Accuracy in osteotomy drilling using a new universal and disposable drill-stop device for dental implant drills: an in vitro study using a bovine rib model.

BACKGROUND: This study aimed to evaluate the surgical accuracy of a new universal disposable stop system for implant drills (FCA Universal Drill Stop). MATERIAL AND METHODS: A total of 60 bovine ribs were included in this in vitro study. The ribs were randomized into three study groups (n=20 ribs per group). In each study group (Group1: drills without stop or control group, Group 2: prefabricated drills with stop or gold standard group, and Group 3: drills with FCA Universal Drill Stop) a total of 100 osteotomies were performed with implant drills in each group, following the drilling sequence for the placement of a dental implant of 10 mm length and 4 mm diameter. The accuracy of the depth of the osteotomies was quantified clinically (with periodontal probe) and radiologically, using ImageJ version 1.48v software. RESULTS: The order of highest to lowest accuracy (clinical and radiological) in the depth of osteotomies was: FCA Universal Drill Stop> prefabricated drills with a stop>drills without stop, with statistically significant differences being observed between both systems with stop with respect to the control group, although not between them. CONCLUSIONS: The new universal disposable stop system for implant drills, offers similar accuracy to prefabricated drills with stop, with both systems being much more accurate than implant drills without stop. Although this experimental evaluation showed favourable results, further clinical studies are necessary.

Bone regeneration in critical-sized mandibular symphysis defects using bioceramics with or without bone marrow mesenchymal stem cells in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats.

OBJECTIVES: To compare new bone formation in mandibular critical-sized bone defects (CSBDs) in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats filled with bioceramics (BCs) with or without bone marrow mesenchymal stem cells (BMSCs). METHODS: A total of 64 adult female Sprague-Dawley rats were randomized into four groups (n = 16 per group): Group 1 healthy, Group 2 diabetic, Group 3 osteoporotic, and Group 4 diabetic-osteoporotic rats. Streptozotocin was used to induce type 1 diabetes in Group 2 and 4, while bilateral ovariectomy was used to induce osteoporosis in Group 3 and 4. The central portion of the rat mandibular symphysis was used as a physiological CSBD. In each group, eight defects were filled with BC (hydroxypatatite 60% and ß-tricalcium phosphate 40%) alone and eight with BMSCs cultured on BC. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). RESULTS: In all groups (healthy, diabetics, osteoporotics, and diabetics-osteoporotics), the CSBDs filled with BC + BMSCs showed greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with CSBDs treated with BC alone (at 4 and 8 weeks). CONCLUSIONS: Application of BMSCs cultured on BCs improves bone regeneration in CSBDs compared with application of BCs alone in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats.

Effects of diabetes on oxidative stress, periodontal ligament fiber orientation, and matrix metalloproteinase 8 and 9 expressions during orthodontic tooth movement.

OBJECTIVES: To evaluate the influence of diabetes on oxidative stress, periodontal ligament (PDL) orientation, and matrix metalloproteinase (MMP) 8 and 9 expressions during orthodontic tooth movement in a rat model. MATERIALS AND METHODS: An orthodontic appliance was placed in 60 Sprague-Dawley rats divided into three groups: normoglycemics (n = 20) and two streptozotocin-induced diabetic groups, one untreated (n = 20) and one insulin-treated (n = 20). At 24, 48, and 72 h and 1 week, rats were sacrificed. At each time point, myeloperoxidase (MPO) and malondialdehyde (MDA) were quantified by spectrophotometry, tooth movement was evaluated by micro-CT analysis, and hematoxylin and eosin staining was used to evaluate PDL fiber orientation and immunohistochemistry staining with semi-quantitative H-score analysis of MMP-8 and MMP-9 was performed.. RESULTS: At 24 h, MPO activity was significantly higher in untreated-diabetics than normoglycemics. At 24 and 48 h, the MDA level in untreated-diabetic rats was significantly higher than in normoglycemics and insulin-treated animals. At 72 h and 1 week, PDL fibers were oriented significantly more irregularly in untreated-diabetics than in normoglycemics. At all time points, MMP-8 and MMP-9 expressions were significantly higher in both diabetic groups than in the normoglycemic group. After the second day, tooth movement was significantly greater in untreated-diabetics than in the insulin-treated and normoglycemic groups. CONCLUSIONS: Mechanical stress in untreated-diabetic rats produces more inflammatory response, oxidative stress, tooth movement, PDL disorganization, and MMP-8 and MMP-9 expressions than among normoglycemics. Insulin reverses these effects, favoring the reorganization of periodontal ligament. CLINICAL RELEVANCE: Our results suggest that the application of orthodontic force in diabetic patients would increase inflammation and delay periodontal restructuring. Insulin would partly reverse this situation although glycemic decompensation episodes may occur. For these reasons, the periods between fixed orthodontic appliance activations should be of sufficient duration to allow adequate tissue recovery.

