Aristidis Arhakis

Salivary Alpha-Amylase Activity and Salivary Flow Rate in Young Adults

The secretion of salivary alpha-amylase (sAA) is more associated with psychoneuroendocrinological response to stress than with the flow rate and age. The aim of this cross sectional study is to build an explanatory model based on patterns of relationship between age 20-39 in resting and stimulated saliva under no stressful condition in healthy volunteers. Both resting and stimulated saliva were collected from 40 subjects. The sAA values were log-transformed, the normality assumption was verified with the Shapiro-Wilk test and the reliability of the measurements was estimated by the Pearsons’ r correlation coefficient. The estimated model was based on the theory of the Linear Mixed Models. Significant mean changes were observed in flow rate and sAA activity between resting and stimulated saliva. The final model consists of two components, the first revealed a positive correlation between age and sAA while the second one revealed a negative correlation between the interaction of age × flow rate in its condition (resting or stimulated saliva), with sAA. Both flow rate and age influence sAA activity.

Social and Psychological Aspects of Dental Trauma, Behavior Management of Young Patients Who have Suffered Dental Trauma

Introduction: Injuries concerning the skull, the mouth and thus potentially involving the mouth and teeth are characterized as major public health problems due to their high prevalence and very serious functional and aesthetic consequences. Pain, aesthetic and functional problems arising from dental trauma significantly disrupt normal function, and impact, often dramatically, on young patients’ quality of life. Procedure: With regards to the behavior management approach to a child who has suffered a dental trauma, dentist’s first step is to be to reassure child and parents. They should feel that the emergency is being properly treated on the part of the dentist and feel safe. The dentist should offer psychological support to child and parents and focus on alleviating any possible pain the child may feel. But, before that, a good level of communication with the child should be established. Conclusion: This can be achieved through the tell-show-do technique, a presentation of the special session’s structure, the positive reinforcement method, the attention distraction method and exploiting the child’s imagination. The detailed description of the treatment to be followed is crucial for reducing the child’s level of stress, as well as that of the parents. Immediately after the completion of treatment, dentist should give listening time to the parents for any queries and include the child who probably wants to share their experience.

An alternative impression technique for individuals with special care needs

Impression making may be complicated in individuals with limited ability to cooperate with caregivers. An alternative technique for obtaining full-arch casts from sectional preliminary impressions is described. The technique is a modification of the procedure advocated for impression making in subjects with limited mouth opening. A pair of partial stock trays is selected to fit the right and left side of the arch. Two sectional irreversible hydrocolloid impressions are made separately. The first cast is placed into the second impression prior to pouring, to obtain a cast of the complete arch. The procedure was used during the treatment of an uncooperative young patient with Lesch-Nyhan Syndrome and provided a simple and reliable means to obtain the diagnostic cast of the mandibular teeth. It is recommended not only for uncooperative patients, but also for patients with special needs; such as those with anatomical restrictions, functional impairment, and movement disorders.

Neurofibromatosis type II dental management, case report, and review of the literature

Α 30-year-old male with features of Neurofibromatosis type II (NF2) including vision and hearing loss, imbalance, and cranial and peripheral nerve tumors, was referred for dental prosthetic rehabilitation. Treatment plan was established to rehabilitate the patient with periodontal, endodontic treatment, extractions, restorative, and prosthetic procedures. Due to severe vision impairment and hearing loss, special communication methods were required in order to achieve patients cooperation, mainly utilizing the sense of touch. Devices such as tablets and smartphones were also used to facilitate communication and patients comfort. The patient was followed up every 3 months. During the recalls special emphasis was given to the oral hygiene and motivation. It was possible to surpass the severe vision and hearing impairments of this special care patient and fully treat him in the dental chair under a multidiscipline protocol.

Etiology, diagnosis, consequences and treatment of infraoccluded primary molars

Infraocclusion is a condition where teeth are found with their occlusal surface below the adjacent teeth, long after they should have reached occlusion. Many terms have been used to describe this condition; the most commonly used being submergence and ankylosis. Infraocclusion is classified as slight, moderate or severe. Studies have shown the commonness ratio of infraocclusion in kids being 1.3-8.9% with an equal male: female ratio. The frequency of infraocclusion of primary molars of mandible is 10-fold higher in contrast to those of the maxilla. Some studies showed that the first mandibular primary molars are most often affected, but others support the second one. Infraoccluded primary molars appear with an increase in 3 year-old children reaching a peak in 8-9 years of age. The main cause is ankylosis, followed by heredity, trauma, infection and various other theories. However, the etiology is still uncertain. Radiographically, an obliteration of the periodontal ligament can be seen using conventional methods and the CT-method can also be used to reveal greater detail. Clinically, other than submersion, a sharp, solid sound is heard on percussion, in contrast to a softer sound in the normal teeth. Infraoccluded primary teeth can cause occlusal disturbances, tilting of the adjacent teeth, supra-eruption of the antagonists, ectopic eruption or impaction of the successor premolars. A treatment decision must take into account whether there is a permanent successor or not. In the first case, patient monitoring is recommended, because these primary teeth usually exfoliate normally. However, in the second case, the therapeutic approach is not standard. The aim of this review of literature was to elucidate the available evidence concerning infraocclusion, its etiology, diagnosis, clinical characteristics, consequences and treatment.

Trauma, solitary bone cyst and delayed eruption of permanent mandibular incisors. An unusual case in a 7-year-old patient

BACKGROUND: Solitary bone cysts (SBC) are uncommon non-neoplastic bone lesions, which present mainly in the mandible. Their aetiology is still obscure, but it has been suggested that they may be a result of trauma in the region. Due to their asymptomatic nature, SBCs are revealed mainly accidentally during routine radiographic examination. Sometimes, patients complain of pain or delayed eruption of teeth. Treatment is recommended because, otherwise, the cyst may become symptomatic or cause a pathologic mandibular fracture. CASE REPORT: A 7-year-old Caucasian boy presented with delayed eruption of his permanent incisors. His parents reported a history of trauma at 3 years of age. The radiographic examination revealed a bony lesion, largely displacing the permanent incisors and preventing their eruption. TREATMENT: Surgical exploration of the lesion was carried out and the histopathological examination result was consistent with a SBC. FOLLOW-UP: Two years after the surgical curettage there was radiographic evidence of considerable bony regeneration. The permanent incisors erupted and were vital. CONCLUSION: Clinicians should be aware that SBC is associated with trauma, mainly of the mandible, and with a possible delay of eruption of the corresponding teeth.