Necrotising ulcerative gingivitis/periodontitis as indicators of HIV-infection.

Necrotising ulcerative gingivitis/periodontitis (NUG/NUP) are well-documented oral manifestations of HIV infection/AIDS. However, no information is available regarding the predictive value of NUG in the diagnosis of HIV-infection in South Africa. OBJECTIVES: The purpose of this study was to determine a possible correlation between NUG/NUP and HIV infection in the as yet undiagnosed patients. METHODS: Eighty-six systemically asymptomatic patients were diagnosed with NUG/NUP. All patients were treated with 400 mg of metronidazole and 500 mg paracetamol, three times a day for five days. Mechanical debridement under local anesthesia was performed five days after the initial consultation. The possible involvement of HIV-infection was explained and patients were advised to have a blood test taken. RESULTS: Fifty-six patients consented and received pre- and post-test counselling. Of the fifty-six patients, thirty-nine were found to be HIV positive with CD+ T cell counts ranging between 9 and 1,205 cells/mm3. There was a statistically significant correlation between CD4+ T cells below 500 cells/mm3 (p = 0.000) as well as with CD4+ T cells below 200 cells/mm3 (p = 0.001) and NUP/NUG. CONCLUSION: From these results it is concluded that in the GaRankuwa and surrounding areas, NUG/NUP in otherwise systemically healthy individuals is strongly correlated with HIV infection, with a predictive value of 69.6 per cent (p = 0.01). It is recommended that patients presenting with these conditions be encouraged to undergo testing to establish their HIV status for appropriate referrals and management.     

Comparative risk judgements for oral health hazards among Norwegian adults: a cross sectional study

Background  

This study identified optimistic biases in health and oral health hazards, and explored whether comparative risk judgements for oral health hazards vary systematically with socio-economic characteristics and self-reported risk experience.     

Prevalence and risk factors associated with denture-related stomatitis in healthy subjects attending a dental teaching hospital in North Jordan

There is scant information regarding the prevalence of denture-related stomatitis (DRS) in Jordan. AIMS: The aims of this study were to investigate the prevalence of DRS in a group of healthy Jordanian subjects wearing removable complete dentures, and to investigate for the factors that may be associated with this infection. MATERIALS AND METHODS: A total of 300 complete denture patients attending a dental teaching centre in North Jordan for replacement dentures were examined thoroughly for the presence of DRS. Demographic data, including denture-wearing habits, duration of denture usage and smoking, were also obtained. Oral mucosal tissues were examined for signs of denture trauma. Dentures were assessed for plaque accumulation. RESULTS: Of the 300 subjects examined, 175 were male and 125 were female. The overall prevalence of DRS in males and females was 52% (157/300). Increased plaque deposits (plaque indices 2 and 3) were significantly more prevalent in subjects with severe forms of DRS (p<0.01). Dentures that were more than 20 years old were located in the group of subjects with grade 2 and 3 infections. A total of 86% of patients with DRS complained of denture trauma compared to 10% of subjects with healthy mucosa, and 87% of the DRS group wore dentures continuously day and night. A total of 70% of subjects with grade 3 DRS were heavy smokers (more than 15 cigarettes/day). CONCLUSION: Local factors studied contributed significantly to the development of DRS in healthy subjects and are important factors to be considered in the pathogenesis of this infection.     

Psychosocial factors as risk indicators of periodontitis

OBJECTIVE: Cross-sectional investigation of associations between psychosocial and periodontal parameters. METHODS: One hundred and ten patients 18-76 years of age were examined clinically and 57 radiographically at the Department of Conservative Dentistry of the University Hospital of Heidelberg: probing depths (PDs) and attachment level (PAL-V) were obtained at six sites per tooth. Inter-proximal bone loss was assessed in 57 patients on panoramic radiographs. Further chemical and general environmental sensitivity, somatization, and smoking status were assessed by several questionnaires. RESULTS: Significant correlations between severe bone loss and age (r=0.38, p=0.004) were observed. PAL-V and PD also correlated with age (r=0.45, p<0.001; r=0.37, p<0.001) and pack years (r=0.21, p=0.031; r=0.3, p=0.002). After adjustment for age, smoking, and sex a negative correlation between chemical odour sensitivity and bone loss, PD=4 mm as well as PAL-V=4 mm was observed. Further, a negative correlation was observed between gastrointestinal sensitivity and PAL-V=4 mm. Psychological stress correlated positively with bone loss. CONCLUSION: The results give evidence for associations of psychosocial factors and periodontal disease. Some environmental traits seem to be related to more favourable periodontal status.     

Dental caries and bone mineral density: a cross sectional study.