Postoperative effects of intra-alveolar application of 0.2% chlorhexidine or 1% hyaluronic acid bioadhesive gels after mandibular third molar extraction: a double-blind randomized controlled clinical trial.

OBJECTIVE: The aim of this study was to analyze the postoperative effects of intra-alveolar applications of 0.2% chlorhexidine (CHL) or 1% hyaluronic (HA) acid bioadhesive gels following the extraction of mandibular impacted third molars (MITMs). MATERIALS AND METHODS: In this double-blind randomized controlled clinical trial, 90 patients with one asymptomatic MITM were randomized into three group (n = 30 per group): group 1 (0.2% CHL), group 2 (1% HA), and group 3 (control). Visual analogue scales (VAS) were used to assess postoperative pain 24, 48, and 72 h and 7 days after surgery. Postsurgical complications were recorded: trismus, alveolitis osteitis, infection, or hematoma. RESULTS: In order from least to greatest, postoperative pain at all evaluation times was 0.2% CHL < 1% HA < control. At 24 h, statistically significant differences were found between both study groups and the control groups (0.2% CHL/control: P = 0.001; 1% HA/control: P = 0.010). At 48 and 72 h, significant differences were only found between 0.2% CHL and the control group (P = 0.229 and P = 0.046, respectively). At 7 days, no significant differences were found between any groups. Comparing the incidence of postoperative trismus, alveolitis osteitis, infection, or hematoma, although complications were more frequent in the control group, no statistical differences between groups were found (P > 0.050). CONCLUSIONS: Both 0.2% CHL and 1% HA bioadhesive gels applied intra-alveolarly minimize the postoperative complications after MITM extraction. Further research is necessary to confirm the present results. CLINICAL RELEVANCE: This study might help to reduce the postsurgical complications in patients after MITM extraction.

Immediate post-extraction implants placed in acute periapical infected sites with immediate prosthetic provisionalization: a 1-year prospective cohort study.

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with immediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p>0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p=0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year.

Prevalence of human papillomavirus in the saliva of sexually active women with cervical intraepithelial neoplasias.

BACKGROUND: The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. MATERIAL AND METHODS: Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. RESULTS: The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p=0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p<0.001; p=0.017; p=0.002; and p<0.001, respectively); condom use was also found to be related to the presence of oral HPV (p<0.001). CONCLUSIONS: The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results.

Bone union formation in the rat mandibular symphysis using hydroxyapatite with or without simvastatin: effects on healthy, diabetic, and osteoporotic rats.

OBJECTIVE: The objective is to compare new bone formation in critical defects in healthy, diabetic, and osteoporotic rats filled with hydroxyapatite (HA) alone and HA combined with simvastatin (SV). MATERIALS AND METHODS: A total of 48 adult female Sprague-Dawley rats were randomized into three groups (n = 16 per group): Group, 1 healthy; Group 2, diabetics; and Group 3, osteoporotics. Streptozotocin was used to induce type 1 diabetes in Group 2, while bilateral ovariectomy was used to induce osteoporosis in Group 3. The central portion of the rat mandibular symphysis was used as a physiological critical bone defect. In each group, eight defects were filled with HA alone and eight with HA combined with SV. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). RESULTS: In all groups (healthy, diabetics, and osteoporotics), the defects filled with HA + SV presented greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with bone defects treated with HA alone. CONCLUSIONS: Combined application of HA and SV improves bone regeneration in mandibular critical bone defects compared with application of HA alone in healthy, diabetic, and osteoporotic rats. CLINICAL RELEVANCE: This study might help to patients with osteoporosis or uncontrolled diabetes type 1, but future studies should be done.

