Despite its important role in the control of periodontal disease, mechanical plaque control is not properly practiced by most individuals. Therefore, adjunctive chemical plaque control using chlorhexidine and antibiotics has also been suggested as an additional therapeutic strategy to augment mechanical plaque control. However, the additional effects of adjunctive antibiotic therapy are small, and topical chlorhexidine therapy is not without side effects. Given current limitations, new approaches for the control of biofilm are required. The new therapeutic approaches discussed in this review are divided into two categories: probiotics and vaccines. Probiotics is an interesting new field of periodontology research that aims to achieve biological plaque control by eliminating pathogenic bacteria. In addition, passive immunization using egg yolk antibody raised against periodontal pathogens may be an effective approach for the treatment of periodontitis. Further study to evaluate the possible effects of these biological plaque control methods against periodontal disease is warranted. (J Oral Sci 54, 1-5, 2012)
Short-chain fatty acids (SCFAs) are metabolites from anaerobic periodontopathic bacteria that induce apoptosis in immune cells such as lymphocytes, monocytes and macrophages. However, it remains unclear if SCFAs from pathogens induce apoptosis in monocytes/macrophages similarly with lymphocytes. This study investigated whether SCFAs-induced apoptosis is equal among the immunoregulatory cells. Cell apoptosis of the employed human cells was evaluated after treatment with culture supernatants from various periodontopathic bacteria or sodium butyrate. Apoptosis and viability were determined by detection of DNA fragmentation and using an MTS assay kit, respectively. Porphyromonas gingivalis and Fusobacterium nucleatum culture filtrates strongly induced apoptosis whereas Prevotella nigrescens and Prevotella intermedia culture filtrates failed to induce apoptosis in the THP-1 and U937 human monocyte and macrophage cell lines. Healthy gingival fibroblasts and oral epithelial cells were resistant to all the culture filtrates. Gas-liquid chromatography detected butyric acid in P. gingivalis (21.0-34.0 mM) and F. nucleatum (36.0 mM) in culture filtrates, whereas, only trace levels were seen in P. nigrescens and P. intermedia. These results suggest that butyric acid produced by periodontopathic bacteria severely damages immunoregulatory cells in a consistent manner and, likewise, could be involved in mediating periodontal chronic inflammation. (J Oral Sci 54, 7-14, 2012)
Aloe vera is a medicinal plant with anti-inflammatory, antimicrobial, antidiabetic and immune-boosting properties. In the present study we investigated the inhibitory activities of Aloe vera gel on some cariogenic (Streptococcus mutans), periodontopathic (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis) and an opportunistic periodontopathogen (Bacteroides fragilis) isolated from patients with dental caries and periodontal diseases. Twenty isolates of each of these bacteria were investigated for their sensitivity to Aloe vera gel using the disk diffusion and microdilution methods. S. mutans was the species most sensitive to Aloe vera gel with a MIC of 12.5 μg/ml, while A. actinomycetemcomitans, P. gingivalis, and B. fragilis were less sensitive, with a MIC of 25-50 μg/ml (P < 0.01). Based on our present findings it is concluded that Aloe vera gel at optimum concentration could be used as an antiseptic for prevention of dental caries and periodontal diseases. (J Oral Sci 54, 15-21, 2012)
Polymeric immunoglobulin receptor (pIgR) plays an intrinsic role in protecting the intestinal tract from invading pathogens. In the present study, we observed a decrease in pIgR in colon lysate from mice with dextran sodium sulfate (DSS) colitis. A decrease in pIgR was detected in both mRNA and protein levels. Histologic examinations revealed marked destruction of intestinal epithelial cells (IECs), and only a small number of regenerating IECs expressed pIgR. These results suggest that the decrease in pIgR was due to the destruction of IECs. Because activation of toll-like receptor 3 slows the progression of DSS colitis, we injected polyriboinosinic: polyribocytidylic acid (poly I:C) intraperitoneally and observed the correlation between pIgR level and severity of DSS colitis. Poly I:C markedly decreased progression of DSS colitis, and pIgR levels significantly recovered. Furthermore, we found that expressions of IFN-γ and TNF-α were higher in DSS colitis. These results indicate that the decrease in pIgR was not compensated for by increased expression of these cytokines. In sum, our findings show that pIgR levels vary according to the severity of DSS colitis and that these changes might be useful as a biomarker of the severity of inflammatory bowel disease. (J Oral Sci 54, 23-32, 2012)
