Maternal Periodontal Status as a Factor Influencing Obstetrical Outcomes.

Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida-primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.

Change in the Caries Status of Pregnant Women in Southeast Hungary and Its Background.

PURPOSE: To examine the caries status of pregnant women in southeast Hungary and compare the results with a similar study completed in the same region ten years earlier to determine whether any improvement has taken place in the past decade. Another objective was to assess the effects of age, socioeconomic status and number of pregnancies on oral health. MATERIALS AND METHODS: The dental examination of 130 pregnant women was carried out at the Dental Clinic of University of Szeged, Faculty of Dentistry in 2011-2013 (group 1). Caries status was examined according to WHO guidelines. In order to compare demographic and socioeconomic factors with DMF indices, find the decisive influencing factors and compare the results with the results of the previous study (group 2), two-way ANOVA and regression analyses were conducted. RESULTS: The number of highly educated, professional, urban participants included in the present group (group 1) was greater compared with that of group 2. Despite the higher age of the pregnant women in present study, statistically significantly lower DMFT (10.05 vs 12.57, p = 0.008) and DMFS (19.41 vs 26.26, p = 0.001) scores were found than ten years ago. In both studies, the regression analyses showed that women's age was the main contributing factor to caries status. CONCLUSION: The lower DMFT and DMFS values and the participants' willingness to participate in the dental screening in the present study group were probably the result of their higher educational background and that they worked as professionals.

[Comparing the function of the temporomandibular joint before and after surgical treatment in a young patient with idiopathic scoliosis. Case presentation]. / Fiatalkori idiopathiás scoliosis mutéti korrekciójának hatása az állkapocs mozgástartományára.

From an anatomic and functional point of view, the stomatognathic system and the upper cervical spine are closely connected. Together with the complex neuromuscular relationships, this generates an important field of cooperation between dentists and orthopedics. The aim of this case report was to demonstrate the improvements of temporomandibular joint (TMJ) function after orthopedic surgery in case of a patient with idiopathic scoliosis. A 15-year-old female patient who had adolescent idiopathic scoliosis was surgically treated in 2016. Functional analyses of the TMJ were performed before the day of the operation and 10 months after the surgery. For detection, an ultrasound-based testing machine was used. The analyses of the data showed that almost all ranges of motions (ROM) were improved. The deviation to the right side was reduced from 8 mm to 2 mm during mouth opening. The patient had limited left lateral movement before the operation, however, after 10 months following the operation, there were free motions towards both sides. The originally asymmetrical protrusion became almost completely symmetrical. Regarding the functions of the TMJ, the surgery was successful; this in itself had a beneficial effect on the range and the path of the mandibular movements without any other treatment. These improved functions are indirect evidences for the connection of the function of the spine and TMJ. Orv Hetil. 2018; 159(50): 2144-2149.

[Effect of the treatment of periodontal disease on the outcome of pregnancy]. / Fogágybetegség kezelésének hatása a terhesség kimenetelére.

INTRODUCTION: Correlations between periodontitis and its effects on the outcome of pregnancies are actually more focused topics. Maternal motivation for a good oral hygiene and preventive dental treatment must be highlighted tasks during pregnancy care. AIM: The authors analysed the effect of the preventive dental treatment during pregnancy and its obstetrical effects. METHOD: In a prospective randomised study, including pregnant women observed for threatening preterm deliveries, patients with dental examination (n = 71) were compared with patients undergoing dental treatment at the same time (n = 79). STATISTICAL ANALYSIS: Univariate comparisons for categorical variables were assessed by χ2 tests and independent Student's t-tests for continuous variables. ORs were compared with Mantel-Haenszel tests. Multivariable logistic regression was performed to evaluate the factors determining the poor periodontal parameters and gingivitis separately. The two-tailed statistical significance level was set at 5%. RESULTS: In the dental treatment group, the neonatal birth weight was significantly higher than in the non-treated group, in case of patients with periodontitis (2990 ± 582.3 g vs 2568.1 ± 699.1 g, p = 0.005). Also the average age at delivery was significantly higher in the treated vs non-treated groups (37.3 ± 1.9 vs 36.0 ± 2.9 weeks, p = 0.027), and the treatment had a beneficial effect on the prolongation of pregnancy, with a higher level of significance in the gingivitis group vs patients with periodontitis groups (p = 0.02 vs p = 0.043). CONCLUSIONS: Dental treatment of expecting women has a beneficial effect on the prolongation of pregnancy by decreasing the rate of prematurity and perinatal complications. Orv Hetil. 2018; 159(24): 978-984.

