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We have previously reported that mast cells (MC) stimulate 3T3 fibroblast migration and proliferation into an in vitro model of wound obtained by producing in a confluent 3T3 monolayer, a midline cut and by scraping the cells from half of the monolayer. The purpose of the present study was to determine the contribution of mast cell-derived histamine to this MC increasing effect. Histamine levels in supernatants of MC/ 3T3 cultures unactivated or activated with either compound 48/80 or anti-IgE antibodies (10 min) did not correlate to the degree of fibroblast migration and proliferation into the wound space (42 h). Various concentrations of histamine were added to 3T3 fibroblast monolayers in the absence of cocultured MC, and fibroblasts beyond the wound line were counted (42 h). Addition of 100 ng/ml histamine had the highest stimulating effect on fibroblast numbers. This effect was abrogated by the addition of cimetidine (an H-2 antagonist). Addition of cimetidine to unactivated MC/ 3T3 cultures did not affect the increasing activity of MC presence on the wounded monolayer, although it diminished the enhancing effect obtained after MC activation with compound 48/80. These results indicate that histamine is partially responsible for the mast cell enhancing effect on fibroblast migration and proliferation in an in vitro model of wound.

Premature loss of primary teeth can lead to malocclusion and/or to esthetic, phonetic, or functional problems. Maintaining the integrity and health of the oral tissues is the primary objective of pulp treatment. It is important to attempt to preserve pulp vitality whenever possible; however, when this is not feasible, the pulp can be entirely eliminated without significantly compromising the function of the tooth. This article provides a concise review of the normal histological characteristics of the primary pulp and briefly describes the dentinogenesis process and the factors affecting the dentin-pulp complex response to stimuli. Finally, the biological basis and rationale for the various modalities of pulpal treatment for the primary dentition are discussed and data on the success rates for the different treatment is presented.

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When confronting a defiant or pre-co-operative young patient with extensive dental decay the dentist must decide between treatment under conscious sedation with passive restraint or general anaesthesia. Although some practitioners prefer to attempt and exhaust sedative techniques in most cases and use general anaesthesia as a last resort, many others do not mandate that alternate approaches first be attempted before treating under general anaesthesia and routinely recommend it as their first choice. What are the considerations involved in this decision-making process? Should the use of conscious sedation with restraint be revisited and perhaps even be considered the preferred method? What is the role of the dentist in the decision-making process? The purpose of this opinion-based paper is to present to the UK dentist a dilemma that paediatric dentists face in the US and in other countries as well and allow the reader to establish an opinion.

Aim. To investigate the impact of video information on parental preoperative anxiety and perception and their preference of conscious sedation versus general anesthesia for the dental treatment of young patients. Method/materials. Parents were given a verbal explanation regarding the two treatment options and were then asked to fill out a prescreening questionnaire. Their preference for mode of treatment was obtained and their preoperative anxiety level was measured on a visual analog scale (VAS). A video film depicting two children under going dental treatment with conscious sedation (CS) and a third child undergoing general anesthesia (GA) for dental treatment was shown to the parent. Following the viewing of the video film a post-screening questionnaire was given. Parents' post screening anxiety was measured and they were asked if their perception and preference of the two modes of treatment remained the same or changed. Results. 40 parents were included and completed the trial. The prescreening anxiety level of parents was 2.79 (± 1.05, SD) and was not significantly different than the post screening anxiety level of 2.91 (± .99 SD, paired t- test p=0.432). The majority of parents preferred CS to GA for the treatment of their child prior to screening of the video. Among the few who chose GA (n=5) all but one changed their choice after viewing the video to CS. However, this difference was not found to be statistically significant due to the small number of subjects in this group (McNemar test, p = 0.125). Most parents voiced the opinion that the video film contributed to their knowledge and also considered GA as having more risks than CS. An interesting finding was that a statistically significant difference was found regarding parent's perception of the two procedures and what they actually saw in the video. The majority of parents stated that their initial perception of GA was not similar to their viewing experience, conversely, CS matched their expectations. Conclusion. Parents' anxiety regarding their child's dental treatment under GA or CS is not affected by the viewing of a video film depicting either method. Parent's perception of GA is different than the actual procedure and may affect their choice of treatment.