Is MRI a viable alternative to CT/CBCT to identify the course of the inferior alveolar nerve in relation to the roots of the third molars?

Clinical Oral Investigations - To assess the reliability of judging the spatial relation between the inferior alveolar nerve (IAN) and mandibular third molar (MTM) based on MRI or CT/CBCT images....     

Periodontal diseases: to protect or not to protect is the question?

For decades, investigations have identified local and systemic humoral immune responses to microorganisms comprising the supra- and subgingival biofilms in the oral cavity. Inflammation and tissue destruction in the periodontium are accompanied by alterations in the quantity, quality, and specificity of antibody. The conundrum in this scenario is the existence of a substantial plasma cell infiltrate at sites of periodontal lesions and a seemingly robust antibody response in the oral cavity and the serum, apparently coincident with progressing disease. Consequently, much effort has been expended to elucidate the critical characteristics of protective humoral responses and to develop strategies for enhancing these unique features. We and others have conducted studies attempting to distinguish disease susceptibility associated with: i) variations in response levels significantly increased to some species with disease, minimal response to others; ii) functional comparisons of antibody subclass differences, genetic regulation, and maturation of responses; iii) microbial and antigenic specificity of the antibody focus on specific pathogens and identification of selected antigens as targets for immunoprotection; and, iv) kinetics of responses during disease and therapeutic interventions linking immune changes with infection and as a measure of treatment success. This report summarizes varied research designs and results, to provide a profile of antibody in health, gingivitis, and periodontitis. These profiles may be used to provide a framework focusing on the humoral response to commensal microorganisms and likely pathogens, as they emerge in the biofilm--etiologic for or in response to disease processes. Models for antibody as a diagnostic adjunct and for predicting protective antibody responses are suggested. These concepts are likely relevant for considering vaccine approaches to periodontitis.     

What does saliva represent to the dentist?

Despite the undoubtedly large impact of saliva on the patient's oral health, little is known about its exact properties and role. More research has been put into serum, when compared to saliva, although that is changing. More and more researchers are interested in the role of certain proteins or electrolytes in an oral disease process. Besides the purely laboratory research, practitioners are also interested in the bacterial colonisation of the oral fluids, especially in assessing a patient's caries risk. The use of bacterial chair-side tests illustrates this aspect of progression in oral health care. For the dental professional, saliva is an important ally in preventing dental caries and mucositis. The lubrication properties and antibacterial/antiviral function of saliva play an important role in the protection of the oral cavity. These aspects may be suppressed in some medically compromised patients. In those cases, the dental professional is faced with a challenge to solve the oral health problems.     

Where's the best place to be born?

A series of large city rankings developed from federal agency reports were reviewed to increase appreciation of the factors that impact the general health of newborns. Efforts to provide the "right start" for the beginning of life may decrease the incidence of children with developmental disabilities.     

CHERI: time to identify the syndrome?

Chiari I malformations are congenital abnormalities that are etiologically heterogeneous. Some studies recognize a probable association between Chiari 1 malformation, delayed language or motor development, and mental retardation with or without epilepsy. The present patient appeared to have an isolated cleft palate and Chiari 1 malformation with co-existing functional and behavioral disorders (i.e., speech delay, mental retardation, and deviant electroencephalography [EEG]). In consideration of the cleft palate population, the implication of the present case study is that more attention should be paid to the developmental milestones in children with cleft palate. Because several cases of Chiari I anomaly co-occurring with mental retardation and deviant EEG or epilepsy have been recognized, it appears justified to identify a syndrome, which is here called CHERI (Chiari 1 malformation with or without cleft palate, deviant EEG or epilepsy, and retarded intelligence with delayed language development). It will be important in the future to describe those cases identified to delineate the clinical picture and to estimate the frequency of the occurrence of various characteristics.     

Does the dental profession know how to care for the primary dentition?

Across the UK many thousands of young children regularly attend the GDS for routine dental care. Once in the dental surgery the same story is repeated countless times - preventive advice is delivered, reassurance given, caries is treated and the case notes are written up by the dentist. The whole interaction is a largely unremarkable event and is accepted by patient, parent and dentist. The records of all these individual clinical episodes remain within each practice and until a patient returns for further care can expect to lay undisturbed.     

Duties to the Patient and Beyond: Where is the Line Drawn?

The decisions in two recent Australian cases, emphasize the tendency for the Courts to place weight on the reliance of patients and others, to act on the advice provided by practitioners. In doing so, the duty of the practitioner to his or her patient has been extended to include third parties such as the patient's sexual partner and the patient's parents. Additionally, the decisions have shown that practitioners need to maintain a level of knowledge in the provision of advice expected of a professional as patients rely heavily on the information provided by the practitioners. This may include information that is available on the Internet.     

Introduction to the Invited （International） Editorial Members

ProfessorMasahikoMoriProfessorMasahikoMoriwasbornonAugust25,1928inKobe,Japan.HegraduatedfromtheOsakaDentalCol鄄lege(DDS)in1950,andcompletedaPh.D.inpathologicalresearchattheOsakaUniversityMedicalSchoolin1958.Duringhisstudies,hewasappointedasInstructor,AssistantandAssociatePro鄄fessoroftheDepartmentofOralSurgeryattheOsakaUniversitySchoolofDentistryuntil1971.Dr.MorimovedtoAsahiUniversitySchoolofDentistryasaProfessorandChairmanoftheDepartmentofOral-MaxillofacialSurgeryuntil1996.He…     

C‐1 esterase inhibitor dysfunction localised to the periodontal tissues: clues to the role of stress in the pathogenesis of chronic periodontitis?

BACKGROUND: C1-esterase inhibitor (C1eIn) is an important modulator of complement activation via the classical pathway. Deficiencies or dysfunction involving this inhibitor underlie the condition of angioneurotic oedema. AIM: The purpose of this report is to describe a female patient who presented at the age of 24 years with an apparently aggressive form of periodontitis and severe oedema, localised to the free gingival tissues. After 21 years of repeated surgical reduction of the gingiva, a diagnosis of C1eIn dysfunction was made. METHODS: Exhaustive serological investigations were performed along with histopathology. RESULTS: All investigations were unremarkable, until the function of the C1eIn molecule was investigated. These demonstrated a functional activity of only 29% and a raised C1q at 157 mg/l. Subsequent repeated investigation with careful specimen handling demonstrated undetectable levels of C1eIn and normal C1q. A diagnosis of C1eIn dysfunction was made, although at present it is unclear whether this represents an unusual variant of hereditary dysfunctional C1eIn deficiency. The patient was managed by various means, including steriodal and non-steroidal drugs, the latter forming part of her maintenance regime. CONCLUSIONS: To our knowledge, this is the first case of angio-oedema localised to the free gingiva. The role of stress in the acute exacerbations of oedema and bone loss is discussed along with the diagnostic pitfalls associated with this case.     

Introduction to the Invited(International) Editorial Member

StephenE.Feinberg,DDS,MS,PhDDr.FeinbergreceivedhisdentaltrainingatNewYorkUniversityandaMastersDe鄄greeinAnatomyfromtheU鄄niversityofMichigan.HecompletedaresidencyinOral&MaxillofacialSurgery,con鄄currentwithaPhDinExperi鄄mentalPathology,atStrongMemorialHospitalandtheU鄄niversityofRochesterMedicalCenter.HeisacertifiedasaDiplomateoftheAmericanBoardofOral&MaxillofacialSurgery.Dr.FeinberghaspreviouslybeenafacultymemberattheUniversityofIowaandTheOhioStateUniversityaswellaspastChai…