Prognosis of caries increment with past caries experience variables

This study aimed to select past caries experience variables as caries predictors and to compare their prognostic accuracy with the variables used in a method of caries prognosis developed in a Swiss child population. The data used for the analyses originated from an 8-year longitudinal study starting in 1980 on caries of 7.5-year-old Dutch children. Stepwise logistic regression analyses provided predictor variables. The newly introduced variables D23fi, D(123)i and D23pifi were interchangeable and the most powerful caries predictors. For the sake of uniformity and ease of application, D23fi (number of fissures of the permanent first molar with non-cavitated or cavitated caries lesions) was chosen as the first variable in the logistic regression equations. The gain in accuracy of the second and third predictor variables (number of sound primary molars and the number of buccal and lingual smooth surfaces of the permanent first molar with non-cavitated or cavitated caries) in the regression equations was limited. The D1 condition of surfaces could be omitted from the prediction models. The present forced three-predictor-regression equations for 7.5-, 9.5- and 11.5-year-old children were evaluated to assess their prognostic performance by using the area under the ROC curve as a measure of prognostic quality. For the present regression equations, the area under the ROC curve was 81-87%, which was higher compared to the Swiss regression equations for caries prognosis.     

Psychological disorder, conditioning experiences, and the onset of dental anxiety in early adulthood

Most studies examining the origins of dental fear and anxiety have relied on cross-sectional data. These are subject to several problems, such as recall and uncertainty concerning temporal relationships. This paper uses longitudinal data from the Dunedin Multidisciplinary Health and Development Study to assess risk factors for the development of dental anxiety in persons between the ages of 18 and 26 years. It was hypothesized that psychological factors would be as important as conditioning experiences in the genesis of dental anxiety over this period. The eight-year incidence of dental anxiety was 16.5%. Five variables entered models predicting onset: multiple fears, symptoms of substance dependence, previous experience of invasive dental treatment, dental visiting pattern, and the extraction of one or more teeth. Separate analyses for those avoiding and those using dental services resulted in different explanatory models. These results indicated that both psychological and conditioning variables contributed to the development of dental anxiety in this population of young adults.     

Effect of occlusal trauma on healing of periapical pathoses: report of two cases

AIM: To present two clinical cases and demonstrate that occlusal trauma may affect healing of periapical pathoses. SUMMARY: Two teeth with periradicular disease did not respond successfully to conventional root canal treatment or endodontic surgery. Occlusal adjustment was finally performed on both cases. After occlusal adjustment, uncomplicated healing and periapical repair occurred in both cases. The findings in these two cases suggest that occlusal trauma may play a role in the healing of periapical pathoses. KEY LEARNING POINTS: Occlusal trauma is positively correlated with changes in periodontal tissues. Although experiments in animals have shown that application of forces to teeth will not induce further periodontal destruction, we believe that some failures of root canal treatment may be due to the presence of occlusal trauma modulating the responses of inflamed periapical tissues or apical pathoses with persistent infection.     

Infant ectopic cervical thymus in submandibular region

Sporadic cases have been reported of ectopic thymic tissue formed along the path of embryologic descent from the mandibular region to the mediastinum, usually manifesting as an asymptomatic mass. Here is reported the case of an 8-month-old boy with a tender palpable mass in the right upper lateral neck. Preoperative posteroanterior chest radiograph revealed normal structures in the mediastinum superior including the thymus. Magnetic resonance imaging showed a 4-cm x 4-cm soft-tissue mass in the left submandibular region. Surgical resection was performed and histopathologic examination showed that the mass was composed of thymic lymphoid tissue and epithelial cells. Immunohistochemical features included positive expression of LCA, CKpan, EMA, CD20 and CD43 antibodies. The clinical 14-month follow up was negative and the child was growing normally after operation. Ectopic thymus in the submandibular region is uncommon; surgical treatment is the definitive means of pathological diagnosis. Prior to surgery, the presence of a mediastinal thymus should be confirmed to prevent the risk of a total thymectomy.     

A congenital teratoma with a cleft palate: report of a case

Teratomas are benign tumors containing cells from ectodermal, mesodermal and endodermal layers. They occur in about 1 in every 4000 births and most commonly in the sacrococcygeal region, followed by the ovaries. Congenital epignathus teratomas are rare embryological neoplasms localised in the region of head and neck. An epignathus is found in approximately 1:35,000 to 1:200,000 live births. This accounts for 2-9% of all teratomas. Size and location of the neoplasm in the oronasopharynx is variable. Teratomas are partly undiagnosed at the time of birth. They may exist with an intracranial extension or as small polyps. Large epignathi can lead to difficult management during and after birth. The case of a newborn girl with a combination of an epignathus and a cleft palate is described. The epignathus presented as a huge mass extending out of the mouth of the infant girl. On the day of birth debulking of the extraoral portion of the tumor, followed by intraoral exstirpation, was performed. The results of the histologic examination indicated a congenital epignathus. Six months later a recurrence was found.     

Factors that affect individual tooth prognosis and choices in contemporary treatment planning

A clinician evaluates a tooth for its quality of health. Once accomplished an estimate of longevity and survival is estimated. With current knowledge about the survival and success of implants a decision is made as to whether to extract or to treat and maintain the tooth. Questions and doubts abound in the decision making process in regards to the prognosis of an individual tooth. Unfortunately in dentistry, as in all biologic sciences, there are no straightforward answers to questions. This article will attempt to review the literature in this area to aid the practitioner in the decision making process with regards to the compromised tooth. The article will focus on the single tooth or implant restoration. Other factors such as the strategic value of a tooth and financial limitations in relation to long-term prognosis will also be discussed.     

