HIV in Indonesia and in neighbouring countries and its social impact

HIV incidence is still increasing in parts of Indonesia and in several Asian Countries. New cases of HIV in Indonesia have risen from 7,000 per year in 2006 to 48,000 per year in 2017. In spite of this increase, the number of newly diagnosed cases of AIDS has decreased from a peak of over 12,000 in 2013 to a little over 9,000 in 2017. The mean prevalence of HIV in Indonesia is 0.41% but there is a ten‐fold difference in the prevalence in different regions with the highest in Papua (5%). Women represent over 35% of new infections per year and of the total (640,000) in Indonesia. Over 50% of HIV diagnoses are made when patients already have AIDS. Stigma and discrimination are still strong barriers in prevention and treatment but also there are considerable challenges in access to appropriate anti‐retroviral therapy. There is a need for further investment in HIV Programs in Indonesia so that prevention can be enhanced, and diagnosis made at an earlier stage. Health Professionals including dentists should be readily willing to provide joint prevention efforts and care to people at risk and with HIV and other infectious diseases to help meet the WHO aims of 2030. Public health programmes are needed to make certain that the general public is aware of HIV testing and the role of dental healthcare workers in facilitating this, thereby further normalising attitudes to people living with HIV.     

Dental and periodontal health in Finnish adults in 2000 and 2011

Objective: We assessed dental and periodontal health in adults aged ≥30 years living in southern and northern Finland as part of the Health 2000/2011 Surveys (BRIF8901).

Material and methods: Clinical findings in 2000 (n?=?2967) and 2011 (n?=?1496) included the presence of teeth and number of teeth with caries, fillings, fractures or periodontal pockets.

Results: Edentulousness decreased in all age groups. The prevalence of those with no caries increased from 67% to 69% in men and from 80% to 85% in women, and of those with no periodontal pocketing from 26% to 30% in men and from 39% to 42% in women. In 2011, the mean number of decayed teeth was 0.8 in men and 0.3 in women, and the corresponding mean numbers of teeth with deepened periodontal pockets 5.6 and 3.7. The gender difference had levelled concerning edentulousness, number of teeth and DMF teeth, but still existed in the occurrence of caries and periodontal pocketing.

Conclusion: The findings were in line with other population-based reports in the 2000s. However, periodontal health in Finland seems not to be as good as in many European countries and in the USA.     

Oral microbiota in smokers and non-smokers in natural and experimentally-induced gingivitis

Abstract. The present study primarily aimed at investigating the oral microbiota in smokers and non-smokers with established gingivitis and monitoring its composition during experimental gingivitis. Secondly, it aimed at examining whether the composition of the microbiota is associated with different levels of gingival inflammation during this experimental gingivitis trial. For this purpose, 25 non-dental university students with gingivitis were recruited. 11 subjects were smokers and 14 were non-smokers. After achieving gingival health, they entered a 14-day experimental gingivitis trial. Plaque and bleeding were assessed before entering into the study (intake), at day 0. day 5 and at day 14 of the experiment. Microbiological samples from mucosal sites and dental plaque (taken at intake, day 0, and day 14) were analysed for the presence of Actinomyces species. Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, Fusobacterium nucleatum, Peptostreptococcus micros. Porphyromonas gingivalis, Prevotella intermedia and Streptococcus species. At day 14 of the experimental period, the level of plaque formation was not different between smokers and nonsmokers, but bleeding scores were lower in smokers than in non-smokers (15% and 30%) respectively, p= 0.01). The change from natural gingivitis to a state of gingival health and a subsequent change from gingival health to experimentally induced gingivitis was accompanied by quantitative alterations in the cultivable microbiota in both groups. Changes were most prominent in the transition from gingival health to experimental gingivitis and were found in dental plaque for Actinomyces species, C. rectus, F. nucleatum, and P. intermedia. Within the group of non-smokers, a distinction was made between subjects with a‘weak’or 'strong’inflammatory response. No relationship with a single bacterial species could be established which would likely explain the differences in levels of inflammation. It is concluded that differences in response to experimental gingivitis are not caused by major differences in the composition of the oral microbiota.     

