Salivary and Serum Chromogranin A and α-Amylase in Periodontal Health and Disease

Background: Salivary stress-related biomarkers in connection with periodontal disease have not been extensively studied. In addition to cortisol as a well-known marker of stress loading, chromogranin A (CgA) and α-amylase (AA) are supposed to link the activity of the neuroendocrine system to local and systemic immune functions and to be related to periodontitis. This study aims to determine CgA and AA in saliva and serum in periodontal health and disease to assess their potential relationship to periodontitis. Methods: Patients with aggressive (AgP) (n = 24) and chronic periodontitis (CP) (n = 34) as well as healthy control (CO) (n = 30) individuals participated in this study. CgA and AA were determined in saliva and serum with enzyme-linked immunosorbent assay and an adapted clinical amylase test; salivary cortisol was determined using mass spectrometry. Clinical parameters of periodontal disease were evaluated, and their possible correlations with stress-related biomarkers were assessed. Results: Significantly higher CgA levels were found in the saliva of patients with AgP compared with those in patients with CP and CO individuals (P <0.001). Salivary cortisol levels were higher in the AgP group compared with those in patients with CP (P <0.05). No differences in serum CgA levels and salivary and serum AA activities were found among all groups. A positive correlation was revealed between salivary AA activity or salivary CgA levels and the extent of periodontitis (P <0.05). Conclusion: The results suggest an association of CgA and cortisol levels as well as AA activity in saliva with periodontitis, especially a significant relationship of salivary CgA and cortisol to AgP.     

Hypnosis and dentistry: water and fire?

At first sight a combination of hypnosis and dentistry may very well appear not to be evident at all. Nevertheless, it works quite well in the everyday dental practice. In this article the author provides an overview of indications in which hypnosis can be used. Anxiety and pain are among the most common indications. Hypnotic techniques in dental practice can be explained at two levels: as a general way of communication between the dentist and his or her patient. Or as an advanced technique in the treatment of severe anxiety. The author discusses the several stages related to the latter technique: the intake interview, the induction, the deepening, the therapeutic stage and the deduction. The author also briefly mentions the disadvantages of hypnosis, but on the other hand encourages every dentist to become a hypnodontist. Not only for the benefit of his patient but also, and not the least, for his or her own well-being. All the more because hypnosis has become a scientific issue involving serious research at many renowned universities, including in Belgium.     

Membrane stretch and salivary glands — facts and theories

Cell shape in salivary glands is affected by mechanical forces. In the acini and ducts cell shape is modified by the contractions of the myoepithelial cells in both the secretory and ductal portions of the glands. At the organ level shape changes are due to muscle contraction during mastication, food intake and speech. All these factors may cause some degree of stretching of salivary cell membranes. Recent studies suggest that physical forces influence signal fansduction, gene expression, secretory function, cell differentiation and proliferation. Here we overview membrane stretch-activated cellular events. Evidence from a variety of tissues suggests that mechanical forces may alter the properties of acinar cells leading to cytoskeletal reorganisation, changes in ion fluxes, modulation of secretory activity and subsequent release of transmitters such as ATP. Transmitters released from acinar cells may modulate the secretory activity of salivary tissue, and interact with classical regulatory pathways.     

Sinus Grafts: Science and Techniques—Then and Now

Introduction

Sinus lifts have been around for more than four decades now, and the amount of changes that we have seen in techniques and armamentarium coupled with the advent of newer materials is worth taking note of.

Materials and Methods

A complete review of the literature was done since the advent of ways and means to augment the posterior maxilla with a run through of various advantages and disadvantages of the same.

Conclusion

In conclusion, we can say that this procedure is today very predictable and offers clinicians a possibility to rehabilitate the posterior maxilla with implant-based solutions.

     

Splinting--when and how?

