Int J of Pediatric Dent 2

INTERNATIONAL JOURNAL OF
PAEDIATRIC DENTISTRY
interscience.wiley.com/journal/ipd
Editor-in-Chief Gran Dahllf Abstracts of the 22nd Congress of the International Association of Paediatric Dentistry Munich, Germany, 1720 June 2009
Volume 19 Suppl. 1 June 2009

The official journal of The International Association of Paediatric Dentistry The British Society of Paediatric Dentistry
INTERNATIONAL JOURNAL OF
Abstracts of the 22nd Congress of the International Association of Paediatric Dentistry Munich, Germany 1720 June 2009
Poster Sessions P01 P22
Disclaimer This abstract book has been produced using author-supplied copy. Editing has been restricted to some corrections of spelling and style where appropriate. No responsibility is assumed for any claims, instructions, methods or drug dosages contained in the abstracts: it is recommended that these are veried independently.
Poster Sessions
Poster Session P01/Endodontics

P011 Application of mineral trioxide aggregate in achieving apical barrier in permanent teeth
S. ALBADRI & F. D. JARAD School of Dental Science, University of Liverpool, Liverpool, UK Introduction: Three children were referred to the childrens dental department for endodontic management of permanent incisors requiring the creation of an apical barrier with the use of Mineral Trioxide Aggregate (MTA). Case 1, a 14-year-old boy presented with two nonvital upper permanent lateral incisors, both with dens invaginatus and incomplete root development. Case 2, a 9-year-old girl presented with a nonvital immature upper left permanent central incisor following a history of trauma. Case 3, a 16-year-old female presented with a nonvital upper right permanent central incisor with an apical root fracture. All cases presented with a chronic sinus and associated periapical radiolucency on the affected teeth. Clinical management: Endodontic treatment was undertaken on all three cases using the microscope. On the rst visits, the teeth were dressed with nonsetting calcium hydroxide. On the following visit, an apical barrier was achieved with the orthograde placement of MTA (Pro Root MTA, Dentsply, Tulsa, USA) and conrmed radiographically. On the same visit, the root canals were obturated using thermoplastic obturation technique. The access cavities were restored with RMGIC over the gutta-percha and composite. At the follow up appointment (ranged from 812 months), all teeth were clinically asymptomatic and radiographic examination revealed signs of healing. Conclusion: The placement of MTA in single visit can be successfully used to achieve an apical barrier for permanent teeth in different clinical scenarios, in which the prolonged use of nonsetting calcium hydroxide was the traditional recommended treatment. in experimental group and a 1:5 diluted formula of formocresol was introduced to the canal orice of the control group. A mixture of reinforced Zinc oxide eugenol paste was then placed over the pulp stump, and the tooth was restored either with stainless steel crown or amalgam. All teeth were then followed clinically and radiographically at 3, 6 and 12 months. Results: Assessing the collected data revealed that from the total of 14 subjects all returned for their follow ups. Clinical success of the individual teeth was found to be achieved in all of the tests and control teeth in this period (100%). This was while radiographic ndings showed a 95% success after 6 and 12 months. Analyzing the data revealed no signicant difference using Fisher exact test too (P > 0.05). Conclusion: It seems that the diode laser energy may be considered as an alternative to formocresol for pulpotomy in primary teeth. A longer period of follow up with a larger number of cases is underway for further and more reliable results.
P013 Dental pulp tissue regeneration in mini-pig by deciduous dental pulp stem cells
Y. T. CHANG1, B. S. LEE1,2,3, Y. I. WANG3,4, H. H. CHANG3,4 & G. F. HUANG3,4 1 Pediatric Dentistry, Graduate Institute of Clinical Dentistry; 2 Operative Dentistry; 3School of Dentistry; 4Pediatric Dentistry, National Taiwan University Hospital, Taipei, Taiwan Introduction: A biological tooth substitute that could replace decayed or lost teeth would provide a vital alternative to currently available clinical therapy. The aim of this study was to establish an animal model of utilizing deciduous dental pulp stem cells (SHED) and tissue engineering method to examine the functional properties of SHED on the injured dental pulp. Materials and methods: SHED were isolated by using enzyme digestion from mini-pigs deciduous teeth. These cells expressed capacity to generate clonogenic cell clusters in culture and were identi?ed to be a population with high proliferation capability. Pulp amputation was performed on four posterior and four anterior teeth of mini-pig and the SHED materials were placed directly on the pulp amputation sites and sealed. The experiments were divided into four groups: 1. gelfoam as control 2. SHED with cultured medium 3. SHED with lovastatin. 4. SHED with odontoblast induction medium were transplanted on to the pulp stumps. The pulp reactions were examined histologically by H&E stain 3 months after the pulp amputation. Results: The result showed that reparative dentin and collagen were regenerated on the amputation sites. The amount of regenerative dentin in each group was roughly similar. However, the SHED + lovastatin group seemed to have a greater amount of reparative dentin above the pulp stump. Therefore, lovastatin might enhance odontoblast differentiation. Conclusion: The regeneration and functional reconstruction capability of SHED in vivo was established which possibly can be utilized for teeth replacement therapy in the future. This study was supported by National Taiwan University Hospital, Taipei, Taiwan
P012 Clinical and radiographic evaluation of diode laser pulpotomy on human primary teeth: a 12-month follow up
G. ANSARI, M. VAHID GOLPAYGANI, I. CHITSAZAN & R. FEKRAZAD Department of Pedodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran Introduction: The purpose of this preliminary investigation was to evaluate the clinical and radiographic success rate of Diode laser pulpotomy in comparison to conventional formocresol pulpotomy of human primary molars. Materials and methods: A randomized, single-blind, split-mouth study was designed with a sample size of 14 children aged 39 years (mean age = 6.5). A total of 20 pairs of teeth from these 14 patients were included based on their need for pulp treatment due to caries exposure. Clinical and radiographic criteria of healthy teeth were considered in case selection. One tooth from each pair was randomly assigned to the Diode laser pulpotomy group while the other was assigned for the formocresol pulpotomy group. Following the routine removal of coronal pulpal tissue in every tooth, Diode laser was applied at 10 W, 20 Hz (with 0.08-mm tip)
2009 The Authors 66 Journal compilation 2009 BSPD, IAPD and Blackwell Publishing Ltd, International Journal of Paediatric Dentistry 19 (Suppl. 1): 66170
Endodontics P014 Effects of sodium uoride on deciduous tooth pulp cells

Y. W. HAN1, M. H. CHEN1,2,3, G. F. HUANG3, H. H. CHANG1,3 & Y. L. WANG2,3 1 Graduate Institute of Clinical Dentistry School of Dentistry; 2 Department of Dentistry School of Dentistry; 3Department of Dentistry National Taiwan University Hospital, Taipei, Taiwan R.O.C. Introduction: Fluoride has been used in dental public health programs for a long time. The aim of this study was to investigate the effects of different concentrations of sodium uoride on the viability, mineralization and differentiation potentials of deciduous tooth pulp cells. Materials and methods: Dental pulp cells were isolated from human deciduous teeth with enzyme digestion and cultured with sodium uoride at 0, 10-6, 10-5, 10-4, 5 10-4 and 10-3 M in regular culturing medium and mineralizing medium. The proliferation, calcication and differentiation potentials of cells were then examined with MTT assay and RT-PCR analysis. The bone- or dentin-related genes (ALP, osteocalcin, type I collagen, DSPP and DMP1) were evaluated after culturing for 5, 10, and 15 days. Results: A cell-based quantitative evaluation of MTT assay showed that the concentration of NaF at 10-6 M and 10-5 M in culturing medium promoted cell proliferation. Whereas the concentration of NaF at 10-6 to 10-3 M in mineralizing medium promoted cell proliferation. Different concentrations of NaF alter the bone- or dentin-related gene expression. It was found that NaF at the concentration of 10-6 to 10-4 M may speed up the differentiation potential of deciduous tooth pulp cells. Conclusion: Our results demonstrated the effects of NaF on the proliferation and differentiation potential of deciduous tooth pulp cells are dose dependent, concentrations of NaF at 10-6 M and 10-5 M are best for cell proliferation and 10-6 to 10-4 M are best for cell differentiation. Conclusion: In primary teeth preparation time, canal transportation with Hero-624 rotary instruments was less compared to K-le. To conclude, we would encourage using rotary instruments on primary teeth.
P016 Estimating the extent of mineralization in hard tissues of young permanent teeth
L. KISELNIKOVA & V. ALPATOVA Department of Pediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: Analysis of the extent of mineralization in hard tissue of young permanent teeth and in permanent teeth of adult patients. Materials and methods: The research was based on the densitometry results of dental volumetric tomography (DVT) combined with Picasso Pro (Watech). We studied the tomograms of 159 patients aged 1225 and tomograms of 36 patients aged 2530 years. Results: While studying the data of comparative densitometry on different areas of young teeth it was revealed that the maximum indicator of enamel mineralization amounted to 1183 20.99 HU units and that of dentin to 706 14.2 HU units; minimal in the apical portion of roots were 348 26.1 HU units. In patients aged 2530 years old the same tendency was revealed. The maximum values in the area of enamel and crown dentin were practically identical to values registered in young permanent teeth i.e., 1207 13.07 HU units in the area of enamel and 756 12.83 HU units in the area of crown dentin. Minimum indicators on the apical portion of the root canal being 543 10 HU units crucially exceeded that of the young group being 348 26.1 HU (P < 0.01). Conclusions: The extent of dentin mineralization in the apical portion of roots in young permanent teeth is much less than in adults. This should be taken into account when planning endodontic treatment.
P015 Comparison of rotary and manual instruments in canal preparation of primary molars
S. H. JAVADI NEJAD, M. ZAREJAHROMI & A. MIRENAYAT Faculty of Dentistry, Department of Pedodontics, Islamic Azad University of Khorasgan, Esfahan, Iran Introduction: Rotary instruments enable a signicant reduction in the preparation time, and cleaner and better shaped root canals. This fact has been studied on permanent teeth.This study was an attempt to compare the NiTi rotary instruments (Hero-624) and K-les in the root canal preparation of primary molars. Time and canal transportation were compared. Materials and methods: This is an experimental, in vitro study. Thirty human extracted primary molars 8 mm in length were selected. After preparing an access cavity, the specimens were further divided into groups, 15 for NiTi and 15 for K-les. Before canal preparation with a # 15 K-le and after canal preparation with a master apical le, canal curvature was evaluated by means of radiovisiography using the Weine technique. Apical transportation was calculated. Time taken for preparation was recorded by chronometer. The results were analyzed with t-test and Mann Whitney U-test. Results: Mean of canal transportation angle was 3.42 for the NiTi group and 7.33 for the K-le group (P < 0.04).Mean instrumentation time was 4.28 for the NiTi group and 8.76 min for the K-le group (P < 0.001). There was a signicant difference between the two groups.
P017 Physical stability of different formulations of an endodontic iodoform-based paste

A. C. V. MELLO-MOURA1, D. P. RAGGIO1, M. A. NICOLETTI2, A. C. GUEDES-PINTO1 & F. M. MENDES1 1 Paediatric Dentistry Department; 2Pharmaceutical Sciences Department, University of Sao Paulo, Sa Paulo, Brazil o Introduction: Guedes-Pinto iodoform-based paste (GPP) is the most common lling material for endodontic treatment in primary teeth in Brazilian dental schools, due to its good results for the past two decades. However, its formula must be manipulated immediately prior to using, becoming an issue in components proportion standardization and increasing of clinical time. Therefore, a premixed manufactured GPP would be desirable, which requires addons to maintain all pharmaceutical aspects, such as physical stability. Materials and methods: This study evaluated the physical stability of the original GPP formula and four new formulations of GPP with different extra excipients (GPP-DE). The physical stability was visually evaluated using a four-grade score scale to classify the changes of consistency, color and homogeneity of all pastes after 150 days of storage at room temperature (20 to 25C) and refrigerated (5 to 7C) conditions. Results: After 150 days, all groups maintained the initial pasteous consistency. The initial color of the original formula (yellow) changed severely to a dark orange aspect, although all four new formulations had a slight change. The original GPP also lost its
2009 The Authors Journal compilation 2009 BSPD, IAPD and Blackwell Publishing Ltd, International Journal of Paediatric Dentistry 19 (Suppl. 1): 66170 67
Poster Sessions
homogeneity, clearly showing components separation and precipitation, while all the new formulations maintained their homogeneity during all 150-days period. The storage condition did not interfere in the physical stability of any studied formulation. Conclusion: The addition of excipients improved the physical stability of the four new formulations (GPP-DE) in comparison to the original formula (GPP). ment were selected for this study. After ethical approval and informed parental consent, treatments were performed by the same pedodontist. 22 selected teeth were divided into two test groups. In group 1, the conventional calcium hydroxide apexication was performed in ten teeth, whereas in group 2, the CHPP apexication was done in 12 teeth. The children were recalled for clinical evaluations every 3 weeks and their radiographical evaluations were done every 3 months with Digora digital radiography system. Chi-square test was used to evaluate the differences between the groups. Results: The follow-up evaluations revealed failure due to resorbing of the formed apical barrier and tenderness to percussion detected at 8-month evaluation in only one tooth treated with CHPP. Apexication was successfully achieved using CHS and CHPP in the remaining 21 teeth. No statistically signicant difference between the groups was observed (P > 0.05). Conclusion: It was concluded that CHPP treated central incisors requiring apexication demonstrated good success. However, long term clinical trials with this material are required.
P018 Clinical and radiographical outcomes of three pulpotomy techniques performed by dental students
A. ALACAM1, M. E. ODABAS ME1, T. TUZUNER2, H. SILLELIOGLU1 & O. BAYGIN1 1 Faculty of Dentistry, Department of Pediatric Dentistry, University of Gazi, Ankara; 2Department of Pediatric Dentistry, University of Karadeniz Technical, Trabzon, Turkey Introduction: The aim of this study was to compare the clinical and radiographical success rate of three pulpotomy techniques (formocresol, calcium hydroxide and calcium hydroxide/iodoform). Materials and methods: Ninety-one primary molars with dental caries in 91 children between 6 and 10 years old were treated by three pulpotomy techniques. The pulpotomies were performed by fth-year undergraduate dental students. Members of senior staff at the clinics supervised all the procedures. Informed consent was obtained from childrens parents. The teeth were randomly assigned to the experimental (calcium hydroxide and calcium hydroxide/iodoform) or control (formocresol) groups. After coronal pulp removal and haemostasis, remaining pulp tissue was covered with calcium hydroxide or calcium hydroxide/iodoform paste in the experimental groups. In the control group, formocresol was placed with a cotton pellet over the pulp tissue for 5 min and removed; the pulp tissue was then covered with zinc oxide-eugenol. All teeth were restored with stainless steel crowns. Clinical and radiographic successes and failures were recorded at 1, 3, 6 and 12-month follow-ups by the authors. Data were statistically analysed with chi-square tests. Results: The follow-up evaluations revealed that the clinical success rate was 89.7 % for formocresol, 33.3% for calcium hydroxide and 17.2 % for calcium hydroxide/iodoform. The radiographic success rate was 89.7 % for formocresol, 33.3 % for calcium hydroxide and 13.8% for calcium hydroxide/iodoform. Conclusions: Formocresol was superior to calcium hydroxide and calcium hydroxide/iodoform pastes in primary molar pulpotomies. Internal resorption was the most common radiographic failure in all three pulpotomy techniques.
P0110 Pulp chamber microora of primary teeth with inammatory symptoms in Costarican children
L. URIBE-LORIO1, S. MORALES2 & C. QUESADA3 1 Centro de Investigacion en Biologa Celular y Molecular; 2Facultad de Odontologa; 3Laboratorio de investigacion en Bacteriologa Anaerobia, Universidad de Costa Rica Introduction: Dental caries is the most important oral disease in Costa Ricas children, and pulpotomy became the most accepted treatment for affected pulps of temporary teeth. For this reason, the present study analyzes the bacterial microora present in the pulp chamber of primary teeth in 16 10-year-old children diagnosed with pulpitis. Permission was conceded by the ethical commitee of the University of Costa Rica, and each subject and guardian gave written informed consent. Materials and methods: Samples were collected aseptically at pulpal horn and root canal from every affected tooth. Each sample was plated on selective media for aerobic bacterial growth and incubated at 37C until the emergence of colonies, which were puried and identied by Biolog semiautomatic system. For anaerobic isolation, a sample was taken by syringe extraction from a microexposition of roots canal and immediatly inoculated in pre-reduced media and incubated at 37C in anaerobic conditions. Results: From 16 samples, 50 bacteria were isolated; in 96.9% of the samples just two or less different morphotypes were cultivated. At pulpal horn and root canal level we identied Dermacoccus, Bacillus and Micrococcus (mouth microora) Microbacterium, Deinococcus, and oportunist pathogens like Pseudomonas and Staphylococcus and Neisseria. Exclusively at root canal we found the anaerobic species Fusobacterium nuclatum, Veillonella, Propionibacterium acnes and Actinomyces meyeri. Conclusion: All root samples analyzed were colonized with aerobic and anaerobic bacteria, some of them previously related with periapical pathologies, and a direct relation between presences of anaerobic bacteria with the severity of inammation was observed.
P019 Comparative evaluation of Ca(OH)2 plus points and Ca(OH)2 paste in apexication treatment
T. CETINBAS BEZGIN1, K. ORHAN2 & H. SONMEZ3 1 Department of Pedodontics; 2Department of Oral Diagnosis and Radiology; 3Department of Pedodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey Introduction: The alkalinity of Ca(OH)2 is used to stimulate the formation of mineralized tissue in the apical part of the immature tooth. Calcium hydroxide plus point (CHPP) [Roeko, Langenau, Germany] is a relatively recent development designed to release calcium hydroxide from a gutta-percha matrix. The aim of this study was to compare CHPP with the conventional calcium hydroxide solution (CHS) clinically and radiographically as materials used in apexication treatment. Patients and methods: Sixteen children, each with at least one necrotic permanent central incisor requiring apexication treat-
Endodontics P0111 Inuence of temporary lling material on bacteria contamination during endodontic treatment
O. E. ZINOVIEVA & L. P. KISELNIKOVA Department of Pediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: To study the inuence of different kinds of temporary lling materials on contamination with bacteria. Materials and methods: Research group included 45 children 1518 years old, who had been cured of 45 cases of chronic brose pulpitis in one-root teeth. The microbiological study had two steps: 1st stage just after mechanical and medicinal intervention: Just after treatment, material was taken with sterile gutta-percha point and sown on a culture medium: meatpeptonium agar, enriched with cattle serum. Then the root canal system was obturated, sterile gutta-percha point was placed on the orice of the canal and the endodontical approach was isolated. All teeth studied were separated into three groups of 15, depending on the temporary lling material. Zink-oxide noneugenol cement, composite and glass-ionomer cement were used as temporary lling materials. Ten days later in the 2nd stage of the microbiological study, material from beneath the temporary lling was also sown on a culture medium. Results: Just after mechanical and medicinal treatment, growth of microora, E. coli and solitary Corinebacteria, was found in 13.3% of the cases. In the other 87.6%, there was no growth of microora. In the second step of the research, using glass-ionomer cement (Group 1) bacteria growth was found in 20% and using zink-oxide noneugenol cement (Group 2) bacteria were found in 70% of the cases and after using composite (Group 3) in 66% of the cavities. Conclusion: None of the indicated materials are able to secure an optimal germetization of the endodontical approach during all stages of the root canal treatment. failure. ANOVA and Student-NewmanKeuls test were used for data analysis. Results: Fracture resistance values exhibited by the RelyX ber post and shoulder preparation with no post were signicantly different from the remaining groups (P < 0.05). Conclusion: RelyX ber post group exhibited the highest fracture resistance values among the different intracanal post-systems.
P0113 Apical microleakage evaluation of chitosan as root lling material

J. J. SHANG, S. H. YANG & X. Y. LIU Department of Pediatric Dentistry, Capital Medical University School of Stamotology, Beijing, PR China Introduction: To evaluate the apical sealing of chitosan as a root canal lling material. Materials and methods: Seventy-ve normal single-rooted teeth from outpatient clinic were randomly divided into ve groups. Each group contained fteen teeth. All crowns were sectioned by high speed bur at the site 12 mm above cementoenamel junction. Each root pulp was extirpated and working length was established and noted. Each canal was ared out by using No.15-No.40 H les to reach the criteria that No.15 le could be passed through apical foramen. Three per cent of hydrogen peroxide solution and normal saline were used to irrigate each canal respectively and alternately. Routine root canal lling with four kinds of materials (chitosan paste, chitosan-barium sulfate paste, zinc oxide eugenol paste, vitapex paste) respectively. The fth group served as control which with no lling materials in the root canals. The capability of apical sealing was assessed by the degree of dye penetration on sections of the teeth. Data were analyzed using SPSS 10.0 q test. Results: There was no signicant statistical difference among the groups of chitosan paste, chitosan- barium sulfate paste and ZOE paste, but there was signicant statistical difference among the above three groups comparing to Vitapex group. There was also signicant statistical difference among four kinds of root canal lling materials comparing to control group. Conclusion: The capability of root canal sealing of chitosan paste was similar to that of traditional ZOE paste.
P0112 Fracture resistance of primary anterior teeth restored with different intracanal post systems
A. M. MASHALY & N. M. KING Faculty of Dentistry, Paediatric Dentistry and Orthodontics, University of Hong Kong, Hong Kong SAR, China Introduction: Several intracanal post-systems have been proposed for the restoration of severely broken down primary incisors. However, there are insufcient data on the strength of the various systems. Thus, the aim of this in-vitro study was to compare the fracture resistance of endodontically treated primary incisors restored with different intracanal post-systems. Materials and methods: Thirty acrylic teeth were sectioned 2 mm above the CEJ followed by obturation of the root canals using Metapex. The teeth were subsequently immersed in melted wax upto 2 mm below the CEJ and embedded in brass cylinders (20 30 mm) using methyl methacrylate acrylic resin. Following resin polymerization, the wax was removed from the resin blocks using hot water and replaced with polyether impression material to simulate the periodontal ligament. The teeth were randomly divided into: (i) no post, (ii) shoulder preparation with no post, (iii) composite post, (iv) wire post, (v) omega loop, and (vi) RelyX ber post groups. Prior to placement of the various post-systems 5 mm of Metapex was removed followed by placement of 2 mm of glass ionomer cement. The teeth were restored using composite resin strip crowns and then subjected to loading using an Instron-1185 at a cross-head speed of 0.5 mm/ min, 2 mm from the incisal edge at 45 to the long axis until
P0114 A comparative evaluation of root canal sealers (study in vitro)

G. V. KIKERI & N. A. SAVELIEVA Department of Conservative and Pediatric Dentistry, Ryazan State I.P. Pavlov Medical University, Ryazan, Russia Introduction: Presently none of available sealers meet the ideal criteria for a root canal sealer. The purpose of this study was to evaluate the apical sealing efciency of four different root canal sealers. Materials and methods: Eighty-eight single fully formed rooted human dentitions were selected and the sealers used were conventional Zinc oxide eugenole, Endomethasone, Sealapex and AH plus. There were four groups, 22 teeth per group. The anatomic crowns were sectioned at proximal cemento-enamel junction and the cleaning and shaping was carried out using the serial step back technique. Cold lateral compaction was standardized. Radiographs were taken to conrm apical and lateral seal. Teeth were subjected to passive 2% methylene blue at pH = 7. Longitudinal sectioning technique was carried out and the average dye penetration (DP mm) and percentage of leakage (PL%) was measured under
Poster Sessions
a stereomicroscope with a calibrated scale eyepiece at magnication 6X and calculated after 48 h and after 30 days. The results were analysed using students t-test. Results: After 48 h: ZnOE showed a maximum DP of 9.75 and PL of 67.53 and AH Plus showed the least: DP 3.42 and PL 23.62. Although all four groups leaked more at the end of 30 days, but Endomethasone had signicantly more DP 11.52 and PL 72.83. AH Plus leaked less, compared with the others: DP 5.0 and PL 37.68. Conclusion: No teeth showed perfect sealing although a standardized, commonly used method was used. The degree of leakage all sealers increased with time. Apparent adequacy of seal lends support to the clinical use of AH Plus. usually contraindicated. In our two cases of young permanent teeth, the combined therapy of systemic antibiotics and conservative pulp management resulted in continuing root development. Clinical management: Case 1: A 6Y7M girl presented a buccal swelling, percussion pain and IRM lling on her mandibular right rst permanent molar. The radiographs showed widened periodontal space around the open apexes. We performed a direct pulp capping with calcium hydroxide and prescribed antibiotics. Four years following the treatment, the tooth was asymptomatic, apical closure and normal periodontal space was evident. Case 2: A 7Y11M boy had a gingival swelling and grade III mobility of maxillary left central incisor. Past dental history revealed multiple traumatic injuries of the tooth. The radiograph showed open apex of the tooth. Pulpotomy with calcium hydroxide at mid-root level was performed and antibiotics prescribed. In three years follow up, dentin barrier formed in mid-root level and the apical part showed continued root formation and increased dentin wall thickness. Conclusion: The case reports demonstrated that in young permanent teeth with open apexes, even with classical signs of irreversible pulpitis, it is possible to allow pulp healing. Infection control combined with conservative pulp management may provide opportunity for pulp regeneration in young permanent tooth.
P0115 Endodontic treatment of a maxillary lateral incisor with two root canals
C. CINAR, A. ALTUNTAS & N. AKAL Faculty of Dentistry, Department of Pediatric Dentistry, University of Gazi, Ankara, Turkey Introduction: The maxillary lateral incisor usually occurs with a single root and canal. Limited clinical reports have shown a maxillary incisor with two root canals. In the present case, radiographic examination and the endodontic treatment of a maxillary lateral incisor with two root canals and normal clinical crown is described. Clinical management: A 10-year-old girl was referred to Gazi University, Pediatric Dentistry Department. She had suffered from swelling associated with maxillary left lateral incisor (#22). Visual examination of the tooth was normal. Radiolucency between maxillary left central and maxillary left lateral incisor was clearly observed. Radiographic examination showed the tooth had two root canals. After routine access cavity preparation, the two root canals were instrumented with H les and irrigated with 2.5% sodium hypochlorite and dried with sterile paper point. Afterwards calcium hydroxide paste was placed into the canals. Patients symptoms were eliminated and the root canal obturation was performed with gutta-percha and a resin based sealer (AH 26, Dentsply- DeTrey GmbH, Germany), using cold lateral condensation technique. Conclusion: Careful radiographic evaluation may lead to idencation of additional canals. This case emphasizes the importance of a pre-operative radiographic examination and clinical management.
P0117 Apexication with MTA on a necrotic immature permanent tooth

F. BEN ABDELOUAHED, V. GOSSIAUX & A. VAN DEN ABBEELE Department of Paediatric Dentistry, Universite Libre de Bruxelles, Brussels, Belgium Introduction: Pulp necrosis on immature permanent teeth leads to an interruption of dentine formation and stops root development. MTA has been suggested to stimulate an apical closure by means of a reparative response in periapical tissues. This case report describes the treatment of a 10-year-old female patient who suffered a traumatic injury a few years ago, resulting in a complicated crown fracture and a subsequent pulp necrosis on tooth 21. The attempt to induce apexication with calcium hydroxide was without success. Clinically, percussion and palpation were normal but there was a slight mobility. X rays showed an incomplete root end formation and a large periapical radiolucency. Clinical management: After anaesthesia and rubber dam isolation, the canal was prepared using protapers and an apex detector. MTA was placed in the whole canal by a hand condensation technique under microscopic supervision. An X ray was taken to assess the adequate placement of MTA and after one week, the setting and the tightness of the MTA were tested with a hand plugger and the tooth was restored with composite. Radiological controls at 6 months and 1 year showed a successful healing and a root regeneration around the MTA material. There were still no signs of clinical symptoms after a 1-year follow up. Conclusion: The apical plug formed with MTA can be interpretated as an articial barrier and an adequate seal against bacterial inltration, leading to a correct healing without any clinical or radiological complications after 1 year.
P0116 Regeneration of symptomatic permanent teeth by antibiotics and conservative pulp management
T. P. TSAI1 & W. H. HUANG2 1 Anthonys Dental Clinic; 2Pediatric Dentistry, Chang-Gung Memorial Hospital, Taipei, Taiwan Introduction: Tender teeth associated with gingival swelling and radiographic pathosis are symptoms of irreversible pulpitis. Under the diagnosis, apexogenesis of open-apexed permanent tooth is
Dental Materials 1
Poster Session P02/Dental Materials 1

P0218 Fluoride releasing capacity and physical properties of a nano-lled ssure sealant
A. KUSGOZ1, T. TUZUNER1, B. KEMER2 & O. SARAY3 1 Department of Paediatric Dentistry; 2Department of Chemistry; 3 Department of Mechanical Engineering, Karadeniz Technical University, Trabzon, Turkey Introduction: The incorporation of nano-particles to the ssure sealant including uoride (F) promotes better physical properties. The aim of this comparative in-vitro study was to investigate the F releasing capacity, Vickers surface microhardness (VHN) and degree of conversion (DC) results of nano-lled, un-lled resinbased and glass ionomer-based ssure sealants. Materials and methods: Forty-ve disk shaped specimens were obtained from Grandio Seal (GS, nano-lled), ClinPro (CL, un-lled) and Fuji Triage (FT, glass ionomer) using teon molds (5-mm diameter, 2-mm depth). After polymerization with light curing unit, specimens were stored in dark environment for 24 h at 37C. The F concentration was measured at 1, 6, 12 h and 1, 4, 7, 15, 30 days by Ion Selective Electrode. The VHN values were measured with microhardness tester under a load of 1 kg/20 s, the DC (%) was studied with FTIR. All data were analyzed with one-way ANOVA, post hoc tests at a signicance level of 0.05. Results: The cumulative amounts of F ions released from FT were signicantly greater than CL and GS (P < 0.05) while no signicant differences were observed between the CL and GS during all study periods (P > 0.05). The VHN values were signicantly different between all groups in the following order GS > FT > CL, respectively (P < 0.05).The results revealed signicant differences regarding DC(%): FT (89%) > GS (55.02%) > CL (%51.10) between all groups (P < 0.05). Conclusion: Comparing to the other tested materials, nano-lled resin based ssure sealant might be considered as a convenient material regarding its uoride content and promising physical properties under these in vitro conditions. Results: The results of microleakage depth were: (1) 325.54 203.34lm; (2) 307.56 200.56 lm; (3) 348.89 206.57 lm; (4) 202.84 201.54. The results of microleakage rate were: (1) 50.22 26.73%; (2) 43.63 27.39%; (3) 51.57 30.09%; (4) 27.16 24.42%. The results of sealant penetration rate were: (1) 65.94 24.42%; (2) 69.94 23.54%; (3) 74.93 22.51%; (4) 74.44 23.58%. And the results of sealant penetration rate were: shallow ssures 91.62 14.86%; deep ssures 56.84 16.83%. Independent-Samples t-test showed Ionosit-seal sealant had significantly less microleakage than all the other sealants tested, and no statistically signicant differences were observed between four groups for the sealant penetration depths. The penetration of all sealants was higher in shallow than in deep ssures. Conclusion: Based on the results of this study, it can be concluded that compomer sealant showed signicant less microleakage than resin sealant, and Sealant penetration ability was signicantly inuenced by the ssure type, not the sealant type.
P0220 Inhibition of mutans streptococci adherence to salivatreated hydroxyapatite by new enamel coating material
S. AIZAWA1, E. FUKUMOTO3, A. YAMADA1, N. TAKAHASHI2 & S. FUKUMOTO1 1 Division of Pediatric Dentistry; 2Oral Ecology and Biochemistry Tohoku University Graduate School of Dentistry, Sendai; 3Division of Preventive Dentistry, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Introduction: Adherence to the tooth surface and the subsequent biolm formation by oral bacteria is an important step in the initiation of dental caries. It is necessary to develop new products, not only restorative materials for the cavity but also materials for preventing dental caries. This study aimed to examine the effects of a newly designed enamel coating material containing pre-reacted glass-ionomer (PRG) ller on bacterial adherence to hydroxyapatite (HA) and acid production. Materials and methods: S. mutans and S. sobrinus were anaerobically grown in a tryptone-based complex medium containing sucrose in the presence of a saliva-pretreated HA disc with or without being coated with a material containing PRG at 37C for 48 h. After incubation, the HA disc was taken out of the medium, washed twice with potassium phosphate buffer, and the biolm formed on the disc was removed using a vortex mixer. Bacterial adherence to the disc was evaluated by determining the optical density. The bacterial culture pH was also measured. Statistical analysis was performed using Mann Whitneys U-test. Results: Coating materials containing PRG inhibited adherence of mutans streptococci to the HA disc, especially in S. sobrinus (OD at 660 nm, noncoat: 0.25 0.11, PRG-coat: 0.06 0.02, P < 0.05). Furthermore, this coating material inhibited the decrease of pH caused by streptococcal acid production. Conclusion: Tooth coating material containing PRG may have a potential role in inhibiting bacterial adhesion to tooth surface and dental plaque formation through suppression of bacterial acid production. Thus, this material may be useful for preventing dental caries.
P0219 Microleakage and penetration ability of different sealants

L. ZHAO & Q. SHI Capital Medical University School of Stomatology, Beijing, PR China Introduction: This in vitro study compared the microleakage and penetration ability of different types of sealants. Materials and methods: Forty extracted sound human third molar teeth were randomly divided into four groups with ten teeth each. The experimental groups were: (1) Concise sealant (unlled resin sealant); (2) Clinpro sealant (low lled sealant); (3) FluroShield sealant (highly lled sealant); (4) Ionosit-seal sealant (compomer sealant). After sealing, specimens were thermocycled (500 30s, 5 and 55 [degrees] C cycles) and then immersed in 5% methylene blue for 24 h. The samples were examined by a stereomicroscope (40 magnication) after sectioning. The following parameters were evaluated: Microleakage, sealant penetration depths, and ssure type.
Poster Sessions P0221 Analysis of GIC clinical procedures knowledge (by questionnaire poll of doctors and students)
E. A. SKATOVA, E. M. NOSOVA, N. A. ANDRONOVA, L. V. SENINA & I. I. MALANCHUK Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: The aim of this study was to evaluate theoretical knowledge of glass-ionomer cements (GIC) working techniques and practical skills in this sphere that doctors and students of Dentistry Department possess. Materials and methods: A questionnaire was devised on the basis of GIC working techniques as described in literature. For carrying out comparative analysis, the respondents were divided: Group 121 paediatric dentists working in state clinics; Group 222 pediatric dentists working in private practices; Group 320 Dentistry students. Results: The lowest level of theoretical knowledge and practical skills was amongst dentists of the state clinics, with 70% of answers being incorrect upon average. The questionnaire established that the level of theoretical knowledge and practical skills in private practices was higher than in state clinics. Analysis of responses given by students showed that the average number of correct answers was 70%. The students gave the lowest number of correct answers to questions concerning conditioners and varnishes, indicating a lack of awareness. Conclusions: 1. All groups surveyed had an insufcient level of knowledge of GIC working techniques. 2. The situation is worst in state clinics, where dentists scored only 35% of correct answers upon average. 3. Dentists in private practices revealed a discrepancy between their level of knowledge (80 % correct answers on average) and the practical aspects of work. 4. Dentistry students are insufciently informed of the need to condition the prepared cavities before applying GICs and to cover llings with protective varnishes. Results: A signicant difference in microhardness was observed between control and experimental groups of all materials, except for compomer group (P < 0.01). No signicant difference was detected between two glass ionomers and giomer groups (P > 0.01) and the average dentin hardness under materials in the studied distances ranged from 83.3 to 61.7, 80.7 to 60.4, 79.9 to 60.8 KHN respectively and that of compomer was ranged from 66.0 to 67.8 KHN. In addition, a signicant difference was found between 20 lm depth and the other depths (P < 0.01). Conclusion: It is suggested that throughout the study period, dentine showed a similar increase in microhardness values with two glass ionomers and giomer.
P0223 A new polishing material; nano-technology liquid polish

D. ATABEK, H. SILLELIOGLU & A. OLMEZ Department of Paediatric Dentistry, Gazi University Faculty of Dentistry, Ankara, Turkey Introduction: The aim of this study was to evaluate the efciency of a nano-technology liquid polish system on surface roughness of two different types of nano-composite resins. Materials and methods: Composite resin materials tested in this study were Ceram-X (Dentsply, USA) and Clearl Majesty Esthetic (Kuraray, Japan). Forty standard samples of each composite resin material were prepared and stored in articial saliva at 37ordm;C for 1 week. The samples of each material were randomly assigned to one of four test groups (n = 10) and contoured with carbide burs except for Group 1 (control). Samples of Group 2 were treated with aluminum oxide impregnated polymer points (Enhance Finishing System, Dentsply, USA) followed by diamond impregnated micro-polishing points (PoGo, Dentsply, USA), whereas specimens in group 3 were treated with only nano-technology liquid polish system (Lasting Touch, Dentsply, USA) and group 4 was treated in order with aluminum oxide impregnated polymer points, diamond impregnated micro-polishing points and nano-technology liquid polish system. Surface roughness values (Ra) of all samples were obtained with optical prolometer. The signicance of difference between groups was assessed with one-way analysis of variance and Kruskal Wallis test. Results: All nishing and polishing techniques created statistically rougher surfaces than the control groups (P < 0.05). The lowest Ra values were detected in Group 4, although signicant differences were not found between Group 2 and 4 (P > 0.05) independent from the type of composite resins. Conclusion: With the combination of nishing and polishing procedures, a nano-technology liquid polish application may provide more glossy surfaces on composite resins.
P0222 Evaluation of microhardness in bovine dentine adjacent to uoride-releasing restorations

D. ATABEK, M. BANI, N. OZTAS & A. ALTUNTAS Department of Paediatric Dentistry, Gazi University Faculty of Dentistry, Ankara, Turkey Introduction: The aim of this study was to evaluate the microhardness of bovine dentine following restoration of experimental cavities with four different types of uoride-releasing restorative materials. Materials and methods: A conventional glass ionomer cement (Fuji II), a resin modied glass ionomer cement (Fuji II LC), a giomer (Beautil) and a compomer (Dyract AP) were evaluated in the study. A total of 40 pairs of bovine incisor teeth were used. Two incisor teeth extracted from the same bovine were randomly assigned to control or experimental groups. Forty standard cylindrical cavities were prepared on the labial root surfaces of experimental groups and were restored with each of the tested materials whereas the other tooth used as untreated control. All specimens were individually suspended in distilled water at 37ordm;C for 30 days. The teeth were sectioned and hardness of bovine dentin was assessed by Knoop indentation (20-lm intervals below the lled surface into the underlying sound dentin from the surface to a depth of 100 lm). Statistical analysis was performed with two-way ANOVA and Fischers PLSD test.
P0224 Fluoride uptake from various uoride-releasing restorative materials by bovine enamel in vitro
M. BANI1, D. ATABEK1, A. BERKKAN2 & N. OZTAS1 1 Faculty of Dentistry, Department of Paediatric Dentistry, Gazi University; 2Faculty of Pharmacy, Department of Analytic Chemistry, Gazi University, Ankara, Turkey Introduction: The aim of this in vitro study was to compare the uoride uptake from four different types of uoride releasing restorative materials by bovine enamel and to determine the effect of time on this uptake. Materials and methods: A conventional glass ionomer cement (Fuji II), resin modied glass ionomer cement (Fuji II LC), giomer (Beautil) and compomer (Dyract AP) were evaluated. A total of 120 bovine enamel slabs were prepared and assigned to one of four
Dental Materials 1
tested materials. Five slabs of each group were used as controls to determine the baseline uoride concentration. The remaining slabs were divided into ve subgroups representing 5 time intervals (1, 7, 14, 21 and 35 days). Each specimen was attached to the tested material and suspended in synthetic saliva according to the time period. After removal, specimens were etched with perchloric acid and the dissolved enamel was analysed in terms of uoride and calcium. The amount of uoride was assessed with direct potensiometric analysis and calcium was determined via atomic absorption spectrophotometry. The results were statistically analysed by ANOVA, Scheffes and Dunnetts T3 tests. Results: In Fuji II group, the F uptake was 0.73 mg F/cm3 at day 1, 0.95 at day 7 and reached 2.26 at day 35 whereas that of Fuji II LC group was 0.65, 0.89 and 1.96 mg F/cm3 respectively. For Giomer, the level of F uptake was 0.79 (day 1), 1.05 (day 7) and reached 2.07 mg F/cm3 (day 35) and that for Dyract AP was 0.38, 0.49 and 1.02 mg F/cm3 respectively. Signicantly higher levels of uoride uptake were observed with both glass ionomers and giomer whereas the least amount of uoride uptake was found with compomer in all test intervals (P < 0.05). No signicant difference was found in the amounts of uoride uptake between two glass ionomers and giomer (P > 0.05). Conclusion: It is concluded that uoride-releasing restorative materials have inuence on enamel uoride acquirement with variations during time intervals.
P0226 Effects of tooth type, dentin adhesives and base materials on occlusal/gingival microleakage
E. CANOGLU, H. C. GUNGOR & Z. C. CEHRELI Department of Paediatric Dentistry, Hacettepe University, Ankara, Turkey Introduction: Although a majority of adhesive/restorative materials are designed primarily for use in permanent teeth, little data exists with regard to their sealing properties on primary teeth. This study compared microleakage of Class-II composite restorations bonded with different adhesive systems and base materials in primary and permanent teeth. Materials and methods: Class-II cavities were prepared in primary and permanent molars. The teeth were bonded either with Single Bond 2 or Adper SE Plus. A resin-based composite was placed either alone (no base) or over one of the following base materials (n = 10/each) 1: Fuji VII; 2: Fuji Triage; 3: Filtek Supreme XT. Following thermocycling and immersion in basic fuchsin, the microleakage was measured using image analysis. The data were analysed with Wilcoxon Signed Ranks Test, MannWhitney U-Test and KruskalWallis One-Way ANOVA at a = 0.05. Results: The greatest and lowest occlusal microleakage were observed in No-base + Adper SE Plus permanent teeth (0.80 0.06); and No-base + Single Bond 2 primary teeth (0.10 0.03), respectively (P < 0.001). As for gingival microleakage, the greatest and lowest values were observed in Fuji VII + Single Bond 2 primary teeth (1.47 0.23) and Fuji VII + Adper SE Plus primary teeth (0.30 0.06), respectively (P < 0.001). Placement of a base material did not signicantly improve resistance to leakage (P > 0.05). Conclusion: With the tested adhesives, occlusal microleakage was similar in both types of teeth, while a lesser extent of gingival seal was observed in primary teeth. The use of a base material did not help decrease microleakage.
P0225 Evaluating GIC bond strength: microshear and microtensile

C. C. BONIFACIO1,2, A. M. SHIMAOKA2, A. P. ANDRADE2, W. E. VAN AMERONGEN1 & R. C. R. CARVALHO2 1 Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands; 2Department of Restorative Dentistry, School of Dentistry, University of Sa Paulo (USP), Sao Paulo, Brazil o Introduction: This in vitro study aims to compare the microtensile (lTBS) and microshear (lSBS) bond strength (BS) tests in order to nd the most reliable method for BS evaluation at the tooth/Glass Ionomer Cement (GIC) interface. Materials and methods: Flat human dentine surfaces were submitted to lTBS and lSBS. The materials used were: high-viscous GIC (Ketac Molar Aplicap 3M/ ESPE -KM), resin-modied GIC (Fuji II LC encapsulated CG Corporation FII), resin-modied nano-ionomer (Ketac N100 3M/ ESPE N100) and microhybrid resin composite (Z100 3M/ESPE). After 24 h of water storage all tests were performed with a universal testing machine (crosshead speed = 1 mm/min). The data was analyzed with twoway ANOVA (P < 0.05) and LSD test. Results: Tests and materials were statistically different, indicating that values for BS obtained per material depend on the test performed. Failure analysis, determined with stereomicroscope (X40), revealed that failures produced by lTBS were mainly cohesive for KM and FII. lSBS failures were mainly adhesives or mixed for all materials. According to lSBS, the BS found for KM and for FII was similar to Z100. Nevertheless, the lTBS revealed that KM results were in line with N100, which were statistically inferior to Z100s and, to a lesser extent to FII. The lTBS results are questionable due to the large percentage of cohesive failures found. Conclusion: The mechanical test that gave the most reliable BS value of the studied GIC is the lSBS method as it presented signicantly more adhesive or mixed failures than lTBS.
P0227 Adhesive systems application substantiation for cavity treatment in teeth with differing enamel mineral content
Z. H. CHUIKO & L. KISELNIKOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: The aim of this study was to build a basis for the application of different adhesive techniques in patients of various age groups considering mineral content of the enamel according to clinical and laboratory research results. Materials and methods: 160 teeth were lled in 70 patients (Group A: 1217 years old and Group B 1825 years old), both with Subgroups 1 (high and medium enamel resistance) and 2 (low enamel resistance). The following adhesive systems were used: Single Bond (total etching technique); Adper Prompt L-Pop (self-etching system). Filtek Z 250 served as lling material. Clinical evaluation of the llings was carried out according to RUGE after 12 months. At the same time, lling edge permeability was tested electrometrically with test equipment ED-01 DentEst from the Russian company Geosoft-Dent. Results: After 12 months, 10% of all llings showed a visible crack at the joint of the lling and tooth, accompanied by surface unevenness rated Bravo. Group B, Subgroup 1 using APL-P accounted for these defects. Other llings were rated as Alfa. An insignicant increase in the electrometric index of Group B using APL-P from 0.41 0.04 to 0.68 0.03 MkA occurred. Only in
Poster Sessions
Group A using APL-P electrometric index reduction from 0.88 0.19 to 0.65 0.14 MkA was observed. Conclusion: The use of the self-etching system for wide clinical practice is recommended, especially for the treatment of cavities in childrens teeth. The total etching technique is recommended for adults with high enamel resistance. 8: i-Bond. In Groups 14, Er: YAG laser was applied in VSP mode by 10 Hz and 300 mj; all self-etch adhesives were applied according to the manufacturers instructions; 3.5 2.0 mm cylindrical molds lled with the respective composites were placed over the adhesives and light cured. Specimens stored in distilled water for 24 h were then subjected to shear bond strength (SBS) test in an Instron Universal Testing machine at a crosshead speed of 1 mm/min. SBS data in MPa was statistically analyzed by one-way ANOVA, Tukey-Kramer MultipleComparisons and unpaired-t tests. Results: Mean + SD values (MPa): Group 1: 16.25 3.54; Group 2: 14.89 3.47; Group 3: 13.88 4.5; Group 4: 9.91 3.35; Group 5: 19.17 7.01; Group 6: 18.74 5.09; Group 7: 14.36 4.67; Group 8: 11.07 3.58. Signicant differences were determined between Groups 14 (P < 0.01), Groups 24 (P < 0.05), Groups 58 (P < 0.01), Groups 68 (P < 0.05). No signicant differences were found between the other groups. Conclusion: Specimens treated with laser demonstrated lower but not signicantly different mean bond strengths than the unlased controls; and Silorane System Adhesive has shown the highest mean SBS values in the lased and unlased groups.
P0228 Effect of chlorhexidine concentration on the mechanical properties of dental adhesive resins
C. W. M. CHUNG, C. K. Y. YIU, N. HIRAISHI & N. M. KING Faculty of Dentistry, Paediatric Dentistry and Orthodontics, The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China Introduction: Matrix metalloproteinases (MMP) have been implicated in collagen degradation within the hybrid layer. Incorporation of chlorhexidine, a potent MMP inhibitor, into dental adhesive resin may help to prevent dentin bond degradation. The objective of this study was to investigate the effect of chlorhexidine concentration on the mechanical properties of experimental dental adhesive resins. Materials and methods: Resin I beams and discs were prepared from three light-cured, experimental copolymer blends (R1, R2 and R3) containing 0.0, 1.0 and 2.0 wt% chlorhexidine diacetate (CDA). The exural strength (FS) and exural modulus (FM) were measured using three-point exural tests after 24 h dry and wet storage. FS and FM were analyzed using two-way ANOVA, with resin material, CDA concentration and storage time as independent factors. Knoop hardness was analysed using two-way ANOVA, with resin material and CDA concentration as independent factors. Results: Incorporation of CDA had no signicant effect on FS of dry and wet R1, R2 and R3 specimens. FM of dry R1, R2 and R3 specimens decreased signicantly (P < 0.05) with increasing concentration of CDA. No signicant effect of CDA on FM of wet R1, R2 and R3 specimens was observed. In general, FS and FM of neat and CDA-incorporated R1, R2 and R3 specimens decreased signicantly (P < 0.05) following water storage. Addition of CDA signicantly (P < 0.05) reduced the Knoop hardness of dry R1, R2 and R3 specimens. Conclusion: Chlorhexidine decreased the exural modulus and Knoop hardness of copolymer blends; no signicant effect on mechanical properties was observed under wet conditions.
P0230 24-month clinical evaluation of a self-etching bonding agent in preventive resin restoration
Y. ZHAO, C. YU & L. H. GE Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China Introduction: Several clinical studies have shown that reliable and long lasting adhesive restorations can be obtained following the total-etch technique. However, scarce information is available on the clinical performance of self-etch adhesives. The objective of this study was to evaluate the clinical effect of a self-etching (Adper Prompt, PT) bonding agent in preventive resin restoration (PRR). Materials and methods: The study was approved by the Human Research Ethics Committee of Peking University (No. IRB00001052-06054). Parental consent for the childs participation was obtained. A total of 142 carious molars from 52 children, were divided randomly into two groups, using PT or Adper Single Bond 2 (total-etch technique) respectively. Then they were restored by owable composite resin (Filtek Flow, 3M ESPE, USA). The modied United States Public Health Service (USPHS) evaluation criteria were used to evaluate the clinical effects at 6, 12, 18 and 24 months recall after treatment. Data were analyzed using SPSS 12.0 for Windows software. Chi-square tests were used to determine signicant differences between two groups. Statistical signicance was considered to be present at the 0.05 level. Results: After 24 months, the recall rate (of the teeth) was 85.9% and the survival rate was 100%. There were no statistically signicant differences between the two groups at retention, marginal sealing, marginal staining, secondary caries and pulp sensitivity. All of them were considered well during 24 months. Conclusion: The result from this study indicated that PT could get satisfying clinical results when used in PRR. Long-term performance needs to be evaluated further.
P0229 Bond strengths of self-etch adhesives in laser pepared cavities

Y. GUVEN, H. COMLEKCI & O. AKTOREN Faculty of Dentistry, Istanbul University, Department of Pedodontics, Istanbul, Turkey Introduction: The use of laser in cavity preparation as an alternative to mechanical rotating instruments has shown contradictary results on bond strengths of adhesives. The aim of this study was to assess and to compare the bond strengths of various self-etching adhesives in lased and unlased dentin surfaces. Materials and methods: 80 extracted noncarious molar teeth were embedded in acrylic resin; at labial dentin surfaces were prepared and wet-ground with 600 grit SiC paper. Specimens were randomly assigned to eight groups (n: 10): Group 1: Er: YAG laser (Fidelis Plus II, Fotona) + Silorane System Adhesive (3M Espe); Group 2: Er: YAG laser + Clearl S3 Bond (Kuraray Co Ltd.); Group 3: Er: YAG laser + G-Bond (GC America Inc); Group 4: Er: YAG laser + iBond (Heraeus Kulzer); Group 5: Silorane System Adhesive; Group 6: Clearl S3 Bond; Group7: G-Bond; Group
Dental Materials 1 P0231 Effects of polymerisation unit on the exural strength of glass carbomer
K. GORSETA, D. NEGOVETIC VRANIC, D. GLAVINA & I. SKRINJARIC Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Croatia Introduction: The aim of this study was to measure the exural strength (FS) of new nano-ionomer cement and to determine if strength can be related to polymerisation unit and applied light intensity. Materials and methods: The FS of commercial glass ionomer (Fuji IX GP Fast, GC) and new nano-ionomer cement (Glass Carbomer) were measured using a method based on ISO9917-2:1998. Specimens (n = 10 per group) were prepared in SS split moulds (2 2 25 mm), compressed and light-cured according to manufacturers instructions, stored at 37C (100% RH) for 24 h. Light curing was carried out immediately after mixing using Bluephase G2 (IvoclarVivadent), Elipar FreeLight 2 and Elipar TriLight (3M ESPE). Each specimen was tested using an Universal testing machine at 1 mm/min crosshead speed and loaded to fracture using a 3-point bending test (l = 20 mm), with 1 kN load cell. Data were analysed by ANOVA and Bonferroni post hoc test P < 0.05. Results: FS of Glass Carbomer (122.29 9.9 MPa) was signicantly higher than value for highly viscous glass ionomer Fuji IX (57.85 7.54 MPa) (P < 0.001). There were no statistically signicant differences in FS of GlassCarbomer samples cured by means of different light sources. FS of Fuji IX GP fast cured with EliparFreeLight (98.87 20 MPa) showed signicantly higher results than samples cured with halogen lamp (31.27 7.49 MPa) (P < 0.001). Conclusion: The nano-ionomer cement Glass Carbomer shows higher exural strength than highly viscous glass ionomer cement cured by different types of curing light. Different types of curing light (halogen lamp and LED lamp) signicantly inuence exural strength of glass ionomer cement. ways to treat the teeth hypersensitivity was developed and manufactured and the treatment effect of the uoride tape in dentin hypersensitivity patients was evaluated and compared with the effect of existing uoride varnish (CavityShieldTM). Patients and methods: Twenty two healthy adult patients (88 teeth) aged in the 20s having dentin hypersensitivity participated in this clinical research and they were divided into two groups of 11 patients in which one group was an experimental group treated with attachment of the uoride tape and the other group was treated with application of the uoride varnish. The uoride product was applied according to the manufacturers instruction and the level of pain in the tooth after giving irritation using compressed air and ice stick was measured just after the application, after 3 days, after a week and after 4 weeks each using visual analog scale (VAS). Results: In the experimental group, VAS scores were 38.636 (air), 62.273 (ice) at an early stage, 30.273 (air), 49.545 (ice) after 3 days, 28.182 (air), 40.000 (ice) after one week, and 26.364 (air), 37.727 (ice) after 4 weeks. Compared with the early VAS scores, all other VAS scores showed the signicant decreases statistically. In the control group, VAS scores were 42.274 (air), 65.909 (ice) at an early stage, 34.091(air), 55.909 (ice) after 3 days, 28.636 (air), 40.909 (ice) after one week, 27.727 (air), 31.364 (ice) after 4 weeks. All VAS scores except the VAS score of 34.091 (air) measured 3 days after (using the irritation examination by the compressed air) showed the signicant decreases statistically when compared with the early VAS scores. Conclusion: The uoride tape used in this clinical research was able to treat the dentin hypersensitivity effectively. Also, when compared to the treatment effect of the uoride varnish no signicant difference was shown.
P0232 The therapeutic effect of uoride-containing adhesive tape on dentin hypersensitivity

H. G. JANG, N. Y. LEE & S. H. LEE Department of Pediatric Dentistry, Chosun University, Gwang ju, South Korea Introduction: In this clinical research, the uoride tape (SCMC5-T) containg NaF which is known as one of the most effective
Poster Sessions
Poster Session P03/Dental Materials 2

P0333 The effects of childrens drinks on the colour stability of restorative materials
E. S. TUNC1, S. BAYRAK1, A. U. GULER2 & N. TULOGLU1 1 Department of Pediatric Dentistry; 2Faculty of Dentistry, Department of Prosthodontics, University of Ondokuz Mays, Samsun, Turkey Introduction: Discoloration of restorative materials may cause patient dissatisfaction and result in additional expenses for replacement. The aim of this study was to evaluate the effects of exposure to various childrens drinks on the colour stability of different aesthetic restorative material commonly used in paediatric dentistry. Materials and methods: Cylindrical specimens (15 2 mm) were prepared from four different restorative materials: Fuji IX, a glassionomer cement (GIC) Fuji II LC, a resin-modied glass-ionomer cement (RMGIC), Dyract Xtra, a polyacid-modied composite resin (PMRC), and Filtek Z250, a composite resin. For each material, 20 specimens were prepared and divided into four groups. Each group was stored in a different solution (distilled water, chocolate milk, cola, grape juice) for 24 h. A colorimeter was used to measure the colour of each specimen both before (baseline) and after staining. Colour change (E*) was calculated, and data was analyzed using two-way ANOVA and Tukey HSD tests. Results: Two-way ANOVA showed the effects of restorative materials, staining agents and their interaction to be statistically signicant (P = .0001). For all restorative materials, the lowest E* values were recorded for specimens stored in distilled water (0.42), followed by chocolate milk (0.88), grape juice (3.45) and cola (3.97). Among the four restorative materials tested, Fuji II LC showed the profoundest colour change (3.71) and Fuji IX the least (1.33). There were statistically signicant differences among above groups (P < 0.05). Conclusion: E* values were acceptable for all materials tested, with the exception of Fuji II LC. Therefore, the use of Fuji II LC is not recommended for use in anterior restorations in children. without the application of APF. Then, all teeth were evaluated using a Scanning Electron Microscope (SEM) in magnications 1000, 2000, 3000 and 4000. Chi-square test was used for statistical analysis. Results: Out of 3 etch-pattern types (I: acid dissolves the enamel rod-core, II: acid dissolves the enamel rod-periphery and III: irregular pattern) in Group 3, etch-pattern type I was more frequently observed (86.7%), but in Group 4, all etch-pattern types (I, II, III) were observed, whereas in Groups 1 and 2, typically etchpattern type II was found (66.7% and 60% respectively, P < 0.001). Conclusion: Etch-pattern type I was more present in permanent teeth and etch-pattern type II was more scanned in primary teeth. Since the acid usually dissolves the inorganic part of the enamel, it may be concluded that in permanent teeth, the enamel rod cores have more inorganic material, while primary teeth have more mineral material in the enamel rod peripheries.
P0335 Clinical evaluation of /F releasing of Esterll /F in primary teeth

M. S. KOSHMAN, A. G. SEDOYKIN & A. P. POLIKARPOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow Russia Introduction: To evaluate the clinical effectiveness of a direct resin based composite material Esterll /F (NII Medpolymer RUSSIA) without bonding system in primary teeth. Patients and methods: A total of 83 restorations (32 class I and 51 class II) were placed in primary molars in 46-year-old children. Following caries removal and cavity preparation, the teeth were restored with owable and condensable materials Esterll /F without bonding system, using acid-etching (enamel 20 s, dentin 15 s). The restorations were evaluated according to the U.S. Public Health Services (USPHS) criteria at the end of one year. The data obtained were analyzed using the Chi-Square-Test. Results: The evaluations showed no statistically signicant difference between class I and class II restorations in terms of the color mismatch, anatomic form, marginal adaptation, and secondary caries (P > 0.05), but they were statistically signicant with regard to cavosurface marginal discoloration (P < 0.05). At the end of one year, the success rate of the class I and class II restorations of the primary molars restored with Esterll /F was 93.7 and 86.3%. Conclusion: The 12-month clinical performance of Esterll /F materials was satisfactory for the restoration of Class I and II primary molars.
P0334 Evaluation of micromorphology of etched primary and permanent enamel following APF treatment
A. R. SARRAF-SHIRAZI1, B. M. AJAMI1, A. EMAMI2 & M. REZAIFAR1 1 Pediatric Dentistry Department and Dental Research Center, Mashhad University of Medical Science, Mashhad; 2Dentist, Shiraz, Iran Introduction: The purpose of this study was to evaluate the etchpattern of permanent and primary enamel with or without the application of Acidulated Phosphate Fluoride (APF) gel. Materials and methods: 60 sound proximal enamel surfaces (30 permanent maxillary rst pre-molar and 30 primary maxillary rst molar) were selected. In Group 1, primary teeth were treated with APF gel for 4 min and then etched with 37% phosphoric acid gel for 30 s. In Group 2, primary teeth were etched, without the application of APF. In Group 3, permanent teeth were treated with APF and then etched. In Group 4, permanent teeth were etched,
P0336 Feature of gap formation between different cavities walls and resin composite systems on primary teeth
A. G. SEDOYKIN, V. M. ELIZAROVA & A. P. POLIKARPOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: The aim of this study was to compare the effectiveness of self-etching, etch-rinse dentin-bonding agents and materials
Dental Materials 2
Esterll /F NII Medpolymer RUSSIA without bonding in achieving a gap-free adaptation between the restorative material and substance of primary teeth. Materials and methods: The authors randomly divided 30 noncarious primary teeth into three groups (self-etching, total-etching and etching without bonding). In the rst group the self-etching system Optibond all-in one Kerr was used and the teeth were restored with Herculite Kerr. In the second group acid-etching was used (enamel: 20 s, dentin: 15 s) in combination with Optibond FL and the restorative material Herculite. In the third group following acid-etching the restorative material Esterll /F without bonding system was applied. Longitudinal sections of the restored teeth were evaluated using scanning electron microscopy (SEM). We estimated length, width and quantity of gaps between restoration and substance of the primary teeth. Results: In all three groups the greatest quantity of gaps was observed in the eld of an angle of a cavity and at one of edges of enamel. Minimal the width and length of a gap in the eld of a dentine-restoration is also was observed in group with Optibond FL. However in this group cracks in the structure of enamel have been found. Statistical results of the SEM analysis revealed fewer gaps in the restorations made with Esterll /F restorative material than Optibond -all-in one agents at the restorationdentin interface in both groups. As the porous layer which forms Optibond-all-in one agents, was regarded by us as a gap. Conclusion: In spite of the fact that Optibond FL showed the best results, Esterll /F can establish adhesive layers for bond of restorative material to dentine of primary teeth. while signicant differences occurred between initial and after treatment group values for G4 (P < 0.05). Conclusion: Bleaching treatment conducted with light had no adverse effect on enamel microhardness.
P0338 Calcium and hydroxyl ion diffusion through dentin comparison study of various materials
V. TZIGKOUNAKIS1, V. MEGLOVA1 & L. TREFIL2 1 Dentistry Department; 2Clinical Biochemistry Department; Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Czech Republic Introduction: Calcium Hydroxide is used as an intracanal medicament in endodontic treatment of dental trauma complications, such as root resorption, because of its antibacterial and antiresorptive properties. Materials and methods: Calcium Hydroxide preparations which are used in Dentistry Department of Faculty Hospital in Pilsen, such as Calxyd and Dentbalzam (in paste form) from Spofa Dental, Calxyl red and blue (in paste form) from OCO and Plus points from Roeko were used in this study. 25 intact pre-molars, extracted for orthodontic reasons, were treated endodontically in vitro. Every fth tooth was lled with one from the above materials. The clinical crowns and the apex were covered by glass ionomer cement. A cavity on the middle root third of each tooth was prepared, simulating root resorption. Subsequently, the teeth were placed into pipes containing saline solution and every 24 h the concentration of calcium ions was measured for 21 days. From that concentration, the pH of each solution was calculated. Results: Calxyl red and blue had the best results among all materials, since 3 weeks after the initial measuring their pH values varied between 12,10 and 12,25. Dentbalzam and Calxyd resulted in pH values of 11.80 and 12.00 respectively. The pH of saline solution with teeth lled with Plus points varried between 11.20 and 11.40. Conclusion: Measurements proved that hydroxyl and calcium ions pass through dentinal tubules into saline solution, causing alcaline environment. Materials in paste form should be preferred, since they cause stronger alcaline environment than the points, in shorter time.
P0337 In-vitro evaluation of the effects of power bleaching on enamel microhardness

E. CAKIR, O. TULUNOGLU, S. OZCAN & M. B. UCTASLI Faculty of Dentistry, Departments of Paediatric Dentistry and Operative Dentistry, University of Gazi, Ankara, Turkey Introduction: This in vitro study aimed to evaluate the surface micro hardness of human enamel subjected to bleaching with Zoom Advanced Power (AP) in-ofce bleaching kit and Opalescence Boost 38% hydrogen peroxide an in-ofce vital bleaching agent. Materials and methods: One hundred recently extracted and intact human impacted third molar teeth were used. The teeth were sectioned into buccal and lingual halves than 150 tooth sections without any enamel crack were selected. These sections were randomly divided into ve groups (n = 30). Bleaching agents were applied according to manufacturers instructions. Three measurements were made from each tooth section using a Vickers Microhardness (Shimadzu HMV, Japan) tester before initial exposure to the bleaching agents and post treatment. The indentations were made on the attened middle third top surface of each specimen using 300-gr loads and a dwell time of 20 s. The three values were averaged to produce one value for each specimen. G1: Control (no light no gel), G2: Opalescence Boost 38% hydrogen peroxide in-ofce bleaching gel, G3: Zoom 2 25% hydrogen peroxide in-ofce bleaching gel, G4: Zoom 2 25% hydrogen peroxide in-ofce bleaching gel and Zoom 2 AP light, G5: Placebo gel and Zoom 2, AP light. Colourless glycerine based placebo gel was used to prevent dehydration. All specimens of a respective group were subjected to the treatment agents for three sequences of 15 min. The data were evaluated with one-way ANOVA and post hoc Tukey tests. Results: Microhardness values for G4 before and after treatment were 345.76 and 358.16 respectively. Statistical analyses revealed no signicant differences among initial enamel groups P > 0.05;
P0339 Effect of chlorhexidine on self-etch bond on primary teeth dentin in vitro

Y. LIU & D. M. YANG Pedodontic Department, Capital Medical University School of Stomatology, Beijing, PR China Introduction: Studies showed that matrix metalloproteinases (MMPs) may partially be responsible for bond strength decrease. Since chlorhexidine (CHX) inhibits MMPs, the purpose of this in vitro study was to investigate the effect of chlorhexidine on dentin bonding durability of self-etch adhesive systems on primary teeth. Materials and methods: 46 sound primary molars were collected with parents informed consent. All molars were sectioned into two halves to expose at dentin surfaces. All-in-one self-etch adhesive systems were applied and followed by composite application in one half (control group), the other was treated with 2% CHX before self-etch. Paired specimens in both groups were submitted to microtensile bond strength test immediate, 75 and 150 days after being stored at artical saliva respectively. Fracture patterns of specimens were observed using scanning electron microscopy (SEM). Pairedsamples t test and Oneway ANOVA were used.
Poster Sessions
Results: Microtensile bond strengths were 44.15 10.09MPa, 23.52 6.75MPa and 27.84 15.31 MPa in the control group at immediate, 75 days and 150 days,respectively, while they were 43.83 11.27 MPa, 24.56 6.36 MPa and 29.16 9.41 MPa in the CHX group. There were no signicant differences between two groups at all test time intervals (P > 0.05). The storage resulted in signicant bond strength reduction in both control and CHX groups at 75 days and 150 days compared to the immediate test (P < 0.05). No signicant differences were found between 75 days and 150 days in each group (P > 0.05). SEM showed that fractures patterns were mainly adhesive fractures in both groups at all observed intervals. Conclusion: This in vitro study suggests that chlorhexidine might not preserve self-etch dentin bond. The aim of this study was to assess the Knoop hardness of resinmodied glass ionomer cements. Materials and methods: Ten specimens of each material were made: G1-VitremerTM (3M-ESPE), G2-KetacTM N100 (3M-ESPE) and G3-Vitro Fill LC (DFL). The materials were dosed and mixed according to the manufacturers instructions and inserted in PVC molds, light cured for 40 s and stored in lubricant (Parafn highly liquid, Merck) at 37ordm;C, for 24 h. The surfaces were wet polished till the excess was removed. The Knoop hardness was determined (Microhardness Tester HVS 100 PANTEC), with 25-g load and 5-s dwell time, with Knoop indenter. On each specimen three indentations were made in upper surface and three in the lower surface. ANOVA and Tukey test were conducted (P < 0,05). Results: The mean Knoop hardness (and SD) of each group were: G1: 69.9 (16.5), G2: 39.3 (8.8), G3: 53.5 (3.1). Signicant differences between the hardness of the materials existed and no signicant difference between the upper and lower surfaces of the same specimen was found. Conclusion: Glass ionomer cement with nanotechnology did not achieve similar Knoop hardness compared to the others materials tested.
P0340 Evaluation of a new material in restoration of primary molars

