We investigated the prevalences and risk factors for peri-implant diseases in Japanese adult dental patients attending a follow-up visit at dental hospitals or clinics as part of their maintenance program. This cross-sectional multicenter study enrolled patients with dental implants who attended regular check-ups as part of a periodontal maintenance program during the period from October 2012 through September 2013. Patients with implants with at least 3 years of loading time were included in the study. The condition of peri-implant tissue was examined and classified into the following categories: healthy, peri-implant mucositis, and peri-implantitis. Patients were also evaluated for implant risk factors. A total of 267 patients (110 men, 157 women; mean age: 62.5 ± 10.7 years) were analyzed. The prevalence of patient-based peri-implant mucositis was 33.3% (n = 89), and the prevalence of peri-implantitis was 9.7% (n = 26). Poor oral hygiene and a history of periodontitis were strong risk factors for peri-implant disease. The present prevalences were lower than those previously reported. The quality of periodontal therapy before and after implant installation and patient compliance and motivation, as indicated by plaque control level, appear to be important in maintaining peri-implant tissue health.
This study investigated the effects of indirect composite polymerization on the postcuring mechanical properties of a fiber-reinforced composite. An indirect composite seated on glass fibers preimpregnated with polymerized monomer was polymerized by 1) photoirradiation using a halogen-fluorescent polymerizing unit for 5 min, 2) method 1 plus secondary heating at 100°C for 15 min, 3) photoirradiation using a metal halide light unit for 60 s, or 4) preliminary polymerization using a halogen light unit for 20 s followed by method 3. After polymerization, the flexural and shear bond strengths of the fiber-reinforced composite were examined, as was the flexural strength of non-fiber-reinforced composite specimens polymerized using the same methods. Among non-fiber-reinforced composite specimens, flexural strength was lower for method 1 than for the other three methods; however, among fiberreinforced composite specimens, the four methods did not significantly differ in flexural strength or shear bond strength. Composite-fiber interface separation without breakage of the fiber after flexural strength testing was not observed in specimens polymerized by methods 2 or 4. In conclusion, use of a conventional unit for high-intensity light irradiation after preliminary irradiation, or light irradiation followed by secondary heating, is recommended for polymerization of composite material seated on polymerized glass fiber.
The aim of this study was to evaluate the effects of melatonin on the oxidative stress in heart tissues after induction of experimental periodontitis in rats. Thirty Wistar Albino male rats were divided into four groups as follows: healthy + saline solution (Hs, n = 7), healthy + melatonin (Hm, n = 7), periodontitis + saline solution (Ps, n = 8), and periodontitis + melatonin (Pm, n = 8). Experimental periodontitis was induced using a ligature placed at the gingival margin of the maxillary second molars. Melatonin was applied intraperitoneally (10 mg/kg) every day for 2 weeks. After sacrificing the rats, serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) levels, and melatonin levels were evaluated. The Pm group exhibited lower alveolar bone loss than the Ps group. Melatonin levels increased in the periodontitis groups, and the Pm group had lower MDA levels and higher GSH-Px levels than the Ps group. These findings suggest that melatonin administration reduces MDA and increases GSH-Px levels in heart tissue, and these effects may be due to its antioxidant properties. Further studies are needed to understand the effects of melatonin on the association between periodontitis and cardiovascular disease.
Drynaria fortunei (D. fortunei), widely used in traditional Korean medicine, is reportedly effective in treating inflammation, hyperlipidemia, bone fractures, oxidative damage, arteriosclerosis, rheumatism, and gynecological diseases. The objective of this study was to evaluate the antibacterial effects of the chloroform fraction of D. fortunei (DFCF) and assess the synergistic effects of DFCF with antibiotics against bacterial pathogens. This was carried out by calculating the minimal inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) and performing checkerboard dilution test and time-kill assays. The MICs/MBCs for DFCF, ampicillin, and gentamicin against all oral strains were >39-2,500/5,000 μg/mL, 0.25-64/0.25-64 µg/mL, and 0.5-256/1-512 µg/mL, respectively. DFCF exhibited the highest activity against the periodontic pathogens Prevotella intermedia and Porphylomonas gingivalis. DFCF in combination with ampicillin showed a strong synergistic effect against oral bacteria (fractional inhibitory concentration (FIC) index ≤0.5), whereas on combining with gentamicin, it reduced the on half-eighth times than used alone (FICI ≤ 0.5). DFCF combined with ampicillin or gentamicin killed 100% of most tested bacteria within 3-4 h. The results of this study demonstrate the antimicrobial and synergistic activity of DFCF and antibiotics against oral pathogens.
Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) are important etiologic agents in human dental caries. Using quantitative real-time polymerase chain reaction assays for the presence of those strains, we examined 145 outpatients with intellectual disability (ID), calculated the proportion of each of these strains to total bacteria, and compared dental caries incidence over 5 years. Plaque samples were collected from all erupted tooth sites, and dental examinations were performed annually to determine numbers of decayed, missing, and filled teeth (DMFT score; World Health Organization caries diagnostic criteria). Elevated DMFT scores were calculated as ∆DMFT, and sites of newly affected caries (∆SNAC) were identified. Sixty-six patients had both strains. The proportion of S. mutans to total bacteria was moderately correlated with DMFT in year 2, ∆DMFT in years 2 and 5, and ∆SNAC in years 2 and 5 (correlation coefficient = 0.470, P < 0.001), while the proportion of S. sobrinus to total bacteria was moderately correlated with DMFT in years 2 and 5, ∆DMFT in years 1, 2, and 5, and ∆SNAC in years 2 and 5 (correlation coefficient = 0.695, P < 0.001). Individuals with ID who harbored both bacterial strains had a higher risk of dental caries and a significantly higher proportion of S. sobrinus to total bacteria.
This in vitro study investigated intraos seous heat production during insertion, with and without pre-drilling, of a self-drilling orthodontic mini-implant. To measure temperature changes and drilling times in pig ribs, a special testing apparatus was used to examine new and worn pre-drills at different speeds. Temperatures were measured during mini-implant placement with and without pre-drilling. The average intraosseous temperature increase during manual mini-implant insertion was similar with and without pre-drilling (11.8 ± 2.1°C vs. 11.3 ± 2.4°C, respectively; P = 0.707). During pre-drilling the mean temperature increase for new drills was 2.1°C at 100 rpm, 2.3°C at 200 rpm, and 7.6°C at 1,200 rpm. Temperature increases were significantly higher for worn drills at the same speeds (2.98°C, 3.0°C, and 12.3°C, respectively), while bone temperatures at 100 and 200 rpm were similar for new and worn drills (P = 0.345 and 0.736, respectively). Baseline bone temperature was approximated within 30 s after drilling in most specimens. Drilling time at 100 rpm was 2.1 ± 0.9 s, but was significantly shorter at 200 rpm (1.1 ± 0.2 s) and 1,200 rpm (0.1 ± 0.03 s). Pre-drilling did not decrease intraosseous temperatures. In patients for whom pre-drilling is indicated, speeds of 100 or 200 rpm are recommended, at least 30 s after pilot drilling.
This study examined the relationship between stimulated salivary flow rate and oral health status in an adult population. Multinomial multivariate logistic regression analysis was used to examine the associations of salivary flow rate with dental caries status and periodontal status at the individual level among 2,110 Japanese adults with ≥10 teeth. Then, a spline model was used to examine the nonlinear relationship between salivary flow rate and teeth with dental caries or periodontal disease in multilevel analysis. Odds ratios were calculated for a 1.0-mL/min reduction in salivary flow rate at a point. After adjusting for confounding variables, participants with a flow rate ≤3.5 mL/min had significantly higher odds ratios for high caries status, and participants with a flow rate ≤1.4 mL/min had a higher odds ratio for broad periodontal disease, than did those with a flow rate >3.5 mL/min. In spline models, the odds ratio for teeth with dental caries or periodontal disease increased with reduced saliva secretion. The present findings suggest that decreased saliva secretion affects both dental caries and general periodontal health status.
