PubMed Health⌕ Search

Biomedical subjects

W H van Palenstein Helderman

Publications and source records attributed to W H van Palenstein Helderman.

At least 19 recordsLinked to original sources
PubMed2006

Salivary mutans streptococci counts as indicators in caries risk assessment in 6-7-year-old Chinese children.

OBJECTIVES: This study aimed to determine whether salivary mutans streptococci (MS) counts in Chinese children had any value in the prediction of new caries in the permanent dentition in the age interval of 6.5-8.5 years. METHODS: Four hundred and thirty-three 6-7-year-old children participated in this 2-year longitudinal study. Salivary MS counts were obtained at baseline with the spatula method. Dentin and enamel caries was recorded at baseline and at the follow-up, 2 years later. Spearman's correlation coefficients were computed. Past caries experience variables at baseline were entered into a multiple regression model with caries increment of the permanent dentition as dependent variable. MS counts were subsequently entered into the model to assess the additional caries predictive value. RESULTS: Spearman's correlation coefficient for MS counts and caries experience of the primary dentition at baseline was 0.48 and for MS counts and caries increment in the permanent dentition 0.12. In the multiple regression model caries increment of the permanent dentition had an adjusted R2 of 0.17 when the past caries experience variables were entered. Adding MS counts in the regression model did not change the R2 value. CONCLUSIONS: Salivary MS counts did not add any caries predictive value when past caries experience variables were used as caries predictors in this Chinese child population.

Child↗
PubMed2006

Caries experience variables as indicators in caries risk assessment in 6-7-year-old Chinese children.

OBJECTIVES: The aim of the present study is to investigate variables of the past caries experience as indicators of future caries in a Chinese child population. METHODS: Caries was recorded at baseline and 2 years later in 433, 6-7-year-old Chinese children. Correlation coefficients between variables of the past caries experience and caries increment were calculated. Stepwise logistic regression analyses provided predictor variables. ROC curves presenting sensitivity as function of (100-specificity) were employed to summarize the obtained information. The area under the ROC curves was used as a measure of predictive accuracy. RESULTS: Twelve variables of baseline caries experience had a significant (p<or=0.05) correlation with caries increment in the permanent dentition. Among the variables, the number of primary molars with enamel or dentine caries, fillings or missings due to caries (d(12)mftmol), the number of fissures of the first permanent molar with enamel caries (D(1)fis) and the number of pits and fissures of the first permanent molar with dentine caries (D(2)pitfis) were the most powerful caries predictors, which resulted in a value of 0.74 under the ROC. CONCLUSIONS: By including non-cavitated caries in the past caries experience of primary molars and permanent first molars, it was possible to construct a screening criterion (d(12)mftmol+D(1)fis+D(2)pitfis), which enabled the selection of true negative children and the selection of a high caries risk group in a 6-7-year-old Chinese child population.

Child↗
PubMed2006

Caries-preventive effect of resin-based and glass ionomer sealants over time: a systematic review.

INTRODUCTION: The difference in preventing dentine lesion development between resin-based and glass ionomer sealant materials is unclear. Two recently published reviews were unable to conclude on the difference because the comparison was an exclusion criterion in one review and there were statistical shortcomings in the relevant papers in the other (Cochrane) review. OBJECTIVES: The aim of the present investigation was to carry out a systematic review on the caries-preventive effect of these two types of sealant materials under more liberal exclusion criteria concerning the statistical presentations in the publications. METHODS: Based on five exclusion criteria, the literature search in the electronic libraries PubMed and MEDLINE and the publications retrieved in the Cochrane review, revealed 12 eligible publications for analyses. A variety of glass ionomers and resin-based sealant materials had been applied in the included studies. Attributable risk (AR) was chosen rather than relative risk (RR), as used in the Cochrane review, because RR is very instable in a low caries population. RESULTS: There was no consistent pattern observed with respect to the caries-preventive effect of either resin-based or glass ionomer sealants. Therefore, it was impossible to calculate an overall AR. CONCLUSIONS: There is no evidence that either resin-based or glass ionomer sealant material is superior to the other in preventing dentine lesion development in pits and fissures over time.

Dental Caries↗
PubMed2006

Caries-preventive effect of a one-time application of composite resin and glass ionomer sealants after 5 years.

