K-antigens in Porphyromonas gingivalis are associated with virulence

We investigated antigens in spreading and non-spreading Porphyromonas gingivalis strains. On the basis of differences in virulence in the mouse model, 8 strains were selected for antiserum production in rabbits. Hyperimmune sera were tested by double immunoprecipitation and immunoelectrophoresis. Besides a common antigen, differences in antigenic composition were observed in the thermolabile antigens between all strains tested. Two different heat-stable antigens were found after heating at 120°C. One such antigen was detected after sonication of the pellet fraction of autoclaved P. gingivalis cells. This antigen cross-reacted with 6 of the 8 immune sera. This somatic antigen was almost neutrally charged and sensitive to sodium periodate treatment, suggestive of lipopolysaccharide. A second heat-stable antigen was detected in the supernatant of autoclaved strains of W 83, W50, HG 184 and A7A1-28. These non-somatic antigens were strain-specific, i.e., no cross-reactivity was found with heterologous hyperimmune sera. An exception was strain W50, which had a non-somatic heat-stable antigen which was recognized by W83 antiserum. These antigens were resistant to DNAse, RNAse and proteinase-K treatment but were degraded by sodium periodate. In immunoelectrophoresis, these antigens appeared to be negatively charged. These properties are characteristics of a K-antigen, which likely represent a thermostable carbohydrate capsule. The presence of K-antigen correlates very well with the serum resistance, the low chemiluminescence, the resistance to phagocytosis and the need for opsonization with specific antibodies for complement-mediated killing of virulent P. gingivalis strains. We propose to designate these antigens in P. gingivalis W83 and W50 as K1, in HG 184 as K2 and in A7A1-28 as K3.     

Microbiology of the pericoronal pouch in mandibular third molar pericoronitis

The microorganisms associated with mandibular third molar pericoronitis were investigated using direct microscopy and anaerobic culture method. The pericoronal pouch was sampled with paper points in A) 8 patients without mandibular third molar pericoronitis and B) 6 patients with mandibular third molar pericoronilis. Under the microscope, the microflora was found to be a complex mixture comprising gram-positive and gram-negative cocci, rods and filaments (including fusiform and curved rods), motile rods and spirochetes. Significantly higher proportions of motile, gram-negative rods were found in group B than in group A. The predominant cultivable microflora of 9 samples: A (4) and B (5) comprised several species of facultative and obligate anaerobic bacteria, namely Peptostreptococcus. Streptococcus, Actinomyces, Eubacterium, Propionibacterium, Veillonella, Porphyromonas, Prevotella, Bacteroides, Fusobacterium, Campylobacter, Staphylococcus, Stomatococcus, Lactobacillus, Neisseria, Capnocytophaga, Haemophilia, Selenomonas and Centipeda species. The microflora in pericoronitis appeared similar to that of diseased periodontal pockets.     

Shear bond strengths of saliva contaminated 'one-bottle' adhesives

The aim of this study was to investigate the effect of saliva contamination on the bond strengths of three one-bottle bonding systems. The dentin of 90 recently extracted, non-carious human molar teeth was exposed and ground wet on 500 grit silicon carbide (SIC) paper to establish a bonding surface in superficial dentin. Specimens were randomly assigned to nine groups of 10 teeth each. Three testing conditions are: (i) contamination with fresh saliva (pH 5.5) after acid etching, (ii) contamination with fresh saliva after bonding application, and (iii) no contamination. Three adhesive systems are: syntac single component, prime & bond NT, and gluma one bond. Cylinders of composite were applied via PTFE (polytetrafluroethylene) split mould and light cured to the dentin surfaces. All specimens were thermocycled (5000 cycles) between baths of 5 and 55 degrees C. Shear bond strengths were measured using an Instron Universal testing machine at a crosshead speed of 1 mm min-1. Two-way ANOVA was used to analyse the data. The results of this study indicated that the saliva contamination of dentin has no adverse effect on the bonding efficiency of one-bottle adhesive systems (P > 0.05). No statistically significant differences were found between the shear bond strengths of tested adhesives.     

Vertical distraction of the severely resorbed edentulous mandible: a clinical,histological and electron microscopic study of 10 treated cases

The aim of this study was to evaluate the clinical and histomorphological results of distraction of the severely resorbed edentulous mandible. In a group of 10 edentulous patients suffering from insufficient retention of their mandibular denture related to a severely resorbed mandible, the anterior segment was augmented as a preimplant surgical procedure using the nonvoluminous Groningen Distraction Device (GDD). Two months after the last day of distraction, a bone biopsy was taken with a trephine, both distraction screws were replaced by endosseous implants and the guide screw was removed. The biopsies were examined by means of light microscopy (LM) and transmission electron microscopy (TEM). Radiographical and histomorphological examination of the biopsies revealed the presence of two cortical zones, one at each end of the biopsies, a poorly mineralized, fibrous interzone in the middle of the distraction gap, and two zones of mineralization between the central fibrous and the peripheral cortical zones. Formation of lamellar bone parallel to the distraction vector was clearly visible in the mineralization zone as well as signs of remodelling at the borderline between the native cortical bone and the generate. Clinical examination showed in all patients that the anterior segment distracted from the mandible body was sufficiently enlarged to enable insertion of endosseous implants with a length of at least 12 mm. One implant was lost during the healing phase, but was successfully replaced thereafter. Implant retained overdentures were fabricated 3 months after implantation. All patients have good function 11.2 +/- 4.3 months after the end of treatment. From this study it is concluded that the GDD has proven to be a reliable tool for augmentation of the anterior segment of a severely resorbed edentulous mandible enabling osseointegration of endosseous load-bearing implants.     

