Comparison of Different Digital Color Measurement Methods on Maxillary Anterior and Canine Teeth: A Clinical Observational Study.

PURPOSE: This clinical observational study aimed to determine the reproducibility of digital color measurement methods of different front teeth. METHODS: Color determination was performed using two spectrophotometric systems (Easyshade Advance; ES and Shadepilot; SP) and digital photography using a camera with ring flash and gray card with subsequent evaluation using computer software (DP; Adobe Photoshop). In 50 patients, at two time points, a digital color determination was performed on maxillary central incisors (MCI) and maxillary canines (MC) by a calibrated examiner. Outcome parameters were: color difference ΔE based on CIE L*a*b* values and VITA color match given by spectrophotometers. RESULTS: SP showed significantly lower median ΔE values (⟨1.2) than ES (⟨3.5) and DP (⟨4.4), while no significant differences were found between ES and DP. For all methods, both ΔE values and VITA color showed lower reliability regarding MC compared with MCI. The ΔE examination of subareas revealed significant differences in MCI for all devices and in MC only for SP. When comparing VITA color stability, SP showed a significantly higher color match than ES (81% and 57%, respectively). CONCLUSIONS: Digital color determination methods tested in the current study provided reliable results. However, there are significant differences between the devices used and the teeth examined.

Oral health-related quality of life of patients after solid organ transplantation is not affected by oral conditions: results of a multicentre cross-sectional study.

BACKGROUND: This multicentre cross-sectional study aimed in examination of oral health-related quality of life (OHRQoL) of patients after solid organ transplantation (SOT). MATERIAL AND METHODS: Patients after SOT (liver, lung and heart) at one out of three German centers (Goettingen, Essen, Leipzig) were included. For comparison, a healthy control (HC) was recruited. OHRQoL was assessed by German short form of oral health impact profile (OHIP G14). Oral examination comprised: decayed-, missing- and filled-teeth index (DMF-T), remaining teeth and periodontitis severity. RESULTS: In total, 196 patients after SOT and 130 HC with comparable age, gender and smoking habits were included (p>0.05). DMF-T and number of remaining teeth was worse in SOT group (p<0.01). OHIP G14 sum score was significantly higher in SOT (3.49 ± 5.73 vs. 1.33 ± 2.63, p<0.01). In contrast to HC, in SOT no associations between OHIP G14 and oral health parameters were found (pi>0.05). Number of remaining teeth was not an independent predictor of OHIP G14 sum score in SOT (ß -0.082, CI95 -0.156 - 0.045, p=0.28). CONCLUSIONS: OHRQoL of SOT recipients is not affected by their oral condition, leading to the assumption that the individual perception of patients physical oral health is not in line with the clinical situation.

Oral health and oral health-related quality of life in patients with oral dystonia indicates their need for dental special care.

BACKGROUND: This retrospective study aimed in the evaluation of oral health and oral health-related quality of life (OHRQoL) of patients with oral dystonia (OD). MATERIAL AND METHODS: Seventeen patients with OD (Meige Syndrome: n=11, Oromandibular Dystonia: n=6) were included, of which seven were examined again at three months after botulinum toxin injection. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14). Within oral examination, dental parameters, remaining teeth and periodontitis severity were assessed. A matched healthy control (HC) was composed for comparison. RESULTS: The OD patients had significantly more carious teeth (0.94 ± 1.75 vs. 0; p<0.01), less remaining teeth (15.65 ± 9.89 vs. 22.22 ± 5.91; p=0.01) and higher dental treatment need than the HC (42.9% vs. 0%; p<0.01). The OHIP G14 sum score of 9.47± 9.82 vs. 1.58 ± 2.79 (p<0.01) as well its dimensions psychosocial impact (4.47 ± 6.45 vs. 0.53 ± 1.16; p=0.03) and oral function (4.35 ± 2.98 vs. 0.47 ± 1.34; p<0.01) were clinically relevant and statistically significant higher in OD compared to HC group. No significant differences could be detected at three months after botulinum toxin injection. CONCLUSIONS: Patients with OD suffer from more dental diseases and have a worse OHRQoL than HC. Dental special care appears recommendable and should be fostered by everyone, who is involved in the treatment of patients with OD.

