Effect of anesthetics containing lidocaine and epinephrine on cardiovascular changes during dental implant surgery

The purpose of this study was to evaluate cardiovascular changes during dental implant surgery using 2% lidocaine with 1:80 000 epinephrine. Eleven normotensive subjects, ranging from 18 to 56 years, were selected to undergo dental implant surgery in the jaw. They were monitored in the pre-, intra-, and postsurgical periods by continuous noninvasive automatic arterial pressure and cardiac frequency measurements taken every 2 minutes. Parameter scores were obtained for the following phases: P1, 15 minutes during preparation of the patient (control period); P2, before anesthesia; P3, immediately after anesthesia; P4, 2 minutes into anesthesia; P5, during incision and detachment; P6, during perforation; P7, during implant placement; P8, during suturing; P9, on completion; and P10, 10 minutes after termination. Individualized statistical analysis for each group during the pre-, intra-, and postoperative periods were performed by analysis of variance. The greatest variations in systolic pressure were increases of 2.29% during phase P2 and 2.59% in phase P5. Diastolic pressure decreased during phase P6 (-2.58%) and increased in P10 (3.27%). The greatest changes in heart rate occurred in phase P10 (-3.24%). There were no statistically significant changes among the evaluated phases (P > .05). In conclusion, there were no changes in the analyzed cardiocirculatory parameters during dental implant surgery (systolic, diastolic, and mean arterial blood pressures and heart rate) in normotensive subjects anesthetized with 2% lidocaine with epinephrine 1:80000.     

Rapid detection of Actinobacillus actinomycetemcomitans using a loop-mediated isothermal amplification method

INTRODUCTION: Actinobacillus actinomycetemcomitans has been implicated in the etiology of aggressive periodontitis. In this study, we applied a novel nucleic acid amplification method, called loop-mediated isothermal amplification (LAMP), which amplifies DNA with high specificity, efficiency and rapidity under isothermal conditions, allowing the rapid detection of A. actinomycetemcomitans. METHODS: We designed the primers for detecting A. actinomycetemcomitans and evaluated the specificity and sensitivity of the assay. RESULTS: The LAMP primers used in this study successfully amplified serotypes a-e of A. actinomycetemcomitans, while other oral bacteria were not amplified. By measuring the precipitation of magnesium pyrophosphate, we could quantify the chromosomal DNA of A. actinomycetemcomitans. The detection limits using the real-time turbidimetry analysis were 5.8 x 10(2)-5.8 x 10(7) copies of A. actinomycetemcomitans template DNA per reaction tube. In addition, the LAMP assay was used for the rapid detection of A. actinomycetemcomitans in clinical specimens from eight individuals. The results with the LAMP method were similar to those using conventional polymerase chain reaction. CONCLUSION: Our results suggest that the LAMP-based assay is very useful for the rapid detection of A. actinomycetemcomitans.     

Longitudinal study of bone density and periodontal disease in men

Bone loss is a feature of both periodontitis and osteoporosis, and periodontal destruction may be influenced by systemic bone loss. This study evaluated the association between periodontal disease and bone mineral density (BMD) in a cohort of 1347 (137 edentulous) older men followed for an average of 2.7 years. Participants were recruited from the Osteoporotic Fractures in Men Study. Random half-mouth dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque, and bleeding. BMD was measured at the hip, spine, and whole-body, by dual-energy x-ray absorptiometry, and at the heel by ultrasound. After adjustment for age, smoking, race, education, body mass index, and calculus, there was no association between number of teeth, periodontitis, periodontal disease progression, and either BMD or annualized rate of BMD change. We found little evidence of an association between periodontitis and skeletal BMD among older men.     

Levels of evidence and journal impact factor in oral and maxillofacial surgery

The aim of this study was to identify the relationship between quality of research, in terms of levels of evidence, and journal impact factor (IF), and to describe the pattern of publications in oral and maxillofacial surgery. All four major journals in this subject area only, and with a published IF, were included in the study. Latest published IF dated 2004 was chosen, and all articles related to its calculation were accessed and classified into four levels of evidence. Correlation between levels of evidence and IF was investigated and the pattern of publications was described. All eligible 932 published articles were analysed. None (0%) were level I evidence, 20 (2%) were Level II, 70 (8%) level III and 337 (40%) level IV; 465 (50%) articles were classified as non-evidence. IF ranged from 0.689 to 1.154. There were statistically significant correlations between levels of evidence and IF (rho=1.0, P<0.01). Among the 465 non-evidence articles, there were 219 (47%) case reports, 91 (20%) animal studies, 52 (11%) laboratory studies, 35 (8%) technical notes, 24 (5%) tutorial articles, and 16 (3%) reviews articles.     

