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Biomedical subjects

S Myllärniemi

Publications and source records attributed to S Myllärniemi.

At least 19 recordsLinked to original sources
PubMed1990

Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a series of 68 patients.

To define the clinical picture and course of the autosomal recessive disease called autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), we report data from our 10-month to 31-year follow-up of 68 patients from 54 families, now 10 months to 53 years of age. The clinical manifestations varied greatly and included from one to eight disease components, 63 percent of the patients having three to five of them. The initial manifestation was oral candidiasis in 41 patients (60 percent), intestinal malabsorption in 6 (9 percent), and keratopathy in 2 (3 percent). All the patients had candidiasis at some time. The earliest endocrine component appeared at 19 months to 35 years of age. Hypoparathyroidism was present in 54 patients (79 percent), adrenocortical failure in 49 (72 percent), and gonadal failure in 15 (60 percent) of the female patients greater than or equal to 13 years of age and 4 (14 percent) of the male patients greater than or equal to 16 years of age. There were multiple endocrine deficiencies in half the patients. From 4 to 29 percent of the patients had periodic malabsorption, gastric parietal-cell atrophy, hepatitis, alopecia, vitiligo, or a combination of these conditions. Dental-enamel hypoplasia and keratopathy were also frequent but were not attributable to hypoparathyroidism. In the patients whose initial manifestation (other than candidiasis) was adrenal failure, the other components developed less often than in the remaining patients. We conclude that the clinical spectrum in patients with APECED is broad. The majority of patients have three to five manifestations, some of which may not appear until the fifth decade. Therefore, all patients need lifelong follow-up for the detection of new components of the disease.

Adolescent↗
PubMed1990

A longitudinal study of occlusal interferences and signs of craniomandibular disorder at the ages of 12 and 15 years.

Occlusal interferences and signs of craniomandibular disorder (CMD) were studied longitudinally in 167 Finnish adolescents at the ages of 12 and 15 years in order to evaluate their importance for orthodontic diagnosis. Of the adolescents sampled 16.8 per cent had received orthodontic treatment. The results showed that occlusal interferences and signs of CMD are quite common. Of the 12-year-olds 25.7 per cent and 30.5 per cent of the 15-year-olds showed palpatory tenderness of the muscles of mastication. Clicking sounds were recorded for 6 per cent of the 15-year-olds. Opening capacity increased with age. Only tow of the adolescents at the age of 12 and none at the age of 15 fulfilled the criteria of functionally optimal occlusion. The number of occlusal interferences increased between 12 and 15 years of age. Both occlusal interferences and clinical signs of CMD were inconsistent in nature. Mediotrusion contracts and protrusion interferences were found to be the most stable occlusal interferences at adolescence. As to pain on mouth opening, the symptom group at the age of 15 consisted of entirely new individuals. No single sign or CMD symptom, nor combination of them, was consistent enough for inclusion in orthodontic screening indices. However, even though the symptomatology changed, only a few of those considered to be symptomatic at the age of 12 were asymptomatic at the age of 15. In accordance with the present state of knowledge, it would thus seem appropriate to add a general statement about the presence or absence of CMD signs and/or symptoms to orthodontic screening indices.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1990

Prevalence of caries and salivary levels of mutans streptococci in 5-year-old children in relation to duration of breast feeding.

144 children with a known breast feeding history were studied for their caries prevalence and level of salivary mutans streptococci. 19% of the children were exclusively breast-fed for more than 9 months and 38% of the children were weaned after the age of 12 months (max. 34 months). The results of the study showed an equal caries prevalence at the age of 5 among children with a longer or shorter period of exclusive breast-feeding (chi 2 = 3.68, 9 df, NS). Exclusive breast-feeding also did not affect the levels of salivary mutans streptococci (chi 2 = 4.87, 9 df, NS). Children who were weaned late did not differ from those who were weaned early with respect to caries experience (chi 2 = 6.12, 9 df, NS), level of salivary mutans streptococci (chi 2 = 5.49, 9 df, NS) or presence of mutans streptococci (chi 2 = 1.53, 4 df, NS). On the basis of our sample we concluded that breast feeding alone cannot be connected with an increased or lowered caries prevalence.

