Orofacial and systemic manifestations in 212 paediatric HIV patients from Chennai,South India

International Journal of Paediatric Dentistry 2010; 20: 276–282 Background. Lesions in the mouth and in other tissues and organs (oral and systemic lesions) in paediatric HIV infection are diverse and show differences in clinical presentation and severity from that of adults. Very little data exist for oral lesions in paediatric population in India. Aim. To document and study oral and more widespread lesions in paediatric HIV seropositive patients. Design. A cross‐sectional study. Setting. Paediatric HIV seropositive patients at tertiary centers: Ragas Dental College and Hospital and YRG CARE, Chennai, India. Patients and methods. Two hundred and twelve paediatric HIV patients aged 0–14 years seen over a period of 1 year were included in the study. Clinical history, oral and systemic examinations were recorded by qualified dental surgeons and physicians. Results. One hundred and thirty‐two patients had oral lesions ranging in number from one to three. Oral lesions included oral candidiasis (OC) (56.1%), gingivitis (10.8%), oral pigmentation (6.1%), depapillation of the tongue (5.7%), ulcers (4.2%), and oral hairy leukoplakia (1.4%). The most common systemic lesion observed was nonspecific lymphadenopathy (74.1%) followed by pruritic eruptions (53.8%), measles (51.4%), and tuberculosis (TB) (49.1%). Thirty‐three (26%) patients were not immunosuppressed, 74 (58%) were moderately immunosuppressed, and 20 (15%) were severely immunosuppressed. Oral lesions exhibited positive correlation with lesions in other parts of the body. Conclusion. Oral lesions are a common feature in paediatric HIV infection. Their management is vital to improve the quality of life of the infected children.     

Chlorhexidine increases the longevity of in vivo resin–dentin bonds

Ricci HA, Sanabe ME, de Souza Costa CA, Pashley DH, Hebling J. Chlorhexidine increases the longevity of in vivo resin–dentin bonds. Eur J Oral Sci 2010; 118: 411–416. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci The aim of this study was to evaluate the mechanical stability of resin–dentin bonds produced in vivo in the presence of chlorhexidine. Children presenting at least one pair of contralateral primary molars with occlusal carious lesions were enrolled in the study. After cavity preparation and phosphoric acid etching, dentin was treated with 5 μl of either 2% chlorhexidine (control group) or deionized water (experimental group). Thirteen pairs of teeth were restored and were collected after physiological exfoliation. The periods in oral function after restoration were divided as follows: up to 30 d; and 1–5, 10–12, and 18–20 months. Beam‐shaped specimens (0.81 mm²) were obtained and subjected to microtensile bond‐strength testing. A significant decrease of the bond strength was observed in the control group starting at the 1–5 month period (30.6%), while in the experimental group this decrease started only after 10–12 months of function (26.3%). The use of chlorhexidine as an adjuvant to the adhesion to dentin did not produce any detrimental effect to the immediate bond strength and was capable of reducing the rate of resin–dentin bond degradation within the first few months after restoration.     

Protein and mucin retention on oral mucosal surfaces in dry mouth patients

Pramanik R, Osailan SM, Challacombe SJ, Urquhart D, Proctor GB. Protein and mucin retention on oral mucosal surfaces in dry mouth patients. Eur J Oral Sci 2010; 118: 245–253. © 2010 The Authors. Journal compilation©2010 Eur J Oral Sci Oral homeostasis depends largely on proteins and mucins present in saliva that coat all oral surfaces. The present study compared the protein composition of residual fluid on mucosal surfaces in subjects with normal salivary flow with that of patients with dry mouth caused by salivary hypofunction. Samples of residual mucosal fluid were collected using paper strips and then analysed by protein electrophoresis and immunoblotting. In both patients and controls, residual fluids on mucosal surfaces (except the anterior tongue in control subjects) had higher protein concentrations than unstimulated whole‐mouth saliva. High‐molecular‐weight mucin (MUC5B) was present in greater amounts on the anterior tongue than on other surfaces in control subjects. In dry mouth patients who were unable to provide a measurable saliva sample, MUC5B was often still present on all mucosal surfaces but in reduced amounts on the anterior tongue. The membrane‐bound mucin, MUC1, was prominent on buccal and labial surfaces in patients and controls. Statherin was still present on surfaces that were dried to remove salivary fluid, suggesting that it may be adsorbed as a protein pellicle. It is concluded that oral mucosal surfaces in dry mouth patients can retain MUC5B and other salivary proteins, although the functional integrity of these proteins is uncertain.     