Association of cytokine patterns and clinical/laboratory parameters, medication and periodontal burden in patients with rheumatoid arthritis (RA).

To evaluate serum levels of the following cytokines in rheumatoid arthritis subjects with periodontal disease: Interleukin-6, -10, -17, and -23. Patients with rheumatoid arthritis frequently suffer from periodontal disease. Both diseases partly result from a dysregulated immune response. The current study aimed to quantify Interleukin-6, -10, -17, and -23 levels in rheumatoid arthritis. It should be investigated if the periodontal disease would have additional modifying effects. A total of 157 patients were included. Serum levels of IL-6, -10, -17, and -23 were measured by ELISA. Serum IL-10 increased with longer duration of morning stiffness and with higher rheumatoid factor and anti-cyclic citrullinated peptide titres. IL-10 was also elevated with longer duration of prednisolone (< 5 mg daily) and leflunomide therapy. Subjects with lower erythrocyte sedimentation rate/longer leflunomide therapy displayed more missing teeth/more clinical attachment loss. IL-17 was higher in subjects with fewer missing teeth if the following criteria were fulfilled: shorter prednisolone (< 5 mg) and methotrexate therapy, more swollen joints, longer morning stiffness. IL-23 finally was increased in subjects with higher rheumatoid factor and in those with higher periodontal probing depth/clinical attachment loss in the following situations: lower rheumatoid factor and shorter leflunomide therapy. Subjects suffering from dental/periodontal burden show an aberrant systemic cytokine availability of serum IL-6, IL-10, IL-17 and IL-23 related to disease activity and medication. This examination underlines the complexity of potential interactions between disease activity and medication related to periodontal burden.

Clinical Evaluation of Chairside-Fabricated Partial Crowns Made of Zirconia- Reinforced Lithium Silicate Ceramic - 2-Year-Results.

INTRODUCTION: In a prospective study, the clinical performance of chairside-fabricated partial-crowns made of zirconia-reinforced lithiumsilicate (ZLS)-ceramic was evaluated after 2 years. MATERIALS AND METHODS: 45 patients (28 female/17 male) underwent restoration with 61 chairside-fabricated ZLS partial-crowns on vital premolars and molars. In variation from the manufacturer's recommendations (minimum material thickness (MMT)=1.0 mm), partial-crowns with reduced material thicknesses were fabricated: group 1, MMT=0.5-0.74 mm (n=31); group 2, MMT=0.75-1.0 mm (n=30). The restorations were luted with either a self-adhesive cement (SAC) or the total-etch technique using a dual-curing composite cement (DC). The MMT and cementation technique (SAC vs. DC) were evaluated as possible covariates of the time-dependent survival (SVR) and success rate (SCR) using univariate log-rank-tests. RESULTS: Forty-four patients with 59 restorations participated in the 2-year follow-up examinations. In group 1 (n=31), there were 2 losses due to ceramic fracture (SVR: 94.0% (95% confidence interval (CI): 0.85-1)). In group 2, no losses were documented (SVR: 100%). In 2 restorations cemented with SAC, recementation was necessary (overall SCR: 93% (CI: 0.87-1)). CONCLUSION: To avoid early material-related fractures, observing the recommended minimum thickness of 1.0 mm is essential. However, further validation of these results in studies with longer observational periods is required.

High prevalence of periodontitis in blood donors and the possibility of questionnaire-based screening - results of a cross-sectional study.

