We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded. The periodontal inflammatory burden index (PIBI) was calculated. Panoramic radiographs were taken and signs of infections recorded. Oral health habits, symptoms and participants' own opinion of oral health were recorded with questionnaires. At the time of examination, 45% of the women had a history of GDM in the index pregnancy. Mild periodontitis (62%) and bleeding on probing (46%) were common. VPI (13% and 17%, p = 0.009) and PIBI (13.1 and 17.5, p = 0.041) were lower among women with a history of GDM compared with those with no history of GDM. There was no difference between groups in DMFT scores. All women reported good subjective oral health. Thus, contrary to our hypothesis, women with a history of GDM showed better oral health parameters than women without a history of GDM.
Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each group was exposed to one test dentifrice [Colgate PreviDent (5000 ppm F), Colgate Winterfresh gel (1100 ppm F), Fluocaril Bi-Fluoré (2500 ppm F) and placebo (without fluoride)] three times daily for three minutes for 4 weeks. In between exposure to the test dentifrices, teeth were stored in a saliva storage solution. An Electrical Caries Monitor measured the electrical resistance at baseline and during the four-week test period at weekly intervals. The measurements were log transformed and Duncan's multiple range test applied. Remineralization was quantified using transversal microradiography. Results: Log mean (SD) electronic carries monitor (ECM) measurements in enamel at baseline and after 4 weeks of exposure to the test dentifrices were 4.07(1.53) and 3.87(0.90) (Placebo-Fluocaril), 4.11(1.86) and 4.64(1.43) (Colgate Winterfresh gel), 4.81(0.9) and 4.21(1.20) (Fluocaril Bi-Fluoré), and 4.60(0.88) and 3.76(0.9) (Colgate PreviDent). Corresponding measurements in dentine were 2.13(0.89) and 3.06(0.87) (Placebo-Fluocaril), 1.87(0.63) and 2.88(1.32) (Colgate Winterfresh gel), 2.47(1.20) and 1.65(0.60) (Fluocaril), and 2.16(0.00), and 2.34(1.07) for Colgate PreviDent. Lesion depth (µm) after microradiography in enamel was 100.1 (Placebo), 50.6 (Colgate Winterfresh gel), and 110.2 (Fluocaril, and 97.1 (Colgate PreviDent), and corresponding values in dentine were 169.7, 154.8, 183.7, and 153.5. The correlation of ECM and microradiographic parameters was negative (p < 0.05). Conclusion: Exposure of artificially demineralized enamel and root dentine to fluoridated dentifrices and saliva storage solution resulted in remineralization as follows: Colgate Winterfresh > Colgate PreviDent > Placebo-Fluocaril > Fluocaril Bi-Fluoré. Remineralization in teeth of the Placebo dentifrice group may be attributed to the presence of calcium and phosphate ions in the saliva storage solution.
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.