Antimicrobial peptides in saliva of children with severe early childhood caries

ObjectiveControversies exist regarding the relationship between the concentrations of antimicrobial peptides (AMPs) and presence of dental caries in children. Thus, the aim of this study was to examine levels of AMPs in saliva of caries-free (CF), early childhood caries (ECC) and severe early childhood caries (S-ECC) children to determine if the levels of these salivary peptides individually or in combinations were related to caries severity and mutans streptococci levels.Design36 to 60 month-old children were selected to participate in this study. Children were grouped into CF group (n = 29), ECC group (n = 25) and S-ECC group (n = 29). Saliva was collected from children for microbiological analysis by culture. Salivary concentrations of cathelicidin LL-37, human β-defensin 2 (hBD-2), human β-defensin 3 (hBD-3) and histatin-5 (HTN-5) were determined by ELISA.ResultsSalivary concentrations of AMPs did not differ among CF, ECC and S-ECC groups. Data showed positive correlations between mutans streptococci levels and salivary hBD-2 or HTN-5. Positive correlations were found between hBD-2, hBD-3, LL-37 and HTN-5. Combinations among AMPs, mainly LL-37, were positively associated with caries levels.ConclusionsSalivary concentrations of AMPs individually were not associated with the severity of early childhood caries. The stimulus of caries appears to trigger a biological response, however, with a combination of these peptides.     

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood

ObjectiveExplore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated.Design36–60 month-old children were grouped into Caries-Free (CF, n = 19), Early Childhood Caries (ECC, n = 17) and Severe Early Childhood Caries (S-ECC, n = 21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot.ResultsS-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group.ConclusionsThis study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.     

The effect of dietary intervention on paraffin-stimulated saliva and dental health of children participating in a randomized controlled trial

ObjectivesThe aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva, and on dental caries.Study designAt 7 months of age 1062 infants (540 intervention; 522 controls) started in the prospective, randomized Special Turku Intervention Project (STRIP) aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis of adult age (www.clinicaltrials.gov NCT 00223600). At 3 years of age, every fifth child was invited to an oral sub-study, and 148 (78 boys) children attended. At 6, 9, 12 and 16 years of age 135, 127, 114 and 88 children were restudied, respectively. Dietary intakes of carbohydrates, protein, saturated fat, calcium, phosphate, and fibre were regularly recorded using 4-day food records. Height and weight were regularly monitored. Paraffin-stimulated saliva samples were collected at 6, 9, 12 and 16 years of age, and analyzed for flow rate, buffer capacity, calcium, phosphate and proteins. Dental health was recorded and expressed as d₃mft/D₃MFT, and as time of caries onset.ResultsDietary intakes of calcium, phosphate and fibre, and salivary flow rate increased with time in both groups (p < 0.001, GLM for repeated measures). Fibre intake and salivary flow rate were higher in the intervention than in the control group (p = 0.042 and p = 0.0394, respectively, GLM for repeated measures). There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate. Children who did not have caries experience (d₃mft/D₃MFT = 0) during the entire follow-up had higher salivary calcium than those who had caries already at 3 years of age. The association between salivary calcium and caries onset was significant up to 12 years of age. Toothbrushing frequency was statistically significantly associated with caries-onset at ages 6 (gamma statistic 0.457, p = 0.046) and 12 years (gamma statistic 0.473, p = 0.019).ConclusionsThe current long-term dietary intervention increased children's paraffin-stimulated salivary flow rate. The concentration of salivary calcium was directly correlated to dental health. Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group.     

Quantitative assessment of salivary oral bacteria according to the severity of dental caries in childhood

