Evaluation of interleukin-1 beta and the ratio of interleukin-1 beta to interleukin-1 receptor antagonist in gingival crevicular fluid during orthodontic canine retraction.

BACKGROUND: Orthodontic tooth movement (OTM) is a complex phenomenon mediated by cytokines, of which interleukin-1 beta (IL­1ß) is potently involved in the remodeling of the periodontal ligament (PDL) and bone. Whether the pattern of IL­1ß release differs at the sides of tension and compression is not yet clarified. OBJECTIVES: The aim of the present study was to evaluate the level of IL­1ß and the ratio of IL­1ß to interleukin-1 receptor antagonist (IL­1RA) in gingival crevicular fluid (GCF) at the tension and compression sides during orthodontic canine retraction. MATERIAL AND METHODS: Seventeen patients scheduled for orthodontic treatment with bilateral extraction of maxillary first premolars and canine retraction were enrolled. Tooth 2.3 was retracted, teeth 1.3 and 3.3 served as controls. Gingival crevicular fluid samples were collected from the tension and compression sides of each tooth at baseline (before the 1st activation - day 0) and at days 2 and 7, and then again before the 2nd activation (day 28) and at days 30 and 35. The levels of IL­1ß and IL­RA were evaluated with the enzyme-linked immunosorbent assay (ELISA). RESULTS: After the 1st activation, a statistically significant increase in the level of IL­1ß was observed at teeth 2.3 (p < 0.03 mesially and p < 0.05 distally) and 1.3 (p < 0.05 mesially and distally), both at the tension and compression sides. The 2nd activation resulted in a gradual increase in the IL­1ß level at both canines; however, statistical significance was reached only for tooth 2.3 (p < 0.05 mesially and p < 0.02 distally). In terms of the IL­1ß/IL­1RA ratio, a significant increase was observed only at the compression side of the experimental tooth (p < 0.01). CONCLUSIONS: An increase in the IL­1ß level in GCF was observed both at the tension and compression sides of the actively retracted canine 2.3 as well as the contralateral canine 1.3; a significant rise in the IL­1ß/IL­1RA ratio was noted only at the compression side of the experimental tooth 2.3, indicating the zone of active bone resorption.

Candida prevalence and oral hygiene due to orthodontic therapy with conventional brackets.

BACKGROUND: Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assess Candida prevalence and the role of oral hygiene during fixed appliance therapy. A further aim was to characterize the isolated yeasts according to their ability to form biofilms. METHODS: Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated. RESULTS: One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) were Candida-carriers (two were colonized after bracket placement) and C. albicans was the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967, p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in the Candida-carriers (adj. R2 = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R2 = 0.92; p = 0.0256). CONCLUSIONS: Treatment with orthodontic appliances promotes Candida yeast colonization, which is variable over time in terms of strain and species, with dominance of C. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.

Knowledge on the guideline-recommended use of antiplatelet and anticoagulant therapy during dental extractions: a contemporary survey among Polish dentists.

BACKGROUND: The number of dental patients requiring periodic or lifelong antiplatelet or anticoagulanttherapy is constantly growing. AIMS: We aimed to determine the level of knowledge on antiplatelet and anticoagulant therapy among Polish dentists. METHODS: self­designed online questionnaire was distributed among dentists to evaluate their knowledge on the use of antiplatelet and anticoagulant drugs in clinical dental practice. RESULTS: The study included 352 dentists. Patients requiring vitamin K antagonists were referred for a cardiac consultation by 64.52%, 57.29%, and 58.55% of dentists with <5, 5-15, and >15 years of experience,respectively (P = 0.003). A similar trend was observed for non-vitamin K antagonist oral anticoagulants among nonsurgical dentists. However, an equal percentage of surgical dentists (39.7%) performedextraction with and without consultation, and they were more likely to perform extraction withoutconsultation than nonsurgical dentists (39.7% vs 27.8%; P = 0.01). Most surgical and nonsurgical dentistspreferred to consult a cardiologist about dual antiplatelet therapy before an invasive procedure (56.9%and 73.81%, respectively; P = 0.03). Extractions in patients on aspirin were accepted by 75.81%, 70.83%, and 49.34% of dentists with <5, 5-15, and >15 years of experience, respectively (P = 0.004), and by 79.31%of surgical and 57.14% of nonsurgical dentists (P = 0.003). CONCLUSIONS: Knowledge on antiplatelet and anticoagulant therapy in patients undergoing dental procedures is unsatisfactory among Polish dentists. Both therapies were discontinued before extractionsmore frequently than recommended in the guidelines, while extractions in patients on aspirin were common.