AIM: The relationship between bone mineral density (BMD), age and dental caries has been studied. Quantitative ultrasonography (QUS) is an economic, non invasive, and reproducible method for measuring both bone mineral density and bone elasticity in growing subjects in large populations. METHODS: This study evaluated the relationship between BMD and prevalence of dental caries (Decayed Missing Filled Tooth - DMFT) in 540 healthy adolescent with mean age 12.3 years, age range 10 to 15 years, resident in two provinces in south Italy. BMD was measured using QUS by calculating the speed of sound (m/s) on the last four fingers of the non dominant hand, with the estimate thus obtained being defined as the AD-SoS (Amplitude-Dependent Speed of Sound and categorised as AD-SoS < or = 1900 m/s and AD-SoS > 1900 m/s). Occurrence of dental caries was defined using the DMFT index (DMFT=0 and DMFT > 0). RESULTS: The results of the multifactorial analysis, carried out with logistic model, confirms the expected statistically significant association between response (DMFT) and explicative variables -- AD-SoS (P < 0.006) and Age (P < 0.004). CONCLUSION: Greater bone mineralisation (AD-SoS1900 m/s) and younger age (Age < or =12 years) are dental caries prevention factors: the probability to have caries for the subjects in such conditions is 0.34, about the half of that recorded in the subjects with lower bone mineralisation and older age (0.62).     

Overweight and obesity as risk indicators for periodontitis in adults

BACKGROUND: Developed and developing countries are facing an obesity epidemic with various health consequences. Few studies have addressed the relationship between obesity and periodontal health. The present study assessed the association of overweight and obesity with periodontitis in Brazilian adults. METHODS: A representative probability sample comprising 706 subjects aged 30 to 65 years from south Brazil was examined clinically and using a structured interview. Overweight and obesity were assessed by body mass index (BMI) using the World Health Organization (WHO) criteria. Individuals with > or =30% teeth with attachment loss > or =5 mm were classified as having periodontitis. Statistical analysis accounted for survey design, and separate analyses were performed for non-smokers. RESULTS: In this population, 60% and 65% of males and females, respectively, were overweight or obese. Periodontitis was observed in 50.7% and 35.3% of males and females, respectively. The percentage of males with periodontitis was similar in the overweight/obese individuals compared to those with normal weight. In females, there was a positive correlation between the BMI index and the occurrence of periodontitis, with a significantly (P < 0.05) higher prevalence of periodontitis in obese than in normal weight females. The multivariable analysis showed that obese females were significantly more likely (odds ratio = 2.1) to have periodontitis than normal weight females. A separate analysis for non-smokers showed that obese females were approximately 3.4 times more likely to have periodontitis than the normal BMI group. There were no significant differences in the prevalence of periodontitis between BMI groups among smokers of both genders and in male non-smokers. CONCLUSIONS: Obesity was significantly associated with periodontitis in adult, non-smoker women. Overweight was not significantly associated with periodontitis. Smoking may attenuate the association of periodontitis with obesity.     

Clinical and other risk indicators for early periodontitis in adults

BACKGROUND: Periodontal diseases affect over half the adults in the U.S., disproportionately affecting minority populations. Periodontitis can be treated in early stages, but it is not clear what features indicate, or could be risk factors for, early stages of periodontal attachment loss. This study aimed to evaluate associations between clinical and other risk indicators of early periodontitis. METHODS: A cross-sectional evaluation of 225 healthy and early periodontitis adults aged 20 to 40 years was performed. Clinical measurements, demographic information, and smoking histories were recorded. Analyses evaluated demographic and clinical associations with health and early periodontitis disease categories and periodontal attachment loss. Patterns of attachment loss at interproximal and buccal/lingual sites were evaluated. RESULTS: Subject age, plaque, and measures of gingivitis exhibited associations with attachment loss and probing depth. More periodontal attachment loss was detected in African-American and Hispanic subjects compared to Asian and Caucasian subjects. Smoking history was associated with attachment loss. At interproximal sites, lower molars most frequently had attachment loss, whereas at buccal/lingual sites, higher proportions of lower bicuspid teeth demonstrated attachment loss compared with other sites. CONCLUSIONS: In this study of subjects with minimal attachment loss, gingival inflammation was associated with early periodontitis. Lower molar interproximal sites were frequently associated with interproximal attachment loss, whereas lower bicuspid teeth were at risk for gingival recession on buccal surfaces.     

