Effects of IL6 C-634G polymorphism on tooth loss and their interaction with smoking habits.

OBJECTIVE: To examine the association between an IL6 (Interleukin-6) polymorphism (C-634G or rs1800796) and tooth loss, and an interaction between the polymorphism and smoking habits for the loss. MATERIAL AND METHODS: Our subjects were 4917 check-up examinees ages 35-69. They reported tooth loss and lifestyle in a questionnaire. We regressed the number of teeth on the IL6 genotype, gender, age, smoking, drinking, diabetes, hypertension, physical activity, energy intake, education, and brushing. We further estimated multivariate-adjusted odds ratios (ORs) for having <20 teeth. RESULTS: Participants with a GG genotype tended to have less teeth than those with CC; ß = -0.798 (95% confidence interval [CI] = -1.501--0.096). Subjects with a GG genotype were more likely to have <20 teeth than those with CC; OR was 1.56 (95% CI = 1.08-2.25). Association between current smoking and tooth loss was stronger among those with GG than among those with CC. In a multiple regression analysis, a significant interaction was found between GG genotype and current smoking in the prediction of tooth loss (P = 0.018). CONCLUSION: The IL6 C-634G polymorphism was significantly associated with tooth loss. Our results suggest greater effects of smoking on tooth loss in GG genotype individuals.

Effectiveness of tobacco counseling training module (TCTM) in enhancing the knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling among undergraduate dental students - An interventional study.

BACKGROUND: Tobacco use has emerged as a major public health issue with increasing tobacco-related morbidity and mortality. Despite evidence that even brief tobacco counseling by health care professionals is effective in motivating a tobacco user to quit, there was a lack of customized tobacco counseling training module (TCTM) for students of dentistry in their existing curriculum. This study was undertaken to evaluate the effectiveness of a customized TCTM in improving KAASS in tobacco counseling among undergraduate dental students. METHODS: TCTM that was previously pilot tested was implemented as a value addition in Public Health Dentistry for two academic years. Changes in knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling were assessed before and after implementation of TCTM. Mean pre and post intervention scores were compared. RESULTS: Mean scores for knowledge, attitude, ability to identify oral manifestations, and self-confidence (KAAS) at baseline were 4.4 ± 0.9, 5.1 ± 0.7, 4.5 ± 1.1, and 1.3 ± 0.4, respectively. Mean KAAS scores post intervention were 13.5 ± 1.0, 8.7 ± 0.4, 9.4 ± 0.7, and 3.5 ± 0.5, respectively. There was a significant improvement in the mean KAAS score post intervention compared to baseline. Tobacco counseling skills also significantly improved among the participants following implementation of the training module (68.8%) did well compared to the baseline (0%). CONCLUSION: TCTM was effective in enhancing knowledge, attitude, ability to identify oral manifestations, and self-confidence in tobacco counseling among undergraduate dental students.

Enhancing identification and counseling skills of dental undergraduate students using a customized Tobacco Counseling Training Module (TCTM) - A piloting of the process using ADDIE framework.

BACKGROUND: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM). METHODS: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22. RESULTS: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills. CONCLUSION: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.

Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease.

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

Antimicrobial Efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum and Porphyromonas gingivalis.

BACKGROUND: The herbal extracts have been effectively tried in the treatment and prevention of many oral diseases. AIM: The aim is to assess the antimicrobial efficacy of Acacia nilotica, Murraya koenigii L. Sprengel, Eucalyptus hybrid, Psidium guajava extracts and their combinations on Fusobacterium nucleatum (Fn) and Porphyromonas gingivalis (Pg). MATERIALS AND METHODS: The extraction process was carried out by Soxhlet apparatus using ethanol as solvent. The combinations of the four plant extracts were prepared by combining an equal quantity of 10% solution of each of the four plant extracts. The antimicrobial efficacy testing of the plant extracts and their combinations on Fn and Pg was performed using agar well diffusion method. Columbia 5% of sheep blood agar plates were used for antimicrobial efficacy testing under anaerobic conditions. The qualitative assay was carried out to identify the various phytochemical constituents. Dimethyl sulfoxide and 0.2% chlorhexidine acted as negative and positive controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. RESULTS: All the individual plant extracts and their double, triple, and quadruple combinations were effective in inhibiting the growth of these bacteria. However, 0.2% chlorhexidine produced the highest mean diameter of inhibition zone. CONCLUSION: The plant extracts in combinations offer enhanced antimicrobial efficacy due to their synergistic action besides slowing the development of bacterial resistance. Hence, these extracts in combinations could be used tried as effective alternates to chlorhexidine.

Antimicrobial efficacy of the combinations of Acacia nilotica,Murrayakoenigii (Linn.) Sprengel, Eucalyptus, and Psidiumguajava on primary plaque colonizers: An in vitro study.

