A shift in caries prevalence from occlusal surfaces to approximal surfaces has been demonstrated by epidemiological studies. Two recent meta-analyses evaluated the performance of visual examination and radiography for carious lesion detection, and reported low sensitivity but high specificity for early approximal caries detection. This suggests that the conventional methods have a higher risk of failing to detect approximal lesions. Consequently, in caries susceptible populations, there is a risk of progression of non-cavitated lesions to irreversible tooth destruction before the lesions are detected. This paper aims to review the performance of unconventional and novel methods for approximal caries detection. In vitro and in vivo studies identified through a MEDLINE search using keywords such as caries detection, approximal caries detection, light fluorescence and dental caries, and transillumination and dental caries were reviewed. The unconventional methods known to be used for approximal caries detection and included in this review are: cone beam computed tomography, fiber-optic trans-illumination, digital imaging fiber optic trans-illumination, near-infrared digital imaging transillumination, optical coherence tomography, laser fluorescence, ultrasound, and LED reflection and refraction.
This study aimed to compare the perception of smile esthetics and alterations among dentistry degree students and laypeople to identify differences in the esthetic perception of black spaces between the maxillary central incisors among Turkish laypeople and students in different study years. Photographs altered to include black spaces of various sizes at the midline were evaluated by 208 dentistry students in years 1-5 and 45 Turkish laypeople. Perceptional differences in different photographs were statistically significant. The students in years 2-5 were more aware of differences between photographs than year 1 students and laypeople. The proportion of participants who decided the most attractive photograph as A was highest among 3rd year students, followed by 5th year students. However, the proportion of students agreeing on the least attractive image was highest among 4th year students, followed by 3rd year students. Photographs A and H were selected as the most and least attractive, respectively, by all participants. The esthetic perception of 1st and 2nd year dentistry students was very different from that of laypeople. To increase esthetic perception among dentistry students, specific lessons with clinical photography should be included in dental education.
The aim of this study was to examine the expression of HOXA7 in oral squamous cell carcinoma (OSCC) and its correlation with clinical features. Sixty tissue specimens were collected from 60 OSCC patients who underwent surgical treatment at the Stomatological Hospital affiliated to Guizhou Medical University. Sixty specimens of normal oral tissue were also collected from 60 age- and sex-matched healthy controls. Expression of HOXA7 was assessed by real time polymerase chain reaction and immunohistochemistry. Relative to the control group, HOXA7 was up-regulated in OSCC tissues at both the mRNA and protein levels (P < 0.05), and HOXA7 expression in poorly differentiated cancers was higher than that in highly differentiated cancers (P < 0.05). HOXA7 expression was higher in patients with stage III and IV cancer than in patients with stage I and II cancer (P < 0.05). Higher HOXA7 expression was also associated with the presence of vascular and nerve invasion, and lymph node and distant metastasis. HOXA7 expression in OSCC is markedly increased at both the mRNA and protein levels, and this is positively correlated with clinical stage and the degree of tumor differentiation. These data suggest that HOXA7 could serve as a diagnostic marker for OSCC or a treatment target.
The aim of this study was to investigate the occlusal contact area (OCA) in individual teeth during low-level tooth clenching in 24 healthy participants. Before measurements were made, the 100% maximum voluntary contraction (MVC) was determined. At baseline, all subjects were instructed to close their mouth and touch the opposing teeth with minimal force. Occlusal contact was recorded during three jaw motor tasks (baseline, 20% MVC, and 40% MVC) using a blue silicone material. OCA thickness was determined from images and defined on five levels: level 1 (0-149 µm), level 2 (0-89 µm), level 3 (0-49 µm), level 4 (0-29 µm), and level 5 (0-4 µm). Premolar and molar OCAs increased significantly from baseline to 20% MVC and 40% MVC. The OCA of each anterior tooth did not change significantly with increasing clenching intensity at all levels. Our findings suggest that premolar and molar OCAs may be altered by low-intensity clenching, affecting the teeth and periodontal tissues.