Melanin pigment and melanocytes may be found in odontogenic cysts and tumors, particularly calcifying cystic odontogenic tumor (CCOT). In the present study we investigated the immunohistochemical expression of the Melan-A/Mart-1 and HMB-45 antigens in 13 Caucasians patients with CCOT. Melan-A/Mart-1- and HMB-45-positive melanocytes were not seen in any of the cases. Our findings are in agreement with the assumption that pigmentation in odontogenic lesions may be a racial phenomenon. (J Oral Sci 54, 33-38, 2012)
The present study evaluated the effect of various surface treatments for zirconia ceramics on shear bond strength between an indirect composite material and zirconia ceramics. In addition, we investigated the durability of shear bond strength by using artificial aging (20,000 thermocycles). A total of 176 Katana zirconia disks were randomly divided into eight groups according to surface treatment, as follows: group CON (as-milled); group GRD (wet-ground with 600-grit silicon carbide abrasive paper); groups 0.05, 0.1, 0.2, 0.4, and 0.6 MPa (airborne-particle abrasion at 0.05, 0.1, 0.2, 0.4, and 0.6 MPa, respectively); and group HF (9.5% hydrofluoric acid etching). Shear bond strength was measured at 0 thermocycles in half the specimens after 24-h immersion. The remaining specimens were subjected to 20,000 thermocycles before shear bond strength testing. Among the eight groups, the 0.1, 0.2, 0.4, and 0.6 MPa airborne-particle abraded groups had significantly higher bond strengths before and after thermocycling. The Mann-Whitney U-test revealed no significant difference in shear bond strength between 0 and 20,000 thermocycles, except in the 0.2 MPa group (P = 0.013). From the results of this study, use of airborne-particle abrasion at a pressure of 0.1 MPa or higher increases initial and durable bond strength between an indirect composite material and zirconia ceramics. (J Oral Sci 54, 39-46, 2011)
Connective tissue growth factor/CCN family 2 (CTGF/CCN2) has been considered to participate in tooth development. To date, the expression and role of CTGF/CCN2 in reparative dentinogenesis have been unclear. Our previous study revealed that matrix metalloproteinase-3 (MMP-3) stimulates cell migration via CTGF/CCN2 expression and secretion in human dental pulp cells, and that this is dependent on dynamin-related endocytosis and independent of protease activity. The objective of the present study was to determine the expression of CTGF/CCN2 in reparative dentin in human carious teeth and to examine the effect of CTGF/CCN2 on mineralization in cultured human dental pulp cells. Minimal expression of CTGF/CCN2 was evident in odontoblasts subjacent to the dentin-pulp junction in healthy teeth, whereas strong expression was detected in odontoblast-like cells lining the reparative dentin subjacent to dental caries. In human dental pulp cells, CTGF/CCN2 promoted mineralization but failed to induce proliferation, suggesting that this molecule has the ability to induce the differentiation of human dental pulp cells. Taken together, the data suggest that CTGF/CCN2 is likely involved in reparative dentinogenesis through formation of hard tissue in human carious teeth. (J Oral Sci 54, 47-54, 2012)
This study aimed to show the effects of metal artifacts on the in vivo micro-CT of mini-implants by measuring bone volume. We drilled a hole in the cortical bone of a rat tibia and embedded a titanium orthodontic mini-implant (diameter, 1.5 mm) in the hole. Twelve individually weighed hydroxyapatite grains (HA grains) were placed around the implant either by one dentist (method 1) or separately by 12 dentists (method 2). In vivo micro-CT was used to scan the model after placement of each grain to measure increases and decreases in bone volume voxel number. The subtracted bone voxel volume increased with HA weight in both methods. Simple linear regression analysis showed a significant correlation between weight and volume in both methods (method 1: regression coefficient: 516.502, P < 0.05; method 2: regression coefficient: 4837.432, P < 0.05). Metal artifacts did not appear to influence measurements of bone volume, although further studies are required to determine the effect of thicker implants. (J Oral Sci 54, 55-59, 2012)
