Schizophrenia and oral healthcare

Schizophrenia is a relatively common form of psychotic illness, which can be extremely debilitating. This article aims to present an overview for the dental team, including the implications for oral health and dental treatment.     

Schizophrenia and dental management: review of the literature.

Schizophrenia is a brain disease that manifests itself with multiple signs and symptoms involving thought, perception, emotion, and behavior. Despite the fact that these manifestations combine in various ways to create considerable diversity among patients, the cumulative effect of the illness is always severe and usually long lasting. Schizophrenia is diagnosed in the presence of certain positive and negative psychotic symptoms, as well as psychologic and cognitive deterioration. In addition to history, medical and psychiatric examinations are used to rule out other possible diagnoses. Schizophrenia is not a rare disorder, and it affects approximately 1% of the general population. Many of these individuals require several hospitalizations, and the financial cost of schizophrenia is substantial. In this article, clinical features of schizophrenia are reviewed, and the important consequences from the perspective of dental practitioners are highlighted.     

K2O-Na2O-Al2O3-SiO2系统牙科微晶玻璃匹配氧化铝陶瓷的初步研究

目的:研究 K₂O-Na₂O-Al₂O₃-SiO₂系统牙科微晶玻璃匹配氧化铝陶瓷的热处理温度制度。方法:根据氧化铝陶瓷的热膨胀系数调整K₂O-Na₂O-Al₂O₃-SiO₂系统牙科微晶玻璃的原材料配比,利用K₂O-Na₂O-Al₂O₃-SiO₂系统牙科微晶玻璃的热处理温度制度形成微晶玻璃-氧化铝陶瓷复合材料;利用偏振光显微镜和X射线衍射分析仪观察样品的形态及显微结构特性,利用材料试验机测试材料的抗压强度。结果:经过原材料组份的调整,白榴石晶粒约1.0 μm、在玻璃基质中分布均匀;微晶玻璃-氧化铝陶瓷复合材料的抗压强度为500 MPa。结论:K₂O-Na₂O-Al₂O₃-SiO₂系统牙科微晶玻璃的热处理温度制度适合匹配氧化铝陶瓷。     

Occlusion (Part 2 of 2)

In the previous Journal of Esthetic and Restorative Dentistry's Talking with Patients, we defined occlusion and malocclusion and discussed when and why malocclusion is a concern. In this issue we will discuss the diagnosis and treatment of malocclusions.     

Characterisation of a Bioactive SiO2-CaO-CaF2-Na2O Glass Used in Composites

ObjectivesTo characterise the ion release, pH changes and apatite formation of a phosphate free bioactive glass.MethodsA SiO₂-CaO-CaF₂-Na₂O glass was synthesized by a melt route with a composition close to the reactive glass in the commercial Cention N® composite. The glass was characterized after immersion in three media: Artificial Saliva pH4 (AS4) Artificial Saliva pH7 (AS7) and in a high phosphate artificial saliva at pH6.5 (AS6.5). The pH and fluoride release were measured using a pH meter and an ion selective electrode. The concentration of Ca, P, Na and Si were measured by ICP-OES. The glass powders after immersion were characterized by FTIR, X-ray powder diffraction and ¹⁹F MAS-NMR.ResultsThe glass increased the pH in all three media. Fluoride was detected in all three media but was much higher in AS 6.5. Calcium fluoride formed in AS4 with a small amount of fluorapatite at long immersion times. Fluorapatite and calcium fluoride formed in AS7, whilst in AS6.5 fluorapatite formed.The ion concentrations in solution after immersion reflected the glass composition and the immersion media with fluorapatite being favoured by higher pHs and phosphate contents in the media.SignificanceThe results demonstrated the ability of the glass to increase the pH and to form fluorapatite in phosphate containing media. This may explain the low incidence of secondary caries found in the commercial composite. Unlike the commercial composite evidence was found for the precipitation of fluorite, which will act to reduce the release of fluoride for preventing secondary caries.     

Fibrillin-2 degradation by matrix metalloproteinase-2 in periodontium

Elastic system fibers, comprised of microfibrils and tropoelastin, are extracellular components of periodontal tissue. During development, the microfibrils act as a template on which tropoelastin is deposited. However, the process of elastic system fiber remodeling is not fully understood. Therefore, we examined whether matrix metalloproteinases (MMPs) are involved in the remodeling of fibrillins (major components of microfibrils) by human gingival fibroblasts and periodontal ligament (PDL) fibroblasts. Gingival and PDL fibroblasts were cultured for 6 weeks. In some cultures, MMP inhibitor or tissue inhibitor of matrix metalloproteinsase-2 (TIMP-2) was added to the medium for an additional 2 weeks. Active MMP-2 (62 kDa) appeared as cell-membrane-associated or in extracellular matrix only in PDL fibroblast cell layers. The addition of MMP inhibitor or TIMP-2 significantly increased fibrillin-2 accumulation in PDL fibroblast cell layers, and decreased the amount of fibrillin-2 fragments, suggesting that active MMP-2 may degrade fibrillin-2, and that MMPs may play a role in the remodeling of elastic system fibers in PDL.