F. SAJADI Department of Pediatric Dentistry, Dental School, Kerman, Iran Introduction: It is claimed that ceramic inserts can reduce polymerization shrinkage and microleakage in posterior tooth-colored restorations. The purpose of this study was to evaluate the gingival microleakage in tooth colored restorations with ceramic - inserts in primary pulpotomized molar teeth. Materials and methods: Forty extracted human primary second molars were prepared with standardized MOD cavities so that the gingival margin was located on the dentin in mesial box and on the enamel in distal box. We used 3 materials in 4 groups: composite resin (3M-Z100), light-cured glass ionomer (Fuji ) and cerana glass ceramic insert (Nordiska, Helsingborg.Sweden). The teeth were randomly divided into 4 groups with 10 teeth in each and restored as follows: Group 1: light-cured glass ionomer. Group 2: light-cure glass ionomer with cerana glass ceramic insert. Group 3: composite resin. Group 4: composite resin with cerana glass ceramic insert. The high intensity program (HIP) was used for light-curing (Ivoclar vivadent, Astralis 7). After termocycling (1000 cycles, 555C) and load cycling (250 000 cycles-80 N), microleakage was evaluated by dye penetration technique (basic fushin 0.5%). Data were statistically analyzed by ANOVA, Kruskal -Wallis and Wilcoxon test at signicance level P < 0.05. Results: No statistically signicant differences were found between the groups with and without cerana in enamel (P = 0.891) and dentin (P = 0.197). Microleakage at the dentin margins was greater than the enamel margins (P = 0.001). Conclusion: The use of cerana in combination with HIP cannot reduce microleakage at gingival margin in class II restorations. However, more studies using other restorative techniques and light curing methods are recommended.
P0342 Effects of MTA on proliferation and differentiation capacity of human pulp cells
M. Y. WANG1, H. LIU1, S. L. LI2 & M. QIN1 1 Department of Pediatric Dentistry; 2Research Laboratory of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Bejing, PR China Introduction: The purpose of the study was to investigate the effects of mineral trioxide aggregate (MTA) and calcium hydroxide on the proliferation and differentiation capacity of pulp cells of primary teeth. Materials and methods: Pulp cells were isolated from the retained primary teeth without apparent root resorption. The cells of 48 passages were used in the study. The experiment was divided into three groups: MTA group, calcium hydroxide group and control group. Cell proliferation was detected by MTT array. Von Kossa staining was employed to observe the formation of mineralized nodules, and mRNA expression level of alkaline phosphatase (ALP) and dentin sialophosphoprotein (DSPP) was determined by Real Time PCR. ANOVA analysis was applied to all the values, and statistical signicance was determined at P < 0.05. Results: Calcium hydroxide-treated cells grew slower than the control signicantly (F = 1792.301 P < 0.01); While MTAtreated cells proliferated signicantly faster than the other two groups (F = 1835.065,P < 0.01). The formation of mineralized nodules was found in both MTA-treated and calcium hydroxidetreated pulp cells. MTA increased mRNA expression of ALP and DSPP in pulp cells (F = 349.651,P < 0.01), whereas calcium hydroxide down regulated them in comparison to the control (F = 1653.001,P < 0.01). Conclusion: MTA is more suitable than calcium hydroxide as pulpcapping agent in primary teeth.
P0341 Knoop hardness of resin-modied glass ionomer cements

A. F. B. CALVO1, E. C. BRANCO2, L. B. CAMARGO1, J. C. P. IMPARATO1 & D. P. RAGGIO1 1 Pediatric Dentistry Department, University of Sa Paulo, Sa o o Paulo; 2Sa Leopoldo Mandic, Campinas, Brazil o Introduction: The constant concerns with prevention and restoration longevity allow researchers to be in constant improvement of dental materials, on the attempt to reproduce dental structure in its aesthetics and physical properties. New materials with different formulations and presentations frequently are introduced to the clinicians, as it is the case of nanotechnology glass ionomer cement.
Dental Materials 2 P0343 The effect of storage media on the solubility of three restorative materials
N. OZALP1, S. BAYRAK2 & Z. OKTE1 1 Faculty of Dentistry, Department of Pedodontics, Ankara University, Ankara; 2Faculty of Dentistry, Department of Pedodontics, 19 Mayis University, Samsun, Turkey Introduction: The purpose of this study was to compare the solubility of three restorative materials in various storage media. Materials and methods: A glass ionomer cement Ionol, a compomer Dyract-Xtra and a micro hybrid composite Esthet-X were used in the study. Forty disk shaped specimens, 10 per each group were prepared in a stainless steel mold according to the manufacturers instructions and then stored in distilled water, cola, orange juice and milk. Over a 30-day test period the specimens in each group were immersed in the storage media at 37C for 3 h a day. Solubility tests were made by using gravimetric test method at 24 h and at days 7, 14, 21 and 30. The data (lg/mm3) were subjected to KruskalWallis and nonparametric multiple-comparison tests using ranked sums. Results: There were statistically signicant differences among materials solubility values in distilled water after 14th day. In cola, Dyract Xtra showed signicantly higher solubility value than Esthet-X and Ionomer (P < 0.05; P < 0.001). In orange juice, Ionomer showed the highest value for solubility (P < 0.001). In milk Ionomer showed signicantly lower solubility than Dyract Extra and Esthet-X (P < 0.05). Conclusion: The results showed that the storage media affects the solubility of restorative materials. and faster application and thus easier to use in paediatric dentistry clinical practice.
P0345 Basic research on biomaterials for restoration of primary teeth

T. MIZUTANI1,2, A. NAKAYAMA1,2, N. TAKANASHI1, H. IWASAKI1,2 & H. MIYAZAWA1,2 1 Department of Pediatric Dentistry; 2Department of Oral Health Promotion, Graduate School of Matsumoto Dental University, Japan Introduction: The restoration of primary teeth should consider not only the various functions, but give sufcient consideration to their replacement by permanent teeth according to physiological root resorption of their roots. We studied the possibility of using a post after root canal lling of primary teeth examining the biomaterials in a medical and an environmental aspect. Materials and methods: In this research, we took up Poly-GlycolicAcid (PGA) and Poly-L-lactic Acid (PLLA), which chemical structure is identied by Attenuated Total Reference with FT-IR as being comparatively simple in several biomaterials. We compared these with resins after examining them, shaped by the standard preparation of extrusion molding. 1. Bending strength test (conforming to ISO4049, JIS T6523), 2. Bending elastic modulus test, 3. Adhesion to cement test (conforming to ISO 11405). And we manufactured the posts for trial by extrusion molding after designing them, which inuenced the occlusal force in primary dentition, the size of primary tooth and the mechanical stresses in the root of primary tooth in trauma. Results: No signicant difference was found between biomaterials and resins. And we could make trial manufactures shaped screw length 9.51 mm, diameter 1.62 mm referred mechanical examinations and several data of primary tooth. Conclusion: It is possible to use biomaterials as restorative materials for the primary tooth which change the composition and orientation.
P0344 Handling time of self-etching adhesives versus etch and rinse adhesives
D. NEGOVETIC VRANIC, K. GORSETA, S. GLAVINA & I. SKRINJARIC Department Paediatric Dentistry, School of Dental Medicine, University of Zagreb, Croatia Introduction: The aim of this study was to test handling time necessary to complete restoration using several different adhesive systems, etch and rinse and self-etching in terms of manipulation time in paediatric dentistry clinical practice. Materials and methods: Tested self-etching adhesive systems were AdheSe (Ivoclar/Vivadent, Lot G2718), Clearl SE Bond (Kuraray Dental, Lot 4194), Clearl S3 Bond (Kuraray Dental, Lot 41120), Adhese One Vivapen (Ivoclar/Vivadent, Lot K10655), Unil Bond (GC, Lot 0406021), Futura Bond NR (Voco, Lot 581031) and Adper Prompt-L-Pop (3M Espe, Lot 223261). Etch and rinse tested systems were Single Bond (3M Espe, Lot 6FN) and Excite (Ivoclar/ Vivadent, Lot J14884). Restorations were made with composite Tetric (Ivoclar/Vivadent, Lot E 46159) according to manufacturers instructions as cylinders of the material. Each cylinder was adhered to enamel with the tested adhesive system. Time necessary to complete each restoration was measured. Statistical analysis was performed using Anova and Tukey HSD test. Results: The score measured produced statistical signicance and conrmed difference among tested adhesives (P < 0.01). Signicantly better time was measured for Prompt-L-Pop (78.7 s), AdheSe One Vivapen (82.7 s) and Clearl S3 (92.4 s) than Excite (115.8 s) and Single Bond (116.7 s). All other tested self-etching systems did not produce statistically signicant difference compared to tested etch and rinse systems. Conclusion: Handling properties of the all in one self etching systems are less time consuming because of the easier manipulation
P0346 Resistance to degradation of bonded restorations to simulated caries-affected primary dentin

M. MARQUEZAN1, D. P. RAGGIO1, B. L. SILVEIRA2, M. TOLEDANO3 & A. L. CIAMPONI1 1 Department of Orthodontics and Pediatric Dentistry, Universidade de Sa Paulo USP, Brazil; 2Department of Restorative Dentistry, o Centro Universitario Franciscano UNIFRA, Brazil; 3Department of Dental Materials, School of Dentistry, University of Granada, Granada, Spain Introduction: This study aimed to investigate the resistance to degradation of resin modied glass ionomer cement (RMGIC) and adhesive/composite restorations in sound and simulated cariesaffected dentin of primary teeth subjected to caries challenge using a pH-cycling model and load-cycling, by microtensile test. Material and methods: Occlusal cavities were prepared in sixty sound exfoliated primary second molars. Half of the specimens were submitted to pH-cycling to induce simulated caries lesions. The teeth were randomly assigned to restoration with one of the two materials: (1) a RMGIC (Vitremer) and (2) a total-etch adhesive system (Adper Single Bond 2) followed by resin composite (Filtek Z100). After storage in distilled water 37C for 24 h, control group specimens were subjected to test procedures while the specimens in the experimental groups were subjected to two different aging methods: load-cycling (50 000 cycles, 90 N, 3 Hz) or carious challenge (pH-cycling: alternately 8 h in demineralizing
Poster Sessions
and 16 h in remineralizing solutions, for 10 days). Teeth were sectioned into 1 mm2 slices and tested to failure under tension. ANOVA and multiple-comparisons tests were used (P < 0.05). Results: Vitremer bond strength was not altered by the condition of dentin. Conversely, Adper Single Bond 2 showed signicantly lower bond strength values when bonded to simulated cariesaffected dentin. Load-cycling did not inuence bond strength for any of the tested materials, while carious challenge resulted in a signicant decrease in microtensile bond strengths of Adper Single Bond 2, but not for Vitremer restorations. Conclusion: The use of Vitremer (RMGIC) is encouraged for pediatric patients with caries activity. This investigation was supported by CAPES #BEX- 4711-06-8. that of amalgam restorations in both dentitions over 1, 2 and 3year periods. Materials and methods: Eleven databases were searched for articles up to 5 January 2008. Inclusion criteria for articles were: abstracts relevant to topic and published in English, Portuguese or Spanish. Exclusion criteria were: lack of randomization, control group, blinding or baseline data; drop-out rate > 35%. Articles were only accepted if they complied with all the exclusion criteria. Logrank tests and multi-level regression analysis were done (P < 0.05). Results: 222 articles were identied of which 16 were included for further review. Of the 16 articles, 6 were excluded and 10 were accepted. Due to heterogeneity in 3 of them, meta-analysis was possible for 7 articles. Data were compared for 1, 2 and 3 year follow-up periods and showed survival rates for ART restorations of 96.2; 93.9; 85.1% and amalgam 93.7; 88.8; 76.6% respectively. There was a statistically signicant difference between the second (P = 0.0346) and third year (P < 0.0001). The chances of amalgam restorations to fail in relation to the ART were 1.69 (CI 95%: 0.803.57) in one year, 1.93 (CI 95%: 1.043.57) after 2 years and 1.74 (CI 95%: 1.372.20) after 3 years. Conclusion: The evidence suggests that the longevity of single surface ART restorations using glass ionomer cement is higher after three years than amalgam restorations in primary and permanent teeth.
P0347 Survival rate of class II ART restorations testing different salivary barriers
T. S. CARVALHO1, W. E. VAN AMERONGEN2, A. DINIZ3, M. BONECKER1 & F. C. SAMPAIO3 1 Department of Pediatric Dentistry, University of Sa Paulo, Sa o o Paulo, Brazil; 2Department of Cariology, Endodontology and Pedodontology, ACTA, Amsterdam, The Netherlands; 3Department of Clinic and Social Dentistry, Federal University of Paraba, Joa o Pessoa, Brazil Introduction: The aim of this study was to evaluate the survival rate of class II ART restorations in primary teeth, made under rubber dam or with cotton wool rolls, after two years. Patients and methods: Prior to the study, the local ethical committee approval and the patients and guardians informed consents were obtained. A total of 2316 children, between 6 and 7 years old, of both genders, from public schools of two medium size cities in Brazil, were examined. 232 children were selected and one tooth having a class II cavity was selected. The children were randomly divided into two groups: a) class II ART restoration made under normal salivary control conditions using cotton wool; and b) using rubber dam. The restorations were assessed by calibrated evaluators (n = 8, Kappa > 0.8) at 6-month intervals for 2 years. Survival analysis using Kaplan-Meier test was carried out to determine the survival rates of the restorations. Results: The survival rates, for 6 months, 1 year, 11/2 year, and 2 years were 65.1%, 49.9%, 37.9% and 26.2%, respectively. Groups a and b had similar behavior patterns. The general survival analysis Kaplan-Meier test showed no statistically significant difference between groups a and b (Log rank = 3.72; gl = 1; P = 0.054). Conclusion: After 2 years, the survival rate of class II ART was critical and there was no difference between the methods of salivary control. Research supported by CAPES.
P0349 Enamel etching of immature and mature permanent teeth in children A comparative study
C. H. SAKKAS, L. O. KHOMENKO & N. V. BIDENKO Department of Paediatric and Preventive Dentistry, O. O. Bogomolets National Medical University, Kyiv, Ukraine Introduction: The aim of this research was to compare the etching patterns of unground enamel surfaces between immature and mature teeth in children. Materials and methods: 40 extracted pre-molars were divided into 2 groups. [Group A-20 immature (uncompleted root development), Group B-20 mature (completed root development) pre-molars]. Buccal surfaces of each group were divided in two areas: mesial and distal. Mesial surfaces were etched with 37.5% H3PO4 for 30 s and the distal for 15 s. The surfaces were examined with a SEM and analysed according to Galil and Wrights classication. Results: In Group A the etched mesial surfaces were lined with remnant etched aprismatic enamel (smallest area) and etched enamel prisms by Type 13 etching patterns (greatest area). For an etching time of 15 s in Group A the etched enamel was almost lined with etched aprismatic enamel. No differences in the degree of surface irregularity after etching for 30 or 15 s were found in Group B. The etched enamel surface was covered by Type 13 etching patterns. 2 variations in the appearance of the Type 2 etching pattern were observed. The rst variation resulted in a preferential loss of enamel in the interprism and prism periphery regions (groups A and B). In the second variation only a preferential dissolution of the prism periphery was observed (group B). Conclusion: Variations in the appearance of the Type 2 etching pattern seemed to depend on the level of maturation in interprism regions.
P0348 Survival rate of ART restorations in primary and permanent dentitions: meta-analysis
M. BONECKER1, E. STRINGHINI JUNIOR2, L. B. OLIVEIRA1 & S. MICKENAUTSCH3 1 Department of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, University of Sa Paulo, Sa Paulo, Brazil; 2School of o o Dentistry, CPO Sa Leopoldo Mandic, Campinas, Brazil; 3Division o of Public Oral Health University of the Witwatersrand, Johannesburg, South Africa Introduction: The traditional material for restoring tooth cavities is amalgam. Some time ago a restorative treatment concept, the Atraumatic Restorative Treatment (ART) has emerged. This meta-analysis compares the longevity of single surface ART to
Growth and Development
Poster Session P04/Growth and Development

P0450 Dental status of parenterally fed children presentation of two cases
A. REMISZEWSKI1, D. OLCZAK-KOWALCZYK1,2, P. SOBIECH1, A. GRZYBOWSKA1 & K. POPINSKA3 1 Department of Paediatric Dentistry, Warsaw Medical University; 2 Department of Oral Pathology, the Childrens Memorial Health Institute; 3Nutrition Clinic, The Childrens Memorial Health Institute, Warsaw, Poland Introduction: Parenteral nutrition is a form of supplementation of nutrients necessary for development of a body that has lost the ability to assimilate nourishment caused by diseases that have been suffered or underdevelopment of the digestive system. Its use comes with a risk of complications, including calcium-phosphate administration and catheter-based infections requiring treatment with antibiotics. They can disturb the course of development processes, including odontogenesis. On the other hand, parenteral nutrition eliminates or limits dental tissue exposure to cariogenic factors. The aim: assessment of the status of dentition and the general development of children fed parenterally. Materials and methods: General development and dentition status of two patients with short intestine syndrome (age 5 and 14 years) were assessed. The 14-year-old boy was also subjected to bone densitometry. The 5-year-old boy had been fed parenteraly since birth and the 14-year-old since he was two. Results: Both patients exhibited height and weight deciency. The 5-year-old patient endured multiple catheter-based infections requiring treatment with antibiotics. The 14-year-old had an incident of many months of antibiotic treatment at the age of two. Results of bone densitometry of the 14-year-old boy were below standard for his age. Dental examination of both boys showed delay in dentition time, irregularities in teeth anatomy, quantitative and qualitative abnormalities in dental tissues. Decay was not stated, despite unsatisfactory condition of oral hygiene. Conclusion: Systemic complications of children fed parenteraly may have a disadvantageous impact on the course of development processes both of primary and permanent dentition. Research should be continued. tion (control group). Following surgery, solid food was given and bred under conventional conditions. At one week (young), 4 months (mature) and 8 months (old) after surgery, measurement of the plasma corticosterone concentration, the Morris water maze test on spatial memory and the counting of the hippocampal neurons on Nissl staining were performed. The data were statistically processed by analysis of variance and, then, by Tukeys multiple comparison procedure. Results: The plasma corticosterone concentration was signicantly lower (P < 0.05), the shortening of the time to reach the platform by the Morris water maze test was signicantly slower (P < 0.05) and the number of neurons was signicantly lower (P < 0.05) in the mature and old mice of the extraction group than in the agematched controls. In the young mice, no signicant difference was noted between the extraction and control groups. Conclusion: The ability of spatial memory declined and the number of hippocampal neurons decreased in mature and old mice, suggesting that the hippocampal function is impaired by the tooth extraction. This study was supported by a Grant-in-Aid for Scientic Research (No.20592420) from the Ministry of Education, Science, Sports and Culture in Japan.
P0452 The effect of different transfusion on dental development in severe talassemic children
P. HOONCHAREON1, V. JIRARATTANASOPA1, A. KAWKUNCHON2 & K. TORCHARUS3 1 Department of Pediatric Dentistry, Mahidol University; 2Division of Pediatric Hematology, Queen Sirikit National Institite of Child Health; 3Division of Pediatric Hematology, Phramongkutklao College of Medicine, Bangkok, Thailand Introduction: Thalassemia is a group of inherited defect in synthesis of haemoglobin resulting chronic anemia. Many studies reported craniofacial deformities, growth retardation and delay dentition in severe thalassemia. Nowadays, blood transfusion treatment has been introduced to promote growth and prevent deformities. Dental development is expected to be affected. Therefore, the objective of study was to evaluate dental development in severe thalassemia under different transfusion. Patients and methods: This research was approved by the Human Subject Committees of Mahidol University, Bangkok, Thailand. All guardians gave written consent. The study conducted on 92 severe thalassemic and 32 healthy children, aged 613 years. Thalassemic subjects had history of pre-transfusion hemoglobin less than 7 g/dl and onset of anemia before 2 years. They were divided into 3 groups according to the frequency of transfusion: 1) high transfusion: more than 12 times/year. 2) low transfusion: 612 times/year. 3) occasional transfusion: less than 5 times/year. All subjects were taken panoramic radiographs. Seven left lower permanent teeth were evaluated developmental stages employed the method of Demirjian et al. The means different between chronological age and dental age were calculated and compared among groups by ANOVA. Results: There were no differences in chronological age and dental age presented in control and high transfusion groups. Low transfusion and occasional groups showed signicant delay
P0451 Effects of tooth extractions on hippocampus in senescence-accelerated mice

M. IINUMA1, H. HIOKI1, Y. ICHIHASHI1, Y. TAMURA1 & K. KUBO2 1 Department of Pediatric Dentistry, Asahi University School of Dentistry, Mizuho Gifu; 2Department of Oral Anatomy, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, Mizuho Gifu, Japan Introduction: The purpose of this study is to evaluate the effects of tooth extractions at young age on the hippocampal function in senescence-accelerated mice P8 (SAM P8). Materials and methods: 60 male SAM P8 mice were used. The upper molar teeth of both sides of 30 mice were extracted under general anesthesia at 1 month after birth (extraction group). 30 control mice were underwent the same anesthesia without extrac 2009 The Authors
Journal compilation 2009 BSPD, IAPD and Blackwell Publishing Ltd, International Journal of Paediatric Dentistry 19 (Suppl. 1): 66170
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dental development aproximately 10 months and 1 year, respectively. Conclusion: Different frequency of transfusion has an effect on dental development. Chronic severe anemia delays dental development and high transfusion may prevent dental retardation. obtained from an institutional ethical committee and childrens parents gave written informed consent. Results: No signicant differences were obtained in calcium, phosphorus and magnesium intakes between groups. PT children had lower dental calcium, phosphorus and magnesium content than AT children: 188.5 10.2 vs 254.3 12.3, 100.4 5.6 vs 138.8 9.2 and 5.3 1.5 vs 6.7 1.3, respectively (P < 0.05). No differences were found in phosphorus content. Conclusions: PT group of children have lower primary teeth calcium and magnesium content, compared with AT children. Mineral supplementation of the early diet may be needed in preterm infants, taking into account that genetic determinants may inuence bone mineralization of PT infants.
P0453 The effect of BTXA injection on mandibular growth in growing rats

S. Y. KWAK, J. Y. KIM & K. T. PARK Department of Pediatric Dentistry, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Introduction: This study assessed the effect of unilateral masseter muscle injection of Botulinum toxin A (BTXA) on mandibular growth in growing rats. Materials and methods: Thirty-six male Sprague-Dawley rats were divided into three groups according to age (Groups 1 to 3, aged 4, 5, and 6 weeks, respectively). Each group was divided randomly into three subgroups (subgroups A, B, and C). Subgroup A served as a control in which the masseter muscles were injected with saline bilaterally. In subgroups B and C, one or both masseter muscles were injected with 3U BTXA, respectively. The experimental animals were sacriced after 4 weeks. Then, the lengths of the mandibular body, condyle, and coronoid process and the heights of the anterior region, coronoid process, and condyle were measured and compared. Statistical analysis was carried out using the KruskalWallis test with Bonferronis correction and multiple comparison test. Results: 1) In Group 1, the mandibular body length and condyle height of subgroups B (BTXA side) and C were shorter than those of subgroup A. 2) In Group 2, the anterior region and condyle heights of subgroups B (BTXA side) and C were shorter than those of subgroup A. 3) In Group 3, the mandibular body length and condyle height of subgroups B (BTXA side) and C were shorter than those of subgroup A. Conclusion: BTXA injection effectively induces site-specic muscular hypofunction and growth change at local skeletal sites.
P0455 Emergence of permanent teeth in a Hungarian child population

J. A. NEMES1 & Z. PAPP2 1 Faculty of Dentistry, Department of Pediatric Dentistry, University za, Hungary of Debrecen, Debrecen; 2Private Practice, Nyregyha Introduction: Published data for permanent tooth emergence in Hungarian children are more than 40 years old. The aim of the study was to determine the age and sequence of eruption of permanent teeth, as well as gender differences in primary school children. Patients and methods: The emergence of permanent teeth was studied in 609 Hungarian children (305 boys and 304 girls) who had longitudinal records of the emergence of all permanent teeth except 3rd molars. Emergence ages were based on their presence or absence in the oral cavity at clinical examination. We calculated ages at clinical eruption of permanent teeth in months. Counts of permanent teeth corresponding to ages from 6 to 14 are also given. The statistic method for the calculation was the MaximumLikelihood-Method. Results: The sequence of tooth eruptions differs signicantly in the lower and upper jaw, whereas no signicant differences existed when comparing the sides of each jaw. The times of tooth eruption is earlier in females than in males. In case of boys there is a tendency for earlier tooth eruptions in the lower jaw. In respect to the tooth eruption sequence, a change was noted in the upper jaw. In contrast to other reports, the second pre-molar in girls has changed places with the canine and erupts prior to this tooth. Conclusion: When compared to the results gained from former observations in this region of Hungary, differences were found. Concerning the entire dentition acceleration of the tooth eruption could be noted.
P0454 Biomarkers of mineral status in primary teeth in children born pre-maturely

E. MORENO1, E. PLANELLS2, D. FLOREA2, E. MILLAN2 & P. PLANELLS1 1 Departament of Estomatologia IV, Universidad Complutense of Madrid; 2Institute of Nutrition, Biomedical Research Center, University of Granada, Spain Introduction: Recent studies have demonstrated that children born pre-maturely (BW < 1.5 kg) have lower bone mineral content and density compared with children born at term gestation. The objective is to study the dental mineralization of children born prematurely (PT) by analyzing calcium, phosphorus and magnesium as biomarkers of nutritional status comparing with a control group of children born at term (AT). Patients and methods: A cohort of 30 healthy children (68 yr) PT group was selected and primary dental mineral status was compared with these of 25 AT children (69 yr). A food intake questionnaire was asked to obtain (Mataix, 2007 software) %RDA intakes of calcium, phosphorus and magnesium. Calcium and magnesium content of wet mineralized samples were determined by atomic absorption spectrometry, phosphorus was analysed in same samples by colorimetric Fiske Subbarow method. Statistical SPSS 16.0 package was used to comparative study. Permission was
O0456 The development of German versions of paediatric sleep quality assessment instruments
D. SAGHERI1, A. WIATER2, R. D. CHERVIN3, J. A. OWENS4 & B. BRAUMANN1 1 Department of Orthodontics, Cologne University Hospital, Cologne, Germany; 2The Childrens Hospital Sleep Disorders Laboratory, Porz am Rhein Hospital, Cologne, Germany; 3Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, USA; 4Academic General Pediatrics, Rhode Island Hospital, Brown University, Providence, USA Introduction: The lack of validated German screening instruments for sleep-disordered-breathing in children makes it difcult to identify such children as part of dental examinations and makes it almost impossible to prevent resulting problems such as mouthbreathing, tongue-thrusting and dentofacial deformities. Further 2009 The Authors
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more, such disorders may well be treated with functional orthodontic appliances. The parent-report Pediatric Sleep Questionnaire (PSQ) and the Childs Sleep Habits Questionnaire (CSHQ) gained widespread use internationally. The aim of this study was to develop German versions of the PSQ and CSHQ. Materials and methods: WHO translation guidelines were followed in order to assure cultural equivalence. A subsequent two-phase validation study based on focus group testing and standardised pre-testing was carried out in order to evaluate acceptance and usability of the instruments. Results: Focus-group testing on subgroups of 20 parents of children with proved sleep disorders and healthy children with the Think-Aloud-method highlighted the need for minor adaptations. Subsequent pre-testing on 46 parents of children with sleep disorders and 235 parents of healthy children established their reliability and construct validity. Analysis of concordance between the 2 instruments (corelation coefcient 0.7) showed substantial agreement. The German PSQ contains 77 questions which cover quality of sleep in 218-year-old children and the German CSHQ contains 45 questions which quality of sleep in 410-year-old children. Conclusion: Conrmatory testing of the PSQ and CSHQ demonstrated their usefulness in identifying both behaviourally and medically based sleep problems. Both instruments can be used to identify sleep-related breathing disorders when plysomnography is not feasible.
P0458 Morphological and chemical aspects of primary teeth from pre-term infants
M. RYTHEN1,2, J. G. NOREN1, F. STEINIGER3, W. DIETZ3 & A. ROBERTSON1 1 Department of Pedodontics, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothtenborg, Sweden; 2Department of Pedodontics, Public Health Service, Region s, of Western Go taland, Gothenburg and Bora Sweden; 3Centre of Electron Microscopy, Friedrich-Schiller-University Jena, Germany Introduction: Clinical and morphological studies have shown enamel aberrations in teeth from pre-term children. This study describes histo-morphology of primary enamel and compares the chemical composition in enamel and dentin in primary teeth from pre-term children with normal children born at term. Patients and methods: Enamel in 44 exfoliated primary teeth, from 14 children with a gestational age below 29 weeks, were examined, using polarized light microscopy (POLMI) and scanning electron microscopy (SEM). Chemical analyses of 17 of the examined teeth and of 36 exfoliated primary teeth from healthy children born at term were performed, using X-ray micro analysis (XRMA). Statistical analysis, using MannWhitney U-test. Written informed consent from the parents and ethical consent by the Ethical Research Committee at the University of Gothenburg, was given. Results: In POLMI the neonatal line was found in 1/3 of the sections. In the postnatal enamel 31 teeth showed a high degree of porosity. The SEM analysis conrmed these ndings. In agreement with the morphological study, the concentration of carbon was higher, the value of calcium and the ratio Ca/P was lower in the outer part of the enamel compared with enamel from healthy children. Conclusion: Enamel mineralization disturbances in primary teeth from pre-term children showed disturbancescompared with teeth from healthy children. These irregularities were localised in the outer enamel layers. This study was supported by grants from the Research & Development Council in the Region of Western Gotaland, Sweden and the Research & Development Council in Southern Alvsborg County, Sweden.
P0457 The central neuronal activity regarding gustatory stimulus in tube-feeding rat
T. OOKA, T. HAINO, S. HIRONAKA & Y. MUKAI Department of Hygiene and Oral Health, School of Dentistry, Showa University, Tokyo Introduction: The purpose of this study was to reveal the changes in activation of central neuronal nucleus involved with feeding and gustatory experience caused by weaning condition when the pups begin to shift from suckling to mastication with the observation using the Fos protein as a marker of immunohistochemistry. Materials and methods: The Sprague-Dawley rats were separated into following 3 groups (5 pups in each group). I) Tube feeding group including rat pups operated gastrostomy at 9 postnatal day, II) tube feeding group including rat pups operated gastrostomy at 14 postnatal day, III) control group (nursed with dam). The tube feeding rats were infused articial milk by gastric tube exclusively without oral feeding. At 21 postnatal day (P21) they were fed the pelleted food. Then, all pups were perfused for xation and extracted the brainstem tissues and prepared to coronal section (50lm in thickness). In the brainstem, we counted the number of Fos-immunoreactive (FI) neuronal cells in nucleus principal sensory nucleus of trigeminal nerve (PrV) and nucleus tractus solitarius (NTS). Results: FI cells were observed in the tube feeding pups obviously, and the statistic comparison showed signicant higher count of FI cells in PrV in comparison to control group. Similarly, NTS showed signicant increment of FI cells in the tube feeding groups compared with the control rat pups. Conclusion: Consequently, it was considered that differences of ingestion pathway and weaning mode in the development stage inuence to the nervous activity in central neuronal nucleus associated with feeding and swallowing function.
P0459 Combined effect of TCDD and uoride on dental hard tissue formation in vitro
E. SALMELA1, A. M. PARTANEN1, C. SAHLBERG1, P. L. LUKINMAA2,3 & S. ALALUUSUA1,4 1 Department of Pediatric and Preventive Dentistry, Institute of Dentistry, University of Helsinki; 2Department of Oral Pathology, Institute of Dentistry, University of Helsinki; 3Department of Pathology, Helsinki University Central Hospital; 4Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland Introduction: The most toxic dioxin congener, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), impairs dental hard tissue formation and mineralization in vitro and in vivo. A further, well-established cause of enamel hypomineralization is excess uoride intake. In a previous in vitro study uoride disturbed or prevented enamel matrix secretion and mineralization. Dentin mineralization was nonhomogeneous. Our aim was to investigate if simultaneous exposure to TCDD and sodium uoride (NaF) can elicit additive effects on dental hard tissue formation in vitro. Materials and methods: Mandibular rst and second molar tooth germs (n = 152) of E18 mouse embryos were cultured for 12 days with TCDD (5, 10, 15nM) or NaF (2.5, 5, 10, 15, 20lM) alone or the two agents in combinations of several concentrations. The
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agents were added to the medium from the start of culture. Control teeth were cultured without TCDD/NaF. The explants were photographed, xed, processed to parafn sections and stained with HE. Morphological changes were studied visually from the photographs and tissue sections. Results: TCDD alone impaired dentin mineralization and enamel formation and NaF reduced enamel matrix secretion. The severity of the effects increased with the concentrations. While the effects of 10 nM TCDD and 15 lM NaF alone were barely detectable but consistent, their combined effect on dental hard tissue formation was clear. Conclusion: Both TCDD and NaF impair dental hard tissue formation, depending on the concentrations. The combined effect of the two agents at concentrations, which alone cause no or barely detectable effects, is clear. for each method was compared with chronological age for each subject. Results: Focal calcications were observed in AI patients. No statistically signicant differences were observed between three age estimation methods. In boys (presenting with a mean age of 8.08 2.7) the mean age estimated using the methods of Haavikko, Demirjian, Nolla was 9.5 1.6; 10.5 2.3; 9.9 2.5, respectively. The mean age calculated with Haavikko, Demirjian, Nolla for girls was 8.78 2.20; 9.48 2.74; 8.86 2.54 and the actual chronological age was 9.08 2.09 for girls. Conclusion: In this study including 38 patients with differents types of AI, the method for age estimation of Haavikko was the most accurate, followed by Nolla and Demirjian.
P0460 Dental development in children with mild-to-moderate hypodontia

E. S. TUNC, S. BAYRAK & A. E. KOYUTURK Faculty of Dentistry, Department of Pediatric Dentistry, University of Ondokuz Mays, Samsun, Turkey Introduction: To compare dental development in a group of children with mild-to-moderate hypodontia and a matched group. Patients and methods: A study group of 70 children (43 females, 27 males) with hypodontia aged 5.312.5 years was race-, age-, and sex-matched with 140 healthy, normal controls. Dental ages of children were calculated using a modied dental-age estimation method. Differences between dental and chronological ages were analyzed by t-test, and the correlation between difference in dental and chronological age and number of missing teeth was analyzed by Spearmans correlation test. Results: Dental development in children with mild-to-moderate hypodontia was signicantly delayed in comparison to the matched group (P < 0.05); however, the mean difference did not exceed 0.3 years in either sex. There was no correlation observed between the difference in dental and chronological age and the severity of hypodontia. Conclusion: Children with mild-to-moderate hypodontia were found to have a delay in dental development of a few months, which was statistically signicant. Due to individual variations, each patient should be individually examined.
P0462 Inuence of feeding methods on the development of the mandibular dental arch
T. YONEZU1, M. YAKUSHIJI1, S. SHINTANI1, N. MATSUBARA2 & H. SIRAI2 1 Department of Pediatric Dentistry, Tokyo Dental College, Chiba; 2 Combi Co, Tokyo, Japan Introduction: The positive impact of breast-feeding on health has been the subject of extensive study and review. However, there is a difference of opinion regarding the inuence of feeding methods on the growth of the jaw of infants. The purpose of this study was to examine various mandibular pre-dental arch parameters in infants. Materials and methods: Infant feeding data were collected and then at age 3 months, these infants were examined and study models obtained. The feeding methods were categorized as breast-fed if the infants were ever breast-fed, and as bottle-fed for those never breast-fed. The samples evaluated consisted of 32 sets of dental casts (breast-fed: 21 infants, bottle-fed: 11 infants) obtained from infants. Pre-dental arch shapes were measured using noncontact, high speed, 3-dimensional shape measuring system (UNISN INC). Digital computerized measurements of the anterior arch length and arch widths at several regions of the dental arch were performed. Comparisons between the breast-feeding and bottle-feeding were performed with the paired Students t-test. Results: Mean anterior arch length (6.4 vs 5.9 mm) was greater in those breast-fed infants. Mean anterior arch width (24.4 vs 23.5 mm) was also greater in those breast-fed infants. However, these parameters were not signicantly different between feeding methods. These results indicated that the arch width of breast-fed infants were, in general, greater than in those of bottle-fed infants. Conclusion: We conclude that the method of feeding may have some inuence on dental arch development during the 3-months period. However, further research is needed to clarify such differences with a larger sample size and also a longer observation period.
P0461 Age estimation of Amelogenesis Imperfecta patients using three different methods: a retrospective study
Z. KIRZIOGLU, K. G. ULU & A. C. ALTUN Department of Pediatric Dentistry, University of Suleyman Demirel, Isparta, Turkey Introduction: Developing teeth are used to assess maturity and estimate age in forensic dentistry, anthropologic studies. The aim of this study is to evaluate age estimation methods for Amelogenesis Imperfecta (AI) patients and refer the appropriate one. Materials and methods: 38 patients with type I, II and III of AI (22 female and 16 male) aged 415 years (average age 9.06 2.36 years) were recruited between the years of 20022008. Informed consents from all participants and/or their parents were provided. The diagnosis of AI was made by three skilled examiners. All patients were evaluated for malocclusion, eruption pattern, dental age, pulpal pathologies, missing and malformed teeth. Dental development was measured on panoramic radiographs in 29 patients aged between 613 years by using methods of Nolla (1960), Demirjian (1973) and Haavikko (1974). Dental age
P0463 Establishment of ameloblasts derived from induced pluripotent stem cells

M. ARAKAKI, A. YAMADA & S. FUKUMOTO Department of Oral Health and Development Sciences, Division of Pediatric Dentistry, University Graduate School of Dentistry, Sendai, Japan Introduction: Recently, it is possible to regenerate neuronal cells, osteoblasts and adipocytes from stem cells in tooth germ and dental pulp. However, it is difcult to regenerate tooth cells, including ameloblasts, from those kinds of stem cells. Establishment of ameloblasts from stem cells may be important to form regenerated tooth and understand the molecular mechanism of
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ameloblast differentiation. The purpose of this study is to differentiate ameloblast and odontoblast from induced pluripotent stem (iPS) cells have been generated from mouse somatic cells by introducing transcription factors. Materials and methods: We performed to culture mouse iPS cells with rat dental epithelium cell line SF2-GFP cells, established in our group. Ameloblast differentiation was analyzed by RT-PCR using LNA primers for ameloblastin gene. Results: The AMBN mRNA of mouse tooth germ, but not those of rat was detected by LNA primers for rat AMBN. These primers are useful to analyse the expression of AMBN in mouse iPS cells. When iPS cells were co-cultured with rat dental epithelium cells, iPS cells showed similar morphology of dental epithelium cell. RT-PCR showed iPS cells expressed AMBN indicating that iPS differentiated into ameloblasts. Conclusion: We found that iPS cells derived from mesenchymal cells could differentiate into ameloblasts by co-culture with dental epithelial cells. This induction method may be useful to form regenerated tooth. signicantly reduced height and/or weight when compared with controls. However, there has been a great increase in childhood obesity over the last decade. The aim of this pilot study was to investigate the body weight of Australian children requiring general anaesthesia (GA) for management of dental caries. Materials and methods: Ethics was obtained from the Human Research Ethics Committee, Sydney West Area Health Service. A retrospective audit was conducted of all children (1113) who required dental treatment under general anaesthesia at Westmead Hospital between January 2007 and June 2008. Records of 447 children (age <72 months) were examined. Basic demographic information, a detailed dental and medical history, dmft, treatment provided and the weight on the day of the surgery were recorded for each patient. Percentiles for weight were calculated using CDC/ NCHS data les that are currently used for Australian norms. Results: The average dmft for this cohort was 9.2. The weight of 74% of boys and 51% of girls was 75th percentile, almost 50% of boys were above the 90th percentile. Less than 5% of children weighed less than the 10th percentile. No relationship was found between rates of caries and weight. Conclusion: The majority of children requiring treatment under GA for EEC presented with a weight above average.
P0464 TMJ internal derangement following condylar fractures: impact on facial growth
P. DEFABIANIS Department of Biomedical Sciences and Human Oncology, Section of Pedodontics, Traumatology and Oro-Facial Malformations in the Growing Patients, Dental School, University of Torino, Italy Introduction: Many clinical studies have shown how jaw injuries are the single most important cause of subsequent TMJ internal derangement. Proper function of the masticatory system is certainly the most inuential variable in facial growth. The aim of the study was to evaluate relationships between post-traumatic internal derangement and disturbed facial growth in children. Patients and methods: 25 children, 16 boys, 9 girls, 14 year of age or younger (mean age: 5.7; range: 39 at the time of injury) were selected out of a group of 74. They all referred a history of major face injury. None of them referred a history of TMJ pain, mechanical dysfunction, orthognatic treatment or TMJ surgery before the trauma. They all had been treated by physiotherapy following a specic treatment protocol and underwent combined clinical and radiographic standardized evaluation for 5 years. None of them was treated orthodontically after the trauma. Results: 19 patients were found to have at least one abnormal and internally deranged TMJ on imaging studies; symptoms included either individually or in various combination pain and/or mechanical TMJ dysfunction. Out of this group, 11 patients showed a mandibular asymmetry with chin deviation to the smaller or more degenerated TMJ. Three patients showed an evident mandibular retrognathia with marked bilateral TMJ remodelling; three patients showed normal TMJ(s) with normal facial structure. Conclusion: These data suggest that in children TMJ derangement may potentially alter mandibular growth.
P0466 Acoustic characteristics of children of the Japanese consonants[s][]

T. SUGIYAMA, J. ASARI, M. SATO & M. INOUE Department of Pediatric Dentistry, Showa University School of Dentistry, Japan Introduction: The articulation of children occurs in association with the developments. We conducted acoustic analysis of these articulations in order to investigate organic effects of the oral cavity, one of the articulation organs. Patients and methods: The subjects were composed of ve healthy children (primary dentition completion) and ve children with cleft lip and palate. The purpose and methods of this study were explained to all subjects, and the articulation was recorded upon obtaining consent. The test sounds were selected as connecting preceding and following vowels of [a] to consonants of [s] and [] as in VCV (vowel-consonant-vowel) syllable [asa] and [aa]. Recording was conducted in a sound insulation room. Results: Regarding children with cleft lip and palate, palatalized articulation was the most frequently identied by the diagnosis based on auditory impression. Results of measurements demonstrated that the maximum sound pressure of children with cleft lip and cleft palate tended lower than that of healthy children. Conclusion: As a diagnosis of speech and language disorders, auditory impression is currently used in clinical setting. On the contrary, acoustic analysis allows the visualization of articulation characteristics of patients based on gures, independent of clinical experience of the user. The study suggested that the utilization of acoustic analysis has a potential to actualize a diagnosis based more on quantitative evidence.
P0465 Body weight of Australian children undergoing treatment of caries under general anaesthesia
H. FUNG1, N. PRABHU1, A. CAMERON1 & A. BLINKHORN2 1 Department of Paediatric Dentistry, Westmead Hospital; 2Faculty of Dentistry, University of Sydney, Sydney, Australia Introduction: Over 90% of dental caries in pre-school children remains untreated in most countries. Previous studies have found that children with early childhood caries (ECC) show a
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Poster Session P05/Morita Prize

P0567 Oral manifestation and behavior attitude of autistic patients in United Arab Emirates
A. S. HUSSAIN, H. M. MUSTAFA & A. H. ZIAD Department of Growth and Development, Ajman University, Ajman, United Arab Emirates Introduction: Autism, Autistic Syndrome (AS), Autistic Disorder (AD), Infantile Autism (IA) and Childhood Autism (CA) are different terms given to the same condition of developmental disabilities. The purpose of the study was to obtain baseline information regarding the oral health status, habits and behavioral attitudes towards dental treatment of a group of autistic children attending rehabilitation centers in Dubai and Sharja Emirates in United Arab Emirates. Materials and methods: A letter was sent to both rehabilitation centers including full description of patient examination procedure and the objectives of the research. After receiving the signed approval from the centers, a self-administered questionnaire in Arabic and English was completed and signed by the parents of each child participating in the research and was reviewed with the childrens trainers. Extra-oral and intraoral examinations were performed in 60 autistic children distributed in three age categories. The parents of all the 60 children (51 males and 9 females) responded to the questionnaires and the collected data were analysed using SPSS software for frequency tables. Results: Extra-oral examination showed that 30 (50%) children showed different signs of trauma due to habits and also expression of temporary madness. 90 % of children showed no soft tissue injuries, 50%) having teeth traumatic injuries. Regarding the behavioral attitude to dental treatment, 30.91% of the children were denitely negative, 35.59% were negatively behaved and only 23.73% reacted positively towards the dental examination. 25% received dental treatment under general anesthesia. Conclusion: Although traumatic injuries and behavior attitude of the examined autistic children did not show statistically signicant differences compared to international studies regarding autistic patients are essential in preventive as well as curative solutions. shape that hinder the aesthetic rehabilitation. Alveolar growth is inhibited, therefore occlusal vertical dimension and facial height are reduced. Clinical management: A 2-year-old girl with complete absence of deciduous teeth presented alterations in hair, breast formation button and facial prole with little development. During oral examination anodontia and lip incompetence were found. Radiographically total agenesis of temporary teeth and absence of denitive germs of incisors and rst molars were observed. The aim is to establish a multidisciplinary treatment plan and start the treatment early through acrylic prosthesis. Conclusion: The rehabilitation should be performed in the rst years of life, to reduce the resorption and atrophy of the alveolar bone and control the vertical dimension allowing to reach a normal masticatory efciency and language development.
P0569 Dental treatment in a patient with a Factor XII decit: case report
M. L. HERMIDA, L. ALVAREZ, W. LEWIS, B. BOGGIA & I. RODRIGUEZ Transfusional Department, Pereira Rossell Hospital, Montevideo, Uruguay Introduction: Factor XII decit is a low prevalence pathology (1 1000000) and there is no scientic evidence to support clinical dental management. We present a case report of a patient with factor XII decit, high risk and high caries activity, mixed dentition, who was integrally treated with the support of the interdisciplinary team of the Hemotherapy Department. Clinical management: A 7-year-old boy, treated at the Transfusion Department of the Pereira Rossell Hospital due to Factor XII deciency was admitted at the dental clinic. According to the clinical and radiographic examination multiple dental extractions were needed. Since this patient do not present an abnormal bleeding time it was decided to perform the dental extractions using local haemostatics and to leave the patient in the hospital under observation. The rst treatment was the less traumatic extraction and local and p.o. transamin were provided. The patient was dismissed from the hospital after 24-h observation and checked again after 48 h. No complications were observed. The following dental procedures were performed in the same way but the patient remained hospitalized for less time. After the 4th session, the patient was dismissed immediately after the dental extraction and scheduled to check up after 24 h. Besides the dental extractions, the patient received routine dental treatment, including ssure sealants, llings and orthodontic treatment. Conclusion: It can be concluded that a patient suffering from Factor XII deciency was successfully and with no complications treated in an ambulatory setup where conventional dental treatment including dental extractions were performed.
P0568 Anodontia in Hypohidrotic Ectodermal Dysplasia (HED), early intervention

` J. HASSI1, M. ZUNIGA2, J. MUNOZ2 & P. GALVEZ2 1 Pediatric Dentistry and Orthodontic Department, University of Chile; 2Private Practice Introduction: Ectodermal dysplasias are infrequently, and are characterized by the abnormal development of the structures from the ectoderm. It is genetically transmitted by different patterns: Autosomal dominant or recessive linked to X. The triad: distroc nails, alopecia or hypotrichosis and palmoplantar hyperkeratosis is usually accompanied by a lack of sweat glands and the total or partial absence of temporal and/or permanent teeth. Dental alteration is the most interesting characteristic of HED. Severe cases are affected with total anodontia. If the temporary and permanent teeth erupt they frequently have a conic
Morita Prize P0570 Oral rehabilitation of Ectodermal Dysplasia with anodontia: a case report
T. ALCAN1, M. I. SALIH2, M. A. DURHAN3 & B. KARGUL3 Departments of 1Orthodontics,2Oral Surgery and3Pediatric Dentistry, Dental School, Marmara University, Istanbul, Turkey Introduction: Dental implants have become an accepted treatment modality for ectodermal dysplasia (ED) with either oligodontia or anodontia patients. However, in anodontia vertical and buccolingual bone dimensions are generally inadequate making dental implantation a challenge. That is why, the use of a surgical guide during implant placement is of high importance in such cases. Clinical management: The clinical management of children with ED provides a unique opportunity for cooperative effort between the pedodontist, orthodontist, prosthodontist and dental surgery. This case report describes the multidisciplinary treatment of an 8-year-old child with ED. The precise position of the two mandibular implants was planned by a software on a virtual basis and the implants were placed using surgical guides by means of stereolithographic solid biomodel (SLA) generated from computed tomography (CT). The treatment included a mandibular overdenture supported by two osseointegrated implants. Conventional removable complete denture was the choice of treatment modality for the maxillary edentulism because of the insufcient bone dimensions. At the end of 1 year the patient presented signicant improvements in oral function and psychosocial activities. The mandibular left implant failed within 9 months, reimplantation was performed thereafter, and both the maxillary and mandibular prostheses were reconstructed. Conclusion: Early implant placement and overdenture is a good multidisciplinary treatment option in poor cooperative ectodermal dysplasia children with anodontia. CT-based imaging and surgical guidence carry both radiographic and clinical information for a succesful surgical and prosthodontic results for ED with anadontia. children rating staff as friendly and kind (VAS = 0.4) and procedures were explained very clearly to them (VAS = 0.6). There were no signicant differences in responses according to gender, with the exception that, before treatment, girls were reportedly more worried about their teeth than boys (P = 0.012, independent t-test). Conclusion: This study found high levels of appearance-related concern in children with visible enamel defects. However, simple and noninvasive treatment was well received and had a positive effect on how children felt about their teeth.
P0572 Clinical evaluation of conventional versus colored compomers for Class II restorations
F. ERTUGRUL, D. COGULU, Y. OZDEMIR & N. ERSIN Department of Pedodontics, Ege University School of Dentistry, Izmir, Turkey Introduction: This split-mouth study evaluated the 12-month clinical performance of conventional (Compoglass F-Ivoclar, Vivadent, Liechtenstein) and colored (Twinky Star-Voco, Cuxhaven, Germany) compomer restorative materials in class II restorations of primary molars. Materials and methods: A total of 196 restorations were placed in 98 children aged between 5 and 10 years old (mean age: 7.43 1.31 years old) that had bilateral matched pairs of carious posterior class II primary molars. The study was approved by the Ethical Committee and written informed consent was obtained from the parents. A split-mouth design was used in which two materials (Compoglass F, Twinky-star) were randomly placed on contralateral sides by three dentists. Clearl S3 Bond (Kuraray Dental, America) was used as adhesive system. At baseline, after 6 and 12 months, restorations were evaluated using modied U.S. Public Health Service criteria for: secondary caries, marginal integrity, marginal discoloration, anatomic form and surface texture. The Alpha + Bravo scores were considered as clinical success. The data were subjected to statistical analysis by Wilcoxon and McNemar tests (P < 0.05). Results: The retention rates were 95% for Twinky star and 94% for Compoglass F at the 6-month recall; 85% for Twinky star and 87% for Compoglass F at the 12-month recall. No statistically signicant difference was found between both compomer materials. Conclusions: The 12-month clinical performances of both materials were satisfactory in class II restorations of primary molars. Colored compomers could be an alternative material in the restoration of primary molars for at least 12 months.
P0571 Management of visible enamel defects: seeking childrens perspectives

G. YESUDIAN, A. ABDUL-KARIM, Z. MARSHMAN, M. FARNAM & H. D. RODD Department of Oral Health and Development, School of Dentistry, Shefeld, UK Introduction: Visible enamel defects may be distressing to young people and have a negative effect on everyday social interaction. This study explored how children felt before, and after, cosmetic improvement of their discoloured permanent incisors. Patients and methods: A 10-item questionnaire, developed with children themselves, was sent to 88 patients who had received microabrasion and/or composite restorations, for a variety of enamel defects, at Shefeld Dental Hospital, UK. Responses were graded using a 10-cm visual analogue scale (VAS) where a score of 10 represented the most negative response, and zero, the most positive. Results: Anonymous replies were received from 62 children giving a response rate of 70%. The mean age of participants was 11.9 years (range 716) and 42% were male. Prior to treatment, children were very worried (VAS = 6.8) and embarrassed (VAS = 6.9) about their teeth and thought they looked yellow/ discoloured (VAS = 7.3). Following treatment, participants reported that their teeth looked much better (VAS = 1.1), they were happier (VAS = 2.2) and were more condent (VAS = 1.6). Feedback about clinical treatment was extremely positive with
P0573 Quality of the interface of primary dentin bonded with antibacterial uoride-releasing adhesive
Y. HOSOYA1, S. ANDO2, K. YAMAGUCHI2, S. OOOKA2 & F. R. TAY3 1 Department of Pediatric Dentistry, Nagasaki University Graduate School of Biomedical Sciences, Medical and Dental Sciences, Nagasaki, Japan; 2Department of Operative Dentistry, Nihon University Dental School, Tokyo, Japan; 3Department of Endodontics, Medical College of Georgia, Dental School, Augusta, USA Introduction: Limited information is available on the physical properties and ultrastructure of resin-dentin interface of primary teeth. We evaluated the quality of interface of sound and cariesaffected primary tooth dentin bonded with an antibacterial uoride-releasing self-etch adhesive.
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Materials and methods: Primary molars were used according to the regulation of Nagasaki University. Dentin was bonded with Clearl Mega Bond FA (Kuraray Medical). A nano-indentation tester was employed for creating indentations vertically across resin-dentin interfaces of the bonded sound and caries-affected primary tooth dentin for determination of hardness (H) and Youngs modulus (Y). Similar resin-dentin interfaces were examined with a SEM/EDX, and with a TEM using ammoniacal silver nitrate tracer for nanoleakage. Post hoc comparisons were performed using Fishers PLSD test at p < 0.05. Results: Signicantly lower values were seen in the H and Y values of the interfacial dentin compared to the underlying dentin in both sound (H: 389 155 MPa, Y: 17.5 5.3 GPa) and cariesaffected (H: 483138 MPa, Y: 22.96.5 GPa) dentin except for the H in caries-affected dentin. No signicant difference between the interfacial dentin and the underlying dentin was observed in the H of caries-affected dentin and the Ca and P contents in both sound and caries-affected dentin. TEM revealed extensive interfacial nanoleakage in bonded sound dentin, while no silver deposit in bonded caries-affected dentin. Conclusions: High Ca and P contents of the interfacial dentin may be useful for remineralizing resin-sparse regions within the interfacial dentin. To avoid the deterioration of bond, sound dentin should not be ground as possible.
P0575 Two-year clinical evaluation of ber-reinforced nanoll resin composite in stress-bearing cavities
N. ERONAT & U. CANDAN Department of Pediatric Dentistry, Ege University, School of _ Dentistry, Izmir, Turkey Introduction: This study evaluated the clinical performance of a nanoll resin composite applied with/without glass-ber layering in stress-bearing anterior and posterior cavities in child patients. Materials and methods: A total of 104 resin restorations (Filtek Supreme 3M ESPE) with (FRC) or without (PC) glass-ber layering (EverStickNet StickTech) using adhesive (Adper Single Bond 3M ESPE) and a owable composite (Filtek Flow 3M ESPE) were placed in extensively carious rst molars (n: 71) and traumatized anterior teeth (n: 33) in 70 child patients (average 10.9, 10.7 years respectively). The restorations were evaluated at baseline, 6, 12, 18 and 24 months after placement using USPHS modied-Ryge criteria. The data were analysed using Fishers exact and chi-square tests and the changes in the parameters using the Cochran Q test (P < 0.05). Results: Survival rates (%) of the restorations with or without ber layering were 97.1 and 97 for the molars and 93.7 and 94.7 for the anterior teeth respectively after two years. There was no secondary caries, change in anatomic form and postoperative sensitivity in any of the restorations within the evaluation periods. Minor changes in some of the anterior and posterior restorations for FRC and PC groups (Bravo score) for marginal adaptation, marginal discoloration and color stability were observed after two years. There was no statistically signicant difference evaluated between the parameters (P < 0.05). Conclusion: The glass ber-reinforced nanoll resin composite restorations applied with owable composite presented similar clinical performance to the nanoll composite material in stressbearing cavities after 2 years. The nanoll composite restorations were found successful in stress-bearing conditions.
P0574 Comparison of remineralization effect between Fuji IX and Surel

A. YETKINER1, C. ERONAT1, D. SIMSEK2 & M. CIFTCIOGLU2 1 Department of Pediatric Dentistry, Ege University; 2Department of Chemical Engineering, Izmir Institute of Technology, Izmir, Turkey Introduction: Nowadays, the remineralization process underneath restorations is explained by the ionic exchange mechanism. Its now acknowledged that, in the presence of uoride ion, it is possible to remineralize or heal earliest caries lesions. The purpose of this study was to evaluate and compare the remineralization effect of a high viscosity glass ionomer cement (Fuji IX) and a packable composite resin (Surel) on caries affected dentine. Materials and methods: Four standard cavities were prepared on four surfaces of the same tooth and articially demineralized dentine was produced in three of the cavities of 21 primary molar teeth. The cavities were assigned to four groups: Group I: cavities were articially demineralized and restored with Fuji IX, Group II: cavities were articially demineralized and restored with Surel, Group III: cavities were articially demineralized and no restoration was applied, Group IV: cavities were not demineralized. The microhardness of the dentine underneath the restorations and in the control group was measured from the cavity oor 7 days, 30 days and 180 days after preparation. Each mineral (F, Sr, Ca, P) loss or gain was also analyzed using Energy Dispersive X-ray Spectrometer. Data were analyzed by repeatedmeasures ANOVA. Results: The mean microhardness (kgf/mm2) at the restorative material/dentin interface at different times for Fuji IX was 49.53 2.91, 50.97 3.31, 62.99 6.29 respectively and 49.78 3.14, 49.40 4.96, 49.66 4.00 for Surel. The 6-month results showed that the microhardness of the dentin underneath Fuji IX was higher than the dentin underneath the Surel composite resin. Fuji IX had a signicant effect on uoride and strontium uptake. Conclusion: The articially demineralized dentine was proved to be remineralized beneath Fuji IX.
P0576 Obesity and dental caries of Greek pre-school children

A. AGOUROPOULOS, S. MAMALI, S. GIZANI & L. PAPAGIANNOULIS Department of Paediatric Dentistry, University of Athens, Greece Introduction: Obesity is a risk factor for several general health problems. The purpose of the present study is to investigate the relationship between obesity and dental caries in pre-school Greek children. Patients and methods: Using one-stage cluster sampling, children were randomly selected from 28 public kindergartens of the major area of Attica, Greece. The study protocol was approved by University of Athens Dental School Ethics Committee. After obtaining parental consent, a clinical dental examination was performed, recording open caries lesions. Weight and height were measured and the Body Mass Index (BMI) as well as z-scores were calculated for each child. Associations were estimated using correlation coefcients and a regression analysis model. A 5% level of signicance was used to evaluate the results. Results: One thousand and forty two children 26 years old were examined, out of which 36.4% had at least one carious lesion. Regarding obesity, 17.5% of the boys were overweight and 5.8% were obese, while 15.8% of the girls were overweight and 6.4% obese. An increase of the boys mean BMI, comparing to the growth charts of the Greek population, was observed. The correlation coefcients as well as the regression analysis results indicate a negative relationship between obesity and dental caries,
Morita Prize
but this was statistically signicant only for 4-year-old boys (P = 0.01) and 5-year-old girls (P = 0.003). Conclusion: The results indicate that children with carious lesions have reduced growth as indicated by the BMI index. Obesity was not found to be a risk factor for dental caries in pre-school Greek children.
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Poster Session P06/Dental Anxiety and Behavioural Management

P0677 Investigation of human reliability relations between child patients and dentist
A. SUGIMOTO, M. OZAKI & W. MOTOKAWA Division of Pediatric Dentistry, Department of Oral Growth and Development, Fukuoka Dental College, Japan Introduction: The psychological relationship between patient and dentist has long been fully recognized as an important relationship. The reason is that child patients are immature both in mind and body. Ozaki et al. have been developing an original method to judge child patients anxiety to dental treatment using a miniature dental ofce and dolls, and our investigation combined their methods with psychological developmental testing. Materials and methods: We made dolls to express psychological attitudes toward dental treatment using a dental chair in the center of a miniature dental ofce. And we had their guardians submit to psychological developmental testing. The 74 children who received treatment were 47 years of age (male; 41, female; 33, average age; 5.6). We obtained informed consent. Results: 1. Many of the children put the representative doll of the patient itself in all patterns (54%). 2. The child patients who put the representative doll itself showed a higher calendar age (5.6 years) and developmental age (5.7 years) than the other type of child. 3. The child who put dolls in line or in one place (14.8%) showed low developmental age (5.4 years), while those who didnt put the representative doll of the patient itself on the dental chair showed a high quotient (104.99) compared to the other type of child. Conclusion: Children who scored high in developmental intelligence had a better understanding of dental treatment. These two factors, the dolls type patterns and the childs social developmental condition, were mutually related. the rst two groups received a single oral dose of extract (3 and 6 mg/kg respectively) while the remaining group received a placebo. Clinical dental examinations were conducted 30 min after the administration of the corresponding medication and the child behaviour was assessed using the Frankl Behaviour Rating Scale. KruskalWallis and MannWhitney tests were used to compare child behaviour between medication groups. Results: There was a statistically signicant difference in child behaviour during dental examination between groups (P = 0.002). In the post hoc comparisons, there were differences between children who received placebo and a dose of 6 mg/kg (P = 0.008) and between children who received doses of 3 and 6 mg/kg (P = 0.017). However, there was no signicant difference between children who received placebo and a dose of 3 mg/kg (P = 0.759). Conclusion: When the behaviour of anxious children was assessed during dental examination, the ethanol extract of M. ofcinalis had a greater effect compared with placebo, the dose of 6 mg/kg being more effective.
P0679 Success rate and side-effects by different inhalation sedation systems in paediatric dentistry
C. VERGALLE, A. A. NEVES, D. DECLERCK & F. VINCKIER Dental School, Unit of Paediatric Dentistry and Special Care, Catholic University of Leuven, Belgium Introduction: The aim of this study was to evaluate treatment outcome regarding patient behaviour (successful or difcult) and possible undesirable side-effects associated with dental procedures undertaken with different sedation inhalation systems in a paediatric population. Patients and methods: A total of 331 procedures (rst-time visits) were evaluated from which 163 were performed during the year 2004 and 168 in 2008. While in 2004 the Kalinox system was routinely used (73.6%), in 2008 it was substituted by the Quantiex system (74.4%). Oral pre-medication (midazolan) was equally used in both years (21.5% in 2004 and 17.3% in 2008), especially if the patient was noncooperative and refused to use the nose mask. Results: Mean age was 6.74 years (2.75), ranging from 31 months (2.4 years) to 15 years with 52% of the studied population being female. There was no signicant difference in the mean age of the patients among the studied years (t-Test, P > 0.05) neither among the type of sedation used (ANOVA, P > 0.05). Observed adverse effects included oversedation (3.2%) and overexcitation (1.3%). 70% of oversedation cases were associated with Kalinox, 20% with Quantiex and 10% with oral pre-medication. 100% of the overexcitation cases were associated with oral pre-medication. Regarding treatment outcome, the use of Kalinox was more frequently associated with successful treatments (v2, P < 0.05). The type of dental treatment (llings, extraction, endodontic treatment) was not related to the treatment outcome (v2, P > 0.05). Conclusion: Kalinox resulted in more successful treatment outcomes but was more frequently associated with undesirable sideeffects in this population.
2009 The Authors
P0678 Child behaviour modulation during rst dental visit after administration of lemon balm
K. PARDO-ALDAVE1, M. E. DIAZ-PIZAN2, L. F. VILLEGAS2 & E. BERNABE2,3 1 Universidad San Martn de Porres, Lima, Peru; 2Universidad Peruana Cayetano Heredia, Lima, Peru,3Department of Epidemiology and Public Health, University College London, London, UK Introduction: This study set out to assess the effect of the ethanol extract of Melissa ofcinalis (lemon balm) at doses of 3 and 6 mg/kg on the behaviour of anxious children during dental examination. Materials and methods: This was a double-blind, randomized, placebo-controlled trial of 90 67-year-old children (51 girls and 39 boys) attending a Maternal and Child Center in Lima, Peru. Children did not have any previous dental experience and were diagnosed as having dental anxiety using the Facial Image Scale. Participants were randomly allocated to three medication groups:
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Dental Anxiety and Behavioural Management P0680 Childrens stress in dental treatment with salivary chromogranin A
C. MITSUHATA, J. SUZUKI & K. KOZAI Department of Pediatric Dentistry, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan Introduction: It is well known that dental treatment can involve stress. This stress can lead to dental anxiety or fear of future dental care. Therefore, it is important to determine whether children are under a high degree of stress. It was reported that salivary chromogranin A (CgA) might be a sensitive and promising index for psychosomatic stress in adults. We investigated whether salivary CgA may also be used as an index of stress in children and suggested that CgA might be used to verify childrens stress levels during dental treatment. Patients and methods: This study investigated the magnitude of stress that children feel during dental treatment. We chose ve children aged 3 or 4 years old who had cavities and needed repeated treatment requiring multiple trips to the dental ofce. Saliva samples were collected before and after each dental treatment using a cotton swab. CgA levels were determined by EIA. In order to evaluate the level of the childrens dental anxiety and personality traits, we used the Childrens Fear Survey Schedule Dental Subscale (CFSS-DS) and a questionnaire that included a personality test. Results: The CgA value was higher before treatment than after treatment. Therefore, children felt some stress in any dental treatment. The CgA score did not correlate with the content of the pre-arranged dental treatment and did not always affect their behavior or expression during treatment. Conclusion: We observed that stress was inuenced by what they experienced before treatment. Conclusion: This study showed that some of the students still have difculty in evaluating the pain felt by the children during dental anaesthesia.
P0682 Pilot study in the adaptation of CFSS-DS Latvian version

