabia. Any individuals ≥18 years
gingivitis had the greatest and least negative impact respectively
who had a visit to the Dental clinic from Mar-Jun 2014 were
on the children’s quality of life.
asked to participate. Baseline characteristics were obtained by the
participated physician. We used the Decayed, Missing, and Filled
(DMF) index (range 1–18) to determine the total number of teeth PR09.17
or surfaces that are decayed (D), missing (M), or filled (F) in an Sublingual administration of atropine eye drops in
individual. children with excessive drooling
Information about healthy eating, smoking, exercise, sleep pat- M. BÅGESUND
tern and teeth brushing were collected. We also measured the
Link€
oping University, Norrk€
oping, Sweden
media consumption by hours that include watching TV, using
computer, video game and using smart phone for entertainment. Background: Drooling can be a severe disability and have high
We used SPSS to analyze the data. impact on daily life. Reversible treatment is preferable.
Conclusions: The primary goal of this study is to assess the rela- Aim: To analyse if sublingual administration of atropine eye
tionship between obesity and the prevalence of dental caries drops is a useful reversible treatment option for severe drooling
in children with disabilities.
PR09.16 Design: The study had a prospective, single-system research
design. The participants served as their own controls. The study
Pattern of presentation of common oral conditions period was three weeks without treatment, four weeks with atro-
and their impact on quality of life of preschoolers in pine eye drop solution 10 mg/ml one drop a day followed by
Lagos, Nigeria four weeks of one drop twice a day. Parents’ rating of their
C. L. NZOMIWU1, E. O. SOTE2 & F. A. OREDUGBA2 child’s drooling assessed on a 100 mm VAS scale and unstimu-
1 lated salivary secretion rate measurement was performed together
Child Dental Health, Lagos University Teaching Hospital, Lagos,
Nigeria; 2Child Dental Health, College of Medicine, University of with notations about side effects and practicality.
Lagos, Lagos, Nigeria Results: Parents’ VAS assessment of drooling decreased from a
median (range) of 74 (40–98) at baseline to 48 (18–88) (P = 0.05)
Background: Children may have one or more dental concerns and 32 (12–85) (P = 0.004) after four weeks of atropine once a
which could be mildly or severely discomforting. The conse- day and another four weeks of atropine twice a day, respectively
quences of oral conditions in preschoolers are of significant inter- (n = 11). Unstimulated salivary secretion rates decreased from
est as the effect is not only on the child but also on the quality baseline to end of study (P = 0.032). Several parents complained
of life of their parents/caregiver. about difficult administration. No irreversible side effects were
Aim: To evaluate the pattern of presentation of common oral noted.
health conditions, their impacts and related treatment experiences Conclusion: Sublingual atropine eye-drops is an alternative for
on the quality of life of young children and their parents/caregiv- treatment of severe drooling in children with disabilities.
ers.
Oral Surgery, Oral Medicine and Oral Pathology Poster Session – PR10
Oral Surgery, Oral Medicine and Oral

Pathology Poster Session – PR10
PR10.01 If treatment is instituted at an early age, it can retain a func-
tional dentition through the use of a combination of aesthetic,
Role of Er, Cr: YSGG lasers in pediatric dentistry restorative, and preventive measures. Proper maintenance of oral
G. KUMAR
structures not only reduces the possibility of oral soft tissue
Pediatric Dentistry, Maulana Azad Institute of Dental Sciences,
trauma but may also provide proper nutritional support and alle-
Delhi, India
viate systemic complications due to nutritional deficiencies.
Background: Many soft and hard tissue pathologies in children Conclusion: Possible treatment modalities for EB will be discussed
can be treated by Paediatric dentist. New technologies such as in order to educate the dental fraternity regarding clinical mani-
lasers enable us to carry out treatments with greater ease and festations and their individualized treatment options. We present
patient comfort than the conventional techniques. a case of dystrophic EB with oral manifestations and its manage-
Aim: The aim of this paper is to review the literature about the ment.
use of Er,Cr:YSGG lasers in Paediatric Dentistry.
Design: The advantage of Er,Cr:YSGG laser over various other PR10.03
group of lasers is that these can be used for both soft and hard
tissue procedures as these are well absorbed by chromophore
Conservative treatment of dentigerous cyst associated
water as well as hydroxyapatite crystals. Laser therapy is the with primary molars
therapy of choice in Paediatric Dentistry due to its known advan- Y. YANG, M. QIN, X. WANG & Y LI
tages especially safety and gentle approach due to minimal inva- Pediatric Dentistry, Peking University School of Stomatology,
sive cavity preparation, reduction in post operative discomfort, Beijing, China
pain and infection; bactericidal and haemostatic effects and faster Introduction: Dentigerous cyst is the most common type of devel-
soft tissue healing. Er,Cr:YSGG lasers are the world’s most opmental odontogenic cyst that is associated with the crowns of
advanced dental lasers, which are ideal for the multidisciplinary
permanent teeth. The cyst is a well-defined radiolucency lesion
dentist who performs a broad spectrum of procedures involving
with fluid accumulation between the epithelium and tooth crown.
the various dental tissues as all dental tissues contain water. The clinical features are craniofacial asymmetry, cortical bone
These deliver the highest level of clinician control, operating effi- expansion, adjacent permanent tooth displacement, and root dila-
ciency, flexibility in tip and accessory selection. For optimal clini-
cerations. However, those arising from primary teeth are rarely
cal results and patient comfort in hard and soft tissue seen. It usually occurs with a nonvital primary tooth spreading
procedures, the erbium lasers have set a new standard of clinical to involve the permanent tooth bud. Marsupialization are the
performance. best options to treat a dentigerous cyst, it can reduce the cyst
Conclusion: Laser technology improves efficiency and quality of
cavity and preserve the tooth involved with the cyst, and physio-
treatment in paediatric patients, but it is essential to have a good logical eruption of the impacted permanent teeth in the dentiger-
knowledge of laser technique and which type of laser is most ous cyst after treatment is observed.
indicated for each oral lesion. Case report: Three cases complaining painless swelling and buccal
bony expansion were referred to Pediatric department at Peking
PR10.02 University Dental Hospital for inspection. Radiographic exami-
Management of dystrophic epidermolysis bullosa: a nation revealed well-defined radiolucency under the lower pri-
mary molar teeth, and the successive premolars were displaced.
rare case report According to previous dental records, the primary molars had
F. A. ALOMARI1 & A. A. DAWASAZ2
1 received pulp treatment. The therapeutic approach included
Oral & Maxillofacial Surgery, King Faisal Medical City, Abha,
extraction of the primary molar involved and marsupialization of
Saudi Arabia; 2King Khalid University, Abha, Saudi Arabia
the lesion. Iodoform gauze packing were inserted into the cystic
Introduction: Epidermolysis bullosa (EB) is a group of hereditary lesion to prevent spontaneous closure. After 3–6 months of treat-
diseases affecting 1 in 17,000 live births worldwide. It consists ment, spontaneous eruptions of the impacted premolars were
skin and mucous membrane blistering in response to minimal observed.
trauma. The genes that cause EB are also involved in develop- Comment: Marsupialization might be the first treatment option
ment and maintenance of a variety of oral tissues. The specific for conservative management of dentigerous cysts in children.
oral manifestations and their severity are defined by the expres- Cyst enucleation was discarded to avoid possible damage to the
sion of genes that are important in cell adhesion and integrity. adjacent teeth and mainly in the unerupted permanent premolars.
Proteins such as Kindlin-1 are important in maintaining mucosal
integrity but appear not to affect tooth formation. Diagnosis of
EB is based on clinical findings, Immunofluorescence and Elec-
tron microscopy. Out of the three major types of EB, Dystrophic
EB is caused by the defect in the anchoring fibril protein that is
located below the basal lamina at the dermal-epidermal basement
membrane zone. Although specific therapies are not yet available
for the prevention of blisters in any of the EB types, these
diseases can certainly be controlled.
PR10.04 Conclusions: OI presents various oral problems, including DI,

which was reported in many of the cases noted in our survey.
Recovery of dentigerous cysts in two pediatric
Periodic oral health management is recommended for OI
patients following decompression by a modified space patients, especially those with DI. We hope to collect additional
maintener cases for development of better dental approaches.
B. SIRINOGLU CAPAN1, G. GOCMEN2, H. GARIP2, S.
AKYUZ1 & K. GOKER2
1 PR10.06
Department of Pediatric Dentistry, Faculty of Dentistry,
Marmara University, Istanbul, Turkey; 2Department of Oral and Dental management of patients with type I spinal
Maxillofacial Surgery, Faculty of Dentistry, Marmara University, muscular atrophy
Istanbul, Turkey J. C. HASSI, R. JARA & S. HOLA
School of Dental Medicine, Medicine Faculty, Pontificia
Introduction: A dentigerous cyst is seen as a well-defined radiolu-
Universidad Católica de Chile, Santiago, Chile
cent lesion of alveolar bone in preadolescents and inhibits the
eruption of the involved permanent tooth. Dentigerous cysts are Introduction: Spinal muscular atrophy type I is an inherited neuro-
detected primarily as incidental findings on radiographs. Decom- muscular disease (Werdnig-Hoffman).It is characterized by a weak
pression is a technique that relieves the pressure within the cyst muscle tone with severe feeding, movement and breathing difficul-
by making a small opening in the cyst and keeping it open. This ties. It requires medical care from birth and hospitalization.
case report presents four cases of dentigerous cyst in children Case reports: At social risk 10 years old male hospitalized patient
associated with primary molars. The preferred treatment for who is at general biological risk due to Spinal muscular atrophy
these cases is decompression followed by a conservative approach type I. He is with invasive mechanical ventilation because of an
using modified space maintainer. unobtrusive airway granuloma.
Case reports: Two patients referred to our clinic because of a Tracheostomy and gastrotomy were done. He has secondary
painless swelling on the mandible. Radiographic examinations of undernourishment to pathology base, cephalic pelvic discrepancy,
all patients showed an unilocular radiolucent area associated with recurrent suppurative otitis, acne and seborrheic dermatitis.
unerupted premolar and roots of primary molars. The lesions are The patient also presents second phase mixed dentition, altered
extending to the lower border of the mandible and caused dis- growth of facial cranium, lip incompetence, incapable of swallow-
placement of the permanent premolar. At first visit non-vital pri- ing, lingual interposition at rest, hyper salivation, eruption and
mary molars were extracted and a modified space maintainer, exfoliation mechanisms altered, gingivitis associated to biofilm,
which suits the cyst lumen, is prepared. Two times in a week the hard deposits and persistence of primary teeth in the mouth that
lesions are irrigated with saline until the lesion is healed. Every are in poor position, mobility and risk of aspiration. Without
week the lesion depth and the long part of modified space main- caries lesions.
tainer measured with a periodontal probe. According to the mea- Emergency: Abscess in relation to 5.5 retained tooth.
surements space maintainer is shortened and replaced again. Dental treatment received: Prophylactic antibiotic one hour
After 6 months panoramic radiographs revealed that the cyst size before the dental procedure. The patient is sedated with midazo-
decreased and the position of the premolar is improved. lam and ketamine.
Comments: This case report shows making decompression on a Bimaxilar supragingival tartar removal was conducted under
dentigerous cyst by modified space maintainer is a new and effec- double suction.
tive conservative technique. Patients must understand the impor- Local anesthetic was infiltrated, primary teeth extractions next to
tance of good oral hygiene for successful treatment. be exfoliated. Abscess drainage retained tooth.
Comments: The pediatric dentist along with a multidisciplinary
PR10.05 team of health professionals, should prevent life-threatening situ-
ations for patients with muscle disorders and swallowing disor-
Nationwide survey of dental problems in patients with ders such as aspiration of the primary teeth next to be exfoliated
osteogenesis imperfecta and of hard deposits fragments. This should be prevented with
R. OKAWA, K. SAGA & K. NAKANO thorough clinical exams and periodic controls.
Department of Pediatric Dentistry, Osaka University Graduate
School of Dentistry, Osaka, Japan
PR10.07
Background: Osteogenesis imperfecta (OI), an inherited skeletal Management of a jaw cyst on a paediatric patient
disorder characterized by various degrees of bone fragility, is with alpha-mannosidosis: a case report
caused by modification of the type I collagen gene. OI is associ-
S. PARMAR1, N. BHUJEL1, C. WILLIAMS1, J. JOHNSON1 &
ated with a variety of manifestations such as growth disturbance,
M. CHAMPION2
blue sclera, and hearing impairment, with dentinogenesis imper- 1
Paediatric Dentistry, Guy’s and St.Thomas’ NHS Trust, London,
fecta (DI) a well-known dental manifestation.
UK; 2Paediatric Metabolic Department, Evelina Children’s
Aim: In a nationwide survey conducted in Japan, we collected
clinical records to analyze oral manifestations of patients diag-
nosed with OI. Introduction: Alpha-Mannosidosis is a rare inherited disorder
Design: A total of 534 clinics were invited to participate, includ- caused by lysosomal alpha-mannosidosis deficiency. This progres-
ing 69 registered to train pediatric dentist specialists by the Japa- sively leads to extensive storage of mannose containing oligosac-
nese Society of Pediatric Dentistry and 465 registered to train charides which accumulates in the lysosomes and cause cells to
oral surgery specialists by the Japanese Society of Oral and Max- malfunction. Subsequently, the clinical manifestations include
illofacial Surgeons. We sent questionnaires regarding the number characteristic skeletal and facial features, immune deficiency,
of OI cases and clinical dental findings of the associated patients. intellectual disability and hearing impairment.
Results: Two hundred twenty-two clinics (42 pediatric dentistry, Case report: A 9-year-old boy was assessed for a routine review.
180 oral surgery) participated, of which 39 (14 pediatric dentistry, The patient was diagnosed with Alpha-Mannosidosis and had
25 oral surgery) experienced a total of 82 OI cases (43 males, 37 undergone bone marrow transplant at the age of 3 years. A pan-
females, 2 unknown), with DI recognized in 52 (63.4%). oral radiograph revealed hypodontia, microdonts and a unilocu-
lar radiolucent area on the left mandible. The radiolucent lesion and untreated dental disease may potentially cause severe infec-
extended from the lateral incisor region to the first premolar tion. Dental intervention and arrangements for on-going oral
region on the same side with a corticated border and associated care should be co-ordinated in accordance with recognised clini-
with unerupted lateral incisor, canine and first premolar teeth cal guidelines. The first audit cycle highlighted challenges in
with displacement. Under general anaesthetic retained primary attaining these standards in two paediatric dental departments in
teeth in the region of the radiolucency were removed along with Sheffield and Liverpool.
a biopsy of the lesion. Following surgical debridement, primary Aim: The second cycle assessed compliance with clinical guide-
closure was achieved. The patient recovered uneventfully follow- lines from the Royal College of Surgeons of England (2012) fol-
ing the general anaesthetic and was discharged the same day. lowing liaison with the respective oncology teams and provision
The tissue specimen was sent for histopathological examination of training to dental staff.
which confirmed a diagnosis of a dentigerous cyst. Design: Data were collected prospectively over a one-year period.
Comments: Acute toxicity induced by chemotherapy for myeloab- The standards were: children should have a dental assessment as
lation may have resulted in defects of the developing teeth lead- soon as possible after cancer diagnosis, with the majority being
ing to hypodontia, microdontia and possibly the complication of seen within one month of diagnosis; and that the routine dental
an unexplained radiolucent lesion of the mandible. Secondary care provider should be informed of the dental management
malignancies including oral solid tumours have been reported plan.
post bone marrow transplantation thus highlighting the impor- Results: Eighty-six children were included in the second audit
tance of investigation and management of unusual radiolucent cycle. The time from cancer diagnosis to dental assessment
lesions post chemotherapy. decreased in both centres. The majority of children were seen
within one month of diagnosis. Although correspondence to the
PR10.08 dentist increased in both centres, no letter was provided for 27%
of patients.
Regional odontodysplasia: a case report Conclusion: Using a co-ordinated approach with oncology teams,
R. ADAMJI1,2 & L. BROWN1,2 improvement in the timely dental management of children with
1
St George’s Hospital, London, UK; 2King’s College London cancer was achieved. To further optimise patient safety and expe-
Dental Institute, London, UK rience, education of dental staff and liaison with the respective
Introduction: Regional Odontodysplasia is a rare, severe disorder oncology teams has taken place to address those standards which
of dental development of unknown aetiology. In this condition have not yet been fully met.
all dental tissues are affected. Diagnosis of this condition is by
clinical and radiographic appearance. In regional odontodyspla- PR10.10
sia the teeth affected are usually confined to one quadrant where Juvenile ossifying fibroma: presentation in two
both primary and secondary teeth are affected. Teeth tend to
have a delayed eruption or fail to erupt completely. We describe
paediatric patients
a child with an interesting initial presentation of this disorder. L. THORNE, L. MARTIN & P. M. SPEIGHT
Case report: A 3-year-old female was referred by her general den- Oral and Maxillofacial Pathology, Charles Clifford Dental
tal practitioner following a 2-month history of recurrent pain Hospital, Sheffield, UK
from the lower right quadrant (LRQ). Clinical examination Introduction: Ossifying fibromas are benign bony neoplasms that
revealed the dentition was caries free. The LRD and LRE occur almost exclusively in the facial bones with a spectrum of
appeared yellow with grossly hypoplastic, hypocalcified enamel clinical and radiographic presentations. Patients are often asymp-
and dentine and LRE had an associated sinus. The LRC and tomatic, however, lesion behaviour can vary and lead to tooth
LRB appeared to have very thin enamel with the pulp hue visi- displacement and facial asymmetry. Juvenile ossifying fibromas
ble. Radiographic examination showed enlarged pulp chambers, (JOF) occur within the first two decades of life, and may be
reduced radiodensity and poor contrast between enamel and den- locally aggressive with a high recurrence rate of 30–60%. It is
tine in LRQ. They displayed the typical image of ‘ghost teeth’. important to distinguish JOF from conventional OF and other
The permanent tooth germs in this quadrant were also affected. fibro-osseous lesions, as well as malignant lesions such as osteo-
Extraction of LRD and LRE was carried out under general sarcoma. We describe two cases of juvenile ossifying fibroma.
anaesthesia. Histopathology confirmed regional odontodysplasia. Case reports: Patient A was a 12 year-old female referred for his-
Comments: Regional odontodysplasia is a rare disorder that can topathological diagnosis of a slow growing, bony maxillary lesion
cause severe dental, growth and development anomalies. Treat- causing proptosis. Histology showed a cellular lesion with focal
ment aims to preserve the affected teeth, however severely affected calcifications. It was focally positive for CDK4, but MDM2 was
teeth have a high risk of infection that may necessitate extraction. negative.
Patient B was an 11 year-old male with a 6 month history of an
PR10.09 enlarging left mandibular swelling. Clinical examination revealed
buccal expansion with multiple tooth displacements. Imaging
Compliance with UK national guidelines for the oral showed an expansile, corticated, multilocular radiolucent lesion
management of oncology patients with central ossifications perforating the superior cortical plate.
J. R. BAILEY1, L. GARTSHORE2, G. T. YESUDIAN3, S. Histopathology showed superficial woven bone, fibrous tissue
CAREW O’DONNELL4 & F. GILCHRIST5 and calcifications.
1
Paediatric Dentistry, Alder Hey Children’s NHS Foundation In both cases, a diagnosis of juvenile trabecular ossifying fibroma
Trust, Liverpool, UK; 2Paediatric Dentistry, University of was made. Treatment by complete excision and curettage was
Liverpool, Liverpool, UK; 3Paediatric Dentistry, Charles Clifford advised.
Dental Hospital, Sheffield, UK; 4Paediatric Dentistry, Harrogate Comments: Juvenile ossifying fibromas are uncommon benign
and District Foundation Trust, Harrogate, UK; 5Unit of Oral bony neoplasms that are locally aggressive and have a high rate
Health & Development, School of Clinical Dentistry, University of of recurrence. In children they can show rapid growth and must
Sheffield, Sheffield, UK be distinguished from other fibro-osseous lesions, and from oste-
Background: In the UK, over 1500 children are diagnosed with osarcoma.
cancer each year. Cancer therapy may cause oral complications
PR10.11 PR10.13
Dental treatment patients with bleeding disorders- Management of tooth extraction presenting in a
prospective study patient with severe haemophilia A
K. CHLEBORAD1, J. PAPEZ1, T. DOSTALOVA1 & V. J. PAPEZ1, K. CHLEBORAD1, T. DOSTALOVA1 & V.
KOMRSKA2 KOMRSKA2
1 1
Department of Stomatology, 2nd Faculty of Medicine Charles Department of Stomatology, 2nd Faculty of Medicine Charles
University in Prague, Prague, Czech Republic; 2Department of University in Prague, Prague, Czech Republic; 2Department of
Pediatric Hematology and Oncology, 2nd Faculty of Medicine Pediatric Hematology and Oncology, 2nd Faculty of Medicine
Charles University in Prague, Prague, Czech Republic Charles University in Prague, Prague, Czech Republic
Background: Children with congenital coagulopathy mostly suffer Introduction: HAEMOPHILIA is a congenital bleeding disorder
haemophilia which is characterized by blood coagulation defect. characterized by a malfunction of blood coagulability. Haemo-
Haemophilia is a recessively hereditary disease with link to chro- philia A is characterized by a deficiency of factor VIII (FVIII)
mosome X, disease is transmitted by females but males fall ill. and accounting for approximately 85% of all cases (incidence
Substitute preparations FVIII and FIX are the main treatment 1:5000 live male births). It is a hereditary blood disorder that is
means before dental therapy. transmitted as an X-linked recessive feature, thus, predominately
Aim: The aim of contribution is prospective study 78 children affecting males over females. This disease can be divided into
with hemophilia in the years 2007 - 2014. three grades, defined as mild, moderate and severe according to
Design: Haemophilia is relatively uncommon disease - despite is the the percentage of factors (standard range over 40%) and their
most frequent congenital coagulopathy. The number of child hemo- plasma levels (standard range 50–100 IU/dL).
philic patients in Czech Republic is 200 in our study we take care Case report: An 11-year-old boy with severe Haemophilia A (per-
about 78 patients with varying degrees of involvement in congenital centage of factor FVIII <1%) was referred for management of
bleeding disorders. Based on ADA recommendation a special card toothache. Clinical examination - tooth 84 - revealed: mobility,
was prepared for every patient containing health information, the non - vital reaction on cold, symptoms of pain, sensitivity to palpa-
type of tooth treatment, mainly hematologic therapy including spe- tion. Before the treatment patient was examined by hematologist
cial materials (fibrin glue, antibiotic), photo and X-ray documenta- and became substitution of factor FVIII - Advate (Antihemophilic
tion. Baseline examination followed one week after therapy. Factor (Recombinant), Baxter). Dental treatment under applica-
Results: Preventive examinations mainly dental calculus remov- tion of local anesthesia (2 ml Supracain 4%, Zentiva) was under-
ing, restorative treatment including endodontics, surgery in local taken including extraction of tooth 84. Wound was sutured and
or general anesthesia (155 extractions, labial frenectomy), and fibrin glue (Floseal haemostatic matrix©, Baxter) was applied. The
orthodontic therapy were evaluated. cover plate was not necessary to use.
Conclusion: Comparison of guidelines (2013) and our prospective Comments: The management of patients with Haemophilia A and
study show step by step the hematological and dental treatment other congenital bleeding disorders has caused a considerable
options. number of problems to the dental profession. There is a need to
simplify planning dental care especially extraction of teeth for
PR10.12 this group of patients and remove number of myths concerning
their management.
An unusual case of pathological primary tooth
mobility
R. FREEMAN & E. HINGSTON
PR10.14
Department of Child Dental Health, University Dental Hopsital Hand-Schüller-Christian disease presenting with
Cardiff, Cardiff, UK recurrent, bilateral, symmetrical mandibular lesions
Introduction: Abnormal mobility of primary teeth can be caused in an 8-year old boy. Report of a case
by trauma, sepsis, early onset periodontal disease, localised E. BIRPOU1, K. CHATZIDIMITRIOU1, C. MATSIOULA1, K.
pathology and underlying systemic disease; the cause must be TOSIOS2, P. CHRISTOPOULOS3 & D. EMMANOUIL1
1
determined so that optimal treatment can be provided. Here, we Department of Paediatric Dentistry, School of Dentistry,
describe the management of a young boy presenting with a sound University of Athens, Athens, Greece; 2Department of Oral
but mobile primary lower incisor. Medicine and Pathology, School of Dentistry, University of
Case reports: A four year old boy was referred to the Paediatric Athens, Athens, Greece; 3Department of Oral and Maxillofacial
Dentistry Unit in Cardiff by his general dental practitioner regard- Surgery, School of Dentistry, University of Athens, Athens, Greece
ing a tender and mobile lower left primary central incisor (71). There Introduction: Hand-Schüller-Christian disease (HSC) is the unisys-
had been a gradual increase in mobility of the tooth over the past tem multifocal form of Langerhans Cell Histiocytosis (LCH) and is
few months and the area was difficult to clean. There was no history primarily seen in infants and children. Head and neck lesions are
of trauma or sepsis and his medical history was unremarkable. found in 70–90% of patients with LCH, mostly in the temporal
Clinical examination revealed 71 to be caries-free but grade 3 bones, jaws, and skin of the auditory meatus. Recognition of early,
mobile, with calculus formation and associated localised gingivi- non-specific signs could facilitate early diagnosis of the disease.
tis. No other teeth were similarly affected. Radiographic exami- Case report: An 8-year-old boy was referred to the postgraduate
nation revealed marked alveolar bone loss localised to 71. A Paediatric Dentistry Department, Dental School, University of
gingival biopsy was undertaken and 71 extracted under local Athens for acute mandibular pain. His medical history included
anaesthesia. On extraction, a foreign object (a small clear plastic otic LCH and diabetes insipidus, consistent with HSC, at age of
cylinder) was found around the root of 71. Histological analysis 11 months and was treated with systemic chemotherapy. Intraoral
revealed inflammatory changes in the apical tissues, most likely examination revealed a pressure sensitive swelling on the buccal
related to the foreign object. and lingual area of the lower second primary molars. Radio-
Comments: This case demonstrates the need to consider foreign graphic examination revealed extensive bone loss around the pri-
objects as a cause of localised tooth mobility and alveolar bone mary molars, without the presence of dental pathology. The
loss in children. primary molars were extracted and part of the lesions were
removed for histological examination, which confirmed the final Case reports: A 7 year old female child presented with pain and
diagnosis of HSC disease. The patient was treated with chemo- swelling in the lower right back tooth region since 1 month. Clin-
therapy (vinblastine/prednisone). Symptoms improved and the ical examination revealed dental caries with pulpal involvement
lesions decreased considerably. In the two year- follow-up visit, and firm swelling in relation to 84 and 85. There was sulcus oblit-
recurrent lesions were recorded in the area of the mandibular per- eration indicating cortical bone expansion resulting in facial
manent molars bilaterally. Biopsy was performed confirming again asymmetry. Radiographically, the lesion was a radiopaque, well-
HSC disease and the patient entered an alternative chemotherapy defined homogeneous calcified mass surrounded by a radiolucent
protocol. Six months later, improvement of the clinical and radio- halo. A diagnosis of benign cementoblastoma was made. Com-
graphic appearance of the mandibular lesions was revealed. prehensive dental care under general anesthesia was undertaken
Comments: Paediatric dentists can contribute to a timely and including surgical excision of the lesion along with 84 and 85, fol-
valid identification of HSC disease by correctly differentially lowed by placement of PRP in the excised cavity. Mandibular
diagnosing lesions of head and neck. immobilization was done for 3 weeks. Histopathologic picture
confirmed benign cementoblastoma. Patient is under evaluation
PR10.15 and has shown no signs of recurrence since 1 year.
Comments: Given the rarity of benign cementoblastoma in chil-
Extraoral lesion evaluation in patient with acute dren, a circumspect vision of paediatric dentists is required to
lymphoblastic leukaemia detect,diagnose and manage such lesions.
R. R. MERGULHÃO1, C. T. LEITE2, P. F. MURC ß A2, J.
CARTUM1, F. L. FONSECA1 & S. VIEIRA3 PR10.17
1
Pediatric Oncology, Faculdade Medicina ABC, Santo Andr e,
Brazil; 2Servicßo de Odontologia, Hospital Estadual Mario Covas, An 18 months review of paediatric oral biopsies at
Santo Andr e, Brazil; 3Pediatrics, Universidade Federal de São the Dental Centre, Lagos University Teaching
Paulo, São Paulo, Brazil Hospital, Lagos, Nigeria
Introduction: Acute lymphoblastic leukaemia (ALL) is a malignant A. S. ADENAIKE1, F. A. OREDUGBA1, M. O. ASHIWAJU1, O.
disorder of lymphoid progenitor cells that affect both children and A. EFFIOM2 & M. O. GBOTOLORUN3
1
adults, with prevalence children age 2–5 years, representing 24% Child Dental Health, Lagos University Teaching Hospital, Lagos,
of all childhood malignancies. The clinical manifestations of the Nigeria; 2Oral Pathology and Oral Biology, Lagos University
disease are inhibition of hematopoiesis by leukemic cells and leuke- Teaching Hospital, Lagos, Nigeria; 3Oral and Maxillofacial
mic infiltration in several organs. The treatment includes multi- Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
agent chemotherapy(QT) and marrow bone transplantation. These Background: Oral and dento-facial pathologic lesions are rare in
therapies and immune suppression make children more prone to children, so are reviews of such lesions in Nigeria. However, their
infections with severe stomatologic complications. Mucositis is the study is useful in assisting the paediatric dentist in diagnosing
most common oral findings precipitated by the side-effects of the and managing these lesions appropriately.
antineoplastic agents but others manifestations were detected as Aim: The aim of the study was to review the pediatric oral biopsies
sensitivity of teeth and pain, xerostomia, ulceration, gingival hem- done between June 2013 and November 2014 from the Dental Cen-
orrhage and impaired taste sensation. tre in Lagos, Nigeria based on age, sex, site and type of lesion.
Case reports: A 6-year-old girl was first diagnosed with ALL and Design: The biopsy records of patients aged 16 years and below
treated according to the QT protocol BFM 2002. She had no which were processed at the Dental Centre over a period of
cavities or gingival bleeding. Fifteen months after the end of the 18 months (June 2013 - November 2014) were retrieved and an
treatment, ALL relapsed and then the ALL-St Jude XV chemo- evaluation of the biopsy result was carried out. The lesions were
therapy protocol started. After two months and eight days the grouped into categories according to age, sex, anatomic site and
child had swelling and pain in the oral cavity, in the left maxilla pathologic diagnosis.
(61, 62 region).He had fever with hematological signs (thrombo- Results: A total of one hundred and seventy biopsy reports were
cytopenia and neutropenia). The swelling extended further into reviewed, of which 26 (15%) cases were from pediatric patients,
cervical area. Computed tomograph of sinusitis were negative for the majority (88%) of which were benign. The distribution of the
local cellulite. The histological diagnosis confirmed oral mucosa pathologies were 9 odontogenic lesions, 4 salivary gland lesions, 7
inflammation and presence of Pseudomonas aeruginosa. She was fibro-osseous lesions and 2 malignant connective tissue lesions. The
medicated with antibiotics, corticosteroids and antifungal agents. most common pathology was ossifying fibroma. There was a slightly
The teeth 61, 62 presented mobility and were extracted. higher male predilection (1.2:1). The ratio of the lesions in mandible
Comments: Oral lesion control and dental hygiene monitoring are to maxilla was 3.3:1 and was predominantly on the left side.
important to care ALL relapsed children. Conclusions: Most of the pathologies in this population were
benign, the most common being ossifying fibroma. The lesions
PR10.16 were more common in the mandible with a male predilection.
Benign cementoblastoma - a rare case report in a
PR10.18
young child
T. SANGEETA, G. BABU KADAKAGERE LAKSHMANA & P. A retrospective study of biopsied oral lesions in Thai
SUBRAMANIAM pediatric patients
Department of Pedodontics and Preventive Dentistry, The Oxford V. VIPISMAKUL
Dental College and Hospital, Bangalore, India Department of Oral Pathology, Chulalongkorn University,
Bangkok, Thailand
Introduction: Cementoblastoma is defined as a tumor of odonto-
genic ectomesenchyme. It is a slow-growing, benign neoplasm Background: The incidence of oral diseases found in children
originating from cementoblasts with unlimited growth potential. and adults are different. Only a few studies were carried out
It represents <1% of all odontogenic tumors. Very few cases have to collect and analyze the data of biopsied oral lesions in chil-
been reported in association with primary teeth. dren.
Aim: To study, retrospectively, the pediatric oral lesions in Thai- Aim: Identify the impact of RAS on children.
land in order to provide epidemiological standpoint and diagnos- Design: A consecutive sample of 25 new patients attending the
tic consideration. joint paediatric oral medicine clinic were given a 28-day diary.
Design: The biopsy records from 1984–2013 were collected from The diary, developed with children’s involvement, contained open
the Department of Oral Pathology, Faculty of Dentistry, Chul- and closed questions. Quantitative data were analysed regarding
alongkorn University, Thailand. Patients age of 0–16 years were frequency, site, size and discomfort from the ulcers. Thematic
included and divided into three groups according to the dentition content analysis was undertaken for the open questions.
period. The lesions were classified into 11 diagnostic categories. Results: Completed diaries from 25 children with a mean age of
Results: Specimens of 1918 patients were recruited. Five most 10 years (range 4–14) were analysed. Participants experienced a
common categories are odontogenic cysts (31.1%), salivary gland mean of 1.8 ulcers per week (range 0–8). Seventy-two per cent of
disease (14.8%), odontogenic tumors (13.9%), gingival and peri- patients
odontal pathology (11%) and bone pathology (8.6%). Ten most (n = 18/25) suffered multi-site ulcers. Ulceration most frequently
common pediatric lesions are dentigerous cyst (18.4%), mucocele affected the lips (35%, n = 41/116), tongue (22%, n = 25/116)
(12.4%), pyogenic granuloma (7.4%), radicular cyst (6.2%), and cheek (21%, n = 24/116). Ulcers were reported moderately
ameloblastoma (5.4%), odontoma (4.3%), odontogenic kerato- painful in 32% of participants (n = 8/25) and severely painful in
cyst (4.2%), fibroma (3.1%), normal dental follicle (2.9%), and 32% (n = 8/25). Participants reported their largest ulcer as fol-
fibrous dysplasia (2.2%), respectively. lows; size of a grain of rice (30%, n = 30/100), size of a Smartie
Conclusions: The detailed information was different from previous (29%, n = 29/100), size of a pound coin (11%, n = 11/100). Qual-
studies, both in Thailand and other countries. This may be due to itative analysis highlighted impacts on daily activities and basic
the different in criteria, age range, and classification of the lesions. functions. Coping mechanisms included watching television or
playing games. Some relief was reported from the use of pre-
PR10.19 scribed medications.
Conclusion: This service evaluation has highlighted that children
A review of three cases to demonstrate the value of are able to provide detailed reports of their ulcers. Further research
coronectomy in reducing postoperative neuropathy in is needed to evaluate whether treatment can reduce impacts.
the management of “high risk” mandibular teeth
S. MARSHALL1, C. BRYANT2 & M. AHLUWALIA1 PR10.21
1
Paediatric Dentistry, King’s College Hospital, London, UK; 2Oral
Surgery, King’s College Hospital, London, UK
A case of eruption of the impacted first molar
associated with the compound odontoma in mandible
Introduction: Coronectomy, or partial odontectomy is a conserva- Y. SHIMADA1, K. SONOBE2, R. UMEZAWA3, Y. ENDO1, H.
tive surgical technique in which the crown of a tooth is removed FESE1 & K. MISHIMA4
but its roots or (root) are deliberately left in situ. In carefully 1
Periatric Dentistry, School of Dentistry, Showa University,
selected cases this alternative to the complete removal of a tooth Tokyo, Japan; 2Sonobe Clnic, Tokyo, Japan; 3Umezawa Clinic,
may represent the treatment of choice in a number of clinical sce- Tokyo, Japan; 4Division of Pathology, Department of Oral
narios. To date the use of coronectomy to reduce the risk of neu- Diagnostic Sciences, Showa University, Tokyo, Japan
ropathy following the extraction of teeth other than mandibular
third molars has not been widely explored. This paper highlights Introduction: In this paper, we introduced an interesting case of
the value of this procedure in other carefully selected clinical sce- the induction of eruption of the impacted first molar associated
narios and reviews the management of three paediatric patients with the compound odontoma by using a brand new method.
who underwent this procedure at King’s College Hospital. Case report: A 7 years and 5 months old boy was referred by a
Case reports: We present the cases of three children who were local private dental clinic to the Department of Pediatric Den-
managed by a multidisciplinary team and underwent a coronecto- tistry of Showa Dental Hospital. His panoramic X-ray findings
my procedure. All had cone beam computer tomography imaging showed the impacted mandibular left side first molar near the
as part of their assessment. The surgery was performed under lower border of mandible and the missing second molar. The
general anaesthetic. None of the children experienced postopera- dental germ of the mandibular left side second molar was not
tive neuropathy. detected. Dental cone beam CT images appeared a cyst cavity
Comments: The three cases presented demonstrate how coronec- extended from the first molar to the original part of the second
tomy can be used as an effective alternative to the removal of molar. And there were several calcified mass of the cyst detected.
teeth in situations where extraction would be associated with an We diagnosed as a compound odontoma according to the exami-
unacceptably high risk of postoperative neuropathy. Coronecto- nation of oral pathology.
my should be considered a risk reducing, but not risk free proce- We enforced enucleation of the odontoma followed by a fenestra-
dure and the preoperative counselling of patients and their carers tion operation of the first molar under general anesthesia on Feb
regarding this is essential. 22, 2014. We adhered the orthodontic button on the occlusal
plane of the first molar by using Super bond resinÒ in order to
pull up the impacted tooth through the fenestration. We could
PR10.20
confirm the complete eruption of the first molar on Nov. 22
Use of diaries to identify the impact of recurrent 2014.
apthous ulceration in children Comments: When we use an orthodontic button introduced in
H. ZAITOUN1, H. ROGERS1 & Z. MARSHMAN2 this case, since the wound is not covered by gingival tissue, we
1
Paedaitric Dentistry Unit, Charles Clifford Dental Services, can keep fenestration and the tooth can erupt smoothly thorough
Sheffield, UK; 2School of Clinical Dentistry, University of the fenestration. Therefore, this method is effective for the erup-
Sheffield, Sheffield, UK tion guidance of the tooth.
Background: Recurrent apthous stomatitis (RAS) commonly