BACKGROUND: Periodontitis is an inflammatory disease of high prevalence and, thus, of potential relevance to the management of blood donation. OBJECTIVES: The aim of this cross-sectional study was to assess periodontal health and its associations to common blood parameters, as well as questionnaire-based periodontitis screening in blood donors. METHODS: Generally healthy blood donors were recruited and underwent oral examination. Thereby, the decayed-, missing- and filled-teeth index (DMF-T) and periodontal status, including periodontal probing depth and clinical attachment loss, were assessed. Based on periodontal status, periodontitis severity was classified into no/mild, moderate or severe. Six yes/no questions regarding periodontal complaints and history were asked. Furthermore, common blood parameters were analysed. RESULTS: A total of 148 participants (mean age 53·33 years) were included. The DMF-T was 15·28 ± 6·44. Nearly three quarters of participants suffered from a periodontitis (moderate 59·5% and severe 14·8%, total periodontitis 74·3%). Periodontitis severity was associated with the history of dental visits caused by periodontal complaints (P < 0·01) and previous periodontal therapy (P < 0·01). Only procalcitonin was initially found to be associated with blood periodontitis severity (P = 0·02). This observation was not confirmed by post-hoc testing between subgroups (Pi > 0·2). No further association between periodontitis severity and blood parameters was found (Pi > 0·05). CONCLUSION: The prevalence of periodontitis in German blood donors is high. However, further studies with sensitive testing of bacteria in peripheral blood are required in order to determine the relevance of this result for the safety of blood components.

Antimicrobial peptides as a possible interlink between periodontal diseases and its risk factors: A systematic review.

Antimicrobial peptides (AMPs) play a critical role in controlling innate and acquired immune responses. Local dysregulation of AMP is implicated in the pathogenesis of periodontal diseases as a response to periodontal pathogen challenge. Changes in AMP expression also characterize tobacco smoking, diabetes mellitus, obesity and rheumatoid arthritis, which are established risk factors of periodontal diseases, suggesting AMP may act as putative mechanistic links between these. The aim was to evaluate and summarize critically the current evidence pertaining to interrelationships between AMPs, periodontal diseases and selected periodontal disease risk factors. General and theme specific keywords were used to search the PUBMED database for studies relevant to AMP, periodontal diseases, smoking, diabetes mellitus, obesity and rheumatoid arthritis and critically reviewed. A total of 131 abstracts and 119 full text articles were screened for relevance; 13 studies were selected for inclusion after critical review. Local AMP dysregulation characteristic to periodontal diseases appears to occur within a broader landscape of complex systemic immune perturbations independently induced by smoking, metabolic and rheumatoid disease. The nature of these interactions and mechanistic pathways involved are inadequately understood. AMPs could be possible mechanistic interlinks between periodontal diseases and its risk factors. However, such evidence is very limited and more in vivo and in vitro studies are necessary to clarify the nature of such relationships. A greater understanding of AMPs as shared mediators is essential for unraveling their value as therapeutic or biomarker candidates.

Integrated analysis of long noncoding RNA-associated competing endogenous RNA network in periodontitis.