This study aimed to assess differences in selected oral bacteria in children according to the severity of dental caries. One hundred and thirty-six children, 36–60 months old were divided into three groups according to caries status: caries-free (CF) (n = 47), early childhood caries (ECC) (n = 40) and severe-early childhood caries (S-ECC) (n = 49). Saliva was collected for detection and quantification of selected oral streptococci, Actinomyces naeslundii, Lactobacillus spp., Bifidobacterium spp., and Scardovia wiggsiae by quantitative-polymerase chain reaction. The results showed that the detection and quantitative levels of S. mutans, S. sobrinus, Bifidobacterium spp. and S. wiggsiae were significantly higher in S-ECC children compared to CF and ECC children, while for S. salivarius were significantly higher in CF compared to ECC and S-ECC children. There was no statistical difference among the clinical groups for S. mitis, S. oralis, A. naeslundii and Lactobacillus spp. levels and detection. S-ECC children had a lower monthly family income, started tooth brushing later and were breastfeed for a longer duration compared to CF children. S. mutans levels were positively correlated with S. wiggsiae and Bifidobacterium spp. levels, lower mother’s education and child bottle-feeding before sleeping and negatively correlated with S. salivarius. It was concluded that in addition to S. mutans, other bacterial species, including bifidobacteria, Scardovia wiggsiae and S. sobrinus, are associated with severity of early childhood caries, although their role in the progress of dental caries remains unclear.     

Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults

ObjectiveTo study the effect of orally administered Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosus GG on the salivary levels of Matrix Metalloproteinases (MMP)-8, MMP-9 and of Tissue Inhibitor of Metalloproteinases (TIMP)-1 in healthy adults. Furthermore, the correlations between MMP-8, MMP-9 and TIMP-1 and plaque and gingival indices, salivary mutans streptococci and lactobacilli counts, and stimulated saliva secretion rate were analysed.DesignThe salivary samples originated from a randomized controlled trial where healthy student volunteers consumed probiotic or placebo lozenges twice a day for four weeks. The saliva samples were collected and clinical parameters measured at the baseline and at the end of the original study. For this study, the salivary levels of MMP-8, MMP-9 and TIMP-1 were analysed with immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA).ResultsIn the probiotic group (n = 29), salivary MMP-9 levels increased (p < 0.01) and TIMP-1 levels decreased (p < 0.01) significantly during the intervention. Furthermore, MMP-9/TIMP-1 ratio differed significantly from the baseline level (p < 0.01). These changes were not observed in the control group (n = 31). In the whole data, salivary MMP-9 and gingival index correlated (r = 0.260, p < 0.05 at baseline and r = 0.354, p < 0.01 at the end of the study). Intergroup differences or correlations with other clinical parameters were not found. Probiotic consumption did not affect the saliva flow rate.ConclusionsIncreased MMP-9 and decreased TIMP-1 levels in saliva may indicate that probiotics have immunomodulatory effects in the oral cavity. Furthermore, increased salivary MMP-9 levels may be an indication of the defensive potential of matrix metalloproteinases.     

Effects of polyphosphates and fluoride on hydroxyapatite dissolution: A pH-stat investigation

ObjectivesThis study investigated the immediate and sustained effect of sodium trimetaphosphate (TMP) and sodium hexametaphosphate (HMP) associated or not with fluoride (F) on hydroxyapatite (HA) dissolution using an erosion-like model, considering as well as the influence of salivary coating.DesignBaseline dissolution rates were determined for HA discs using a pH-stat system. In the first set of experiments, HA discs were treated with 1100 μg F/mL, 1% or 8% of HMP, 1% or 8% of TMP and 1100 μg F/mL associated with 1% or 8% of HMP or TMP, totaling 9 groups (n = 8). In a second phase, HA discs were kept in pooled human saliva at 37 °C for 2 h before treatment with deionised water and 1100 μg F/mL associated with 1% or 8% of HMP or TMP, totaling 5 groups (n = 8). The post-treatment dissolution rate was determined from three consecutive 30-min assays. Data were analysed using 2 and 3-way ANOVA followed by Fisher and Holm–Sidak methods, respectively (α = 0.05).ResultsAll test solutions promoted reduction in HA dissolution rate when compared to baseline control in the first post-treatment run (p < 0.001). However, a synergistic effect was only observed between fluoride and 1% HMP. Moreover, the duration of inhibitory effect was greater when 8% HMP and 1 or 8% HMP associated with F were assessed (p < 0.001). The presence of salivary coating led to higher protection for all groups when compared to discs without coating (p < 0.001).ConclusionThe reduction of HA dissolution rate, as well as the duration of this effect were influenced by fluoride, type and concentration of phosphate salt and the presence of a salivary coating.     