The purpose of the current study was to determine if saliva contains biomarkers that can be used as diagnostic tools for Sjögren’s syndrome (SjS). Twenty seven SjS patients and 27 age-matched healthy controls were recruited for these studies. Unstimulated glandular saliva was collected from the Wharton’s duct using a suction device. Two μl of salvia were processed for mass spectrometry analyses on a prOTOF 2000 matrix-assisted laser desorption/ionization orthogonal time of flight (MALDI O-TOF) mass spectrometer. Raw data were analyzed using bioinformatic tools to identify biomarkers. MALDI O-TOF MS analyses of saliva samples were highly reproducible and the mass spectra generated were very rich in peptides and peptide fragments in the 750-7,500 Da range. Data analysis using bioinformatic tools resulted in several classification models being built and several biomarkers identified. One model based on 7 putative biomarkers yielded a sensitivity of 97.5%, specificity of 97.8% and an accuracy of 97.6%. One biomarker was present only in SjS samples and was identified as a proteolytic peptide originating from human basic salivary proline-rich protein 3 precursor. We conclude that salivary biomarkers detected by high-resolution mass spectrometry coupled with powerful bioinformatic tools offer the potential to serve as diagnostic/prognostic tools for SjS. (J Oral Sci 54, 61-70, 2012)
Activation-induced cytidine deaminase (AID) induces cytosine deamination to generate somatic hypermutation and class switch recombnation in immunoglobulin genes. AID expression is upregulated by inflammatory cytokines such as interferon-γ and tumor necrosis factor (TNF)-α, which in turn induce p53 mutations in inflammatory or cancer cells. In this study, the effects of growth factors, cytokines or sodium butyrate on AID mRNA expression were examined in human OSCC-derived cells using real-time RT-PCR. Expression of AID mRNA was detected in OSCC cells and the expression was increased by EGF, TNF-a, or sodium butyrate. These results suggest that aberrant AID expression may play an important role in the dysplasia-carcinoma sequence in the oral cavity. (J Oral Sci 54, 71-75, 2012)
Porphyromonas gingivalis FimA fimbriae have been classified into 6 genotypes (types I–V and Ib) based on the diversity of the fimA genes encoding the fimbrial subunits. We investigated the prevalence of fimA genotype in Japanese children. Dental plaque specimens were obtained from 400 subjects (age; 2 to 15 years), including 134 with healthy gingiva, 239 with gingivitis and 27 with periodontitis, and then analyzed by polymerase chain reaction. P. gingivalis was detected in 1.5%, 10.0% and 29.6% of these subjects, respectively. Significant differences were observed with regard to P. gingivalis infection among the groups [chi-squared analysis: gingivitis vs. healthy, P < 0.01, odds ratio (OR) = 7.4; periodontitis vs. healthy, P < 0.001, OR = 27.8]. In P. gingivalis-positive subjects with periodontitis, the most prevalent fimA types were type Ib/type II combination (37.5%) and type IV (37.5%), followed by type II (25.0%), while type IV (33.3%) and type II (29.2%) were most often detected in those with gingivitis. Our results suggest that the presence of P. gingivalis is associated with periodontal diseases, and that the type II, IV and Ib/II combination are the most common among fimA genotypes. (J Oral Sci 54, 77-83, 2012)
Dental treatment is reported to be the greatest unattended health need of people with a disability. The aim of the present study was therefore to quantify the prevalence of oral diseases with a psychosomatic component (recurrent aphthous stomatitis, burning mouth syndrome, and oral lichen planus) in psychiatric patients and to screen these patients for any other oral disorders, so that better care could be provided. In this cross-sectional, single-assessment study, 150 psychiatric patients were evaluated for presence of oral disorders. They were screened based on their socio-demographic profiles, clinical profile, and standardized psychiatric scales. The prevalence of recurrent aphthous stomatitis (RAS), burning mouth syndrome (BMS), and oral lichen planus (OLP) was 19.33%(29 patients), 20.66% (31 patients) and 5.33% (8 patients), respectively, amongst all psychiatric patients. The prevalence of burning mouth syndrome was much higher in patients taking psychiatric medications (25%) than in drug–naïve patients. On screening for other oral disorders, 35.33% of psychiatric patients had at least one other such disorder. We concluded that this patient group experiences a considerable burden of occult oral disorders necessitating thorough oral care. We also described the possible causes of the higher prevalence of oral disorders in psychiatric patients. (J Oral Sci 54, 85-91, 2012)