affects children with potential to cause significant pain and mor-
bidity. Solicited diaries can be used to contemporaneously record
symptoms and impacts to tailor patient management.
PR10.22 tive statistics were used, the data analysed using Microsoft Office
Excel 2003.
Severe external root resorption in a 13 year old boy
Results: 434 complete records were retrieved. Fifty-five percent of
with primary hyperoxyluria lesions occurred in the 6–11 year-old group (55.3%), followed by
B. PATEL1, A. CASAUS1, C. BROWN1 & V. CLARK2 12–16 year-old (29.0%) and 0–5 year-old groups (15.7%), with
1
Paediatric Dentistry, Birmingham Dental Hospital, Birmingham, female predilection (58.3%). Cystic lesion gave the largest num-
UK; 2Birmingham Children’s Hospital, Birmingham, UK ber of specimens (62.4%), followed by neoplasm (16.4%), inflam-
Introduction: Primary Hyperoxyluria is an autosomal recessive matory lesions (12.7%) and others (8.5%). 83% of 271 cystic
metabolic disease in which there is excessive urinary oxylate lesions were mucous extravasation cysts. The lesions were man-
excretion. It is estimated to occur in 1–3 per 1,000,000 people. It aged accordingly such as excision, marsupialisation, resection
is defined as a defect in the glyoxylate metabolism pathway in and referral for chemotherapy and other adjuvant treatment.
the liver. Crystal deposition is prominent in the kidneys and bone Conclusions: A majority of the lesions were benign, requiring
but uncommon in oral tissues. minimal intervention. Although malignant lesions in children are
Case reports: A 13 year old Syrian boy was referred to Birming- rare, early detection and diagnosis are important. Recognition of
ham Dental Hospital due to mobile anterior teeth. He com- the clinicopathological features should alarm the clinician that
plained of pain on eating localised to his upper anteriors. There growth and anatomy of the maxillofacial structures may have
was no history or evidence of trauma. Medically, he has Primary been altered by the pathology or even the treatment received.
Hyperoxaluria and had undergone liver and kidney transplants
in 2010 at the Birmingham Childrens Hospital. The kidney trans- PR10.25
plant was unsuccessful and currently remains on dialysis. A preventive approach to two non-syndromic
Clinically, the attached gingivae had well defined and discreet yel-
low deposits localised to the anterior region. In addition, the
pediatric patients with oral self-mutilation
upper incisors were mobile. Radiographically, the bone had a E. KARAALIOĞLU, D. AKAY KOTAN, A. ALAC ß AM & N.
generalised mottled appearance. There were crestal radiolucencies ÖZTAŞ
involving the lower premolars, loss of lamina dura of the man- Paediatric Dentistry, Gazi University, Ankara, Turkey
dibular incisors and evidence of extensive root resorption of the Introduction: Self-mutilation (SM) describes a form of behaviour-
upper anteriors. al disorder characterised by an intentional damage to a part of
Opinions from the periodontology and radiology department the body without a conscious purpose to commit suicide. This
were sought and a diagnosis of severe external root resorption case report presents the treatment planning of two non-syndro-
due to oxylate crystal deposition was made. mic patients with SM.
After liaising with his medical team, the plan is for preventive Case report: The first patient referred to the clinic with complain-
therapy, extraction of mobile teeth and provision of a removable ing of swelling of the buccal mucosa. An irregularly shaped, well-
appliance. defined lesion was noted on the right side of buccal mucosa sur-
Comments: This case highlights the importance of taking a multi- rounded by keratotic areas. An acrilic resin applience was
disciplinary approach in tackling a difficult and rare dental predesigned firstly. After a month, similar lesions were appeared on
sentation in a child. surface of the left side of buccal mucosa and lower lip, then SM
was confirmed. The patient consulted to psychiatry clinic. It was
decided to use a thermoplastic retainer for maxillary arch. The
PR10.23 injuries were healed with no evidence of additional trauma. On
recall examination after 12 month, there was no sign of SM.
Abstract withdrawn
The second patient was applied with a lesion on left buccal area.
The lesion appeared to be nodular, elliptical, localised and pain-
less. Preliminary intervention was performed with a thermoplastic
PR10.24 retainer for all day use. The patient was also referred to the oral
Oral & maxillofacial pathological lesions in children surgery clinic for biopsy. Fibroepithelial hyperplasia was detected
managed at the Department of Paediatric Dentistry which contributed with chronic trauma and SM was diagnosed.
3 weeks later, lesion has almost completely healed. The patient
Kuala Lumpur Hospital
was followed-up for 12 months and no signs of recurrens oc-
N. N. N. YUNUS1, J. M. SHARIF1 & N. M. AREFFIN2
1 cured. Patients are still under control.
Paediatric Dentistry, Kuala Lumpur Hospital, Kuala Lumpur,
Comments: Dentists can play an important role in diagnosing SM
Malaysia; 2Paediatric Dentistry Unit, Department of Rstorative
and appropriate preventive methods must be developed for each
Dentistry, National University of Malaysia, Kuala Lumpur,
individual patient.
Malaysia
Background: Studies have been done worldwide to analyse the PR10.26
type of lesions seen in children who present with various oral
and maxillofacial lesions, with clinical signs and symptoms some-
Ameloblastic fibro-odontoma: a case report
times differing from those in adults. Physiological and anatomical H. H. CHIANG1, Y. F. WU2 & S. S. HSUEN3,4,5
1
factors may influence their management. Department of Pediatric Dentistry, China Medical University
Aim: This study was to identify oral and maxillofacial lesions Hospital, Taichung, Taiwan; 2Departments of Oral &
seen and managed at the Paediatric Dental Department, Kuala Maxillofacial Surgery, China Medical University Hospital,
Lumpur Hospital and to compare the epidemiological data with Taichung, Taiwan; 3Department of Oral Pathology, China Medical
other centres. University, Taichung, Taiwan; 4School of Dentistry, China
Design: This was a retrospective study involving records of chil- Medical University, Taichung, Taiwan; 5Department of Law,
dren who presented with oral and maxillofacial lesions from year National Chung Hsing University, Taichung, Taiwan
2000 until 2014. Apart from patients’ demographic data, diagno- Introduction: The ameloblastic fibro-odontoma (AFO) is an unu-
sis and management of the lesions were also recorded. Descrip- sual mixed odontogenic tumor comprising of ameloblastic
fibroma (AF) and ameloblastic odontoma. This tumor exhibits
progressive growth and causes considerable deformity and bone PR10.28

destructure.
Comparison between sleep history, pain in head areas
Case reports: A 11-year-old male was referred to our institution
due to delay erupted left permanent molars. Neither dental his- and masseter bite force between children with and
tory reported local trauma or infection at lesion site, nor medical without sleep bruxism on primary and mixed
history revealed remarkable systemic diseases. Panoramic radiog- dentition
raphy showed an impacted left lower first molar with an well- C. M. T. SILVA1, N. A. ALENCAR1, A. BIRRA2, L. C. MAIA1
defined, radiolucent lesion enclosed the crown. It contained a & A. G. ANTONIO1
radiopaque mass of apparently calcified material close the alveo- 1
Pedodontic Department, Universidade Federal do Rio de Janeiro,
lar mucosa. Under general anaesthesia, the tumour was removed Rio de Janeiro, Brazil; 2Orthodontic Department, Universidade
through intra-oral approach. Microscopically examination of sec- Federal do Rio de Janeiro, Rio de Janeiro, Brazil
tions stained with hematoxylin and eosin showed scattered cords
of odontogenic epithelium in a loose primitive-appearing stroma Aim: This study compared the sleep history, pain in head areas
that resembles the dental papilla. The calcifying element is char- and masseter bite force (MBF) between children on the primary
acterized by foci of enamel and dentin matrix formation in the (P) and mixed (M) dentition (D), with and without bruxism.
close relationship to the epithelial structures. Histologic examina- Design: Children were classified as bruxers according to the
tion made diagnosis of AFO. America Academy of Sleep Medicine criteria; and the children’s
Comments: This lesion appears to be true neoplasms. The nature dentition was evaluated by clinical exams. Sample (n = 66; mean
and the relationships between mixed odontogenic tumours and age = 5.33 1.10) was divided into groups (G): G1 = bruxers on
related lesions are still controversial. However, distinguishing PD (n = 17); G2 = non-bruxing children on PD (control, n = 16);
between a developing odontoma and an AFO may be difficult G3 = bruxers on MD (n = 17) and G4 = no bruxers on MD
based on histopathologic grounds alone. (control, n = 16). A questionnaire about sleep history (nightmare,
drooling, snore, sleeptalking and enuresis nocturna) and pain in
head areas (face, ear and head) was applied to parents. The
PR10.27 MBF was assessed through electromyography.
Uncommon gingival sulcus bleeding following full Results: Children on PD (G1 and G2) did not differ from those
mouth rehabilitation in a 3-year old child with severe on MD (G3 and G4) considering drooling, snore, sleep talking
iron deficiency: a case report and enuresis. However, we observed more nightmares in G3 than
in G1 (P = 0.001), without difference among G2 and G4
C. L. TSAI
(P = 0.758). No difference was detected between the dentitions,
Department of Pediatric Dentistry, Kaohsiung Chang-Gung
both for bruxers and non-bruxing children, related to ear and
Memorial Hospital, Kaohsiung, Taiwan
facial pain (P > 0.05). Although bruxers on PD and MD pre-
Introduction: Iron deficiency anemia (IDA) is the most common sented similar headache percentages (P > 0.05), controls had
cause of anemia worldwide and results from inadequate iron sup- more headache during the MD (P = 0.025). We observed that
ply. The clinical manifestations of iron deficiency anemia can be the MBF of G1 was lower than in G3 (P < 0.05), but it was not
subtle, but irreversible delayed cognitive and emotional develop- detected in controls (P > 0.05).
ment may occur if the anemia is severe and prolonged. In this Conclusion: In conclusion, nightmares are more prevalent on
case I describe an unusual bleeding following full mouth rehabili- bruxers with MD. Apart from the type of dentition, the headache
tation due to severe iron deficiency anemia. episodes are similar only in bruxers. However, the dentition
Case report: A 3-year-old girl diagnosed as mild mental retarda- exerts difference on MBD patterns between the groups.
tion and developmental delay was referred for management of
full mouth rampant caries. Pre-operational complete blood data PR10.29
showed iron deficiency anemia (Hb 7.4 g/dL) with higher platelet
count. Comprehensive dental care without extraction under gen- Lateral periodontal cyst in a 8 year old male: a case
eral anesthesia was performed. After dental treatment, blood report
continuously oozed from the gingival sulcus around stainless steel N. TZIALLA1, M. KATSOUDA1, K. ARAPOSTATHIS1, A.
crowns with little blood clot formation. Gauze packing with ELIADES2, A. TSIRLIS2 & N. KOTSANOS1
1
1:100,000 epinephrine was performed for localized hemostasis. Department of Paediatric Dentistry, Aristotle University of
The Hb concentration dropped to 4.7 g/dL and controlled by Thessaloniki-School of Dentistry, Thessaloniki, Greece;
2
PRBC transfusion. The prescription of ferrous gluconate was for Department of Oral Surgery, Surgical Implantology and Oral
iron supplement. The girl kept on iron supplement treatment and Radiology, Aristotle University of Thessaloniki-School of
periodic follow-up at pediatric clinic. Now, the girl is 10 years Dentistry, Thessaloniki, Greece
old. Her cognitive and physical development has caught up with
Introduction: Lateral periodontal cyst (LPC) is an odontogenic
the normal range and her oral health is stable.
cyst of developmental origin on the lateral surface of the root of
Comments: The uncommon prolong bleeding could not have
a vital tooth. It has characteristic histopathological features and
foreseen. Subtle bleeding manifestations can occur in patients
is generally asymptomatic. LPC appears on radiographs as a
with IDA with delay in platelet aggregation and adhesion which
round or teardrop-shaped, well circumscribed radiolucency that
can be reversed by iron therapy. Regarding the severe IDA
can be misdiagnosed as a lesion of endodontic origin. The most
patients as bleeding disorder patients is suggested.
common treatment for LPC is surgical enucleation. LPC arise
preferentially in individuals aged between 40 and 70 years and
irrespective of gender. We describe a young male patient with a
LPC in the upper central incisors, a rare case for his age.
Case reports: An 8-year-old boy was referred to the Paediatric
Dentistry Department of Aristotle University of Thessaloniki
with a 10 month history of pain and swelling on the buccal sur-
face of the upper left central incisor (#21). The patient was in
good oral health with no history of trauma. Clinical examination
revealed a gingival enlargement labially to #21 and mobility of diagnostic biopsy parents differed intervention. Child reported
the four upper incisors with positive vitality tests. Radiographic back after 8 months with gross swelling of the face and disfigure-
examination revealed a well defined solitary oval-shaped radiolu- ment and inability to take solid because of intraoral maxillary
cency between the roots of the displaced upper central incisors. growth. Incisional Biopsy confirmed diagnosis of MNETI and
Dental treatment was performed under local anesthesia and CT scanning revealed the extent of hard tissue involvement.
included the surgical enucleation of the lesion. The histological Based on the histopathological report the Surgical intervention
examination of the specimen confirmed that the lesion was LPC. involved resection of the tumor and reconstruction. Considering
Comments: The appropriate clinical and radiographic examina- the Margins of the surgical specimen for the presence tumor cells
tions aided to the correct diagnosis and treatment approach of a and owing to the tumor size, Child was subjected to chemother-
young boy’s LPC. apy. Prosthetic rehabilitation was done post chemotherapy.
Comments: Timely intervention with aggressive management is
PR10.30 prudent owing to its rapid growth and high recurrence rate.
Compound odontoma and delay eruption of

