Transparent epoxy resin root canal models were used to evaluate vertical condensation techniques for obturating lateral canals. The root canal model was configured with a straight main root canal and four right-angled lateral canals at 1.0 and 3.0 mm from the apex. Root canal obturation was performed with Thermafil, Obtura II, or NT condenser. Obturation volume in lateral canals was measured by three-dimensional microcomputed tomography, and one-way analysis of variance was used to analyze differences between groups. Lateral canals at 1.0 and 3.0 mm were uniformly filled by all obturation methods. Among the three obturation methods, Thermafil resulted in the highest obturation volumes for all lateral canals.

The occlusal vertical dimension (OVD) in guinea pigs is maintained by tooth eruption and grinding. It has been reported that the experimentally raised OVD recovers to the innate OVD within a few days in guinea pigs. However, the mechanisms underlying OVD adjustment are not entirely understood. This study thus aimed to clarify whether the experimentally reduced OVD would recover. Bite-reduced guinea pigs were created by applying bilateral intermaxillary elastics for 10 days. Guinea pigs without elastics were used as a control. The OVD after removal of the elastics in the experimental group was compared with that of the control group. Jaw movement during chewing was also compared between the experimental and control groups. After removal of the elastics, the experimentally reduced OVD did not recover fully and a significant difference was observed between the experimental and control groups for up to 25 days during the recording period. The minimum closed position during chewing was significantly higher in the experimental group than in the control group, whereas the maximum open position was no different between the groups. The present findings indicated that the experimentally reduced OVD could not be fully recovered, suggesting that reduction of the OVD may have limited influence on jaw movement.

The aim of this study was to compare the 5-year outcome of full-arch mandibular fixed prosthetic rehabilitation using the All-on-4 concept in smoking and nonsmoking patients. This retrospective cohort study included 200 patients (n = 100 smokers, n = 100 nonsmokers), 119 women and 81 men, with an average age of 53.7 years, rehabilitated in immediate function with 800 implants. Implant cumulative survival rate estimation (Kaplan-Meier with log-rank test) and marginal bone resorption (MBR) at 5 years (Mann-Whitney test) were compared between both groups. Multivariable analysis was used to investigate potential risk indicators for MBR ≥ 2.8 mm at 5 years. Nine patients (4.5%) were lost to follow-up. Four patients lost eight implants, specifically one nonsmoking patient (n = 1 implant) and three smoking patients (n = 7 implants), resulting in a cumulative survival rate estimation of 99.0% and 96.9% for nonsmokers and smokers, respectively (P = 0.296). The average (standard deviation) MBR at 5 years was 1.68 mm (0.76 mm) and 1.98 mm (1.02 mm) for nonsmokers and smokers, respectively (P = 0.045). Smoking (odds ratio = 2.92) was the only risk indicator significantly associated with MBR ≥ 2.8 mm in multivariable analysis. Smoking should not be an absolute contraindication for rehabilitation of the edentulous mandible through the All-on-4 concept; however, smoking habits were significantly associated with MBR ≥ 2.8 mm.

We investigated the chemical interaction between zirconia surfaces and functional monomers using X-ray photoelectron spectroscopy (XPS). Two types of zirconia disks cleaned with piranha solution were treated with one of two phosphate primers (Alloy Primer, Clearfil Ceramic Primer) or a carboxylic primer (Super-Bond C&B Monomer), and rinsed 3 times with acetone. XPS analysis revealed that phosphorus was incorporated into zirconia when the surface was treated with a primer containing phosphate monomer (10-methacryloyloxydecyl dihydrogen phosphate; MDP). However, the S 2p peak of a triazine dithiol monomer (6-[N-(4-vinylbenzyl)-n-propylamino]-1,3,5-triazine-2,4-dithione; VTD) and Si 2p peak of silane (3-trimethoxysilylpropyl methacrylate; TMSPMA) were not detected in the spectra of the primed surface. The [C]/[Zr] ratio for the surface treated with a carboxylic anhydride (4-methacryloyloxyethyl trimellitate anhydride; 4-META) primer was smaller than that treated with MDP. These results demonstrated that 4-META and MDP adsorbed to zirconia, whereas the VTD and TMSPMA did not.

