Retrieval of a periodontally compromised tooth by allogeneic grafting of mesenchymal stem cells from dental pulp: A case report.

Objective To report a case of successful allogeneic grafting of mesenchymal dental pulp stem cells (DPSCs) as preliminary findings in a patient with periodontal disease enrolled into clinical trial ISRCTN12831118. Methods Mesenchymal stem cells from the dental pulp of a deciduous tooth from a 7-year-old donor were separated from the pulp chamber and processed via enzymatic digestion and centrifugation. DPSCs were passaged and cultured on a 35 × 13 mm culture dish in minimum essential medium-alpha, without supplementation. After reaching 80% confluency, 5 x 106 allogeneic DPSCs in 250 µl phosphate buffered saline were seeded onto a dry scaffold of lyophilized collagen-polyvinylpyrrolidone sponge placed in the left lower premolar area of a 61-year-old patient with periodontal disease. Surgical access to the lower premolar area was achieved using the flap technique. Results At 3 and 6 months following allogeneic graft, the patient showed no sign of rejection and exhibited decreases in tooth mobility, periodontal pocket depth and bone defect area. Bone mineral density had increased at the graft site. Conclusions Regenerative periodontal therapy using DPSCs of allogeneic origin may be a promising treatment for periodontal disease-induced bone defects.

Dental health in antique population of Vinkovci - Cibalae in Croatia (3rd-5th century).

Roman city Cibalae (Vinkovci) - the birthplace of Roman emperors Valentinian I and Valens was a very well developed urban ares in the late antique what was evidenced by numerous archaeological findings. The aim of this paper is to get insight in dental health of antique population of Cibalae. One hundred individuals with 2041 teeth dated to 3rd - 5th century AD have been analyzed for caries, antemortem tooth loss, periapical diseases and tooth wear. Prevalence of antemortem tooth loss was 4.3% in males, 5.2% in females. Prevalence of caries per tooth was 8.4% in males, 7.0% in females. Compared to other Croatian antique sites, ancient inhabitants of Roman Cibalae had rather good dental health with low caries prevalence and no gender differences. Statistically significant difference was found between males in females in the prevalence of periapical lesions and degree of tooth wear. Periapical lesions were found only in males.

Incidence of dental lesions in musk shrews (Suncus murinus) and their association with sex, age, body weight and diet.

Both wild and laboratory strains of the musk shrew (Suncus murinus) have a high incidence of periodontitis. The authors completed necropsy examinations in 51 shrews to identify dental lesions including tooth loss, mobility and fractures. Dental lesions were identified in significantly more females than males, and older animals were more likely to have lesions present. Shrews with one or more dental lesions weighed significantly less than those without lesions present. Dietary supplementation with mealworms did not significantly affect the incidence of dental lesions or the body weight of male or female shrews. The authors recommend routine body weight measurement as a simple, noninvasive method of detecting shrews with an increased likelihood of having dental lesions.

Associations between smoking and tooth loss according to the reason for tooth loss: the Buffalo OsteoPerio Study.

BACKGROUND: Smoking is associated with tooth loss. However, smoking's relationship to the specific reason for tooth loss in postmenopausal women is unknown. METHODS: Postmenopausal women (n = 1,106) who joined a Women's Health Initiative ancillary study (The Buffalo OsteoPerio Study) underwent oral examinations for assessment of the number of missing teeth, and they reported the reasons for tooth loss. The authors obtained information about smoking status via a self-administered questionnaire. The authors calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) by means of logistic regression to assess smoking's association with overall tooth loss, as well as with tooth loss due to periodontal disease (PD) and with tooth loss due to caries. RESULTS: After adjusting for age, education, income, body mass index, history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (≥ 26 pack-years) were significantly more likely to report having experienced tooth loss compared with never smokers (OR = 1.82; 95 percent CI, 1.10-3.00). Smoking status, packs smoked per day, years of smoking, pack-years and years since quitting smoking were significantly associated with tooth loss due to PD. For pack-years, the association for heavy smokers compared with that for never smokers was OR = 6.83 (95 percent CI, 3.40 -13.72). The study results showed no significant associations between smoking and tooth loss due to caries. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Smoking may be a major factor in tooth loss due to PD. However, smoking appears to be a less important factor in tooth loss due to caries. Further study is needed to explore the etiologies by which smoking is associated with different types of tooth loss. Dentists should counsel their patients about the impact of smoking on oral health, including the risk of experiencing tooth loss due to PD.

