Capillaroscopy is a non-invasive diagnostic technique that is fundamental in viewing peripheral circulation and in studying microangiopathies. The morphological study of microcirculation is of fundamental importance, mainly because the microvascular bed is directly involved in the etiopathogenesis of autoimmune disorders and acute and chronic inflammatory pathological conditions. The value of capillaroscopic investigation as a diagnostic means in cases of peripheral microcirculation disorders has been confirmed by numerous studies. Other studies used capillaroscopic investigations to evaluate microcirculation damage not as a complication of disease (diabetes), but as its initial stage, and therefore to make a diagnosis. Capillaroscopy is an interesting method of studying microcirculation, because of the possibility of studying small vessels in vivo by means of a microscope. Today, it has become more reliable, thanks to the development of observation tools (photography, videomicroscopy). This review describes in detail various aspects of the microcirculation of the oral mucosa. (J Oral Sci 51, 1-10, 2009)

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1,25-Dihydroxyvitamin D₃ [1,25(OH)₂D₃; 1,25-dihydroxycholecalciferol or calcitriol] is the active form of vitamin D₃, a lipid-soluble vitamin that plays a role in calcium and bone metabolism. Recently, vitamin D₃ has been shown to function in cancer prevention, immunity and cardiovascular regulation. 1,25(OH)₂D₃ exhibits physiological and pharmacological effects by activating the vitamin D receptor (VDR), a transcription factor of the nuclear receptor superfamily. 1,25(OH)₂D₃ plays a role in maintaining oral health through its effects on bone and mineral metabolism and innate immunity, and several VDR gene polymorphisms have been reported to be associated with periodontal disease. VDR ligands should prove to be useful in the treatment and prevention of periodontal disease. (J Oral Sci 51, 11-20, 2009)

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This study evaluated the influence of water storage conditions and the effect of metal priming agents on bond strength and durability of four luting agents joined to gold alloy. Disk specimens were cast from a gold alloy (Degudent U), and the surfaces were ground flat with abrasive paper. Three surface conditions employed were: unprimed, primed with Alloy Primer, and primed with Metaltite. Three resin-modified glass ionomers (RMGIs; Vitremer Luting Cement, Fuji Lute, and Xeno Cem Plus) and a resin adhesive (Super-Bond C&B) were used for bonding the gold alloy. Unprimed specimens bonded either with Fuji Lute or with Super-Bond C&B were immersed in water at 5, 37, and 55°C for 7 days, or subjected to thermocycling (5,000 cycles; 5°C, 1 min and 55°C, 1 min). In addition, specimens were bonded with 12 combinations comprising three surface conditions and four luting agents, and thermocycled for 20,000 cycles. Shear bond strengths were then determined and analyzed statistically. Thermocycling was useful for evaluation of the bonding durability of RMGIs. Application of two metal priming agents combined with RMGIs considerably enhanced the bond strength to the gold alloy. (J Oral Sci 51, 21-28, 2009)

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Although daily low-intensity pulsed ultrasound (LIPUS) can accelerate osteogenic differentiation of the rat clonal cell line ROS 17/2.8, the molecular mechanism that underlies this phenomenon is unclear. The purpose of this study was to determine which molecules exposed to daily LIPUS treatment stimulate osteogenic differentiation. The cells were cultured in the presence and absence (control) of LIPUS stimulation. LIPUS treatments consisted of 1.5-MHz ultrasound administered at an intensity of 30 mW/cm², 20 min daily for 7 days. The expression of bone morphogenetic proteins (BMPs) and their receptors involved in osteogenesis were measured using real-time PCR and/or Western blot analysis. Phosphorylation of the mothers against decapentaplegic 1 (Smad1) protein was determined by Western blotting. Daily LIPUS treatment significantly increased the expression of BMP-2, -4, and -7 and their receptors, and also phosphorylation of Smad1. Noggin markedly inhibited the daily LIPUS-induced phosphorylation of Smad1. Our findings demonstrate that the osteogenic activity of daily LIPUS may be mediated by BMPs in ROS 17/2.8 cells. (J Oral Sci 51, 29-36, 2009)

