In this paper we determine the caries frequency in children of the Early Iron Age (EIA) (the 9th -the 3d centuries BC) and the Medieval populations (the 8th -the beginning of the 15th century AD) from the Ukraine area, and compare the results with the data from several European populations who lived at the same time. The EIA is presented by 41 children skeletons, three of which were Cimmerian (the 9th -the 7th centuries BC) from the territory of contemporary Poltava region; 38 skulls from the territory of contemporary Poltava region and Crimea represented Scythian period (the 7th -the 3d centuries BC). Remains of 24 children from the Medieval populations were also examined, three of which were the ancient Hungarians from the Poltava region (the 8th -the 9th centuries AD), 6 Khazars from the Kharkiv region (the 8th -the 9th centuries), 1 child related the Old Rus culture from the Kyiv region (the 9th century), and 14 representatives of the nomadic populations in the Golden Horde period (the 13th -the beginning of the 15th century) from the Poltava and Zaporizhzhya regions. Taking in consideration the letter archaeobotanical studies we suggest that there were no major changes in the plants exploited during all the studied periods. The frequency of carious lesions in children from the Medieval populations (8.3% in individuals, 0.5% in deciduous teeth, and 0.4% in permanent teeth) is only slightly higher than those from the EIA period (2.4% in individuals and 0.2% in deciduous teeth). These indexes were not larger those of majority of European populations dated to the same historic period. Further isotopic, chemical and palaeobotanical studies of the additional sites, with sufficient sample sizes, allow us to learn so much more of the cariogenic factors in children of the past populations from the Ukraine area.
Viral diseases with oral manifestations are common in the practice of pedodontist, however, sometimes their diagnosis is complicated due to the similar clinical manifestations. A huge number of viruses are present in oral cavity, especially from Herpesviridae family, however, the most of them are asymptomatic. Cold, systemic diseases and stress provoke the activation of viruses with different clinical manifestations. Therefore, a dentist can be the first who diagnoses not only herpetic gingivostomatitis, but also other viral diseases. The aim of the article was to analyse the oral manifestations of viral diseases in children in order to optimize their diagnostics. This article analyses clinical cases and reviews of diseases in English in Google database from 2011 to May 2020 (and earlier publications) by Keywords: «herpetic gingivostomatitis», «recurrent aphthous stomatitis», «oral manifestations of infectious mononucleosis», «herpetic angina», «oral manifestations of cytomegalovirus infection», «recurrent herpetic gingivostomatitis», «oral manifestations of varicella virus», «oral manifestations of herpes zoster», «roseola infantum», «herpangina», «hand, foot and mouth disease», «oral manifestations of measles», «rubella», «oral manifestations of papillomavirus», and «oral manifestations of human immunodeficiency virus». Viruses which have oral manifestations were characterized by transmission. Mostly airborne viruses are represented by Herpesviridae family. The differential diagnosis of primary herpetic gingivostomatitis includes recurrent aphthous stomatitis which forms ulcers on non-keratinised oral mucosa without a vesicle phase. Recurrent herpetic infection doesn’t have difficulties in diagnostics, but could be complicated by erythema multiform with clear target lesions. Vesicles, erosions in oral cavity associated with vesicles on hear part of head help to distinguish chickenpox from herpetic infection. Compared to Herpes simplex virus infection, Herpes zoster has a longer duration, a more severe prodromal phase, unilateral vesicles and ulceration, with abrupt ending at the midline and postherpetic neuralgia. Roseola is characterized by small papules on skin and palate which appears when severe fever in prodromal period subsides and disappears after 1-2 days. Oral vesicles associated with foot and hand rush differentiate enterovirus stomatitis from chickenpox and roseola. The distribution of the lesions of herpangina (palate, tonsils) differentiates it from primary herpetic gingivostomatitis, which affects the gingivae. Comparing with roseola and rubella, measles has a bigger size of rush and specific oral localization on buccal mucosa. Mild fever and skin rush which appears on face and extensor surfaces of body and extremities help to distinguish rubella from measles and roseola. Viruses transmitted through biological liquids are represented in oral cavity by infectious mononucleosis and cytomegalovirus. The vesicles and ulcers on the tonsils and posterior pharynx in case of these infections can resemble herpetic stomatitis, but liver and spleen enlargement allows to exclude this diagnose; also cytomegalovirus erosions heal for long time. Cervical lymphoadenopathy differentiates them from herpetic angina. Laboratory diagnostics is based on detection of antibodies to virus or virus DNA in blood helps to make diagnosis of infectious mononucleosis and