Biomedical subjects

D Declerck

Publications and source records attributed to D Declerck.

At least 37 records · Page 2Linked to original sources

PubMed1999

The effect of periodontal therapy on the number of cariogenic bacteria in different intra-oral niches.

Several publications have reported an increased susceptibility for root caries after periodontal therapy. It has been suggested that newly exposed roots were less resistant to cariogenic species. This study examined the hypothesis that the increased susceptibility could also be related to an intra-oral microbial shift during the initial phase of the periodontal therapy from a perio-pathogenic to a more cariogenic flora. 10 patients with severe periodontitis were followed for 8 months after thorough scaling and root planing in combination with optimal plaque control. At baseline and after 4 and 8 months, samples were taken from the saliva, the tongue dorsum and the supragingival interdental spaces. These samples were cultured both aerobically and anaerobically in order to determine the total number of colony forming units (CFU) per sample as well as the number of CFU of Streptococcus mutans and Lactobacillus species. Oral hygiene parameters were recorded at the same visits. Finally, at baseline and at the 8 months follow-up, changes in caries activity and periodontal health were registered. Although the total number of aerobic and anaerobic CFU in samples from the tongue and the saliva remained nearly constant over the entire observation period (variations within 0.5 log), significant (p< or =0.05) increases in the number of S. mutans could be detected, especially at month 8. The significant decrease in the total number of anaerobic CFU in samples from the teeth was not associated with a reduction in the number of S. mutans, so that also for this niche the relative proportion of the latter increased. The number of lactobacilli species for the different niches showed only negligible changes (within 0.5 log values), except for samples from the teeth for which a small (1 log), but statistically significant (p<0.01), reduction could be detected. The periodontal conditions improved for all patients, but the caries activity could not be arrested. These findings seem to indicate that the increased caries susceptibility after periodontal therapy might partially be explained by a significant increase in the number of S. mutans due to ecological changes within the oral cavity. The clinical consequence of this observation would be to advocate a more strict caries preventive program during initial periodontal therapy.

Adult↗

PubMed1998

Oral health status in Belgian 3- to 5-year-old children.

The aim of this study was to determine the need for oral health care in young Belgian children in the municipality of Leuven, Belgium. The sample consisted of 750 boys and girls (3 years = 200, 4 years = 200 and 5 years = 350). Clinical examination was carried out by one examiner and duplicate recordings were made on 10% of the sample. The clinical examination included recording of: (1) plaque index; (2) gingival index; (3) caries index; and (4) fluorosis index. Plaque and gingival indices were recorded at six sites of smooth surfaces on selected teeth. Occlusal plaque was also registered. Before the clinical examination for caries and fluorosis, the children had their teeth professionally cleaned with toothbrushes and dental floss and dried by means of gauze bandages. In all age groups, the percentage of plaque-free sites was of the order of 60% and sound gingiva was identified at 83% of the recorded sites. The percentages of caries-free children were 69% (3 years), 57% (4 years) and 52% (5 years). The mean deft scores (standard error) were 1.37 (+/- 0.21), 1.76 (+/- 0.21) and 2.03 (+/- 0.17). The corresponding mean defs scores were 2.04 (+/- 0.44), 2.46 (+/- 0.35) and 3.75 (+/- 0.42). Non-cavitated active lesions, included in the defs scores, represented about 50% of all caries lesions. Early signs of dental fluorosis were identified in 19% (3 years), 17% (4 years) and 9% (5 years) of children. The need for oral health care in the population studied is mainly related to non-operative treatment procedures aimed at controlling the progression of disease.

Belgium↗

PubMed1998

Malocclusion, dental injuries and dental anomalies in the primary dentition of Belgian children.

AIM: To estimate the prevalence of malocclusion, dental injuries and dental anomalies in a sample of 3-5-year-old Belgian children. DESIGN: A cross-sectional study of 3-5-year-olds attending kindergartens in the municipality of Leuven, Belgium. METHODS: A total of 750 boys and girls participated in the study. The children were examined at the University School Health Centre in connection with their obligatory medical check-up. The clinical examination was performed by one examiner using generally accepted criteria for these oral conditions. RESULTS: 10.1% of the examined children had posterior cross-bite whereas over-bite was seen in only 2.0% of the sample. Open-bite was detected in 32.0% of the studied population. Boys showed a tendency for a higher frequency of malocclusions than girls. Traumatic injuries were identified in 18.0% of children. These were almost entirely restricted to maxillary incisors. Crown fractures were responsible for 42% of all injuries. The following dental anomalies were seen: six cases of supernumerary teeth, three cases of hypodontia, five cases of double teeth and one case of conical maxillary lateral incisor. CONCLUSION: Our findings emphasize the importance of early detection of these oral conditions in order to permit effective and long-term planning, according to the child's individual requirements.