L. KRONINA1, M. RASCEVSKA2 & R. CARE3 1 Pediatric Department, Institute of Stomatology, Riga Stradins University; 2Faculty of Pedagogy and Psychology, Latvian University; 3Department of Conservative Dentistry, Riga Stradins University, Riga, Latvia Introduction: The aim of the study was to adapt one of the most widely used questionnaires for assessing childrens dental anxiety and fear Childrens Fear Survey Schedule Dental Subscale (CFSS-DS) in Latvian version, to evaluate its validity and reliability in Latvian sample. Patients and methods: Two independent interpreters translated the CFSS-DS questionnaire from English into Latvian. Data of 30 children (mean age 7.2 years, SD = 2.07, range 412, male 47%, female 53%), whose parents gave informed consent, were evaluated. Parents answered 15 questions, evaluating their childrens fear in ve-point Likert scale before the visit in the Department of Pediatric Dentistry, Institute of Stomatology. Results: The mean CFSS-DS score was 28.75 (SD = 8.14, ranges = 1750). The internal reliability (Kronbach alpha) of total scale was high (a = 0.82). Convergent validity was satisfactory, calculating the Pearsons correlation between individuals totals and item 1 ((fear of dentists), r = 0.576, P < 0.01). Scores were higher in boys (M = 30.5, SD = 8.92) than in girls (M = 27.0, SD = 7.35, P < 0.05). CFSS-DS didnt show a statistically signicant age correlation in this stage of adaptation (r = -0.029, P = 0.88). All 15 questions formed an appropriate one factor structure according to the original questionnaire (after a provisional factor analysis). Conclusion: CFSS-DS Latvian version has good psychometric properties, high internal reliability and satisfactory validity. A sample of 150200 respondents must be analysed to assess the quality of adapted CFSS-DS Latvian version.
P0681 Evaluation of childrens pain by students during dental anaesthesia

A. MARIE-COUSIN, A. HUET, B. HINGANT, J. C. ROBERT & J. L. SIXOU Department of Paediatric Dentistry, University of Rennes 1 and CHU of Rennes, France Introduction: Dental anaesthesia (DA) is often feared by patients and practitioners because of the pain generated by this procedure. The way dental anaesthesia is appreciated by the children and the way practitioners can anticipate childrens pain may inuence the treatment session. The aim of this study was to assess the ability of students to evaluate childrens pain during dental anaesthesia. Materials and methods: Students (5th year) working at the dental hospital of Rennes were asked to evaluate the pain felt by young patients during 101 buccal inltration anaesthesias. The pain was evaluated using a visual analogue scale, VAS, scored 0 to 10. The pain as evaluated by the patients was recorded on the same scale. Students were also asked to evaluate pain during needle penetration and injection. Results presented here are restricted to anaesthesia performed on nonanxious children (Venham modied score of 02). The results were analysed using the chi-square test. Comparisons were considered signicant at P < 0.05. Results: No pain was recorded by children (26/101) signicantly more often than by students (13/101) (P = 0.02). Pain assessment by the students was identical, very close or close (difference from 0 to 1) to that of the children in 66 cases. It was considered very different (difference >3) in 9 cases. Signicantly more differences were noted when DAs were performed to treat anterior teeth (P = 0.04).
P0683 Do uncooperative children feel more afraid of the dentist than those who cooperate well?
A. CZERLINSKI1, D. J. KOENEN1, H. LANG1 & P. KROPP2 1 Department of Operative Dentistry and Periodontology; 2 Department of Medical Psychology, University of Rostock, Germany Introduction: During dental treatment children are usually under psychological pressure. As a result there is a more or less marked clinical manifestation of fear of dental treatment that is often falsely equated with fear of the dentist. Until now there has been no method that measures the qualitative and quantitative impact of the atmosphere at the dental practice and the dentists behaviour on the young patients readiness to cooperate. The objective of the present study is the implementation and evaluation of a questionnaire on this subject. Patients and methods: 88 patients from 4 to 18 years of age participated in this study. The questionnaire consists of different parts: dental chart, parents professions, Sarnat-score and fearrelated questions. With the help of the Sarnat-behaviour-scale the young patients were divided into two groups: the cooperative and the noncooperative children. The chi-square distribution also
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revealed these two groups. Statistical analysis was performed using the chi-square test. Results: As regards the dentists ability to explain and his wish to help there are statistically signicant differences between the groups of the cooperative and the noncooperative patients. Children who do not cooperate are more often afraid of the environment and treatment at the dentists. Those young patients who are in good oral health (DMF-T/dmf-t- index <10) are signicantly more cooperative. Conclusion: The study shows that the dentists personality alone has only a minor effect on childrens willingness to cooperate. As earlier studies have shown parents with an academic or middle class background spend more time on the oral health education of their children, who consequently have clearly better DMF-T/dmf-tindex gures. the patients lled a social questionnaire. Sweating was recorded, and salivary cortisol concentration was measured before and 20 min after the dental treatment. Caries experience was measured by dmf-t index, unstimulated and stimulated saliva production was detected. The study was approved by Institutional Ethical Committee, and written informed consent was obtained from the guardians of the children. The data were analyzed for statistical signicance by Chi-Square and independent sample t-test. Results: Signicant correlations between the mothers qualication, the childrens dmf-t and DAS were found. DAS signicantly correlated with the salivary cortisol concentration and sweating scores signicant correlation between the salivary cortisol concentration, stimulated saliva production and the sweating scores occurred. Conclusion: The measurement of salivary cortisol concentration, sweating scores, stimulated salivary production and DAS were reliable and valid measurings of dental anxiety in children aged 7 years.
P0684 The effects of extraction on recovery characteristics in deeply sedated pediatric patients
L. OZER1, Z. B. OKTEM1 & Z. KUCUKYAVUZ2 1 Department of Pedodontics; 2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara, Turkey Introduction: Dental extraction is a traumatic procedure for young children. This procedure can be very difcult to manage for these children. Therefore, deep levels of sedation are often required for behaviour management. The aim of this study was to determine recovery characteristics and side effects in children undergoing restorative treatment with or without dental extractions. Patients and methods: The study was consisted of 68 children, aged 37 years. 34 children were assigned to the restorative treatment with extraction group (group E) and 34 to the restorative treatment group (group R). Written informed consent was obtained from parents. Childrens behaviours were assessed using (i); modied Frankl Behaviour Rating Scale during pre-operative period, (ii); Houpt Behaviour Rating Scale during venipuncture period, (iii); modied Wilton Behaviour Scale (WBS) at recovery time. All side effects observed during and after sedation were recorded. T-test and chi-square test were used for the statistical analysis. Results: The most common side effects in both groups during the early recovery period were dizziness, sleepiness and agitation. The incidences of WBS scores of 1 and 2 (agitated and restless) were higher in group E than in group R; however, this difference was statistically signicant at 15 min only. Conclusion: This study did not show that dental extraction has any apparent effect on recovery characteristics in deeply sedated pediatric patients. This conclusion can be attributed to the additional doses of sedative agents that all children in Group E received prior to extraction for a deeper sedation level.
P0686 Dental anxiety patterns in adolescents born pre-term compared with matched controls
S. BROGARDH-ROTH1, K. STJERNQVIST2, L. MATSSON1 & G. KLINGBERG1 1 Faculty of Odontology, Department of Paediatric Dentistry, Malmo University; 2Department of Psychology, Lund University, Sweden Introduction: A high frequency of cognitive and behavioural disturbances has been reported in pre-term children. It is not known if this affects the childrens apperceptions or behaviours during dental treatment. The aim was therefore to investigate dental behavioural management problems (BMP) and dental anxiety (DA) in pre-term children from age 314, and to compare with matched controls. Materials and methods: 187 pre-term children (2332 weeks of gestation), born 199496 were followed regarding BMP and DA. Comparisons were made with matched full-term controls. Data on BMP were collected from dental records for the ages 3 and 6 years. During the school years, parents were interviewed twice regarding BMP in their children. Two periods of time were covered; preschool period, and early school years. Finally, at 1214 years the children lled out the CFSS-DS scale, measuring DA. Results: During pre-school years pre-term children showed significantly more BMP at various kinds of dental treatments (32% vs 15%; P < 0.001). This was conrmed in the rst interviews of the parents (20% vs 10%; P = 0.028). At the second interviews, covering early school years, no differences were found between the groups. This was also veried by the childrens scorings on CFSSDS at age 1214 where no differences in mean scores were revealed. Conclusion: Children born pre-term seem to have a high prevalence of BMP during pre-school years. But this difference decreases with increasing age, possibly reecting a catch-up. At school years and early adolescence no differences were seen between the groups regarding BMP or DA.
P0685 Measurements of dental fear in 7-year-old children

D. GALAMB1, A. LENKEY2, J. MATH3 & M. ALBERTH1 1 Faculty of Dentistry, Department of Pediatric Dentistry; 2 Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center; 3Institute of Psychology, University of Debrecen, Debrecen, Hungary Introduction: Previous studies did not examine the objective parameters of dental fear in small schoolchildren. The aim of the study was to compare the subjective and objective parameters of dental anxiety in 7-year-old children. Materials and methods: Forty-one 7-year-old children were randomly chosen. Corahs Dental Anxiety Scale (DAS) was applied to evaluate the level of the childrens dental anxiety. The parents of
P0687 The German version of the child perceptions questionnaire association to overall well-being
K. BEKES1, H. G. SCHALLER1 & C. HIRSCH2 1 Department of Paediatric Dentistry, Martin-Luther University Halle-Wittenberg, Halle; 2Department of Paediatric Dentistry, University of Leipzig, Leipzig, Germany Introduction: The aim of the present study was to examine the validity of the Child Perceptions Questionnaire (CPQ11-14) by
2009 The Authors
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exploring the association between oral health related quality of life (OHRQoL) with the overall well-being in a random population sample of 11- to 14-year-old children in Germany. Patients and methods: 1589 children were drawn from a nationwide sample considering the size of the selected communities. The children completed the German version of the CPQ11-14 questionnaire consisting of 50 questions about oral problems with 5 options for responding (the problem can occur: very often, often, sometimes, hardly often, never). Additionally, the children were interviewed for their overall well-being, which was measured using a 5-point scale ranging from 1 (excellent general health) to 5 (very bad general health). Statistical analysis (ANOVA) was performed to test the differences of CPQ11-14 summary score between the different groups using SPSS 16.0. Results: Following mean CPQ-G scores were evaluated within the different overall well-being groups: score 1 (excellent): 7.1 (7.5), score 2 (good): 9.0 (7.7), score 3 (moderate): 11.9 (10.1), score 4 (bad): 18.5 (15.6), score 5 (very bad): 20.5 (20.5). ANOVA revealed signicant differences between the groups (P < 0.001). Conclusion: Self-report of impaired well-being is linearly associated with impaired oral health related quality of life in children using the CPQ-G. The results support the validity of the CPQ-G as an instrument to measure the OHRQoL in 1114-year-old German children. The study was supported by GABA International.
P0689 Guidelines for nonpharmacologic behavior management: changes through the last 20 years
K. ARAPOSTATHIS, V. BOKA, E. L. EXARCHOU & N. KOTSANOS Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Greece Introduction: The aim of this study is to present the changes of the clinical guidelines on nonpharmacologic behaviour management for the paediatric dental patient through time. Materials and methods: We searched for all the guidelines published in English language through the links of the IAPD, EAPD, AAPD and HSPD web pages. Results: The rst AAPD guidelines were developed in 1989 and were revised several times. The Australesian Academy of Paediatric Dentistry follows the AAPD guidelines. Those from The Royal College of Surgeons of England (no revision since 2002) are followed in Great Britain. In addition, there is a newly prepared draft of guidelines from the EAPD. There are no main changes in the methods: Tell-show-do, Voice control, Nonverbal communication, Positive Reinforcement, Distraction and Negative Reinforcement. Parental consent used to be written or verbal, now has to be written for most the techniques. Parental presence/absence is proposed in 1996 for the rst time. Limitations appear increased on physical restraint over time, now called protective stabilisation. Hand Over Mouth Exercise is lately eliminated in AAPD guidelines, does not appear in the EAPDs draft, while it is still present in the UK guidelines. The last ve years special attention is given on the dental team behaviour, more so in dentists behaviour and communicative skills. Conclusion: There have been quite a few guideline changes over the last 20 years, aiming to decrease dental fear and anxiety, while reecting societal changes towards less intervening techniques and more documented behaviour by the dental profession.
P0688 Which pre-medication agent is more comfortable for anxious children in dental treatment?
O. BAYGIN1, H. BODUR2 & B. ISIK3 1 Department of Paediatric Dentistry, Karadeniz Technical University Faculty of Dentistry, Trabzon; 2Department of Paediatric Dentistry,3Department of Oral and Maxillo Facial Surgery, Gazi University Faculty of Dentistry, Ankara, Turkey Introduction: In paediatric dentistry sedation procedures are required when there is no possibility to carry out dental treatments. We aimed to evaluate the most comfortable pre-medication protocol used in anxious children scheduled for dental treatment under N2O/O2 sedation by assessing parents and childrens apprehension. Materials and methods: In this randomised controlled clinical trial, the comfort of three pre-medication agents was compared. After ethic committee approval and parental informed consent, 60 healthy children aged between 58 years, having no sedation or general anesthesia experience and being incompliant with dental treatment (Frankl Behaviour Scale 3) were enrolled to this study. The treatment regimens were as follows: Group A: Oral administration of 1 mg/kg hydroxizine hydrochloride suspension. Group B: Oral administration of 0.7 mg/kg midazolam. Group C: Oral administration of 3 mg/kg ketamine + 0.25 mg/kg midazolam. Control Group: No oral pre-medication. Following pre-medication, 40% N2O and 60% O2 were administered to all groups. Sedation protocol was evaluated using RSS (Ramsay Sedation Scale), recovery time of children and the comfort of the treatment was assessed pre-operatively and postoperatively according to the parents and childrens likert-answers. Data were statistically analysed with ANOVA, Kruskal Wallis was performed (at P < 0.05). Results: All tested agents were found to be acceptable both for parents and children. Signicant differences were observed in 0.7 mg/kg midazolam group compared to the others (P < 0.05) regarding the comfort of pre-medication procedure. Conclusion: 0.7 mg/kg midazolam seems to be a more comfortable agent for parents and children when used as a pre-medication protocol in anxious children.
P0690 Reliability of the salivary alpha-amylase activity as an index of psychological stress

K. AOYAGI, H. KARIBE, Y. HAGIWARA, T. KAWAKAMI & K. SHIMAZU Department of Pediatric Dentistry, Nippon Dental University, Tokyo, Japan Introduction: The salivary alpha-amylase activity (sAMY) had been widely noted as an index of psychological stress in dental patients. Recently, a hand-held sAMY Monitor which can easily measure sAMY has appeared. The purpose of this study was to investigate (1) the diurnal uctuation of individual sAMY levels, (2) its day-by-day uctuation during the week and (3) the gender difference regarding the sAMY. Materials and methods: For each purpose, (1) 6 subjects (4 females, 2 males; average age 37.5 years), (2) 11 subjects (6 females, 5 males; average age 33.9 years) and (3) 30 subjects (15 females, 15 males; average age 31.8 years) participated in this study. Using the sAMY Monitor, the sAMY level was measured (1) once every hour from 10 a.m. to 4 p.m. (7 times/day), (2) at every 10 a.m. on Monday, Wednesday and Friday (3 times/week) and (3) without any restriction. Repeated-measures ANOVA and the t-test were used for the statistical analyses. This study was approved by the Ethics Committee of Nippon Dental University. Results: During the experimental period, no signicant differences were observed in the sAMY levels among the different times of day or different days of the week (P = 0.311 and 0.291, respectively).
Poster Sessions
No signicant difference in the sAMY level was found between males and females (P = 0.962). Conclusion: These results suggest that the individual sAMY level remains relatively stable under normal conditions. Even though there are wide-ranging differences in the sAMY levels among individuals, these differences are not inuenced by gender. Support: Grant-in-Aid for Young Scientists (No.20890239). Results: There was signicant correlation between the systolic blood pressure, pulse rate, sweating scores and salivary cortisol concentration. The salivary alpha-amylase activity did not correlate with the parameters of the other objective methods and the DAS. From the objective measurements only the salivary cortisol concentration and the sweating scores showed signicant correlation with the results of the DAS. Conclusion: The measurements of systolic blood pressure, pulse rate, sweating scores and salivary cortisol concentration were accurate and reliable assessment tools for dental stress. However, the salivary alpha-amylase activity did not appear as specic marker of dental fear. The measurement of sweating (sudometry) is reproducible, simple, quick, inexpensive and a nonthreatening method for the evaluation of fear. Our study suggests that measurement of sweating can replace the subjective and other objective methods to assess dental fear in pediatric dentistry.
P0691 Relationship between dental anxiety, oral health status and sociodemographic factors in children
Z. KIRZIOGLU, A. C. ALTUN, K. G. ULU & Y. ERDOGAN Department of Pediatric Dentistry, University of Suleyman Demirel, Isparta, Turkey Introduction: The objective of this study is to assess the inuence of dental and maternal anxiety on the oral health status of children and to determine the sociodemographic factors that related to dental anxiety. Patients and methods: A questionnaire was used to collect information about age, sex, nutritional status, socioeconomic status, education level and occupations of parents, reasons and frequency of dental visits. The Dental Subscale of Childrens Fear Survey Schedule (CFSS-DS) and Corah Dental Anxiety Scale (DAS) was administered to the children and their parents. Children aged 4 14 years and their parents participated in this study. The dental anxiety scores, relationship between the sociodemographic factors and patients anxiety were determined. Dentition status and treatment needs along with decayed, missing, and lled teeth (DMFT) index were recorded. All data were determined statistically by using SPSS 13.0 software program with chi-square, Mann Whitney, Pearson correlation and KruskalWallis test. Results: The mean age was 7.42 2.89 years. The anxiety (CFSSSF) scores of the patients ranged from 14 to 68 (Mean = 28.72 11.71). A positive correlation was found between the anxiety of children and their mothers (r = 0. 20; P< 0.01). The children aged 6 and smaller are more affected from their mothers than children aged 7 and higher, but the difference is not statistically signicant. Conclusion: The level of dental anxiety in children is affected by their mothers. The results of such studies could be used as an appropriate tool to encourage favourable dental behaviours for children.
P0693 Dental anxiety in 711-year-old children and its relationship to dental caries
A. AKBAY OBA1, C. T. DULGERGIL2 & I. SAROGLU SONMEZ1 1 Department of Pediatric Dentistry; 2Department of Operative Dentistry, School of Dentistry, University of Krkkale, Turkey Introduction: The aims of this cross-sectional study were to evaluate the level of dental fear among 711-year-old schoolchildren and to assess the dental caries relation to dental fear. Patients and methods: 275 children aged 7 to 11 years were included in the study. This study was approved by the institutional ethical committee and written informed consent for participation of the children in the study was obtained from all parents. Before the dental examination each subject was advised to answer the CFSS-DS questionnaire by himself/herself. The children having 38 and more CFSS-DS values were included to the group with dental fear, others to without dental fear group. All dental examinations were performed in school premises according to WHO criteria. Chi-Square, t-tests, Pearson Correlation, ANOVA was used in statistical analysis. Results: Mean CFSS-DS value was 28.17, and the rate of children who have experienced dental fear was 14.54%. It was found that DMFT-dfs increased signicantly with increasing CFSS-DS values. Children were most afraid of Choking, Injections and Having somebody put instruments in their mouth. No signicant differences in fear scores between boys and girls were found in this study. Conclusions: The results demonstrate that the prevalence of dental fear in Turkish child population is not very high in comparison to reports from other countries. Furthermore, dental fear could be thought as a caries risk factor and by providing extra attention for these children, the development of high dental fear may be prevented.
P0692 Sudometry for assessing dental fear in adolescents

M. ALBERTH1, D. GALAMB1, A. LENKEY2, A. OLAH2 & J. MATH3 1 Faculty of Dentistry, Department of Pediatric Dentistry; 2 Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center; 3Institute of Psychology, University of Debrecen, Debrecen, Hungary Introduction: Dental fear is a common health care problem in the child population. The aim of the present study was to nd a new reliable, simple, patient friendly and inexpensive method for assessing dental fear. Materials and methods: The study group consisted of 32, randomly selected 1214-year-old adolescents. Corahs Dental Anxiety Scale (DAS) was used for evaluation of dental fear. Blood pressure, pulse rate and sweating were recorded, salivary cortisol concentration and alpha-amylase activity were measured before and 20 min after the dental treatment. Permission was obtained from Instutional Ethical Committee, and the parents of the students gave written informed consent. Chi-Square test and independent sample t-test were used for statistical analysis.
P0694 A case report of Trichotillomania and its inuence on dental treatment

D. TSIANTOU, D. VELONIS & N. KOTSANOS Department of Paediatric Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece Introduction: Trichotillomania (TTM) is a relatively common cause of childhood alopecia. It is a repetitive behaviour that causes noticeable hair loss or substantial physical damage. This report presents the dental treatment of a 10-year-old boy with trichotillomania.
2009 The Authors
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Clinical management: The patient was referred to our clinic in October 2007. Upon extraoral examination, a bald area was noted at the frontal scalp. The boy had been removed from his family and was hosted in a SOS village. He was followed by a dermatologist and a psychologist. Intraoral and radiographic exam revealed treatment needs for caries and the patient was scheduled for restorative dental treatment. He was also referred for orthodontic treatment. He was not very cooperative for dental treatment during his visits at either clinic. Tell-Show-Do, positive reinforcement and voice control were the methods that were used for the achievement of the cooperation. Conclusion: TTM in children is a disorder with psychological background, that may interfere with ideal cooperation between the patient and the pediatric dentist. TTM can also be accompanied by oral habits, such as nail biting or digit sucking, or anxiety disorders. Thus, the dentist should be aware of these conditions in order to recognize them, be able to refer the child to a psychologist and efciently manage the patient in the dental ofce.
Poster Sessions
Poster Session P07/Dental Anomalies

P0795 Relationship between lower second pre-molars and molars in the formative stage
E. K. JUN, S. I. LEE, K. T. JANG, S. H. HAHN & S. H. LEE Department of Pediatric Dentistry, School of Dentistry, Seoul National University, Seoul, Korea Introduction: The aim of this study was to examine the relationship between the time of appearance of lower second pre-molars and the formative stages of lower second molars and review the associated literature. Patients and methods: In all, 798 patients between the chronological ages of 3 and 13 years, who visited the Department of Pediatric Dentistry, Seoul National University Dental Hospital, Korea were examined. From pre-treatment panoramic radiographs we could get 1596 samples of lower second pre-molars and molars. Patients with systemic disease and generalized tooth anomalies were excluded. Total 1516 samples were selected and the formation stage of tooth germs was evaluated according to the method of Demirjian et al. (1973) Results: Among 1516 samples, the percentage of the same formative stage was 49.3%, the later formation of lower second molars compared with lower second pre-molars was 44.6% and the earlier formation was 5.5%. The frequency of more than 3 stage difference was 4.5% and the congenital missing of lower second pre-molars was 45 (3.0%) and lower second molars was 2 (0.002%). Conclusions: 1. The formative stage of lower second pre-molars is similar or slightly faster compared with that of lower second molars. 2. If the tooth germ of the lower second pre-molar has not appeared by stage D of lower second molar formation, the probability of congenital missing will be very high. 3. There will be a higher correlation between the congenital missing of lower second pre-molars and the formative stage of lower second molars rather than the chronological age. epithelium. We have reported that ERK1/2 phosphorylation induced by TGF-b1 regulates expression of ameloblastin via GJIC (Yamada A. et al IADR 2008). Here, we focused on the ERK1/2 phosphorylation via intracellular movement of calcium ion. Materials and methods: To analyse the effect of intracellular calcium concentration in TGF-b1 induced phosphorylation of ERK1/2, we used calcium signaling inhibitor, BAPTA-AM and calcium ionophore, ionomycin. ERK1/2 phosphorylation induced by TGF-b1 with or without gap junction inhibitor, oleamide was analyzed. Results: TGF-b1 mediated ERK1/2 phosphorylation was reduced by increasing of intracellular calcium. On the other hand, ERK1/2 phosphorylation was induced by decrease of intracellular calcium. Conclusion: Concentration of intracellular calcium level may regulate ERK1/2 phosphorylation and ameloblastin expression. This regulatory mechanism is important to understand the pathogenic mechanism of ODDD.
P0797 Prevalence of three-rooted primary mandibular rst molars among Taiwanese children
J. F. LIU1, M. G. TU2, M. J. JOU3 & S. Y. CHEN2 1 Department of Pediatric Dentistry, Taichung Veterans General Hospital; 2School and Department of Dentistry, China Medical University and Hospital; 3Department of Anatomy, China Medical University, Taichung, Taiwan Introduction: Knowledge of tooth and root canal anatomy is important for dental practice and for identifying features of anthropologic signicance. The occurrence of three-rooted permanent mandibular rst molars is considered a racial characteristic of Mongoloid populations, but there is little information on threerooted primary mandibular rst molars. The aim of this study was to determine the prevalence of three-rooted primary mandibular rst molars in Taiwanese children. Patients and methods: The bite-wing radiographs of 227 subjects that had previously been obtained in the Department of Pediatric Dentistry, Taichung Veterans General Hospital in Taichung City, Taiwan, from January 2004 to December 2007 were retrospectively screened and examined. The gender, symmetry, and frequencies of occurrence of three-rooted primary mandibular molars were recorded. Images of 121 subjects (54 boys and 67 girls) with bilateral primary mandibular rst molars were studied. Results: Six (4.96%) three-rooted primary mandibular rst molars were found in the 121 subjects (mean [range] age, 5.8 [2.4 10.4] years), with a bilateral incidence of a symmetrical distribution of 16.67%. The prevalence of three-rooted teeth did not differ signicantly between the right and left sides of the mandible, or with gender. Conclusion: The results of this study indicated that approximately 4.96% of Taiwanese subjects have three-rooted primary mandibular rst molars and bilateral occurrence is about one-sixth of such individuals. Pediatric dentists should take into account the prevalence of these multirooted anomalies in primary mandibular rst molars among the Taiwanese individuals.
P0796 Intracellular calcium regulates enamel matrix expression via gap junctional communication
A. YAMADA1, E. FUKUMOTO2, T. IWAMOTO1 & S. FUKUMOTO1 1 Division of Pediatric Dentistry, Department of Oral Health and Development Sciences, Tohoku University Graduate School of Dentistry, Sendai; 2Division of Preventive Dentistry, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Introduction: Gap junctional intercellular communication (GJIC) is important for tissue organization, especially in ectodermal tissue and cardiac muscle. Gap junctional proteins oligomerize to form gap junction membrane channels that span the extracellular space. They allow the direct transfer of ion, metabolites and other small second messenger from neighboring cells. Gja1 is one of the gap junctional proteins and highly expressed in tooth germ (Fukumoto E. et al IADR 2005). Further, Gja1 null-mice showed disturbance of tooth germ, salivary gland, and lung morphogenesis, as similar to the phenotype of occulodento digital dysplasia (ODDD). Gja1 may regulate proliferation and ameloblastin expression in dental
Dental Anomalies P0798 The study of impacted supernumerary teeth in infants by means of cone-beam CT
W. MOTOKAWA & M. OZAKI Department of Oral Growth and Development, Fukuoka Dental College, Japan Introduction: Clinical pediatric dentistry offers many opportunities for extracting supernumerary teeth. It is written in textbooks that the suitable time for removing impacted supernumerary teeth is when the permanent incisors exhibit 50% of their root development. But, impacted supernumerary teeth in the primary dentition may cause space and eruption problems in the adjacent teeth. We think that it is preferable to remove supernumerary teeth at an early stage. However, it was difcult to verify the positional relationship of supernumerary teeth to the adjacent normal unit. Then, we examined the position of supernumerary teeth in 3D images taken by cone-beam CT. Materials and methods: The study cases consisted of 175 children (male: 136, female: 39) who visited Fukuoka Dental College, Medical and Dental Hospital. Three-dimensional images of dentition data for supernumerary teeth by cone-beam CT (3DX multiimage micro CT, Morita Co.) were utilized. Results: 1. Cases of supernumerary teeth in infants at our pediatric clinic have increased since cone-beam CT was introduced in our hospital. 2. When extracting the impacted supernumerary teeth in an infant, we could conrm their position precisely and reduce damage to adjacent teeth. 3. In addition, cone-beam CT enabled us to measure distances precisely because an image is not distorted. Conclusion: We can conrm supernumerary teeth and their positional relationship to a neighboring permanent tooth in three dimensions using cone-beam CT. As a result, the removal of the impacted supernumerary teeth was possible at an early stage without damaging the permanent dental germs.
P07100 Management of dens evaginatus in pre-molars in the School Dental Service (Singapore)
O. C. EU & J. J. NG School Dental Service, Youth Health Division, Health Promotion Board, Singapore Introduction: Dens evaginatus is a developmental anomaly that occurs most commonly in pre-molar teeth, it consist of an enamel covered tubercle enclosing dentin and pulp tissue that protrudes from the occlusal surface of an otherwise normal tooth. Identication and management is clinically important because fractures or worn down tubercles can lead to pulpal necrosis or periapical lesions. In the School Dental Service (Singapore), dental therapists are the main service provider; hence they are likely to be the rst to identify and manage the dens evaginatus. This retrospective cohort study aims to evaluate the ability of the dental therapists to identify and manage dens evaginatus of the premolars using the enamo-plasty preventive resin restoration method. Patients and methods: A total of 705 pupils were treated by the dental therapists for prophylactic management of dens evaginatus from January 2008 to March 2008, 198 were selected to be examined by a dentist, out of which 120 pupils were examined 6 months post treatment. Results: A total of 353 dens evaginatus were noted in the 120 pupils by the dentist, only 26 pre-molars (7.37%) were not identied and charted by the therapists. 86% of the composite resin restorations placed by the therapists were intact and only 4 dens evaginatus showed signs and symptoms, of which two developed buccal abscesses. Conclusion: Hence this study showed that dental therapists are able to identify and manage dens evaginatus in their school dental clinics.
P0799 Double primary teeth and the correlation with the permanent successors
Y. T. LIN & Y. T. LIN Department of Pediatric Dentistry, Chang Gung Memorial HospitalKaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan Introduction: The existence of double primary teeth associated with further problems of the permanent successors may have deleterious effects on the developing occlusion and esthetics. The esthetic and functional problems in primary and permanent dentition often require proper treatments. The purpose of this study was to compare the distribution of the different types of double primary teeth and their relationship to the permanent successors. Patients and methods: A total of 7868 patients from pediatric dental clinic of Chang Gung Memorial Hospital-Kaohsiung Medical Center were selected for this study. The children received oral examination and panoramic radiography, and the position of the primary double teeth and the condition of the permanent successors were recorded. Results: 63% of the double teeth involved the mandibular lateral incisor and canine. Approximately 55% of the cases experience further problems in the permanent successors. Hypodontia is the most common problem occurring in the permanent successors. Conclusion: The close relationship of the double primary teeth with the permanent successors would justify a radiographic examination to evaluate the number and condition of permanent successors in order to consider a proper treatment plan in advance.
P07101 Eculiarities of enamel formation in the rst permanent molars of children living in an area of endemic uorosis
S. S. BOGOMOLOVA & L. P. KISELNIKOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: The mineralization processes in permanent teeth with uorosis and the degree of their caries resistance are poorly studied. This study examines the basic value of mineralization (BVM) and caries resistance in the rst permanent teeth of children living in an area where uorosis is endemic. Materials and methods: Two groups of 20 children each, aged 68 years old living in an area where uorosis is endemic (Moscow Region, Odintsovo) were examined. Children in the rst group had very mild and mild forms of uorosis according to Deans Fluorosis Index (1942). Children in the second group had no uorosis. While determining the BVM of erupting rst molars, the electrometric method (Kiselnikova 1990) was applied. The degree of mineralization was determined using the electrometric device Dentest (manufacturer Geosoft, Moscow, Russia). Enamel Resistance Test (TER-test, Okyshko 1983) was used to determine the functional resistance of enamel. This method allows dening the degree of physiological acid resistance of enamel on a 10point scale. Results: Conductivity in teeth with uorosis had an average value of 16.5 lA + 0.5. Teeth free of uorosis had an average value of conductivity as 8.2 lA 0.47 (at < 0.01). Average values of the TER test in both groups were signicantly different: 7.9 (low degree of resistance) and 2.33 (high degree of resistance) accordingly.
Poster Sessions
Conclusion: The BVM and enamel resistance of permanent teeth with uorosis of children living in an area where uorosis is endemic is noticeably lower than that of permanent teeth without uorosis for children, living in the same area. Results: 5483 students were found to have atleast 1 dens evaginatus; hence the prevalence of dens evaginatus is 2.72%. There were more females (3.29%) presenting with dens evaginatus than males (2.19%). The prevalence for Chinese, Indian and other races are 3.6%, 0.14% and 1.24% respectively. Conclusion: This report has the greatest sample ever, capturing 97% of children from age 9 to 12, and the prevalence of dens evaginatus is 2.72% in Singapore.
P07102 Designing a clinical tool to record molar incisor hypomineralisation

M. APPS1, S. HIBBERT1 & E. MAHONEY2 1 Paediatric Dentistry Department, Westmead Hospital, Sydney, Australia; 2Hutt Valley District Health Board, Lower Hutt, New Zealand Introduction: Molar incisor hypomineralisation (MIH) is a wellrecognised clinical problem and is an important reason for complex treatment in young children. The management of more severe cases of MIH requires a multi-disciplinary approach and is a major contributor in referrals to specialist centres. Furthermore, MIH accounts for a signicant number of rst permanent molar extractions. Accordingly, accurate clinical records of MIH are required to facilitate discussion between clinicians. Records are also important for medico-legal reasons. The aim of this project was to develop an accurate, succinct and user-friendly tool for recording and describing teeth affected by MIH. Materials and methods: A clinical tool was introduced to audiences at dental seminars and conferences (general dentists, post-graduate students and paediatric dentists) and participants were asked to use it to record the details of teeth affected by MIH that were displayed on a projector screen. Five pilot studies have been conducted with groups in Australia and New Zealand using photographs of affected molars and incisors. The clinical tool has been rened according to feedback. Results: Large inter-observer variability was observed for the recording of defects on posterior teeth, while the results for recording the defects on anterior teeth were more consistent. Conclusion: Developing a clinical tool to measure dental defects is a complex process. The nal version of the clinical tool is presented.
P07104 Enamel microstructure and genetic analysis of rough hypoplastic amelogenesis imperfecta
A. PAVLIC1, L. JURECIC2, M. KRIZNAR SKAPIN3 & S. ALALUUSUA4,5 1 Department of Paediatric and Preventive Dentistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; 2Community Health Centre, Nova Gorica, Slovenia; 3Community Health Centre, Celje, Slovenia; 4Department of Paediatric and Preventive Dentistry, Institute of Dentistry, University of Helsinki, Helsinki, Finland; 5 Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital Introduction: The main clinical manifestations of rough hypoplastic amelogenesis imperfecta (AI) are severely reduced enamel thickness and rough tooth surface. Materials and methods: The aim of the study was to characterise, macroscopically and microscopically, the rough hypoplastic AI enamel observed in six patients (ranged in age from 6.5 to 15 years). Patients descended from three unrelated families, all with autosomal dominant mode of inheritance. Enamel microstructure was observed under light microscope (LM) and scanning electron microscope (SEM). In order to conrm the mutation we performed sequence analysis of polymerase chain reaction (PCR) amplied products of all exons and exon/intron boundaries of the enamelin (ENAM) gene of all patients (n = 6), their siblings (n = 2) and parents (n = 6). Results: Five patients from two families had heterozygous ENAM gene mutation g.8344delG. Microstructural enamel changes of their teeth were similar: thin, prismless and very porous enamel layer of unrecognisable structure was laminated, and cracks were spreading perpendicular to dentin-enamel junction (DEJ). ENAM mutation was not found from the patient of the third family. The microstructure of the enamel of his tooth was also aberrant but it differed from the previous samples. Although also porous, with voids of different sizes were disseminated throughout the bulk of the enamel. Enamel prisms could be distinguished. Conclusion: Characteristics of enamel microstructure of patients with clinically similar phenotype of rough hypoplastic AI can diverge. On the contrary, enamel microstructure seems to correlate well with the genotype.
P07103 Prevalence of dens evaginatus in pre-molars in Singapore

J. J. NG & O. C. EU School Dental Service, Youth Health Division, Health Promotion Board, Singapore Introduction: Dens evaginatus is a developmental anomaly that presents with an enamel covered tubercle enclosing dentin and pulp tissue that protrudes from the occlusal surface of posterior teeth and lingual surface of anterior teeth. The prevalence of dens evaginatus is between 1 and 4%, and it occurs most commonly in Mongoloids. All the previous prevalence studies were based on either examination of patients that presented for routine dental treatment or random sampling of children from primary schools. The School Dental Service of Singapore (SDS) provides free dental care to primary school children aged 712 years, about 97% of primary school children participated in the school dental service each year. Since 2005, the SDS has invested in a system (IDEASIntegrated Dental Electronic Assessment for Students) to computerize the documentation and management of dental records. With these data, we aim to report the prevalence of dens evaginatus in Singapore. Patients and methods: Only pupils aged 9 to 12 were included in this report. In year 2008, a total of 201 599 students were examined by the school dental therapists.
P07105 Prevalence of dental developmental anomalies: a radiographic study

K. DALCI1, A. ALANKUS KALENDER1, L. OZKAN1, L. VAHDETTIN2 & S. CETINER1 1 Department of Pediatric Dentistry; 2Department of Orthodontics, Near East University, Lefkosa, Cyprus Introduction: Aim of the study was to determine the prevalence of developmental dental anomalies and the gender differences of these anomalies in patients attending the Near East University, School of Dentistry, Department of Pediatric Dentistry; a retrospective study based on panoramic radiographs of 274 patients was planned.
Dental Anomalies
Patients and methods: Panoramic radiographs of children aged between 2 and 18 years were studied (mean age was 9.5 and SD was 4.2) in detail for the presence of agenesis, supernumerary teeth, microdontia, infra occlusion of deciduous teeth, dilacerations, impacted teeth, taurodontism, fusion and germination. Also systemic diseases, trauma history, caries presence and the need for orthodontic treatment were recorded. Results: It was found that 20.07% of the total group had at least 1 developmental dental anomaly. The distribution of these anomalies by sex was 30 boys (20.27%) and 25 girls (19.84%). The most common anomaly was agenesis and infra occlusion and was found to be more prevalent in males than females. Conclusion: This retrospective study was the rst attempt to investigate the developmental anomalies of children attending the pediatric dentistry clinic living in the northern part of Cyprus. Agenesis was the most common developmental anomaly in the Turkish population of northern Cyprus followed by impacted teeth.
Poster Sessions
Poster Session P08/Prevention 1

P08106 Microleakage of ssure sealant: beveling of ssures on buccal surfaces of teeth
F. MAZHARI, M. MEHRABKHANI & S. SADEGHI Pediatric Department, Mashhad University of Medical Sciences, Mashhad, Iran Introduction: The purpose of this study was to assess the effect of beveling the margins of ssures on buccal surfaces in permanent molars on marginal microleakage of ssure sealants. Materials and methods: This in vitro study was performed on buccal surfaces of 20 extracted permanent third molars. The teeth were randomly divided into two groups of ten teeth. Group I: performing enameloplasty [opening the ssures using Fissurotomy bur (SS White, Lakewood, NJ USA)], conditioning with phosphoric acid (37% phosphoric acid for 20 s), placing bonding [enamel ` bonding agent (Margin Bond, Coltene Whaledent )], and then ssure sealant (Seal Rite, Pulp Dent, USA). Group II: all stages were similar to group I except for beveling the margins of buccal ssures (0.5-mm bevel) after enameloplasty. Teeth were then thermocycled, stained with 0.5% basic fuchsin, sectioned and examined for marginal microleakage. MannWhitney test was used for statistical analysis. Results: No dye penetration was seen in the group II (with bevel), but there was a 60% microleakage in group I (without bevel) (P < 0.001). Conclusion: In permanent molar teeth, beveling the margins of ssures on the buccal surfaces appears to reduce the marginal microleakage of ssure sealants. viscosity sealant showed more microleakage than low viscosity sealant (20% vs 80% without microleakage) (P = 0.041). With applying dentin bonding agent low viscosity sealant had less microleakage than high viscosity sealant (100% vs 30% without microleakage) (P = 0.007). There was no signicant difference between high and low viscosity sealants in the enamel bonding groups (40% vs 60% without microleakage) (P = 0.218). Conclusion: The ndings of this study demonstrate that viscosity of sealants had a signicant effect on the degree of microleakage.
P08107 Retention and caries prevention of a resin-based sealant and a glass-ionomer used as a ssure sealant: a clinical study
T. ULUSU1, M. E. ODABAS, T. TUZUNER2, H. SILLELIOGLU1 & O. BAYGIN1 1 Faculty of Dentistry, University of Gazi, Department of Pediatric Dentistry Ankara; 2Faculty of Dentistry, University of Karadeniz Technical, Department of Pediatric Dentistry Trabzon, Turkey Introduction: The purpose of this study was to compare the retention and the caries preventive effect of a glass- ionomer used as ssure sealant (Fuji VII, GC Corporation, Japan) and a lightcured, uoride-releasing sealant (Fissurit F, Voco, Germany). Materials and methods: The study was conducted according to a split mouth randomized clinical trial. The children with at least one pair of caries free permanent rst molars with deep pit and ssures were included in the study. The children were selected from a population with a high risk of dental caries. Informed consent was obtained from the parents. Sealant materials were applied by fthyear undergraduate dental students on 242 ssures of rst molars in 121 children, 615 (mean 9.8) years of age. Two researchers at the clinics supervised all the procedures. At 6 and 12 months follow-up examinations for sealant retention were performed by two other researchers. Data were statistically analysed with chi-square tests. Results: After 6 and 12 months, the total retention of Fuji VII was 52.1% and 42.1% and those of Fissurit F was 51.2% and 43.8%, respectively. No caries was detected at 6 months in all sealanttreated teeth. The incidence of caries in Fuji VII treated molars at 12 months was 0.8% and that of 2.5% in Fissurit F. Conclusion: The glass-ionomer sealant tested in the present study had better retention and caries protective effect than the resinbased sealant used.
P08107 The effect of sealant viscosity and different bonding agents on sealant microleakage in vitro
M. MEHRABKHANI, F. MAZHARI & S. SADEGHI Faculty of Dentistry, Paediatric Dentistry, Mashad University of Medical Sciences (Mums), Mashad, Iran Introduction: The aim of this study was to evaluate the effect of sealant viscosity and applying bonding agent on the marginal integrity of sealants. Materials and methods: Sixty extracted sound pre-molars were divided in two groups (n = 30). In one group a high viscosity sealant (seal Rite with 34%ller, Pulp Dent) and in the second group a low viscosity sealant (seal Rite with 7% ller, Pulp Dent) was used. Each group was divided into three subgroups (n = 10) without any bonding system, with enamel bonding (Margin Bond, Colton) and with dentin bonding (Excite, Vivadent). After sealant placement, the teeth were thermocycled (1000 cycles, 5C and 55C) and immersed in 0.5% basic fuchsin solution for 24 h. Specimens were sectioned and dye penetration was scored using a stereomicroscope. Data analysis was done by using MannWhitney-U-Test, KruskalWallis-Test and ordinal regression tests. Results: Ordinal regression tests showed that ssure sealants and bonding agents had a reciprocal effect on the microleakage degree (P = 0.037). Bonding agent and type of bonding had no signicant effect on microleakage in low and high viscosity groups (P = 0.114, P = 0.648). Without using bonding agent high
P08109 Comparison of new and 3-month-old tooth brushes in the removal of plaque in children
B. MALEKAFZALI, H. ABBASSI & A. MIRFASIHI Pediatric Dentistry, Beheshti University, Tehran, Iran Introduction: There is inconclusive evidence about the relationship between toothbrush wear and plaque removal. This clinical trial aimed to validate or invalidate noninferiority in the plaque removal efcacy of old versus new toothbrushes in the hands of 79-yearold children.
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Methods and material: Single examiner blinded, randomized, crossover study was conducted in 93 students aged between 79year-old children.at baselines each of students was given a new toothbrush which they used for 3 months. The students attended on two occasions following 48-h periods of no oral hygiene. Following plaque scoring, students brushed with a new tooth brush at one visit and with a brush that they had used previously for 3 months at the other visit. Brushing time was 60 s. Plaque was then re-scored and the percentage reduction in plaque score calculated. The amount of wear of the 3-month-old brushes was determined by measurement of brushing surface areas. Results: Plaque scores after each 48-h period of no oral hygiene were not signicantly different. The percentage reduction in plaque scores achieved with the new brushes was not signicantly different from those achieved with the 3-month-old brushes. Both the new and 3-month-old tooth brushes reduced plaque score by approximately 5657%. Compared with new brushes in the same subjects, no signicant differences were found for plaque score reduction for 3-month-old brushes with minor, moderate or marked wear. Conclusion: The 3-month-old tooth brushes were as effective as new brushes in plaque removal.
P08111 Comparative plaque removal efcacy of two power toothbrushes in children

T. RIMMER1, D. PAYNE1, M. OLSON2, P. SCHMITT2 & A. MASTER2 1 4 Front Research, Chester, UK; 2Philips Oral Healthcare, Snoqualmie, WA, USA Introduction: The aim of the study was to compare the plaque removal efcacy and safety of Philips Sonicare For Kids (SFK) at high setting and Colgate children Battery (CBT) toothbrushes in children aged 710 years. Materials and methods: 69 healthy children (mean age 8.4 years) participated in an EC approved single-blind, randomized, parallel design study. Informed consent/assent (with parent) was obtained. Subjects abstained from brushing for 26 6 h prior to examination visits. At V2 subjects were screened for eligibility (Turesky modied Quigley-Hein Plaque Index (TPI) >1.8). Eligible subjects were instructed on use of both devices (SFK and CBT) in alternating manner at home (twice daily for 2 min) for a oneweek familiarization period. At V3, baseline TPI was scored followed by randomization and a supervised 2-min brushing session with the assigned device. Post brushing scores were obtained by scoring TPI. Safety was assessed in oral soft tissue examinations at V3. ANOVA was used for the primary statistical analysis. Results: 62 children (32 females, 30 males) completed the study. The mean (SD) overall TPI for the pre-brushing scores at V2 was 3.21 (0.49) and 3.29 (0.37), for SFK and CB respectively. Postbrushing mean percent reductions for SFK and CBT were 66% and 53% overall (P = 0.0003), 62% and 51% for posterior (P = 0.0037) and 65% and 53% for interproximal (P = 0.0002) respectively. No adverse events were reported. Conclusions: SFK removed signicantly more plaque than childrens CBT in 710-year-old subjects. Both toothbrushes were safe on oral tissues. Research was supported by Philips Oral Healthcare.
P08110 Professionally applied toothbrushing study to evaluate plaque removal in children

M. PELKA1, K. RUMI1, A. PELKA1, M. DELAURENTI2 & J. WEI2 1 Dental Clinic 1, Erlangen, Germany; 2Philips Oral Healthcare, Snoqualmie, WA, USA Introduction: Compare the plaque removal efcacy of Philips Sonicare for Kids (SFK) at high and low power level settings and Oral B Stages3 Manual (MTB) toothbrushes in a professionally applied brushing session in children aged 47 years. Materials and methods: 68 healthy children (38 girls, 30 boys; mean age 5.3 years) participated in an IRB approved single-blind, randomized, split mouth design study. Informed consent/assent (with parent) was obtained. Subjects were screened for eligibility (Turesky modied Quigley-Hein Plaque Index (TPI) >1.8). Eligible subjects were randomized to SFK high, low, MTB by quadrant and were brushed accordingly by a clinical hygienist. TPI was scored at 1 and 2 minute interval equivalents by quadrant by a blinded examiner. Safety was assessed in oral soft tissue examinations. For statistical analysis, MANOVA for a split-mouth design was applied and P-values were adjusted using the Dunnett-Hsu adjustment. Results: The mean (SD) overall for baseline TPI was 3.06 (0.41), 2.84 (0.41) and 2.90 (0.46) for SFK high, low and MTB respectively. Adjusted mean post-brushing overall percent reduction for SFK high, low and MTB was 41, 42 and 29%, respectively at 1-min, and 67, 65 and 49%, respectively at 2-min. SFK high and low versus MTB comparisons are statistically signicant at both time intervals. No adverse events were reported. Conclusions: SFK removed signicantly more plaque than childrens MTB at 1 and 2 min intervals in 47-year-old subjects with professional applied brushing. Both toothbrushes were safe on oral tissues. Research was supported by Philips Oral Healthcare.
P08112 Brushing-duration and use-interaction patterns of manual versus sonic toothbrushes in children
J. STRATE, J. DEFENBAUGH, A. MASTER, P. SCHMITT & W. JENKINS Philips Oral Healthcare, Snoqualmie, WA, USA Introduction: The aim of the study was to compare the brushing duration and use interaction patterns in Children age 710 years using a Philips Sonicare For Kids power toothbrush (SFK) versus Oral-B stages 4 Manual toothbrush (MTB). Patients and methods: Sixty healthy subjects (31-F, 29-M) were enrolled in an IRB-approved randomized, parallel design 2-week study. Informed consent/assent was obtained. At V1 eligible subjects were randomized and provided brushing instructions. They performed an on-site brushing session immediately thereafter. It was timed and video-recorded for duration and use interaction data collection. A home use period of 2-weeks commenced with the assigned product in order for subjects to familiarize to the device. At V2 the brushing and recording procedure was repeated and subjects were dismissed. Longitudinal and between-group comparisons were assessed for duration and ergonomic use interaction events. Statistical analysis was performed using the Wilcoxon Test. Results: Thirty-one subjects were randomized to SFK and twentynine to MTB. A longer median brushing duration was observed for SFK users at both time-points. SFK (122 s) as compared to MTB
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(83 s) at V1 (P = 0.012) and SFK (120 s) as compared to MTB (73 s) at V2 (P = 0.0001). In video analysis review by an ergonomic expert, use interaction brush artifacts occurred more frequently with MTB than SFK, 1.56 as compared to 0.80. Conclusion: Children age 710 years brushed signicantly longer with SFK than MTB following immediate product introduction and after a period of home use. Use interaction comparison suggests that form factor may inuence the frequency of artifact occurrence. Supported by Philips Oral Healthcare. manner at home (twice daily for 2 min) for a 1-week familiarization period. At V2, baseline TPI was performed followed by randomization and a supervised 2-min brushing session with the assigned device. Post brushing TPI scores were then obtained. Safety was assessed in oral soft tissue examinations at V2. ANOVA was used for the primary statistical analysis. Results: The mean (SD) overall TPI for the baseline scores at V2 was 3.25 (0.69) and 3.22 (0.59), for SFK and MTB respectively. The randomization was balanced for gender. Post-brushing mean percent reductions for SFK and MTB were 45% and 27% overall, 43% and 25% for posterior teeth and 44% and 24% for interproximal sites respectively (P < 0.001). No adverse events were reported. Conclusions: SFK removed signicantly more plaque than childrens MTB in 710 year-old subjects. Both toothbrushes were safe on oral tissues. Research was supported by Philips Oral Healthcare.
P08113 Plaque removal efcacy of two power toothbrushes in children

J. L. MILLEMAN1, M. S. PUTT1, A. MASTER2, M. OLSON2 & P. SCHMITT2 1 University-Park Research Center, IN, USA; 2Philips Oral Healthcare, Snoqualmie, WA, USA Introduction: The aim of the study was to compare the plaque removal efcacy and safety of Philips Sonicare For Kids (SFK) at high setting and Crest Spin Battery powered (CSB) toothbrushes in children aged 710 years. Materials and methods: 59 healthy children (mean age 8.5 years) participated in an IRB approved single-blind, randomized, parallel design study. Informed consent/assent (with parent) was obtained. Subjects abstained from brushing for 26 6 h prior to examination visits. At V1 subjects were screened for eligibility (Turesky modied Quigley-Hein Plaque Index (TPI) >1.8). They were instructed on use of both devices (SFK and CSB) in alternating manner at home (twice daily for 2 min) for a 1-week familiarization period. At V2, baseline TPI was scored followed by randomization and a supervised 2-minute brushing session with the assigned device. Post brushing TPI scores were then obtained. Safety was assessed in oral soft tissue examinations at V2. ANOVA was used for the primary statistical analysis. Results: 57 children (35 females, 22 males) completed the study. The mean (SD) overall baseline TPI at V2 was 3.34 (0.54) and 3.33 (0.55), for SFK and CSB respectively. Post-brushing mean percent reductions for SFK and CSB were 46% and 24% overall, 46% and 25% for posterior teeth and 45% and 22% for interproximal sites respectively (P < 0.0001). No adverse events were reported. Conclusions: SFK removed signicantly more plaque than childrens CSB in 710 year-old subjects. Both toothbrushes were safe on oral tissues. This research was supported by Philips Oral Healthcare.
P08115 Number, length and end-rounding quality of bristles in manual child toothbrushes
T. ILERI KECELI, B. TEZEL, M. D. TURGUT, M. TEKCICEK & Z. C. CEHRELI Department of Paediatric Dentistry, Hacettepe University, Ankara, Turkey Introduction: The number, length and end-rounding quality of bristles play an important role in the overall effectiveness of manual toothbrushes. The aim of the study was to evaluate those properties in manual child toothbrushes available in Turkey. Materials and methods: 11 different brands of manual child toothbrushes were obtained. The bristles were digitally photographed under a stereomicroscope from the longitudinal and crosssectional aspects at standard magnication. The length and number of bristles were calculated on digital micrographs using open-source image analysis software (ImageJ). Bristle end-rounding was evaluated using image analysis based on the Silverstone and Featherstone scale. The data were evaluated statistically with ANOVA and chi-square tests (both P = 0.05). Results: The minimum and maximum length of bristles were 6.63 mm (Stages 1, Oral-B) and 9.26 mm (Yombi Timba, Vepa), respectively. The mean number of tufts per toothbrush was 27.27. The mean number of bristles packed into a tuft hole varied from 41.8 (Dr. Difas, Difas) to 68.4 (Stages 1, Oral-B). The ratio of acceptable versus nonacceptable end-rounding varied both within different regions of each toothbrush and between those of different brands (P < 0.05). Conclusion: The child toothbrushes displayed a great a variety in number, length and end-rounding quality of bristles. Overall, Colgate Smiles 26 (Colgate) and Stages 1 (Oral-B) displayed the best acceptable end-rounding morphology.
P08114 Plaque removal efcacy of sonic versus manual toothbrushes in children

M. S. PUTT1, J. L. MILLEMAN1, W. JENKINS2, M. OLSON2 & P. SCHMITT2 1 University-Park Research Center, IN, USA; 2Philips Oral Healthcare, Snoqualmie, WA, USA Introduction: Compare plaque removal efcacy of Philips Sonicare For Kids (SFK) at high setting and Oral B Stages4 Manual (MTB) toothbrushes in children, 710 years. Materials and methods: 58 healthy children enrolled and 4 withdrawn (32 females, 22 males; mean age 8.3 years) in an IRB approved single-blind, randomized, parallel design study. Informed consent/assent (with parent) was obtained. All subjects abstained from brushing for 26 6 h prior to examination visits. At V1 subjects were screened for eligibility (Turesky modied QuigleyHein Plaque Index (TPI) >1.8). Eligible subjects were enrolled and instructed on use of both devices (SFK and MTB) in alternating
P08116 Impact of different recommendations on the amount of toothpaste used for infants
S. BURNIK1, T. TOMAZEVIC2 & R. KOSEM1 1 Department of Paediatric and Preventive Dentistry, University Medical Centre Ljubljana; 2Faculty of Medicine, Department of Paediatric and Preventive Dentistry, University of Ljubljana, Slovenia Introduction: Supervised toothbrushing with an appropriate amount of uoride toothpaste is important to control caries and minimise the risk of uorosis in young children. We used data gained in the rst two months of our ongoing study to nd out
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which recommendation on amount of toothpaste leads to the most appropriate use. Materials and methods: The study population consisted of participants of parenting classes organized by the University Medical Centre Ljubljana, Division of Gynaecology, which approved the protocol. Expectant parents were asked to apply the amount of toothpaste, which they considered appropriate for an infant, to a toothbrush. During one-hour lecture on various aspects of oral health they were recommended to apply a pea sized amount (group A), an amount comparable with the size of a childs ngernail (group B) or to use transverse technique (group C). The applied quantity was measured by two examiners, blinded for the given recommendation, before and 3 to 7 days after the lecture. Paired t-test and oneway ANOVA with Tukey post hoc comparisons were used. Results: All three recommendations signicantly (P<0.05) reduced the amount of toothpaste. Before the lecture, the average amount in groups A (n = 41), B (n = 28) and C (n = 40) was 0.39 0.19 g, 0.32 0.14 g and 0.33 0.16 g, respectively. After the lecture, it decreased to 0.31 0.11 g, 0.26 0.11 g and 0.25 0.07 g, respectively; groups A and C differed significantly (P < 0.05). Conclusion: The amount of toothpaste was reduced after any kind of given recommendation; however, the impact of the three recommendations seems to differ.
P08118 The inuence of foods and tooth brushing on Streptococcus mutans

K. YANAGITA, M. OZAKI, Y. NOMURA & W. MOTOKAWA Pediatric Dentistry, Fukuoka Dental College, Japan Introduction: Recently it is often reported that dental caries in children has decreased. However there are many children with severe dental caries. Decreasing the number of streptococcus mutans in children is important for caries prevention. We researched the inuence of tooth brushing, diet habits and troches containing the antibodies from egg yolks on the number of streptococcus mutans. Patients and methods: We collected saliva of 57 children in the kindergarten of Kurume city, Japan and counted the number of streptococcus mutans in their saliva. The collective comprised 29 boys and 28 girls ranging from 3.2 to 6.4 years of age with an average of 5.1 years. Parents were asked to ll out a questionnaire about nutritional habits and oral hygiene including 50 items about their childrens eating habits. The data of the number of streptococcus mutans (dependent variable) and 50 variables of eating habits and tooth brushing ( independent variable ) were analyzed with multiple regression analysis (SPSS 12.0J for Windows). Results: 1. R-square showed 0.76 in this multiple regression analysis. So we could clarify some factors inuencing on the number of streptococcus mutans in children. 2. The variable of troches made from egg yolks showed signicant standard partial regression coefcient (= -0.203, P < 0.05). Conclusion: In this multiple regression analysis, it was also suggested that the number of streptococcus mutans might be decreased by the troches made from egg yolks.
O08117 Oral hygiene management of pediatric transplantation patients

Y. WAGNER & R. HEINRICH-WELTZIEN Department of Preventive Dentistry, Friedrich-Schiller-University of Jena, Germany Introduction: Organ transplantation patients and patients receiving chemotherapy and/or radiation during cancer treatment need specialized dental care. The purpose of this study was to judge oral care protocols used in German bone marrow transplantation (BMT) centers. Materials and methods: A telephone interview was made with all 21 BMT centers, asked for oral hygiene regimens used. The responses were analyzed using descriptive statistics and compared with a variety of guidelines. Results: There is no uniform oral care regimen in German BMT centers. 14.3% of the BMT centers used neutrophil count as a base for changing oral hygiene regimen and 47.6% used platelet count, respectively. Five of them decide individually or prohibit toothbrushing with beginning of the high-dose chemotherapy (14.3%). When toothbrushing is discontinued the centers recommend mouthrinses with chlorhexidine, mixtures of plant extracts containing topical anesthetics and iodine solution for oral care. Several BMT centers believe that toothbrushing increases the risk of infection although the AAPD guideline (2008) recommends that thrombocytopenia is no exclusion criterion. Special recommendations for using uoride preparations for caries risk prevention or dietary counseling regarding the cariogenic potential of carbohydrate rich dietary supplements were not given. Conclusion: To minimize the risk of oral and associated systemic complications in pediatric transplantation patients the child and the parents should be advised about the importance of an optimal oral care. There is a need for close collaboration between the pediatricians and the dental specialists to reduce the long-term sequelae of cancer therapies and to improve the childs quality of life.
P08119 Caries preventive effect of Biuorid12 on rst permanent molars

N. NEHRING1, M. WAGNER2, T. TSEREKHAVA3, N. SHAKOVETS3 & A. BORUTTA1 1 Dental School/WHOCC, Friedrich-Schiller University of Jena, Germany; 2Department of Business Statistics, Friedrich-Schiller University of Jena, Germany; 3Dental School, University of Minsk, Belorussia Introduction: Research has shown that dental caries can be prevented effectively through establishment of uoride programmes. The aim of a three-year follow-up was to evaluate the caries preventive effect of Biuorid12 (VOCO GmbH, Cuxhaven, Germany) on permanent molars. Patients and methods: After a baseline (DMFT/DMFS) 451 rst graders (mean age: 6.24 years) of primary schools (Minsk, Belorussia) with high caries risk were randomised and divided into a test group (group A) and a control group (group B). Subjects of group A were treated with Biuorid12 two times a year, whereas subjects of group B were educated only. Statistical signicances were calculated using the t-test at a signicant level of 5%. Permission to conduct the study was obtained from the institutional ethical committee. Parents gave written informed consent. Results: At baseline 96 % of all subjects were free of caries (DMFT = 0) in their permanent molars, 2% showed an actual treatment need (DMFT > 0, DT > 0). The caries prevalence in group A amounted to 0.01 DMFT/DMFS. The corresponding data for group B showed a DMFT/S of 0.04. After 3 years the caries prevalence in group A increased up to 0.5 DMFT/S, in group B up to 0.9 DMFT (DMFS = 1.0) The caries incidence was signicantly higher in Gr. B than in group A (PDMFT = 0.03; PDMFS = 0.01).
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Conclusion: It could be concluded that Biuorid12 showed a caries preventive effect and can be used in preventive programmes. The study was supported by VOCO GmbH, Cuxhaven, Germany. Conclusion: Fluoride varnish treatment resulted in a signicant reduction of lesion depth s compared with APF gel. Fluor Protector? and CavityShield TM provided a similar effect.
P08120 Urinary uoride excretion in pre-school children exposed to uoridated salt (150 ppmF) in Belarus
T. V. PAPRUZHENKA & T. N. TSERAKHAVA Chair of Paediatric Dentistry, Belarusian State Medical University, Belarus Introduction: Belarusian Caries Prevention Programme recommends use of F-salt (250 100 ppmF, actually 150ppmF-) both at household and daycare institutions. The Objective of the study was to measure 24 h urinary F-excretion for pre-school children who did or did not consume F-salt. Patients and methods: 24-h urine samples were collected in 2 cities ([F] in water is 0.10.3 ppm) from 5 groups of 1.53.0 year-old children:1) children not eating F-salt (n = 20); 2) children eating F--salt at home and F--free salt at the 10h day-care (n = 20); 3) children eating F-free salt at home and F-salt at day-care (n = 21); 4) children in an orphanage eating all daily meals cooked with F-salt (n = 23); 5) children eating F-salt with all meals as their 24-h home diet (n = 11). The volumes of the samples, [F] and 24h F--excretion were measured; the data were tested using t-test. Results: The mean 24-h F--excretion for children in group 1, 2, 3, 4, and 5 were 0.07 0.02 mg F-, 0.08 0.01 mg F-, 0.30 0.10 mg F-, 0.44 0.17 mg F-, and 0.18 0.15 mg F-, respectively (P1,2>0,5, P1,3<0.001, P1,4<0.001, P1,5<0.001). Conclusions: Natural 24-h F--excretion and, hence, F_intake for pre-school children in Belarus is low. F intake for children eating F-salt varies signicantly depending on a childs life style: the intake remains low for children ingesting salt only as a part of their home ration; it reaches the lower limits of the optimum for children day-care; and comes to the upper limits of the optimum for children living at orphanage.
P08122 Fluoride concentrations of tap waters in Greece for up to 6 months

G. MASTORAKIS & K. J. TOUMBA Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds, UK Introduction: The aim of the study was to evaluate the uoride concentration and its uctuations in tap water over a period of up to 6 months from different regions of Greece. Materials and methods: 5 mL of tap water were collected each month from residencies or public services and analyzed in triplicate using Ion Chromatography. Tap water samples were collected between 1020th of each month (between February-July 08) and the cities included were: Athens prefecture (4 areas): (Cholargos, Kamatero, Keratsini, Piraeus), Thessaloniki prefecture (3 areas): (Polichni, Ano Touba, Kalamaria), Veroia prefecture (2 areas): (East, Central), Argos prefecture (1 area), Thiva prefecture (1 area), (Thiva), Heraklio prefecture (1 area): (Heraklio). Results: The uoride level varied for each area and was: 0.023 0.034 ppmF (Cholargos), 0.0160.029 ppmF (Kamatero), 0.032 0.075 ppmF (Keratsini), 0.0280.038 ppm F (Piraeus). For Thessaloniki region the uoride levels ranged from: 0.020.11 ppm F (Kalamaria), 0.0310.14 ppm F (Ano Touba), 0.0280.12 ppm F (Polichni). For the rest of the cities, the Fluoride uctuations were: 0.030.034 ppm F (Central Veroia), 0.0250.032 ppm F (East Veroia), 0.0550.23 ppm F (Argos), 0.0450.085 ppmF (Thiva), 0.0160.083 ppm F (Heraklio). Conclusions: Considerable variations in tap water were observed over a period of 6 months, even if the areas were supplied from the same natural source.
P08121 Effect of uoride varnish on the enamel demineralization

E. Y. YOON, S. H. LEE & N. Y. LEE Department of Pediatric Dentistry, College of Dentistry, Chosun University, Gwangju, Republic of Korea Introduction: The aim of this study was to evaluate the effect of uoride varnish application on enamel decalcication. Materials and methods: Eighty bovine enamel blocks were divided randomly into 4 groups. Group I is the control group. Group II was treated with the APF gel and washed after 4 min. Group III and Group IV were treated with Fluor Protector? and CavityShield TM and washed after 1 min. Decalcication was created by placing all specimens into articial acidic solution (pH 4.0). Then the optical density of the lesions was measured by visible light uorescence and the lesion depths were measured. Results: 1. The optical density of Group II was higher than Group I but lower than Group III and IV (P < 0.05) and there was no difference between Group III and IV (P < 0.05) at 48 h. 2. The optical density of Group IV was highest at 72 h (P < 0.05). 3. Mean lesion depths were 205.36 42.85 lm and 210 44.60 lm in Group I and II but the difference was not statistically signicant (P > 0.05). 4. Mean lesion depths were 80.03 21.66 lm and 77.46 27.72 lm in Group III and IV but no signicant difference could be shown between the two groups (P > 0.05)
P08122a Dental erosions in young adults and lifestyle factors during young ages
H. ISAKSSON1, L. K. WENDT2, G. KOCH1, D. BIRKHED3 & C. ULLBRO1 1 Department of Paediatric Dentistry, The Institute for Postgraduate Education, Jo ping, Sweden; 2Centrum of Oral Health, School nko of Health Siences, Jo ping University, Jo ping, Sweden; nko nko 3 Department of Cariology, Institute of Odontology, Sahlgrenska Academy at Go teborg University, Sweden Introduction: Few studies are performed on dental erosions in young adults. Most of these studies are cross-sectional and give limited information on presumptive etiological factors which can occur during childhood and adolescence. The present study aims to analyse lifestyle factors which can explain dental erosions found in young adults. Material and methods: In the present study a cohort of ve hundred individuals have been longitudinally followed from one year to twenty years of age concerning oral health and lifestyle factors, including consumption pattern and oral hygiene measures. At twenty years of age the individuals were exposed to a clinical and radiographic oral examination. During the twenty-year-period, clinical examinations and questionnaires have been repeatedly performed including registration of life style factors. The study is ethically approved and informed consent has been achieved. Results: The presentation will report data on dental erosions correlated to lifestyle factors over time.
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Poster Session P09/Prevention 2