Breast Feeding↗
PubMed1989

Symptoms of craniomandibular disorder in a sample of Finnish adolescents at the ages of 12 and 15 years.

Subjective symptoms of craniomandibular disorder (CMD) were studied longitudinally in 167 children at the ages of 12 and 15 in order to investigate their importance for orthodontic diagnosis. The results showed that symptoms are quite common in adolescents (64-67 per cent). However, most of the adolescents experienced their symptoms only occasionally. Frequent occurrence of various, single symptoms of CMD varied from 0 to 7.2 per cent. Recurrent headache was reported by 24 per cent of the adolescents at the age of 12, and by 22 per cent of them at the age of 15. The number of reported symptoms did not increase between the ages of 12 and 15 years, which is in agreement with other studies. The symptoms of CMD did not appear to be consistent. Locking of the joint was found to be the most stable symptom. About 50 per cent of those reporting TMJ-clicking, unexplainable ear symptoms or bruxism at the age of 12, had lost this symptom by the age of 15. For pain on mouth-opening, the symptom group at the age of 15 consisted of entirely new individuals. Because of their inconsistent nature during the final stages of occlusal development, too much attention should not be paid to single occurrences of CMD symptoms. In individual cases, however, important information for diagnosis and treatment planning can be obtained. Symptoms of craniomandibular disorder, recurrent headache, and oral parafunctions should be elicited and recorded at annual dental check-ups of children and adolescents.

Adolescent↗
PubMed1989

Streptococcus mutans infection level and caries in a group of 5-year-old children.

The level of Streptococcus mutans in stimulated saliva and its association with caries experience was evaluated in 149 5-year-old children. In general, salivary S. mutans levels were low, and it was detected only in 46% of saliva samples. There was, however, a clear association between salivary levels of S. mutans and caries experience (chi 2 = 53.65, p less than 0.001). Salivary examination was supplemented with plaque samples in 47 children. The number of S. mutans positive surfaces increased with increasing salivary levels. S. mutans was most often isolated and comprised the highest proportion in the approximal samples. The number of children with high salivary S. mutans levels was very low (6%) when taken into account that 13% of the children were fairly caries active (dmfs greater than or equal to 5). This most probably means that in evaluation of caries risk, the salivary S. mutans screening level is different in preschool children and in older children. The level should be determined in longitudinal studies before applying to preschool children.

Bacteriological Techniques↗
PubMed1988

Dominant inheritance of tooth malpositions and their association to hypodontia.

Four kindreds with family-specific malposition of cuspids were studied. Besides malposition of cuspids, the members also showed varying combinations of other anomalies: malposition, malformation or hypodontia of upper lateral incisors, second bicuspids and lower central incisors. The pedigrees provided convincing evidence for autosomal dominant transmission of the abnormalities studied. Their nature and location allow the assumption that they represent different expressions of one dominant gene causing a primary disturbance in the critical marginal area of the embryonic dental lamina.

Adolescent↗
PubMed1986

Ketoconazole is effective against the chronic mucocutaneous candidosis of autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED).

Ketoconazole was administered as a single daily oral dose of 200 mg to 12 patients with chronic mucocutaneous candidosis (CMC) of autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED). The study was double-blind and placebo-controlled, with 4-month therapy periods and crossover, and transfer to open-label ketoconazole therapy in cases of failure. During the double-blind trial, all six initially ketoconazole-treated patients showed a clear clinical and mycological improvement. In contrast there was no change or worsening in the initially placebo-treated group (p = 0.001). Oral candidosis cleared up in all patients, but more rapidly (less than 2 weeks) in those aged less than 25 years than in older patients (4-10 weeks; p = 0.001). Similarly, nail candidosis improved more rapidly in the younger group. All patients had a recurrence of the candidosis during 36-48 months of post-therapy follow-up. The recurrences likewise responded to ketoconazole. In one patient serum transaminase activities were transiently and marginally elevated during 2-6 weeks of therapy.

