Hemagglutinin activity and heterogeneity of related Porphyromonas gingivalis proteinases

Thiol-dependent proteinases that are expressed and released by Porphyromonas gingivalis are considered virulence factors in periodontitis because of their potential to effect matrix degradation and inflammation. A number of P. gingivalis thiol-proteinases have been described, however, with similar biochemical characteristics. In this report we demonstrate that an isolated P. gingivalis proteinase consists of nonco-valently associated peptides and that slight variations in the association pattern of these peptides could result in different proteinases with different affinities and activities. We also describe the co-purification of thiol-proteinase activity with hemagglutinin activity and demonstrate that each type of activity has similar inhibition profiles. With the use of monoclonal antibodies against the P. gingivalis proteinase we follow proteinase released into the culture medium over the course of 10 days and, by Western blot analysis, demonstrate that many of the proteinases with varying molecular weight are related. The identification of a single, immunoreactive, 140 kDa proteinase detected early in the culture and in association with the P. gingivalis cells suggests that multiple proteinases may originate from a single 140 kDa proteinase.     

Influence of masticatory muscle pain on electromyographic activities of cervical muscles in patients with myogenous temporomandibular disorders

The present study tested the hypothesis that the resting electromyographic (EMG) activities of sternocleidomastoid and trapezius muscles of myogenous temporomandibular disorder (TMD) patients would be significantly greater than healthy individuals. Eight masticatory muscle pain patients without disc interference disorders (DID) and 30 patients with DID along with 41 matched control subjects were included in the study. The resting EMG activities of sternocleidomastoid and trapezius muscles were recorded with a portable EMG machine. Pain intensities described over the muscles were recorded with a 100 mm visual analogue scale. The two groups of patients had significantly higher resting activities compared with control subjects. Patients (in both groups) who had pain in sternocleidomastoid and trapezius muscles reported significantly higher resting activities in the respective muscles than patients who were free of pain and the controls. The presence of pain over the examined muscles showed significant association with the myogenous TMDs without DID. The observed association of the cervical muscles with myogenous TMDs is expected to be a result of functional link between masticatory and cervical muscles. The present findings suggest that the myogenous TMDs without DID could be a distinct sub-group that can be a part of broader regional or generalized diseased entity.     

Prefrontal modulation during chewing performance in occlusal dysesthesia patients: a functional near-infrared spectroscopy study

Objectives

Neuropsychological associations can be considerable in occlusal dysesthesia (OD) patients who routinely complain of persistent occlusal discomfort, and somatization effects in the superior medial prefrontal cortex and the temporal and parietal regions are also present. However, the relationship between physical activity, i.e., chewing, prefrontal cognitive demand, and psychiatric states in OD patients remains unclear. We investigated this relationship in this study.

Materials and methods

OD patients (n = 15) and healthy control (n = 15; HC) subjects were enrolled in this study. Occlusal contact, chewing activities of the masticatory muscles, prefrontal activities, and psychiatric states such as depression and somatization, of the participants were evaluated. Functional near-infrared spectroscopy was used to determine prefrontal hemodynamics and the Symptom Checklist-90-R was used to score the psychiatric states.

Results

We observed a significant association between prefrontal deactivation during chewing and somatization subscales in OD patients. Further, there were no significant differences with regard to the occlusal state and chewing physical activities between the OD patients and HC subjects.

Conclusions

Chewing-related prefrontal deactivation may be associated with somatization severity in OD patients.

Clinical relevance

fNIRS is a functional imaging method that uses the principal of neuro-vascular couplings. It is applicable for evaluation of psychiatric state based on prefrontal cortex blood flow in patients with psychiatric disorders.

     

Federal supports for state oral health plans

The past decade has witnessed both a proliferation of state oral health plans that include very specific proposals for action and an emergence of federal laws that include support for oral health. This paper provides an overview of state oral health priorities for action as reflected in 40 oral health plans that were developed independently by states. It examines four federal laws - the 2002 Safety Net Improvement Act, the 2009 CHIP Reauthorization Act, the 2009 economic stimulus law, and the 2010 health reform law - to identify opportunities for alignment with action steps proposed in state plans. This analysis identifies 23 categories of activity proposed by states in their action plans and determines that all but six of these activities are now supported by one or more of these four federal laws. State activities undertaken through grants provided under the 2002 Safety Net Improvement Act are analyzed as an example of how states can leverage federal legislation to advance their oral health plans. The paper concludes with consideration of the steps needed for states to promote their oral health plans by leveraging the full capacity of federal legislation.     