cytomegalovirus infections. Viruses transmitted through direct contact with mucosa and biological liquids represented by human papillomavirus (HPV) and human immunodeficiency virus (HIV). HPV in oral cavity represent by benign epithelial hyperplasia which might persist and transform to malignant. Therefore, histological examination plays important role in diagnostics of HPV. Oral manifestations such as candidiasis, herpes labialis, and aphthous stomatitis represent some of the first signs of HIV immunodeficiency. Oral lesions also associated with HIV in children are oral hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, and Kaposi’s sarcoma. Rapid necrotization and long-term healing of oral lesions help to suspect HIV and prescribe the blood test for the detection of antibodies to the virus. Oral mucosa is often the first to be affected by viral infections. A thorough anamnesis and examination is the key to accurate diagnostics of the most oral viral lesions and their adequate treatment. Biopsy, examination of antibodies to the virus in the blood or polymeraze-chain reaction to the virus in the bioptate or blood are performed in case of diagnostic difficulties. Laboratory methods had to use more widely for the diagnostics of recurrent or unclear lesions of the oral mucosa in children.
In Europe, two species of hantaviruses, Puumala orthohantavirus (PUUV) and Dobrava orthohantavirus (DOBV), cause hemorrhagic fever with renal syndrome in humans. The rodent reservoirs for these viruses are common throughout Ukraine, and hence, the goal of this study was to identify the species and strains of hantaviruses circulating in this region. We conducted surveillance of small rodent populations in a rural region in northwestern Ukraine approximately 30 km from Poland. From the 424 small mammals captured, we identified nine species, of which the most abundant were Myodes glareolus, the bank vole (45%); Apodemus flavicollis, the yellow-necked mouse (29%); and Apodemus agrarius, the striped field mouse (14.6%) Using an indirect immunofluorescence assay, 15.7%, 20.5%, and 33.9% of the sera from M. glareolus, A. glareolus, and A. flavicollis were positive for hantaviral antibodies, respectively. Additionally, we detected antibodies to the hantaviral antigen in one Microtus arvalis, one Mus musculus, and one Sorex minutus. We screened the lung tissue for hantaviral RNA using next-generation sequencing and identified PUUV sequences in 25 small mammals, including 23 M. glareolus, 1 M. musculus, and 1 A. flavicollis, but we were unable to detect DOBV sequences in any of our A. agrarius specimens. The percent identity matrix and Bayesian phylogenetic analyses of the S-segment of PUUV from 14 M. glareolus lungs suggest the highest similarity (92–95% nucleotide or 99–100% amino acid) with the Latvian lineage. This new genetic information will contribute to future molecular surveillance of human cases in Ukraine.
Odontological studies of ancient populations represent different indicators related to health state, lifestyle and human diet. The aim of this paper is to determine the dental health indicators in the Chernyakhov population (the end of the IVth c. AD) from Ukraine. The paper also attempts to identify the relationship between sex and these indicators in the studied population. The sample analysed consisted of the dental remains of 25 adult individuals (11 males and 14 females) and 8 children individuals excavated from the cemetery at the archaeological site of Shyshaki (Poltava region of Ukraine). A total of 760 teeth were examined for caries, tooth wear and calculus clinically, and 647 teeth of adults were observed radio-graphically. The studied population presents frequency of caries in individuals of 12.5%. This indicator in adult male and female dentition is 42.86% and 14.0% respectively, and 25% in children. The presented population frequency of caries teeth was 0.88%. Females presented higher caries rate than males (2.72 % females vs. 0.36 % males) (p<0.05). The most frequent were caries lesions of cementum-enamel junction (40%) and combined lesions of crown and root (40%) with no difference in terms of sex. Frequency of dental wear in adult individuals and 8-10 year-old individuals was 100%. The studied population represented TWI (tooth wear index) in adults (2.26), which increased with aging, but the difference in terms of sex is insignificant. Calculus was observed in 64.28% of the females and 63.33% of the males, showing no statistical difference (p>0.5). These findings confirm a very low rate of caries teeth in the territory of Shyshaki during the Late Roman period, which could be related to regional diet and concentration of fluorine in drinking water. The Chernyakhov population presents high dental wear and similar frequency of dental calculus when compared to the population from Roman Britain. Females presented significantly higher frequency of caries than males, whereas no significant sex differences were found regarding dental wear, calculus, and localisation of caries lesions. The authors presume that dental health indicators in the Chernyakhov culture need to be studied more with bigger sample size and data of the populations from other regions of Ukraine.