Case report: scurvy in an epileptic child on a ketogenic diet with oral complications.

BACKGROUND: Epilepsy is a symptom of cerebral dysfunction, where there is a sudden and disorganised discharge of electrical activity from a group of neurones, producing symptoms that range from sensory absences to convulsive movements and unconsciousness. Fasting is recognised as reducing the frequency of epileptic seizures in difficult to control patients. The ketogenic diet is a high fat, low carbohydrate and adequate protein diet that mimics the biochemical effects of fasting. It is deficient in some essential elements that require supplementation. CASE REPORT: A 9-year old girl with learning difficulties, developmental delay and refractory epilepsy was placed on the ketogenic diet in 2003. Prior to starting the diet she had had as many as 12 tonic seizures/day, with prolonged periods of non-convulsive status epilepticus. Subsequent to being placed on the diet, the frequency of her seizures reduced markedly; there were long periods during which she had none. In late 2006, the patient inhaled a primary molar. This was retrieved by emergency bronchoscopy and at the same time the remaining primary teeth were extracted. Three weeks later she was admitted to hospital with low-grade fever, persistently bleeding sockets, oedema of her hands and feet, a petechial rash and bruising. A differential diagnosis included: liver disease, bleeding dyscrasia, oncological pathology or scurvy. The most striking finding amongst a number of investigations was a vitamin C level of 0.7 micromol/l (Deficiency: < 11 micromol/l). Accordingly a diagnosis of scurvy was made. TREATMENT: The patient was prescribed ascorbic acid 500 mg twice/day. Three weeks later the patient's vitamin C level was 141.5 micromol/l; the dose was therefore reduced to 250 mg once/day. FOLLOW-UP: At two-month review, the signs and symptoms of scurvy had resolved. CONCLUSION: Inhaling a tooth and scurvy are both rare occurrences. Paediatric dentists should be aware of the possible implications of a ketogenic diet.

Beverage consumption and the prevalence of tooth loss in pregnant Japanese women: the Osaka Maternal and Child Health Study.

Recently, there has been growing interest in the impact of beverage consumption on dental health because changes have occurred in the types and quantities of beverage consumed. This cross-sectional study investigated the relationship between consumption frequencies of various beverages and the prevalence of tooth loss among young adult women. Study subjects were 1002 pregnant Japanese women. Tooth loss was defined as previous extraction of one or more teeth. Dietary habits were evaluated by a validated dietary history questionnaire. Logistic regression analysis was used to estimate the odds ratios and their 95% confidence intervals of tooth loss. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous one month, season when data were collected and body mass index. Of the 1002 subjects, 256 women had lost one or more teeth. Coffee consumption was independently associated with an increased prevalence of tooth loss. When subjects were divided according to consumption of coffee with or without sugar, an increased prevalence of tooth loss was found only in subjects who consumed coffee without addition of sugar. Compared with the lowest consumption of green tea, the intermediate but not the highest consumption of green tea was associated with an increased prevalence of tooth loss. There was no measurable association of intake of milk, black tea, cola, or 100% fruit juice with the prevalence of tooth loss. The findings suggest that coffee consumption might be associated with an increased prevalence of tooth loss among young adult women.

Reconstruction of post-orthognathic aseptic necrosis of the maxilla.

We present the reconstruction of near total aseptic necrosis of the maxillary alveolus that occurred after a Le Fort I osteotomy eight years previously.

Oral trauma, mouthguard awareness, and use in two contact sports in Turkey.

The purpose of the present study was to evaluate the occurrence of dental hard and soft tissue injuries during participation in contact sports, and the awareness and use of mouthguards in a young adult sample of semi-professional or amateur boxers and tae kwon do participants in Turkey. The samples consisted of 274 young adults [174 male (63.5%) and 100 female (36.5%)] aged between 17 and 27 years of which 185 (67.5%) were tae kwon do practitioners, and 89 (32.5%) were boxers. The participants answered a standard questionnaire. All answers were evaluated and then statistical analyses were performed. Of the total sample, 61 of the subjects (22.3%) suffered dental trauma. Of these sufferers, 32 (17.3%) were boxers and 29 (32.6%) were tae kwon do practitioners. It was found that 19 (6.9%) athletes lost their teeth post-trauma. Of the 54 subjects (19.7%) suffering soft tissue injuries, 44 were female (81.5%), while only 10 were male (18.5%), of which 40 (74.1%) were tae kwon do practitioners and 14 (25.9%) were boxers. Of the total sample of 274 subjects, 228 (83.2%) were well informed about mouthguard usage. Of the total sample, 153 (55.8%) of the subjects used mouthguards, all of which were boil-and-bite type. The results of our study indicate that dentists and sports authorities in Turkey should promote the use of mouthguards in contact sports such as tae kwon do and boxing, which have a serious risk for dental and oral soft tissue trauma and tooth loss.