Idiopathic male infertility related to periodontal and caries status.

OBJECTIVES: This study was undertaken to evaluate the possible correlation between the periodontal and dental status and sperm pathology in idiopathic male infertility. METHODS: The periodontal and caries status and semen quality of 199 men presented with unexplained male infertility were examined. Periodontal and dental factors were analysed by sperm pathology categories. RESULTS: A total of 106 men had normal sperm parameters, whereas 93 men had some type of spermpathology; 27.95% had oligozoospermia, 23.65% asthenozoospermia, 16.12% cryptozoospermia, 32.25% combined oligo-asthenozoospermia. Poor periodontal status was found in about half of the study group (45.7%). The DMFT index was not a significantly higher in any of the spermpathology groups. The odds ratio of calculus, bleeding on probing (BOP) and BOP at ≥50% of the teeth were significantly higher in the combined group (AOR = 1.04, AOR = 1.13, AOR = 4.92, respectively) in multivariate analyses compared to those in the normozoospermia group. Gingival bleeding in the history and urban residency were the only predictors for pathospermia shown by the logistic regression model (AORs were 1.82 and 2.26, respectively). CONCLUSIONS: Some features of poor periodontal status, as gingival bleeding in the history, presence of calculus and BOP, were associated with oligo+asthenozoospermia in men with idiopathic infertility.

[Performance indicators of maxillofacial surgery inpatient departments]. / Az arc-, állcsont-szájsebészeti aktív fekvobetegosztályok teljesítménymutatói.

INTRODUCTION: In Hungary, the number and structure of the maxillofacial surgery departments underwent significant changes in recent decades. AIM: The aim of our study was to present the actual performance indicators of maxillofacial inpatient departments and based on the available data to compare the departments. METHOD: The study was based on the number of beds founded by the National Health Insurance Fund. Performance data were supplied by the National Health Insurance Fund Administration. The assessment included the following indicators: number of beds institutional breakdown by type, number of reimbursed cases, the weighted case number, hospital stay, bed occupancy rates and average length of stay. RESULTS: In the examined period 40% of active beds (65) were in university hospitals. The distribution of reimbursed cases was similar. The university hospitals showed higher weighted case number and case-mix index. The oral surgery departments' bed occupancy rate (45.75%) was below the national average. CONCLUSION: The indicators show significant differences among different departments in the examined period. Orv. Hetil., 2017, 158(12), 447-453.

[Reimbursement of public dental care in Germany, the United Kingdom, Hungary and Poland]. / A fogászati ellátás finanszírozása Németországban, az Egyesült Királyságban, Magyarországon és Lengyelországban.

INTRODUCTION: Dental treatments have the highest rate among medical interventions and their reimbursement is also significant. AIM: The aim of the study was to compare the outcome of the reformed healthcare system process on public dental services in four European countries. METHOD: Assessment base for the comparison of reimbursement of dental treatments and dental fee schedules provided by the health insurance funds were used. The following indicators were examined: the ratio of public dental services and the main oral health indicators. Among dental fee schedules, reimbursement of general dental activity, prevention, operative dentistry, endodontic and oral surgery were selected. RESULTS: The lowest value of population to active dentist ratio was found in Germany (population to active dentist ratio: 1247) and the highest in Hungary (population to active dentist ratio: 2020). Oral health indicators showed significant differences between the West-European and East-European countries. On the other hand, the ratio of completely edentulous people at the age of 65yrs did not show great variations. Reimbursement of public dental treatments indicated significantly higher value in Germany and the United Kingdom compared to the other countries. CONCLUSIONS: Reimbursement of public dental services varies considerably in the selected European countries.

[Incidence of combination syndrome based on the orthopantomograms made between 2009 és 2014 at the Department of Prosthodontics, University of Pécs, Hungary]. / A kombinációs szindróma gyakorisága a Pécsi Tudományegyetem Klinikai Központ Fogpótlástani Tanszékén a 2009 és 2014 között készült orthopantomogramok alapján.

