Fluoridation in Anglesey: a clinical study of dental caries in mothers at term.

A study of dental caries was carried out involving 1537 mothers who attended St David's Hospital, Gwynedd, between July 1986 and July 1987 for their confinement. The study was 'blind' in respect of residence. The mean DMFT value for mothers with continuous residence in the non-fluoridated Gwynedd mainland was 13.6 and the mean DMFT value for mothers living in the Anglesey Health Unit who had consumed fluoridated mains water from birth was 30% lower at 9.5 (P less than 0.0001). The confidence interval for the difference between means was 3.4-4.9. The samples from the two areas showed no significant differences in social class and age group structures. The percentage of Anglesey mothers with DMFT exceeding 15 was less than one-sixth of that for mainland mothers and the percentage of those with DMFT less than 6 was three times greater. The mean DMFS value for occlusal sites in premolars was 3.9 for mainland Gwynedd and for Anglesey 52% less at 1.9 (P less than 0.0001) with a confidence interval of 1.6-2.4. For smooth surface sites in posterior teeth, the difference was not as pronounced, with a mean DMFS value for mainland of 20.3 and for Anglesey 42% less at 11.8 (P less than 0.0001) with a confidence interval of 7.5-9.6. The results showed that child-bearing women continued to enjoy important benefits from water fluoridation into their early thirties.     

Digital subtraction arthrography and arthrofluoroscopic dynamic observations on TMJ dysfunction syndrome

Digital subtraction arthrography and arthrofluoroscopic dynamic observation were performed for seventy cases with TMJ dysfunction syndrome. A comparative study between the findings of digital subtraction arthrography and the operative findings was carried out for eleven cases who underwent surgery. It has been found that digital subtraction arthrography can overcome the disadvantages of conventional arthrography and has important diagnostic value for TMJ dysfunction syndrome, especially for disc perforation. In addition. The procedure of digital subtraction arthrography, the normal and abnormal manifestations of digital subtraction arthrograms were described in the present study.     

T‐cell independent production of salivary secretory IgA after hematopoietic stem cell transplantation in children

This study examined the recovery of secretory IgA (S‐IgA) in saliva after hematopoietic stem cell transplantation (HSCT) in 35 children and young people between the ages of 3 and 27 years (mean = 13.6), and compared this recovery with that of serum immunologic constituents. Reference values for human salivary S‐IgA in saliva were obtained from 77 healthy control subjects between the ages of 7 and 25 years (mean = 11.4). In the 35 patients, a nadir of secretory IgA concentrations in saliva (S‐IgA) was observed between the 3rd and the 4th month, and a return to normal values 1 year after HSCT. Serum IgA concentrations reached their nadir in the 6th month, and normalized in the 18 months after HSCT. The recovery of T‐helper cells (CD4⁺/3⁺) was also delayed to beyond 18 months. We found a significant correlation between the reconstitution pattern of S‐IgA and that of T‐helper lymphocytes, but no correlation was found between the post‐transplant evolutions of S‐IgA and serum IgA, or between S‐IgA and T‐helper cells. The recovery of S‐IgA was more rapid than that of serum IgA and appeared to be T‐helper cell independent.     

The effect of ketoprofen creams on periodontal disease in rhesus monkeys

Ketoprofen creams were evaluated for the treatment of periodontal disease in a placebo-controlled, double-blind study in the rhesus monkeys, Macaca mulatta. Two formulations containing ketoprofen (1%), with or without vitamin E, were evaluated against appropriate controls (8 monkeys per group). Two weeks prior to treatment, the animals received prophylaxis on only the left side of the mouth (spontaneous model). Selected teeth on the right side of the mouth were ligated (ligature model). The creams were administered to the gingiva once daily at a standard dose of 1.8 ml per monkey for 6 months. Clinical assessments were made 2 wk before initiation, at baseline and 1, 2, 3 and 6 months post-treatment. The clinical parameters included plaque formation, gingival redness, edema, bleeding on probing and Ramfjord Attachment Level measurements (RAL). Radiographs were taken at 2 wk before initiation, baseline and at 3 and 6 months post-treatment. Digital subtraction radiography was used to measure vertical linear bone loss along the interproximal root surfaces of the left and right mandibular first molars. Gingival crevicular fluid (GCF) was collected for biochemical assays on PGE₂, TxB₂, LTB₄, IL-1β and TNFα. There were no significant differences among groups with respect to gingival indices. Radiographic data demonstrated significant positive effects on bone activity in both groups treated with ketoprofen formulations with improvement over time in the ligature model (0.01 ≤p≤ 0.04). The placebo group exhibited bone loss of 1.96±0.48 and 1.40±0.56 mm per site at 3 and 6 months, respectively. The group treated with ketoprofen cream showed an apparent bone gain of 0.28±0.41 and 0.78±0.47 mm per site at 3 and 6 months, respectively. The group treated with ketoprofen cream containing vitamin E showed a mean bone loss of 0.41–0.48 mm per site at 3 months with improvement to an apparent bone gain of 0.31±0.44 mm per site at 6 months. The biochemical data demonstrated early and significant suppression of GCF-LTB₄ by both ketoprofen formulations at 1 month, which preceded the significant suppression of GCF-PGE₂ at 2 and 3 months in the ligature model (p≤0.003) and at 2 to 6 months in the spontaneous model (p≤0.02). We conclude that ketoprofen at 1% level in suitable topical vehicles can effectively inhibit GCF-LTB₄ and GCF-PGE₂ and positively alter alveolar bone activity in the ligature-induced model of periodontitis in the monkey.     

