Ballıkaya E, Eymirli PS, Yıldız Y, Avcu N, Sivri HS, Uzamış-Tekçiçek M. Oral health status in patients with mucopolysaccharidoses. Turk J Pediatr 2018; 60: 400-406.The aim of this study is to assess oral clinical and radiological findings of patients with mucopolysaccharidoses (MPS) which are a group of rare inherited disorders of glycosaminoglycan catabolism. In this retrospective and descriptive study, records of all patients with MPS over 3 years of age managed at Division of Pediatric Metabolism, who were all referred to Department of Pediatric Dentistry for evaluation of their oral health status were assessed. Oral examinations were performed in 30 patients with determination of DMFT/S, dmft/s, dental plaque and gingival indices and panoramic radiological assessment was performed in 12 patients. Twenty-seven (90.0%) patients had dental caries and 19/21 (90.5%) had gingival inflammation. Radiological examination in 12 patients with panoramic image showed short mandibular ramus (100.0%), enlarged dental follicles (83.3%), taurodontism (75.0%), flat mandibular notch (66.7%). In association with the bone structure and morphology of the jaws, 11 patients (91.7%) had trabecular variation similar to osteoporotic disease. Condylar defect was observed in all patients, which might lead to temporomandibular joint disorders. Pulp chamber with three horns, which had never been reported in MPS before, was observed in panoramic images of 2 of 7 patients with MPS-VI. Oral clinical and radiological changes are very common in this population of MPS patients. These changes may impair opening of the mouth, eating and chewing and thus affect their quality of life. Regular dental counseling, preventive applications and dental treatments must be included in multidisciplinary team approach of MPS patients to provide better oral health.

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Introduction: Parental-Caregiver Perceptions Questionnaire (P-CPQ) is one of the scales used for evaluating the quality of life of children. Dental caries is an important factor affecting oral health-related quality of life. It was aimed to translate into Turkish and evaluate the psychometric properties of the P-CPQ with the evaluation of dental caries status of 6-to 14-year-old children. Methods:Children-parent pairs attending to paediatric dental clinic were involved.After the translation and adaptation of the scale, the data were collected from the parents with the Turkish version of the P-CPQ and a short questionnaire, and then, the intra-oral examination of the children was performed by a paediatric dentist.Statistical analysis was performed by using SPSS version 22.0 and SPSS AMOS 22.The significance level was 0.05. Confirmatory factor analysis for construct validity; and item analysis, item discrimination index and the Cronbach alpha internal consistency coefficient for reliability measurement were calculated. Discriminant validity was tested by comparing the median P-CPQ scores between children with caries experience and those without.Results: Totally, 312 children-parent pair (52.9% female) participants were involved.The mean age of participated children was 9.00 ± 1.89. P-CPQ score was calculated by summing the scores of all 31 items; the mean score of the parents was 18.8 ± 12.8. Cronbach's alpha for the total scale was 0.87 and ranged from 0.680-0.795 for four subscales. The relationship between total and subscales was found to be statistically significant. Confirmatory factor analysis, item analysis and item discriminant index were approved. Model fit values were admissible.Conclusions: Turkish version of P-CPQ was created, and it had good internal consistency reliability of subscales and found to be valid in 6-to 14-year-old children.

The long‐term prognosis of previously traumatized immature permanent teeth treated with guided endodontic repair is well documented, but little is known about how these teeth respond to further traumatic injury after treatment. This case report presents the 10‐year clinical and radiographic findings of two patients with traumatized maxillary incisors who underwent guided endodontic repair treatment and sustained two further traumatic injuries. Three crown‐fractured maxillary central incisors with pulp necrosis were treated with a protocol that used 2.5% NaOCl irrigation, 3–4 weeks medication with calcium hydroxide or ciprofloxacin‐metronidazole paste, induction of apical bleeding, and coronal sealing with mineral trioxide aggregate. One tooth sustained subluxation and a crown fracture after 20 months and 7 years, respectively. Two other teeth had a luxation injury at 9 months and subluxation 6.5 years after the repair treatment. One subluxated and one luxated tooth remained free of symptoms for 10 years with radiographic evidence of progressive root canal calcification, while the other luxated incisor required root canal treatment after 7.5 years. Although teeth treated with the so‐called “regenerative” endodontic techniques do not possess true pulp tissue, the reparative tissue may respond to traumatic injuries in a similar manner to teeth with normal pulps.

Regenerative endodontic treatment (RET) may not be suitable in some necrotic young permanent molars due to coexistent roots with closed and open apices, and/or inadequate apical bleeding in one or more roots. Here, we present a combined treatment approach utilising conventional root canal treatment in the closed‐apex roots and RET on the open‐apex roots of necrotic young molars. The closed‐apex roots of 8 molars received root fillings, and their open‐apex roots were treated with a regenerative endodontic procedure. In another molar, the failed RET on one root was retreated by conventional root canal filling, preserving other revitalised roots. After 4–6 years, all teeth showed periapical healing in the absence of clinical symptoms. The combined conventional and regenerative treatment approach can yield favourable healing outcomes in necrotic, young molar roots with different levels of apical closure. Likewise, failed revitalised roots can be retreated separately with conventional root filling.