The treatment of patients having a completely edentulous maxillary arch and lower anterior teeth present is frequent in the dental practice. In these cases some specific changes can be detected in the oral cavity and on orthopantomograms. These signs were summarized and described first by Kelly (1972). Aim of the study was to examine the presence of the specific signs of the combination syndrome among the patients between 2009 and 2014. With the help of the electronic patient registry system used by the University of Pécs, 319 patients were filtered who were diagnosed with anodontia code (K0000 International Classification of Diseases (ICD)) in the examined period. 220 patients' orthopantomograms were evaluated searching for specific symptoms of the combination syndrome. 34 patients had complete edentulous maxilla and anterior teeth in the mandible. 4 patients (11.7%) showed the main sign of the combination syndrome, i.e. the maxillary anterior bone loss. Hypertrophy of maxillary tuberosity (9 cases, 26.4%), extrusion of the lower anterior teeth (6 cases, 17.6%) and great resorption of the distal mandibular ridge (16 cases, 47%) was diagnosed on the X-rays. The clinical examination of three patients supported the radiological findings. The combination syndrome was detectable, but the incidence rate was lower in this population in comparison with the data available in dental scientific publications.

Dimensional Accuracy of Two-Step Impressions Measured on Scanned Casts in CAD.

PURPOSE: The purpose of the study was to find out how light-body impression material thickness influences the horizontal dimensional accuracy of casts examined on a scanned model. MATERIALS AND METHODS: Customized manikin mandibles were used for impression taking with a dual-phase impression method. These mandibles were prepared in a way that allowed the control of light-bodied impression material thickness. First premolars were prepared for a full crown by supragingival chamfer on both sides in all mandibles. For the measurements, buccal and lingual reference points were made at the preparation margin. Impressions were taken at nine thickness levels and a control level (TTotal = 10; 0-1.2 mm), and the reference points' average distance was compared across thickness levels on both the left and right side. We carried out three measures for each specimen and used three specimens per thickness level. Total sample size was N = 180, creating a sizable database to understand the influence. RESULTS: The results indicated that light-body impression material thickness had no influence on the horizontal dimension of a die measured on scanned dies in these specific circumstances. CONCLUSIONS: The thickness of light-body impression material in the dual-phase impression taking technique did not have a significant influence on the horizontal accuracy of scanned dies, which makes the technique safe and reliable for single crown restorations without having to take extra precautions for the thickness of light-body impression material.

Push-Out Bond Strength of Glass Fiber Endodontic Posts with Different Diameters.

(1) Background: The retention of intraradicular posts is an important factor for the prognosis of endodontically treated teeth. The purpose of this study was to evaluate the push-out bond strength (PBS) of the posts relating to their diameter and region of the root. (2) Methods: A total of 40 premolar teeth (decoronated and root canal-filled) were divided into four groups (n = 10). After post-space preparation, different sizes (1.0, 1.2, 1.5, and 2.0 mm) of glass fiber posts were luted with resin cement into the root canals. After placement, 2 mm thick slices were cut from the roots according to their apical, middle, and coronal regions (n = 116). Push-out tests were carried out in a universal testing machine on each slice. A statistical evaluation of the data was applied. (3) Results: When comparing the diameter, the 2.0 mm posts had the highest PBS (111.99 ± 10.40 N), while the 1.0 mm posts had the lowest PBS (99.98 ± 8.05 N). Divided by the surface of the bonded area, the average PBS value was the highest for the 1.0 mm posts (18.20 ± 1.67 MPa) and the lowest for the 2.0 mm posts (12.08 ± 1.05 MPa). (4) Conclusions: Within the limitations of the study, when comparing the regions of the roots, no significant differences were found among the PBS values of the three regions (p = 0.219). When comparing the diameters, significant differences were shown between the PBS values of the four groups (p = 0.023 and p = 0.003, respectively).

[Minimally invasive method for the restoration of localized anterior tooth wear. A case report]. / Minimál invazív módszer alkalmazása frontfogak területére korlátozott fogkopás helyreállításakor. Esetismertetés.