Attitudes of dental implantologists in Spain to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients.

BACKGROUND: The implantologists frequently prescribe antibiotics, analgesics and anti-inflammatories in dental implant surgery. The aims of this study were to evaluate the attitudes of implantologists in Murcia (Spain) to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients during different implant dentistry procedures, and to see how these are influenced by individual dentist's academic level, professional experience, and ongoing training (attending courses or reading scientific literature on medication use). MATERIALS AND METHODS: This cross-sectional study included a total of 200 implantologists from the Murcia area (Spain), who each completed a two-page questionnaire consisting of 26 questions. RESULTS: The implant procedure in which most dentists (n=97) prescribed antibiotics was multiple implant surgery with flap raising, in which 55.6% of these 97 respondents used a prophylactic antibiotic regime for 7 days after implant placement. All subjects (n=200) prescribed analgesics for eight out of the eleven procedures included in the survey and anti-inflammatories in six. Dentists with higher academic levels or longer professional experience prescribed more antibiotics, but those who underwent continuous training (attending courses or reading scientific literature) reduced antibiotic prescription. CONCLUSIONS: Dentists often prescribed antibiotics, analgesics and anti-inflammatories in almost all implant procedures in healthy patients, but ongoing training reduced the frequency of antibiotic prescription in some procedures.

Salivary myeloperoxidase and malondialdehyde are increased in patients exhibiting an asymptomatic mandibular impacted third molar.

BACKGROUND: To determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy control, and to determine how biomarkers are modified by extraction. MATERIAL AND METHODS: 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues were obtained during surgery to measure biomarkers. One month after extraction, saliva samples were collected to assess changes of oxidative stress. RESULTS: Salivary MPO and MDA showed positive correlation with concentrations in follicular tissue (MPO: correlation coefficient=0.72, p=0.025; MDA: =0.92, p=0.001). Patients with asymptomatic MITMs showed higher salivary concentrations of oxidative stress biomarkers than healthy control subjects, with statistical significance for both MPO (p<0.001) and MDA (p<0.001). One month after extraction, salivary biomarkers decreased significantly in the study group (p<0.001). CONCLUSIONS: Salivary MPO and MDA are higher among patients with one asymptomatic MITM, but these levels decrease significantly one month after surgical extraction. The large decrease in oxidative stress biomarkers could justify third molar extraction despite the absence of symptoms.

Oral status, quality of life, and anxiety and depression in hemodialysis patients and the effect of the duration of treatment by dialysis on these variables.

This study aimed is to evaluate the oral health status, quality of life, anxiety and depression among hemodialysis patients and to analyze the effect of the duration of dialysis on these variables. 120 patients on hemodialysis and 120 control subjects underwent oral examination, periodontal evaluation, xerostomia study using a Visual Analogue Scale (VAS), sialometry evaluation; quality of life (QOL) using the OHIP-14 questionnaire and anxiety/depression. Bleeding index, CPTIN, clinical attachment level, and probing depth were significantly higher in the hemodialysis group than the control group (p < 0.001). VAS scores were higher in patients on hemodialysis with significant differences in 6 of the 8 domains (p ≤ 0.05). Unstimulated whole saliva was significantly lower in hemodialysis patients than control subjects (p < 0.001). OHIP-14 scores showed significantly poorer QOL in patients on hemodialysis than control subjects (p = 0.042). Hemodialysis patients presented greater depression and anxiety than control (p < 0.001). Periodontal health was worse among the patients who had been in treatment >10 years, xerostomia and sialorrea was worse in patients treated for 5-9.9, and >10 years, QOL was worse in patients who had spent <1 year; depression and anxiety was greater among those treated for 1-2.9 years. In conclusion, Oral health, QOL, anxiety and depression are worse in patients on hemodialysis, and oral health deteriorates as the time spent in dialysis lengthens, but patients in treatment for <3 years presented the poorest QOL and the greatest anxiety and depression.