A Description of Dental Public Health Programs for the Elderly

The changing oral health status of older adults has focused attention on the need to broaden oral health promotion and prevention activities for this group. The Oral Health Working Group of the US Surgeon General's Workshop: Health Promotion and Aging recently reported that more activities are needed in education and service for older adults—areas that fall within the purview of state and local health agencies. Although dental public health programs for older adults have received more attention, the current breadth and variety of state dental health activities for older adults is unknown. This telephone survey of state dental health departments found that among the 10 states with the largest older adult populations, five were providing oral health programs for the elderly. The 30 states reporting the existence of oral health programs for the elderly account for 58 percent of the total US elderly population. Oral health activities were quite varied, with the majority of states focusing on institutionalized patients and their care givers. Respondents reported that access to dental consultants with gerontological training and information on model oral health programs for older adults would assist program development. Public health agencies play a significant role in improving the quality of life for the nation's elderly. Dental public health programs clearly have demonstrated the ability to improve health prevention and health promotion among younger populations. It is crucial to utilize these skills to begin to enhance the oral health and quality of life of older adults, as well.     

Surgical treatment of choanal atresia in CHARGE association: case report with long-term follow-up.

A patient affected by a multisystem malformation, the CHARGE association, is described. The choanal atresia is one of the stigmata characterizing this syndrome. The main anomalies of the association, the surgical correction (choanoplasty with endoscopic transnasal approach followed by the application of nasal stenting) and a comparison with different techniques are reported.     

Primary meningioma of the scalp as a late complication of skull fracture: case report and literature review

A case of primary meningioma of the scalp is presented in which the anatomical association with a previous skull fracture is demonstrated and pathogenesis discussed. The investigations and surgical treatment are briefly described. Review of the literature reveals a strong association between trauma of the central nervous system and intracranial meningioma. Occasional reports also exist of extra-cranial meningioma following trauma. This is, however, the first report of such an association in the scalp.     

The role of the dentist in the diagnosis, screening and followup of lesions of the oral mucosa

The early detection and follow up of oral mucosa lesions are a must for every dentist. The importance of these activities is tremendous for oral cancerous and precancerous lesions, so every dentist is officially responsible for this important role in the public health. The modalities of such early detection and follow up are described.     

Congenital lip pits and facial clefts

Two families with congenital lower lip pits in association with cleft lip and palate, and isolated cleft palate are described. The presentation, mode of inheritance, aetiology, treatment and genetic significance are reviewed.     

Prevalence of dental caries in obese and normal-weight Brazilian adolescents attending state and private schools

OBJECTIVE: To measure the association between dental caries and obesity in adolescents aged 12 to 15 years attending state and private schools. BASIC RESEARCH DESIGN: Cross-sectional study. RESEARCH SETTING: State and private schools in the state of Paraiba, Brazil. Participants: 1665 obese and 1665 normal-weight adolescents. MAIN OUTCOME MEASURES: These were chosen by means of an anthropometric study using height/age and weight/height indices, adopting as baseline the National Center for Health Statistics indices. The diagnostic criteria for caries were those of the World Health Organization (1997). RESULTS: The average DMFT for obese adolescents from state schools was 4.27 and for those of normal weight it was 4.25 (p = 0.7802). In private schools, the corresponding figures were 1.90 and 1.91, respectively (p = 0.1151). In state schools, the caries prevalence amongst the obese group was 50.9% and amongst those of normal weight, 52.4% (p = 0.5393). In private schools, it was 9.0% amongst the obese group and 9.6% amongst those of normal weight (p 0.6790). CONCLUSIONS: There was no statistically significant association between dental caries and obesity. Caries levels were higher amongst adolescents attending state schools.     