Temporomandibular joint disorders (TMJD) involve orofacial pain and functional limitations that may limit important daily activities such as chewing and speaking. This observational case-control study attempted to identify factors associated with TMJD development, particularly inflammation. The study participants were patients treated at Karolinska University Hospital, Stockholm, Sweden. The cases were patients who received a diagnosis of TMJD, chronic closed lock, or painful clicking and were treated surgically during the period from 2007 through 2011. The control group was randomly selected from among patients who had undergone tooth extraction and was matched by age and sex. A total of 146 cases and 151 controls were included in the analyses. The response rate was 55.3% for the case group and 21.8% for the control group. The male:female ratio for patients with TMJD was 1:4.4. TMJD was significantly associated with pneumonia (odds ratio [OR], 2.1), asthma (OR, 2.1), allergies (OR, 1.8), headache (OR, 3.1), general joint hypermobility (OR, 3.8), orofacial trauma (OR, 3.9), rheumatism (OR, 2.5), and orthodontic treatment (OR, 2.4) (P < 0.05 for all outcomes). In conclusion, autoimmune diseases and inflammatory conditions are associated with increased risk of TMJD. Moreover, certain lung disorders may predict subsequent development of TMJD.

We evaluated the effects of three different surface treatments and two different bonding procedures on shear bond strength of resin composites to different computer-aided design/manufacturing (CAD/CAM) ceramics with or without thermocycling. The test specimens were prepared from three different CAD/CAM ceramics (Group A, IPS e.max CAD; Group B, IPS e.max ZirCAD; Group C, Vita Suprinity). They were divided into eight subgroups according to the surface treatment and bonding procedures. After resin composite was applied to the surfaces of all test specimens, they were stored in distilled water for 24 h at 37^°C. Next, half of the test specimens were subjected to a thermocycling procedure, and the other half were stored in distilled water at 37°C throughout thermocycling. The shear bond strength was performed using a universal testing machine. Statistical analysis revealed that the ceramic types (P > 0.0031) and thermocycling (P > 0.0021) did not, but the surface treatment technique did significantly affect the shear bond strength values (P < 0.05; except group C). Higher bond strength values were observed with HF etching in Groups A and C compared with the other tested surface treatments.

A study was performed to investigate whether expression of aquaporin (AQP) 3 and 5 has potential as a marker for distinguishing dry mouth from Sjögren’s syndrome. Twenty-five patients underwent labial minor salivary gland biopsy (dry mouth, n = 9; Sjögren’s syndrome, n = 16; control, n = 8). All patients were interviewed about their medical history and subjective oral symptoms, and intraoral examinations were conducted. Quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry were used to examine the expression and localization of AQP3 and 5. Significant differences in oral dryness, dry eye, medical history, and Saxon test results were revealed among the groups. However, there were no significant inter-group differences in expression of mRNA for AQP3 and 5. Immunohistochemical staining for AQP3 was localized mainly in the basolateral and part of the ductal cell membrane, and was barely evident in the apical membrane of acinar cells. AQP5 was localized to the basolateral and apical membrane and cytoplasm, but not the ductal cell membrane. Staining intensity for AQP3 in the apical membrane was significantly stronger in Sjögren’s syndrome, and that for AQP5 was significantly weaker in dry mouth. Taken together, the present data suggest that expression of AQP3 and 5 may be a marker for distinguishing between patients with dry mouth and those with Sjögren’s syndrome.

Regeneration of tissue, including bone, using mesenchymal stem cells (MSCs) has been progressing rapidly. Regeneration of bone requires the presence of an appropriate environment and efficient chemotaxis of cells to the target site. Differentiation of MSCs into mesenchymal cells has received considerable attention, but the effect of MSCs on chemotaxis is not well understood. In this study, we investigated the effect of MSCs on chemotaxis of RAW264 cells via C-C motif chemokine ligand 2 (CCL2). Balb/c mouse bone marrow-derived MSCs and RAW264 cells, which are osteoclast precursor cells, were co-cultured without cell contact. The gene expression of CCL2 in MSCs and CC-chemokine receptor 2 (CCR2) in RAW264 cells was determined using quantitative real-time PCR. Analysis of RAW264 cell chemotaxis was performed using the Boyden chamber assay. mRNAs for CCL2 and CCR2 were significantly upregulated upon co-culture in comparison to culture of either cell type alone, and the number of chemotactic RAW264 cells was significantly increased by co-culture. MSCs enhanced the chemotaxis of RAW264 cells, possibly via CCL2-CCR2 interaction, suggesting the potential utility of MSCs for tissue regeneration.