Evaluation of the psychoemotional status of young adults with symptoms of temporomandibular disorders.

BACKGROUND AND PURPOSE: Temporomandibular disorders (TMD) are among the most frequent pathologies of the stomatognathic system. One problem often associated with TMD is the psychoemotional status. The aim of study was to evaluate the psychoemotional status of young adults with pain symptoms associated with TMD. MATERIAL AND METHODS: We analyzed the data of 260 volunteers. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) form was used to diagnose TMD. The relationships between TMD/RDC clinical diagnoses and psychoemotional status, as described by the Beck's Depression Inventory (BDI) and Perceived Stress Scale (PSS-10), were analyzed. We divide the group into four on the basis of RDC/TMD Axis I diagnosis. Group 0 included 30 students lacking TMD symptoms. Group I consisted of 30 people with myofascial pain (group IA in RDC/TMD). Group II contained 23 people with disk displacement with reduction (group IIA in RDC/TMD). Group III contained ten people (Group III diagnosis, often associated with pain). RESULTS: We did not find statistically significant differences between the study groups. In subjects with pain (Groups I and III), we found the mean value on the BDI and PSS-10 scales to be higher than among the pain-free subjects (Groups 0 and II). CONCLUSION: In young adults with TMD accompanied by pain, psychoemotional status should also be evaluated.

Prevention of infective endocarditis during dental extractions among Polish dentists - a contemporary nationwide survey.

INTRODUCTION: Infective endocarditis (IE) is a potentially life-threatening condition. According to current ESC (European Society of Cardiology) guidelines, the use of antibiotic prophylaxis should only be reserved for specific dental procedures with interruption of consistency of the oral mucosa such as extractions and should be reserved for patients with the highest risk of developing IE. The aim of this study was to assess the knowledge of need for IE prophylaxis in de ned clinical settings among Polish dentists. MATERIAL AND METHODS: A specially self-designed internet questionnaire was created concerning the topic of infective endocarditis prophylaxis in specific clinical scenarios for patients undergoing dental extractions during outpatient visits. The survey was made available to the dentists via internet and was active in March 2018. RESULTS: there were 352 Polish dentists who completed the survey. Antibiotic prophylaxis for IE during dental extractions was used in 93% of cases with prior IE, 89% with artificial heart valve, 69% with biological valve, 28% with pacemaker, 54% with coronary stent, 73% with cyanotic heart defect, 58% with diabetes mellitus, 20% after prior myocardial infarction and 54% with heart valve disease. There was a significant relationship between the time of working as a physician (>15 years) and more outdated or improper IE prophylaxis (p = 0.04). CONCLUSIONS: the management of patients for infective endocarditis prophylaxis undergoing dental extractions is suboptimal. Antibiotic therapy is overused in some clinical scenarios and on the other hand underutilized in those recommended by the current ESC guidelines.

Coexistence of tooth agenesis and ovarian cancer - a systematic literature review.