Expression of the T‐cell‐specific adapter protein in oral epithelium

Kolltveit KM, Schreurs O, Østrem J, Søland TM, Khuu C, Berge T, Messelt E, Hayashi K, Granum S, Spurkland A, Schenck K. Expression of the T‐cell‐specific adapter protein in oral epithelium. Eur J Oral Sci 2010; 118: 159–167. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci The multifunctional T‐cell‐specific adapter protein (TSAd) was originally described in T cells but is also expressed in epithelial cells from the respiratory tract and in endothelium. In this study, we found expression of TSAd messenger RNA (mRNA) and protein in both human and murine oral mucosal epithelium as well as in human primary oral keratinocyte cell cultures. In TSAd^?/? mice, the mucosa and skin appeared macroscopically normal, but severe disturbances were observed in the fine structures of the basal membrane and intercellular epithelial spaces upon analysis using transmission electron microscopy. Oral epithelial cells from TSAd^?/? mice displayed decreased migration compared with cells from wild‐type mice, whereas overexpression of TSAd in a human epithelial cell line resulted in impaired proliferation. This study is the first to show that TSAd is expressed in normal oral mucosa, that it is important for the normal ultrastructural morphology of the epithelium and the basal membrane, and that it is involved in the migration and proliferation of oral keratinocytes.     

Sodium bicarbonate solution as an anti‐erosive agent against simulated endogenous erosion

Messias DCF, Turssi CP, Hara AT, Serra MC. Sodium bicarbonate solution as an anti‐erosive agent against simulated endogenous erosion. Eur J Oral Sci 2010; 118: 385–388. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci This study investigated whether sodium bicarbonate solution, applied on enamel previously exposed to a simulated intrinsic acid, can control dental erosion. Volunteers wore palatal devices containing enamel slabs, which were exposed twice daily extra‐orally to hydrochloric acid (0.01 M, pH 2) for 2 min. Immediately afterwards, the palatal devices were re‐inserted in the mouth and volunteers rinsed their oral cavity with a sodium bicarbonate solution or deionized water for 60 s. After the washout period, the palatal devices were refilled with a new set of specimens and participants were crossed over to receive the alternate rinse solution. The surface loss and surface microhardness (SMH) of specimens were assessed. The surface loss of eroded enamel rinsed with a sodium bicarbonate solution was significantly lower than the surface loss of eroded enamel rinsed with deionized water. There were no differences between treatments with sodium bicarbonate and deionized water for SMH measurements. Regardless of the solution used as an oral rinse, eroded enamel showed lower SMH than uneroded specimens. Rinsing with a sodium bicarbonate solution after simulated endogenous erosive challenge controlled enamel surface loss but did not alter the microhardness.     

Oral distress in primary Sjögren's syndrome: implications for health-related quality of life

