S. H. Al-Jundi

Molar Incisor Hypomineralisation: prevalence in Jordanian children and clinical characteristics

AIM: To investigate Molar Incisor Hypomineralisation (MIH) in Jordanian children in terms of prevalence, distribution and severity of defects. METHODS: A cross-sectional national study with a representative sample was used. A multistage random sampling system yielded 3,666, 7–9 year-old schoolchildren, from 97 public, private and UNRWA schools from Amman, Irbid and Al-Karak. A questionnaire of six sections was sent to the parents with a consent form to participate in the study. A total of 3,241 children participated resulting in a response rate of 88.4%. A single calibrated investigator examined all children using established criteria for MIH and molar hypomineralisation (MH). Analysis of data was performed with a p value set at 0.05. RESULTS: Of the children examined, 570 (17.6%) were diagnosed with MIH with more females affected than males (53% vs. 47%). The 570 subjects were distributed as MIH cases in 196 children (34.4%) and MH cases in 374 children (65.6%) given that at least one incisor was erupted. Mandibular molars and maxillary central incisors were more frequently affected (p<0.05). No significant difference was found between right and left sides of the mouth. Most defects were mild in severity (44%) and severity increased with age and was related to the number of teeth affected (p<0.05). MIH teeth were more severely affected than MH teeth. CONCLUSIONS: MIH was common among 7–9 year-old Jordanian children with a prevalence of 17.6% and was gender related. MH was more common than MIH and can be considered a mild form of an MIH spectrum. Majority of MIH and MH cases were mild in nature but demonstrated an age-related severity.

The importance of soft tissue examination in traumatic dental injuries: a case report

Traumatic dental injuries (TDIs) represent one of the main oral health problems in children, with variable prevalence rates. The issue of unmet treatment needs and inadequate emergency management of TDIs have surfaced up lately in dental literature, indicating that some TDIs present late for treatment, which may complicate management of these injuries. Soft tissue injuries usually accompany other dental injuries therefore thorough clinical and radiographic inspection of soft tissue wounds can not be over emphasized, even in late presentation cases. Tooth fragments may be embedded in soft tissues, even in late presentation cases, and may go unnoticed in the presence of urgent situations. This case report presents a child with a fractured tooth fragment embedded in the lower lip for 18 months, which went unnoticed until the child presented later for treatment of the fractured incisor, highlighting the importance of soft tissue exploration even in late presentation trauma cases.

Factors affecting preoperative anxiety in children undergoing general anaesthesia for dental rehabilitation

AIM: The primary aim was to examine anxiety levels, and to identify factors affecting preoperative anxiety among healthy children undergoing general anaesthesia for dental rehabilitation. A secondary aim was to assess parental distress and attitude to accompanying their children during this procedure. STUDY DESIGN: Observational cross sectional study. METHODS: Anxiety levels of 118 children admitted to the Day Case unit of King Abdullah teaching hospital in Irbid, Jordan, for dental rehabilitation under general anaesthesia (GA) were assessed at different phases (before and during induction of GA) using the Global Mood Score (GMS) with parental presence. The effect of certain variables such as age, sex, reason for referral, past GA experience, accompanying parent, and parental distress, on children’s anxiety during this procedure were assessed using multivariate analysis. The level of significance was <0.05. Parental distress and attitudes to accompanying their children were assessed using a structured questionnaire. RESULTS: There was a significant increase of child anxiety on GMS reaching its highest level in phase three (induction phase). A multivariate test (MANOVA) showed that previous experience of the child with GA, and reason for referral to dental rehabilitation under GA, significantly predicted child anxiety (P-value of 0.019 and 0.012) respectively. However, parental distress, accompanying person, age, and sex of the child, did not affect child anxiety. Parental distress was at its highest level in phase three, mothers were significantly more stressed than fathers and parental distress was significantly increased when a child was <5 years of age. CONCCLUSION: Factors contributing to increased child anxiety during induction of GA for dental rehabilitation were age, previous GA experience, and referral for GA at a very young age. Most parents, especially mothers, were distressed during the induction phase, therefore sufficient preoperative preparation of those children and parents is necessary to achieve best patient management.