OBJECTIVES: Dental agenesis - a congenital lack of teeth - is one of the most frequently diagnosed developmental defects of dentition. Genetics is a crucial factor in the etiology of this disorder. Missing teeth can be caused by mutation in genes including MSX1, PAX9, AXIN2, and EDARADD. As is also true for ovarian cancer, over 20% of cases are associated with hereditary factors. Mutations in the BRCA1 and BRCA2 genes are said to be the most frequent of these. The aim of this study was to provide a systematic review of the literature on the coexistence of ovarian cancer and tooth agenesis. MATERIAL AND METHODS: Publications were searched for in the online databases PubMed, SCOPUS, and Wiley Online Library. Current and archival issues of the Journal of Stomatology and Dental and Medical Problems were also searched. The key words used to find relevant publications were: ovarian cancer, hypodontia, and tooth agenesis, in various combinations. RESULTS: Three publications were qualified to this review. Two of these compared the incidence of hypodontia in women with ovarian cancer and in healthy women, and the other was aimed at locating the gene responsible for the coexistence of ovarian cancer and tooth agenesis. As shown by these studies, women with ovarian cancer are (depending on the study) 3.3 or 8.1 times more likely to have hypodontia than healthy women. However, no specific gene was found that might be responsible for the coexistence of ovarian cancer and tooth agenesis.

Frequency of temporomandibular disorders diagnoses based on RDC/TMD in a Polish patient population.

OBJECTIVE: To assess the frequency and age distribution of Axis I and Axis II diagnoses among Polish patients with temporomandibular disorders (TMD). METHOD: One hundred sixty-three (n = 163) consecutive adult patients seeking TMD treatment were assessed based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines. Descriptive statistics on the frequency of diagnoses and mean age of the diagnostic groups was performed. RESULT: Frequency of muscle disorders, disc displacements, and other joint disorders was 56.9, 48.9, and 31%, respectively. Disc displacement was the most common diagnosis in younger patients. Severe somatization and depression were shown in 11.9 and 15.8% of patients, respectively. Only 10.5% of the patients showed severe pain-related impairment. Females tended to have higher psychosocial scores than males. DISCUSSION: The frequency of Axis I TMD diagnoses in Polish patients is similar to other populations, whereas Axis II findings slightly differ from previous reports from other countries.

Do Dietary Habits Influence Trace Elements Release from Fixed Orthodontic Appliances?

The objective was to investigate the effect of dietary habits on the release of Cr and Ni ions from orthodontic appliances by hair mineral analysis. Patients (N = 47) underwent electronic questionnaire survey to investigate the effect of dietary habits on Cr and Ni levels in hair. The research was carried out on hair sampled at the beginning and in the 4th, 8th, and 12th months of the treatment. The content of Cr and Ni in the collected samples was determined by ICP-OES. The study showed that consumption of acidic dietary products may have the effect on increasing the release of Cr and Ni ions from orthodontic appliances. The release of Cr from orthodontic appliances in patients who consumed fruit juice, coffee, yoghurt, and vinegar was higher. The coefficients enabling comparison of metal ions release pattern at a given sampling points were defined. The comparison of the coefficients yielded the information on the possible magnification of metal ions released as the result of the additional factor consumption of acidic food or drink that intensifies metal ions release. The following magnification pattern was found for chromium: coffee (7.57 times) > yoghurt (2.53) > juice (1.86) > vinegar (1.08), and for nickel: vinegar (2.2) > coffee (1.22) > juice (1.05). Yoghurt did not intensify the release of nickel. Concluding, orthodontic patients should avoid drinking/eating coffee, yoghurt, fruit juices, and vinegar.

Correlation between age and gender in Candida species infections of complete denture wearers: a retrospective analysis.

AIM: Denture-related stomatitis is a disorder that often affects denture wearers. The purpose of this study was to evaluate the intensity, genera, and frequency of yeasts in the oral cavity of complete denture wearers in terms of subject gender and age. MATERIALS AND METHODS: Nine hundred twenty patients (307 males and 613 females) with complete upper dentures were selected for the study and divided into four age groups: ≤50 years, 51-60, 61-70, and >70 years. Yeast samples were taken as a smear from the palate. The data were collected from January 15, 2007 to January 15, 2012. RESULTS: The distribution of the number of yeast colonies by gender was statistically significant (P=0.02). Across all subjects, there was a statistically significant relationship between the intensity of yeast growth and the gender (P=0.01). In every age group, the number of infection-free individuals was greater among males than females. Intermediate, intense, and abundant growth of yeast occurred most frequently in the youngest group of females. CONCLUSION: The genera of Candida species and the frequency of yeast infection in denture wearers appear to be influenced by both age and gender. The complete denture wearers ≤50 years of age appeared to have the greatest proclivity to oral Candida infections.

