This bibliographic review provides a general view of the etiology, characteristics and treatment of dentinal hypersensitivity, so that professionals can use this information in the therapeutic management of this clinical condition. For this purpose, the authors have analyzed whole texts of relevant articles on the subject. This study showed that the predisposing factors associated with the causes of dentinal hypersensitivity must be controlled or eliminated, by educating the patient regarding the excessive intake of acidic food, as well as providing guidance on the proper tooth brushing technique and analysis of occlusion. Effective treatment must be preceded by a proper diagnosis, established after the exclusion of any other possible causes of the pain. These cases must be managed efficiently, quickly and permanently. The availability of a wide variety of treatment could be an indicator that there is still no effective desensitizing agent to completely resolve the patient's discomfort, or that it is difficult to treat, irrespective of the available treatment options. Even with the large number of published studies, it has not been possible to reach a consensus about the product that represents the gold standard in the treatment of dentinal hypersensitivity. (J Oral Sci 51, 323-332, 2009)
The aim of the study was to determine the oral health status and investigate the association of oral health status with various socio-demographic (age, gender, parent's education, income) and clinical variables (aetiology for mental disability and IQ level) among mentally disabled subjects. The study sample comprised 225 mentally retarded subjects aged 12-30 years attending a special school in Udaipur, India. Caries status, oral hygiene status and periodontal status were assessed by DMFT Index, Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion and Community Periodontal Index, respectively. Chi-square test, one way analysis of variance (ANOVA), multiple linear stepwise regression analysis, and multiple logistic regression analysis were employed for statistical analysis. There was a statistically significant difference (P = 0.001) between all the age groups in all the variables of Oral hygiene index and DMFT index. The oldest age group had the highest scores for all the indices measured. Having Down's syndrome, parents with lower educational status and low I.Q. were the most important predictors for poor oral health status. The present study highlighted that the oral health status of this mentally retarded population was poor and was influenced by aetiology of the disability, I.Q. level, and parent's level of education. (J Oral Sci 51, 333-340, 2009)
Tooth development is regulated by a reciprocal series of epithelial-mesenchymal interactions. With the large number of genes involved in the odontogenesis process, the opportunity for mutations to disrupt this process is high. Mutational analysis has revealed genes that are major causes of non-syndromic hypodontia. The most common permanent missing teeth are the third molars, second premolars, and maxillary lateral incisors. Although hypodontia does not represent a serious public health problem, it may cause masticatory and speech dysfunctions and esthetic problems. Msx1 (Muscle Segment Box) is believed to play an important role in tooth development. To further investigate the role of the gene in human hypodontia, we analyzed genotypes in a family with hypodontia using the SSCP assay. Examinations of all affected and unaffected members of the family studied indicated that 5 of the 10 family members had hypodontia, and it was possible to observe polymorphisms/mutation by SSCP as bands with an anomalous migration pattern in individuals with hypodontia. Our data suggest that Msx1 gene polymorphism is associated with hypodontia. (J Oral Sci 51, 341-345, 2009)
The aim of this study was to investigate the initial stability of mini-implants when placed slanting or perpendicular to the bone surface, and to examine the effects of differences in tractional direction. Titanium mini-implants were inserted into rabbit nasal bones, slanting (60°, 120°) or perpendicular (90°) to the bone surface. These implants were then loaded with a force of approximately 2 N, using a NiTi coil spring. The mobilities on the traction and non-traction sides were assessed using the Periotest device immediately after placement and after traction for two weeks. Then, the tissues with the mini-implants were resected, and the contact between the bone and the implant was examined by electron microscopy. There was a tendency for the mobilities of the mini-implants at 60° and 120° to be smaller than those at 90° when measured before and after traction. The bone-implant contact lengths at 60° were significantly longer than those at 90°. There was no significant difference in the bone-implant contact ratio among the different angles. Correlations were evident between implant mobility and contact length or contact ratio. It is concluded that in clinical practice, implants inclined to the bone surface tend to have better primary stability. (J Oral Sci 51, 347-353, 2009)