FCP-COMPLEX is a newly-developed solution that contains fluoride, calcium, and phosphoric acid. It has the potential to reinforce caries-affected dentin. The purpose of this study was to evaluate the effect of FCP-COMPLEX on the morphology of bovine artificial caries-affected dentin (ACAD). FCP-COMPLEX, 2% sodium fluoride solution, and distilled water were applied to bovine ACAD and the effect on acid-induced damage was observed. Scanning electron microscopy was used to evaluate morphology after acid application. Energy dispersive X-ray spectroscopy was used for mapping and quantitative analyses of the dentin surface, and for line analysis of dentin-adhesive interface. The FCP-COMPLEX precipitated on the dentin surface and fluoride, calcium, and phosphorus were detected at a higher level in the FCP-COMPLEX group. The area of acid damage in caries-affected dentin was reduced by FCP-COMPLEX. In conclusion, FCP-COMPLEX significantly increased the deposition of fluoride onto bovine ACAD and inhibited demineralization.
The present study aimed to assess the efficacy of using botulinum toxin (BTX) in temporomandibular joint disorders, particularly pertaining to myofascial pain from masseter and temporal muscles. The study included 11 patients who were diagnosed with masseter and temporalis myofascial pain. Visual analog scale for pain and pressure algometry were conducted initially, after 1 month of conservative therapy (control group), and after 1 month of BTX type A injections (study group). Data were statistically analyzed (analysis of variance and Wilcoxon’s test) to determine intergroup differences. Both conservative therapy and BTX injections showed reduction in pain scores and increase in pain threshold compared with baseline, and statistically significant differences were noted between both groups. Thus, BTX injections appear to be effective in management of chronic myofascial pain targeting masseter and temporalis muscles.
We investigated the short-term clinical outcomes of narrow-diameter short-length implants for the fixed-prosthetic partial rehabilitation of extremely resorbed jaws. Twenty-three patients requiring partial rehabilitations with narrow-platform short-length implants in any jaw were included in this study. In total, 30 implants 3.3 mm in diameter and 7 (n = 15 implants) or 8.5 (n = 15 implants) mm in length were inserted. The primary outcome measure was implant cumulative survival rate (CSR); the secondary outcome measures were marginal bone resorption at 1 and 3 years and the incidence of biologic and mechanical complications. Five patients (21.7%) with six implants (20%) were lost to follow-up. Two implants failed in two patients, yielding a CSR at 3 years of follow-up of 93.4%. The average (standard deviation) marginal bone resorption was 1.34 mm (0.95 mm) after the first year and 1.38 mm (0.78 mm) after the third year. Biologic complications occurred in three patients; mechanical complications occurred in three patients. Despite the limitations of the study, our findings show that the use of new narrow-diameter short-length implants for the rehabilitation of extremely atrophic regions is viable in the short-term, and can be considered a treatment alternative in extremely resorbed jaws.
Residual periodontal ligament (PDL) and cement mass on the roots of extracted teeth are factors that considerably affect tooth transplantation. Therefore, when normal extracted teeth are used for autologous transplantation, it is necessary to regenerate the PDL of the root surface. Here we describe a method to examine human PDL cell adhesion on sterilized root surfaces. Sample teeth were extracted during orthodontic treatment. PDL cells were obtained from healthy periodontal tissue explants from teeth extracted for orthodontic reasons. We developed a method for adhering PDL cells to sterile root surfaces using three-dimensional culture for 3 weeks. We evaluated the adhesion of human PDL cells to the sterilized root surfaces biochemically and histologically. The adherent PDL cells presented new projections on the sterile root surfaces. Therefore, PDL cells can adhere to sterile root surfaces.