Osteoporosis and the risk of tooth loss.

Osteoporosis and osteopenia may influence periodontal disease and tooth loss. Although many studies suggest that in elderly men and women, maintenance of normal bone mineral density is associated with improved tooth retention, the evidence is still inconclusive. Hormone replacement therapy and calcium and vitamin D supplements that are used to prevent or treat osteoporosis appear to have beneficial effects on tooth retention as well. Future prospective studies, including randomized clinical trials, are needed to confirm these findings.

Oleozón en el tratamiento de la periodontitis simple moderada / Oleozone in the treatment of moderate and simple periodontitis

La periodontitis es una de las formas más frecuentes de enfermedad periodontal, constituyendo la primera causa de mortalidad dentaria a partir de los 35 años de edad. Se considera una afección inmunoinflamatoria crónica donde la microbiota del surco y la respuesta del hospedero son factores de riesgo primordiales. Investigaciones en todo el mundo han demostrado que los gérmenes periodontopáticos predominantes son los microorganismos móviles, Gram negativos y anaerobios, siendo las formas no móviles, aerobias y facultativas, Gram positivas extremadamente frecuentes en surcos con gingivitis o sanos. Diferentes enfoques de tratamientos se han utilizado pero la enfermedad subsiste subclínicamente y es difícil mantener estables los resultados; por lo que nos propusimos evaluar los efectos del Oleozón en el tratamiento de la periodontitis simple moderada. Se realizó un ensayo clínico fase III, aleatorizado, controlado y a simple ciegas en 84 pacientes de más de 35 años, de uno y otro sexo, afectados de periodontitis simple moderada que acudieron al servicio de Periodoncia. Se distribuyeron en dos grupos, uno experimental tratado con Oleozón y otro control con clorhexidina acuosa al 0,2 por ciento. Se evaluaron los pacientes a los 21, 90 y 180 días y con intervalos de 1 mes hasta cumplir 9 meses del postoperatorio. En el grupo experimental se observaron mejores resultados clínicos y microbiológicos.No se evidenciaron reacciones adversas...(AU)

Initial extractions and tooth loss during supportive care in a periodontal population seeking comprehensive care.

BACKGROUND/AIMS: This retrospective survey was aimed at determining the prevalence of tooth extractions and the dental pathologies associated with them during both the active and maintenance phase of periodontal therapy in a periodontal population seeking comprehensive dental care. METHODS: A total of 273 randomly selected subjects from the oral prophylaxis clinic of the University of Berne were included. All subjects had received comprehensive care consisting of periodontal and restorative treatment and participated in a supervised maintenance program for an average of 67+/-46 months (range 5 to 278 months). The population consisted of 39.6% current smokers and 27.8% previous smokers. 6.2% of the patients had gingivitis, 20.5% mild periodontitis, 48.4% moderate and 24.9% severe periodontitis. The average frequency of the recall visits was 4.4+/-1.5 appointments/year (range 1.7-12 appointments/year). RESULTS: Results indicated that 574 out of a total of 6503 teeth were extracted; 311 teeth were extracted during active therapy and 263 during the supportive periodontal care (SPC) phase of therapy. 46% of patients received tooth extractions as part of their active treatment and 41% during their participation in the secondary prevention program. In the subgroup whose treatment plan included extractions the average number was 2.5+/-1.6 teeth per patient. Likewise, the patients who received extractions during recall lost an average of 2.35+/-1.9 teeth per subject with an incidence of 0.4+/-0.37 teeth per patient per year. These data reinforce the concept that a minority of the population is responsible for the majority of tooth extractions, both during active therapy and SPC. Periodontal disease was the only pathology observed at 57% of the extracted teeth; while caries, endodontic pathology and technical problems in the absence of periodontitis were observed in 29% of cases. CONCLUSIONS: These observations indicate that the rendered treatment was effective in the long-term maintenance of the dentition of these subjects and suggest that advanced periodontal disease represented the major cause of tooth loss in this population.

Dental effects of diet and coca-leaf chewing on two prehistoric cultures of northern Chile.