BACKGROUND AND OBJECTIVES: Long noncoding RNAs (lncRNAs) play critical and complex roles in regulating various biological processes of periodontitis. This bioinformatic study aims to construct a putative competing endogenous RNA (ceRNA) network by integrating lncRNA, miRNA and mRNA expression, based on high-throughput RNA sequencing and microarray data about periodontitis. MATERIAL AND METHODS: Data from 1 miRNA and 3 mRNA expression profiles were obtained to construct the lncRNA-associated ceRNA network. Gene Ontology enrichment analysis and pathway analysis were performed using the Gene Ontology website and Kyoto Encyclopedia of Genes and Genomes. A protein-protein interaction network was constructed based on the Search Tool for the retrieval of Interacting Genes/Proteins. Transcription factors (TFs) of differentially expressed genes were identified based on TRANSFAC database and then a regulatory network was constructed. RESULTS: Through constructing the dysregulated ceRNA network, 6 genes (HSPA4L, PANK3, YOD1, CTNNBIP1, EVI2B, ITGAL) and 3 miRNAs (miR-125a-3p, miR-200a, miR-142-3p) were detected. Three lncRNAs (MALAT1, TUG1, FGD5-AS1) were found to target both miR-125a-3p and miR-142-3p in this ceRNA network. Protein-protein interaction network analysis identified several hub genes, including VCAM1, ITGA4, UBC, LYN and SSX2IP. Three pathways (cytokine-cytokine receptor, cell adhesion molecules, chemokine signaling pathway) were identified to be overlapping results with the previous bioinformatics studies in periodontitis. Moreover, 2 TFs including FOS and EGR were identified to be involved in the regulatory network of the differentially expressed genes-TFs in periodontitis. CONCLUSION: These findings suggest that 6 mRNAs (HSPA4L, PANK3, YOD1, CTNNBIP1, EVI2B, ITGAL), 3 miRNAs (hsa-miR-125a-3p, hsa-miR-200a, hsa-miR-142-3p) and 3 lncRNAs (MALAT1, TUG1, FGD5-AS1) might be involved in the lncRNA-associated ceRNA network of periodontitis. This study sought to illuminate further the genetic and epigenetic mechanisms of periodontitis through constructing an lncRNA-associated ceRNA network.

Effects of octenidine mouth rinse on apoptosis and necrosis of human fibroblasts and epithelial cells - an in vitro study.

This study aimed at comparing the cytotoxicity of a new octenidine mouth rinse (MR) on gingival fibroblasts and epithelial cells using different established MRs. Octenidol (OCT), Chlorhexidine 0.2% (CHX), Meridol (MER), Oral B (OB), and control (PBS only) were used. Human primary gingival fibroblasts (HGFIBs) and human primary nasal epithelial cells (HNEPCs) were cultivated in cell-specific media (2 × 105 cells/well) and treated with a MR or PBS for 1, 5, and 15 min. All tests were performed in duplicate and repeated 12 times. The apoptosis and necrosis were determined using a Caspase-3/7 assay and LDH assay, respectively. The data were analyzed using two-way analysis of variance with subsequent Mann-Whitney U-test. No significant differences could be found between the incubation times of the MR, neither for apoptosis nor necrosis (p > 0.05). Regarding apoptosis of HGFIBs, MRs had no influence at all. In HNEPCs, OCT induced relevantly lower apoptosis than CHX (p = 0.01). Considering necrosis, MER showed the lowest numbers of necrotic HGFIBs and HNEPCs, whereas OB induced the highest number of necrotic cells. The differences between both MR were statistically relevant (p < 0.01). OCT did neither differ from the other MRs nor from the control (PBS) in induction of necrosis in both cell types. In conclusion, the slightly negative effect of OCT considering apoptosis and necrosis of HGFIBs and HNEPCs is nearly the same or even lower compared to the established MRs included in this study. The results confirm that OCT is a potential alternative to CHX.

Dialysis vintage time has the strongest correlation to psychosocial pattern of oral health-related quality of life - a multicentre cross-sectional study.

BACKGROUND: Aim of this cross-sectional, multicentre study was to investigate associations of dialysis vintage time in haemodialysis (CKD5D) patients with oral health-related quality of life (OHRQoL) and dental and periodontal treatment need. MATERIAL AND METHODS: CKD5D patients were divided into subgroups according to dialysis vintage time in different dialysis centres in Germany. OHRQoL was assessed with oral health impact profile (OHIP-G14). Dental treatment need was classified as presence of carious lesions. Periodontal treatment need was defined as periodontal screening index score (PSI) 3-4. RESULTS: In total, 190 participants were divided into the subgroups according to the time on CKD5D: 0 - 2 (n = 29), 3 - 5 (n = 35), 6 - 8 (n = 34), 9 - 12 (n = 29), 13 - 20 (n = 34) and >20 years (n = 29). The overall treatment need in the total cohort was 92% (dental 56%, periodontal 88%) with a total OHIP-G14 sum score of 4.17 [2; 0-5] without a significant correlation. Time on CKD5D was inversely correlated with the OHIP G14 score (p<0.01, R = -0.201). The pattern psychosocial impact was significantly associated with the dialysis duration (p<0.01) and showed a negative correlation to the OHIP-G14 (R = -0.283, Spearman's rho test p<0.01). For oral function also a negative correlation with OHIP-G14 was detected (Spearman's rho: -0.183). CONCLUSIONS: Patients with a prolonged dialysis vintage time show an improved OHRQoL, which might be mainly caused by the positive development of psychosocial pattern of OHRQoL. The oral health situation of HD patients seems unsatisfying, independently of dialysis vintage time and OHRQoL. Accordingly, an improvement in oral health situation of CKD5D patients is mandatory necessary. Thereby, consideration of psychosocial aspects especially at the beginning of CKD5D therapy and a sensitization regarding oral health issues with increasing vintage time might be recommendable.