The aim of the present trial was to (1) compare the caries-preventive effect of glass ionomer sealants, placed according to the atraumatic restorative treatment (ART) procedure, with composite resin sealants over time and (2) investigate the caries-preventive effect after complete disappearance of sealant material. Forty-six boys and 57 girls, mean age 7.8 years, were randomly divided into two treatment groups in a parallel-group study design. A light-polymerized composite resin sealant material and a high-viscosity glass ionomer were each placed in 180 fully erupted first molars in their respective treatment groups. Evaluation took place annually for 5 years by calibrated examiners. After 5 years, 86% composite resin and 88% glass ionomer sealants did not survive. Three categories of re-exposure periods for caries development in pits and fissures after complete loss of sealants were distinguished: 0-1, 1-2 and 2-3 years. In the 2- to 3-year group, 13 and 3% of pits and fissures previously sealed with composite resin and glass ionomer, respectively, were diagnosed as having developed a dentine lesion. The relative risks (95% CI) of dentine lesion development in surfaces sealed with glass ionomer compared to those sealed with composite resin after 3, 4 and 5 years were 0.22 (0.06-0.82), 0.32 (0.14-0.73) and 0.28 (0.13-0.61), respectively. The relative risks of dentine lesion development in pits and fissures previously sealed with glass ionomer compared with composite resin over re-exposure periods of 1-2 and 2-3 years were 0.26 (0.14-0.48) and 0.25 (0.09-0.68), respectively. We conclude that the caries-preventive effect of high-viscosity glass ionomer sealants, placed using the ART procedure, was between 3.1 and 4.5 times higher than that of composite resin sealants after 3-5 years. Furthermore, high-viscosity (ART) glass ionomer sealants appear to have a four times higher chance of preventing caries development in re-exposed pits and fissures of occlusal surfaces in first molars than light-cured composite resin sealant material over a 1- to 3-year period. A well-designed clinical trial using different types of oral health personnel should be implemented to confirm these initial results.

Cariostatic Agents↗
PubMed2006

Risk factors of early childhood caries in a Southeast Asian population.

A retrospective cohort study on ECC and associated factors was conducted among mothers with 25- to 30-month-old infants in a community where prolonged breastfeeding was common practice. All infants who consumed sugary supplementary food or rice that was pre-chewed by the mother, or who fell asleep with the breast nipple in their mouths, had ECC. Infants without those habits, and who were breastfed up to 12 months, had no ECC. Breastfeeding during the day beyond the age of 12 months was not associated with ECC, but infants who were breastfed at night > 2 times had an OR for ECC of 35 (CI 6-186), and those who were exposed to > 15 min per nocturnal feeding had an OR for ECC of 100 (CI 10-995). The present study indicates that, in this population, besides the consumption of sugars and pre-chewed rice, nocturnal breastfeeding after the age of 12 months poses a risk of developing ECC.

Breast Feeding↗
PubMed2006

Caries-inhibiting effect of chlorhexidine varnish in pits and fissures.

Evidence regarding the caries-inhibiting effect of chlorhexidine varnish is inconclusive. This study investigated the caries-inhibiting effect of the varnish EC40 on pits and fissures of first permanent molars. A two-year randomized controlled trial was carried out among 461 six- to seven-year-old children. In a split-mouth design, one group of molars received EC40 at baseline, 6, 12, and 18 months, and another group at baseline, 3, 12, and 15 months. Control molars did not receive EC40. Adherence to the treatment protocol was good. The dropout rate was 17%. Blinded examiners performed dental examinations. The caries-inhibiting effects of the two EC40 application schemes were comparable. The prevented fraction of caries was 25% (95%CI, 1%, 49%, p = 0.04) after 2 years and 9% (95%CI, -11%, 29%, p = 0.20) one year after termination of the trial, suggesting a short-term benefit from the use of EC40. The efficiency of EC40 is questionable in low-caries-incidence child populations.

Anti-Infective Agents, Local↗
PubMed2006

Plaque removal by young children using old and new toothbrushes.

There is inconclusive evidence about the relationship between toothbrush wear and plaque removal. This randomized cross-over clinical trial aimed to validate or invalidate non-inferiority in the plaque-removal efficacy of old vs. new toothbrushes in the hands of 7- and 8-year-old children. The lower limit for non-inferiority was set a priori as a difference in plaque score<15%. Children (n=101) brushed, in the first session, with either their 14-month-old toothbrush or a new one, and in the second session vice versa. The mean Quigley-Hein plaque score, before and after children brushed with old brushes, was 2.9 and 2.4, and with new brushes 2.8 and 2.1. The plaque score after they brushed with the new toothbrush was 10.9% lower (p<0.001) than after they brushed with the old toothbrush. The confidence interval of 7.6%-13.9% was within the acceptance band (<15%), and non-inferiority of old toothbrushes in the hands of these children was validated.

Child↗
PubMed2004

Oral health in Syria.