Synergistic effect of photodynamic therapy and alendronate on alveolar bone loss in rats with ligature-induced periodontitis.

BACKGROUND AND OBJECTIVE: Photodynamic therapy (PDT) and antiresorptive drugs, such as alendronate (ALN), have been shown to reduce alveolar bone loss. The aim of this study was to evaluate the possible synergic effects of combining PDT and ALN on bone loss in periodontitis in rats. MATERIAL AND METHODS: Periodontitis was induced by ligature in 60 Wistar rats randomized into the following groups: control (Group 1); PDT (Group 2); ALN 0.01 mg/kg (Group 3); ALN 0.25 mg/kg (Group 4); PDT + ALN 0.01 mg/kg (Group 5); and PDT + ALN 0.25 mg/kg (Group 6). The rats were killed on day 12 and the mandibles were processed for macroscopic morphometric analysis, micro-computed tomography to analyze bone mineral density (BMD) and histological analysis. Gingival samples were collected to evaluate myeloperoxidase (MPO) and malonaldehyde (MDA) levels. RESULTS: Bone loss and inflammatory activity in histological studies, from the greatest to least was: control > ALN 0.01 mg/kg > PDT > ALN 0.25 mg/kg > PDT + ALN 0.01 mg/kg > PDT + ALN 0.25 mg/kg, while the order from least to greatest BMD was: control < ALN 0.01 mg/kg < PDT < ALN 0.25 mg/kg < PDT + ALN 0.01 mg/kg < PDT + ALN 0.25 mg/kg. The order of MPO and MDA activity from greatest to least was: control > ALN 0.01 mg/kg > PDT > ALN 0.25 mg/kg > PDT + ALN 0.01 mg/kg > PDT + ALN 0.25 mg/kg. The positive results obtained in the group treated with PDT + ALN 0.25 mg/kg showed statistically significant differences (P ≤ .05) compared with the other 5 groups for BMD, MPO and MDA. CONCLUSION: Combined approach therapy of PDT + ALN 0.25 mg/kg demonstrated a protective effect on alveolar bone loss.

Cytoprotective effects of melatonin on zoledronic acid-treated human osteoblasts.

OBJECTIVE: To evaluate the cytoprotective effects of melatonin (MLT) on zoledronic acid (ZA)-treated human osteoblasts. METHODS: Human osteoblasts were exposed to ZA (1, 5, 10, 50, 100 and 300 µM) and MLT (1, 10, 50, 100 y 200 µM) for 24, 48 and 72 h of incubation, to evaluate their effects on cell viability. RESULTS: As ZA concentration increased, greater reductions in cell viability of human osteoblasts were induced whether at 24, 48 or 72 h incubation. At 24 h incubation with MLT, greatest cell viability was obtained when low dose of MLT was applied (without significant differences); 48 and 72 h incubation presented the greatest cell viability with the highest MLT concentrations (100 and 200 µM). MLT at concentrations of 100 and 200 µM would appear to have a certain cytoprotective effect on ZA-treated human osteoblasts with low concentrations of ZA (1 y 5 µM), whether at 24, 48 or 72 h; however, at ZA concentrations ≥10 µM the possible cytoprotective effects of MLT were low at 24 h incubation. CONCLUSIONS: MLT has a cytoprotective effect on ZA-treated human osteoblasts and could represent a promising preventative alternative for patients at risk of bisphosphonate-related osteonecrosis of the jaw.

Incidence of peri-implantitis and oral quality of life in patients rehabilitated with implants with different neck designs: A 10-year retrospective study.