Association of time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected bacteria of patients after solid organ transplantation.

BACKGROUND: Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT). MATERIAL AND METHODS: 169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Periodontal probing depth (PPD) and clinical attachment loss (CAL) were assessed. Periodontal disease severity was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were investigated for eleven selected potentially periodontal pathogenic bacteria using polymerasechainreaction. RESULTS: The mean PPD and CAL as well as prevalence of Treponema denticola and Capnocytophaga species was shown to be different but heterogeneous depending on time under immunosuppression (p<0.05). Furthermore, only the medication with Cyclosporine was found to show worse periodontal condition compared to patients without Cyclosporine (p<0.05). Prevalence of Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum was reduced and prevalence of Parvimonas micra and Capnocytophaga species was increased in patients under immunosuppression with Glucocorticoids, Mycophenolate as well as combination therapy. CONCLUSION: Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT. Patients under Cyclosporine medication should receive increased attention. Differences in subgingival biofilm, but not in clinical parameters were found for Glucocorticoids, Mycophenolate and combination therapy, making the clinical relevance of this finding unclear.

Active matrix metalloproteinase-8 and periodontal bacteria depending on periodontal status in patients with rheumatoid arthritis.

BACKGROUND AND OBJECTIVES: The aim of this clinical cross-sectional study was to determine the level of active matrix metalloproteinase-8 (aMMP-8) and periodontal pathogenic bacteria in gingival crevicular fluid in patients with rheumatoid arthritis (RA) with varying periodontal conditions. MATERIAL AND METHODS: In total, 103 patients with RA and 104 healthy controls (HC) were included. The assessment of periodontal status included periodontal probing depth, bleeding on probing and clinical attachment loss. Periodontal disease was classified as healthy/mild, moderate or severe. For the determination of aMMP-8 levels using enzyme-linked immunosorbent assay and periodontal pathogenic bacteria using polymerase chain reaction, samples of gingival crevicular fluid were taken from the deepest gingival pockets. The statistical analyses used included a Mann-Whitney U-test, a chi-squared test or a Fisher's exact test, and the significance level was set at α = 5%. RESULTS: We found that 65% of patients with RA and 79% of HC had moderate to severe periodontal disease (p = 0.02). The prevalence of periodontal pathogens was almost equal (p > 0.05). Furthermore, depending on periodontal disease severity only minor differences in bacterial prevalence were detected. With increasing severity of periodontal disease, higher aMMP-8 levels were observed. Accordingly, a significant difference in patients with moderate periodontal disease (RA: 15.3 ± 13.8; HC: 9.1 ± 9.1; p ≤ 0.01) and severe periodontal disease (RA: 21.7 ± 13.3; HC: 13.1 ± 8.6; p = 0.07) was detected, with a greater tendency in the latter group. CONCLUSION: The increased aMMP-8 levels in the RA group indicate that the presence of RA appears to have an influence on the host response at a comparable level of bacterial load and periodontal disease severity.

Oral health-related quality of life in patients on chronic haemodialysis and after kidney transplantation.

