Relationship of metabolic syndrome to periodontal disease in Japanese women: the Hisayama Study

Recent studies have suggested that several systemic conditions--such as obesity, hypertension, hyperlipidemia, and diabetes--are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome--abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level--in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6-16.4) and 4.2 (95% confidence interval = 1.2-14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.     

Lip impressions: a new method for monitoring morphological changes in orofacial granulomatosis

AIM: To develop and evaluate an objective method for assessing lip size and treatment-related morphological changes in orofacial granulomatosis (OFG) patients. MATERIALS AND METHODS: Patients with swollen lips because of OFG (n=21) were enrolled. A light-body polyvinylsiloxane material was used to take lip impressions before and after treatment (n=10), or during treatment (n=11). Plaster models were cast from the impressions and the lips were measured using callipers. The intra-examiner and inter-examiner reproducibility of the technique were assessed. RESULTS: OFG patients had significantly larger lips than controls (P<0.0001). The coefficient of variation on repeated measurements of the same impression was 1.6% and for duplicate impressions was 2.6%. Significant reduction in lip size was shown in all 10 patients after diet restriction (P<0.002). Seven of 11 patients whose impressions were taken at least 3 months after the initiation of cinnamon- and benzoate-free diet also showed reduction in lip size during follow up (P<0.002). CONCLUSIONS: Serial lip impressions appear to be reliable for routine quantification of morphological changes of the lips in OFG patients. We present a new reproducible and sensitive method for assessing changes in lip size in response to treatment in OFG.     

The effect of aspirin on gingival crevicular fluid levels of inflammatory and anti-inflammatory mediators in patients with gingivitis

BACKGROUND: Inflammatory and anti-inflammatory mediators may play a significant role in patients with gingivitis. The purpose of this study was to assess the short-term effects of the systemic administration of two different concentrations of aspirin (81 and 325 mg/day, by mouth) on clinical periodontal parameters and gingival crevicular fluid (GCF) levels of 15-epi-lipoxin A4 (15-epi-LXA4), lipoxin A4, leukotriene B4 (LTB4), prostaglandin E2 (PGE2), and interleukin (IL)-6 and -1beta in a sample of naturally occurring gingivitis patients. METHODS: At day 0, after initial screening for entry, baseline periodontal parameters, including bleeding on probing (BOP), periodontal probing depths (PDs), and plaque index (PI) were measured, and GCF was sampled from 12 intrasulcular sites with filter paper strips for the measurement of six types of inflammatory and anti-inflammatory mediators using competitive enzyme immunoassay and enzyme-linked immunosorbent assay (prevalues). Forty-seven subjects were assigned randomly to one of three treatment groups: placebo (15 subjects); aspirin, 81 mg (16 subjects); and aspirin, 325 mg (16 subjects) once daily. On day 7, subjects were recalled for the measurement of periodontal parameters and collection of GCF samples for the measurement of six types of mediators (postvalues). RESULTS: Changes in inflammatory and anti-inflammatory mediator levels were not statistically significant for any of the three treatment groups. However, when pre- and postvalues were compared in the subjects receiving aspirin, 325 mg, there was a negative trend in the relationship between 15-epi-LXA4 and PGE2, whereas the relationship between LTB4 and PGE2 was not as strong. This might indicate that the subjects responding to aspirin-mediated PGE2 suppression effects produced higher 15-epi-LXA4 in GCF than non-responders. No statistically significant differences in PD and PI between pre- and postvalues were found for any of the three treatment groups. However, the results demonstrated a significant increase in BOP when aspirin, 325 mg was compared to placebo (P <0.001) and aspirin, 81 mg (P = 0.001). CONCLUSIONS: Aspirin can have an affect on BOP in naturally occurring gingivitis patients. Although most of the inflammatory mediators did not show significantly detectable changes after aspirin treatment for 7 days, the trend of aspirin-associated increases of 15-epi-LXA4 implied that this recently discovered aspirin-dependent eicosanoid may be associated with the increased incidence of BOP observed in the subjects who received aspirin therapy.     

A new method for lateral pterygoid electromyographic electrode placement

STATEMENT OF PROBLEM: Making electromyographic recordings of the lateral pterygoid muscle (LP) is difficult because of potential electrode damage to, for example, the maxillary artery and long buccal nerve, and because of pain and reduced jaw mobility characteristic of many orofacial pain patients. PURPOSE: The purpose of this study was to develop a reliable intraoral placement technique for the inferior head of the lateral pterygoid (IHLP) that minimizes jaw displacement. MATERIAL AND METHODS: In 2 dried skulls and 7 human cadavers, it was estimated that, with the mandible in an ipsilateral closed position, a straight needle could be used to position fine-wire electrodes into the midportion of IHLP by inserting the needle through the mucosa adjacent to the distal root of the maxillary second molar, towards the external auditory meatus and parallel to the buccal alveolar bone of the maxilla. The needle avoided the maxillary artery and long buccal nerve. Using this approach in 5 adults, 2 fine-wire electrodes were placed into the IHLP. Placement was verified by computer tomography (CT) and electromyography. RESULTS: In all subjects, the ideal insertion depth to place the electrodes in the middle of IHLP was 29 mm. CONCLUSIONS: This technique is a reliable method for IHLP electrode placement for patients with impaired jaw function, minimizing risk of damage to major structures.     

