In Vitro Risk Assessment of Dental Acid Erosion Caused by Long-Term Exposure to Oral Liquid Bandages.

Oral mucosa inflammation can cause severe pain and interfere with eating, reducing quality of life. However, few options for self-care are available. An oral liquid bandage forms a protective film over the affected area. We aimed to assess the acid erosion risk when a newly developed oral liquid bandage (ORAPLA) is accidentally deposited on teeth and to examine the relative acid erosion risk at multiple time points of the maximum recommended duration of continuous use. ORAPLA was applied to both enamel and dentin blocks from 45 bovine anterior mandibular teeth, and an acid challenge was performed in a simulated oral cavity with artificial saliva, with one exposure cycle lasting 6 h. The enamel showed substantial defects and a decrease in Vickers hardness after nine cycles, with no change in surface roughness. Dentin showed an increase in parenchymal defects and surface roughness and a trend toward decreased Vickers hardness with increasing exposure time. We found no significant acid corrosion in enamel after up to nine times the upper limit of normal use time or in dentin after up to six times the upper limit. We conclude that the acid erosion risk due to accidental attachment to teeth is low, and in the human oral cavity with salivary buffering and remineralization, likely even lower.

A Validation Study of the National Database of Health Insurance Claims and Specific Health Checkups of Japan Regarding the Annual Number of Tooth Extractions Performed Across the Entire Japanese Population.

This report describes a validation study of data in the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) obtained by nationwide surveys on tooth extractions. The following 3 data sources on tooth extractions in Japan were compared: (1) the Nationwide Survey of the Reasons for Permanent Tooth Extractions in Japan (a previous survey conducted by the present authors); (2) the Statistics on Medical Care Activities in Public Health Insurance; and (3) the 4th NDB Open Data Japan. Source 1 was a nationwide survey conducted in 2018; sources 2 and 3 comprised data that are freely available for use by the public. In Source 1, 2,345 of 5,250 dentists approached responded to the questionnaire (recovery rate: 44.8%). The number of extracted teeth among younger age groups (aged 25-50 years) reported in Source 1 was lower than that in the other two sources. In contrast, the number of extracted teeth among older age groups reported in Source 1 was higher than that reported in the other two sources. However, when stratified by age group, all differences across the 3 sources regarding the mean annual number of tooth extractions were <0.05 teeth/year. The present results suggest that the NDB is a reliable resource for data on tooth extractions performed across the entire Japanese population.

Evaluation of Public Health Expenditure by Number of Teeth among Outpatients with Diabetes Mellitus.

The relationship between public health expenditure and number of teeth was investigated in patients with diabetes mellitus using data obtained from the Japanese National Database of Health Insurance Claims and Specific Health Checkups. Data on medical, dental, and pharmacy claims generated between April 2015 and March 2016 were analyzed in patients with diabetes mellitus aged 50-74 years who used outpatient services during this period. Patients initiating medical and pharmacy claims related to diabetes mellitus were defined as having diabetes mellitus. Number of teeth was defined as number of teeth in conjunction with periodontitis due to the nature of the data source. Descriptive statistics were used to investigate the association between number of teeth and public health expenditure. Data on a total of 1,017,758 patients with diabetes mellitus were analyzed. Patients with the fewest teeth incurred higher medical expenses. The largest mean difference in medical expenditure was observed between patients with 5-9 teeth and those with over 28 teeth. The results of this study suggest that public health expenditure on patients with diabetes mellitus differs based on number of teeth.

Inspiratory/expiratory xenon-enhanced area-detector CT: Capability for quantitative assessment of lung ventilation changes in surgically treated non-small cell lung cancer patients.