OBJECTIVES: The objective of the study was to evaluate oral health-related quality of life (OHRQoL) depending on dental and periodontal situation in patients on haemodialysis (HD) and after kidney transplantation (KTx) compared to healthy controls (HC). SUBJECTS AND METHODS: OHRQoL was assessed using the German short form of Oral Health Impact Profile (OHIP G14). Dental health was estimated using the decayed, missing and filled teeth index (DMF-T). Periodontal health was classified as healthy/mild or moderate/severe periodontitis. STATISTICAL ANALYSIS: Mann-Whitney U-test, Kruskal-Wallis test, chi-square test and Fisher's test. RESULTS: Eighty-seven HD patients, 39 KTx patients and 91 HC were included. Significant differences in DMF-T, D-T, M-T and F-T scores were identified between groups (P < 0.001). The prevalence of moderate/severe periodontitis was significantly higher in the HD and KTx group compared to HC (P = 0.002). Differences in OHIP G14 between groups were neither clinical relevant nor statistically significant (P = 0.199). A significant effect of DMF-T (P = 0.012), M-T (P < 0.001) and periodontitis (P = 0.023) on the OHIP G14 scores was identified only in HC. CONCLUSIONS: Improvement in dental care of HD and KTx patients is required. OHIP G14 values provide a subjectively considered low importance of oral health in HD and KTx patients, leading to need of motivation and sensitisation of these patients.

Cytotoxic effects of octenidine mouth rinse on human fibroblasts and epithelial cells - an in vitro study.

OBJECTIVES: This study compared the cytotoxicity of a new octenidine mouth rinse (MR) against gingival fibroblasts and epithelial cells with different established MRs. METHODS: The following MRs were used: Octenidol (OCT), Chlorhexidine 0.2% (CHX), Listerine (LIS), Meridol (MER), Betaisodona (BET); and control (medium only). Human primary gingiva fibroblasts and human primary nasal epithelial cells were cultivated in cell-specific media (2 × 10(5) cells/ml) and treated with MR for 1, 5, and 15 min. Each test was performed 12 times. Metabolism activity was measured using a cytotoxicity assay. A cellometer analyzed cell viability, cell number, and cell diameter. The data were analyzed by two-way analysis of variance with subsequent Dunnett's test and additional t-tests. RESULTS: The cytotoxic effects of all MRs on fibroblasts and epithelial cells compared to the control depended on the contact time (p < 0.001). OCT and BET showed less influence on cell metabolism in fibroblasts than other MRs. OCT also demonstrated comparable but not significant results in epithelial cells (p > 0.005). Cell numbers of both cell types at all contact times revealed that OCT showed a less negative effect (p > 0.005), especially for epithelial cells compared to CHX after 15 min (p < 0.005). OCT and BET showed the best results for viability in fibroblasts (p > 0.005), but MER showed less influence than OCT in epithelial cells (p < 0.005). CONCLUSIONS: OCT is a potential alternative to CHX regarding cytotoxicity because of its lower cell-toxic effect against fibroblasts and epithelial cells.

Oral health of dental assistants and patients receiving maintenance--an investigation based on a district of Thuringia, Germany.

OBJECTIVES: The aim of the study was to assess data for the oral health behaviour and oral health of dental assistants (DAs) and patients (PTs) who regularly received preventive dental care. METHODS: One-hundred DAs (38.8 years) and 100 PTs (44 years) participated in the study conducted in the Unstrut-Hainich region of Thuringia, Germany. A questionnaire established oral hygiene and smoking habits. The dental examination included the caries index DMF-T, evaluation of the periodontal situation (PSI) as well as gingival inflammation [papilla bleeding index (PBI)]. RESULTS: Seventy-seven DAs and 46 PTs used dental floss regularly. Twenty-four DAs and 27 PTs were smokers. The mean DMF-T of DAs was 12.5, which was significantly lower than the DMF-T of PTs (17.0) (P < 0.001). The main reason for this difference was the number of missing teeth (DAs: 0.9, PTs: 4.8; P < 0.001). In both groups, several participants required periodontal treatment. Nevertheless, the number of DAs with PSI scores 3 or 4 was significantly lower (9%) than the corresponding number of PTs (63%) (P < 0.001). The PBI showed a significant difference between the groups (DAs = 0.1, PTs = 0.3; P < 0.01). CONCLUSIONS: Although the oral health of the participating DAs clearly exceeded the results found for PTs, it was concluded that DAs did not avail themselves of their job-related knowledge and skills and so failed to optimize their personal oral health behaviour.

