Risk behaviors and their association with presence of S.mutans or S.sobrinus and caries activity in 18-month-old Japanese children

The purpose of this study was to investigate risk behaviors associated with the presence of S. mutans or S. sobrinus and caries activity. The subjects were 448 mother-child pairs who underwent dental health examinations between February 2004 and November 2004 when the children were 18 months old. Caries activity was assessed by the Cariostat test. The presence of S. mutans and S. sobrinus was detected using PCR techniques. Questionnaires regarding risk behaviors were completed by the mothers. A statistically significant correlation was found for the detection of S. mutans and/or S. sobrinus in children and mothers (P < 0.01). High-risk mothers were more likely to have high-risk children (P < 0.001). In children in whom bacteria were detected, breast-feeding was ranked as the most important risk factor (P < 0.01), followed by eating snacks while playing (P < 0.01), getting snacks from neighbors (P < 0.05), being cared for by grandparents (P < 0.05) and pre-chewing of children's food by mothers (P < 0.05). In children with high caries risk, breast-feeding and pre-chewing were the most important risk factors (P < 0.01), followed by taking meals at irregular intervals and mothers not attending maternity classes (P < 0.05).     

Risk behaviors and its association with caries activity and dental caries in Japanese children

The aim of this study was to assess risk behaviors and its association with caries activity and dental caries in Japanese children. The subjects were 392 young Japanese children who underwent dental health check-up at 18, 30 and 42 months of age. Oral examinations, Cariostat tests and dental health questionnaires were carried out at each time. The caries prevalence of children was 1.5% at 18 months, 9.9% at 30 months and 28.1% at 42 months. Caries activity based on the Cariostat scores of children was correlated with caries status (caries-free/carious) at 42 months. In children with caries during each examination period at 42 months, eating snacks while playing was ranked as the most important behavioral risk (P < 0.001), followed by breast-feeding (P < 0.01), non setting of time for snacks (P < 0.05) and frequency of snacks (P < 0.05) at 18 months old; non brushing by mother (P < 0.05) and eating snacks while playing (P < 0.05) were ranked highest at 30 months old. In addition, eating snacks while playing (P < 0.001) at 42 months old was the only a significant factor for children with caries. Caries activity and risk behaviors were associated with caries experience at different age periods of childhood.     

In vivo comparison between measurement from two fluorescence-based devices of occlusal and smooth surface caries in primary and permanent teeth

Fluorescence-based devices are adjunct tools for caries detection. Both DIAGNOdent 2095 (LF) and DIAGNOdent 2190 (LF pen) were developed for this application. The purpose of this in vivo study was to compare the relationship between the measurements obtained using the LF and LF pen devices in primary and permanent teeth. The same sample of occlusal and smooth surfaces caries were evaluated by one examiner using both LF and LF pen devices in children. For occlusal caries, measurements were made at 51 sites in primary teeth, and at 83 sites in permanent teeth. For smooth surface caries, measurements were made at 63 sites in primary teeth, and 163 sites in permanent teeth. The values obtained with the LF pen for occlusal caries in primary and permanent teeth (17.6 ± 2.14, 20.6 ± 1.40, respectively) were significantly higher than those obtained with the LF (9.7 ± 1.24, 11.3 ± 0.78). For caries on smooth surfaces, the values obtained with the LF pen for primary and permanent teeth (8.2 ± 1.22, 7.2 ± 0.45) were higher than those obtained with the LF (4.5 ± 0.57, 3.3 ± 0.23). For both occlusal and smooth surface caries, the values were significantly different between the two devices (P < 0.01). The Spearman's correlation coefficients comparing the LF and LF pen values for primary and permanent teeth were Rs = 0.87 and 0.86 for occlusal caries and 0.80 and 0.74 for smooth surface caries, respectively. Values from both devices showed high correlation coefficients, indicating similar principle of function. However, the actual values were significantly different, which indicated that the values obtained with the two devices did not agree. The LF pen should be used with caution in patients for whom the LF is already being used to manage caries.     

Age-related changes of pulpal blood flow in primary teeth measured by laser Doppler blood flowmetry

The purpose of the present study was to examine age-related change of the pulpal blood flow (PBF) in human primary teeth. PBF of 21 healthy upper primary central incisors in 12 children (age: 3 years 11 months–7 years 3 months) was measured by laser Doppler flowmetry (LDF). Recordings were made with and without opaque black rubber dam application. On 10 of the examined teeth, repeated measurements were made on different occasions: twice on 4 teeth (3 subjects) and 3 times on 6 teeth (3 subjects). The results obtained were as follows: PBF with dam application was significantly decreased with increasing age of the subjects (P < 0.05, Spearman ranks order correlation, n = 21). In the repeated measurements, PBF showed a tendency of decrease with age. These results indicate that PBF in human primary incisors is reduced with age.     