Putative periodontal and teeth in pathogens on titanium implants and teeth in experimental gingivitis and periodontitis in beagle dogs

The microflora around titanium implants and teeth in 4 beagle dogs was analyzed in order to follow the longitudinal development from healthy conditions to experimental gingivitis and periodontitis. A 2-month plaque control program was performed to establish healthy conditions on titanium implants and control teeth (baseline, day 0). Subgingival bacterial samples and radiographs were obtained. The plaque control was ceased and all measurements were repeated on day 21 (gingivitis). A new period of plaque control was initiated to re-establish healthy conditions (day 49). A cotton ligature was placed subgingivally around the implants and the control teeth to induce tissue breakdown. The ligatures were removed on day 91. The study was completed with registrations on day 121 (periodontitis). No significant microbiological difference was found between titanium implants and teeth in healthy conditions and in gingivitis and periodontitis. The mean total viable count increased 10 times on implants as well as on teeth. Streptococci were dominating at baseline: 40.2% on implants and 60.6% on teeth and decreased in gingivitis to 11.7% and 5.4%. When periodontitis had developed, the proportion of streptococci was < 1%. At baseline few Porphyromonas gingivalis and Prevotella intermedia were detected. They increased at gingivitis to 37.4% and 21.0%; when periodontitis developed, they comprised about 25.0%. Microbial colonization and establishment on titanium implants with healthy gingiva, experimental gingivitis and periodontitis follow the same pattern as on teeth.     

Malocclusions and traumatic injuries in disabled schoolchildren and adolescents in Kuwait

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3–20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.     

Volatile compounds in air and oral saliva in healthy people, and in periodontitis and gingivitis patients

21 healthy persons, 7 patients with chronic generalized periodontitis and 4 patients with chronic generalized gingivitis aged between 18 and 42 years were examined. Air from the oral cavity was collected with a special device; liquid samples were collected by washing the oral cavity with sterile water. Chemical compounds of the air and the washed liquid were analyzed by chromato-mass-spectrometry, gas-adsorption and gas-liquid chromatography. The content of dimethyl sulphide, dimethyl disulphide increased in the oral air and such volatile short chain fatty acids (VSCFA) as butyrate, propionate, acetate rose, but their aldehydes (butyraldehyde, acrolein, acetaldehyde decreased in oral fluid during periodontitis. The concentration of these compounds were found to be between the levels in control persons and during periodontitis. The content of pentane decreased in oral air. That depended on the intensity of inflammation and vessel disturbances. The results suggest that VSCFA produced by Porphyromonas, Prevotella, Fusobacterium and other periodontopathic bacteria, penetrate the oral mucosa and severely harm the periodontal tissue. The increase of dimethyl sulphide contributed to oral malodor during periodontal inflammation.     

Caries status and microbial conditions in children in 1973 and 1984

Abstract — In 1973 all 9–12-yr-old children in a county in Sweden were examined with regard to caries prevalence, salivary Streptococcus mutans and lactobacilli. Eleven years later the same parameters were analyzed in 250 randomly selected children of the same age and from the same county. Both the number ofcariogenic microorganisms and the caries prevalence were significant-ly lower in 1984 than in 1973 (P<0.001). The lower number of S. mutans and lactobacilli could be due to several EBctors and is probably one of the reasons for the low caries prevalence in the children in the present study.     