The prognosis of a tooth following trauma is critical. This depends on various factors, including the type of splint used for immobilization and the immobilization period. This article discusses the above factors with an added note on splint removal. CLINICAL RELEVANCE: This article is relevant for clinicians who treat traumatic injuries as it should help them to decide on the type of splint to be used and the period of immobilization.     

Fluoride release from NaF‐ and AmF‐impregnated toothpicks and dental flosses in vitro and in vivo

The aim of this study was to determine the fluoride release from toothpicks and dental flosses in vitro and in vivo, and to evaluate various approximal administration methods. In vitro, a total of 23 commercially available toothpicks and dental flosses and 3 prototypes impregnated with sodium fluoride (NaF), amine fluoride (AmF), or a combination of these two were tested. Fluoride release was determined for up to 24 h using an ion‐specific electrode. A large variation was found between the products; most fluoride being released after 30 min. Generally speaking, toothpicks produced higher values than flosses. In vivo, the fluoride concentration in both treated and non‐treated approximal areas was evaluated after using 2 different types of toothpicks and 4 dental flosses and after different application methods—such as a fluoride gel and fluoride solution. The mean fluoride concentration in oral fluid was up to 10 times higher at the treated sites than at the non‐treated sites. Use of a fresh toothpick or a fresh piece of dental floss in each approximal space resulted in higher values compared with using one and the same toothpick/floss for the whole dentition. An interdental brush dipped in 0.2% NaF gel and a mouthrinse with 0.2% NaF resulted in elevated fluoride concentrations at the same level as when multiple toothpicks were used. To conclude, there are large variations in the fluoride release from various brands of fluoridated toothpicks and dental flosses. Treatment with a fluoridated toothpick or a dental floss can be expected to give elevated fluoride concentrations in the approximal area up to 60 min. Another interesting method for administering fluoride in the approximal area is to use an interdental brush dipped in fluoride gel.     

Anti-inflammatory and Mineralization Effects of ProRoot MTA and Endocem MTA in Studies of Human and Rat Dental Pulps In Vitro and In Vivo

Introduction

Few studies have reported direct pulp capping in inflamed pulp conditions. The purpose of this study was to investigate the in vitro and in vivo responses of dental pulp during direct pulp capping using various pulp capping materials in inflamed conditions.

Dentin matrix proteins and soluble factors: intrinsic regulatory signals for healing and resorption of dental and periodontal tissues?

Dentin contains numerous polypeptides and signaling molecules sequestered in a mineralized matrix. The exposure and release of these molecules occur as a consequence of injury to the pulp and periodontal ligament, which may result from luxation, orthodontic movement or infections of tooth and periodontal structures. When released at these sites, dentin constituents have the potential to act on different surrounding cells, including periodontal cells, osteoblasts, osteoclasts and inflammatory cells, and to affect the course of dental disease. Experimental studies have highlighted the interactions between dentin and cells from tooth and periodontal tissues and reveal dentin to be a cell adhesive, signaling and migratory stimulus for various mesenchymal and inflammatory cells. These results support the hypothesis that dentin molecules might function as regulatory signals for the healing and resorption of dental and periodontal tissues. Data from recent and classical investigations are summarized, many open questions are discussed, and current hypotheses concerning the mechanisms of tooth resorption and periodontal healing are outlined. Many questions regarding the importance of dentin as a source of multifunctional molecules remain unanswered and provide important directions for future studies.     

Dentists’ knowledge,attitudes and practices regarding Hepatitis B and C and HIV/AIDS in Sanandaj,Iran

Background

Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Thus, it is necessary to evaluate the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control and basic principles.

Methods

This cross-sectional study recruited 106 dentists in Sanandaj, Iran. The dentists’ KAP regarding hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV/AIDS were evaluated. Chi-square test, student’s t-test, and one-way ANOVA were used to assess differences between the groups. Data were analyzed in Stata 12.