The association of Enamelin,Lactoferrin, and Tumour necrosis factor alpha gene polymorphisms with high caries susceptibility in Chinese children under 4 years old

ObjectiveThe aim of this study was to assess the role of ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 in high caries susceptibility.DesignThe present case–control study included 1005 unrelated children under 4 years old: 505 with severe caries (dmft index ≥4) and 500 who were caries-free (dmft index = 0 and without white-spot lesions). Questionnaires were obtained from parents and gardians about the children’s diet and oral behavioural habits. All the children received dental examinations and oral swabbing for human genomic DNA collection. ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 were genotyped by Sanger sequencing.ResultsThe frequency of the ENAM rs3796703 T allele (6.7% in the caries group and 4.2% in the caries-free group), CT genotype (12.7% in the caries group and 8.4% in the caries-free group), TNF-α rs1800629 A allele (4.8% in the caries group and 6.8% in the caries-free group), and AG genotype (8.7% in the caries group and 13.2% in the caries-free group) were significantly different between the caries and caries-free groups (p < 0.05). No significant difference was found in the LTF rs1126478 allele frequency and genotype distribution between the two groups. The ENAM rs3796703 CT genotype increased caries susceptibility by 60.9% compared to the CC genotype (β = 0.746, OR = 1.609), and the TNF-α rs1800629 AG genotype reduced caries susceptibility by 47.4% compared to the GG genotype (β = −0.642, OR = 0.526). In terms of habits covariates, prolongation of night feeding time by 1 month increased caries susceptibility by 3.3% (β = 0.033, OR = 1.033); additionally, sweets and acidic drinks consumption 1–2 times per day increased caries susceptibility by 218.2% (β = 1.158, OR = 3.182), and consumption 3 or more times pe/r day increased susceptibility by 883.5% (β = 2.286, OR = 9.835) compared to non-consumption. Topical fluoride application decreased caries susceptibility by 43.0% (β = −0.562, OR = 0.570).ConclusionsThe ENAM and TNF-α genes are likely associated with caries experience in Chinese children. The ENAM rs3796703 CT genotype might be involved in caries susceptibility, while TNF-α rs1800629 AG genotype might be involved in caries protection.     

Genes expressed in dental enamel development are associated with molar-incisor hypomineralization

Genetic disturbances during dental development influence variation of number and shape of the dentition. In this study, we tested if genetic variation in enamel formation genes is associated with molar-incisor hypomineralization (MIH), also taking into consideration caries experience. DNA samples from 163 cases with MIH and 82 unaffected controls from Turkey, and 71 cases with MIH and 89 unaffected controls from Brazil were studied. Eleven markers in five genes [ameloblastin (AMBN), amelogenin (AMELX), enamelin (ENAM), tuftelin (TUFT1), and tuftelin-interacting protein 11 (TFIP11)] were genotyped by the TaqMan method. Chi-square was used to compare allele and genotype frequencies between cases with MIH and controls. In the Brazilian data, distinct caries experience within the MIH group was also tested for association with genetic variation in enamel formation genes. The ENAM rs3796704 marker was associated with MIH in both populations (Brazil: p = 0.03; OR = 0.28; 95% C.I. = 0.06–1.0; Turkey: p = 1.22e?012; OR = 17.36; 95% C.I. = 5.98–56.78). Associations between TFIP11 (p = 0.02), ENAM (p = 0.00001), and AMELX (p = 0.01) could be seen with caries independent of having MIH or genomic DNA copies of Streptococcus mutans detected by real time PCR in the Brazilian sample. Several genes involved in enamel formation appear to contribute to MIH.     

