Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombosis. On the other hand, antiplatelet and anticoagulant drugs have also been associated with an increase in the bleeding time and risk of postoperative hemorrhage. Because of this, some dentists still recommend the patient to stop the therapy for at least 3 days before any oral surgical procedure. However, stopping the use of these drugs exposes the patient to vascular problems, with the potential for significant morbidity. This article reviews the main antiplatelet and anticoagulant drugs in use today and explains the dental management of patients on these drugs, when subjected to minor oral surgery procedures. It can be concluded that the optimal INR value for dental surgical procedures is 2.5 because it minimizes the risk of either hemorrhage or thromboembolism. Nevertheless, minor oral surgical procedures, such as biopsies, tooth extraction and periodontal surgery, can safely be done with an INR lower than 4.0. (J. Oral Sci. 49, 253-258, 2007)
The Oral Impacts on Daily Performance (OIDP) is a well-known oral health-related QOL instrument used internationally. The aim of this study was to develop and test a Japanese version of the OIDP for use in interviews. Following an internationally established method, the OIDP scale was translated using standardized methodology that consisted of forward translation, pilot study and backward translation. A pilot study was carried out using the revised version with 47 local residents (range, 40-105 years). In the item analysis of this study, there were no missing values or ambiguous responses. Twenty-eight percent of the participants replied that they ‘had discomfort caused by an oral health problem’ in the ‘eating’ items. Cronbach's alpha coefficient was 0.77, indicating the internal consistency reliability of the questionnaire. Denture wearers had significantly higher OIDP scores in covariance analysis with age and sex as adjustment factors (P < 0.05). Based on the results, the questionnaire was re-evaluated. A back translation was produced and approved by the original author. Further assessment and validation of this scale is needed in a study with larger sample size. (J. Oral Sci. 49, 259-264, 2007)
The aim of this study was to evaluate the antibacterial and antifungal properties of polyether impression materials using the agar diffusion test. Three different types of polyether impression materials (P2, Penta Soft and Penta) were tested to determine their ability to inhibit the growth of Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The areas of inhibition zones were measured visually with a 0.1-mm incremental Boley gauge. In all groups, none of the samples of the P2 polyether impression material exhibited antibacterial or antifungal activity against any of the microorganisms. All Penta Soft and Penta samples exhibited antibacterial activity against E. faecalis and S. aureus, and only Penta samples exhibited antifungal effect against C. albicans, which decreased progressively as the setting time of the material increased. (J. Oral Sci. 49, 265-270, 2007)
The aims of this study were to compare nitric oxide (NO) levels in stimulated whole saliva from individuals with and without generalized chronic periodontitis (GCP), and to evaluate correlations between these levels with a clinical diagnostic parameter. According to specific criteria, 30 individuals were divided into three groups: one comprising individuals without periodontitis (GC), a second comprising individuals with moderate GCP (GM), and a third comprising individuals with advanced GCP (GA). Samples were collected and NO levels measured. NO in the GCP group (GM: 7.78 μM; GA: 15.79 μM) was higher than in the GC group (5.86 μM). NO levels in the GA group were significantly higher (P < 0.0001) than in the GC group, and could also differentiate (P < 0.0001) the moderate and advanced forms of the disease. In addition, positive correlations between NO level and the number of teeth with a probing depth of ≥ 4 mm (r = 0.54) and ≥ 7 mm (r = 0.68) were observed. In conclusion, NO levels are elevated in individuals with GPC and are correlated with a periodontal clinical parameter. These results reveal that this form of periodontal disease and its severity are related to salivary nitrite concentration, indicating that NO may serve as a potential biological marker for detection and/or monitoring of GCP. (J. Oral Sci. 49, 271-276, 2007)
The purpose of this study was to evaluate the effect of acidic priming agents on adhesive bonding to SUS XM27 stainless steel. Disk steel specimens were primed with one of the following materials; Acryl Bond, All-Bond 2 Primer B, Alloy Primer, Estenia Opaque Primer, Eye Sight Opaque Primer, Metal Primer II, M.L. Primer, MR Bond, and Super-Bond Liquid. The specimens were then bonded with an acrylic resin designed for denture repair (Repairsin), and bond strengths were determined. Unprimed specimen was used as control. The average bond strengths before thermocycling varied from 21.3 to 51.0 MPa, whereas post-thermocycling bond strengths ranged from 3.0 to 37.0 MPa. Of the nine priming agents, the Acryl Bond, All-Bond 2 Primer B, Estenia Opaque Primer, and MR Bond materials showed significantly higher bond strength after application of thermocycling. Within the limitation of the current experimental settings, it can be concluded that the use of the four acidic priming agents is recommended for bonding SUS XM27 stainless steel with Repairsin self-polymerizing repair material. (J. Oral Sci. 49, 277-281, 2007)