Belgium↗

PubMed1998

[Fluoride dentifrices].

The introduction of fluoride-containing dentifrices is held responsible for the important decrease in caries prevalence that was seen in the past decades. Fluoride in toothpaste is available in different formulations and combinations. Differences exist between dentifrices regarding the concentration of fluoride in the paste. Optimal results are obtained at levels of 1000 ppm fluoride. The efficiency of low-dose products is still a matter of further investigation. More research is necessary to determine the amount of toothpaste that should be used and the optimal frequency of use.

Cariostatic Agents↗

PubMed1998

[Definitive injuries to the teeth. Lesions of hard tissue and pulp].

Tooth infraction and enamel fracture are the most simple traumatic crown lesions. When necessary the lesions can be covered with composite material. Follow-up of the traumatized tooth is necessary since pulp necrosis and obliteration can develop. In case of an uncomplicated fracture involving enamel and dentine immediate protection of the dentinal wound is important for the preservation of tooth vitality. In case of a negative vitality test, an endodontic treatment will be performed in case of a tooth with open apex only when supplemental clinical and or radiological signs of pulp necrosis are present. When a complicated enamel-dentine fracture is present, an endodontic treatment will be performed when root formation is complete. In case of a wide open apex, a pulp capping, partial pulpotomy or cervical pulpotomy will be performed in order to preserve vitality of pulpal tissues at the level of the root. Crown root fractures can be superficial, deep or vertical. In case of a superficial localisation of the fracture line, restoration with composite material or with the fractured tooth segment is indicated. Deep crown-root fractures can only be restored when the fracture line is localized not deeper than at 1/3 of the length of the root. In case of a vertical fracture, extraction is the only possibility. Root fractures on immature teeth are in most cases unilateral and have a good prognosis. In teeth with completed root formation, fractures at the level of the cervix have a poor prognosis. The fractured segment will be removed. Only when the remaining root segment is long enough, this part can be maintained. In case of a fracture at the mid-root level, repositioning and rigid splinting for a period of 8 weeks is necessary. When the tooth becomes non-vital, endodontic treatment is performed on the coronal part. Root fracture in the apical part does not necessary result in enhanced tooth mobility and immobilisation is not always necessary. Healing of a root fracture is only possible when the tooth is immobilized for a sufficiently long period. Regular control of tooth vitality is necessary since pulp necrosis can lead to an inflammatory reaction at the level of the fracture line.

Dental Enamel↗

PubMed1998

[Injuries to the permanent teeth. Periodontal lesions].

Tooth luxations are relatively common. In case of concussion or subluxation the tooth is not displaced. The treatment will consist of relief of the tooth. Most frequent complications are pulp necrosis and obliteration of pulpal tissues. In case of extrusive luxation pulpal tissues and the periodontal ligament are injured. When tooth mobility is increased flexible splinting should be considered. Endodontic treatment is necessary after extrusive luxation of a tooth with completed root formation. Teeth with open apex often show pulpal obliteration after extensive luxation. Lateral luxation is more complex than extrusive luxation since the alveolar bone is also damaged. Repositioning and splinting of the tooth are necessary. When the apical foramen in closed, endodontic treatment will be necessary. Teeth with incomplete root formation will develop pulp obliteration. Following lateral luxation, external root resorption and loss of marginal bone are not infrequent. Intrusive luxation is the type of trauma with most unfavorable prognosis. All intruded teeth will become necrotic and external root resorption and marginal bone loss are frequent. There is no consensus regarding the therapeutic approach. Orthodontic extrusion or surgical mobilisation are possible options. In case of avulsion, both the pulpal tissues and the periodontal ligament are disrupted. Preservation of the vitality of the periodontal ligament covering the root will determine the prognosis of the reimplanted tooth. Therefore the tooth will be repositioned as soon as possible. When this is not possible, milk or a specific solution are most appropriate for tooth conservation. When the reimplanted tooth has complete root formation, devitalization will be performed one week after after repositioning. In case of a tooth with open apex revascularisation can be awaited. Healing of the periodontal ligament will determine prognosis. When a normal ligament is obtained during healing or when surface resorption is obtained, the tooth can be preserved for a long period. When progressive replacement resorption (ankylosis) develops, most teeth can remain in position for about 10 years. When inflammatory resorption develops, the tooth will be lost within a short time.

Dental Pulp Calcification↗

PubMed1998

[Fractures of the alveolar process].

