Impaired healing response of periodontal furcation defects following flap debridement surgery in smokers. A controlled clinical trial

OBJECTIVES: The purpose of the present parallel-design, controlled clinical trial was to evaluate the treatment outcome of periodontal furcation defects following flap debridement surgery (FDS) procedure in cigarette smokers compared to non-smokers. MATERIALS AND METHODS: After initial therapy, 31 systemically healthy subjects with moderate to advanced periodontitis, who presented at least one Class I or II molar furcation defect, were selected. Nineteen patients (mean age: 40.3 years, 15 males) were smokers (>or=10 cigarettes/day) and 12 patients (mean age: 44.8 years, 3 males) were non-smokers. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS), probing pocket depth (PPD), vertical clinical attachment level (v-CAL), and horizontal clinical attachment level (h-CAL) were assessed immediately before and 6 months following surgery. RESULTS: Overall, statistically significant v-CAL gain was observed in smokers (1.0 +/- 1.3 mm) and non-smokers (1.3+/-1.1 mm), the difference between groups being statistically significant (p=0.0003). In proximal furcation defects, v-CAL gain amounted to 2.3+/-0.7 mm in non-smokers as compared to 1.0+/-1.1 mm in smokers (p=0.0013). At 6 months postsurgery, non-smokers presented a greater h-CAL gain (1.3+/-1.1 mm) than smokers (0.6+/-1.0 mm), with a statistically significant difference between groups (p=0.0089). This trend was confirmed in both facial/lingual (1.4+/-1.0 versus 0.8+/-0.8 mm) and proximal furcation defects (1.2+/-1.3 versus 0.5+/-1.2 mm). The proportion of Class II furcations showing improvement to postsurgery Class I was 27.6% in smokers and 38.5% in non-smokers. After 6 months, 3.4% of presurgery Class I furcation defects in smokers showed complete closure, as compared to 27.8% in non-smokers. CONCLUSIONS: The results of the present study indicated that (1) FDS produced clinically and statistically significant PPD reduction, v-CAL gain, and h-CAL gain in Class I/II molar furcation defects, and (2) cigarette smokers exhibited a less favorable healing outcome following surgery in terms of both v-CAL and h-CAL gain.     

Precipitation hardening in a dental low-gold alloy

Age-hardening characteristics in a dental low-gold alloy composed of 40.0 wt% Au-35.0 wt% Ag-7.9 wt% Pd-7.0 wt% Cu-5.0 wt% In-3.5 wt% Zn-1.5 wt% Sn, were investigated by means of the hardness test, XRD study, SEM observations and EPMA. The following results were obtained. The age-hardening was characterized by a precipitation of Cu-rich alpha2 phase in the a phase. The softening that occurred following prolonged ageing was due to the heterogeneous formation of the fine nodular precipitates composed of the Ag-rich alpha1 phase and the Cu-rich alpha2 phase at the grain boundaries of the a phase.     

Education of dentists in China

China is geographically located in the east of Asia and its population exceeds 1.3 billion. An understanding of dental education in China is thus of interest. However, as there is little published information on this topic, this paper provides information about China regarding its dental history, dental school system including curriculum and dental licensure. High school graduates take a nationwide entrance examination to apply for dental school, of which there are more than 50 in China. A five year dental education leads to the BDS degree. Dental school graduates must then pass the nationwide licensure examination to practise dentistry. Currently, there are not adequate numbers of dentists to provide the necessary oral health care for people living outside metropolitan areas.     

A demographic analysis of vertical root fractures

Teeth with vertical root fractures (VRFs) have complete or incomplete fractures that extends through the enamel, dentin and pulp, down the long axis of the tooth. Several different variables were investigated and statistically evaluated as to their correlation with the presence of VRFs. Specifically analyzed were gender, tooth location, age, radiographic and clinical findings, bruxism, and pulpal status. The data were collected from three different endodontists, from three different geographic locations, comprising a total of 227 teeth. Although VRFs may occur in conjunction with any of the parameters investigated, only certain factors were found to occur in a significant number of cases. The results indicate that VRFs are statistically more prevalent in mandibular molars and maxillary premolars. They are associated with periradicular bone loss, pain to percussion, extensive restorations, and seem to occur more often in females and older patients. However, VRFs are not necessarily related to periapical bone loss, a widening of the periodontal ligament space, associated periodontal pockets, a sinus tract, particular pulpal status, or bruxism.     

Isolation and characterization of Lactobacillus species inhibiting the formation of Streptococcus mutans biofilm

Oral bacterium S11 was isolated from the saliva of young children without dental caries and with little or no visible supragingival plaque. The S11 strain showed 99.5% similarity with Lactobacillus fermentum, and was identified on the basis of biochemical characteristics and a 16S rDNA sequence. S11 strain and its culture supernatant significantly inhibited the formation of the insoluble glucan produced by Streptococcus mutans Ingbritt. S11 did not affect the multiplication of S. mutans Ingbritt, but the adherence of S. mutans Ingbritt onto cuvette walls was inhibited completely.     