Salivary hemoglobin (Hb) for screening of periodontitis is approved under the pharmaceutical affairs law of Japan. Two reagents are commercially available for the modified fecal occult blood test: Saliva Hemo Plus and OC-AUTO S Latex Reagent. We simultaneously measured split specimens from 561 samples by using these two methods and compared the differences and agreement between both methods. Moreover, saliva samples were collected from 10 subjects at five time points during the day for analysis of circadian variations and fluctuation. The Pearson’s correlation coefficient for these two reagents was 0.794. The Bland-Altman plot of differences in salivary Hb levels measured by the two reagents indicated that the difference included fixed errors (0.55 μg/mL). On analysis of circadian variations, no statistically significant differences were observed using the Friedman test. However, fixed errors were observed between wake-up time and before dinner and before lunch and before dinner, and no random errors were observed by Bland-Altman analysis. In conclusion, the salivary Hb levels measured using OC-AUTO S Latex Reagent were lower than those measured using Saliva Hemo Plus, along with a tendency for higher levels in the morning. Thus, when performing salivary tests these observations must be considered.
Rehabilitation for dysfunctions of eating and swallowing should be considered in terms of not only motor but also sensory function. Sensory information from a bolus in the mouth plays an important role in eating and swallowing. Therefore, this study investigated oral stereognosis in 184 healthy adults with normal eating and swallowing function in order to obtain normative data. Oral stereognosis was assessed by using 20 intra-oral test pieces with different shapes. The subjects manipulated the test pieces in the mouth and identified their shapes. At this time, the test scores and response times for answering were recorded. The results revealed differences in oral stereognosis depending on the age of the subjects and the test pieces employed. The younger group had higher test scores and shorter response times than the older group, except for comparisons between the 20s and 30s age groups. In addition, response time was negative correlated with test scores (r = −0.956, P < 0.001). These results indicate that oral stereognosis decreases with age.
The antibacterial activity of an extract and several fractions of Sophora flavescens (S. flavescens) root alone and in combination with antibiotics against oral bacteria was investigated by checkerboard assay and time-kill assay. The minimum inhibitory concentration/minimum bactericidal concentration (MIC/MBC) values for all examined bacteria were 0.313-2.5/0.625-2.5 μg/mL for the n-BuOH fraction, 0.625-5/1.25-10 μg/mL for the EtOAc fraction, 0.25-8/0.25-16 μg/mL for ampicillin, 0.5-256/1-512 μg/mL for gentamicin, 0.008-32/0.016-64 μg/mL for erythromycin, and 0.25-64/0.5-128 μg/mL for vancomycin. The n-butanol (n-BuOH) and ethyl acetate (EtOAc) fractions exhibited stronger antibacterial activity against oral bacteria than other fractions and extracts. The MICs and MBCs were reduced to between one half and one quarter when the n-BuOH and EtOAc fractions were combined with antibiotics. After 24 h of incubation, combination of 1/2 MIC of the n-BuOH fraction with antibiotics increased the degree of bactericidal activity. The present results suggest that n-BuOH and EtOAc extracts of S. flavescens root might be applicable as new natural antimicrobial agents against oral pathogens.
Studies have failed to identify the molecular mechanisms that regulate the genotoxic and cytotoxic effects of methacrylate resins, which are important in the biocompatibility of dental materials. Interleukin (IL)-6 has a crucial role in the control of acute-phase protein response during inflammation. In humans, the synthesis and release of two major acute-phase proteins, C-reactive protein and serum amyloid A, are regulated by IL-6. This study focused on IL-6 and activation of its receptors gp80 and gp130 in human gingival fibroblasts in order to assess the effects of the commercial acid resins Jet Kit, Unifast, and Duralay on control of inflammation.
This study investigated changes in periodontal outcomes after nonsurgical periodontal treatment (NSPT) and evaluated associations of change in salivary resistin level with periodontal outcomes in obese Malaysians with chronic periodontitis. Sixty-two obese adults with chronic periodontitis were randomly divided into a test group (n = 31), which received NSPT, and a control group (n = 31), which received no treatment. Plaque score (PS), gingival bleeding index (GBI), probing pocket depth (PPD), and clinical attachment loss (CAL) were measured at baseline and at 6 and 12 weeks after NSPT. Salivary resistin levels were evaluated by using an enzyme-linked immunosorbent assay. PS was significantly lower in patients who received NSPT than in the control group at 6 and 12 weeks (P < 0.05). In the NSPT group the percentages of sites with shallow and moderate pockets decreased significantly, but there was no significant change in deep pockets. Resistin levels significantly decreased after NSPT (P < 0.05). Change in salivary resistin level was not significantly associated with periodontal outcomes. In obese Malaysians, NSPT significantly improved PS and GBI, and improved PPD and CAL for shallow and moderately deep pockets but not for deep pockets. Salivary resistin level was not associated with improvement in either periodontal variable.