Periodontitis was reported to be associated with chronic obstructive pulmonary disease (COPD), and both diseases are related to smoking. To identify associations between periodontitis, smoking, and COPD, this cross-sectional study enrolled 1474 Japanese men (mean age 55.2 ± 8.9 years) surveyed between 2003 and 2006. Periodontal status was evaluated by using the community periodontal index. Periodontitis was defined as the presence of at least one sextant with a pocket depth ≥4 mm. Lung function was measured by spirometry, and COPD was defined as ratio of forced expiratory volume after 1 second to forced vital capacity of <0.70. Logistic regression analysis showed that the association between COPD and smoking was stronger for men with periodontitis (odds ratio 2.45; 95% confidence interval 1.37-4.37) than for those without periodontitis (odds ratio 1.64; 95% confidence interval 0.91-2.94), after adjusting for age, number of present teeth, body mass index, alcohol intake, occupation, hypertension, and diabetes. The association between smoking and COPD was significant for men with periodontitis but was weaker for those without periodontitis. These findings suggest that periodontitis modifies the association between smoking and COPD.

Amelotin (AMTN) is induced upon initiation of apoptosis by transforming growth factor beta1 (TGFβ1) and is mediated by Smad3 in gingival epithelial cells (GE1 cells). This upregulation of AMTN gene expression is temporary, and the mechanism responsible is still unclear. The present study investigated the transcriptional downregulation of TGFβ1-induced AMTN gene expression in GE1 cells during the progression of apoptosis. To examine time-dependent changes in the levels of AMTN, Smad3 and Bax mRNA induced by TGFβ1, real-time PCR analyses were performed. Immunocytochemistry was carried out to detect the expression of Smad3 and Bax. Transient transfection analyses were performed using mouse AMTN gene promoter constructs of various lengths including Smad response elements (SBEs), in the presence or absence of TGFβ1. Changes in Smad3 binding to SBEs resulting from overexpression of Bax were examined using ChIP assays. Overexpression of Bax dramatically downregulated the levels of TGFβ1-induced AMTN mRNA and transcription of the AMTN gene. Smad3 binding to SBEs in the mouse AMTN gene promoter was induced by overexpression of Smad3 or TGFβ1, and this was inhibited by Bax overexpression. These results show that the levels of AMTN mRNA induced by TGFβ1 and Smad3 are decreased by robust expression of Bax in gingival epithelial cells.

The aim of this in vitro study was to determine the effect of violet-blue light on the metabolic activity of early Streptococcus mutans biofilm, reincubated at 0, 2, and 6 h after 5 min of violet-blue light treatment. S. mutans UA159 biofilm cells were cultured for 12 to 16 h in microtiter plates with Tryptic Soy broth (TSB) or TSB with 1% sucrose (TSBS) and irradiated with violet-blue light for 5 min. After irradiation, the plates were reincubated at 37°C for 0, 2, or 6 h in 5% CO₂. Colorimetric tetrazolium salt reduction assay was used to investigate bacterial metabolic activity. Mixed model ANOVA was used to find the difference between the violet-blue light treated and nontreated groups. Bacterial metabolic activity was significantly lower in the violet-blue light group for TSB than in the nontreated group (P < 0.0001) regardless of recovery time. However, the differences between metabolic activity in the treated groups without sucrose decreased over time. For TSBS, metabolic activity was significantly lower with violet-blue light at 0 and 2 h. Violet-blue light inhibited the metabolic activity of S. mutans biofilm cells in the light-treated group. This finding may present a unique treatment method for patients with active caries.

The aim was to compare the peri-implant clinical and radiographic inflammatory parameters and whole salivary cotinine levels among cigarette smokers (CS), waterpipe smokers (WS) and never-smokers (NS). Thirty-four CS (Group 1), 33 WS (Group 2), and 31 NS (Group 3) were included. Peri-implant plaque index (PI), bleeding-on-probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Unstimulated whole saliva samples were collected and whole salivary cotinine levels were measured. Peri-implant PI and PD were higher in Groups 1 (P < 0.05) and 2 (P < 0.05) than in Group 3. Peri-implant BOP was significantly higher in Group 3 than in Groups 1 (P < 0.01) and 2 (P < 0.01). Peri-implant MBL was significantly higher in Groups 1 (P < 0.05) and 2 (P < 0.05) than in Group 3. There were significant differences in PI, BOP, PD, and CBL between Groups 1 and 2. There was no significant difference in the whole salivary cotinine levels in Groups 1 and 2. Peri-implant sites with plaque accumulation, PD, CBL, and whole salivary cotinine levels were higher in CS and WS than in NS, but did not differ between CS and WS.