Enger TB, Palm Ø, Garen T, Sandvik L, Jensen JL. Oral distress in primary Sjögren’s syndrome: implications for health‐related quality of life.
Eur J Oral Sci 2011; 119: 474–480. © 2011 Eur J Oral Sci The aims of the study were to evaluate oral distress in patients with primary Sjögren’s syndrome (pSS) compared with age‐ and sex‐matched Norwegian normative data, to estimate the occurrence of oral symptoms in pSS, and to evaluate the impact of oral distress on health‐related quality of life (HRQoL). The Medical Outcomes Study 36‐Item Short‐Form Health Survey (SF‐36) was used to assess HRQoL, and the Oral Health Impact Profile 14 (OHIP‐14) was used to measure oral distress. Of the 246 pSS patients invited to participate in the study, 177 (72%) responded. Data were analysed for the female participants (n = 163). Significant deviations from normative estimates were found in all OHIP‐14 item results, and the findings indicated a high level of oral distress among the pSS patients. Health‐related quality of life was decreased among pSS patients, with the largest deviations from normative estimates related to general health and role physical. The patients with high levels of oral distress scored significantly lower than patients with low levels of oral distress in five of the SF‐36 subscales, indicating that oral conditions have a marked impact on general quality of life. In conclusion, oral distress in pSS is pronounced and severe, and should receive increased attention with a view to improving the quality of life for these patients.     

Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation,and direct pulp capping vs. partial pulpotomy

Bjørndal L, Reit C, Bruun G, Markvart M, Kjældgaard M, Näsman P, Thordrup M, Dige I, Nyvad B, Fransson H, Lager A, Ericson D, Petersson K, Olsson J, Santimano EM, Wennström A, Winkel P, Gluud C. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 2010; 118: 290–297. © 2010 The Authors. Journal compilation©2010 Eur J Oral Sci Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow‐up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (?22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.     

Changes in toothbrushing frequency in relation to changes in oral health‐related knowledge and attitudes among children – a longitudinal study

Tolvanen M, Lahti S, Hausen H. Changes in toothbrushing frequency in relation to changes in oral health‐related knowledge and attitudes among children – a longitudinal study. Eur J Oral Sci 2010; 118: 284–289. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci The aim of this study was to determine the associations between changes in self‐reported toothbrushing frequency and the knowledge and attitudes related to oral health. The study population consisted of all fifth and sixth graders who started the 2001–2002 school year in Pori (n = 1,691); of these, 1,362 were monitored throughout the 3.4‐yr study. Data were gathered by questionnaires before, in the middle, and after the follow‐up, which was divided into two periods. Associations between changes in toothbrushing frequency, sum score of knowledge items, and sum scores of items in attitudinal factors were studied. The attitudinal factor structure was determined by principal component analyses. The associations were evaluated using mean values and general linear models for repeated measures. Toothbrushing frequency and knowledge and attitudes related to oral health improved among the same children during the study, with the changes usually taking place in the same time‐period. In different time‐periods, different children’s toothbrushing and oral health‐related knowledge and attitudes improved. Based on our results, changes in knowledge, attitudes, and behavior are related, but children are ready for change at different times. Therefore, oral health promotion should be designed to be a continuous process rather than a short‐term intervention.     

Energy transfer,volumetric expansion,and removal of oral biofilms by non‐contact brushing

Busscher HJ, Jager D, Finger G, Schaefer N, van der Mei HC. Energy transfer, volumetric expansion, and removal of oral biofilms by non‐contact brushing. Eur J Oral Sci 2010; 118: 177–182. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Non‐contact removal of oral biofilms offers advantages beyond the reach of bristles, but it is unknown how energy transfer for removal from brush‐to‐biofilm occurs. In the present study we evaluated non‐contact, oral biofilm removal by oscillating‐rotating and sonic toothbrushes, and their acoustic output up to 6 mm distance. Whereas some brushes removed biofilm when used at a distance of up to 6 mm, others lost efficacy at a distance of 2–4 mm from the biofilm. Loss of efficacy was accompanied with high standard deviations and volumetric biofilm expansion. Both sonic and oscillating‐rotating brushes caused fluid flows and the inclusion of air‐bubbles, while non‐contact acoustic energy‐transfer was demonstrated to decay with distance for both types of brushes. We put forward the following mechanism for non‐contact removal: (i) brush energy is absorbed by biofilm, resulting in the visco‐elastic expansion of the biofilm; (ii) if the energy absorbed is sufficient and deformation is beyond the yield point, biofilm removal occurs; and (iii) if deformation is in the plastic range but below the yield point (i.e. at the limiting distance for non‐contact removal), biofilm is expanded but not removed.     