PR10.32
mandibular right 1st permanent molar in a seven-year
old boy Acquired toxoplasmosis of a cervical lymph node in a
C. W. YEN1, M. H. SHEEN1,2, S. T. HUANG1,2 & S. Y. HSIAO2 seven-year old boy: a case report
1
Department of Oral Hygiene, College of Dental Medicine, P. A. FEE & M. DHILLON
Kaohsiung Medical Universtiy, Kaohsiung City, Taiwan; 2Division Oral and Maxillofacial Surgery, Aberdeen Royal Infirmary,
of Paediatric Dentistry, Department of Dentistry, Kaohsiung Aberdeen, UK
Medical University Hospital, Kaohsiung City, Taiwan Introduction: Toxoplasmosis is a parasitic infection divided into
Introduction: The mean age of the time in diagnosis an odontoma congenital and acquired forms. The latter form may be asymp-
is 14 years. Odontooma occur somewhat more frequently in max- tomatic, or present with lymphadenopathy, fever, fatigue and
illa than in mandible. The compound type is more often seen in malaise. In children the cervical lymph nodes are most commonly
the anterior maxilla; complex odontoma occur more often in the affected. This report describes a case of a seven-year-old boy
molar regions of either jaw. who presented with a five-year history of cervical lymphadenopa-
Case reports: This seven-year-old boy was a regular-dental-fol- thy. A brief review of the literature on toxoplasmosis has also
low-up patient in Division of Paediatric Dentistry of Kaohsiung been noted.
Medical University Hospital for more than 3 years. From the Case reports: Following urgent referral from GP to regional Oral
regular dental examination in July 2013, the bilateral mandibular and Maxillofacial Surgery Department, seven-year-old boy pre-
1st permanent molars were unerupted while maxillary 1st perma- sented with five-year history of mass in right posterior triangle of
nent molars were starting eruption. The mandibular left 1st per- neck. Initially presented age two with a history of slow growth.
manent molar erupted after 5-month follow up, but the Clinical examination revealed two by one centimetre soft and
mandibular right 1st permanent molar was found delay eruption. freely mobile mass right posterior triangle, with further one centi-
The panorex showed an odontogenic like legion between mandib- metre lymph node inferiorly. Management included ultrasound
ular right 1st permanent molar and 2nd primary molar. The imaging and excision of lymph nodes under General Anaesthetic.
operation was done in February 2014 with enucleation of odon- Following histopathology and referral to Paediatrics, patient and
toma and operculectomy for mandibular right 1st permanent mother were advised diagnosis of toxoplasmosis entirely benign
molar eruption, 2 main odontogenic-like segments were sent for in males, with no further treatment advised.
histopathological examination. Histopathology confirmed com- Comments: Toxoplasmosis is a disease with mild symptoms. The
pound odontoma. The mandibular right 1st permanent molar clinical picture is not specific, but suggestive features include a
was partial eruption in April, full crown exposure in July, and relatively short history, presence of cervical lymphadenopathy
full eruption in November 2014. The patient still keep regular and relative lymphocytosis in peripheral blood. However this dis-
follow up at our OPD. ease is often not considered in patients with unexplained cervical
Comments: This is a rare compound odontoma case founded in adenopathy. The majority of these patients attend operating the-
very early age. The paediatric dentists are very important for atres with a suspected diagnosis of malignant neoplasm, generat-
those children who are in mixed dentition, and regular dental fol- ing anxiety and, at times, unnecessary surgery is performed.
low up is also important. In this way, any delayed tooth eruption Toxoplasmosis should be included in the differential diagnosis of
can received further examination in early age. patients with cervical lymphadenopathy.
PR10.31 PR10.33
Melanotic neuro-ectodermal tumor of infancy Long term effects of radiation therapy and
S. NAMINENI1 & G. K. VELAGAPUDI2 chemotherapy in tooth formation and development. A
1
Pediatric Dentistry, Rainbow Hospital for Women and Children, case series report
Hyderabad, India; 2Rainbow Hospital for Women and Children, S. PAPANAKOU, E. PANAGIOTOU, O. PANAGOPOULOU,
Hyderabad, India K. TZOUANAKI & K. KAVVADIA
Introduction: MNTI- Melanotic Ectodermal Tumor of Infancy is Paediatric Dentistry, National and Kapodistrian University of
relatively a rare neoplasm with osteolytic character. Less than Athens, Athens, Greece
500 cases were reported world wide. Going by the literature, it is Introduction: The age of the patient, the stage of crown/root for-
known to affect Maxilla during infancy in 90% of the cases. It’s mation and the radiation and/or chemotherapeutic drug dose
peculiar nature of early onset, rapid growth, affect oral intake received are the most important risk factors for dental develop-
and result in gross disfigurement. ment disturbances. The objective of this report is to present five
Case reports: A 4 month old child presented at Pediatric Den- cases of paediatric cancer survivors with developmental dental
tistry of Rainbow hospital for women and Children with a swol- anomalies and their long term follow up.
len gum on left posterior Maxilla. In spite of advice for
Case reports: 1st case: 11 years old male treated with radio/ PR10.35
chemo therapy (R/CT) for brain tumor when 5 years old. Follow
Case series of paediatric odontomas: are we
up time (FUT): 5 years. Clinical and radiographic findings
(CRF): arrest of root formation and microdontia. communicating the link with Gardner’s syndrome?
2nd case: 8 years old male treated with RT when 2 years old for M. H. CONNOLLY1, M. LITTLE2, M. NUGENT1 & P. SLOAN3
1
optic glioma. FUT: 3 years. CRF: teeth aplasia, arrest of root Oral and Maxillofacial Surgery, City Hospitals Sunderland,
formation, short and conical roots. Sunderland, UK; 2Oral and Maxillofacial Surgery, James Cook
3rd case: 12 years old male with Langerhans cell Histiocytosis University Hospital, Middlesbrough, UK; 3Oral Pathology, School
treated with CT when 5, 8 and 10 years old, for head and neck of Dental Sciences, Newcastle upon Tyne, UK
lesions. FUT: 3 years, CRF: vertical bone loss in mandibular Introduction: Odontomas are benign odontogenic tumours (hem-
molar and premolar area. artomas) subdivided into compound and complex types. Odonto-
4th case: 15 years old girl treated with CT and total body irradi- mas consist of dental tissues, arranged as ‘toothlets’ (compound)
ation when 3 years old for neuroblastoma. FUT: 2 years, CRF: or unrecognizable (complex) structures. Most are diagnosed as
aplasia of premolars, abnormal root formation and microdontia. incidental radiographic findings in adolescents. Their aetiology is
5th case: 5 years old male treated with R/CT for neuroblastoma unknown, but there is an association with hereditary conditions
when 3 years old. CRF: Severe early childhood carries, abnormal including Gardner’s syndrome (GS).
crown formation of mandibular first premolars. GS is a rare but serious condition resulting in premalignant colo-
Comments: Childhood cancer survivors may present tooth devel- nic polyps. Other findings include jaw osteomas (including odon-
opmental anomalies that may negatively influence their oral tomas); in approximately 80% of cases. As jaw lesions are
health. known to precede the detection of bowel polyps, appropriate
monitoring of patients diagnosed with odontomas and early diag-
PR10.34 nosis of GS will likely lead to long term optimum treatment out-
Clinical and pathohistological profiles of chronic comes.
Case reports: Six cases of odontomas in patients (aged 6 - 13) are
odontogenic infections with microvascular presented from the Sunderland OMFS Department; four complex
proliferation in children with permanent dentition and two compound. All were successfully enucleated, including
T. KUTLLOVCI1,2, S. ILJOSKA3, A. BEGZATI4, A. REXHEPI1, two large odontomas. Histological reports confirmed the diagno-
B. XHEMALJI1 & N. KUTLLOVCI5 sis. None of these patients presented with other signs of GS and
1
Department of Pediatric Dentistry, University Dentistry Clinical all were discharged. None of the discharge letters allude to the
Center of Kosova, Prishtina, Kosovo; 2University of Prishtina, significance of this diagnosis and in two cases the GP’s were not
Prishtina, Kosovo; 3Department of Pediatric Dentistry, Saints copied into communications.
Cyril and Methodius University of Skopje, Skopje, Macedonia, the Comments: Although awareness exists among dentists, there is lit-
Former Yugoslav; 4Department of Pediatric Dentistry, University tle emphasis on future monitoring for potential GS. It is likely
of Prishtina, Prishtina, Kosovo; 5General Medicine, University of that GP’s are less aware of the significance of this diagnosis. Per-
Prishtina, Prishtina, Kosovo haps a care pathway with appropriate review intervals should be
initiated for patients with odontomas to help with early detection
Background: The apical periodontitis as an infection is the result
of this rare, but serious condition. GP’s should be included in
of endodontic infections and is manifested when the immunologi-
communications and the link with GS highlighted.
cal system of the host is activated from microorganisms which
penetrate in to the dental pulp through the root canals. PR10.36
Aim: The aim of this study is to compare the clinical diagnosis Case report of Williams syndroum in Saudi Arabia
and the pathohistological identification in chronic odontogenic H. BANGAR1 & N. ALGHANIM2
infections with microvascular proliferation in children with per- 1
Peadiatric Dentistry, Riyadh Collage, Riyadh, Saudi Arabia;
manent dentition. 2
King Saud University, Riyadh, Saudi Arabia
Design: In our study we included 36 children with permanent
dentition and with chronic apical changes and granulomas, in Introduction: Williams syndrome is a rare genetic disorder that
which children the indication for extraction of the teeth that affects a child0 s growth, physical appearance, and cognitive devel-
caused the odontogenic infections was set and from the extracted opment. People who have Williams syndrome are missing genetic
teeth we verified the diagnosis using pathohistological methods material from chromosome 7, including the gene elastin. This
(vascular proliferation). gene0 s protein product gives blood vessels the stretchiness and
Results: From 36 children with chronic apical changes and granu- strength required to withstand a lifetime of use. The elastin pro-
lomas, 9(25.00%) of them had chronic apical periodontitis, from tein is made only during embryonic development and childhood,
which 6(16.67%) of the children did not have microvascular pro- when blood vessels are formed. Because they lack the elastin pro-
liferation, 1(2.78%) child had a medium level and 2(5.56%) chil- tein, people with Williams Syndrome have disorders of the circu-
dren had signification microvascular changes (proliferation). latory system and heart.
A total of 6 (16.67%) children had chronic apical periodontitis Case report: An 10-year-old Saudi boy diagnosed with Williams
with a fistula. 5 (13.89%) children did not have microvascular Syndrome presented for dental care at Pediatric Dentistry Clinics
proliferation and 1 (2.78%) child had a medium level of micro- at Riyadh collage, Riyadh, Saudi Arabia. The boy was born
vascular proliferation. A total of 5(13.89%) children had chronic through full term pregnancy and the delivery was uneventful.
apical periodontitis with parulis,from which 3 (8.33%) children The family history did not reveal any further occurrence of WS.
didn0 t have microvascular proliferation, 1 (2.78%) child had a The child was diagnosed with aortic insuficy didnt require any
low level of microvascular proliferation and 1 (2.78%) child had surgical treatment only follw up every year and prophlactic anti-
severe microvascular proliferation. biotic cover with extesive treatment.have pulmonary artery steno-
Conclusions: The findings from this study show the importance of sis at birth which improved by the age of 6 years. The child had
histopathological examination for the correct determination of mild mental retardation and was very frinendly. The patient was
periapical lessions in childrens permanent teeth. 115 cm tall and weighing 34 kg at initial visit. The patient dis-
played the characteristic “elfin face” appearance including full
prominent cheek, periorbital fullness, mild hyperopia (vertical
strabismus), wide mouth with thick lips, long philtrum, small Conclusion: In mixed dentition stage, panoramic radiograph
nose and depressed nasal bridge. should be taken to screening pre-eruptive intracoronal absorp-
Conclusion: There is no cure for Williams syndrome. Patients tion. Early detection and early treatment is important to this
must be continually monitored and treated for symptoms defect.
throughout their lives.
PR10.38
PR10.37 Painless and bloodless surgery in pedodontics
Investigation and countermeasures of 43 pre-eruptive V. S. BHAT1 & S. S. BHAT2
1
intracoronal absorption Prosthodontics, Yenepoya University, Mangaluru, India;
2
Z. DONGFANG Pedodontics, Yenepoya University, Mangaluru, India
Stomatology Hospital of Xi’an Jiaotong University College of Introduction: The goal of paediatric dentistry is to provide pre-
Medicine, Xi’an, China ventive education to parents and patients as well as interception
Aim: To investigate the characteristics and treatment methods of and therapy of dental diseases in a minimally invasive way using
pre-eruptive intracoronal absorption. a stress-free approach. New technologies enable simpler treat-
Design: By retrieving the Pubmed database about case reports ments to be carried out than with conventional techniques.
and epidemiological literatures of pre-eruptive intracoronal Lasers have been used in the dental field since few decades.
absorption, the characteristics of the disease and the treatment Case reports: This poster will highlight some of the clinical appli-
methods should be found out and noted in the clinical work and cations of diode lasers especially in young children. Procedures
make it get timely treatment. like frenal revisions, fibroma excision, operculectomy, tongue tie
Results: 34 case reports (1978~2013), a total of 43 teeth influ- corrections will be highlighted. Laser is very effective in paediat-
enced, and 6 articles of epidemiology investigation were obtained. ric dentistry and enables optimal preventive, interceptive, and
The disease occurs between 6 and 20 years old, mostly in the minimally invasive interventions for soft tissue procedures.
stage of mixed dentition, with the incidence of 1.55% to 1.55% Comments: The laser is a good tool for soft tissue management
in people, and 0.5% 2.1% in teeth, no racial and gender differ- in children. Due to almost totally bloodless field and faster heal-
ences. This disorders of unerupted permanent teeth were usually ing, Lasers find more acceptance among the pediatric patients
found during routine radiographic examinations of children with and their parents. Laser treatment involves a reduction in the use
otherwise good oral health by the orthodontist. Few toothache of medication (anaesthetics, analgesics and antibiotics) and in
had been reported. Pre-eruptive intracoronal absorption used to intra-operative and post-operative bleeding. It eliminates the need
appear mostly in the second permanent molar (47.5%), next in sutures and produces faster wound healing and less scarring. It is
the permanent canine(17.5%) and first permanent molar(15.0%), important for the professional to understand the physical charac-
single or multiple, mostly because of the neighbor tooth translo- teristics of the different laser wavelengths and their interaction
cation, or the chronic perioapical disease of the preceding pri- with the biological tissues to ensure that they are used in a safe
mary teeth. Treatment is clinical observation, or filling after way, in order to provide the benefits of this technology to young
eruption of the tooth, removal and making the adjacent teeth patients.
moving forward to replace it was also be choosed.
Education, Service Evaluation and Audit

Poster Session – PR11
PR11.01 student has to practice the different specialties of dentistry for
not <12 months. Recent reports from Libya showed that dentists
Final year dental undergraduates0 self-assessed were blaming the dental education system for not adequately pre-
confidence in paediatric dentistry pare them to fulfill their roles as dental practitioners and that
S. RAJAN1,2, S. W. Y. WONG1, X. Q. WONG1 & R. D. dental graduates are not proficient in performing most of dental
VAITHILINGAM3 procedures.
1
Department of Paediatric, Dentistry and Orthodontics, University Aim: To explore graduated dentists’ views and opinions concern-
of Malaya, Kuala Lumpur, Malaysia; 2Melbourne Dental School, ing dental education related factors which hamper their compe-
University of Melbourne, Carlton, VIC, Australia; 3Department of tency in practicing dentistry after graduation.
Restorative Dentistry, University of Malaya, Kuala Lumpur, Design: This qualitative study involved semi-structured interviews
Malaysia of newly graduated dentists from different dental schools in
Background: Self-assessment based on benchmarked professional Libya. Participants were identified through their social groups on
standards is an excellent tool to assist in improving the dental Facebook by two interviewers; those who accepted to take part
curriculum. Areas of strength and weaknesses can be identified. in the study were asked questions about their personal experi-
It can also act as a baseline standard when significant changes ences of studying dentistry in Libyan universities. The interviews
are introduced to the dental curriculum. were recorded and transcribed and then analyzed using thematic
Aim: The aims of this prospective cross-sectional study were two- analysis of latent contents.
folds: Results: A total of thirty five dental graduates were interviewed
(i) to investigate self-assessed confidence of final year dental for this study. The most common themes to emerge were: insuffi-
undergraduates in paediatric dentistry at University of Malaya, cient training, shortage of resources, poor admission and educa-
(ii) to gather baseline level of self-confidence for the old dental tion polices, failure of management, lack of infra-structures, the
curriculum. need of postgraduate training, shortage of qualified staff, unpre-
Design: 65 undergraduates completed anonymised questionnaires paredness to practice independently.
which was formulated based on expected professional competen- Conclusions: This study showed that the barriers to dental training
cies in three domains namely clinical skills, patient management, in Libya are numerous, interact and overlapping. There is a need for
and professional development and clinical governance. Visual immediate and long term plans to improve the quality of dental edu-
analogue score (VAS) represented by a 10 cm line with score ‘0’ cation and to support the emerging dental workforce.
no confidence at all and ‘10’ complete confidence was used to mea-
sure the level of confidence. PR11.03
Results: The overall analysis of self-assessed confidence was very Placement of preformed metal crowns (PMCs) by
positive with median VAS ≥5 cm in; clinical skills,
7.66 1.31 cm (range = 2.41–9.97 cm: n = 62; 95.4%), patient
dental hygienist / therapist (DHT) Vocational
management 7.73 1.27 cm (range = 5.09–9.95 cm: n = 64; Trainees in Scotland: a service evaluation
100.0%) and professional development and clinical governance, G. C. JACKSON1 & R. R. WELBURY2
1
8.13 1.21 cm (range = 5.22–10.00 cm: n = 64; 100.0%). High Remote and Rural Dental Postgraduate Fellow, NHS Education
confidence was reported for routine dental care (fillings and pre- for Scotland, Inverness, UK; 2Dental School, University of
ventive care) while lower confidence reported for basic life sup- Glasgow, Glasgow, UK
port (median VAS = 5.65 cm) and pulp therapy for immature
Background: Studies have identified the utility of PMCs for man-
permanent teeth (median VAS = 5.95 cm). agement of carious primary molars, acknowledging the impor-
Conclusions: The final year dental undergraduate students of Uni- tance of patient and parental acceptance. The evolving role of
versity of Malaya appear to have good overall self-assessed confi- DHTs has been identified, requiring further investigation.
dence in core areas in paediatric dentistry and similar areas of low
Aim: This study focuses on diagnosis and management of carious
confidence was reported by undergraduates at other dental schools. primary molars. Patient and parent satisfaction and cost effec-
tiveness of placement of PMCs by DHTs were evaluated. Atti-
PR11.02 tudes to increased professional autonomy for DHTs were
A qualitative study of new graduates’ views of investigated.
Design: Data was collected in 2 audit rounds following placement
barriers to dental training in Libya of PMCs using a “faces” scale for children and a Likert scale for
K. S. BEN SALAH1, A. EL AWAMI2 & A. ARHEIAM3,4
1 parents. DHTs were questioned on their attitudes to the use of
Periodontics, University of Benghazi-Faculty of Dentistry,
PMCs and increased professional autonomy.
Benghazi, Libyan Arab Jamahiriya; 2Ministry of Health,
Results: 133 PMCs were placed (110 children) by 10 DHTs over
Benghazi, Libyan Arab Jamahiriya; 3Community and Preventive
an 8-month period. 10.5% of PMCs placed had radiographs
Dentistry, Benghazi University - Faculty of Dentistry, Benghazi,
available. Mean time taken to place PMCs was 13.4 min. The
Libyan Arab Jamahiriya; 4Health Service Research, University of
proportion of PMCs taking >20 min to place fell from 13.5%
Liverpool, Liverpool, UK
(round 1) to 1.7% following structured training 4 months into
Background: In Libya, studying dentistry involves five undergrad- the module. 92% of patients chose the “very happy” (60%),
uate academic years followed by an internship year wherein the “happy” (21%) or “neutral” (11%) MCDASf face following
PMC placement. 81% of parents said the PMC was “easier” or Design: Clinics operate within the Paediatric Dentistry Unit every
“much easier” than a filling. 81% of parents were “very happy” 2–3 months, with an average of 12 patients per session. Clinics
or “happy” with appearance of the PMC. 98% of parents are attended by consultants in Paediatric Dentistry and in Oral
(n = 42) found a visual communication resource useful. Medicine. Referrals are accepted from general dental practitio-
Conclusions: Low availability of radiographs represents a missed ners, community dentists, general medical practitioners, internal
diagnostic opportunity. PMC placement by DHTs results in high referrals and from other medical specialities. Patients referred
patient and parent satisfaction, comparable to other studies. include those with e.g. recurrent oral ulceration, orofacial granu-
DHTs showed engagement with developments in increased pro- lomatosis, recurrent herpes infections, etc.
fessional autonomy. Results: This service has improved the management of paediatric
dental patients with oral soft tissue conditions, by improving ser-
PR11.04 vice efficiency, promoted inter-specialty medical/dental patient
management and has also offered educational opportunities for
An audit of sedation record keeping in the public professionals.
dental service Conclusions: The provision of a joint Oral Medicine/Paediatric
S. O’RAW, J. DIAMOND & K. MCCAIG Dentistry service ensures that patients receive multidisciplinary
Dental, NHS Lanarkshire, Motherwell, UK care, thereby improving their management. Communication has
been improved between the Paediatric Dentistry Unit and other
Background: The Scottish Dental Clinical Effectiveness Pro-
medical specialities e.g. Paediatric Gastroenterologists, as a result
gramme (SDCEP) has published guidelines for “Conscious Seda-
of this new service.
tion in Dentistry”. They stipulate “treatment procedure” details
that should be recorded in clinical records during episodes of
sedation. Complete and accurate record keeping is a GDC PR11.06
requirement as set out in “Standards for the Dental Team”. Comprehensive dental care under general anaesthesia:
Aim: (1) To audit current record keeping practice for patients carer feedback and satisfaction
undergoing intravenous/inhalation sedation and to compare this F. SOLDANI, S. NOVEERA & H. TATE
with SDCEP guidelines.
Bradford District Care Trust, Bradford, UK
(2) To compare and contrast compliance with SDCEP guidelines
for intravenous vs inhalation sedation. Background: The Care Quality Commission (Outcome 16)
Design: A retrospective audit of 50 clinical records of sedation requires assessment and monitoring of the quality of service pro-
patients attending Motherwell Health Centre between 1/1/14 and vision, with the NHS ‘Friends and Family Test’ being an impor-
15/5/14 was completed. 20 patients received inhalation sedation tant tool to allow patient/carer feedback on their experience.
and the remaining 30 received intravenous. Data gathered was Aim: To gain carer feedback and determine carer satisfaction
compared to SDCEP guidelines. regarding their child’s comprehensive dental care under general
Results: Dose, route of administration and dental treatment pro- anaesthetic (CCGA).
vided was recorded in 100% of cases. Design: At the CCGA pre-assessment appointment, a carer ques-
Details of monitoring and time of delivery was recorded in 60% tionnaire information leaflet was provided to carers of patients
of cases. There was 100% compliance for intravenous records scheduled for CCGA. Approximately two weeks post-CCGA, a
but 0% compliance for inhalation records. Patient Support Officer telephoned carers and invited them to
Patient reaction/success of sedation was recorded in 58% of participate in the telephone questionnaire. Data was collected
cases. There was 90% compliance for intravenous records and using a standardised pro-forma until responses from 30 carers
5% compliance for inhalation records. were gained.
Personnel present in the surgery were never recorded. Results: In total, 36 carers were successfully contacted between
Conclusion: Results show important information is being omitted June-October 2014; six declined involvement. All carers felt they
from clinical records. A copy of the SDCEP guidelines (Appen- had been given sufficient, clear and easy to understand pre-opera-
dix 2) has been circulated to relevant staff. It was recommended tive information about their child’s procedure. Regarding those
that particular attention be paid to inhalation sedation record children who felt pain (87%)/ felt sick (43%)/ were sick (23%),
keeping. A re-audit is planned for 6 months time where it is the majority of carers felt this was the same as expected (42%,
hoped 100% compliance will be achieved. 62% and 74%, respectively). Eating improved for most patients
post-operatively (63%); sleeping was largely no different (67%).
PR11.05 Overall, 93% of carers were satisfied with the treatment provided
and 97% would recommend the service to friends and family.
Development of a joint paediatric dentistry/oral Constructive comments were received regarding improvements
medicine clinic within a hospital setting required on the ward.
D. ELTAHLAH1, S. HUGHES1, P. ATKIN2 & M. COLLARD1 Conclusions: Carers reported high levels of satisfaction with the
1
Paediatric Dentistry, University Dental Hospital Cardiff, Cardiff, service provided. Feedback suggests carers were given appropri-
UK; 2Oral Medicine, University Dental Hospital Cardiff, Cardiff, ate pre-operative information and side-effects were generally as
UK expected. Collaborative teamwork with ward staff is required to
further improve the carer/patient experience.
Background: Children with oral soft tissue conditions often
require a multi-disciplinary approach. At the University Dental
Hospital Cardiff, a joint Paediatric Dentistry/Oral Medicine ser- PR11.07
vice was recently set up to improve the management of paediatric Parent reported reasons for non-attendance to
patients, both those with soft tissue conditions referred to the appointment at hospital paediatric dental department
Paediatric Dentistry department and those referred to a predomi-
S. WALLEY, K. LEE & S. ALBADRI
nantly adult Oral Medicine Department. Paediatric Department, Liverpool Dental School, Liverpool, UK
Aim: The aim of this service is to improve patient care by using a
multi-disciplinary approach and to ensure children receive care in Background: Little is known about the reasons for child non-
an appropriate Paediatric setting. attendance at specialist dental services, however, improving
understanding of the reasons why children 0 did not attend0 PR11.09

(DNA) is essential if service improvements are to be made.
Patient and parents/carers satisfaction on the joint
Aim: To establish the reasons given by parents for non-atten-
dance and elicit their opinions regarding strategies to reduce orthodontic-paediatric clinic (JOP)
DNAs. R. ALSOURANI1, P. KANDIAH2 & H. DHALIWAL3
1
Design: After project registration with the clinical effectiveness Paediatric Dentistry, University of Leeds, Leeds, UK; 2Paediatric
unit, all children (n = 145) who DNA their dental appointment Dentistry, Leeds Dental Institute, Leeds, UK; 3Orthodontic
at Liverpool University Dental Hospital in October 2013 were Deaprtment, Leeds Dental Institute, Leeds, UK
identified (DNA rate: 22.7%). Parents with available telephone Aims: The aim was to determine if patients and parents were sat-
numbers (n = 113) were contacted, on two occasions, and permis- isfied following their appointment on the JOP clinic. The stan-
sion requested to participate in a structured interview. Questions dard set was 90% satisfaction from parents & patients following
elicited reasons for non-attendance, preferred method(s) of the JOP appointment.
appointment communication and strategies to reduce DNAs. Design: All patients and parents attending the monthly JOP clinic
Results: Forty parents agreed to take part, giving an overall were asked to complete the questionnaires after their appoint-
response rate of 35%. The profile of participants was representa- ment. The questionnaires were given out by the nursing staff.
tive of the non-attending cohort (P < 0.05) in relation to; reason Results: The data collected from Aug 2014-Jan 2015 was analysed
for referral, age and clinic non-attended. Reasons for non-atten- as interim results. There were 6 clinics during this time period
dance included forgetfulness (20%), unaware of appointment with 42 complete and 3 incomplete questionnaires.
(18%) and illness (10%). Text messages were the preferred In terms of the patients, majority seemed to know why they had
method of appointment reminder (50%). Seventy-six percent of been referred (86%). Most of the patients had not been worried
parents suggested strategies to reduce DNAs, from which two about their appointment (62%) and felt that their concerns had
major categories emerged; communication and appointment been listened to by the JOP team (83%) and knew what was hap-
times. pening at the next visit (83%).
A new hospital booking system is being implemented and the In terms of the parents, they too understood why their child had
DNA rate will be monitored. been referred (86%) and the length of time for the appointment
Conclusion: The low response rate appears to be similar to other was acceptable (90%). All parents felt that the JOP team was
surveys of hospital non-attendance. Findings indicate a need to polite and informative.
develop innovative strategies designed to reduce non-attendance Conclusion: The feedback from the initial analysis seemed to sug-
at paediatric dental appointments. gest both patients and parents were happy with the care given on
the JOP clinic. The plan for this review is to continue with the
PR11.08 data collection to gain further feedback.
An audit of complete documentation of allergy status
in the Paediatric Dentistry Department, King’s PR11.10
College Hospital Reasons for and sources of referral to paediatric
A. PATEL1, M. YASIN2, A. LIM2, T. ATIEA2, J. MITCHELL1 & dentistry
M. KABBAN1 M. G. BROSNAN & B. K. DRUMMOND
1
Paediatric Dentistry, King’s College London, London, UK; Oral Sciences, University of Otago School of Dentistry, Dunedin,
2
King’s College London, London, UK New Zealand
Background: Assess whether allergies are accurately documented Background: The University of Otago Paediatric Dentistry service
in dental records for children attending the department. provides contracted care for children referred from throughout
Aim: All children with allergies will have appropriate documenta- Otago and Southland in the South Island of New Zealand.
tion completed in dental records. Therefore it is important to have an accurate understanding of
Design: Retrospective sample: Children with an allergy attending the numbers of referrals and care being requested.
a new patient consultation February 2013 (first cycle) and July Aim: To determine the reasons for and source of referrals to the
2014 (second cycle). A proforma was completed using patient discipline of Paediatric Dentistry at the University of Otago
records to determine documentation of allergies. School of Dentistry.
Results: First cycle: 161 records were assessed, 11 children (7%) Design: Consecutive referral letters for children and adolescents
had known allergies. Second cycle: 251 records were reviewed, 35 were reviewed over a six-month period. The reasons for referral,
children (14%) had known allergies. To facilitate improvement source of referral, age and gender of the child and medical status
results and recommendations from the first cycle were dissemi- were recorded. The children were placed in three different clinics
nated via staff meetings, hand-outs and e-mail. Whether the aller- - undergraduate, postgraduate and staff.
gic substance was written in clinical records on the alerts table Results: Over the six-month period 163 children and adolescents
showed a significant improvement from 15% (first cycle) to 56% attending the Dental School for the first time were reviewed
(second cycle). The orange alert sticker was placed on the front before placement in the different clinics. The majority of children
cover of the clinical records in 31% cases (first cycle) and were referred by Dental Therapists (55%), dentists (19%), emer-
improved to 63% (second cycle). gency (18%). The main reason for referral was for management
Conclusions: The second cycle of this audit highlighted there had of caries including early childhood caries early (50%), challenging
been a marked improvement in the departments’ allergy docu- behaviour (12%), dental anomaly (15%) or medical reasons
mentation particularly placing alert stickers on records and (13%). 81% recorded the medical status. 67% were referred to
recording allergies in the folder cover. Further improvement is the undergraduate clinic and 33% to staff and postgraduates.
necessary to reduce the risk of allergic reactions occurring and Conclusion: This clinical audit highlighted the significant reasons
improved patient safety due to poor record keeping. A third cycle for children and adolescents attending the clinics. It also identi-
is planned following dissemination of recent findings. fied the sources of referral and is allowing us to communicate
more efficiently with the referrers.
PR11.11 Conclusions: Due to a lack of high quality studies, there are no

gold standards for treatment methods for auto transplantation of
Service evaluation of the 0 piggy back0 service
teeth. Appropriate case selection is key in determining success.
provided by Newcastle Dental Hospital Tooth transplants are a viable option for tooth replacement in
V. HIND, Y. S. CHAU, C. R. VERNAZZA, L. BURBRIDGE & the growing child.
M. MOFFAT
Department of Child Dental Health, Newcastle upon Tyne NHS
Foundation Trust, Newcastle upon Tyne, UK PR11.13
Paediatric dental anaesthesia safety: where are we
Background: Clinicians provide an exodontia service for medi-
cally compromised children having other medical procedures
now post-WHO surgical safety checklist?
under general anaesthesia. This takes clinicians away from other S. KHAN & T. KANDIAH
duties and is expensive of their time. Dental and Maxillofacial Department, Surrey and Sussex NHS
Aims: To prospectively evaluate the 0 piggy back0 service provided Healthcare Trust, Redhill, UK
by paediatric dentists to other medical specialities at Newcastle Background: The use of paediatric dental general anaesthesia
upon Tyne NHS Foundation Trust hospitals. (PDGA) is an appropriate way of facilitating care for uncoopera-
Design: Data was gathered using a standard pro forma for all tive children where intervention is justified. In 2009, the imple-
0
piggy back0 procedures seen over a seven month period, June- mentation of the National Patient Safety Agency (NPSA)
December 2014 inclusive of timings, pathways of referral, the ‘Reducing the risk of retained throat packs (TP) after surgery’
specialities involved and the treatment completed. There was a protocol and the ‘World Health Organisation (WHO) Surgical
need to better understand the service with an aim to make it Safety Checklist (SSC)’ ultimately aimed to reduce comorbidity
more efficient. and post-surgical complications. Although developed for general
Results: Seventeen patients were seen with a mean procedure time surgery, their relevance to PDGA is obvious.
of 15 min. However, one patient took all day to be seen(10 h) Aim: To investigate the PDGA team for compliance with the
and the mean waiting time for the other 16 patients was 67 min WHO SSC and NPSA TP usage recommendations.
(range 0–4.3 h) mainly due to delays in theatre running, Ten Design: A standardised data collection form was designed which
patients were seen by consultants, 7 by paediatric trainees on lists incorporated the WHO SSC and NPSA TP recommendations.
from a wide number of specialities. An undisclosed member of the dental team utilised this form to
The cost of this service in terms of staff salary was £101 per collect prospective data. The verbal and documented compliance
patient with 27.88 h, £1373 (£82,318 consultant salary) wasted in were recorded by observing the PDGA team, and assessment of
waiting in theatres. anaesthetic chart, operative notes, and peri-operative care plans
Conclusions: Information to be shared with medical specialities to respectively.
encourage closer liaison and to increase the amount of notice Results: The first cycle (n = 100), showed higher verbal compli-
given for procedures. Aim to limit the wasted time in theatre. ance to WHO SSC (up to 99.5%) than documented compliance
Need for a paediatric dentist available at children0 s hospital on (82%). TP checks/documentation were also assessed with compli-
set sessions on a regular basis. ance falling as low as 68% in areas. After training and updating
the PDGA team the second cycle, nearing completion, has shown
PR11.12 significant improvements in adherence to set gold standards.
Conclusion: SSC and TP usage checks play important roles in the
An audit of Auto transplantation cases carried out at
PDGA setting. Effective team working accompanied with regular
Birmingham Dental Hospital from 2006 to 2014 training and audit will ensure that we are always improving our
D. SHELAT & A. JAMES standards of care delivery and that patient safety is kept at the
Paediatric Department, Birmingham Dental Hospital, Birmingham, forefront.
UK
Background: Auto transplanted teeth provides an extra treatment PR11.14
modality in the armamentarium of replacing teeth. Auto trans- An audit for preformed stainless steel crown
plants can provide an aesthetic outcome with high success rates.
These can form an alternative to a removable prosthesis in the
documentation: indications for placement and post
growing child and implants in later life. operative instructions
Aim: To establish the number of viable and aesthetic teeth pres- S. A. ALRAEESI & M. ALHALABI
ent following their auto transplantation. Our further objectives Paediatric Dentistry, Dubai College of Dental Medicine, Dubai,
were to identify factors that would contribute to a successful out- United Arab Emirates
come and establish a recommended protocol for this procedure.
Background: Stainless steel crowns (SSCs) are prefabricated
Design: This was a retrospective audit of 21 clinical cases out of
crown forms adapted to individual primary molars and cemented
a possible 24. Various parameters were investigated including:
to provide a definitive restoration. Indications for placement of
reason for transplant, stage of development of the donor tooth,
SSCs are documented in the literature. Accurate delivery and
pre-operative assessments, surgical technique, splinting method
documentation of Post operative instructions as well as documen-
and duration, postoperative care, subsequent dental treatment
tation of indications for SSCs placement are essential compo-
and any complications.
nents in providing the highest quality care.
Results: 87% of our auto transplanted teeth were viable, aesthetic
Aim: The aim of this audit was to assess the documentation of
teeth post auto transplantation with 67% of cases being carried
the indications for placement of SSCs in primary molars as well
out due to dental trauma. In 61% of cases the donor tooth had
as the post operative instructions given to the parents after SSC
an open apex, all cases had pre-operative radiographs and were
insertion in the paediatric department.
splinted post-surgery. 24% required occlusion altering devices
Design: Data was collected by case note evaluation of all SSCs
post operatively in the healing period and 57% received antibiot-
placed in the paediatric clinic for a six month period. Documen-
ics. Post-surgery 83% of teeth were built up with composite and
tation of the SSCs indications including SSCs’ insertion after
all cases went onto orthodontic treatment.
pulp therapy and documentation of post operative instructions
after insertion of SSCs were measured. The results were analyzed two stages: Theoretical lecture, “PFDI in Children”, was pro-
using Simple descriptive statistic. vided first, and followed by a lecture supported by video record-
Results: During 49 dental visits, 135 crowns were inserted. The ings of real clinical case demonstrations. Students’ opinions were
indications for placement of SSCs were documented in patients’ evaluated by means of a questionnaire administered before, dur-
files in 131 out of 135 cases (97.1%). In 70 cases out of 70 ing and after the lectures.
(100%), SSCs were inserted on pulpally treated molars. In 29 out Results: Before the study, only 47.9% of students believed in the
of 49 visits (59.2%) post operative instructions were documented possibility of PFDI in children, whereas after the study the per-
in patients’ files. centage had risen to 67.7% (P = 0.0001). Theoretical lecture was
Conclusions: The findings from the audit highlight many areas of found to be statistically more effective in changing opinions of
good practice that were observed. A second cycle of the audit will students than than video assisted lecture (P = 0.0001).
be conducted to re-evaluate the compliance with the recommenda- Conclusions: Theoretical lecture was found to be effective in
tions given for those aspects that fell short of the standards. changing opinions of PFDI. Effectiveness of a video assisted lec-
ture in changing the opinions of dental students toward PFDI
PR11.15 was found to be inconclusive.
Audit of paediatric dental referrals into a community