Wolinella recfa in adult gingivitis and periodontitis

Wolinella recta has been associated with adult periodontitis, but its role in the disease remains uncertain. This report clarifies the distribution of W. recta in periodontally healthy and diseased subjects, and treated patients with recurrent disease. A specific polyclonal rabbit antiserum against W. recta strain 372 was used for indirect immunofluorescence localization of W. recta in dental plaque from untreated and treated patients. Supragingival plaque was collected from 15 periodontally healthy individuals (H), 10 adults with mild gingivitis (G1), 8 with severe gingivitis (G2) and 15 with periodontitis (AP). Subgingival samples from 23 diseased sites (G2 and AP) were examined as well. There was a significant difference (p = 0.000) between the proportions of W. recta in subgingival (4.4%) vs. supragingival (0.3%) plaque samples from AP. A significant difference (p = 0.000) in W. recta proportions was also detected between subgingival plaque samples of AP (4.4%) vs. G2 (1.2%). No significant difference in the mean % of W. recta was found between supragingival plaque of AP (0.3%) and G2 (0%), and samples of G1 (0.01%) and H (0.1%). In a separate study, 85 adults previously treated for moderate to severe adult periodontitis were monitored over a 12-month period for evidence of disease recurrence. Recurrent disease was detected at 32 sites in 18 subjects. Of these, 20 sites in 13 subjects were positive for W. recta. With subjects as the experimental unit, a significant increase in the proportions of W. recta was found at sites with recurrent disease (3.12%) as compared to stable, paired control sites (0.24%), but only when sites with breakdown and positive for W. recta were compared with their controls. These results indicate that W. recta is associated with some, but not all sites with advanced adult periodontitis. The association of W. recta with gingivitis was not statistically significant.     

Analysis of resin tags formation in root canal dentine: a cross sectional study

Aim  To evaluate the length, density and quality of resin tags formed by penetration of various types of adhesive systems into dentinal tubules at various cross section levels of the root canal in correlation to the density of dentinal tubules.
Methodology  Thirty mandibular premolars were instrumented and fibre posts were inserted with three different adhesive systems with and without activator: etch & rinse XP Bond and XP Bond/Self Cure Activator; self-etch (two-step) AdheSE and AdheSE/AdheSE DC Activator and self-etch (one-step) Hybrid Bond and Hybrid Bond/Hybrid Brushes. The resin tags were evaluated from slices obtained from sections perpendicular to the long axis of the teeth at 3, 6, and 9 mm from the root apex under a Confocal Laser Scanning microscope.
Results  In all groups, lack of continuity of resin tag length, density and quality was observed not only from the cervical to the apical region of each root canal, but also in a mesio-distal direction to the long axis of the root. Application of etch & rinse adhesive in contrast to the self-etch adhesives provided the formation of the shorter, but considerably denser, more homogeneous and not interrupted resin tags with similar length. Use of the activator for all types of adhesives significantly increased the completeness ( P  = 0.014) and continuity ( P  = 0.024) of resin tags.
Conclusions  None of the investigated adhesives were able to completely infiltrate the dentinal tubules in the entire root canal. Use of the etch & rinse adhesive system and the activators significantly increased the density and the quality of resin tags.     

Mycoplasma in relation to gingivitis and periodontitis

In this study, mycoplasma were enumerated in the gingival crevicular fluid (GCF) of gingivitis and periodontitis patients. GCF samples were obtained from the mesial (approximal) gingival crevice or periodontal pocket of the maxillary right first permanent molar. Samples were cultured anaerobically on a medium selective for mycoplasmas as well as on a non-selective medium to obtain a total anaerobic count. Mycoplasmas were present in the GCF of both gingivitis and periodontitis patients, but a greater % was obtained from the GCF of patients with periodontitis. The proportions of mycoplasma appeared to be independent of the disease activity as expressed by bleeding on probing (PBI), but to be related to probable pocket depth, as shown by the higher %s in periodontitis than gingivitis for a given PBI. On the basis of an increased proportion in relation to disease severity, mycoplasmas would therefore appear to be amongst those micro-organisms associated with CIPD.     

Prevalence and risk indicators of gingival recessions in an Italian school of dentistry and dental hygiene: a cross-sectional study

Objectives

The aim of this cross-sectional study is to (i) determine the prevalence, extent, severity, and distribution of gingival recessions and patient perception in a young population and (ii) to identify potential risk indicators.

Material and methods

Two hundred fifty-one students with a mean age of 22.9 ± 4.7, attending the School of Dentistry and Dental Hygiene of Vita-Salute San Raffaele University (Milan, Italy) were included. The subjects had undergone a clinical evaluation, by two calibrated examiner, and a questionnaire. Demographic and clinical data were collected to evaluate association of these factors with gingival recessions.

Results

The prevalence of gingival recessions at patient and tooth level was 39% and 5.2%, respectively. The only factor associated with the presence of GR was age. On the other hand, age and smoking were associated with the extent, whereas BOP, NCCLs and KT were associated with the severity. Out of 98 subjects presenting at least one GR, 63 (64%) were conscious of the presence of the GR. NCCLs were also strongly associated with the perception of the recession by the patient.

Conclusions

There is a low prevalence of buccal gingival recessions in this sample of Italian students. More than 50% of the sample was aware of the problem. Almost all patients presenting symptomatology or aesthetic concern requested appropriate therapy.

Clinical relevance

The findings highlight the low relevance of gingival recessions in daily practice and the importance of controlling potential risk indicators in young populations.