The effect of initial treatment of periodontitis on systemic markers of inflammation and cardiovascular risk: a randomized controlled trial

Taylor B, Tofler G, Morel‐Kopp M‐C, Carey H, Carter T, Elliott M, Dailey C, Villata L, Ward C, Woodward M, Schenck K. The effect of initial treatment of periodontitis on systemic markers of inflammation and cardiovascular risk: a randomized controlled trial. Eur J Oral Sci 2010; 118: 350–356. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Observational studies indicate that chronic periodontal disease is associated with adverse cardiovascular outcomes. The aim of this study was to determine whether initial periodontal treatment has a beneficial effect on systemic markers of inflammation and cardiovascular risk. One hundred and thirty‐six adults with chronic periodontitis were allocated to either intervention or control groups in a 3‐month randomized controlled intervention study. The intervention group received initial periodontal treatment, whereas the control group did not receive that treatment until after the study. Blood levels of cardiovascular risk factors, and of hematological, inflammatory, and metabolic markers, were measured at the beginning and the end of the study, and differences were calculated. Fibrinogen level was the primary outcome measure. Data for 61 persons in the intervention group and for 64 persons in the control group were available for statistical analysis. Compared with the control group, the intervention group showed a non‐significant trend for a lower fibrinogen level. Significant increases in hemoglobin and hematocrit were seen after treatment, showing that initial periodontal treatment, a relatively simple and cost‐effective intervention, has systemic effects.     

Nuclear and cytoplasmic expression of Met in oral squamous cell carcinoma and in an organotypic oral cancer model

Brusevold IJ, Søland TM, Khuu C, Christoffersen T, Bryne M. Nuclear and cytoplasmic expression of Met in oral squamous cell carcinoma and in an organotypic oral cancer model. Eur J Oral Sci 2010; 118: 342–349. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Met, the hepatocyte growth factor receptor, is important in transducing signals for tumour growth and metastasis. The aim of this study was to examine the pattern of Met expression and its value as a prognostic factor in oral squamous cell carcinomas (OSCCs). The material consisted of 53 OSCCs and five healthy controls from normal oral mucosa supplied with cell lines, 10 organotypic models supplied with oral cancer cells, and three organotypic models supplied with normal keratinocytes. Met protein expression was assessed by immunohistochemistry and western blotting. Met expression was scarce and limited to the basal layer in normal oral mucosa, but was more extensive in the tumours. Cytoplasmic expression of Met was found in the majority of the tumours, and nuclear expression was found in 72%, including a high fraction of the cells located at the invasive front. Organotypic models with normal or malignant oral cells yielded principally similar results as in the mucosa and the cancers, respectively. A smaller amount of Met immunoreactivity was detected, by western blotting, in the nuclear fraction of cultured oral cancer cells. In conclusion, Met was upregulated in OSCCs and was also found in the nucleus. However, Met was not a marker for prognosis in this study.     

Microbiota around teeth and dental implants in periodontally healthy,partially edentulous patients: is pre‐implant microbiological testing relevant?