Reverse 'see-saw' relationship between Graves' disease and myasthenia gravis; clinical and immunological studies

Although the association of two distinct autoimmune diseases, Graves' disease (GD) and myasthenia gravis (MG), is rare, the relationships of clinical and immunological activities between the two diseases remain unknown. In the present study, we investigated whether there exist any relationships between clinical and immunological activities of GD and MG as well as any common characteristics of their HLA antigens in five patients with concomitant association with GD and MG. The present study clearly showed positive relationships between the clinical activities of GD and MG in all five cases. Except for two cases, one with undetectable acetylcholine receptor antibody and another with few sample number, there were positive relationships between two circulating auto-antibodies against TSH receptor and acetylcholine receptor as well as their immunological and clinical activities in the remaining three cases. Furthermore, the present serological HLA typing study revealed that all five cases had common HLA-DQ3. Therefore, our study clearly demonstrates a reverse 'see-saw' relationship between GD and MG based on their clinical and immunological features, and suggests that HLA-DQ3 may play a potential pathogenic role in the concomitant development of the two diseases.     

Dental hygienists in Poland

The activities of dental hygienists in Poland since 1974 are described. About 600 dental hygienists graduated in Poland up to 1977 but only 32% of them are still working in the profession. Their main activities are: dental health education, fluoride prophylaxis and assisting in dental clinics. Although the work of about 50% of the hygienists is poorly organized, they are regarded as useful in dental care by 23 Heads of district dental clinics who employ dental hygienists.     

Basaloid squamous carcinoma of the oral cavity: Report of a case

A case of basaloid squamous carcinoma that involves the posterior buccal mucosa is described. The major histopathologic feature is a carcinoma with a basaloid pattern in association with squamous differentiation. The basaloid cells exhibit large and vesicular nuclei and eosinophilic clear or vacuolated cytoplasm. Cells are distributed in cords, trabeculae, or lobules that occasionally show glandular arrangement. The majority of the tumor cells are positive for keratin and a large group of cells distributed in glandular arrangement are positive also for vimentin.     

Periodontal disease and the metabolic syndrome

The metabolic syndrome (MetS) is a spectrum of conditions that increase the risk of cardiovascular disease and diabetes mellitus. The components of MetS include dysglycemia, visceral obesity, atherogenic dyslipidemia (elevated triglycerides and low levels of high‐density lipoprotein) and hypertension. An association of periodontal disease and MetS has been suggested. This association is believed to be the result of systemic oxidative stress and an exuberant inflammatory response. When examined individually, the components of the MetS that are most closely related to the risk of periodontitis are dysglycemia and obesity, with lesser contributions by atherogenic dyslipidemia and hypertension. Data suggest that the odds of periodontitis increase with the number of MetS components present in an individual. The direction of the relationship between MetS and periodontal disease cannot currently be determined because the majority of studies are cross‐sectional. The association between MetS and periodontitis, however, suggests that improved understanding of this association could promote interprofessional practice. Evidence suggests that periodontal therapy can reduce the levels of inflammatory mediators in serum. If this finding is confirmed, periodontal treatment could become part of therapy for MetS. Oral health providers who identify patients at risk for MetS could refer them to a medical provider, and physicians could refer patients to dentists to ensure that patients with MetS receive a dental evaluation and any necessary treatment. These clinical activities would improve both oral and general health outcomes.     

Potential Association of Paraoxonase‐1, Type 2 Diabetes Mellitus,and Periodontitis

Background: The association between periodontitis and systemic diseases, including cardiovascular diseases and diabetes mellitus (DM), has been recognized repeatedly. Paraoxonase‐1 (PON‐1) is involved in the prevention of atherosclerosis, and decreased enzyme activity in patients with DM has been shown. The aim of this study is to investigate a possible correlation between decreased PON‐1 activity and the association between impaired glucose metabolism or DM and periodontitis. Methods: PON‐1 phenotype distribution and enzyme activities were characterized by measuring the hydrolysis of phenylacetate and paraoxon in serum samples of 87 patients with type 2 DM and 46 patients with pre‐DM showing impaired fasting plasma glucose and/or impaired oral glucose tolerance. The control group comprised 64 individuals with normal fasting plasma glucose and normal glucose tolerance. Altogether, 154 study participants were available for complete clinical periodontal examination. Results: No difference in periodontitis prevalence existed between the study groups. However, patients with DM had an increased risk of suffering from generalized periodontitis (adjusted odds ratio = 4.05; 95% confidence interval = 1.24 to 13.18; P = 0.02), and their PON‐1 activity was reduced compared to controls. In contrast, patients with pre‐DM showed neither an increased periodontitis risk nor an impaired paraoxonase status. PON‐1 was not associated directly with periodontitis. Nevertheless, concerning patients with DM, poor oral hygiene, male sex, and PON‐1 phenotype were found to be significant predictors for periodontitis extent. Conclusions: Type 2 DM, but not a prediabetic state, increases the risk of generalized periodontitis. PON‐1 status in patients with type 2 DM may contribute to this association.     