Adolescent↗
PubMed1982

Identification of cases requiring orthodontic treatment. A longitudinal study.

The present paper is a report on the second part of a longitudinal study dealing with the identification of children requiring orthodontic treatment. The series consisted of 200 children selected at random. The children were first examined at the age of 7 and next time at the age of 10. At the second examination 38% were found not to need any orthodontic treatment, while it was considered necessary to follow the occlusal development in 19%, and 43% were found to need treatment. The treatment need was urgent in 17%, moderate in 16% and slight in 10%. The re-examination of the untreated children at the age of 10 offered a possibility of checking the orthodontic prognosis made at the age of 7. It was concluded that only children showing cross bites and severe Class II malocclusions can reliably be selected for treatment at the age of 7. At this age misjudgements can be made with regard to dental arch crowding, open bite, deep bite, overjet and distal occlusion. Furthermore, it was concluded that a final decision concerning the need of orthodontic treatment cannot always be made even in 10-year-old children. The study will be continued by examinations at the ages of 12 and 14.

Child↗
PubMed1978

Oral findings in the autoimmune polyendocrinopathy-candidosis syndrome (APECS) and other forms of hypoparathyroidism.

Of twenty-eight patients aged 4 to 28 years with the autoimmune polyendocrinopathy-candidosis syndrome (APECS), twenty-seven had chronic oral candidosis, twenty-five had HPT, twenty-three had enamel hypoplasia, and nineteen had hypoadrenocorticism. Of three patients with other forms of hypoparathyroidism, none had any associated disease or oral abnormality. In nineteen cases candidosis was the first manifestation of APECS. Its occurrence was independent of the other components of the syndrome. The occurrence of enamel hypoplasia also was independent of HPT. Possibly, the enamel organ was affected by an autoimmune episode. No delayed maturation, resorption, or root hypoplasia was observed. Tooth impaction occurred in three patients.

Adolescent↗
PubMed1978

Dental maturity in hypopituitarism, and dental response to substitution treatment.

In 25 patients with hypopituitarism the relation of skeletal and dental maturity and the effects on it of substitution therapy for 2-4 years were analyzed. Dental age was retarded less regularly and to a lesser degree than skeletal age and statural growth. In most patients dental age was within the range of 0-2 s.d. All components of dental development seemed equally retarded. Changes in dental delay during GH treatment were variable, but in most cases parallel to the changes in statural and skeletal delay. When treatment was discontinued the lag in dental age increased, showing a response similar to that of skeletal age.

Adolescent↗
PubMed1978

Craniofacial and dental study of mulibrey nanism.

Dental and craniofacial features of 17 children and young adults suffering from the recently discovered mulibrey nanism syndrome are described and discussed. The present data do not allow any definite craniofacial typification of the syndrome. However, several findings suggest that we may be dealing with persistence of infantile structural relationships in the craniofacial area.

Adolescent↗
PubMed1976

Results of surgical exposure of impacted cuspids and bicuspids in relation to patients' somatic and dental maturation.

The aim of the study was to correlate the rate of postoperative eruption of impacted teeth after surgical exposure to the patient?S' SOMATIC AND DENTAL DEVELOPMENT. THIS RELATIONSHIP WAS ANALYZED IN 31 PATIENTW WITH IMPACTED CUSPIDS OR BICUSPIDS, 12 OF WHOM WERE OVER 25 AND 19 UNDER 21 YEARS OF AGE. Surgical uncovering of the impacted teeth was carried out and the degree of subsequent eruption was evaluated 4 months after the operation. On uncovering the crown was exposed as far as the cementoenamel juction and the surrounding bone was covered with mucous membrane. Dental age and growth rate were used as variables describing individual somatic and dental maturation. After surgical uncovering eruption took place in all but one tooth. Eruption was quicker and more complete in children who were still growing than in young adults. The eruption process was also more favorable in dentitions still under formation than in cases with completed dental development. Early intervention and total surgical uncovering of the crown are advocated in cases of impacted teeth.

Adolescent↗