Maternal age at birth and other risk factors in early childhood caries.

PURPOSE: The objective of this study was to identify the impact of mother's age and other child care practices on the children's oral health. METHODS: The study consisted of 646 mother-child pairs who participated in the community oral health program at 1.5 and 3 years old. A questionnaire was designed to collect demographic data, household environment, dietary habits, and oral hygiene practices. Oral examination was carried out by skilled pediatric dentists. Plaque samples taken from the buccal surface of maxillary molars from both child and mother pairs were assessed using Cariostat. T test and logistic regression models were used to analyze the data. RESULTS: Caries occurrence was associated with the following: mother's age at childbirth, specifically at 22 years old and younger (odds ratio [OR] = 3.02, 95% confidence interval [CI] = 1.85-4.92, P < .001); frequency of between meal snacks of more than 4 times/day (OR = 2.53, 95% CI = 1.09-5.91, P = .03); and child's caries activity test score at 1.5-year-old equal to or greater than +1.5 (OR = 2.10, 95% CI = 1.48-2.99, P = .002). CONCLUSION: The mother's age at childbirth, high-risk caries activity test scores at an earlier age, and frequency of snacking were found to be important early childhood caries risk factors.

Mechanical and Functional Properties of a Novel Apatite-Ionomer Cement for Prevention and Remineralization of Dental Caries.

Especially in pediatric dentistry, prevention by the control of initial lesions prior to cavitation is very important, and application of a pit and fissure sealant is essential to achieve this. Numerous reports have suggested that resin-based sealants are inferior to sealants based on glass-ionomer cement (GIC), because of GIC's many advantages, such as fluoride ion release properties and its good adhesion to tooth structures. However, the use of GIC is impeded due to its low flexural strength and fracture toughness. In this paper, we developed and characterized an apatite-ionomer cement (AIC) that incorporates hydroxyapatite (HAp) into the GIC; this development was aimed at not only reinforcing the flexural and compressive strength but also improving some functional properties for the creation of the material suitable for sealant. We examined the influence of differences in the compounding conditions of GIC powder, liquid, and HAp on flexural and compressive strengths, fracture toughness, fluoride ion release property, shear bond strength to bovine enamel, surface pH of setting cements, and acid buffer capability. These methods were aimed at elucidating the reaction mechanism of porous spherical-shaped HAp (HApS) in AIC. The following observations were deduced. (1) HAp can improve the mechanical strengths of AIC by strengthening the cement matrix. (2) The functional properties of AIC, such as acid buffer capability, improved by increasing the releasing amounts of various ions including fluoride ions. The novel AIC developed in this study is a clinically effective dental material for prevention and remineralization of tooth and initial carious lesion.

Increase in bone metabolic markers and circulating osteoblast-lineage cells after orthognathic surgery.

Increased mineralisation rate and bone formation after surgery or fracture is the regional acceleratory phenomenon (RAP), and its systemic impact is the systemic acceleratory phenomenon (SAP). The proportion of circulating osteoblast lineage cells, including osteocalcin-positive (OCN+) cells, in the peripheral blood is markedly higher during pubertal growth and in patients with bone fractures. This study aimed to elucidate the dynamic changes in bone metabolic activity after orthognathic surgery by longitudinal prospective observation. Peripheral venous blood samples were collected from patients who had undergone orthognathic surgery, and serum bone metabolic markers and the proportion of OCN+ cells were measured. Orthognathic surgery induces systemic dynamic changes in bone metabolic activity by targeting steps in the bone healing process and related proteins, such as surgical stress/inflammation (C-reactive protein), bone resorption (type I collagen C-telopeptide), and bone formation (alkaline phosphatase and bone-specific alkaline phosphatase). During the early post-operative period, the population of OCN+ cells significantly increased. Confocal microscopy revealed that OCN proteins were localised in the cytoplasm in Triton X-100-treated OCN+ cells. Furthermore, OCN, ALP, and COL1A1 gene expression was detected in OCN+ cells, suggesting the contribution of the local maturation of bone marrow-derived OCN+ cells at the site of bone healing.

Influence of Porous Spherical-Shaped Hydroxyapatite on Mechanical Strength and Bioactive Function of Conventional Glass Ionomer Cement.