Meijndert L, van der Reijden WA, Raghoebar GM, Meijer HJA, Vissink A. Microbiota around teeth and dental implants in periodontally healthy, partially edentulous patients: is pre‐implant microbiological testing relevant? Eur J Oral Sci 2010; 118: 357–363. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci This study aimed to assess the prevalence of seven periodontal marker pathogens, before implant placement and 1 yr after loading, in periodontally healthy individuals and to assess the long‐term effectiveness of pre‐implant reduction of pathogens to below threshold levels. In 93 individuals needing single tooth replacement, pooled subgingival microbiological samples from standard sites were cultured and analyzed before implant treatment and 1 yr after loading. Threshold levels commonly used in periodontology to predict periodontal breakdown were applied. Subjects with levels of pathogens above these thresholds received initial periodontal treatment including systemic antibiotics when indicated. At baseline, 49.5% of periodontally healthy subjects harboured one or more marker pathogens above threshold levels. Periodontal treatment reduced the pathogen levels below threshold values in 78.3% of these initially colonized subjects. In all cases Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were reduced to below threshold. At 1 yr after loading, periodontal pathogens were present above threshold levels in 74.1% of all subjects. It is concluded that in almost half of periodontal healthy individuals the subgingival biofilm harbours periodontal pathogens above threshold values. Long‐term effectiveness of pre‐implant reduction of the selected marker pathogens appeared limited in our patient population, making pre‐implant reduction unpredictive for post‐implant levels of these pathogens. Thus, considering the applied microbiological criteria, generalized pre‐implant microbiological testing is not contributory in periodontally healthy subjects.     

Altered inorganic composition of dental enamel and dentin in primary teeth from girls with Turner syndrome

Rizell S, Kjellberg H, Dietz W, Norén JG, Lundgren T. Altered inorganic composition of dental enamel and dentin in primary teeth from girls with Turner syndrome. Eur J Oral Sci 2010; 118: 183–190. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci In Turner syndrome (TS) one X‐chromosome is missing or defective. The amelogenin gene, located on the X‐chromosome, plays a key role during the formation of dental enamel. The aim of this study was to find support for the hypothesis that impaired expression of the X‐chromosome influences mineral incorporation during amelogenesis and, indirectly, during dentinogenesis. Primary tooth enamel and dentin from girls with TS were analysed and compared with the enamel and dentin of primary teeth from healthy girls. Qualitative and quantitative changes in the composition of TS enamel were found, in addition to morphological differences. Higher frequencies of subsurface lesions and rod‐free zones were seen in TS enamel using polarized light microscopy. Similarly, scanning electron microscopy showed that the enamel rods from TS teeth were of atypical sizes and directions. Using X‐ray microanalysis, high levels of calcium and phosphorus, and low levels of carbon, were found in both TS enamel and dentin. Using microradiography, a lower degree of mineralization was found in TS enamel. Rule induction analysis was performed to identify characteristic element patterns for TS. Low values of carbon were the most critical attributes for the outcome TS. The conclusion was that impaired expression of the X‐chromosome has an impact on dental hard tissue formation.     

Possible predictors of discontinuation of specialized dental treatment among children and adolescents with dental behaviour management problems

Gustafsson A, Broberg AG, Bodin L, Berggren U, Arnrup K. Possible predictors of discontinuation of specialized dental treatment among children and adolescents with dental behaviour management problems. Eur J Oral Sci 2010; 118: 270–277. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci This study aimed to identify potential predictors of non‐attendance among children and adolescents with dental behaviour management problems (DBMP). A group of 179 patients, 7.5–19 yr of age, was grouped into 56 ‘non‐attenders’ (discontinued treatment, missed appointments, or ≥ 20% cancellations) and 123 ‘attenders’. In addition to data from an introductory interview and dental recordings, baseline data from psychometric measures of fear and other personal and parental characteristics were included in logistic regression analyses and tree‐based modelling. The non‐attenders had higher scores on impulsivity and sociability and lower socio‐economic status (SES) than the attenders, and they lived more often in single‐parent families. Logistic regression analyses and tree‐based modelling point to SES and parental anxiety as important predictors for non‐attendance within this group of children and adolescents. To predict, and possibly to prevent, non‐attendance among children and adolescents referred for specialized dental care because of DBMP, we must consider their lives and family situations as well as their personal characteristics and oral health status. Further research should focus on whether the observed associations between non‐attendance and factors such as personal characteristics, family and psychosocial factors, and previous dental experiences, also hold for those who remain in regular dental care.     

