Ana Lucia Seminario

Dental sealants and restorations and urinary bisphenol A concentrations in children in the 2003-2004 National Health and Nutrition Examination Survey

BACKGROUND Resin-based dental sealants and composites contain bisphenol A-glycidyl methacrylate, a bisphenol A (BPA) derivative. The authors hypothesized that a greater number of sealants or restorations would be associated with higher urinary BPA concentrations. METHODS The authors examined urinary BPA measurements (in nanograms per milliliter) and oral examination data for 1,001 children aged 6 to 19 years from data sets of the 2003-2004 National Health and Nutrition Examination Survey (NHANES). They categorized children according to number of occlusal sealants and number of restorations, with four categories in each of the two groups. They estimated associations by using unadjusted and adjusted tobit regression models. RESULTS The lowest quartile of BPA concentrations ranged from 0.3 ng/mL to 1.9 ng/mL, whereas the highest quartile ranged from 7.3 ng/mL to 149 ng/mL. In adjusted analysis, children with seven to 16 sealants had geometric mean BPA concentrations 25 percent higher than those of children with no sealants (95 percent confidence interval [CI], -14 percent to 82 percent; P = .23). In adjusted analysis, children with seven to 42 restorations had geometric mean BPA concentrations 20 percent higher than those of children with no restorations (95 percent CI, -6 percent to 53 percent; P = .13). Neither of these adjusted estimates was statistically significant. CONCLUSIONS Though the findings were in the direction hypothesized, the authors did not observe a statistically significant association between a greater number of sealants or restorations and higher urinary BPA concentrations. Additional studies are needed to determine the extent of oral and systemic exposure to BPA from resin-based dental restorative materials over time. PRACTICAL IMPLICATIONS Dentists should follow this issue carefully as it develops and as the body of evidence grows. There is insufficient evidence to change practice at this time.

From Newborn to Toddler: Report of Two Cases of Congenital Granular Cell Tumor

A congenital granular cell tumor (CGCT) is an uncommon benign soft tissue lesion that usually arises from the alveolar ridge in newborns. It can severely interfere with the respiratory and feeding systems, if left untreated. We present the cases of 2 newborn infants with protruded intraoral tumors that severely compromised breastfeeding. The tumors were removed by water laser without the need for suturing or pain medication. Histopathologic assessment was performed for definitive diagnosis, and the children were followed until full primary dentition was observed without any sign of CGCT recurrence.

Survival of Teeth Restored with Atraumatic Restorative Treatment in aPediatric Rural Population

Objectives: To determine the overall 5-year survival rate of teeth treated by atraumatic restorative treatment (ART) delivered by general practitioners in a rural population in Washington State, USA. Methods: Inclusion/exclusion criteria included children (≤ 12 years and younger) who received ART on asymptomatic carious primary teeth without history of previous restoration (N=178). For this longitudinal study, data collection included demographics, health status, initial date of ART placement, date of ART re-placement, and baseline dmft/DMFT. Variables collected at follow ups included appointment dates, dmft/DMFT, final restorative treatment, pulp therapy, and extraction. Descriptive statistics were calculated for all variables while Kaplan-Meier survival curves were used to summarize overall treatment success. Unadjusted and adjusted hazard ratios (HR) from Cox Proportional Hazard Regression with robust standard error were used to compare survival rates for variables of interest (P<0.05). Results: The overall 5-year survival rate of primary teeth receiving ART restorations was 69.5%. While age, gender, baseline dmft/DMFT, tooth type, and number of ART surfaces were not associated with tooth survival time, child’s health status had a significant association (p=0.02). Conclusion: Among this pediatric rural population, a significant tooth survival rate was observed following treatment with ART. Replenishing ART was successful in extending survival tooth until their natural exfoliation or placement of a definitive restoration.

Chemomechanical versus drilling methods for caries removal: an in vitro study

The purpose of this study was to compare the performance of chemomechanical caries removal (CMCR) with that of conventional drilling for efficacy of caries removal, time spent, morphological changes and microhardness of surface dentin, and microleakage of subsequent restorations. Forty-six carious deciduous molars were randomly divided into two groups: one each for caries removal by (1) CMCR and by (2) drilling. The completeness of caries removal was evaluated by visual and tactile criteria and a caries detector device. Twenty teeth in each group were restored with glass ionomer (GI) and subjected to thermocycling before undergoing microleakage and microhardness tests. In each group, three restored teeth were used for polarized light microscopic analysis, and three unrestored teeth for scanning electron microscopy (SEM). There was no significant difference in the completeness of caries removal between groups. However, time spent for caries removal by CMCR was significantly longer than that required for drilling. Restorations in the CMCR group had significantly more microleakage than those in the drilling group. Dentin hardness of the cavity floor after CMCR was also significantly lower. Microscopic analyses showed roughened and irregular dentin surfaces in the CMCR group, unlike the smooth surfaces observed in the drilling group. In conclusion, CMCR was as efficacious as drilling in term of completeness of caries removal, but required longer excavation times and resulted in lower microhardness of residual dentin as well as more microleakage after restorations with GI. Further laboratory and clinical evaluations on the efficiency and performance of CMCR for the durability of subsequent restorations are required.

Intrauterine Growth Restriction and Preterm Birth Were not Associated with Primary Teeth Caries

Article Title and Bibliographic Information Are intrauterine growth restriction and preterm birth associated with dental caries? Saraiva MC, Bettiol H, Barbieri MA, Silva AA. Community Dent Oral Epidemiol 2007;35(5):364-76. Level of Evidence Level 3: Other evidence. Strength of Recommendation Grade Not applicable. Purpose/Question To investigate the association of small for gestational age (SGA), fetal growth restriction, and preterm birth with dental caries. Source of Funding Information not available. Type of Study/Design Cross-sectional analytical study.