OBJECTIVES: To evaluate peri-implant bone loss, the presence of peri-implantitis, aesthetic satisfaction, and quality of life in patients with implant-based prosthetic restorations using implants with or without smooth necks, placed in different bone positions. MATERIALS AND METHODS: 400 patients received 1,244 implants: 515 with smooth neck monitored over an average of 6.44 ± 2.55 years and 729 without smooth neck monitored over 5.61 ± 2.52 years. Radiographic bone loss, presence of periimplantitis, implant loss, quality of life (OHIP-14), and patient satisfaction with prosthetic esthetics were evaluated, comparing groups. RESULTS: 120 implants developed peri-implantitis, 15 with a 2.5 mm smooth neck and 105 without smooth neck. Patients without smooth-necked implants showed a worse quality of life with statistically significant difference (p < 0.001). Patient satisfaction with prostheses was higher among the group without smooth neck. CONCLUSIONS: Implants with smooth polished necks would appear to suffer less bone loss and peri-implantitis, and lead to better patient quality of life. However, implants without smooth necks placed crestally led to higher patient satisfaction with aesthetics.

Application of chlorhexidine, fluoride and artificial saliva during radiotherapy: an in vitro study of microleakage in Class V restorations.

BACKGROUND: The aim of this study was to evaluate the effect on microleakage in Class V restorations of daily applications of artificial saliva, fluoride mouthrinses and chlorhexidine to irradiated bovine teeth. METHODS: Class V cavities were created in 60 bovine teeth. The teeth were divided randomly into two groups: the first group (n = 30) was subjected to radiotherapy until the teeth had received a total accumulated dose of 60 Gy; the second group (n = 30) was used as a control group. Both groups were divided into three subgroups (n = 10): in Group A teeth were submerged in Xeros Dentaid(®) artificial saliva; Group B teeth were submerged in a solution of 1% amine fluoride; Group C teeth were submerged in 0.12% chlorhexidine. All treatments were applied three times a day for six weeks. Afterwards microleakage into the composite restorations was measured using MIP4 image software. RESULTS: It was seen that radiation caused increases in microleakage in composite restorations. Statistically significant differences were found in the artificial saliva group (p = 0.013) and the chlorhexidine group (p = 0.023). CONCLUSIONS: Microleakage in composite restorations was greater among radiated teeth.

Synergic effect of curcumin or lycopene with irradiation upon oral squamous cell carcinoma cells.

OBJECTIVE: An in vitro study was carried out to evaluate the effect of curcumin, lycopene, and irradiation upon oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Curcumin and lycopene were administrated at doses of 3, 4.25, 5.50, and 6.75 µM in PE/CA-PJ15 OSCC cultures irradiated with different doses (1, 2.5, and 5 Gy), followed by evaluation of the effects upon cell viability, apoptosis, and migration after 24, 48, and 72 h of incubation. RESULTS: The application of curcumin or lycopene to the tumor cells during 24, 48, and 72 h without irradiation exerted an inhibitor effect upon cell viability and increased cell apoptosis. The maximum reduction in cell viability and the peak apoptotic effect was recorded with the 5.50 and 6.75 µM doses, for both curcumin and lycopene. Likewise, curcumin and lycopene exerted a synergic effect upon both variables on applying irradiation. Lastly, the 5.50 and 6.75 µM drug doses, together with 5 Gy of irradiation, yielded the greatest decrease in cell migration capacity with both curcumin and lycopene. CONCLUSIONS: Curcumin and lycopene increase cytotoxic activity in the PE/CA-PJ15 cell line and reduce cell migration capacity, while the combination of curcumin or lycopene with irradiation exerts a synergic effect.

Effect of mobile phones on micronucleus frequency in human exfoliated oral mucosal cells.