Measurement of proteases in human subgingival dental plaque by fluorescence polarization

Fluorescence polarization (FP) was examined as a rapid quantitative method to assay the proteases in subgingival plaque. Protease activity was measured by a decrease in FP at 0.5-min intervals over 5 min, using BODIPY®--casein, a protein substrate. To quantitate activity, the least absolute deviation (LAD) slope for each assay was determined. Protease activity increased with the quantity of plaque (r=0.416, P<0.001). Of the 208 subgingival plaque samples, 87 contained detectable protease activity, with a mean of about 4 μg trypsin equivalents above a general background of 1 μg per site. The mean plaque protease activity of 89 paired samples from 15 individuals had decreased by 1.1 μg trypsin equivalents per site when measured at 8 months after tooth scaling and root planing (P<0.01). Most isolates of Porphyromonas gingivalis, Treponema denticola, Prevotella nigrescens, and Prevotella intermedia implicated in the pathogenesis of adult periodontitis exhibited high activity in the FP assay. The assay is rapid, quantitative and requires only one-tenth of the plaque sampled using a single pass with a Gracey curette at a single tooth site.     

Variations in the prevalence and extent of periodontitis

A national survey of employed adults showed a decrease in the extent and severity of periodontal disease in comparison with findings from earlier studies. Using data from that survey, this report evaluates the association of socioeconomic factors--race, education, income and dental insurance, as well as most recent dental visit--with the prevalence and extent of periodontal disease. Periodontitis was more prevalent and usually more extensive in persons who are black, have less education or had not seen a dentist in three or more years. Having dental insurance was not associated with better periodontal health.     

In vitro resistance to fracture of porcelain inlays bonded to tooth

To assess the resistance to fracture of ceramic inlays, extracted sound human molars were restored with different ceramic materials and glass-ionomer or composite resin luting cement. Compression forces were applied to the specimens until they fractured, and maximal force developed, extent and location of fractures, and the micromorphology of the fractured surfaces were studied. Inlays made of Vitadur N with aluminum oxide profile and bonded with composite resin demonstrated the highest resistance among the restorative combinations, but their resistance was still lower than that of intact (control) teeth. The extent of fracture increased proportionally to the fracture resistance of the specimens. Scanning electron microscopic observation confirmed the effectiveness of the adhesion between composite resin and etched ceramic and the absence of sufficient micromechanical anchoring between glass-ionomer cement and etched ceramic.     

Humoral immune response to selected subgingival plaque microorganisms in insulin-dependent diabetic children

Juvenile diabetics have been shown to have an increased susceptibility to gingivitis and periodontitis following puberty. However, little data are available on changes in the microbial flora that occur at the onset of puberty. This study was performed to determine if antibacterial antibody titers to selected periodontal disease-associated microorganisms might be helpful in revealing changes in plaque flora at the onset and conclusion of puberty. Sera was obtained from 35 subjects (ages 7 to 18 years) selected from a population of insulin-dependent diabetics. The subjects were given a thorough medical examination which included an assessment of sexual maturation and a dental examination which included the recording of onset and magnitude of bleeding according to the papillary bleeding score. Antibody titers to A. naeslundii (AN), B. intermedius (BI), B. gingivalis (BG), F. nucleatum (FN), A. actinomycetemcomitans (AA), C. ochracea (CO) and T. denticola (TD) were determined using the microELISA. Stratification of antibody titers by age groups (less than or equal to 12 years, 12 to 15 years, greater than 15 years) revealed that titers to AN increased significantly (P less than 0.025, ANOVA) and progressively (P less than 0.05, regression analysis) with increasing age. In contrast, the titers to FN were maximal in the under 12 year group and decreased with age (ANOVA, P less than 0.05; regression analysis, P less than 0.05). There were no significant variations in titers observed for the other microorganisms. Stratification by sexual maturity revealed a similar progressive decrease of the titer to FN (ANOVA, P less than 0.05; regression analysis, P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)     

Cell proliferation after flap surgery, root conditioning and fibronectin application

This study evaluated the effects of citric acid demineralization and autologous fibronectin application on cell proliferation after mucoperiosteal flap surgery. Three adult rhesus monkeys were used. After flaps were raised, the roots were surgically exposed and planed. Surfaces on the experimental sides were decalcified with citric acid, and after thorough rinsing, the inner aspect of the flaps and the roots were bathed with 1 ml of autologous plasma fibronectin in normal saline (400 micrograms m/ml) and the flaps sutured. Contralateral teeth, acting as controls, were treated only with the surgical procedure. One hour prior to sacrifice, the animals were injected with an intravenous injection of tritiated thymidine (1 microCi/gm body weight). Surgeries were staggered to produce the following time periods: 3, 7, 15, 21 and 28 days. After processing, autoradiographs were obtained for evaluation, and labeled cells were counted in five compartments at 400 x: (1) oral epithelium, (2) crevicular area, (3) supracrestal connective tissue, (4) coronal periodontal membrane and (5) coronal bone marrow. Forty tissue sections per procedure (20 slides per tooth) were counted and means obtained for the three monkeys. Differences between experimental and control values were statistically evaluated for each component, at each time interval, using pairwise t tests. Fibronectin-treated areas showed significantly increased cellular proliferation (P less than 0.01) during the first 2 weeks, affecting mainly all the supracrestal tissues. Histologically, the establishment of a well-organized fibrinous clot at 3 days was noted in these areas. Results show a faster healing after surgery with the use of citric acid and fibronectin. It was concluded that citric acid followed by fibronectin enhanced cellular proliferation.