Wear localized on front teeth is quite common; the restoration of the lost tissue is generally difficult due to the lack of vertical space between the upper and lower teeth. The traditional prosthetic method would include further tooth preparation for complete crowns and for increasing the occlusal vertical dimension. By applying the Dahl concept the necessary vertical space can be created with the preservation of the tooth tissue in a relatively short period of time. Definitive restoration can be made for the replacement of lost enamel and dentine with a direct or indirect method. Due to the Dahl concept the preparation of the teeth and its potentially harmful consequences can be avoided, the treatment is non- or minimally invasive. In the presented case the lost palatal and incisal tooth tissue was replaced with palatal E.max Press ceramic laminate. After cementing the laminate the patient was advised to wear a night guard, because of bruxism, to counteract the extreme load on the laminates.

Associations Between Temporomandibular Pain and Biobehavioral Variables in Dental Students in Response to an External Stressor.

AIMS: To assess changes in temporomandibular disorder (TMD) pain and multiple biobehavioral variables relevant to TMDs in response to an external stressor. METHODS: Self-reported data using online DC/TMD questionnaires were collected from volunteer dentistry graduate students. Data collection was performed on two occasions: during a non-exam period of the semester and during the subsequent exam period. Changes in the proportion of students with pain, differences in pain grade, and severity of biobehavioral status were measured and compared over the two periods. The association between severity of non-exam-period biobehavioral status and pain presence was also tested to assess whether biobehavioral variables can predict pain occurrence or persistence. Chi-square test, Wilcoxon signed-rank test, ANOVA, and Kruskal-Wallis tests were used for data analysis. P < .05 was considered significant. RESULTS: Of the 213 enrolled students, 102 remained after data reduction. In the non-exam period, the proportion of individuals with pain was 24.5%; in the exam period, the proportion was 54.9%, and more students had a higher pain grade. The severity of all biobehavioral variables was higher in the exam period, but there was no association between changes in the presence of pain and changes in biobehavioral variables. Higher anxiety and parafunction levels were found in those who reported pain on both occasions. CONCLUSION: Exam periods initiate readily measurable changes in the psychologic status of many students, as well as alterations in their temporomandibular pain. Higher levels of anxiety and oral behaviors during non-exam periods seem to be predictors for persisting pain.

[Pregnant women's oral hygiene knowledge and habits after the second millennium in South-East Hungary]. / Terhes nok szájhigiénés ismeretei, szokásai az ezredfordulón Délkelet-Magyarországon.

Among the predisposing agents for inflammatory periodontal lesion dental plaque is the most important, but different local and systemic factors may influence the seriousness or progression of periodontitis. Hormonal changes during pregnancy belong to the systemic aggravating factors. The aim of the present study was to assess pregnant women's oral hygiene knowledge and habits, and if these have a relationship with age, residence, educational level and profession/occupation. Questionnaires were used for the data collection. 275 pregnant women, who underwent prenatal care at the Department of Obstetrics and Gynecology in Szeged, volunteered to answer the questions. The results showed that almost all the women brushed their teeth daily, but only about one third of them used special oral hygiene tools, like dental floss. Many of the women claimed to have gingival bleeding when brushing their teeth. More then 70% visited a dentist during pregnancy. There was a significant relationship between educational level and the use of dental floss (p=0.004) and gingival bleeding (p=0.023) Oral hygiene education, dental and periodontal treatment of pregnant women need more emphasis during prenatal care.

[Effect of decontaminating solutions on titanium surface: an in vitro study of human epithelial cell culture]. / Dekontamináló anyagok hatása a titánfelszín biointegrációs tulajdonságaira: in vitro humán epithel sejtkultlúra vizsgálatok.

INTRODUCTION: The effects of three different decontaminating solutions in clinical use for peri-implantitis therapy on the chemical structure and surface roughness of commercially pure (CP) Ti were investigated. A further aim was to survey the response of the biological environment to these changes, by examining the attachment and proliferation of human epithelial cells after treatment of the Ti surfaces with these solutions. MATERIALS AND METHODS: CP (grade 4) machined titanium discs (CAMLOG Biotechnologies AG, Switzerland) were treated with 3% H2O2 (5 min), saturated citric acid (pH = 1; 1 min) or chlorhexidine gel (CHX, 5 min). The surface properties were followed through the use of X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM). The epithelial cell attachment and proliferation was examined by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and bicinchoninic acid (BCA) protein-content assays. RESULTS: XPS showed an intact TiO2 layer on each sample and CHX was adsorbed by the surface, as C-O and/or C=O bond formation was revealed. AFM results gave no significant changes in the roughness after treating the surfaces with the cleaning solutions. While MTT and BCA assays did not show significant differences in epithelial cell attachments, the cell proliferation was significantly increased after H2O2 treatment as compared to CHX (not shown by BCA assays). CONCLUSIONS: The applied decontaminating agents do not damage the Ti surface. H2O2 can be used effectively in decontaminating the implants affected by peri-implantitis, as the human epithelial cell growth was improved, in contrast with CHX.