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We aimed to establish a reliable method of localizing an impacted maxillary canine on the sole basis of assessment of a single panoramic radiograph, and to determine the validity and reproducibility of the method. Panoramic radiographs of 50 subjects with a total of 68 impacted canines were analysed. The Canine Incisor Index (CII), Canine Canine Index (CCI), control Canine Incisor Index (c-CII), Zone (apical, middle, coronal) and Sector (I, II, III, IV) were determined on digitized panoramic radiographs. Comparison of the CII and CCI values of labially or palatally impacted canines revealed a statistically significant difference (P < 0.05). Comparison of labial and central canine impactions revealed no relation to CII or CCI (P > 0.05). There was a significant difference between palatal and central canine impactions in relation to CII (P < 0.05), but no significant difference between the two with respect to CCI (P > 0.05). Correct prediction of palatal canine impactions by differential magnification on a panoramic radiograph is possible in 77% of cases. Vertical and horizontal restrictions have no value in recognition of labiolingual position of impacted maxillary canines. The panoramic radiograph cannot be used as a sole radiograph for reliable localization of impacted maxillary canines. (J Oral Sci 51, 37-45, 2009)

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The aim of this study was to determine patient satisfaction with urgent oral care and to evaluate the association between patient satisfaction and different aspects of such care. A 5-point Likert scale questionnaire on patient satisfaction (score 1 = very dissatisfied; score 5 = very satisfied) was administered to 741 adults. Chi-squared test and logistic regression analysis were used to identify associations between dependent and independent variables. The mean patient satisfaction score was 3.79 (SEM = 0.02). Cleanliness of the clinic; hospitality of the dentist; and effectiveness of local anaesthesia; had the highest mean satisfaction scores of 4.0 to 4.15. Cost of treatment and explanation of treatment had the lowest mean scores (2.79 and 3.17 respectively). Sixty-eight percent of respondents were satisfied with urgent oral care. Rural residents were more satisfied with cost of treatment than urban residents (P < 0.0001). Urban residents were more satisfied with explanation of treatment than rural residents (P < 0.0001). Women were more satisfied with many aspects of oral care than men (P < 0.05). It is concluded that adult Tanzanians have moderate levels of satisfaction with urgent oral care. Cost of treatment and explanation of treatment are the two aspects of urgent oral care that are least satisfactory for patients. (J Oral Sci 51, 47-54, 2009)

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The aim of this study was to evaluate the effect of RaCe, FlexMaster and ProFile rotary instruments on smear layer formation by scanning electron microscopy. Eighty-four caries-free freshly extracted human single-rooted teeth were selected and divided into three groups, each containing 28 teeth. The teeth were instrumented with rotary instruments sequentially: Group A: ProFile Rotary Instruments; Group B: FlexMaster Rotary Instruments; and Group C: RaCe Rotary Instruments. Instrumentation was performed by the crown-down method and according to the manufacturer's instructions. The specimens were then examined with SEM according to Hülsmann's classification. One-way ANOVA and a post hoc Tukey test were used for statistical analysis. The results showed that there were no statistically significant differences among the three groups in the coronal third (P = 0.39), but at the apical and middle thirds there were statistically significant differences between the RaCe group and the other groups (P < 0.05). Smear layer in the RaCe group was less than that in the ProFile and FlexMaster groups, but the difference between the ProFile group and FlexMaster group was not statistically significant (P > 0.05). It was concluded that RaCe Rotary Instruments produce less smear layer than FlexMaster and ProFile Rotary Instruments. (J Oral Sci 51, 55-60, 2009)

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Recently, the distribution of dental caries has been shown to be skewed, and precise prediction models cannot be obtained using all the data. We applied a balancing technique to obtain more appropriate and robust models, and compared their accuracy with that of the conventional model. The data were obtained from annual oral check-ups for schoolchildren conducted in Japan. Five hundred children were followed from ages 5 to 8, and the three-year follow-up data were used. The variables used were salivary levels of mutans streptococci and lactobacilli, 3-min stimulated saliva volume, salivary pH, fluoride usage, and frequency of consumption of sweet snacks and beverages. Initially, conventional models were constructed by logistic regression analysis, neural network (a kind of prediction method), and decision analysis. Next, the balancing technique was used. To construct new models, we randomly sampled the same number of subjects with and without new dental caries. By repeated sampling, 10 models were constructed for each method. Application of the balancing technique resulted in the most robust model, with 0.73 sensitivity and 0.77 specificity obtained by C 5.0 analysis. For data with a skewed distribution, the balancing method could be one of the important techniques for obtaining a suitable and robust prediction model for dental caries. (J Oral Sci 51, 61-68, 2009)

