Malka Ashkenazi

Development of odontoma-like malformation in the permanent dentition caused by intrusion of primary incisor--a case report.

A case is presented of a 10-year-old girl, referred for consultation for failure of the maxillary central incisor to erupt. At 18 months, the patient underwent intrusion of the right central primary incisor, which re-erupted several months later. Radiographic examination revealed a complex odontoma-like malformation located next to the floor of the nose, away from the permanent incisors. Clinical examination revealed space loss of the corresponding permanent incisor and severe hypoplasia of the permanent right lateral incisor. Because of its deep location, it was decided not to remove the odontoma, but to recommend yearly radiographic follow up to rule out the development of a dentigerous cyst. This case describes a very rare complication of intrusion of primary incisors and emphasizes the importance of follow up until eruption of the corresponding permanent teeth.

Age-associated changes of the mandibular foramen position in anteroposterior dimension and of the mandibular angle in dry human mandibles.

The effect of age on the anteroposterior (A‐P) position of the mandibular foramen (MF) and on the size of the gonial angle (GA) was evaluated in this study. From an Israeli Bedouin population, 121 dry mandibles with primary (36), mixed (26), and permanent dentitions (59) were analyzed. The A‐P position of the MF perpendicular to the posterior border of the ramus was measured with a digital caliper. A mandibulometer was used to evaluate the GA. The MF distance from the posterior border of the ramus increased significantly with age by 66% from primary (7.75 mm) to permanent (12.9 mm; P < 0.001). Similarly, the MF distance from the posterior border of the ramus relative to the total ramus width in A‐P dimension increased significantly (21.4%) with altered dentitions from primary (0.28) to late permanent dentition (0.34; P < 0.001). The GA decreased significantly with age from 140.17° ± 5.9° (primary dentition) to 123.61° ± 6.9° (late permanent dentition; P < 0.001). The anterior movement of the MF and the decreased size of the GA that occurred with changing dentition were related to growth process. The MF moves anteriorly, and the GA decreases with age. Anat Rec, 2011.

Post-operative pain and use of analgesic agents in children following intrasulcular anaesthesia and various operative procedures

Aim To characterise post-operative pain (PDP) and use of analgesic agents in children.Methods The study consisted of 472 children, who received routine dental treatment. Teeth were anaesthetised by a computerised delivery system, either intrasulculary (CDS-IS) or by local infiltration (CDS-IF). Information regarding post-operative pain and use of analgesic agents was obtained by a telephone call within 24 hours after treatment.Results The overall incidence of PDP was 38%. 60.9% of the children who experienced PDP were given an analgesic agent. Incidence and severity of pain were significantly associated with type of dental procedure. The highest incidence was found after root canal treatment (62.5%) and preformed crowns (60.8%). A higher incidence of PDP was found in teeth with history of pain or abscess as compared to teeth with restoration or caries (p <0.01). Incidence of pain was not associated with restoration material, extension, depth or type (occlusal vs proximal) of restoration, multiple restoration, gender, mode of CDS anaesthesia, or effectiveness of anaesthesia during dental treatment. Analgesic drugs were given mainly after preformed crowns, root canal filling and extractions.Conclusions PDP and analgesic use in children is common, especially after root canal filling, preformed crowns and extractions. CDS-IS is not associated with increased PDP.

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.

Effect of computerized delivery intraligamental injection in primary molars on their corresponding permanent tooth buds

OBJECTIVE To evaluate the prevalence of developmental disturbances in permanent teeth in which buds were exposed to intraligamental injection (ILI) delivered by a computer controlled local anaesthetic delivery (C-CLAD). METHODS The study population consisted of 78 children (age 4.1-12.8 years) who received ILI-C-CLAD to 166 primary molars. A structured form was designed to include information regarding age at treatment, gender, type of treated tooth, tooth location, type of dental treatment, and type of developmental disturbance(s) present in the associated permanent tooth. Teeth, which received regular anaesthesia or were not anaesthetized by local anaesthesia, served as controls. RESULTS Five children had developmental defects. In C-CLAD-ILI exposed teeth, one child had two hypomaturation defects. The corresponding primary teeth were extracted. No defects were found on the control side. In two children, hypoplastic defects were found only in the control teeth (one in each child). One suffered from a dentoalveolar abscess in the corresponding primary tooth. Diffuse hypomaturation defects were found in two children on both the C-CLAD-ILI exposed and control sides. CONCLUSION In the primary dentition, C-CLAD-ILI does not increase the danger of developmental disturbances to the underlying permanent dental bud.

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.