Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study

BACKGROUND: The prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. Although there have been several studies examining this question, the results are conflicting, with previous estimates ranging from 20% to 83%. There have been only 2 studies examining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.3%, respectively. METHODS: The current study aimed to address the problems associated with these studies by examining a sample of patients taking one of 3 calcium channel blockers, who were drawn from a community-based population in northeastern England. Nine hundred eleven (911) subjects were recruited from general medical practices in the area. Of these, 442 were taking nifedipine, 181 amlodipine, and 186 diltiazem. In addition, 102 control subjects were examined. Drug and demographic data for each subject were recorded. The periodontal condition of all subjects was assessed including plaque index, papillary bleeding index, and a photograph of the anterior gingivae for subsequent analysis of overgrowth severity. RESULTS: More than six percent (6.3%) of subjects taking nifedipine were seen to have significant overgrowth. This overgrowth was statistically greater than the amount of overgrowth seen in either of the other 2 drug groups or the control population. The prevalence of gingival overgrowth induced by amlodipine or diltiazem was not statistically significant when compared to the control group. The severity of overgrowth within the nifedipine group was found to be related to the amount of gingival inflammation and also to the gender of the subject, with males being 3 times as likely to develop overgrowth than females. CONCLUSIONS: The prevalence of clinically significant overgrowth related to chronic medication with calcium channel blockers is low, i.e., 6.3% for nifedipine. Males are 3 times as likely as females to develop clinically significant overgrowth. The presence of gingival inflammation is an important cofactor for the expression of this effect.     

Hypocalcification type amelogenesis imperfecta in permanent dentition in association with heavily worn primary teeth, gingival hyperplasia, hypodontia and impacted teeth

A female patient with hypocalcification type amelogenesis imperfecta in permanent dentition in association with heavily worn primary teeth, gingival hyperplasia, hypodontia and impacted teeth is presented.     

Diversity of oral asaccharolytic Eubacterium species in periodontitis--identification of novel phylotypes representing uncultivated taxa

Oral asaccharolytic Eubacterium species are associated with periodontal disease and other oral infections. The aim of this study was to use a culture-independent molecular technique to determine the diversity of asaccharolytic Eubacterium species in subgingival plaque in periodontitis. An oligonucleotide PCR primer designed to amplify 16S rRNA genes of the oral asaccharolytic Eubacterium branch of the phylogenetic tree was constructed. This primer was used together with a universal primer in PCRs to amplify gene sequences directly from a single subgingival plaque sample. Fifty PCR products were purified by cloning, fully sequenced and subjected to molecular phylogenetic analysis. The sequences were assigned to four groups within a single lineage of the low G + C gram-positive bacteria. Group I (58% of the cloned sequences) was assigned to a branch that included Eubacterium nodatum, and Group II (22%) to a branch including Eubacterium infirmum. Group III (8%) was distinct from but related to E. infirmum at the species level, and Group IV (12%) was another novel taxon more distantly related to E. infirmum and E. nodatum.     

Mechanical response to functional loading around the threads of retromolar endosseous implants utilized for orthodontic anchorage: coordinated histomorphometric and finite element analysis

A 3-dimensional bone-implant finite element model was created. The objective was to further investigate the mechanical environment of cortical bone adjacent to the threads of a retromolar endosseous implant used for orthodontic anchorage to mesially translate mandibular molars in response to normal functional loading. This study emphasizes the stress invariants around and between the threads of the implant for future comparison to histomorphometric data from an ongoing clinical study. A strong stress pattern change was found immediately around the implant, which was reflected by a moderate change of stresses between the threads and a significant increase in stress at the tips of the threads.     

High-dose-rate mold brachytherapy of early gingival carcinoma: a clinical report

Two elderly edentulous patients with the diagnosis of early stage cancer of the upper gingiva were treated by customized dental mold brachytherapy. Locoregional tumor control was achieved in both patients. One patient is alive without any evidence of disease 36 months after treatment, the other patient died of distant metastasis shortly after brachytherapy. Brachytherapy, being easy to apply with short treatment time and good acute tolerance, is a good choice and effective modality for the management of early stage gingival cancer, particularly in elderly patients.     