Detection of periodontopathogenic bacteria in pregnant women by traditional anaerobic culture method and by a commercial molecular genetic method.

To culture facultative and strict anaerobic bacteria is a well-established method for analyzing subgingival plaque samples. Micro-IDent and micro-IDent Plus (HAIN Lifescience GmbH, Nehren, Germany) tests are two commercially available rapid PCR-based methods for the identification and quantification of putative periodontopathogen bacteria. In this study, we compared these commercial PCR-based hybridization methods with conventional anaerobic culture technique. A total of 36 subgingival plaque samples were collected from periodontal pockets of pregnant women with chronic localized periodontitis. Aliquots of these samples were evaluated with species-specific probes provided by micro-IDent and micro-IDent Plus tests simultaneously, and from the same samples anaerobic and capnophylic bacteria were cultured on selective media. The overall agreement between both methods was excellent for Eubacterium nodatum, Tannerella forsythia and Porphyromonas gingivalis (97-92%), fair for Capnocytophaga sp, Eikenella corrodens, Actinobacillus actinomycetemcomitans, and Prevotella intermedia (91-89%) and poor for Fusobacterium nucleatum, Parvimonas micra (Micromonas micros), and Campylobacter rectus (86-78%). Discrepancies in the results may be explained by inability of culture method to distinguish between closely related taxa (e.i P. intermedia/Prevotella. nigrescens), and problems of keeping periodontopathogen bacteria viable, which is required for successful detection by standard culture method. Nucleic acid-based methods may replace cultivation method as frequently used methods in microbiological diagnosis of progressive periodontitis, thus micro-IDent and micro-IDent Plus tests can be recommended where culture of periodontopathogenic bacteria is not performed in routine microbiology laboratories to analyze subgingival plaque samples.

Effect of antifungal gels incorporated into a tissue conditioning material on the growth of Candida albicans.

OBJECTIVE: The aim of this study was to examine the effectiveness of antifungal gels incorporated into a tissue conditioner which inhibits the growth of Candida albicans in vitro. BACKGROUND: The release of drugs from relining materials has been demonstrated earlier. However, the incorporation of antifungal agents in gel form has not yet been studied. MATERIALS AND METHODS: Visco-gel(®) tissue conditioner was prepared with chlorhexidine digluconate and miconazole in gel form in a concentration of 5, 10, 15, 20 and 25% by volume. Sample discs were prepared and placed on Sabouraud Dextrose Agar (SDA) plates which had been previously inoculated with C. albicans, and incubated aerobically at 37 °C. To investigate antifungal activity over time, Visco-gel discs containing 20%v/v miconazole were prepared and immersed in water for different time periods before being placed on SDA plates inoculated with C. albicans. RESULTS: Chlorhexidine digluconate gel added to tissue conditioner had no inhibition effect on the growth of C. albicans. Incorporation of miconazole gave a dose-related inhibitory effect on candidal growth. Immersion of the discs in water showed an inverse relationship between time of immersion and degree of inhibition. CONCLUSION: Miconazole added in gel form to Visco-gel(®) had an inhibitory effect on the growth of C. albicans in vitro.

Could Poor Periodontal Status be a Warning Sign for Worse Pregnancy Outcome?