Fractures of the alveolar bone plate or processus alveolaris can easily be diagnosed by clinical examination and radiological check-up. These fractures require repositioning and rigid fixation. Pulp degeneration and resorption can be avoided when endodontic treatment is carried out early on.

Alveolar Process↗

PubMed1997

Oral health condition of 12-year-old handicapped children in Flanders (Belgium).

The dental condition of 626 12-year-old handicapped children with mild mental or moderate to severe mental retardation or learning impairment, being 25% of the population of each of these groups, was examined in Flanders. An evaluation of oral cleanliness showed poor oral hygiene in 31.8% of the children. No significant differences were found in oral cleanliness among types of handicapping conditions. The mean DMFT score was 2.9 (s: 2.6) and DMFS score was 5.4 (s: 5.6). Almost 21% of the children were free of caries or fillings. No significant differences were found among groups of handicapped children. Handicapped children presented a low level of restorative care (restorative index score: 48.7%). Mildly mentally retarded children demonstrated the lowest restorative index (43.9%). The caries experience of first permanent molars represented the largest part of the DMFT score (64.1%). Sealants were present in 7.9% of children examined. A considerable percentage of mildly mentally retarded children and learning impaired children did not brush daily (22.1% and 20.9%) and did not receive help with toothbrushing from their parents or carers (91.0% and 94.7%, respectively).

Belgium↗

PubMed1997

The validity of a medical risk-related history for dental patients in Belgium.

The aim of this study was to establish whether a patient-administered medical risk-related history (MRRH) for dental patients was valid. The MRRH, which was developed in the Netherlands, has now been tested in Belgium, where it was completed by total of 99 patients. Their answers were compared with the results of a verbal history, taken by a physician experienced in pre-assessment control. This verbal history was considered the 'gold standard'. The sensitivity and specificity of the medical questionnaire proved to be sufficiently high (88 per cent and 98 per cent respectively) and Cohen's Kappa displayed close agreement (0.87). These figures were only slightly lower than those obtained in Holland. The MRRH is valid for the registration of medical problems in dental patients but the answers need to be checked personally by the dental practitioner. Since the present trial was a limited one, the study will be expanded to nine countries in Europe.

Adult↗

PubMed1997

[Dermatofibrosarcoma Darier and Ferrand. Immunohistochemistry study of 38 cases. Research on a specific marker].

This is a retrospective pathological and immunohistochemical study of 38 cases of dermatofibrosarcoma protuberans. It is a rare dermal and subcutaneous spindle cell tumor which may be difficult to diagnose. We tested the value of the CD34 antibody and compared this series with 15 fibrous histiocytomas and II neurofibromas. Thirty-one dermatofibrosarcoma protuberans were positive for CD34 and 7 were negative. All the fibrous histiocytomas were negative. Nine neurofibromas were positive with variable expression of CD34 antigen. The CD34 antibody seems to be a sensitive marker to differentiate dermatofibrosarcoma protuberans from fibrous histiocytoma. It is specific for the dermatofibrosarcoma protuberans in the context of differential diagnosis between these two tumors. The role of immunohistochemical staining remains useful within the anatomoclinical context.

Adult↗

PubMed1996

Caries-related salivary microorganisms and salivary flow rate in bone marrow recipients.

Cancer treatments often induce oral complications. In this study we investigate longitudinally the salivary gland function, the salivary caries-related microorganisms, and buffer capacity in bone marrow recipients. Stimulated saliva samples were taken midmorning. The salivary factors were studied in 42 patients from before transplant until 4 months after transplant. A dramatic reduction (66%) of salivary flow rate is noticed in all patients at 1 month after transplant, and only a partial recovery (42% reduction) is seen after 4 months. A clear shift toward a lower buffer capacity and a higher amount of cariogenic microorganisms is seen posttransplant. This shift is more pronounced when total body irradiation was included in the pretransplant conditioning therapy. These findings indicate that the studied parameters in transplant recipients can contribute to a higher caries risk and oral complications during the early posttransplant period.

Adolescent↗

PubMed1996

Salivary caries risk factors in long-term event-free survivors of pediatric malignant diseases.

In this study we demonstrated that caries prevalence and Plaque Index in long-term event-free pediatric oncology patients are related to Streptococcus mutans, Lactobacillus counts and buffer capacity obtained by chairside saliva tests. The scores showed a significant correlation between the microbiological findings and caries experience in both groups. The results were compared with a control group. A similarity in the results was found between the study and control groups. In a subgroup consisting of children who were diagnosed with cancer maximum two years before oral examinations, no significant differences with a control group was noticed. In this study we did not find any evidence of long-term effects on the studied salivary caries risk factors in children who are long-term event-free after cytotoxic treatment. Chairside tests seem to be useful in this patient group: they provide us information which can contribute to the determination of the individual caries risk, and help to motivate the patient and health care workers to maintain optimal oral hygiene.