Acute lymphoblastic leukemia (ALL), the most common type of leukemia in children, has diverse oral cavity complications. While periodontal alterations in such patients are widely known, there were no studies evaluating gingival health from the time of diagnosis to the remission phase. In our study, we, therefore, analysed the frequency of periodontal diseases and the gingival indices in the different phases of ALL in children. Children aged 7-15 years were involved into the cross-sectional study. Therein, 160 children with ALL were divided into three groups: L1 – 50 children examined before the initiation phase, L2 – 50 children examined after 1 month of the chemotherapy, L3 – 60 children examined in permanent hematologic remission. The control (HC) included 150 healthy children. The L1, L2 and L3 groups had significantly worse gingival indices and frequency of gingivitis than the HC group (p < 0.0001). Frequency of gingivitis increased from before the initiation to the remission phase, but significantly only in 7-11 year-old children (p = 0.0004). Gingival indices increased after 1 month of chemotherapy (p < 0.0001), but decreased in the permanent remission phase (p < 0.0001). Our study stresses the need for children with ALL to not only require prevention courses before the initiation and during the chemotherapy phases, but also in the permanent remission phase to minimize the long-term impact of leukemia treatment on gingival health.
Developmental dental hard tissues disorders are rarely diagnosed both in children and adults, and their treatment is a problem for dentist. Despite the fact that molecular genetics studies allow to discriminate some dentine disorders, pathogenesis of radicular dentin dysplasia is still obscure. Type I dentin dysplasia is characterized by normal or slightly coloured crowns with no roots or only rudimentary roots, reduced pulp space in permanent teeth and incomplete or total obliteration of the pulp chambers, and periapical radiolucent areas or cysts which might result in premature loss of tooth. Fortunately, teeth demonstrate higher resistance to caries than normal teeth do. Dentin dysplasia type II is characterized by yellow, brown, grey, translucent primary teeth with complete pulpal obliteration. Permanent teeth are normal or might be slightly coloured. Roots are normal in size, but pulp chamber has pulp stones. A third type of dentine dysplasia or focal odontoblastic dysplasia has radiographic aspects of the other two types of disease. Also dentine dysplasia type I has subtypes Ia, Ib, Ic and Id. Dentine dysplasia Ia is characterized by complete obliteration of the pulp, disorder of root development, and many periapical radiolucent areas. A single small horizontally oriented and half-moon shaped pulp is presented in case of dentine dysplasia Ib, roots have a few millimetres length and frequent periapical radiolucencies. Dentine dysplasia Ic is characterized by the presence of two horizontal or vertical semicircle-shaped pulpal remnants which surround dentine in pulp chamber. Also teeth have shortened roots and variable periapical radiolucencies. Dentine dysplasia Id is characterized by the distinct pulp chambers with pulp stones in the coronal third of the root canal; periapical radiolucencies are possible as well. Aim of this study was to analyse clinical case of dentine dysplasia in 8,5-year-old boy. A 8,5-year old boy patient with parents came to a dental office due to caries cavity in tooth 62. Shape of tooth crowns was not changed and teeth with no signs of mobility; white lines and spots on teeth are were detected. Based on age, the decision of orthopantomogram was made to evaluate status of primary and permanent teeth. The image showed almost obliterated pulp chamber in both erupted and developing teeth and considerably shortened, blunted and malformed roots without a visible lumen of root canals in primary teeth. Periapical lesions were found about roots of primary molars and follicles of teeth 12 and 14 without caries lesions. Patient's medical history revealed no disturbance in general health. Clinical examination of the patient's mother did not show dental hard tissues disorders, but radiograph examination revealed such disorder in the orthopantomogram. Thus, history, clinical and radiographic findings revealed this case as dentine dysplasia type I subtype 1c inherited from mother. Oral rehabilitation of patients with dentine dysplasia type I require effective prevention and a complex approach. Thus, meticulous oral hygiene measures and dietary instructions, regular check-ups twice a year were established for this patient; orthodontic consultation was recommended. Varnish «Ftoplen-LC» was applied on the permanent teeth 3 times. To prevent early exfoliation, plan of preventive measures was developed included application of fluoride varnish twice a year and fissure sealing in the premolars in 9-10 years and in the second premolars in 12-13 years. Treatment of dentine dysplasia I type that depends on patient age and severity of disease may include also filling of carious teeth, orthodontic, surgical and orthodontic treatment. In this regard, dentist has to know developmental dental hard tissues disorders and select measures to prolong the retention of affected teeth maintaining them as long as possible.