Craniofacial morphology in patients with hypophosphataemic vitamin-D-resistant rickets: a cephalometric study.

Hypophosphataemic vitamin-D-resistant rickets (HVDRR) is a hereditary disease mainly transmitted as an X-linked dominant trait and characterized by certain general clinical signs (Filho HM, de Castro LC, Damiani D. Arq Bras Endocrinol Metab. 2006;50:802). In literature, only one study had been published in 1965 on the cephalometric findings in patients with HVDRR (Marks SC, Lindahl RL, Bawden JW. J Dent Child. 1965;32:259). This is the first detailed study on craniofacial characteristics of patients with HVDRR in the dental literature. The aim of this study was to determine the effect of HVDRR on the parameters of the craniofacial skeleton of young Jordanian patients using cephalometric analysis. Lateral cephalometric radiographs were made for 22 Jordanian children (aged 2-16 years) diagnosed with HVDRR. The cephalometeric parameters of HVDRR group were compared with those of normal control group matched for gender and chronological age using paired t-test. The HVDRR group had a significant increase in the SNBa angle (P < 0.01); as well as reduced anterior cranial base length (P = 0.01), reduced maxillary length, corpus mandibular length and mandibular height (P = 0.01, 0.04 and 0.008 respectively). The cranial base and gonial angles were significantly increased in diseased individual, but the SNA and ANB angles were significantly reduced (P = 0.018 and 0.000 respectively). The angulation of the lower incisor to mandibular plane was also significantly reduced in the diseased group compared with Jordanian norm (P = 0.004). Patients with HVDRR have deficiency in the anterior cranial base length, ramus height and cranial base angle. Patients with HVDRR also have class III skeletal relationship.

Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study

ABSTRACT Aim: The aim of this study is to assess and compare the efficacy of Jordanian propolis and full concentration mature coconut water in their ability to preserve periodontal ligament (PDL) cell viability after exposure of PDL cells to up to 120 minutes dry storage. Materials and methods: PDL cells were obtained from sound permanent first molars which were cultured in Dulbeccos Modified Eagles Medium (DMEM). Cultures were subjected to 0, 30, 45, 60, 90 and 120 minutes dry storage times then incubated with 100% mature coconut water, Jordanian propolis and DMEM for 45 minutes at room temperature (18-26°C). Untreated cells served as controls at each dry storage time tested. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test and the level of significance was 5% ( p < 0.05). Results: Up to 60 minutes dry storage, no significant improvement on the percentage of viable cells was found from soaking in all tested media. On the other hand, soaking in mature coconut water only resulted in higher percentages of viable cells at >60 minutes dry storage. However, this improvement was not significant (p > 0.05). Conclusion: Avulsed teeth which have been left dry for <45 minutes should be replanted immediately, whereas avulsed teeth which have been left dry for >45 minutes may benefit from soaking for 45 minutes in mature coconut water. How to cite this article: Al-Haj Ali SN, Al-Jundi S, Mhaidat N. Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study. Int J Clin Pediatr Dent 2013;6(3):161-165.

Effect of Coconut Water Concentration on Survival of Bench-Dried Periodontal Ligament Cells

ABSTRACT Background : Coconut water is a biological and sterile liquid. It contains a variety of electrolytes, sugars and amino acids. The purpose of this study is to evaluate the effect of concentration and maturity of coconut water on its ability to preserve human PDL cell viability after exposure to dry time of up to 120 minutes using an in vitro cell culture model. Methods : PDL cells were obtained from sound permanent first molars which were cultured in Dulbecco’s Modified Eagle’s Medium (DMEM). Cultures were subjected to 0, 30, 60, 90 and 120 minutes dry periods then incubated with 100 and 50% young and mature coconut water for 45 minutes at room temperature (18-26°C). Untreated cells at 0 and 120 minutes, and cells incubated in DMEM served as controls. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test, and the level of significance was 5% (p < 0.05). Results : 100% mature coconut water (MCW) was better than 50% dilutions obtained from mature or young coconuts. However, no significant benefit to the cells was noticed from the addition of the soaking step prior to 30 minutes dry time. Conclusion : Avulsed teeth which are left dry for > 30 minutes may be benefited from soaking in 100% mature coconut water; further studies on simulated avulsion in animal models are needed to verify the above results.