P09123 Results of a 1-year Dental Programme for pre-school and school children in Moscow Russia
L. P. KISELNIKOVA, T. E. ZUEVA, M. V. MIROSHKINA, S. I. SOKOLOVA & M. M. NAGOEVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: To estimate the results of introducing the Dental Programme for pre-school and school children. Patients and methods: The Dental Programme included clinical examination of 641 children at the age from 3 to 12 years, lessons in hygiene and oral health 3 times a year and controllable hygiene. All participants in the programme were divided into group 1- preschool children (n = 326, age 36 years) and group 2 school children (n = 315, age 712 years). In this study, the dynamics of oral hygiene were analysed using the Fedorov-Volodkina Index (group 1) and the Simplied Oral Hygiene Index - OHI-S (group 2). Results: Before the programme began, it was noted that the children in group 1 had a hygiene index of 2.09 + 0.17. The children in group 2 had 2.67 + 0.26. By analyzing the Plaque indices, a signicant decrease in both groups was revealed. Group 1 showed an average decrease of 32% (P < 0.01) and group 2 a decrease of 46% (P < 0.001). Conclusion: Among pre-school and school children, the level of oral hygiene was found to be low. As the Dental Programme progressed, positive dynamics of the oral hygiene appeared and due to the Programme a signicant improvement was achieved in both groups, the strongest change being revealed in group 2. Conclusion: School nurses should use their advantage of profession to promote oral hygiene activities, and assist teachers to promote and cooperate with school oral hygiene programs.
P09125 Quantitative analysis of periodontopathogens in subgingival plaque in adolescents by real-time PCR

N. Y. YANG, Q. ZHANG & Q. SHI Pedodontic Department, School of Stomatology, Capital Medical University, Beijing, PR China Introduction: Gingivitis is the most common chronic infection in adolescents, the prevalence is about 7090% in China, some gingivitis gradually progresses to periodontitis. It is generally accepted that P. gingivalis, A. actinomycetemcomitans, P. intermedia and F. nucleatum are putative periodonto-pathogenic bacteria. The present study quanties the 4 putative periodontopathogens in subgingival plaque by real-time quantitative polymerase chain reaction, to observe the prevalence of periodontopathogens in adolescents. Patients and methods: Forty-seven 12- to 18-year-old adolescents participated in this study, 16 with gingivitis, 15 with periodontitis and 16 with healthy gums. In each study subject, subgingival plaque samples was collected using six sterile 45# paper points. A real-time polymerase chain reaction assay was employed to determine the subgingival counts of P. gingivalis, A. actinomycetemcomitans, P. intermedia and F. nucleatum. Statistical analysis was performed using ANOVA. Results: The mean logarithm of counts in healthy, gingivitis and periodontitis subjects was 3.55 0.67, 4.95 1.39 and 5.81 1.20 for P. gingivalis, 3.05 0.81, 4.30 1.33 and 5.31 1.14 for P. intermedia, 0.75 1.08, 2.02 1.33 and 2.21 1.13 for A. actinomycetemcomitans, 3.69 0.85, 4.30 1.19 and 5.08 0.95 for F. nucleatum, respectively. Signicant differences were found between healthy and gingivitis subjects for P. gingivalis (P < 0.01), P. intermedia (P < 0.05) and A. actinomycetemcomitans (P < 0.01). For F. nucleatum, there was no signicant difference between healthy and gingivitis subjects (P > 0.05), but a signicant difference between healthy adolescents and periodontitis subjects occurred (P < 0.01). Signicant differences were also found between adolescents with gingivitis and periodontitis subjects for P. gingivalis (P < 0.05), P. intermedia (P < 0.01), and F. nucleatum (P < 0.05), but not for A. actinomycetemcomitans (P > 0.05). Conclusions: Our survey indicated that P. gingivalis, P. intermedia, A. actinomycetemcomitans and F. nucleatum might be associated with periodontal diseases in adolescents.
P09124 Oral health practice in Taiwanese primary schools

T. CHIANG, S. HUANG, S. LIU, S. SHIE & Y. CHO Department of Dental Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: Taiwan has been encouraged to promote childrens oral health throughout the past 10 years and, in result, childrens oral condition has been greatly improved. However, Taiwan still has not met the goals set by the World Health Organization (WHO). Students oral hygiene habits and oral hygiene activities are promoted by school. This study aimed at detecting the knowledge of primary school teachers and school nurses in relationship to their own oral health practices. Materials and methods: There were 267 schools and 2526 questionnaires in total, with an 86.68% return rate. The collected data from the questionnaires were processed and analysed with the statistical software JMP. A stratied multi-stage cluster sampling analyses based on the administration area and urban/rural area was carried out using the teachers as the Probabilities Proportional to Size (PPS). Results: The mean ndings were: 1) 65% of faculty and nurses brushed their teeth 3 times a day. 2) 52.1% of them brushed their teeth by Bass Method. 3) 53.7% of the teachers and school nurses visited a dentist routinely. The school nurses practices of oral health seem to be better in comparison to the teachers.
P09126 A pilot study: A communication sheet to improve childrens preventive care

R. FITZGERALD & C. CAMPBELL Department of Paediatric Dentistry, Glasgow Dental Hospital and School, Glasgow, UK
Poster Sessions
Introduction: During a regional prevention audit project based on national guidelines, it became apparent that the majority of children seen for emergency treatment or G.A. assessment received no preventive advice. Furthermore, there was minimal communication with the primary care practitioner (PCP) regarding this. A communication sheet for PCPs was formulated to resolve this issue. Prior to implementing this communication sheet a pilot study was undertaken. This aimed to establish if: the new communication sheet was welcomed by the PCP; if it gave sufcient information on the patients proposed tertiary care and subsequent primary care needs; and crucially, if it aided preventive planning for the childs improved future oral health. Materials and methods: Over the pilot study period the details of the PCPs referring children for either GA assessment or the emergency clinic were collated. An introductory letter, sample communication sheet and questionnaire were sent to the PCPs. This communication sheet outlined a preventive package. This included the optimal time interval for radiographs, uoride application, dietary counselling, oral hygiene instruction and application of ssure sealant. Results: All respondents found the communication sheet useful. The majority agreed sufcient information was present regarding both clinical information (90%) and treatment provided (80%). The preventive package strategy was thought to be helpful by most respondents (89%). Conclusions: The sheet was welcomed with minor alterations required prior to implementation within the paediatric department. The need for an oral health educator to educate this high caries risk group is highlighted.
P09128 Air quality in a busy university pediatric dental clinic

N. KARIYA1, O. RODIS2, M. NISHIMURA1, S. MATSUMURA2 & T. SHIMONO2 1 Dental Hospital; 2Department of Behavioral Pediatric Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama City, Japan Introduction: The aim of this study was to assess the probability of the spread of infection among patients from airborne bacteria as a result of the ow of people in a university dental clinic. Materials and methods: Brain Heart Infusion agar medium was strategically placed in eleven locations in a dental clinic while counting the number of people who went in and out of the clinic at the same time. The medium was left uncovered at certain areas, such as doorways, walls, tabletops, and was changed ve times during the duration of the day during three consecutive Tuesdays and Sundays. The number of the bacterial colonies in the BHI agar medium was counted after incubation at 37C for 48 h. Results: The number of the bacterial colonies on brain heart agar nutrient medium had signicant associations with and the number of people who went in and out of the clinic, specically in the special patients room (P = 0.001) and doorways (P = 0.05). No signicant associations were seen in tabletops or walls. However, signicant associations were seen between locations of each plate according to area of the dental clinic such as plates placed on tabletops (ranging from P = 0.05 to P = 0.001) in the central part of the clinic and between plates in the special room and doorway (P = 0.05). Conclusion: Central areas of the clinic are seen as areas with higher trafc and may pose a threat to the spread of airborne infection. Dental clinic layout may therefore be of great concern in deciding for proper placements for dental chairs.
P09127 Oral health educational program for HIV(+) mothers

M. E. GUERRA, A. RODRIGUEZ, S. RODRIGUEZ & V. TOVAR n Centro de Atencio a Pacientes con Enfermedades Infectocontagiosas, Facultad de Odontologa Universidad Central de Venezuela Introduction: Aim of this study was to describe the outcome of a training program for HIV(+) mothers to detect opportunistic infections by themselves and to prevent dental caries in mother and child. Materials and methods: By Venezuelan law all pregnant women should be tested for HIV 3 times during pregnancy. From 2003 to 2007 HIV(+) pregnant women were recruited at the Hospital Universitario de Caracas. At the rst visit each mother was interviewed and examined by a dentist. Then, mothers received an interactive educational program on the clinical manifestations of HIV-related opportunistic infections and dental caries. The training focuses on early identication of lesions, seeking appropriate care once lesions are detected and in-home preventive practices. The program is provided at the rst visit and refreshers at each preand post-partum visit, every 3 months. Results: 123 mothers participated on a regular basis in the program (missed <4 visits). In addition, 43 had emergency visits due to pain, 34 mothers missed >4 visits. After training mothers were capable of detecting early signs of disease (HIV infection and dental caries). Conclusion: The capacity to detect and monitor the intraoral manifestations of HIV provides a feeling of empowerment, and lesions are detected and treated early. In addition, preliminary data show a secular trend towards less prevalence of dental caries in their children. A follow-up of missing mothers indicate that the most common barrier is transportation to the hospital.
P09129 Oral health related knowledge/attitude of school faculties in Taiwanese primary schools
Y. LIU, S. HUANG, S. LIU, S. SHIE & Y. CHO Department of dental hygiene, Kaohsiung medical university, Kaohsiung/Taiwan Introduction: School is an important place to promote oral hygiene activities. The knowledge and attitude of school teachers and nurses will have a direct inuence on students. This research focused on the comparison of oral health related knowledge and attitude of school teachers and nurses in primary schools in Taiwan. Materials and methods: There were 267 schools and 2526 questionnaires answered by the school teachers and nurses extracted from the primary schools in Taiwan. The research applied stratied multi-stage cluster sampling method based on the administration area and urban/rural area, using the teachers as the Probabilities proportional to size (PPS) and proceeding with questionnaires. The collected data were processed and analysed by statistical software JMP. We surveyed several schools and awarded a maximum score of 100 based on 15 questions dealing with change of the oral anatomy, prevention of pathologic changes and uoride use. The mean scores were calculated as number of correct answers/15 questions. Results: The mean score of oral health related knowledge and attitude of primary school teachers and nurses were 74.5 12.6, 75.7 5.7 and 85.5 11.4, 80.3 5.9, respectively. The existence of an oral health promoting program and the availability of a uoride mouth rinse programs were the factors with statistically signicant inuence. Conclusion: The school nurses knowledge and attitude towards oral health are better than that of the teachers.
Prevention 2 P09130 Dental education project for pre-school children: towards healthier rst permanent molars
R. LUCA, I. A. STANCIU, C. FARCASIU, A. MUNTEANU & A. OLARU Paediatric Dentistry Department, Carol Davila University, Bucharest, Romania Introduction: The rst permanent molar is the most caries susceptible tooth in the permanent dentition. The aim of our study was to decrease caries prevalence on this tooth by means of a preventive program addressing both children and adults involved in their education. Materials and methods: The program started in March 2006, is ongoing and focuses on 47-year-old pre-school children, their parents, teachers and caregivers. Children are examined in kindergartens. Following examination, instructions about adequate daily tooth brushing are given using oversized models, puppets, cartoons according to the Tell-Show-Do technique. Oral hygiene kits and theme games are given away as presents. Parents knowledge about the rst permanent molar is 1) assessed by self-administered questionnaires and 2) improved by theme workshops. Parents and teachers are informed about the importance of the rst permanent molar, proper oral hygiene and early regular dental check-ups by use of slides and video presentations. Results: 937 children from 12 kindergartens in Bucharest were examined. 918 of them were taught how to preserve their healthy smiles. In 2006, 95.98% of the rst permanent molars of children aged 67 years (n = 329 children) were caries-free. In 2008, the corresponding gure was 97.03% (n = 378 children). Most of the children examined in 2008 took part in the program during 2 years. Conclusion: Prevention programs addressing both young children and their parents/caregivers could help decrease caries prevalence on permanent teeth. Conclusion: Prophylactic programs using dental sealants or dental sealants with uoride represents the optimal approach to improve childrens oral health.
P09132 Long-term effects on oral health of preventive activities in pre-school children

A. SUNDELL, C. ULLBRO & G. KOCH The Department of Paediatric Dentistry, the Institute for Postgraduate Dental Education, Jo ping, Sweden nko Introduction: In 1990 four groups of 25-year-old pre-school children with high caries activity (mean ds 12) took part in different intensive preventive programmes for 2 years. 112 children took part in the study at start and 84 completed it. After 2 years no differences in caries increment were found between the four groups. The children developed as a mean one new ds per year. The aim of this study was to analyze if there was a persistent effect on oral health of the preventive activities instituted 11 years earlier. Materials and methods: Bitewing radiographs from all the participating children at the age of 15 years were requested from the public dental clinics and examined. If bitewing radiographs were missing or of poor quality bitewings from the age of 14 or 16 years were used. Radiographs from 88 patients were possible to examine. Out of these 88 patients 63 had completed the preventive programmes (test) and 25 did not (control). The proximal surfaces from the distal surface of the rst pre-molar to the mesial surface of the second molar were diagnosed. Manifest and initial cavities and lled proximal surfaces were registered. Results: At the age of 15, 17.5% of the children who completed the preventive programmes (test) were caries-free compared to only 4% of those who did not complete the programmes (control). Conclusion: Preventive programmes involving young high caries active children have a long-term effect on oral health behaviour.
P09131 Prevention of dental decay from theory to every day practice

A. MUNTEAN, M. MESAROS, A. SERBANESCU & M. SIMU Department of Paediatric Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania Introduction: Despite progress of preventive methods, dental decay represents a problem for childrens oral health in the City of ClujNapoca, Romania. Our study presents the preventive strategy applied in a private dental practice, in order to moderate tooth decay prevalence. Patients and methods: Three groups of children, selected according to school age (1st primary) were followed up for two years. Group 1 had a general dental check-up once a year. In Group 2 ssure sealants on occlusal surfaces of rst permanent molars were placed. Group 3 was provided with a protocol including dental sealants on occlusal surfaces of rst permanent molars and topical uoride application. Dental status was assessed every year using the DMFT index. We calculate dft index to appreciate the attitude for treatment. Statistical analyses were performed with Statview application for Windows to compute descriptive statistics. Students t-test was used to compare means. Results: At the initiation of the study, there were no statistical differences between DMFT indexes for the three groups (G1 = 1.61, G2 = 1.63, G3 = 1.73). After two years DMFT indexes increased for the three groups (G1 = 3.43, G2 = 2.39, G3 = 2.10) with statistical differences between G1and G2 or G3 (P < 0.0001) and no differences between G2 and G3 (P = 0.173).
P09133 Bidobacterium lactis Bb12 may reduce the risk of respiratory infections in children
T. TAIPALE1, K. PIENIHAKKINEN2, P. ALANEN2, J. JOKELA1 & E. SODERLING2 1 Korpilahti-Muurame Health Care Center, Muurame; 2Institute of Dentistry, University of Turku, Turku, Finland Introduction: Probiotic bacteria are connected with improved immune response. We studied the effect of early administration of Bidobacterium lactis Bb12 (Bb12) on 1) oral colonisation of Bb12 and 2) the risk of infectious diseases. Patients and methods: The RCT study was found ethically acceptable by the local ethical committee and parents gave written, informed consent. The probiotic-tablet containing 100 mg xylitol in addition to Bb12 was administered to the infants (from 12 mo to 8 mo) with a novel slow-release pacier. The control tablet contained only xylitol. The daily dose of Bb12 was lg 10 CFU. At the age of 8 mo oral swabs were collected for Bb12 determination (PCR) and the families registered in special diaries breastfeeding habits, pacier use, dietary habits, medication and all infections. Results: The baseline characteristics of the two groups were similar. Approximately 60% of the children were breast-fed for 8 mo. Bb12 was not detected in the oral samples. The daily duration of pacier sucking and occurrence of otitis media were not associated with each other. No signicant differences between the groups were observed in gastrointestinal symptoms, otitis media or use of antibiotics. However, 22 out of 34 (65%) infants receiving Bb12 and 33 out of the 35 (94%) receiving the xylitol control experienced respiratory infections (RR 0.69; 95% CI 0.53, 0.89).
Poster Sessions
Conclusion: Probiotics may decrease the risk of respiratory infections in breast-fed children. The study was supported by Emil Aaltonen and Sohlberg Foundations, Finnish Dental Society Apollonia and Finnish Dental Association. physiological and biochemical characteristics. Yeasts were identied by their pseudomycelium and chlamydospores on rice agar. Results: Mutans streptococci and lactobacilli could be estimated between 86% and 100% in all dentin samples. However, the frequency of C. albicans was higher in upper incisors (between 67% and 71%) than in rst (14%) and second molars (29%). In the samples of teeth of the lower jaw C. albicans could not be harvested. Conclusion: The occurrence of C. albicans in young children with ECC could have an impact on general health and may have a negative inuence on development of the defence system in young children. Therefore the prevention of ECC is very important to keep children from serious oral and general diseases.
P09134 The dental hygiene/dietary behavior of young children with S-ECC in southern Taiwan
H. Y. HU1, S. T. HUANG1,2,3, R. S. TANG4, S. Y. HSIAO1 & H. S. CHEN1,3 1 Department of Dentistry, Division of Pediatric Dentistry, Kaohsiung Medical University Hospital; 2Department of Oral Hygiene, Kaohsiung Medical University; 3Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 4Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: The oral health goal of WHO is that 90% of 5-year old should be caries free in 2010. In 1997, the Department of Health in Taiwan reported that the prevalence rate of dental caries was 60% in 23-year-old children. The aim of this study was to analyze the association between S-ECC (Severe-Early Childhood Caries), dental hygiene and dietary behavior of children/caregivers/ parents in order to identify possible risk factors. Material and methods: Children with S-ECC (n = 108) aged 2 to 5 years who visited the division of Pediatric Dentistry of Kaohsiung Medical University Hospital (KMUH) were recruited for this survey. The oral hygiene and dietary habits were recorded with a standardized questionnaire which was completed by the parents/ caregivers of the S-ECC children. The data were analysed using the software Microsoft Access and the statistical software JMP (version 7.0, SAS Institute, Cary, NC, USA). For statistical comparisons Chi-square test and ANOVA were used. Results: 1. The caregivers education level was associated with the score of dental health knowledge. 2. There was a total score 100 for 10 questions in case of completely correct answer, the average score of caregivers dental health knowledge was 46.05. 3. The caregivers dental hygiene behavior included clean mouth after meal, were associated with the childrens tooth brushing habit. Conclusion: The parents/caregivers knowledge and habits inuence the childrens oral health. Therefore, tooth friendly advices are mandatory in the parents and caregivers.
P09136 Knowledge of parents of 3-year-old children about early dental health care promotion
_ A. RAHMAN, T. SPANIER, K. MEYER & H. GUNAY Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Germany Introduction: Aim of this study was to determine to what extent and from whom parents receive information about early dental health care promotion, and if this has an effect on the prevalence of caries in their children. Materials and methods: 442 randomly selected parents of 3 to 4-year-old children were asked to ll in a questionnaire. Afterwards the children were examined according to WHO criteria. The statistical analysis was performed with SPSS 15.0. Differences between groups were analysed using t-test (P < 0.05). Results: 52.2% had received dental health care advice during the general pediatric examination. 79.3% of the children in the sample had seen a dentist at the average age of 2.1. The median dmft value was 0.85 (0.80 for children from German families and 1.21 for children of immigrants). 61.3 % of respondents stated that they had not received any information regarding potential dental or peridontal problems during pregnancy. 40.3% reported gingival bleeding. Only 31.4% had received individual preventive treatments, predominantly professional tooth cleaning. A statistically signicant correlation (MannWhitney-Test) of the caries prevalence with the following factors was documented: nutritional advice given during gravidity, comprehensive individual preventive treatment, rst dental examination at an early age, controlled dental care carried out by parents from the time the rst tooth erupts. Conclusion: Therefore, it is decisive that dentists, pediatricians, gynecologists and midwives work together to implant the idea of an early dental health care of their children in the minds of pregnant women.
P09135 Early childhood caries (ECC) and the occurrence of candida albicans
S. KNEIST, K. SENF, A. HARZENDORF, A. UDHARDT & A. BORUTTA Friedrich-Schiller-University of Jena, Centre of Dentistry, Jena, Germany Introduction: ECC is still a public health problem and it needs more research to prevent it. The aim was to analyse the caries associated microora in infected dentine of 15-year-old children with ECC (n = 15). Patients and methods: Samples of infected dentine were collected from 25 incisors and molars for microbiological examination. The samples were inoculated onto MSB agar (mutans streptococci, MS), onto rogosa agar (lactobacilli, LB) and sabouraud agar (yeasts) and incubated at 37 C for 48 h. Counts of total germs (CFU) were enumerated, and after colonies were isolated and identied (n = 166 MS, n = 152 LB, n = 128 yeasts) the percentage of MS, LB and yeasts in the CFU was enumerated. The identication was performed macroscopically as well as by
P09137 The nutritional status of young children with S-ECC in southern Taiwan
R. S. TANG*1, S. T. HUANG2,3,4, M. C. HUANG5,6, F. H. CHUANG7 & H. S. CHEN3,4 1 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University; 2Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University; 3 Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 4Division of Pediatric Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital; 5Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital; 6Faculty of Medicine & Respiratory Care, College of Medicine, Kaohsiung Medical University; 7 Department of Dentistry, Division of Endodontic Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Prevention 2
Introduction: Malnutrition is prevalent in children with Severe Early Childhood Caries (S-ECC). The purpose of this study was to survey the nutrition status of children with S-ECC. Materials and methods: A cross-sectional design was applied. Children with S-ECC (n = 108) aged from 2 to 5 years who visited the division of Pediatric Dentistry of Kaohsiung Medical University Hospital (KMUH) were recruited for this survey. The value of BMI (Body Mass Index) and biochemical measures including hemoglobin, hematocrit, red blood cell (RBC), mean corpuscular volume (MCV), serum iron, serum albumin and serum calcium were collected. Our data of BMI and biochemistry were compared with the average data of general children in Taiwan published by the Department of Health, Executive Yuan, Taiwan and KMUH respectively. The results were analyzed by jmp 7.0. Results: Prevalence rates of children with underweight using BMI as index were 34.58%. Prevalence rates of biochemical measures under normal limits were 25% in hemoglobin, 56.48% in hematocrit, 37% in MCV, 32% in serum iron, 1.96% in serum albumin, 1% in serum calcium. Conclusion: The children aged 25 years with S-ECC may encounter some degree of malnutrition problems such as impairment of growth or anemia. Preventive strategy for these malnutrition problems in children with S-ECC may need to be emphasized and implanted in routine dental practice. infants were caries free. The caries decay of the infants was registered at a mean d14mft of 0.53 and d14 mfs of 1.34. Higher scores of salivary MS correlated signicantly with higher caries decay in infants (r = 0.7). The mean scores of salivary lactobacilli of the mothers amounted to 2.9 and in the infants to 1.5. There was a weak correlation between levels of Lb in saliva of infants and d1 4 mfs (r = 0.13). Conclusion: The data suggest that MS scores >0 for the infants are risk factors for caries. High counts in mothers are associated with an early colonization of their infants.
P09138a The erosive potential of lollipops

H. S. BRAND1, D. L. GAMBON2, A. PAAP1, M. S. BULTHUIS1, E. C. I VEERMAN1 & A. V. NIEUW AMERONGEN1 1 Department of Dental Basic Sciences, Section of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam; 2 Bambodino Pediatric Dental Clinic, Rotterdam, The Netherlands Introduction: Consumption of acidic candies can contribute to the development of dental erosion. At this time no information is available on the erosive potential of lollipops and the protective role of saliva. To determine the erosive potential of several commercially available lollipops and the protective effect of saliva. Materials and methods: The erosive potential of lollipops was determined in vitro by measuring the pH and neutralisable acidity. Subsequently, 10 healthy volunteers tested different types of lollipops. Whole saliva was collected 5 min before, 15 min during and 10 min after consumption. Salivary ow rate and pH were determined. Results: Fruit avored and cola avored lollipops have a very low pH (2.32.4). Yogurt-containing and salmiak avored lollipops have much higher pH values (3.84.7). The neutralisable acidity showed a large variation from <200 ll to >1700 ll 0.1M NaOH. In vivo, lollops induced 2.5 to 4.7-fold increase in salivary ow rate with a concomitant drop in salivary pH. For fruit avored and cola avored lollipops the salivary pH dropped below pH 5.5. For strawberry yogurt and salmiak lollipops, the salivary pH remained above this critical value. The volunteers did not report signicant differences in preferences for the lollipops. Conclusions: Lollipops differ considerable in erosive potential, with fruit avored and cola avored lollipops having the highest risk for developing dental erosion. This information is of use for clinicians counseling juvenile patients with dental erosion.
P09138 Occurrence of Cariogenic microora in infants and their mothers

T. TSERAKHAVA & N. SHAKAVETS Department of Paediatric Dentistry, Belorussian State Medical University Introduction: The purpose of this study was to assess the level of salivary mutans streptococci and lactobacilli in 12-month-old children and their mothers. Patients and methods: 79 infants aged 12.1 months and their mothers were involved. The dental caries status (d14 mft) of the infants was examined, and the salivary mutans streptococci and lactobacilli of the infants as well as their mothers were determined by CRT bacteria (Ivoclar Vivadent/Liechtenstein). Results: 76% of the mothers and 13% of the infants harboured high salivary MS counts. 4% of the mothers and 72% of the infants harboured the lowest salivary MS count. The levels of MS in saliva of mothers and infants with high MS scores had the medium strength of straight correlation (r = 0.43). 86.1% of the
Poster Sessions
Poster Session P10/Jens Andreasen Award

P10139 Discolouration of teeth following avulsion and replantation, a randomised controlled trial
P. F. DAY1, M. S. DUGGAL1, A. HIGH2, A. ROBERTSON3 & S. WESTLAND4 1 Department of Paediatric Dentistry,2Department of Oral Pathology,3Department of Medical & Dental and4School of Design, University of Leeds, UK Introduction: Currently nonsetting calcium hydroxide (Ultracal XS) is recommended as the initial medicament following avulsion and replantation for mature teeth. There is some experimental evidence to suggest Ledermix placed as an inter-visit dressing may improve the periodontal healing following this injury. The aim was to investigate using a multi-centre randomised controlled trial (m-cRCT) the effect of two root canal medicaments (Ledermix and Ultracal XS) on the discolouration of avulsed and replanted teeth. Patients and methods: The effect of any discolouration was investigated in three ways: Patient satisfaction with the colour, clinical photographs taken at baseline and 12 month reviews and estimation of colour change using CIELAB scores for baseline and 12 month photographs. Results: These preliminary results report on 19 patients (23 teeth) recruited to this m-cRCT. Ten patients (12 teeth) were randomised to the Ledermix group and 9 patients (11 teeth) to the Ultracal XS group. At 12 months, 7 patients (all from the Ledermix group) were concerned with the discolouration of their tooth. There was signicant discolouration of teeth from baseline with Ledermix causing a darkening and grey brown discolouration (mean change L* = -5.1, a* = 0.6, b* = -1.2 and DE = 8.1) and Ultracal XS causing a yellowing of teeth (L* = 3.1, a* = 0.5, b* = 3.2 and DE = 6.1). Between the two groups there was a signicant difference for the L* and b* variables (Independent t-Test). Conclusion: Both root canal medicaments cause discolouration, with Ledermix proving less acceptable to patients. Cohen tests. Results were analysed using Fishers Exact tests and Repeated Measures ANOVA. Results: Mean follow up time was 10.8 months. The overall clinical success rate was 95.5% and the overall relative radiographic success rate was 86.4%. There were no statistically signicant differences in clinical or radiographic outcomes between Group 1 and Group 2. Both groups showed a statistically signicant reduction in periapical pathology over time (P < 0.05). A signicant relationship was identied between nondivergent apical anatomy and ideal positioning of the MTA plug (P = 0.04). Interestingly, cervical discolouration was observed in 18.2% of teeth after MTA placement (all in Group 2). Conclusions: Both commercial brands of white MTA showed similar favourable clinical and radiographic outcomes. One-step apexication using both white MTA ProRoot and white MTA Angelus can be proposed as a suitable, time efcient, acceptable alternative to traditional calcium hydroxide apexication.
P10141 Management of a complicated trauma case of avulsed permanent teeth

A. S. BOUGA & G. P. VADIAKAS Department of Paediatric Dentistry, School of Dentistry, University of Athens, Greece Introduction: A Caucasian 10-year-old boy, presented at the graduate clinic of the paediatric dentistry department, approximately 50 min after having his front teeth knocked out during an accident at school. Teeth were placed into milk immediately after the accident. Extra-oral examination revealed skin lacerations in the perioral region and a deep laceration in the lower lip. Intraorally, teeth #31, 41 & 42 had been avulsed, while tooth #11 had sustained an extrusive luxation injury and #21 an enameldentin crown fracture. An alveolar bone fracture at the anterior region of the mandible was present. Clinical management: a) Immediate treatment: Replantation of #31, 41 & 42 and splinting with an orthodontic wire and resin, repositioning of #11 and splinting, temporary restoration of fractured #21 and instructions to patient and parents b) Following visits: Pulp extirpation and initiation of endodontic treatment in teeth #11, 31, 41 & 42 710 days post-replantation, splint removal after 3 weeks, completion of endodontic treatment, t of a custom made athletic mouth-guard and follow up of traumatized teeth for development of post-traumatic complications. Complications: During treatment (1.5 months post-replantation), multiple sites of external inammatory root resorption in #42, 41 & 31 were noted along with a stula between #41 and 42. After further instrumentation, the resorptive process was arrested 4.5 months later. The 2-year follow up examination revealed no further complications. Conclusion: Early replantation and proper management improves the longevity of avulsed teeth, although, transient inammatory resorption may develop.
P10140 One step apexication using two types of mineral trioxide aggregate
A. MOORE, M. F. HOWLEY & A. C. OCONNELL Department of Public & Child Dental Health, Dublin Dental School and Hospital, Dublin, Ireland Introduction: The clinical and radiographic success of one step apexication in nonvital immature permanent incisors in children was investigated comparing two types of white MTA. Materials and methods: Ethical approval was granted and informed consent was obtained from the parents or guardians of all participants. Twenty-two nonvital traumatised permanent incisors with open apices in 21 children (mean age 10 years) were recruited. Teeth were alternately assigned to Group 1 (white MTA ProRoot) or Group 2 (white MTA Angelus) for apexication. Clinical and radiographic review took place at 3, 6, 12 and 18 months. Two calibrated, blinded examiners evaluated all radiographs. Examiner agreement was assessed using Kappa-
Jens Andreasen Award P10142 Tooth avulsion in growing patients: mini-implant rehabilitation?
A. MURRI DELLO DIAGO & L. GIANNETTI University of Modena and Reggio Emilia, School of Dentistry, Department of Paediatric Introduction: Dental avulsion represents 116% of all dental traumas and denitely has the most therapeutic implications. The most affected age is between 9 and 10 years, the period in which greatest craniofacial growth and development takes place. An immediate replantation is the treatment of choice, although it may not always be possible. In the event that replantation cannot be placed or has failed, the physician is faced with a wide range of treatment options that can affect a patients quality of life. Implant rehabilitation has been considered in growing patients, but implants can act as ankylosed teeth and are unable to follow the normal growth of maxillary bones. The goal of this study was to evaluate the effectiveness of implant-prosthesis rehabilitation in growing patients using mini-implants. Materials and methods: The sample included 12 patients aged from 10 to 14 years. All patients presented missing anterior teeth, requiring insertion of 13 mini-implant xtures with immediate prosthetic loading. Radiographic and clinical evaluations were conducted 1 year or more after the surgical procedure. The aim of the clinical and radiographic evaluation was to exclude the presence of perimplantitis and to evaluate the mini-implant infraocclusion. Results: No patients showed perimplantitis. All patients showed low values of infra-occlusion of the mini-implant-supported crowns: the vertical step measured on radiographs varied between 0.28 and 1.35 mm. Conclusion: The proposed technique made it possible to obtain rehabilitation of the traumatised frontal section in a single session, with immediate high aesthetic and functional success, and high patient satisfaction. follow-up period of 1 year. The following variables were registered: sex, age, type of luxation injury, associated hard tissue injuries, complications, stage of root development, severity of injury, treatment method. Results: A total of 226 luxated incisors were included in the study. Pulp necrosis was the most frequent complication developed, associated mostly with intrusive luxation (72%), followed by lateral (27%) and extrusive luxation (26%) and subluxation (11%). Intrusions yielded the highest frequency of root resorption (48%), while lower frequencies were found in other types of luxation (3 23%). Signicantly higher prevalences of pulp necrosis in lateral and extrusive luxation were found among teeth with fully developed roots (P < 0.05). More severely intruded teeth showed increased prevalences of pulp necrosis (P < 0.001), however, even in teeth with a mild intrusion, pulp necrosis developed in a high prevalence (56%), regardless of the stage of root formation. Conclusion: Pulp necrosis is the most frequent complication following luxation injuries and is mostly related to the stage of root development. The occurrence of pulp necrosis is increased in more severely intruded teeth, although the risk is high, even in cases of a mild intrusion.
P10145 Parents ability to recall past injuries to maxillary primary incisors in their children
K. SHEINVALD-SHUSTERMAN & G. HOLAN Department of Pediatric Dentistry, The Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel Introduction: We evaluated parents ability to recall past injuries to their childrens maxillary primary incisors. Materials and methods: Clinical and radiographic trauma-related major and minor signs observed in the rst dental visit of 727 preschool children, were recorded. Major signs included: crown fracture, coronal discoloration, internal resorption, pulp canal obliteration, swelling, stula and periapical lesion. Minor signs included: enamel cracks, sensitivity to percussion, dull or metallic sound on percussion, increased mobility and widened periodontal ligament. Children were divided into groups: CT-certainly traumatized (presenting major signs or combination of three minor signs), PT-Probably traumatized (presenting 1 or 2 minor signs) and NT-not traumatized. Accompanying parents were asked to recall past injuries to their childs teeth. Possible replies were: no; yes and probably yes. Disagreement between parents was recorded as yes. Crown fracture, coronal discoloration, swelling, stula and avulsion were dened as observable signs of trauma. Results: 118 (16.2%) children were accompanied by fathers, 411 (56.6%) by mothers and 198 (27.2%) by both. CT-group had 464 (63.8%) children, PT-group 103 (14.2%) and NT-group 160 (22%), with no gender pre-dilection. Parents positive recall was similar for boys (33.3%) and girls (31.0%). Mothers recalled trauma in 32.6% and fathers in 27.1%. Parents failed to recall trauma in 52.6% of the CT-group children and in 43.5% of the PT-group children. Parents failed to recall trauma in 51.6% of the children who had observable signs of trauma. Conclusion: Parents denial of a previous dental trauma in their childrens primary incisors is reliable in less than 50%.
P10143 Abstract withdrawn P10144 Luxation injuries to permanent incisors-factors affecting development of complications
G. VADIAKAS, I. VASILOUDIS, A. BOUGA & L. PAPAGIANNOULIS Department of Paediatric Dentistry, School of Dentistry, University of Athens, Greece Introduction: The aim was to study the occurrence of posttraumatic healing complications in luxated permanent incisors and factors that are possibly related to their development. Materials and methods: The study material was based on longitudinal data sets from dental records of patients at a pediatric dental trauma clinic. Dental records of 252 patients were reviewed. All teeth were treated during the period 20002009 with a minimum
Poster Sessions
Poster Session P11/Dental Trauma

P11146 Mineral trioxide aggregate in the treatment of internal root resorption: case report
_ C. DEVECI Department of Pedodontics, Gazi University Faculty of Dentistry, Ankara, Turkey Introduction: Hard tissues of the permanent teeth may undergo inammatory internal root resorption as a consequence of trauma. Once detected, treatment must aim the complete removal of the resorptive tissue from the root canal system with attempt to prevent further loss of hard tissue. Mineral trioxide aggregate (MTA) has satisfactory properties for solving many endodontic problems, including: biocompatibility, favourable sealing ability, mechanical strength and a capacity to promote periradicular tissue healing. The aim of this case report is to describe the treatment and 3-year follow-up of an inammatory internal root resorption case due to trauma managed by the combination of root canal treatment and internal MTA repair. Clinical management: A 9-year-old female patient with traumatic internal root resorption affecting tooth 11 (FDI) was presented. Late referral of patient caused substantial loss of tooth structure, including cementum and chronic apical inammation. Root canal therapy was initiated with massive irrigation of 5% NaOCl and calcium hydroxide paste for 10 months. Then, the resorption defects were repaired with MTA and the canal treatment completed with AH 26 and gutta-percha point. The nal restorations were nished with glass-ionomer cement covered with light-cured resin composite. Follow-up radiographs over 36 months demonstrated the maintenance of functional teeth. No complications were observed during this follow-up period. Conclusion: Internal root resorption following trauma is a common complication violating the viability of the permanent teeth. MTA serves as an adequate treatment option in the treatment of these cases afterwards massive debridement and calcium hydroxide paste dressing for the infection eradication. was employed to test the signicance of association between variables. Results: 80.6% professionals and 37.7% semiprofessional athletes had an experience of oral soft tissue laceration and dental injuries in basketball practice. The difference between the two groups is signicant (P < 0.05). The incidence of dental and oral injuries was related to the length of training time (P < 0.01). About 59% of athletes ranked the risk of orofacial and dental injury in basketball as medium. Although the awareness of mouthguards among the basketball players was very high (80.1%), only one of them had used the custom-made mouthguard. Most of the athletes gained the knowledge about mouthguards from foreign players (33.5%), media (24.8%) and teammates/classmates. Conclusion: Athletes should be informed about the high risk of oral injuries when participating in contact sports. Dentists should play a more signicant role in the program of promoting mouthguard use to prevent oral injury occurring in sport participation.
P11148 Anastrophic impacted maxillary permanent incisor: a case report

S. JUNG1, F. OBRY1, R. MATHIS2 & M. C. MANIERE1 1 Department of Paediatric Dentistry; 2Faculty of Dentistry, Department of Orthodontics, Strasbourg, France Introduction: Traumas occurring in primary dentition can lead to developmental disturbances of the underlying permanent tooth germs, including eruption abnormalities. Anastrophy, which corresponds to a 180 rotation of the developing tooth germ, remains however rare. Clinical management: A 6-year-old girl was referred to the Department of Paediatric Dentistry of Strasbourg for asymmetric eruption of permanent central incisors. History of dento-alveolar trauma affecting the primary incisors during early childhood was reported by the parents. Previous extraction of a mesiodens was performed at the age of 5. Oral examination revealed presence of the left permanent central incisor with persistence of the contralateral primary tooth. Panoramic radiograph and computedtomography showed anastrophic impaction of the right permanent central incisor, which was located just below the nasal cavity oor. A second supernumerary tooth in a median location was also identied. Removal of the mesiodens and the right central primary incisor followed by surgical exposure and bonding of an orthodontic attachment on the vestibular face of the anastrophic impacted tooth were performed under general anaesthesia. The orthodontic traction with upper xed appliance and elastomeric chain allowed to move the right permanent central incisor into its physiological position in about 20 months. Conclusion: This case report underlies the importance of a close clinical and radiological follow-up after traumatic injuries in primary dentition in order to allow an early management of the sequelae of permanent germs.
P11147 Basketball players experience of dental injury and awareness about mouthguard in China
W. L. MA Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, China Introduction: The objective of the present study was to describe the occurrence of orofacial, particularly dental injuries in basketball, and to survey the athletes awareness concerning the use of mouthguards during basketball training and competition. Patients and methods: A pilot questionnaire was designed and tested with basketball players. Two hundred and thirty-six male athletes were surveyed. Seventy-seven players were professional players. The others were semiprofessionals. The questionnaire contained the time of basketball training, the knowledge and attitude toward mouthguards, the evaluation of the dental injury risk in basketball, and the awareness of dental injury prevention. All data were entered into the SPSS 10.0 database. Descriptives and crosstabs were used for the data while the chi-square statistic
Dental Trauma P11149 Restoration using the avulsed crown following loss of an upper permanent incisor
M. EIDE, A. KEIGHTLEY & C. CAMPBELL Department of Child Dental Health, Glasgow Dental Hospital and School, Glasgow, Scotland, UK Introduction: An 8-year-old male attended after 16 h, having sustained an avulsion injury to the upper left central incisor (UL1) the previous evening during a fall at Laser Quest. At the initial visit the child believed the avulsed tooth was swallowed, as it had not been found. On examination, the patient was in the mixed dentition, with an upper partially erupted left lateral incisor. The UL1 socket was beginning to heal. A periapical radiograph conrmed the avulsion of the UL1. However, the patient returned the next day with the UL1 stored in milk, having found the avulsed incisor at the Laser Quest Arena. The accident and emergency referral for a chest x-ray was now unnecessary. Clinical management: At the initial visit, impressions were taken to provide the patient with an upper removable appliance to replace the UL1. Upon retrieval of the avulsed UL1, the patient and parent were eager to proceed with using the avulsed crown as a composite and wire retained bridge pontic. The case will be reviewed regularly on the departments trauma clinic to ensure continued aesthetic and functional success. The eruption of the upper lateral incisors will be closely monitored. Conclusion: Avulsion of permanent teeth constitutes 0.53% of reported dental injuries. The best aesthetic results are achieved by re-implantation of the avulsed tooth. This is not always possible. An alternative restorative method using the natural crown as a resin-retained bridge pontic also allows for a good aesthetic result. early endodontic treatment by their necrosis, in order to avoid infections elsewhere in the body.
P11151 Esthetic management of complicated crown fracture in an immature permanent incisor

S. SHIFA, M. S. MUTHU, M. FARZAN, V. CHARANYA & S. A. GOURI Pedo Planet, Pediatric Dental Centre, Chennai, India Introduction: Dental trauma is common in the pediatric population with dental injuries occurring with a prevalence of 619% for all children and adolescents. Crown fractures are fractures involving enamel and dentin and it can be complicated with the involvement of pulp or uncomplicated without the involvement of pulp. Use of the fractured fragment in the restoration of a fractured tooth is always advantageous when compared to other treatment options like ceramic/composite restorations or prosthetic rehabilitation. Clinical management: An 8-year-old boy accompanied by his parents, reported to Pedo Planet Pediatric Dental Center, Chennai, India with the complaint of fractured upper front teeth during play approximately 8 h before. Intraoral examination revealed that the patient had horizontal complicated crown fracture in 21, the entire coronal pulp exposed and the fracture line was at the cervical third of the crown. An oblique complicated crown fracture was also seen in 11 with a pinpoint exposure of the mesial pulp horn. Direct pulp capping was done in 11 and composite build up was done. Apex was closed in 21 with MTA (apical barrier technique) intracanal composite post was placed and fragment reattachment was done. Follow up of the tooth after 3 and 8 months showed a good outcome. Conclusion: This case discusses management of complicated crown fracture with fragment reattachment aided with apical barrier technique and placement of intracanal bonded composites.
P11150 From intrusive luxation to acute relapsing glomerular nephritis

K. GINZELOVA Department of Paediatric Stomatology, Charles University, 2nd Medical School, Prague, Czech Republic Introduction: Serious periodontal soft tissue injuries can result from intrusive luxation during deciduous dentition. The trauma intrudes the deciduous tooth into the dental alveolus. Children aged 13 years are most often affected. Materials and methods: During 6 months, a 12-month-old childs intruded tooth spontaneously re-emerged. The parents neglected to bring their child for subsequent examinations of the reerupted tooth. At age 4, the child suffered 4 serious renal infections in 6 months. A stomatological examination discovered necrosis and periapical enlargement of the tooth that was traumatized 3 years earlier. Given the diagnosis and the patients age (5 years), the tooth was extracted. A comparison of bacteriological tests of the patients urine and extracted tooth conrmed identical discovery of the infection. Twelve months passed after the extraction without a reccurrence of renal infection. The permanent tooth has yet to emerge. During the past 5 years (20042008) we have diagnosed 11 intruded deciduous teeth in 11 children. Results: Based on identical bacteriological test results of urine and the extracted tooth, and considering that there was no reccurence of renal infection for a year after extraction, we believe that the source of the urinary tract infections was the endodontic untreated deciduous tooth. Of 11 other cases of intruded teeth, only two resulted in dental necrosis. These, however, received proper treatment in time. Conclusion: The purpose of this presentation is to highlight the importance of following the teeth after trauma and performing
P11152 Unraveling permanent incisor a case report

C. SAMPATH REDDY Department of Pedodontics, Sri Sai College of Dental Surgery, Vikarabad, India Introduction: An 8-year-old girl reported with an unaesthetic smile due to unerupted permanent central incisors in the maxillary anterior region. Clinical and Radiographic examination revealed intruded tooth # 51, facial and distal migration of # 11 and 21 which were impacted. History revealed that the child fell down at 9 months of age, losing tooth # 61 and missing # 51 which was in fact intruded. The intrusion of # 51 due to trauma clearly caused disturbance in tooth mineralization of # 11 and 21 and also affected teeth # 12 and 22. Clinical management: On Surgical exposure # 12, 51, 11 and 21 were visible, teeth # 21 and 12 were in line of eruption, tooth # 51 was intruded, and tooth # 11 was displaced labially and distally. Evident enamel hypoplastic changes were seen in teeth # 21, 11 and 12. Extraction of # 51 was done. Enough windows were created for eruption of # 12 and 21 and composite built up for teeth # 11 and 21 was planned after complete eruption. Conclusion: The enamel hypoplastic changes in permanent teeth vary depending on the intensity of trauma to primary teeth, timing of the injury and stage of permanent tooth formation at the time of trauma. The child needs regular follow up till the teeth #11 and 21 are completely erupted. Alignment & aesthetics will be needed in future.
Poster Sessions P11153 Multidisciplinary treatment to a subgingival complicated crown-root fracture

J. WANG & P. F. MAO Department of Pediatric Dentistry, School of Dentistry, Shanghai Jiao Tong University, Shanghai, China Introduction: A 12-year-old boy fractured his right maxillary central incisor following a bicycle accident. The fracture line was located 1 mm supra-gingivally on the labial aspect, and extended to the mesio-palatal area subgingivally, minimally invading the biological width. The fragment was still connected with the tooth by some dentin and cemetum on the palatal aspect. Pulpal exposure was observed. The root was fully developed and there was no apparent periapical pathosis. Clinical management: The fragment was stabilized to the tooth remnant in its original place using temporary wire composite splint. The fracture line was sealed with glass-ionomer cement temporally. 2 weeks after root canal therapy, the restoration of the tooth was performed using fragment reattachment with ber post. The root canal was shaped for matching post according to manufacturers instruction, then the splint and the glass-ionomer cement sealer were removed, the fragment was reattached using owable composite and RelyX Fiber Post(3M) was cemented. Finally, a circumferential bevel along the fracture line was prepared. The bevel and the cavity of the pulp chamber entrance were lled with resin (Z250, 3M). Clinical examination was conducted at 1-, 6-, 12and 18-month for follow-up, and it was observed that both endodontic and restorative treatments remained clinically acceptable for the entire time. Conclusion: With the aid of temporary splint and ber post, it may be an alternative procedure to stabilize the fragment in its original position in stead of extracting in cases of subgingival complicated crown-root fracture that minimally invades the biological width. Conclusions: There was a tendency of root canals of fractured teeth to narrow and become obturated after pulpotomy from radiograph. It should not be followed up for too long a time when the roots have completely formed; nally, root canal treatment should be performed on the teeth.
P11155 Prevalence of traumatic dental injuries in pre-school children in Brazil

D. HESSE1, G. A. V. C. BONINI1, C. C. BONIFACIO2, F. M. MENDES1 & M. BONECKER1 1 Department of Pediatric Dentistry, Dental School, University of Sao Paulo, Sao Paulo, Brazil; 2Department of Pediatric Dentistry, ACTA, Amsterdam, The Netherlands Introduction: Traumatic dental injuries (TDI) constitute an important public health problem due to its high prevalence and negative impact on childrens quality of life. Epidemiological studies suggest that TDI at this age varies from 10 to 38%. The aim of this study was to verify the prevalence of TDI in pre-school children and its associated factors. Patients and methods: The study was approved by Local Ethical Committee and written consent was obtained from childrens guardian. A cross-sectional survey was performed through clinical examination of 359 pre-school children (aged 13 years) enrolled in 12 public nursery schools in Itatiba, Brazil. Socioeconomic factors were assessed by questionnaire to parents (Jarman index). Clinical exams were performed by two examiners previously trained and calibrated (kappa = 0.65 to 1.00) regarding TDI (Andreasen criteria) and malocclusion (Moyers criteria). Poisson regression was performed to evaluate the association of TDI and explanatory variables and then, prevalence ratio (PR) and 95% condence interval (95%CI) were calculated. Results: The results showed that TDI were identied in 52.9% of children. Poisson regression after adjusting showed higher prevalence of TDI in children with 3 years old compared to younger (PR = 1,55; 95% CI = (1.092.19). Prevalence for children living with more than 5 people at the same house was lower than for children living with 3 people or less (PR = 0.69; 95% CI = 0.50 0.97). Prevalence for children with overjet (PR = 1.23; 95% CI = 1.011.49) was higher than for those with crossbite (PR = 0.58; 95% CI = 0.350.96). Conclusion: There was a high prevalence of dental trauma in preschool children. Prevalence increased with age and it was related to malocclusion.
P11154 The clinical and radiographic changes of fractured immature teeth after pulpotomy
R. Z. JIA RZ1, S. G. ZHENG2 & G. ZHANG2 1 Pedodontic Department, Capital Medical University School of Stomatology; 2Pedodontic Department, Peking University School of Stomatology, Beijing, China Introduction: To observe the radiographic representation of immature anterior fractured permanent teeth after pulpotomy, this was followed by radiographic measurements. Thereafter, it may be used as a reference for deciding whether root canal treatment should be done after the roots have completely formed. Materials and methods: Information on 31 immature anterior fractured permanent teeth after pulpotomy (25 cases) was analyzed retrospectively. Radiographic measurements were separately taken of 100 healthy maxillary central incisors (50 cases) and the maxillary central incisors of 12 cases after pulpotomy in which roots had completely formed. We had obtained permission from the institutional ethical committee (IRB00001052-06016). Results: Roots could continue developing after pulpotomy, root length and periapical conguration were both similar in healthy teeth, but some root canals could become narrow, even almost obturated in the apical direction of the root. The measurements showed there was no signicant difference of root canal width between healthy right and left maxillary central incisors at the site of 1/4, 1/2, 3/4 of the root, but in the pulpotomy group, the root canal width at the same site of the teeth differed signicantly from the contralateral healthy incisor.
P11156 Traumatic injuries of permanent teeth in schoolchildren _ in Kadkoy region of Istanbul

U. KABALAY, J. ATUKEREN, Y. AYDIN, B. DOGUSOY & S. ERGENELI Kadkoy Municipalitys Dental Clinics, Kadikoy, Istanbul, Turkey Introduction: The purpose of this study was to assess the incidence of dental traumatic injuries to the anterior teeth of public _ schoolchildren, living in Kadkoy region of Istanbul, Turkey. Materials and methods: In whole 204 teeth of 7- to 15-year-old schoolchildren were examined in Kadkoy Municipalitys dental clinics. A total of 256 traumatized were evaluated. Results: More boys (61%) suffered traumatic injuries than girls (39%). Maxillary central incisors were the most affected teeth (92%) and the most common type of crown injury was the enameldentin fracture (57%). Falls were the major cause of the trauma (65%). 24.5% of injuries involved more than one tooth. Great
Dental Trauma
proportions of the traumatized teeth were not treated after the injury (92%). Conclusion: Educational programs about the dental injuries for parents and teachers are very important in the management of dental trauma. Dentists should be more knowledgeable and careful about the consequences of a delay. patients (11.36%) might have beneted. Contact sports commonly a cause of avulsions did not occur in this audit, i.e., rugby. This may have been because mouthguards were worn in these sports. The causes of avulsions in this audit suggest that preventing all sports avulsions would require a mouthguard for even the most casual of sporting activity. This would be impractical.
P11157 Epidemiological survey of dentofacial trauma occurrence on children at county emergency unit
A. J. NOGUEIRA, R. NOGUEIRA & G. F. EMMI , , Federal University of Para Odontology, Belem, Para Brazil Introduction: This study reveals the occurrence of trauma on children from 0 to 12 years old, producing an epidemiological map through identication of the most frequent trauma type, predominant cause, time passed until professional treatment, the most susceptible gender and age, furthermore to establish the relation between age and type of trauma. Materials and methods: 152 children from 0 to 12 years old were registered without distinction of race or gender in a period of six months in the Emergency Unit of Ananindeua country ParaBrasil. Results: On the survey 176 types of trauma were registered, 5 (3%) on dental tissue, 50 (28%) on periodontal tissue, 14 (8%) on bone support and 107 (61%) on the gum or oral mucosa. The main trauma causes were: 73 (47%) falling down, 48 (32%) practicing sports, 4 (3%) physical aggression, and 27 (18%) other causes. Only 148 had information concerning the time passed until they started receiving treatment, where 76 (52%) looked for treatment in 30 min, 28 (19%) between 30 min and 60 min, 11 (7%) between 1 h and 2 h and 33 (22%) more than 2 h after the trauma occurred. 94 (62%) were males and 58 (38%) were females. Conclusion: The conclusion reached is that the gum and oral mucosa lesions are the most frequent types of trauma, featuring at all ages, and falling down is the most related cause. The patients arrive at the Emergency Unit in 30 min, most frequently seen on males, and the trauma frequency decreases as the children grow up.
P11159 Traumatic dental injuries in children with attention decit/hyperactivity disorder

A. AVSAR1, S. AKBAS2 & T. ATAIBIS1 1 Department of Pedodontics, Ondokuz Mays University; 2Faculty of Medicine, Department of Paediatric Stomatology, Samsun, Turkey Introduction: The aim of this study was to assess the frequency and distribution of traumatic injuries in 247 children with attention decit/hyperactivity disorder who were 716 years old and attended the Ondokuz Mays University, Medical Faculty, Department of Child Psychiatry at Samsun, Turkey. Patients and methods: This study was approved by the Ethical Committee of Ondokuz Mays University. Written informed consent was obtained from the parents. Each psychiatric diagnosis was based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Traumatic dental injuries were recorded using the classication of the Andreasen & Andreasen. All of the data were analyzed using a Chi-square test. Results: Thirty-two per cent of the ADHD children presented 103 traumatized teeth. The frequency of dental injuries peaked in children who were 1012 years of age, and showed no signicant difference between subtypes of ADHD or gender. The maxillary central incisors were the most vulnerable to injury, and there were no differences between the right and the left sides in terms of susceptibility. Uncomplicated crown fracture (52.4%) and complicated crown fracture (16.6%) were the most commonly encountered types of injury. The main causes of dental injury were falls, collisions with objects, violence, and trafc accidents, and there was no difference in the frequencies of these causes between subtypes of ADHD, age, or gender. Only 5.1% of the ADHD children sought treatment within the rst 24 h of the injury. Conclusions: Children with ADHD were at an increased risk of traumatic dental injuries.
P11158 How many avulsions are preventable?

A. KEIGHTLEY1, G. WRIGHT1 & R. WELBURY2 1 Glasgow Dental Hospital & School; 2University of Glasgow Dental School, Glasgow, Scotland Introduction: To identify the number of avulsions during sporting activity that may prevented by mouthguards. Materials and methods: A retrospective audit of cases notes of avulsion cases caused by sport between 2001 and 2007. Data was extracted for gender, age at trauma, cause of avulsion, and number of teeth avulsed. Results: 68 teeth from 44 patients were included. 27 patients (61.36%) were male. Mean age at time of avulsion was 10 years for males (SD 32 months), and 9 years 4 months for females (SD 33 months). Numbers of avulsion patients by each sport were: cycling 16 (36.4%); trampoline 5 (11.4%); golf 5 (11.4%); soccer 4 (9.1%); swimming 3 (6.8%); skateboard 3 (6.8%); scooter 2 (4.6%); motorsport 2 (4.6%); horse riding 2 (4.6%); hockey 1 (2.3%); and cricket 1 (2.3%). Number of teeth avulsed by each sport were: cycling 20 (29.4%); horse riding 10 (14.7%); trampoline 9 (13.2%); golf 6 (8.8%); soccer 5 (7.4%); motorsport 5 (7.4%); skateboard 4 (5.9%); swimming 3 (4.4%); scooter 3 (4.4%); hockey 2 (2.9%); cricket 1 (1.5%). Conclusion: If soccer, hockey and cricket are the sports where a mouthguard would normally be recommended then only ve
P11160 The prole of dental trauma presenting to a specialist centre recorded on a computer database
P. KANDIAH & P. DAY Department of Paediatric Dentistry at the Leeds Dental Institute, Leeds, UK Introduction: The computer database for dento-alveolar trauma (CDDT) was introduced to prospectively record paediatric trauma cases presenting to Leeds Dental Institute. We present a prole of trauma seen at this specialist centre compiled using this database. Patients and methods: Trauma details from patients presenting in the rst 16 months (April 2007August 2008) of the CDDT were analysed. This included the frequency of different diagnoses, gender, day and month of presentation. Results: 171 children presented with trauma of which 78% involved permanent teeth, 20% involved primary teeth and 2% were injuries to the mixed dentition. The mean number of teeth injured in both dentitions was 2. Almost 60% of the trauma cases involved boys. The mean age of trauma presentation was 2.9 years old for primary and 11 years old for permanent teeth. The peak days of presentation were on Mondays and Wednesdays and the peak months were June and August 2007. 77% of the primary teeth
Poster Sessions
injured presented with injuries to the PDL alone, with 21% of the injuries involving both hard tissue and the PDL. In the permanent dentition 43% teeth had only PDL injuries, 23% had hard tissue fractures only and 34% had hard tissue fractures and PDL injuries. Conclusion: The CDDT provides a systematic method of recording and analysing dental trauma data such as the results presented in this study. The CDDT can compile a detailed prole of any clinical unit or clinicians trauma workload in Britain. CDDT is available via the secure N3 NHS network. of their traumatised permanent incisors were invited to take part in the study. Coping strategies, social support, oral health related and general health related quality of life (OHRQoL) (HRQoL) were assessed using postal questionnaires. Clinical information regarding the childs dental injury was obtained from patient records. Written informed consent was obtained from parents and ethical approval was obtained from Shefeld National Research Ethics Service. Two multiple linear regressions were conducted for OHRQoL and HRQoL. Results: 108 children completed and returned the questionnaires (44% response rate). Participants had a mean age of 12 years (range = 716) and 62% were males. No relationship existed between clinical variables and impact. Predictors of OHRQoL were gender, use of behavioural avoidance coping strategies and time since injury. These variables explained 31% of the variance within OHRQoL. Predictors of HRQoL in children were OHRQoL, the use of behavioural avoidance strategies and peer social support. These variables explained 59% of the variance within HRQoL. Conclusion: This study demonstrates that there are important psychosocial factors which predict childhood adjustment to dental trauma. The clinical and theoretical implications of these ndings are discussed.
P11161 Retrospective analysis of dentofacial trauma patients attending the Royal Childrens Hospital, Melbourne
F. SOLDANI, N. KILPATRICK & J. LUCAS Department of Dentistry, Royal Childrens Hospital, Melbourne, Australia Introduction: The aim of this study was to examine age, gender, type of injury, aetiology of injury, time to presentation, complexity of injury and outcome at one-year post-dentofacial trauma. Patients and methods: Retrospective case note analysis of all patients attending the Royal Childrens Hospital, Melbourne with a dentofacial injury between April 2006 and March 2007. Results: The departmental database identied 253 children who had experienced a dentofacial injury. Of these, 160 sets of records were preliminarily available for data collection. In total 324 injured teeth were noted: 245 primary and 79 permanent teeth. The peak age for trauma was seen in the 03-year-old age range (52%), with males representing 59% of the study population. The mean time from injury to presentation was 8.6 h with 69% of injuries occurring indoors. The maxillary central incisors were the most commonly affected tooth in both the primary and permanent dentition (65% and 65%, respectively). The majority of primary and permanent tooth injuries were periodontal/luxation injuries only (86% and 48%, respectively). Complex injuries affecting both periodontal and dental hard tissue occurred in 4% of primary injuries and 15% of permanent injuries. Outcome at one-year posttrauma was dependent upon the pulp/periodontal status of the patient with no long-term follow-up required or patient discharged occurring in 38% and 43%, respectively. Conclusion: The results of this study emphasise the complexity of the management of dental trauma and the numerous factors involved. To aid in the development of management protocols data for dentofacial trauma should be recorded consistently.
P11163 Predictors for pulp necrosis in permanent incisors following crown fractures with concurrent luxation
E. F. LAURIDSEN1, N. V. HERMANN1, S. A. CHRISTENSEN2 & J. O. ANDREASEN3 1 Faculty of Health Sciences, Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, University of Copenhagen; 2 Resource Centre for Rare Oral Diseases, Copenhagen University Hospital; 3Department of Oral and Maxillo-facial Surgery, Resource Centre for Rare Oral Diseases, Copenhagen University Hospital, Copenhagen, Denmark Introduction: The purpose of the study was to identify and weight predictors for pulp necrosis (PN) following crown fractures with or without a concurrent luxation injury. Materials and methods: The study material includes 803 permanent teeth with crown fractures (infractions, enamel fractures, enameldentin fractures and complicated fractures) of which 573 have a concurrent luxation injury (concussion, subluxation, extrusion, lateral luxation or intrusion). The teeth were compared to a group of 565 luxated teeth without crown fracture. All teeth were examined according to standardized protocol including clinical, photographic, and radiographic registration. Initial treatment was provided at the Copenhagen University Hospital from 1972 to 1985 with a follow-up period ranging from 10 month to 22 years. Logistic regression analysis was performed to identify and weigh predictors. Results: Following predictors were signicantly related to PN: type of luxation, type of crown fracture, pulp test at time of injury, and root development. The results indicate that especially enameldentin fractures and infractions contribute to the risk of PN, which is probably due to the possible access of bacteria in to the pulp via dentinal tubules. Conclusion: The model showed that crown fractures increase the risk of PN signicantly for all types of luxation. Type of luxation, pulp test at time of injury and root development was however equally strong or stronger predictors and have to be taken in to consideration when making a risk assessment.
P11162 Factors that inuence childrens psychosocial adjustment to dentoalveolar trauma

