Total viable counts, ATP, and endotoxin levels as potential markers of microbial contamination of dental unit water systems

OBJECTIVES: To determine if either ATP or endotoxin concentrations in water supplied by dental unit water systems (DUWS) correlated with total viable counts (TVC), and therefore could be used as a rapid, chairside measure of levels of microbial contamination. DESIGN: A prospective trial. METHOD: Fifty-seven water samples were taken from the 'triple spray', air rotor and source water supplies from 25 dental units in eight practices. The samples were assayed for endotoxin concentration, total ATP and TVC. A pilot study was performed to assess the relationship between TVC and total cell counts, as determined by flow cytometry. RESULTS: ATP concentrations ranged from 22 to 958 relative light units (RLU) and free endotoxin ranged from 25 to 600 EU ml(-1). TVC varied from not detected to 2.16 x 10(4) CFU ml(-1). The ATP method proved to be a simple and rapid method that could be used at the chairside. However, there was no correlation between ATP or endotoxin concentrations and TVC in DUWS. TVC generally underestimated the total cell count by 50 to 500 fold. CONCLUSION: Half of the water samples from DUWS exceeded recommended levels of TVC. However, ATP and endotoxin concentrations in DUWS water samples did not correlate with these TVC data and therefore could not be recommended as an alternative assay to TVC for measuring bacterial contamination or for monitoring water treatment efficacy.     

Squamous cell cancer of the buccal mucosa in young adults

BACKGROUND: Squamous cell carcinoma of the buccal mucosa is predominantly a cancer of elderly people and is seen rarely in young adults. Although many aetiological factors have been postulated, tobacco alone has been implicated as the main factor in the aetiology of such cancers at any age. PATIENTS AND METHODS: A retrospective analysis of 46 patients with cancer of the buccal mucosa who were under the age of 35 years at the time of presentation was made to evaluate their survival and predictors of survival. The details were extracted from the computerised records and case records of the Regional Cancer Centre, Trivandrum, India. These were analysed with particular emphasis on risk factors, clinical extent, and treatment. Survival was analysed by the Kaplan-Meier method, and differences in survival were compared using the log-rank test. RESULTS: The male:female ratio was 6.7:1. Almost all the patients (n = 42, 91%) used either tobacco or alcohol, with tobacco chewing being the most common. The 3 and 5 years disease-free survival were 72 and 61%, respectively. Non-smokers and patients with an advanced T stage at presentation had significantly worse prognoses.     

Use of bar-clip attachments to enhance the retention of a maxillofacial prosthetic obturator: a clinical report

Precision attachments are commonly used in prosthetic dentistry but are still questioned in maxillofacial prosthetics. The aesthetic enhancement and functional rigidity provided by attachments are favourable features to many challenging clinical situations such as class-III defect (Aramany's maxillectomy classification). Surgical reconstruction is the standard treatment for this type of defect repair. However, owing to the need for dental rehabilitation and patient reserve, prosthetic rehabilitation was the modality chosen in this clinical case. The use of bar attachments is described in this paper as providing increased stability and retention of the prosthesis, and improved obturator water and airtightness.     

In vitro analysis of 'smear layer' on human dentine using ac-impedance spectroscopy

OBJECTIVE: To analyse smear layers on human dentine using ac-impedance spectroscopy. METHODS: Dentine samples were prepared from extracted, sound, third molars. Impedance measurements were carried out on dentine samples before and after etching. After measuring, samples were examined under scanning electron microscope (SEM) to correlate electrical measurements with structure. RESULTS: Marked differences in impedance before and after etching were demonstrated. SEM investigation showed that a smear layer overlies dentine surfaces before etching, but completely disappeared after etching, leaving open dentinal tubules. CONCLUSIONS: The clinical removal of smear layers is still subjective. This objective method, based on combined ac-impedance and admittance measurement in vitro, has the potential to allow development of standardised techniques and if developed further may be of use in vivo.     

Adjustment of the occlusal vertical dimension in the bite-raised guinea pig

In humans, the inappropriate occlusal vertical dimension (OVD) causes several orofacial disorders, such as bruxism and pain in the masticatory muscles and temporomandibular joint. However, it is still unclear how strictly the OVD is adjusted. To answer this question, we studied the temporal change of the OVD in bite-raised young guinea pigs. The OVD was raised by fixation of a bite-raising appliance to the lower incisors, and increased by either 3 or 1.5 mm at the first molars. After the space produced between the upper and lower molars was filled within 10 days due to eruption of the molars, the appliance was removed. In the bite-raised animals, the raised OVD was reduced until it attained that observed in the control animals, after which the OVD increased according to cranial growth. These results show that the OVD is developmentally changed and strictly controlled.     