The influence of pressure changes on endodontically treated teeth during simulated dives.

AIM: To measure and evaluate pressure changes in the pulp chambers of extracted teeth exposed to hyperbaric conditions during root canal treatment. METHODOLOGY: A pressure sensor was inserted and sealed into the pulp chambers of extracted human molars (n = 6). The teeth were subjected to simulated dives to 4.5 bar in a diving chamber. During the simulated ascents and descents, the pressure within the pulp chamber was measured, and the difference between the pressure inside the pulp chamber and the pressure in the diving chamber was calculated. Each tooth underwent two dives with an intact pulp chamber, with a calcium hydroxide dressing, after root canal filling, and after adhesive sealing of the pulp chamber floor with a composite. Differences were analyzed statistically (P < 0.05) using one-way analysis of variance (anova). RESULTS: There were no significant pressure differences in teeth with an intact pulp chamber and teeth with a calcium hydroxide dressing. After root filling, however, the increase in pressure inside the pulp chamber was significantly lower (P < 0.05) than that in the diving chamber. After adhesive sealing of the pulp chamber floor with a composite, the pressure inside the pulp chamber was significantly lower (P < 0.05) than the pressure in the diving chamber. CONCLUSIONS: In root canal treatment, canal orifices should be sealed with an adhesively bonded composite filling before a dive. The use of a calcium hydroxide dressing after root canal preparation does not disqualify patients from diving.

Efficacy of two different CHX-containing desensitizers: a controlled double-blind study.

The aim of this study was to compare the effectiveness and duration of action of the tooth desensitization agent Cervitec (C) vs that of the new Cervitec Plus (C+). In this monocentric, single-center, three-armed, controlled, double-blind study, 120 subjects were randomly assigned to one of three groups:group I received Cervitec Plus (C+), group II received Cervitec (C), and group III received placebo (P). Varnishes were applied after base-line determination of cervical dentin hyper-sensitivity using a pain score of one or higher.Re-evaluation was performed 1, 7, 30, and 90 days after application. Statistical evaluation was carried out using nonparametric statistics for relative effects and analysis of variance(ANOVA). Thirty days after application of Cand C+, all hypersensitivity decreased significantly in relation to baseline measurements(p<0.001), with no changes taking place in the placebo group. Significant differences were observed between C and C+ vs placebo(p<0.001), whereas no significant difference between C and C+ was seen after 30 days(p=0.840). After 90 days, the reduction in hypersensitivity with C+ was still significant compared with baseline measurements(p=0.001). However, C was not significantly different compared with baseline measurements (p=0.05). Analysis of all hypersensitive posterior teeth examined showed no significant difference between C and C+ after 90 days(p=0.362). For anterior teeth, the difference between C and C+ was significant (p=0.012).Both C and C+ reduce cervical tooth hypersensitivity, whereas C+ reduces hypersensitivity for a longer period of time.

Oral health in adult patients with congenital coagulation disorders--a case control study.