OLP is a chronic inflammatory disease of unknown etiology that may develop into squamous-cell carcinoma. Cytokeratins, which are important components of the cytoskeleton, are excellent epithelial differentiation markers used to study neoplastic and inflammatory diseases. To study the profile of cytokeratins in OLP and their possible association with dysplastic alterations, monoclonal antibodies were used for cytokeratins 10, 13, 14 and 19, in 26 samples of OLP. The streptavidin-biotin technique was employed in paraffin-embedded tissue sections. Sample analysis revealed suprabasal expression of cytokeratin 10 in 16/17 samples, 14 of them with reduced expression; suprabasal expression of cytokeratin 13 in 18/23, 16 of them with delay; basal and suprabasal expression of cytokeratin 14 in all samples; and focal basal expression of cytokeratin 19 in 4/21. Expression of cytokeratins 10, 13 and 14 was altered in OLP lesions. The inflammatory process and hyperkeratosis or parakeratosis seem to have interfered with the expression of these CKs. Cytokeratin 19 was expressed in the lesions, in a pattern similar to that mentioned in the literature for the non-keratinized oral mucosa. The presence of mild dysplasia did not change the expression of the cytokeratins studied. No differences in pattern of expression were observed between keratinized and non-keratinized areas in the lesions caused by OLP. (J Oral Sci 51, 355-365, 2009)
Oral squamous papilloma (OSP) is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass. Twelve patients suspected to have oral papilloma underwent excisional biopsy for histopathologic and immunohistochemical analysis. The majority of the patients (75%) were females, and the most prevalent site was the tongue, followed by the palate. The round and whitish form was present in 58.4% of the cases. The lesions were softened/flaccid in 66.7% of cases and a pedunculated attachment was seen in 75% of the lesions. The histopathologic examination revealed hyperparakeratosis, occasional basal hyperplasia, and koilocyte-like cells in 100% of the specimens. Immunohistochemical assays utilizing BP53-12 and Pab240 antibodies for p53 protein showed negative or weak immunostaining (91.6%) for both immunomarkers in all the epithelial layers examined. The findings suggest the benign nature of the lesions and small possibility of becoming malignant. (J Oral Sci 51, 367-372, 2009)
The purpose of this quantitative systematic review was to appraise the evidence on the caries-preventive effect of glass ionomer cement (GIC) in relation to resin-based fissure sealants. Nine English and two Portuguese databases were searched (15 January 2008). Randomized clinical trials and systematic reviews were considered for inclusion. Trial exclusion criteria were: drop-out rates > 33%; no randomization; baseline differences in groups not statistically adjusted; and no clinically important outcomes were presented. Two authors reviewed the articles independently. The outcome measure for the caries preventive effect was caries absence on sealed teeth. Of the 112 identified articles, 25 were selected for review. Of these, 14 were excluded and 11 accepted (8 trials; 3 systematic reviews). The accepted reviews provided no evidence of superiority of either sealant material. Six trials were included for meta-analysis. The pooled odds ratio was 0.96, 95% CI 0.62-1.49, indicating no difference in the caries-preventive effect of GIC and resin-based fissure sealant material. This systematic review with meta-analysis found no evidence that either material was superior to the other in the prevention of dental caries. Thus, both materials appear equally suitable for clinical application as a fissure sealant material. (J Oral Sci 51, 373-382, 2009)