Influence of enamel thickness on quantification of mineral loss in enamel using laser-induced fluorescence

The objective of this study was to evaluate the effect of enamel thickness on the quantification of white-spot lesions with laser fluorescence. One hundred and twenty 3-mm-diameter human ground and polished enamel specimens were used. Specimens were illuminated by a 488-nm argon laser, images were acquired through a 540-nm high-pass filter and stored on the Quantitative Light-Induced Fluorescence (QLF) program. Specimens were divided into two groups and demineralized for 48 or 96 h and QLF images were again acquired. Fluorescence radiance (FR) of both sound (FR(s)) and demineralized (FR(d)) enamel was determined using the QLF program. Change in fluorescence radiance (Delta FR, %) was determined as follows: Delta FR = FR(d)/FR(s) x 100. One thin section was obtained for transverse microradiography analysis. Enamel and dentin thickness of the thin sections were measured. There was a good correlation between QLF parameters and enamel thickness. It can be concluded that the FR observed for similar lesions depends on the actual enamel thickness.     

Three-dimensional reconstruction studies and morphometric analysis of rudimental tooth primordia in the upper incisor region of the sheep (Ovis aries,Ruminantia)

The functional dentition of the domestic sheep lacks all upper incisors and the upper canines. Nevertheless, occurrence of a dental lamina and rudimental tooth primordia had been described in the upper incisor region of the sheep. The aim of this study was to describe temporo-spatial pattern of origin and regression of these rudimental tooth primordia by light microscopy, computer-aided three-dimensional reconstruction and morphometry of the dental epithelium. Transient existence of a dental lamina in the upper incisor region of the sheep and three epithelial thickenings on its deep mesenchymal margin has been observed at day of ontogeny (DO) 48-53. They could not been identified as full-value tooth primordia, because they did not induce differentiation of tooth mesenchyme, but they could represent last remnants of functional upper incisors in early ancestors of ruminants. Additionally, a large rudimental upper canine primordium near the sutura maxilloincisiva occurred at DO43, reached early cap stage at DO52 and started to regress at DO53. Thus, our findings showed a discrepancy between the embryonic and adult dental pattern in the sheep. Similar molecular mechanisms as described for diastemal tooth rudiments in rodents could be involved during regression of rudimental tooth primordia in the upper incisor region of the sheep.     

Helicobacter pylori and Campylobacter rectus share a common antigen

AIM: The aim of this study was to investigate the presence of antigens with immunological cross-reactivity in periodontopathogenic bacteria and Helicobacter pylori, the pathogen associated with gastritis and peptic ulcers in human. MATERIALS AND METHODS/RESULTS: Among the putative periodontopathogens tested (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola), cross-reactive bands were only detected in C. rectus by SDS-PAGE/Western immunoblotting analysis using a polyclonal antibody directed to H. pylori cells. One of these cross-reactive antigens, a 64-kDa band antigen, also reacted with a monoclonal antibody directed to the human heat shock protein (HSP) 60. The N-terminal amino acid sequence of this C. rectus protein revealed a high degree of homology with corresponding regions of other HSPs belonging to the HSP60 family, indicating that the 64-kDa antigen was a GroEL protein. The nucleotide sequence of the C. rectus GroEL protein coded for a 547 amino acid protein with a predicted size of 57.8 kDa. Comparison of the alignment of the deduced amino acid sequence of the GroEL protein of C. rectus with that of H. pylori showed a high degree of similarity throughout its length (76.8%). GroEL protein from C. rectus possessed the ability to stimulate production of IL-6 by a confluent monolayer of human gingival epithelial cells and was cytotoxic when used at a high concentration. CONCLUSIONS: This study reveals an immunological relationship between H. pylori and C. rectus, and clearly indicates that one of the shared antigens is a GroEL protein possessing a biological activity that might play a role in the initiation and progression of periodontal disease.     

Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report

AIM: To compare mineral trioxide aggregate (MTA) with calcium hydroxide when used as pulp-capping materials in human teeth. METHODOLOGY: Eleven pairs of maxillary third molars in subjects between 20 and 25 years of age were subjected to mechanical pulp exposure. The exposed pulps were capped with MTA or calcium hydroxide, covered with ZOE and restored with amalgam. A total of 14 teeth were extracted after periods of 1 week (two molars) 2 months (three molars), 3 months (five molars), 4 months (two molars) and 6 months (two molars). RESULTS: Histological evaluation demonstrated less inflammation, hyperaemia and necrosis plus thicker dentinal bridge and more frequent odontoblastic layer formation with MTA than calcium hydroxide. CONCLUSIONS: Although the results favour the use of MTA, more studies with larger samples and a longer follow up are suggested.