Effect of arginine on the growth and biofilm formation of oral bacteria

BackgroundAlkali production via arginine deiminase system (ADS) of oral bacteria plays a significant role in oral ecology, pH homeostasis and inhibition of dental caries. ADS activity in dental plaque varies greatly between individuals, which may profoundly affect their susceptibility to caries.ObjectiveTo investigate the effect of arginine on the growth and biofilm formation of oral bacteria.Methods and resultsPolymicrobial dental biofilms derived from saliva were formed in a high-throughput active attachment biofilm model and l-arginine (Arg) was shown to reduce the colony forming units (CFU) counts of such biofilms grown for various periods or biofilms derived from saliva of subjects with different caries status. Arg hardly disturbed bacterial growth of Streptococcus mutans, Streptococcus sobrinus, Streptococcus sanguinis and Streptococcus gordonii in BHI medium, but only inhibited biofilm formation of S. mutans. Scanning electron microscope (SEM) showed S. mutans biofilms harboured fewer cells grown with Arg than that without Arg, even in the initial 2 h and 8 h phase. Confocal laser scanning microscope (CLSM) images of poly-microbial dental and S. mutans biofilms revealed the biofilms grown with Arg had lower exopolysaccharide (EPS)/bacteria ratios than those without Arg (P = 0.004, 0.002, respectively). Arg could significantly reduce the production of water-insoluble EPS in S. mutans biofilms (P < 0.001); however, quantitative real-time PCR (qRT-PCR) did not show significantly influence in gene expression of gtfB, gtfC or gtfD (P = 0.32, 0.06, 0.44 respectively).ConclusionsArg could reduce the biomass of poly-microbial dental biofilms and S. mutans biofilms, which may be due to the impact of Arg on water-insoluble EPS. Considering the contribution to pH homeostasis in dental biofilms, Arg may serve as an important agent keeping oral biofilms healthy thus prevent dental caries.     

Sodium fluoride effect on erosion–abrasion under hyposalivatory simulating conditions

ObjectivesTo investigate the effect of fluoride (0, 275 and 1250 ppm F; NaF) in combination with normal and low salivary flow rates on enamel surface loss and fluoride uptake using an erosion–remineralization–abrasion cycling model.DesignEnamel specimens were randomly assigned to 6 experimental groups (n = 8). Specimens were individually placed in custom made devices, creating a sealed chamber on the enamel surface, connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min followed by artificial saliva at 0.5 (normal flow) or 0.05 (low flow) ml/min, for 60 min. This cycle was repeated 4×/day, for 5 days. Toothbrushing with abrasive suspensions containing fluoride was performed for 2 min (15 s of actual brushing) 2×/day. Surface loss was measured by optical profilometry. KOH-soluble fluoride and enamel fluoride uptake were determined after the cycling phase. Data were analysed by two-way ANOVA.ResultsNo significant interactions between fluoride concentration and salivary flow were observed for any tested variable. Low caused more surface loss than normal flow rate (p < 0.01). At both flow rates, surface loss for 0 was higher than for 275, which did not differ from 1250 ppm F. KOH-soluble and structurally-bound enamel fluoride uptake were significantly different between fluoride concentrations with 1250 > 275 > 0 ppm F (p < 0.01).ConclusionsSodium fluoride reduced enamel erosion/abrasion, although no additional protection was provided by the higher concentration. Higher erosion progression was observed in low salivary flow rates. Fluoride was not able to compensate for the differences in surface loss between flow rates.     

Efficacy of a mouthwash containing 0.8% arginine,PVM/MA copolymer,pyrophosphates, and 0.05% sodium fluoride compared to a commercial mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride and a control mouthwash containing 0.05% sodium fluoride on dentine hypersensitivity: A six-week randomized clinical study

ObjectiveEvaluate the efficacy of 0.8% arginine, potassium nitrate and sodium fluoride mouthwashes on dentine hypersensitivity reduction.MethodsSix week randomized, double blinded, two cell, parallel single centre clinical study in the Dominican Republic; subjects were randomized into three treatment groups: mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (arginine); mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride (potassium nitrate); a control mouthwash containing 0.05% sodium fluoride (negative control). Tactile and air-blast dentine hypersensitivity assessments were conducted at baseline, thirty minutes post rinsing and two, four, and six weeks of twice-daily product use. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise comparisons (α = 0.05) were done.ResultsSeventy-five subjects were enrolled; 69 subjects completed the study. There were no differences after thirty minutes of a single use, among the three groups with respect to mean tactile and air blast hypersensitivity scores compared to potassium nitrate and negative control mouthwashes (p < 0.05). The arginine group presented a statistically significant improvement in the mean tactile scores compared to potassium nitrate and negative control groups after two, four, and six weeks (p < 0.001) of product use; the arginine group showed a statistically significant enhancement in air blast hypersensitivity mean scores compared to potassium nitrate and negative control groups after two (p = 0.001), four (p < 0.001), and six weeks (p < 0.001) of product use.ConclusionA mouthwash containing arginine provides a significant and superior reduction in dentine hypersensitivity compared to potassium nitrate and a negative control mouthwash after two weeks.     