Results

The results showed that the majority of the subjects in the study population (53.8%) were female. The mean?±?standard deviation (SD) for age and work experience was 39.6?±?9.80 and 10.6?±?8.7?years, respectively. The mean?±?SD for knowledge, attitude and practices of participants was 37.3?±?3.01, 22.9?±?4.80 and 24.07?±?5.06, respectively. The results also indicated that dentists’ higher level of knowledge about HBV, HCV and HIV/AIDS was significantly influenced by work experience (≥10?years; P?<?0.001) and graduation year (after 2006: P?<?0.001). Positive attitude towards HBV, HCV and HIV/AIDS was considerably influenced by age group (<?30?years: P?=?0.021), work experience (≥10?years: P?<?0.001), and workplace (dental office: P?=?0.016).

Conclusions

The results of this study demonstrated a satisfactory level of knowledge and attitude of dentists about HBV, HCV and HIV/AIDS infections, but some gaps were observed, suggesting that higher knowledge level of dentists plays a very important role in forming the attitudes and practices regarding patients with HBV, HCV and HIV/AIDS.

     

Perioperative Laboratory and Diagnostic Testing—What is Needed and When?

Preoperative patient evaluation is an essential component of any surgical practice. A complete history and physical, along with appropriate diagnostic tests, are performed routinely to ensure a safe and predictable delivery of care. Oral and maxillofacial surgeons use this principle in everyday practice. Regardless of type of surgery and practice (office-based dentoalveolar surgery, orthognathic surgery, trauma, elective aesthetic surgery), oral and maxillofacial surgeons must formulate a decision-making process and a treatment plan regarding the perioperative management of patients. The anesthetic plan and the surgical plan must be assessed preoperatively.     

Remote monitoring and “Tele-orthodontics”: Concept,scope and applications

Tele-orthodontics is a broad term that encompasses remote provision of orthodontic care, advice, or treatment via information technology. The Purposes of the article were two-fold: (1) to review the rather new concept, applications and scope of teleorthodontics, and (2) to present preliminary results of a study with and without Dental Monitoring™ (DM) usage on appointment efficiency, patient perspectives and patient demographics. The sample was comprised of 74 consecutively treated Invisalign® patients using DM™ and 85 consecutively completed Invisalign® patients. An online questionnaire was given to the DM™ group to assess the patients’ perspective on the ease of use and benefit to treatment experience using a 5-point Likert scale. Also requested was a list of 5 benefits and problems while using DM™. Independent t-tests were used to determine any inter-group differences in, number of appointments and age; a chi-square test was used for differences between genders. Significance was set at P ≤ 0.05. Mean number of appointments was significantly lower by 1.68 appointments for DM compared to control (P < 0.001). Age averaged 3.2 years younger for the DM group (P < 0.05). More males used DM than the control group (31.6% vs 16.7%, P < 0.05, respectively). The mean Likert scale rating for “ease of use” was 4.31 out of 5.0, while benefit to treatment experience rating was 4.4. The most oft-mentioned perceived benefits were “better communication” (47 times), “increased convenience” (44 times), “reduced number of appointments” (40 times), and “ease of use” (38 times). The most oft-mentioned problems were related to the “difficulty of taking scans” (27 times) and “reduced communication” (12 times). Preliminary study results suggest the number of appointments may be reduced with Dental Monitoring. In addition, there was a positive patient perception on the use of DM.     

Level of agreement between self-administered and interviewer-administered CPQ₈₋₁₀ and CPQ₁₋₁₄