Bone reactions to anorganic bovine bone (Bio-Oss) used in sinus augmentation procedures: a histologic long-term report of 20 cases in humans

Many materials are used for sinus augmentation procedures. Anorganic bovine bone (Bio-Oss) has been reported to be osteoconductive, and no inflammatory responses have been observed with the use of this biomaterial. One of the main questions pertaining to Bio-Oss concerns its biodegradation and substitution by host bone. Some investigators have observed rapid replacement by host bone, while other researchers observed slow resorptive activity or no resorption at all. The aim of the present study was to conduct a long-term histologic analysis of retrieved specimens in humans where Bio-Oss was used in sinus augmentation procedures. Specimens were retrieved from 20 patients after varying periods from 6 months to 4 years and were processed to obtain thin ground sections. Bio-Oss particles were surrounded for the most part by mature, compact bone. In some Haversian canals it was possible to observe small capillaries, mesenchymal cells, and osteoblasts in conjunction with new bone. No gaps were present at the interface between the Bio-Oss particles and newly formed bone. In specimens retrieved after 18 months and 4 years, it was also possible to observe the presence of osteoclasts in the process of resorbing the Bio-Oss particles and neighboring newly formed bone. Bio-Oss appears to be highly biocompatible and osteoconductive, is slowly resorbed in humans, and can be used with success as a bone substitute in maxillary sinus augmentation procedures.     

Accuracy of implant impression splinted techniques: effect of splinting material

Three implant impression techniques, using 3 different splinting materials, were assessed for accuracy in a laboratory model that simulated clinical practice. For group A, an autopolymerizing acrylic resin was used to splint transfer copings. In group B, a dual-cure acrylic resin was used, and for group C, plaster, which was also the impression material, was used. A metal implant master cast with an implant master framework was made to accurately fit to the cast. This cast was the standard for all impressions. For each group, 15 impressions were made. Polyether impression material was used for groups A and B. The accuracy of the stone casts with the implant analogues was measured against the master framework, using strain gauges. A multiple analysis of variance with repeated measures was performed to test for significant differences among the 3 groups. Additional analyses of variance were carried out to locate the source of difference. The statistical analyses revealed that a significant difference existed between groups A and B and between groups B and C but not between groups A and C. Impression techniques using autopolymerizing acrylic resin or impression plaster as a splinting material were significantly more accurate than dual-cure acrylic resin. Plaster is the material of choice in completely edentulous patients, since it is much easier to manipulate, less time consuming, and less expensive.     

Influence of firing times and temperature on color stability of low-fusing porcelains for high-functional gold alloys

The purpose of this study was to investigate the effect of firing conditions on color stability. Three commercially available porcelains for high functional gold alloys, Carrara (CA), Deguceram Gold (DE) and Duceragold (DU) were used. In this study color stability was investigated under fire treatment of 1st, 3rd, 5th times and firing temperatures of 0, 20, and 40 degrees C higher than the manufactures standard temperature (CA: 845 degrees C, DE: 780 degrees C, DU: 780 degrees C). L* was degreased in CA 5 times, DE 3 times, DU by repeated firing. No difference was observed among L* of firing temperatures DE and DU, but L* was degreased in CA with firing temperatures of 40 degrees C higher. a* was degreased in CA, DU, DE with repeated firing, a* was degreased 5 times at firing temperatures of higher. b* was degreased in DU, but b* was increased in CA and DE with 5 firings. b* was increased with 5 findings at firing temperatures of 40 degrees C higher.     

Congenital infiltrating lipomatosis of the face

Congenital infiltrating lipomatosis of the face is a rare clinical entity. Since it was first described by Slavin and colleagues in 1989, only a few cases have been reported in the literature. A 6-year-old girl with congenital infiltrating lipomatosis of the right side of the face is presented, and treatment modalities are discussed.     

Application of CT imaging for dental implant simulation

Accurate diagnosis and exact treatment planning are very important for successful implant treatment. Pretreatment examination and simulations using CT can be especially effective information sources, and diagnosis by CT imaging before treatment substantially enhances the security and safety of the treatment plan. New interactive CT software (SIM/Plant) which enables diagnosis of bone morphology and quality, and also implant simulation on a personal computer through multiplanar reformation of CT images, has been developed. Stereolithography models (SLMs) are reproduced anatomical morphological models of an individual patient's bone structure from the information obtained by the CT scan, and is fabricated out of light cure resin. In this article, SLMs and SIM/Plant for simulation of various examinations and diagnosis incorporating CT information are described, and their features are introduced.