Promotion of enamel caries remineralization by an amelogenin-derived peptide in a rat model

ObjectiveAn amelogenin-derived peptide has been shown to promote remineralization of demineralized enamel in an in vitro model of initial caries induced by pH cycling. The present study examines whether the peptide exerts similar effects within the complex oral environment in vivo.DesignSpecific pathogen-free Sprague-Dawley rats (n = 36) were infected with Streptococcus mutans, given ad libitum access to Diet 2000 and drinking water supplemented with sucrose (10%, w/v), and then randomly divided into three groups treated with 25 μM peptide solution, 1 g/L NaF or deionized water. Molar teeth were swabbed twice daily with the respective solutions for 24 days. Then animals were killed, their jaws were removed and caries lesions were analyzed using the quantitative light-induced fluorescence-digital (QLF-D) technique to measure changes in mineral content. To verify QLF-D results, caries were scored for lesion depth and size using the Keyes method, and analyzed using polarized light microscopy (PLM).ResultsMineral gain was significantly higher in teeth treated with peptide or NaF than in teeth treated with water (p < 0.05), based on the QLF-D results (ΔF and ΔQ). Incidence of smooth-surface and sulcal caries based on Keyes scores was similar in rats treated with peptide or NaF, and significantly lower in these groups than in rats treated with water (p < 0.05). Lesions on teeth treated with peptide or NaF were shallower, based on PLM. No significant differences were observed between molar enamel caries treated with peptide or NaF.ConclusionsThis amelogenin-derived peptide can promote remineralization in a rat caries model, indicating strong potential for clinical use.     

Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children

ObjectiveTo compare the effectiveness of annual topical application of silver diamine fluoride (SDF) solution, semi-annual topical application of SDF solution, and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth.MethodsA total of 212 children, aged 3–4 years, were randomly allocated to one of three groups for treatment of carious dentine cavities in their primary teeth: Gp1-annual application of SDF, Gp2-semi-annual application of SDF, and Gp3-annual application of glass ionomer. Follow-up examinations were carried out every six months to assess whether the treated caries lesions had become arrested.ResultsAfter 24 months, 181 (85%) children remained in the study. The caries arrest rates were 79%, 91% and 82% for Gp1, Gp2 and Gp3, respectively (p = 0.007). In the logistic regression model using GEE to adjust for clustering effect, higher caries arrest rates were found in lesions treated in Gp2 (OR = 2.98, p = 0.007), those in anterior teeth (OR = 5.55, p < 0.001), and those in buccal/lingual smooth surfaces (OR = 15.6, p = 0.004).ConclusionAnnual application of either SDF solution or high fluoride-releasing glass ionomer can arrest active dentine caries. Increasing the frequency of application to every 6 months can increase the caries arrest rate of SDF application.Clinical significanceArrest of active dentine caries in primary teeth by topical application of SDF solution can be enhanced by increasing the frequency of application from annually to every 6 months, whereas annual paint-on of a flowable glass ionomer can also arrest active dentine caries and may provide a more aesthetic outcome.     

A new optical detection method to assess the erosion inhibition by in vitro salivary pellicle layer

ObjectivesApplication of the recently developed optical method based on the monitoring of the specular reflection intensity to study the protective potential of the salivary pellicle layer against early enamel erosion.MethodsThe erosion progression was compared between two treatment groups: enamel samples coated by the 15 h-in vitro-formed salivary pellicle layer (group P, n = 90) and the non-coated enamel surfaces (control group C, n = 90). Different severity of the erosive impact was modelled by the enamel incubation in 1% citric acid (pH = 3.6) for 2, 4, 8, 10 or 15 min. Erosion quantification was performed by the optical method as well as by the microhardness and calcium release analyses.ResultsOptical assessment of the erosion progression showed erosion inhibition by the in vitro salivary pellicle in short term acidic treatments (≤4 min) which was also confirmed by microhardness measurements proving significantly less (p < 0.05) enamel softening in the group P at 2 and 4 min of erosion compared to the group C. SEM images demonstrated less etched enamel interfaces in the group P at short erosion durations as well.ConclusionsMonitoring of the specular reflection intensity can be successfully applied to quantify early erosion progression in comparative studies. In vitro salivary pellicle (2 h) provides erosion inhibition but only in short term acidic exposures.Clinical significanceThe proposed optical technique is a promising tool for the fast and non-invasive erosion quantification in clinical studies.     