In a 1998 review article, Laurell and colleagues performed a meta-analysis of relevant guided tissue regeneration (GTR) articles over the previous 20 years (1). The purpose of the present research was to expand on that work, particularly searching for trends discriminating between bioabsorbable and non-bioabsorbable barriers, as well as the use of enamel matrix derivative, with respect to interproximal bony defects. The most recent periodontal journals were reviewed and a search of PubMed (National Institutes of Health) was conducted via the internet covering 1990 to the present. Forty-nine articles were found to be relevant and within established parameters. The data were analyzed using (a) a variation of the methods described in Laurell et al. (1) and (b) statistics appropriate for inter-group comparisons. In most respects, all membranes and enamel matrix derivative (EMD) delivered better outcomes, in the range of 1 to 2 mm, than open flap debridement. The use of any barrier type or EMD configuration was found to yield more Clinical Attachment Level (CAL) gain than any open flap configuration. Other than collagen without grafts versus non-bioabsorbables without grafts, no other comparison between membranes or between membranes and EMD found any significant differences (P > 0.05). GTR was confirmed to be superior to open flap debridement. (J Oral Sci 51, 383-400, 2009)
This study was conducted to examine the activity of alpha-mangostin against Candida albicans, the most important microorganism implicated in oral candidiasis. Its activity was compared to Clotrimazole and Nystatin. Results showed that alpha-mangostin was effective against C. albicans, the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were 1,000 and 2,000 μg/ml, respectively. The C. albicans killing activity of alpha-mangostin was more effective than Clotrimazole and Nystatin. The cytotoxicity of alpha-mangostin was determined and it was found that alpha-mangostin at 4,000 μg/ml was not toxic to human gingival fibroblast for 480 min. The strong antifungal activity and low toxicity of alpha-mangostin make it a promising agent for treatment of oral candidiasis. (J Oral Sci 51, 401-406, 2009)
Management of oral candidiasis depends on an accurate diagnosis, identification and elimination of predisposing factors, and, often, use of antifungal agents. Chronic hyperplastic candidosis (CHC) is considered a premalignant lesion of the oral mucosa, occurring as speckled or homogeneous white lesions. If the lesions are untreated, a minor proportion may become dysplastic and progress to carcinoma. The traditional treatment of this lesion is based on the use of antifungal agents. The aim of this study was to examine the efficacy of 0.18% isotretinoin for treatment of nystatin-resistant candidiasis. Isotretinoin was administered topically twice a day for one month to six patients affected by nystatin-resistant CHC. In all six patients, daily antimycotic topical therapy with nystatin for 30 days had failed to resolve the candidal stomatitis. After one month of isotretinoin treatment, five of the six patients were negative for Candida, whereas in untreated control patients the situation was unchanged. Only one patient with suspected sicca syndrome was found to have oral Candida 15 days after the last administration of isotretinoin. None of the patients had any complaints about the medication. These findings suggest that 0.18% isotretinoin applied twice a day for one month is able to suppress nystatin-resistant candidiasis. (J Oral Sci 51, 407-410, 2009)
Mandibular second premolars and maxillary central incisors usually have one root, one canal, and one apical foramen. However, some studies have revealed anatomic variations in these teeth. The aim of the present study was to investigate such variations in canal configuration, foramina, lateral and accessory canals and apical deltas in the root apex of human maxillary central incisors and mandibular second premolars, using a clearing technique and stereomicroscopy. One hundred maxillary central incisors and 137 mandibular second premolars were collected, and India ink was injected into their canals. The teeth were then demineralized with 0.5 N nitric acid, cleared with methyl salicylate, and studied at × 5 and × 16 magnification. The incidence of one canal and one apical foramen was 100% for maxillary central incisors and 94.16% for mandibular second premolars. The main apical foramen was located in the center of the root apex in 21.89% and 17% of mandibular second premolars and maxillary central incisors, respectively. Lateral and accessory canals were found in 84.50% and 77.15% of maxillary central incisors and mandibular second premolars, respectively. Several foramina were found in 11% of maxillary central incisors and 24.08% of mandibular second premolars. Apical deltas were seen in 4.38% and 2% of mandibular second premolars and maxillary central incisors, respectively. The rate of anatomic variations in the apical part of the tooth, especially in posterior teeth, is thus considered to be high. (J Oral Sci 51, 411-415, 2009)