PR11.17
dental service requiring treatment plan modifications
1
S. L. CHARNOCK & R. WASSALL 2 What is the burden of care for adolescent dental
1
Northumbria Community Dental Services, Newcastle Upon Tyne, patients? A service evaluation
UK; 2School of Dental Sciences, Newcastle University, Newcastle J. K. E. HOOK1, T. PARK2, S. ALBADRI1 & M. M. F. SKENE3
1
Upon Tyne, UK Paediatrics, University of Liverpool, Liverpool, UK; 2University
of Liverpool, Liverpool, UK; 3Paediatrics, University Dental
Background: To assess the documentation of treatment plans for
Hospital Manchester, Manchester, UK
referred paediatric patients from general dental practitioners
(GDPs) to Northumbria community dental services (NCDS), to Background: Adolescent patients can have many oral health
improve understanding of the patient journey and communica- problems. Social issues, diet and other factors can increase oral
tion between services. disease incidence.
Aim: To evaluate the proportion of referrals from GDPs to Aim: To determine the burden of care for adolescent dental
NCDS resulting in changes to the GDPs requested treatment patients with caries presenting to a specialist paediatric dentistry
plan by community dentists. At a local level, the clinical team unit and identify potential barriers to care.
agreed the standard for the audit: 90% of GDPs requested treat- Design: The project was registered with the clinical effectiveness
ment plans should be followed. unit. All new patients aged 12–16 years presenting to the unit
Design: A retrospective random sample of 69 referrals, from 1st between September 2013 and February 2014 were invited to com-
January to 31st March 2014, was collected from the referral log- plete a questionnaire at initial consultation. A proforma was
books at four main NCDS clinics. The patient records were completed to gauge anticipated dental need.
reviewed and the information gathered into an electronic data Results: Thirty one patients participated. The main diagnosis was
collection form. of dental caries, the average DMFT was 6. Ninety percent
Results: Of the 69 referrals audited, 58 referral letters (84.0%) (N = 28) reported suffering at least one episode of toothache, just
from GDPs had specified treatment plans, however 38 children over half (52%, N = 16) stated the pain had kept them awake at
required NCDS to formulate a different treatment plan (65.5%). night. Only sixty seven percent (N = 22) reported attending for
Following assessment at NCDS, 68 patients (98.5%) had an ite- regular recall appointments.
mised treatment plan recorded and this was followed for 51 A Visual Analogue Scale (VAS) was used to assess the partici-
(75.0%) patients. 16 patients required the treatment plan to be pants’ attitudes to oral health and treatment. Relating to motiva-
modified, and for 13 the updated treatment plan was documented tion towards oral health, the mean score was 7.2. With regards
prior to continuing active treatment. to how worried participants were before attending the dentist,
Conclusions: The audit highlights the need to actively manage the the mean score was 5.6.
referral process into NCDS to support staff and provide a high Free text responses showed many children were most concerned
quality, safe and caring service. Therefore, one audit recommen- about the use of needles. When asked if there was anything that
dation is to explore an electronic dental referral portal to enable would make it easier for them to attend some stated ‘pain free’
management of the referral process, and improve communication and treatment without using needles.
between GDPs and NCDS. Conclusions: The main barrier to these patients accessing dental
care was anxiety and phobia of needles. There is a demand for
PR11.16 tailored adolescent dental care.
Role of a 0 video assisted lecture’ on changing

PR11.18
Albanian undergraduate students’ opinions regarding
pain free dental injections in children Teaching of overlapping subjects in paediatric
O. O. KUSCU1, D. HYSI2, E. CAGLAR1, C. TOTI2 & E. dentistry
DROBONIKU2 C. V. LYTTLE, F. R. STOOPS, A. CRIGHTON & R. R.
1
Private Dental Office Istanbul/Tirana, Istanbul, Turkey; 2School WELBURY
of Dentistry, Tirana University, Tirana, Albania Paediatric and Oral Medicine Departments, University of Glasgow,
Glasgow, UK
Aim: To assess the effectiveness of a video assisted lecture in
changing the opinions of dental students toward pain free dental Background: Undergraduate UK teaching to satisfy the General
injections (PFDI) in children. Dental Council should demonstrate interdisciplinary and inter-
Design: The Fifth grade students (n:62) of University of Medicine professional education and learning. Paediatric Dentistry is “den-
of Tirana, Facuty of Dental Medicine participated in the study. tistry in miniature” as aspects of all dental specialties are relevant
Informed consents were obtained. The study was conducted in in child dental care.
Aim: Investigate the level of integration of paediatric dentistry PR11.20

with other dental subjects in UK and Ireland dental schools.
Prescribing audit based in a paediatric dentistry
Identify areas where collaborative teaching would be most benefi-
cial. hospital department
Design: Internet delivered questionnaire to teaching leads in Pae- D. SINGH, M. LAU, F. MCDOWALL & C. CAMPBELL
diatric Dentistry in the UK and Ireland. Oral Health Directorate, NHS Greater Glasgow and Clyde,
Results: 14 dental schools responded. All had collaboration in Glasgow, UK
course planning or delivery in the subjects investigated, but not Background: Antimicrobial resistance is recognised by the World
all subjects in all schools. Most frequent were Orthodontics Health Organisation as a serious threat to public health and
(85%) and Oral Medicine (62%) with Human Disease (38%) and restricting antibiotic prescribing to cases clinically appropriate is
Periodontology (23%) lowest. Half of respondents had no collab- necessary. In addition, all medicines prescribed should be justified
orative teaching in Radiology or Oral Surgery. This level of and documented clearly.
cooperation was felt appropriate for 70% respondents consider- Aim: Based on a pre-approved audit which was developed by
ing Radiology and Orthodontics falling to 50% for Oral Medi- NHS Education for Scotland’s Translation Research in a Dental
cine and 45% for Human Disease. Most respondents felt the Setting. The aims included:
time allocated in other disciplines for teaching Paediatric topics To review antibiotic prescribing to ensure best practice guid-
was correct (mean 73%). Respondents outlined the key areas of ance is being followed.
other dental disciplines that are important for collaborative Consider alternatives to antibiotic prescribing.
teaching with Paediatric Dentistry. Review prescribing of all medicines for quality of prescriptions
Conclusion: There is variation in collaborative paediatric dental and the necessary paper work.
teaching in UK and Ireland dental schools. Orthodontics has Implement changes to meet guidance recommendations, if
most interaction but some core areas, (Radiology and Oral required.
Surgery) have no integration in course planning or delivery in Design: The standards were based on:
50% of responding schools. This could impact the student’s view The Scottish Dental Clinical Effectiveness Programme’s Drug
of dental care of the child and may not meet regulatory Prescribing for Dentistry guidance.
standards. The General Dental Council standards.
26 prescriptions and patient notes were retrospectively examined.
PR11.19 The medicine prescribed, the reason why and whether an up-to-
The use of dental dam during pulp therapy in date medical history was recorded was noted. For antibiotics, the
notes were checked for a record of the clinical symptom and fac-
paediatric patients tors influencing the decision to prescribe an antibiotic and, if so,
B. H. GHAITH, M. ALHALABI & M. KOWASH what type.
Paediatric Dentistry, Dubai College of Dental Medicine, Dubai, Results:
United Arab Emirates Eight antibiotic prescriptions were included, 50% with no clini-
Background: Microbes play a major role in the pathogenesis of cal symptom recorded in the notes.
pulpal pathology and can reduce the overall success rate of the 18 other medicines including toothpaste and chlorhexidine
root canal treatment. Dental dam (DD) is effective in eliminating were prescribed, with 44% having no recorded justification.
microbial contamination from the operating field during end- 46% of the patients had no up-to-date medical history.
odontic therapy. The UK National Clinical Guidelines on pulp Conclusions: Full compliance with the standards was not met.
therapy for primary molars recommend the use of DD for all Recommendations have been communicated with the department
pulp therapy procedures. and the audit will be repeated in 3 months time.
Aim: To assess whether the paediatric dentists are using DD dur-
ing pulp therapy for both primary and permanent teeth in Dubai PR11.21
College of Dental Medicine paediatric clinic.
Fluoride varnish application in paediatric patients and
Design: Data were collected retrospectively from the electronic
patient files during a 6 months period. A data sheet was used to the role of incentivisation in improving clinician
record the pulp therapy type, whether the procedure was per- behaviours
formed under local or general anaesthesia, the use of DD, rea- F. R. STOOPS, E. DUNBAR, F. HOGG & C. CAMPBELL
sons for not placing DD and the child’s Frankl rating. Paediatric Dentistry, Glasgow Dental Hospital, Glasgow, UK
Results: A total of 86 pulp therapy procedures were performed.
Background: A Cochrane review found young people treated with
The overall percentage of using DD during pulp therapy was 65%
fluoride varnish (FV) experienced on average a 43% reduction in
(56 out of 86). Out of the 30 cases performed without the use of
decayed, missing and filled tooth surfaces (DMFT).1 A Scottish
DD, only 4 cases had documentation of the different reasons.
Government Heat Target focused on topical fluoride preventive
Conclusions: More than half of the pulpal procedures were per-
strategies “at least 60% of 3 and 4 year olds in each SIMD
formed under the isolation of DD and the majority were docu-
quintile are to have fluoride varnishing twice a year by March
menting it; however there were deficient areas in the
2014.2” Monitoring FV application rates (FVA) and implement-
documentation; especially the reasons for not placing it. A staff
ing clinician behaviour change designed interventions are
meeting was held to present the findings and encourage the prac-
required to meet these targets. 3
titioners to utilize the DD while performing pulpal therapeutic
Aims:
procedures. Re-audit cycle is planned after 6 months.
1. To evaluate the impact of a quality improvement project (QIP)
at Glasgow Dental Hospital to improve FVA rates.
2. To identify whether personal feedback and incentivisation
improve FVA rates.
A target of 80% compliance for FVA was set by the Department
of Paediatric Dentistry (GDH).
Design: Treatment sessions were randomly selected each week, the diagnostic yield of these investigations is unclear. Therefore
including all grades of staff. Notes were analysed to determine the benefit of performing these investigations routinely has not
FVA rates. The results were then communicated to the staff, with been established.
‘Fluoride Leader boards’ to highlight performance, with the lea- Aim: To investigate the diagnostic yield of pre-operative phle-
der receiving a small reward. botomy (excluding haemoglobin electrophoresis) in healthy pae-
Results: A positive shift has already been identified in the depart- diatric patients and any resultant alteration to patient
ments QI results for FVA rates, although this is not consistently management.
met. 4 Design: This retrospective service evaluation examined the case
There is further evidence of improvement since using behavioural notes of all patients under 16 years of age who had a GA for
change methods. The competitive nature of the leaderboard and dental treatment between 01/03/2013 and 30/09/2013. All healthy
the incentivisation programme may be the main drivers. patients with pre-operative phlebotomy were identified, and their
Conclusions: Tailoring implementation interventions to barriers cases were followed to completion. Indication for all tests was
based on behaviour change strategies has lead to improvements. recorded, along with diagnostic yield, change to clinical manage-
Further work on this is required to investigate if these improvement and intra-operative complications associated with this
ments can be maintained. result.
Results: Interim results show that of 11 patients who had pre-
PR11.22 operative investigations, two had abnormal results. No patient
required altered pre-operative or intra-operative management as
The utilisation of theatre time for paediatric dental a consequence of these blood results.
care using propofol intravenous sedation Conclusions: The findings of this service evaluation highlight the
K. L. SWALES1, L. MCCLEAN1, V. SRINIVASAN1, S. ROLFE2 importance of ensuring that pre-GA phlebotomy is only ordered
& M. THIRUKKAMU2 when clinically relevant. A number of factors must be considered,
1
Department of Child Dental Health, University Dental Hospital including the psychological ramification of phlebotomy for chil-
Manchester, Manchester, UK; 2Department of Anaesthetics, Royal dren who may be anxious and the financial implications of these
Manchester Children’s Hospital, Manchester, UK interventions. This will help ensure the appropriate allocation of
NHS resources. The results of this service evaluation will inform
Background: The use of intravenous sedation (IVS) to provide
departmental policy regarding appropriate pre-GA phlebotomy.
dental treatment in the anxious paediatric patient is safe and well
tolerated. The Department of Health uses key performance indi-
cators to set targets for improvements in efficiency and standards PR11.24
of service in theatre utilisation. Antibiotic prescribing practices of East Surrey
Aim: The aims of this prospective study was to assess the effi- Hospital Dental and Maxillofacial department
ciency and utilisation of theatre time within the paediatric IVS T. KANDIAH, A. PATRICK & T. STOKES
service.
Dental and Maxillofacial Dept, East Surrey Hospital, Redhill, UK
Design: A total of 50 consecutive episodes of dental treatment
using IVS for suitable paediatric patients meeting the AIVS selec- Background: There is considerable use of antimicrobial therapy
tion criteria (for UDHM) were audited over a period of within the dental profession. With the rise in antibiotic resistance
7 months. A data capture sheet was used to record data on oper- the judicious use of antibiotics must be regulated, appropriate,
ating times and possible influencing factors; patient demograph- and evidence based.
ics, clerking, anaesthetic view, cannulation and treatment, Aim: This retrospective audit is designed to examine antibiotic
recovery and discharge. The utilisation of theatre time was calcu- prescribing practice within the dental department at East Surrey
lated to evaluate the proficiency and productivity of the service. Hospital and to compare this process with national guidelines
Results: In total 50 patient contacts were recorded for the audit, (SDCEP, FGDP, NICE).
of these 40 patients were treated. Only a third of sessions saw the Design: 100 patients’ clinical records were to be analysed, 50
optimum number of patients treated, theatre utilisation (55%) patients from the Emergency Dental Service (EDS) and 50
and compliance to NHS best practice indicators was recorded as patients seen within dental outpatients, per audit cycle. Assess-
below the national standard (77%). Suggestions for improvement ment included age, gender, and GDP registration status as well
and an action plan was implemented to be used in the second as clinical diagnosis, temperature, appropriateness of prescrip-
audit cycle. tion, and the complete detail of the antibiotics prescribed.
Conclusions: The findings from the present study highlight the Results: First cycle showed 100 prescriptions were recorded in
importance of auditing theatre timings and compliance with best clinical notes, 94 recorded with all essential information. Seventy
practice indicators in order to improve efficiency, reducing cos- two had no documented diagnosis and 62 gave no indication for
tings, waiting lists and patient experience as a consequence. antibiotics; 22 patients had local measures alongside antibiotics.
Overall, 884 patients were seen, 614 (69%) were issued a pre-
PR11.23 scription. Changes were implemented including further training,
a logbook, and proformas.
A service evaluation of diagnostic yield of pre- Second cycle near completion; early results indicate decreased use
operative phlebotomy for healthy paediatric dental of antimicrobial therapy, near complete compliance with record
patients receiving treatment under general anaesthetic keeping, and an increased percentage of notes recording tempera-
L. RIDSDALE1, S. BARRY2 & R. BALMER1 tures, diagnosis and clinical justification.
1 Conclusions: There is significant use of antimicrobial therapy pre-
Department of Paediatric Dentistry, Leeds Dental Institute,
Leeds, UK; 2Department of Paediatric Dentistry, University dominantly within the EDS, and areas where 100% compliance
Dental Hospital Manchester, Manchester, UK is not being attained. The measures implemented after the first
cycle have made a significant improvement to reaching national
Background: Current NICE guidelines do not recommend routine guidelines regarding prescribing practices, however further meth-
pre-operative phlebotomy for healthy children undergoing gen- ods need to be developed for continual improvement.
eral anaesthetic (GA) for dental procedures. Phlebotomy investi-
gations are often performed at the discretion of the surgeon, but
audit the documentation in patient records. There were 24 and

PR11.25
30 items to be recorded for inhalation sedation (IS) and intrave-
Audit of 0 Did Not Attend0 (DNA) appointments for nous sedation (IV) respectively. The data for Round 1 was col-
0–16 year old children across Leeds Community lected retrospectively, for about 20 cases per dentist. A meeting
Dental Service (CDS) was held to discuss the findings of Round 1 and to identify areas
M. KALKANI1 & S. KINDELAN2 of improvement in record keeping. Second round data were then
1
Paediatric Dentistry, University of Leeds, Leeds Dental Institute, collected prospectively. A target of 80% compliance was set for
Leeds, UK; 2Paediatric Dentistry, Leeds Community Dental both rounds.
Service, Leeds, UK Results: A total of 12 dentists took part in Round 1; while one
dentist withdrew in Round 2. Round 1: 99 IS and 140 IV records
Background: There are many reasons for a child not to be were audited. Percentage of items which achieved 80% compli-
brought to a dental appointment. In some cases, failure to attend ance was 37%. Round 2: 55 IS and 118 IV records were audited.
raises concerns about safeguarding. Repeated non-attendance for Percentage of items which achieved 80% compliance increased to
health appointments should be seen as an alert for possible child 100%.
neglect. Leeds CDS treats a very vulnerable patient group, Conclusions: The audit was successful in improving the documen-
including children with medical comorbidities, learning disabili- tation of conscious sedation in primary dental care.
ties and children with pre-existing safeguarding concerns.
In 2013, Leeds Community Healthcare Trust (LCHT) produced
a DNA protocol, which described clinicians’ responsibilities fol-
PR11.27
lowing individual patient risk assessment. An audit comparing record keeping in electronic and
Aim: Identify children who were not brought to dental appoint- paper formats on a paediatric dentistry student
ments and ensure LCHT protocol is followed. teaching clinic
Design: 1st cycle: Computer records of all children who had K. L. O’DONNELL1, A. MAXWELL2, W. ANDERSON3, V.
failed to attend in May 2014 were reviewed and evidence of the SHADRICK3, G. L. RICHARDSON4 & J. I. FOLEY5
following was recorded: 1
2
Risk assessment and action plan by the dentist Charles Clifford Dental Hospital, Sheffield, UK; 3University of
Documented discussions with parents/carers/other profes- Aberdeen, Aberdeen, UK; 4Glasgow Dental Hospital, Glasgow,
sionals UK; 5Edinburgh Dental Institute, Edinburgh, UK
Administrative staff action Background: At completion of undergraduate training, dental stu-
Actions: dents are expected to fulfil criteria laid out by the General Dental
Meeting with the LCHT safeguarding team regarding DNA Council(GDC) in the “Standards for Dental Professionals” docu-
letters ment. This includes guidance regarding record keeping. As
Training to the dental team regarding the protocol increasing numbers of dental practices move to electronic patient
2nd cycle (March 2015): Re-audit, using the same inclusion crite- records(EPR), it is essential that an equal standard of record keep-
ria, and comparison with previous results. ing is maintained when compared to paper-based records(PBR).
Results: 1st cycle: 108 children failed to attend their dental Aim: To compare the quality of record keeping in the Depart-
appointments across Leeds CDS during May 2014. 54% did not ment of Paediatric Dentistry at the University of Aberdeen Den-
have a risk assessment recorded and 41% did not have a docu- tal School and Hospital prior to and following the introduction
mented action plan. 50% of “high-risk” DNAs were not ade- of EPR on the undergraduate student clinic.
quately followed-up. Design: In Round 1, 150 patient records were examined retro-
2nd cycle: results will be presented and further action plan deter- spectively (50PBR and 100EPR) from patients who had attended
mined. the department for an examination with a fourth year dental stu-
Conclusions: Successful implementation of LCHT protocol will dent. Data were collected for various demographic and clinical
enable dealing with DNAs consistently, promote attendance and criteria and added to a Microsoft Excel spreadsheet. Six months
safeguard vulnerable children. elapsed, and data collection for Round 2 (100 EPR) was com-
pleted as in the first round.
PR11.26 Results: Recording of patient demographics was maintained at
>95% throughout round 1 and 2. Medical history recording
An audit of documentation of conscious sedation in decreased in EPR in Round 1 and 2 when compared to PBR.
primary dental care Improvements were noted in recording of dental charting in EPR
C. A. YEUNG1 & S. A. KHAN2 round 1, while recording of treatment plan and diagnosis
1
Public Health, NHS Lanarkshire, Bothwell, UK; 2Hamilton decreased in EPR round 1 and 2.
Dental Centre, Hamilton, UK Conclusions: The quality of record keeping obtained with the
Background: In June 2012, the Dental Clinical Effectiveness Pro- EPR appeared to be inferior in some areas compared to the
gramme (SDCEP) published the second edition of the dental clin- PBR. Feedback on the EPR has been provided to staff- and stu-
ical guidance on Conscious Sedation in Dentistry dent groups and re-audit is recommended.
(www.sdcep.org.uk/?o=2331). It recommends the documentation
for each patient includes details of pre-sedation assessment, the
visit for dental treatment under conscious sedation, the treatment
procedure and the recovery.
Aim: To audit the documentation of conscious sedation in pri-
mary dental care.
Design: All dentists in Lanarkshire Health Board who conducted
conscious sedation were invited to participate in this audit. Based
on the recommendations of the SDCEP guidance on conscious
sedation in dentistry, a data collection form was developed to
PR11.28 initial missed appointment, 48% of patients had incomplete treat-

ment and were at risk of ongoing pain.
Current referral trends for paediatric dental
Conclusion: The findings from the present study highlight defi-
extractions under general anaesthesia at the ciencies in practitioner management of non-attendance. A depart-
University Dental Hospital, Cardiff mental protocol has been developed to aid practitioners in
L. DAVIES, A. SPRINGALL, S. KING & M. COLLARD identifying patients at risk of dental neglect to ensure continuity
Paediatric Dentistry Department, University Dental Hospital, of care, communication with relevant professionals and to pro-
Cardiff, UK mote safeguarding of paediatric dental patients.
Background: Despite efforts to improve levels of oral health in
Wales, there is still a high demand for paediatric dental extrac- PR11.30
tions under general anaesthetic (GA) at the University Dental A survey of paediatric dentistry undergraduate
Hospital (UDH), Cardiff. teaching in the UK
Aim: To evaluate the nature of the GA referrals, the average
W. HAYAT & S. SOOD
patient profile, effectiveness of the pre-operative assessment pro-
Paediatric Dentistry, Kings College London, London, UK
cess (compared to 2011 National Clinical Guidelines) and the
subsequent management of these patients. Background: The General Dental Council (GDC) sets educational
Design: Data collection form completed for each patient on all standards for dental schools in the United Kingdom (UK) to
GA assessment clinics at the Paediatric Dental Unit, UDH, Car- guide undergraduate education. There are many challenges faced
diff, for eight months (July 2012-March 2013). by the Universities to provide the perfect educational experience
Results: Of the 288 referrals for paediatric dental GA in this per- and this is recognised by the GDC.
iod, 92% of patients proceeded to extraction of teeth under GA. Aim: To assess the current teaching of paediatric dentistry, at an
The majority (84%) of patients required extraction of deciduous undergraduate level, across UK dental schools.
teeth, with an average number of 6.6 teeth being extracted per Design: Online questionnaires were emailed to the course leaders
patient. 41% of the population studied were aged five years or in each of the UK dental schools. Results were analysed.
younger, with a mean age of 6.6. Only 1.4% of cases were Results: There was a wide variation in the teaching and experi-
deemed suitable for treatment under a different behavioural man- ences of paediatric dentistry across the 11 dental schools, which
agement modality. The 2011 National Clinical Guidelines for the responded. The variation occurred in the number of students per
use of GA in Paediatric Dentistry were closely followed. year (50–160). The didactic teaching methods varied: number of
Conclusion: Of those patients who were assessed on the GA lectures ranged (6–35), seminars (10–35), clinical skill laboratories
assessment clinic very few were deemed suitable for treatment (2–36) and joint lectures (0–15). Clinical teaching occurred in
under different behavioural management modalities. This may dental hospitals and outreach clinics. Clinical procedures are
have been partly due to the stringent vetting of referrals before taught in all dental schools but the students clinical experiences
patients are allocated to this clinic. Caries in the deciduous denti- varied. Non-specialist teachers teach the majority of students and
tion was the most common cause for referral, with a large per- there is a wide variation in the format of examinations and in
centage of referred patients being under the age of five. course assessment.
Conclusion: A comprehensive insight into the range of undergrad-
PR11.29 uate paediatric dentistry experience gained by students has been
achieved and lack of harmonisation can be seen. Standardisation
Non-attendance of paediatric dental patients: an in course assessment and didactic could be achieved with integra-
audit to assess practitioner action tion and communication with the Universities. Standardisation of
S. BHATIA1 & S. HUGHES2 clinical teaching may be difficult due to the variation of disease
1
Paediatric Dentistry, University Dental Hospital Cardiff, Cardiff, and populations in the UK. However, a “gold standard” blue-
UK; 2University Dental Hospital Cardiff, Cardiff, UK print in undergraduate paediatric dentistry is needed to harmo-
nise academic teaching.
Background: Dentists have a statutory duty of care to protect
patients. Repeatedly failing to attend essential follow up appoint-
ments that are necessary for a child’s health and wellbeing may PR11.31
alert practitioners to safeguarding issues, including those of dental An audit of parent satisfaction in a paediatric dental
neglect (NICE 2009). Sharing relevant information with other department, Eastman Dental Hospital, UCLH
professionals is vital to ensure safeguarding of paediatric patients.
M. NEIL & A. JOHNSON
Aim: The aim of this audit was to assess how practitioners are
Department of Paediatric Dentistry, Eastman Dental Hospital,
managing non-attendance at the unit of Paediatric dentistry,
London, UK
UDH, Cardiff; to identify deficiencies and to produce a protocol
to promote safeguarding. Background: Patient and parent feedback / satisfaction is a fun-
Design: Data was retrieved of 100 patients who missed appoint- damental component of good clinical governance. Questionnaires
ments and information obtained about demographics, medical, are often used to seek information from parents in paediatric
dental and social histories, number and type of missed appoint- areas completed with the child0 s input.
ments. Information regarding practitioner action in response to Aim: To determine the current levels of satisfaction amongst par-
non-attendance was collected within a 6 month time frame, ents of paediatric patients and compare these with the two previ-
including access to ongoing care and communication with other ous audit cycles carried out in 2009 and 2012.
professionals. Design: Parents were asked to complete a questionnaire with 38
Results: Dental caries (56%) was the most common dental prob- questions relating to all topics including environment, staff and
lem among patients who missed appointments. In most cases waiting times over a 3 week period. The gold standard was
(41%) patients were discharged following their missed appoint- 100% satisfaction in all areas. This had not been previously
ment(s). The families were communicated in 74% of cases and achieved and therefore improvement in previous weak areas was
other professionals in 70% of cases. At 6 months following their examined.
Results: Following a pilot of 10 questionnaires, a total of 75 and at follow-up. Radiographs were independently reviewed by
questionnaires were completed. Parent satisfaction was positive two calibrated examiners.
in most aspects of care but areas for improvement are in raising Results: Data of 25 non-vital immature incisor teeth (n = 25)
awareness of the hospital play specialist and future appointment from 24 patients were analysed. Mean age at initial trauma was
arrangements. The best feedback was in relation to interactions 7.7 years (range 6–11) and mean duration of treatment was
with the reception staff, nurses and dentist. 10.4 months (range 1–23).
Conclusions: As the standard was not fully met, organisational Pre-operative discolouration was noted by both clinician and
changes have been implemented and hospital play services pro- patient in 24% of cases (n = 6/25). Immediate clinical outcomes
moted as they are not fully utilised. A fourth cycle will be carried revealed 92% (n = 22/25) were asymptomatic and 8% (n = 3/25)
out in 12 months time. had an associated sinus. Immediate radiographic outcomes con-
firmed 72% (n = 18/25) had a satisfactory Biodentine plug, 20%
PR11.32 (n = 5/25) were under-extended and 8% (n = 2/25) poorly con-
densed. Periapical pathology was evident in 88% (n = 22/25) of
Acceptability and efficacy of nitrous oxide inhalation cases.
sedation from a parent/patient perspective At follow-up (range 4–7 months), 16 teeth (n = 16/25) were
A. B. AMMARI reviewed. All were asymptomatic, one patient (n = 1/16) reported
Soho Centre for Heath and Care, Community and Specialist discolouration. There were radiographic signs of periapical heal-
Dental Services, Central London Community Healthcare NHS ing in 81% (n = 13/16) of cases.
trust, London, UK Conclusions: This service evaluation highlights that Biodentine is
an effective and inexpensive material for root-end closure yielding
Background: Nitrous oxide inhalation sedation (IS) has been
good patient satisfaction and clinical outcomes. Further studies
reported to be an ideal technique for managing paediatric dental
are required to fully evaluate success.
patients with dental anxiety.
Aim: To determine child patient and parent acceptability and effi-
cacy of IS for dental treatment in a specialist paediatric dentistry PR11.34
community setting. Assessment of the reason for referral to secondary
Design: Twenty prospective, questionnaire-based surveys were care and the assessment therein of children with
undertaken between 1st September 2014 and 1st December 2014
in Soho Centre for Heath and Care. Following verbal explana-
Molar Incisor Hypomineralisation
tion, informed consent was obtained to participate. Survey ques- M. AL-CHIHABI & S. BARRY
tionnaires were completed separately by the patient and the Paediatric Dentistry, Manchester Dental Hospital, Manchester,
parent following the first dental treatment using IS. UK
Results: Patients were five males and five females; mean age Background: Molar Incisor Hypomineralisation (MIH) is a com-
8.2 years (range: 5.1–11.5 years). Five patients had extractions mon dental anomaly in the paediatric population with a reported
only, four patients had restorative treatment and one patient had prevalence of between 5.6 and 37.3%. The majority of patients
a combination of both. Nine patients had local anaesthetic (LA). are managed in primary care with only a subset attending sec-
All parents and 70% of patients felt that IS was required for ondary dental care. Greater understanding of the reasons for
treatment. Fewer patients (80%) than parents (100%) felt that referral to secondary care and evaluation of the initial secondary
the patient coped with IS. All parents and 88% of patients care appointment may assist in service development for these
thought that IS helped with LA. Ninety percent of parents and patients.
80% of patients thought that IS helped with dental treatment. Aim: To assess the reason for referral to secondary care and the
None of the parents and only 20% of patients thought the assessment therein of patients with MIH.
patient will cope in the future without IS. All parents and Design: A retrospective audit of fifty sets of patients’ notes was
patients felt that the treatment has met their expectation. All par- undertaken. Information that was deemed to be essential for a
ents would recommend us to their friends and only one patient referral letter and secondary care assessment was prospectively
would not. agreed and a proforma was developed. The gold standard was
Conclusion: Both patients and parents were satisfied with the ser- inclusion of all essential information.
vice and the efficacy of IS for dental treatment. Results: Seventy percent of patients were referred for a second
opinion. Other reasons for referral included pain and sensitivity
PR11.33 (20%) and aesthetic concern (10%). In only 7/50 cases however
was the referring diagnosis MIH, with misdiagnoses including
An evaluation of the use of biodentine as an apical hypoplasia, fluorosis and amelogenesis imperfecta. At the second-
barrier ary care appointment, relevant medical history was recorded for
S. C. HUGHES, A. WALLACE & H. ZAITOUN only 42% of patients. 10 patients required a further referral to
Department of Paediatric Dentistry, Charles Clifford Dental an orthodontist.
Hospital, Sheffield, UK Conclusion: Although well described in the literature this retro-
Background: Apexification for non-vital immature incisors can be spective audit suggests that diagnosis of MIH may need to be
induced chemically with calcium hydroxide or by placement of a improved in primary care settings. It also highlights the need to
barrier with materials such as Mineral Trioxide Aggregate and improve the investigation of MIH in secondary care. These defi-
Biodentine. There are no studies evaluating the use of Biodentine cits may be improved by the development of national guidelines
in this application. for the management of these patients.
Aim: Evaluate the clinical and radiographic outcomes of root-end
closure for non-vital immature incisors using Biodentine.
Design: Clinical and radiographic records of patients who
received treatment with Biodentine were retrospectively reviewed.
Age at initial trauma, root development, treatment provided and
patient satisfaction; were recorded pre-treatment, post-treatment
PR11.35 with operator status, procedures undertaken, and any complica-