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The efficacy of a test dentifrice containing nano-sized (several tens to hundreds of nm) calcium carbonate (hereafter NC) on enamel lesion remineralization was studied in an in vitro system that employed collagen-coated wells for cell culture, as a model of oral surfaces for NC retention. The well surfaces were treated with the test dentifrice and briefly rinsed with distilled water. Thin sections of enamel with artificial subsurface demineralization were remineralized in the plate wells containing remineralizing solution. The dentifrice treatment was repeated twice a day (in the morning and evening) for 20 days. After remineralization, microradiographic analysis was performed to evaluate the rate of lesion remineralization on the sections. The test dentifrice showed a statistically significant mineral gain (48.8% decrease in ΔZ % × μm from the baseline value), indicating lesion remineralization, whereas the placebo dentifrice without NC did not. An elevated Ca concentration in the remineralizing solution was also observed after a single treatment with the test dentifrice. We conclude that the test dentifrice has potential to remineralize incipient enamel lesions due to the unique properties of NC, which is retained on oral surfaces, thereafter releasing Ca ions into oral fluids (saliva, plaque). (J Oral Sci 51, 69-77, 2009)

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Many recent studies have assessed the prevalence and role of herpesviruses in the etiopathogenesis of periodontal diseases, which has led to the realization of intricate interactions between viruses and bacteria within periodontal pockets. It has also been shown that the occurrence of herpesviruses may vary depending upon the age of the patient and the race of the population studied. Thus, the present study aimed at detecting herpes simplex virus type 1 and 2 (HSV 1 and 2), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in periodontal pockets of Indian patients with chronic and aggressive periodontitis. Subgingival plaque samples (n = 33) were collected from 19 randomly chosen chronic periodontitis and 14 aggressive periodontitis patients. Herpesviruses were detected using multiplex polymerase chain reaction technique. Chronic periodontitis patients revealed presence of HSV-1 in 19 (100%) samples, HSV-2 in 3 (15.7%), EBV in 15 (78.9%) and HCMV in 5 (26.31%) samples. Samples from aggressive periodontitis patients showed the presence of HSV-1 in 8 (57.14%), EBV in 4 (28.57%) and HCMV in 1 (7.14%), whereas HSV-2 was not detected in any specimen. In this population, herpesviruses were found more frequently in chronic periodontitis than in aggressive periodontitis patients and their prevalence may vary according to the age and race of the patient. (J Oral Sci 51, 79-86, 2009)

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The formation of dental biofilm caused by oral bacteria on tooth surfaces is the primary step leading to oral diseases. This study was performed to investigate the preventive and reducing effects of panduratin A, isolated from Kaempferia pandurata Roxb., against multi-species oral biofilms consisting of Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus. Minimum inhibitory concentration (MIC) of panduratin A was determined by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution assay. Prevention of biofilm formation was performed on 96-well microtiter plates by coating panduratin A in mucin at 0.5-40 μg/ml, followed by biofilm formation at 37°C for 24 h. The reducing effect on the preformed biofilm was tested by forming the biofilm at 37°C for 24 h, followed by treatment with panduratin A at 0.2-10 μg/ml for up to 60 min. Panduratin A showed a MIC of 1 μg/ml for multi-species strains. Panduratin A at 2 × MIC for 8 h exhibited bactericidal activity against multi-species planktonic cells for 8 h. At 8 × MIC, panduratin A was able to prevent biofilm formation by > 50%. Biofilm mass was reduced by > 50% after exposure to panduratin A at 10 μg/ml for 15 min. Panduratin A showed a dose-dependent effect in preventing and reducing the biofilm. These results suggest that panduratin A is applicable as a natural anti-biofilm agent to eliminate oral bacterial colonization during early dental plaque formation. (J Oral Sci 51, 87-95, 2009)

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The aim of the present study was to compare the performance of hospital clinics with and without adjunct mobile services for the delivery of secondary prevention for caries in Thai schoolchildren. A dental survey was conducted in schools served by different dental services. 711 schoolchildren were selected from primary schools in Southern Thailand by multistage cluster random sampling. WHO basic oral health survey methods were employed to evaluate three outcomes of secondary prevention: 1) Coverage of secondary prevention – all filled teeth (FT+D_FT) among caries experienced teeth (DMFT), 2) Effectiveness of secondary prevention – successfully filled teeth (FT) among all filled teeth (FT+D_FT) and 3) Protective effect of secondary prevention- successfully filled teeth (FT) among caries experienced teeth (DMFT). The respective percentages were 74.3, 97.5 and 72.5 in the children served by hospital-only services, and 41.3, 97.2 and 40.2 in the other group. From clustered logistic regression modeling, only the first and third outcomes were significantly different between the two access groups. This study showed that adjunct mobile service may be less effective in secondary prevention. (J Oral Sci 51, 97-102, 2009)