Glass-ionomer-cement (GIC) is helpful in Minimal Intervention Dentistry because it releases fluoride ions and is highly biocompatible. The aim of this study is to investigate the mechanisms by which hydroxyapatite (HAp) improves the mechanical strength and bioactive functioning of GIC when these materials are combined to make apatite ionomer cement (AIC). A conventional GIC powder was mixed with porous, spherical-HAp particles (HApS), crystalline HAp (HAp200) or one of two types of cellulose. The micro-compressive strengths of the additive particles were measured, and various specimens were evaluated with regard to their compressive strengths (CS), fluoride release concentrations (fluoride electrode) and multi-element release concentrations. The AIC was found to release higher concentrations of fluoride (1.2 times) and strontium ions (1.5 times) compared to the control GIC. It was detected the more release of calcium originated from HApS than HAp200 in AIC. The CS of the AIC incorporating an optimum level of HAp was also significantly higher than that of the GIC. These results suggest that adding HAp can increase the release concentration of ions required for remineralization while maintaining the CS of the GIC. This effect does not result from a physical phenomenon, but rather from chemical reactions between the HAp and polyacrylic acid of GIC.

Risk factors related to aggressive condylar resorption after orthognathic surgery for females: retrospective study.

OBJECTIVE: The aim of the present study was to identify the risk factors for aggressive condylar resorption (ACR) after orthognathic surgery. METHODS: A total of 25 female patients with osteoarthritis (OA) scheduled for orthognathic surgery were divided into two groups: those who exhibited ACR (ACR (+), n = 8) and those who did not exhibit ACR (ACR (-), n = 17) after surgery. Clinical indices were used to determine the extent of mandibular advancement, the presence of temporomandibular disorder (TMD), and relevant medical treatment histories (including the use of oral contraceptive (OC) medication. TMJ dysfunction was clinically evaluated in terms of pain, the presence of sounds (clicks or crepitus), and disc displacement, joint effusion (JE), and synovial hyperplasia (SH); these were further investigated with the aid of magnetic resonance imaging (MRI). The cephalographic findings were compared with the normal profiles of Japanese subjects. RESULTS: The mean (with SD) extent of mandibular advancement was 11.4 mm (2.4) in ACR (+) and 4.1 mm (1.8) in ACR (-). The TMD medical history of ACR (+) was much more extensive than that of ACR (-); all patients in ACR (+) had a history of OC use. More patients in ACR (+) than in ACR (-) had TMJ dysfunction and disc displacement, JE, and SH on MRI. Preoperative cephalograms showed that ACR (+) patients exhibited counterclockwise rotation of the mandible and retrognathism that was attributable to a small sella-nasion-B (SNB) angle, a wide mandibular plane angle, and a negative inclination of the ramus. CONCLUSIONS: The present findings suggest that the development of ACR after orthognathic surgery to treat mandibular retrognathism may be associated with coexisting TMJ pathologic abnormality.

Effects of porous-hydroxyapatite incorporated into glass-ionomer sealants.

The purpose of the present study was to evaluate the mechanical and chemical properties of a novel glass ionomer cement for use as a pit and fissure sealant containing a porous hydroxyapatite, namely, apatite ionomer cement (AIC). Control sealant samples were used Fuji III (GIC-S). The experiment sealant samples (AIC-S) consisted of porous spherical hydroxyapatite (HApS) particles added at 28 wt% to GIC-S powder. The GIC-S and AIC-S samples were evaluated through mechanical strength measurements, scanning electron microscopy observations, energy dispersive X-ray spectroscopy analysis, fluoride ion release tests, and antibacterial tests. The flexural strength of the AIC-S was significantly higher than that of GIC-S for each period, 1 h, 24 h and 1 year. The fluoride release dose for AIC-S was consistently higher than that for GIC-S. In addition, the antibacterial properties of AIC-S were superior to those of GIC-S. The novel AIC-S may be a more suitable sealant material for pits and fissures with intact and/or infected enamel.

Single-step simultaneous side-by-side placement of a self-expandable metallic stent with a 6-Fr delivery system for unresectable malignant hilar biliary obstruction: a feasibility study.