tions encountered.
Pediatric dentistry undergraduate program:
Results: 224 patients in total were seen over 34 lists. Overall, the
comparing students performance before and after theatre was in use for 78.02% of time available, combining
curriculum reorientation anaesthetic and operating times. Lists started an average of
A. E. HADDAD1, M. C. SKELTON-MACEDO2, J. S. L. 9 min late and finished an average of 39 min early.
ROMERO1, D. P. RAGGIO1, C. J. F. ALENCAR3 & M. S. Conclusions: Slightly above average theatre utilisation time com-
BONECKER1 pared with a national gold standard of 77%. Suggested main
1
Orthodontics and Pediatric Dentistry, University of Sao Paulo/ improvements to be made to further increase efficiency: decrease
Faculty of Dentistry, Sao Paulo, Brazil; 2Teledentistry Center, delays to the start of the list, decrease delays between patients;
University of Sao PauloPaulo/Faculty of Dentistry, Sao Paulo, improved planning to reduce any significant over- or under-run-
Brazil; 3Pediatric Dentistry, University Paulista/Faculty of ning, and introduction of a stand-by list to reduce impact of
Dentistry, Sao Paulo, Brazil patients failing to attend.
Background: The undergraduate course at the Faculty of Den-
tistry, University of Sao Paulo (FOUSP) underwent recently a PR11.37
curricular restructuring in order to meet the National Curriculum Developing an oral health clinical practice guideline
Guidelines. It has been supported by the Ministry of Health, as for a children’s hospital
many other courses all over the country, through the National
K. J. OLIVER1, M. HO2, T. A. PARSONS1, P. J. JUDD1 & M. J.
Program of Reorientation of Vocational Training in Health and
CASAS1
the Education Program for Work in Health. The new curriculum 1
Dentistry, The Hospital for Sick Children, Toronto, ON, Canada;
was organized as from 3 main cycles: diagnosis and treatment 2
Nursing Practice, The Hospital for Sick Children, Toronto, ON,
planning, promotion and prevention, and rehabilitation. In this
Canada
regard, the Discipline of Pediatric Dentistry has also been
restructured to fit the new model. Background: Oral care is often neglected when children receive
Aim: The aim of this study was to compare the performance of medical care in hospital. Physicians, nurses and allied health pro-
the former and the new curriculum dental students, in different fessionals in ambulatory clinics and in-patient units are in a
kind of evaluations and also in their global evaluation. unique position to detect disease and facilitate oral care for these
Design: The evaluation included theoretical, practical and clinical children. Few organisations have developed evidence-based
performance. guidelines to support medical staff with oral care.
Results: The test grades (from 1 to 10) of two students0 classes Aim: To develop an evidence-based oral health clinical practice
were compared by means of T test. Fifty-five students belonged guideline for a children’s hospital.
to the new curriculum class while 53 to the old one. The theoreti- Design: Two members of a multidisciplinary guideline develop-
cal evaluation showed no difference of performance between the ment group identified and independently assessed relevant pub-
two groups. The practical test grades0 mean were 7.08 and 6.61 lished guidelines using the AGREE II tool. Guidelines with
respectively. The global performance mean were 6.40 and 5.93 evidence-based recommendations relevant to the clinical ques-
respectively and a statistical significant difference was found tions were considered for inclusion. Recommendations were col-
between the two groups (P = 0.02 CI = 0.08–0.05 at the practical lated and adapted using the ADAPTE methodology. In addition,
evaluation and P = 0.0017 CI = 0.18299 at the global evalua- systematic literature search was undertaken by two group mem-
tion). bers to evaluate the existing evidence base. Searches were limited
Conclusions: The students belonging to the restructured curricu- to English language, children <18 years and published since 2004.
lum presented better practical and global performance as com- Scientific papers in the medical and dental literature were
pared to the former curriculum ones. assessed using the GRADE process.
Results: Search strategies identified 11 existing guidelines from
PR11.36 which 18 relevant recommendations were adapted to the pro-
posed guideline. Fifty-seven of 308 identified papers were deemed
Use of theatre time for paediatric dental operating to be relevant to the scope of the proposed guideline. After eval-
lists at the Eastman Dental Hospital, University uation, ten recommendations were developed based on the qual-
College London Hospitals ity and strength of available evidence. The combination of
P. COOPER, U. DEVALIA & A. PATRICK existing guidelines and systematic literature review enabled the
Paediatric Dentistry, Eastman Dental Hospital, London, UK creation of an evidence-based clinical practice guideline.
Conclusion: Evidence-based guidelines for paediatric oral health
Background: The department of Paediatric Dentistry at the East- care at a children’s hospital have been created.
man Dental Hospital provides comprehensive dental care under
general anaesthesia. This is predominantly for patients unable to
undergo treatment with either local anaesthesia alone, or with PR11.38
inhalation/IV sedation. This may be due to: age of the child, extent Impact of educational program for institutionalized
of dental decay, anxiety, complexity of treatment, and/or medical special-care patient’s guardians
conditions. Improved utilisation of theatres reduces waiting lists, S. MONSALVES, S. KRAMER, € P. ESPINOZA & M. VALLE
improves efficiency, reduces cost, and contributes to improved Pediatric Dentistry, University of Chile, Santiago, Chile
patient care and experience. Theatre utilisation is identified as one
of six key performance indicators by the Department of Health. Background: Patients with special healthcare needs may have
Aim: Service evaluation to determine utilisation of theatre time trouble complying with appropriate oral hygiene techniques,
for paediatric comprehensive care lists at the Eastman Dental requiring additional support. Institutionalized patients need spe-
Hospital. cially-trained staff assistance to maintain optimal oral hygiene.
Design: Data was collected prospectively using a proforma. This Aim: The aim is to assess an educational program’s effectiveness
was conducted over a 3 month period from October 2014 to Jan- on preventative and oral hygiene measures for special-care
uary 2015. Anaesthetic and operating times were recorded, along patient’s guardians.
Design: This Educational Program was implemented on guard- PR11.40

ians/parents as well as care-givers of twenty institutionalized
Preventing ECC: the “play-way”
patients. Patients’ diagnoses included Down syndrome, severe
N. SRIVASTAVA, V. ADLAKHA, A. BHARADWAJ & M.
cognitive impairment, and Autism.
MOHAN
The educational program consisted of three practical sessions
Paedodontics & Preventive Dentistry, Subharti Dental College &
(once a week for three weeks) including topics on tooth brushing,
Hospital, Meerut, India
dietary advice, and special adaptation of tooth brushing imple-
ments. Background: Early Childhood Caries (ECC) is a serious public
The Oral Hygiene Index was assessed before and after imple- health problem in both developing & industrialised countries. It
menting the educational program. Additionally, a questionnaire begins early in life, progresses rapidly in those who are at high
was completed by parents on dental care habits. risk and often left untreated. The relationship between breast-
Results: Oral hygiene Index improved from 95% to 50%. Oral feeding and ECC is considered to be complex and confounded by
hygiene habits: before intervention five patients brushed twice a a number of social variables including child & parental education
day, eleven patients once a day and seven only a few times a and socioeconomic status.
week. At the end of the study ten patients brushed twice a day Although a challenge, the disease can be effectively prevented by
and the other ten once a day. Parents also found it easier to a number of measures like early examination, identification of
brush their children’s teeth. Dental treatment: before the inter- individual risk factors, initiation of preventive care procedures
vention only one patient attended his dental appointments regu- and above all through child & parental education.
larly. At the end of the intervention the average attendance of Various aids are available today to educate the masses about a
the cohort improved to 90%. particular disease but educating children and parents about initi-
Conclusions: The educational program focused on patient’s guard- ation, prevention, interception and management of ECC has
ians dramatically improved patient’s oral hygiene and dental care always been a complex and challenging task.
habits and also increased families’ commitment to dental care. Aim: This paper discusses an innovative, interesting and simple
way of educating children and parents about early childhood car-
PR11.39 ies with Dos and Don’ts through “Snakes & Ladders” game
which can be displayed in chart form and/ or touch screen.
Evaluation of the clinical documentation during the
use of nitrous oxide inhalation sedation for dental
PR11.41
treatment
G. K. HUSSAIN, I. HUSSEIN, M. KOWASH & M. ALHALABI Acceptability of fissure sealants on undergraduate
Dubai College of Dental Medicine, Dubai, United Arab Emirates clinics
R. KAUR, R. MATTIOZZI, M. OGRETME & S. SOOD
Background: Nitrous Oxide conscious sedation is a useful behav- Paediatric Dentistry, King’s College London Dental Institute,
iour management technique for anxious children undergoing den- London, UK
tal treatment. Contemporaneous and accurate documentation are
essential components of high quality patient care and informed Background: The placement of fissure sealants, particularly in the
consent for the procedure. occlusal surfaces of permanent molars, reduces caries in high risk
Aim: The aim of this audit was to evaluate the documentation of children. It is perceived as a simple technique, utilised in acclima-
the use of nitrous oxide sedation in a postgraduate paediatric tisation and a component of the dental curriculum. However, it
dentistry setting pre, intra and post-operatively. has been shown to be underutilised in practice.
Design: A total of 30 dental records were audited retrospectively Aim: The aim of this pilot study was to see opinions regarding
during the period between November and May 2014 in the paedi- fissure sealant placement by the child, parent and student.
atric dentistry clinic. Documentation of pre-operative instruc- Design: A prospective questionnaire was completed on 4th and
tions, informed consent, flow rate, N2O percentage level, 5th year dental student clinics. The questionnaire was completed
treatment duration, duration of post nitrous 100% of O2 and by each patient, parent and operator. Questions included age,
post-operative instructions were evaluated. Descriptive statistics gender, undergraduate year and previous experience. Likert scale
were used to analyse the data. was used to assess dental visit satisfaction and treatment experi-
Results: The percentage of the accurate documentation of preop- ence. Open-ended questions explored the indications of sealant
erative instructions was 96.7%, informed consent was 96.7%, placement, acceptability of the procedure and likelihood of hav-
flow rate was 46.7%, N2O percentage level was 74%, treatment ing or doing the procedure again.
duration was 66.7%, post nitrous 100% of O2 was 46.7% and Results: 16 questionnaires collected. Majority of children were
post-operative instructions was 0%. males above 7 years old; happy to attend for treatment and to
Conclusions: The findings highlight the deficiency in documenta- return. Common complaint was the taste. Undergraduates were
tion of sedation reports. It is of critical importance to have mainly female, confident in sealant placement before treatment
proper documentation to achieve best standards. The results of but less confident in the outcome of the procedure. This was
the audit were discussed in a meeting with all the practitioners in dependent upon previous experience. Comments included find-
the department where recommendations were made and imple- ing” moisture control and positioning more difficult than antici-
mented. A re-audit cycle will be conducted after 6 months to pated”. Overall the parent was happy.
assess the improvement in documentation. Conclusions: Fissure sealant placement shown to be an acceptable
technique by children. Further research required in the perceived
acceptability by the clinician.
PR11.42 Conclusions: This audit highlighted the fact that often children
are inappropriately referred which can place them at risk of fur-
Three dimensional virtual reality system for pediatric
ther dental problems. There is still room for improvement which
dental training is crucial to protect paediatric patients.
M. OZAKI, T. HASHIMOTO & I. KAORI
Fukuoka Dental College, Fukuoka, Japan
PR11.44
Background: Effective diagnostic capabilities and good drilling Audit of caries risk assessment and caries prevention
technique are both vital skills for Pediatric dentists. Typical train-
ing approaches include the use of synthetic replica teeth or real
within the salaried dental service
teeth extracted from patients. L. DUFFY
Aim: We are currently developing a computer-based virtual real- Zetland House Dental Clinic, Salaried Dental Service,
ity dental training simulation that accurately reproduces the dril- Northallerton, UK
ling experience in a computer-generated environment allowing Background: Community dental services treat many high-caries-
for easy repetition, performance evaluation, and representation risk children, who require a thorough caries-risk assessment
of a wide range of anatomical and pathological variations. (CRA) and individual caries prevention plan, according to their
Design: Train early-stage students in basic psychomotor skills caries-risk status.
required for tooth preparation, including mirror and drill control. Aim: To assess the identification, documentation and subsequent
Use a modular system design that allows for easy implementation preventive treatment planning of children of high-caries-risk
of new simulations. Make the interface intuitive for students and referred to the salaried dental service in Northallerton.
instructors. Make it easy to create new pathological cases for Standards: 100% of children should receive a:
testing and training. a) caries-risk assessment b) caries-risk status c) individual caries
Results: The average duration of each training session for the prevention plan consistent with the Department of Health’s
two training groups. As can be seen, practice time decreased (DoH) Prevention toolkit.
sharply for participants in the real-world training group, while it Design: Computer notes of 100 children were retrospectively analy-
increased for those in the simulation group. sed for the documentation of factors involved in CRA and pre-
Conclusion: Based on conversations with participants and obser- scription of caries prevention. Patients were included if they were:
vations during training, we theorize that this difference is due in a) attending new patient or recall examinations b) aged 16 or
part to participants in the simulation group finding their task younger c) had at least one carious lesion.
more engaging and less intimidating than those in the real-world Results: Dietary habits were documented in 43% of casenotes
group. The results of the experiment are encouraging, in that the and oral hygiene in 85%. A caries-risk status was assigned to
simulation group experienced no recognizable negative training 48% of patients. In terms of prevention, 35% of children were
effects and performed on par or better than the real-world train- prescribed dietary advice, 77% oral hygiene instruction, 75% fis-
ing group. We will begin a modified and expanded version of the sure sealants, and 85% fluoride application. Of the casenotes
same study based on the experience gained from the pilot study. analysed, 40 patients were seen by junior dentists, 20 by dentists
undergoing further training and 40 by senior dentists. The level
PR11.43 of detail documented decreased with increasing seniority of staff.
Conclusions: These findings highlight a need for the service to
Improving the appropriateness of paediatric referrals
improve the provision and documentation of caries-risk assess-
to community dental services: a completed cycle ments to enable prescription of an appropriate caries prevention
A .J. COMERFORD plan.
Community Dental Services, Barts Health NHS Trust, London, Action Plan: (a) Implementation of a caries-risk assessment and
UK prevention computer template b) Staff training on DoH toolkit
Background: Inappropriate paediatric referrals from general den- and importance of record keeping.
tal practitioners (GDPs) to special care community dental ser-
vices can result in a delay in children receiving adequate dental PR11.45
care in a timely fashion. With reports showing dental problems Utilization of dental services among secondary school
as the leading cause of paediatric hospital admissions, it is crucial
that all children receive best dental care when required, prefera-
students in Port Harcourt, Nigeria
bly from their GDP where suitable. J. EIGBOBO1 & C. OBIAJUNWA2
1
Aim: To assess whether all paediatric referrals to the community University of Port Harcourt, Port Harcourt, Nigeria; 2University
dental services of Barts Health NHS Trust meet the referral crite- of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
ria for special care dentistry. Background: The regular use of dental services has been associ-
Design: 575 referrals and patient files were examined. Informa- ated with optimal oral health. Reports in some parts of Nigeria
tion was collected regarding stated reason for referral and have shown poor utilization of dental services and there is pau-
whether this corresponded with clinician’s records. Other factors city of information in the South-South region of Nigeria.
noted include whether special care was required e.g. inhalation Aim: To determine the frequency/pattern of dental visits and
sedation or referral for general anaesthetic. identify barriers to utilization of dental services among children
Results: 38% of referrals were deemed inappropriate. 83% of Design: This was a cross sectional study done among secondary
children were referred as phobic however only 46% of these were school children in Port Harcourt, Nigeria. Information was elic-
recorded to have needed adjuncts for phobia. Many referrals ited by means of a self administered questionnaire. These
were suitable for treatment with GDP and did not require special included socio-demographic characteristics, reported visits during
care. This resulted in children delayed in receiving their required the previous year, pattern of dental visits and the barriers to uti-
dental care whilst awaiting referral. Changes implemented lization..
included stricter referral criteria with consequences of inappropri- Results: There were 200 school children; 98(49%) males and 102
ate referrals emphasised. Also offered was information on treat- (51%) females with a mean age of 13.3(+1.1) years. Dental visits
ing children in the general dental practice. Second cycle showed a were deemed important by 187(93.5%) children; but 19.5% of
reduction in inappropriate referrals to 19%.
them were afraid of visiting the dentist. Although 60.7% of them The FOUSP Pediatric Dentistry discipline has used this teaching-
reasoned that dental visits should be at least once a year, 32.0% learning methodology since 2008. The graduate students use the
respondents suggested that visits should be when there are symp- Moodle platform with complementary and supplementary activi-
toms. Only 42 (21%) pupils had been to the dentist in the last ties to the classroom, where they perform asynchronous activities
12 months. and receive feedback from tutors. Undergraduates are assessed
The barriers to utilization of dental services majorly included no by their participation and performance in activities.
perceived needs (64.3%), cost of treatment (10.1%) and access to Aim: This paper compares the performance achieved in the ques-
dental clinic (5.4%). Demographic variables had no significant tion of the statement of anesthetic technique on dummy in Objec-
association with reported visits and pattern of visits. tive Structured Clinical Examination (OSEC), among students
Conclusion: Utilization of dental services among these school chil- who accessed or not the virtual object of learning on the plat-
dren was low. There is a need to increase oral health awareness form.
by having an effective school oral health programme Design: The sample consisted of 120 undergraduate students.
After assessment of the student performance in Objective Struc-
PR11.46 tured Clinical Examination (OSEC) and the compiled data from
participation in e-learning, linear regression analysis was per-
Repeat attendance by paediatric patients on general formed to determine the association between student perfor-
anaesthetic lists over 5 years, Oxfordshire Salaried mance and the use of the instrument or the student’s interest by
Primary Care Dental Service (OSPCDS) the feedback.
N. A. ACKUAKU & E. NGUYEN Results: The results showed that the undergraduates who watched
Oxfordshire Salaried Primary Care Dental Service, Oxfordshire, the video (Anesthesia complex pterygomandibular in children)
UK available on the Virtual Learning Environment (VLE) and found
that the feedback given by the tutor were more likely to get bet-
Background: OSPCDS provides treatment to a range of patients, ter note on the question of anesthesia were respectively 2.4 (95%
general anaesthesia (GA) may form a part of this. National Clin- CI: 0.02–0.25) and 2.5 (95% CI: 0.01–0.17).
ical Guidelines in Paediatric Dentistry state that repeat GAs are Conclusions: The students who pledged to participate in blended
undesirable in terms of 0 morbidity, potential mortality, associated learning performed better in the practical assessment. Therefore,
behavioural and emotional effects as well as cost0 . The current the b-learning and the virtual object developed for anesthesia
mortality rates associated with GA in developed countries is esti- pterygomandibular complex in children benefited students in the
mated at 1:100,000. teaching-learning process.
Aim: The aim of this audit was to investigate the number of pae-
diatric patients between 01/04/2009 to 31/03/2014 with more than
one GA episode, with the objective of producing recommenda-
PR11.48
tions to reduce repeats. Child abuse and role of the paediatric dentist
Design: A query was run on the patient database to identify qual- B. VARDHANA1 & K. R. VIJETHA2
1
ifying patients. Individual patient data was analysed and entered Department of Dentistry, ESIC Medical College & Hospital,
into a predesigned spread sheet. Gulbarga, India; 2Anupam Dental Care Centre, Gulbarga, India
Results: Of 2793 patients 62 (2.2%) had repeats. There was a
total of 56 retreated teeth and 28 patients (45%) with retreated Background: Child abuse is a major public health problem all
teeth. 76% of patients had evidence of oral hygiene or other pre- over the world and in India. We as Paediatric Dentists are able
ventative advice and 29% had diagnostic imaging. to identify physical evidence of injuries to children especially in
the regions of the head and neck, orofacial structures and even
Conclusions: Overall there was a low repeat GA rate (2.2%) by
following the recommendations below the trust may be able to arms. When such injuries are of suspicious origin, we have an
further limit its incidence of repeats. obligation to document and report. A number of children go
missing every year. CRY (2007) estimates suggest: 8945 children
Recommendations for the trust include; reinforcing hygiene and
preventative advice regularly in line with NICE recall guidelines, go missing in India every year, 500,000 children are forced into
as well as suggesting recall for referring GDP’s. Ensuring imaging sex trade every year, children form 40% of the total population
is carried out for all where possible. Greater use of Hall tech- of commercial sex workers.
Aim: To assess the preparedness of the Paediatric Dentist in iden-
nique stainless steel crowns and topical fluoride under GA and
considering whether primary teeth should be extracted or Hall tifying a potential case of child abuse and ability to report the
crowned only, rather than filled under GA. same and to give an insight about the vital signs of an abused
child (esp. the girl child in India).
Design: The study was conducted as a review as to what are the
PR11.47 forms of abuse and the role the paediatric dentist ought to play.
Effect of b-learning in Objective Structured Clinical And the awareness of the same amongst the Paediatric Dentist
Examination (OSEC) in practice assessment population in 2 cities in India.
Results: The results indicate Paediatric Dentists are well aware of
pterygomandibular technique the role they ought to play as mediators, psychologists, inform-
C. J. F. ALENCAR1,2, A. F. B. CALVO2,3, M. BONECKER3 &
ers. But many deflect the fact that they avoid the embarrassing
A. E. HADDAD3
1 situation of confronting the parent about the same.
Orthodontic and Pediatric Dentistry, University of Sao Paulo,
Conclusion: Therefore, Child Abuse is a serious problem with an
São Paulo, Brazil; 2Orthodontic and Pediatric Dentistry,
alarming increase by the day in India which needs quick atten-
University Paulista/Faculty of Dentistry, Campinas, Brazil;
3 tion and immediate reporting by the Paediatric Dentist.
University of Sao Paulo / Faculty of Dentistry, São Paulo, Brazil
Background: The use of e-learning combined with traditional
teaching is a trend and became a challenge of higher education.
Basic Science Research Poster Session – PR12

