Peripheral osteoma of the mandible: case report and review of the literature.

BACKGROUND: Osteoma is a benign often asymptomatic neoplasm, consisting of well-differentiated mature bone. This paper reports a case of peripheral osteoma located in the anterior mandibular region and provides a review of the literature about this lesion in the jaws. PATIENT AND METHODS: A 43-year-old white woman presented with a swelling in the left mandible of 7 years duration. The English literature was reviewed over the past 76 years and data about location, histopathology and number of the peripheral osteomas, sex, and age of the patients were evaluated. RESULTS: Data analysis showed 69 well-documented cases of peripheral osteoma. Peripheral osteomas are more frequent in the mandible than the maxilla and the cancellous type was most frequent; males and females are equally affected in the mandible; the age range was 9-85 years. CONCLUSION: The peripheral type of osteoma is most common in the lower jaws, occurs at the surface of the cortical bone and is sessile or pedicled.     

Marginal leakage of polyacid-modified composite resin restorations in primary molars: an in vitro study

The purpose of this in vitro study was to compare the marginal leakage in primary molars restored with 2 polyacid-modified composite resins (Dyract AP - Dentsply and F2000 - 3M) and a composite resin (Filtek Z250 - 3M) as control. First and second primary molars were used for preparation of cavities on the proximal surfaces, with extension of the gingival margin to the cementoenamel junction. Restorations were accomplished after total etching and application of the respective adhesive system, and were divided into groups according to the restorative system and the number of adhesive layers used. The teeth were stored in distilled water for 7 days, followed by thermocycling with 500 cycles at 5oC - 55oC, with one minute in each bath. Thereafter, teeth were prepared for immersion in 0.5% methylene blue solution for four hours. The teeth were sectioned in mesiodistal direction for assessment of dye penetration. According to the results of the Kruskal-Wallis test, the three restorative materials employed did not completely avoid marginal leakage at the gingival margin of primary molars. The marginal leakage of PMCR F2000 (4.06 and 3.95) displayed to be higher than the marginal leakage observed for the materials Dyract AP (2.7 and 2.55) and Filtek Z250 (2.25 and 2.43). The number of adhesive layers did not influence the degree of leakage of the three materials.     

Analysis of the condyle/fossa relationship before and after prosthetic rehabilitation with maxillary complete denture and mandibular removable partial denture

STATEMENT OF PROBLEM: The influence of the loss of posterior teeth on the condylar position and on temporomandibular disorders (TMDs) remains a controversial issue. PURPOSE: This study investigated whether prosthetic rehabilitation promoted modification of the condylar position in subjects without symptoms of TMDs. MATERIAL AND METHODS: The temporomandibular joints (TMJs) of 12 women (age 37 to 74), all with existing maxillary complete dentures but no removable partial denture (RPD) restoring the Kennedy class I partially edentulous mandibular arch and no clinical signs of TMDs according to the criteria established by Helkimo, were viewed in maximal intercuspal position with corrected lateral tomography before and after prosthetic rehabilitation with a new maxillary complete denture and a mandibular RPD. Before prosthetic rehabilitation, a mandibular stabilizing base was fabricated to prevent the existing maxillary complete denture from dislodging during tomographic examination. Two methods were used to evaluate tomograms: (1) linear measurements of the subjective narrowest anterior and posterior intra-articular joint spaces made from the tomograms by use of a digital caliper and (2) linear measurements of the anterior and posterior intra-articular joint spaces on the basis of drawings and tracings. Repeated-measures analysis of variance followed by orthogonal contrasts were used to evaluate differences between measurements carried out on the same subject under the different test conditions of the study (before prosthetic rehabilitation, before prosthetic rehabilitation with a mandibular stabilizing base in position, and after prosthetic rehabilitation) (P<.05). RESULTS: Before prosthetic rehabilitation, a predominance of posterior condylar positions was observed. Before prosthetic rehabilitation with a mandibular stabilizing base in position, a significant decrease was observed in posterior condylar positions (P=.03). This decrease was more marked after prosthetic rehabilitation (P=.02). The subjective evaluation and comparison on the basis of drawings and tracings used to analyze the tomograms produced similar results (P=.70). CONCLUSION: Within the limitations of this study, significant changes in the condylar position occurred after prosthetic rehabilitation in subjects without symptoms of TMDs.     