PURPOSE: To evaluate the capability of inspiratory/expiratory Xe-enhanced ADCT for assessment of changes in pulmonary function and regional ventilation of surgically treated NSCLC patients. METHOD AND MATERIALS: Forty consecutive surgically treated NSCLC patients underwent pre- and postoperative inspiratory/expiratory Xe-enhanced ADCT and pulmonary function tests. For each patient, pre- and post-operative data were analyzed and pre- and post-operative wash-in (WI) and wash-out (WO) indexes and ventilation ratio (VR=[WI-WO]/WI) maps generated by means of pixel-by-pixel analyses. Differences between pre- and postoperative WI (ΔWI), WO (ΔWO) and VR (ΔVR) were also determined. To determine the relationship between all ventilation index changes and pulmonary functional loss, Pearson's correlation was used to correlate each ventilation index change with the corresponding pulmonary functional parameter change. In addition, stepwise regression analysis was performed for all ventilation index changes and each corresponding pulmonary functional parameter change. RESULTS: FEV1/FVC% change showed fair or good and significant correlations with ΔWI (r = 0.39, p = 0.01) and ΔVR (r = 0.68, p = 0.001), %FEV1 change good or moderate and significant correlations with ΔWI (r = 0.56, p = 0.0001) and ΔVR (r = 0.76, p < 0.0001), and %VC change moderate yet significant correlation with ΔWI (r = 0.65, p < 0.0001) and ΔVR (r = 0.67, p < 0.0001). Stepwise regression analysis demonstrated that FEV1/FVC% change (r2 = 0.56, p < 0.0001) significantly affected two factors, ΔVR (p < 0.0001) and ΔWI (p = 0.006), as did %FEV1 change (r2 = 0.68, p < 0.0001) [ΔVR (p < 0.0001) and ΔWI (p = 0.0001)], and %VC change (r2 = 0.63, p < 0.0001) [ΔVR (p < 0.0001) and ΔWI (p = 0.0001)]. CONCLUSION: Inspiratory/expiratory Xe-enhanced ADCT has the potential to demonstrate that pre- and postoperative ventilation status of surgically treated NSCLC patients correlates with pulmonary function.

Risk assessment of fluoride daily intake from preference beverage.

BACKGROUND/PURPOSE: Tea, coffee and alcohol beverages are called preference beverage and are drunk habitual and in large quantities. Therefore, there is a high possibility that a health risk is caused by the contained components, and risk assessment of intake is essential. However, the risk assessment of fluoride intake from preference beverages has not been sufficiently performed. MATERIALS AND METHODS: This study estimated the daily fluoride intake from preference beverages by measuring the fluoride concentration of infusion liquid and measuring the total fluoride content by the microdiffusion method. In addition, Hazard Quotient (HQ) was calculated for children and adults to assess the risk of fluoride intake. RESULTS: As a result of this study, tea was the highest in all sample species, the infusion of tea was 1.06-6.68 mg/L and the total fluoride content of tea was 47.05-291.98 mg/kg. Green tea showed the next highest value, 0.26-4.09 mg/L, 21.91-83.68 mg/kg. Herbal tea fluoride levels were 0.07-0.17 mg/L and 0.05-1.90 mg/kg, Unique tea was 0.03-0.60 mg/L and 0.03-32.37 mg/kg, Coffee was 0.03-0.15 mg/L and 0.04-0.64 mg/kg. CONCLUSION: The HQ values calculated from the average daily fluoride intake (DFI) of preference beverages were all within the safe range. Some products made from Camellia sinensis, such as tea and green tea, had 1.66 mg/day as DFI at maximum, and the Child's HQ exceeded 1. These results suggest that habitual consumption of some products requires risk management of dental fluorosis.

Evaluation of tooth loss among patients with diabetes mellitus using the National Database of Health Insurance Claims and Specific Health Checkups of Japan.

BACKGROUND: Although diabetes mellitus is reported to be related to tooth loss, there is limited population-based evidence for this relationship. We investigated the actual situation of tooth loss by performing a population-based survey using information obtained from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) in Japan. METHODS: Medical, dental and pharmacy claims data generated between 1 April 2015 and 31 March 2016 were obtained and analysed. Patients with medical and pharmacy claims of diabetes mellitus were allocated to the diabetes mellitus group. Patients with medical claims of acute upper respiratory inflammation, but without claims of diabetes mellitus, were allocated to the control group. The number of claims involving tooth loss, treatment of periodontal disease and visits to medical and dental institutions were obtained from the NDB. Descriptive statistics were used to compare the nature of tooth loss between patients with diabetes mellitus and the control groups. RESULTS: There were 5,248,405 patients in the control group and 1,570,082 patients in the diabetes mellitus group. Patients in the diabetes mellitus group showed a higher level of tooth loss than patients in the control group, among both sexes. Patients with diabetes mellitus tended to lose their posterior teeth at an earlier age than patients in the control group. Moreover, patients in the diabetes mellitus group showed greater tooth loss, regardless of whether or not periodontal disease was treated. CONCLUSION: Patients with diabetes mellitus show a higher level of tooth loss than those without diabetes mellitus, based on the results of a population-based survey.

Factors Associated with Undergoing Regular Dental Check-ups in Healthy Elderly Individuals.