The purpose of this study was to evaluate the effect of spreader penetration depth on apical microleakage using the lateral compaction method. A total of 96 extracted maxillary central incisors were instrumented using the step-back method, and randomly divided into the following four experimental groups: A) with tug-back and spreader penetration 1 mm short of the working length; B) without tug-back and spreader penetration 1 mm short of the working length; C) without tug-back and spreader penetration to the working length; D) with tug-back and spreader penetration to the working length. Microleakage evaluation was conducted using the dye penetration method, and ANOVA test was used for statistical analysis. The results showed that there was a significant difference in the amount of microleakage between the groups with spreader penetration to the working length and the groups with spreader penetration 1mm short of the working length. There was no significant difference between the groups with and without tug-back. (J. Oral Sci. 49, 283-286, 2007)
The objective of this study was to find the sites with proliferative activity in the human gingival epithelium, where stem cells are likely to exist. Gingival tissues were excised from 16 adult patients and immunohistochemically examined for the presence of bromodeoxyuridine (BrdU)-incorporating, p63- and low affinity nerve growth factor receptor (p75NGFR)-expressing cells. BrdU-incorporating cells were rarely present in the junctional epithelium. The number of BrdU-incorporating cells in the sulcular and oral gingival epithelia was significantly higher than that found in the junctional epithelium (ANOVA, P < 0.01). A considerable number of p63-positive nuclei were detected in the basal layer to lower spinous layers in the sulcular and oral gingival epithelia, but only few p63-positive cells were present in the junctional epithelium. p75NGFR-positive cells were exclusively located in the basal layer in the sulcular and oral gingival epithelia, and in limited basal area in the junctional epithelium neighboring the sulcular epithelium. In the oral gingival epithelium, intense immunostaining of BrdU, p63 and p75NGFR was correspondingly observed on the base and side of the rete ridges. These areas probably exhibit high proliferative activity owing to the presence of stem cells. (J. Oral Sci. 49, 287-291, 2007)
This study aimed to determine the anti-erosive effects of xylitol, fluoride and a xylitol/fluoride combination used as an additive in an acidic drink or as mouthrinse after enamel was exposed to an acidic drink, in vitro. Human third molars were divided into 7 groups (A-G). Samples from groups A to D were immersed for 5 min in orange juice only (A), orange juice plus either 25% xylitol (B), F¯ 1 ppm (C) or a 25% xylitol/F¯ 1 ppm combination (D), respectively. Samples from groups E to G were immersed in orange juice for 5 min and then in either 40% xylitol (E), F¯ 227 ppm (F) or a 40% xylitol/F¯ 227 ppm combination (G), for 1 min respectively. This process was performed four times daily for 14 days. Mineral loss was determined from the lesion depth and surface hardness. Erosion depth progressively increased in all groups, except E, where erosion depth was significantly lower than group A. Surface microhardness progressively decreased in all groups, except E, where hardness was significantly higher than group A. This study demonstrated that addition of xylitol, fluoride or a xylitol/fluoride combination to an acidic drink or post-treatment with fluoride or a xylitol/fluoride combination could reduce, but not prevent, enamel erosion. (J. Oral Sci. 49, 293-297, 2007)
Titanium is used worldwide to make osseointegrable devices. The favorable characteristics that make this material desirable for implantation are i) its mechanical proprieties and ii) its biocompatibility. The latter has been demonstrated by in vivo studies with animal models and clinical trials over a forty-year period. However, the exact genetic effect of the titanium layer on cells is still not well characterized. To detect the genetic effect of titanium surfacing on osteoblasts without porosity as a confounding variable, a meta-analysis of genetic expression profiling obtained from several titanium surfaces was performed. One hundred seventy-three genes were selected, 84 up-regulated and 95 down-regulated. Among them, the most notable were genes that participate in osteoblast differentiation and bone regeneration, such as TIMP1, PTN, and RUNX1. Titanium surfacing has i) a direct genetic effect on osteoblasts, ii) induces several bone-related genes, and iii) is relevant to the osseointegration process. These properties should be taken into consideration in separating the effect of porosity (i.e. the micro-dimension) from implant coating (i.e. the nano-dimension). (J. Oral Sci. 49, 299-309, 2007)
Neonatal exposure of rats to bisphenol-A, an endocrine disruptor, has recently been proposed as a possible animal model of attention-deficit hyperactivity disorder, because such rats exhibit motor hyperactivity and impaired habituation to a novel environment 4-5 weeks after bisphenol-A pretreatment. To extend the original experiments, the present study additionally analyzed the effects of neonatal exposure to bisphenol-A (20 and 40 μg) on rat habituation to a novel environment and drug-induced behavior particularly at a later stage after bisphenol-A pretreatment. Single intracisternal administration of bisphenol-A (20 μg) into 5-day-old male Wistar rats did not cause any significant changes in habituation, as assessed in terms of locomotor activity, rearing, sniffing and grooming in rats at 8 weeks of age. Methylphenidate (1 and 3 mg/kg, i.p.), a psychostimulant, dose-dependently enhanced locomotor activity in both vehicle- and bisphenol-A (20 μg)-pretreated rats at 8 weeks of age, whereas other behaviors, i.e. rearing, sniffing and grooming, were not significantly affected. Additional challenge with apomorphine (1 mg/kg, i.v.), a dopamine receptor agonist, in vehicle- and bisphenol-A (20 and 40 μg)-pretreated rats at 10 weeks of age elicited a similar level of repetitive jaw movements measured by a magnet-sensing system under freely moving conditions during both the dark and the light phases. Thus, the effects of apomorphine did not differ between bisphenol-A-pretreated and vehicle-pretreated rats. It is concluded that, though some behavioral changes are evident in rats at an early stage (4-5 weeks) after neonatal treatment with bisphenol-A, the pretreatment does not induce any behavioral changes in habituation to a novel environment or in response to methylphenidate and to apomorphine at a later stage (8-10 weeks). (J. Oral Sci. 49, 311-318, 2007)
