Anti-cardiolipin antibodies in sera from patients with periodontitis

Antiphospholipid antibodies are commonly found in patients with systemic lupus erythematosus or the antiphospholipid syndrome, and a subset of such antibodies is associated with prothrombotic events such as stroke and with adverse pregnancy outcomes and fetal loss. We examined sera from 411 patients who were clinically characterized as to their periodontal disease status for serum levels of beta2-glycoprotein I-dependent anti-cardiolipin autoantibodies (anti-CL). The prevalence of patients with chronic periodontitis (CP) and generalized aggressive periodontitis (GAgP) positive for anti-CL (16.2% and 19.3%, respectively) was greater than that in healthy controls (NP) and localized aggressive periodontitis (LAgP) patients (6.8% and 3.2%). Patients with these autoantibodies demonstrated increased pocket depth and attachment loss compared with patients lacking the antibodies. Analysis of the data indicates that patients with generalized periodontitis have elevated levels of autoantibodies reactive with phospholipids. These antibodies could be involved in elevated risk for stroke, atherosclerosis, or pre-term birth in periodontitis patients.     

Behçet's syndrome

A dentist referred a 35-year-old woman to the department of oral and maxillofacial surgery because of recurrent aphtous-like changes of the oral mucosa and persisting pain. She also experienced similar complaints about her eyes and genitals. This combination of symptoms was suspect for Beh?et's disease.     

The protective effect of TiF4, SnF2 and NaF on erosion of enamel by hydrochloric acid in vitro measured by white light interferometry

The purpose of this in vitro study was to compare the protective effect of TiF4, SnF2 and NaF (all 0.5 M F) on the development of erosion-like lesions in human dental enamel. Four enamel specimens from each of 6 extracted molars were polished and embedded in epoxy resin. The enamel surfaces of 3 specimens from each tooth were treated with the different fluoride solutions for 2 min. Following fluoride treatments, the specimens were immersed in 0.01 M HCl (pH 2.0), for 2, 4 and 6 min in order to mimic a gastric reflux situation. One specimen from each tooth was used as a control and was only exposed to acid. The etching depths (in micrometres) after 6 min were: TiF4 0.8 (SD 0.8), SnF2 3.5 (SD 0.7), NaF 5.3 (SD 0.4), and 7.0 (SD 0.3) for the control specimens. Compared to the control, TiF(4) protected the enamel surface from acid attack almost completely (88%), while SnF2 reduced the etch depth after 6 min by 50% and NaF by 25%.     

Oral lesions of HIV disease and HAART in industrialized countries

The epidemiology of HIV-related oral disease in industrialized nations has evolved following the initial manifestations described in 1982. Studies from both the Americas and Europe report a decreased frequency of HIV-related oral manifestations of 10-50% following the introduction of HAART (highly active antiretroviral therapy). Evidence suggests that HAART plays an important role in controlling the occurrence of oral candidosis. The effect of HAART on reducing the incidence of oral lesions, other than oral candidosis, does not appear as significant, possibly as a result of low lesion prevalence in industrialized countries. In contrast to other oral manifestations of HIV, an increased prevalence of oral warts in patients on HAART has been reported from the USA and the UK. HIV-related salivary gland disease may show a trend of rising prevalence in the USA and Europe. The re-emergence of HIV-related oral disease may be indicative of failing therapy. A range of orofacial iatrogenic consequences of HAART has been reported, and it is often difficult to distinguish between true HIV-related oral disease manifestations and the adverse effects of HAART. A possible association between an increased risk of oral squamous cell carcinoma and HIV infection has been suggested by at least three epidemiological studies, with reference to the lip and tongue. These substantial and intensive research efforts directed toward enhancing knowledge regarding the orofacial consequences of HIV infection in the industrialized nations require dissemination in the wider health care environment.     

Occlusal contacts during lateral excursions in children with primary dentition

The presence of non-working occlusal contacts in adults is considered abnormal and may initiate parafunctional activity. Few studies have looked for non-working occlusal contacts in children with primary dentition. The purposes of this study were (1) to prove the existence of non-working-side occlusal contacts, and (2) to quantify their area during lateral excursion in children with primary dentition. To achieve this purpose, we developed a measurement system that combined a tracking system for mandibular movements with a three-dimensional digitizer for tooth shape. Ten children were selected for this study. Estimated occlusal contact area of the primary second molar on the non-working side was 0.8 mm2, in contrast to 2.0 mm2 on the working side, at 3.0 mm of movement of the lower incisor. All children examined had some occlusal contacts on the non-working side during the first part of lateral excursion.     

