Haim Sarnat

Comparison of dental findings in patients with isolated growth hormone deficiency treated with human growth hormone (hGH) and in untreated patients with Laron-type dwarfism

The effect of human growth hormone (hGH) on dental structures was investigated by comparing two groups of patients with hypopituitarism. One group of 19 patients with isolated growth hormone deficiency who received hGH replacement therapy was compared with a group of 13 patients with high immunoreactive growth hormone and IGF-I deficiency, Laron-type dwarfism, who could not benefit from hGH treatment. Plaster casts of the dentitions and panoramic radiographs were obtained from all patients and analyzed for dental age, arch length, arch circumference, and width of teeth. the main findings were that (1) hGH therapy did not accelerate dental age but enhanced bone age; (2) the mandible was significantly smaller in the untreated group but no significant difference was found between the groups in the maxilla; (3) third molars were missing in more than 90% of the patients with Laron-type dwarfism whereas hypodontia of other teeth was found in 30% of all the patients; and (4) crowding was less prevalent than expected and the mesiodistal width of the teeth seemed to be smaller.

Physiologic pigmentation of the oral mucosa in Israeli children

Physiologic melanin pigmentation (racial pigmentation) of the oral mucosa varies in prevalence among different races and ethnic groups. The purpose of this study was to investigate the prevalence of physiologic pigmentation in Israeli Jewish children of different ethnic origins. A total of 1,300 children, 6 to 10 years of age, was examined. Physiologic pigmentation was found in 13.5% of the population studied. Children of Eastern origin showed a significantly higher prevalence of pigmentation compared with Ashkenazi and Sephardic groups. Because melanin pigmentation can be enhanced by mechanical and chemical stimulation (smoking), this study may serve as a baseline for investigation of melanin pigmentation in various ethnic groups.

Tooth exfoliation and osteonecrosis of the maxilla after trigeminal herpes zoster

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Periodontal ligament injection: spread of the solution in the dog.

Investigations of the spread of anesthetic solutions administered with the periodontal ligament injection have reported conflicting findings. The purpose of this investigation was to study the distribution of the injected fluid by macroscopic and microscopic techniques. One third of the liquid of the carpules (2% lidocaine with 1:100,000 epinephrine) was replaced with India ink as a marker. Injections were made with a pressure syringe, (Ligmaject) at 90 sites in 12 dogs. Twenty-five control sites were injected with a marked solution without a vasoconstrictor (3% mepivacaine). Seven dogs were killed within 24 h; the others after 5 days. Spread of the ink was studied in undemineralized slices, in three-dimensional cleared specimens, and in histological sections. The solution usually reached the alveolar crest, seeped under the periosteum, and entered into bone marrow spaces alongside vascular channels. The ink spread along the path of least resistance, influenced by the intricacies of anatomical structures and fascial planes, rather than penetrating into the periodontal ligament or in the root canal. In the controls without a vasoconstrictor the spread was more diffuse. Five days postoperatively, carbon particles were present only within macrophages.

The effect of toothbrush design on the ability of nurses to brush the teeth of institutionalized cerebral palsy patients

AIM To compare the effectiveness of two toothbrush designs in tooth brushing by nurses of individuals with cerebral palsy. METHODS Following instruction, nurses brushed the teeth of 21 individuals with a single-headed-toothbrush, and 22 with a triple-headed-toothbrush. After one month, the nurses brushed their patients with the other toothbrush, following instruction. Tooth brushing performance skill was evaluated and scored using the TB-PS-I/Ashkenazi index following the first brushing as well as on a recall visit one month later. RESULTS After 1 month, 7.6% of the nurses required further instruction following brushing with the triple-headed toothbrush compared to 15% after brushing with the single-headed. Reductions in plaque and gingival indices were greater after using the triple- headed than single-headed toothbrush. More nurses preferred the triple-headed toothbrush (75.5% compared to 22.6%). CONCLUSION Brushing by nurses of cerebral palsy patients was more effective and instruction better retained with a triple-headed compared to single-headed toothbrush.Aim: To compare the effectiveness of two toothbrush designs in tooth brushing by nurses of individuals with cerebral palsy. Methods: Following instruction, nurses brushed the teeth of 21 individuals with a single-headed-toothbrush, and 22 with a triple-headed-toothbrush. After one month, the nurses brushed their patients with the other toothbrush, following instruction. Tooth brushing performance skill was evaluated and scored using the TB-PS-I/Ashkenazi index following the first brushing as well as on a recall visit one month later. Results: After 1 month, 7.6% of the nurses required further instruction following brushing with the triple-headed toothbrush compared to 15% after brushing with the single-headed. Reductions in plaque and gingival indices were greater after using the triple- headed than single-headed toothbrush. More nurses preferred the triple-headed toothbrush (75.5% compared to 22.6%). Conclusion: Brushing by nurses of cerebral palsy patients was more effective and instruction better retained with a triple-headed compared to single-headed toothbrush.

The relationship between nurses' oral hygiene and the mouth care of their patients.

To investigate the extent to which a relationship may exist between nurses’ own oral hygiene and their commitment and capability of following instructions for tooth brushing with conventional and triple-headed toothbrushes, to cerebral palsy (CP) children. The study included 43 individuals with CP and their 44 nurses. A structured questionnaire was designed to assess I. Demographic characteristics of the nurses II. Nurses’ knowledge and maintenance of their own oral-hygiene and that of their CP patients. Nurses’ ability to follow instruction for tooth-brushing was evaluated and scored using the TB-PS-I/Ashkenazi index following the first brushing, as well as on a recall visit one month later. More nurses (72.7%) reported routine tooth-brushing in the morning than in the evening (40.9%). Most nurses (73%) reported not flossing their teeth at all, and more than half reported visiting their dentist only when they suffer pain. A positive correlation was found between the nurses’ knowledge of preventive oral measures and their compliance with their own oral hygiene and with that of their CP patients. Similarly, a positive correlation was found between nurses’ receiving previous instruction for correct oral hygiene and their maintenance of their patients’ oral hygiene. Institutions for CP patients should disseminate information on oral hygiene to staff, as a means of increasing their maintenance of their patients’ oral health.