The calcifying odontogenic cyst (COC), first described by Gorlin et al. in 1962, represents a heterogeneous group of lesions that exhibit a variety of clinicopathologic and behavioral features. COC has been categorized under two basic groups namely, cystic and neoplastic. Even after several classifications and sub-classifications, COC remains an enigma. Very few cases of ameloblastomatous COC have been reported in the literature. In this report, we present a case of ameloblastomatous COC / Gorlin's cyst, emphasizing on the rarity of the lesion and distinguishing it from ameloblastomatous ex COC pictographically. (J. Oral Sci. 49, 319-323, 2007)
Apexification with calcium hydroxide is associated with certain difficulties, such as the very long treatment time required, the possibility of tooth fracture, and incomplete calcification of the bridge. Use of an apical plug is an alternative treatment for open apices, and this has gained popularity in recent years, employing mineral trioxide aggregate (MTA) for optimal results. Here we report the successful treatment of two maxillary central incisors that had open apices and periapical lesions using MTA apical plugs after the root canals had been debrided and rinsed with 2.5% NaOCl. Calcium hydroxide paste was then placed in the canals for 1 week, before the apical portion of the canals (5 mm) was filled with the MTA plug. The remaining portion of the root canal was then sealed with a post and crown. After 6 months of follow-up, the clinical and radiographic appearance of the teeth showed a decrease of the periapical lesions. At 2 years, although the left post had been lost and the periapical lesion of the left central incisor had subsequently deteriorated, the right central incisor had healed successfully. Considering the importance of a coronal seal, the use of MTA for apical plugging appears to be a valid option. (J. Oral Sci. 49, 325-329, 2007)
The ameloblastic fibro-odontoma (AFO) is a rare odontogenic tumor that occurs predominantly in children and is generally associated with unerupted teeth. The choice of treatment for this entity is conservative surgery with enucleation and its prognosis is excellent. However, preserving the associated impacted teeth may make complete removal of the lesion difficult and may explain some cases of recurrence. A case of AFO in a 6-year-old girl treated with enucleation and preservation of an impacted lower left first permanent molar is reported. After two years of follow-up, there were no signs of recurrence and complete spontaneous eruption of the preserved tooth was observed. The present report indicates that the degree of involvement of the impacted tooth by AFO is a fundamental aspect to be considered during radiological analysis and surgical assessment. We concluded that preservation of the impacted permanent teeth associated with this tumor should always be considered and carried out with caution, since they are clearly not included in the surgical cavity. (J. Oral Sci. 49, 331-335, 2007)
This case report describes a simple method for identifying the citizenship of a denture wearer by marking the telephone country code number inside the denture base. A wax pattern for the denture framework was prepared on the refractory cast. A piece of embossing tape, containing the country code (81, Japan), Japanese prefectural code, and abbreviation of the dental clinic where the denture was fabricated, was placed on the metal framework. A titanium-aluminum-niobium (Ti-6Al-7Nb) alloy was cast in the mold, and the denture was then fabricated by the conventional method. The casting satisfactorily reproduced the embossed letters, and the plate was identifiable through the gingiva-colored acrylic denture base resin. Since an embossed metal plate integrated with the skeleton is embedded in the denture base resin material, the current denture marking technique serves as a simple procedure for insertion of an undegradable denture identification mark which makes it possible to identify the nationality of the denture wearer. (J. Oral Sci. 49, 337-340, 2007)
When a tooth is avulsed and replanted following traumatic dental injury, complications such as replacement and inflammatory resorption may occur. Ultimately, resorption may result in loss of the tooth. This case report describes a traumatic injury to a permanent tooth resulting in complete root resorption within a short period, which required surgery. In the present case, improper treatment measures such as dry condition of the avulsed tooth before replantation and extra-oral retrograde root canal filling may have led to rapid complete root resorption. Even if it is impossible to avoid resorption completely, the overall knowledge of both dentists and patients regarding traumatic dental injuries should be improved to delay the progress of resorption. (J. Oral Sci. 49, 341-344, 2007)
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