J. M. PORRITT, S. R. BAKER & H. D. RODD Department of Oral Health and Development, University of Shefeld, Shefeld, UK Introduction: Dentoalveolar trauma occurs commonly in childhood and may necessitate demanding courses of treatment. However, there has been little research investigating the psychosocial impact of such dental injuries. The aim of this study was to explore the psychosocial factors which inuence childhood adjustment to dental trauma, sequelae and related treatment. Patients and methods: 244 children who attended the paediatric dental clinic, Charles Clifford Hospital, Shefeld, for management
Epidemiology 1
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P12164 Early childhood caries in children up to 4 years of age in Chile
M. E. GUEVARA, G. SIFRI, C. BARRIOS, N. TORRES & M. CUEVAS n, Pediatric Department, San Sebastian University, Concepcio Chile Introduction: The prevalence of ECC (Early Childhood Caries) has been a signicant public health issue. For this reason, it has been studied in children two and four years old. As a pathology, it is considered to be severe, of rapid advance, aggressive, expensive and difcult to handle. The main objective of our investigation was to determine the prevalence in a population of 500 children at social risk in the age group of 04 years. Patients and methods: We examined 180 Chilean children from ve Integra kindergartens in SanPedro, VIII Region. The exam was conducted by only one examiner, during the morning, with a dental mirror and a frontal LED lamp, from December 2007 to January 2008. The data was registered in the WHO Medical Records and we used the dmft for the calculation of caries. For the statistical calculations, we used the SPSS 15.0. Results: The dmft was higher among girls (2.7) with a prevalence of 53%. Among boys, the dmft was 2.3 with a prevalence of 44%. The dmft was zero in children that were 0 to 11 months old. For those who were 12 to 23 months old, it was 1.05 with a prevalence of 17%, from 24 to 35 months old, it was 1.65 with a 26% prevalence, and among children 36 months and older, the dmft came to 4.68 with a prevalence of 57%. Conclusions: The prevalence of ECC in children 04 year-olds was 49%. The dmft was 2.5 on average. Therefore, it is urgent and necessary to implement caries preventive programs for these children and to do research on the risk factors that inuence the prevalence of cavities of this pathology. The patron was San Sebastian University. overweight were 2.25, 3.45, 2.5 and 2.78 respectively. The least amount of decay and llings was seen in those who were underweight and the most amount of decay and llings was observed in those at risk of overweight (P = 0.03). Furthermore the mean of weight in children with 5 decays and more was signicantly higher than that of others (P = 0.002). By increasing the educational level of parents, the percentage of caries decreased signicantly in children (P < 0.0001).There was no signicant relation between dft and BMI(r = 0.016, P = 0.69). Conclusion: The lowest and the highest dft values were observed in underweight and at risk of overweight respectively. Also, by increasing the mean of weight, the decay increased signicantly, and parents with high educational level had more caries free children.
P12166 Caries pattern and the related socio-economic factors in pre-school children in Taiwan
Y. S. HONG1, S. T. HUANG2,3,4, S. Y. HSIAO4 & H. Y. LIU1 1 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University; 2Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University; 3 Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 4Department of Dentistry, Division of Pediatric Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Introduction: The purpose of this study was to determine the caries pattern and the relationship between caries and socio-economic factors in pre-school children in Taiwan. Materials and methods: Stratied multi-stage cluster sampling was used in this cross-sectional study. A total number of 3044 children aged 36 years throughout Taiwan received an oral examination. Each subject was categorized into one of the ve caries patterns: caries free, pit and ssure defects, facial-lingual lesions, molar approximal lesions and facial-lingual with molar approximal lesions. The socio-economic status of childrens family was assessed by parental occupation and education level. The Chi-square test was used to analyse the association between caries patterns and socio-economic factors. Results: The percentage of caries-free children decreased with age, only 26.5% of total samples were caries-free in 5-year-old children. The facial-lingual pattern along with the pit and ssure pattern show a slight decrease from 3- to 5-year-olds, while the faciallingual/molar approximal pattern increases signicantly with age. The molar approximal pattern occupies the least part among all age groups. Children from families with a higher socio-economic status have lower caries rates. Conclusion: Caries pattern of pre-school children changes with age. Most of the caries lesions were observed in the investigated age group were located on smooth surfaces. Socioeconomic factors are related to caries pattern in pre-school children.
P12165 The relation between dental caries and BMI in preschool children in Babol, Iran
M. GHASEMPOUR, K. HAJIAN, Z. MOAZEZY & M. ZAVAR Pediatric Dentistry Department, Babol University of Medical Sciences, Iran Introduction: The aim of this study was to evaluate the relationship between dental caries and BMI in pre-school children. Materials and Method: This descriptive-analytical study was on 600 pre-school children of kindergartens in Babol, Iran. The (dft) counts were obtained. The Body mass index (BMI; kg/m2) was calculated, and participants were categorized using age- and gender-specic criteria as underweight (<5th per cent), normal (5th85th per cent), at risk of overweight (>85th and <95th per cent), and overweight (>/ = 95th per cent). The relationships between dft and BMI were assessed using the chi-square and t-test. Results: Among 600 children, 62% were normal, 22.7% were underweight and 6% of them were at risk of overweight and 9.3% of them were overweight. 32.5% of children were caries free and mean dft values in underweight, normal, at risk of overweight and
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Poster Sessions P12167 Research of sealant treatments for the intervention in school children of Aborigines
H. J. HSIEH1, S. T. HUANG2,3, C. C. TSAI2,4, M. J. CHIOU5 & C. D. LIAO6 1 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University; 2Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University; 3Department of Dentistry, Division of Pediatric Dentistry, Chung-Ho Memorial Hospital, Kaohsiung Medical University; 4Department of Dentistry, Division of Periodontal Dentistry, Chung-Ho Memorial Hospital, Kaohsiung Medical University; 5Taoyuan Township Public Health Center, Kaohsiung County, Taiwan; 6Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: The children in aboriginal area have a worse dental status in comparison to urban. Therefore, the priority of this project was to lower the caries prevalence and to promote oral health. Our program included oral hygiene instructions for one year and follow-ups for a consecutive year. Further, we applied pits and ssures sealants on occlusal surfaces of permanent rst molars in school-children of Tao-Yuan County, Taiwan, to evaluate the dental health outcomes. Materials and methods: The study design is purposive sampling. The treatment group consisted of 122 and the control group of 148 school children aged from 6 to 9 years old (7.54 0.59). The treatment group was examined every 6-month and the pit and ssure sealants were assessed. The control group received oral examination without any treatments. The sealing procedure was performed mainly by dentists and resin-based sealants (3M) were applied. The data were analyzed using the JMP 5.0. Results: The baseline DMFT of treatment and control group were 0.95 and 1.33 respectively. The nal mean DMFT values amounted to 1.54 and 1.62. A total of 589 molars were sealed. In the treatment group 64.85% 40.32 permanent molars were nondecayed an in the control groups 54.42% 37.21. The P-value amounted to 0.0205. Conclusion: Pit and ssure sealant are effective in preventing occlusal caries in permanent molars. 12-year-old children. 0.6 teeth per child needed one-surface restorations and 0.5 teeth needed two-surface restorations. 0.1 teeth needed more than three-surface restoration. 0.2 teeth needed pulp therapy and 0.3 teeth needed extraction. Conclusion: The DMFT index and caries prevalence had increased promptly in this study.
P12169 Assesment of hygiene procedures among dental practitioners in Istanbul, Turkey

N. BEKIROGLU1 & B. KARGUL2 1 Biostatistics Department, Medical School; 2Pediatric Dentistry, Dental School, Marmara University, Istanbul, Turkey Introduction: The risk of infectious disease transmission is an inherent part of dental practice. The aim of this study was to investigate the hygienic quality of dental practices based on the selfawareness expressed by dentists respondents to a questionnaire about the hygiene characteristics of practice and the preventive procedures in general dental practices in Istanbul, Turkey. Materials and methods: In this questionnaire; the ways of cleaning, disinfection, sterilization of the dental equipment and instruments and disposable materials were investigated. The SPSS was used to analyze the data of the study. Results: A Hundred and twenty general dental practitioners were participated to the survey in Istanbul, Turkey. Of the total respondents, 60 were males (50%) and 60 were females (50%). The remarkable point was that the majority of general dental practitioners were applying general infection control procedures in their clinics. As regards general hygiene rules, no statistically signicant differences between genders (P = 0.088) The results were with regard to the protection as follows: 55.5% of the general dental practitioners wear caps, 84.2% wear masks. 87.5% of general dental practitioners wear gloves routinely in their clinical work. 99.2% of them do the oor cleaning daily with using the disinfectant solution. 53.8% of practitioners sterilize their dental equipment and instruments with an autoclave and 90% use an antiseptic or disinfectant solution. Conclusion: In conclusion, the results of this study conrm a good structural and organizational status, but there is the need for further education concerning in a number of areas such as hygiene characteristics of practice and the preventive procedures of crossinfections.
P12168 Oral health status and treatment needs of elementary school children in Taiwan
Y. C. HOU1, Y. S. LIN3, S. T. HUANG1,2 & S. Y. HSIAO1 1 Department of Dentistry, Division of Pediatric Dentistry, Kaohsiung Medical University Hospital; 2Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 3Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: According to previous research the oral health status of Taiwanese elementary school children has to be assessed as low. Current national public health policies include uoride containing mouth rinses and regular tooth brushing in a nationwide schoolbased oral health prevention program. The aim of this study was to analyze the oral health status and treatment needs of children from elementary schools in Taiwan. Materials and methods: 4416 children from 1- to 6-grade schools were recruited by a stratied cluster sampling method with probability proportional to size. Subjects were examined according to WHO (1997) basic methods. Results: In 6-year-old children, DMFT index and caries prevalence of permanent teeth were 0.25 and 10.44%. The DMFT index and caries prevalence of permanent teeth were 2.2 and 67.0% in
P12170 Oral status of 12- to 18-year-old students in Taiwan

J. LIN1,4, S. T. HUANG2,3,4, N. T. WANG1, S. Y. HSIAO4 & H. S. CHEN3,4 1 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University; 2Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University; 3 Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 4Department of Dentistry, Division of Pediatric Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Introduction: The aim of this study was to investigate the current oral status in adolescents aged from 12 to 18 years. Materials and methods: A total of 4416 students from the cities and counties in Taiwan were included in this study. Stratied survey sampling design and Probability Proportional to Size (PPS) were used for the selection of 384 12- to 18-year-old students. Subjects were examined for according WHO (1997) basic method. Data were analyzed using SAS 8.2 and JMP 5.1.
Epidemiology 1
Results: The mean DMFT index for each age group ranged from 2.8 up to 5.1, respectively. The caries prevalence in the permanent dentition was between 42.8% and 57.8%. The mean number of decayed teeth needing treatment was 2.0. The adolescents had an average of 1.2 teeth needing one surface lling. For the plaque index, 81.5% showed a thin or moderate plaque accumulation. In 5.7% of the cases heavy plaque accumulation were found. In 34.7% of the adolescents a mild gingivitis was diagnosed, in 2.8% a severe gingivitis and in 29.5% calculus was found. For the calculus index, 24.9% had less than 1/3 calculus deposit, and only 3.4% had calculus deposition of more than 1/3. For the CPI index, among the participants aged 1518 years 25.97% had healthy gingival tissue, 30.2% had bleeding, 32.8% had calculus deposits, 11.0% had pocket depth more than 45 mm. Conclusion: Compared with the results surveyed in 2000, the oral health status of adolescents aged 1218 years old has improved. The caries prevalence decreased by approximately 30%.
P12172 Caries prevalence of 3- to 12-year-olds in Moscow (Russia)

L. P. KISELNIKOVA, T. E. ZUEVA, M. V. MIROSHKINA, S. I. SOKOLOVA & A. A. ALIBEKOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: Aim of this study was to estimate prevalence and intensity of caries at pre-school and school children in Moscow. Patients and methods: Within the scope of a dental program a clinical dental examination was performed in 641 children (3- to 12year-olds) who were born and live in Moscow. Clinical examination was made by the criteria recommended by WHO (1997). Results: A low caries prevalence of 10.1% was found for the primary dentition in the group of 3 year-olds. Caries prevalence increased with age and amounted to 47.5% in 9-year-old children. The caries prevalence increased in the permanent dentition from 10.3% (6-year-olds) up to 63.1% (12-year-olds). The dmft values were 1.2 0.2 in 4-year-olds and 3.9 0.5 9-year-olds. The DMFT amounted to 0.6 0.1, 1.5 0.2 and 3.5 0.3 in 6-, 8- and 12-year-old children. Conclusion: High caries levels were found in pre-school and school children in Moscow.
P12171 Oral health knowledge of 8- to 12-year-old Turkish children and of their parents
G. SEYDAOGLU1, M. C. DOGAN2, S. UGUZ3, R. S. DILER4 & C. SARITURK1 1 Department of Biostatsitics, University of Pittsburgh, USA; 2 Department of Pedodontics, Faculty of Dentistry, Cukurova University, Adana-Turkey; 3Department of Psychiatry, Faculty of Medicine; 4Western Psychiatric Institute and Clinic, University of Pittsburgh, USA Introduction: This regional cross sectional study should describe oral health behaviors, knowledge and attitudes among 8- to 12-year-old Turkish children and their families. Further we aimed to assess potential risk factors. Materials and methods: A total of 2675 children aged between 8 and 12 years who could read and write were randomly selected from 15 different schools representing a total of 255 schools of Adana. A total of 2458 children were included in the study. Children asked to out ll the self-administered questionnaire in their classroom supervising by a researcher and a questionnaire send to their parents that answered at home. Three different scales have produced based on the questions about knowledge, attitudes and behaviors for children and for their mothers and fathers and compared with t-test and one-way ANOVA. Results: Attitudes towards dental care were found positive; 75.1% of children brushed their teeth regularly and 92.2% of the pupils used uoridated toothpaste. During the previous 12 months 29.6% visited a dentist once or twice and 11.1% for more than three times. In total 69.7% thought that poor oral hygiene may induce dental caries. Other mentioned reasons for dental caries were 1) visiting the dentist not regularly (38.1%), 2) not proper diet (32.8%), 3) using too much antibiotics (27.6%) and heredity (16.4%). The knowledge, attitudes and behavior scales were found to be associated with education of family, age, oral health status, unhealthy lifestyles, socio-economic status and ethnic origins. Conclusion: Community-oriented oral health programs which considering the socio-economical factors should be established.
P12173 Caries patterns of under 3-year-old children in Taiwan

C. T. TSENG1, Y. C. TAI1, S. T. HUANG2,3,4, H. Y. LIU4 & C. C. CHEN1 1 Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University; 2Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 3Department of Dentistry, Division of Pediatric Dentistry, Kaohsiung Medical University Hospital; 4School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: Prevention of Early Childhood Caries should begin in children before the age of three. The aim of this study was to analyze caries status and pattern in <3-year-old Taiwan children. Materials and methods: 672 children under the age of three were selected by stratied cluster sampling in Taiwan. The research was done after permission of the Institutional Review Board. The protocol of examination was based upon the WHO criteria. Additionally, a structured questionnaire was answered by the parents/caregivers. Results: 665 children were examined. The ECC prevalence was 40.7% in 2-year-olds. S-ECC was found in 28.4% of the children, the mean deft/defs index was 1.4/2.0. Caries status deteriorated from age 1 to 2. The mean number of carious teeth was higher in maxillary arch compared to that of the mandibular arch. The most susceptible carious teeth or surfaces were the anterior teeth and their smooth surfaces, followed by pit and ssure area. The risk factor of caries on smooth surfaces was correlated with the plaque accumulative status. The odds ratio of caries induction in children with mild or moderate plaque accumulation is 3.04 or 5.58 times compared to that of children with clean teeth. Conclusions: The caries status of children under three years old is still poor in Taiwan. Prevention programs should be implemented.
Poster Sessions P12174 Oral health and molar-incisor-hypomineralisations (MIH) in Turkish children
E. YAMAC YILMAZ, D. ONER OZDAS, G. AREN & Z. AYTEPE Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey Introduction: The aim of this study was to determine the frequency of Molar-Incisor-Hypomineralisations (MIH) in patients as well as to describe the oral health status in a group of Turkish children living in the eastern region of the country. Patients and methods: A total of 457 children (mean age: 11.1 1.8) living in the eastern part of Turkey were assessed in this study. Oral health examinations were carried out for all the children using the methods and criteria advocated by standardized criteria of the WHO by the same examiner after getting informed consent. Statistical analysis was done with NCSS 2007 & PASS 2008 Statistical Software package (Utah, USA) using chi-square, KruskalWallis-Test and MannWhitney-U-Test with signicant level P < 0.05. Results: A total of 457 children (304 boys, 153 girls) were assessed in this study (mean age: 11.1 1.8). The mean dft/DMFT scores amounted to 3.5 2.2/3.0 1.9 in boys and to 3.5 2.1/ 3.3 1.6 in girls respectively (P = 0.931/ P = 0.087). Although there was no statistically signicant difference between both genders; a signicant difference was observed between age groups (P < 0.01). MIH was observed in 87 children (19%) in the whole group (boys n = 54; girls n = 33). There was no statistically signicant difference found between both genders. A statistically signicant difference was observed between age groups and MIH presence (P < 0.01). The most and least MIH affected regions of mouth were left upper side (85.1%) and the left lower side (66.7%) of the mouth. Conclusion: MIH was observed in 19% of children and the frequency increases with age. A carefully managed recall program for those children who are affected is recommended. Conclusion: Children attending the kindergartens in Kecioren and Altindag where the education level of the mother is lower and also children consuming sweets frequently and using feeding bottle had higher levels of caries. The high level of dmft scores in children points out the necessity of effective preventive dental health care programs.
P12176 Prevalence of malocclusion in 6-8-year-old schoolchildren in Santiago: 20052006

G. ZILLMANN1, A. MUNOZ2, R. ORTIZ1, J. HASSI1 & S. ECHEVERRIA1 1 blica, Departmento del Area de Odontopediatra; 2Area Salud Pu nin y ortopedia dentomaxilar, Facultad de Odontologa, o Universidad de Chile Introduction: Malocclusion reects biological variability of dental occlusion. The prevalence in children is important to guide effective oral health policy and to plan effective interventions. The aim of this study was to determine the prevalence of malocclusion in school children from 6 to 8 years in Santiago, Chile in 2005. Patients and methods: A representative sample of 1729 school children from 6 to 8 years (845 boys and 884 girls), stratied by socioeconomic level and without severe systemic diseases, was examinated. After giving informed consent signed by their parents, the children took part in an extra and intraoral exam sitting in a chair in orthostatic position. The exam methods and malocclusion diagnosis was conducted using the criteria of WHO. Results: At 6 years, 49.0% of the children presented mild to moderate malocclusion. At 7 years, 70.1% had some type of malocclusion, while the 8 years up to a 75.8%. Statistically signicant differences were observed at 6 and 8 years in relation to socioeconomic level, showing a higher proportion of malocclusions in the high socioeconomic level. There were no statistically signicant differences in relation to gender. Conclusion: There is a trend to increased malocclusion in children of older ages, which coincides with the establishment of the mixed dentition. The highest prevalence of malocclusions was found for high socioeconomic status. Not based on facts in results, not examined.
P12175 Evaluation of oral health and caries prevalence in 3-5-year-old children

K. DALCI1, B. KURKCU2 & S. CETINER1 1 Department of Pediatric Dentistry, Near East University, Lefkosa, Cyprus; 2Department of Pediatric Dentistry, Ankara University, Ankara, Turkey Introduction: The aim of this study was to determine the prevalence of early childhood caries and oral health of 35-year-old children attending state kindergartens in Ankara. Materials and methods: 440 children (220 girls, 220 boys) aged between 3 and 5 years attending the state kindergartens in the 5 biggest municipalities in Ankara were examined for caries using the dmft index. Questionnaires were sent to the childrens families in order to evaluate their sociodemographic condition, oral health habits, frequency of sweetened food consumption and modality of sweetened beverage consumption. Results: The mean dmft scores in the 345 year-old groups were found to be 1.5, 2.2 and 2.5 respectively. The distribution of children with dmft > 0 with respect to age was 47.8, 57.7 and 57.7 respectively. The dmft score distribution in 35-year-old groups with respect to municipalities are as follows: Cankaya 1.8; Kecioren 3.5; Mamak 1.6; Yenimahalle 2.4; Altndag 2.5. In Cankaya and Mamak municipalities where the mean education level of the mother was high, the dmft scores were signicantly lower than in the municipalities where the mean education level of the mother is low.
P12177 Decline in acute necrotizing ulcerative gingivitis in IleIfe, Nigeria

C. A. ADEKOYASOFOWORA1, K. C. NDUKWE2 & K. E. ADEBIYI2 1 Faculty of Dentistry, Department of Child Dental Health, Obafemi Awolowo University, Nigeria; 2Department of Oral/Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University Introduction: Acute necrotizing ulcerative gingivitis (ANUG) contributed to a signicant loss of teeth in Nigerian children in the last two decades. The aim of this study was to nd out the current trend of this disease. Patients and methods: This study analyzed 23 cases of (ANUG) among children who sought treatment at the Dental Hospital, Obafemi Awolowo University, IleIfe, Nigeria in a 2-year period (January 2006December 2007) after seeking approval from the ethical committee of the institution. The data of the present study was compared with a similar study in the same hospital a decade ago (19961997). Results: The peak incidence of (ANUG) was among 35-year-old children and 73.9% of the cases were between 27 years old. Positive history of recent febrile illness was reported in 19 cases (82.6%). The result indicated that patients presenting with (ANUG)
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decreased signicantly when compared with the precedent study in which 160 patients had to be treated. This observation might indicate that (ANUG) is on the decline in IleIfe. Possible predisposing factors in (ANUG) such as malnutrition, infectious childhood diseases and several factors which might be attributed to the decline such as changes in dietary pattern, brushing technique, immune compromise, an increasing dental awareness and promotion of dental health care are discussed. Conclusion: It is suggested that children at risk should be advised to maintain good oral hygiene, adequate nutrition and good health care. A population based study is suggested to ascertain the observed decline in (ANUG) in these semi-urban Nigerian children. along with Socio-demographic indicators associated with oral health. Chi-square, Students t-test or ANOVA were utilized for assessing data. Results: 62.9% of the 12 and 71.1% of the 15-year-old adolescents were affected by caries with a total DMFT score of 2.05 and 3.19 respectively. First and second molar DMFT index was 1.41 for the 12 and 2.48 for the 15 year olds, meaning 68.8 % and 77.8% of the total caries experience of the adolescents is present on posterior teeth, counting for 69.1% and 76.5% of caries that can be prevented to a large extent by sealants. Concerning the use of sealants, only 7.8% of the adolescents presented at least one sealed molar. Conclusions: The majority of dental caries of Greek adolescents examined was found on the occlusal surfaces of the posterior teeth, calling for a national preventive program with sealants which could eliminate caries to a large extent. This study was supported by a Colgate-Palmolive grant.
P12178 Caries and sealant prevalence on occlusal surfaces in permanent molars in Greek adolescents
C. OULIS & E. BERDOUSES Department of Paediatric Dentistry, Dental School, University of Athens Introduction: The aim of this study was to evaluate prevalence of caries of rst and second permanent molars of Greek adolescents, ages 12 and 15, and in connection with sealant utilization to determine the appropriateness of a National sealant program. Patients and methods: A stratied cluster sample was selected according to WHO guidelines, including 1.224 12- and 1.257 15year-old Greek adolescents living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Chi-square, Students t-test or ANOVA were utilized for assessing data. Results: 62.9% of the 12 and 71.1% of the 15-year-old adolescents were affected by caries with a total DMFT score of 2.1 and 3.2 respectively. First and second molar DMFT index was 1.4 for the 12 and 2.5 for the 15 year olds, meaning 68.8% and 77.8% of the total caries experience of the adolescents is present on posterior teeth, counting for 69.1% and 76.5% of caries that can be prevented to a large extent by sealants. Concerning the use of sealants, only 7.8% of the adolescents presented at least one sealed molar. Conclusions: The majority of dental caries of Greek adolescents examined was found on the occlusal surfaces of the posterior teeth, calling for a national preventive program with sealants which could eliminate caries to a large extent.
P12180 Evidence-based medicine in paediatric dentistry

S. FEIERABEND Department of Conservative Dentistry and Periodontology, University of Wu rzburg, Germany Introduction: The development of paediatric dentistry as an independent branch of dentistry differed enormously throughout the world. Even today the postgraduate studies vary with regard to their requests. Paediatric dentistry in Germany was very popular before World War I, but afterwards it has taken nearly 80 years to regain a similar importance. Evidence-based medicine has become an indispensable topic over the last decade world-wide. It has been of interest to investigate how evidence-based medicine has been implemented in German, European and international paediatric dentistry. Materials and methods: The well-known databases PubMed and The Cochrane Library were searched for the following terms: (paediatric dentistry) or dentistry & children. Further specications in searching were carried out additionally. For these two databases the results were classied into number of randomized-controlled trials, clinical trials, meta-analyses, reviews and case-reports. The German database MEDPILOT.DE was searched for the term Kinderzahnheilkunde (engl.: paediatric dentistry) to see how many articles are published in German only. The level of evidence was also taken into account. Guidelines were discussed separately, especially their process of origin. Results and conclusion: In contrast to other dental subjects the number of high-level-studies in paediatric dentistry is remarkable: For example, compared to periodontics/periodontology the number of reviews is very similar. When the search was carried out, the number of reviews in paediatric dentistry was 7%, in periodontology 9%, respectively. The impression of missing evidence may be caused rather by the consequence of general difculties to conduct studies on or with children.
P12179 Prevalence of caries on the rst and second permanent molars of Greek adolescents and use of sealants
C. OULIS, E. BERDOUSES & M. MICHALAKI Department of Paediatric Dentistry, Dental School, University of Athens Introduction: The aim of this study was to evaluate prevalence of caries of rst and second permanent molars of Greek adolescents, ages 12 and 15, and in connection with sealant utilization to determine the appropriateness of a National sealant program. Patients and methods: A stratied cluster sample was selected according to WHO guidelines, including 1224 12- and 1257 15-year-old Greek adolescents living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants
2009 The Authors
P12181 Comparison of a basic and risk-specic school-based preventive programme for caries-risk students
C. DROSEN1, H. SENKEL2 & R. HEINRICH-WELTZIEN1 1 Department of Preventive Dentistry, Friedrich-Schiller University of Jena; 2Health Department of the Ennepe-Ruhr-District, Schwelm, Germany Introduction: An annual risk-specic caries preventive programme (RPP) based on health promotion and application of uoride
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varnish has been carried out in four elementary schools in the German Ennepe-Ruhr-District since 2001. Aim of the present study was to assess the effectiveness of this additional programme in comparison to the stand alone basic school-based preventive programme (BPP) after 3 years. Materials and methods: The dental health status of 10-year-old students (n = 127) who were involved in the BPP/RPP and 106 same age students who were involved exclusively in the BPP was examined. Both groups were comparable with respect to caries risk and caries experience. Caries was scored on cavitation level (WHO, 1997); no radiographs were taken. Parents of all participating students had given written informed consent. Pearsons chi-square test and MannWhitneys U-test were used to determine signicant differences in caries prevalence and caries experience between both groups. Results: Neither the caries prevalence (BPP: 47%/21% primary/ permanent dentition versus RPP: 53%/17% primary/permanent dentition), nor the caries experience revealed a signicant difference between both risk groups (BPP: 1.6 dmft/0.4 DMFT versus RPP: 1.6 dmft/0.3 DMFT). Conclusion: The additional RPP seems to be of no benet for dental health in caries-risk students compared to the stand alone BPP. This may be due to its low frequency of only one application per year which is not in line with evidence based recommendations for using uoride varnish. Therefore, we suggest refraining from additional risk-specic health promotion activities in favour of enhancing the BPP by the application of uoride varnish twice a year.
Epidemiology 2
Poster Session P13/Epidemiology 2

P13182 Provision of dental general anaesthesia for children and associations with social deprivation
F. GILCHRIST1, S. A. CRAIG1, H. D. RODD1, A. KING2 & Z. MARSHMAN2 1 Department of Oral Health and Development, School of Dentistry, Shefeld; 2NHS Shefeld, UK Introduction: This study investigated the provision and distribution of episodes of care under general anaesthetic (GA) for management of dental caries in children in Shefeld, UK. The sociodemographic prole of service users was also explored. Patients and methods: Data for all paediatric dental GA lists were obtained from June 2007 to July 2008 from Shefeld Childrens Hospital. Patient data included age, postcode, attendance type and dental diagnosis. Only data from patients undergoing treatment of dental caries were analysed. Population data, postcodes and the percentage of households receiving income support/unemployment benets were used to produce rates of dental GAs per 1000 children for each neighbourhood in Shefeld. Results: There were 1633 episodes of dental care provided under GA, of which 1502 were solely for the management of caries. The mean age of patients was 6.6 years (range 115 years). The majority of GAs were daycase admissions (n = 1447, 96.3%). The average rate of dental GA per 1000 children in Shefeld was 11.07. The rate ranged from zero GAs per 1000 children in the least deprived neighbourhood to 23.7 per 1000 children in the most deprived neighbourhood. There was a signicant relationship between deprivation and GA rates (r = 0.76, P < 0.01). Approximately 58% of the variation in GA rates between neighbourhoods could be explained by deprivation. Conclusion: Marked differences exist in the use of GA services for the management of dental caries in children in Shefeld which reect greater disease levels and poorer access to routine care in areas of high social deprivation. male and 73 female, failed to attend at least one visit during a course of treatment. Of these, 63 (41%) did not attend any appointments. Eight pre-school children aged 2 to 5 years (Mean = 4 years, SD = 0.74) and 144 school children aged 6 to 16 years (Mean = 11 years, SD = 3.48) failed to attend. The prole of the typical patient who failed to attend was a boy, aged 11, who lives within 5 miles of the Dental Hospital. Conclusion: The clinical experience of individual students is varied. A large number of patients failed to attend their Undergraduate appointment, resulting in wasted clinical resources and teaching time. Further analysis of the treatment needs for those patients who failed to attend is required to ensure more efcient utilisation of teaching time. Patient information leaets have been designed to encourage attendance for prevention and routine dentistry with Undergraduate students.
P13184 Effect of health counseling of women in childbed on childrens dental health

S. GREINER1, T. BISCHOF2, G. BORGERT2 & R. HEINRICHWELTZIEN1 1 Department of Preventive Dentistry, Friedrich-Schiller University of Jena, Germany; 2Zahnprophylaxe Vorarlberg GmbH, Bregenz, Austria Introduction: Aim of this study was to compare dental health in 5- and 8-year-old children whose mothers received education and counseling on caries prevention on postnatal stations with that in children whose mothers did not receive such interventions. Patients and methods: 778 children from Vorarlberg/Austria were involved in the study. 29% of the children had an immigrant background. Mothers of 206 children aged 5 years and of 176 children aged 8 years had received personal counseling and education on postnatal stations by dental health educators. The control group enclosed children (190 5-year-olds; 170 8-year-olds) of mothers without any health promoting interventions. Children were examined according to the WHO oral health survey standard (1997). Parents of all participating students had given written informed consent. MannWhitneys U-test was used to determine signicant differences in caries experience between both groups. Results: Children whose mothers had participated in the caries prevention program on postnatal stations revealed a signicantly lower caries experience (5-year-olds: 1.5 dmft/3.1 dmfs; 8-yearolds: 1.9 dmft/4.3 dmfs) than children whose mothers were not subjected to such intervention (5-year-olds: 3.3 dmft/7.7 dmfs; 8-year-olds: 4.3 dmft/11.2 dmfs). Signicant differences in dental health were also found in children with immigrant background, favoring children of mothers having received counseling (5-yearolds: 4.3 dmft/8.7 dmfs; 8-year-olds: 4.7 dmft/12.5 dmfs) compared to children of mothers who had no counseling (5-year-olds: 4.9 dmft/11.9 dmfs; 8-year-olds: 6.6 dmft/18.2 dmfs). However, the inequality in dental health compared to native children could not be compensated by the intervention. Conclusion: Counseling and education of mothers on postnatal stations seems to be an effective community-based approach to improve dental health in pre-school and school-children with and without emigrational background.
P13183 The pattern of attendance of the paediatric patient to the undergraduate clinic
L. GARTSHORE & S. ALBADRI Paediatric Dentistry Department, Liverpool University Dental Hospital, Liverpool, UK Introduction: Poor attendance of Paediatric Patients to the Undergraduate Clinic at the Dental Hospital has been recognised as a signicant problem. This has an impact on the quality and the consistency of training provided to Undergraduate dental students. The aim of this audit was to assess the extent of the problem and to identify means of encouraging patient attendance. Patients and methods: The training record portfolios of 60 nal year Undergraduate students were analysed. Data recorded included the number of patients contacted for appointments and the number of patients who failed to attend. The patients details including age, gender and postcode were also recorded for those children who failed to attend. Results: In total 249 children (age range 2 to 16 years) were contacted for appointments. 152 children (61%), of which 83 were
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Poster Sessions P13185 Characteristics of children treated for early childhood caries in Tygerberg, Cape Town
N. MOHAMED1 & J. BARNES2 1 Department of Paediatric Dentistry, University of the Western Cape; 2Department of Community Health, University of Stellenbosch, Cape Town, South Africa Introduction: Problematically, large numbers of children under six years of age have to be treated by reason of early childhood caries (ECC). As there is currently no research-based information pertaining to this particular community, certain baseline information is needed in order to plan future intervention strategies to reduce the incidence of ECC. The aim of our study was to determine the epidemiologic prole of these children and identify risk factors for ECC in this patient pool. The specic habits, beliefs and cultural factors that may play a role will also be investigated. Materials and methods: Records of 140 patients kept by the Paediatric Dentistry Division were included in this survey. Results: Most of the patients originate from economically disadvantaged areas. Diet, feeding and oral hygiene habits were shown to be the most signicant factors which contributed to the development of ECC in these patients. All the children were either breast- or bottle-fed past one year of age. More than 90% of the children went to sleep with the bottle or while on the breast and were also fed on demand during the night. On average, children were bottle-fed up to 23 months of age. Where oral hygiene practices were concerned, 52.6% of children brushed their own teeth without supervision. Frequency of brushing varied between subjects. Conclusion: The results of this study demonstrate that there is a need for culturally appropriate education campaigns to inform parents especially those in disadvantaged communities about the importance of oral health and the prevention of oral disease. the most likely interventions (24%), followed by a prescription for antibiotics (20%). Most children required further treatment, commonly involving general anaesthesia (31%). There were some interesting differences between the centres for interventions provided, reecting available dental resources and the needs of children in those regions. Conclusion: These ndings suggest that children who seek urgent hospital dental care are from vulnerable backgrounds, with poor access to dental care and mostly present with caries-related sequelae.
P13187 Salivary antioxidant status of healthy and type 1 diabetc children

D. ONER OZDAS1, S. CAN TROSALA2, Y. GUVEN2 & G. AREN1 1 Faculty of Dentistry, Department of Pedodontics; 2Faculty of Dentistry, Department of Biochemistry, Istanbul University, Istanbul, Turkey Introduction: Antioxidants are the elements of the defense system, which are responsible for removal of the harmful effects of free radicals and reactive oxygen species. Lipid peroxidation often occurs in response to oxidative stress and and a great variety of aldehydes is formed when lipid peroxides break down in biological systems. The aim of this study is comparing the salivary antioxidant status in children type I insulin-dependent diabetes mellitus (type1 DM) as compared to healthy controls. Patients and methods: 68 children (n = 40 girls, n = 28 boys), divided into 3 groups: 22 children with type 1 DM of long duration (Group A); 22 newly diagnosed children with DM (Group B) and 24 healthy children (Group C). Mean age of groups A, B, C were 10.3, 13.0, 11.0 years respectively. Saliva samples were collected after gaining ethical approval from each child. The total antioxidant capacity of the saliva samples were analyzed with the ferric reducing/antioxidant power assay (FRAP) which is a colorimetric method. The thiobarbituric acid reactive substances (TBARS) concentration in saliva has been determined which measures various aldehydes derived from lipid hydroperoxides. All data were analyzed with MannWhitney-U-Test and/or KruskallWallis-Tests. Results: Mean FRAP values of each group is 129.5 lM, 146.1 lM and 148.3 lM and mean TBARS content of each group is 2.1 nmol/mL, 2.0 nmol/mL and 2.0 nmol/mL. No statistically signicant differences were observed in antioxidant status between Group A, B and C. Conclusion: There is no difference in salivary antioxidant status between children suffering from DM type 1 and healthy children.
P13186 Emergency dental care for children: an attendance prole

A. MORGAN1, C. PATCHETT2, S. ALBADRI3, C. DEERY1 & H. D. RODD1 1 Paediatric Dentistry Department, Charles Clifford Dental Hospital, Shefeld; 2Paediatric Dentistry Department, University Dental Hospital of Manchester, Manchester; 3Paediatric Dentistry Department, School of Dental Science, University of Liverpool, Liverpool Introduction: Access to National Health Service dentistry in the U.K. has become an increasing problem, following changes to dentists service contracts. Availability of urgent dental care, particularly for vulnerable groups, is of specic concern. This study aimed to determine the prole and outcomes of children presenting for urgent dental treatment at three U.K. dental hospitals. Patients and methods: Fifty consecutive patients, from paediatric departments in Liverpool, Manchester and Shefeld Dental Hospitals, were included in the survey. Demographic data including age, social deprivation, relationship to their escort, primary diagnosis and treatment outcome were recorded. Results: 150 children were seen over a 2-month period. The mean age was 8.8 years (SD = 3.92), and most were accompanied by their parent or guardian (97%). The majority of children came from areas ranked as highly socially deprived. Less than half had a general dental practitioner (47%), and a quarter had attempted to access dental care elsewhere (27%). The most common diagnosis was dental caries (65%) and, of those, the majority sought treatment due to toothache (76%). Advice and reassurance were
P13188 Knowledge of parents about oral health in children with heart disease
H. NOOROLLAHIAN Department of Pediatric Dentistry, Mashhad University of Medical Siences, Mashhad, Iran Introduction: Parents of children with endocarditis frequently have a lacking knowledge about this heart disease in Zahedan, Iran. Transient bacteremia in dentistry is discussed as an important initiating factor in bacterial endocarditis. The aim of this study was evaluate the knowledge about importance of prevention of dental caries in parents whose children had heart disease. Patients and methods: In this descriptive cross sectional study a nonrandom sampling was used and 320 parents (125 fathers, 195 mothers) referred to the Heart Clinics of Zahedan were evaluated by a questionnaire. The questions were about the demographic
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information and their knowledge about oral health and its relation to heart disease. Data were analyzed using MannWhitney-U-Test and KruskalWallis-Tests. Results: The results showed that the mean of knowledge was 21.3 10.1 of 100. The fathers knowledge (24.4 8.7) was higher in comparison of the mothers (19.23 10.3).The rural families knowledge was more than the urbans (22.5 9.8 and 14.51 11.2 respectively). Conclusion: Our study showed a limited knowledge of the parents about the interactions between oral hygiene and the risk of the onset of an endocarditis. Materials and methods: 104 Japanese, 95 Hungarian and 102 German patients panoramic X-rays were investigated according to Linds index (Lind V: Short root anomaly. Scand. J. of Dent. Res. 1972; 80:85.). The panoramic X-rays were performed at Semmelweis, Asahi and Freiburg University between 2001 and 2008. One way ANOVA, two tailed t-test and correlation t-test was used to evaluate the data. Results: One way ANOVA showed that signicant differences between sexes, nations and tooth types (both P < 0.001) existed. T-test showed signicant differences between the same types of teeth of the different ethnic groups (P < 0.05). The greatest correlation was found between German and Hungarian root-crown ratio (correlation coefcient 0.95, P 0.08), and the least one between Japanese and German root-crown ratio (correlation coefcient 0.66, P 0.19). Conclusion: Root-crown ratio seems to be a representative factor in the investigated nations. Signicant difference was found in rootcrown ratio between nations, sexes and the different tooth types.
P13189 Epidemiological evaluation of temporomandibular disorder in a group of Iranian students

M. EBRAHIMI, H. DASHTI & M. ARGHAVANI 1 Department of Pediatric Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences; 2Department of Prosthodontics, Mashhad Dental School, Mashhad University of Medical Sciences; 3Dentist, Mashhad, Iran Introduction: Temporomandibular Disorder (TMD) is the most common condition that affects temporomandibular joint. TMD is a general term, comprising pain and dysfunction of muscular apparatus. Determination of pre-dominant characteristics of this disease is difcult, because many signs and symptoms contribute to this disease. Studies have shown that the number of TMD patients has increased in recent years. The aim of this study was to determine the prevalence of temporomandibular disorder in a group of Iranian students. Patients and methods: In this descriptive cross-sectional study 800, students aged between 14 and 18 years attending high schools in Mashhad, Iran, were examined. In this study the cluster sampling method was applied. Ethical committee of Mashhad University of Medical Sciences approved this research (# 86743). Parents were sent an information sheet about the study, and just children with informed consent were examined. The history of related signs, symptoms and etiologic factors was evaluated. Data were analyzed by Chi-Square Test, Fisher Exact Test, Logistic Regression and MannWhitney-U-Test. Results: The prevalence of TMD was 34.7%. The most frequent TMD sign was clicking. Muscle tenderness and temporomandibular joint tenderness were less prevalent. The most important etiologic factor of TMD was pre-mature contact at protrusive movement of the lower jaw and the next ones were clenching and bruxism. Conclusion: The prevalence of signs and symptoms of TMD was fairly high among Iranian adolescence and it was higher in girls than boys. Acknowledgement: This study was supported by a grant from Mashhad University of Medical Sciences Research Council. Their nancial aid is acknowledged.
P13191 Oral health awareness in 8- to 12-year-olds in Adana, Turkey

M. C. DOGAN1, G. SEYDAOGLU2 & C. SARITURK2 1 Faculty of Dentistry, Department of Pedodontics; 2Faculty of Medicine, Department of Biostatsitics, Cukurova University, Adana, Turkey Introduction: Aim of this study was to describe the awareness of the own dental health of 8- to 12-year-old Turkish children. Materials and methods: A total of 2458 children aged between 812 years old who could read and write, were randomly selected from 15 different schools representing a total of 255 schools of Adana. Of the total 2435 mothers and 2266 fathers lled a questionnaire at home. Children attending to 1st 2nd 3rd 4th 5th classes asked out ll the self-administered questionnaire in their classroom supervising by a researcher. Results: Self-assessment of dental status of children was generally good (66.4%), 24% of the pupils answered that their teeth were quite poor and 9.6% claimed having very poor teeth. Of the total 2435 mothers, 36.1% were mentioned their dental health status is good, it was 35.4% for the fathers. There was a weak correlation between parents and children self-assessment dental health status. Parents declared that 15.9% of the children have been visited the dentist before age 6 due to different problems. 7.2% of children said that other pupils made fun of their teeth; 31.5% had experienced once or twice toothache and 15.5% had more than three times toothache during the previous 12 months. Risk factors such as age, gender, socio-economic status, ethnic origins were evaluated for all groups. Conclusion: The self-assessment of oral health status should be completed by objective data of an oral examination.
P13190 Comparing the root-crown ratio of Japanese, Hungarian and German young population
B. RENCZ, M. IINUMA, B. REMPORT, G. FABIAN & I. TARJAN 1 Department of Paedodontics and Orthodontics, Semmelweis University, Budapest, Hungary; 2Department of Paediatric Dentistry, Asahi University School of Dentistry, Hozumi, Japan Introduction: The aim of the study was to compare Japanese, Hungarian and German healthy, young populations root-crown ratio to know, if there are any relations between the populations.
2009 The Authors
P13192 Abstract withdrawn
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Poster Sessions P13193 Parents awareness on their children malalignment and malocclusion in China
W. XIAOJING1, L. YINGFENG1, S. HIROSHI2 & Y. MASASHI2 1 Department of Pediatric Dentistry, School of Stomatology,The Fourth Military Medical University, Xian, China; 2Department of Pediatric Dentistry, Tokyo Dental College, Masago, Mihama-ku, Chiba, Japan Introduction: Aim of this study was to investigate parents awareness on their children problems of malalignment and malocclusion in China. Patients and methods: A pre-structured questionnaire was distributed to parents visiting the Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University. Results: The sample consisted of 783 children with a mean age of 7.2 years old (SD = 2.4), and 51.3% of their presenting main complaints was to obtain treatment of dental caries and its complication, While 35.0% of their presenting main complaints was to obtain consultation about or treatment of malalignment and malocclusion. 65.1% of the parents had shown their concern about the problems of malalignment and malocclusion of their children, with a degree of 56.6% for upper anterior teeth dentition and 47.4% of the lower anterior teeth dentition. The rate of coincidence of malalignment and malocclusion between presenting main complaints and clinical diagnosis was 59.6%. The results also indicated meaningful association between malalignment and malocclusion concern and orthodontic treatment needs assessed by their parents education level. However, some patients with great needs do not express malalignment and malocclusion concern. Conclusions: More and more parents in China showed their concerns about their children problems of malalignment and malocclusion. Therefore, efforts need to be exerted to enhance the attention of parents on current situations of malalignment and malocclusion of their children. P = 0.893; v2:0.14, P = 0.705; v2:0.26, P = 0.61). We detected all four third molars in only 40% of 656 patients aged from 4 to 13 years old. The earliest age for third molar crypt formation was 5 years. Conclusions: Third-molar development among the Turkish white population occurs at an earlier age than in other populations for almost all stages when we compared this study with the previous studies.
P13195 The related factors of bruxism in children

X. ZHU, S. G. ZHENG & C. YU Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China Introduction: Bruxism has been dened as a nonfunctional contact of the teeth and that includes clenching or grinding in a nonvoluntary form, rhythmical or spasmodic. Most people thought that there were many factors affecting the occurrence of bruxism, the focus were occlusion and psychology. But most studies of bruxism were performed in adults, the study of bruxism in children especially in the primary and mixed dentition, seldom found in the literature. The aim of this study was to nd the relative factors of bruxism in children through evaluation of psychology and occlusion in children with bruxism. Patients and methods: 59 children were included in the bruxism group and 58 children in control group, aged 410 years. Oral and temporomandibular joint examinations (about teeth, occlusion and TMJ situation) were taken on each child, and the parents were asked to ll the questionnaires regarding the normal situation and behavior problems of children. Each child was scored according to the same method, the data were statistically calculated, and the relationships between the factors and the occurrence of bruxism and the abrasion degree of teeth were analysed. Results: Odds ratios for psychology factor, occlusal factor, specic sleep posture, parents heredity specify and relatives heredity were 1.1, 1.5, 4.5, 11.2 and 8.8 respectively. The standardized coefcient of occlusal factor and time length of bruxism to the degree of teeth abrasion were 0.239 and -0.345. Conclusion: Specic sleep posture, psychology-, occlusal- and heredity factor seem to be related factors for child bruxism. The degree of teeth abrasion increases as the occlusal condition gets worse.
P13194 Radiographic evaluation of third molar development in a group of Turkish children

E. YAMAC YILMAZ, A. PINAR ERDEM, E. SEPET & Z. AYTEPE Department of Pedodontics, Istanbul University, Istanbul, Turkey Introduction: The aim of this study was to evaluate the crypt formation and calcication of the maxillary and mandibular third molars according to age and gender on panoramic radiographs in a group of Turkish children. Patients and methods: After gaining ethical approval, a total of 656 children (355 boys and 301 girls, age 413 years, mean age: 9.16 2.04) that referred to the Istanbul University, Faculty of Dentistry,Department of Pedodontics were assessed in this study, and their orthopantomographs were examined. The mandibular third molar was staged according to Moorrees et al. Statistical analysis was done with NCSS 2007 package program using chisquare test with signicant level P < 0.05. The criteria for inclusion in the sample were the availability of an orthopantomography of adequate quality and no history of medical or surgical disease that could affect the presence and development of permanent teeth, including third molars. Results: No statistically signicant differences were observed in third molar presence and developmental stages between genders (v2:0.75, P = 0.386; v2:5.9; P = 0.544). When the segmental presence of the third molar was compared with genders no statistical differences were observed (v2:0.05, P = 0.815; v2:0.01,
P13196 Use of sealants among general dental practitioners and paediatric dentists in Greece
M. SIFAKAKI, M. MICHALAKI, E. BERDOUSES & C. OULIS Department of Paediatric Dentistry, Dental School, University of Athens, Greece Introduction: Although sealants have widely been recommended as one of the best preventive measures in managing dental caries of the pits and ssures, their usage is not as common in the profession as expected. The aim of this study was to evaluate the extent and patterns of using sealants by dentists in Greece and explore attitudes and beliefs of the profession that affect their use. Patients and methods: 1214 general dental practitioners (669 males and 545 females) and 52 paediatric dentists (28 males and 24 females) answered 20 questions about prevention and use of sealants. The mean age of the sample was 45.3 10.7 years. Results: The data suggested that although 68.8% of the general dental practitioners believed in prevention and 59% believed in the effectiveness of sealants only 30.3% applied them in practice, while 41.5% did not believe that sealants are effective and they dont use
Epidemiology 2
them. On the contrary, all paediatric dentists believed in prevention and the effectiveness of sealants and 96.1% used them routinely. Among the reasons the dentists mentioned for not using sealants 34.4% claimed that the problem is nancial (parents dont pay), 13.7% dont believe in them, while 28% dont know how to use them. Conclusions: The use of sealants among general dental practitioners in Greece is low and dentists need more information and training on effectiveness and use of sealants. shortage of trained dental staff, equipment and drugs. The increasing rate of caries illustrates the importance of strengthening dental emergency services and primary care in rural areas.
P13199 Oral health status according to WHO criteria and laser uorescence measurements
S. KADIC1, V. PICEK1, O. LULIC DUKIC2, B. DELIJA2 & Z. SOSTAR3 1 Department of Paediatric Dentistry, Dental Polyclinic Zagreb; 2 Department of Paediatric Dentistry, School of Dental Medicine, University of Zagreb; 3City Ofce for Health, Labour, Social Protection and War Veterans, Zagreb, Croatia Introduction: The purpose of this study was to analyse the oral health status of children in Zagreb, Croatia, by using visual and laser uorescence methods. Patients and methods: The study comprised of 638 children aged 714 years from two elementary schools in Zagreb. Patients parents gave written, informed consent and permission had been obtained from the ethical comitee of School of Dental Medicine. Children were examined in a dental polyclinic by two calibrated examiners, using visual methods (WHO 1997). DMFT, DMFS and deft values were recorded. Additionally, laser uorescence device DIAGNOdent (KaVo) was used to examine total of 2552 rst permanent molars. The results of these two methods were correlated. Data were statistically analysed using chi-square test. Results: Average mean DMFT = 3.2, average mean DMFS = 4.2 and average mean deft = 3.2 were found analysing data for all children (aged 714 years) included in the study. Regression analysis showed that the DMFT value increased by 1.0 and DMFS value by 1.6 for each year of age. Only 25.7% of all children (aged 714 years) were caries free. Agreement of the results obtained by visual examination and DIAGNOdent was 76.3% (v2, P < 0.001) for occlusal, 94.1% (v2, P < 0.001) for buccal and 92.6% (v2, P < 0.001) for oral surfaces. Conclusion: This study has found a statistically signicant agreement in the results obtained by visual examination and laser uorescence. We concluded that DIAGNOdent can be used as a helpful supplementary tool in caries diagnosis. The results of DMFT, DMFS and deft indices indicate the need for additional investments in preventive programs.
P13197 Abstract withdrawn P13198 Some issues on dental public health in in rural parts
G. GONCHIG1, M. MYAGMARJAV2 & U. KHASBAZAR3 1 Shidet-Od dental clinic, Ulaanbaatar; 2Mongolian Development Institute,3Rural Public Health Centre, Khuvsgul, Mongolia Introduction: The lack of dental hygienists and epidemiologists in Mongolia result in a weak status of dental public health. Yet the supply of dental techniques and the number of private dental clinics are increasing in central areas of Mongolia. The basic toothbrushing utensils are supplied by foreign countries, particularly from China. According to the health statistical data (20052007) the progression of oral diseases and HIV infection including hepatitis B and C are increasing in Mongolia due to inadequately sterilized, reusable hypodermic needles and other medical practices. Patients and methods: This study was implemented by the research group including dentists, nurses, public health doctors and local physicians. 50 children aged between 8 and 15 years in Khuvsgul a rural area of Mongolia were selected. Data were obtained with questionnaires and interviews for key personal and clinical examinations were performed. Results: In this study high rates of caries were found in 8 to 10 year-old children. They try to obtain treatment, but due to the low level of the rural health sectors, there are sparse rural health centers that provide dental care. Conclusion: Dental preventative service and public health are critical in rural areas of Mongolia. The relatively high rates of dental diseases in tertiary hospitals are particularly troubling due a
Poster Sessions
Poster Session P14/Cariology 1

P14200 Caries risk, cariogenic bacteria and the cariostat: from childhood through old age
O. RODIS1, S. MATSUMURA1, N. KARIYA2, Y. OKAZAKI1 & M. NISHIMURA2 1 Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2Dental Hospital, Okayama University, Shikata-cho, Okayama City, Japan Introduction: Early caries experience usually leads to future caries and eventual loss of teeth. Japan implemented the 8020 program to encourage citizens to maintain 20 teeth at 80 years of age. However, this goal can never be achieved if tooth loss occurs early in life. The Cariostat, a caries activity test, is a colorimetric test showing acid-producing capacity of cariogenic bacteria from plaque samples. This study summarizes the use of the Cariostat in assessing caries risk and presence of cariogenic bacteria from children, adults and the elderly. Patients and methods: Participants were residents of Okayama Prefecture who gave informed consent. There were 143 motherchild pairs, 399 elementary school children and 160 8020 achievers. Caries risk was assessed by the Cariostat and presence of cariogenic bacteria was checked by DNA detection. Data regarding DNA detection and caries risk were analysed and performed using SPSS statistical software package. Results: Cariostat-assessed high caries risk was seen in 29.4%, 68.5%, 48.1% and 35.6% of young children, their mothers, elementary students and 8020 achievers, respectively. High caries risk was signicantly associated with the presence of S. mutans and S. sobrinus in all age groups while presence of S. mutans in children were associated with high risk mothers. Conclusion: Caries risk and presence of cariogenic bacteria should be assessed at regular intervals to prevent early tooth loss. If our long-term goal is to have more teeth as we grow older, then caries risk assessment must be started early in life. analysed with SPSS 15 software. The research was approved by the Ethics Committee of Kerman University of Medical Sciences. Results: The average saliva levels of S-IgA in infants with S-ECC (18.3 mg/dl) was higher than of infants without S-ECC (9.5 mg/dl); the difference was signicant (t-test, p-value <0.05). Conclusion: According to this study, it can be concluded that the null hypothesis has to be rejected. The higher level of S-IgA in infants with S-ECC may be caused by the more severe immune response.
P14202 The prevalence and etiological factors of dental erosion in children

M. MENDERES, D. COGULU & N. ERSIN Department of Pedodontics, Ege University School of Dentistry, Izmir, Turkey Introduction: The aim of this study was to assess the prevalence of dental erosion in children and to evaluate the etiological factors. Materials and methods: A total of 170 children aged between 612 years old were included in the study and a detailed history was recorded. WHO criteria and the dental erosion index proposed by OSullivan were used in the diagnosis of caries and erosion, respectively. In addition, the location, distribution, and extension of affected area and severity of dental erosion were recorded. Salivary ow rate and buffering capacity were also detected from the obtained saliva. All data were analysed by using chi-square and Mann Whitney U tests. Results: The prevalence of dental erosion was found as 25% (n = 43). No statistically signicant difference was found in the prevalence of erosion between boys and girls. Incisal and occlusal surfaces were the mostly affected surfaces than the others (86%, n = 37). Enamel loss was the most prevalent type of dental erosion (67%, n = 29). In 98% of the children who exhibited erosion more than half of the surfaces were affected by erosion. Conclusion: The results of this study indicated that gastro-oesophageal reux, bruxism and consumption of acidic beverages were effective factors for dental erosion. In addition, it could be concluded that the presence of dental erosion could be a diagnostic clue in the early detection of a systemic disease.
P14201 Levels of S-IgA among the infants with or without early childhood caries
H. R. POURESLAMI Department of Paediatric Dentistry, Member of Kerman Oral & Dental Diseases Centre, Dental School, Kerman, Iran Introduction: Saliva has different immunologic factors which play important roles in protecting the teeth. The aim of this study is to evaluate the levels of total secretory IgA (S-IgA) in two groups of infants with or without severe Early Childhood Caries (S-ECC). As null hypothesis it was presumed that both groups would have equal S-IgA values. Patients and methods: This was a cross sectional study that evaluated 44 infants, 20 infants with S-ECC & 24 infants without S-ECC, 8 to 24 months of age. The infants of three nurseries in Kerman city (Iran) were selected and their saliva samples were collected under dened conditions. The levels of S-IgA were assessed with nephlometric method. The obtained data were
P14203 Functional analysis of ATP transporter proteins associated with antibiotic resistance in Streptococcus mutans
M. MATSUMOTO-NAKANO, K. NAGAYAMA, S. INAGAKI, K. FUJITA & T. OOSHIMA Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan Introduction: Streptococcus mutans, a major pathogen of dental caries, is known to have a large number of sugar metabolism transporters, termed ATP-binding cassette (ABC) transporters, which are involved in the uptake of carbohydrates. The basic structure of ABC transporters consists of four domains; two integral membrane domains and two ATPase subunits. In this
Cariology 1
study, we performed a functional analysis of the ABC transporters in S. mutans. Materials and methods: The SMu0836 and SMu0837 genes were determined to be possible S. mutans ABC transporters based on the complete UA159 genome sequence database. Next, those genes decient mutant strains were constructed by inserting an erythromycin resistant gene into SMu0836 and SMu0837 genes, respectively, of S. mutans MT8148 and the mutant strains were selected. Test strains were then cultured in the presence of tetracycline, chloramphenicol, kanamycin, and penicillin at 37C for 18 h, after which the optical density values were measured at 600 nm. In addition, the expressions of SMu0836 and SMu0837 with a sublethal concentration of chloramphenicol were analysed using a real-time reverse transcription polymerase chain reaction method. Results: Both mutant strains were signicantly less sensitive to chloramphenicol than MT8148, while the expressions of SMu0836 and SMu0837 were elevated in MT8148 when the strain was cultured with sublethal concentrations of chloramphenicol. In addition, chloramphenicol had effects on the expression of SMu0836 and SMu0837 at the transcription level. Conclusion: These results suggest that the ABC transporters of S. mutans play an important role in chloramphenicol transport.
P14205 Inltration of resin adhesive into proximal early caries lesions according to pre-treatment methods
H. J. KIM, J. H. SHIN, M. J. KIM, S. Y. LEE & S. KIM Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Busan, Korea Introduction: Early enamel caries are known to be remineralized by improved oral hygiene including uoridation, however it may be unreliable since it totally depends on the patients cooperation. Sealing the earlier lesions with low-viscous light-curing resins has been tried as an alternative to it. However, compared with lesion body underneath, the surface layer of early enamel caries may interfere with the inltration of resin adhesives due to relatively lower pore volume. Therefore adequate surface treatment was thought important to remove a part or whole of the surface layer to enhance the inltration. The aim of the study was to search for the adequate pre-treatment method prior to applying resin adhesives on natural proximal early caries lesions. Materials and methods: 39 extracted primary molar teeth showing early caries lesion on proximal enamel were used for this study. The teeth samples were divided into 5 groups and surface treatment was done as follows: Group 1; only carefully cleaned with water, group 2; etched with 15% HCl for 15 s, group 3; etched with 35% phosphoric acid for 15 s, group 4; etched with 35% phosphoric acid for 30s, and group 5; cleaned with 0.5% NaOCl. Results: Following results were obtained by evaluating the surface features with scanning electron microscopy and confocal laser scanning microscopy for the cross-sectioned specimens after inltration of resin adhesives. (i) Group 2 showed clearly removed surface layer, group 3 and 4 showed partially and irregularly removed surface and group 5 showed slightly removed surface layer. (ii) Average inltration depth of resin adhesives for each group was 6.85~23.09 lm. (iii) Group 2 showed the deepest inltration, followed by group 4, group 3, group 5, group 1, and all groups except group 5 showed signicant differences (P < 0.01). Conclusion: The most adequate pre-treatment method on early proximal caries lesions for deep inltration of resin adhesive was to etch with 15% HCl for 15 s.
P14204 Inuence of chlorhexidine and xylitol on oral microora in children with ECC
E. V. KIRILLOVA, L. P. KISELNIKOVA & N. S. POPOVA Department of Pediatric Dentistry, and V. N. Tsarev, Department of Microbiology, Moscow State University of Medicine and Dentistry, Russia Introduction: The aim of this study was to investigate the preventive effect of a remineralization gel with antibacterial properties on the oral microora in patients with Early Childhood Caries (ECC). Patients and methods: Thirty 12- to 36-month-old children with ECC were included in this study. The patients were splitted randomly into 2 groups (n = 15). In the rst group a remineralization gel (R.O.C.S.) containing xylitol (10%) and calcium glycerophosphate was applied 5 times per day for 1 month. In the second group 0.1% chlorhexidine was applied once a day during 710 days. Additionally, a calcium/phosphate gel was applied 5 times per day within a time interval of one month. Before and after this preventive intervention dental plaque samples were collected and the microora was investigated by standard microbiological methods. Results: In the rst group the following results were registered after intervention: 45.4% reduction of S. mutans. 45.5% for Actinomyces spp. and P.melaninogenica, 33.5% for F. nucleatum, contamination reduction of S. mutans (5.5 0.25 to 4.5 0.2 lg CFU, P < 0.05), S. sanguis (7.2 0.3 to 6.5 0,2 lg CFU, P < 0,05), F.nucleatum (5.3 0,1 to 4.5 0.1 lg CFU, P < 0.05); Veillonella parvula population increase in 46.7% of patients, C. albicans elimination in all patients. In the second group a slight reduction of cariogenic streptococci and actinomyces (P < 0.05) was found, a reduction of P. gingivalis (206.7%), a reduction of P. melaninogenica (5.1 0.2 to 4.6 0.2 lg CFU, P < 0.05); an increase of F. nucleatum (6.733.3%) and C. albicans (26.740.0%). Conclusion: After application of the remineralization gel a reduction of relevant caries-associated bacteria was measured in comparison to 0.1% chlorhexidine.
P14206 The antibiotic activity of Actinomyces isolated from black-stained primary teeth to S.mutans
J. H. SHIN, M. J. KIM, S. Y. LEE, H. J. KIM & S. KIM Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Busan, Korea Introduction: Many reports showed that children with black stain have lower caries experience than children with other colored or without tooth stain. The black stain of teeth is made of ferric sulde, resulted from the reaction between hydrogen sulde produced by bacterial action and iron in the saliva or gingival exudates. Chromogenic bacteria are known as Actinomyces and Bacteroides melaninogenicus and the main causative bacteria in primary dentition are known as Actinomyces. The aim of this study is to assess the antibiotic activity of Actinomyces in plaque from black stained primary teeth to Streptococcus mutans. Materials and methods: Plaque samples were obtained from four children, 26 years of age, who had black stains on all erupted primary teeth. 16 different Actinomyces spp. were isolated and antibiotic activities were examined with paper disc method. PCR method was used for identication of Actinomyces spp. This study obtained the approval of IRB and informed consent from parents of children. The results were as follows: (i) No.1 and No.5
Poster Sessions
Actinomyces spp. showed the antibiotic activity to Streptococcus mutans and the activity of No.5 Actinomyces spp. could compete with that of Oxacillin. (ii) No.1 and No.5 Actinomyces spp. also exhibited the antibiotic activity to Bacillus cereus, Bacillus subtilis commonly used as experimental bacteria for testing antibiotic activity. (iii) By PCR analysis which was performed for identication of No.1 and No.5 spp., No.5 spp. matched Actinomyces viscosus at 97% level but No.1 spp. didnt match. Conclusion: Conclusively, this study shows that some species of Actinomyces in plaque from black stained primary teeth have a antibiotic activity against Streptococcus mutans. dental student) examined 99 investigation sites on the occlusal surfaces of the teeth using the following methods: ICDAS-II, the laser uorescence devices DIAGNOdent (DD) and DIAGNOdent Pen (DDPen), and the uorescence camera VistaProof (VP). Bitewing radiographs (BW) were taken and assessed for presence of caries at D3-Level (dentine caries). Correlations among all methods were assessed using Spearmans rank correlation coefcient (rs). Results: rs with bitewing radioagraphy were: Examiner A: 0.60 (ICDAS-II), 0.44 (DD), 0.36 (DDPen), 0.48 (VP); Examiner B: 0.60 (ICDAS-II), 0.39 (DD), 0.41 (DDPen), 0.45 (VP). 30 sites were found by BW to have dentinal caries. The performance of different methods in detecting dentinal caries was: Examiner A: 60% (ICDAS-II), 70% (DD), 73.3% (DDPen), 73.3% (VP); Examiner B: 56.6% (ICDAS-II), 76.7% (DD), 80% (DDPen), 80% (VP). Conclusions: All uorescence methods showed similar performances in detection of dentine caries, whether they were used by a dental student or an experienced examiner. The correlation with bitewing radiography was moderate for the uorescence methods and high for ICDAS-II. Supported by Durr Dental, Bietigheim Bissingen, Germany.
P14207 Effect of extremely low frequency magnetic eld on enamel microhardness in rats
B. KARGUL1, I. YAVUZ2, Z. AKDAG2, A. DURHAN1 1 Department of Paediatric Dentistry, Dental School, Marmara University, Istanbul; 2Department of Paediatric Dentistry, Dental School, Dicle University , Diyarbakr, Turkey Introduction: Numerous sources of electromagnetic elds exist in nature and in the occupational and residential environments. In nearly all instances, these elds pose no obvious threat to human health or safety and are generally discussed as an inevitable byproduct of modern technology. Materials and methods: The experiments were performed on 30 4 months old male Sprague-Dawley rats, obtained from Medical Science Application and Research Center of Dicle University (DUSAM) were divided into three groups: two experimental and one cage-control. Principles of Laboratory Animal Care and the rules of Scientic and Ethics Committee of Dicle University Health Research Center were followed. The rst and second experimental group (n = 10) were exposed to 100 lT and 500 lT Extremely Low Frequency Magnetic Field (ELF-MF)ELF-MF during 10 months, 2 h a day respectively. For the cage control, nothing applied to rats in this group and they completed their life cycle in the cage during the study period. It was investigated the effect of long term ELF-MF exposure on microhardness of enamel surface in rats was determined for each group. Results: The decrease of microhardness in second experimental group was found to be statistically signicant relative to cagecontrol group (P < 0.05). However, no statistical difference was found in between rst and second experimental groups (P > 0.05). From the results it can be concluded that 500 lT magnetic eld strengths may have a certain negative effect on enamel mineralization. Conclusion: Microhardness levels of enamel decreased in exposed groups according to cage-control group. Further investigations are necessary to analyse the effect of ELF-MF on teeth.
P14209 Reproducibility of three uorescence methods for occlusal caries diagnosis in permanent teeth
S. M. ROSEN1, K. PIEPER1, V. STACHNISS2, M. HEINZELGUTENBRUNNER1 & A. JABLONSKI-MOMENI1 1 Dental School, Department of Paediatric and Community Dentistry; 2Dental School, Department of Operative Dentistry, Philipps-University, Marburg, Germany Introduction: This in vitro study aimed to assess the reproducibility of three uorescence methods for caries detection when used by an experienced and a novice examiner. Materials and methods: 53 freshly extracted permanent teeth were available for the study. Prior to extraction, informed consent was obtained from patients for use of their extracted teeth for research purposes. 99 investigation sites on the occlusal surfaces of the teeth were examined by an experienced dentist (A) and a nal-year dental student (B) using the laser uorescence devices DIAGNOdent (DD) and DIAGNOdent Pen (DDPen) and the uorescence camera VistaProof (VP). All sites were examined twice within the same day. Intraclass-correlation coefcients (ICC) were calculated for intra/inter-examiner reproducibility. Correlations among the uorescence methods were assessed using Spearmans correlation coefcient (rs). Results: Intraexaminer-reproducibility (ICC) for examiner A was: DD: 0.95, DDPen: 0.97, VP: 0.81 and for examiner B: DD: 0.98, DDPen 0.98, VP: 0.95. Inter-examiner- reproducibility (ICC) was: DD: 0.86, DDPen 0.93, VP: 0.76. Signicant positive correlations were observed among all methods (P < 0.001). rs for examiner A were: 0.93 (DD/DDPen), 0.79 (DD/VP), 0.78 (DDPen/VP) and for examiner B: 0.93 (DD/DDPen), 0.76 (DD/VP), 0.76 (DDPen/VP). Conclusion: All three uorescence devices showed good reproducibility whether they were used by experienced or less experienced investigators and the results were highly correlated between methods. The ndings support the view that nal-year dental students are able to apply a uorescence system as a supportive device for caries diagnostic purposes. Supported by Durr Dental, Bietigheim-Bissingen, Germany.
P14208 Performance of ICDAS-II and uorescence methods for detection of occlusal caries
A. JABLONSKI-MOMENI1, S. M. ROSEN1, H. M. SCHIPPER1, M. HEINZEL-GUTENBRUNNER1 & K. PIEPER1 1 Dental School, Department of Paediatric and Community Dentistry, Philipps-University, Marburg, Germany Introduction: The aim of this in vitro study was to assess the performance of three uorescence methods for the detection of dentine caries as compared to radiographic detection. Materials and methods: 53 freshly extracted permanent teeth were available for the study. Informed consent was obtained from patients prior to extraction about the use of teeth for research purposes. Two examiners (A: experienced dentist, B: nal-year
Cariology 1 P14210 Contribution of recA gene for gtf expression by Streptococcus mutans
S. INAGAKI, M. MATSUMOTO-NAKANO, K. FUJITA, K. NAGAYAMA & T. OOSHIMA Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan Introduction: Streptococcus mutans has been implicated as a primary causative agent of dental caries and is known to synthesize adhesive glucans from sucrose by the action of glucosyltransferases (GTFs; GTFB, GTFC, and GTFD), which are considered to mediate rm adherence of the bacterial cells to tooth surfaces, leading to biolm formation. The recombinase A (RecA) protein has been shown to be essential for transformation of plasmid and chromosomal DNA in Streptococcus pneumoniae. In this study, we analysed the contribution of RecA of S. mutans to biolm formation. Materials and methods: A RecA-decient mutant strain (RAD) was constructed from S. mutans strain MT8148 by insertional inactivation of the recA gene encoding RecA. Test strains were grown in Todd-Hewitt broth in the presence or absence of sucrose, then inoculated into 96-well multi-titer plates. The quantity of biolm was determined following crystal violet staining at an optimal density of 570 nm. Furthermore, expressions of the genes encoding GTFs in MT8148 and RAD were investgated using real-time reverse transcription polymerase chain reaction (RT-PCR) assays. Results: The RAD strain was found to have a lower quantity of sucrose-dependent biolm formation than MT8148. In addition, RT-PCR results showed that the level of expressions of the gtfB or gtfD genes in strain RAD were signicantly lower than those in MT8148. Conclusion: These results suggest that RecA may be an important factor for gtfB and gtfD expression in S. mutans for biolm formation. students reported that 60% of full time and 33% of part-time faculties were knowledgeable about Cariogram. Eighty-two percent reported that they will not be using cariogram in their private ofces. Conclusion: A substantial proportion of students felt that Cariogram was easy to understand, however, they do not intend to use it in their private ofces.
P14212 Identication of oral Streptococci by denaturing gradient gel electrophoresis (DGGE)