PR12.01 The distance and area of gravity center movement of the middle
group was less than that of the deflection group.
Parathyroid hormone: increased tooth mobility after After this study, we want to study the relationship of the body’s
orthognathic surgery? equilibrium function and occlusal balance in children with mixed
W. NEZAR1 & A. H. MUHAMAD2 dentition and permanent dentition.
1
Orthodontics, Arab -American University, Jenin, Palestinian
Territory, Occupied; 2Arab -American University, Jenin,
Palestinian Territory, Occupied
PR12.03
Distinct post-transcriptional regulation of
Introduction: Following orthognathic surgery, increased tooth
mobility is observed clinically and is utilized for postsurgical
monocarboxylate transporter 1 expression between
orthodontic tooth movement. It was suggested that the increase neurons and non-neuronal cells in the mouse brain
may result from a surgery-associated alteration of parathyroid C. TAKASAKI & Y. YAWAKA
hormone (PTH) and calcium metabolism. Hokkaido University Graduate School of Dental Medicine,
Design: 30 young adult patients were divided into a mandibular Sapporo, Japan
osteotomy group (Group A, n = 20) and an untreated control Background: Monocarboxylates, such as the lactate and ketone
group (Group B, n = 10). Tooth mobility was evaluated using
bodies, have been known to represent substantial energy substrates
the Periotest device. Tooth mobility, serum PTH and calcium lev- for the developing brain. Rapid transport of them across the plasma
els were determined repeatedly for both groups. membrane of cells is essential for the carbohydrate, fat, and amino
Results: The tooth mobility was increased significantly in the acid metabolisms. The transport is facilitated by proton-linked
Group A patients in the first 10 days post-surgery. All serum
monocarboxylate transporters (MCTs). Of 14 isoforms of MCTs so
PTH and calcium mean levels were within normal ranges. No sig- far identified, MCT1, MCT2 and MCT4 expressed in the brain.
nificant differences were found between the measurements of Aim: The aim of this study was to clarify cellular expression of
both groups. The serum calcium levels recorded at the 1st post-
MCT1 in the mouse brain.
surgery day were slightly lower in the operated patients com- Design: We examined cellular expression of MCT1 in the mouse
pared to the control group. brain by fluorescent in situ hybridization and immunohistochemistry.
Conclusion: It can be concluded that the increased facility of Results: In the hippocampal CA1, high neuronal expression was
orthodontic tooth movement immediately post-surgery was con-
shown by intense MCT1 mRNA signals in pyramidal cells
firmed by Periotest measurements, while no association was expressing vesicular glutamate transporter-1 (VGluT1) mRNA.
found with surgery-related altered levels of PTH and calcium. Low expressions were also found for GABAergic interneurons
Since dietary effects can be ruled out, the increase of clinical expressing 67 kDa-glutamic acid decarboxylase (GAD67)
tooth mobility may rather result from preoperative orthodontic
mRNA, astrocytes expressing plasmalemmal glutamate trans-
forces and/or the post-surgical elimination of masticatory muscu- porter GLAST mRNA, and capillary endothelial cells expressing
lar influences. vascular endothelial growth factor receptor-1 (VEGFR1) mRNA.
By immunofluorescence, however, MCT1 immunoreactivity was
PR12.02 intense in astrocytes expressing 3-phosphoglycerate dehydroge-
The relationship between children’s primary teeth’s nase and capillary endothelial cells expressing glucose trans-
porter-1, but negative in pyramidal cell dendrites and somata
occlusal and body’s gravity center movement expressing microtubule-associated protein-2. Such a dissociated
Y. JI
transcription and translational control in neurons was also found
Pediatric Dentistry, Dalian Stomatological Hospital, Dalian, China
in Purkinje cells in the cerebellum and cholinergic neurons in the
Design: Forty nursery school children, ages 4–5 years (21 boys, dorsal motor nucleus of vagus nerve.
19 girls with Hellman’s dental age of IIA whose overjet and over- Conclusions: Neuronal expression of MCT1 is transcriptionally
bite were normal and had no skeletal problems) with cooperative active, but suppressed at the post-transcription levels. Through
behavior were the subjects of this study. Informed consent was this mechanism, predominant MCT1 expression in astrocytes and
acquired from the children’s parents or guardians. capillary endothelial cells is constructed in the brain.
All the data were analyzed with SPSS11.0 for Windows statistical
package. t-test was used to examine the difference between the PR12.04
occlusal balance center of the middle group and the occlusal bal-
ance center of the deflection group(Distance and Area of GCM).
Salivary a- Amylase activity, Immunoglobulin A, G
Results: For occlusal ability, the average occlusal contact area and total protein concentration in children with
was found to be 10.47 mm2 and average occlusal pressure was different level of dental caries
41.6 MPa.The distance and area of gravity center movement M. GHASEMPOUR1, S. MAHJOUB2, A. MOSTAFAZADEH2 &
were less for eyes-opened than eyes-closed. (A significant differ- A. RAHMATI2
1
ence was found between the occlusal balance of the middle group Pediatric Dentistry Dentistry, Babol University of Medical
(n = 10) and the occlusal balance of the deflection group (n = 30) Sciences, Babol, Iran; 2Babol University of Medical Sciences,
in the distance and area of gravity center movement with eyes- Babol, Iran
opened and closed.
Conclusion: The relationship between body’s equilibrium function Background: Amylase Activity, Immunoglobulin A, G and total
and occlusal balance in children with primary dentition exists. protein concentration in saliva may be related to the susceptibil-
ity to dental caries.
Aim: The aim of this study was determination of Amylase Activ- PR12.06
ity and Immunoglobulin A, G and total protein concentration in
Isolation, identification and biological characteristics
saliva of children with different level of dental caries.
Design: One hundred six children in the age group of 4–6 years of Beagle stem cells from pulp of deciduous teeth
were divided into 3 groups. Group one, 36 Caries-free children F. LIU, Y. LIU, S. S. DAI, N. H. MA & Q. Y. GUO
with dfs <1, Group two 38 children with 510. Three groups were Department of Pediatric Dentistry, Stomatology Hospital of Xi’an
matched for age and gender. Jiaotong University, College of Medicine, Xi’an, China
The unstimulated mixed salivary sample was collected from each Background: Nowadays, stem-cell-based tissue engineering was
child. considered as the most promising alternative for pulp regenera-
Measurements of Alpha-Amylase Activity, total protein concen- tion. Beagle is an appropriate model for dental research.
tration were performed by Colorimetric technique. Aim: The aim of the present study is to isolate and characterize
Also, the level of salivary IgA and IgG was determined by the Beagle stem cells from pulp of deciduous teeth.
ELISA. Data were analyzed by student t-test, non-parametric Design: Using enzyme tissue block method for primary culture of
Mann-Whitney and Anova test. Beagle stem cells from pulp of deciduous teeth, and the cell colo-
Results: There were no significant differences between groups nies were picked and expanded for the following measurement of
regarding the salivary concentrations of total protein and IgA biological characteristics.
(P > 0.05). Mean values of Amylase Activity in group 3 Results: Beagle stem cells from deciduous pulp were harvested by
(39.85 IU/L) was significantly higher than group 1 (35.55 IU/L) enzyme tissue block method and the cell colony formation rate
(P < 0.05) and mean values of IgG Concentration in group 3 was 32%. Immunohistochemistry staining and flow cytometry
(0.4 mg/dL) was significantly higher than group 1(0.28 mg/dL) analysis confirmed the cells were derived from mesenchymal tis-
and 2 (0.27 mg/dL) (P < 0.05). sue, rather than from the epithelial tissue. Abilities of adipogenic
Conclusions: Our results revealed that increase in the salivary and osteogenic/ odontoblasts differentiation were verified after
Alpha-Amylase activity and IgG concentration was associated being induced.
with presence of caries. Conclusions: The Beagle stem cells from pulp of deciduous teeth
were defined as mesenchymal origin and had multilineage differ-
PR12.05 entiation abilities. It might be a capable candicate cell resource
The role of AEG-1 in dental pulp cells during for pulp regeneration.
inflammatory reaction
M. HE PR12.07
Department of Pediatric Dentistry, Wuhan University Hospital of Anti-growth effects of triple/double antibiotic paste
Stomatology, Wuhan, China on stem cells from exfoliated deciduous teeth
Background: AEG-1 (Astrocyte Elevated Gene 1) was originally (SHED)
identified and cloned in astrocytes from HIV-infected embryos. A Y. Y. TU1, T. Y. CHEN1,2, Y. H. CHANG1,2 & Y. C. HSU2,3
1
large number of studies have shown that AEG-1 played a critical Pediatric Dentistry, Kaohsiung Chang Gung Memorial Hospital,
role in tumor angiogenesis, drug resistance and the process of Kaohsiung, Taiwan; 2Graduate Institute of Medical Science,
invasion and metastasis. Recent studies have also demonstrated College of Health Sciences, Chang Jung Christian University,
that AEG-1 played an important function in other physiological Tainan, Taiwan; 3Innovative Research Center of Medicine, College
and pathological processes, such as innate immune, development, of Health Sciences, Chang Jung Christian University, Tainan,
inflammation, and neural degenerative diseases. Taiwan
Aim: To investigate the role of AEG-1 in dental pulp cells during
Background: Typically, triple antibiotic paste (TAP) or double
inflammatory reaction and possible molecular mechanism.
antibiotic paste (DAP) had been used in regenerative endodontic
Design: Human dental pulp cells (DPCs) were treated by different
procedures for disinfection. TAP/DAP are also used to treat pri-
concentrations of LPS and then the mRNA and protein expres-
mary tooth with periapical abscess. However, the effects of tri-
sion levels of AEG-1 and its target NF-kB were detected by RT-
ple/double antibiotic paste on stem cells from exfoliated
PCR and western blot. After DPCs were treated by NF-kB
deciduous teeth (SHED) were still unclear.
inhibitors parthenolide overnight and then treated with LPS for
Aim: The purpose of this study is to evaluate the anti-growth
1 h, the expression level of AEG-1 were detected. Knocking
effects of TAP or DAP on stem cells from exfoliated deciduous
down AEG-1 by shRNA, DPCs were transfected by NF-kB-Ta-
teeth (SHED).
luc luciferase plasmids and treated by LPS for 6 h, NF-kB-
Design: SHED were isolated and primary cultured from human
dependent luciferase activity were detected.
deciduous teeth. SHED were cultured and subjected to either
Results: LPS up-regulates AEG-1 in DPCs which is dose-depen-
non treatment or various dosage including TAP or DAP. For
dent. Parthenolide can inhibit LPS-mediated up-regulation of
evaluation, cell viability and cell cycle was investigated with
AEG-1 in DPCs. NF-kB-dependent luciferase activity decreased
MTT assay and PI stain by flow cytometry on the 3rd day.
when knocking-down AEG-1 in DPCs treated by LPS.
Results: Our results indicated that, after treated with 1 mg/mL
Conclusions: AEG-1 up-regulation is NF-kB-dependent in DPCs
TAP or DAP for 3rd days, about 40% of SHED growth was
during inflammatory defense. The underlying mechanism
inhibited which was significantly than control group (0 mg/mL).
involved in crosstalk between AEG-1 and NF-kB pathway
Conclusion: Our data showed that the SHED cells proliferation
needed further research.
were inhibited by TAP or DAP in a dose-dependent manner.
PR12.08 into tetR locus confermed by PCR.The growth rate of the

mutant was similar level compared with wild type. The MIC of
Changes of alveolar bone volume for healthy and OFLX and AZM in wild type was lower than that the mutant.
ovariectomized rats in ligature induced experimental Conclusion: These date suggest that tetR is associated with resis-
periodontitis tance to OFLX and AZM in T. denticola.
J. DAI & Y. ZHANG
Wuhan University Hospital of Stomatology, Wuhan, China PR12.10
Background: Osteoporosis is thought to contribute to pre-existing Role of Wnt signaling in dental mesenchyme during
alveolar degeneration although the association between periodon- serial tooth formation
tal disease and osteoporosis is not fully characterized. J. SHIMOMURA-KUROKI1,2, M. JUSSILA1 & I. THESLEFF1
Aim: The aim of the present study was to observe the initial 1
Institute of Biotechnology, University of Helsinki, Helsinki,
changes in the mandibular alveolar bone for healthy and ovariec- Finland; 2The Nippon Dental University, School of Life Dentistry
tomized (OVX) rats in ligature induced experimental periodonti- at Niigata, Niigata, Japan
tis of first molars.
Design: At time points ranging from 0, 3, 7 and 11 days follow- Background: Wnt signaling plays an important role during tooth
ing ligature placement, Micro-CT analysis was performed to cal- morphogenesis. The inhibition of canonical Wnt signaling arrests
culate vertical bone loss as well as bone volume loss in the root the tooth morphogenesis at an early stage. On the other hand,
furcation area. Furthermore histological analysis was performed forced activation of Wnt signaling in dental epithelium leads to
to calculate the loss of alveolar bone crest height from the ce- continuous formation of supernumerary teeth. However, the role
mento-enamel junction. TRAP staining was visualized to observe of Wnt signaling in dental mesenchyme has remained less well
osteoclast activity and number. elucidated.
Results: OVX animals demonstrated significant vertical bone loss Aim: The aim of this study is to examine the role of mesenchy-
at all time points when compared to normal animals and that mal Wnt signalling during the serial addition of posterior molars.
significant bone loss was observed over time in both groups con- In particular, we investigated the relationship between Wnt,
firming the ligature model. In the furcation area, a significant Fgf10 and the stem cell marker Sox2 during the initiation of the
decrease in bone volume/total volume and trabecular thickness mandibular 2nd molar tooth bud.
was observed in the OVX group as assessed by Micro-CT analy- Design: TCF/Lef:H2B-GFP (Wnt reporter) and wild type mouse
sis at 11 days. The histological analysis also revealed that alveo- embryos were used in this study. Mandibular 1st molar tooth
lar bone crest height was significantly reduced in OVX animals buds were dissected from E14.5 mouse embryos and cultured
when compared to normal animals at all time points. TRAP ex vivo in an organ cultures for 7 days to observe the formation
staining further demonstrated that a higher intensity staining was of the 2nd molar. Radioactive in situ hybridization and immuno-
observed in the OVX animals and the intensity of TRAP staining histochemistry were performed using tooth buds from E14.5 and
peaked at 3 days post ligature placement. E15.5 embryos.
Conclusions: The results from the present study suggested that an Results: The organ culture experiment showed that the expression
osteoporotic phenotype has the potential to speed periodontal of Lef1 (Wnt target) localized in dental cusps of 1st and 2nd
breakdown. molar during development. The expression of Fgf10 and Sox2
was detected especially on distal side of the first molar in E14.5
mouse embryos. In addition, strong expression of Axin2 was
PR12.09
detected in the dental mesenchyme during the morphogenesis of
Analysis of the tetR dependent regulation in 2nd molar.
Treponema denticola Conclusions: These results indicate that mesenchymal Wnt signal-
Y. ARAI1, S. SHINTANI1 & K. ISHIHARA2 ling is involved in the development of mandibular 2nd molar.
1
Pediatric Dentistry, Tokyo Dental Collage, Tokyo, Japan;
2
Microbiology, Tokyo Dental Collage, Tokyo, Japan PR12.11
Background: Treponema denticola is frequently isolated from Maternal occlusal disharmony suppresses cell
chronic periodontitis and apical periodontitis and plays an proliferation in the hippocampus of pups
important role for development and progression of the disease. M. IINUMA1, S. MORI1, H. KONDO1, C. MURABAYASHI1, Y.
In the treatment of periodontitis,antimicrobial agent was often TAMURA1 & K.Y. KUBO2
used. Resistance to the antimicrobial agents affect the outcome 1
Pediatric Dentistry, Asahi University, Mizuho, Japan; 2Seijoh
of the therapy. University, Toukai, Japan
Aim: TetR is repored to regulate antibiotic resistance in a num-
ber of microorganisms, however, the concrete function in T. den- Background: Exposure of pregnant female rodents to stress has
ticola has not clarified yet. The aim of this study is to clarify the profound effects on the behavior of their adult pups. We recently
role of the tetR in antibiotic resistance of T. denticola. reported that occlusal disharmony leads to deficits in learning
Design: To inactivate the TetR of T. denticola, the ermFermAm and memory, and neuronal degeneration in the hippocampus of
cassette was inserted in the tetR of T. denticola ATCC35405 by aged mice through the induction of chronic stress. Neurogenesis
overlap PCR. Obtained fragment was transformed into T. denti- regulation occurs at several different levels, e.g., by cell prolifera-
cola by electropolation. Clones deficient tetR was isolated in TY- tion.
GVS agar containing 40 mg/mL erythromycin. To evaluate Aim: The aim of this study was to determine which aspect of
resistance to antibiotic of the mutant, wild type strain and neurogenesis regulation is influenced in the hippocampus of pups
mutant of tetR was inoculated in TYGVS medium containing obtained from dams with occlusal disharmony during pregnancy
azythromycin (AZM) or ofloxiacin (OFLX). After 7 days incuva- induced by raising the bite.
tion under annerobic condition, minimum inhibitory concentra- Design: Twenty male DDY mouse pups (4-mo-old) from preg-
tion (MIC) was determined visually. nant mice with occlusal disharmony and 20 male pups from con-
Results: Nine clones were grown in TYGVS agar plate containing trol pregnant mice were used. The bite of the pregnant mice was
erythromycin. In all clones, insertion of ermFermAm cassette was raised to induce occlusal disharmony by placing dental composite
resin on the teeth under anesthesia during the last week of preg- Aim: Since subpulpal lobes (SLs) appear during MRT formation
nancy. Control mice were anesthetized but the bite was not in human and rat, the aim of this study is to clarify the MRT
raised. We measured plasma corticosterone levels by radioimmu- formation with SLs histologically and immunohistochemically
noassay, learning ability in the Morris water maze, and cell pro- using rat molar.
liferation in the hippocampus by bromodeoxyuridine injection. Design: Maxillary second molars (M2s) from postnatal (PN) 8–
Results: Plasma corticosterone levels of pups obtained from bite- 18 days in Wistar rats embedded in paraffin wax by conventional
raised dams were significantly greater than those of controls. method after decalcification and frontal sections were made for
Pups obtained from dams in the bite-raised condition during hematoxylin-eosin and immunohistochemical staining with anti-
pregnancy required significantly more time to reach the platform heat shock protein (HSP) 27, anti-pan keratin (CK) and anti-
in the Morris water maze and exhibited significantly decreased bone morphogenetic protein (BMP) 4 antibodies. Some speci-
proliferation of newborn hippocampal cells. mens were observed by stereomicroscope.
Conclusions: These findings suggest that learning deficits in pups Results: Epithelial projection (EP) exhibiting anti-CK immuno-
obtained from dams with occlusal disharmony during pregnancy positive elongated from cervical portion toward the center of
result from altered neurogenesis in the hippocampus. dental papilla at PN8. With the passage of time, dental papilla
cells facing the part of EP showed columnar and immunoreacted
PR12.12 for anti-HSP 27 antibody after PN11. Immunopositive reaction
for BMP4 in the dental papilla cells facing the EP was markedly
CCL17 enhances saliva IgA response and protection observed in PN15 as compared to PN8. From PN11, SLs
of anti-caries DNA vaccine appeared on bifurcation area and grow horizontally. Finally,
Y. YAN each SLs and dentin projection fused completely until PN18.
School of Stomatology, Tongji University, Shanghai, China Conclusion: Bifurcation area in rats was formed the growth of
the SLs and fusion of the SLs and dentin projection. SLs were
Background: We previously identified the specific up-regulation of
formed by odontoblasts differentiated from the cells facing a part
mRNA expression levels of CCL17 in targeted anti-caries plas-
of EP.
mid transfected dendritic cells (DCs) by gene array analysis, sug-
gesting an important role CCL17 played in enhanced immune
response. PR12.14
Aim: We investigated the effect of CCL17 DNA administration Cross-talk between PDGF-BB and BMP-2 is
on immune responses to an anti-caries DNA vaccine pCIA-P. important for the stemness of dental pulp stem cells
Design: The plasmid encoding CCL17 protein, designated as
Y. SUGAWARA, M. ARAKAKI, K. SAITO, A. YAMADA & S.
pCCL17/VAX was constructed by inserting murine ccl17 gene
FUKUMOTO
into the vector pVAX1. Chemotactic effect of CCL17 expressed
Division of Pediatric Dentistry, Tohoku University Graduate
by pCCL17/VAX on DCs was assessed in vitro and in vivo. School of Dentistry, Sendai, Japan
Experimental rat caries model was established and immunized
with pCIA-P or with pCIA-P plus pCCL17/VAX intranasally. Background: The process of tooth development is well-regulated
Serum PAc-specific IgG and salivary PAc-specific IgA antibody by epithelial-mesenchymal interactions. Dental mesenchymal cells
levels were assessed by ELISA. Caries activity was evaluated by contain PDGFRa positive dental pulp stem cells because they are
the Keyes method. The colonization of Streptococcus mutans derived from neural crest cells.
(S. mutans) on rat teeth was assayed by culture samples on solid Aim: We focused on the role of PDGFs and their receptors on
MSB medium. the odontoblast differentiation and epithelial-mesenchymal inter-
Result: CCL17 showed strong chemotactic activity on DCs in vitro actions.
and in vivo. CCL17 promoted the production of specific IgG in Design: We used SF2 cells, a rat dental epithelial cell line, and SP
serum and secretory IgA in saliva of rats by intranasal immuni- cells, a mouse dental pulp stem cell line. To investigate the role
zation with pCIA-P plus pCCL17/VAX. Furthermore, we found of epithelial-mesenchymal interactions for SP cells differentiation
that enhanced IgA responses in saliva were associated with the into odontoblasts, SF2 and SP cells were co-cultured using 6-well
inhibition of S. mutans colonization of tooth surfaces and plate and cell culture insert. Further, to examine the interaction
endowed better protection with significant fewer caries lesions. between BMP2 and PDGF-BB for SP cells differentiation into
Conclusions: Our study demonstrates that CCL17 could enhance odontoblasts, SP cells were cultured with PDGF-BB, BMP2, or
specific IgA responses in saliva and protective ability of pCIA-P, both PDGF-BB and BMP2 for 48 h, and then RT-PCR was per-
providing an effective mucosal adjuvant candidate for intranasal formed to identify the expression of DSPP.
immunization of an anti-caries DNA vaccine. Results: Co-culture of SF2 with SP cells was most effective for
stimulation of DSPP expression in SP cells, and the presence of
PR12.13 Noggin inhibited the expression. Epithelial BMPs may regulate
odontoblast differentiation. In fact, BMP2 induced DSPP expres-
Immunohistochemical observation for multirooted sion in SP cells. Further, PDGF-BB decreased DSPP expression
tooth formation in rat in SP cells cultured with BMP2 and inhibited the smad5 phos-
E. OSAWA1, T. YAMAZAKI2, H. YAMAMOTO2 & S. phorylation induced by BMP2 indicating that PDGF-BB is one
SHINTANI1 of the negative regulator of BMP2 signaling and odontoblast dif-
1
Department of Pediatric Dentistry, Tokyo Dental College, Tokyo, ferentiation.
Japan; 2Department of Histology and Developmental Biology, Conclusions: Interaction between dental epithelial cells and dental
Tokyo Dental College, Tokyo, Japan pulp stem cells promote odontogenic cell differentiation and
PDGF-BB inhibits odontoblast differentiation by BMP2 because
Background: A molar of most mammals is multirooted tooth
of inhibition of smad phosphorylation and may be important to
(MRT) to bear the heavy bite force. Although many studies on
keep stemness.
tooth crown development have been reported, there is little infor-
mation on tooth root development. Especially, the mechanism of
MRT formation is still unknown.
PR12.15 of EL mice comparing controls. We could support this result

using both real-time PCR and ISH.
Time-sequenced expression of Notch in enamel organ
Conclusions: Our results suggest that the cause of M3 agenesis of
cells of mouse incisor after mechanical injury EL mice may be a low level of Fgf20 expression in M3 in the
S. C. WANG, Q. R. YIN & J. TONG bud stage of EL mice.
Department of Preventive Dentistry, School of Stomatology, The
Fourth Military Medical University, Xi’an, China
PR12.17
Background: Notch signaling is essential in the development of Investigation of influencing factors for dental caries
enamel. Involvement of Notch in enamel organ cells of the con-
tinuously growing mouse incisor is yet to be investigated.
susceptibility using mice
Aim: To observe the expression pattern of Notch signaling in A. HIRAKI1, C. ENDO2, S. YAMAMOTO-NEMOTO2, K.
enamel organ cells of mouse incisor after mechanical injury. SHIMIZU2 & T. SHIMIZU2
1
Design: Twenty selected mice, divided into four groups, were Department of Pediatric Dentistry, Nihon University Graduate
used in the study. Mechanical injury was established by grinding School of Dentistry at Matsudo, Matsudo, Japan; 2Department of
off crown 1/2 of mice mandibular incisors using diamond bur. Pediatric Dentistry, Nihon University School of Dentistry at
The mice were sacrificed and specimens were processed respec- Matsudo, Matsudo, Japan
tively at 3 d, 5 d, 7 d after injury for each group. Expression of Background: Differences in caries susceptibility are caused by
Notch1 and Notch2 in enamel organ cells was observed using many environmental factors and genetic factors. Many studies of
immunohistochemical staining. environmental factors such as dietary sugar level or oral flora
Results: Notch signaling in enamel organ cells was activated and were reported, but little is still known about the genetic factors
showed time-sequenced changes after mechanical injury. In con- influencing susceptibility.
trol incisors, both Notch1 and Notch2 were absent from amelo- Our previous study showed that inbred mice strains such as
blasts and weakly observed in stratum intermedium and stellate C57BL/6 (B6) and C3H/Heslc (C3H) revealed high and low car-
reticulum cells. In 3 d group, intense expressions of Notch1 and ies susceptibility, respectively, and reported that genetic factors
Notch2 were observed in ameloblasts and stratum intermedium play a role in caries susceptibility.
cells, and expression in stellate reticulum cells was sporadic. In In quantitative trait locus (QTL) analysis, the QTL on chromo-
5 d group, Notch1 and Notch2 were still obviously expressed in some 2 was predicted to be highly associated with dental caries.
ameloblasts, stratum intermedium cells, and stellate reticulum To verify the effect of the QTL on chromosome 2, we previously
cells also showed intensive staining. In 7 d group, the expressions constructed consomic mice termed B6-Chr.2C3H, whose chromo-
of Notch1 and Notch2 decreased in all cell layers. some 2 derived from B6 was replaced with that from the low car-
Conclusions: Notch signaling in enamel organ cells of mouse inci- ies susceptibility C3H strain.
sor can be activated by mechanical injury, suggesting that Notch B6-Chr.2C3H showed low caries susceptibility suggesting that
signaling may be involved in the regulation of repair after tooth mice chromosome 2 was related to caries susceptibility.
injury. Aim: The aim of present study was to investigate phenotype
influencing caries susceptibility of B6-Chr.2C3H.
PR12.16 Design: We examined the stimulated saliva secretion volume, the
histologic characteristic of the submandibular gland and the
Comprehensive expression analysis of the gene in
enamel hardness of B6 and B6-Chr.2C3H.
connection with mouse lack tooth development of Results: Total stimulated saliva secretion volume was higher in
symptoms B6-Chr.2C3H than B6. On the other hand, no clear differences
N. OGAWA1, W. MORITA2 & T. SHIMIZU2 were shown in the other traits.
1
Department of Pediatric Dentistry, Nihon University Graduate Conclusions: Our results suggested that the gene influencing vol-
School of Dentistry at Matsudo, Matsudo, Japan; 2Department of ume of salivation exists on chromosome 2 and may play an
Pediatric Dentistry, Nihon University School of Dentistry at important role in dental caries susceptibility.
Matsudo, Matsudo, Japan
Background: Tooth agenesis is the most common developmental PR12.18
anomaly of the human dentition and little is still known about Differentiation potential of dental pulp stem cells
the genetic factors. Congenital tooth agenesis is rarely observed derived from hypophosphatasia model mouse
in inbred mouse strains. However, the epilepsy-like disorder (EL)
E. YOKOI1, S. YAMAMOTO-NEMOTO2 & T. SHIMIZU2
mouse has a 100% incidence of absence of the third molars 1
Department of Pediatric Dentistry, Nihon University Graduate
(M3s) without any generalized craniofacial anomalies. EL mice
School of Dentistry at Matsudo, Matsudo, Japan; 2Department of
therefore may be a good model for the genetic study of agenesis
Pediatric Dentistry, Nihon University School of Dentistry at
of M3s or other types of tooth agenesis in humans.
Matsudo, Matsudo, Japan
Aim: The aim of this study was to identify the candidate genes
for tooth agenesis in EL mice. Background: Hypophosphatasia (HPP) is a hereditary skeletal dis-
Design: M3 development is arrested in the bud stage on postnatal ease lead to mutations of the gene encoding tissue-nonspecific alka-
day 3 (P3) in EL mice. 10 EL and 10 control mice were sacrificed line phosphatase (TNAP). These mutations result in deficient
under anesthesia on P3. The heads were immediately embedded activity of TNAP leading to rickets often causing death in the short
and serial sections were prepared using a cryostat. A total of 40 life. Although TNAP is expressed in various tissues, the HPP symp-
M3s from each strain were dissected out under a dissection toms appear primarily in bones and teeth. However, these mecha-
microscope, and total RNA was extracted. mRNA expressional nisms of calcification is not revealed to biological and pathological.
analysis was carried out using DNA microarray, real-time PCR Aim: The purpose of this study was to identify the differentiation
and in situ hybridization(ISH). potential of dental pulp stem cells (DPSCs) derived from HPP in
Results: In DNA microarray analysis, a significantly low level of TNAP knockout (Alp2-/-) mice.
expression of Fgf20, which is one of the essential growth factors Design: Alp2-/- mice develop skeletal disease at day 6–8 and usu-
for early tooth development, was observed in M3s tooth germs ally die of their disease at postnatal day 20. We used day 4–10
Alp2-/- and Alp2+/+ as control mice, sacrificed by decapitation. while growth rate and biofilm quantity formed in the presence
The heads were immediately dissected out under a dissection and absence of glutamine were also determined. In addition, fluo-
microscope, and pulled out M1, M2, and incisor from maxillary rescence efflux measurements using N-phenyl-2-naphtylamine
and mandibular bone. After picked up of dental pulps from (NPN) were carried out to analyze the transporter function of
teeth, the dental pulps were incubated under fixed conditions for the glnP gene.
DPSCs. Then, total RNA was extracted from DPSCs and RT- Results: The growth rate of Dglnp was slightly lower than that of
PCR analysis. the parental strain. On the other hand, in the presence of gluta-
Results: In RT-PCR analysis, the cells collected from dental mine, Dglnp growth was similar to that in its absence, while that
pulps of Alp2-/- mice expressed Pdgf-a, PKG and Sac1 which are of MT8148 in the presence of glutamine was significantly lower
essential DPSCs makers for differentiation potential. than that in its absence. Furthermore, the quantity of biofilm
Conclusions: Our results suggest that the Alp2-/- mouse DPSCs formed by Dglnp was significantly greater than that by MT8148.
have differentiation potential. It is that the DPSCs having differ- Also, addition of 25 or 50 lg/mL of NPN increased the fluores-
entiation potential with a background of HPP helps a pathologic cence intensity of MT8148 and Dglnp, though that of the latter
study of HPP in the future. was significantly lower.
Conclusions: Our results suggest that glnP is associated with glu-
PR12.19 tamine transport, especially in regard to import related mole-
cules.
Dental pulp stem cells from natal teeth: isolation and
morphological study PR12.21
K. M. REZENDE1, J. P. ZUIM2 & M. BONECKER € 1
1
Pediatric Dentistry, University of Sao Paulo, São Paulo, Brazil; Intra-accumbal administration of endomorphin-2
2
University of Sao Paulo, São Paulo, Brazil decreases accumbal acetylcholine efflux of freely
Background: Because of their similar characteristics with other
moving rats
mesenchymal stem cells, the study of dental stem cells has Y. KIGUCHI1, S. YAMAMOTO-NEMOTO2, K. SHIMIZU2 & T.
become a focus of various types of research. Natal teeth have sig- SHIMIZU2
1
nificant occurrence in newborns, usually where the treatment is Department of Pediatric Dentistry, Nihon University Graduate
surgical removal. School of Dentistry at Matsudo, Matsudo, Japan; 2Department of
Aim: The aim of this study was to isolate, cultivate and study the Pediatric Dentistry, Nihon University School of Dentistry at
stem cell morphology characteristics obtained from natal teeth. Matsudo, Matsudo, Japan
Design: The population of adherent cells were obtained by Background: Nucleus accumbens (NAc) is one of the terminal
explant method and separated with STRO-1 marker by magnetic areas of mesolimbic dopaminergic neurons that project from the
technique. Kinetic assays Colony forming unit-fibroblasts (CFU- ventral tegmental area. NAc contains cholinergic neurons and
F), and growth curve of were performed. For morphological animal experiments have shown that selective depletion of these
analysis, the cells were analyzed by SEM and HE and the ionic neurons impairs cognitive function, including memory (Laplante
elementios were detected EDS X-ray microanalysis. et al., 2012). Opioids are applied to control persistent pain in
Results: It was possible to isolate and expand stem cells natal children and amnesia is a recognised adverse effect. There are
teeth pulp with STRO-1 marker. These proved clonogenic and three subtypes of opioid receptors: mu, delta and kappa. Accum-
proliferative. The most prevalent form fibroblastic morphology bal cholinergic neurons express mu receptors that are thought to
was the most significant and ionic characteristics were expressed exert inhibition of cholinergic activity. Endomorphin (EM)-2 is a
as Cl, S, and In these cells. putative endogenous mu receptor agonist (Zadina et al., 1997)
Conclusion: It was possible to isolate and culture stem cells from that has been shown to increase accumbal dopamine (DA) with-
the pulp of natal teeth. Molecular tests more sensitive and differ- out stimulating mu receptors (Okutsu et al., 2006).
entiation in vitro and in vivo is necessary to complement these Aim: We investigated the role of mu receptors in the effects of
findings so that in future become viable in cell-based therapy. EM-2 on extracellular acetylcholine (ACh) in NAc of freely mov-
ing rats.
PR12.20 Design: In vivo microdialysis was used to collect accumbal sam-
ples and to infuse drugs into the NAc.
Functional analysis of the glutamine metabolism gene Results: Intra-accumbal infusion of EM-2 (6 and 30 nmol) reduced
in Streptococcus mutans ACh levels in a dose-related manner. The EM-2 (30 nmol)-induced
Y. MORIKAWA, Y. TAKASHIMA, K. FUJITA & M. decrease of ACh was prevented by co-administration of the selec-
MATSUMOTO-NAKANO tive mu receptor antagonist CTOP (3 nmol), which failed to alter
Department of Pediatric Dentistry, Okayama University Graduate basal ACh. The dose of drug infused into NAc indicates the total
School of Medicine, Dentistry and Pharmaceutical Sciences, amount (mol) over the 30-min infusion time.
Okayama, Japan Conclusions: This study shows that intra-accumbal infusion of
Background: Streptococcus mutans, a biofilm forming bacterium, EM-2, which increased accumbal DA efflux without activating
possesses a large number of transporters that function as import/ mu receptors, decreases accumbal ACh efflux through mu recep-
export molecules. Among them, the PII protein family is com- tor stimulation.
posed of proteins that regulate glutamine synthesis activities in
various bacterial species.
Aim: In the present study, we identified the glutamine transporter
in S. mutans analyzed its functions.
Design: The SMU.732 gene corresponding to glnP in S. mutans
and homologous to the glutamine transporter gene in Bacillus
subtilis, was extracted according to complete genome information
available in a database. We then constructed a glnP-inactivated
mutant strain (Dglnp) and evaluated its cariogenic properties,
PR12.22 ner. Resveratrol has an AMPK-dependent inhibitory effect on