Lichen planus (LP) is a chronic T-cell-mediated mucocutaneous inflammatory disease that targets stratified epithelia, including those lining the oral cavity. The intraoral variant of LP (OLP) is associated with interferon (IFN)-γ production by infiltrating T lymphocytes; however, the role of epithelial cells in the etiopathogenesis OLP is not completely understood. There is however a growing body of evidence regarding the involvement of epithelial-derived cytokines, immune receptors, and costimulatory molecules in the pathobiological processes that promote and sustain OLP. In the present study, we used a reverse transcriptase-polymerase chain reaction assay to assess whether CD40—a receptor found mainly on antigen presenting cells—and the costimulatory molecule CD86 were expressed in oral keratinocytes (three strains of primary normal oral keratinocytes and the H357 cell line) in the presence or absence of IFN-γ. To further characterize the involvement of CD40 in OLP, expression and distribution of receptor and ligand (CD40/CD154) in tissues from OLP were evaluated by immunohistochemistry. The present results are the first to show that both CD40 and CD86 are constitutively expressed at low levels in oral keratinocytes and that their expression was enhanced by IFN-γ stimulation. The intensity of CD40 staining in OLP tissues was strong. Taken together, the results strongly suggest that CD40 and CD86 play a role in the pathophysiology of oral inflammatory diseases such as OLP.
This in vitro study aimed to investigate the efficacy of tannin-fluoride and milk-fluoride mixtures on human enamel erosion after exposure to inappropriately chlorinated pool water. Enamel specimens were immersed in swimming pool water (pH 2.7) for 30 min and in each test reagent for 4 min once a day for 60 consecutive days (group I: control, group II: tannin-fluoride, group III: milk-fluoride, group IV: tannin-fluoride before and milk-fluoride after erosive challenge, and group V: milk containing tannin-fluoride before and after erosive exposure). Surface microhardness was assessed on days 0, 30, and 60. Scanning electron microscopy (SEM) and electron probe microanalysis (EPMA) were performed after treatment of samples for 60 days. Surface microhardness of experimental groups was ranked as follows: group III > group IV-group V > group II > group I (P < 0.05). Moreover, SEM images revealed deposition of substances on erosive enamel surface after treatment with tannin-fluoride and milk-fluoride mixtures. Furthermore, EPMA profiles showed decrease of phosphorus and increase of fluoride content in groups II and IV. In conclusion, we demonstrated that treatment with fluoridated milk with or without tannin-fluoride has protective effects against enamel erosion caused by low-pH swimming pool water.
Dry mouth occurs frequently in aged individuals, as well as in patients who are hospitalized, receiving multiple drugs, undergoing radiation treatment to the head and neck, or wearing a removable denture prosthesis, use of mouth rinse being often an option for relief. In the present study, we performed microbiological assessments of subjects given three different commercially available mouth rinses commonly employed in clinical practice (Peptisal, Biotène, ConCool) to determine their effects. For bacterial clearance in vitro, Peptisal showed the highest level of suppression of oral indigenous bacteria found in both planktonic formations and biofilm. Furthermore, the inhibitory effects of these agents on biofilm formation on acrylic resin plates were examined using scanning electron microscopy. Again, Peptisal proved superior, because acquisition of resistance to antimicrobial peptides by a sensitive microbial strain was rarely observed. We conclude that Peptisal is an effective mouth rinse for clearance of planktonic and biofilm microorganisms present in the oral cavity.
The present study aimed to evaluate proinflammatory cytokine and vitamin D levels in rheumatoid arthritis (RA) and chronic periodontitis (CP) patients and healthy individuals before and after initial periodontal treatment. Overall, 17 CP patients with RA (RA + CP), 18 systemically healthy CP patients (CP), and 18 healthy controls (C) were included. Clinical periodontal measurements were recorded and gingival crevicular fluid (GCF) and blood samples were recorded. RA + CP and CP patients received nonsurgical periodontal treatment. Vitamin D, tumor necrosis factor (TNF)-α, receptor activator of nuclear factor-KB ligand (RANKL), and OPG levels were determined in GCF and serum. Baseline clinical parameters were similar in all periodontitis groups (P > 0.05) but were higher than that in controls (P < 0.05). Periodontal treatment improved clinical parameters in all periodontitis groups (P < 0.05). GCF vitamin D levels were higher in RA + CP and CP groups than in healthy controls, but these levels decreased in the RA + CP group after periodontal treatment (P < 0.05). Serum RANKL and GCF TNF-α levels in RA patients decreased after periodontal treatment (P < 0.05). Within the limitations of this study, the results suggested that GCF vitamin D levels are increased in RA patients and decrease after periodontal treatment; therefore, local vitamin D levels might be an important indicator of periodontal bone loss.