I. KONISHI, T. HOSHINO, Y. KONDO & T. FUJIWARA Department of Pediatric Dentistry, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Introduction: Viridans streptococci are considered to be principal species of indigenous microbiota in oral cavity, and are associated with bacteremia and subacute bacterial endocarditis. Therefore, the microbial analysis is of clinical importance in Pediatric Dentistry. Since viridans streptococci are highly homologous, it is difcult to identify them by the conventional methods such as the 16S rRNA gene analysis. Therefore, new attempts have to be made. Materials and methods: We phylogenetically analysed the rod shape-determining protein gene (rodA), which is associated with cellular morphology, cell division, and sensitivity for antibiotics. Streptococcal strains isolated from human saliva and brushing uid, and reference strains in our laboratory were used. Denaturing gradient gel electrophoresis (DGGE) analyses based on the diversity of the rodA gene (rodA-DGGE) were performed with the DCode universal mutation detection system (Bio-Rad), according to the manufacturers instructions. Results: The rodA-DGGE analysis clearly identied and classied viridans streptococci. Moreover, we developed a more convenient rodA-DGGE method for detecting 9 popular streptococcal species, namely, S. sobrinus, S. sanguinis, S. oralis, S. mitis, S. vestibularis, S. salivarius, S. infantis, S. gordonii, and S. mutans in the clinical samples derived from oral cavity. Conclusion: This newly developed rodA-DGGE method proved useful in detecting oral streptococci and the species which were difcult to cultivate and/or isolate. Thus, analysis of oral microbiota by rodA-DGGE together with 16S rDNA-DGGE may be a good alternative in the microbial diagnosis of streptococcal infection.
P14211 Senior dental students experience with cariogram in a rediatric dental clinic
C. GONZALEZ1 & C. OKUNSERI2 1 Department of Developmental Sciences/Pediatric Dentistry; 2 Department of Clinical Services/Dental Public Health, Marquette University School of Dentistry, Milwaukee, WI, USA Introduction: Teaching caries risk assessment at the pre-doctoral level has become an important component of dental schools curriculum to enhance management of dental caries. The study objective was to assess pre-doctoral dental students experience with caries risk assessment computer program Cariogram at the Pediatric Dentistry clinic at Marquette University School of Dentistry. Materials and methods: In 2005, sophomore dental students were introduced to Cariogram in the spring semester. The students received a 50-min lecture on caries risk assessment and a demonstration of Cariogram use in children in a pediatric dentistry didactic course. Sophomore dental students completed a casebased written examination that tested their knowledge and application of the Cariogram. After a 2-year clinical exposure to the Cariogram, the students now seniors completed an anonymous eleven-item questionnaire on their experience with the caries risk assessment tool. Each item on the questionnaire was scored on a 5point Likert scale and descriptive statistics was done. Results: Eighty-three percent of the students completed the survey. While 38% were neutral, 44% agreed that cariogram was easy to understand. Thirty-six percent felt it was easy to apply and 22% reported that it was useful in determining preventive procedure. The
P14213 Correlation of biological properties and expression prole of glucan-binding protein B in Streptococcus mutans clinical isolates
K. FUJITA, M. MATSUMOTO-NAKANO, Y. TAKASHIMA, S. INAGAKI & T. OOSHIMA Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan Introduction: Streptococcus mutans is known to be a primary causative agent of dental caries and its major surface proteins, including glucan-binding proteins (Gbps: GbpA, GbpB, GbpC, and GbpD), are regarded to be important factors related to its glucan-binding properties. In the present study, we focused on GbpB, and investigated the relationships between its expression proles and glucan-binding in various S. mutans clinical isolates. Materials and methods: One hundred S. mutans strains isolated from Japanese children at our clinic and 100 from Finnish children who visited the Helsinki University Hospital were analysed. Western blotting analysis of GbpB was performed to assess the expression prole in each strain, while dextran-binding activity was evaluated based on glucan-binding properties of each strain.
Poster Sessions
Results: Three types of GbpB expression were identied, which were categorized as single band (S-type), multiple band (M-type), and no visible bands (N-type). More than 80% of the strains isolated in Japan were classied as S-type, while the distribution frequency of S-type in strains isolated in Finland was approximately 40%. In contrast, the distribution frequency of N-type in Japan (4%) was lower than that in Finland (20%). The dextranbinding assay also revealed that the N-type possessed a signicantly lower level of activity than the other types. Conclusion: These results suggest geographical differences in GbpB expression proles in S. mutans clinical strains, while strains without GbpB expression have a low level of virulence for development of dental caries. several purposes. It possesses several biological activities such as anti-oxidative, anti-inammatory, antibacterial and antiviral activities. Although the antibacterial activity of Scutellaria baicalensis Georgi has already been demonstrated, little is known about its antibacterial activity against oral pathogens in vitro. Therefore, the aim of this study was to evaluate the antibacterial activity by Scutellaria baicalensis Georgi extracts and effect on the Streptococcus mutans biolms. Materials and methods: Streptococcus mutans ATCC 25175 was our main test organism. Biolms were formed on polystyrene microtitre plate. The biolms of S. mutans at different phases of growth were exposed to Scutellaria baicalensis Georgi extracts at different concentrations (0, 0.0625, 0.125, 0.25 mg/mL). Biolm formation was also quantied by a modication of a crystal violet assay. Biolm formation are expressed as mean SD. Results were compared by Schaffers multiple comparison tests. A value of P < 0.05 was considered statistically signicant. Results: The activity of Scutellaria baicalensis Georgi extracts in removing S. mutans biolm was dependent on the concentration, exposure time and the phase growth of biolm. A concentration of 0.25 mg/mL of Scutellaria baicalensis Georgi extracts completely inhibited biolm formation by S. mutans at adherent phases of growth, whereas Sub-MIC (0.062 mg/mL) concentration removed 60% of biolm at plateau accumulated phase. Conclusions: Scutellaria baicalensis Georgi extracts shows promising effects as an antibacterial agent for inhibiting and removing S. mutans biolms in vitro.
P14214 Black stain: a PCR microbiological study of cariogenic and periodontopathogenic microora
B. BARTSCH1, S. EICK2 & R. HEINRICH-WELTZIEN3 1 Health Department of Rhein-District, Neuss; 2Institute of Medical Microbiology, Friedrich-Schiller-University, Jena; 3Department of Preventive Dentistry, Friedrich-Schiller-University, Jena, Germany Introduction: Black stain is a characteristic extrinsic discoloration on human teeth with microbiological entity, which is associated with a low caries experience. Aim of this study was to compare the cariogenic and periodontopathogenic microora of black stain and nondiscoloured plaque samples from children. Patients and methods: 46 children with black stain (black stain group) and 47 children with nondiscoloured plaque (control group) aged 6 to10 years were included in this study. The study was approved by the ethic committee of the University Hospital of Jena. Parents of all participating children had given written informed consent. Samples of black stain and nondiscoloured dental plaque were collected from the tooth surfaces by using sterile scalpels. The DNA of 93 samples in total was extracted and real-time PCR was performed to determine the bacterial load of cariogenic and periodontopathogenic species. Mann-Whitneys U-test was used to determine signicant differences of the microora between both groups. Results: Plaque samples of the black stain group contained a signicantly higher number of Actinomyces naeslundii (P = 0.007) and showed a tendency to more Porphyromonas gingivalis compared to the nondiscoloured plaque samples of the control group. Contrary, there were lower numbers of Fusobacterium nucleatum (P = 0.001), lactobacilli (P = 0.001) and Streptococcus mutans (not signicant) in the black stain samples compared to the nondiscoloured plaque samples. Conclusion: The results suggest that the low levels of lactobacilli and mutans streptococci in black stain samples contributes to the low caries experience. Black stain might be associated with pigmented and parodontopathogenic bacterial species (Porphyromonas gingivalis/Actinomyces naeslundii).
P14216 The correlation between the mean DMFT and odontogenic infections in children
T. ADEMAJ-KUTLLOVCI1, A. BEGZATI1, K. MEQA2, A. J. BEGZATI1 & B. BRUCI1 1 Department of Pedodontics and Preventive Dentistry; 2Department of Periodontology and Oral Medicine, Dentistry School, University of Prishtina, Prishtina, Kosova Introduction: The aim of this study was to show the correlation between the DMFT index values and odontogenic infections. Materials and methods: We declare that this study was permitted by the ethical committee of the Dentistry School. The study included 337 10- to 15-year-old children. The statistical signicance was tested using Chi-square test for P < 0.05. Results: The caries prevalence of the examined children was 94.3%, while the DMFT index was 4.55. The structure of DMF was: 68.5% for decay, 17.7% for lled and 13.9% for extracted/ missing teeth due to caries. There were 127 teeth found presenting with the following pathologic ndings: chronic apical periodontitis, secondary caries with periapical lesion, as well as gangrenous radix relicta with sinuses and periapical lesions, as the causes of the odontogenic infections (abscesses, cellulites and phlegmona). The most affected tooth was the rst permanent molar. The most affected teeth were maxillary teeth (54.3%), while mandibular teeth were affected in 45.7% of cases. The Chi-square test showed correlation between mean DMFT and odontogenic infections for P < 0.05. Conclusion: It can be concluded that the higher DMFT values are in direct correlation withodontogenic infections.
P14215 In vitro activity of Scutellaria baicalensis Georgi extracts against Streptococcus mutans biolms
C. DUAN1, S. MATSUMURA2, N. KARIYA2 & T. SHIMONO2 1 Department of Pediatric Dentistry Zhong Shan Hospital of Dalian University, Dalian, China; 2Department of behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine Dentistry Sciences, Okayama, Japan Introduction: Scutellaria baicalensis Georgi has been used for thousands of years in traditional Chinese medicine practice for
Cariology 1 P13217 A clinical study of enameloplasty applied in deep pit and ssure of young permanent molars
Y. CHANG, G. LIHONG, Z. YAN & Z. XIMING Department of Second Dental Centre, Peking University School & Hospital of stomatology, Peking, China Introduction: Decisions regarding prevention and treatment of dental caries lesions forming in pits and ssures of young permanent molars can be challenging because of their complicated pit and ssure structures and sometimes the lesion may be hidden. This study was to investigate the effect of enameloplasty in treating this kind of molars. Patients and methods: 164 permanent molars were selected from 64 children aged 615 year old. The examining indexes were: pit and ssure pigment (), black immersed around pit and ssure (), soft on probing (), probe block (). The operators made the treatment plan via those indexes rst. After using the small bur to open the ssures (enameloplasty technique), the operators determined the nal treatment method: pit and ssure sealant, preventive resin restoration (PRR), and lling. Data were analysed using multi-factor regression. Statistical signicance was considered to be present at the 0.05 level. Results: Multi-factor regression showed that the indexes of pit and ssure pigment, probe soften and probe block contributed more to the nal choice of treatment method. Correlation analyse showed the treatment strategy before and after using enameloplasty technique were highly correlative (r = 0.897). Conclusion: The conventional examining indexes of deep pits and ssures were still credible and effective. It is helpful to detect early caries beneath deep pits and ssures by applying enameloplasty technique.
P14217a An in vitro comparison of visual inspection, bite-wing radiography and laser uorescence methods for the diagnosis of occlusal caries
S. J. POURHASHEMI Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences Tehran, Iran Introduction: The correct detection and diagnosis of non cavitated occlusal caries is essential for prevention programs. The aim of this study was to compare accuracy and reproducibility of visual inspection (VI), bitewing radiography (BW) and laser uorescence (LF) methods in diagnosis of occlusal caries. Materials and methods: The study was done on 80 extracted permanent pre-molars which seemed to be intact or with primary caries in ssures. Three trained dentists examined the teeth in four stages: Visual Inspection, Radiographic Examination, Laser Fluorescence and Histological Examination as gold standard. Sensitivity, specicity, positive and negative predictive values, and accuracy of all methods were calculated and compared. Additionally, ROC curves for LF were calculated. Results: The accuracy was 58.9% for VI, 45.1% for BW and 94.8% for LF. Kappa coefcient for inter-examiner reproducibility was 0.57 and 0.341 in visual inspection and BW radiography, respectively. Inter- and intraexaminer reproducibility coefcients (Kappa coefcients) of LF method were 0.784 and 0.836, respectively. The mean intraexaminer reproducibility coefcient in VI method was 0.612 using Kappa coefcient. Conclusion: Although accuracy and reproducibility of LF method was higher than VI and BW, it is better to use this method together with other methods to reduce diagnostic faults.
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Poster Session P15/Cariology 2

P15218 Abstract withdrawn P15219 Characterization of enamel remineralization under sealants via polarized light microscopy
R. P. RUSIN1, K. J. DONLY2, I. HAEBERLEIN3 & A. M. PFARRER1 1 3M ESPE, Maplewood, MN, USA; 2University of Texas Health Science Center, San Antonio, USA; 33M ESPE, Seefeld, Germany Introduction: The objective was to characterize the remineralization behavior of enamel lesions when coated with either a resinbased sealant or an experimental resin-modied glass ionomer material. Materials and methods: Extracted human molars with articial caries-like lesions were sectioned longitudinally into 100 lm sections; photographed via PLM with imbibing media of water (nD = 1.33; showing > 5% porosity), followed by an imbibing media of Thoulets 1.41 solution (nD = 1.41; showing > 10% porosity). Acid-resistant varnish was applied to all surfaces, leaving only the external tooth surface with lesion exposed. Three treatments were applied: untreated control group (UNTR); lesion coated with Ultraseal XT Plus Pit & Fissure Sealant (UXT); lesion coated with experimental resin-modied glass ionomer (EXM-OVR). The sections were toothbrushed with water daily for 30d. The acid-resistant varnish was removed; sections imaged via PLM again. The lesion body area was quantied via computerized imaging before and after, and percent remineralization calculated. Data were analysed via one-way ANOVA and compared with Fishers t-test (P < 0.05). Results: The percent remineralization (stdev,n) with water imbibition was for UNTR 10.08 (7.14,9)a, UXT 2.96 (4.21, 9)a and EXMOVR 6.87 (10.10,9)a as well as with Thoulets imbibition for UNTR 1.51 (4.79,10)b, UXT 7.08 (6.06, 10)b, EXM-OVR 30.28 (21.84,10)a. Within each imbibition set, superscript letters denote groups that are not statistically different. Conclusions: A resin-modied glass ionomer coating applied over an enamel lesion resulted in signicantly enhanced remineralization compared to an untreated control; a resin-based sealant applied over the lesion did not change the remineralization behavior versus the control. This research was supported, in part, by 3M ESPE. This study reported the validity of using a microfocus X-ray computed tomography (lCT) to evaluate the effects of CPP-ACP on demineralized dentin. Materials and methods: Bovine dentin specimens (n = 40) were prepared and divided into four groups equally. Each specimen was stored in demineralizing solution (pH 5.3) for 23.5 h. Then each group was immersed in 4 kinds of treatment solution conditioned by the presence of MI with/without uoride for 30 min. This process was followed by collecting lCT images of the specimens. The set of treatments was repeated four times. The lCT images were analysed by using software (TRI-BON, RATOC, Japan) to determine the effects of remineralization and to compare the previous data by microradiography and polarized light photomicrography. Results: By using lCT it was possible to serially observe the de/remineralization process on the same site of each specimen. Compared with the previous results, lCT images were suited for quantifying the effects of CPP-ACP; however it is difcult to measure the initial remineralization. Conclusion: Using lCT is a reliable method to evaluate the effects of CPP-ACP on demineralized dentin. Support: Grant - in - Aid for Young Scientists (#20791594).
P15221 Selection of lling materials for conservative adhesive restorations in occlusal ssures
E. S. BOYARKINA & L. P. KISELNIKOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: Within the framework of wide adoption of minimal invasive technologies the method of conservative adhesive restoration (CAR) takes the rst place in treatment of ssure caries. Different combinations of lling materials and sealants are used in CAR successfully. The aim of our study was to investigate the clinical performance of different lling materials used for conservative adhesive restorations in occlusal ssures in vivo and in vitro. Materials and methods: The method of CAR was applied in 53 molars in children at the age from 6 to14. GIC Fuji IILC (GC) and resin sealant UltraSealXTplus (Ultradent) were used in 26 teeth (1st group), owable composite Charisma Flow (Heraeus Kulzer) and resin sealant UltraSealXTplus (Ultradent) were used in 27 teeth (2nd group). Method of adhesive strength determination by shift (testing machine Instron) was realized to determine adhesion degree between lling and sealant within limits of CAR. Samples from the same materials were made in vitro and two analogous groups were formed. Results: After one year excellent states of the llings was detected in 92% of teeth in the 1st group and in 94% of the teeth in the 2nd group. Marginal leakage was detected in 8 and 6% of the llings, respectively. Adhesive strength amounted to 15.5 2.4 MPa in 1st group and 22.0 2.8 MPa in 2nd group. The ndings indicate evidence of higher adhesion between a resin sealant to a owable composite than to GIC (in 1.4 times, P < 0.05). Conclusion: A combination of owable composite and resin sealant may be advisable to use within application of CAR in ssure caries treatment.
P15220 Micro-computed tomographic evaluation of effects of CPP-ACP on demineralized dentin

S. WARITA, K. OGATA, K. SHIMAZU, T. KAWAKAMI & H. KARIBE Department of Pediatric Dentistry, Nippon Dental University, Tokyo, Japan Introduction: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been known as an additive in MI Paste (MI; GC Co., Japan) which is one of the products for caries prevention. In our previous study the use of MI with uoride has suggested the inhibitory effect on demineralized dentin.
Cariology 2 P15222 Use of atraumatic restorative treatment by pediatric dentistry professors in Brazil
C. FELL1, L. B. CAMARGO2, J. C. P. IMAPARATO2, A. E. HADDAD2 & D. P. RAGGIO2 1 Sao Leopoldo Mandic; 2Pediatric Dentistry Department, University of Sa Paulo, Sa Paulo, Brazil o o Introduction: The aim of this study was to evaluate the use of ART by professors of Pediatric Dentistry in Brazil and the evaluation of associated factors. Materials and methods: A structured questionnaire was made with questions relating to socio-demographic characteristics, educational level and ART. Results: Of the 721 questionnaires sent, approximately 38% (n = 280) were returned. Descriptive statistics and logistic regression analysis were conducted to verify the association between variables and the use of ART (a = 5%). Of those interviewed, 87.9% and 85.7% have already used ART. Professionals with postgraduate course are 7 times more likely to use ART (OR = 7.42, 95% CI 2.1026.23) compared to professionals level graduate. The amount of time that had passed since their graduation inuenced the professors experience in using ART. Professionals who had graduated over 15 years ago had twice the chance of having used this type of therapy in comparison to less experienced professionals (OR = 2.46, 95% CI 1.155.26). There was no difference between the Brazilian regions in relation to the use of ART. Conclusion: It was concluded that the ART philosophy is being dissipated throughout Colleges of Dentistry, thus contributing to the training of professionals who are aware of their true role as health educators and meeting the needs of the Brazilian reality. Ceraburs). In large cavities, the Ceraburs removed less carious dentin (74.6%) than carbide burs (84%), probably due to differences in the employed excavation end-point. Conclusion: The protocol has shown to be applicable to cariesexcavation studies.
P15224 Microhardness of dentine under glass ionomer cement after three different caries removals
C. THANAOLARN, V. JIRARATTANASOPA & A. PHONGHANYUDH Department of Pediatric Dentistry, Mahidol University, Bangkok, Thailand Introduction: The aim of the study was to evaluate the microhardness of the remaining dentine under glass ionomer cement (GIC) restorations in primary molars using three caries removal approaches. Patients and methods: Forty-three primary molars from 32 schoolchildren, aged 812 years, were recruited. Approval was provided by Mahidol University Ethic Committee. Written informed consent was obtained from each parent and child. Participants having deep dentinal caries without sign and/or symptom of irreversible pulpitis and pathologic nding from radiographs were included. The teeth were randomly allocated into 3 study groups: group (i) partial soft caries removal by spoon excavation, group (ii) all soft caries removal by spoon excavation (ART), and group (iii) conventional caries removal by burs. All cavity preparations were restored with GIC (Fuji IX, GC Corp., Japan). After 36 months exfoliated teeth were processed for microhardness measurement with Knoop indenter (FM-700, Future-Tech Corp, Japan). The dentine under restoration was divided into three zones: close to restoration, intermediate, close to pulp. Six values of Knoop hardness were obtained from each zone. The mean microhardness of dentine among three groups was calculated using One-way ANOVA. Results: After 36 months, 10 teeth in each group were evaluated. There were no statistically signicant differences in the microhardness of the three zones among groups (P > 0.05). Similarly, the microhardness of the three zones were not different within groups (P > 0.05). Conclusion: The microhardness of the remaining dentine after using partial soft caries removal approach followed by GIC restoration was comparable to that of ART and conventional approaches.
P15223 Correction of artefacts and calibration of lCT for studying caries-excavation methods
A. A. NEVES, E. COUTINHO, S. JAECQUES, P. LAMBRECHTS & B. VAN MEERBEEK Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, Catholic University of Leuven, Belgium Introduction: This study presents a method to correct artefacts during reconstruction of lCT projections of carious teeth, along with pre-processing steps to segment and thresholding for 3D-evaluation of caries-excavation techniques. Materials and methods: A beam-hardening curve was obtained from a wedge-shaped hydroxyapatite (HAp) block after scanning in a high-resolution lCT (Skyscan 1072, Skyscan, Belgium) and tting the curve with 5th order polynomials. The correction was further applied to reconstruct the tooth slices. Calibration into HU units and mineral density was obtained by scanning, reconstructing and processing stacks of HAp phantoms with different mineral densities (0.25, 0.75, 3.14 g/cm3). A median lter was applied to the tooth slices and a connected threshold grower was used to produce a nal mask, which was used to blank-out undesired structures (background/areas of partial volume effects). A threshold for the caries lesion (8-bit gray value = 75; mineral density = 1.11g/cm3) was obtained after correlating the lCT values with nano-hardness data obtained from carious areas (Nanoindenter, CSM Instruments, Switzerland). Results: Excavation with carbide burs or with a new line of ceramic instruments (Ceraburs, Komet, Germany) was performed in molars presenting small (13 mm3) or large caries lesions (45 mm3), from which a pre- and post-excavation lCT scan was obtained. The percentage of removed carious tissue was not different in the small cavities (80.5%-carbide burs, 80.3%-
P15225 The clinical performance of the occlusal minimally invasive restorations in primary molars
A. M. RADUCANU1, C. HERTELIU2, I. FERARU1 & I. CRISTEA1 1 Department of Paediatric Dentistry, U.M.F. Carol Davila, Faculty of Dental Medicine; 2Department of Statistics and Econometrics, University of Economics, Bucharest, Romania Introduction: Minimally invasive procedures for small occlusal lesions in primary teeth are an important part of new restoration methods that can be successfully applied in children. The objective of this study was the evaluation of the clinical performance of the direct occlusal restorations in primary molars, applied by the minimally invasive method, using adhesive materials, in comparison with the classical method, using amalgam. Materials and methods: A number of 258 direct occlusal restorations were placed in 144 patients with a mean age of 5 years and 5 months. The restorations were grouped in two samples: classical
Poster Sessions
amalgam llings (n = 124) and minimally invasive restorations (n = 134). Results: The restorations median survival time was calculated using Kaplan-Meier statistics and survival tables methods and showed differences between the two groups. The median survival time of classical amalgam restorations (4.6 years) was higher in comparison to minimal invasive restorations (4.0 years) (P < 0.1 for Log-Rank test and P < 0.05 for Breslow and Tarone-Ware tests). The overall failure rate was 18.2%. In detail, 19.4% of the minimal invasive restorations and 16.9% of the amalgam llings failed over the study period. Conclusions: The survival rate of the minimal invasive restorations was slightly lower in comparison to the amalgam restorations. randomly into 11 groups and were treated respectively according to the grouping criteria. Samples were immersed in a 2-day pHcycling solution again for acid challenge. For acid resistance evaluation, calcium concentration dissolved from the enamel surface was analysed by ISE-trol. Scanning electron microscopy was used to assay geographic changes of enamel surfaces, and polarized light microscopy was also used to observe the optical phenomenon alternation. Finally, impedance was detected by an impedance analyzer. Results: The control group and Er: YAG laser groups showed a statistically signicant (P < 0.05) higher calcium concentration compared with the APF group and the other two laser groups. From SEM, the melting and re-crystallization surfaces and crater-like holes of 120 lm in diameter were found in the CO2 laser and Nd:YAG laser groups, and Type I, II, III etching patterns were found in Er:YAG laser groups. From PLM, the reversal of birefringence was observed in all laser groups. Finally, AC impedance and equivalent circuit analysis was useful for the evaluation of the contributor after laser irradiation on the decalcied enamel. Conclusions: Application of Nd: YAG laser, CO2 laser and APF on enamel incipient caries will increase acid resistance. The effects of lasers are better than APF.
P15226 Assessment of manual restorative treatment (MRT) with amalgam: results after 5 years
I. M. SCHULER1, B. MONSE2 & R. HEINRICH-WELTZIEN1 1 Department of Preventive Dentistry, University Hospital Jena, Germany; 2Department of Education, Health and Nutrition Center, Cagayan de Oro, Philippines Introduction: The aim of this study was to evaluate the survival rates of amalgam restorations in manually prepared cavities in high caries Filipino children. Provision of restorative treatment was part of a 5 year comprehensive school based oral health program in the Philippines. Materials and methods: Cavities were prepared using hand instruments and for lling an encapsulated amalgam, mixed with a manual powered triturator. The parents of the children gave written informed consent. At the nal evaluation of the program a total of 1333 restorations in permanent teeth of 627 Filipino children were evaluated using ART criteria (Holmgren et al., 2000). Results: The mean observation time was 2.7 years, the overall survival rate of the amalgam-restorations was 95.3%. Related to the age of restoration a maximum failure rate of 7.3% was found for 4-year-old restorations. The overall failure rate of the class II restorations was 11.4% compared with 4.4% for the class I restorations. The survival rate of large occlusal restorations was 94.1% compared with 96.6% for small occlusal restorations. The experience and professional level of the operator did not inuence the survival rate of the MRT restorations. Conclusion: Especially for extensive occlusal lesions of permanent teeth in high caries risk populations amalgam can be considered as a suitable lling-material in ART-prepared cavities.
P15228 Effects of an ART restoration on dentin

N. L. VISSER, C. P. J. M. BOON, W. E. VAN AMERONGEN & A. M. KEMOLI Department Cariology Endodontology Pedodontology, Academic Centre of Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands Introduction: Atraumatic restorative technique (ART) was developed to meet some particular needs of dental treatment in developing countries. A lot of ART restorations fail, especially Class II restorations. The objective of this research is to explore whether, in this context, the most appropriate solution for failed ART restorations is re-restoration or leaving the preparation further unlled. Materials and methods: In 2006 a group of children in Kenya has been treated with the ART technique. Out of this group 192 children who lost their Class II restoration and still had the treated molar in situ were selected. The time span for which the restoration has functioned is known and the colour, hardness and coloured dentin (with a caries detector) have been evaluated. Results: 66% of the molars were scored with hard dentin, 78% with dark dentin and 51% with non coloured dentin. There is a positive correlation of these criteria with the time the restoration has functioned. The molars were scored with hard dentin in 59.5% of the cases when they have lost the restoration within 06 months, between 612 months 60.7% scored hard dentin and between 12 18 months 92.3%. Non coloured dentin was scored in 45.9%, 53.6% and 61.5% of the molars at the same retention times. Conclusion: The outcomes of this research indicate that according to clinical criteria re-restoration of these molars is dependant on the retention time and the expected life time of the tooth.
P15227 Effects of lasers and uoride on the acid resistance of human decalcied enamel
C. C. CHEN1 & S. T. HUANG2,3,4 1 Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University; 2Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University; 3Dentistry for Children and Disabled, Chung-Ho Memorial Hospital, Kaohsiung Medical University; 4Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: In order to preserve healthy enamel and increase acid resistance of incipient carious lesions, Nd: YAG laser, CO2 laser, Er: YAG laser and APF were used to treat incipient carious lesions. Materials and methods: Two hundred and twenty samples from human caries-free pre-molars were immersed in a 2-day pH-cycling solution for incipient caries formation. All samples were divided
Cariology 2 P15229 Inuence of the Hall-technique on the open bite and the crown length
W. E. VAN AMERONGEN & L. RADEMAKERS Academic Centre of Dentistry Amsterdam (ACTA), Department Cariology Endodontology Pedodontology, Amsterdam, Netherlands Introduction: The consequence of placement of preformed metal crowns (PMCs) without preparation is that the bite will be propped open. However, it is unknown how fast the open bite disappears and whether this is caused by extrusion of the adjacent teeth or intrusion of the teeth directly involved. The aim of this study was to get more information about the open bite, created by using the Hall- technique. Materials and methods: In 66 children, mean age 5 year 7 months, 114 PMCs were placed. The open bite was scored by measuring the distance between upper and lower cuspid just before placing the crowns, immediately thereafter and after 1741 days. For the purpose of this study 48 crowns were used. Of another 18 crowns, its neighbors and opposing teeth the crown length was measured immediately after treatment and after 1 month. The study was approved by the Ethical Committee and informed consent was obtained from the parents. Results: Before treatment the overbite between the cuspids was 2.4 mm (SD 1.1). Immediately after placing all crowns the bite was propped open to 0.5 mm (SD 1.8). This difference was signicant. After 17 days (n = 19) the open bite was reduced from 2.5 to 1.8 mm, meaning that the bite was not fully closed again (P = 0.038). After 41 days (n = 27) the open bite was further reduced (from 2.2 to 1.9 mm; P = 0.256). The crown length of teeth with PMCs and their opposing teeth reduced signicantly (P = 0.046 and 0.02 resp.) and that of the adjacent teeth did not change (P = 0.739). Conclusion: Due to intrusion the open bite is reduced in a period of a good month. second group were noted to show a rise of 4% in dentine mineralization, which was as insignicant as it was unreliable. Conclusions: The use of calcium-based materials for prolonged caries treatment of permanent teeth with incomplete mineralization enhances mineralization of dentine and helps prevent pulpitis.
P15231 Delivery of treatment in a peadiatric dental practice changes over a 10-year period
N. KOTSANOS1,2 & M. KOSTOPOULOU2 1 Department of Pediatric Dentistry, Aristotle University; 2Paediatric dentist, Thessaloniki, Macedonia province, Greece Introduction: We aimed to study whether treatment needs and preferred treatment delivery has changed in a Greek private paediatric dental practice over a 10-year period. Materials and methods: We screened the charts of all patients who shoed for an initial comprehensive examination, by K.N. only, at the part-time practice. These were 174 during 1996 and 186 during 2006. Parameters including age, gender, caries indices, reasons for visiting, source of referral, type of treatment needs (pulp treatments, extractions), treatment plan completion and response to recall, were examined and analysed with descriptive statistics. Results: Mean age was similar in both groups, approx. 7.5 years. There was no signicant difference in most parameters, i.e., DMFT: 0.7 vs 0.96, dmft: 2.9 vs 2.5, referrals from a dentist: 45% vs 40%, referral from a paediatrician: 12% vs 16%, patients who completed the treatment plan: 76% vs 74%, 1st recall attendance: 33% vs 32% for 1996 vs 2006, respectively. The only most notable difference was a drop from 35 to 13% in pulp treatments (not accompanied by any increase in extractions), the greatest proportion of these were vital puplotomies. Conclusion: No signicant differences were evident regarding the needs, planning and delivery of dental treatment between 1996 and 2006. The only signicant decrease found in the number of pulpotomies is perhaps explained on the basis of increased experience and the shift from amalgam to resin modied glassionomer cements, both aiding to a more conservative approach towards indirect pulp capping vs pulpotomy in deep cavities.
P15230 Validation of a prolonged lling method of dental caries treatment of children

M. A. SHEVCHENKO, L. P. KISELNIKOVA & N. V. OZHGIKHINA Department of Paediatric Dentistry, Moscow State Medicine and Dentistry University, Moscow, Russia Introduction: Raising the efcacy of treating caries in permanent teeth with incompletely mineralized hard dental tissues. Patients and methods: Treated for dentine caries during the rst two years after eruption were 39 subjects aged 613 years. In the rst group (29 teeth), carious cavities underwent mechanical preparation and coating of their walls and oors with Dycal calcium hydrate for 1 months time, following which the inlays were removed and cavities permanently lled. The second group (40 teeth) was treated likewise except for the coating which was a zinc oxide-based Dentin-paste. Before doing both temporary and permanent lling the dentine mineralization was checked using the Russian-made Geosoft Dent-Est electrometer. Results: Initially, dentine electrical conductivity in both groups was the same - 63.97 0.65 mcA, 44.38 0.77 mcA, and 45.29 0.81 mcA in the rst, and 63.87 0.76 mcA, 44.39 0.93 mcA, 44.27 0.66 mcA in the second group, respectively. After the one-month calcium hydrate treatment, the dentine conductivity in the rst group showed a signicant (P < 0.001) decrease of 68.09% in the oors and 57.42% and 58.17% in the walls of the treated cavities. The cavities in the
P15232 The inuence of ozone on retention of sealing material: a clinical study

W. DUKIC1, O. LULIC DUKIC1, A. ERDELJAC1 & S. KADIC2 1 Department of Pediatric Dentistry, School of Dental Medicine, University of Zagreb; 2Department of Pediatric Dentistry, Dental Polyclinic Zagreb, Zagreb, Croatia Introduction: The aim of the present study is to clinically analyse the inuence of pre-treatment of enamel with ozone prior to ssure sealing with owable composite material, on retention of the seal. Retention of the nanohybrid owable composite material as a material for ssure sealing was also analysed through the clinical period of 24 months. Materials and methods: Group A consisted of 79 healthy permanent molars who were treated with ozone from KaVo Healozone device before the application of Voco Grandio Flow owable composite. Group B consisted of 75 healthy permanent molars who were also sealed with Voco Grandio Flow but without the pre-treatment with ozone. Testing of the materials retention was conducted after 24 months of clinical use. Following values were assessed: 0complete retention, 1-loss of 1/3, 2-loss of 2/3, 3-complete loss of seal, 4-caries. Chi square test was used for statistical analysis.
Poster Sessions
Results: After 24 months of clinical use, complete retention was found on 82.3% of the teeth in group A, and 84% in group B. Caries was found in 1.3% of the cases in group B only. No statistically signicant differences between the groups (v2 = 1.976; P = 0.577) were found. Conclusion: Considering the fact that ozone had no negative effect on retention of the sealing material after 24 months, we concluded that it can be used as pre-treatment of enamel before ssure sealing. Sealing the ssures with nanohybrid owable composite showed a high degree of retention and consequently excellent prevention of occlusal caries. Materials and methods: Sixty recently extracted sound third molars were randomly assigned to three groups for three different sealing materials (n = 20). Each sealant group was then randomly divided into two as uncontaminated (n = 10) and saliva contaminated (n = 10) prior to sealant replacement. The samples were thermocycled in water for 500 cycles between + 5 and + 55C with a dwell time of 30 s and immersed in 1% methylene-blue for 24 h in 37C. The samples were then sectioned and scored on a 3 point rating scale using a light microscope. MannWhitney-U-test was used for statistical analysis. Results: In uncontaminated group, mean microleakage scores for Helioseal F, Enamel Loc and Fuji VII were 0.37, 0.65 and 0.90 respectively. The difference was statistically signicant among three ssure sealants (P < 0.05). In the presence of saliva contamination, mean microleakage scores were 0.53, 0.77 and 0.90 for Helioseal F, Enamel Loc and Fuji VII respectively. Helioseal F group was given signicantly the lowest score (P < 0.05), whereas no signicant difference was noted between Enamel Loc and Fuji VII groups. Conclusions: Under both uncontaminated and saliva contaminated conditions, the light cured resin based pit-and-ssure sealant Helioseal F yielded lower microleakage scores compared to Enamel Loc and Fuji VII.
P15233 The effect of ozone pre-treatment on the microleakage of ssure sealants

S. B. CEHRELI1, Z. YALCINKAYA1, T. DEMIR1 & G. GUVEN-POLAT2 1 Department of Paediatric Dentistry, Baskent University Faculty Dentistry; 2Department of Paediatric Dentistry, Center of Dental Sciences, Gulhane Medical Academy, Ankara, Turkey Introduction: This study investigated the effect of ozone pretreatment on the microleakage and marginal integrity of ssure sealants placed with or without a self-etch adhesive. Materials and methods: Freshly-extracted, unerupted human permanent third molars were randomly assigned into two main groups (n = 48), in which the ssures either received ozone pre-treatment (Group A) or were left untreated (Group B). Teeth were further divided into two subgroups randomly (n = 12/each) so that half of teeth received conventional ssure sealants (Fissurit F, Voco, Germany), while ssures of the remaining teeth were treated with a self-etch adhesive (Clearl Protect Bond, Kuraray, Japan) before placement of the sealant. Following thermal cycling (1000X), the specimens were sealed with varnish and immersed in 0.5% basic fuchsin for 24 h. Then, the specimens were sectioned and photographed digitally. The extent of dye penetration on the toothsealant interface was measured by image analysis software (ImageJ). The data were analysed statistically with Kruskal Wallis and MannWhitney U tests (P = 0.05). Two randomlyselected sections from each group were observed under SEM. Results: Ozone-pre-treatment of ssures signicantly reduced the microleakage, regardless of the application mode of the ssure sealant (P < 0.001). When sealants placed with or without a selfetch adhesive are compared, microleakage scores did not reveal signicant differences in Group A. However, in Group B, conventional ssure sealants demonstrated lower microleakage scores (P = 0.009). Sections observed under the SEM demonstrated better adaptation of the sealant in ozone-pre-treated specimens. Conclusion: Within the limitations of this in vitro study, it was observed that ozone pre-treatment favorably affected marginal integrity of ssure sealants.
P15234a Risk factors for early childhood caries (ECC) in 25 year-old children
M. YILDIRIM, A. PATIR & F. SEYMEN Department of Pedodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey Introduction: There are numerous risk factors signicantly related to ECC. The most important are high-frequency intake of sugary snacks and drinks in a bottle, particularly during the night. The aim of this study was to determine the association of dietary habits and socioeconomic status for early childhood caries among 2 5 year-old children. Patients and methods: A total of 200 children (aged 25 years) were examined for gender, dmft, dmfs, dietary and brushing habits, duration and contents of bottle feeding, number of individuals in the family, educational level and occupation of parents, and socioeconomic status. Ethical approval and informed consent were obtained. Statistical analysis was performed by using NCSS 2007 software and one-way ANOVA, tukey test, t-test, chi-square test were performed between the groups. Results: Gender (P = 0.031), number of main meals (P = 0.017) and drinking milk before sleeping (P = 0.038) were positively associated with bottle feeding, and total income negatively (P = 0.0001). For children who were using a bottle, the mean average of dmf and dmfs scores were 9.88 and 15.5 respectively. Statistically signicant differences were found between dmf, dmfs scores of bottle feeding and nonbottle-feeding groups (P = 0.0001). The anterior caries pattern was more pronounced for bottle feeding only than for breast-and-bottle feeding and only breast feeding (P = 0.0001). Socioeconomic status was found to be signicantly associated with dmf and dmfs scores (P = 0.004, P = 0.036). Conclusion: ECC was more prevalent in pre-school children, especially those of low socioeconomic status. It was concluded that night-time breast-feeding in children, using a bottle at night and during the day correlated with the etiology of ECC.
P15234 Effect of saliva contamination on microleakage of three different ssure sealants

A. R. ALPOZ & A. A. K. TOPALOGLU Ege University, School of Dentistry, Department of Pedodontics, Bornova, Izmir, Turkey Introduction: Considering the multi-steps involved in the placement of ssure sealants, saliva contamination is inevitable. Fissure sealants with simplied application steps are in market today. This study compared the microleakage of three different ssure sealants namely, Helioseal F, Enamel Loc, Fuji VII under saliva contaminated and uncontaminated conditions.
Syndromes and Genetics
Poster Session P16/Syndromes and Genetics

P16235 Zinsser-Engman-Cole syndrome: a case report
B. BADRE1, A. BOUSFIHA2, M. C. MANIERE3, A. BLOCHZUPAN3,4, S. EL ARABI1 1 Department of Paediatric Dentistry, Faculty of Medicine Dentistry, Casablanca, Morocco; 2Department of Paediatrics, Faculty of Medicine, Casablanca, Morocco; 3Department of Paediatric Dentistry, Faculty of Dentistry, Strasbourg University, France; Reference Centre for Oral Manifestations of Rare Diseases, Hopitaux Universitaires de Strasbourg, France; 4IGBMC, Inserm, U964; CNRS, UMR7104, Illkirch, France Introduction: Zinsser-Engman-Cole (ZEC), (OMIM #305000) syndrome is a rare, often fatal, inherited disease. The main clinical features of this multi-system bone marrow failure disease are mucocutaneous, haematological anomalies and an increased predisposition to cancer opportunistic infections and other abnormalities. The orodental manifestations described in this syndrome are leukoplakia, early tooth loss and dental anomalies. We report one case of this syndrome to illustrate the orodental features. Clinical management: We present the case of twin boys, 15 years old, affected with ZEC. One of the two boys died after serious septic cutaneous complication (probable leprosy). The orodental ndings observed in the case reported here are multiple caries and periodontal disease with resorption of alveolar bone and premature tooth loss. The other clinical signs are skin pigmentation, nail dystrophy, sparse hair, leukoplakia in the mouth and testicular atrophy. The treatment consisted of extraction of damaged teeth under antibiotic treatment with conservative treatment of the other teeth and achievement of total prosthesis of the upper maxillary and partial prosthesis of mandible. Regular monitoring has been established to maintain good hygiene for the remaining teeth, and to prevent leukoplakia. Conclusion: ZEC syndrome also known as Dyskeratosis congenita is a very polymorphous disease where ve responsible genes have been identied (DKC1, hTERC, hTERT, TINF2, NOP10) encoding components of the telomeres and telomerases assuming critical functions in aging and cancer. It is important to correctly diagnose ZEC as this can have major implication for the clinical management of the patient. that the parents belong to the same family and that the sister of the patient had died at the age of 6 months suffering from Tetralogy of Fallot. Clinical examination of our patient revealed Polydactyly, short stature and hairy skin. Oral examination exhibited general caries involvement, conical and peg shaped teeth and a yellowish lump on the left side of the tongue. Under general anaesthesia all destroyed teeth were extracted and the remaining teeth were restored with composite restorations. Surgical excision of the lump on the tongue was performed. Histological examination showed it is brous tissue. Follow up examinations are performed every 6 months in the Pediatric Cardiology Clinic. Conclusion: Genetic counseling is recommended for prospective parents with any family history of (EVC) syndrome. It provides parents with the knowledge to make intelligent, informed decisions regarding possible pregnancy and its outcome. Children with EVCS can live their life normally not needing to be hospitalized unless they have other problem such as heart disease.
P16237 FloatingHarbor syndrome: orofacial manifestations and dental management

N. CHRYSAFI, S. GKOURTSOGIANNI & M. S. DUGGAL Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds, UK Introduction: Floating-Harbor syndrome is a rare genetic disorder initially described in 1973. Approximately 30 cases have been reported in literature up to the present. A 5-year-old female diagnosed with Floating-Harbor syndrome was referred to the Department of Paediatric Dentistry, Leeds, for dental management. The patient had the major features of the syndrome: short stature, speech delay and a characteristic face. On physical examination patients height was 91 cm and weight 15 Kg. Learning difculties were mentioned by parents. Triangular face with prominent nose, deep-set eyes, long eyelashes, short smooth ltrum, thin upper lip and short neck were evident. Extra-oral examination revealed class III skeletal pattern. On intraoral examination caries, extensive surface loss of all incisors, hypomineralised canines and primary molars, as well as malocclusion were diagnosed. Panoral radiographic examination revealed delayed dental age. Delayed bone age and celiac disease are common manifestations of the syndrome, however, only the former was evident in our case. Clinical management: Dental treatment under general anaesthesia included pulpotomies and stainless steel crowns, extraction of primary teeth with poor long-term prognosis, ssure sealants on non carious teeth and smoothening of sharp edges of anterior teeth. On clinical and radiographic examination 5 months post-operatively, no caries and furcational pathology were present, all restorations were intact and patient maintained very good oral hygiene. Conclusion: Very few cases of Floating-Harbor syndrome have been reported. The aim of this case presentation is to emphasize the craniofacial characteristics and to give insight into the general features involved in this multi-system condition.
P16236 Ellis-van Creveld syndrome (case report)

H. BANGAR & M. ALSIMI Pediatric Dentistry Department, Riyadh Military Hospital, Riyadh, Saudi Arabia Introduction: Chondroectodermal dysplasia (Ellis-van Creveld syndrome) is an autosomal recessive syndrome that was initially reported by Ellis and van Creveld (EVC) in 1940. A higher prevalence has been reported among certain populations such as the Amish and the Arabs of the Gaza strip. Today, the syndrome has been described in other population such as our community in Saudiarabia. Clinical management: A 5-year-old girl presented from Al-Taheel Rehab Center in Riyadh city for examination. Anamnesis showed
Poster Sessions P16238 RothmundThomson syndrome: a case report

_ M. C. DOGAN1, H. OZTUNC2, I. SASMAZ3 & B. ANTMEN3 1 Department of Paediatric Dentistry; 2Department of Oral Diagnosis and Radiology, School of Dentistry, Cukurova University, Adana, Turkey; 3Department of Paediatric Haematology, School of Medicine, Cukurova University, Adana, Turkey Introduction: Rothmund-Thomson syndrome (RTS) is an autosomal recessive disorder characterized by developmental skeletal abnormalities and poikilodermatous skin changes. The relationship between RTS and immune function impairment is described in the literature. In this case report an association with myelodysplastic syndromes is reported. Clinical management: In this case report, the dental and periodontal features of RTS in a 6-year-old female are presented. In addition, periodontal bone topography and maxillofacial structures were assessed by an Ultra Cone Beam CT Scanner. Skeletal structures were found normal. Maxillary pre-molars were found to be congenitally missing.Untreated caries lesions were detected in all primary teeth. The gingiva was very fragile and gingival bleeding occured spontaneously. The patient did not allow the restoration of her teeth under local anaesthesia and besides due to the present medical status general anaesthesia was contraindicated. Conclusion: All the ndings indicate that preventive approaches are important and not only the dentists but also haematologists must focus on oral hygiene of patients with RTS before the dental and periodontal problems have occured.
P16240 Unusual dental ndings in a girl with RussellSilver syndrome

V. L. GOPALAKRISHNAN, C. W. M. CHUNG & N. M. KING Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China Introduction: RussellSilver syndrome (RSS) is a congenital disorder of unknown aetiology characterised by pre-natal and post-natal growth retardation, short stature, limb asymmetry, facial dysmorphism and oral abnormalities. This case report describes the general features, and in particular the dental ndings and their signicance, in a Chinese girl with RSS who has been followed up at our dental hospital over the past eighteen years. Clinical management: This patient was referred to our hospital at 13 months of age because of the presence of an unrepaired cleft palate and failure to thrive. Characteristically, her body weight and height were consistently below the 3rd percentile, with her head circumference on the 25th percentile. She also exhibited mental retardation and bilateral hearing loss. Examination revealed frontal bossing with triangular facies and a cleft of the palate. Furthermore, she presented with down-turned corners of the mouth and small maxillary and mandibular dimensions. Following closure of the palate, her dental development was reviewed and found to be delayed in both the primary and permanent dentitions. Severe crowding and tilting of the teeth were subsequently noted in addition to a double tooth in the primary dentition. Panoramic radiographs have revealed two congenitally missing pre-molars, impacted mandibular rst permanent molar, a macrodontic mandibular incisor and some teeth with bulbous crowns and short, fused roots. Conclusion: Few reports describe unusual dental ndings in patients with RSS. Nevertheless, the presence of dental anomalies, especially short roots along with intellectual impairment can limit treatment options, especially orthodontic therapy.
P16239 A case report of Pallister-Killian syndrome (PKS): new dental ndings

R. Y. DU, C. W. M. CHUNG & N. M. KING Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Pokfulam, Hong Kong SAR, China Introduction: Pallister-Killian syndrome (PKS) is a sporadic condition with autosomic tetrasomy of chromosome 12 p, resulting in a mosaic distribution of the supernumerary isochromosome. We report a case of PKS affecting an 11-year-old girl with 12 p mosaicism (karyotype 46, XX). Diagnosis was conrmed at 2 years of age. She presented with alopecia, dysmorphic facies, diaphragmatic hernia, PDA and a dilated aorta root. Extra-oral ndings included facial asymmetry, low implantation of the ears and sparse eyebrows. The dental ndings included delayed eruption, macrodont maxillary right central incisor (or double tooth) with congenital absence of the lateral incisor in both the primary and permanent dentitions. There was an anterior single tooth crossbite, spacing, and a posterior cross-bite. Clinical management: The discrepancy in size between the maxillary permanent right and left central incisors presented a treatment dilemma, because reduction of right central incisor was impractical, so the left central incisor was built up to improve the aesthetics of the anterior region. All of the invasive procedures were performed under prophylactic antibiotic cover according to the advice of her paediatrician. Due to her delayed dental development, orthodontic treatment has not yet been carried out. Conclusion: In PKS dental anomalies, such as macrodontia, may be present. The management of this anomaly should be cognisant of the systemic problems and yet able to provide an aesthetic outcome.
P16241 Ketone utilization disorder and hypodontia

A. ALACAM1, Z. A. GUCLU1 & A. HASANOGLU2 1 Department of Pediatric Dentistry, Faculty of Dentistry; 2 Department of Pediatric Metabolism and Nutrition, Faculty of Medicine, Gazi University, Ankara, Turkey Introduction: Ketone Utilization Disorder is a deciency in mitochondrial acetoacetyl-CoA thiolase. Children with lack of this enzyme are unable to break down proteins, resulting toxic build-up in body tissues. There are only 50 cases reported at the literature but there is no evidence for oro-dental ndings. Clinical management: In this study a 10-year-old male patient with the Ketone Utilization Disorder was examined. Dental examination showed normal intraoral soft tissues but there was delayed eruption of anterior mandibular permanent teeth. Also deep caries lesions in the primary molar teeth were detected. In the radiological evaluation, congenital missing of ve permanent teeth indicating hypodontia was observed. There was no family history of delayed eruption or hypodontia. Calcium deciency according to special diet of the patient may explain the caries prone structure of the primary teeth. Dental restorations were completed and it is planned to monitor the patient until the end of the craniofacial growth, when it will be again evaluated and forwarded for the nal oral rehabilitation. Dental examination is an important parameter which must be taken into consideration in the future case reports. Conclusion: Congenital missing of permanent teeth is an important dental observation in this case as no previous publications reported

the association of hypodontia and this deciency. Further investigation would probably be required to show the relationship of oro-dental ndings and Ketone Utilization Disorder.
P16244 Airway characteristics implications in Pierre Robin Sequence on intubation for dental treatment
Y. PALMON1 & P. BOKSENBOJM2 1 Pediatric Dentistry Clinic; 2Surgical Day Care Unit, Anesthesia Department, Barzilai Medical Center, Ashkelon, afliated to the Faculty of Health Sciences Ben-Gurion University of The Negev, Israel Introduction: Pierre Robin Sequence (PRS) is a congenital disorder including: cleft palate, micrognatia, glossoptosis and airway obstruction. The oral cavity is smaller than usual, muscle development may be poor and the airway itself may be narrow, resulting in breathing difculties and feeding problems. Clinical management: A 5-year-old girl was diagnosed as having PRS and severe Early Childhood Caries. Her medical history included: surgical closure of Cleft Palate, Failure to Thrive, Asthma, Strabismus and Mental Retardation. Due to her medical and dental conditions, dental treatment was performed under General Anaesthesia. To avoid hypoxia during induction, a exible beroptic bronchoscope device was used for the intubation. Vital signs were normal throughout the procedure. The recovery was uneventful and the child was released 3 h after the dental treatment was completed. Conclusion: This case demonstrates the important problems associated with PRS during General Anaesthesia. The use of a exible beroptic bronchoscope device for intubation is mandatory for airway security.
P16242 Levy-Hollister syndrome case report

B. HAVLOVICOVA1, R. IVANCAKOVAR1 & J. JUTTNEROVA2 1 Department of Dentistry, University Hosp. and Medical Faculty, Charles University; 2Department of Genetics, University Hospital, Hradec Kralove, Czech Rep Introduction: The extremely rare Levy-Hollister syndrome is an autosomal dominant disorder with multiple dysfunction of renal functions and abnormalities in orofacial region. Clinical management: A Two year-old boy was referred to the Department of Paediatric Dent., University Hosp., Hradec Kralove because of recurrent mucous lesions. Based on clinical and ultrasonic examination these orofacial signs were found: unilateral congenital absence of the lacrimal duct, bilateral congenital absence of parotid and submandibular salivary glands resulting in severe dryness of oral mucosa and abnormally shaped primary teeth. Subsequent paediatric and radiographic examination revealed the diagnosis- Levy-Hollister syndrome. Therapy was focused to the substitution of saliva and primary prevention of dental caries. Conclusion: Early recognition of this disorder and continuous dental care should reduce the long-term morbidity in affecting patients.
P16243 Ectodermal dysplasia a case report

S. NATESH, V. ANANTHAN, V. RAJENDREN & R. APATHSAKAYAN Department of Pedodontics and Preventive Dentistry, Sri Ramachandra Dental College, Porur, Chennai, India Introduction: Ectodermal Dysplasia is a group of closely related conditions involving at least two of the ectoderms (hair follicles, sweat glands, teeth, nails, salivary glands). Oral ndings are important and usually multiple abnormalities affect both function and aesthetics. This plays a major role in the psychological development of the child as the condition manifests itself at an early age. Clinical management: A patient with ectodermal dysplasia requires counseling as well as extensive dental treatments. Here a case report of an 8 year old girl who reported to the dental clinic with complaints of dryness of mouth is presented. Medical history revealed that the child had intolerance to heat, no sweating and lack of lacrimation. The mother had early loss of primary and permanent teeth. For the child a history of extraction of all primary teeth due to rampant caries one year before was elicited. Dental examination revealed absence of all primary teeth. The maxillary and mandibular central & lateral incisors and rst molar teeth were present and the orthopantomograph revealed the presence of the remaining permanent tooth buds. A removable partial denture was given to maintain function and aesthetics until the eruption of the permanent teeth. regular follow up and review has been done. Conclusion: Rehabilitation of the patient with a removable partial denture which was aimed at restoring function provided a big psychological boost to the patient. This emphasizes the need for early diagnosis of oligodontia due to ectodermal dysplasia and its treatment in young children.
P16245 Management of anodontia in hypohidrotic ectodermal dysplasia

G. L. RICHARDSON, F. MACAULAY & K. E. HARLEY Department of Paediatric Dentistry, Edinburgh Postgraduate Dental Institute, Edinburgh, UK Introduction: Ectodermal Dysplasia (ED) is a rare inherited disorder in which two or more ectodermally derived structures either fail to develop or are abnormal in their development. Approximately 150 variations exist of which around three-quarters exhibit oral anomalies including abnormalities in eruption patterns, alveolar ridge volume, salivary secretions and most frequently tooth number (hypodontia or anodontia). Hypohidrotic Ectodermal Dysplasia (HED) or Christ-Siemens-Touraine syndrome is the most common form of ED with a reported incidence of 1/10,000 to 1/100,000 births. Affected individuals are characterised by hypohidrosis, hypotrichosis and oro-facial abnormalities. Clinical management: Two male patients (Child A: 2-years-old; Child B: 4-years-old) with conrmed HED were referred to the Department of Paediatric Dentistry. In each case the parents were concerned regarding the lack of development of the primary dentition and its impact on their child. On extra-oral examination, both children had light-coloured scanty hair, frontal bossing and dry skin consistent with HED. Intraoral examination revealed an absent primary dentition and subsequent radiographs conrmed anodontia in both cases. Following careful case evaluation, each child was provided with a set of complete removable maxillary and mandibular dentures (Child A at 3-years-old; Child B at 4-yearsold). Both adapted well to denture wear and their parents perceived an improvement in their overall well-being. At subsequent reviews (Child A over 5 years; Child B over 1 year) both continue to progress well with replacement dentures provided for Child A due to growth.
Poster Sessions
Conclusion: Appropriate dental intervention in children with HED can help facilitate well-being. After uoride application, periodic follow up has been done every 3 months. After 18 months of follow-up, the dentures are functioning well and so far, no more primary teeth have appeared. Conclusion: Patients with IP need interdisciplinary coordination; thereby resulting in better treatment and improved quality of life. Routine follow-up and consulting ophthalmologists, dentists, and neurologists are essential.
P16246 Phenotype and treatment of amelogenesis imperfecta with unerupted and resorbed permanent teeth
A. STROIANU, S. SEGAL & U. ZILBERMAN Pediatric Dental Clinic, Barzilai Medical Center, Ashkelon, Israel Introduction: Amelogenesis Imperfecta (AI), the earliest dental syndrome recognized in human ancestors, is a collection of diverse inherited disorders, featuring enamel defects in the absence of signicant nondental symptoms. AI phenotypes vary and are categorized as hypoplastic, hypocalcied and hypomaturation types. The different conditions are caused by mutations in a variety of genes that are critical for enamel formation. The aim of this presentation is to describe the phenotype of a rare case of AI and the dental treatment provided. Clinical management: A.D., a 16-year-old Bedouin girl was referred for dental treatment to the Pediatric Dental Clinic at Barzilai Medical Center, Ashkelon. Her major complaint was brown discolorations of the permanent teeth and missing teeth, a condition that affected some other members of her family. Based on clinical and radiographic oral examination and the family pedigree, she was diagnosed as suffering from autosomal recessive hypoplastic Amelogenesis Imperfecta combined with eruption defects and crown resorption of permanent teeth. Due to the extensive and complex dental treatment, the dental work was performed under general anaesthesia. The treatment included aesthetic composite restorations for all anterior teeth, surgical exposure of unerupted canine, pre-molars and molar and coverage of all permanent pre-molars and molars with SSC. A 6-month follow-up showed improved Quality of Life. Conclusion: This rare case of AI demonstrates the phenotype variability of this AI disorder and the complex approach needed for restorative treatment.
P16248 Uncommon oral ndings in Ellis-van Creveld syndrome: a case report

B. TEZEL1, T. ILERI KECELI1, M. TEKCICEK1, M. D. TURGUT1 & Y. ALANAY2 1 Department of Paediatric Dentistry; 2Clinical Genetics Unit, Department of Paediatrics, Hacettepe University, Ankara, Turkey Introduction: Ellis-van Creveld syndrome (EVC) is an autosomal recessive disorder characterized by short ribs, polydactyly, growth retardation and ectodermal and heart defects. Common dental ndings of EVC are abnormal fraenal attachments, malformed teeth, supernumerary teeth, hypodontia, eruption disturbances and enamel hypoplasia. In the present case, uncommon dental ndings of the syndrome including talon cusp, taurodontism, double tooth and root dilaceration are presented. Clinical management: A 3.5-year-old girl with EVC was referred to the paediatric dentistry clinic. Intraoral examination revealed constricted palate and shallow upper and lower sulci. There were multiple abnormal upper and lower fraenal attachments along with a broad upper labial fraenum. A talon cusp was detected on carious maxillary primary left central incisor. The mandibular primary right molars and mandibular primary left rst molar were also carious. The teeth were generally malformed. In the radiographic examination missing maxillary and mandibular primary lateral incisors were detected. The mandibular primary left central incisor was horizontally impacted since its root was dilacerated. There was an unerupted permanent double tooth located in the right maxillary anterior region. Taurodontism of the mandibular primary rst and second molars was also detected radiographically. The carious teeth of the patient were restored with a poly-acid modied resin composite (Dyract eXtra, Dentsply DeTrey, Konstanz, Germany). The patient has been under control for 8 months to observe any changes in the mouth. Conclusion: Although EVC has typical oral mucosal and dental anomalies, the presented uncommon oral ndings may help to establish a proper diagnosis of the syndrome.
P16247 Dental management for patient with incontinentia pigmenti: a case report
J. M. SU Dental Department, Show-Chwan Memorial Hospital, Chang-Hua, Taiwan Introduction: Incontinentia pigmenti (IP), also known as BlochSulzberger syndrome, is a rare, X-linked, dominantly inherited disorder of skin pigmentation that is often associated with ocular, dental and central nervous system abnormalities. This report describes a patient with incontinentia pigmenti who exhibited multiple missing teeth in both arches. The dental anomalies and treatment procedure are presented. Clinical management: A girl with incontinentia pigmenti presented with the chief complaint of only two upper incisors being erupted by the age of one year and eight months. Clinical exam found that she had pigmentation over her body including the extremities and trunk. One of her eyes was blind. Intraoral exam found that only two maxillary peg-shaped incisors had erupted. After thorough palpation of her ridges, more tooth buds were suspected to exist. Therefore, it was planned to supply the child have dentures made after all of the expected primary teeth had erupted. Two years after the rst appointment, 8 more teeth had erupted, the 4 canines being peg-shaped. Dental treatment under general anaesthesia was planned due to her poor cooperation. Full mouth rehabilitation was performed; the pegged incisors restored using composite resin. Maxillary and mandibular dentures were fabricated and delivered.
P16249 Infantile Malignant Osteopetrosis: dental ndings and management in 2 siblings

H. J. TONG & M. S. DUGGAL Child Dental Health, Leeds Dental Institute, Leeds, UK Introduction: Infantile Malignant Osteopetrosis in children is a rare autosomal recessive genetic disorder characterized by impaired osteoclastic functions. The estimated prevalence is 1 in 300,000 births. Osteoclastic equilibrium in these patients is altered, where bone apposition continues without normally balanced resorption. Patients present with short stature, skeletal malformations, predispositions to fractures, haematopoiesis dysfunctions, and cranial nerve compressions. They are also at risk of developing osteomyelitis of the jaws. Allogenic bone marrow transplantations have been proposed as a viable treatment option. Clinical management: The oral ndings of 2 sisters are presented. Only the older sibling had undergone bone marrow transplantation. Similarities in clinical features observed included delayed
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tooth eruption and exfoliation, hypodontia, enamel hypoplasia, and tendency for caries and periodontal disease. Radiographic examination revealed bone sclerosis leading to failure of eruption, impacted and ankylosed teeth; periodontal membrane defects; abnormal tooth shape and missing molar roots; atypical pulp morphology; and disturbances in enamel mineralization. Carious teeth were restored and options for replacement of missing teeth were explored. Strong preventive regimes and frequent recalls were implemented. Conclusion: The development of the dentition is severely disturbed in both siblings with osteopetrosis. Despite having undergone bone marrow transplantation, the older sibling did not appear to present with osteoclastic normalization. Oral presentations of the older sibling did not markedly differ from that of the younger sibling. There was no catch up dental development, therefore normal tooth eruption and development was not reestablished. Management is aimed at preservation of existing dentition and rehabilitation of function. presents with vast numbers of neurobromas and patches of skin hyperpigmentation. The aim of this presentation is to present the combined therapeutic dental treatment in a patient diagnosed with neurobromatosis. A 15 year-old Caucasian girl, diagnosed with neurobromatosis presented at the graduate clinic of the paediatric dentistry department. Extra-oral examination revealed no evident skin lesions, while intraoral and radiographic examination revealed multiple carious lesions, partial anodontia, retention of primary teeth and taurodontism. Clinical management: The dental management was performed in two phases and with the cooperation of the prosthodontic department. The rst stage involved restorative care of all carious lesions and the second phase involved the prosthetic rehabilitation of the missing teeth. Most of the primary and permanent teeth, regardless of their mobility, were retained and a partial upper denture was constructed. The treatment was satisfactory and in the 6 and 12-month post-operative follow-ups the patient reported no further problems or symptoms. The treatment performed to date is provisional until growth is completed. Conclusion: This was an intermediate phase in order to temporarily improve aesthetics and restore function, in terms of occlusion. Once growth is completed a more interfering treatment plan will be plausible.
P16250 Dental management of a young girl diagnosed with neurobromatosis

K. SEREMIDI, A. BOUGA, I. VASILOUDIS & G. VADIAKAS Department of Paediatric Dentistry, School of Dentistry, University of Athens, Greece Introduction: Neurobromatosis or von Recklinghausen disease is an autosomal dominant condition, rst described by von Recklinghausen in 1882. It is a rare condition occurring once every 2000 or 3300 births. The disease is a gene mutation, where the anomalies affect mesoderm and neuroectoderm. It commonly
Poster Sessions
Poster Session P17/Oral Medicine and Pathology

P17251 Pathologic root resorption of maxillary primary central incisors
J. E. LEE, C. H. CHUNG, H. J. CHOI, S. O. KIM & B. J. CHOI Department of Pediatric Dentistry, Yonsei University, College of Dentistry, Seoul, Korea Introduction: Physiologic root resorption occurs from the apex of the primary teeth close to the permanent teeth. Pathologic root resorption occurs on root surfaces due to various factors, such as dental trauma, inammation, replantation, orthodontic treatment, delayed or irregular eruption of teeth, or growing cysts or tumor. In children, the most frequently affected teeth from trauma are the maxillary primary central incisors. Pathologic root resorption initiates from the traumatized pulp or periodontium. Clinical management: These cases involve patients (age?) who visited the department of pediatric dentistry at Yonsei university dental hospital with the chief complaint of trauma of the maxillary primary incisors. We chose 10 maxillary primary incisors among those children, where the root resorption was observed in their periapical radiographs. The features of root resorption were classied according to Rubels types of pathologic root resorption of maxillary primary central incisors. Conclusion: Pathologic root resorption was observed in various patterns in all of the 10 traumatized maxillary primary central incisors. Although the teeth with pathologic root resorption were treated with pulpectomy, the resorption process continued. tumour recurrence. The parents were reassured and the condition was diagnosed as Freys Syndrome. The long-term plan is to review the patient. Fortunately, the condition is often resolves spontaneously. In fact treatment in the paediatric age group is unnecessary and often ineffective. Conclusion: This case highlights a rare complication in a paediatric oncology case. It is important for a paediatric dentist to be aware of these lesions and possible differential diagnoses.
P17253 Management of Arteriovenous malformation