chronic constriction injury (CCI)-evoked astrocyte and micro-
The impaction of pulpitis of different degree on cell
glia activation in spinal trigeminal nucleus (STN). The antino-
proliferation and osteoblastic differentiation of DPSC ciceptive effects of resveratrol were partially mediated by
in Beagle immature premolars reduced phosphorylation of MAP kinases and decreased pro-
L. LONG1, Z. YUMING2 & G. LIHONG2 duction of proinflammatory cytokines in an AMPK-dependent
1
Peking University School and Hospital of Stomatology, Beijing, manner.
China; 2Pediatric Dentistry, Peking University Hospital and Conclusions: In summary, our results indicate that AMPK activa-
School of Stamatology, Beijing, China tion in STN glia via resveratrol may have utility in the treatment
of CCI-induced neuroinflammation and further implicate AMPK
Background: It is found that there are stem cells in inflamed tis-
as a novel target for the attenuation of trigeminal neuralgia.
sue. There are few articles exploring the stem cells in pulpitis and
not comparable because the degree of the inflammation is differ-
ent. So the impaction of inflammation on stem cells is debatable. PR12.24
Aim: To compare the proliferation and osteoblastic differentia- Expression of receptor activator of NF-jß ligand and
tion of DPSCs isolated from normal and inflamed pulps of differ- osteoprotegerin in chronic periapical granuloma of
ent degree in Beagle immature premolars, and provide evidence
for the use of IDPSC.
deciduous teeth
Design: This study evaluated 14 Beagle’s young premolars (21 J. SHANG, N. YANG, H. ZHAO & Y. ZHOU
roots). In the experiment group, irreversible pulpitis was induced Department of Pedodontics, Capital Medical University School of
by pulp exposure and the inflamed pulps were extracted at 2 and Stomatology, Beijing, China
6 weeks after the pulp chamber opening. For the control group, Background: Receptor activator of NF-jß ligand (RANKL) and
normal pulps were extracted immediately after the exposure. HE osteoprotegerin (OPG) are the ultimate factors controlling the
staining and Real-time PCR were performed to confirm of the osteoclast differentiation, activation, maturation and apoptosis
inflammation. The cells were isolated from the inflamed and nor- process. However, the expression of RANKL and OPG in
mal pulps (IDPSC and DPSC). Cell proliferation and osteoblastic chronic periapical granuloma progression of deciduous teeth have
differentiation potential were compared of the two cells. not yet been fully elucidated.
Result: Inflammation cells infiltration was observed in the Aim: Our study aimed to detect the distribution and expression
inflamed pulps by HE staining. The expression of inflammatory of RANKL and OPG in chronic periapical granulomas of decid-
factor was much higher in the 6 week inflamed pulp. IDPSC had uous teeth, and assess its relationship with degree of infiltration
higher potential of cell proliferation and osteoblastic differentia- of inflammatory cells.
tion potentials. Furthermore The osteoblastic differentiation Design: A total of 85 samples of chronic periapical granuloma in
potentials of IDPSC from 2 week inflamed pulp were higher than deciduous teeth were harvested. Hematoxylin-eosin (HE) staining
that of 6 weeks. was used to determine the inflammatory cell infiltration grading
Conclusion: The potential of cell proliferation and osteoblastic (mild, moderate-inflammatory and severe-inflammatory cell infil-
differentiation of DPSC was enhanced at early stage of irrevers- tration groups), and immunohistochemistry and Enzyme-linked
ible pulpitis, and reduced at late stage in Beagle immature pre- immunosorbent assay (ELISA) to disclose the distribution and
molars. expression of RANKL and OPG.
Results: Immunohistochemistry results showed RANKL and
PR12.23 OPG were both expressed in periapical granulomas. In addition
to inflammatory cells and epithelial cells, they were also
Activation of AMPK suppresses glia activation and
expressed on the vascular endothelium. ELISA results showed
alleviates trigeminal neuralgia RANKL and OPG were detected at a higher level in severe-
Y. YANG1, L. HU2 & L. WANG1 inflammatory cell infiltration group than in mild inflammatory
1
Affiliated Dental Hospital of Nanjing Medical University, cell-infiltration group and control group (P < 0.05), whereas
Nanjing, China; 2Nanjing Medical University, Nanjing, China there was no significant difference between severe-inflammatory
Background: Trigeminal neuralgia (TN) is the most common type and moderate-inflammatory cell infiltration groups. However, no
of neuralgia, however, underlying mechanisms have not been significant difference of RANKL and OPG expression was
completely elucidated, and the outcomes of pharmacological or detected between mild-inflammatory cell infiltration groups and
surgical treatments are often disappointing. Activation of adeno- control group.
sine monophosphate (AMP)-activated kinase (AMPK) has been Conclusion: Cytokines RANKL and OPG in periapical granulo-
associated with beneficial effects that include the inhibition of mas of deciduous teeth increase with the aggravation of inflam-
inflammatory nociception and the attenuation of morphine antin- matory severity and appear to be a contributing factor for bone
ociceptive tolerance. remodelling in the progression of periapical granulomas.
Aim: In this study, we investigated the impact of AMPK activa-
tion via resveratrol treatment on trigeminal neuralgia. PR12.25
Design: Peripheral nerve injury was produced using the model of Construction of Cadherin11 expression vector and its
chronic constriction injury of the trigeminal nerve (CCI). Ani-
mals were treated with resveratrol intraperitoneal injection after
effect on the growth of rat dental pulp cells
surgery. We assess mechanical allodynia by measuring with- Y. WU
drawal threshold. The spinal trigeminal nucleus were harvest to Guangxi Medical University, Nanning, China
quantify changes of the phosphorylated protein levels of NR1, Background: Cadherin11 (Cdh11) is a cell adhesion molecule,
NR2B, ERK, PKC, and TNF-a, IL1-b by western blotting and associated with bone formation and differentiation of mesenchy-
observe the glia activation by immunohistochemistry and western mal cells.our previous immunohistochemistry study showed there
blotting. is positive expression of Cadherin11 in rat dental pulp tissue, but
Results: We observed that the AMPK activators resveratrol sig- the role of cdh11 in the tooth development process is unclear.
nificantly attenuated trigeminal pain in a dose-dependent man-
Aim: To investigate the effect of adenovirus expressing cadeher- PR12.27

in11 (Ad-Cadherin11) on proliferation of rat dental pulp cells.
Photodynamic antimicrobial therapy reduces the
Methods: The replication adenoviral vector encoding cadherin11
gene was constructed by using homologous recombinant modal- production of lactic acid by Streptococcus mutans
ity. Cultured the rat dental pulp cell in vitro, observed the expres- biofilms
sion of enhanced green fluorescent protein by fluorescent T. C. SILVA1, A. F. F. PEREIRA2, D. RIOS1, T. M. OLIVEIRA1
microscopy, and detected the virus transfection efficiency. Trans- & M. A. A. M. MACHADO1
1
fected the rate dental pulp cells with Ad-cadeherin11,detected the Department of Pediatric Dentistry, Orthodontics and Public
target gene expression by immunocytochemistry and PCR,and Health, Bauru School of Dentistry/University of São Paulo, Bauru,
the exogenous gene modified rat dental pulp cells were compre- Brazil; 2University of São Paulo/Hospital for Rehabilitation of
hensively studied on their biological features, in terms of mor- Craniofacial Anomalies, Bauru, Brazil
phology, and draw the cell growth curve.
Background: Current technologies as Photodynamic antimicrobial
Results: Constructed adenovirus carrying the Cadherin11 target
therapy (aPDT) might contribute to improve the results of mini-
gene expression vector, measured the titer is 1 9 1010 TU/ml.
mal invasive treatment of dental caries.
Higher transfection efficiency could be obtained at MOI of 50.
Aim: To assess the efficacy of different parameters of aPDT on
Cadherin11 gene modified rat dental pulp cells did not show
the production of lactic acid by Streptococcus mutans biofilms.
obvious changes in cell viability, but dental pulp cells after gene
Design: S. mutans UA159 biofilms were grown on dentin discs in
modification still had some adult cells proliferation.
BHI medium plus 0.2% sucrose 24 h (phase I) and, subsequently,
Conclusion: Cadherin11 gene modified rat dental pulp cells did
treated by aPDT using 0.25 mg/mL PhotogemÒ combined with
not show obvious changes in cell viability, but dental pulp cells
0, 75 or 150 J/cm2 visible red LEDs (BiotableÒ, 630 nm, 50 mW/
after gene modification still had some adult cells proliferation.
cm2). After that, biofilms were re-incubated in BHI medium for
additional 24 h (phase II). The viability of bacterial cells was
PR12.26 determined by CFU counts on BHI agar plates. The concentra-
Researches on expression of glutamate receptors in tions of lactic acid in samples of culture media collected after
human odontoclasts and effects on viability of phases I and II were determined by enzymatic spectrophotome-
try. Data were evaluated by t test and one-way ANOVA and
odontoclasts post-hoc Tukey tests (P < 0.05).
F. HUANG1, H. KONG1, H. HE2, Z. GAO1 & J. LIU1 Results: The concentration of lactic acid significantly decreased
1
Department of Paediatric Dentistry, Guanghua School of after all treatments. PhotogemÒ alone was not able to reduce the
Stomatology, Sun Yat-sen University, Guangzhou, China; CFU counts of S. mutans, although it considerably decreased the
2
Guangdong Provincial Key Laboratory of Stomatology, Guanghua lactic acid concentration of 2.16 (0.12) to 1.62 (0.05) mmol/L.
School of Stomatology, Sun Yat-sen University, Guangzhou, China aPDT reduced significantly the CFU counts. A slight reduction
Background: Physiological root absorption of deciduous teeth is of the viability of S. mutans biofilms observed after the increase
regulated by various factors, mainly mediated by odontoclasts. of light density contrasted with the remarkable reduction of lactic
But the potential mechanism is not yet clear. Odontoclasts have acid concentration of 0.79 (0.17) to 0.35 (0.24) mmol/L.
similar morphology and function to osteoclasts. Many studies Conclusion: aPDT was able to reduce the production of lactic
have demonstrated that glutamate and NMDA glutamate recep- acid by S. mutans biofilms.
tors are involved in regulating formation and activation of osteo-
clast. Whether the receptors are involved in regulating activation PR12.28
of odontoclasts, has not yet been reported.
Deciduous periodontal ligament stem cells regulate
Aim: The aim of this study was quantify the expression of gluta-
mate receptors NR1, NR2B and GluR1 in cultured odontoclasts the formation and apoptosis of osteoclast during
and further to explore the effects of NMDA glutamate pathway physiologic root resorption
on regulating activation of odontoclasts. L. WU, Q. WANG & X. WANG
Design: Odontoclasts were isolated from human deciduous teeth Department of Pediatric Dentistry, School of Stomatology, The
and cultured in vitro. While odontoclasts were identified by mor- Fourth Military Medical University, Xi’an, China
phological and functional studies. Then the expression of gluta-
Background: Deciduous tooth is the only organ which can exfoli-
mate receptors NR1, NR2B and GluR1 in odontoclasts was
ate physiologically in human. The research of physiolocial root
detected by immunofluorescence. In addition, the variation of
resorption of deciduous tooth is of great significance for reveal-
Ca2+ concentration in odontoclasts in different conditions was
ing the potential mechanism of organs exfoliation.
studied using laser scanning confocal microscopy. Lastly, influ-
Aim: To explore the potential regulative mechanism of deciduous
ence of MK801 (NMDA receptor antogonist) on F-actin ring in
periodontal ligament stem cells (PDLSCs) in formation and
odontoclasts was observed by Phalloidin-FITC labeling.
apoptosis of osteoclast during physiologic root resorption.
Results: NR1, NR2B and GluR1 expression was specifically
Design: PDLSCs were isolated and cultured from deciduous
detected in the cytoplasm of cultured odontoclasts. The inflow of
tooth with different degrees of root resorption (UN, no resorp-
Ca2+ to intracellular of odontoclasts and the formation of F-
tion; M, moderate resorption; S, severe resorption) and perma-
actin ring was reduced but not be prevented by MK801
nent tooth.We examined the expression of RANKL, OPG and
(P < 0.05).
FasL, which are key factors to osteoclast status, of PDLSCs
Conclusions: NR1, NR2B and GluR1 are expressed by odonto-
from each group through real time-PCR and western blot. In
clasts. MK801 has effects on Ca2+ concentration in odontoclasts
addition, we identified numbers of TRAP (+) osteoclast-like cells
by regulating NMDA pathway, and also influences resorptions of
by TRAP staining and apoptotic cells by TUNEL staining after
odontoclasts by regulating the formation of F-actin ring.
PDLSCs co-cultured with RAW264.7.
Results: Real time-PCR and western blot assays indicated that
the expressions of RANKL were downregulated while OPG and
FasL were upregulated significantly in M group. The TRAP
staining results showed that the number of TRAP (+) osteoclast-
like cells were increased significantly in M group co-cultured with Aim: To determine whether the ionic content of saliva is associ-
RAW264.7, while TUNEL staining showed that the number of ated with caries experience.
apoptotic cells were decreased in M group co-cultured with Design: Children who attended randomly selected pre-school cen-
RAW264.7. tres in inner-Melbourne were invited to participate. Consented
Conclusions: The different expression pattern of RANKL, OPG children (n = 119) gave an unstimulated saliva sample, had their
and FasL may contribute to the formation and apoptosis of teeth brushed and a dental examination. Dental caries was
osteoclast in the proscess of physiological root resorption in recorded using the International Caries Detection and Assess-
deciduous tooth. ment System criteria (ICDAS II). The saliva samples were de-
identified and frozen; pH was measured using a microelectrode,
PR12.29 the samples were centrifuged, the supernatants diluted, acidified,
mixed, filtered and injected into a labelled vial. Levels of detect-
Withdrawn abstract. able inorganic ions were quantified for each sample using an
automatic ion chromatography system (Dionex). Statistical analy-
PR12.30 sis utilised descriptive statistics, cross-tabulations and chi-squared
tests, binary logistic regression and the Mann-Whitney U test.
The effects of graded concentrations of xylitol and Results: Fluoride concentration was statistically significantly
erythritol on Streptococcus mutans and sobrinus higher in children with clinically sound teeth compared to those
growth with cavitated caries lesions (ICDAS >3; P = 0.005). Ammonium,
K. W. WHITE1,2, C. M. LE1,2, A. L. VORACHEK1,2, M. sodium, chloride and lactate concentration levels were statistically
MERCHANT1,2, W. KABAT1,2 & M. L. CANNON1,2 significantly higher in children with caries including white spot
1
Northwestern University, Feinberg School of Medicine, Chicago, lesions (ICDAS >1) compared to children without (ICDAS <2;
IL, USA; 2Ann and Robert H. Lurie Children’s Hospital of P = 0.007, 0.02, 0.03, 0.03 respectively).
Chicago, Chicago, IL, USA Conclusion: Specific ionic contents of saliva in 3–5 year old chil-
dren were associated with caries experience.
Background: Xylitol and erythritol are known inhibitors of Strep-
tococcus mutans and sobrinus; however, the pharmacodynamics
of these polyols has not been adequately characterized.
PR12.32
Aim: The purpose of this study was to investigate in vitro the The effect of cadherin-11 on the migration and
effect of graded concentrations of xylitol and erythritol on Strep- differentiation of rat dental pulp cells
tococcus mutans and sobrinus growth and then investigate the B. GAO
pharmacodynamic interaction of xylitol and erythritol. Guangxi Medical University, Nanning, China
Design: Graded concentrations of xylitol and erythritol were
added to Todd Hewitt Broth (THB) with 1% sucrose or brain- Background: Cadherin11 (Cdh11) is a cell adhesion mole-
heart infusion (HBI) with 1% sucrose. Strains of Streptococcus cule, associated with bone formation and differentiation of mes-
mutans and sobrinus were inoculated into either 2 mL of BHI or enchymal cells.our previous immunohistochemistry study showed
THB. These suspensions were inoculated into culture plates. At there is positive expression of Cadherin11 in rat dental pulp tis-
48 h, bacterial growth was observed, and optical density was sue, but the role of cdh11 in tooth development process is
measured using confocal microscopy (620 or 640 nm). unclear.
Results: Control groups demonstrated growth of all strains. Xyli- Aim: To investigate the effects on the migratory and odontogenic
tol showed inhibited growth of all four strains at 300 mg/mL; ability of rat dental pulp cells by transfection with adenovirus
erythritol showed inhibition of all four strains at 270 mg/mL, vector encoding cadherin-11.
and 2/4 strains were inhibited at 150 mg/mL. Bactericidal effects Design: The dental pulp cells were primarily cultured, then trans-
were not observed even at the highest concentration. For strain fected with pDC316-mCMV-EGFP-Cadherin11. Immunohisto-
68 and 78, xylitol and erythritol were not synergistic but possibly chemistry staining were performed to detect the expressions of
additive. Synergistic interactions were shown in strain 75, but cad-11 protein. Alizarin red staining and cetylpyridinium chloride
biomass reduction was inconclusive. For strain 41, the data sug- assay were performed to investigate the odontogenic ability of
gested an antagonistic interaction of xylitol and erythritol in a rat dental pulp cells. Then the adhesion and migration of rat
dose-dependent manner. dental pulp cells were tested.
Conclusions: Complete growth inhibition of Streptococcus mutans Results: The immunohistochemistry staining showed that rat den-
and sobrinus growth can occur at 300 mg/mL of xylitol and tal pulp cells transfected by pDC316-mCMV-EGFP-Cadherin11
270 mg/mL of erythritol. Though additive effects were noted, could express the cad-11 protein at a high level. ALP activity of
xylitol and erythritol showed a lack of synergistic inhibition. experimental group was significantly upregulated, and the formed
calcified nodules of experimental group was significantly
increased (P < 0.05). Cadherin-11 also influenced the adhesion
PR12.31 and migration of rat dental pulp cells (P < 0.05).
Salivary biomarkers in early childhood caries Conclusion: Cadherin-11 may promote the odontoblast differenti-
D. C. ELSBY1,2, K. B. HALLETT1,2 & D. J. MANTON1,2 ation and migration of rat dental pulp cells.
1
Melbourne Dental School, University of Melbourne, Melbourne,
VIC, Australia; 2Department of Dentistry, Royal Children’s PR12.33
Hospital, Melbourne, VIC, Australia
The influence of etching and re-mineralization time
Background: The literature is conflicting regarding the relation- on enamel re-mineralization of deciduous teeth
ship between dental caries experience and salivary ionic concen-
J. WANG & H. CHEN
trations; and this relationship in 3–5 year old children has not
School of Stomatology, Shanghai Jiaotong University, Shanghai,
been investigated extensively. A need exists to determine the asso-
China
ciation between pH, flow rate and ionic content of saliva and
caries experience. Aim: To study the effect of etching time and remineralization
time on the enamel re-mineralization of deciduous teeth.
Design: Twenty-eight primary incisors were used in this experi- PR12.35

ment. Four rectangular windows were created in the labial sur-
Confirmation of a new mutation in the PTH1R-gene
face of each incisor, randomly assigned to four treatment groups
(Group A, B, C, D). The windows in group A, B, C, D were over two generations
etched 30s, 60s, 90s and 120s respectively with 32% phosphoric S. FEIERABEND1, B. HARTMANN2, E. HELLWIG1 & J.
acid gel. All the samples were rinsed and re-mineralized in artifi- FISCHER2
1
cial saliva. cofocal laser scanning microscopy (CLSM)was applied Department of Operative Dentistry and Periodontology,
to study the de-/re-mineralization. Average Lesion Fluorescence University Medical Center, Centre for Dental Medicine, University
(AF) for each sample was recorded at each time point of 0, 2, of Freiburg, Freiburg, Germany; 2Institute for Human Genetics,
24 h. The data was analyzed with repeated measurement. The University Medical Center, University of Freiburg, Freiburg,
significance was 0.05. Germany
Results: The results of MANOVA showed both etching time and Background: Primary failure of eruption (PFE) is defined as the
re-mineralization time had a significant effect on the value of AF inability of one or more permanent teeth - preferably posterior
(P < 0.0001, P < 0.0001 respectively). Bonferroni analysis indi- teeth - to erupt fully into the oral cavity. Heterozygous mutations
cated that the difference of AF between each group was signifi- of the parathyroid hormone receptor 1 (PTH1R, MIM 168468)
cant except that between 90s and 120s. The difference of AF have been identified to be causal via an autosomal dominant trait
between each time point within each group was significant. of inheritance.
Conclusions: It was inferred the etching time was no more 60s, Aim: Only recently, several new mutations in the PTH1R-gene
and the re-mineralization time may be 24 h when the acid-resis- have been discovered, merging the number of known mutations
tance and remineralization potential of primary teeth were exam- to 27. The newly identified frameshift mutation c.322delT has
ined. been identified in two brothers so far. Here, we present the segre-
Keywords: Primary teeth, Enamel, De- and re-mineralization, gation- and DNA-analysis of a family over two generations in
CLSM. which one parent and two siblings are affected with the respective
mutation.
PR12.34 Methods: PFE was clinically and radiographically diagnosed in
Comparative investigation of six self-etch adhesives the siblings and their father. Informed consent prior to participa-
tion was obtained from three affected and one unaffected family
for bonding to dentin of primary teeth member. Ethylenediaminetetraacetic acid (EDTA) blood samples
H. WEBER1, T. OSCHMANNN1, S. LÜCKER1, R. were obtained, and after extraction of the DNA the coding exons
FRANKENBERGER2 & N. KRAMER € 1
1 of the PTH1R-gene were investigated via amplicon sequencing.
Pediatric Dentistry, Medical Center for Dentistry, University Results: The frameshift mutation c.322delT was identified in one
Medical Center Giessen and Marburg, Campus Giessen, Giessen, parent (father) and the two siblings (brothers), while the other
Germany; 2Operative Dentistry and Endodontics, Medical Center parent (mother) did not display any possibly pathological or so
for Dentistry, University Medical Center Giessen and Marburg, far unclassified variant (UV).
Campus Marburg, Marburg, Germany Conclusions: This analysis identified the c.322delT mutation in
Background: There are many studies concerning l-tensile tests of the PTH1R-gene within this family. Frameshift mutations are
bondings in the permanent dentition. Nevertheless, due to the considered to be deleterious. The confirmation of this mutation
different structure of dentin the transfer to the 1. Dentition is not within a family with a two generation pedigree endorses the
allowed. results in two siblings found prior to this analysis.
Aim: The aim of this in vitro study was to compare 5 new self-
etch adhesives regarding microtensile bond strength (l-TSB) to PR12.36
dentin of primary teeth in control to a well-established adhesive
Using the deciduous tooth as a tool to record early
(Prime and Bond NT).
Design: Thirty freshly extracted primary molars were ground to zinc nutrition
expose caries-free dentin. Specimen were bonded with 6 self-etch N. A. WAHONO1,2,3, W. DIRKS1, D. FORD2,3 & R.
adhesives (Prime and Bond NT (PBNT)/Dentsply De Trey), Gae- VALENTINE1,2,3
1
neal Bond (GB)/GC- America, Scotchbond Universal (SU)/ School of Dental Science, Newcastle University, Newcastle Upon
3MEspe, Clearfil SE Bond (CFSE)/Kuraray, Optibond XTR Tyne, UK; 2Institute for Cell and Molecular Biosciences,
(OXTR))/Kerr, One Coat 7 Universal (OC7U)/Coltene). Filtek Newcastle University, Newcastle Upon Tyne, UK; 3Human
Z250 (3M Espe) was used as resin composite. Light curing was Nutrition Research Centre, Newcastle University, Newcastle Upon
performed with a LED lamp (Bluephase, Ivoclar-Vivadent). After Tyne, UK
24-h storage (distilled water, 37°C), resin-dentin beams were cut Background: It is long established that early life nutrition can
and 608 resin-dentin sticks were subjected to l-TSB tests (TC550, have long - life consequences for health. These events are known
Syndicad). Fracture analysis was carried out at 409 magnifica- as ‘programming’ events. Zinc is an abundant micronutrient and
tion under a fluorescence microscope (AZ 100 M, Nikon) and has essential roles in human growth and development. Thus, zinc
under SEM (Amray, Liebscher). nutrition exposure during early life becomes an interesting micro-
Results: The following values of l-TBS (MPa [SD]); pre-test fail- nutrient to study. Zinc deposition within deciduous teeth has
ures (n. %) were determined (Same letters represent statistical been reported by previous studies. Deciduous teeth develop from
subgroups P > 0.05 ANOVA mod. LSD): PBNT 48[14]B; 0,0%, the prenatal/in utero period. Therefore the present study overall
GB 28[16]A; 0,0%, SU 51[23]B; 2,1,9%, CFSE 28[15]A; 2,2,7%, aim is to explore the usefulness of deciduous teeth as a tool to
OXTR 57[16]B; 0,0% and OC7U 70[17]C; 0,0%. record zinc nutrition exposure during early life.
Conclusion: Within the limits of this study, the new self-etch Aims: Zinc is obtained from human diets and the distribution
adhesives SCU, OXTR, and OC7U seem to be suitable for the throughout the body and within cells is regulated by a saturable
use in primary dentition. carrier-mediated transport mechanism, known as a zinc trans-
porter protein. Therefore, our preliminary study is focussing on
the expression of zinc transporter genes within dental pulp of
teeth.
Design: RNA from dental pulp extracted from the deciduous regenerative medicine due to their self-renewal capacity and mul-
human teeth was prepared using TriZol (Ambion) RNA isola- tipotency ability .Several studies have indicated that cryopre-
tion. RNA from Caco-2 cell line also isolated, to be used as con- served dental pulp tissues of SHED is a retrievable and practical
trol tissues in the study. Then zinc transporter gene expression source for cell-based therapy. However, the studies of long-period
was analysed using an RT- PCR based method. storage SHED are limited.
Results: There is a differential pattern of zinc transporters Aim: to investigate the ability of SHED cryopreserved over
expressed in pulp extracted from deciduous human teeth. 5 years in terms of clonogenicity, self-renew and multipotential
Conclusion: There is a role for zinc transporter in dental pulp of differentiation.
deciduous human teeth. Design: Human freshly isolated SHED (fSHED) were compared
with cryopreserved SHED (cSHED) in terms of cell proliferation
PR12.37 rate (n = 6), colony-forming efficiency (n = 3), multilineage differ-
entiation capacity (n = 4).
Characterization of long-term cryopreserved stem Result: There was no significant difference between fSHED and
cells from human exfoliated deciduous teeth cSHED with regard to morphology, proliferation, or osteogenic
S. KAMOLMATYAKUL1 & O. PARNKAEW2 and adipogenic differentiations.
1
Preventive Dentistry, Prince of Songkla University, Hadyai, Conclusion: These data suggest that our long-term cryopreserved
Thailand; 2Price of Songkla University, Hadyai, Thailand SHED could be retrieved and they presented similar characteris-
tics as freshly isolated ones.
Background: Stem cells from human exfoliated deciduous teeth
(SHED) have been considered to be a promising source for
Diagnosis and Imaging Poster Session – PR13