The purpose of this study was to determine the distribution of healthy elderly individuals undergoing regular dental check-ups and identify any environmental or associated oral factors. A cross-sectional questionnaire survey was used to interview 216 individuals attending 2 welfare facilities for the elderly, of whom 160 were included in the final analysis. Items comprised age, sex, number of residual teeth, frequency of teeth/denture cleaning, subjective chewing ability, denture use, oral status, regular dental check-ups, visitation of the same dentist, number of dental visits in the past year, General Oral Health Assessment Index (GOHAI) (Japanese version) score, living situation, and use of routine medication. Individuals undergoing regular dental check-ups were defined as those with a primary dentist whom they saw for dental check-ups at least once a year. The rate of individuals undergoing regular dental check-ups was 75.0% in men aged 60-74 years, 58.8% in women aged 60-74 years, 70.0% in men aged 75 years or over, and 45.3% in women aged 75 years or over. Logistic regression analysis revealed a higher number of residual teeth (odds ratio [OR]=2.664 in comparison with those with fewer than 20 teeth, p=0.0427); cleaning teeth/dentures 3 or more times per day (OR=2.546 in comparison with cleaning them twice per day or less, p=0.0157); and a higher GOHAI score (OR=2.742 in comparison with those with a GOHAI score of less than 58, p=0.0263) as factors significantly correlated with undergoing regular dental check-ups. In conclusion, the results revealed that individuals undergoing regular dental check-ups had 20 or more residual teeth, cleaned their teeth/denture 3 or more times per day, and had a higher GOHAI score. This indicates that the best predictive factor for undergoing regular dental check-ups in healthy elderly individuals is their GOHAI score.

Comparison of Xenon-Enhanced Area-Detector CT and Krypton Ventilation SPECT/CT for Assessment of Pulmonary Functional Loss and Disease Severity in Smokers.

OBJECTIVE: The objective of this study was to compare the capability of xenon-enhanced area-detector CT (ADCT) performed with a subtraction technique and coregistered 81mKr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity in smokers. SUBJECTS AND METHODS: Forty-six consecutive smokers (32 men and 14 women; mean age, 67.0 years) underwent prospective unenhanced and xenon-enhanced ADCT, 81mKr-ventilation SPECT/CT, and pulmonary function tests. Disease severity was evaluated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. CT-based functional lung volume (FLV), the percentage of wall area to total airway area (WA%), and ventilated FLV on xenon-enhanced ADCT and SPECT/CT were calculated for each smoker. All indexes were correlated with percentage of forced expiratory volume in 1 second (%FEV1) using step-wise regression analyses, and univariate and multivariate logistic regression analyses were performed. In addition, the diagnostic accuracy of the proposed model was compared with that of each radiologic index by means of McNemar analysis. RESULTS: Multivariate logistic regression showed that %FEV1 was significantly affected (r = 0.77, r2 = 0.59) by two factors: the first factor, ventilated FLV on xenon-enhanced ADCT (p < 0.0001); and the second factor, WA% (p = 0.004). Univariate logistic regression analyses indicated that all indexes significantly affected GOLD classification (p < 0.05). Multivariate logistic regression analyses revealed that ventilated FLV on xenon-enhanced ADCT and CT-based FLV significantly influenced GOLD classification (p < 0.0001). The diagnostic accuracy of the proposed model was significantly higher than that of ventilated FLV on SPECT/CT (p = 0.03) and WA% (p = 0.008). CONCLUSION: Xenon-enhanced ADCT is more effective than 81mKr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity.

Dynamic Contrast-Enhanced Perfusion Area-Detector CT: Preliminary Comparison of Diagnostic Performance for N Stage Assessment With FDG PET/CT in Non-Small Cell Lung Cancer.

