Comparing Modified Huddart-Bodenham Scoring System and GOSLON Yardstick to Assess Dental Arch Relationships in Unilateral Cleft Lip and Palate Patients.

OBJECTIVE: To test the reliability of the modified Huddart-Bodenham (MHB) numerical scoring system and its agreement with the GOSLON Yardstick categorization for assessing the dental arch relationships in unilateral cleft lip and palate (UCLP) cases. DESIGN: A retrospective study. SETTING: Faculty of Dentistry, The University of Hong Kong. PATIENTS: Forty-one nonsyndromic UCLP consecutive patients attending the Joint Cleft Lip/Palate Clinic at Faculty of Dentistry in the University of Hong Kong were selected. INTERVENTIONS: Study models at 8 to 10 years old (T1) and 10 to 12 years old (T2) were obtained from each patient. MAIN OUTCOME MEASURES: Models were rated with the MHB scoring system and GOSLON Yardstick index. The intra- and interexaminer reliabilities as well as correlation of both scoring systems were evaluated. Furthermore, to investigate the outcome measurements consistency, the MHB scoring system and GOSLON Yardstick were independently used to compare the dental arch relationships from T1 to T2, with the samples split into intervention and nonintervention groups. RESULTS: The MHB scoring system presented good intra- and interexaminer agreement, which were comparable to those of the GOSLON Yardstick. The correlation between the MHB scoring system and GOSLON Yardstick scores was good. Both scoring systems showed similar results when assessing the change in the dental arch relationships from T1 to T2. CONCLUSIONS: The MHB scoring system can be used as an alternative method to the commonly used GOSLON Yardstick for assessing dental deformities in UCLP patients. Both scoring systems showed similar results in assessing the improvement in dental arch relationships.

Treponema denticola associates with increased levels of MMP-8 and MMP-9 in gingival crevicular fluid.

OBJECTIVES: The aim was to assess the association between the presence of site-specific subgingival micro-organisms and the levels of matrix metalloproteinases-8 and matrix metalloproteinases-9 (MMP-8 and MMP-9) in gingival crevicular fluid (GCF). MATERIALS AND METHODS: The patient group consisted of 56 subjects with periodontitis and the control group of 43 subjects without periodontitis. GCF samples from four test sites for each subject were collected. Polymerase chain reaction was used to detect the presence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola. MMP-8 concentrations were analyzed by a time-resolved immunofluorometric assay, and MMP-9 levels were determined by enzyme-linked immunosorbent assay. Student's unpaired t-test, chi-square test, and Fisher's exact P-value were calculated. RESULTS: The presence of T. denticola in the test sites was significantly higher in the patient group than in the control group. The presence of T. forsythia and T. denticola was associated with increased levels of MMP-8 in the test sites. Respectively, site-specific presence of T. denticola was associated with an increase in MMP-9 levels in three of the four test sites. CONCLUSIONS: The presence of subgingival micro-organisms in GCF, particularly T. denticola, appeared to induce a host response with an increased release of MMP-8 and MMP-9 in the test sites.

Prevotella nigrescens and Porphyromonas gingivalis are associated with signs of carotid atherosclerosis in subjects with and without periodontitis.

BACKGROUND AND OBJECTIVE: Oral microorganisms may be involved in the development of cardiovascular diseases, and Porphyromonas gingivalis is one of the periodontal microorganisms that has been found in carotid atheroma. The aim of this work was to study subgingival microorganisms and early carotid lesions in subjects with and without periodontitis. MATERIAL AND METHODS: Eighty-eight subjects with periodontitis and 40 subjects without periodontitis underwent dental examinations in 2003. The presence of the periodontal microorganisms Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia was analyzed from subgingival plaque using PCR amplification. The common carotid artery was scanned using ultrasound and the calculated intima-media area (cIMA) was measured. The association between periodontitis, the cIMA value and the presence of periodontal microorganisms, together with several confounders, was studied in a multiple logistic regression model. RESULTS: Smoking [odds ratio (OR) = 5.64; p = 0.001), level of education (OR = 5.02; p < 0.05) and the presence of P. gingivalis (OR = 6.50; p < 0.05) were associated with periodontitis. Explanatory factors for the increased cIMA were periodontitis (OR = 4.22; p < 0.05), hypertension (OR = 4.81; p < 0.05), high body mass index (OR = 5.78; p < 0.01), male gender (OR = 3.30; p < 0.05) and poor socioeconomic status (OR = 4.34; p < 0.05). P. nigrescens (OR 4.08; p < 0.05) and P. gingivalis (OR 7.63; p < 0.01) also appeared as explanatory variables associated with increased cIMA values. CONCLUSION: This cross-sectional study showed that P. nigrescens and P. gingivalis were significantly associated with increased cIMA values.

A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions--a pilot study.