To investigate long-term nonsurgical treatment outcomes in patients with generalized aggressive periodontitis (GAgP) and the impact of root abnormalities (RAs) and other patient-level factors in relation to GAgP progression. Patients (n = 64) from a GAgP cohort who completed active nonsurgical periodontal treatment and consented to re-evaluation after 3 to 11 (mean 5.3) years, were enrolled. RAs were identified using radiographs. Periodontal parameters (e.g., probing depths [PDs], and tooth loss [TL]) were investigated. Multivariate analysis was performed to identify factors contributing to TL and bone level alteration (∆BL). After treatment, the mean number of sites with PDs > 5 mm decreased from 54.3 to 17.2. Annual TL was 0.11/patient. Twenty-one patients (32.8%) had >4 teeth with root abnormalities (RA-teeth) and exhibited a higher risk for TL (univariate odds ration [OR] = 3.52, multivariate logistic OR = 6.57). Factors correlated to ∆BL were sites with residual PD > 5 mm (β = −0.400) and observation time (β = −0.210). Nonsurgical treatment provides beneficial outcomes in GAgP patients. Higher incidence of RAs and high prevalence of residual deep pockets have a negative impact on long-term outcomes. Practical implications: in cases of GAgP with residual deep pockets and high incidence of RAs, clinicians must emphasize that long-term outcomes of nonsurgical treatment may be compromised.
We evaluated changes in clinical variables and microbiological profiles of periodontopathogens among 56 patients with moderate to severe CP who were randomly assigned to oral hygiene instruction (OHI; n = 28) or nonsurgical periodontal treatment (NSPT; n = 28). Periodontal variables were assessed and subgingival plaque samples were obtained from deep pockets (≥5 mm) at baseline and 3 months after treatment. Real-time polymerase chain reaction was used to quantify Actinobacillus actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, and Prevotella intermedia. All clinical variables significantly improved in both groups. Improvements in gingival bleeding index (GBI), probing pocket depth (PPD), and periodontal attachment loss (PAL) were significantly greater at 3 months after treatment in the NSPT group. At baseline, the prevalences of all pathogens were high. Significant reductions in microbial count were observed for A. actinomycetemcomitans and T. forsythia (P ≤ 0.05) in the NSPT group. None of the improvements in clinical variables was associated with changes in microbiological profiles. At 3 months after treatment, NSPT was associated with significantly greater improvements in GBI, PPD, and PAL as compared with OHI. A. actinomycetemcomitans and T. forsythia counts were significantly lower in the NSPT group.
The effects of bodybuilding and protein supplements on periodontal tissues have not yet been evaluated. The present study aimed to examine the periodontal status and interleukin (IL)-1β, apoptosis-associated speck-like protein containing C-terminal caspase-recruitment domain (ASC), and caspase 1 (CASP1) gene expression levels of body builders compared with those of controls. Twenty-five bodybuilders with gingivitis (BB-G) who used protein powder supplements were compared with 25 nonexercising males with (G) and 25 without (H) gingivitis. Saliva, gingival crevicular fluid (GCF), and serum were collected for gene expression analysis. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded. GI and BOP were higher in group BB-G and G than in group H (P < 0.01), but PI, PD, and CAL were similar between groups (P > 0.05). In GCF, CASP1, ASC, and IL-1β expression were upregulated in group G compared with groups BB-G and H (P < 0.01). In addition, ASC (P < 0.05) and IL-1β (P < 0.01) were downregulated in group BB-G compared with group H. CASP1, IL-1β (P < 0.01), and ASC in the saliva were downregulated in group BB-G compared with groups H and G (P < 0.05). CASP1, IL-1β, and ASC may play a role in the pathogenesis of gingivitis. Bodybuilding and supplement usage may decrease gingival inflammation by downregulating CASP1, IL-1β, and ASC.