巨噬细胞功能和炎症消退机制及与牙周炎关系研究进展

巨噬细胞是人体固有免疫系统中重要的组成部分,具有强大的识别、吞噬、清除细菌及外来异物的功能。牙周炎是一种以牙龈炎症和牙槽骨丧失为特征的慢性感染性疾病,是成年人失牙的主要病因。目前已经明确,牙周炎的组织破坏是由宿主对感染的免疫应答引起的,巨噬细胞作为宿主免疫应答的重要组成部分,在炎症的发生发展中起重要作用。近年研究显示,巨噬细胞在炎症消退过程中亦扮演着重要作用。本文就巨噬细胞在炎症的发生、发展及消退中的作用进行综述,并总结了其在牙周炎发展及治疗中可能的作用。     

Salivary cystatin activity and cystatin C in natural and experimental gingivitis in smokers and non-smokers

Background: Recent studies show that subjects with natural gingivitis or periodontitis have elevated levels of salivary cystatins compared to periodontally healthy individuals. Increased glandular output of cystatins in inflammatory conditions suggests an active, most likely protective, rôle for these proteins in inflammatory processes. Furthermore, it has been shown that the development of gingival inflammation is suppressed in smokers during experimental gingivitis. Aims: The purpose of the present study was to investigate whether (i) the levels of salivary cystatins in natural gingivitis are related to smoking status, and (ii) to study whether experimentally induced gingivitis is associated with changes in salivary cystatin levels, in both smokers and non‐smokers. Material and Methods: Whole saliva samples were taken in relation to natural gingivitis, gingival health and 14‐day experimental gingivitis in 25 non‐dental students (14 non‐smokers and 11 smokers). The salivary flowrate was determined. Samples were analyzed for levels of protein, cystatin and cystatin‐C. Results: Salivary flow and protein concentrations in cleared human whole saliva samples of non‐smokers and smokers were not different from each other at any timepoint during the trial. With regard to cystatins, the results showed that in the state of natural gingivitis cystatin activity is lower in smokers as compared to non‐smokers. In smokers, the resolution of natural gingivitis to the state of gingival health did not result in a change of cystatin activity and levels of cystatin C. At the end of the 14‐day experimental gingivitis period, smokers showed a decrease in cystatin activity and cystatin C as well as lower outputs of cystatin activity and cystatin C. Conclusion: Smoking is associated with lower cystatin activity and output of cystatin C during gingival inflammation.     

Age-related changes in immunoglobulin isotypes in whole and parotid saliva and serum in healthy individuals

Mucosal Infections account for the majority of infections seen in elderly people, but little is known of whether mucosal immunity decrease with age. The objective of this study was to investigate the effect of age on the levels of salivary and serum immunoglobulins and the salivary immunoglobulin secretion rates in a healthy adult population. Healthy subjects (116 total) were divided into the following age groups: 20–39; 40–59; 60–79 and >80 years. Unstimulated (resting) whole and stimulated parotid saliva and serum were collected from all participants. Salivary and serum immunoglobulins were quantified by enzyme-linked immunosorbent capture assays. The levels of serum immunoglobulin G (IgG) and IgM were significantly reduced in the oldest age group, whereas no significant reduction in the level of IgA with age was observed. The IgG and IgA levels in whole saliva increased significantly in the oldest age group D, but no changes were detected in IgM levels. No significant changes in any immunoglobulin levels with age were found in parotid saliva. However, significant reductions in the secretion rates of IgA and IgM, but not IgG, in whole saliva were detected in the oldest age group. No significant changes in the secretion rates in parotid saliva were found with age. Our results demonstrate a decline in immunoglobulin secretion rates in saliva and in circulating immunoglobulin concentrations with increased age, which may contribute to the increased susceptibility of elderly individuals to infectious diseases.     