OBJECTIVE: The purpose of this project was to create a modified CBT model to determine the impact on increased adherence to oral hygiene instructions. In a pilot study test, this model was compared with traditional instructions. METHOD: Tools developed and tested in this pilot study were a self-reporting questionnaire, a visual information consisting of pictures and a diary to document according to a modified CBT method. Four participants were divided into two groups, control group and CBT group. At the first visit, all participants answered a self-reporting questionnaire. The clinical examination consisted of measuring the PI, GI and GBI. The same information and instructions were given. All received toothbrushes, dental floss and professional tooth cleaning. The CBT group was instructed to document their feelings and thoughts in a diary. After 3 weeks, the participants answered the same questionnaire, and the same clinical measurements were conducted at the re-examination. The CBT group brought their diaries for evaluation. RESULT: At the end of the study, there was a difference in PI, GI and GBI between the groups. The levels of PI, GI and GBI had decreased more in the CBT group than in the control group. The questionnaire also showed that the CBT group had increased their knowledge and awareness about oral health. CONCLUSION: This pilot study shows that using a modified model of CBT, by keeping a diary, resulted in increased adherence to oral hygiene and knowledge about gingivitis, compared with traditional instructions.

Risk for the development of atherosclerosis in women with a high amount [corrected] of dental plaque and severe gingival inflammation.

INTRODUCTION: Chronic infection and inflammation are considered to be risk factors in the development of cardiovascular diseases; the chronic inflammatory and microbial burden caused by the dental plaque in these individuals may predispose them to atherosclerotic process. AIMS: The aims were to study the involvement of a high level of dental plaque, severe gingival inflammation and periodontitis in the development of early atherosclerotic process in women. METHODS: Forty-six randomly chosen women with periodontitis and 21 periodontally healthy women were subjected to a comprehensive clinical oral examination, including oral hygiene status and level of gingival inflammation. Atherosclerotic risk factor analysis and carotid ultrasonography were performed. Common carotid artery intima-media thickness (IMT) and lumen diameter were measured and intima-media area (cIMA) was calculated. The following statistical methods were used: analysis of variance, chi-squared tests and multiple logistic regression analysis. RESULTS: There were highly significant differences between the patients and controls in the amount of dental plaque, gingival inflammation as well as bleeding on probing and pocket depth. The mean values of IMT and cIMA were significantly higher in women with periodontal disease than in controls. Multiple logistic regression analysis identified periodontitis as a principal-independent predictor of both the common carotid artery cIMA and IMT. CONCLUSIONS: The present results indicate that a high amount of dental plaque, severe gingival inflammation as well as periodontitis seem to be associated with the development of atherosclerotic lesions in women already at its early and subclinical stages.

Emerging horizons of salivary diagnostics for periodontal disease.

The field of salivary diagnostics to allow risk determination for periodontal diseases is advancing. New technologies in proteomics, genomics and nanotechnologies have continued the discovery of discriminatory periodontal disease biomarkers. This review briefly overviews biomarker studies that have been completed in saliva for the detection of periodontal disease since 2010. Disease specific biomarkers could be used in risk determination, treatment planning and disease progression. Currently, diagnostic tests are commercially available, and the development of point-of-care tests is expanding. Even though challenges remain, salivary diagnostics for periodontal disease is promising and could facilitate the diagnostics and treatment in a clinical practice by dental practitioners.

Self-reported oral problems, compared with clinical assessment in an epidemiological study.

OBJECTIVES: To study self-reported oral problems in relation to periodontal clinical findings in an epidemiological investigation. MATERIALS AND METHODS: 1676 individuals, 828 men and 848 women, participated. The clinical examination comprised the number of remaining teeth excluding third molars, plaque index (PLI), gingival index (GI), bleeding on probing (BOP%), calculus index (CI) and the number of teeth with pocket depth (PD) > or =5 mm. Participants answered a questionnaire concerning smoking and snuffing habits and described in their own words any oral problems present. Analysis of variance (anova), unpaired t-test and chi-squared test were the statistical methods used. RESULTS: The questionnaire was completed by 99.4% of participants. Problems of the teeth and mouth were reported by 28.9% of respondents comprising 31.8% females and 26.2% males. The difference between the sexes was statistically significant (P < 0.05). Of the reported oral problems, 57.4% was of periodontal origin. The differences between subjects with and without self-reported mobile teeth showed significant clinical outcome in PLI (P < 0.001), CI (P < 0.01), GI (P < 0.001), BOP% (P < 0.01), the number of teeth with PD > or = 5 mm (P < 0.001) and the number of remaining teeth (P < 0.001). The differences between subjects with and without self-reported periodontal disease and with and without bleeding gingiva also showed significant differences in CI (P < 0.05), GI (P < 0.05) and the number of teeth with PD > or = 5 mm (P < 0.05) and in PLI (0.001), CI (P < 0.01), GI (P < 0.001) and BOP% (P < 0.001) respectively. CONCLUSIONS: Present study clearly shows that self-reported periodontal problems were confirmed by clinical assessments.