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The purpose of this study was to compare the sealing ability of different tapered gutta percha cones that were used with lateral compaction and single cones in canals prepared with various root canal instruments. One hundred extracted maxillary incisor roots were used. In group 1, 30 roots were prepared with stainless steel instruments (SS) and then filled by the lateral compaction technique using .02 tapered master cones. In group 2, 30 roots were prepared with ProFile^® nickel titanium instruments (NiTi) and filled in the same way as group 1. In group 3, 30 roots were filled by the single cone technique using 0.06 tapered gutta-percha cones. The remaining 10 teeth were taken as two control groups. Apical and coronal leakage was evaluated using the fluid filtration model. Considering the effects of the instrumentation, no statistically significant differences were found between the groups prepared with SS and NiTi (P > 0.05). When the effects of obturation technique were taken into consideration, the ProFile^® instruments and lateral compaction resulted in significantly less coronal leakage than the SS instruments and lateral compaction (P < 0.05). There were no significant differences in apical leakage among any of the groups (P > 0.05). (J Oral Sci 51, 103-107, 2009)

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The aim of this study was to compare the effects of orthodontic extrusive and intrusive forces on histological changes of the human dental pulp. In this clinical trial, 52 sound upper first premolars from 26 patients scheduled for extraction for orthodontic reasons were selected. They were divided into 2 groups, based on the time intervals for histological evaluation (3 days and 3 weeks). In each group, 10 teeth received orthodontic extrusive forces, 10 teeth underwent intrusive forces, and 6 teeth served as controls. After each period, teeth were extracted and prepared for histological examination under light microscopy and some histological parameters were evaluated. The data were statistically analyzed by Kruskall-Wallis and Mann Whitney tests. Of the parameters evaluated, just vacuolization and disruption of the odontoblastic layer showed statistically significant differences between the control group and both of the experimental groups in each test period (P < 0.05). Additionally, there was no significant difference between 3-day and 3-week intervals in each experimental group, except for fibrosis in the extrusive group which significantly increased after 3 weeks of force application (P = 0.001). Histological pulp changes following extrusive and intrusive force applications for 3 days and 3 weeks show no difference from each other. (J Oral Sci 51, 109-115, 2009)

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The potential f or malignant transformation of oral lichen planus is still controversial. The expression of proteins related to cell proliferation and apoptosis in oral lichen planus and epithelial dysplasia was analyzed to evaluate the true potential for malignant transformation of this disease. Twenty-four cases of each lesion were subjected to the streptoavidin-biotin technique for identifying the immunohistochemical expression of PCNA, p53, bax, and bcl-2 proteins. Of the 24 cases of oral lichen planus, 14 (58.33%) were positive for PCNA, 10 (41.67%) for p53, 4 (16.67%) for bcl-2 and 12 (50%) for bax, whereas of the 24 cases of epithelial dysplasia, 20 (83.33%) were positive for PCNA, 10 (41.67%) for p53, 6 (25%) for bcl-2, and 20 (83.33%) for bax. Chi-squared test showed no statistically significant differences between the expression of p53 and bcl-2 in oral lichen planus and epithelial dysplasia, regardless of the grade (P > 0.05). However, the expression of PCNA and bax was significantly increased in epithelial dysplasia (P < 0.05). The results of this study showed that alterations in expression of these proteins are observed in oral lichen planus and epithelial dysplasia, suggesting the potential for malignant transformation in both lesions. (J Oral Sci 51, 117-121, 2009)

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Color characteristics of the shades for different filler type resin composites were compared in the reflectance and transmittance modes, and specular component included (SCI) and specular component excluded (SCE) geometries for reflectance mode. Resin composites and shades used in this study were submicron filled Estelite Σ (Σ: Inc, A2, A3, B3, C2, OA2, OA3) and nanofilled Filtek^TM Supreme XT (XT: Clear, A2E, A2B, A3B, C2B, A2D, A3D). Resin disks of 2 mm in thickness and final polish with 2,400-grit silicon carbide paper were kept in 100% humidity. One week after curing, color of the resin disks were measured with a spectrophotometer. Both for Σ and XT, reflectance of each of all shades measured with SCI were significantly higher than those with SCE. Compared to the values with SCI and SCE, the L* with SCI were significantly higher for all shades of Σ and XT, however, a* and b* were depended with brands and shades. Different filler type resin composites showed different color characteristics, reflectance, transmittance and L*a*b* distribution. In some shades, color difference between the measurement with SCI and SCE was visually perceptible level. It would be concluded that the color of resin composite measured with the SCI and SCE geometries differed. (J Oral Sci 51, 123-130, 2009)