Interleukin-1β (IL-1β) stimulates expression of the highly inducible enzyme cyclooxygenase-2 (COX-2) via activation of nuclear factor kappaB (NFκB), and consequently provokes prostaglandin E2 (PGE2) synthesis, which induces inflammatory responses. In this study, the contribution of protein kinase C (PKC) to IL-1β-induced PGE2 synthesis in human gingival fibroblasts was investigated. The PKC activator phorbol 12-myristate 13-acetate (PMA) stimulated PGE2 release and COX-2 mRNA expression, as shown in human gingival fibroblasts stimulated by IL-1β. However, PMA showed only a weak effect on the formation of COX-2-NFκB DNA-protein complex, whereas IL-1β had a clearly stimulatory effect. In cells in which PMA-dependent PKC was down-regulated, PMA failed to induce the formation of NFκB DNA-protein complex and reduced the release of PMA-induced PGE2, whereas IL-1β stimulated the formation of COX-2-NFκB DNA-protein complex and PGE2 release. The atypical PKC (aPKC) inhibitor Gö6983 clearly suppressed the formation of COX-2-NFκB DNA-protein complex and PGE2 release stimulated by IL-1β but not the inhibitor of conventional PKC (cPKC) and the novel PKC (nPKC) inhibitor Gö6976. These observations suggest that aPKC is involved in IL-1β-induced PGE2 synthesis, which is controlled by transcription of the COX-2 gene via the NFκB-dependent pathway in human gingival fibroblasts. (J Oral Sci 51, 417-423, 2009)
The external gonial angle is an important angle of the craniofacial complex. It is significant for the diagnosis of craniofacial disorders. Lateral cephalogram and orthopantomograms can be used to determine this angle. In this study, we compared the external gonial angle determined from the two mentioned radiographs in Class I patients. We collected the radiographs of 70 patients with Angle's Class I (22 men and 48 women). The patients' age ranged from 15-30 years with a mean age of 18.24 years. The data gained were statistically evaluated by t-test. The following results were obtained. The mean value of the gonial angle in the lateral cephalogram was 125.00° (men, 124.9° and women, 125.04°) and in the orthopantomogram was 124.17° (men 123.68°, women 124.39°). The difference between these rates was 0.83° (men 1.22°, women 0.64°) and not significant (P = 0.406). Based on the obtained results, we can conclude that panoramic radiography can be used to determine the gonial angle as accurately as a lateral cephalogram. In addition, we can determine the right and left gonial angles of a patient in the orthopantomogram without interferences due to superimposed images of anatomical structures in a lateral cephalogram. For determination of the gonial angle, an orthopantomogram may be a better choice than a lateral cephalogram. (J Oral Sci 51, 425-429, 2009)
The purpose of this study was to investigate the development of shear bond strength of resin composites using self-etching primer systems. Four different types of self-etching primer systems with different combinations of their recommended resin composites were used. Bovine incisors were mounted in self-curing resin and the facial surfaces were wet ground on #600-SiC paper to expose the dentin. The shear bond strengths of ten samples per test group were measured at a crosshead speed of 1.0 mm/min after storage for 5, 10, and 60 min, and 24 h in distilled water at 37°C. One-way ANOVA followed by Dunnett's test (α = 0.05) was used to examine the significance of differences between the mean bond strength at 24 h and each of the other storage periods. The dentin bond strengths of all the materials tested increased with prolonged storage time. Such differences in the changes in bond strength might have clinical implications if a restoration is subjected to high stress immediately after it has been placed. It is important to consider the development of dentin bond strength to allow the materials sufficient maturation time prior to functional loading or application of other forms of external stress. (J Oral Sci 51, 431-436, 2009)