Strength of tunnel-restored teeth with different materials and marginal ridge height

ObjectiveThe aim of the study was to investigate the strength of the marginal ridge of tunnel preparations with different marginal ridge heights, using different restorative materials.Materials and methods120 sound premolars were randomly divided into three groups of standardized tunnel preparations with a remaining marginal ridge height of 1.5 mm, 2.5 mm and 3.5 mm, respectively. In each tunnel group, 10 teeth were filled with all four newly developed adhesive materials that had not previously been used in tunnel preparation: Ketac Aplicap, Fuji IX, Fuji II LC and Beautifil Flow F02. The control group comprised 10 sound teeth. All teeth were subjected to incremental dynamic force testing. Remaining marginal ridge height and restoration material were the independent variables. The mean maximum energy (MEI) score was the dependent variable. Data were analyzed, using one- and two-way analysis of variance. Scheffe's test and Student's t-test were used for comparison between groups.ResultsBoth restorative material (P < 0.0001) and remaining marginal ridge height (P < 0.0001) had a statistically significant effect on the mean MEI score of tunnel-prepared teeth. At the 2.5 mm of remaining marginal ridge height, no statistically significant difference in mean MEI score existed between Beautifil Flow F02-filled tunnel-prepared teeth and sound teeth.SignificancePremolars tunnel-restored with Beautifil Flow F02 at 2.5 mm distance from the marginal ridge were as strong as sound teeth.     

Complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia in pediatric cleft lip and palate surgery: a randomized comparison study

Careful choice of anesthetic agents in pediatric patients reduces the frequency of anesthesia-related complications. The frequency and type of intraoperative and postoperative complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia were compared in 140 consecutive children (aged 3 months to 10 years) undergoing cleft lip and palate repair. Midazolam–fentanyl anesthesia was induced with midazolam (0.05 mg/kg), fentanyl (0.005 mg/kg) and vecuronium (0.1 mg/kg), and maintained with the same agents according to the defined parametars. Sevoflurane–fentanyl anesthesia was induced and maintained with sevoflurane (5–8 vol% and 0.8–1 vol%, respectively) in an oxygen/air mixture and supplemented with fentanyl (0.005 mg/kg). Both groups were comparable in basic demographic data, hemodynamic and respiratory parameters. Difficult intubation occurred in 6 of 76 children (midazolam–fentanyl group) and 4 of 64 children (sevoflurane–fentanyl group) (P = 0.754). Ventricular extrasystole and bronchospasm occurred in one patient each in the sevoflurane–fentanyl group. Postoperatively, emergence agitation was observed in the sevoflurane–fentanyl group (17 cases; P < 0.001); postoperative nausea and vomiting occurred in 2 children (midazolam–fentanyl group) and 3 children (sevoflurane–fentanyl group) (P = 0.660). Midazolam-based anesthesia in children is safer than sevoflurane-based anesthesia regarding occurrence of emergence agitation.     

A Study of dental caries prevalence in 12–14 year old school children in Ibadan,Nigeria

The aim of the study was to determine dental caries prevalence among a representative sample of 12–14 year old school children in Ibadan, Nigeria with a view of determining Restorative Index and Met Need Index of the studied population. Dental caries was diagnosed according to the WHO method. Out of the 577 children in the age group, 65 children (11.2%) had dental caries experience as expressed with the DMFT index. More than 85% of the children were caries free. A mode of one DMFT was the highest score for the children although a 14-year-old pupil had DMFT score of 6. Female children had higher mean DMFT score of 2.03 ± 1.13 compared with 1.78 ± 1.0 for males (P > 0.05). The Restorative Index (RI) and Met Need Index (MNI) for the children were very low as only the 14-year-old children had an RI of 3.45% and MNI of 0.11. Restorative Index reflects the restorative care of those who have suffered the disease and it is measured as a ratio of filled to filled plus decayed teeth percent that is F/F+D percent. Met Need Index is an indication of treatment received by an individual and it is measured by the ratio of the mean missing plus filled teeth to mean decayed, missing and filled teeth that is M+F/DMF. Since cost of management, which may be out of the reach of these children, has been identified as one of the factors militating against their receiving treatment, the result of this study suggest that oral health education with emphasis on correcting snacking habits of school children is desirable.     