Ramos‐Jorge ML, Vieira‐Andrade RG, Martins‐Júnior PA, Cordeiro MMR, Ramos‐Jorge J, Paiva SM, Marques LS. Level of agreement between self‐administered and interviewer‐administered CPQ_8–10 and CPQ_11–14. Community Dent Oral Epidemiol 2011. © 2011 John Wiley & Sons A/S Abstract – Objectives: The aim of the present study was to assess the psychometric properties and level of agreement between the self‐administered and interviewer‐administered Child Perceptions Questionnaire (CPQ) for children between 8 and 10 years of age (CPQ_8–10) and between 11 and 14 (CPQ_11–14) years of age. Methods: A randomized cross‐over study was carried out, involving 180 children (Group 1 – 90 children between 8 and 10; Group 2 – 90 children between 11 and 14 years of age) in the state of Minas Gerais, Brazil. All children completed both administration modes of the CPQ; half of each group received interviewer‐administered mode first [Subgroup A (CPQ_8–10n = 45) and Subgroup C (CPQ_11–14n = 45)], and the other half performed the self‐administered mode first [Subgroup B (CPQ_8–10n = 45) and Subgroup D (CPQ_11–14n = 45)]. Test–retest reliability of each mode of administration was tested on 60 children (30 for CPQ_8–10; 30 for CPQ_11–14), who were not included in the other analyses. The level of agreement between scores on the self‐administered and interviewer‐administered versions of the CPQ_8–10 and CPQ_11–14 was established using the intraclass correlation coefficient (ICC). The order of presentation of both instruments was tested considering the four subgroups (A, B, C and D). The calculation of effect size proposed by Cohen (1992) was used to test the clinical significance of the findings. Results: Both the self‐administered and interviewer‐administered versions of CPQ_8–10 and CPQ_11–14 demonstrated acceptable psychometric properties. Agreement between the administration modes for the CPQ_8–10 and CPQ_11–14 was 0.90 and 0.88 (ICC), respectively. With the exception of the functional limitation subscale, the scores of the subscales and overall score on the CPQ_8–10 were significantly higher in the group of children who responded to the interviewer‐administered measure first. With the CPQ_11–14, statistically significant differences were found only for the emotional well‐being subscale. Conclusions: Both administration modes of the CPQ_8–10 and CPQ_11–14 demonstrated satisfactory psychometric properties and a high level of agreement. Although statistically significant differences were observed for oral symptoms, emotional well‐being and social well‐being, with the first administration of the interviewer‐administered version, the effect of the order of administration had small to medium effects on the CPQ scores.     

Comparison and evaluation of marginal and internal gaps in cobalt–chromium alloy copings fabricated using subtractive and additive manufacturing

Purpose

To evaluate the marginal and internal gaps of cobalt–chromium (Co–Cr) alloy copings fabricated using subtractive and additive manufacturing.

Metallurgical analysis and fatigue resistance of WaveOne and ProTaper Nickel–Titanium instruments

The aim of the study was to evaluate cyclic fatigue resistance of two NiTi instruments and to analyse their surface, fractographic and matrix morphology under ESEM/EDS and optical microscopy. WaveOne Primary and ProTaper Universal F2 brand new instruments were subjected to fatigue testing in an artificial canal with 5.0 mm radius and 60° angle of curvature. Seventy-two instruments were divided into three groups (n = 24), according to the selected kinematics: WaveOne using reciprocation (A); ProTaper using reciprocation (B) or rotation (C). Time to fracture was recorded. Data were analysed with ANOVA and Tukey test. ESEM/EDS analysis was conducted on new files to examine surface characteristics and on fractured fragments to identify the fractographic features. Metallographic analysis was performed with optical microscope on new instruments to evaluate alloy properties. Significant differences were found with Group A, which was statistically more resistant to cyclic fatigue (P < 0.05) than the other groups. Surface analysis of new instruments showed both in WaveOne and ProTaper files the presence of deep milling marks. ESEM fractographic analysis of WaveOne showed multiple crack origins with an area of fatigue propagation wider than ProTaper instruments, in which a single crack origin could be detected. EDS analysis confirmed the equiatomic NiTi composition. Metallographic analysis under optical microscope revealed in WaveOne instruments the presence of nano-crystalline martensitic grains embedded in austenite matrix, presence which could not be found in ProTaper files. WaveOne NiTi files revealed higher resistance to fatigue stress, suggesting extended working time in clinical applications.