The aim of this study was to analyze the molecular structure of enamel with fluorosis using micro-Raman spectroscopy and compare it with that of healthy enamel. Eighty extracted human molars were classified into four fluorosis groups according to the Thylstrup-Fejerskov Index (TFI) [TFI: 0, Healthy enamel; 1-3, mild; 4-5, moderate; 6-9, severe fluorosis]. All samples were analyzed by micro-Raman spectroscopy. The integral areas of ν1 (960 cm−1) phosphate peak as well as B-type carbonate peak (1070 cm−1) were obtained to analyze structural differences among the specimens. Although the differences were not statistically significant (P > 0.05), the mean of integral areas of ν1 phosphate peak among groups indicated greater mineralization in the severe fluorosis group. However, there were statistically significant differences in the intensities, and the integral areas of B-type carbonate peak among groups (P < 0.05). Therefore, mineralization of the carbonate peak at 1070 cm−1 decreased significantly in fluorotic groups, suggesting that carbonate ions are easily dissolved in the presence of fluoride. Although structurally fluorotic teeth are not more susceptible to dental caries, serious alteration in its surface topography may cause retention of bacterial plaque and formation of enamel caries. Micro-Raman spectroscopy is a useful tool for analyzing the molecular structure of healthy and fluorotic human enamel. (J Oral Sci 54, 93-98, 2012)
Forty two single-rooted teeth, prepared with the Mtwo system, were divided into three groups based on the filling method: control, “Single-cone” (n = 20) (Mtwo gutta-percha single-cone tapered according to the diameter, length and conicity of the preparation) and “Combined system” (n = 20) (BeeFill 2in1). The parameters studied were apical leakage, gutta-percha adjustment, number of voids, presence/absence of sealer, root canal morphology, residual fragments, and filling of lateral/accessory canals. A dye penetration test was carried out (methylene blue). The teeth were embedded in resin, cut transversally and observed. The data were analyzed with non-parametric Mann-Whitney and Spearman tests. Comparative tests between the two groups showed that the “Combined system” was superior in terms of apical leakage (P < 0.01), gutta-percha adjustment (P < 0.05) and filling of lateral/accessory canals (P < 0.05). There were statistically significant correlations between master cone adjustment and root canal morphology (P < 0.01) in the “Single-cone” group. In the “Combined system” group, a relation was observed between the voids and root canal morphology (P < 0.05) and between voids and residual fragments (P < 0.05). The quality of obturation with warm gutta-percha was better than that of the tapered single-cone technique. Root canal morphology influences gutta-percha adjustment. Residual fragments on the root canal reduce sealing ability. (J Oral Sci 54, 99-104, 2012)
Squamous cell carcinomas (SCCs) account for approximately 95% of all oral malignant neoplasms and for about 38% of all malignant head and neck tumors, especially affecting the tongue and lips. The aim of this study was to evaluate the immunohistochemical expression of MMP-9 and VEGF in oral SCC according to the occurrence of metastasis. Eighteen cases of tongue SCC without metastases and 17 cases of tongue SCC with metastases were subjected to immunohistochemical methods. High immunohistochemical expression of MMP-9 and VEGF by neoplastic cells and stroma was observed in tongue SCCs at the invasion front. Metastatic tumors tended to express higher levels of MMP-9 and VEGF than non-metastatic tumors, but the difference was not significant (P > 0.05). Spearman’s correlation test showed no significant correlation between VEGF-immunopositive vessels and metastasis (P > 0.05). The present results demonstrate the importance of the expression of MMP-9 and VEGF for the development of SCC of the tongue. However, no significant association was observed between the overexpression of MMP-9 or VEGF and the presence of metastases. (J Ora Sci 54, 105-111, 2012)