Using the agar diffusion method, we conducted an in vitro study to evaluate the antimicrobial activity of mineral trioxide aggregate (MTA), new endodontic cement (NEC) and Portland cement at different concentrations against five different microorganisms. A base layer was made using Muller-Hinton agar for Escherichia coli (ATCC 10538) and Candida (ATCC 10231). For Actinomyces viscosus (ATCC 15987), Enterococcus faecalis (ATCC 10541) and Streptococcus mutans (ATCC 25175) blood agar medium was used. Wells were formed by removing the agar, and the materials were placed in the well immediately after manipulation. The plates were kept at room temperature for 2 h for prediffusion, and then incubated at 37°C for 72 h. The inhibition zones were then measured. The data were analyzed using ANOVA and the Tukey test to compare the differences among the three cements at different concentrations. The positive controls showed bacterial growth, while the negative controls showed no bacterial growth. All materials showed antimicrobial activity against the tested strains except for Enterococcus faecalis. NEC created larger inhibition zones than MTA and Portland cement. This difference was significant for Portland cement (P < 0.05), but not for MTA (P > 0.05). Among the examined microorganisms, the largest inhibition zone was observed for Actinomyces group (P < 0.05). The antimicrobial activity of the materials increased with time and concentration (P < 0.05). It was concluded that NEC is a potent inhibitor of microorganism growth. (J Oral Sci 51, 437-442, 2009)
This study evaluated the microhardness and elemental composition of various ceramics immersed in acidic agents. One hundred and five discs of fluorapatite-leucite (IPS d.SIGN) and fluorapatite ceramics (IPS e.max Ceram) were randomly divided into 7 groups of 15 each. Five groups were alternately immersed in acidic agents (citrate buffer solution, pineapple juice, green mango juice, cola soft drink and 4% acetic acid) for 30 min and deionized water for 5 min in 7 cycles at 37°C. Two groups were continuously immersed in 4% acetic acid at 80°C for 16 h and deionized water at 37°C for 245 min. Vicker's microhardness and elemental composition were recorded before and after immersion. Data were analyzed using two-way repeated ANOVA and t-test at a significance level 0.05. For IPS d.SIGN, there was statistically significant difference in microhardness values between before and after immersion in the green mango, cola soft drink and 4% acetic acid for 16 h (P < 0.05). However, for IPS e.max Ceram, there was no significant difference between before and after immersion in any of the groups (P > 0.05). EDX results of both ceramics found that the elemental percentage of Na, K, Zr, Al and Si decreased after being immersed in acidic agents. (J Oral Sci 51, 443-450, 2009)
The aim of the present study was to histologically analyze the effects of bovine and human demineralized bone matrix and a Ricinus communis polymer on the bone regeneration process. Two surgical bone defects were created in rabbit calvaria, one on the right and the other on the left side of the parietal suture. Eighteen rabbits were divided into three groups. In Group I, the experimental defect was treated with bovine demineralized bone matrix, Group II with human demineralized bone matrix, and in Group III, the experimental cavity was treated with polyurethane resin derived from Ricinus communis oil. The control defects were filled with the animals' own blood. The animals were sacrificed after 7 and 15 weeks. Histological analysis revealed that in all groups (control and experimental), bone regeneration increased with time. The least time required for bone regeneration was noted in the control group, with a substantial decrease in the thickness of the defect. All materials proved to be biologically compatible, but polyurethane resorbed more slowly and demonstrated considerably better results than the demineralized bone matrices. (J Oral Sci 51, 451-456, 2009)
Central odontogenic fibroma (COF) is a rare tumor that accounts for 0.1% of all odontogenic tumors. It has been defined as a benign neoplasm, which appears in the jaw. Clinically, the lesion grows slowly and leads to cortical expansion. Radiologically, the most common finding is multilocular radiolucency. In some cases, it may be associated with root resorption or displacement. Histologically, the lesion is characterized by mature collagen fibers and numerous fibroblasts. COF responds well to surgical enucleation with no tendency for malignancy or recurrence. Here, a case of central odontogenic fibroma of the mandible in a 71-year-old man is described. The lesion was an asymptomatic mass with well-defined borders covered by normal mucosa. The lesion presented as a multilocular radiolucency in relation to the root of the canine. The lesion was surgically removed and analyzed histopathologically. There were no postoperative complications. (J Oral Sci 51, 457-461, 2009)