Inflammatory disorders of the periodontium, gingivitis and periodontitis are among the most prevalent diseases worldwide. A few studies have found poorer oral health in patients with congenital coagulation disorders (CCD) like haemophilia and von Willebrand's disease compared with non-affected controls. The aim of this study was to investigate the effect of congenital coagulation disorders on oral health and periodontal (alveolar) bone loss. This is a case control study comparing oral health and periodontal bone loss of patient with congenital coagulation disorders with matched healthy subjects. The examination included dental status (DMF-T), assessment of oral hygiene (modified Quigley-Hein-Index: QHI) and a dental panoramic X-ray for assessment of alveolar bone loss caused by periodontal disease. A total of 15 patients with CCD (Haemophilia A: n = 8, von Willebrand's disease: n =7) were matched with 31 non-affected controls. We observed no clinical relevant difference of oral health (DMF-T, QHI) between patients with CCD and controls despite better oral hygiene (QHI) of patients with CCD. Moreover, there was a statistically significant difference in periodontal bone loss, but the observed difference is not clinically meaningful. Unlike previous studies carried out mainly in children we found no evidence that oral health or periodontal status in adult patients with CCD is worse than that in healthy subjects. However, larger studies and longitudinal studies in adults are needed to confirm our results.

Efficacy of syringe irrigation, RinsEndo and passive ultrasonic irrigation in removing debris from irregularities in root canals with different apical sizes.

AIM: To compare of the efficacy of syringe irrigation, RinsEndo (Dürr Dental, Bietigheim, Germany) and passive ultrasonic irrigation (PUI) in the removal of dentinal debris from simulated irregularities in root canals with different apical sizes. METHODOLOGY: Thirty extracted human pre-molars were randomly divided into three groups (n = 10) followed by root canal preparation with rotary FlexMaster NiTi instruments (VDW, Munich, Germany) to size 30, 0.02 taper (group 1), size 40, 0.02 taper (group 2) or size 50, 0.02 taper (group 3). The teeth were split longitudinally, and a standard groove and three hemispherical-shaped cavities were cut into the root canal halves. Grooves and cavities were filled with dentinal debris before each irrigation procedure and the root halves were reassembled. In all groups three different irrigation procedures were performed with 30 mL NaOCl (1%) and (i) syringe, (ii) RinsEndo and (iii) PUI. The amount of remaining debris was evaluated under a microscope with 30x magnification and a four score system. The data were analysed with a non-parametric analysis of covariance and multiple comparisons using the Tukey adjustment (P = 0.05). Results Passive ultrasonic irrigation removed debris significantly better from the artificial canal irregularities than RinsEndo and syringe irrigation irrespective of the root canal diameter. Only in group 1 (30, 0.02 taper) the difference between PUI and RinsEndo was not statistically significant (P = 0.99). RinsEndo demonstrated significantly better results than syringe irrigation in all groups (P < 0.001). CONCLUSIONS: Ultrasonic irrigation is more effective than syringe irrigation or RinsEndo in removing debris from artificial extensions in straight root canals.

Microbiological findings at tongue piercing sites: implications to oral health.

BACKGROUND: Body piercing enjoys a widespread popularity among juveniles and young people. The tongue is the most commonly pierced oral site. Tongue jewellery, however, can damage the teeth and periodontium and may provide an ideal environment for microorganisms. The aim of this report was to investigate if and in case in which amount periodontopathogenic organisms can be found at tongue piercing sites. METHODS: Patients with tongue piercings visiting the authors' dental office for a dental check-up volunteered. A questionnaire was used to collect data on the type of material used in the piercing, the time the device was in place, oral and piercing hygiene practices and smoking habits. The dental examination included an oral hygiene index and the periodontal screening index. From the surface of the piercing jewellery adjacent to the tongue perforation, microbiological samples were collected and analysed for the presence of 11 periodontopathogenic bacteria. RESULTS: A total of 12 patients with tongue piercing were asked and examined. Their tongue piercings had been in place between 2 and 8 years. The microbiological analysis showed an increased or substantially increased concentration of periodontopathogenic bacteria in all cases. It became obvious that the longer a piercing had been in place, the more pronounced was the shift from bacteria with a moderate periodontopathogenic potential to bacteria with a high periodontopathogenic potential. CONCLUSION: Tongue piercing provides a potential reservoir for periodontopathogenic bacteria.