Fabrication of a digitally scanned, custom-shaped abutment: a clinical report

A procedure for the creation of a custom, anatomic implant abutment copy milled with digitally scanned information has been described. The definitive restoration was a custom-machined abutment with a ceramic crown that had an aluminous oxide core.     

Ultrastructure of early mineral deposition during hyaline layer formation in rat molars

There is no consensus on whether the first mineralized layer, the hyaline layer, that is juxtaposed to root dentine is a variety of dentine or cementum or even a tissue of epithelial origin. Some suggest that there is no intermediate tissue between the acellular extrinsic fibre cementum (AEFC) and the root dentine. Here, to study hyaline layer formation and mineralization we examined by transmission electron microscopy the early stages of root development in upper molars from 10 to 13 day old Wistar rats. In addition to conventionally processed material, undemineralized and unstained sections were examined, which showed the deposition of fine mineral crystals in contact with the mineralized surface of root dentine. Early mineralization of the hyaline layer occurred in the region of the inner basement membrane, which persisted between the inner cellular layer of Hertwig's epithelial root sheath and the outer mineralized root dentine. When the root sheath began its fragment, collagen fibrils from the developing periodontal ligament began to insert into the mineralising hyaline layer, which was 0.5-0.8 micron wide. As the fragmentation of the root sheath HERS increased, more collagen fibrils appeared intermingled with the mineralising hyaline layer. In more advanced stages, when the hyaline layer had become fully mineralized and the formation of the AEFC began, the hyaline layer could no longer be identified. Thus, the hyaline layer is clearly discernible at early stages of periodontal development. Subsequently, it is masked by intermingling of cementum and dentine and therefore it is not possible to detect it in the formed roots of rat molars.     

The role of team dentistry in improving access to dental care in the UK

The role of professionals complementary to dentistry (PCDs) in improving access to NHS primary dental care is discussed. The pattern of under-supply of dentists in poor socio-economic areas is highlighted and identified, in drawing a parallel to the workings of primary medical teams, as a possible area where PCDs could be used.     

Reliability of assessing interproximal bone loss by digital radiography: intrabony defects

AIM: The aim of the present study was to assess the reproducibility and validity of linear measurements of interproximal bone loss in intrabony defects on digitized radiographic images after application of different filters and magnifications. METHODS: Immediately before surgery 50 radiographs of 50 periodontally diseased teeth exhibiting interproximal intrabony defects were obtained by a standardized technique in 50 patients. Intrasurgically the distances from the cementoenamel-junction (CEJ) to the alveolar crest (AC) and from the CEJ to the deepest extension of the bony defect (BD) were assessed. All radiographs were digitized by a flatbed scanner (resolution: 600x1200 dpi). Using the FRIACOM-soft ware, the linear distances CEJ to AC and CEJ to BD were measured at 50 intrabony defects on digitized but unchanged radiographic images and also after use of 2 different basic image processing modes (filters: enhancement of grey level differences, spreading of grey values) with 7-fold and 14-fold magnification by 2 different examiners. RESULTS: Repeated measures MANOVA revealed reproducibility of the measurement of the distance CEJ to AC to be significantly influenced by examiner (p=0.027) and filter in combination with the height of 2 wall component of the intrabony defect (p=0.066). For the distance CEJ to BD filters had significant influence on reproducibility in correlation with vertical angulation difference (p=0.001). On the average in this study radiographic measurements tended to overestimate the amount of bone loss as assessed by intrasurgical measurements (CEJ-AC: 0.74-1.91 mm; CEJ-DB: -0.04-0.77 mm). Validity of measurement of the distance CEJ-AC was shown to be significantly influenced by the depth of the intrabony defect (p<0.003). Validity of the distance CEJ-BD was significantly influenced by intrasurgically assessed bone loss (p=0.029), horizontal angulation (p=0.066). Filters influenced the validity only in combination with examiner (p<0.001). CONCLUSIONS: In this study, the chosen digital manipulations (filters: spreading, structure) of radiographic images failed to result in statistically significantly more reproducible or valid measurements of interproximal bone loss within intrabony defects when compared to the digitized but unchanged images. All radiographic assessments on the digitized images except for use of enhancement of grey level differences (structure) came close to the intrasurgical gold standard.     

Unresectable primary tumor of head and neck: does neck dissection combined with chemoradiotherapy improve survival?

A study regarding patients with primary and previously untreated advanced histologically proven squamous cell carcinoma of the head and neck was performed to compare two treatment modalities: neck dissection followed by chemoradiotherapy (Group I) versus chemoradiotherapy alone (Group II). Fifty-four patients were randomly chosen to receive Group I or II treatment. Our results demonstrate that Group I treatment has a higher and statistically significant disease-specific survival rate. We suggest that an association of neck dissection plus chemoradiotherapy can be useful in the event of unresectable advanced carcinomas.