Susceptibility locus for non‐syndromic cleft lip with or without cleft palate on chromosome 10q25 confers risk in Estonian patients

Nikopensius T, Birnbaum S, Ludwig KU, Jagomägi T, Saag M, Herms S, Knapp M, Hoffmann P, Nöthen MM, Metspalu A, Mangold E. Susceptibility locus for non‐syndromic cleft lip with or without cleft palate on chromosome 10q25 confers risk in Estonian patients. Eur J Oral Sci 2010; 118: 317–319. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Non‐syndromic cleft lip with or without cleft palate (NSCL/P) is one of the most common birth defects and has a multifactorial etiology that includes both genetic and environmental factors. Recently, two novel susceptibility loci and three suggestive loci for NSCL/P were identified by a genome‐wide association scan (GWAS) in a German population with subsequent independent replication in a mixed European population. The aim of the present study was to investigate whether these newly detected loci confer similar effects in the North‐East European Baltic population. A total of 101 NSCL/P patients and 254 controls from Estonia were included. A significant association was observed for rs7078160 (P = 0.0016) at chromosome 10q25, which confirms the association of this locus with NSCL/P in the Baltic population. No significant association was found for the other four loci, a result that may have been attributable to the limited power of the sample.     

Oral HIV‐associated Kaposi sarcoma

J Oral Pathol Med (2012) Kaposi sarcoma (KS), an AIDS defining condition, remains one of the most commonly HIV‐associated neoplasms. While the use of highly active antiretroviral therapy (HAART) has brought about a dramatic decrease in the prevalence and incidence of AIDS‐KS worldwide, this has not been the case in resource‐poor sub‐Saharan African countries, where HIV has reached epidemic proportions and human herpesvirus‐8 infection is endemic. Oral involvement is a common manifestation of AIDS‐associated KS and may be an early presenting finding of HIV infection. The clinical manifestation of oral KS can vary and may have an unpredictable course ranging from mild to fulminant. Rapidly progressive facial lymphoedema associated with extensive advanced oral KS portends a poor prognosis. Oral KS may regress with antiretroviral therapy or may flare up as part of the immune reconstitution inflammatory syndrome. The oral lesions of AIDS‐KS are best managed with HAART together with systemic chemotherapy. This article provides a review of contemporary knowledge of the biology, pathology, clinical features and management of oral AIDS‐KS.     

Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and in the nasal cavity of the mouse

Vaziri Sani F, Kaartinen V, El Shahawy M, Linde A, Gritli‐Linde A. Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and nasal cavity of the mouse. Eur J Oral Sci 2010; 118: 221–236. © 2010 The Authors. Journal compilation© 2010 Eur J Oral Sci The aim of this study was to analyse the hitherto largely unknown expression patterns of some specific cellular and extracellular molecules during palate and nasal cavity development. We showed that epithelia of the developing palate and the vomerine epithelium express similar sets of structural proteins. With the exception of keratin 15, which becomes barely detectable in the elevated palatal shelves, nearly all of these proteins become upregulated at the presumptive areas of fusion and in the adhering epithelia of the palate and nasal septum. In vivo and in vitro analyses indicated that reduction in the amount of keratin 15 protein is independent of Tgfβ–Alk5 signalling. Foxa1 expression also highlighted the regionalization of the palatal and nasal epithelia. Owing to the lack of reliable markers of the palatal periderm, the fate of peridermal cells has been controversial. We identified LewisX/stage‐specific embryonic antigen‐1 as a specific peridermal marker, and showed that numerous peridermal cells remain trapped in the medial epithelial seam (MES). The fate of these cells is probably apoptosis together with the rest of the MES cells, as we provided strong evidence for this event. Heparan sulphate, chondroitin‐6‐sulphate, and versican displayed dynamically changing distribution patterns. The hitherto‐unknown innervation pattern of the developing palate was revealed. These findings may be of value for unravelling the pathogenesis of palatal clefting.     

