Faculty Bibliography

AIM: The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. STUDY DESIGN: Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. METHODS: The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. STATISTICS: Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. CONCLUSION: Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.

Hypohidrotic ectodermal dysplasia (HED) is characterized by clinical manifestations of severe hypodontia or anodontia, hypotrichosis, hypohidrosis, and specific facial appearance. Affected males show complete expression of clinical features of this condition. Their mothers, who are gene carriers, express only some signs, which are usually very mild. Currently available clinical methods are not sufficient for routine identification of the HED heterozygous gene carriers. The purpose of this study was to identify and describe the facial characteristics of HED patients and their mothers and to evaluate the usefulness of craniofacial pattern profile analysis (CFPP) in the diagnosis of this syndrome and the detection of gene carriers. In this study six affected males and their mothers were evaluated. Z-scores for each variable were calculated and compared with age- and sex-matched controls. Anthropometric analysis showed a specific dysmorphic pattern in CST patients that includes decreased skull base width (t-t: -1.67 Z); decreased forehead width (ft-ft: -1.8 Z), decreased midface depth (sn-t: -2.02 Z), markedly decreased total facial height (n-gn: -3.4 Z), and markedly decreased maxillary arc (t-sn-t: -2.5 Z). Gene carriers showed a similar tendency in their pattern profiles. They showed the same tendency towards lower Z-values for forehead width, facial height, and mouth width. The values for these measurements were between those of the affected and healthy controls. The most pronounced findings were increased head width (eu-eu: +2.83 Z), increased lower face width (go-go: +2.06 Z), and reduction of total facial height (n-gn: -0.95 Z). They also displayed increased nose width (al-al: +2.41 Z) and increased biocular distance (ex-ex: +2.01 Z). When used in conjunction with other methods the anthropometrics pattern profile analysis can considerably enhance detection of gene carriers for HED and increase objective assessment of the craniofacial region in HED patients.

The aim of the present study was to determine and assess the variables most involved in the etiology of a child's dental fear. The study was performed on a sample of 89 children aged from 5.5 to 12.5 years and their mothers. The sample comprised 37 children with experience of dental trauma (19 boys and 18 girls) and 52 children without experience of dental trauma (28 boys and 24 girls). Corah Dental Anxiety Scale (DAS) was applied to evaluate the level of the child's (CDAS) and mother's (MDAS) dental anxiety. Broome's Child Medical Fear Questionnaire (CMFQ) was used to assess the child's fear of medical treatment. Hollingshead Two Factor Index of Social Position (ISP) was calculated to assess socio-economic status of the family. Cluster analysis differentiated one group of dentally anxious children with the highest level of maternal anxiety (MDAS = 14.44) and the lowest socio-economic status (ISP = 41.94). Another group of extremely anxious children (CDAS = 14.31) showed the highest fear of medical treatment (CMFQ = 22.08) and rather low socio-economic status. One group represented children with the lowest CDAS (5.63), lowest MDAS (8.46), and lowest CMFQ (13.54). Linear regression analysis showed high correlation between previous traumatic medical experiences and a child's dental anxiety using the linear model CDAS' = b0 + b1 x CMFQ. The analysis revealed that a child's dental fear mostly depends on early negative medical experience, while material dental anxiety and socio-economic circumstances seem to be of less importance.

Ectodermal dysplasia is a heterogeneous condition characterized by affected ectodermal structures, among which the teeth and skin with its derivatives (hair sweat glands) are the most frequent. The aim of this work is to present the analysis of dental traits in five families (affected boys and their mothers) with hypohidrotic ectodermal dysplasia (HED), and to evaluate the importance of orofacial and dental findings in the determination of female HED gene carriers. Hypodontia (oligodontia) was found in all the patients. The mothers, gene carriers, had either hypodontia or a reduced size of teeth with a particular morphological, peg shape. In patients with hypohidrotic ectodermal dysplasia the deciduous second molar teeth were mostly affected by taurodontism. The characteristic dental finding in heterozygous females of the mandibular peg shaped incisors and canines, as well as of hypodontia or peg shaped upper lateral incisors can be used as a reliable criterion for the detection of HED gene carriers.