Periodontal disease and pre-eclampsia: a systematic review

AIM: This review evaluates the possible relationship between periodontal disease and pre-eclampsia, a major pregnancy complication. A generalized inflammatory response plays an important role in the pathogenesis of pre-eclampsia. Because periodontal disease is a low-grade inflammatory state, periodontal disease might contribute to the pathogenesis of pre-eclampsia. MAIN FINDINGS AND CONCLUSION: A literature search of PubMed, EMBASE and CINAHL until August 2010 revealed 12 eligible observational studies and three randomized-controlled trials (RCTs). It appeared difficult to compare these studies, due to variations in definitions of periodontal disease and pre-eclampsia, timing of periodontal examination and inadequate control for confounding factors. Eight observational studies reported a positive association, while four studies found no association. None of the RTCs reported reductions in pre-eclamptic rate after periodontal therapy during pregnancy. Therefore, it is questionable whether periodontal disease plays a causal role in the pathogenesis of pre-eclampsia. The observed association in eight observational studies might be the result of induction of periodontal disease due to the pre-eclamptic state or it may be an epiphenomenon of an exaggerated inflammatory response to pregnancy. Larger RCTs with pre-eclampsia as the primary outcome and pathophysiological studies are required to explore causality and to dissect biological mechanisms involved.     

Embryology of the central part of the face, closure of palate folds, and the maxillo-septal syndrome

A bstract — The development of the central part of the face was studied in the embryonic stages from the CR 10 mm length stage to the CR 30 mm length stage with particular attention to the development and disappearance of the nasal fin and its association with cleft lip. Two embryos with cleft of the primary palate are described, and a skull with congenital absence of the primary palate. Synchronous and asynchronous closure of the palate folds and the probable aetiology of the maxillo-septal syndrome are described.     

Oral health activities of early head start teachers directed toward children and parents

Objectives: This cross‐sectional study examined Early Head Start (EHS) teachers' oral health program activities and their association with teacher and program characteristics. Methods: Self‐completed questionnaires were distributed to the staff in all EHS programs in North Carolina. Variables for dental health activities for parents (four items) and children (four items) were constructed as the sum of responses to a 0‐4 Likert‐type scale (never to very frequently). Ordinary least squares regression models examined the association between teachers' oral health program activities and modifiable teacher (oral health knowledge, values, self‐efficacy, dental health training, perceived barriers to dental activities) and program (director and health coordinator knowledge and perceived barriers to dental activities) characteristics. Results: Teachers in the parent (n = 260) and child (n = 231) analyses were a subset of the 485 staff respondents (98 percent response rate). Teachers engaged in child oral health activities (range = 0‐16; mean = 9.0) more frequently than parent activities (range = 0‐16; mean = 6.9). Teachers' oral health values, perceived oral health self‐efficacy, dental training, and director and health coordinator knowledge were positively associated with oral health activities (P < 0.05). Perceived barriers were negatively associated with child activities (P < 0.05). Conclusion: The level of oral health activity in EHS programs is less than optimal. Several characteristics of EHS staff were identified that can be targeted with education interventions. Evidence for effectiveness of EHS interventions needs to be strengthened, but results of this survey provide encouraging findings about the potential effects of teacher training on their oral health practices.     

Regulatory compliance in the dental office

Dentists in the private sector, as well as their academic counterparts, must comply with a variety of federal, state, and local regulations. The scope of this regulation ranges from specifying who may engage in the practice of dentistry to the disposition of extracted teeth. In this review, some requirements imposed by various regulatory agencies are described. Because of the importance of state and local oversight, each clinician must determine what state and local requirements exist for them. A number of states have enacted various regulations that are more stringent than the federal versions. It is necessary, therefore, to seek appropriate local counsel regarding applicable statutes and regulations.