Prevalence of 6 putative periodontal pathogens in subgingival plaque samples from Romanian adult periodontitis patients

Abstract The aim of the present study was to determine by standard cultivation procedures the detection frequencies of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum. Actinobacillus actinomycetemcomitans, Bacteroides forsythus, and Capnocytophaga species as well as various enteric rods in subgingival plaque samples form Romanian adult periodontitis patients. DNA probe analysis (Affirm^TM DP Microbial Identification Test) was also used, parallel to cultivation, to identify P. gingivalis. A. actinomycetemcomitans, and B. for- sythus, in deep (≥6 mm) and intermediate (4–5 mm) pockets in some of the subjects investigated. Paper points were used to sample 86 deep pockets in 36 patients and 27 intermediate pockets in 9 of the 36 patients. The x² test was used to test for significance of differences between results obtained by cultivation and DMA analysis in both intermediate and deep pockets. P. gingivalis was recovered in a high percentage of the patients (75,8%) and sites (63.6%) examined, followed by P. intermedia, F. nucleatum, and A. actinomycetemcomitans, respectively. Capnocytophaga species were present in almost all subjects. Enteric rods were recovered in 61.1% of the patients and 55.8% of the sites. Except for this high prevalence of enteric rods, the present group of patients had the periodontal species monitored in %s similar to those commonly perceived in the West. The Affirm M DP Test and cultivation showed poor correlation in detecting P. gingivalis. A. actinomycetemcomitans, and B. forsythus. The cultivation prevalence of P. gingivalis and P. intermedia in deep pockets was similar to their prevalence in intermediate ones. Overall, the prevalence of the periodontal pathogens investigated in the present Romanian periodontitis patients is similar to what has been revealed in matching Norwegian and other Western periodontitis patient populations. The high prevalence of enteric rods in the Romanian patients may have been an artifact resulting from prolonged transport of the samples in VMGA III.     

Evaluation of the castability of a Co-Cr-Mo-W alloy varying the investing technique

The purpose of this study was to compare the castability of Co-Cr-Mo-W (Remanium 2000), Ni-Cr (Durabond) and Co-Cr-Mo (Vera PDI) alloys invested with either conventional (phosphate- and silica-based) or mixed investing techniques. A 10 X 10 mm square-shaped nylon net containing 100 open squares served as a template for construction of wax patterns, which were invested with phosphate-based investment (Termocast), silica-based investment (Refrafil) and mixed investing technique (2-mm layer phosphate investment plus filling with silica investment). Forty-five cast specimens (5 per experimental condition) were obtained and sandblasted with aluminum oxide. The number of completely reproduced cast segments was counted to obtain a percentage designated "castability value", which indicated the accuracy of the alloy to reproduce mold details. Statistical analysis using two-way ANOVA and Tukey's test showed that, comparing the alloys, Remanium 2000 had statistically similar castability (p>0.05) to Vera PDI and lower than Durabond (p<0.05). Considering the mixed technique results, Remanium 2000 yielded lower castability value (p<0.05) than Durabond and Vera PDI alloys, which showed similar results to each other (p>0.05). In conclusion, the castability of the Co-Cr-Mo-W alloy (Remanium 2000) was comparable to that of the Co-Cr alloy (Vera PDI) and worse than that of the Ni-Cr alloy (Durabond). Except for Remanium 2000, the mixed investing technique considerably improved the accuracy of the alloys to reproduce cast details, compared to the phosphate-based investment. The mixed investing technique appears as a viable alternative to improve castability of base metal alloys without decreasing the surface quality of the metallic pieces.     

Association of endodontic infection with detection of an initial lesion to the cardiovascular system

Introduction

Dental infections might predispose toward the onset of cardiovascular disease (CVD). To date, only a few studies, yielding inconclusive findings, have investigated the potential correlation between apical periodontitis (AP) and CVD. The aim of this study (as the first part of a prospective study) was to evaluate, in the absence of CV risk factors, whether subjects with AP were more exposed to the pathogenetic indices of an atherosclerotic lesion.

Methods

Forty men between the ages of 20 and 40 years who were free from periodontal disease, CVD, and traditional CV risk factors were enrolled in the study; 20 subjects had AP, and 20 acted as controls. All subjects underwent dental examination and complete cardiac assessment: physical examination, electrocardiogram, conventional and tissue Doppler echocardiography, and measurement of endothelial flow reserve (EFR). The following laboratory parameters were tested: interleukins -1, -2, and -6 (IL-1, IL-2, IL-6), tumor necrosis factor alpha, and asymmetrical dimethylarginine (ADMA). Data were analyzed by using the 2-tailed Student's t test, Pearson t test (or Spearman t test for nonparametric variables), and multivariate linear regression analysis.

Results

Echocardiography revealed no abnormalities in any of the subjects studied. ADMA levels were inversely correlated with EFR (P < .05) and directly correlated with IL-2 (P < .001). Patients with AP presented with significantly greater blood concentrations of IL-1 (P < .05), IL-2 (P < .01), IL-6 (P < .05), and ADMA (P < .05) and a significant reduction of EFR (P < .05).