The present study was designed to investigate the effect of laminin-1 (LN-1 or LN-111) on an odontoblast-like cell line, MDPC-23. Wells of non-treated polystyrene plates were coated with various concentrations of LN-1 (0.1, 1, 10, and 100 µg/mL) and left to dry for 2 days. Water-coated surfaces were used as controls. MDPC-23 cell proliferation, differentiation and mineralization were evaluated in terms of the CCK-8 assay, ALP activity, real-time RT-PCR and Alizarin red staining. The data indicated that LN-1 promoted the proliferation of MDPC-23 cells in a concentration-dependent manner. Moreover, it enhanced ALP activity and expression of key odontogenic genes (DMP-1 and DSPP) upon addition of mineralization reagents, leading to significant promotion of calcification by the cells. These results demonstrate that LN-1 acts as an adhesive for odontoblast-like cells, allowing up-regulation of odontogenic genes and accelerating matrix mineralization. In the context of the present study, the optimal LN-1 coating concentration for MDPC-23 cells was suggested to be 100 µg/mL.

This study assessed push-out strength, cement layer thickness, and interfacial nanoleakage of luted fiber posts fabricated with computer-aided design/computer-assisted manufacture (CAD/CAM) technology after use of 1 of 3 scanning techniques, namely, direct scanning of the post space (DS), scanning of a polyether impression of the post space (IS), and scanning of a plaster model of the post space (MS). Thirty premolars were randomly assigned to three groups corresponding to the scanning technique. Posts were computer-designed and milled from experimental fiber-reinforced composite blocks. The mean (±SD) values for push-out strength and cement thickness were 17.1 ± 7.7 MPa and 162 ± 24 μm, respectively, for DS, 10.7 ± 4.6 MPa and 187 ± 50 μm for IS, and 12.0 ± 7.2 MPa and 258 ± 78 μm for MS specimens. Median (interquartile range) interfacial nanoleakage scores were 3 (2-4) for DS, 2.5 (2-4) for IS, and 3 (2-4) for MS. Post retention was better for fiber posts fabricated by DS technique than for those fabricated by IS and MS. Cement thickness did not differ between DS and IS specimens, but the cement layer was significantly thicker in the MS group than in the other two groups. Scanning technique did not affect sealing ability, as the three groups had comparable nanoleakage values.

The present study was conducted to investigate the influence of rehydration with diluted sports drink and water gargling on salivary flow, pH and buffering capacity during exercise. Nineteen participants performed a 30-min bicycle ergometer exercise at 80% of maximal heart rate while consuming a sports drink, followed by gargling with water, or no gargling, immediately after the exercise (Exp. 1). The same experiment was then conducted on 9 participants who drank 1.5-fold diluted sports drink (Exp. 2-A) and 10 who drank 2-fold diluted sports drink (Exp. 2-B). Paraffin-stimulated whole saliva samples were collected for 3 min before, during and after exercise, and salivary parameters were examined using a hand-held pH meter. Statistical significance was assessed using multi-factor ANOVA and Turkey-Kramer test (P < 0.05). The decrease in salivary pH was significantly suppressed after water gargling in Exp. 1 (P < 0.01) and Exp. 2-A (P < 0.001). Dilution of the sports drink had an interactive effect with water gargling in Exp. 2-B (P < 0.01). These results suggest that gargling with water suppresses the decrease of salivary pH resulting from sports drink rehydration during ergometer exercise, but that this effect may be lost if athletes consume sports drink that has been diluted 2-fold with water.

Dry mouth sensation, also known as xerostomia, is a common clinical problem with an increasing prevalence. Although recent studies have reported promissory results of malic acid, none have evaluated the impact of malic acid on the oral health-related quality of life (OHRQoL) of patients with xerostomia. Thus, this study aimed to evaluate the impact of 1% malic acid, combined with fluoride and xylitol, on the OHRQoL of patients with xerostomia. We enrolled 70 patients and randomly allocated them into two groups: the intervention group (applied topical sialogogue with 1% malic acid) and the control group (applied a placebo). We assessed the OHRQoL and severity of xerostomia before and after treatment with the Spanish version of the Oral Health Impact Profile-14 questionnaire (OHIP-14sp) and a visual analogue scale (VAS), respectively. In addition, stimulated and non-stimulated salivary flow rates before and after treatments were also measured. In total, 60 patients completed the study. According to the VAS, both sprays significantly improved dry mouth sensation (P < 0.001). However, OHIP-14sp total scores decreased significantly in the intervention group from 20.8 ± 10.4 to 16.5 ± 9.5 (P < 0.001), indicating an improvement in the OHRQoL. No significant differences were observed in the control group (P > 0.05). Furthermore, non-stimulated salivary flow rates significantly increased in the intervention group from 0.25 ± 0.22 to 0.33 ± 0.33 mL/min (P < 0.001). Overall, this study demonstrated that malic acid improves the OHRQoL and dry mouth sensation in patients with xerostomia.