BACKGROUND: The rise in disease incidence, increased resistance of pathogenic bacteria to currently used antibiotics and chemotherapeutics, opportunistic infections in immunocompromised individuals, and financial considerations in developing countries necessitates alternate preventive and treatment strategies for oral diseases. OBJECTIVE: The objective of the study is to assess the antimicrobial efficacy of triple and quadruple combinations of Acacia nilotica (AN), Murraya koenigii (Linn.) (MKL) Sprengel, Eucalyptus (Euca), and Psidium guajava (PS) on primary plaque colonizers. MATERIALS AND METHODS: The phytochemicals in four plants were extracted using Soxhlet apparatus. The dried extracts were diluted with dimethyl sulfoxide (DMSO) to prepare stock solutions (100 mg/ml) of each plant. The triple and quadruple combinations were prepared after mixing equal quantities of stock solutions from each plant extracts. The antimicrobial efficacy testing was done on Streptococcus mutans, Streptococcus sanguis, and Streptococcus salivarius using agar well diffusion method. Chlorhexidine of 0.2% composition and DMSO were used as positive and negative controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. RESULTS: The combination of AN + MKL Sprengel + Euca + PS produced the highest mean diameter of inhibition zone (23.5 ± 2.17 mm) against S. mutans. The combination of AN + MKL Sprengel + Euca produced the maximum antimicrobial efficacy against S. sanguis (19.83 ± 1.33). CONCLUSION: All the triple and quadruple combinations of the plant extracts offered antimicrobial benefits either superior or comparable to 0.2% chlorhexidine against S. mutans, S. sanguis, and S. salivarius.

The spectrum of radiographic findings in primary hyperparathyroidism.

The aim of this study was to assess the spectrum of radiographic findings in primary hyperparathyroidism (PHPT). The study group consisted of 16 women and 7 men whose Ca levels were at least two or three times higher than normal. The average age was 55.3 in women and 49.4 in men. We detected carcinoma in 1, hyperplasia in 1, multiple adenomas in 4, single adenoma in 17 patients. The most common finding in the skeletal system was the decreased bone mineral density (BMD) and the complete loss of the lamina durae dentium. BMD was found lower in women than in men. This result attributed the increased number of postmenopausal patients in our study group. The second most common finding in our study group was subperiosteal bone resorption. Brown tumors (BTs) were located at maxilla in one, widespread in one, mandibula in two, long tubular bones in four patients. Renal stone disease was found in five, spastic colon in two, gastric ulcer in one, mitral valve calcification in one patients. We demonstrated no pathologic changes consistent with PHPT in remaining seven patients.

Temporomandibular disorders and functional somatic syndromes: deliberations for the dentist.

Temporomandibular disorder (TMD) is an umbrella term for a collection of disorders affecting the temporomandibular joint (TMJ) and associated tissues. TMD is not a rare pathology for the dentist. The most common presenting symptom is pain, which causes the patient seek immediate treatment. Management is dictated by the cause. The most 'famed' causes include trauma, inflammation, aging, parafunctional habits, infections, neoplasms, and stress; and these are always considered in the differential diagnosis of TMJ pain. There are some less 'famed' causes of TMD, which are characterized by increased pain sensitivity due to psychosocial factors; these include myofascial pain syndrome and functional somatic syndromes (FSS) such as fibromyalgia and chronic fatigue syndrome. They present with chronic pain, fatigue, disability, and impairment in ability to perform daily activities. A non-systematic search in the English literature revealed numerous studies describing the occurrence of TMD in these conditions, along with few other oral manifestations. TMD has been even considered to be a part of the FSS by some. In these patients, TMD remains a recurring problem, and adequate management cannot be achieved by traditional treatment protocols. Awareness of these conditions, with correct diagnosis and modification of management protocols accordingly, may resolve this problem.

The effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface.

BACKGROUND: Bonding brackets to fluorosed enamel remains a clinical challenge and bracket failure at the compromised enamel interface is common. OBJECTIVE: To check the effect of air abrasion on the retention of metallic brackets bonded to fluorosed enamel surface. MATERIALS AND METHODS: Sixty freshly extracted human premolar teeth having moderate to severe dental fluorosis as per Dean's criteria were collected and divided into three groups of 20 each. The groups were treated as follows: In group I, acid etching was followed by bonding with Transbond XT ; in group II, sandblasting and acid etching was followed by bonding with Transbond XT ; and in group III, sandblasting and acid etching was followed by bonding with Enlight LC . An Instron universal testing machine was used for determining the debonding force, and from this the shear bond strength was computed. The sample with highest shear bond strength from each group was selected for the scanning electron microscopy (SEM) study. The prepared specimens were examined under a JSM-840A scanning electron microscope (JEOL Ltd, Tokyo, Japan) operated at 20 kV. Photographs were taken at progressively higher magnifications of ×50, ×100, ×500, and ×1000 to view the enamel surface and the adhesive remaining on the enamel surface after debonding. The shear bond strengths of the groups were compared using the one-way ANOVA (analysis of variance) and Tukey post hoc test. The distribution of adhesive remnant index (ARI) score was compared using the Chi-square test. RESULTS: The mean shear bond strength in group I was 10.36 MPa, with a standard deviation of 0.225. The corresponding values in group II and group III were 11.41 ± 0.237 MPa and 11.39 ± 0.201 Mpa, respectively. There was a statistically significant difference between the three groups in the mean shear bond strength values. CONCLUSION: Sandblasting followed by acid etching provides significantly higher bond strength values compared to acid etching alone, irrespective of the bonding material employed.