S. AL-BAHLANI Al-Nahdha Hospital, Muscat, Oman Introduction: Arteriovenous malformations (AVM) are uncommon vascular abnormalities which can either be developmental defects present from birth, acquired or secondary to trauma. Large AVM is a problem because of disgurement, risk of enlargement, bleeding and rupture of the lesion which can be life threatening. General management of these cases are complex and are very challenging for plastic surgeons, however, many successfully treated cases are well documented in the literature Jeong H et al., Acta Oto-Laryngologica 2006; 126(3): 295300. Dental management of these cases is challenging due to risk of severe bleeding. Clinical management: This case report represents a 10-year-old girl with a large AVM affecting the right side of her face including mandible and the right side of the tongue. This case was managed by embolization, partial glossectomy and popescu suturing since 2004. The paper will present general management, dental ndings and dental management of the patient. Conclusion: In conclusion, dental management of this case was very challenging due to a large swelling affecting the right side of the cheek and tongue, risk of bleeding and difcult behaviour. The dental treatment provided was comprehensive and included prevention, restorations and behaviour management.
P17252 Freys syndrome, a complication of congenital haemangiopericytoma

H. ZAITOUN1, M. FARMAN1 & A. Y. YOUSEFPOUR2 1 Department of Paediatric Dentistry; 2Department of Oral and Maxillo-facial Surgery, School of Clinical Dentistry, Shefeld, UK Introduction: Freys syndrome is characterized by recurrent episodes of facial gustatory ushing and/or sweating, limited to the cutaneous distribution of the auriculotemporal nerve. The condition has rarely been reported in children where it is normally a sequel of perinatal birth trauma. Clinical management: A 16-month-old boy was referred by paediatric oncology with recurrent, unilateral facial ushing of the left cheek which had been present for 8 months. The ushing only occurred during mastication. There was no associated discomfort, swelling or perspiration. Of signicance was a previously diagnosed congenital haemangiopericytoma, a rare vascular tumour. The lesion had presented on the left cheek and parotid region, extending to skull base on MRI. Diagnosis was conrmed by incisional biopsy at 10 weeks of age and managed with Chemotherapy. On examination extra-orally there was a biopsy scar posterior to the left ear. There was no lymphadenopathy, swelling or facial ushing. However on stimulation, a orid ushing of the left cheek occurred extending from the left pre-auricular area to the corner of the mouth. Importantly, a subsequent MRI excluded
P17254 Alteration in odontogenesis caused by chemotherapy and radiotherapy in childrens oncology report of two cases
L. ARANEDA1,2, F. YURGENS3, S. PARROCHIA2, M. PINTO2 & ZUNINO2 1 Childrens Hospital Roberto del Ro; 2Escuela Odontologia Fac. Medicina-Clinica Alemana-Universidad del Desarrollo; 3Hospital San Jose, Santiago, Chile Introduction: Children with cancer have higher survival rates when treated with therapeutic oncology. Unfortunately it also causes disturbances in the formation of other body tissues and in odontogenesis. Radiation simultaneously affects the bone, periodontal ligament and pulp, causes the teeth to have abnormalities in their shape and size, and delays eruption. The magnitude is given by the childs age, the anatomical area irradiated and the frequency. Chemotherapy interferes with the cycle and cellular
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metabolism, can cause irregularities in the matrix and surface enamel microdontia, taurodontism, and prevent root development. The nature and extent of the effects vary with the type of drug used, its dose and the frequency of cycles of treatment. Panoramic X-rays taken prior to therapy are used to predict the development of dental abnormalities. Clinical management: Report of a girl of 12 with acute lymphoblastic leukaemia treated with chemotherapy and radiotherapy for 7 years. The clinical and radiographic examination showed irregularities in the surface enamel in the incisors and rst permanent molars. The second case is a child of 12 with a retinosarcoma treated with chemotherapy and radiotherapy from 2 years of age. We can observe slow growth and bone development, delayed eruption of premolars, and altered shape and size. The dental treatment is preventive and restorative planned with a view to the future. Conclusion: The sequelae of oncologic therapy pose challenges to dentistry. The imaging is essential in the diagnosis of disorders of odontogenesis and helps in planning the preventive treatment, rehabilitation and orthodontic. base, ranging in diameter from 0.1 cm to 1 cm, frequently coalescing. Lesion colour varies from red to white, depending on the extent of keratinization, MEH is found predominately in communities living in poverty in North, Central and South America and Greenland. The condition appears mainly in children and adolescents and regresses spontaneously. The aetiological factors and pathogenesis of MEH are speculative. A high incidence in close-living communities and among family members indicates a viral pathogenesis however host-factors such as immune-suppression, genetic predisposition, malnutrition and poor hygiene are key putative aetiological factors initiating the proliferation of connective tissue in MEH lesions. Clinical management: A 13 year old boy presented to the Royal Dental Hospital of Melbourne for dental examination. Intra-oral examination revealed several asymptomatic, exophytic, pink, sessile, smooth surfaced nodules situated on the lateral borders of the tongue and the lingual surface of the lower lip. The subject is of Somalian background and one of 11 siblings aged 222 years old living with their parents in an over-crowded residence. Examination of other family members revealed the presence of similar lesions in two younger sisters. The mother could recall a history of similar lesions in her mouth during her childhood. An incisional biopsy performed on the 13-year-old boy conrmed the diagnosis of MEH histopathologically. Conclusion: The family was informed of the benign nature of the lesions and close monitoring will continue.
P17255 Unexplained oral self-mutilation in a young boy: a case report

R. G. E. C. CAUWELS & L. C. M. MARTENS Department of Paediatric Dentistry & Special Care, PaeCaMeD Research, Ghent University, Ghent, Belgium Introduction: A boy of 3 years old presented at the paediatric clinic of the University Hospital Ghent with failure to thrive. For 6 months he suffered from an eating disorder and depression. Since then, he auto-extracted ve primary mandibular teeth for which no explanation could be found. After anamnesis, no explainable preexisting condition could be found. Only a few numbers of conditions are known presenting self-mutilation: hereditary sensory neuropathy, LeschNyhan syndrome and congenital indifference to pain syndrome. Clinical management: At the moment of the rst dental visit and after consultation by pediatricians, the boy was examined for other clinical manifestations in the head region to exclude child abuse. During the last 6 months, the child started to refuse feeding and did not enjoy child activities anymore. Recently he was put on an antidepressive and sedative regimen. Oral examination revealed the loss of 5 primary teeth. Because of active movements of the tongue, the alveolar bone remained uncovered and became necrotic. The remaining teeth showed normal mobility. Since a few weeks he started grinding his teeth night and day. It was decided to treat the extraction wounds under general anaesthesia. Although restriction of the hands, the child continued and succeeded this mutilation, extracting eight primary teeth and two germs from the permanent dentition the following week. Finally, presence of a rare cancer was diagnosed. Once the oncology treatment was started, the child stopped his self-mutilating behaviour. Conclusion: From this case it is obvious that self-mutilation may be related to chronic pain.
P17257 Fanconi anaemia manifesting as a squamous cell carcinoma after bone marrow transplantation
_ _ _ A. PINAR ERDEM1, G. IKIKARAKAYALI1, N. YALMAN2, G. AK3 & E. SEPET1 1 Department of Pedodontics; 2Department of Medical Biology; 3 Department of Oral Surgery and Medicine, Istanbul University, Istanbul, Turkey Introduction: Fanconis anemia (FA) is a rare autosomal recessive disorder characterized by various congenital malformations, progressive bone marrow failure at a very young age and of solid tumours development. Clinical management: This poster reports a rare case of a squamous cell carcinoma (SCC) of the mandible in a FA patient. A 16year-old boy with FA assisted at the Istanbul University Faculty of Medicine Department of Hematology, who had been submitted to bone marrow transplantation (BMT) at the age of 6. Ten years after the BMT, he was referred to Istanbul University, Faculty of Dentistry, with a mass on the right side of the mandible and pain complaint. The lesion was examined with CT and MR imaging and diagnosed as SCC after an incisional biopsy.Oral examination disclosed caries of molar teeth, periodontitis and restricted oral opening. There was a fungating purulent lesion of the right side of the mandible. He had severe mucositis interrupting his oral feeding. The panaromic radiograph showed a radiolucent lesion of the mandible extending from the right lower rst molar to the retromolartrigonum. It was a primer carcinoma with lenph metastasis that couldnt be resected. The patient underwent irradiation three times. He died few months later, dependant of malnutrition. Conclusion: FA patients receiving BMT should have a close follow-up. Careful examination should be directed to mucosal membranes, because these patients present increased risk for SCC. Risk factors must be considered and avoided; diagnosis and monitoring of preneoplastic elds might be a quantum step forward to early diagnosis and even prevention of SCC in FA patients.
P17256 Multifocal epithelial hyperplasia in Australiaa case report

C. L. HALL, M. MCCULLOUGH, C. ANGEL & D. J. MANTON Paediatric Dentistry, School of Dental Science, University of Melbourne, Melbourne, Australia Introduction: Multifocal epithelial hyperplasia (MEH) presents as painless, single or multiple nodular or papular lesions with a sessile
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Poster Sessions P17258 Oral rehabilitation of a child with gastroesophageal reux disease: case report
A. KARAGIANNI, M. ANGELOPOULOU, D. ZAMPELI & G. VADIAKAS Department of Paediatric Dentistry, University of Athens, Greece Introduction: Gastroesophageal reux disease (GERD) is dened as the symptoms and/or complications of the involuntary passage of the gastric contents into the oesophagus. Frequent episodes of regurgitation result in an acidic environment in the oral cavity that can cause dental erosion, which ranges from changes in enamel surface characteristics to extensive loss of tooth tissue. Clinical management: A 3 year old girl with GERD was referred to the postgraduate clinic of the paediatric dentistry department of Athens University for dental restoration. The main clinical manifestations were dental sensitivity, loss of occlusal vertical dimension, and poor aesthetics along with dental caries. An individualized preventive program with emphasis on dietary counselling and diet modications, uoride supplementation and appropriate practicing of oral hygiene measures was applied. The functional and aesthetic rehabilitation of the patient included composite resin restorations and stainless steel crowns. The patient has been followed for 2 years since then without complications. Conclusion: GERD is a frequent disorder in children and paediatric dentists should be aware of the changes in the oral environment and the dental complications of this condition. Management should focus on preventive measures aiming to counteract the acid attack on the teeth. such as Crohns as the cause of swollen lips. Oral manifestations can on occasions solely lead to initial diagnosis and management.
P17260 Solitary bone cystan unusual case report in a 7 yearold patient

D. LAZARIDOU1, A. ARHAKIS1, N. KOTSANOS1, A. KEVREKIDOU1 & K. ANTONIADIS2 1 Department of Paediatric Dentistry, Aristotle University, Thessaloniki; 2Department of Oral and Maxillofacial Surgery, Thessaloniki, Greece Introduction: Solitary bone cysts (SBC) are pathological cavities which occur most commonly in the proximal ends of the humerus and femus. A lesion with similar features found in the jaws, primarily in the mandible, may be classied in the same entity. SBC in the jaws are usually seen in patients 1020 years of age. Males are affected more often than females (3:2). The aetiology of the SBC is still obscure, but there are several theories suggested, such as infection, trauma and intraosseous vascular abnormalities. The radiographic examination shows a radiolucent, well dened lesion. The histological examination reveals that the SBC have no epithelial lining, but brous lining. The treatment of choice is enucleation of the cyst. Clinical management: A 7-year-old boy was referred by his general practitioner to the Department of Paediatric Dentistry, Aristotle University of Thessaloniki. A panoramic radiograph revealed a large, radiolucent lesion which extended in the anterior region of the mandible between the roots of the primary incisor teeth interrupting their eruption. The patient was treated under general anaesthesia in collaboration with the department of the Oral and Maxillofacial Surgery. The cyst was excised and the histological examination showed no epithelial lining. After a 2 year follow-up period, a considerable bony regeneration was evident, as well as a spontaneous eruption of the involved teeth. Conclusion: This study reports an unusual case of a solitary bone cyst and describes the clinical aspect, the radiographic appearance and the histological features of this lesion.
P17259 Oral-anal Crohns Disease with Staphylococcus aureus infection

R. KAUR & J. FEARNE Paediatric Dental Department, Dental Hospital, Royal London Hospital, New Road, London, UK Introduction: A 6-years old female presented to the emergency department concerned about sore corners of the lips and mouth ulcers for 6 months. GMP diagnosed nasal congestion and mouth breathing as the cause. Medically she was asthmatic, had dry skin, complained of a sore throat and suffered from constipation requiring hospitalisation once. Extra-oral examination revealed bilateral angular chelitis and enlarged lips were noticeable. Intraorally there was glossitis and generalised gingival inammation; the gingivae were erythematous, oedematous and gingival tags were associated with the lower right quadrant. A cobblestone thickening with ssuring and hyperplastic folds were found in the lower anterior labial mucosa and left buccal mucosa. No ulcers were visible and erosion was associated with her primary molars. Differential diagnoses included viral or bacterial stomatitis, orofacial granulomatosis, Crohns Disease, Sarcoidosis or Angioedema. Clinical management: A full blood count blood test was arranged and revealed high serum B12. Chlorhexidine gluconate 0.2% was prescribed for her gingival health and she was referred to Oral Medicine. Oral medicine examination found vaginal tags and anal stula, commonly seen in Crohns disease, and cause of bowel upset. Orofacial swelling, cracking of the lips and secondary bacterial infection were also noted. Flucloxicillin was prescribed for her Staphylococcus aureus infection. In addition patch testing for hypersensitivity was arranged and referral to Gastroenterology. Conclusion: Further investigations are necessary when clinical signs of orofacial granulomatosis present, to exclude other diseases
P17261 Adenomatoid odontogenic tumour associated with primary molar: report of an unusual case
P. EELATAWEEWUD1, S. VISUTTIWATTANAKORN2 & S. POOMSAWAT3 1 Department of Pediatric Dentistry; 2Department of Surgery; 3 Department of Oral Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand Introduction: A 7 year-old Thai girl presented with normal looking edentulous area at lower right second primary molar location. The patient was healthy and asymptomatic. No enlargement, sign of inammation and any compromised function were found. Panoramic and periapical radiographs revealed an embedded completely formed primary molar of which coronal part was covered with a well-dened unilocular radiolucency, 1cm in diameter, with traced calcication inside. No formation of the permanent successor was observed. No displacement of adjacent teeth reected less invasive and slow progressive lesion. Differential diagnoses were dentigerous cyst and adenomatoid odontogenic tumor. Clinical management: Under parental consent for treatment and report, excisional biopsy of the cystic-like mass and enucleation of the involved tooth were performed under general anaesthesia. The retrieved specimen appeared as a thick brous capsule with irregular inner wall and a regular primary molar. Histological nding of the capsule was consistent with adenomatoid odonto 2009 The Authors
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genic tumour, which is a rare, benign odontogenic tumour usually associated with permanent tooth with female and maxilla predilection. Space maintenance and the supraerupted opposing tooth were managed to preserve a good occlusion. After one year, normal bone healing is observed; no recurrence tumour and the permanent successor are detected. Conclusion: The case is uncommon for this type of tumour as it is associated with young patient in her rst decade of life and with primary tooth in posterior region of mandible. Enucleation of the involved tooth is unavoidable. Although tumour recurrence is rare, the occlusion integrity is compromised demanding continual multidisciplinary approaches. Clinical management: Comprehensive intraoral examination revealed a pedunculated brous lesion approximately 1.5 cm size on the right maxillary alveolar process, in the region of the unerupted canine. The surface of the lesion was smooth, healthy pink and non-hemorrhagic. There were no signs of pain or discomfort upon palpation. There was no lymphadenopathy. Maxillary occlusal radiograph revealed no intraosseous pathology. The clinical impression was that of congenital epulis. Clinical pictures were taken and the Oral and Maxillofacial Pathologist was consulted. Urine analysis to assess vanillylmandelic acid (VMA) to rule out neurectodermal tumour of infancy was negative. Patient was scheduled for weekly follow-ups; at each appointment the lesion regressed in size. At 4 months of age the lesion had regressed to about 5 mm in size; the patient was scheduled for monthly appointments. At 9 months of age, the lesion has self-resolved. Maxillary anterior teeth are erupting without complications. Conclusion: The conservative management of the patient with closely scheduled evaluations prevented unnecessary surgery and anaesthesia exposure in a neonate with congenital epulis.
P17262 A difcult diagnosis of a large unilocular radiolucency in the mandible

N. LUSH1, V. LOPES2 & K. E. HARLEY3 1 Department of Paediatric Dentistry; 2Department of Oral Surgery; 3 Department of Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK Introduction: Spontaneous resolution of dentigerous cysts has previously been reported in the literature, though infrequently; cases have demonstrated radiographic resolution over an extensive period of time. The following case presents an incidental radiographic nding, of a large unilocular radiolucency in the right angle of the mandible. This was identied on an orthopantomogram (OPG) in a 16 year old patient, referred to the paediatric dentistry department for an unrelated reason. Clinical management: Radiographic, computed tomography (CT) scanning and a surgical opinion suggested the following provisional diagnoses: ameloblastoma, dentigerous cyst and isolated bone cyst respectively. However, following subsequent surgical exploration of the lesion, an empty bone cavity was discovered containing only a small fragment of follicular tissue. This was excised and sent for histopathological analysis. A conrmed diagnosis of dentigerous cyst was made. It is speculated that this cyst had undergone spontaneous decompression, most likely through an unidentied communication with the oral cavity. Spontaneous resolution has been reported previously, although patient groups have tended to be older. These cases were identied through radiographic follow up of patients who received no surgical intervention. It is anticipated that bony healing will be evident in this patient within 18 months. Conclusion: In conclusion, it is not always possible to accurately predict the nature of mandibular radiolucent lesions on the basis of radiographic ndings alone, and surgical exploration and pathological analysis remains essential.
P17264 Amelogenesis imperfecta in 11 year-old girl: a case report

A. I. SASMIT & A. M. KANIA Department of Pediatric Dentistry Padjadjaran University, Bandung-West Java, Indonesia Introduction: The term of amelogenesis imperfecta is usually applied to inherited defect of enamel of both primary and permanent teeth. Diagnosis is based on a combination of the mode of inheritance and clinical and radiographic appearance. The appearance usually ranges from makedly hypoplastic enamel to varying degrees of hypomineralization with altered colour and translucency. The management of this disorder is varying from making appropriate diagnosis, to seek for mode of inheritance and phenotype; genetic counselling; early orthodontic assessment; and restorative dentistry. Clinical management: This paper describes a case of 11 year-old girl who came to Pediatric Dentistry Clinic, Dental Hospital, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia. Her chief complaint is anaesthetic colour of her front teeth. She is a very shy girl, because she always was being teased by her friends. Clinical and radiographic examination showed an appearance of amelogenesis imperfecta. From the anamneses, it was found that her close relative have the same disorder. The treatment is to restore the front teeth with composite veneer, and metal crown for the posterior teeth. Conclusion: After being treated, the patient satised with the outcome for her attractive smile and she is able to chew comfortably. It is concluded that, with the right treatment, it can enhance the patients self esteem and a proper function of mastication.
P17263 Spontaneous regression of congenital epulis: a case report

P. RITWIK1, R. BRANNON2 & R. MUSSELMAN1 1 Department of Pediatric Dentistry, LSU School of Dentistry New Orleans, USA; 2Oral and Maxillofacial Pathology LSU School of Dentistry New Orleans, USA Introduction: A three week old African American female was referred to the Special Childrens Dental Clinic, New Orleans for the evaluation and treatment of cysts in her gums. The patient was born at full term via normal vaginal delivery. Prenatal history was uneventful. The mother reported that the patient was born with a lesion in her mouth, and it had decreased in the size over the 3week period. There were no problems in feeding.
P17265 Intraoral osseous choristoma in a newborn: a case report

D. SOTERIOU1, E. PAPADOPOULOU2, N. NIKITAKIS2 & G. VADIAKAS1 1 Department of Paediatric Dentistry; 2Department of Oral Pathology, Dental School, University of Athens, Greece Introduction: Choristoma is dened as a tumour-like mass of normal cells developed in an abnormal location. Osseous choristoma is an uncommon benign lesion of the oral cavity, which appears as a tumorous mass of normal bony structure with mature
Poster Sessions
cells and is usually found in the tongue. The aim of this presentation is to report a case of osseous choristoma located in the intraoral soft tissues of a newborn. A 7 month Caucasian male presented at the Graduate Department of Paediatric Dentistry, University of Athens with a mass of soft tissue attached in the alveolar crest of the anterior region of the mandible. Clinical examination revealed a 0.8 0.5 0.3 cm tumour-like mass, rm in texture with a smooth surface and a sessile base. No primary teeth had erupted yet. Clinical management: The mass was removed by surgical excision under local anaesthesia. histopathological examination showed mature bone with peripheral osteoid within a brous connective tissue stroma. A diagnosis of osseous choristoma was rendered. Patient has been followed for 1 year since then and no recurrence of the lesion has been noted. Conclusion: Although choristomas are rare lesions in the oral cavity of children, they should be included in the differential diagnosis of such cases. phosphopeptide containing product (Tooth Mousse GC Corporation, Australia), daily 0.05% neutral sodium uoride mouth rinse and quarterly professional 1.23% neutral sodium uoride application, sugar free chewing gum and salivary substitute, was implemented. Restorative rehabilitation was performed using stainless steel crowns on the hypoplastic molars and the patient remains under frequent review to keep the salivary hypofunction and caries rate under control. Conclusion: The case report highlights denitive diagnosis being crucial in cases of salivary gland aplasia, allowing comprehensive treatment planning, with focus on prevention and treatment of rampant dental caries.
P17267 Irritation broma in a 3 year-old child: a case report

K. TAOUFIK, C. REPPA & G. VADIAKAS Department of Pediatric Dentistry, Dental School, Athens University, Athens Greece Introduction: The aim is to present the management of a broma in the gingiva of the anterior maxilla, in a preschool child. A 3 yearold boy visited the Pediatric Dentistry Department of Athens University for an oral lesion observed by his mother. The clinical examination revealed a well demarcated solitary nodule localized on the gingival papillae, between teeth #61 and 62. The nodular mass was asymptomatic, had an ovoid shape, smooth surface, rm texture, a sessile base and a light pink colour. Its size in the larger dimension was 5 mm. The patient was caries free, but had a poor oral hygiene. Clinical management: The treatment plan included application of a preventive program, conservative surgical excision, and oral hygiene instructions to the parents for the post-treatment period, histological examination of the removed tissue and follow up. The option of a high frequency electrosurgical device for the surgical removal was preferred based on the patients young age and the lesions characteristics. The histological examination ndings were compatible with the diagnosis of irritation broma. Poor oral hygiene was considered a contributing factor to the condition. After one week the healing process was not satisfactory, as the oral hygiene continued to be poor and parental education was repeated. At the 12-month follow up no recurrence of the nodule was present, while the oral hygiene of the patient had improved dramatically. Conclusion: Irritation bromas are lesions that occasionally develop in the gingivae of young children. Maintenance of good oral hygiene is critical in managing successfully such lesions.
P17266 A case of bilateral parotid and submandibular salivary gland aplasia

S. S. TAJI1, N. W. SAVAGE1, T. HOLCOMBE2, F. KHAN3 & W. K. SEOW1 1 The University of Queensland, Brisbane, Australia; 2Kingston Oral Health Centre, Queensland Health, Brisbane, Australia; 3Private Practice, Brisbane, Australia Introduction: Bilateral aplasia of major salivary glands is a rare congenital condition with less than 50 cases reported since 1885. The resulting salivary hypo-function affects the health of the oral hard and soft tissues as well as general health. A case report describing a 10 year old boy with bilateral aplasia of the submandibular and parotid salivary glands is presented. The subject was referred by his general practitioner regarding persistent dry mouth, with an otherwise uneventful medical history. Extraoral examination showed recurrent eczema, thin hair, thin eyebrows, and facial features including frontal bossing and brachycephalic face suggestive of dysmorphic features. Intraoral examination showed total lack of saliva, numerous carious lesions as well as evidence of enamel hypoplasia on the erupted teeth. Clinical management: The salivary gland aplasia was diagnosed using a sodium pertechnetate (Tc-99 m) scintiscan which showed no detectable activity in the parotid or submandibular salivary glands. An intensive preventive regime including oral hygiene and dietary evaluation and advice, nightly application of a casein
Syndromes and Genetics/Oral Medicine and Pathology
Poster Session P18/Syndromes and Genetics/ Oral Medicine and Pathology

P18268 A novel DSPP mutation (p.V18D) causing dentinogenesis imperfecta type II
M. KIDA1, T. TSUTSUMI2, M. SHINDOH3 & T. ARIGA1 1 Department of Pediatrics; 2Hinode Dental Ofce; 3Oral Pathology and Biology, Hokkaido University Graduate School of Dentistry, Japan Introduction: Dentinogenesis imperfecta (DGI) is a hereditary disease with abnormal dentin formation. We had a chance to examine a Japanese family with autosomal dominant DGI type II. We performed mutation analysis of the DSPP responsible for DGI, and found a novel mutation. Furthermore, we demonstrated the histological ndings of DGI-II affected teeth, which were characterized in the molecular pathogenesis background. Materials and methods: Genomic DNA isolated from PBMCs from family members, as well as that from control individuals, were analysed. Coding exons of the DSPP, together with their anking introns, were PCR-amplied and then directly sequenced. Non-carious primary incisors from proband and an age-matched normal control were sectioned with and without HE staining. These samples were examined by conventional light microscopy. Result: The probands primary tooth crowns were uniformly amber brown, and enamel on the occlusal surfaces was often dislodged, exposing the soft dysplastic dentin, which led to rapid attrition. The analysis revealed a mutation (c.53T> A, p.V18D, g1192T> A) involving the rst nucleotide within the DSPP gene of exon 3. Histological examination showed the dentin tubules in DGI specimens from the proband were wide and the number of tubules reduced compared to that of the normal control counterpart. Unregulated or poorly orientated dentin tubules were also observed. Conclusion: We have identied the novel mutation (p.V18D) of the DSPP in a Japanese family with DGI-II. DSPP V18 residue is highly conserved among other mammalian species. Though the unique histological feature was not demonstrated in the present case with the novel mutation (p.V18D) of the DSPP, we believe these results would greatly help us to understand the pathogenesis of DGI. Materials and methods: PUBMED search using the keyword KBG syndrome yielded 20 articles. Due to disparities in the quality of evaluations in the reports any physical feature that was not discussed was assumed to be absent. Five cases had to be excluded from the nal analysis due to inadequate information. Results: Of the 54 cases including the present case, 36 (66.6%) were males, 25 (46.2%) had at least one affected rst-degreerelative and parent-to-child transmission was documented in 12 instances. Mental retardation or global developmental delay was reported in 42 (77.7%) cases and 46 (85.1%) exhibited shortness of stature. Oral features were evident in 53 (98.1%) cases; macrodontia was present in 49 (96%) documented cases; the present case was the only report to exhibit hyperdontia and a talon cusp. The other clinical features observed were craniofacial anomalies (90.7%) followed by abnormalities of the nose (88.8%), hands (88.8%), mouth (74%), eyes (70.3%), eyebrows (68.5%), philtrum (61.1%), ears (59.2%), low hairline and lower extremity. Conclusion: The cardinal features of KBG syndrome include facial dysmorphism, short stature, skeletal anomalies and mild developmental delay. Of the oral ndings macrodontia of the maxillary central incisors occurred in majority of the cases. This is the rst report of KBG syndrome in a Chinese subject and also the only report to exhibit hyperdontia and a talon cusp.
P18270 The clinical study on a Chinese family with amelogenesis imperfecta

J. ZHONG, L. GE & S. ZHAO Department of Pediatric Dentistry, Peking University School of Stomatology, Beijing, China Introduction: Amelogenesis imperfecta (AI) represents a group of inherited disorders which are clinically heterogeneous and exhibit tooth enamel defects in the absence of systemic manifestations. The purposes of our study were to realize the clinical and genetic features of a Chinese family with Amelogenesis imperfecta (AI). Patients and methods: The AI family was checked by the genealogy surveying way, and conditions have been analysed from a genetics perspective and a genealogy was constructed. The permission of our study was obtained from Peking University Health Science Centre of Ethical Committee. Results: There were 4 generations in the pedigrees, AI patients were present in each generation, and the men and women were affected equally. Conclusion: The ndings proved that the characteristic of the pedigrees was dominant inheritance. According to Witkops classication (1971), the patients clinical phenotypes in the family were diagnosed as hypomaturation AI.
P18269 KBG syndrome clinical features and specic dental ndings

A. A. ALMANDAEY1, R. P. ANTHONAPPA2 & N. M. KING2 1 Paediatric Dentistry, Hamad Medical Corporation Qatar; 2 Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China Introduction: KBG syndrome was rst reported by Herrmann et al. in 1975. This investigation sought to distinguish the most frequent manifestations of KBG syndrome and present specic dental ndings in a 9-year-old Chinese boy.
Poster Sessions P18270 A survey of oral biopsies from paediatric patients at the University hospital
M. TOMIZAWA1, T. TSUDA2, S. HAYASHI-SAKAI2 & F. IIZAWA2 1 Department of Oral Health and Welfare, Faculty of Dentistry, Niigata University; 2Division of Pediatric Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan Introduction: It is important for paediatric dentists to identify various oral lesions in children. Materials and methods: We examined 331 biopsy records of children aged 019 years collected over a 29-year period (1979 2008). All specimens were taken at the Paediatric Dentistry Clinic and sent to the Department of Oral Pathology at Niigata University Medical and Dental Hospital. The lesions were classied into 4 categories: inammatory/reactive lesions, tumour/ tumour-like lesions, cystic lesions and other anomalies. Malignant tumours were referred to the Oral Surgery Department and therefore, not included. Results: There were 150 specimens from males and 181 from females (male: female ratio = 1: 1.2). A high prevalence was found in each of the 8-, 9- and 10-year-old groups. Inammatory/reactive lesions formed the largest group of biopsy specimens (58.0%), followed by tumour/tumour-like lesions (19.9%), other anomalies (12.4%) and cystic lesions (9.7%). Of the 192 inammatory/ reactive lesions, pericoronal myxobrous hyperplasia (Yonemochi et al., J Oral Pathol. Med 1998; 27: 441452) was the most prevalent lesion (45 cases) followed by mucous extravasation cyst (44 cases) and brous hyperplasia (40 cases). Of the 61 tumour/tumour-like lesions, odontoma formed the largest group (45 cases) followed by ameloblastic broma (10 cases). Of the 32 cystic lesions, dentigerous cyst was the most prevalent (11 cases) followed by radicular cyst (6 cases). Dental anomalies like supernumerary teeth, hypoplastic teeth and natal teeth were included as other anomalies. Conclusion: Paediatric oral lesions differ from those of adults; therefore pathological diagnoses of the oral specimens are necessary in paediatric dentistry. tests. Comparisons for the prevalence of intestinal parasitic infections among case group were performed using the Chi-square test. Results: Parasitic infections were observed among 19% (22% cases & 16% controls) of the total study population. A statistically signicant relationship was observed between infection with pathogenic parasites and bruxism (P < 0.05). Also, the prevalence of Enterobius vermicularis (16% in the study group and 4% in the control group) indicated a signicant relationship between infection with this parasite and the development of bruxism habits (P = 0.046). Finally, a signicant relationship was revealed between parents with a history of bruxism and frequency of bruxism among their children (P < 0.05). Conclusion: Our ndings suggest that pathogenic parasites may serve as the cause for the initiation of bruxism habits among children.
P18273 Dentilisin involvement in coaggregation between Treponema denticola and Tannerella forsythia
Y. SANO1, M. YAKUSHIJI1, S. SHINTANI1 & K. ISHIHARA1 1 Department of Pediatric Dentistry; 2Department of Microbiology, Tokyo Dental College, Chiba, Japan Introduction: Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis are frequently coisolated from periodontal lesions, and this combination of microorganisms has become known as the red complex. Coaggregation plays a key role in the formation of biolm by these microorganisms. Although several adhesion factors have been identied for T. denticola, the ligand by which it achieves coaggregation remains to be determined. The purpose of this study was to clarify the component involved in coaggregation between T. denticola and T. forsythia. Materials and methods: Coaggregation between T. denticola and T. forsythia was evaluated by measuring OD660 using a spectrophotometer or visual turbidimetric method. T. forsythia ATCC43037 and T. denticola ATCC35405, ATCC33520, ATCC33521, K1 (dentilisindecient mutant from ATCC35405), KpSano7 (dentilisin-decient mutant from ATCC33520) and DMSP3 (major outer sheath proteindecient mutant from ATCC35405) were used in this study. Results: T. denticola coaggregated with T. forsythia within 30 60 min. Coaggregation was inhibited by heat treatment of T. denticola, whereas that of T. forsythia was not. Disaccharides such as sucrose, maltose and lactose reduced coaggregation by approximately 50%. Magnitude of coaggregation differed among T. denticola strains in accordance with their dentilisin activities. T. denticola K1 and KpSano7 did not coaggregate with T. forsythia, whereas T. denticola DMSP3 did. Serine protease inhibitor PMSF treatment of T. denticola ATCC35405 abolished its activity, but did not affect its coaggregation reaction with T. forsythia. Conclusion: The results indicate that dentilisin is involved in coagregation between T. denticola and T. forsythia.
P18272 Investigation of the correlation between intestinal parasitic infections and bruxism among preschool children
M. TEHRANI1, N. PESTECHIAN2, H. YOUSEFI3 & H. SEKHAVATI4 1 Department of Pediatric Dentistry, School of Dentistry, Isfahan University of Medical Sciences; 2School of Medicine, Isfahan University of Medical Sciences; 3School of Medicine, Isfahan University of Medical Sciences; 4Dental Practitioner, Torabinejad Research Center, Isfahan, Iran Introduction: Given the fact that bruxism is a prevalent oral habit among children and a potential destructor of oral tissues, the present study aims to investigate the relationship between intestinal parasitic infections and bruxism among kindergarten children. Materials and methods: Questionnaires were administered among parents of kindergarten children in Isfahan to select 50 children identied by their parents to be in the habit of bruxism and 50 without the habit as control. Informed consent was obtained prior to the investigation. Parents were delivered sampling instruments with proper instructions to collect samples from both groups for parasitological tests. The diagnostic parasitological tests involved the direct stool smear, formol-ether concentration, and Scotch tape
P18274 Gingival expression of SOD and NOS mRNA in NOS1 knockout mice
M. ISHIOKA1, H. WATANABE2, Y. ISHIZUKA3, T. YANAGISAWA4 & S. SHINTANI1 1 Department of Paediatric Dentistry, Tokyo Dental College; 2 Division of Oral Histology, Department of Morphological Biology, Ohu University School of Dentistry; 3Department of Periodontology, Tokyo Dental College; 4Department of Ultrastructural Science, Tokyo Dental College, Japan Introduction: Active oxygen and free radicals play an important metabolic role in cells and tissues. However, little is known about
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the morphological dynamics of their related enzymes in gingiva. We investigated gingival mRNA expression of active oxygenscavenging and free radical-synthesizing enzymes in normal and neuronal nitric oxide synthase (NOS1) knockout (KO) mice to elucidate the mutual dynamics of these enzymes in NOS1 deciency. Materials and methods: Five-week-old normal and NOS1 KO mice were used. mRNA expression in their gingiva was investigated by in situ hybridization. Animals were maintained and used in accordance with recommendations in the Guide for Care and use of Laboratory Animals, prepared by the institute of laboratory Animal Resource, and guidelines for treatment of experimental animals in Tokyo Dental College. Results: In normal mice, NOS1, manganese superoxide dismutase (Mn-SOD) and endothelial nitric oxide synthase (NOS3) mRNAs were positive in the lamina propria mucosae, although the signal of NOS3 mRNA was weak. Mn-SOD and NOS3 mRNAs were also positive or weakly positive immediately below the horny layer. Additionally, a positive signal for NOS1 mRNA was observed in the epithelial basal layer. However, inducible nitric oxide synthase (NOS2) mRNA was negative in all tissues. In NOS1 KO mice, no expression of NOS1 mRNA was observed, as expected. However, NOS2 and NOS3 mRNAs were strongly expressed in the basal cell layer in KO mice. Furthermore, NOS3 mRNA was also expressed in the lamina propria layer. Conclusion: Taken together, the results suggest that NOS2 and NOS3 compensate for NOS1 in the gingiva under NOS1-decient conditions.
P18276 Clinic and subgingival bacteria research on aggressive periodontitis and chronic periodontitis
D. Y. LI & L. Y. GAO Oral Basic Department, Ninth Peoples Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, PR China Introduction: To investigate prevalence of aggressive periodontitis (AP) and chronic periodontitis (CP) in middle school students at Huangpu District in Shanghai, and to study on their clinical characteristics and subgingival bacteria. Materials and methods: Of 9548 students aged 1119 years, 73 subjects were diagnosed having juvenile periodontitis in 2002. Recently, 64 patients were further consultation. Base on the 1999 new classication of periodontal disease, they were classied anew by clinical examination and radiographic examination. Samples of 18 patients were taken to analyze subginginval bacteria including Actinobacillus actinomycetemcomitans (Aa), G- obligatory anaerobic black bacteria and Fusobacteria. Results: Ten subjects (15.6%) of 64 subjects were diagnosed as AP; 54 subjects (84.4%) of 64 subjects were presented with light and moderate CP. In longitudinal comparison, community periodontal index of treatment of AP patients had signicant difference (P < 0.01). In the CP patients, there was a signicantly positive correlation between CPITN, SBI and Cl-S, respectively (P < 0.01). Of 128 separate species 185 (66.4%) were facultative anaerobes. 143 (33.6%) were obligatory anaerobes in AP patients, of 133 separate species, 65 (48.9%) were facultative anaerobes, 68 (51.1%) were obligatory anaerobes in CP patients (P < 0.01).There was a signicant difference in the number of patients positive for Aa (P < 0.05). Conclusion: There is difference in aetiology and pathology between AP and CP. Due to use of different classications and diagnostic criteria of the disease, epidemiological investigation before may overestimate the prevalence of juvenile periodontitis (AP, new classication). AP may be closely related to Aa.
P18275 Can mesiodentes be resorbed?

T. MENSAH, C. ULLBRO & G. KOCH Department of Paediatric Dentistry, The Institute of Postgraduate Dental Education in Jo ping, Sweden nko Introduction: Mesiodens is the most common supernumerary tooth with a prevalence of 13%. Eight to 23% of the mesiodentes erupt spontaneously, while the rest are impacted, about half of them are in an inverted position. Absolute indications for removal are eruption disturbances of the permanent incisor or hindrance for orthodontic treatment. This means that a large number of mesiodentes are not removed and may cause problems later on. However, there have been case reports indicating that the impacted mesiodens will be resorbed over time. If this is generally true the treatment planning for mesiodentes may be possible to change. The aim with this study is to investigate the radiographical changes and the frequency of resorptions in mesiodentes left in situ. Materials and methods: About 100 individuals where mesiodentes have been left in situ will be radiographically followed. The material is collected from three areas in Sweden; Stockholm, Gothenburg and Jonkoping. The study has been approved by an ethical committee. Preliminary results and conclusion: In the so far collected material there are a number of cases showing different levels of resorption over time. The study and the analyses of the material will be nished during the spring and detailed results will be ready to be presented in Munchen June 2009.
P18277 Some salivary parameters of children with and without black stain
A. GARAN1, S. AKYUZ1, L. KOC OZTURK2 & A. YARAT2 1 Departments of Paediatric Dentistry,2Basic Science, 3Dental School, Marmara University, Istanbul, Turkey Introduction: Black stain is an aesthetic problem and has signicant effect on the personality and self condence. The prevalence of the black stain in a group of Turkish children is 18.5% that is higher than other populations. There are very few biochemical studies about black staining in the literature (Reid & Beeley 1977, 1976 and Surdacka 1989). So the purpose of the present study was to compare some salivary parameters of children with and without black stain. Materials and methods: Totally 52 randomly selected children (boys 27, girls 25) ages between 513 years were divided into two groups: Study group (n = 27) had black stain, control group (n = 25) had no staining. Whole saliva samples were collected from children without any stimulation and buffering capacity, ow rate, pH, total calcium and total protein levels were determined and statistical analysis was performed using the Statistical Program of Social Science (SPSS 16) for Windows. Statistical signicance was considered at the 5% level. Results: No signicant differences were found between groups in any parameters (P > 0.05).
Poster Sessions
Conclusion: Since the prevalence of the black stain in a group of Turkish children was high, other factors that may be related to black stain need to be investigated. group A) was observed. Microora dissemination atypical of childrens oral cavity has risen in 1.5 times. Conclusion: Local immunocorrectors make diverse correction of microbiological and immune shifts that normalizes microbiocenisis and shortens a disease period.
P18278 IMUDON for treating atopic cheilitis in children

L. N. DROBOTKO, S. Y. STRAKHOVA, V. M. ELIZAROVA & A. V. DIKAYA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: This was to study the course of atopic cheilitis and optimize cheilitis treatment using IMUDON (INN mixture of bacteria lysates) having immunomodulatory properties and corrective indices of local immunity. Materials and methods: Forty four children aged 815 years were selected for the study. All of them had obvious manifestations of atopic neurodermitis combined with atopic cheilitis: skin edema round the mouth, inltration and peeling of the red border of the lips, radial banding, papular spots in the mouth corners. The children felt pain while eating and constant itch of lips. They were divided into two groups: 20 were treated traditionally (Bepanthen and methiluracil ointments), 24 received a prescription to take IMUDON (68 pills per day during 34 weeks). Results: The condition of the children treated traditionally improved after three to four days but after ointment withdrawal manifestations appeared again. Those treated with IMUDON had signicant improvements only in six to fourteen days. At the end of the treatment manifestations of atopic cheilitis in three children completely disappeared, signicant improvements were found in nineteen persons and two children had no effect. There was an increase of concentration of lysozyme and segmental immunoglobulin in saliva. And it is just the point facilitating healing of ssures in the mouth corners and removing oral mucosa inammation. All the children had a good drug response and liked the IMUDON avour which is important while treating children. Conclusion: IMUDON increases a local immunity index that leads to disease regress. 92% of the children had favorable clinical results.
P18280 Vermilion border and tongue at children with diseases of the alimentary tract
A. V. GORELOV, V. ELIZAROVA & A. DIKAYA Moscow State University of Medicine and Dentistry, Department of Pediatric dentistry, Moscow, Russia Introduction: The aim of the present work was the study of peculiarities and general regularities of clinical displays of glossitis and cheilitis in patients with pathology of digestive system. Patients and methods: Fifty three children, in the age 1017 years, with the diagnosis are clinically surveyed: ulcerative colitis, Crohn disease-15 (Group A), chronic mucous colitis-20 (Group B), chronic gastritis, gastroduodenitis-18 (Group C). The group of comparison was made by 35 children without pathology (Group D). Results: Changes were discovered on the vermilion border at 43 examined patients. Edema and dryness of the lips, angular and commissural cheilitis were revealed. Small rifts were discovered on vermilion border. All children had changes in papillae of the tongue, showing hypertrophy liform papillae, mainly in medial and distal parts of back of the tongue. The hypertrophy fungiform papillae occur on periphery of tongue and on its tip. Thick white, yellowish, grey plaque was situated on a back of the tongue - at 53 patients. Ribbed tongue, furred tongue and geographical tongue were revealed. The tongue plaque index (Yaegaki K., 1998) was 2.8 in Group A; 2.2 in Group B; 2.4 in Group C; 1.3 in Group D respectively. Index WTC (Winkel Tongue Coating, E. Winkel, 1998) was 9.9 in Group A; 7.6 in Group B; 9.3 in Group C; 3.8 in Group D respectively. Conclusion: Diseases of various departments of digestive system at all children reveal on a mucous membrane dorsal surface of tongue and in vermilion border of the lips.
P18279 Clinic and laboratory aspects of herpetic stomatitis severity course in children
L. N. DROBOTKO & S. Y. STRAKHOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: Aim of this study was to investigate the local immunity in the oral cavity in children with acute herpetic stomatitis (AHS). Materials and methods: 100 children diagnosed with different stages of AHS were selected for this study. In mild cases the number of the lesions in the oral cavity was 5, in the moderate cases up to 1015. Samples of childrens from saliva were collected at the very beginning of the disease. The activity of lysozyme and secretory immunoglobulin A concentration were investigated by immunoferment analysis. Microbiocenosis structure of Staphylococcus aureus, Streptococcus pyogenes groupe A, Staphylococcus epiderm, Candida albicans were also studied. Results: SgA and lysozyme concentration correlate with the severity and nature of AHS. The microbiocenosis structure in the oral cavity has cut down twice relative to concentration of bacteria typical of this biotope. A three-fold increase of the number of pathogens (Staphylococcus aureus and Streptococcus pyogenes
P18281 Bucodental health in children with HIV

C. ANDREUCIC2, L. ARANEDA1, 2, I. GALAZ1, I. ESPINOZA2 & M. PINTO2 1 Childrens Hospital Roberto del Ro; 2Universidad de Chile, Santiago, Chile Introduction: 270 HIV(+) children are living in Chile. Caries, plaque, gingivitis and orofacial injuries are described as major oral problems. The objective of this study was to investigate the dental and mucosal characteristics in a group of HIV(+) children and to compare them with healthy controls. Materials and methods: Twenty three HIV(+) children aged between 2 and 14 years were examined in the Hospital de Ninos Roberto del R o. The controls consisted of 60 healthy children without HIV infection. The children were classied and examined according to the WHO standard. Orofacial lesions were examined and diagnosed according to Classication and Diagnosis in HIV Infected Children, (Ramos-Gomez and coworkers). Statistical analysis was performed with Software Systat (version 11). Mann WhitneyU-Test, the KruskalWallis-Test and Chi-Square-Test were used with signicance level set to P < 0.05. Results: Regarding caries experience no signicant differences were found between both groups (HIV: DMFT = 3.5, dmft = 5.9; Controls: DMFT = 2.54, dmft = 4.3). Index of

hard deposits amounted to 0.1 for HIV children and 0.053 for the control group. DDE in HIV children with permanent teeth amounted to 52, for primary teeth to 49. Orofacial lesions were only observed in children with HIV. Conclusion: In this study, the children with HIV had a similar caries experience compared to healthy children. However the DDE and OHI-S were signicantly larger. health educational programs in dispensary centres for children with cleft and lip palate.
P18283 Taste perception evaluation in a hundred healthy children sample

E. BARDELLINI, F. AMADORI, S. BONADEO, P. FLOCCHINI & A. MAJORANA University of Brescia, Italy Introduction: The aim of this study was to carry out a standardized assessment of taste in 100 healthy children sample. Materials and methods: 100 healthy children (aged between 4 and 12) referred to the Paediatric Department of Dental Clinic in Brescia were enrolled. Children were divided into two groups (A and B) including 50 patients each. The study was carried out using a taste perception test, composed in two phases: the rst one was the identication of the stimulus (bitter, sour, salty, sweet, water) and the second one was the valuation of stimulus intensity. Stimulus consisted in 16 sterile solutions containing sapid substances in different concentrations and 1 solution containing water as placebo, at the temperature of 24C; stimulus intensity was evaluated through an analogical scale from 0 to 10 (where 0 corresponds to a neutral stimulus = water, and 10 to the maximum intensity). The data were collected and, through statistical analysis, mean and standard deviation of threshold values and intensity, in four administrations, for each taste and for placebo, were obtained. Validation of taste test was obtained comparing the results of group A and group B, collected from different operators. Results: Threshold and intensity values were similar, with a no statistical signicant difference (P > 0.05) for all the four sapid solutions and for placebo. Conclusions: The identication of normal taste parameters in healthy children will allow comparing, in a following phase, dysgeusia conditions in childhood.
P18282 Dental health of children with cleft lip and palate

A. E. ANUROVA, V. M. ELIZAROVA & V. D. SHCHEGOLEVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Russia Introduction: Cleft lip and palate compound about 30% from all human congenital defects. Birth rate of children with cleft lip and palate varies from 1:500 to 1:1000 of neonates. During last 100 years the frequency of this defect has increased in 3 times. This was to study dental health of children with cleft and lip palate. Materials and methods: 98 children with cleft and lip palate at the age from 1 to 17 were examined according to the criteria of WHO. Results: Caries prevalence was 70% in primary occlusion (33 children), 92% in mixed occlusion (34 children) and 98% in permanent occlusion (31 children). Caries intensity was determined as follows: dmft = 4.3; dmft/DMFT = 8.9; DMFT = 9.5 pro tanto. Enamel hypoplasia (local and general) was detected in 8% of children. Malocclusion had 100% of children. Gingivitis with different severity had 85% of patients. Oral hygiene level was good in 27% of cases, satisfactory level was detected in 41% of children and poor oral hygiene had 32% of patients. 70% of children were never trained how to treat their teeth. Conclusions: (i) Dental health care for children with cleft lip and palate must be priority and it should be improved because of high level of dental diseases prevalence and intensity in these children. (ii) It is necessary to activate the realization of preventive and
Poster Sessions
Poster Session P19/Orthodontics

P18285 Odontoma associated with impacted teeth: three case reports
H. ZHU Department of Stomatology, Beijing Childrens Hospital, Capital Medical University, Beijing, China Introduction: The occurrence of odontoma is uncommon, especially in the primary dentition. The most frequent cause of discovery is the retention or impaction of the tooth. The article describes three cases in different dentition stage with impacted teeth caused by the presence of the odontomas. Their clinical features and treatment are discussed. Clinical management: Case 1: A 4-year-old girl presented with an impacted mandibular right primary canine due to the presence of an odontoma. Treatment included the surgical removal of lesion and the follow up of the spontaneous eruption. The impacted primary canine erupted in 2 weeks. Case 2: An eight-year-old girl presented with the chief complaint of the permanent tooth unerupted. Radiographs revealed that an odontoma was present with an impacted maxillary right central incisor. Treatment included the surgical removal of lesion, simultaneously bonding the xed orthodontic appliance for closed traction. Seven months later, the impacted incisor was located in the dental arch. Case 3: A 17-year-old boy presented with an impacted upper right canine because of an odontoma. The primary canine was retained. The operation removed the lesion, and orthodontic appliance was applied for arch expansion and traction. 10 months later, the impacted canine was moved to the dental arch. Conclusion: All cases achieved good clinical result. Odontomas can occur in any dentition stage. It more often are located above the crown of the impacted tooth usually incisor and canine. For Impacted permanent teeth, a combined surgical and orthodontic treatment is necessary. Clinical management: The clinical cases described here include cases that were followed for 6 months after the primary canine was extracted to treat an ectopically erupting maxillary canine using panoramic radiographs. In these cases, the eruption path did not improve. Therefore, rapid palatal expansion was performed using a hyrax expander and the root angulation of the permanent lateral incisors was changed mesially. With this procedure, the normal eruption path of the ectopic maxillary canine was restored. These cases were followed up more than 6 months, and the treatment results were well-maintained. Conclusions: In properly selected cases, modication of the root angulation of the maxillary lateral incisor combined with rapid palatal expansion is effective for preventing impaction of an ectopic maxillary canine without resorting to surgical methods.
P19287 Autotransplantation: using cone beam CT and computer-aided rapid prototypingtwo case reports
R. FITZGERALD, D. L. CROSS, R. A. MCKERLIE & P. MCLAUGHLIN Department of Paediatrics and Orthodontics, Glasgow Dental Hospital and School, Glasgow, UK Introduction: Auto-transplanted teeth can preserve the alveolar ridge and erupt normally in contrast to ossointegrated implants which are unsuitable for children. Spiral CT and rapid computeraided prototyping has been used previously to aid autotransplantation of adult molar teeth. In this case report we combine cone beam CT (CBCT) and computer-aided prototyping to produce a surgical template for the immature donor tooth in a child. Clinical management: One patient had a combination of hypodontia affecting the upper lateral incisors and a severely ectopic maxillary canine. The other had an upper central incisor with a poor prognosis. Both were assessed using CBCT. Data from the CBCT was used to produce a copy of an unerupted lower premolar tooth using a 3D printer. This 3D model was copied in wax, adding 1.5 mm was to the apex to allowing for root development between the scan and auto-transplantation procedure, and then cast in cobalt chrome. The surgical template was used as a guide intraoperatively to prepare the new socket before extraction of the donor tooth. As a consequence extra-oral time for the donor teeth was under 1 min. Follow-up over twelve months showed the teeth were positive to sensibility tests and no signs of root resorption. Conclusion: Autotransplantation is a useful for dealing with missing units in children. We demonstrate a technique to aid autotransplantation of immature teeth, which makes the surgical procedure easier, reducing time from extraction to transplantation. The increased availability of CBCT should result in this method being applicable to more cases.
P19286 Rapid palatal expansion for the treatment of an ectopically erupting maxillary canine
K. T. PARK & J. Y. KIM Department of Pediatric Dentistry, the Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Introduction: After third molars, the most frequently impacted tooth is the maxillary permanent canine. In the early stage of impaction, the eruption path of the permanent canine is angulated more mesially than normal. Untreated, such an ectopically erupting maxillary canine becomes permanently impacted. If an ectopic maxillary canine is identied soon enough, it can be treated by extracting the corresponding primary canine. When the lesion has progressed further, however, extraction of the primary canine is not sufcient for treatment. A good treatment option for an ectopic permanent canine that has progressed involves modifying the root angulation of the maxillary lateral incisor combined with rapid palatal expansion.
Orthodontics P19288 The early treatment of ectopically erupting bilateral maxillary canines: a case report
S. HAYASHI-SAKAI1, T. TSUDA2 & Y. TAGUCHI2 1 Pediatric Dental Clinic of Medical and Dental Hospital of Niigata University; 2Division of Pediatric Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan Introduction: The purpose of this report was to describe an unusually severe ectopic eruption of bilateral maxillary canines in a young patient aged 7 years 8 months, and to discuss the effects of early intervention such as extraction of the predecessors and fenestration of the affected canines. Clinical management: The patient was referred to the authors clinic for a consultation regarding bilateral ectopically erupting maxillary canines with an ectopic eruption of the maxillary right rst molar. After improvement of the rst molar, the affected canines were fully erupted and aligned in occlusion 3 years 7 months after the extraction of the primary canines. Before treatment, the ndings on the orthopantomogram were as follows: there was no direct cause, both canine tooth germs were situated in very high positions, and the cusp tips of neither canine overlapped with the roots of the adjacent lateral incisor (Sector 1). Conclusion: The maxillary left canine impacted horizontally in a mesio-distal direction (axial angulation: 90 degrees) could be successfully guided to eruption by early intervention such as the extraction of predecessors and three fenestrations. Even in severely ectopic cases, therefore, it is considered that traction may be postponed until no effect of fenestration can be detected in cases of early discovery and intervention when the crown top is situated in Sector 1.
P19290 Management of ectopically erupting lower second primary molar by modied Halterman appliance: a case report
S. K. KIM, S. J. KIM, Y. C. CHOI, K. C. KIM & J. H. PARK Department of Pediatric Dentistry and Institute of Oral Biology, College of Dentistry, Kyung Hee University, Seoul, South Korea Introduction: Ectopic eruption, abnormal eruption path, can occasionally cause root resorption and dislocation of adjacent teeth. Impaction of primary second molar caused by ectopic eruption path occurs rarely but relatively more in the mandible. Untreated ectopically erupting primary molars can cause severe malocclusion, root resorption of adjacent tooth and periodontal disease. Therefore, early diagnosis and treatment of ectopically erupting primary molar is very important. Among various kinds of orthodontic appliances to treat ectopic eruption, Halterman appliance is preferred by clinicians because it is relatively comfortable and easy to fabricate. Clinical management: A 4 year-old patient with a chief complaint of ectopically erupting primary molar visited the clinic. Lower left second primary molar was locked behind and under the rst primary molar and ankylosis was suspected in the furcation area. Before choosing extraction as a treatment option, in attempt to improve the axis of the impacted tooth, Lingual arch type modied Halterman appliance was used. Band was fabricated on lower right second primary molar and lower left rst primary molar, and button was placed on the left second primary molar. Spring was added on the distal surface of the band to apply force distally. 5 months later, ectopically positioned tooth reached to normal occlusal plane level and the succeeding tooth follicle, the second premolar, also moved successfully with no unusual root resorption or inammation. Conclusion: Modied Halterman appliance is very efcient in treating ectopic eruption. A Patient with an ectopically erupting primary molar was successfully treated with modied Halterman appliance and direct button bonding system.
P19289 Orthodontic traction of an impacted tooth using a modied removable appliance: a case
D. S. LEE1,2, M. J. KIM1, J. H. SHIN1, S. KIM1 & T. S. JEONG1 1 Department of Pediatric Dentistry, School of Dentistry, Pusan National University; 2Seo-Myeun Childrens Dental Clinic, Busan, Korea Introduction: Forced orthodontic eruption of an impacted tooth can be performed with either xed or removable appliances. Fixed appliances do not require special patient cooperation and can produce precise tooth movements. On the other hand, the wire attached to the impacted tooth may be more easily deected than with removable appliances, causing undesirable movements of adjacent teeth. Such movements are minimized with removable appliances because the force is dissipated through the acrylic, which is anchored not only by the teeth, but also by the mucosa and palate. Removable appliances require less chair time, promote better oral hygiene, and are more aesthetic, and the forced eruption can start as soon as the appliance is installed. Clinical management: In the case here, to assist the eruption of impacted upper tooth, an appliance which vacuum forming polyvinyl acetate-polyethylene embedded lingual buttons was designed. In the rst phase of treatment the tooth was erupted with a removable appliance with a hook for elastic attachment. In the second phase the impacted tooth was exposed, aligned with modied removable appliance. Although nal precise alignment can not be maintained in every case by removable appliances, in the whole process of the extrusion and alignment of impacted tooth, the modied removable appliance was simple, aesthetic, and effective in force control than the ordinary removable appliance. Conclusion: Forced eruption of impacted upper tooth can be carried out successfully with the modied removable appliance.
P19291 Correction of anterior cross bite using different techniques

N. LOGANATHAN & S. STEPHEN Department of Paediatric Dentistry, Sydney Dental Hospital, Sydney, Australia Introduction: Localized anterior cross bite warrants early intervention to avoid unfavourable changes to the developing or existing dentition. Several methods have been proposed to correct anterior cross bite and they use either tipping or bodily movement. This report presents few of those methods such as lower acrylic inclined plane, removable appliances with nger springs, screws which involves tipping movement and the xed 2x4 appliance which uses bodily movement. Clinical management: Lower acrylic inclined plane is an effective treatment method for correction of anterior cross bite and this technique was selected in a 7 year old girl. The patients anterior cross bite involving the permanent maxillary central incisors was resolved in two weeks with no damage to teeth or marginal gingival tissues. Other common method for correcting anterior cross bite is using removable acrylic appliance with posterior bite plane and nger springs/screw to tip the maxillary teeth labially. This appliance was chosen for the correction of a single tooth cross bite on a co-operative 8 year old boy and the anterior cross bite was corrected in ten weeks. A 13 year old boy presented with a single tooth cross bite which required bodily movement for
Poster Sessions
correction, hence a xed 2x4 appliance was preferred. The patients were followed up for a minimum 6 months and none of the patients showed any relapse. Conclusion: Anterior cross bite requires early and immediate treatment and decision on the choice of the technique is based on patients compliance, cost, time, type of tooth movement required and clinicians judgement. primary anterior teeth in a 3-year-old female patient following failure of replantation. Clinical management: Dental treatment consisted of an anterior aesthetic xed appliance made with the crown of the patients natural tooth. Due to severe root resorption and excessive mobility, the traumatized incisor was extracted. The tooth was transferred into sterile saline solution until one day before laboratory procedures. Appliance design included an orthodontic wire with adjustment loops soldered to maxillary molar bands. Thus, the loops allow making necessary adjustments to allow maxillary growth. This case offers an effective treatment option for the replacement of a missing tooth, providing an ideal pontic with same colour, shape and size of the adjacent teeth. Conclusion: It can be considered as a non invasive alternative for children that allow them to tolerate the effects of tooth loss better.
P19292 Autotransplantation of maxillary canine using the stereolithographic model: report of 2 cases
S. J. KIM, S. K. KIM, K. C. KIM, S. C. CHOI & Y. C. CHOI Department of Pediatric Dentistry and Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul, South Korea Introduction: Autogenous tooth transplantation, or autotransplantation, is the surgical movement in one individual of a vital or endodontically treated tooth from its original location in the mouth to another site. This procedure involves extraction of the donor tooth, measurement of the root form and amount of periodontal ligament, preservation of donor tooth, preparation of recipient socket, positioning of donor tooth, suturing, and temporary splinting. Transplant success depends primarily on the specied requirements from the client, donor tooth, and recipient site. Especially, healthy periodontal ligament cell of donor tooth is the most important factor for high degree of success. It can be obtained by minimizing the extra-alveolar time and mechanical damage during surgery. The 3-dimentional computed tomography (CT) data of the donor tooth were used to generate accurate solid plastic replica of biological structures (stereolithographic models). The replica can replace the donor tooth during the procedure of recipient socket preparation. Replica inserted in prepared socket allows checking the articulation and occlusion. After this procedure, the donor tooth can be positioned quickly on the recipient site. Clinical management: 2 cases of autotransplantation of a maxillary canine are presented. Clinical and radiographic examination showed that one had an impaction of the right maxillary canine blocked by lateral incisor. The other showed an ectopic erupted canine with ankylosis. Conclusion: Clinical results indicate that by means of rapid prototyping technique, we can shorten the extra-alveolar time of autotransplantation, and minimize mechanical injuries to periodontal ligament cells.
P19294 Functional appliance with raising tongue trainer

T. WATANABE Tatsuya Koyanagi, Yuuji Funabashi, Naomi Uno and Syouko Matsuhisa, Owari orthodontic clinic, Aichi, Japan Introduction: An anterior crossbite in a serious case causes an inhibition of a normal maxillary growth. As a lower tongue position is related to the mandibular position, the improvement of a lower tongue position might be effective for an anterior crossbite correction. In this case report, we describe the treatment of two patients with anterior crossbite with a lower tongue position using a functional appliance with raising tongue trainer. Clinical management: We had two cases of an anterior crossbite with a lower tongue position. The rst patient was referred at 7 years of age; the second patient was 8 years old. Both patients had an anterior crossbite with a lower tongue position. The treatment consisted of a protocol where the Functional appliance with raising tongue trainer was used for 10 h a day. The rst case showed an improvement of the anterior crossbite after 2 months. The second case showed an improvement after 3 months. In addition, there was also an improvement of the lower tongue position in both cases. Conclusion: Functional appliance with raising tongue trainer in patients with good compliance can improve the severity of an anterior crossbite and a lower tongue position. It is important to assure a normal growth and function of oral health at an early age. Because an anterior crossbite may cause an abnormal maxillary growth and a lower tongue position may cause an abnormal mandibular position.
P19293 Aesthetic xed appliance using a natural tooth: a case report

M. G. MARTINEZ & A. C. MEDINA Department of Paediatric Dentistry, Faculty of Dentistry, Central University of Venezuela Introduction: One of the most important and valid reasons for replacing missing incisors is to restore a natural appearance and thus provide an opportunity for normal psychological development. The premature loss of a solitary primary maxillary anterior tooth usually is due to a direct trauma or its consequence, although the anterior teeth may be lost due early childhood caries. Some of the factors for placing an anterior aesthetic appliance are: preservation of space, masticatory function, speech development, tongue habits and self-image. Suitable restoration of these teeth improves aesthetics and contributes to space preservation and function. The use of human enamel is an alternative technique that allows a harmonious oral rehabilitation in very young children. The purpose of this report is to describe the oral rehabilitation of
P19295 Orthodonic treatment possibilities of allergic patients

} G. VITALYOS, J. TOROK, T. RADICS & C. S. HEGEDUS Faculty of Dentistry, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary Introduction: During the past two decades there is an increased incidence of oral allergic diseases in orthodontics, mainly because of the frequent use of dental appliances containing nickel or polymers. The inammatory response often manifests in allergic contact stomatitis, which makes wearing of the appliance impossible for the patients. Clinical management: In our poster we present two cases with nickel-allergy, where we used epoxy resin coated wires. We demonstrate that the use of these coated wires makes the treatment period uneventful, without any objective or subjective sign or symptom.
Orthodontics
Conclusion: Nickel containing metal alloys is widely used in dentistry because of the favourable physical properties of the metal. The corrosion releases nickel ion which are responsible for the local allergic reactions in the oral cavity. Coated wires where there is less corrosion to be found are not only safe to use but more aesthetic. They can be alternative therapeutic appliances in orthodontics in case of nickel allergy. improvement, potentially better access, high spatial resolution and lower cost. Patients and methods: This study assessed cephalometric 2D and 3D measurements and the analysis of CBCT cephalograms of the volume and centroid of the maxilla and mandible, in 20 clinical cases. Results: With a few exceptions the linear and angular cephalometric measurements obtained from CBCT and from conventional cephalograms did not differ statistically (P > 0.01). There was a correlation between the variation in the skeletal malocclusion and growth direction of the jaws, and the variation in the spatial position (x, y, and z) of the centroids and their volumes (P < 0.01). Conclusion: The 3D cephalometric analysis is easier to interpret than 2D cephalometric analysis. In contrast to those made on projective radiographies, the angular and linear measurements detected on 3D become real, moreover the fewest points to select and the automatic measurements made by the computer drastically reduced human error, for a much more reliable reproducible and repeatable diagnosis.
P19296 Orthodontic treatment needs of children: comparison of three indices

F. SEYMEN1, M. YILDIRIM1, A. PATIR1, E. B. TUNA1 & G. ACAR2 1 Department of Pedodontics; 2Department of Endodontics, Istanbul University, Faculty of Dentistry, Istanbul, Turkey Introduction: Orthodontic indices used for measuring of the malocclusion prevalence and assessment of the treatment need are of utmost importance for the treatment planning. The aim of this study was to evaluate the orthodontic treatment needs of children using IOTN (Index for Orthodontic Treatment Need), DAI (Dental Aesthetic Index) and ICON (Index of Complexity, Outcome and Need) and to evaluate the relationship among the three indices. Patients and methods: 100 children (aged 1012 years) were examined for age, gender, malocclusion, over-jet, overbite, open-bite and crossbite. The study models of subjects were used to compare the DAI, the Dental Health Component (DHC) and the Aesthetic Component (AC) of IOTN and ICON. Ethical approval and informed consent were obtained. Statistical analysis was performed by using NCSS 2007 software and regression analysis was performed between the results. Results: Overbite, overjet, open bite and crossbite were observed in 66%, 70.7%, 72% and 71% of the subject. The mean average scores of DAI, IOTN-DHC, IOTN-AC and ICON indices were 25.44, 2.46, 4.17 and 38.67. Statistically signicant differences were found between the crossbite and DAI, IOTN-DHC, IOTN-AC and ICON scores (P = 0.022, P = 0.009, P = 0.002, P = 0.016). There was a statistically positive relationship between DAI and IOTN-DHC, IOTN-AC and ICON scores (P = 0.0001). Positive relationships were determined between ICON and IOTN-AC, IOTN-AC and IOTN-DHC scores (P = 0.0001). DAI, IOTN and ICON were highly associated statistically (P = 0.0001). Conclusion: DAI, IOTN and ICON were found to be signicantly correlated with each other regarding the prevalence of malocclusion and orthodontic treatment need.
P19298 Prevalence of hypodontia in some children attended in Mashhad School of Dentistry

