Péter Kivovics

Dental Status and Oral Health of Patients with Epilepsy: An Epidemiologic Study

Summary:  Purpose: We performed a dental survey of epilepsy patients to examine their oral health by statistical means and to provide a guide for the dental treatment of these patients.

Anatomical changes in the structure of the temporomandibular joint caused by complete edentulousness.

BACKGROUND The posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion shows significant flattening. OBJECTIVE The aim of this present study was to reveal a possible correlation between edentulousness and the flattening of the eminence and to find out whether this deformation is connected to age. MATERIAL AND METHODS Thirty patients were examined in three groups, each consisting of 10 persons (group I: 18- to 25-year-old patients with maintained occlusion, group II: patients over 60 with maintained occlusion, group III: edentulous patients over 60). The three groups were compared according to dental status, age, sex and side. Measurements were carried out on orthopantomographic images taken with Kodak 8000 Digital Panoramic System. The angle of the posterior slope of the articular eminence relative to the Frankfort plane was measured on both sides. Data were analysed statistically with the one-way anova test (α = 0.05). RESULTS The highest values were measured in group I (right side: 39.8 ± 5.4°, left side: 43.0 ± 5.9°), values were somewhat lower in group II (right side: 38.9 ± 4.7°, left side: 39.5 ± 7.4°) and were the lowest in group III, which was significantly lower on both sides than the results of group I and group II (right side: 29.8 ± 6.0°, left side: 31.9 ± 5.2°, p < 0.01). The correlation coefficient between age and the flattening of the eminence in group I, II and III was 0.23, 0.35 and 0.92, respectively. CONCLUSION The flattening of the articular eminence could be correlated with age; however, the rate of deformation is significantly higher in completely edentulous patients than in patients with maintained occlusion.

Long-term effects of chemotherapy on dental status of children cancer survivors

Background: The aim of this study was to investigate the long-term effects of chemotherapy on the dental and gingival health and dental disturbance parameters of children cancer survivors. Procedure: Thirty-eight children (mean age 12.2 ± 0.5 years) who underwent chemotherapy at 4.29 ± 1.71 years of age formed the study group. Forty age- and gender-matched healthy children with a similar socioeconomic background served as controls. Subjects’ caries status (number of decayed, missing, or filled permanent teeth [DMF-T]) was recorded according to World Health Organization criteria. Subjects’ periodontal status was recorded according to the community periodontal index system. Radiographic dental examination was used to analyze dental malformations. Results: DMF-T, D-T (number of decayed permanent teeth), and F-T (number of filled permanent teeth) were significantly higher in the study group compared to the controls (4.61 ± 3.71, 3.97 ± 4.45, respectively, and 0.58 ± 0.14 vs. 2.21 ± 1.01, 0.84 ± 1.82, and 1.18 ±1.07, respectively. The most frequent dental disturbances were root malformation (52.6%) and agenesis (47.4%). Conclusions: According to our examination dental status of long-term survivors is worse than in controls. Hence proper oral hygiene for children cancer survivors (CCS) is critical. In order to meet the need for dental care in CCS health authorities are encouraged to revitalize the dental services Long-term follow-up of CCS is necessary to monitor their dental growth and oral health.

Late Effects of Multiagent Chemotherapy on Salivary Secretion in Children Cancer Survivors

Objective: The aim of this study was to investigate the later oral consequences of chemotherapy on the oral health of children with emphasis on the cariological status and the major and minor salivary gland function. Method: Thirty-eight 12-year-old children (mean age 12.3 ± 0.58 years) who underwent chemotherapy were evaluated after 5 years of treatment. Forty age- and sex-matched healthy children with similar socioeconomic backgrounds served as controls. Subjects’ cariological status was explained by the number of decayed, filled, missing permanent teeth (DMF-T), and unstimulated and stimulated whole saliva flow rates were measured by the spitting method. Palatal saliva flow rate using a Periotron meter (Oraflow Inc., Plainview, NY) and salivary buffer capacity using CRT buffer (Ivoclar Vivadent AG, Schaan, Lichtenstein) were also investigated. Results: Children who underwent chemotherapy had significantly more decayed teeth than healthy controls (3.97 ± 3.58 vs 0.84 ± 1.75, respectively, p < 0.001). Recipients of chemotherapy had significantly lower stimulated whole saliva flow rate (0.84 ± 0.35 vs 1.13 ± 0.46 ml/min, p < 0.05) compared to the controls. Palatal saliva flow rate was at the same time significantly higher in the test group compared to the controls (1.64 ± 0.87 vs 0.46 ± 0.32 ml/min/cm2, respectively, p < 0.001). High levels of buffer capacity of the saliva could be detected in a significantly higher prevalence in the patient group compared to the controls (high: 81.6% vs 40%). Conclusions: According to these results, chemotherapy in children might result in a decreased stimulated whole saliva flow rate, hyposalivation, and, consequently, increased caries risk. Although these processes might be compensated to a limited extend by the increased minor saliva flow rate, resulting in a higher buffer capacity, nutrition and oral hygiene control of children obtaining cancer therapy is essential in the preservation of the oral tissues.