Women with a recent history of early-onset pre-eclampsia have a worse periodontal condition

OBJECTIVE: Pre-eclampsia is a complication of pregnancy characterized by systemic vascular dysfunction and pathological changes in placental arteries. Growing evidence of chronic infection as an aetiological factor in vascular diseases prompted us to study maternal periodontal disease in subjects with early-onset pre-eclampsia (<34 weeks). METHODS: A case-control study was carried out on 17 early-onset pre-eclamptic women and 35 controls with uncomplicated pregnancies in a period of 3-28 months postpartum. All were Caucasians. Full-mouth periodontal examinations were performed to determine the periodontal condition. Subgingival-plaque samples were analysed by anaerobic culture techniques for the presence of seven bacterial periodontal pathogens. Potential confounders as age, smoking, educational level and body mass index were determined. RESULTS: Severe periodontal disease was found in 82% of the pre-eclamptic and in 37% of the control group (p=0.009). After adjusting for age, smoking and educational level, the odds ratio was 7.9 (95% CI: 1.9-32.8). The periodontopathic microorganism Micromonas micros was more prevalent in the case group (p=0.040) while Campylobacter rectus was more prevalent in the control group (p=0.047). CONCLUSION: These results indicate that Caucasian women with a recent history of early-onset pre-eclampsia have a worse periodontal condition, as compared with women with uncomplicated deliveries.     

Radiographic quantification of alveolar bone level changes. Predictors of longitudinal bone loss

The purpose of the present study was to determine the relative importance of a set of predictors for the radiographic change in alveolar bone level over 2 years in a group of 180 subjects and to assess the fit of the applied multivariate model. The included predictors were age, sex, initial bone level, type of initial lesion, tooth type, proximal tooth surface, calculus, and the presence of metal crowns or proximal fillings. The multivariate method of choice was multiple classification analysis. The results indicated that in descending order tooth type, initial bone level, and age were the most important predictors. Sex, calculus, and crown and filling margins also showed significant direct effects (beta) on longitudinal bone loss (p less than 0.05). However, their relative importance was far less than that of tooth type, initial bone level, and age. Proximal side showed no significant direct effect. Using seven predictors, the applied multivariate model explained 20% of the variance in longitudinal bone loss.     

Periodontal inflamed surface area: quantifying inflammatory burden

Background: Currently, a large variety of classifications is used for periodontitis as a risk factor for other diseases. None of these classifications quantifies the amount of inflamed periodontal tissue, while this information is needed to assess the inflammatory burden posed by periodontitis.
Aim: To develop a classification of periodontitis that quantifies the amount of inflamed periodontal tissue, which can be easily and broadly applied.
Material and Methods: A literature search was conducted to look for a classification of periodontitis that quantified the amount of inflamed periodontal tissue. A classification that quantified the root surface area affected by attachment loss was found. This classification did not quantify the surface area of inflamed periodontal tissue, however. Therefore, an Excel spreadsheet was developed in which the periodontal inflamed surface area (PISA) is calculated using clinical Attachment Level (CAL), recessions and bleeding on probing (BOP).
Results: The PISA reflects the surface area of bleeding pocket epithelium in square millimetres. The surface area of bleeding pocket epithelium quantifies the amount of inflamed periodontal tissue. A freely downloadable spreadsheet is available to calculate the PISA.
Conclusion: PISA quantifies the inflammatory burden posed by periodontitis and can be easily and broadly applied.     

A new solution for the removal of the smear layer

Various organic acids, ultrasonic instruments, and lasers have been used to remove the smear layer from the surface of instrumented root canals. The purpose of this study was to investigate the effect of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) as a final rinse on the surface of instrumented root canals. Forty-eight extracted maxillary and mandibular single-rooted human teeth were prepared by using a combination of passive step-back and rotary 0.04 taper nickel-titanium files. Sterile distilled water or 5.25% sodium hypochlorite was used as intracanal irrigant. The canals were then treated with 5 ml of one of the following solutions as a final rinse: sterile distilled water, 5.25% sodium hypochlorite, 17% EDTA, or a new solution, MTAD. The presence or absence of smear layer and the amount of erosion on the surface of the root canal walls at the coronal, middle, and apical portion of each canal were examined under a scanning electron microscope. The results show that MTAD is an effective solution for the removal of the smear layer and does not significantly change the structure of the dentinal tubules when canals are irrigated with sodium hypochlorite and followed with a final rinse of MTAD.     

Ewing sarcoma of the jaws

Three cases of Ewing sarcoma in the jaw bones are presented. The first patient is a 43-year-old woman with a rapidly growing tumor in the hard palate. The second patient is a 9-year-old girl with tumor in the left mandibular ramus and body. In both patients, the tumors were excised with significant safe margins. However, postoperative histopathologic evaluation revealed the presence of tumor cells in bony margins, necessitating a second surgery. The third patient is a 9-year-old boy with tumor in the right mandibular ramus and body. In patients 1 and 2, chemotherapy failed to control the tumor; however, in patient 3, chemotherapy resulted in significant shrinkage of the tumor and no further growth.