The aim of this paper is to describe and analyse the oral health situation in Syria in the last two decades and to propose recommendations for improvement of the current situation. The epidemiological data on caries of the last two decades did not indicate a decrease in the DMFT value of various age groups, nor was a decrease in the percentage of untreated caries apparent. The unequal distribution of oral health care continued to exist throughout the country, despite an enormous increase in the number of dentists from about 2,000 in 1985 to about 14,500 in 2002. The affluent part of the population is served with technically oriented expensive dental services. The public sector suffers from limited finance, the absence of appropriate technology in restorative dentistry and the lack of a community and preventive oriented approach. It is recommended to utilise dental hygienists in the public sector, since these auxiliaries if appropriately trained can offer the preventive and curative oral care wanted and demanded by the poor and that the government and the people can afford.

Adolescent↗
PubMed2003

Comparison between restorations in the permanent dentition produced by hand and rotary instrumentation--survival after 3 years.

OBJECTIVES: In the early 1990s, the Ministry of Education in Syria introduced a school oral health programme based on preventive and educational activities only. A restorative component was missing at that time. A few years later, the Atraumatic Restorative Treatment (ART) approach was considered an option to complement the oral health programme but little was known about the longevity of ART restorations in permanent teeth. The null hypothesis which was researched in this trial was: there is no difference between the survival of restorations placed through the ART approach using glass ionomer and those produced through the traditional approach using amalgam (MTA) in permanent dentitions after 3 years. METHODS: Using a parallel group design, 679 grade 2 children, with a mean age of 7.5 years, participated. A total of 369 children were treated through the ART and 310 children through the MTA approach. Eight dentists produced a total of 1118 single- and multiple-surface restorations. RESULTS: The 3-year dropout of the single-surface restorations was 15.3%. Testing the null hypothesis for all single- and multiple-surface restorations revealed a statistically significant difference between the two approaches in favour of the ART approach (P = 0.04). The study showed a 3-year cumulative survival percentage of single-surface ART and MTA restorations of 82.1 (SE = 1.9%) and 76.9% (SE = 2.3%), respectively. The difference was not statistically significant. The number of 3-year surviving multiple-surface restorations was too low for further analyses. The main failure characteristics for both single-surface ART and MTA restorations were restoration missing and gross marginal defect. The 3-year survival percentage of both single-surface ART and MTA restorations varied widely among the eight operators resulting in an operator effect (P = 0.01). CONCLUSIONS: The null hypothesis was rejected in favour of the ART approach. It is recommended to select the ART approach to complement the educational and preventive activities of the school oral health programme in Syria.

Child↗
PubMed2003

[Identification of caries risk patients 1. An overview of predictive models].

The ability of dentists to select caries risk patients on the basis of what they see and know, varies considerably. There is a need for objective methods. Methods using bacterial counts and salivary tests appeared to be inferior compared to methods based on the caries experience of the patient. There are two models, Nexø and Dentoprog, using the caries experience as caries predictor. The well documented Nexø method does not predict caries increment, but gives the provider a tool to target preventive intervention to those patients in need. The Dentoprog method is accurate, but has only one level of caries risk, which is considered by most providers as too low and thus unpractical.

DMF Index↗
PubMed2003

[Identification of cries risk patients 2. A new method for the selection of caries active children].

This paper presents a method, which, on the basis of the caries experience, predicts the caries increment up to the age of 15 years. This method provides the best caries prediction so far available. By applying the principles of medical decision-making cut-off points of risk can be assessed, whereby children can be selected as at risk or not at risk. The method is applicable in child populations with different caries incidences and meets the requirements of accuracy. With the user-friendly method, more than 80% of the children at risk can be identified and selected.

Adolescent↗
PubMed2003

[Decision making in cariology].

By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the probability of correct and incorrect decisions are multiplied by the utility of the decision outcomes. The treatment outcome with the highest expected utility should be selected. Complex decision tasks such as the estimation of an individual's caries risk or the diagnosis of bone disorders are currently available as computer applications. Also, a preliminary version of a computer programme which detects caries lesions from bitewing radiographs independent from the dentist has become available. It is expected that the applicability of decision analyses will increase when implemented in the dental practice software packages.

Decision Making↗
PubMed2002

[The shortened dental arch concept: a treatment strategy for the mutilated dentition].

The minimum number of teeth needed to satisfy functional demands has been subject of several studies. However, since functional demands can vary from individual to individual, this number cannot be defined exactly. It has been demonstrated that shortened dental arches comprising the front teeth and the premolars, can meet the requirements of a functional dentition. The shortened dental arch concept may be considered a strategy to reduce the need for complex restorative treatment in the posterior regions of the mouth. It implies that the prompt replacement of absent molars by a removable partial denture leads to overtreatment and discomfort. The shortened dental arch concept is based on circumstantial evidence, and not contradict current theories of occlusion and fits well in a problem-solving approach.