Ceramic primers consisting of γ-methacryloxypropyl trimethoxysilane (γ-MPS) and either 4-methacryloyloxyethyl trimellitate (4-MET) or 10-methacryloyloxydecyl dihydrogen phosphate (MDP) are useful for facilitating bonding of resin cement to silica-based ceramic surfaces. However, bond stability at the resin-ceramic interface differs among commercial ceramic primers. To determine the ability of 4-MET or MDP to hydrolyze the methoxy group in γ-MPS, the author designed two-bottle experimental ceramic primers comprising γ-MPS solution and an activator solution of 4-MET or MDP. The effects of the type of acidic monomer on contact angle and ceramic bond durability of resin were investigated. MDP and 4-MET promoted chemisorption of γ-MPS on the ceramic surface and enhanced the ceramic bond strength of the resin. However, thermocycling decreased ceramic bond strengths, as reflected by the increased number of bonded specimens that exhibited interfacial resin failure. Bond strength was greater for 4-MET-activated ceramic primer than for the MDP-activated ceramic primer, although most bonded specimens exhibited interfacial resin failure. Degradation behavior differed between the 4-MET-activated and MDP-activated ceramic primers.
Free radicals play important roles in the mechanisms underlying lichen planus (LP). Uric acid (UA) is an important anti-oxidant in plasma. Prolactin (PRL) is an immunomodulatory hormone that may promote LP, as has been documented in other autoimmune disorders, such as systemic lupus erythematosus, rheumatoid arthritis, and psoriasis. PRL has multiple immune-stimulatory effects and promotes the development of such autoimmune disorders. Prolactin and uric acid may serve as biomarkers of disease activity in lichen planus. The aim of the present study was to evaluate the roles of depression, stress, and anxiety in LP, as well as serum levels of UA and PRL as potential biomarkers of disease activity and compare these findings with those of the control group. Thirty-nine patients clinically diagnosed with oral LP (study group) and 39 age- and sex-matched controls (control group) were selected in this study. Serum UA and PRL levels were measured. The Depression Anxiety Stress Scale-21 was used for psychometric evaluation of LP patients and controls. Serum UA level was found to be significantly higher in the control group as well as during the remission phase of disease in the study. There was no significant difference in serum PRL levels between cases and controls. Depression and stress scores were higher in the study group.
Osteoporosis and periodontal disease are linked by an altered receptor activator of nuclear factor κB ligand and osteoprotegerin ratio (RANKL/OPG), and medical treatment with bisphosphonate (BP) may help control these molecules. The effect of BP on clinical findings and gingival crevicular fluid (GCF) values of RANKL and OPG using enzyme-linked immunosorbent assays was evaluated in postmenopausal women; 13 patients with both chronic periodontitis and osteoporosis (group A), 12 systemically healthy patients with chronic periodontitis (group B), 12 periodontally healthy patients with osteoporosis (group C), and 10 systemically and periodontally healthy individuals (group D). Recordings were repeated at the end of months 1, 6, and 12 in groups A, B, and C. At the baseline, groups A and B exhibited the lowest OPG values (P < 0.05). After periodontal treatment, OPG values were markedly increased at the end of 6th month in group A and 12th month in group B (P < 0.008). There was no significant difference in GCF RANKL values among groups (P > 0.05) or during the observation period (P > 0.008). The use of BP may be effective in preventing periodontal breakdown by controlling the levels of these markers in osteoporosis as an adjunct to periodontal treatment.
Eagle’s syndrome is a rare clinical entity associated with craniofacial and cervical pain. It is caused by an elongated or deviated styloid process and/or calcification/ossification of the stylohyoid ligament. Complete ossification and aberrant thickening of the stylohyoid chain is the most unusual manifestation. We report a patient who presented with complaints of foreign body sensation, dysphagia and moderate submandibular pain caused by unilateral complete ossification, abnormal thickening and hypertrophy of the stylohyoid chain. This case was also unique in that histopathological investigation demonstrated mature bone with both compact and cancellous bone as well as bone marrow.
Skeletal Class III malocclusion with mandibular prognathism is often associated with mandibular asymmetry, and patients with Cl III deformity and asymmetry may undergo orthognathic surgery to improve facial function and esthetics. However, the long-term stability of mandibular setback surgery has been considered “problematic”. We report a 25-year-old female patient who was diagnosed as having a skeletal Class III relationship, mandibular asymmetry and unilateral crossbite. She underwent bilateral sagittal split-ramus osteotomy and orthodontic therapy, and this led to improvement of her dentofacial relationship, esthetics and occlusion. The outcome was stable after 8 years of retention. This case shows that asymmetry correction using mandibular setback surgery for skeletal Class III deformity can yield long-term stability.
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