Biomedical subjects
Publications and source records attributed to M S Duggal.
Child cancer patients require a great deal of intensive treatment and support. This paper provides an account of the dental problems a practitioner will encounter with these children and discusses how they may be managed.
About 8 ml of saliva were collected from each of 272 children, living in rural areas in North India, equally distributed into age groups 4-7 and 12-16 yr and stratified into low, moderate and high caries groups. The salivas were analysed for Zn, Cu, Fe, Mn by atomic absorption spectrophotometry and for F with a fluoride-sensitive electrode. The elements Cu and F had a consistent, inverse relationship with caries experience. The concentration of Zn, Fe and Mn in saliva did not have any consistent relationship with caries experience.
A 14-year-old patient suffering from congenital absence of almost her entire permanent dentition was referred by her GDP. Management of the case required an integrated orthodontic and restorative approach. The authors describe how the imaginative use of a combination of relatively simple techniques achieved a greatly improved dental appearance for the patient.
The cariogenic potential of a range of fruit drinks was assessed on the basis of plaque pH by the plaque harvesting method. In addition, the inherent pH and titratable acidity of each drink was analysed. The effects of so-called 'no sugar added' and 'sugar-free' drinks were compared with a standard 10% sucrose drink for their effect on plaque pH in vitro, on a group of volunteers, using the Cariogenic Potential Index (CPI). All drinks had a low inherent pH and some a high titratable acidity. All the drinks also depressed the plaque pH below 5.5 within 5 minutes of drinking and had a CPI equal to or greater than a standard 10% sucrose solution.
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The object was to find out whether site-specific variations of pH might correlate with those of oral clearance as indicated by past studies using fluoride, sucrose and glucose as markers. Eleven subjects with 24 h growth of dental plaque rinsed the mouth with a 10% solution of sucrose. The pH of plaque, harvested from the labial or buccal cervical and approximal regions of certain teeth or groups of teeth, was then measured. The results confirmed previous reports that plaque pH varies from site to site in the mouth; the pattern observed was similar in each of the subjects. In the anterior part of the mouth, concentrations of hydrogen ion were invariably higher in plaque from the upper than from the lower surfaces of the teeth. The reverse pattern was found in the posterior part. This site-specific pattern was similar to that of oral clearance, as indicated by comparison with known values for glucose concentrations, a finding consistent with the view that site-specific pattern of plaque pH may reflect or at least be influenced by such differential clearance patterns.
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Hypocalcified amelogenesis imperfecta is characterized clinically by a yellow-brown colored enamel that is prone to severe attrition, often leading to rapid destruction of the crown. While the enamel is thought to be poorly mineralized few studies have evaluated the mineral content, or the histological or microradiographic features of this specific AI type. The purpose of this investigation was to examine teeth affected with autosomal dominant hypocalcified AI histologically using light microscopy (LM), scanning electron microscopy (SEM), and to evaluate the degree of enamel mineralization chemically and with microradiography. Four AI teeth were obtained from an affected individual for comparison with age-matched teeth from normal healthy individuals. Thin sections approximately 100 microns were cut with a diamond disc for examination by LM and microradiography. Using SEM, fractured enamel samples were examined either untreated or after removal of organic material using NaOCl or urea. Normal and AI enamel particles were dissected from thin sections to evaluate the mineral per volume and carbonate content. The enamel was not uniformly affected in all areas of the teeth with the lingual surfaces of the mandibular central incisors appearing clinically and histologically normal. The affected enamel was porous and appeared opaque with LM. Both SEM and LM showed the enamel to be prismatic with relatively normal prism morphology. However, the enamel crystallites were rough and granular compared with those of normal enamel. Extraction to remove organic material did not change the appearance of the crystallites indicating their granular appearance was due to mineral and not residual organic material such as enamel protein. Microradiography showed the enamel was less radiodense and therefore poorly mineralized compared with normal enamel. This was confirmed by chemical determination of the mineral per volume, which showed some areas of the AI enamel had as much as 30% less mineral compared with normal enamel. The carbonate content was found to be similar in AI and normal enamel. Hypocalcified AI is associated with decreased mineralization as well as ultrastructural defects in the crystallite structure. The combined histological and biochemical features of hypocalcified AI seen in this investigation indicate that this AI type is distinctly different from the hypoplastic and hypomaturation AI types.