Salivary levels of calcium,phosphorus, potassium,albumin and correlation with serum biomarkers in hemodialysis patients

ObjectivesEvidences suggest that hemodialysis patients have reduced salivary flow and changes in the composition of salivary secretion. These changes may reflect local and systemic disorders. The objectives of this study were to compare the salivary levels of calcium (Ca), phosphorus (P), potassium (K) and albumin in hemodialysis patients and healthy subjects, and to investigate a possible correlation between their serum and salivary levels.DesignA case–control study was conducted with 60 hemodialysis patients (HD group) and 37 systemically healthy individuals (control group). Stimulated saliva samples were collected for biochemical analysis (Ca, P, K and albumin). Serum data were collected in the HD group. Statistical analysis included t-test, Pearson correlation and simple linear regression.ResultsThe HD group exhibited higher salivary levels of Ca, P, and albumin (p < 0.05). There was a significant positive correlation between serum PTH and salivary phosphorus (r = 0.342, p = 0.009), and between serum PTH and salivary potassium (r = 0.306, p = 0.020). An increase of 100 pg/dL in serum PTH was associated with an elevation of salivary P levels (0.34 mg/dL, p = 0.009), and salivary K levels (0.20 mmol/dL, p = 0.02), in the HD group.ConclusionsThe findings suggest that HD patients present increased levels of salivary components (Ca, P, and albumin), and changes commonly observed in HD patients, such as hyperparathyroidism, appear to have an influence on salivary composition.     

Macrophage activating factor: A potential biomarker of periodontal health status

ObjectiveIn periodontitis, activated macrophages not only initiate immune responses to periodontal-pathogen infections, but also damage the periodontal tissues by releasing a series of inflammatory cytokines. Macrophage-activating factor (MAF) and macrophage-chemotactic factor (MCF) are two important mediators involved in macrophage accumulation, activation and function. This study analyzed the levels of salivary MAF and MCF in healthy individuals and those with different periodontal diseases, and assessed the usefulness of salivary MAF and MCF as diagnostic biomarkers in periodontal tissue health status.DesignNinety-five saliva specimens were collected from healthy individuals (n = 19), and patients with gingivitis (n = 19), mild periodontitis (n = 17), moderate periodontitis (n = 20), and severe periodontitis (n = 20). Pocket probing depth (PPD) and alveolar bone loss (ABL) were recorded via periodontal probing and dental radiography, respectively. Salivary MAF and MCF concentrations were assayed using enzyme-linked immunosorbent assays.ResultsMAF level tended to increase in saliva as periodontal diseases progressed (healthy periodontium < gingivitis < mild periodontitis < moderate periodontitis < severe periodontitis). The concentration of salivary MAF in periodontitis correlated positively with ABL (r = 0.758) and PPD (r = 0.779). In contrast, salivary MCF levels increased significantly only in periodontitis.ConclusionsSalivary MAF levels correlate positively with tissue destruction in periodontal diseases. It is a potential valuable biomarker that could be used to assess periodontal health status.     

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A

ObjectiveTo evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations.DesignIn this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA.ResultsPoorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P < 0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5–6 mm were significantly higher in both diabetic groups compared to control group (P < 0.05). Poorly controlled T2DM group had significantly higher sites with CAL ≥ 7 mm than other groups (P = 0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P < 0.05). In both diabetic groups, probing depths 5–6 mm and CAL 5–6 mm were associated with higher salivary CHGA concentration (P < 0.05).ConclusionsThe findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL ≥ 7 mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.     

Relationship among microbiological composition and presence of dental plaque, sugar exposure, social factors and different stages of early childhood caries

Objective

This cross-sectional study aimed to investigate the relationship among microbiological composition of dental plaque, sugar exposure and social factors, as well as the presence of visible plaque in preschoolers with different stages of early childhood caries.

Design

A total of 169 children were clinically examined according to the World Health Organisation criteria + early caries lesions and were divided into three groups: caries-free (n = 53), early caries lesions-ECL (n = 56), and cavitated caries lesions-CCL (n = 60). The presence of clinically visible dental plaque on maxillary incisors was recorded. After that, dental plaque from all buccal and lingual smooth surfaces was collected and the number of colony-forming units of mutans streptococci and total microorganism, as well as the presence of lactobacilli was determined. Daily frequency of meals containing sugar was assessed by a diet chart whereas social factors were evaluated by a questionnaire. The data were analysed by chi-square test followed by multiple logistic regressions (α = 0.05, confidence interval = 95%).