An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study

AimTo evaluate the microleakage of recently available glass ionomer based restorative materials (GC Fuji IX GP, GC Fuji VII, and Dyract) and compare their microleakage with the previously existing glass ionomer restorative materials (GC Fuji II LC) in primary and permanent teeth.MethodOne hundred and fifty (75 + 75) non-carious deciduous and permanent teeth were restored with glass ionomer based restorative materials after making class I cavities. Samples were subjected to thermocycling after storing in distilled water for 24 h. Two coats of nail polish were applied 1 mm short of restorative margins and samples sectioned buccolingually after storing in methylene blue dye for 24 h. Microleakage was assessed using stereomicroscope.ResultSignificant differences (P < 0.05) were found when inter group comparisons were done. Except when GC Fuji VII (Group III) was compared with GC Fuji II LC (Group II) and Dyract (Group IV), non-significant differences (P > 0.05) were observed. It was found that there was no statistically significant difference when the means of microleakage of primary teeth were compared with those of permanent teeth.ConclusionsGC Fuji IX GP showed maximum microleakage and GC Fuji VII showed least microleakage.     

Assessment of gingival biotype and facial hard/soft tissue dimensions in the maxillary anterior teeth region using cone beam computed tomography

ObjectiveThis study sought to assess the relationship between facial gingival and bone dimensions in maxillary anterior teeth region using cone beam computed tomography (CBCT).DesignThis study assessed 621 maxillary anterior teeth in 144 patients. In the sagittal plane, facial bone thickness (BT) and gingival thickness (GT) were measured at the crestal level and at 2, 4 and 6 mm apical to the cementoenamel junction (CEJ). The dentogingival complex (DGC) dimensions and the distance from the CEJ to bone crest were also measured on CBCT scans. To determine the gingival biotype, GT at 2 mm apical to the gingival margin was measured and GT <1.5 mm was categorized as thin while GT ≥1.5 mm was categorized as thick. The data were analyzed using SPSS version 21 via repeated measures ANOVA and the Cochrane’s Q, chi-square and independent samples t-tests.ResultsThe BT around the maxillary central and lateral incisors and canine teeth at 4 and 6 mm apical to the CEJ was significantly different in thick and thin gingival biotypes (P < 0.05). The mean GT at 2 and 4 mm apical to the CEJ was significantly different around central and lateral incisors (P < 0.05). Thickness of crestal bone was significantly different between the two gingival biotypes around central and lateral incisors (P < 0.05).ConclusionThe two gingival biotypes had significantly different mean BT; different biotypes and their relationship to BT varied around anterior maxillary teeth.     

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.     

Preoperative plasma fibrinogen predicts cervical metastasis in patients with stage I/II carcinoma of the tongue

The aim of this study was to evaluate the association of preoperative plasma fibrinogen levels with clinico-pathological parameters and disease-free survival in patients with oral tongue squamous cell carcinoma (OTSCC). We retrospectively studied 76 patients with OTSCC who underwent a partial glossectomy only, at a single centre, between 1996 and 2007. Among the 76 patients, 30 eventually developed cervical metastasis. Preoperative plasma fibrinogen levels were determined and correlated with clinico-pathological findings by t-test or analysis of variance methods. Univariate and multivariate analyses were used to determine the association of preoperative plasma fibrinogen levels and disease-free survival. Elevated levels of plasma fibrinogen were positively related with growth type (P < 0.001), differentiation (P < 0.001), thickness (P < 0.001), and the infiltrative growth ratio (P = 0.032). Univariate analysis showed that growth type (P < 0.001), differentiation (P < 0.001), thickness (P < 0.001), and preoperative plasma fibrinogen levels (P < 0.001) were significantly correlated with disease-free survival. Multivariate analysis showed that the plasma fibrinogen level remained an independent factor for disease-free survival after partial glossectomy for OTSCC (P = 0.029). A high preoperative plasma fibrinogen level is an independent predictor of cervical metastasis after partial glossectomy for OTSCC. A conservative supraomohyoid neck dissection is appropriate in patients with stage I/II carcinoma of the tongue whose preoperative plasma fibrinogen is >300 mg/dl.     

Intraligamentary anaesthesia as a possible anaesthetic option in oral implantology: a retrospective analysis

This investigation was conducted to analyse the usefulness of intraligamentary anaesthesia (ILA) as an alternative anaesthetic procedure in oral implantology. Forty consecutive patients with single-tooth gaps in the posterior mandible were included in the analysis. Implant insertion was performed after ILA of the gap-delimiting teeth (two injections distal to the mesial tooth, two injections mesial to the distal tooth). Implant surgery was performed successfully under ILA of the gap-delimiting teeth in 39 cases. Injection pain correlated significantly with lower periodontal probing depths (<3 mm) of the delimiting teeth (P = 0.003). The total amount of anaesthetic solution and the pain during surgery were significantly higher if a root canal-treated tooth was present in the area of surgery (P = 0.010 and P = 0.020, respectively). Overall, the mean pain score during treatment was low at 0.76 ± 0.51 on a numerical rating scale from 0 to 10. At the control visit, no major complication was encountered. All implants were successfully restored with single crowns after a healing period of 2 months. Taking into consideration the limitations of the study, ILA seems to fulfil all conditions to be defined as an alternative, minimally invasive anaesthetic technique for the insertion of single-gap implants.     