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The lack of information on oral health in Laos makes it difficult to estimate the need and methods for preventing oral disease. This study identified problems concerning the oral health of Lao children. The study subjects were 59 school children who lived in Pakkading District. Dental caries, gingivitis malocclusions, temporomandibular joint (TMJ) disorders, dental plaque, and calculus were examined. We observed an average of 1.6 decayed, missing, and filled teeth (DMFT) and 4.1 decayed and filled deciduous teeth (dft) per child. 25.4% had gingivitis scores from 16 to 20 on the papillary, marginal, and attached (PMA) index; 29.6% had one or more occlusal abnormality; and 0% had signs of TMJ disorders. 93.5% of the children had at least one buccal or lingual tooth surface with plaque covering more than two thirds of the surface; 32.6% had dental calculus. Oral health promotion programs for children should prioritise prevention and treatment of caries. It is likely that the high rate of gingivitis in Lao children is due mainly to unsuccessful plaque control in daily life. In addition to descriptive epidemiological studies of dental diseases in other areas, the influence of sociological and behavioural factors on oral health should be analyzed epidemiologically to promote child health. (J Oral Sci 51, 131-135, 2009)

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Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histologic variants of lipomas arising from fat tissue. Although angiolipoma is the most common tumor in the trunk and extremities of young people, it occurs infrequently in the head and neck region. The authors present the clinical and histological features of a non-infiltrating angiolipoma excised from the cheek of a 22-year old man. Clinical examination showed a soft, mobile, approximately 4 × 3 cm mass that could be palpated anterior to the masseter muscle. The mass was removed by an intraoral approach. Angiolipoma was confirmed on histopathologic evaluation. Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. They are usually painless, soft, round and mobile. The diagnosis is based on both clinical and histologic characteristics. The treatment is surgical excision. (J Oral Sci 51, 137-139, 2009)

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Trismus is a pathological condition of the muscles of mastication which commonly affects patients who have undergone dental procedures, oral surgery, and radiation therapy for head and neck cancer. The purpose of this case report is to describe the use of dynamic splinting, a noninvasive modality to reduce trismus which occurred in a patient following multiple dental procedures. A 26 year old man of African descent was referred for severe trismus and pain following three dental procedures on the lower right molars. The patient presented with Maximal Interincisal (opening) Distance (MID) of only 5mm and mastication muscle spasticity. Following physical therapy (massage, ultra sound, NMES, moist heat) three times per week for two months and additional treatment of dynamic splinting for four weeks (TID) the patient increased his MID to 52mm and returned to normal eating and speaking. (J Oral Sci 51, 141-144, 2009)

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A very rare case of bilateral supernumerary teeth in the maxillary canine region and its management through a 3-step-conservative approach and 5-year-follow up is presented in this report. A 7-year-old Caucasian boy presented with 2 erupted supernumerary primary maxillary canines (53s and 63s) and two unerupted supernumerary permanent maxillary canines (13s and 23s). The treatment was carried out in three steps. In the first step, we removed teeth 53s and 63s. As the second step, early removal of teeth 53 and 63 and cementation of a space maintenance appliance (Nance's arch) were performed. In the third step, teeth 13s and 23s were removed, and the Nance's arch was maintained until the complete eruption of teeth 13 and 23. The management of this case with a proper treatment plan enabled us to solve the problem without complex procedures. (J Oral Sci 51, 145-150, 2009)

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A case of peripheral ossifying fibroma (POF) in the mandibular gingiva of a 30-year-old man is described. The lesion was asymptomatic, firm, pinkish red and pedunculated histologically showing cellular, fibrous connective tissue stroma with calcified osseous and cementum-like calcifications. Lesions histologically similar to peripheral ossifying fibroma (POF) have been given various names in the existing literature. Therefore, the controversial varied nomenclature and possible etiopathogenesis of peripheral ossifying fibroma are discussed. (J Oral Sci 51, 151-154, 2009)

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Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin with a relative frequency of 2.2 - 7.1%. As the histogenesis of AOT is still uncertain, it is sometimes categorized as a hamartomatous lesion rather than a true neoplasm. We report a case of AOT in the right maxillary anterior region in a 20-year-old woman. The tumor showed some unusual and aggressive features that suggested it was a true neoplasm. (J Oral Sci 51, 155-159, 2009)

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