Two ancient cultures of northern Chile, the Chinchorro (9000-3500 BP) and the Maitas Chiribaya (850-700 BP) were examined for dental pathology in search of possible correlations between dental health, diet, and the cultural practice of coca-leaf chewing. The Chinchorro occupied the river mouth of the Azapa valley, subsisting almost exclusively on a maritime economy. The Maitas Chiribaya, descendants of migrant highlanders, had a rather well-developed agricultural subsistence base. The Chinchorro demonstrated extreme attrition rates and a correspondingly high frequency of periapical abscesses. They were essentially caries-free and enjoyed a moderate antemortem tooth loss frequency. The Maitas Chiribaya suffered light attrition; a high caries frequency, especially at the cementoenamel junction of crown and root, and a remarkably high antemortem tooth loss frequency. The cultural practice of coca-leaf chewing is implicated in the excessive posterior edentulism of the Maitas Chiribaya.

Bone loss and oral state in patients on home parenteral nutrition.

BACKGROUND: The purpose was to analyze changes in the mandible and the forearm bone mineral content and oral state in patients on home parenteral nutrition due to short bowel syndrome in relation to the bone mineral values and oral findings in a normal population. METHODS: The bone mineral content was measured by dual-photon absorptiometry and the dental and periodontal state were studied in 15 adults patients (12 women, and 3 men, aged 26 to 65 years). All patients were on free oral intake as a supplement to the parenteral nutrition. RESULTS: Forty-seven percent of the patients (2 males, 2 young and 3 elderly females) showed mandibular osteoporosis (Z-scores < -2.00), and all young females showed Z-scores < 0. Moreover, 34% of the patients showed osteoporosis in the forearm bones (Z-scores < -2.00) and also radiographic signs of osteoporotic fractures of the columna. The dental and the periodontal state in the patients did not differ clearly from that of the normal Danish population of the same age. CONCLUSIONS: Such patients seem to have a high risk of developing systemic osteoporosis, including the jaws, but apparently do not show a higher risk for deterioration of the dental or periodontal state than age-matching normals from the same population.

Fish-eaters and farmers: dental pathology in the Arabian Gulf.

Twelve skeletal samples, previously published, from the Arabian Gulf have been used to trace differences in diet and subsistence patterns through an analysis of dental pathology. The skeletons date from 3,000 BC to AD 1,500 and cover a variety of geographical locations: off-shore islands, Eastern Arabia, and Oman. The dental conditions analyzed are attrition, caries, calculus, abscessing, and antemortem tooth loss (AMTL). Results indicate four basic patterns of dental disease which, while not mutually exclusive, correspond to four basic subsistence patterns. Marine dependency, represented by the Ras el-Hamra population, is indicated by severe attrition, low caries rates, wear-caused abscessing, and a lack of AMTL. The second group of dental diseases--moderate attrition and calculus, low rates of caries, wear-caused abscessing, and low-moderate rates of AMTL--affects populations subsisting on a mixture of pastoralism or fishing and agriculture (Failaka, Umm an-Nar, Bronze Age Maysar, Bronze Age Shimal, and Iron Age Galilah). Mixed farming populations (Iron Age Maysar and Islamic Bahrain) experienced low-moderate attrition, high rates of caries and calculus, abscessing due to caries, and severe AMTL. The final group of dental diseases affects populations practicing intensive gardening (Bronze and Iron Age Bahrain, and Sites 3 and 5, Ras al-Khaimah). These groups experienced slight attrition, high rates of caries, low rates of calculus deposition, and severe AMTL.

Number of remaining teeth among adults in communities with optimal and low water fluoride concentrations.

The aims of this study was to compare the dental health status measured as the number of remaining teeth, also considering local fluoride administration in two sociologically equal communities with optimal and low drinking water fluoride concentrations. The study is based on self-answer enquiries and clinical examinations. To be part of the study the subjects were required to have used a drinking water with a fluoride concentration representative of the community for all their lives. The participants were 30-40 years old: 320 met the criteria in the optimal fluoride concentration community compared to 284 in the low fluoride community. Of these 18% did not turn up to the clinical examination. The results of the study show no differences in the number of still remaining teeth between optimal and low fluoride communities respectively. There were also no statistically significant differences as to the reasons for toothloss. The number of remaining teeth were neither influenced by local fluoride administration in the two groups. Removable dentures were only present in 0.9% with no differences between optimal and low fluoride communities.