Effect of grape seed proanthocyanidins extract on alteration of mechanical properties of metaphysis tibia bone in rats fed a low-calcium diet

The effects of grape seed proanthocyanidins extract (GSPE, 3 mg in 100 g of high-calcium diet with a calcium content of 1697 mg/100 g) on rat metaphysis tibia formation following feeding of a low-calcium diet (30% of calcium in the standard diet) were investigated by examining bone density, mineral content, geometric and bone strength. Five-week old male Wistar rats (n = 40) were randomly divided into a control (Co) group, a low-calcium diet (LC) group, a low-calcium diet • high-calcium diet (LCH) group, and a lowcalcium diet • high-calcium diet with supplementary GSPE (LCHG) group. The metaphysis tibia bones were analyzed using three-dimensional peripheral quantitative computed tomography (pQCT), while whole tibia bones were tested for mechanical resistance using a material testing machine. We found no significant differences in body weight among the 4 groups. All bone parameters in the LC group were significantly lower than these in the Co group (P < 0.01). Furthermore, trabecular bone density (TrBD), trabecular bone mineral content (TrBMC), cross-sectional moment of inertia to the reference axis y (yCSMI), and stress-strain index to the reference axis x (xSSI) in the LCHG group were significantly higher than those in the LCH group (P < 0.05; P < 0.01; P < 0.05; P < 0.05, respectively), while stiffness in the LCHG and LCH groups were significantly higher than that in the LC group (P < 0.01). We concluded that a mixture of high-calcium and GSPE in the diet has a more beneficial effect on bone formation for the treatment of metaphysis tibia bone debility in rats than does a high-calcium diet alone.     

Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants

Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P < 0.05). No statistically significant difference in pink aesthetic score (P = 0.379, 6 months postoperative) or marginal bone loss (P = 0.449 at 3 months postoperative, P = 0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P < 0.0001) and the time to complete the surgical procedure (P = 0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.     

Associations between caries activity,salivary buffer tests and caries increment in Mongolian children

The aim of the study was to evaluate caries increment in combination with a caries activity test (CAT21 Test) and a salivary buffer test (CAT21 Buf Test)—to predict future caries activity in Mongolian preschool children living in Ulaanbaatar City. The effectiveness of combining both tests and deft (decayed, extracted, filled teeth) means was also investigated. The caries prevalence in subjects was 94%, and deft mean value was 6.8. The caries increment after one year was 2.3 teeth. From the distribution of CAT21 Test scores a low risk was found in 38.6% and high risk in 61.4% of the examined children. From the CAT21 Buf Test scores, the high risk (lower buffer capacity) was found in 79.8% of the examined children. When the combination CAT21 Test and CAT21 Buf Test scores were divided into four groups (low-low/lowhigh/ high-low/high-high), the mean def-teeth showed a significant difference among the four groups (ANOVA P < 0.001). One year after the caries increment was evaluated in combination with the CAT21 Test scores and CAT21 Buf Test scores, the low-low risk group showed the lowest mean def-teeth. On the other hand, the high-high risk group showed the highest mean def-tooth (ANOVA P < 0.05). Based on these results, the CAT21 Test and CAT21 Buf Test are useful for clinical application of preschool children in predicting future caries activity. Furthermore, when the CAT21 Test and the CAT21 Buf Test were combined, a higher correlation was shown with the caries status.     

Effect of storage in artificial saliva and thermal cycling on Knoop hardness of resin denture teeth

