The oral health of adults with learning disabilities: A secondary analysis of the Adult Dental Health Survey 2009.

OBJECTIVES: Adults who have learning disabilities are a vulnerable group, little is known about their oral health and how this affects their quality of life. The aims of this secondary analysis of data from the 2009 Adult Dental Health Survey (ADHS) were to describe the oral health status of adults with learning disabilities, determine if severity of learning disability is associated with oral health and identify some of the methodological complexities of working with this population. The survey yields the most recent representative data on the oral health of adults with learning disabilities in England and importantly, contains information about oral health related quality of life (OHRQoL). BASIC RESEARCH DESIGN: Secondary analysis of data from a supplemental survey of adults with learning disabilities collected alongside the 2009 ADHS. PARTICIPANTS: 607 participants with a diagnosed learning disability aged 18 years and over. RESULTS: Adults with learning disabilities had similar levels of active dental caries, fewer natural teeth, and fewer fillings than comparable participants from the general population. Self-reported oral and general health were worse for adults with learning disabilities than the general population. Possible associations between the severity of learning disability and the numbers of decayed, missing or filled teeth were identified. However, large amounts of missing data limited the analysis. CONCLUSIONS: There are important questions relating to the accessibility of existing self-reported oral health questionnaires and the reliability of proxy-reported questions about OHRQoL that should be addressed to give a fuller picture of the oral health of adults with learning disabilities.

Dentition of Chilean paleo-Indians and peopling of the Americas.

Teeth of 12 cremated paleo-Indians (11,000 years old) from caves in southern Chile have crown and root morphology like that of recent American Indians and north Asians, but unlike that of Europeans. This finding supports the view that American Indians originated in northeast Asia. This dental series also suggests that paleo-Indians could easily have been ancestral to most living Indians, that very little dental evolution has occurred, and that the founding paleo-Indian population was small, genetically homogeneous, and arrived late in the Pleistocene.

The effect of an inhibitor of matrix metalloproteinases on colonic inflammation in a trinitrobenzenesulphonic acid rat model of inflammatory bowel disease.

BACKGROUND: Recent publications have reported that matrix metalloproteinases (MMPs) are expressed in colonic tissue taken from ulcerative colitis and Crohn's disease patients. AIM: To evaluate the effects of a matrix metalloproteinase inhibitor, marimastat, on colonic inflammation in experimental colitis induced by trinitrobenzenesulphonic acid (TNBS)-ethanol in the rat. METHODS: Rats were dosed (by mouth) for 7 days (b.d.) with either sulphasalazine (50 mg/kg), marimastat (40 mg/kg) or vehicle. TNBS-ethanol was administered rectally on the 4th day of dosing. On the last day of dosing, colons were removed and assessed for inflammation using myeloperoxidase activity, production of soluble TNFalpha (tumour necrosis factor alpha), clinical score and histological assessment. In addition, the bioavailability and effect of marimastat on a range of MMPs were assessed in-vitro. RESULTS: In this study we have confirmed that marimastat is a broad spectrum MMPI with a bioavailability of 5%. TNBS rats dosed with sulphasalazine had a significantly lower (P < 0.05) myeloperoxidase activity, TNFalpha production and a markedly lower clinical score. Similarly, rats dosed with marimastat had a significantly lower (P < 0.05) myeloperoxidase activity and clinical score, but the TNFalpha production was not significantly reduced. CONCLUSIONS: Dosing rats with TNBS-induced colitis using sulphasalazine or marimastat produced a significant reduction in tissue injury and inflammation.

Effect of low-viscosity resins on the performance of dental adhesives.

PURPOSE: To determine whether the use of low-viscosity intermediate resins (LVR) reduces microleakage of dental adhesive systems. MATERIALS AND METHODS: Wedge-shaped Class V cavities were prepared in sound extracted molars. Occlusal margins were in enamel and gingival margins were in dentin/cementum. Five adhesive systems (All-Bond 2, Clearfil Liner Bond 2, OptiBond, Prime & Bond and Scotchbond Multi-Purpose) were applied to the preparations strictly according to manufacturers' directions on one side of the tooth and with the addition of LVR (OptiBond FL Adhesive or Protect Liner F) on the other. All cavities were restored with Z100 resin composite. Specimens were then stored in water at 37 degrees C for 24 hours, thermocycled 800x, stained with silver nitrate, sectioned, and evaluated for leakage. Marginal penetration of silver nitrate was scored on 0-3 scale. RESULTS: Statistical analysis (Kruskal-Wallis non-parametric ANOVA) revealed a significant difference (P < 0.0001) in leakage at dentin margins. Multiple pairwise comparisons of control groups revealed considerable overlapping between groups, but with a trend toward less leakage by OptiBond and Clearfil Liner Bond 2. Leakage of Scotchbond Multi-Purpose was significantly reduced when Protect Liner F was used.

Orthopaedics.

Orthopaedic surgery is a large and expanding speciality. There are approximately five million clinic attendances each year in this country and musculo-skeletal complaints are the commonest presentation in General Practice. This review examines three key areas within orthopaedics, fracture management, sports medicine and the new subspeciality of minimally invasive orthopaedics and highlights areas of recent advancement, significant research and ongoing debate.

Subtotal reconstruction of the hemimandible with an autogenous cancellous bone and marrow graft.

The use of an autogenous cancellous bone and marrow graft for subtotal reconstruction of the mandible is illustrated with a case report. The rationale of the treatment plan and the operative technique are discussed. Three years of postreconstruction follow-up examinations show good results with this technique.

Xylitol associated changes in amylase and protein content of monkey parotid saliva.

The purpose of this study was to examine amylase activity in the parotid saliva of monkeys fed a high sugar diet supplemented for 3-day periods with either sucrose or xylitol. All monkeys fed xylitol displayed a significant elevation of amylase activity and total protein content in their parotid saliva. The specific activity of amylase (units/mg protein) did not differ between the two diets. The possible importance of this observation to the purported cariostatic action of xylitol is discussed.

The purification and characterization of biological 6-sulphatoxymelatonin and comparison with synthetic 6-sulphatoxymelatonin.

We have purified the major metabolite of melatonin, 6-sulphatoxymelatonin, from urine and compared it to its synthetic counterpart. For preparation of the biological material, oral melatonin was administered to human volunteers and their urine extracted onto Amberlite XAD-2 resin to remove urea; the glucuronide metabolites of melatonin were removed by silica chromatography; and 6-sulphatoxymelatonin was separated from N-acetyl serotonin sulphate, the other sulphate metabolite of melatonin, by preparative thin-layer chromatography. Synthetic 6-sulphatoxymelatonin was produced by reacting 6-hydroxymelatonin with chlorosulphonic acid in dimethylformamide; the reaction mixture was purified on Florisil and preparative thin-layer chromatography was used to remove indolic by-products of the reaction. Elemental and X-ray microanalysis of the biological and synthetic products showed that classical methods used for their purification introduced inorganic impurities, such as silicon- and chlorine-containing compounds, which were not detectable by thin-layer chromatography, infrared spectroscopy, nuclear magnetic resonance spectroscopy, or gas chromatography-mass spectrometry. We introduced further purification steps to remove these inorganic impurities, monitoring the process using elemental and X-ray microanalysis. Extensive characterization of the resulting purified products showed that the biological and synthetic compounds were identical.