Conclusions

Increased ADMA levels and their relationship with poor EFR and increased IL-2 might suggest the existence of an early endothelial dysfunction in young adults with AP.     

The rise and fall of the Latino dentist supply in California: implications for dental education

The purpose of this study was to determine the number of Latino dentists in California, identify the schools and countries where they were educated, and compare Latino dentist demographics with that of the state's new demographics. From the 2000 California Department of Consumer Affairs list of 25,273 dentists, we identified Latino U.S. dental graduates (USDGs) by "heavily Hispanic" surnames and Latino international dental graduates (IDGs) by country and school of graduation. From the 2000 U.S. census Public Use Microdata Sample (PUMS), we described Latino dentist characteristics such as Spanish language capacity and practice location. The number of Latino dentists acquiring licenses to practice in California has fallen dramatically, by nearly 80 percent, between 1983 and 2000. This decline is not merely an affirmative action issue; it results in an issue of access. Latino dentists are far more likely to speak Spanish and be located in a heavily Latino area than non-Latino dentists. Currently, although the supply of Latino dentists is dwindling, the Latino population is growing rapidly. In California and out-of-state schools, first-year matriculation of Latino USDG must increase. Further, non-Latino dentists should be prepared and given incentives to learn Spanish and locate practices in areas of need. The reintroduction of IDG Latino dentists needs to be seriously considered.     

Isolation of Candida dubliniensis in denture stomatitis

Objective

To describe the isolation of Candida dubliniensis from a patient with denture stomatitis and to compare with the presence of yeasts in the oral cavities of denture wearers.

Design

One hundred and fifty-two Candida isolates were recovered through oral swabs from denture as well as the underlying mucosa from 100 patients wearing denture. For detection and identification of fungal isolates, standard phenotypic and genotypic methods were used.

Results

Forty-five of 100 denture wearers suffered from denture stomatitis. Seventy-three Candida isolates were recovered from 38 denture wearers without denture stomatitis. In this group, Candida albicans was the predominant species (58.9%), followed by Candida tropicalis (15.1%), Candida guilliermondii (13.7%), Candida glabrata (9.6%), and Candida parapsilosis (2.7%).Seventy-nine isolates were yielded from 40 patients suffering from denture stomatitis. C. albicans was also the most frequently isolated species (58 isolates, 73.4%), followed by C. glabrata and C. tropicalis (7 isolates each, 8.9%), and Saccharomyces cerevisiae (2 isolates, 2.5%). One isolate was yielded of the following species: Candida famata, Candida krusei, C. parapsilosis and C. guilliermondii. Moreover 1 isolate was phenotypic and genotypic identified as C. dubliniensis genotype 1.

Conclusions

C. albicans is the predominant fungal species isolated from denture wearers. C. dubliniensis could be isolated from adults with denture stomatitis.     

Prevalence of mutans streptococci isolated from complete dentures and their susceptibility to mouthrinses

The aims of this study were to evaluate the incidence of mutans streptococci (MS - sessile form) on complete maxillary dentures after use of a specific denture paste, and to determine the minimum inhibitory concentration (MIC) and maximum inhibitory dilution (MID) of 3 oral mouthrinses: Cepacol, Plax and Periogard. Seventy-seven complete denture wearers were randomly assigned into 2 groups, according to the product used for denture cleaning: Control group - conventional dentifrice (Kolynos-Super White); and Test group: experimental denture cleaning paste. Denture biofilm was collected at baseline and after 90 and 180 days after treatment by brushing the dentures with saline solution. After decimal serial dilution, samples were seeded onto agar sucrose bacitracin to count colonies with morphological characteristics of MS. MS identification was performed by the sugar fermentation tests. After this procedure, brain heart infusion broth (BHI) was added to oral mouthrinses (Plax, Cepacol e Periogard) and seeded on Petri dishes. The colonies were seeded using the Steers multiplier and, after the incubation, the MIC and MID of the mouthrinses were calculated. The results showed an incidence of 74.0% (n=57) of MS in the 77 complete dentures examined in the study, being 76.3% (n=29) of the Control group (conventional dentifrice) and 71.8% (28) of the Test group (experimental denture cleaning paste). In both groups, the number of positive cases for MS decreased from day 0 to day 180. In the Test group there was a slight decrease in the incidence of Streptococcus mutans 90 days after use of the experimental denture cleaning paste, which was not observed in the Control group. As regards to mouthrinses, for both groups, Periogard showed antimicrobial action with the highest dilution, followed by Cepacol and Plax. In conclusion, the incidence of MS in complete dentures was high and Periogard was the mouthrinse with the strongest antimicrobial action against MS. The experimental denture cleaning paste showed a slight action against S. mutans after 90 days of treatment.