Case report: hypophosphatemic rickets and aggressive periodontitis: a review of the role of dentine matrix protein 1 in the pathogenesis.

BACKGROUND: The association between hypophosphatemic rickets (HR) and excessive periodontal breakdown was reported in mice models of HR. In humans, this is the first report of a possible association between HR and periodontal breakdown. CASE REPORT: The following presents a report of a case of a 15 year-old child diagnosed with HR at age 9 years, with atypical premature spontaneous loss of teeth due to periodontal defects in the absence of dental abscesses, dental caries, or trauma. The case is discussed in the context of relevant literature; the possible role of dentine matrix protein 1 in the aetiology of such periodontal defects in patients with HR is also discussed. CONCLUSION: Spontaneous loss of teeth in the absence of abscess formation is not one of the reported features of HR, however, this report may alert clinicians of the possibility of such association especially in the autosomal recessive type. Further case reports and more elaborate genetic and molecular testing is needed to verify this especially in late diagnosis cases.

Dental arch dimensions in children with hypophosphataemic Vitamin D resistant rickets.

AIM: This study evaluated dimensions of the dental arches of children affected with hypophosphataemic vitamin D resistant rickets (HVDRR), since no reports are available in the literature on the effect of this disease on the dental arches. STUDY DESIGN: comparative cross sectional. METHODS: The dimensions of the dental arches of 21 Jordanian children aged 3–16 years with HVDRR were measured and compared to those of matched healthy controls, using Paired t-test at the confidence level of 95%. One examiner performed all measurements on the models in a blind manner. RESULTS: Compared with healthy controls, a significant reduction in all transverse dimensions of the maxillary arch of diseased individuals was seen. Maxillary arch depth and arch perimeter were also significantly reduced in diseased individuals (P value 0.000 0.009, respectively). In the mandibular arch, a significant reduction was found in the inter-incisor, intercanine and inter-first premolar widths in patients with HVDRR compared with normal controls (P values 0.005, 0.015 and 0.0035 respectively). Mandibular arch depth and arch perimeter were also significantly reduced. CONCLUSIONS: There is a trend towards smaller dental arches in patients with HVDRR compared with healthy controls. The results of the present study necessitate further exploration of the effect of this disease on dental arch development to improve dental management of this special need population.

Prevalence of oral lesions among Jordanian children

Introduction: Prevalence studies on oral lesions in children are scarce, and none of them was conducted in Jordan. Objectives: To determine the prevalence of oral mucosal lesions among Jordanian children. Materials and Methods: A stratified cluster random sampling technique was used to select a sample of first and sixth-grade school children. Systematic oral examination was performed using natural light, and lesions were diagnosed based on the clinical diagnostic criteria proposed by the WHO. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA), and P < 0.05 was considered statistically significant. Data were analyzed using Chi-squared test or Fishers exact test where appropriate. Results: The study included 1366 school children (639 [46.8%] males and 727 [53.2%] females) of whom 620 (45.4%) were 6-year-old and 746 (54.6%) were 12-year-old. The prevalence of oral lesions among children was 47.4%, without a significant difference in prevalence between males (46.6%) and females (47%). Prevalence was significantly higher in 12-year-old children (50%) compared to 6-year-old children (44.2%; P = 0.032). The most commonly diagnosed lesions were racial pigmentation (16.8%), fissured tongue (14.6%), and hematoma (5.3%). Discussion: Oral mucosal lesions are common in children in general, with no overall preference to gender, but the prevalence increases significantly with age. General dental practitioners and pediatric dentists should be aware of the common oral mucosal lesions in their communities for optimum diagnosis, management, and possible prevention. Conclusions: Oral lesions are common among Jordanian children and dentists should be aware of their diagnosis and management.