OBJECTIVE: In the last two decades, the use of mobile phones has increased enormously all over the world. The controversy regarding whether radiofrequency (RF) fields exert effects upon biological systems is a concern for the general population. An evaluation is made of DNA damage and cytokinetic defects, proliferative potential, and cell death because of RF radiation emitted by mobile phones in healthy young users. STUDY DESIGN: This cohort study was carried out in 50 Caucasian mobile phone users. We collected two cell samples from each subject (a total of 100 cell samples), corresponding to the right and left cheek mucosa, respectively. Case histories and personal information were assessed, including age, gender, body height and weight, history of cancer, smoking and alcohol consumption, exposure to chemical carcinogens or radiation, and dietary habits. Sampling comprised cell collection from both cheeks with a cytobrush, centrifugation, slide preparation, fixation, and staining, followed by fluorescent microscopic analysis. A total of 2000 exfoliated cells were screened for nuclear abnormalities, especially micronucleus. RESULTS: No statistically significant changes were recorded in relation to age, gender, body mass index, or smoking status. A comparison of the results vs the control area according to the side of the face on which the mobile phone was placed, and in relation to the duration of exposure (years) to mobile phone radiation in the total 100 samples, yielded no significant differences. CONCLUSIONS: No genotoxic effects because of RF exposure were observed in relation to any of the study parameters.

Pyostomatitis vegetans. Clinical marker of ulcerative colitis.

Pyodermatitis-pyostomatitis vegetans (PV), a rare disorder of the skin and oral mucosa, is considered a highly specific marker for inflammatory bowel disease, especially ulcerative colitis. We have presented the case of a patient with PV. This report emphasizes the relationship of PV to inflammatory bowel disease and the importance of the oral lesions as initial presenting signs of systemic disease or activity.

Dental students' knowledge of and attitudes toward anticoagulation dental treatment: assessment of a one-day course at the University of Murcia, Spain.

The aim of this study was to determine a group of Spanish dental students' knowledge of and attitudes toward anticoagulated patients and clinical practice and to assess the need for additional education in this area. A survey with sections on demographics and knowledge of general coagulation, anticoagulation treatment, clinical practice, local hemostatic measures, and antibiotic prophylaxis was distributed to students before and after a one-day course on oral anticoagulation. The response rate was 67.1 percent (n=96). Of the respondents, 78.1 percent (seventy-five) were women. The students who benefited most from the course were third-year students since they had the lowest level of knowledge at the beginning of the course (p>0.05). Fifth-year students and postgraduates had a good initial level of knowledge (87 percent). This study identified a lack of knowledge among this group of Spanish dental students prior to the course, but participating in the course led to considerable improvement.

Patient information preferences and behaviour in relation to oral biopsies.

Our aim was to study the impact of information on the behaviour of patients who were to have an oral biopsy specimen taken. Patients were randomly assigned either to be given the basic information about oral biopsy or a more extensive amount of information. The Krantz Health Opinion Survey was used as a measure of preferences in decisions made about oral biopsy, and we used a questionnaire to assess anxiety. A total of 260 patients were studied. The participants were satisfied with the information provided (both form and content), but significantly more of those given basic information would have liked to know more (p=0.02). We conclude that information exerts a clear effect on patients' attitude to oral biopsy. Provision of preoperative information leads to significantly less anxiety in all patients having a procedure under local anaesthesia. The results emphasise that patients need to be adequately informed about oral biopsy.

Measurement of atherosclerosis markers in patients with periodontitis: a case-control study.

BACKGROUND: It is suggested that periodontitis enhances the process of vascular inflammation leading to atherosclerosis. The present study explores the effect of periodontitis in relation to the clinical and ultrasound markers of carotid atherosclerosis. METHODS: Sixty systemically healthy patients >45 years of age (30 with chronic periodontitis and 30 without periodontitis) were studied in a university dental school. Traditional cardiovascular risk factors for atherosclerosis were evaluated. Carotid intima-media thickness (IMT) was assessed by ultrasound. RESULTS: The internal carotid IMT was 0.77 and 0.81 mm in the periodontal disease and control groups, respectively, with no statistically significant differences between the two groups (P = 0.538). There were significant differences in the presence of carotid atheroma plaques and the severity of periodontitis (P = 0.003). In the logistic regression analysis, significant differences in terms of age and periodontitis were recorded in relation to the presence of atheroma plaques in the carotid intima. CONCLUSION: The severity of periodontitis was seen to influence the presence of carotid atheroma plaques.