Notch signaling is involved in osteogenic differentiation; however, its role differs depending on cell type and differentiation stage. Here, we investigated the involvement of Notch signaling in the osteogenic differentiation of retinoic acid-treated embryoid bodies derived from mouse gingival fibroblast-derived induced pluripotent stem cells (mGF-iPSCs). When cultured in osteogenic media, mGF-iPSCs showed an increase in their expression of osteogenic marker genes and deposited a mineralized matrix. Furthermore, increased levels of mRNA for Notch1, Notch2, and Hey1 were observed. In the presence of DAPT, a Notch signaling inhibitor, during osteogenic induction, mRNA levels for osteogenic marker genes were significantly decreased; however, no difference was noted in mineral deposition. Moreover, activation of Notch signaling using Jagged1-immobilized surfaces resulted in a slight increase of in vitro mineralization on days 3 and 7 of osteogenic induction. Significant upregulation of Dlx5, Bsp, and Col I mRNA expression was observed in mGF-iPSCs cultured on Jagged1 surfaces. In conclusion, inhibition and activation of Notch signaling was shown to decrease and increase mGF-iPSC osteogenic differentiation, respectively. However, the responses were not robust, suggesting the involvement of additional signaling pathways.
SIRT1 is a NAD-dependent histone deacetylase that is important in a wide variety of physiological and pathophysiological processes. Although many studies have examined the relationship between SIRT1 and cancer, the role of SIRT1 in tumor malignancy is controversial. Here, we examined the effects of the SIRT1 activator CAY10591 in gingival epithelial carcinoma Ca9-22 cells. CAY10591 treatment dose- and time-dependently increased SIRT1 level and activity. The treatment decreased cell growth and induced cell-cycle repressor p21 levels. In addition, dimethyl sulfoxide significantly reduced cellular invasion and migration, and CAY10591 enhanced this decrease. Quantitative PCR analysis showed that CAY10591 decreased expression of several invasion/migration promoter genes and induced repressor genes. Our findings suggest that CAY10591 suppresses cell growth and invasion/migration activity in gingival squamous cell carcinoma Ca9-22 cells.
This study investigated the antifungal effects of low-molecular-weight chitosan solution on Candida albicans in denture stomatitis in comparison with nystatin suspension. This randomized, sing-leblind clinical trial included 40 patients diagnosed with denture stomatitis. Patients were divided into two groups, wherein one was treated with chitosan and the other with nystatin for 2 weeks. Changes in the erythematous area were recorded during and after treatment. A palatal smear was obtained for each patient before and after treatment to determine the number of blastospores and mycelia of C. albicans. The results were compared using the Mann-Whitney U test, revealing that the chitosan solution significantly decreased the erythematous surface area, burning sensation, time required for clinical improvement, and number of blastospores and mycelia. The antifungal efficacy of chitosan along with its inherent biocompatibility makes it a promising candidate for use as an antifungal mouthwash.
This study evaluated and compared the effect of conventional and digital wax-ups on three lateral occlusion variables: contact number, contact area, and steepness. Dental casts of 10 patients with Angle Class I relationship were included in the study. All patients required fixed prosthodontic treatment that would affect lateral occlusion. The casts of all patients received conventional and digital wax-ups. For pretreatment, conventional wax-up, and digital wax-up casts, contact number, contact area, and occlusion steepness were measured at four lateral positions, that is, at excursions of 0.5, 1.0, 2.0, and 3.0 mm from maximal intercuspation. Lateral occlusion scheme variables were affected by use of diagnostic wax-ups. For all types of casts, contact number decreased as excursion increased. The two types of wax-ups had similar contact number patterns, and contact number was significantly greater for these casts than for pretreatment casts in the earlier stages of excursion. Similarly, contact area gradually decreased with increasing excursion in the pretreatment and conventional and digital wax-up casts. There was only a minimal decrease in occlusion steepness as excursion increased. However, lateral occlusion was generally steeper for digital wax-up casts.