Bilateral variation of the masseteric myotatic reflex and the silent period in young humans

Increased bilateral differences in jaw reflexes have been considered as pathological findings. The aim of this study was to investigate the normal variation between sides in the jaw jerk and the silent period and determine the range of its boundaries, using the present experimental set-up. Electromyographic data were simultaneously recorded from the right and left masseter muscles by surface electrodes, using a computerized recording and analysis system. The reflexes were elicited by chin taps during mandibular rest and at moderate intercuspal clenching in 20 healthy dentate adults (10 males and 10 females) with a mean age of 26 years. The reflexes were always elicited bilaterally and no overall significant differences were observed between sides for occurrence, latency, duration and amplitude of the jaw jerk and for the latency and duration of the silent period (P > 0.05). However, in the individual analysis significant bilateral variation was occasionally recorded, particularly for the jaw jerk at rest and mainly in the amplitude measurements. On the other hand, in the silent period duration measurements individual variation was very limited. Bilateral individual latency differences for the jaw jerk did not exceed 1 ms at rest (x = 0.3 +/- 0.3 ms) and 0.7 ms at clench (x = 0.3 +/- 0.2 ms), while latency differences for the silent period did not exceed 0.8 ms for the early type (x = 0.4 +/- 0.2 ms) and 4.8 ms for the late phase of depression (x= 1.9 +/- 1.7 ms). Bilateral differences for the silent period duration did not exceed 7.1 ms (x = 2.2 +/- 2.3 ms) in the early type (simple + early phase of combined types) and 3.3 ms (x = 1.5 +/- 0.9 ms) in the total duration of the combined types.     

Effectiveness of gutta-percha removal with and without the microscope

The microscope may be useful in retreatment to enhance removal of gutta-percha (GP) and to identify deficiencies in the original treatment. This study compared the effectiveness of GP removal with and without a microscope. Forty-five extracted canines were stepback prepared and obturated with GP and Roth's sealer using lateral condensation. Teeth were stored for 17 months in a humidor, then divided into four groups: group 1 (n = 20)--GP removal without aid of the microscope (group 1 criteria for GP removal was lack of GP on final files and on paper points agitated within the chloroform-filled canal); group 2 (n = 20)--GP removal with the microscope. (In addition to group 1 criteria, canals were inspected with the microscope; additional GP was removed when identified. In both groups, GP was removed using a combination of mechanical instrumentation, chloroform solvent, and K-files); group 3 (n = 3)--positive control, canals remained obturated; and group 4 (n = 2)--negative control, canals were neither prepared nor obturated. Teeth were split longitudinally, photographed, then divided into thirds to compare the apical, middle, and cervical thirds. Remnants of GP and sealer on the canal wall were traced with a digitizer, and the remaining mean % GP was analyzed by t test. Group 1 had 8.3% remaining GP, and group 2 had 7.3% remaining GP. There was no significant difference demonstrated between the two experimental groups.     

Histologic observations of periodontal wound healing after treatment with PerioGlas in nonhuman primates

The effect of PerioGlas (synthetic bone particulate) on wound healing of experimental palatal periodontal defects in monkeys was evaluated. Chronic periodontal defects were created on the palatal aspects of maxillary molars and premolars. Open-flap debridement was performed. Experimental sites received PerioGlas, while control sites received no further treatment. Histologic measurements were performed on new bone, new cementum, epithelial downgrowth, and recession. Results showed significantly more new cementum and less epithelial downgrowth in the sites that received PerioGlas (P < 0.05). The present results indicate that PerioGlas may enhance periodontal wound healing outcomes.     

Microbial factors and gingival crevicular fluid aspartate aminotransferase levels

Abstract. The aim of this cross-sectional study was to investigate the clinical application of chairside tests for gingival crevicular fluid (GCF) aspartale amino-transferase (AST) levels and plaque BANA hydrolysis activity with the presence of the periodontal pathogens Porphyromonas gingivalis and Actinohacillus action-mycetemcomitans. The study comprised 100 periodontitis sites (pocket depths≥4 mm. GI = 3) from 10 patients with chronic adult periodontitis and 100 control sites (pocket depths <4 mm. GI<3) from 10 periodontally healthy patients comprising 55 healthy sites (pocket depths <4 mm. GI=0) and 45 gingivitis sites (pocket depths <4 mm, GI=1 or 2). The values for both BANA hydrolysis and AST levels were significantly higher in samples from periodontitis compared with gingivitis and healthy sites (p<0.001), A. actinomycetemcomitans was identified in 45% and P. gingivalis in 17% of periodontitis sites but neither pathogen was recovered from control sites and there was no significant correlation with (he clinical parameters measured. There was no significant relationship between the presence of P. gingivalis and/or A. actinmycetemcomitans with BANA hydrolysis or AST levels. A significant correlation (p=0.0017) was observed between BANA hydrolysis and pocket depth and between AST hydrolysis and the GI (p=0.01). This study failed to demonstrate a positive association between chairside analysis of GCF metabolites for AST levels and/or BANA hydrolysis with P. gingivalis and A. actinomycetemcomitans. However, the GCF metabolites had a significant correlation with periodontally diseased sites in patients with chronic adult periodontitis and may help confirm clinical observations.     

Extended bleaching of tetracycline-stained teeth: a 5-year study

Bleaching tetracycline-stained teeth is the most challenging form of tooth lightening. This article reports on 44 subjects who bleached their tetracycline-stained teeth for 6 months using trays with reservoirs overnight in a half-mouth designed study and 2 of 3 different concentrations of carbamide peroxide (10%, 15% or 20%). The subjects were followed for 5 years. The area evaluated was the middle third of the teeth. More than 55% of tooth lightening occurred within 1 month; after 5 years, more than 65% of the maximum tooth whitening remained for all 3 gel concentrations. Tooth whitening can be accomplished with any of the 3 concentrations used.