The castability, mechanical properties, and fracture characteristics of Ti-15Mo-5Zr-3Al alloy were compared with those of Ti-6Al-7Nb alloy and pure titanium (CP Ti) for application of this β-type titanium alloy in cast dental prostheses. Cast specimens were prepared with a centrifugal casting machine. A tensile test was performed according to ISO standard 22674. The castability index for Ti-15Mo-5Zr-3Al was lower than those for Ti-6Al-7Nb and CP Ti. The tensile strength of Ti-15Mo-5Zr-3Al was 852 MPa, which was lower than that of Ti-6Al-7Nb and higher than that of CP Ti. The proof strength of Ti-15Mo-5Zr-3Al was 799 MPa, which was comparable to that of Ti-6Al-7Nb and higher than that of CP Ti. The elastic modulus of Ti-15Mo-5Zr-3Al was 81.0 GPa, which was lower than the values for Ti-6Al-7Nb and CP Ti. Elongation of Ti-15Mo-5Zr-3Al was 5.1%, which was comparable to that of Ti-6Al-7Nb and less than that of CP Ti. The shape of the fractured segment was narrower for Ti-15Mo-5Zr-3Al than for Ti-6Al-7Nb and CP Ti. The deformation characteristics of Ti-15Mo-5Zr-3Al may result in decreased stress relative to increased strain during plastic deformation in the stress-strain diagram. In conclusion, Ti-15Mo-5Zr-3Al alloy has a low elastic modulus and exhibits limited ductile plastic deformation in cast dental prostheses.

This large-scale study cross-sectionally examined the periodontal status and prevalence of “red complex” bacteria (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) in Japanese adults. A total of 977 participants were enrolled in the study. Probing depth (PD), bleeding on probing (BOP), and bone crest level (BCL) were recorded, and the presence of red complex bacteria in the saliva was examined using polymerase chain reaction. The mean BCL value and the percentage of sites with a PD ≥4 mm or the presence of BOP were significantly higher in older participants. The detection rates of P. gingivalis, T. denticola, and T. forsythia were 46.3%, 76.4%, and 61.1%, respectively. The P. gingivalis detection rate significantly increased with age, while those of T. denticola and T. forsythia were comparably high for all age groups. A close correlation between P. gingivalis and the percentage of sites with PD ≥4 mm was indicated by nonlinear canonical correlation analysis. Current smokers exhibited a more advanced disease condition and a significantly higher P. gingivalis detection rate than non-smokers. In conclusion, periodontal condition worsens with age, and P. gingivalis appears to be the red complex bacterium most closely associated with periodontitis.

The aim of the present study is to evaluate the transverse strength, modulus of elasticity, surface roughness, hardness, and water sorption/solubility of nanoparticle zirconium oxide (nano-ZrO₂) added to heat-cured poly(methyl methacrylate) (PMMA) after thermocycling. The specimens were divided into four groups according to the ratio of nano-ZrO₂ addition to heat-cured PMMA; group 1: 5% nano-ZrO₂; group 2: 10% nano-ZrO₂; group 3: 20% nano-ZrO₂, and group 4 (control): PMMA without nano-ZrO₂. A statistically significant decrease in transverse strength was observed by all additional rates of nano-ZrO₂ compared with group 4 (control; P < 0.025). When hardness results were evaluated, groups 1 and 2 showed statistically higher values compared with groups 3 and 4 (P < 0.025). The surface roughness of group 3 was statistically higher than the other groups (P < 0.025), but it was within the clinically acceptable limits. As the nano-ZrO₂ addition rate increased, water sorption/solubility values of the specimens also increased. Although nano-ZrO₂ addition had an adverse effect on some mechanical and physical properties of heat-cured PMMA, it increased hardness values, implying that the addition of nano-ZrO₂ would contribute positively to some mechanical properties of PMMA denture base material when nano-ZrO₂ was homogeneously distributed in PMMA.

For treatment of severe bimaxillary protrusion in adults, a condition known to be among the most difficult to manage, both the maxillary and mandibular anterior teeth must be fully retracted using all the extraction space available. This article reports the treatment of an adult with severe high-angle bimaxillary protrusion. To correct the protrusion of the anterior teeth, orthodontic anchor screws (OASs) were used to provide absolute anchorage during anterior retraction. Acceptable occlusion, facial profile, and balance were achieved. OASs appear to be very useful for treatment of severe bimaxillary protrusion in adults.