Metameric effect between natural teeth and the shade tabs of a shade guide

Corcodel N, Helling S, Rammelsberg P, Hassel AJ. Metameric effect between natural teeth and the shade tabs of a shade guide. Eur J Oral Sci 2010; 118: 311–316. © 2010 The Authors. Journal compilation©2010 Eur J Oral Sci The objective of this study was to evaluate metameric effects, that is, the dependence of the colours of teeth and shade tabs on the illuminant used. The colours of 49 teeth of 37 participants and of the corresponding shade tabs of the 3D‐Master (VITA Zahnfabrik; colour match ΔE_ab< 2) were measured using an intra‐oral spectrophotometer (VITA Easyshade). Spectral reflectance data (from 400 to 700 nm) were recorded. Commission Internationale de l’Éclairage (CIE) L*a*b* values were calculated for D65 (reference daylight), A (incandescent light), and TL84 (store/office light) as reference illuminants. A modified metamerism index (Mod‐M) and hue‐angle ratios were calculated to express differences between tooth and tab colour relative to the difference observed under D65 illumination. The Mod‐M for teeth and tabs was greater than unity (indicating a greater colour difference relative to D65) by 57.1% for A and by 49.3% for TL84. Hue‐angle ratios of teeth and tabs using the test illuminants were different from those obtained using the standard illuminant D65. If teeth and shade tab matching is conducted using daylight illumination, the colour difference may not be the same under other lighting conditions, leading to perceptible, or even unacceptable, colour differences under these conditions.     

CRISPLD2 polymorphisms are associated with non‐syndromic cleft lip with or without cleft palate in a northern Chinese population

Shi J, Jiao X, Song T, Zhang B, Qin C, Cao F. CRISPLD2 polymorphisms are associated with non‐syndromic cleft lip with or without cleft palate in a northern Chinese population. Eur J Oral Sci 2010; 118: 430–433. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Non‐syndromic cleft lip with or without cleft palate (NSCLP) is the most common craniofacial birth defect. This complex genetic disorder results from interactions between genes and environmental factors. Numerous genes have been reported in studies demonstrating association between the cleft lip and palate phenotypes and the alleles at single‐nucleotide polymorphisms (SNPs) within specific genes. Recently, the cysteine‐rich secretory protein LCCL domain containing 2 (CRISPLD2) has been revealed to be a novel candidate gene for NSCLP. The SNPs rs1546124, rs4783099 and rs16974880 in CRISPLD2 were highly significant in Caucasian and Hispanic multiplex families but showed no association in Colombian and Irish populations. In the current study, we examined these three SNPs in a northern Chinese population and found an association between these polymorphisms and NSCLP in both single‐marker and haplotype analyses. Our data further strengthen the conclusion that altered CRISPLD2 is associated with NSCLP susceptibility.     

Low prevalence of human papillomavirus infection in the healthy oral mucosa of a Northern Italian population

J Oral Pathol Med (2012) 41 : 16–20 Background: Oral cancer is the sixth most common malignancy in developed countries, representing almost 3% of malignant tumors. Tobacco use and alcohol consumption are well‐established risk factors. However, the observation that most patients with oral cancer have not been exposed to these risk factors suggests that additional causes may promote oral carcinogenesis. A link has been suggested between human papillomavirus (HPV) and oral cavity cancer but the significance of HPV contribution to oral carcinogenesis as well as the prevalence of HPV infection in normal oral cavity mucosa remains debated. Methods: In this study, the prevalence of oral HPV infection was evaluated in 81 randomly selected Northern Italian subjects with clinically normal oral mucosa using a nested PCR on DNA extracted by oral smears. Results and conclusions: No HPV‐related lesions were detectable in any of the smears analyzed by cytological approach. nPCR identified HPV DNA in only one (1.2%) of the specimens obtained from clinically healthy oral mucosa and subsequent characterization assigned the positive case to HPV type 90. These data suggest that the incidence of HPV infection in the healthy population might be very low and that other risk factors are likely responsible to promote oral carcinogenesis.