National Italian Guidelines for caries prevention in 0 to 12 years-old children.

AIM: Oral and dental health improved tremendously over the last fifty years in Italy but still prevalence of dental caries in children remains a significant clinical problem. This report describes the National Italian Guidelines for caries prevention. METHODOLOGY: A panel of experts coordinated by the Italian Society of Paediatric Dentistry (SIOI) planned to elaborate the national Italian guidelines for caries prevention in children. The structure of the guidelines has been planned to follow the principles of modern caries treatment and management as well as science based dentistry. The main procedure was based on a hierarchic evaluation of literature. CONCLUSION: The guidelines are planned for dentist working in primary dental care, however, they are also designed to be of interest for other care professionals such as paediatricians, gynecologists, pharmacists and general medical practitioners and also for parents and/or guardians of the children.     

Oral health impact of periodontal diseases in adolescents

The need for treatment of destructive periodontal diseases is based on observations made by oral health professionals, who, prompted by clinical findings, recommend treatment. We hypothesized that clinical signs of periodontal destruction have an impact on the oral-health-related quality of life of adolescents. We conducted a cross-sectional study among 9203 Chilean high school students sampled by a multistage random cluster procedure. We recorded clinical attachment levels and the presence of necrotizing ulcerative gingivitis. The students answered the Spanish version of the Oral Health Impact Profile and provided information on several socio-economic indicators. The results of multivariable logistic regression analyses (adjusted for age, gender, and tooth loss) showed that both attachment loss [OR = 2.0] and necrotizing ulcerative gingivitis [OR = 1.6] were significantly associated with higher impact on the Oral Health Related Quality of Life of adolescents. Individuals in lower socioeconomic positions systematically reported a higher impact on their oral-health-related quality of life.     

Glomus tumor of the index finger

A 41-year-old female patient presented with localized worsening subungual pain of her right index finger. Subsequent diagnostic evaluation revealed the presence of a glomus tumor. A glomus tumor is a rare tumor with a predilection for the hand. Classic symptoms include pain, pain with pressure, and pain with cold temperature. We present a completely updated literature review that addresses the epidemiology, pathology, presentation, diagnostic evaluation, classification, histology, genetics, and treatment options for glomus tumors.     

Consensus conference on immediate loading: the single tooth and partial edentulous areas

PURPOSE: A consensus conference was held to determine what the parameters should be for the immediate functional loading of the single-tooth implant restoration and short-span fixed implant-supported bridgework. MATERIALS: Forty-one clinicians and researchers presented cases and situations relating to the topic. A panel then distilled questions that were presented to the audience (430) at large. Answers were gleaned to formulate a consensus. RESULTS: Ten distinct answers evolved that constituted the essence of guidelines for clinicians to be aware of when undertaking immediate loading. These guidelines are contained within the body of the text. CONCLUSIONS: Extreme caution and adherence to a universal generic protocol are suggested for clinicians who are involved with single-tooth and short-span multiple-teeth implant replacements as related to immediate loading as defined within this text.     

A clinical trial of Empress II porcelain inlays luted to vital teeth with a dual-curing adhesive system and a self-curing resin cement

PURPOSE: The aim of the study was to clinically evaluate Empress II inlays cemented with a dual-curing bonding agent and a self-curing luting system. MATERIALS AND METHODS: Forty patients were selected to receive one Empress II inlay. Empress II is a heat-pressed glass ceramic containing lithium disilicate and lithium orthophosphate crystals, purported to provide higher stress resistance and improved strength. The restorations were placed between March and May 2000. Recalls were performed after 6, 12, 24, and 36 months. At the 3-year recall, 7 patients were lost to follow-up. Inlays were evaluated for postoperative sensitivity, marginal integrity, marginal leakage, color stability, surface staining, retention, and surface crazing (microcracks). RESULTS: At the 3-year recall, all the restorations were in place and only one showed postoperative sensitivity (at the first recall, 1 week after placement). Only 3 inlays showed slight marginal staining, and 4 inlays showed gaps, with little surface staining or microcracks. CONCLUSIONS: No inlay debonded or fractured during theobservation period. All the evaluated inlays were in place and acceptable.     

Hydrolysis of functional monomers in a single-bottle self-etching primer--correlation of 13C NMR and TEM findings

Self-etching primers/adhesives that combine acidic methacrylate monomers with water in a single bottle are hydrolytically unstable and require refrigeration to extend their shelf-lives. This study tested the null hypothesis that one year of intermittent refrigeration of a 4-MET-containing simplified self-etching primer does not result in hydrolytic changes that are identifiable by transmission electron microscopy and (13)C NMR spectroscopy. Human dentin was bonded with UniFil Bond immediately after being unpacked, or after one year of intermittent refrigeration at 4 degrees C. Fresh and aged primers were analyzed by NMR for chemical changes. Ultrastructural observations indicated that there was an augmentation in etching capacity of the aged adhesive that was not accompanied by resin infiltration or effective polymerization. New NMR peaks detected from the aged ethanol-based primer confirmed that degradation occurred initially via esterification with ethanol, followed by hydrolysis of both ester groups in the 4-MET. Hydrolysis of functional methacrylate monomers occurs despite intermittent refrigeration.