Bacterial community profiles of endodontic abscesses from Brazilian and USA subjects as compared by denaturing gradient gel electrophoresis analysis

This study compared the bacterial community profiles of the microbiota associated with acute apical abscesses from Brazilian and USA patients using denaturing gradient gel electrophoresis (DGGE). DNA was extracted from purulent exudate aspirates and part of the 16S rRNA gene was amplified by polymerase chain reaction and separated by DGGE. The resulting banding patterns, which were representative of the bacterial community structures in samples from the two locations, were then compared. Distinct DGGE banding patterns were observed from different samples. Ninety-nine bands with distinct positions in the gels were detected, of which 27 were found only in the USA samples and 13 were exclusive to Brazilian samples. Four of the 59 shared bands showed very discrepant findings with regard to prevalence in the two locations. Cluster analysis of DGGE banding profiles showed a great variability in the bacterial populations associated with teeth with abscesses regardless of the geographical location. Two big clusters, one for each location, were observed. Other clusters contained a mixture of samples from the two locations. The results of the present study demonstrated a great variability in the bacterial community profiles among samples. This indicates that the bacterial communities of abscesses are unique for each individual in terms of diversity. The composition of the microbiota in some samples showed a geography-related pattern. Furthermore, several bands were exclusive for each location and others were shared by the two locations and showed great differences in prevalence.     

Osseointegrated implants as an adjunct to facemask therapy: a case report

Branemark Implants were placed in the zygomatic buttresses of the maxilla in a 12-year and 1-month-old female patient with a Class III malocclusion caused by maxillary growth retardation secondary to repair of a unilateral cleft lip and palate defect. The implants were left to integrate for 6 months followed by placement of customized abutments that projected into the buccal sulcus. Elastic traction (400 g per side) was applied from a facemask to the implants at 30 degrees to the occlusal plane for 14 hours per day for 8 months (ages 12 years and 10 months to 13 years and 6 months). The maxilla moved downward and forward 4 mm rotating anteriorly as it was displaced. The change in the maxillary occlusal plane resulted in a secondary opening of the mandible. There was a 2 degrees increase in the SN-mandibular plane angle and an increase in nasion to menton distance of 9 mm. Clinically, this resulted in an increase in fullness of the infraorbital region and correction of the pretreatment mandibular prognathism. There was an increase in nasal prominence as the maxilla advanced. This contributed to the increase in facial convexity. The secondary dental change frequently seen in standard facemask therapy was avoided. The displacement of the maxilla was stable 1 year beyond cessation of facemask therapy. The patient's midface profile was improved by age of 13 years and 6 months. Details of the clinical procedure and treatment changes are presented.     

The clinical assessment of oral dryness is a significant predictor of salivary gland hypofunction

OBJECTIVES: To compare subjective complaints of xerostomia and salivary gland dysfunction and a clinical assessment of oral dryness with an objective measurement of salivary gland dysfunction, in a group of UK patients attending a Dry Mouth Clinic. The aim of the study was to identify signs and symptoms that may be of predictive value for salivary gland hypofunction (SGH) in clinical practice. METHODS: This prospective study investigated 214 patients who attended a Dry Mouth Clinic, held at Liverpool University Dental Hospital. Patients gave a history of xerostomia for a minimum of 6 months and were asked standardised questions to subjectively assess oral dysfunction. The oral mucosa was then clinically assessed for dryness and sialometry was performed. Unstimulated whole saliva flow rates (UFR) of < 0.2 ml min-1 were considered to be indicative of SGH. RESULTS: One or more symptoms of oral dysfunction were reported in 178 (83%) patients, in addition to xerostomia. The clinician diagnosed oral dryness in 105 patients. Objective evidence of SGH was found in 125 (58%) of patients. The clinicians' subjective assessment of oral dryness was indicative of a reduced UFR (P < 0.0001) and a significant predictor of an UFR < 0.2 ml min-1 using logistic regression analysis (odds ratio 9.6; 95% CI 4.8 and 19.3). The mean UFR of patients who reported symptoms of oral dysfunction was significantly lower than the mean UFR of patients who reported no oral dysfunction. Using logistic and multiple regression analyses, symptoms of oral dysfunction were not found to be significant predictors of either an UFR < 0.2 ml min-1 or a reduced UFR. CONCLUSIONS: The clinical assessment of oral dryness was a significant predictor of SGH, in this selected group of patients. Patients who complain of xerostomia may have additional symptoms of oral dysfunction indicative of a reduced UFR.