PurposeThis study aimed to evaluate the effect of different storage periods in artificial saliva and thermal cycling on Knoop hardness of 8 commercial brands of resin denture teeth.MethodsEigth different brands of resin denture teeth were evaluated (Artplus group, Biolux group, Biotone IPN group, Myerson group, SR Orthosit group, Trilux group, Trubyte Biotone group, and Vipi Dent Plus group). Twenty-four teeth of each brand had their occlusal surfaces ground flat and were embedded in autopolymerized acrylic resin. After polishing, the teeth were submitted to different conditions: (1) immersion in distilled water at 37 ± 2 °C for 48 ± 2 h (control); (2) storage in artificial saliva at 37 ± 2 °C for 15, 30 and 60 days, and (3) thermal cycling between 5 and 55 °C with 30-s dwell times for 5000 cycles. Knoop hardness test was performed after each condition. Data were analyzed with two-way ANOVA and Tukey's test (α = .05).ResultsIn general, SR Orthosit group presented the highest statistically significant Knoop hardness value while Myerson group exhibited the smallest statistically significant mean (P < .05) in the control period, after thermal cycling, and after all storage periods. The Knoop hardness means obtained before thermal cycling procedure (20.34 ± 4.45 KHN) were statistically higher than those reached after thermal cycling (19.77 ± 4.13 KHN). All brands of resin denture teeth were significantly softened after storage period in artificial saliva.ConclusionStorage in saliva and thermal cycling significantly reduced the Knoop hardness of the resin denture teeth. SR Orthosit denture teeth showed the highest Knoop hardness values regardless the condition tested.     

Comparative study of the effect of warm saline mouth rinse on complications after dental extractions

The aim of the present study was to determine the effect of saline mouth rinse on postoperative complications following routine dental extractions. Patients aged ≥16 years, who were referred to the oral surgery clinic with an indication for non-surgical extraction of pathologic teeth, were prospectively and uniformly randomized into three groups. Group A (n = 40) were instructed to gargle six times daily with warm saline and group B (n = 40) twice daily; group C (n = 40) were not instructed to gargle with warm saline and served as controls. Information on demographic characteristics, indications for extraction, and the development of complications, such as alveolar osteitis, acute inflamed socket, and acute infected socket, was obtained and analyzed. There were no significant differences between patients who gargled six times daily with warm saline and those who gargled twice daily with reference to either alveolar osteitis or acute inflamed socket (P > 0.05). However saline mouth rinses at either frequency were beneficial in the prevention of alveolar osteitis in comparison with those who did not rinse. A twice-daily saline mouth rinse regimen is more convenient, and patient compliance may be better than with a six times daily rinse regimen.     

Racial disparity of Crouzon syndrome in maxilla and mandible

The racial disparity of facial features in craniosynostosis patients is not fully understood. The aim of this study was to explore the difference in maxillary and mandibular morphology and spatial position in Asian and Caucasian Crouzon syndrome patients. Ninety-one computed tomography scans were included (12 Asian Crouzon syndrome patients, 22 Asian controls; 16 Caucasian Crouzon syndrome patients, 41 Caucasian controls) and measured using Materialise software. The maxillary and mandibular volumes of Asian patients were both reduced by 19% (P = 0.102 and P = 0.187), and those of Caucasian patients were reduced by 15% (P = 0.142) and 14% (P = 0.211) when compared to the respective race-specific controls. Maxilla length of Asian patients was reduced by 6.36 mm (14%, P = 0.003), while the reduction in Caucasian patients was 4.88 mm (10%, P = 0.038). ANS was retracted 11.99 mm (P < 0.001) in Asian patients and 11.54 mm (P < 0.001) in Caucasian patients. The ANB angle was narrowed by 13.17° (P < 0.001) in Asian patients compared to Asian controls, and by 7.02° (P < 0.001) in Caucasian patients compared to Caucasian controls. The retrusive midface profiles of Asian and Caucasian Crouzon syndrome look similar; both result from the combined effect of hypoplastic size and backward displacement. However, the insufficiency was found to be more a failure of the anteroposterior maxillary length in Asian patients, and more due to posterior maxillary positioning in Caucasian patients. Therefore, prognathism in Crouzon syndrome patients is more likely caused by displacement rather than elongation of mandibular length in both races. Crouzon syndrome results in the same extent of overall volume deficiency of the maxilla and mandible in these races.     

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.     

‘Out of house’ virtual surgical planning for mandible reconstruction after cancer resection: is it oncologically safe?

The purpose of this study was to investigate whether the time delay between ‘out of house’ proprietary virtual surgical planning (OH-VSP) of the mandibular resection for oral cancer and the actual surgery results in compromised margins and oncological disadvantage for the patient. Outcomes of patients who had OH-VSP of their mandibular resection and reconstruction were compared with those of patients who had the same surgery using a conventional non-VSP approach. The groups were similar in patient demographics, tumour stage and size, nodal status, and reconstruction complexity. VSP resulted in a significant reduction in operating time (P < 0.01). VSP did not affect bony (P = 0.49) or soft tissue (P = 0.22) margin status. In summary, VSP reduced the operating theatre time, and despite the time interval between bony resection planning and surgery, there was no compromise to the oncological safety of the operation.