BACKGROUND: Bilateral self-expandable metallic stent (SEMS) placement for the management of unresectable malignant hilar biliary obstruction (UMHBO) is technically challenging to perform using the existing metallic stents with thick delivery systems. The recently developed 6-Fr delivery systems could facilitate a single-step simultaneous side-by-side placement through the accessory channel of the duodenoscope. The aim of this study was to evaluate the feasibility of this procedure. METHODS: Between May and September 2013, 13 consecutive patients with UMHBO underwent a single-step simultaneous side-by-side placement of SEMS with the 6-Fr delivery system. The technical success rate, stent patency, and rate of complications were evaluated from the prospectively collected database. RESULTS: Technical success was achieved in 11 (84.6%, 95% confidence interval [CI]: 57.8-95.8) patients. The median procedure time was 25 min. Early and late complications were observed in 23% (one segmental cholangitis and two liver abscesses) and 15% (one segmental cholangitis and one cholecystitis) patients, respectively. Median dysfunction free patency was 263 days (95% CI: 37-263). Five patients (38%) experienced stent occlusion that was successfully managed by endoscopic stent placement. CONCLUSIONS: A single-step simultaneous side-by-side placement of SEMS with a 6-Fr delivery system was feasible for the management of UMHBO.

Hydroxyapatite particle characteristics influence the enhancement of the mechanical and chemical properties of conventional restorative glass ionomer cement.

The aims of this study were to improve the mechanical and chemical properties of conventional restorative glass ionomer cement (GIC) by adding hydroxyapatite (HAp) preparations with different characteristics, and to investigate the underlying reaction mechanisms. Fuji IX GP® was used as the control GIC. The experimental GICs consisted of four HAp-particles with different characteristics added at 8 mass% to Fuji IX-powder. All cements were prepared by mixing with Fuji IX-liquid (P/L=3.6). Four HAp-particles were analyzed, and then the mechanical strengths and the fluoride-ion- release-recharge-behaviors of five GIC groups were evaluated. The results of this study demonstrate that the addition of HAp particles with highly reactive properties such as high specific surface area can enhance the flexural strength and fluoride ion release properties of conventional restorative GIC. Our results further indicate that HAp functions as an adsorbent and an ion exchangeable agent, resulting in improved mechanical and chemical properties of GIC.

Surface morphological changes in monolayers of aromatic polyamides containing various N-alkyl side chains.

We synthesized new aromatic polyamides (poly-(N-alkylated benzamides), abbrev. PABA(n)) having both a rigid main chain and a flexible side chain with different lengths. We investigated the solid-state structures, that is, the molecular orientation and surface morphology, of organized molecular films of PABA(n) by performing surface pressure-area (pi-A) isotherm, in-plane and out-of plane X-ray diffraction (XRD), polarized infrared spectroscopy, and atomic force microscopy (AFM) measurements. The solid-state structure of poly-(N-methyl benzamide) (PABA(1)) belonged to the monoclinic system, whereas PABA(3), PABA(4), and PABA(5) showed an orthorhombic packing pattern. PABA(7) and PABA(8) formed amorphous polymers. In the case of PABA(17), a two-dimensional hexagonal lattice was formed as a subcell consisting of side chains. These polymer monolayers were highly condensed on a water surface at 15 degrees C. Out-of-plane XRD measurement results showed that the PABA(1), PABA(3), PABA(4), and PABA(5) multilayers showed large periodicities of 50-60 A. From AFM observation results, it was found that these aromatic polyamides formed single particle layers of hydrophilic groups localized at the bottom of the particles. On the other hand, PABA(7) and PABA(8) monolayers showed irregularity and exhibited shapeless morphologies. In addition, an organized molecular film of PABA(17) formed a highly ordered layer structure (periodicity of 30 A) and a giant circular domain (diameter of 20 nm) made of a side chain crystal. The PABA(17) monolayer showed a hexagonal packing pattern formed due to van der Waals interaction between the flexible side chains. From these experimental findings, it was concluded that the polymer synthesis method employed in the present study can be directly used to control the crystal structure (the third order structure of polymers), molecular arrangement, and surface morphologies of polymer monolayers.