Effects of dentin bonding agents on bonding durability of a flowable composite to dentin

The present study evaluated the bonding durability of a flowable composite on bovine dentin using dentin bonding agents with different numbers of application steps: Scotchbond Multipurpose (three steps), Prime & Bond NT and One-Step (two steps), AQ Bond and Prompt L-Pop (one step). Shear bond strength tests were performed, and resin-dentin interface and fracture mode were observed. There were no significant differences in bond strength among the specimens within 37 degrees C storage group (p > 0.05) and post-thermocycling group, except between Prompt L-Pop and Scotchbond Multipurpose (p < 0.05) in the post-thermocycling group. Further, Scotchbond Multipurpose and One-Step showed significantly lower bond strengths after thermocycling (p < 0.05). It was thus shown that the use of simplified bonding agents did not necessarily improve the bonding strength of flowable composites.     

Zygomaticomandibularis muscle

The aim of this study was to elucidate the precise anatomy of the zygomaticomandibularis muscle through cadaveric dissection and magnetic resonance imaging (MRI). Five fresh human cadavers and 10 fixed cadavers were dissected. Nine preserved human cadavers were used for the MRI study. Four volunteers took MRIs of their head as well. Zygomaticomandibularis muscle was found in all the cadaveric specimens. It is a fan shaped muscle. The length of the muscle is 25.1 +/- 4.6 mm, and the width at the zygomatic arch is 16.6 +/- 4.2 mm. The thickness is approximately 4.8 +/- 1.9 mm. It originates from the deep layer of the deep temporal fascia approximately 1 cm above the zygomatic arch and is inserted into the superior border and outer surface of the mandible between the coronoid process and mandibular notch. The deepest layer of the masseter muscle covers the lateral surface of zygomaticomandibularis. We believe that this muscle functions as coordinator of the temporalis and masseter in mammals with strong masticatory power but is a degraded or rudimentary muscle in humans.     

Nasal reconstruction with double-layer tensor fascia lata-wrapped diced rib cartilage in a patient with severe dorsal collapse

For patients with large dorsal defects due to posttraumatic deformities, rib cartilage or calvarial bone is used for reconstruction. Problems such as graft contour, distortion, limited amounts, and donor morbidity continue to exist for cartilage and bone grafts. To overcome the limitations of such grafts, many authors have used diced cartilage wrapped with fascia. However, diced cartilage wrapped with fascia is not suitable for structural support in cases of dorsal nasal collapse. We describe a technique using a dorsal structural graft for a 28-year-old man who had severe dorsal nasal collapse after a traffic collision. For enhancement of strength, we harvested a thick segment of the tensor fascia lata and applied 2 layers. A large amount of rib cartilage was inserted between the thick fascia layers. The tensor fascia lata wrapped with diced cartilage graft for dorsal augmentation is fraught with structural graft, similar to bone or cartilage grafts. This semirigid technique may be another option for dorsal structural support of severe nose deformities.     

Eight-week histological analysis on the effect of chitosan on surgically created one-wall intrabony defects in beagle dogs

OBJECTIVE: To evaluate the periodontal tissue regenerative effects of a chitosan/collagen sponge applied to preclinical one-wall intrabony defects surgically created in beagle dogs. MATERIAL AND METHODS: 4 x 4 mm one-wall intrabony defects were surgically created in the bilateral maxillary first and third, and the mandibular second and fourth premolars. The surgical control group received a flap operation only, while the buffer control group was treated afterwards with a phosphate-buffered saline/collagen sponge (CS) and the chitosan group was treated with a chitosan/cs. The subjects were killed 8 weeks after the operation, and a comparative histological examination was performed. RESULTS: The amount of junctional epithelium migration was 2.30+/-1.24 mm in the surgical control group, 1.49+/-1.25 mm in the buffer control group, and 0.26+/-0.59 mm in the chitosan group. A significant difference was exhibited only between the surgical control and the chitosan group (p<0.05). The amount of connective tissue adhesion was 0.68+/-0.60, 1.07+/-0.91, and 0.41+/-0.42 mm in the surgical control, buffer control, and the chitosan group, respectively. The amount of cementum regeneration was 1.42+/-0.49, 1.60+/-0.41, and 3.46+/-0.78 mm in the surgical control, buffer control, and the chitosan group, respectively. A significant difference was seen between the chitosan group and the rest (p<0.01). The amount of alveolar bone regeneration was 1.00+/-0.77, 1.52+/-0.37, and 2.43+/-0.44 mm in the surgical control, buffer control, and the chitosan group, respectively. A significant difference was observed between the chitosan group and the rest (p<0.05). CONCLUSION: The results demonstrate the beneficial effect of the chitosan/cs on the one-wall intrabony defects of beagle dogs. The inhibited apical migration of epithelium and the increase in the amount of new bone and new cementum suggest the potency of chitosan in inducing periodontal tissue regeneration.