OBJECTIVE: The objective of our study was to directly compare the capability of dynamic first-pass contrast-enhanced (CE) perfusion area-detector CT (ADCT) and FDG PET/CT for differentiation of metastatic from nonmetastatic lymph nodes and assessment of N stage in patients with non-small cell lung carcinoma (NSCLC). SUBJECTS AND METHODS: Seventy-seven consecutive patients, 45 men (mean age ± SD, 70.4 ± 5.9 years) and 32 women (71.2 ± 7.7 years), underwent dynamic first-pass CE-perfusion ADCT at two or three different positions for covering the entire thorax, FDG PET/CT, surgical treatment, and pathologic examination. From all ADCT data for each of the subjects, a whole-chest perfusion map was computationally generated using the dual- and single-input maximum slope and Patlak plot methods. For quantitative N stage assessment, perfusion parameters and the maximum standardized uptake value (SUVmax) for each lymph node were determined by measuring the relevant ROI. ROC curve analyses were performed for comparing the diagnostic capability of each of the methods on a per-node basis. N stages evaluated by each of the indexes were then statistically compared with the final pathologic diagnosis by means of chi-square and kappa statistics. RESULTS: The area under the ROC curve (Az) values of systemic arterial perfusion (Az = 0.89), permeability surface (Az = 0.78), and SUVmax (Az = 0.85) were significantly larger than the Az values of total perfusion (Az = 0.70, p < 0.05) and distribution volume (Az = 0.55, p < 0.05). For each of the threshold values, agreement for systemic arterial perfusion calculated using the dual-input maximum slope model was substantial (κ = 0.70, p < 0.0001), and agreement for SUVmax was moderate (κ = 0.60, p < 0.0001). CONCLUSION: Dynamic first-pass CE-perfusion ADCT is as useful as FDG PET/CT for the differentiation of metastatic from nonmetastatic lymph nodes and assessment of N stage in patients with NSCLC.

Relationship between amount of overtime work and untreated decayed teeth in male financial workers in Japan.

OBJECTIVE: Continuous or frequent overtime work has been shown to have harmful effects on human health. Meanwhile, one of the main reasons for tooth loss is caries. The aim of this study was to assess the relationship between overtime work and untreated decayed teeth in male financial workers. METHODS: The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. Participants filled out a questionnaire about their oral health, behavior, and working conditions. Participants comprised a total of 951 financial male workers, aged 25-64 years. RESULTS: The likelihood of tooth decay increased with amount of overtime work (p=0.002). After adjusting for age, income, educational background, oral hygiene behavior, snacking behavior, regular dental visitation, bad interpersonal relationships at work, and smoking habit, a multiple logistic regression analysis found that participants with 45-80 h of overtime work (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.23-5.33) or over 80 h of overtime work (OR, 3.01; 95% CI, 1.13-7.97) were more likely to have untreated tooth decay. The percentage of participants who gave "too busy with work" as the reason for leaving decayed teeth untreated increased with amount of overtime (p<0.001). CONCLUSION: These results indicate that overtime work is strongly related to untreated decayed teeth. In addition to oral health education and dental checkups, decreasing stress and decreasing the amount of overtime work may also have a positive effect on oral health in the workplace.

Relationship between job stress and subjective oral health symptoms in male financial workers in Japan.

OBJECTIVE: The aim was to assess subjective oral health symptoms and job stress, as measured by self-assessment of how demanding the job is, in male financial workers. METHODS: The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. For the stress check, 7 items about how demanding the job is were selected from The Brief Job Stress Questionnaire (BJSQ). Participants comprised a total of 950 financial male workers, ages 25 to 64. RESULTS: Participants who answered "I can't complete my work in the required time" had more decayed teeth (p=0.010). Participants who felt that their job is highly demanding (answered affirmatively to 6 or all 7 items) were more likely to report "often get food stuck between teeth" (p=0.030), "there are some foods I can't eat" (p=0.005), "bad breath" (p=0.032), and "jaw makes clicking sound" (p=0.032). The independent variable of total stress score of 24-28 was found to be correlated to at least three oral health symptoms (OR: 3.25; 95%CI: 1.66-6.35). CONCLUSION: These results indicate that certain job stress factors are associated with certain oral health symptoms, and that oral health symptoms are likely predictors of job stress.

Hybrid Type iterative reconstruction method vs. filter back projection method: Capability for radiation dose reduction and perfusion assessment on dynamic first-pass contrast-enhanced perfusion chest area-detector CT.