Adult↗
PubMed2001

A review of the oral health status in Syria.

AIM: To estimate the prevalence and severity of dental caries and periodontal diseases in Syria and to determine possible secular changes in the last two decades. METHODS: Epidemiological studies performed between 1980-1999, using the WHO criteria for dental caries and the CPITN criteria for periodontal diseases in Syria were retrieved and reviewed. RESULTS: The caries experience of 5-year-old children was high (dmft of 4.7-5.2). The estimated DMFT score of 12-year-old Syrian children was 1.9-2.3. A secular change of the caries experience in the last two decades was not apparent. The amount of untreated caries lesions was high and had not changed substantially in the last two decades. The D component comprised 72-90% of the DMFT of 12-15-year-old children and 26-30% of the DMFT of 35-44-year-old Syrians. The majority of 15-24-year-olds, and more than 80% of the 35-44-year-olds had calculus. Despite the widespread and chronic existence of calculus, only 3-11% of the 35-44-year-old persons had one or more deep periodontal pockets. CONCLUSION: The caries experience in Syria is moderately low and does not seem to have changed in the last two decades. The increased output of graduate dentists in the last decade has not changed the large amount of untreated caries lesions. In Syria, where the prevalence of unmet (caries) treatment needs is high, regular removal of calculus (scaling) for the sake of preventing periodontal pockets should not have a high priority in the oral health services.

Adolescent↗
PubMed2001

The possibility of previous epidemiological data to serve as baseline for future national oral health surveys--a study in Vietnam.

AIM: The purpose of this paper is to review the most recent epidemiological data (1985-2000) on dental caries and periodontal diseases in Vietnam in an attempt to obtain a 'baseline' for future national oral health surveys. METHODS: Studies on periodontal diseases and caries were included when CPITN and WHO caries criteria had been applied and when the sample size was at least n = 200 for each age group. RESULTS: Almost all subjects had calculus. The median number of sextants with calculus in the 15-19-year- and in the 35-44-year-olds was 4.2 and 5.0, respectively. Only 2-7% of the 35-44-year-olds had one or more deep periodontal pockets. The estimated DMFT of the 12-, 15- and 35-44-year-olds was 1.8, 2.0 and 5.4, respectively, in the years around 1990. CONCLUSION: This review shows that (often neglected) epidemiological studies from the past on caries and periodontal diseases can contain comprehensive data sets that provide an estimate of the past oral health status which may serve as a baseline for future national surveys.

Adolescent↗
PubMed2001

The value of salivary bacterial counts as a supplement to past caries experience as caries predictor in children.

This study aimed to determine whether salivary mutans streptococci and lactobacilli counts could add any value to a combination of caries experience variables that was recently presented for the prediction of caries. Sixty-nine children at the age of 7.5 yr participated in this longitudinal study. Microbiological data were obtained at the ages of 7.5, 9.5 and 11.5 yr and caries data at the ages of 7.5. 9.5. 11.5, 13.5 and 15.5 yr. Spearman's correlation coefficients were computed, and forward multiple regression analyses were carried out using bacterial counts and caries experience parameters as explanatory variables and caries increment as a dependent variable. The explained variance (adjusted R2 value) was the measure used to assess the additional value of bacterial counts to the caries predictive potential of the combined parameters of the past caries experience. Correlation coefficients between bacterial counts and 4-yr caries increment were from 0.22 tip to 0.54. In all cases, the simultaneous streptococcus mutans-lactobacilli counts showed a statistically non-significant additional adjusted R2 value of <0.06. The results do not lend support to the concept that these salivary bacterial counts are useful additional caries predictors for the mixed dentition, when a combination of caries experience parameters is used.

Adolescent↗
PubMed1999

The shortened dental arch concept and its implications for oral health care.

The minimum number of teeth needed to satisfy functional demands has been the subject of several studies. However, since functional demands--and consequently the number of teeth needed--can vary from individual to individual, this minimum number cannot be defined exactly. In general, occlusion of a complete dental arch is preferable. However, this goal might be neither attainable, for general, dental or financial reasons, nor necessary. Many studies demonstrate that shortened dental arches comprising the anterior and premolar regions can meet the requirements of a functional dentition. Consequently, when priorities have to be set, restorative therapy should be aimed at preserving the most strategic parts of the dental arch: the anterior and premolar regions. This also implies that in cases of a shortened dental arch, the prompt replacement of absent posterior molars by free-end removable partial dentures leads to overtreatment and discomfort. The shortened dental arch concept is based on circumstantial evidence: it does not contradict current theories of occlusion and fits well with a problem-solving approach. The concept offers some important advantages and may be considered a strategy to reduce the need for complex restorative treatment in the posterior regions of the mouth.

Adult↗