DNA hybridization arrays for gene expression analysis of human oral cancer

DNA hybridization arrays permit global gene expression profiling to be done in a single experiment. The evolution and challenges of DNA hybridization arrays are reflected in the variety of experimental platforms, probe composition, hybridization/signal detection methods, and bioinformatic interpretation. In tumor biology, DNA hybridization arrays are being used for gene/gene pathway discovery, diagnosis, and therapeutic design. Similar applications are advancing our understanding of oral cancer cell biology.     

Changes in prevalence and treatment need for traumatic dental injuries among 14-year-old children in Newham,London: a deprived area

OBJECTIVE: The study was carried out to assess the prevalence of traumatic injuries to the permanent incisors of 14-year-old schoolchildren in Newham in 1998-99, the treatment needed and to compare the results with data from 1995-96. Also, to test whether different levels of deprivation within an area would increase the risk of dental injury. BASIC RESEARCH DESIGN: A cross-sectional study was carried out. One dentist (SM) carried out all dental examinations. Upper and lower permanent incisors were examined for dental injuries. The examiner recorded the type of damage sustained, any treatment carried out and the treatment need. PARTICIPANTS: 411 14-year-old schoolchildren in Newham in 1998-99. Results The prevalence of traumatic injuries was 43.8% (95% CI 39.0, 48.7) in 1998-99, compared to 23.7% (95% CI 22.0, 25.5) in 1995-96. Boys sustained statistically significantly more dental injuries than girls, 50.2% and 37.1% respectively (P<0.01). In 1998-99 92.7 per thousand incisors were damaged, 6.7 per thousand incisors were treated and 28.9 per thousand incisors needed treatment. Two components of the Jarman Index were associated with dental injuries. Overcrowded household was statistically significantly related to dental injuries in both studies. Ethnicity was associated with dental injury in 1998-99, but not tested in 1995-96. CONCLUSIONS The prevalence of traumatic dental injury in Newham increased from 23.7% to 43.8% between 1995-96 and 1998-99, it was higher than the overall prevalence in the United Kingdom (17%) and its treatment had been neglected. Area-based measures of deprivation such as an overcrowded household and ethnicity were predictors of traumatic dental injuries.     

Adhesion of Porphyromonas gingivalis strains to cultured epithelial cells from patients with a history of chronic adult periodontitis or from patients less susceptible to periodontitis

BACKGROUND: The present study aimed to explain the interindividual variation in periodontitis susceptibility by differences in the initial adhesion rate of Porphyromonas gingivalis to the pocket epithelium of these individuals, and/or by inter-P. gingivalis strain differences in association capacity (adhesion and internalization). METHODS: Adhesion assays were performed on epithelial monolayers (cultured in vitro from pocket epithelium belonging to patients who were less or more susceptible to chronic adult periodontitis) using 11 genetically different clinical strains of P. gingivalis. RESULTS: Both the disease category (less susceptible versus susceptible) and the interstrain variation were found to have a significant effect (both P <0.05) on the initial bacterial association. The chronic adult periodontitis group showed significantly more association of P. gingivalis when compared to less susceptible patients (4.2 x 10(6) versus 3.5 x 10(6)). Also, the interstrain variation was significant, with strains Pg 4 and 5 representing the least and best associating bacteria (1.8 x 10(6) colony forming units for Pg 4, 9 x 10(6) for Pg 5). CONCLUSIONS: These results indicate that periodontitis susceptibility is influenced by both the interindividual differences in pocket epithelium (allowing more adhesion of P. gingivalis) or by the strain type by which the patient is infected (intra-species differences in adhesion capacity).     

The roles of the N-terminal portions of various tachykinins in promoting salivation

OBJECTIVES: In order to determine the active sites for salivation of various tachykinins, the regulatory roles of the N-terminal portion of various newly-synthesized tachykinins were studied after i.p. injection of rats using the submandibular glands as model organs. METHODS: N-shortened oligopeptides from kassinin, eledoisin, neurokinins A (NKA) and NKB were synthesized by the multipin peptide synthesis method. Amino acids were eliminated one by one to form octa- to undeca-peptides adjoining the inactive or less active heptapeptides and various heptapeptides, in which an amino acid in position 8 (Xaa8), numbering as in an undecapeptide, was replaced with Tyr, Phe, Ile or Val. RESULTS: The N-terminal amino acids in positions 1 to 4 could be activators or inhibitors, depending on whether the C-terminal heptapeptide was inactive or less active. The Xaa8 residue, in combination with amino acids in positions 5 and 6, seemed to be very important in determining the sialogogic activity of a heptapeptide. The discrimination between NKA and NKB appeared due to the N-terminal amino acid sequence in positions I to 4 including Phe or Ser in position 6. CONCLUSIONS: It is concluded that the N-terminal amino acids in positions I to 4 serve as either activators or inhibitors depending upon the sialogogic activity of the C-terminal heptapeptide, in which particular amino acids in positions 5, 6 and 8 regulate its activity.