PURPOSE: To directly compare the capability of hybrid-type iterative reconstruction (i.e., adaptive iterative dose reduction using 3D processing: AIDR 3D) and filter back projection (FBP) for radiation dose reduction during dynamic contrast-enhanced (CE-) perfusion area-detector CT (ADCT) for lung and nodule perfusion assessment. MATERIALS AND METHODS: Thirty-six patients with lung cancers who underwent perfusion ADCT (SD-ADCT) at 120 mA and were enrolled in this study. ADCT data at 80 mA (reduced-dose ADCT: RD-ADCT), 60 mA (low-dose ADCT: LD-ADCT) and 40 mA (very low-dose ADCT: VLD-ADCT) were computationally simulated using SD-ADCT data, and reconstructed with and without AIDR 3D. Image noise and lung and nodule perfusion parameters were evaluated using ROI measurements. To determine the utility of AIDR 3D for dose reduction, image noise was compared between each protocol with and without AIDR 3D by means of the t-test. Correlations and limits of agreement for parameters obtained with SD-ADCT and other protocols were also evaluated. RESULTS: Image noise of all protocols with AIDR 3D was significantly lower than that of LD-ADCT and VLD-ADCT without AIDR 3D (p<0.05). Significant correlations for image noise between SD-ADCT and all protocols with AIDR 3D (0.45 ≤ r ≤ 0.99, p<0.0001) were equal to or better than that without AIDR 3D (0.28 ≤ r ≤ 0.99, p<0.0001). The limits of agreement for perfusion parameters with AIDR 3D were smaller than those without AIDR 3D for each tube current. CONCLUSION: AIDR 3D is more effective than FBP for dose reduction of perfusion ADCT while maintaining image quality and reducing measurement errors.

Iterative reconstruction technique vs filter back projection: utility for quantitative bronchial assessment on low-dose thin-section MDCT in patients with/without chronic obstructive pulmonary disease.

OBJECTIVES: The aim of this study was to evaluate the utility of the iterative reconstruction (IR) technique for quantitative bronchial assessment during low-dose computed tomography (CT) as a substitute for standard-dose CT in patients with/without chronic obstructive pulmonary disease. METHODS: Fifty patients (mean age, 69.2; mean % predicted FEV1, 79.4) underwent standard-dose CT (150mAs) and low-dose CT (25mAs). Except for tube current, the imaging parameters were identical for both protocols. Standard-dose CT was reconstructed using filtered back-projection (FBP), and low-dose CT was reconstructed using IR and FBP. For quantitative bronchial assessment, the wall area percentage (WA%) of the sub-segmental bronchi and the airway luminal volume percentage (LV%) from the main bronchus to the peripheral bronchi were acquired in each dataset. The correlation and agreement of WA% and LV% between standard-dose CT and both low-dose CTs were statistically evaluated. RESULTS: WA% and LV% between standard-dose CT and both low-dose CTs were significant correlated (r > 0.77, p < 0.00001); however, only the LV% agreement between SD-CT and low-dose CT reconstructed with IR was moderate (concordance correlation coefficient = 0.93); the other agreement was poor (concordance correlation coefficient <0.90). CONCLUSIONS: Quantitative bronchial assessment via low-dose CT has potential as a substitute for standard-dose CT by using IR and airway luminal volumetry techniques. KEY POINTS: • Quantitative bronchial assessment of COPD using low-dose CT is possible. • Airway luminal volumetry with iterative reconstruction is insusceptible to dose reduction. • Filtered back-projection is susceptible to the effect of dose reduction. • Wall area percentage assessment is easily influenced by dose reduction.

Dental-care utilization patterns and factors associated with regular dental check-ups in elderly.

The purpose of this study was to investigate dental care utilization patterns in the elderly and to evaluate factors associated with regular dental check-ups in this age group. A total of 211 elderly people (50 men, 161 women) aged between 60 and 98 years were investigated. A cross-sectional survey by questionnaire was carried out on visitors to the Mihama Ikiiki Plaza (an institution for the elderly) in the city of Chiba, Japan between July and September, 2008. Items on the questionnaire included self-reported oral status, use of dentures, use of regular medication, oral problems, cleaning of teeth/dentures and dental care utilization patterns. The results showed that 135 (64.0%) of the responders had visited a dentist in the past year, 185 (87.7%) had visited the same dentist and 85 (40.3%) had had regular dental check-ups. A stepwise multiple logistic regression analysis adjusting for age and sex revealed that the factors associated with regular dental check-ups were significantly higher ADLs (odds ratio (OR)=0.439 in the partially insured and 0.192 in the fully insured in comparison with healthy subjects, p=0.0012), visiting the same dentist (OR=11.978 in comparison with not visiting the same dentist, p=0.0183) and cleaning teeth/dentures three or more times per day (OR=1.962 in comparison with cleaning them two or fewer times per day, p=0.0368). In this study, a higher ADL, visiting the same dentist and cleaning teeth/dentures three or more times per day were associated with having regular dental check-ups in the elderly. The best predictive factor for regular dental check-ups was a high ADL in the elderly.