Adolescent↗

PubMed1996

Quantitative determination of immunological components of salivary gland secretion in transplant recipients.

Cancer therapies often induce oral complications. We studied longitudinally the major salivary immunoglobulin content in 42 transplant recipients using an enzyme-linked immunosorbent assay. A dramatic decrease in both sIgA and IgG is noticed post-transplant compared to pretransplant values. Only a small recovery of these immunoglobulin concentrations is seen after approximately 4 months. The reduction of sIgA and IgG in saliva could contribute to the frequent oral complications seen in these patients after transplantation and increase the risk of developing dental caries.

Adolescent↗

PubMed1995

Quantitative determination of immunologic components of salivary gland secretion in long-term, event-free pediatric oncology patients.

OBJECTIVES: Chemotherapy influences the human immune system. Salivary alterations occur during cancer treatment. In this article we examine the salivary immunoglobulin content in pediatric patients who were long-term event-free and correlate these findings with different oral factors. STUDY DESIGN: Fifty-two children of a study group and 63 children of a control group were examined at our University Hospital. Caries prevalence and plaque index were scored. Whole saliva samples were taken for determination of slgA and IgG concentrations and Streptococcus mutans and Lactobacillus counts. For statistical analysis the Dental Survey Plus (Providence Software Services, Bristol, England) software package was used. RESULTS: Concentrations of slgA and IgG were within normal limits in both groups; slgA level increased with age. A negative correlation between slgA concentration and caries experience was not found in all age groups. No correlation with other salivary parameters was found. CONCLUSION: Salivary content of slgA and IgG can return to normal after cytotoxic therapy in these children. Salivary IgA seem to play a role in the development of dental caries in this population.

Adolescent↗

PubMed1995

Dental caries, gingival health, and oral hygiene of long term survivors of paediatric malignant diseases.

Fifty two children who had had cancer and been treated with chemotherapy, and who were long term event free, were examined for caries prevalence, gingival health, and oral hygiene and compared with a control group. A higher dental caries prevalence for the 14-17 year age group was noted. The restorative index was significantly lower in the age group 10-13. There were no significant differences in gingival index, plaque index, or toothbrushing frequency. It is concluded that these patients should be considered as at high risk for caries after cancer treatment. Professional dental follow up should be integrated in the medical follow up.

Adolescent↗

PubMed1995

[Dental care in patients undergoing radiotherapy of the head and neck].

Radiotherapy involving the oral cavity and salivary glands induces a wide range of alterations in oral tissues and salivary gland functions which may result in oral side effects. Some of these are inevitable and transient such as radiation mucositis, some however may be permanent such as xerostomia. Others however are preventable, and are caused by poor radiation techniques, application of excessive radiation doses or lack of necessary preventive measures. Frequent complications in these patients are development of caries, dental hypersensitivity, rapidly progressive periodontal disease and loss of taste. Occasionally, trismus and osteoradionecrosis may develop. Careful treatment planning before start of radiotherapy with adequate dosimetry and careful shielding of the healthy tissues as well as close monitoring of the oral cavity with strict application of preventive measures (dental care protocol) can significantly reduce the incidence of these complications. The private practitioner should keep in mind the life-long precautions that are necessary when treating these patients.

Dental Caries↗

PubMed1995

[Mucous lesions associated with hematologic diseases].

Mucosal lesions are a frequent finding in patients with hematologic malignancies. Early diagnosis and institution of adequate therapeutic modalities can significantly reduce the morbidity and even mortality in these patients. Primary lesions are the consequence of infiltration of the oral tissues by malignant cells. Secondary lesions result from the condition of bone marrow suppression induced by replacement of the blood forming tissue by malignant cells. Lesions caused by the oncologic treatment, directly or indirectly, are called tertiary lesions. This article describes and illustrates the different types of lesions.

Adolescent↗

PubMed1995

[The medical history through a list of medical risks. Practical use in dental medicine].

A medical risk related patient-administered history (MRRH) was developed for use in routine dental treatment with or without local anesthesia by the general dental practitioner. The fixed guidelines of the ASA classification may be under discussion. Of course, there are other divisions and combinations conceivable and deviation of the standards may be inevitable. However, the present proposal is to be used for investigation purposes, which makes fixed guide-lines imperative. This MRRH, tested in Belgium, proved to be valid in comparison with the "gold standard", a verbal history taken by a physician experienced in pre-assessment control. The most reliable results can be obtained by a combination of the medical questionnaire and the additional verbal history.

Coronary Disease↗