PURPOSE: The aim of the present study was to analyse the role of the main diagnostic signs of poor periodontal status, probing depth (PD) ≥4 mm and bleeding on probing (BOP) ≥50%, both simultaneously and individually in preterm birth (PB) and their effect on the birth weight (BW). Prematurity is a major health concern and it is the leading contributing factor to neonatal morbidity and mortality worldwide. Conflicting results exist on the relation between poor maternal, periodontal status and adverse pregnancy outcome, including preterm deliveries and low birth weight (LBW). MATERIALS AND METHODS: Seventy-seven PBs and 165 deliveries at term were analysed out of 242 patients. The perinatal factors such as gestational age (GA) and BW were analysed by BOP, categorised as ≥50% (high BOP) vs <50% (non-high BOP) and PD ≥4 mm vs <4 mm, in combination or separately. RESULTS: The obtained results suggest that maternal periodontal inflammation, represented particularly by BOP, might be a triggering factor and can be associated with PB and LBW. For women with high BOP the adjusted odds ratio (AOR) for LBW was 2.28-fold and they were likely to have PB, with a 2.02-fold higher rate. CONCLUSION: An increasing tendency of BOP seemed to be associated with a tendency to PB and LBW. Further investigations are necessary to underline this relationship, but the role of good oral health status in general, and particularly in case of pregnancy, is unequivocal.

Prevention of preterm delivery with periodontal treatment.

OBJECTIVE: To demonstrate the role of periodontal treatment (PT) in the prevention of preterm delivery (PD). METHODS: A comparative prospective study of two groups of pregnant women with threatening PD was carried out at the Department of Obstetrics and Gynaecology of the University of Szeged: group A (n = 39) comprised patients who were merely examined dentally for periodontitis, and group B (n = 44) consisted of patients who received periodontal treatment during pregnancy. RESULTS: Periodontitis was identified in 19 cases (48.7%) in group A and in 18 cases (40.9%) in group B. The mean birth weight of the newborns was significantly higher in group B (3,009.1 g) than in group A (2,580.8 g; p = 0.007). The rate of premature birth was significantly lower in the group who received PT (p = 0.012, odds ratio = 3.5, 95% confidence interval = 1.38-8.86). CONCLUSIONS: The PT of pregnant women can decrease the rate of premature birth and consequently lead to a better neonatal health outcome.

[Streptococcus mutans colonization on titanium surfaces treated with various fluoride-containing preventive solutions]. / A Streptococcus mutans kolonizációja különbözô fluoridot tartalmazó prevenciós oldatokkal kezelt titánfelszínen.

Fluoride is a reductive agent and may modify the oxide layer of titanium (Ti) in the transgingival region of dental implants. The low pH and the high fluoride concentration of prophylactic mouthwashes and gels (used in caries prevention) may play a role in this phenomenon. Our main goal was to examine whether changes on the surface structure of Ti caused by high fluoride concentration and acidic pH alter the adherence and the colonization of bacteria. Polished commercially pure Ti discs (CP grade 4, Camlog, Biotechnologies AG, Switzerland) were used in the study. Each sample was treated for 1 hour with one of the solutions: mouthwash containing 0.025% (250 ppm) fluoride, a gel containing 1.25% (12500 ppm) fluoride, and a solution of 1% NaF (3800 ppm fluoride), pH 4.5. The surface structure of the discs was analyzed by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). The colonization of Streptococcus mutans was studied by scanning electron microscope (SEM) after a 5-day incubation period. The roughness of the treated sample surfaces (Ra), as revealed by AFM measurements, increased 1.3 times for the gel and the mouthwash, and approximately seven folds for the 1% NaF solution, as compared to the control surface. The high fluoride concentration and acidic pH of the gel and the 1% NaF solution resulted in a strong corrosion and a modification of the composition of the Ti surface. The XPS spectra showed the formation of a fluoride containing complex (Na2TiF6) bound strongly to the surface. A correlation was revealed between the roughness of the surface and thickness and maturity of the S. mutans bacterial colonies developed on the modified Ti surface. High fluoride concentration and acidic pH increased the roughness of the Ti surface. Bacterial biofilm colonization on this rough surface proved to be more mature. The amount of bacteria was increased due to the changes in the surface caused by fluoride treatment. The present study indicates that high fluoride concentration in an acidic pH environment may affect the development of a healthy transgingival epithelial junction on the Ti surface. This work was supported by the SIMI-NAS Project of the 5th FWP of the European Commission (Growth Program, GRD3-2001-61801), the Hungarian Ministry of Economy and the EC (GVOP-3.2.1.-2004-04-0408/3.0), the Hungarian Ministry of Health (ETT, 434/2006), and the Hungarian Scientific Research Fund (OTKA F-68440).