We used the short-form of the Oral Health Impact Profile (OHIP-14) to assess the impact of periodontal diseases on the quality of life of Jordanian adults. A systematic random sample of 400 individuals was selected from patients referred to the periodontics clinic at the Dental Teaching Center in Irbid, Jordan. Those willing to participate were examined by specifically trained dentists and requested to complete the Arabic short-form version of the OHIP-14 questionnaire. Multivariate analysis of differences in OHIP-14 subscales among the periodontal disease groups was conducted using the general linear model multivariate procedure. This study included 400 adults (164 men and 236 women) aged between 18 and 60 years, with a mean (SD) of 36.7 (11.9) years. Of the 400 participants, 41.8% had chronic gingivitis, 19.8% had mild periodontitis, 23.3% had moderate periodontitis, and 15.3% had severe periodontitis. “Fairly often” or “very often” was reported for one or more items of the OHIP-14 by fewer than one-third of patients with gingivitis (32.9%) or mild periodontitis (31.6%), by about one-half of patients with moderate periodontitis (53.8%), and by about two-thirds of those with severe periodontitis (63.9%). There was a statistically significant association between the severity of periodontal disease and OHIP-14 scores (P < 0.05). Severe chronic periodontitis had a significantly greater impact on quality of life, specifically with regard to physical pain and physical disability (P < 0.05). Physical pain and physical disability were the dimensions most affected, and all OHIP-14 scores were significantly associated with severity of periodontal disease after adjusting for common confounders. (J Oral Sci 54, 113-120, 2012)
The purpose of this study was to evaluate the depth of cure and Knoop hardness of indirect composite materials polymerized with different laboratory curing units. Five composite materials designed for fixed restoration veneer (Artglass, Ceramage, Epricord, Prossimo, and Solidex) were filled into a cylindrical mold and then light-exposed by using the respective proprietary laboratory curing unit or two metal halide curing units (Hyper LII and Twinkle X). Depth of cure was determined by a scraping technique, as described in ISO 4049. Composites also underwent Knoop hardness testing after immersion in water. The results (n = 5) were analyzed with the Kruskal-Wallis test and Dunn’s multiple comparison test. For three materials (Prossimo, Artglass, and Epricord), depth of cure after polymerization with the Twinkle X unit was greater than that after polymerization with the respective proprietary units. For the Ceramage and Artglass materials, the Twinkle X unit resulted in the highest Knoop hardness number (KHN), whereas, for the Prossimo material, the Hyper LII unit resulted in the highest KHN. The metal halide units were effective in enhancing the post-polymerization properties of specific composite materials while reducing exposure time. (J Oral Sci 54, 121-125, 2012)
Endodontic treatment of teeth with perforating internal root resorption represents a clinical challenge. In most cases, extraction of the tooth and subsequent replacement with an osseointegrated implant is indicated. Presented herein is a case report of a maxillary lateral incisor with advanced perforating internal root resorption in the middle third of the root and the presence of a sinus tract. Mineral Trioxide Aggregate (MTA) was used with the aid of a surgical microscope in order to fill the resorption area after conventional root canal therapy of the apical segment. At the follow-up after 11 years and 8 months, the patient was clinically asymptomatic and the sinus tract had disappeared. The radiographic examination and computerized tomography indicated periodontal bone repair. (J Oral Sci 54, 127-131, 2012)
Concrescence is a rare developmental anomaly with an overall incidence of 0.8% in the permanent dentition. While many case reports describe the treatment of concrescence with extraction, there are few reports of non-surgical root canal treatment (NSRCT), due to the atypical root form, canal morphology, and technical difficulties involved in concrescence. This unique case report describes a technical modification of NSRCT that can retain joined posterior maxillary teeth to maintain natural posterior occlusion without surgical intervention or dental implants, thereby avoiding the risk of damage to a large portion of the alveolar bone near the maxillary sinus. (J Oral Sci 54, 133-136, 2012)
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