Oral melanoacanthoma (OMA) is a rare benign lesion characterized by colonization of acanthotic epithelium by dendritic melanocytes. Although its pathogenenesis remains uncertain, its clinical behavior and spontaneous remission suggest a non-neoplastic nature. Clinically, it may present as a solitary or multifocal lesion; however these two variants exhibit different features. The clinical appearance of OMA is not pathognomonic and biopsy is mandatory. OMA requires no treatment or periodic observation. Here, we report a case of OMA with diffuse lesions also affecting the tongue in a 74-year-old black woman, whose diagnosis was based essentially on clinical and histological features. The immunohistochemical profile is also presented. (J Oral Sci 51, 463-466, 2009)
Glandular Odontogenic Cyst (GOC) is a rare developmental cyst of the jaws. The histological features of GOC strongly suggest an origin from the remains of dental lamina. Radiographically, GOC presents as well-defined radiolucencies with uni- or multilocular appearance. A case of GOC in a 54-year-old black female is presented here. Clinical, histological and imaging features were evaluated. Due to the high tendency of recurrence and the aggressive potential of GOC, careful clinical and radiological evaluation must be carried out. CT scans are recommended because they provide accurate information about locularity of the lesion, cortical integrity, expansion of the lesion and involvement of the contiguous soft tissue. (J Oral Sci 51, 467-470, 2009)
Taurodontism can be defined as a change in tooth shape caused by the failure of the Hertwig's epithelial sheath diaphragm to invaginate at the proper horizontal level. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cementoenamel junction are the characteristic features. Permanent molars are most commonly affected. Endodontic treatment of a taurodont tooth is challenging and requires special handling because of the proximity and apical displacement of the roots. Here, we report a case in which endodontic treatment of the maxillary right first molar with taurodontism was performed. In this case, the maxillary right second molar and maxillary left first and second molars were also taurodont teeth. (J Oral Sci 51, 471-474, 2009)
Dens evaginatus is a developmental anomaly characterized by the presence of an accessory cusp composed of enamel and dentine, usually containing pulp tissue. This condition is clinically important because of fracture or wear of the tubercle, which can frequently lead to the major complication of pulp necrosis and periapical infection. Treatment varies according to pulp condition, tubercle integrity, and stage of root development. Here we report a case of bilateral dens evaginatus with large periapical lesions. Non-surgical root canal treatment using calcium hydroxide medication was performed for both mandibular second premolars. At the 3-year postoperative recall examination, the teeth were asymptomatic and radiographically showed healing of the periapical lesions. (J Oral Sci 51, 475-479, 2009)
Naso-oral fistula, as the name suggests, is an abnormal communication between the nasal and oral cavities. It is an extremely rare clinical entity encountered in routine rhinology clinics across the world. The occurrence of this fistula due to rhinolithiasis is much rarer. We present one such case in a 40-year-old man, who came to us for assessment of a “hole” in his palate. The cause of this naso-oral fistula was found to be a rhinolith in the right nasal cavity. This report emphasizes that trainee rhinologists should be vigilant about this little recognized and rare condition. (J Oral Sci 51, 481-483, 2009)
Calcifying epithelial odontogenic tumor (CEOT) is a benign epithelial odontogenic tumor occurring most frequently in the posterior part of the lower jaw. Extraosseous CEOT is one of the rarest forms of this tumor, and few such cases involving the maxillary gingiva have been reported in the literature. Here we present a case that showed progressive enlargement in the left maxillary gingival area over a period of 11 years. Clinical examination showed an ulcerated mass measuring 52 × 38 mm located adjacent to the lateral incisor and canine. Histologically, the tumor showed proliferation of sheets and cords of epithelial cells with granular, eosinophilic cytoplasm and round to oval nuclei. In other areas, the epithelial cells exhibited a clear, vacuolated cytoplasm and foci of eosinophilic, homogeneous material representing amyloid deposition. The present case of extraosseous CEOT with clear cells was considered to be a very rare form of this tumor. (J Oral Sci 51, 485-488, 2009)
We describe a rare case of large congenital lipoma in the upper lip of a six-month-old infant. Surgical excision of the tumor was successful, with satisfactory esthetic and functional results. (J Oral Sci 51, 489-491, 2009)
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