Biocompatibility of sealers used in apical surgery: a histological study in rat subcutaneous tissue

The aim of this study was to evaluate the biocompatibility of sealers used in apical surgery in rat subcutaneous tissue. Sterile polyethylene tubes were filled with the following sealers: Sealapex, Sealapex with addition of zinc oxide, Sealer 26, Sealer 26 with thicker consistency (greater powder-to-resin ratio) and White MTA. The tubes were implanted in the dorsum of male rats and after 7, 21 and 42 days, the animals were killed, obtaining 5 specimens for each sealer in each evaluation period. The lateral surface of the tube was used as negative control. The inflammatory reaction to contact with the sealers was classified as absent, mild, moderate and severe. At 7 days, all sealers caused similar inflammatory reactions in the connective tissue of the animals, with most specimens presenting a moderate to intense chronic inflammatory reaction, with presence of multinucleated giant cells. At 21 days, Sealer 26 and Sealer 26 with thicker consistency presented more intense inflammatory reaction (p=0.004), whereas after 42 days, the inflammatory reaction ranged from absent to mild with statistically similar results for both materials (p=0.08). Except for MTA, all sealers presented foreign-body granulomatous reaction at 42 days. All sealers but Sealapex presented a statistically significant decrease of the inflammatory reaction over time. In conclusion, all sealers caused moderate to severe inflammation in the earlier evaluation period. However, Sealer 26 and Sealer 26 with thicker consistency caused more intense inflammatory reactions after 21 days of contact with the tissues and no granulomatous reaction was observed for MTA at the final period of analysis.     

Factors influencing the cost-effectiveness of community health center dental programs in the U. S. A.

abstract The community health center has been viewed by many Americans as an important mechanism for the improvement of health of the urban poor. The millions of dollars allocated for a relatively small percentage of the population, however, has led to some criticisms of the concept. This paper deals with factors influencing the cost of dental services in a community health center and an analysis of several existing programs. The major factors affecting the cost effectiveness of the clinics appear to be the (1) broken appointment rate, (2) age distribution of the population served, (3) mixture of services rendered, and (4) additional community services rendered. Programs which have low broken appointment rates and which treat both adults and children seem to maintain a higher revenue-cost ratio. This ratio was in the range of 0.78 to 1.10 for the three dental programs studied.     

A preliminary report on prevalences of oral mucosal lesions in a Swedish population

ABSTRACT A study has been conducted to assess the prevalence of oral soft tissue lesions. In cooperation with the public health screening organization of the County of Uppsala in Sweden, all inhabitants older than 14 years of age in two communities, Håbo and Enköping, will be called for examination. So far, 8,696 individuals have been examined. Preliminary prevalence figures on 33 lesions are reported.     

Osteonecrosis of the jaws in patients with a history of receiving bisphosphonate therapy: strategies for prevention and early recognition

BACKGROUND: Bisphosphonates, inhibitors of osteoclasts, have been shown to alleviate many of the devastating consequences associated with metastatic bone disease. However, recent reports have shown that bisphosphonates may cause osteonecrosis of the jaws. Since the publication of these initial reports, the authors have treated several patients with osteonecrosis of the jaws who had a history of receiving bisphosphonate therapy. METHODS: The authors reviewed the medical records of patients who visited their clinic between September 2003 and December 2004 and who had osteonecrosis of the jaws and a history of having received bisphosphonate therapy but no irradiation to the head and neck. RESULTS: Eleven patients (four female and seven male) with a mean age of 69 years were included in this report. They had received bisphosphonate therapy for a mean duration of 34 months. Radiographic data showed loss of bone density at sites of osteonecrosis, and histologic examination demonstrated necrosis of bone without evidence of metastases. CONCLUSIONS AND CLINICAL IMPLICATIONS: Further research is required for better understanding of the role of bisphosphonates in the development of osteonecrosis of the jaws. Until more is known, the authors recommend that measures be taken to prevent osteonecrosis those at risk, including identifying patients with a history of having received bisphosphonate therapy before they undergo dental surgery. To help identify such patients, the authors propose the use of a screening questionnaire. When feasible, physicians should consult with their patients' general dentists or oral surgeons before patients begin bisphosphonate therapy.     

Microbial complexes detected in the second/third molar region in patients with asymptomatic third molars.

PURPOSE: Our goal was to report the detection and levels of pathogenic bacteria in subgingival plaque samples taken from the distal of all second molars in 295 patients with asymptomatic third molars. PATIENTS AND METHODS: Data assessing oral health were collected from each of these healthy patients (ASA Classes I and II). Probing depth (PD), at 6 sites per tooth, including third molars, was obtained to determine periodontal status. Subgingival plaque samples were taken from the distal of all second molars before periodontal probing. The presence and levels of 11 bacterial species were determined using whole chromosomal DNA probes and checkerboard DNA-DNA hybridization. Detected bacterial species were grouped into clusters of periodontal pathogens designated as "red" or "orange" complex microorganisms as described by Socransky et al (J Clin Periodontal 25:134, 1998) who found an association of these specific microorganisms with periodontitis. RESULTS: As a group these relatively young patients were periodontally healthy. "Orange and red" complex microorganisms were detected at levels equal to or greater than 10(5) more often if patients had a PD equal to or greater than 5 mm with periodontal attachment loss at the distal of second molars or around third molars at their entry examination. In patients with no PD equal to or greater than 5 mm in the third molar region, "orange and red" complex microorganisms were detected at levels equal to or greater than 10(5) more frequently than would be anticipated in patients with little clinical evidence of periodontal disease. CONCLUSIONS: The clinical findings of increased periodontal PDs and periodontal attachment loss coupled with colonization of periodontal pathogens support the concept that clinical and microbial changes associated with the initiation of periodontitis may present first in the third molar region in young adults.     

Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions: the report of the ADEA President's Commission

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.