Vascular status in human primary and permanent teeth in health and disease

The present study sought to compare the vascular status of human primary teeth with that of human permanent teeth, and to determine whether caries or painful pulpitis was associated with changes in vascularity. Coronal pulps were removed from 62 primary and 62 permanent mandibular molars with a known pain history. Teeth were categorized as intact, moderately carious or grossly carious. Pulp sections were labelled with Ulex europaeus I lectin (UEIL), which is a marker of human vascular endothelium. Image analysis was then used to quantify the percentage area of UEIL-labelled tissue (vascularity) and the number of blood vessels present within three regions: the pulp horn, the subodontoblastic region, and the mid-coronal pulp. Only the mid-coronal region of the primary tooth pulp was found to be significantly more vascular than the corresponding area of the permanent tooth pulp. Both dentitions showed a significant increase in vascularity within the pulp horn region with caries progression, but this was not accompanied by an increase in vessel number. There was no correlation between vascularity and pain symptoms. These findings suggest that the primary tooth pulp is more vascular than its successor within the mid-coronal region. However, the functional and clinical significance of this finding remains speculative.     

蛋白质组学技术及其在口腔医学中的应用

蛋白质组是后基因组时代出现的一个新兴研究领域.它的研究主要是先通过双向凝胶电泳和差异凝胶电泳等方法分离蛋白质,然后再用质谱技术和Edman测序法等方法进行鉴定.目前蛋白质组研究得到人们的关注,并且成为生物技术中的一个重要领域.本文就蛋白质组研究的主要技术及其在口腔医学领域中的应用作一综述.     

下颌骨恶性血管内皮与外皮瘤的临床病理观察(附4例报告)

本文根据作者经治发生于下颌骨的4个恶性血管内皮与外皮瘤病例，结合文献复习，探讨其临床病理特点、诊断治疗与预后等问题。发现该病发生于颌骨者十分罕见，临床易发生误诊，因此，临床医生遇有颌骨肿块生长迅速，疼痛呈持续性且逐渐加重，X线片提示有溶骨性破坏，诊断也应考虑患本病的可能，尽早手术治疗，并于术中行冰冻活检协诊。一般认为本病预后差，但如组织学形态分化较好，治疗及时，切除范围适当，也可获得较佳疗效。     

Plasminogen activators in normal and malignant oral epithelium in vivo and in vitro.

Urokinase-type (uPA) and tissue-type (tPA) plasminogen activators were identified by fibrinolytic autography in the sulcus epithelium of human gingival mucosa but not in the orthokeratinized gingival epithelium. Fibrinolytic activity was present only over blood vessels in frozen sections of oral squamous cell carcinomas, the malignant epithelial cells showing no plasminogen activator activity. Plasminogen activators could not be demonstrated in either the sulcus or gingival epithelium by immunofluorescence, but both uPA and tPA were found in occasional squamous carcinoma cells. Fibrinolytic activity of culture fluids from epithelial explants grown in vitro from human gingival mucosa showed marked variation, but activity was much higher in the culture supernatants than in the cell lysates. Fibrinolytic activity of culture fluids from epithelial explants of squamous cell carcinomas was low both in supernatants and lysates. Zymogram overlays of sodium dodecyl sulphate-polyacrylamide electrophoretic gels from culture supernatants showed that the low fibrinolytic activity of culture supernatants of oral squamous cell carcinomas was due to the associated presence of plasminogen activator inhibitors. The fibrinolytic activity in the zymogram was due predominantly to uPA but some lysis was due also to tPA.     

Streptococcus mutans and dental caries in urban and rural schoolchildren in Thailand

Two groups of Thai schoolchildren aged 11-13 yr were examined for dental caries, dental fluorosis and Streptococcus mutans. One hundred children lived in an urban district, Bangkok, and 71 children in a rural district, Petchaboon. Saliva samples were analyzed for S. mutans by the spatula method. The fluoride content of the drinking waters was also determined. The prevalence of caries, diagnosed according to WHO, was 89% in Bangkok and 18% in the rural district. Mean DMFT was 3.46 and 0.38 respectively. S. mutans was found in 98% of the urban children and in 82% of the rural. The differences in distribution between S. mutans and DMFT classes were statistically significant for the total sample. Mild fluorosis was present in some of the rural children.