PR13.01 PR13.03
A study on factors associated with the eruption Double dilacerations in an erupted upper central
disorder of first permanent molars incisor: a case report
J. Y. KIM1, M. S. KIM1, J. M. SUN1, G. T. KIM2 & S. C. CHOI1 L. M. MILLAR1, K. J. DONALDSON2, L. M. BROCKLEBANK3
1
Pediatric Dentistry, Kyung Hee University, School of Dentistry, & L. L. K. CHUNG4
Seoul, Korea; 2Oral and Maxillofacial Radiology, Kyung Hee 1
Department of Paediatric Dentistry, Glasgow Dental Hospital and
University, School of Dentistry, Seoul, Korea School, Glasgow, UK; 2Department of Radiology, Glasgow Dental
Hospital and School, Glasgow, UK; 3Dental School, University of
Background: Ectopic eruption of the maxillary first permanent
Glasgow, Glasgow, UK; 4Department of Orthodontics, Glasgow
molars could be frequently seen. A first permanent molar with a
Dental Hospital and School, Glasgow, UK
minor degree of impaction usually will be spontaneously cor-
rected. However, if there is a greater degree of impaction, it will Introduction: Double dilacerations are not commonly reported,
not be self-corrected. with only one case report found following a literature search.
Aim: The purpose of this study was to find out the factors that Cone beam computed tomography (CBCT) is an evolving imag-
are associated with the ectopic eruption of first permanent molar ing technique and its main use in paediatric dentistry is for locali-
and predict the ectopic eruption in sample of growing Korean sation of unerupted teeth and in detecting root resorption.
children. This case describes diagnosis, through the use of CBCT, of dou-
Design: Retrospective study was done using the panoramic radio- ble dilacerations affecting an upper left central incisor (21) which
graphs of patients in the early mixed dentition stage. In the had nevertheless erupted.
affected patients, two types of ectopic eruption (reversible and Case report: A 12-year-old boy was referred to Glasgow Dental
irreversible) were distinguished. A method was designed to evalu- Hospital and School, concerned over the appearance of his
ate the angle between second primary molar, first permanent “squint teeth.” There was a history of trauma to the deciduous
molar and the tooth germ of second permanent molar using the dentition.
long axis of each tooth was measured on the radiographs and the Oral examination: mixed dentition; 21 erupted with an unusual
angle between the occlusal plane were measured. Occlusal rela- morphology and area of hypoplastic enamel; 22 erupted palatal
tionship of primary molar was also observed. to 21 and in crossbite; moderate crowding in both arches and
Results: As degree of impaction was greater compared with con- poor oral hygiene.
trol group, the value of intermolar angulation and occlusal plane Plain imaging: a panoramic radiograph (DPT) and an upper
angle between second primary molar, first permanent molar and anterior oblique occlusal radiograph showed what appeared to be
tooth germ of second permanent molar was getting smaller. an unerupted supernumerary superimposed on 21. CBCT was
Conclusions: The degree of angulation of first permanent molar carried out with a limited height field of view to investigate this.
and tooth germ of second permanent molar has significant rela- This provided a definitive diagnosis of “double dilacerations”
tionship with possibility of self-correction. Also correlation affecting 21, and revealed that no supernumerary was present.
between inclination of the occlusal plane and degree of impaction Comments: What initially appeared to be a common anomaly
was observed. turned out to be a much rarer entity. Monitoring of further erup-
tion and oral hygiene instruction is required. Future treatment
PR13.02 options will include fixed appliances with composite masking or
veneering of 21.
Cone beam CT in pediatric patients Without CBCT, had only plain films been available, diagnosis
H. E. TAVAKOLI, S. MOHSENI2 & H. I. TAVAKOLI3 would have been incorrect, which may have resulted in inappro-
1
Oral and Maxillofacial Radiology, Shahid Sadoghi Dental priate invasive treatment.
University, Yazd, Iran; 2Shahid Sadoghi University, Yazd, Iran;
3
Tehran University of Medical Sciences, Tehran, Iran
PR13.04
Background: Radiographs are valuable aids in the oral health The influence of fissure sealants on values of laser
care of children. They are used to diagnose oral diseases and to
monitor dentofacial development and the progress of therapy.
fluorescence
New imaging technologies have added three-dimensional capabil- T. TOYAMA1, Y. MATSUBARA1, O. FUKUTA1, M.
ities that have many applications in dentistry. MALINOWSKI2, J. K. TOUMBA2 & M. S. DUGGAL2
1
Cone beam computed tomography (CBCT) has improved diag- Pediatric Dentistry, Aichi Gakuin University, Nagoya, Japan;
2
nosis and treatment planning in dentistry. The decision to use University of Leeds, Leeds, UK
CBCT should be based on the diagnostic information required. Background: Laser fluorescence can be used for non-invasive
As with any other radiographical technique, routine use of CBCT diagnosis of caries in pits and fissures caries.
is not acceptable. CBCT usage must be justified on a patient case Aim: The aim of this study was to investigate whether caries
individual basis. under a sealant can be detected by the laser fluorescence device.
Aim: In this presentation we discuss about CBCT application in Design: In order to study the influence of the distance of the
pediatric patients. probe from the carious lesion on the fluorescence values, 24
extracted molars with fissure caries were obtained. The laser fluo-
rescence device used was DIAGNOdent (Kavo., Germany). The
probe was placed at a distance of 0.0, 0.3, 0.5, 0.8 and 1.0 mm
vertically from the carious lesion and values were measured. attacks of pain and pulmonary compromise, widespread organ
Next, the influence of the sealant when placed between the probe damage that can lead to death. Oxidative stress plays an impor-
and the carious lesion on the DIAGNOdent values was investi- tant role in pathophysiology of sickle cell anaemia as it destroys
gated. The sealant was placed in two thickness’s; 0.3 and free radicals and thereby depleting the protective mechanisms
1.0 mm, and in four shades; red, yellow, clear (natural) and white such as antioxidants in serum. These antioxidants present in the
(opaque) on the flat side of the experimental tooth, and the DI- body are very essential to protect the harmful oxidation-reduc-
AGNOdent value’s were measured. tion reactions avoiding oxidative damage to the cells.
Results: A decline of measured value was observed when the dis- Aim: To evaluate and compare the Total Antioxidant Capacity
tance increased between the probe and the carious lesion. Also (TAC) of serum and saliva in sickle cell anemia patients.
there was a tendency for the fluorescence values to decline with Design: 4–12 year old children (N = 100) were selected and
increasing thickness of the sealant. divided into two equal groups: Children suffering from sickle cell
Conclusions: Our results showed that distance from the lesion, anemia and healthy controls. Blood and saliva samples were col-
thickness of the sealant and the shade of the sealant influenced lected aseptically from both groups and were subjected to phosp-
the fluorescence values, and therefore the results obtained with homolybdenum method. Absorbance was read
the use of DIAGNOdent when used for diagnosis of fissure caries spectrophotometrically at 695 nm. Concentration of total antioxi-
under a sealant should be interpreted with caution. dants was obtained by plotting the absorbance of test against
standard graph.
PR13.05 Results: TAC in serum (10.89 2.26) and saliva (11.17 1.19)
of sickle cell anaemia patients was reduced when compared with
Diagnostic bitewing radiographs: an audit of serum and saliva of the healthy children respectively. Levels of
compliance with national guidance TAC were found to be statistically significant in serum and saliva
A.M. HARGAN1 & P. FEE2 in sickle cell anaemia patients. Reduction in the total antioxidant
1
Public Dental Officer, NHS Lanarkshire, Coatbridge, UK; capacity was noted as the age advances as antioxidant defense
2
Senior House Officer, Dundee Dental Hospital, Dundee, UK mechanisms are not sufficient to prevent age related increase in
oxidative damage.
Background: Scottish Dental Clinical Effectiveness Programme
Conclusion: Saliva, a non invasive biomarker could be an alterna-
(SDCEP) Guidance on Prevention and Management of Dental
tive for assessing the antioxidant status in sickle cell anaemia
Caries in Children report “bitewing radiographs are an important
patients.
adjunct to visual diagnosis of caries”. SDCEP Guidance recom-
mend practitioners take bitewing radiographs at intervals based
on the child’s risk of developing caries: 6–12 month intervals for PR13.07
children at increased risk, for children considered low and med- An audit of the documentation of dental radiographic
ium risk with primary teeth at 12–18 month intervals, and at examination justification
two-yearly intervals for these children with permanent teeth.
D. AHMED, K. KOWASH & M. AL HALABI
Aim: This audit was planned to assess current compliance with
Paediatric Dentistry, Dubai College of Dental Medicine, Dubai,
SDCEP Guidance by dentists working in a Public Dental Service United Arab Emirates
Clinic in Lanarkshire.
Design: Data was collected by retrospective review of patient Background: A routine dental radiographic examination where
records from a computerised patient management system for 70 radiographs are exposed regardless of the presence or absence of
patients attending examination appointments over a five-month clinical signs and symptoms is unacceptable. According to the
period with all dentists working at a Public Dental Service Clinic. European guidelines on radiation protection in dental radiology,
A Gold Standard was set - “100% of patients meet current the selection of radiographs should be based on the individual
SDCEP Guidance”. patient’s history and clinical examination, where the dental radio-
Results: 38% of patients met current SDCEP Guidance regarding graphic examination will add new information to aid in the
bitewing intervals. Following an educational meeting with the patient’s dental treatment planning.
dentists to present findings and targets for improvements exami- Aim: To evaluate whether the justification for exposing dental
nation appointments were extended to allow necessary radio- radiographs has been documented in the files of patients attend-
graphs to be taken and reported on. A second round of data ing the paediatric dentistry clinic with a targeted standard of
collection was completed for 54 patients attending examination 100%.
appointments over a three-month period. 72% of cases met Design: A retrospective case note evaluation of children aged
SDCEP Guidance representing a significant improvement in com- twelve years and younger who attended the pediatric dentistry
pliance. clinic. Data was collected over a six months period using a data
Conclusions: Bitewing radiographs are necessary for diagnosing collection sheet.
early interproximal carious lesions which would otherwise remain Results:
untreated. Auditing compliance to SCDEP guidance can increase Dental radiographs taken in 167 visits.
diagnostic information and improve patient oral health out- Justification documented for 11 visits (6.6%).
comes. Justification not documented for 156 visits (93.4%).
Thus only 6.6% of dental radiograph justifications have
PR13.06 been documented in the patients’ files.
3% of the files were missing the documentation for radio-
Determination of total antioxidant capacity of serum graphs exposed.
and saliva in sickle cell anaemia patients The clinical notes template used in the clinic includes only
S. BALIGA, P. BHATIYA & N. THOSAR the need for documenting type of radiograph taken and findings
Pedodontics, Preventive Dentistry, Sharad Pawar Dental College, but not the justification.
Wardha, India Conclusion: This audit has highlighted the deficiencies in our
practice of patient file documentation. Recommendations for
Background: Sickle cell anemia is a congenital haemoglobinopa-
improvement had been made where the clinical note template
thy characterized by deformed red blood cells, acute episodic
was updated by adding a dental radiographic examination justifi-
cation note and a second audit cycle is planned to measure the For all roots, the location of the AF with respect to the RA was
outcomes. identified on CBCT images.
Results: The AF was located within 2 mm coronal to the RA in
PR13.08 100% of roots in Group 1, within 3 mm coronal to the RA in
90.2% of roots in Group 2 and within 3 mm coronal to the RA
Influence of exposure settings on the visibility of in 74% of roots in Group 3.
anatomical landmarks in intraoral radiography Conclusions: WL for primary teeth with PTG located below the
A. A. AL-HUMAIRI & A. JOB primary tooth RA should terminate at 2 mm coronal to the RA.
School of Dentistry and Health Sciences, Charles Sturt University, For primary teeth with PTG located between the RA and the
Wagga Wagga, NSW, Australia apical third or between the apical one-third and two-thirds, WL
should terminate 3 mm and more than 3 mm coronal to the RA
Background: Intra-oral radiograph examination is widely used
respectively.
with low but frequent absorbed dose, especially with paediatric
patients. It is suggested that frequent low dose exposure can pro-
voke risks of stochastic effects. PR13.10
Aim: To evaluate the bite-wing image quality and the visibility of Validation of method for evaluating pain caused by
different anatomical landmarks with respect to different exposure temporomandibular disorders in youngsters with an
settings using visual grading analysis.
Design: Ethical and radiation safety approvals were obtained.
intellectual disability
Digital posterior bite-wing radiographs at settings of 70, 66, 63 G. DUGASHVILI1, G. MENABDE2, M. JANELIDZE2, L. VAN
and 60 kV, range of (2–8) mA were taken to dry skull with wax DEN BERGHE1 & L. MARKS1
1
simulating soft tissue. The focus-soft tissue simulate distance was Centre of Special Care in Dentistry, PaeCoMeDis, Gent
20 cm and a rectangular collimator (35 9 45 mm2) was used. University Hospital, Gent, Belgium; 2Ilia State University,
Photostimulable phosphor (PSP) digital radiography systems- Scientific Research Institute of Medicine, Tbilisi, Georgia
technology was used, and the exposure times were 1.6 and 1.25 s. Background: The Universal Pain Assessment Tool (UPAT) is cre-
Several anatomical landmarks were selected due to their clinical ated to assess the pain level of patients with limited communica-
relevance, and the images were evaluated by dentists with clinical tion skills. UPAT gives clinicians the ability to consult the pain
experience ranging from 8–25 years based on the visibility of management team more often in order to lead to a more early
these landmarks. Intra and inter-observer agreement were intervention.
assessed. Aim: The purpose of this study was to determine, whether the
Results: The results from the evaluation of the quality of the UPAT could be used as a valid instrument to collect data and
bite-wing images indicate that the VGAs are higher for low-kV assess pain levels caused by temporomandibular disorders
settings. In turn, the clinical image quality improves when the (TMD) in people with ID.
tube voltage is reduced. Despite that the trend of the VGAs as a Design: Non-down syndrome ID Athletes aged between 15 and
function of tube-voltage are obvious, significant differences were 23 years, participating from different countries, were screened
not demonstrated. However, exposure time and image quality did during the Special Olympics European games 2014. The clinical
not display a notable relation. scores of possible functional jaw pain were collected using the
Conclusion: An adequate clinical image quality of a bite-wing UPAT, as the athletes were asked to indicate pain severity on a
radiograph is achievable by reducing the tube-voltage, subse- visual scale during jaw movements.
quently leading to decreased radiation dose. Results: Overall 204 youngsters were screened. The majority of
participants were male (133 male and 71 female patients). The
PR13.09 distribution of age ranged from 15 to 23 years with a mean age
of 19.25 (SD = 2.53). The results of the UPAT indicated the exis-
Cone beam computed tomography evaluation of the tence of pain related to the temporomandibular joint (TMJ),
effect of permanent tooth germ on localization of probably caused by TMD, in 32% of the athletes.
deciduous teeth apical foramen Conclusions: According to the results of the present study, the
S. SARI1, A. E. ZEREN1, L. DURUTÜRK1, O. GÜLEN2 & K. UPAT demonstrated to be a useful tool, in order to detect the
KAMBUROĞLU3 existence of functional jaw pain caused by TMD. Moreover it
1
Pediatric Dentistry, Ankara University/Faculty of Dentistry, possibly could be considered as a valid instrument for collecting
Ankara, Turkey; 2Oral and Maxillofacial Radiology, 75th Year data considering pain intensity caused by TMD in people with
Dental Hospital, Ankara, Turkey; 3Oral and Maxillofacial ID.
Radiology, Ankara University/Faculty of Dentistry, Ankara,
Turkey PR13.11
Background: Physiological root resorption causes continuous Detection of occlusal caries among children in
change in the position of the apical foramen (AF) in primary Madinah, KSA, according to WHO basic methods,
teeth, making determination of working length (WL) difficult.
Aim: This study aimed to evaluate the relationship between pri-
ICDAS II and laser fluorescence
mary tooth AF, primary tooth root apex (RA) and permanent O. S. BAHAKAM, M. A. MIRZA, H. A. AL-OFI,
tooth germ (PTG) on Cone-beam computed tomography (CBCT) Z. M. AL-HARBI, W. SAADI & A. BHAYAT
images in order to identify a radiographic reference point for the Taibah University, Medina, Saudi Arabia
termination of WL. Background: Caries is one of the most prevalent diseases affecting
Design: A total of 115 root canals were evaluated from CBCT young children worldwide. There are only few reports on Madi-
images divided into three groups according to location of the nah children, (Saudi Arabia) using DMFT.
PTG, as follows: Group 1 (n = 14): PTG located below the pri- Aims: To compare the WHO criteria (DMF and plaque index),
mary tooth RA; Group 2 (n = 51): PTG located between the pri- ICDAS II criteria, and laser fluorescence measurements in detect-
mary tooth RA and the root apical third; Group 3 (n = 50): ing the prevalence and severity of dental caries amongst children
PTG located between the root apical one-third and two-thirds. between 8 and 12 years.
Design: Ethical approval was obtained from the Research & Eth- PR13.13
ics Committee at Taibah University, College of Dentistry. A total
Temporomandibular joint changes detected by cone
of 520 children 8–12 years-old, from Al-Madinah, Saudi Arabia,
were recruited in this randomized clinical trial. Four parameters beam computed tomography in children with sleep
(Silness and Lowe plaque index, DMFS, ICDAS II and laser flu- bruxism and painful symptoms
orescence measurements) were measured, mainly on first perma- K. V. DIAZ-SERRANO1, F. LORENCETTI-SILVA2, F. G.
nent molars, by four students in anonymous way. Data were LEITE3, P. NELSON-FILHO1 & F. W. PAULA-SILVA1
1
analyzed using Chi-square, Regression Correlation and Indepen- Pediatric Dentistry, School of Dentistry of Ribeirão Preto,
dent T test using SPSS21 statistical package. University of Sao Paulo, Ribeirao Preto, Brazil; 2School of
Results: Preliminary results showed the prevalence of dental car- Dentistry of Ribeirão Preto, University of Sao Paulo, RIbeirao
ies was as follow: Preto, Brazil; 3Ophthalmology, Otolaryngology and Head and
About 14.5% of the 8–12 year-old children had caries in the per- Neck Surgery, Medical School of Ribeirão Preto, University of
manent dentition according to DMFS, caries lesions were Sao Paulo, Rbeirao Preto, Brazil
recorded as ICDAS II was about 75.5% (score 1–6), while Diag-
Background: Although the impact of bruxism on the stomatogna-
nodent measure was 36.7% (reading 12–99).
thic system is unclear, it is a risk factor for TMD. Early detec-
Silness and Lowe plaque index was 1.79.
tion of changes in TMJ structures by CBCT, possibly associated
Conclusions: This study showed the diagnostic potential of the
with sleep-bruxism, would permit the interception of dysfunc-
ICDAS II criteria in comparison to the traditional WHO criteria
tional problems in its initial stages.
by means of DMFS also the ICDAS II use seems to bring addi-
Aim: To assess bone changes in the temporomandibular joint
tional information in comparison to DIAGNOdent while it0 s
(TMJ) structures and condyle-articular fossa relationship in
more reliable when compared to DMFS, study showed that IC-
symptomatic children with sleep bruxism by cone beam com-
DAS II is more reliable than DMFS and DIAGNOdent in
puted tomography (CBCT) imaging.
detecting occlusal dental caries.
Design: Twenty 7–11 year-old children were selected based on
parent’s report about the presence of audible tooth grinding
PR13.12 sounds or tooth clenching during sleep and orofacial pain on
Prevalence of angulation of the maxillary canine awakening or in function. Children were subjected to clinical and
germ CBCT examinations. Data were analyzed using Freeman-Halton
extension of Fisher’s exact test (a = 5%).
V. L. CASTELLANOS-CONTRERAS, I. A. VERDUGO-
Results: Asymmetries of TMJs were found in 60% of the children
VALENZUELA, C. A. FREGOSO-GUEVARA, M. A.
and condyle flattening in 100%. Osteophytes in the right-condyle
ZAMUDIO-GOMEZ & M. E. TORRES-ARELLANO
were associated with moderate and severe pain in the ipsilateral
Universidad Autónoma de Baja California, Tijuana, Mexico
TMJ (P = 0.04). Anterior position of the right-condyle was asso-
Background: This study assessed the angulation of the canine ciated with left-temporal-muscle pain (P = 0.03). When the left-
germ at different age as a guide to establish the possible impac- condyle was centered, contralateral pain was reported in the
tion of maxillary canines. Most studies focus on the localization right-temporal-muscle (P = 0.04). Anterior and posterior right-
of the maxillary impacted canines, no studies about the angula- condyle-fossa relationship was associated with mild and severe
tion of the canine germ were found. pain, respectively, in the ipsilateral masseter-muscle (P = 0.01).
Aim: To determine the prevalence of the angulation of maxillary Conclusions: Bone changes in the TMJ and alterations in the con-
canine germ with age and gender. dyle-articular fossa relationship detected by CBCT showed asso-
Design: This cross-sectional observational study in 100 panoramic ciation with painful symptoms in the joint region and
radiographs of patients from the Clinic Orthopedics and Ortho- masticatory muscles in children with sleep bruxism.
dontics of Pediatric Dentistry Postgraduate Program based on
the criteria of Erickson and Kurol modified: canine angulation in PR13.14
relation to the middle line defined by grades 1, 2 and 3.
Results: Measurements were taken on radiographs of 200 canines External root resorption of several permanent teeth:
of children between 4 and 11 years old. The higher frequency in a diagnostic clue
the angulation canine germ in relation to the midline was grade 1 G. AHBAB1, V. VERHAEGHE1, D. DECLERCK1, I.
with 62%. The 60.5% were females in grade 1 and 65% male in BAILLEUL-FORESTIER1 & T. DE RAVEL DE
grade 1. The highest frequency in all ages was grade 1 except at 2
L’ARGENTIERE
1
the age of 10 it was found in grade 2 with a 56.30%. Department of Oral Health Sciences and Department of
Conclusions: The origin of the canine germ is apical, distal and Dentistry, Unit of Pediatric Dentistry and Special Dental Care,
palatal in relationship with its final position. Based on the results KU Leuven, Leuven, Belgium; 2Centre for Human Genetics, KU
obtained in this study concludes that the most frequent angula- Leuven, University Hospitals Leuven, Leuven, Belgium
tion of the maxillary canine germ is grade 1 except on the
Introduction: Apical root resorption can be localized (single
10 years old it may be in grade 2, regardless of gender.
tooth) or generalized (multiple teeth) and is usually associated
with well-defined local or systemic factors. Idiopathic external
root resorption involving several permanent teeth is an unusual
pathologic condition.
Case report: In January 2013, a 19-year-old boy was referred to
the paediatric dentistry unit of the University Hospitals Leuven
for advice on the management of an ectopically positioned upper
canine. The patient had no complaints. Radiographic examina-
tion (peri-apical and panoramic) revealed generalized resorption
of the roots of upper and lower front teeth. Medical anamnesis
revealed moderate intellectual disability of unknown origin and
no other systemic conditions. The patient had no history of den-
tal trauma, orthodontic treatment or tongue malpositioning. cation (sudden death), abnormal ossification of limbs, slow
Family history showed a sister, mother and maternal uncle with motor development, delayed platelet response to collagen expo-
moderate intellectual disability and epilepsy. The sister also had sure. Patients show typical facial characteristics.
platelet dysfunction. Array CGH analysis and mutation analysis Comments: In these siblings, dental findings led to the diagnosis
of the ARX and FMR-1 genes did not reveal the cause. of a very rare genetic disease, accompanied by possible life-
A literature search directed us to a very rare syndrome called threatening health problems. This case illustrates the role of the
Singleton-Merten. Oral findings include acute root resorption dentist in detection.
and early tooth loss, delayed tooth eruption, immature roots,
high caries activity and aggressive alveolar bone loss. Affected
persons present general health problems: extensive aortic calcifi-

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Poster sessions

British Society of Paediatric Dentistry Poster Prize Session – PZ01

British Society of Paediatric Dentistry Dental

Methods: We developed a two-tailed questionnaire addressing PZ03.06

PZ03.11 Demineralisation in dentin: 1: 144.2 [20.9], 2: 150.3 [37.0], 3:

Regional odontodysplasia. A report of two cases

understanding of the reasons why children 0 did not attend0 PR11.09

audit the documentation in patient records. There were 24 and

the furcation is starting, a mesial drift of this molar may be PZ03.40

Morita Prize Entries (Case Reports Posters) –

NuSmile Restorative Case Report Poster

NuSmile Restorative Research Poster Prize

Jens Andreasen Poster Prize Entries – PZ05

PZ05.05 ment was continued with gingivectomy and restoration of the

PZ05.12 Comments: So far, no consensus or conclusive evidence on the

Preventive Dentistry Poster Session – PR01

PR01.15 difference was found in incidence of caries between two groups,

saturation of fluoride ions into hydroxyapatite crystals restores PR01.34

index (Aproximal Silness & L€ oe Index) and gingival bleeding PR01.37

(n = 185). Parents also answered a questionnaire including ques- PR01.40

cept of probiotics may be beneficial also for orthodontic patients. PR01.47

A retrospective longevity study of occlusal sealants

Design: 70 enamel specimens were prepared from sound human PR01.55

PR01.57 nance of localization in the premolar/molar segment and in

Aim: To develop and test interventions to increase PCP involve- PR01.62

Dental Anomalies Poster Session – PR02

PR02.04 Comments: Patient reported improvement in appearance and

multiple supernumerary teeth associated with non- syndrome PR02.44

A percentage of 95% of dentists surveyed found it relevant to PR02.59

Dental Anxiety and Behavioural

Results: A total of 562 children distributed in 13 primary schools PR03.06

The effectiveness of using visual pedagogy in dental

avoidance behaviour and interference of daily life. Assessment PR03.13

PR03.32 61.98%, meanwhile more than 33.33% of them considered that

Epidemiology and Dental Public Health

schools. Subjects’ background information including birth char- PR04.13

Caries experience in children with cleft lip and palate

Design: Cross-sectional observational study, done in two Libyan PR04.55

tition, compromised esthetics, psychological trauma or social PR04.62

Conclusions: pediatric patient is predisposed to various systemic and oral dis-

PR04.67 by one calibrated paediatric dentist. Mutans Streptococci (MS)

Dento-Alveolar Trauma Poster Session – PR05

tion in many cases, even though a poor prognosis is explained to PR05.17

PR05.30 Conclusions: Our study showed that pro-inflammatory cytokines

Orthodontics and Craniofacial Growth and

Introduction: The two main theories of canine impaction are the

Background: Three-dimensional computerized system with land-

Background: The identification and interception of dento-maxil- PR06.28

Periodontology and Microbiology Poster

Conclusion: It was shown that OA and UA inhibited growth and

Restorative Dentistry Poster Session One –

problems such as endodontic lesion, tooth wear, occlusal trauma, PR08-1.35

Background: PRG cement contains S-PRG filler, has fluoride

PR08-1.44 Wallis H nonparametric test was used to determine intergroup

Restorative Dentistry Poster Session Two –

PR08-2.04 Design: Twelve-freshly extracted sound human deciduous molars

PR08-2.07 Although long term follow up, no evidence of root development

Aim: To evaluate the maturation of the setting cement using PR08-2.16

PR08-2.25 Results: 182 restorations were assessed. 76 amalgam restorations