Results

High levels of mutans streptococci (OR = 2.28), high total sugar exposure (OR = 5.45) and presence of dental plaque (OR = 2.60) showed significant association with ECL (p < 0.05). High total microorganism count (OR = 5.18), high solid sugar exposure (OR = 2.50) and the presence of lactobacilli (OR = 24.99) revealed significant association with CCL (p < 0.05).

Conclusions

These results support the conclusion that dietary sugar experience influenced the microbiological composition of dental plaque. Moreover, the early stage of caries is highly affected by mutans streptococci and visible dental plaque on maxillary incisors whereas cavities are strongly related to lactobacilli and total microorganism.     

Sex differentials in caries frequencies in Medieval London

ObjectiveTooth decay is one of the most common oral infections observed in skeletal assemblages. Sex differentials in caries frequency are commonly examined, with most studies finding that females tend to have a higher frequency of carious lesions (caries) compared to males. Less research has examined differences in caries between males and females with respect to age in past populations. Findings from living populations indicate that caries frequencies are higher in females, at least in part, because of the effects of estrogen and pregnancy. We are interested in the interaction of age, sex, and caries in medieval London, during a period of repeated famines, which might have exacerbated underlying biological causes of caries sex differentials.DesignWe examined caries in adults from two medieval London cemeteries dating to c. 1120–1539 AD: St. Mary Spital (n = 291) and St. Mary Graces (n = 80) to test the hypothesis that males and females have different caries frequencies irrespective of age. The association between maxillary molar caries and sex was tested using hierarchical log-linear analysis to control for the effects of age on caries frequencies.ResultsThe results indicate a higher frequency of maxillary molar caries in females (P < 0.00), and that the age distribution of caries differs between the sexes (P = 0.01), with a consistent increase in frequency with age for females until late adulthood, but not males.ConclusionsThe difference in caries frequencies is not explained by differences in the age distributions of the sexes. Differences in the age patterns of caries for males and females could be the result of biological factors that present during reproductive age, differences in diet, or differential access to resources during famine.     

Efficacy in reducing dentine hypersensitivity of a regimen using a toothpaste containing 8% arginine and calcium carbonate,a mouthwash containing 0.8% arginine,pyrophosphate and PVM/MA copolymer and a toothbrush compared to potassium and negative control regimens: An eight-week randomized clinical trial

ObjectiveEvaluate the efficacy of three regimens integrating toothpaste, toothbrush and mouthwash in reducing dentine hypersensitivity.MethodsEight-week single-centre, three-cell, double-blind, randomized study was conducted in the Dominican Republic. Subjects entered one of the three regimens: (1) toothpaste containing 8% arginine and 1450 ppm mono-fluorophosphate, in a calcium carbonate base, a soft-bristle toothbrush followed by a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride; (2) toothpaste containing 5% potassium nitrate and 1450 ppm sodium fluoride, a soft-bristle toothbrush, followed by a mouthwash containing 0.51% potassium chloride and 230 ppm sodium fluoride; and (3) toothpaste containing 1450 ppm mono-fluorophosphate, a soft-bristle toothbrush followed by a fluoride/arginine free mouthwash. Tactile and Air-Blast dentine hypersensitivity measurements were performed at baseline, two, four, and eight weeks. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise (α = 0.05) were used. Kaplan–Meier survival analysis was performed to evaluate Time to Treatment Improvement.Results120 subjects were enrolled, 118 completed the study. The Tactile hypersensitivity mean scores showed statistically significant improvement at two, four and eight (p ≤ 0.001) weeks in the arginine regime; the potassium regime did not show significant (p ≥ 0.05) improvement. Air-Blast Hypersensitivity scores had a statistically significant decrease at two (p = 0.006), four (p = 0.006) and eight (p = 0.002) weeks in arginine and potassium regimes (p ≤ 0.05). The most effective treatment proved to be arginine (p ≤ 0.05) compared to the potassium regime.ConclusionArginine regimen provided the greatest reduction in Tactile and Air-Blast dentine hypersensitivity compared to potassium and negative control regimens; and provides faster dentine hypersensitivity relief than potassium regimen.