Dental fluorosis is caused by ingesting too much fluoride while the teeth are developing. Poltava region belongs to Buchach fluorine hydrogeological province which ground waters are characterized by a high content of fluorine. Such districts as Myrgorod, Lubny, Gadyach, Globino, Mashivka, Shyshaky and Novy Sanzshary have fluoride concentration in drinking water from 2,5 tо 7 mg/l. It is known that the overdose of fluoride has deleterious effect on enamel development, generating a hypomineralized porous subsuperfacial enamel. Mild fluorosis transforms into moderate fluorosis with brown pigmentation over time and increasing the severity of fluorosis is associated with increasing the patient`s dissatisfaction. There are a few different ways that dental fluorosis can be treated. Local remineralisation therapy is the most careful way to reduce or eliminate fluorosis spots. Enamel microabrasion removes the outer porous enamel with pumice after it has been partly demineralized by the acid; topical fluoride that remineralized the enamel follows microabrasion. A teeth whitening can return teeth to their former glory in a single visit. Infiltration technique is the novel approach to fluorosis management which masks white spots. Veneers or crowns are the next option that restores teeth gleaming appearance. Unfortunately, previous reviews that have analyzed contemporary methods of fluorosis treatment didn’t determine their indications depending on the disease severity and the enamel maturation. Purpose of the study was to systematize the methods of dental fluorosis management offered last years and to determine the indications for their use depending on the severity of the disease and the maturity of the tooth enamel. Searching strategy for identification of scientific publications published between the years 2009 - May 2019 was conducted by reviewers independently through Google. The search strategy included keywords "dental fluorosis management", «teeth whitening», «teeth microabrasion», «infiltration for fluorosis treatment» and it was complementated by checking references of the relevant review articles and the eligible studies for additional useful publications. Over the last 10 years few articles were dealt with minerals, vitamins, adaptogens, antitoxicants prescription for fluorosis management. Such tooth pastes as «R.O.C.S» and «Novyi zhemchuh calcium» showed efficacy in local remineralisation therapy of fluorosis in children. Infiltration technique was used for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. Different tooth whitening techniques were offered and only some of them include local remineralisation therapy that can stabilize clinical result. Carbamide and orthophosphoric acid were utilized for whitening of immature fluorosis teeth. Microabrasion in children's teeth was effective in combination with following fluoridation, for example Tooth Moose. Direct and indirect restorations are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results. Whereas veneers and crowns are indicated in mature fluorosis teeth, choice of direct composite restorations doesn’t depend on tooth maturity. Treatment of fluorosis of various severities in children should include endogenous use of medicines that increase the enamel remineralisation. Local remineralisation therapy is indicated for mild fluorosis in immature teeth and for moderate fluorosis in combination with bleaching and microabrasion. Infiltration technique is recommended for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. In the case of inefficiency of minimally invasive methods or severe fluorosis, direct or indirect restorations are conducted. Promising direction in fluorosis treatment is the development of new methods for fluorosis management, including general and local remineralization therapy, as well as infiltration technique.
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