M. SHABZENDEDAR1, B. AJAMI2 & M. MEHRJERDIAN3 1 Department of Pediatric Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences; 2Department of Pediatric Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences; 3Mashhad, Iran Introduction: Congenital absence of one or a few teeth, known as hypodontia is one of the most common anomalies in dental development. This condition occurs either individually or as an accompanying symptom of a syndrome. The prevalence for permanent teeth is common, namely between 1.69.6%. The objective of this study was investigating the prevalence of hypodontia in 914 years old children attending Mashhad School of Dentistry in 2007. Patients and Materials: In this descriptive cross-sectional study, a total of 600 panoramic radiographs of 914-year-old children (351 girls and 249 boys) were available for examination. Ethical committee of Mashhad University of Medical Sciences has approved this research (#286252). All related ndings were recorded in related forms. The data were processed using Exact and Chi-square tests. Results: The prevalence of hypodontia in the girls was 9.2%, in the boys 8.8%, and in both sexes combined 9%. The most and the least frequent absent teeth were the mandibular second premolars and the maxillary central incisor (observed in only 1 child), respectively. The most commonly absent teeth were the mandibular second premolars, the maxillary lateral incisors, the mandibular central incisor, and the maxillary second premolars, in that order. Conclusions: This study showed the high frequency of hypodontia among the examined population. Thus, due to the complicated treatment, accurate examination of children for on-time diagnosis of this developmental anomaly is crucial. This study was supported by a grant from Mashhad University of Medical Sciences Research Council.
P19297 The true three-dimensional craniofacial anatomy: 3-D versus 2-D cephalometric analysis
G. FARRONATO, U. GARAGIOLA, D. FARRONATO & D. DE NARDI Department of Orthodontics, School of Dentistry I, University of Milan, Milan, Italy Introduction: The aim of this study was to combine the huge amount of information of low dose Cone Beam CT with a cephalometric simplied protocol thanks to the latest informatics aids. Lateral cephalograms are two-dimensional (2-D) radiographs that are used to represent three-dimensional (3-D) structures. Cephalograms have inherent limitations as a result of distortion, super imposition and differential magnication of the craniofacial complex. This may lead to errors of identication and reduced measurement accuracy. The advantages of CBCT over conventional CT include low radiation exposure, imaging quality
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Poster Sessions P19299 Three-dimensional space changes after premature loss of a primary rst molar
J. H. LEE, J. Y. KIM & K. T. PARK Department of Pediatric Dentistry, Sungkyunkwan University School of Medicine, the Institute of Oral Health Science, Samsung Medical Center, Seoul, Korea Introduction: It is generally accepted that a space maintainer is required when a primary rst molar is lost before complete eruption of the rst permanent molar. However, the space loss after a permanent rst molar is fully erupted is controversial. This study examined the spatial changes subsequent to premature loss of a maxillary primary rst molar after the permanent rst molar is fully erupted. Materials and methods: Thirteen children, 5 girls and 8 boys, scheduled to undergo premature extraction of a maxillary primary rst molar owing to caries or failed pulp therapy were selected. Spatial changes were investigated using a three-dimensional digital model by comparing the primary molar space and arch width, length, and perimeter before and after extracting the maxillary primary rst molar. The inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent rst molars adjacent to the extraction site were also investigated. This study was reviewed and approved by the Institutional Review Board of Samsung Medical Centre. Statistical analysis consisted of paired t-tests, Students t-test, two-way ANOVA and Wilcoxons two-sample test. Results: The mean D+E space changes between the initial and nal examinations of the extraction and control side were 0.57 0.83 mm and 0.31 0.38 mm respectively. There was no signicant space loss at the extraction side compared to the control side. No consistent ndings were seen regarding the inclination or angulation changes at the extraction side. Conclusion: The premature loss of a maxillary primary rst molar has limited inuence on the space in permanent dentition. to evaluate orthodontic treatment need in 4th and 5th grade students of Al-Mabrur Primary School. Patients and methods: This is a descriptive study with survey technique. All of the 4th and 5th grade students who came to school on the day of the study were included. The total sample comprised 115 students. Results: Six (5.2%) of them did not need orthodontic intervention, while 109 (94.8%) students required orthodontic treatment. Three students exhibited anterior open bites and 2 students anterior cross bites. In 80 students an Angle class II malocclusion was found and in 2 students an Angle class III malocclusion. 15 students had deep bites. Conclusion: It was concluded that the majority of 4th and 5th grade students of Al-Mabrur Primary School need orthodontic treatment.
P19301 Ultrasound bone measurement age changes in cerebral palsy children before orthodontic treatment
S. BABII Department of Paediatric Dentistry,Odessa State Medical University, Odessa, Ukraine Introduction: Orthodontic rehabilitation in cerebral palsy (CP) children is performed mostly with the use of functional orthodontic appliances. To increase their efciency it is important to determine the appropriate age for therapy. The aim of this study was to determine the dynamic changes of different UBM-parameters and to reveal age groups with the maximum and minimum values. Patients and methods: 25 CP-patients (16 boys and 9 girls) were examined before orthodontic treatment. The permission was obtained from the institutional ethical committee and directly from the parents of each patient. The mean age was 5 years (SD = 2.4 year) The UBM of os calcaneus was carried out on the Sonost 2000 (Osteosys, Korea). The following parameters were assessed: bone quality index (BQ), the velocity of the ultrasound wave transmission through the bone tissue (SOS) and the broadband ultrasound wave attenuation (BUA). Sex-related differences of all UBM-parameters were assessed. All patients were agematched and divided into 8 age groups. Age groups with the maximum and minimum values were compared. Results: Sex-related differences of all 3 UBM-parameters were statistically signicant (P < 0.001). In the age span of 111 years there are 2 maximum-value age groups (4 and 8 years) and 1 minimum-value age group (6 years). Comparison of all UBMparameters in the age groups of 4 (BQ = 78.5 0.6; SOS = 1622.2 2.7; BUA = 23.2 0.1) and 6 (BQ = 66.3 0.5; SOS = 1534.5 1.3; BUA = 19.5 0.2) years revealed statistically signicant (P < 0.001) differences between all UBMparameters. Conclusion: The results of this study show differences in values in UBM in different age groups. Further studies should examine the potential of UBM as a diagnostic method in orthodontic treatment of children with CP.
P19300 Orthodontic treatment need in 4th and 5th grade students in Al-Mabrur, Bandung (Indonesia)
A. SETIAWAN, D. S. LATIF & R. SAPTARINI Department of Pediatric Dentistry Padjadjaran University, Bandung-West Java, Indonesia Introduction: Period of preadolescence is a period of great changes in a childs life. The child is starting to pay attention to him/her and begins to realize if there is something wrong, especially in the face. This is as a part of an identity seeking. Good and interesting performance will improve his/her self esteem. Tooth alignment is a part that supports facial performance. Many parents do not realize that their children have an abnormality in tooth alignment which makes orthodontic treatment necessary. The aim of the study was
Dental Trauma
Poster Session P20/Dental Trauma

P20302 Measurement of pulpal blood ow oscillation in luxated permanent incisors by laser Doppler owmetry
T. SHIRAKAWA1,2, M. TAKEUCHI2 & T. KIKUIRI3 1 Division of Oral and Craniomaxillofacial Research, Dental Research Center; 2Department of Pediatric Dentistry, Nihon University School of Dentistry, Tokyo; 3Dentistry for Children and Disabled People, Department of Oral Functional Science, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan Introduction: Pulpal blood ow oscillation in luxated incisors was assessed non-invasively by laser Doppler owmetry (LDF), and usefulness of both low-frequency and heartbeat synchronous oscillatory components in the owmetric signal was discussed. Patients and methods: A total of 20 children aged 715 years and 8 healthy adults were included in this study. A LDF probe was positioned at the buccal surface of each tooth at least 2 mm apart from the gingival margin by using a dark coloured rubber splint, and the pulpal blood ow was continuously measured. Flowmetric signal from the luxated teeth was compared with that from control teeth. This research project was approved by the Research Ethics Committee of Nihon University School of Dentistry. Results: Pulpal vitality of luxated teeth could be assessed more precisely by introducing power spectral analysis (maximum entropy method) into detection of both low-frequency and heartbeat synchronous uctuations in the owmetric signals. Lowfrequency uctuations (0.010.05 Hz) as well as uctuations synchronous with the heartbeat were observed in the owmetric signals from luxated upper incisors in which the pulps had survived the trauma. These periodic uctuations were not detected in the owmetric signals from non-vital teeth. A luxated tooth that was accompanied by root fracture showed a gradual decrease in blood ow level concomitantly with the formation of secondary dentin in the pulp chamber. Conclusion: Detection of both low-frequency and heartbeat synchronous uctuations in the owmetric signal increases the reliability of LDF for the assessment of pulpal vitality in luxated teeth. Results: A total of 1.125 patients 2 years of age, representing a total of 1.886 injuries were included. 176 (15.6%) of the patients had fallen while using a pacier. 12.9% of the injuries were fractures of the hard dental tissues, 64.2% were luxation injuries, 1.0% were injuries to the alveolar bone, and 21.9% were soft tissue injuries. Of children falling while using a pacier, 11.9% had crown fractures, compared to 20.0% of children who had fallen while not using a pacier (P < 0.05). Exarticulation was seen in 64.8% of children who had fallen while using a pacier, compared to 54.8% of children falling while not using a pacier (P < 0.05). Furthermore, injuries of the soft tissues were less frequent in children falling while using a pacier (28.4% vs 38.3%) (P < 0.05). Conclusion: This study indicates that use of pacier inuences the type of traumatic injuries in young children. Thus, the pacier may also have a shielding effect a type of mouth guard effect.
P20304 School teachers knowledge on dental trauma rst aid

K. ARAPOSTATHIS1, A. KEVREKIDOU1, A. MICHAILIDOU2, V. TOPITSOGLOU2 & S. KALFAS2. 1 Department of Pediatric Dentistry; 2Department of Preventive Dentistry, Periodontology and Implant Biology; School of Dentistry, Aristotle University of Thessaloniki, Greece Introduction: The study aimed to examine the knowledge of teachers on providing rst aid in dental trauma. Materials and methods: Totally, 228 pre-school and primary school teachers (150 $, 78 #), working in Northern Greece (49 schools, 46% in urban area), with a mean age of 43 years (SD = 6.5) and mean years in duty 17.22 (SD = 8.5), lled in a questionnaire for dental trauma care. In the statistical analysis, the age, gender, years in duty, school location (urban or rural) and previous knowledge were the independent variables tested. Results: Only 11% of the teachers stated having been informed in giving rst aid for dental trauma and 5% being able to provide it. About 51%, 36% and 17% correctly answered on how to manage bleeding, tooth fracture and avulsion, respectively. Correct answers for tooth fracture management were given by 40.7% of women and 27.6% of men (x2 = 14.3, d.f. = 2, P = 0.001,). The corresponding gures for tooth avulsion were 20.7% and 10.2% (x2 = 12.3, d.f. = 2, P = 0.002,). These differences were signicant. The age of the teacher (mean: 45.2 6.5, F(2.218) = 5.464, P = 0.005) and the years in duty (mean:20.4 8, F(2.217) = 2.263, P = 0.049) correlated with a lack of knowledge. The only difference in correct answers was found between the teachers that had received information (11%) and the rest regarded the storage of avulsed tooth (x2 = 10.481, d.f. = 4, P = 0.030,). Conclusion: Similarly to the ndings from other countries, most of the pre-school and primary school teachers in Northern Greece have insufcient knowledge in giving rst aid for dental trauma.
P20303 Use of pacier and type of dental injury in children 02 years

B. H. STERGAARD1, J. O. ANDREASEN2, S. S. AHRENSBURG2 & S. POULSEN1 1 Department Pediatric Dentistry, School of Dentistry, Aarhus University; 2Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Denmark Introduction: Use of pacier is common among young children, and traumatic injuries are frequent in young children, especially due to falls. The purpose of this study was to assess the relation between use of pacier at the time of injury and type of traumatic injury. Materials and methods: The study is based on data on traumatic dental injuries in children presenting at the Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Denmark during the years 19711983.
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Poster Sessions P20305 Knowledge, attitude and practices of school teachers in Lagos on the emergency management of dental trauma
O. O. ORENUGA, O. O. OLATOSI & B. C. NWANIA Department of Child Dental Health, College of Medicine University of Lagos/ Lagos University Teaching Hospital, Nigeria Introduction: The study assessed the knowledge and practices of a group of primary and secondary school teachers on the emergency management of dental trauma. Materials and methods: The schools were selected randomly. A pre-tested questionnaire made up of 3 sections was used for the study. Section A was on demographic details of the respondent and rst aid training background. Section B and C assessed the teachers knowledge and practices of dental trauma in children. Data was collated and analysed using the Epi-Info statistical software (2007). Results: A total of 367 teachers participated in the study, 100 males and 267 females. A total of 51.2% had received formal training in rst-aid. Only 29.8% had received advice on the management of dental trauma. Concerning the management of tooth fracture and avulsion, 30.5 and 18.8% respectively were able to indicate the appropriate management. The teachers had poor knowledge on the best transport medium for avulsed tooth. Only 5 (1.4%) pointed out that milk was the medium of choice for avulsed teeth. Previous rst aid training was signicantly associated with the choice of transport medium for avulsed tooth, P = 0.001. Finally, 92.4% of respondents indicated that they had never received advice on the emergency management of dental avulsion. Conclusion: The study shows that the knowledge of primary and secondary school teachers in Lagos, Nigeria on the management of dental trauma is grossly inadequate. Educational campaign programs on emergency management of dental trauma by pediatric dentists and community health dentists in schools at all levels should be encouraged. Conclusion: These case reports demonstrate the ability of MTA in sealing root fractures and the efcacy of using the endodontic microscope.
P20307 Management of avulsed permanent incisors with an immature apex: two case reports
K. TAOUFIK1, A. AGRAFIOTI2, D. ZAMPELI1 & G. VADIAKAS1 1 Department of Pediatric Dentistry; 2Department of Endodontology, Dental School, Athens University, Athens, Greece Introduction: The aim is to present two cases of avulsed permanent teeth with an immature apex that were treated by use of MTA. The rst case concerned an 8 year-old girl who visited the graduate clinic of Pediatric Dentistry, University of Athens after the avulsion of tooth #41 and crown fracture of teeth #11 and #21. The injury took place 6 days ago and #41 was maintained for 2 h in dry gauze and then was replanted and splinted with sutures in the childrens hospital. The patient was advised to visit our department 5 days later. In the second case, an 8 year-old boy with cystic brosis came to our clinic 2 h after the avulsion of #21. The tooth had been maintained for 60 min in a dry environment and then was placed in saline. Tooth #11 had sustained a crown fracture. The patient was taking chemoprophylaxis on a daily basis for his medical condition. Clinical management: In both cases the apex of the avulsed teeth was immature. The treatment plan included replantation of the avulsed tooth -second case-, splinting, pulp extirpation, endodontic treatment with MTA as an apical plug and gutta-percha and follow up. The teeth have been followed for 1 year post trauma and a slow progression of replacement resorption has been noted. Conclusion: The use of MTA in the management of avulsed permanent teeth with an immature apex is an acceptable technique, even in cases with a poor prognosis.
P20306 Microscopic management of three patients with root fractures using mineral trioxide aggregate
G. ABOU AMEIRA, L. FOO & P. BRIGGS Department Paediatric Dentistry, St Georges Hospital, UK Introduction: MTA has shown highly promising clinical results in management of non vital traumatised incisors. This report describes three cases of non vital traumatised incisors with different types of root fractures managed with MTA under the endodontic microscope in the Paediatric Dentistry Unit at St Georges Hospital. Clinical management: First: An 8 years old boy was referred following a vertical crown root fracture of UL1. Although the long term prognosis of UL1 was poor due to the crown root fracture, an orthodontic opinion was sought and advice given to try to retain the tooth in the arch for at least 18 months. Therefore decision was made to try to obturate the root canal with MTA to attempt seal the fracture line (18 months follow up). Second: An anxious 8 years old girl was referred following a cervical third root fracture and a crown fracture of UL1. Although the long term prognosis of the UL1 was poor due to the position of the root fracture, it was decided to retain the tooth in the arch for as long as possible by MTA obturation (6 months follow up). Third: A 12 years old girl was referred following a middle third root fracture of UL1. MTA obturation of the UL1 was carried out to the fracture line followed by surgical removal of the infected apical 1/3 (14 months follow up).
P20308 Replacement of a lateral luxated primary incisor by using composite inclined plane
V. ARIKAN & S. SARI Ankara University, Faculty of Dentistry, Department of Pedodontics, Ankara, Turkey Introduction: Primary teeth injuries are common for young children and the majority of these injuries are luxations because of the resilient bone around the primary teeth. For lateral luxated primary teeth, in the absence of occlusal interference, follow-up for spontaneous repositioning can be done, otherwise, if repositioning with pressure is impossible, the treatment choice for these teeth is usually extraction. Clinical management: This case report describes repositioning of a lateral luxated primary central incisor with occlusal interference by using a composite inclined plane and its 1 year follow-up. The patient was a 4 years old girl and applied to our clinic three days after the injury. The tooth could not be replaced because of the time interval and it has an occlusal interference. After the root canal treatment, an inclined plane was prepared on the lower primary incisors by using composite resin. The tooth was replaced in two weeks and the inclined plane was then removed. The treatment was successful both clinically and radiographically after 1 year follow-up. Conclusion: As a conclusion, usage of a composite inclined plane with careful follow-up can be an alternative to extraction for lateral luxated primary incisors with occlusal interference.
Dental Trauma P20309 The observation of dental trauma using limited cone beam CT: case report
J. ASARI, T. SUGIYAMA, K. YAMASHITA, M. KADENA & M. INOUE Showa University School of Dentistry, Department of Pediatric Dentistry, Japan Introduction: Currently, tooth replantation is commonly performed in cases of complete dislocation, and the subsequent long-term observation and prognosis are very important. While a wide variety of symptoms are seen in poor prognosis cases, lesion in the apical area is relatively frequently encountered in clinical situations. However, detailed diagnosis has been difcult due to the limitation of 2D imaging diagnosis of lesions in the apical area of replanted teeth. Here we report 3 cases on the qualitative and quantitative observation of apical lesions by using CBCT. Clinical management: Three children (8, 9 and 10-year-old, male) were out-patient with a chief complaint of dental trauma. The tooth replantation was performed in our department, and subsequent apical lesions occurred in four anterior teeth, on which observations were made. Usually, we used Dental-type Xray lms, but the images were unclear. So we used a Cone-Beam CT for image capturing and 3D construction software was used for image analysis. Buccolingual spread of the lesion and resorption of the alveolar bone area were well observed in CBCT images. Lesion size (volume) could be observed by 3D construction software. Conclusion: Although the radiation exposure dose is an issue of concern, CBCT is considered to be a useful technique for the observation of traumatized teeth, especially of tissues surrounding the apical area. This technique, in combination with the quantitation of lesion volume by 3D construction software, is also thought to be useful for determining the therapeutic strategy. Conclusion: In dental trauma cases, patient-based treatment decisions are of importance in providing optimum care of the individual affected tooth.
P20311 Post-traumatic aesthetic approach in primary teeth: case report

A. L. COSTA, M. T. XAVIER, J. C. RAMOS & B. P. LEMOS Department of Dentistry, Coimbra Medical and Dental School, Portugal Introduction: Primary teeth generally do not cause concern in terms of bleaching since they typically are very white. However, trauma to the anterior primary teeth between eruption and exfoliation can result in colour changes, compromising aesthetic and social interaction of the child. Patient demand for aesthetic resolutions and the trend for non-invasive dental treatments have led to the improvement of diverse materials and whitening techniques that are capable of re-establishing a patients smile without affecting dental structure. Clinical management: This clinical case of a four-year- old girl shows a bleaching technique applied in traumatized and darkened primary incisors using a simple and time-saving method for whitening discoloured root-lled, associating intracoronal and extracoronal bleaching with 35% hydrogen peroxide as bleaching agent light activated. This technique is simple and usually shows immediate satisfactory results but a resin based- composite veneer can be a positive addition in the nal result. Three years later, and after 6 months recall appointments, we could observe ankylosis of one of the incisors (probably related to trauma) and extraction became the valid option. There was no apparent structural damage to the permanent tooth. Conclusion: Bleaching intends to preserve dental structure already weakened and to show immediate aesthetic results. There is a deciency of evidence-based science in the literature that addresses the prognosis of bleached nonvital teeth in children. Therefore, it is important to always be aware of the possible complications and risks that are associated with the different bleaching techniques.
P20310 Management of horizontal root fracture in mature permanent teeth: two cases reports
N. ALTAY, S. BEKTAS, E. CANOGLU & H. C. GUNGOR Department of Paediatric Dentistry, Hacettepe University, Ankara, Turkey Introduction: Horizontal root fractures are traumatic injuries which mainly occur in the middle third of the root followed by apical and coronal third of the root. The teeth with immature root formation most often have a greater potential for maintenance of pulp vitality. These case reports present the management of horizontal root fractures with and without active treatment. Clinical management: Case 1: A 10-year-old girl was presented following a traumatic injury which resulted in horizontal root fracture (middle third) of maxillary left central incisor and avulsion of her maxillary right central incisor. Splinting of the fractured tooth was initiated and left in place for 3 months. Avulsed tooth was replanted within 2 h of the injury. Following pulpectomy, the root canal was lled with Ca(OH)2 and the tooth was splinted for 7 days. Root canal therapy was completed in the 4th month. During the next 3 years along with ankylosis of right central incisor, healing with connective tissue of root fractured left central incisor was noted. Case 2: After having a bicycle accident six weeks earlier, an 11-year-old girl presented with slight mobility of her maxillary right central incisor. Without initiating any active treatment, the patient was scheduled for regular visits at close intervals only. At the 2nd year follow-up, it was observed that the tooth healed uneventfully with calcied tissue.
P20312 Management of multiple traumatized teeth

P. K. DHANPAL & N. M. KING Paediatric Dentistry and Orthodontics, The University of Hong Kong, Hong Kong SAR Introduction: Traumatic dental injuries to the teeth and supporting structures have a peak incidence at 910 years old for the permanent dentition. The management of avulsed central incisors, complicated crown-root and uncomplicated fractures of lateral incisors in a 13 year old boy is presented in this poster. Clinical management: The patient presented with avulsed maxillary central incisors, a complicated crown-root fracture of tooth 22 and an uncomplicated crown fracture of tooth 12. In order to maintain pulp vitality, restore normal aesthetics and function, and the lost tooth structure for the uncomplicated crown fracture of the right maxillary lateral incisor it was restored using composite resin. The complicated crown-root fracture of the left lateral incisor (tooth 22) was treated with a Cvek pulpotomy. Root planning and maintenance of proper oral hygiene brought about the resolution of the pseudo-pocket caused by the crown-root fracture. The missing tooth structure was restored using composite resin. The avulsed maxillary central incisors were not recovered at the time of the accident. A modied Nance palatal appliance with acrylic teeth was used to replace the missing teeth. This however, is only the short term treatment, the denitive treatment plan will probably
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involve orthodontic treatment to align his teeth, porcelain crowns and dental implants, which can only be considered once growth has ceased. Conclusion: Management of dental trauma should be minimally invasive and based on sound diagnosis including both short term and long-term treatment options. Clinical management: An 11-year-old boy presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiograph and computed tomography views conrmed the greenstick (incomplete) fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial brous union of the fracture segments and remodelling with normal functional stimulus. Non-rigid mandibular splint was applied in order to remove the direct pressure of the fracture side of the mandible. At 1, 3, 6 and 12 months clinical and radiological examination revealed uneventful healing with reduction of the condylar head and remodelling of condylar process following conservative treatment. Conclusion: The following points should be taken into consideration while managing condylar fracture in children: condylar fractures are usually greenstick type due to childs bone more exible and more likely to bend than break completely. Conservative approach is acceptable with unilateral greenstick type fracture. Developing dentition and growth potential of the condyles should be considered. After treatment the patient must be followed for a long period to assess malocclusion, dysarthrosis, and deformation of the mandible.
P20313 Conservative approach of condylar fracture in growing patient: one year follow-up
E. B. TUNA1, A. DUNDAR1, B. CANKAYA2 & K. GENCAY1 1 Department of Pedodontics; 2Department of Oral Surgery, Istanbul University Faculty of Dentistry, Istanbul, Turkey Introduction: Mandibular fracture is the commonest craniofacial trauma. Problems associated with condylar fractures are disturbances in occlusion, growth, malfunction of the TMJ and mandibular deformity. Condylar fractures in children are especially important due to the risk of a mandibular growth-centre in the cartilage of the condylar head and can retard growth and cause facial asymmetry.
Dental Anomalies
Poster Session 21/Dental Anomalies

P21315 Two cases of eruption disturbance of primary teeth
R. OKAWA, K. NAKANO, M. MATSUMOTO & T. OOSHIMA Department of Pediatric Dentistry, Osaka University, Osaka, Japan Introduction: Eruption disturbance generally occurs in permanent dentition, while it is rare in primary teeth. Herein, we present two cases of eruption disturbance found in primary teeth. Clinical management: Case 1 was a 5Y7M-old girl with eruption disturbance of the maxillary right second primary molar due to the presence of a lesion, seen as a small radiopaque mass in a radiograph. Enucleation was performed and a pathological examination diagnosed the mass as an odontoma. Thereafter, the tooth did not emerge and fenestration of the gingival tissue was done, after which emergence into the oral cavity was noted at the age of 6Y6M. Case 2 was a 10Y4M-old girl with eruption disturbance caused by abnormal formation of the tooth germ. She was referred to our clinic by an orthodontist, and a radiographic examination showed the maxillary right second primary molar and permanent successor in inverted positions. Computed tomography examinations were performed to clarify the three-dimensional positions of these teeth, which revealed that the primary molar was located close to the inferior part of the maxillary sinus, while the permanent successor was in the apex region of an adjacent permanent tooth. We decided to perform periodical examinations to follow the locations and movements of these teeth. Conclusion: Although eruption disturbance in primary dentition is regarded as a rare clinical nding, it is important to understand the possible aetiology, such as in the present cases. In addition, it is important to identify eruption disturbance in the early stage for appropriate treatment planning. in tooth #75. The permanent teeth which have erupted so far appear normal, but their pulps are obliterated. Conclusion: The atypical characteristics of this case made DNA analysis mandatory in order to set a proper diagnosis. It is clear that a better classication for this type of dentin anomalies should be used, where DD type II, DGI type II and DGI type III are forms of the same disease DSPP inherited defect, varying in severity. This may also lead in a revision of the rarity of DD type II.
P21317 Abstract withdrawn P21318 Dentinogenesis imperfecta type II: case report
R. PITROU, D. ZAMPELI & D. EMMANOUIL Department of Paediatric Dentistry, University of Athens, Greece Introduction: Dentinogenesis imperfecta (DI) type II or hereditary opalescent dentin is a dentin disorder, characterized by abnormal dentin structure, which follows an autosomal dominant pattern of transmission and generally affects both the primary and permanent dentition. Mutations in the genes encoding the major protein constituents of dentin seem to underlie this disorder. Patients and methods: A 7 year old male was referred to the postgraduate clinic of the Paediatric Dentistry department, School of Dentistry, University of Athens, for evaluation. Clinical examination revealed amber, opalescent primary and permanent teeth, with relatively bulbous crowns and marked cervical constriction along with dental caries. Radiographic examination revealed pulp canal obliteration in most of the primary and permanent teeth, which also had short and narrow roots. The diagnosis of DI type II was based on family history and the detailed clinical and radiographic examination. Differential diagnosis from other disorders of similar clinical appearance was made in order to apply the appropriate preventive and treatment plan. Treatment involved the removal of sources of pain and a protection of the posterior teeth from wears and fractures with the placement of stainless steel crowns. Conclusion: Early diagnosis and treatment of DI is fundamental in order to obtain a favorable prognosis and prevent extensive deterioration of the dentition and occlusion.
P21316 Dentin dysplasia (DD) type II: report of an atypical case

K. TAOUFIK, C. REPPA, R. PITROU & D. EMMANOUIL Department of Pediatric Dentistry, Dental School, Athens University, Athens Greece Introduction: DD is a rare type of dentin defect. This is a case report of a 4 year-old female with no contributory medical history who came to the postgraduate department of Paediatric Dentistry, University of Athens, after a previous diagnosis of dentinogenesis imperfecta (DGI). Clinical examination revealed amber tooth discoloration, abscesses, wear of the occlusal surface of primary molars and a scissors bite. There was no presence of caries and the oral hygiene was very good. Radiographic examination revealed bulbous crowns, pulp canal obliteration, thistle tube-shaped pulp chambers in canines, absence of the characteristic contrast between enamel and dentin and a periapical lesion in tooth #64. Clinical management: The treatment plan included genetic testing, behaviour modication, application of a preventive program, and treatment of affected teeth, orthodontic assessment and follow up. The result of DNA analysis was dentin dysplasia type II-like phenotype. During the follow up period )2 years- the occlusal wear continued, there was enamel loss of primary teeth and abscess
P21319 The co-occurence of mesiodens and talon cusp: two case reports
B. AKSOY, T. ILERI KECELI & H. C. GUNGOR Department of Paediatric Dentistry, Hacettepe University, Ankara, Turkey Introduction: Talon cusp is a tooth shape anomaly which causes various functional and aesthetic problems. Mesiodens is a supernumerary tooth located in the central region of the premaxilla between two central incisors. Although, talon cusp and mesiodens are sometimes reported as associated dental anomalies, their co-
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occurrence has not been reported before. The aim of this presentation is to report two cases of erupted mesiodentes with talon cusps. Clinical management: Case 1: An 8-year-old boy referred to the paediatric dentistry department with the chief complaint of the abnormal shape of a tooth in his upper jaw. His medical history was non-contributory. On clinical examination an erupted mesiodens with a palatinal talon cup was noted between his maxillary central incisors. Upon consultations, the mesiodens was extracted and a space closure procedure was initiated. Case 2: The patient was a 5-year-old boy who presented for the unpleasant shape of his upper teeth. He had a unremarkable medical history. The clinical examination revealed two abnormally-shaped teeth with talon cusps between maxillary primary lateral incisors. His parents reported that those teeth had erupted after his central incisors shed occurring one year earlier. It was decided to keep these erupted mesiodentes until the eruption of permanent central insicors along with a composite resin restoration to provide them with an aesthetic and pleasant appearance. Conclusion: In the presented mesiodens cases patients needs formed treatment decisions. Either keeping them for better aesthetics and function was chosen or in the other case extraction of the mesiodens was necessitated.
P21321 Molar incisor hypomineralization clinical management

P. FISCHER, V. BARDENHEUER, N. HAJEK-AL KHATAR & L. PIEHLMEIER Kids Dental Care Center, Mu nchen, Germany Introduction: Molar Incisor Hypomineralization (MIH) is a clinical condition of systemic origin, which is characterized by qualitative enamel defects of the rst permanent molars frequently associated with affected incisors. Treatment plan, restorations or extractions and maintenance are inuenced by a number of factors such as the extent of affected enamel, the presence of caries lesions, occlusion, aesthetics, and hypersensitivity of the MIH teeth, orthodontic condition and compliance of the patient. Clinical management: A six-year old girl was referred to our paediatric dental clinic through her GDP because of the clinical appearance and increased sensitivity of the six-year molars. The clinical ndings showed three of the rst permanent molars were affected with MIH; one molar was found totally sound. Different degrees of severity of hypomineralization with caries defect were recorded, thus inuencing the choice for restorative management. The affected teeth were restored with composite resin material or stainless steel crown. The sound tooth was sealed. The treatment was performed under general anaesthesia, caused by the patients lack of cooperation and hypersensitivity of the affected teeth. The patient is in a four-month recall period for oral examination and prophylaxis. Conclusion: Knowledge about the clinical appearance of MIH and very early diagnosis as soon as the rst permanent molars erupt plays an important role in planning of treatment, maintenance and prognosis. Because of the different degree of affection in one patients mouth, individual judgement of each of the affected teeth is absolutely necessary in order to provide effective treatment.
P21320 Report of two cases of dentin dysplasia with rootless teeth

A. PINAR ERDEM1, B. BALLI1, H. KURT2, I. ULUKAPI1 & E. SEPET1 1 Department of Pedodontics; 2Department of Prosthodontics, Istanbul University, Istanbul, Turkey Introduction: Dentin dysplasia (DD) is a hereditary disorder of dentin formation, marked by a normal appearance of coronal dentin associated with pulpal obliteration, faulty root formation, and a tendency for peripheral alveolar bone lesions without obvious cause. DD is subclassied into three groups. A 9 year old boy with the complaint of mobility, red and swollen gingiva of his right upper rst premolar and a 10 year old female with the chief complaint of severe mobility of the teeth was referred to Istanbul University, Faculty of Dentistry, and Department of Pedodontics. Radiographic examination of the rst case revealed short and defective roots, obliterated pulp cavities, decient root formation and taurodontism (DD type I).The second case presented both characteristics of DD type I and II (DD type III); no roots or short and malformed roots, obliterated pulp chambers, pulp calcications, taurodontism and dens invaginatus and abnormal crown morphology. Clinical management: In the rst case treatment strategy was to protect the primary teeth as long as possible, so composite and amalgam restorations, partial pulpotomies were performed. In the second case all teeth were extracted due to hyper mobility. Masticatory and aesthetic rehabilitation of the patient was performed with total removable dentures. The patients are under regular control since 2 years. Conclusion: DD is a rare inherited abnormality of the dentin that may lead to premature exfoliation of the primary and permanent teeth. Early diagnosis of the condition will also help to prevent or delay loss of dentition.
P21322 Fibre-reinforced composite post restorations in molar incisor hypomineralization: a case report
S. PEKER, S. GUNER & B. KARGUL Department of Paediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey Introduction: MIH (Molar Incisor Hypomineralization) is a common clinical condition and is dened as hypomineralization of systemic origin of one to four permanent rst molars frequently associated with affected incisors. Hypomineralized teeth are more prone to caries and can cause severe restorative problems. The management of MIH depends largely on the severity of the enamel defect. Fibre Reinforced Composite (FRC) posts seem to have become increasingly popular for the restoration of endodontically treated teeth. This case report presents an experimental clinical technique to reconstruct severely damaged endodontically treated anterior teeth using direct bre reinforced post systems. Clinical management: An 11 year old girl had applied to our department with severely hypomineralized lower central incisors. The patient had experienced severe fever diseases during the rst years of her life according to her clinical history. First of all, mandibular central incisors with periapical lesions were endodontically treated, then gingivoplasty was performed for osseous crown lengthening with Er:YAG laser (Fotona, Fidelis Plus III). Glass bre reinforced posts (Superpost, Superdont) were placed using adhesive system and teeth were restored with composite core and composite matrix crown. The restorations were assessed according to predetermined clinical and radiographic criteria. These clinician-
Dental Anomalies
mediated evaluation methods conrmed the good clinical performance of the restorations. Conclusion: The clinical application of bre reinforced posts and direct resin composites is a successful treatment option for highly damaged teeth with endodontic lesions, that conserves remaining tooth structure and results in good patient compliance. remaining root surface was capped with Mineral Trioxide Aggregate (MTA, Angelus, Londrina, PR, Brazil). The remaining crown was restored with a composite resin (TPH, Dentsply, Konstanz, Germany). The tooth was evaluated periodically. After 15 months, the tooth showed progressive root development with no sign of periapical pathology. With the eruption of the permanent canine, no orthodontic treatment was needed to close the space due to hemisection. Conclusion: In selected fusion cases, the use of MTA on root perforations may eliminate the need for root canal treatment before hemisection. This method also allows physiological root development in immature teeth.
P21323 Long-term conservative management of regional odontodysplasia

S. OLMEZ, M. D. TURGUT & I. GUZELER Department of Paediatric Dentistry, Hacettepe University, Ankara, Turkey Introduction: Regional odontodysplasia (RO) is a developmental anomaly characterized by atypically shaped teeth, eruption problems and ghost-like appearance in radiographs. The treatment of RO includes extraction of the involved teeth followed by prosthetic rehabilitation, autotransplantation or preservation of the involved teeth. In the present case, 6 years follow-up of a RO case including conservative management is presented. Clinical management: Retained maxillary primary right central incisor was detected in a healthy 8 year old girl. The radiographic evaluation revealed the ghost-like appearance and delayed root formation of the underlying permanent central incisor. The diagnosis of RO was established and the patient was scheduled for recall appointments to observe the development of the affected tooth. After 2 years, the primary predecessor was extracted due to severe mobility. A xed space maintainer was inserted in order to prevent space loss and for aesthetic reasons until the time for a xed prosthetic approach. After 4 years, the affected teeth had completed root formation. The root was short with a large pulp chamber. No periapical pathology, gingival swelling or abscess formation were encountered during 6 years follow-up of the case. Conclusion: With close patient follow-up, the unerupted teeth can be retained in RO cases to provide normal jaw development and to maintain adequate bone for dental implants or other rehabilitation methods for the future. Fixed space maintainers can be used to prevent space loss and to improve aesthetic appearance in such cases.
P21325 Developmental disturbances of teeth after cancer therapy: case reports

H. J. KIM, H. K. HYUN, Y. J. KIM, J. W. KIM & C. C. KIM Department of Pediatric Dentistry, School of Dentistry, Seoul National University, Seoul, Korea Introduction: Chemotherapy and radiotherapy proved conservative and effective in treating head and neck tumours. Both of these cancer therapies, however, will also have aberrant effects on normal tissue, including developing dental organs of children. The purpose of this report is to describe ve clinical cases of developmental disturbances of teeth after chemotherapy and radiotherapy. Clinical management: Five children were treated at an early age with multimodal cancer therapy, including surgery, chemotherapy and radiotherapy for retinoblastoma (2 children), neuroblastoma (2 children) and rhabdomyosarcoma (1 child). Their radiological ndings showed rootless teeth, prematurely closed root apexes, microdontia, agenesis of permanent tooth and aberrant eruption. All of them had restorative and preventive therapy performed on them and needed a periodic recall check. Conclusion: If cancer therapy is needed at the age of tooth formation, especially in the head and neck region of children, it might affect stages of odontogenesis. It is difcult to distinguish the effects of chemotherapy from those caused by radiation because many children receive both types of treatment and both therapies cause similar dental abnormalities. The nature and severity of dental developmental disturbances might depend on the age of the child undergoing cancer therapy, the doses and schedules of treatment, and the anatomic region treated.
P21324 Hemisection and vital treatment of a fused tooth: a case report

T. ILERI KECELI1, H. G. KECELI2, M. D. TURGUT1, Z. YILMAZ3 & M. TEKCICEK1 1 Department of Pediatric Dentistry, Hacettepe University; 2 Specialist in Periodontology, Private Practice; 3Department of Endodontics, Hacettepe University, Ankara, Turkey Introduction: Dental fusion is dened as the union between the dentin and / or enamel of two teeth. Fusion may be partial including only the crowns or total including crowns and roots. Root canal treatment followed by hemisection is one of the treatment options in total fusion cases. However, vitality could not be maintained in many cases. In the present report, hemisection and vital treatment of a fused tooth is presented. Clinical management: A complete type of fusion between the maxillary permanent right lateral incisor and a supernumerary tooth was detected in a 9-year-old boy. There were two separate root canals. Since the fusion caused aesthetic and orthodontic problems, it was planned to remove the supernumerary part of the fused tooth with a hemisection procedure. The fused tooth was separated with a diamond bur and the supernumerary tooth was extracted. The pulp perforation site on the coronal third of the
2009 The Authors
P21326 Management of an unerupted dilacerated maxillary central incisor with transplantation: case report
G. M. KELLY & A. C. O CONNELL Division of Public and Child Dental Health, Dublin Dental School and Hospital, Dublin, Ireland Introduction: This case presents the orthodontic and surgical management of an unerupted dilacerated maxillary central incisor, secondary to trauma to the predecessor, with space loss due to mesial drift of the maxillary lateral incisor and the results of its management over a 5 year period. Clinical management: The lateral incisor was successfully distalised with orthodontic treatment initially and it was planned to use traction to align the unerupted central incisor. However, due to the severity of the dilaceration and the position of the central incisor, orthodontic extrusion was not feasible. It was decided to extract, root treat and transplant the tooth into a surgically prepared site, with a view to retaining the incisor short-term. This would encourage bony inll and alveolar bone growth for the future implant placement. Within the rst year of transplantation,
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ankylosis of the incisor had occurred. However, with frequent reviews and replacement of the calcium hydroxide dressing in the canal, the surgical defect healed and there was continued bone development. The tooth acted as an aesthetic space maintainer and retained bone for future implant placement. The canines have erupted and the tooth is scheduled for extraction during the next phase of orthodontic treatment. Future treatment will require interdisciplinary orthodontic and prosthetic management of the site to maximise success for future implant placement. Conclusion: This case represents the successful interdisciplinary management of a complex case. restored with GC Gradia Direct colour Bleach White material, grinding and polishing. Case 2: A 15 year-old girl complained of aesthetic defects and incorrect dentition. 6 years before the patient had asked for a consultation and was diagnosed as follows: deep traumatic occlusion and dental uorosis. Before brackets were placed the enamel defects were reconstructed. Following orthodontic treatment the bracket xing material was removed and the gum was retracted using a retraction suture. The hard tissues were reconstructed using GC Gradia Direct color BW material. During a repeat examination 6 months later a recurrence of orthodontic pathology was discovered and the restoration was corrected. Conclusion: Patients were re-examined after 6 and 12 months and had no complaints. Clinical examination established an absence of pathological changes and aesthetic properties were satisfactory. We can recommend using nanocomposite Bleach White Colors to treat dental uorosis in children.
P21327 Conservative management of hypomineralised enamel defects

R. MATUSIAK & K. E. HARLEY Department of Paediatric Dentistry, Edinburgh Postgraduate Dental Institute, Edinburgh, UK Introduction: Enamel opacity is the generic term used to describe a localised discolouration of enamel; it can be white or brown, diffuse or dened. Enamel opacities can be caused by demineralisation or may be the result of a defect in enamel formation. There are known to be over one hundred aetiological factors associated with enamel defects and it is often difcult to relate the observed defect to a specic cause. A number of techniques developed to manage hypomineralised defects in the paediatric patient have included microabrasion, composite-resin restorations and placement of composite-resin or porcelain laminate veneers. Clinical management: Vital bleaching is a conservative technique which can be used to improve the appearance of hypomineralised defects. Bleaching improves the colour of teeth via the release of hydrogen peroxide which oxidises chromogens in enamel and dentine. It can be carried out as an isolated procedure or as an adjunct prior to placement of intra- and extra-coronal composite restorations and ceramic veneers. This case describes the use of the vital bleaching technique alone to improve the appearance of enamel defects. Ten percent carbamide peroxide gel was placed in custom-made bleaching trays and worn by the patient for a period of two weeks. A signicant improvement in appearance was seen thus obviating the need for any invasive treatment. Conclusions: Conservative management of hypomineralised defects can be successfully achieved using home vital bleaching. This procedure is readily acceptable to the paediatric patient.
P21329 Restorative management of primary teeth affected by hypoplastic amelogenesis imperfecta

S. SOOD & K. E. HARLEY Department of Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK Introduction: A 3 year old boy attended the Department of Paediatric Dentistry, Edinburgh Dental Institute for management of his hypoplastic and discoloured teeth. The patient was identied as having Autosomal Dominant Hypolastic Amelogenesis Imperfecta. Such defects are difcult to restore in the primary dentition and many treatment options are available. Classically the molars are restored with preformed metal crowns and either polycarbonate crowns, composite strip crowns or pre-veneered metal crowns are used for the anterior teeth. This young boy was treated using indirect composite crowns to restore the function and aesthetics of the primary dentition. Clinical management: An indirect restorative technique with composite resin was used to restore all the maxillary primary teeth. No preparation of the teeth was undertaken. Alginate impressions were made for construction of special trays which were used to make silicone impressions. Accurate casts enabled the construction of Gradia Indirect Micro-Ceramic-Composite crowns. Gradia is hybrid micro-ne ceramic/pre-polymer ller with a urethane dimethacrylate matrix. It produces a ceramic composite with high strength, good wear resistance and a crown that can be polished to a high standard. The teeth were isolated, etched with 37% phosphoric acid, washed and dried. The indirect crowns were cemented with RelyX Unicem, a dual-cured resin cement, polished and occlusion adjusted. On review the crowns were functioning well and were highly aesthetic. Conclusion: The technique used is a suitable alternative to the traditional methods of restoring hypoplastic primary teeth. The procedure facilitates oral rehabilitation of the primary dentition with a highly aesthetic outcome.
P21328 Using nanocomposites in restorative treatment of dental uorosis in children

E. A. SKATOVA, Y. N. NAZAROVA, S. S. BOGOMOLOVA, G. A. OSIPOV & G. R. BADRETDINOVA Department of Paediatric Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia Introduction: Children and teenagers nowadays expect to have a highly aesthetic smile. But sometimes it is difcult to restore dental aesthetics, especially in cases of uorosis when the colour of the teeth does not coincide with the VITA scale. Clinical management: Case 1: A 13 year-old girl complained of an aesthetic defect. Clinical examination and anamnesis revealed uorosis of the teeth (ICD-10 OO30). There were pigment spots and enamel defects on the vestibular surfaces of teeth 11 and 12. Excision of the pathologically damaged and pigmented tissue was performed following inltration anaesthesia. The affected teeth were then
P21330 Prosthetic rehabilitation of hypodontia: two cases report

_ I. UZEL1, A. K. A. TOPALOGLU1, B. OZPINAR2, G. UZEL2 & B. GOKCE2 1 Department of Pediatric Dentistry; 2Department of Prosthodontics, Ege University, Izmir, Turkey Introduction: The prosthetic treatment of young patients with missing teeth is a challenge for the dentist. An early prosthetic
2009 The Authors
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management with regard to function, phonetics, aesthetics is important to ensure a normal psychological development of these children and to promote a normal tooth and jaw development. Clinical management: This clinical report addresses prosthetic rehabilitation of 12- and 6-year-old child patients with partial anodontia resulting from a congenital defect, hypohydrotic ectodermal dysplasia, and early missing primary teeth respectively. A restorative dental management with removable prosthodontic appliances was described, and the prosthetic therapeutic alternatives were discussed. Removable partial dentures without a metal framework that allow required modications during follow-up were applied until the completion of oral and maxillofacial development at which denitive treatment is considered. Conclusion: The results were signicant improvements in speech, masticatory function, and facial aesthetics, contributing to the development of normal dietary habits, and the improved and more rapid social integration of these children. is thought to be caused by infolding of the dental papilla during development, which allows the invagination of the inner dental epithelium. Dens invaginatus has been classied into 3 types according to the depth of the invagination and the degree of communication with the periodontal ligament or the periradicular tissue (Oehlers, 1957) Clinical management: 11-year-old boy with cleft lip and palate was referred to our dental department complaining of intermittent pain from his left maxillary lateral incisor. Intraoral examination disclosed the presence of a maxillary left lateral incisor with unusual morphological features. The crown of the tooth had a pegshaped appearance. Radiological evaluation conrmed a periapical lesion. A clinical diagnosis was established of dens invaginatus (Oehlers Type 2). As an endodontic treatment of this case was doubtful and could compromise the future cleft bone graft, it was decided to extract the left maxillary lateral incisor. After extraction, the tooth was prepared for histological examination. Conclusions: The histological evaluation showed complexity of cases with dens invaginatus and the clinical challenges they may pose. Endodontic treatment of dens invaginatus teeth requires careful analysis of the conguration of the root canal system. The root canal morphology of these teeth can be very complex and in many cases it is difcult to detect and differentiate between the main and the invaginated canals.
P21331 Dens invaginatus or dens in dente: a case report, histological evaluation

S. VAN BEVEREN1, M. PETEIN2, T. H. DUJARDIN3, A. VANDEN ABBEELE4 & A. SHAYEGAN1 1 Department Paediatric dentistry of Childrens Hospital of Queen Fabiola; 2Pathology and genetic department; 3Department of orthodontics of Childrens Hospital of Queen Fabiola; 4Department of adult and children operative dentistry, Universite Libre de Bruxelles, Brussels, Belgium Introduction: Dens invaginatus or dens in dente is a rare malformation of teeth resulting from the invagination of the tooth crown before biological mineralization occurs. The anomaly
Poster Sessions
Poster Session 22/Special Needs Patients

P22332 Dental treatment under general anaesthesia for a cleft palate child with heart disease
Y. HORIKAWA1, Y. MIYAUCH1, S. YOSHIMURA2, M. SATO1 & M. INOUE1 1 Department of Pediatric Dentistry; 2Department of Dental Anesthesiology, Showa University School of Dentistry, Tokyo, Japan Introduction: For pediatric patients with severe congenital heart disease and in consideration of the risk of fatal infective endocarditis, prophylactic administration of antibiotics is recommended in surgical procedures with possible bleeding problems. Here, we report a case of a child with severe heart disease who had dental treatment under general anaesthesia and intravenous sedation. Clinical management: A 4.2-year-old male; with multiple dental caries was treated. The past medical history comprised a complete endocardial cushion defect. A radical operation was performed at the age of 5 months; in addition the patient has a right lung hypoplasia without arterial circulation being completely nonfunctional. Furthermore the patient exhibited a bilateral cleft lip and palate. Considering the difculty of systemic management and physical burden on the patient, the duration of general anaesthesia was set to a maximum of 3 h. AMPC was administered intravenously; four teeth were extracted and eight teeth with caries were treated. Conclusion: It is difcult to give large doses of antibiotics to young children for endocarditis prophylaxis. Since a child is too young for intravenous drip, intravenous sedation is applied concurrently with intravenous drip; however, trials show that it takes too long to administer the dose of intravenous sedation, and the patient is often more uncooperative during subsequent dental treatments. Therefore, general anaesthesia was considered to be more appropriate as the general management of treatment and safety was improved. existing in his mouth, manufactured by an original simple method. Six months follow-up points out that restorative treatment provided psychosocial and functional comfort to the young boy. Conclusion: This clinical report demonstrates the importance of the prosthodontic treatment for oral rehabilitation in children with ED. The partial and complete removable dentures associated with the acrylic crown can be a reversible and inexpensive method of treatment for ED patients.
P22334 Orthodontic management of patients with disabilities: report of three cases

A. TRIKALIOTIS1, E. KAKLAMANOS2, D. VELONIS1, N. KOTSANOS1 & N. TOPOUZELIS2 1 Department of Paediatric Dentistry; 2Department of Orthodontics, Aristotle University of Thessaloniki, Greece Introduction: Orthodontic service utilization has steeply increased during the second half of the 20th century, but this was true only among cooperative patients. Recently a number of articles appeared underscoring the need for such services to young people with disabilities, as these services may improve patient self-condence and employment opportunities. The orthodontic management of these patients is challenging and usually requires the cooperation of orthodontists and paediatric dentists for behavioural modication and possible use of pharmacological methods. We report on three cases involving a combination of paediatric dental and orthodontic services. Clinical management: The rst case is a 15-year-old quadriplegic male with mental retardation. Chief complaint was a large painful growth buccal to #46 secondary to occlusal trauma. Using parental assistance and protective stabilization with a Molt mouth prop, treatment was based on oral hygiene and a xed lingual-arch-type appliance for expanding lower arch width between #36 and #46. The second case is a 10-year-old female with learning and speech disabilities and dental phobia. Orthodontic therapy was intended due to the existence of a supernumerary #11 and anterior crowding. Behavioural techniques and a papoose board where used to attach brackets on upper dental arch. The third case involved a 22-year-old female, moderately cooperative with kinetic and mental disability. Due to much protruded #11, #21 and severe space inadequacy, the treatment consisted of extraction of those teeth and xed appliance therapy. Conclusion: Orthodontic needs in this patient population are underserved. Services can be met, perhaps not ideally, but effectively, by orthodontic-paediatric-dental teamwork.
P22333 Hypohidrotic ectodermal dysplasia: prosthodontic treatment in a paediatric patient

M. PAUNA1, A. M. RADUCANU2, I. V. FERARU2 & R. ANGHELESCU3 1 Prosthodontics Department, U.M.F. Carol Davila, Faculty of Dental Medicine; 2Paediatric Dentistry Department, U.M.F. Carol Davila, Faculty of Dental Medicine; 3Paediatric dentist, Bucharest, Romania Introduction: This clinical report describes the oral rehabilitation of a 7-year-old male diagnosed with hypohidrotic ectodermal dysplasia and anodontia. Ectodermal dysplasia (ED) comprises a large, heterogeneous group of inherited disorders, which are dened by primary defects in the development of 2 or more tissues derived from the embryonic ectoderm (skin, hair follicles, nails, teeth, sebaceous and sweat glands). Our patient exhibited the typical general and cranio-facial features of ED as well as emotional and behavioural problems. The patient presents only one conical primary central incisor. Clinical management: The treatment was focused to improve his aesthetic needs and oral functions and included the fabrication of removable prostheses and of an acrylic crown on the single tooth
P22335 Childhood diabetes as a dental risk factor

K. KARPATI1, K. KURTI2, E. KOKAI1 & G. KOCSIS SAVANYA1 1 University of Szeged Faculty of Dentistry; 2University of Szeged Faculty of Medicine, Szeged, Hungary Introduction: Nowadays diabetes mellitus means a great epidemiological problem. Today in Hungary approximately 4050 thou-
Special Needs Patients

sand diabetic patients are recorded and 2600 children under 14 years are among them. Most of the new juvenile onset diabetes patients come from age group 35 and the 1013. Patients and methods: We analysed the effect of the special diet for patients with Type I diabetes on the dentititon. The follow-up surveys took place in 1993 (n = 52; age 618), 2004 (n = 50; age 618), and in 2007 (n = 46; age 618). We registered the individual DMF-T values and the presence or absence of plaque. Oral hygiene, eating habits and information about past dental treatment was collected with a questionnaire. The results were compared with non-diabetic patients of the same age. Mean DMF-T values and caries frequency were calculated. Results: During the rst examination the mean DMF-T value of diabetic patients amounted to 4 (caries frequency: 75%), the corresponding gures for non-diabetics were 5.06 and 92% respectively. The second (and third) examinations revealed mean DMF-T-scores of 3.78 (2.86) and a caries frequency of 75% (27%) for diabetics and mean DMF-T-scores of 4 (4.04) and a caries frequency of 68% (54%) for non diabetics. Some cases show that childhood diabetes, especially in neglected cases, could adversely inuence the state of the dentition and the oral cavity. Conclusion: Diabetes mellitus patients need special consultation, continuous and close monitoring not only about the dental but also the periodontological status and a close cooperation between the paediatric dentist and the paediatrician.
P22337 Research of utilizing TEACCH on oral hygiene education for autistic children
Y. H. HO1 & S. T. HUANG1,2 1 Department of Oral Hygiene; 2Division of Pediatric Dentistry, Kaohsiung Medical University Introduction: Care givers of handicapped children in Taiwan lack proper oral health knowledge; consequently the oral health condition of handicapped children is worse than oral health of non handicap controls. The aim of this study was to explore how to use TEACCH (Treatment and Education of Autistic and related Communication handicapped Children) and improve their quality of life. Materials and methods: 25 autistic preschool children participated in the study. They belonged to the Home for the Disabled, Social Affairs Bureau, Kaohsiung City Government. Structural questionnaires were applied and TEACCH was used in training autistic children oral hygiene education in principle. All of them received 12 instructions of teaching oral hygiene education and tooth brushing techniques. The research instruments consisted of questionnaires and specic oral examinations. Results: According to the results, the plaque index was reduced by 29.4% after oral hygiene instruction (OHI) combined with TEACCH technique. The difference was statistically signicant. No signicant differences between boys and girls and different age groups were observed. TEACCH was generally well received by autistic children. Conclusion: TEACCH can be used to improve their quality of life (QOL) and help them to maintain a good oral hygiene condition in the future.
P22336 Oral ndings in patients with NF1

L. KONDO1, F. AMADORI1, P. FLOCCHINI1, G. PIANA1 & A. MAJORANA2 1 Department of Dental Science, Special Care Patients Unit, Alma Mater Studiorum University of Bologna; 2Department of Pediatric Dentistry, University of Brescia, Italy Introduction: Neurobromatosis 1 (NF1) is a multisystemic genetic disorder that affects the skin (freckling and cafe-au-lait macules), nervous system (neurobromas, optic gliomas and learning disabilities) and skeletal system (pseudoarthroses). Dental abnormalities can occur in association with oral neurobromas and other oral ndings have poorly been described in Literature. The aim of this report is to describe oral ndings in patients affected by neurobromatosis 1, in order to increase the knowledge about oral manifestation and to conrm the literature. Materials and methods: A total of 49 patients with NF1, 28 female and 21 male patients, affered to two different Dental Clinics (Brescia and Bologna), were evaluated with orthopantomograms and an objective exam. Data are recorded on OMS clinical charts and statistical analysed using the software package STATA 9.0 for Mac. Results: Novel ndings are observed, for example the occurrence of taurodontic or suspect taurodontic teeth. Other oral ndings are described: increase in dental caries, poor oral hygiene level, enamel hypoplasia, agenesia, and skeletal abnormalities in the jaws, early or delayed eruption. Conclusion: The high frequency of dental abnormalities in people affected by NF1 was expected, because the misregulation of all factors involved in tooth and skeletal development, but new data were raised. Our study needs more conrmation, but a coded relation between NF1 patients and their oral manifestation could be useful to improve their dental care program and their quality of life.
P22338 Oral health of underprivileged Romanian children: special needs versus normal kids
A. VINEREANU1, A. GARRET-BERNARDIN2, S. JUNG2, F. CLAUSS2 & D. ANDRITOIU1 1 Department of Pediatric Dentistry, University Carol Davila, Bucharest, Romania; 2Department of Pediatric Dentistry, University of Strasbourg, Strasbourg, France Introduction: Paediatric dentistry is still an underserved eld in Romania. Access to dental care is difcult for children with special needs and/or socio-economically deprived. The aim of this study was to evaluate oral health in a group of underprivileged children and youngsters and nd potential factors that may inuence it. Material and methods: 169 underprivileged subjects (92 male, 113 special needs, 119 institutionalized), aged 422 years (13.18 4.36) were examined in ofce by volunteer dentists. Personal data, social status, handicap degree, presence of caries, previous treatments, calculus, plaque and gingivitis were recorded. Results: DMF-T was 5.28 5.13; dmft was 4.3 4.3. 69.2% of the patients had poor oral hygiene and gingivitis. Calculus was found in 46.2% of the subjects. Normal patients had less calculus, plaque and gingivitis than special needs ones (P < 0.01) and more previous treatments (P = 0.16). Patients living with own/foster families had less calculus than institutionalized ones (P < 0.01). 64.5% of the entire group had never seen a dentist before. 95% of the previous treatments were given during volunteer programs. Normal subjects living with own/foster families had more previous dental treatments than institutionalized ones (P < 0.01). Conclusion: Oral health of Romanian underprivileged children and youngsters is relatively poor. Their access to dental care is limited. Special needs children have poorer oral health and more limited access to dental care than normal kids. Normal children living with
Poster Sessions
families have better access to dental care than institutionalized ones. Partly supported by Docteurs Sourire (France) and Special Olympics Romania.
P22340 Oral health status of cardiac surgical children in Istanbul

E. BOZDOGAN1, A. DINDAR2 & O. AKTOREN1 1 Department of Pedodontics, Faculty of Dentistry; 2Department of Paediatric Cardiology, Istanbul Faculty of Medicine, Istanbul University,Istanbul, Turkey Introduction: Oral health care is of vital importance in children with cardiac disabilities. The purpose of this study was to assess the oral health status of cardiac surgical children (CSC) and to analyze the parents knowledge and attitudes to oral health in Istanbul, Turkey. Patients and methods: 35 children operated for the cardiac problems in Paediatric Cardiology Clinics of Istanbul Medical Faculty and 35 matched healthy children attending the Clinics of Pedodontics at Istanbul University were evaluated for caries indices (WHO criteria), aproximal plaque index (API), modied sulcus bleeding index (modSBI). The parents oral health knowledge and attitudes were assessed by questionnaire. Informed consent and ethical approval were obtained. The ndings were analysed by Students t, MannWhitney U, chi-square and Fishers exact v2 tests. Results: In CSC group (mean age: 8.25 3.89), the mean dft, dfs, DMFT, DMFS were determined as 3.83, 7.0, 2.2 and 3.0, respectively; the mean API and mod SBI were found as 45.26 18.07 and 8.74 5.29. In control group, the mean dft, dfs, DMFT, DMFS were recorded as 6.8, 11.17, 1.9, 2.26; mean API and mod SBI as 41.04 17.03 and 7.63 2.76. No signicant differences were found in API and mod SBI values between the groups. Antibiotics usage before dental procedures has been found signicantly higher (P < 0.01) in CSC group. No signicant differences were found in parents knowledge of endocarditis and in frequencies of visiting dentist periodically, toothbrushing, preventive dental procedures between the groups. Signicantly less (P < 0.01) CSC had visited dentist before and had llings than controls. Conclusion: The data has revealed that the comprehensive preventive and restorative dental care should be administered to paediatric cardiac patients.
P22339 Monitoring of healthy and handicapped patients within treatment under general anaesthesia
A. BUCEK, M. STANKOVA, K. GINZALOVA & T. DOSTALOVA Charles University, 2nd Medical School, Department of Pediatric Stomatology, Prague, Czech Republic Introduction: This study evaluated the results gained from documentation of child patients, who have undergone treatment under general anaesthesia at the Pediatric Dentistry Department. The aim of the study was to evaluate the inuence of handicap on the oral health, the possibilities of premedication and medication in relation to dental care. Patients and methods: A sample of 1836 children (1123 boys and 713 girls) of our dental clinic was evaluated. In a retrospective study the difference between healthy and handicapped patients was examined by evaluating their oral health records. Care before the dental treatment, i.e., premedication, antibiotic prophylaxis and mouth rinsing with antiseptic agents were observed. Proper dental therapy and care after dental treatment - namely quiescent regime, elevated head position, cooling with an ice pack, giving analgesics in case of need, not rinsing the mouth on the day of intervention, check follow-up 10 days later patients with or without difculties, the wound healing, and space-maintainer preparation (3 month later) were analysed. Results: A total of 16 816 teeth were treated. Caries prevalence DMFT - dmft was examined, types of lling materials were observed, pure oral hygiene and periodontal disease prevalence were evaluated. The inuence of handicap on the length of hospitalization was calculated. Conclusion: The use of general anaesthesia in paediatric dentistry has a wide impact and application coverage especially for handicapped patients usually for the extraction less for teeth restoration. The study was supported by the project IGA MZCR 99914.

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INTERNATIONAL JOURNAL OF

Volume 19 Suppl. 1 June 2009

Poster Sessions P01 P22

Poster Session P01/Endodontics

Endodontics P014 Effects of sodium uoride on deciduous tooth pulp cells

P017 Physical stability of different formulations of an endodontic iodoform-based paste

P0113 Apical microleakage evaluation of chitosan as root lling material

P0114 A comparative evaluation of root canal sealers (study in vitro)

P0117 Apexication with MTA on a necrotic immature permanent tooth

Poster Session P02/Dental Materials 1

P0219 Microleakage and penetration ability of different sealants

P0223 A new polishing material; nano-technology liquid polish

P0222 Evaluation of microhardness in bovine dentine adjacent to uoride-releasing restorations

P0225 Evaluating GIC bond strength: microshear and microtensile

P0229 Bond strengths of self-etch adhesives in laser pepared cavities

P0232 The therapeutic effect of uoride-containing adhesive tape on dentin hypersensitivity

Poster Session P03/Dental Materials 2

P0335 Clinical evaluation of /F releasing of Esterll /F in primary teeth

P0337 In-vitro evaluation of the effects of power bleaching on enamel microhardness

P0339 Effect of chlorhexidine on self-etch bond on primary teeth dentin in vitro

P0340 Evaluation of a new material in restoration of primary molars

P0341 Knoop hardness of resin-modied glass ionomer cements

P0345 Basic research on biomaterials for restoration of primary teeth

P0346 Resistance to degradation of bonded restorations to simulated caries-affected primary dentin

Growth and Development

Poster Session P04/Growth and Development

P0451 Effects of tooth extractions on hippocampus in senescence-accelerated mice

P0453 The effect of BTXA injection on mandibular growth in growing rats

P0455 Emergence of permanent teeth in a Hungarian child population

P0454 Biomarkers of mineral status in primary teeth in children born pre-maturely

Growth and Development

P0460 Dental development in children with mild-to-moderate hypodontia

P0463 Establishment of ameloblasts derived from induced pluripotent stem cells

Growth and Development

P0466 Acoustic characteristics of children of the Japanese consonants[s][]

Poster Session P05/Morita Prize

P0568 Anodontia in Hypohidrotic Ectodermal Dysplasia (HED), early intervention

P0571 Management of visible enamel defects: seeking childrens perspectives

P0574 Comparison of remineralization effect between Fuji IX and Surel

P0576 Obesity and dental caries of Greek pre-school children

Poster Session P06/Dental Anxiety and Behavioural Management

P0682 Pilot study in the adaptation of CFSS-DS Latvian version

P0681 Evaluation of childrens pain by students during dental anaesthesia

P0685 Measurements of dental fear in 7-year-old children

Dental Anxiety and Behavioural Management

P0690 Reliability of the salivary alpha-amylase activity as an index of psychological stress

P0692 Sudometry for assessing dental fear in adolescents

P0694 A case report of Trichotillomania and its inuence on dental treatment

Dental Anxiety and Behavioural Management

Poster Session P07/Dental Anomalies

P07102 Designing a clinical tool to record molar incisor hypomineralisation

P07103 Prevalence of dens evaginatus in pre-molars in Singapore

P07105 Prevalence of dental developmental anomalies: a radiographic study

Poster Session P08/Prevention 1

P08111 Comparative plaque removal efcacy of two power toothbrushes in children

P08110 Professionally applied toothbrushing study to evaluate plaque removal in children

P08113 Plaque removal efcacy of two power toothbrushes in children

P08114 Plaque removal efcacy of sonic versus manual toothbrushes in children

P08118 The inuence of foods and tooth brushing on Streptococcus mutans

O08117 Oral hygiene management of pediatric transplantation patients

P08119 Caries preventive effect of Biuorid12 on rst permanent molars

P08122 Fluoride concentrations of tap waters in Greece for up to 6 months