Reactive oxygen species, if produced in excess by oxidative phosphorylation, contributes to mitochondrial DNA damage and progressive respiratory chain dysfunction, leading to various diseases including carcinogenesis. Mitochondria are susceptible to oxidative stress (OS) owing to lack of introns, protective histones, and DNA repair enzymes. However, mitochondria are protected from OS by numerous antioxidants such as superoxide dismutase 2 (SOD2), catalase, glutaredoxin 2 (GLRX2), reduced glutathione (GSH), glutathione peroxidase (GPX), and thioredoxin 2 (TXN2). To obtain insights regarding expression of these mitochondrial antioxidants in oral squamous cell carcinoma (OSCC), we performed qualitative and quantitative estimations of key molecular players of mitochondrial antioxidants during various stages of OSCC by immunoblotting with specific antibodies against antioxidant enzymes and/or biochemical assays. Different mitochondrial antioxidants varied in their expression levels as OSCC progressed. The levels of GPX1, GPX4, and catalase reduced with progression of OSCC. However, GLRX2, PXR3, TXN2, and reduced GSH gradually increased. Expression of SOD2 decreased initially in Stages II and III of OSCC but increased in Stage IV. In conclusion, our findings indicate a complex interplay of various mitochondrial antioxidants in different stages of OSCC, and further insights regarding these molecular players can help us better understand the pathogenesis of OSCC in context of mitochondrial redox status.
The purpose of this experiment was to investigate whether low-intensity pulsed ultrasound (LIPUS) irradiation can inhibit dentoalveolar ankylosis in transplanted rat teeth. LIPUS irradiation (the pulsed ultrasound signal had a frequency of 3.0 MHz, a spatial average intensity of 30 mW/cm2, and a pulse ratio of 1:4) was performed on the face over the re-planted teeth of rats for 4 weeks. After the rats were euthanized, we measured mobility (Periotest value [PTV]) of the transplanted and control teeth using a Periotest. Finally, we performed histological evaluation to detect ankylosis. PTVs tended to be significantly lower for re-planted teeth than for control teeth. Histological evaluation revealed that the roots of all re-planted teeth were coalescent with alveolar bone. Furthermore, no ankylosis was observed in three-fifths of the re-planted teeth following LIPUS irradiation. These results indicate the potential efficacy of LIPUS to inhibit dentoalveolar ankylosis.
The effects of bittern water (BW), obtained from the ocean floor, on cariogenic bacteria and saliva secretion were examined. Streptococcus mutans was mixed with BW for 1, 3, 5, 10, and 20 min to explore the bactericidal effects of BW against cariogenic bacteria. Bacterial viability was calculated by counting the number of colony-forming units on Brain Heart Infusion agar plates. The results indicated a bacterial viability of more than 35% even after 20 min of incubation. Subsequently, the effects of BW on saliva secretion and the salivary concentration of secretory IgA (sIgA) were examined. Gargling with BW significantly augmented saliva secretion. Although the sIgA concentration was reduced, the total sIgA secreted into saliva was increased significantly. Our findings indicate that the use of BW may be a new strategy for the treatment of various oral diseases, including dry mouth.
This study attempted to identify appropriate materials for restoration of enamel defects in the primary dentition, which were classified by severity and region with the modified developmental defects of enamel index. To identify the most appropriate materials, we used restorative materials to protect teeth and evaluated clinical outcomes of restoration. Three materials were used for restoration or repair after dislodgement of restorations. Our findings in this case suggest that, because of its durability and esthetic advantages, adhesive resin is beneficial for patients with enamel defects, particularly for restorations of less than two-thirds of the extent of the defect.