Contribution of initial lymphatics to oral wound healing after tooth extraction.

Lymphatics are involved in the resolution of inflammation and wound healing, but their role in the oral wound healing process after tooth extraction has never been investigated. We therefore sought to evaluate the healing process following the extraction of maxillary molars in two transgenic mouse models: K14-VEGFR3-Ig mice, which lack initial mucosal lymphatic vessels, and K14-VEGFC mice, which have hyperplastic mucosal lymphatics. Maxillary molars were extracted from both transgenic mouse types and their corresponding wild-type (WT) controls. Mucosal and alveolar bone healing were evaluated. A delayed epithelialization and bone regeneration were observed in K14-VEGFR3-Ig mice compared with their WT littermates. The hampered wound closure was accompanied by decreased levels of epidermal growth factor (EGF) and persistent inflammation, characterized by infiltrates of immune cells and elevated levels of pro-inflammatory markers in the wounds. Hyperplastic mucosal lymphatics did not enhance the healing process after tooth extraction in K14-VEGFC mice. The findings indicate that initial mucosal lymphatics play a major role in the initial phase of the oral wound healing process.

Traumatic dental injuries: Knowledge assessment of dentists in the Norwegian Public Dental Service of Vestland.

BACKGROUND/AIM: Most children and adolescents in Norway attend the Public Dental Service (PDS) where they are treated free-of-charge until the age of 19 years. Thus, general dentists employed in the PDS are the primary care providers for traumatic dental injuries (TDI) in young patients. This cross-sectional study assessed the knowledge of PDS general dentists on the acute management and follow-up of TDI and its socio-demographic and attitudinal covariates. MATERIALS AND METHODS: All general dentists employed in the Vestland County PDS, Western Norway, (N = 170) received an online questionnaire. Socio-demographic and professional profiles of respondents as well as attitudinal indicators were queried. Clinical case scenarios on emergency treatment and further follow-ups of TDI were used to calculate a dental trauma knowledge score (DTKS; range: 0-21). Mann-Whitney U tests and Kruskal-Wallis tests determined differences between the demographic subgroups. Logistic regressions determined the potential of single factors in explaining the variability in dental trauma knowledge. RESULTS: The response rate was 46%. Most participants (60.5%) had not participated in a TDI course after graduation but would like such a course (84.2%). Mean DTKS was 13.82 (±2.6). Knowledge scores differed significantly between age groups (p = .014) and years since graduation (p = .0018). Younger dentists and recently graduated dentists scored highest. Dentists under the age of 30 years scored higher than 30-39- and 40-49-year-old dentists in these areas: emergency treatment of crown fractures with pulp exposure, identification of complications after avulsion, and management of severe intrusive luxation injury. CONCLUSION: Younger dentists had a higher theoretical knowledge of TDI. Continuing professional development among dentists in the Norwegian PDS is needed for emergency treatment and complication management after TDI.

Serum and salivary inflammatory biomarkers in juvenile idiopathic arthritis-an explorative cross-sectional study.

BACKGROUND: Biomarkers may be useful in monitoring disease activity in juvenile idiopathic arthritis (JIA). With new treatment options and treatment goals in JIA, there is an urgent need for more sensitive and responsive biomarkers. OBJECTIVE: We aimed to investigate the patterns of 92 inflammation-related biomarkers in serum and saliva in a group of Norwegian children and adolescents with JIA and controls and in active and inactive JIA. In addition, we explored whether treatment with tumor necrosis factor inhibitors (TNFi) affected the biomarker levels. METHODS: This explorative, cross-sectional study comprised a subset of children and adolescents with non-systemic JIA and matched controls from the Norwegian juvenile idiopathic arthritis study (NorJIA Study). The JIA group included individuals with clinically active or inactive JIA. Serum and unstimulated saliva were analyzed using a multiplex assay of 92 inflammation-related biomarkers. Welch's t-test and Mann-Whitney U-test were used to analyze the differences in biomarker levels between JIA and controls and between active and inactive disease. RESULTS: We included 42 participants with JIA and 30 controls, predominantly females, with a median age of 14 years. Of the 92 biomarkers, 87 were detected in serum, 73 in saliva, and 71 in both biofluids. A pronounced difference between serum and salivary biomarker patterns was found. Most biomarkers had higher levels in serum and lower levels in saliva in JIA versus controls, and in active versus inactive disease. In serum, TNF and S100A12 levels were notably higher in JIA and active disease. The TNF increase was less pronounced when excluding TNFi-treated individuals. In saliva, several biomarkers from the chemokine family were distinctly lower in the JIA group, and levels were even lower in active disease. CONCLUSION: In this explorative study, the serum and salivary biomarker patterns differed markedly, suggesting that saliva may not be a suitable substitute for serum when assessing systemic inflammation in JIA. Increased TNF levels in serum may not be a reliable biomarker for inflammatory activity in TNFi-treated children and adolescents with JIA. The lower levels of chemokines in saliva in JIA compared to controls and in active compared to inactive disease, warrant further investigation.