Quantitation of condylar position in temporomandibular joint. A methodological study.

Ten CBCT scans of asymptomatic patients were evaluated on sagittal slices to obtain condylar position in temporomandibular joint. Measurements focused on antero-posterior and superior-inferior position of the condyle. The study the study was performed to investigate reproducibility of the method described before using Dahlberg formula. The method seems to be fair reproducible.

Do soft drinks affect metal ions release from orthodontic appliances?

OBJECTIVE: The effect of orange juice and Coca Cola(®) on the release of metal ions from fixed orthodontic appliances. MATERIALS AND METHODS: A continuous flow system designed for in vitro testing of orthodontic appliances was used. Orange juice/Coca Cola(®) was flowing through the system alternately with artificial saliva for 5.5 and 18.5h, respectively. The collected samples underwent a multielemental ICP-OES analysis in order to determine the metal ions release pattern in time. RESULTS: The total mass of ions released from the appliance into orange juice and Coca Cola(®) (respectively) during the experiment was calculated (µg): Ni (15.33; 37.75), Cr (3.604; 1.052), Fe (48.42; ≥ 156.1), Cu (57.87, 32.91), Mn (9.164; 41.16), Mo (9.999; 30.12), and Cd (0.5967; 2.173). CONCLUSIONS: It was found that orange juice did not intensify the release of metal ions from orthodontic appliances, whereas Coca Cola(®) caused increased release of Ni ions.

The Polish face in profile: a cephalometric baseline study.

BACKGROUND: This study reports the cephalometric evaluation of a group of adolescent Polish individuals describing dento-facial structure as well as details of incisor position and soft tissue characteristics. The results should reveal morphological features specific to Polish persons and serve as a comparative material for future diagnostic procedures. METHODS: The study was based on an analysis of cephalgrams of 122 Polish adolescents average age 18 years 6 months analysed in a computer system using the Kracovia composite system analysis describing dento-facial morphology ad modum Björk as well as soft tissue factors. The control material was based on published reports by Björk (Dento-facial characteristics) Riketts and Holdaway (soft tissue profile). RESULTS: The comparative study revealed a slight reduction in the sagittal jaw relationship with a significant reduction in the vertical jaw relationship and a distinctive mandibular morphology with a reduced jaw angle and an increase in the "Beta angle". These findings were reflected in the soft tissue pattern. The soft tissue profile reflected the skeletal cephalometrics observation. CONCLUSION: The dento-facial profile of Polish adolescents demonstrates specific characteristics which should be taken into account when diagnosing facial form in connection with orthodontic treatment planning in particular Polish patients.

Metal ions released from fixed orthodontic appliance affect hair mineral content.

The objective was to evaluate metal ion accumulation in hair of patients undergoing orthodontic treatment with fixed appliances in time. The patients (N = 47) participated in a questionnaire survey. Hair sampling was performed at the beginning and in the 4th, 8th, and 12th month of the treatment. The content of metals (Cr, Ni, Fe) in hair was analyzed by ICP-OES equipped with USN nebulizer. The peak release of Cr and Fe occurred after 4 months of the treatment, and the peak release of Ni gradually increased throughout the whole year of the therapy. During 1 year treatment, an average accumulation of metals in hair tissue was 7.42 ± 14.19 µg of Ni, 8.94 ± 13.1 µg of Cr, and 131 ± 279 µg of Fe. The mean content of Cr was higher than the 90th percentile value for this element. The upper limit of literature reference ranges for Cr, Ni, and Fe in hair was not exceeded. The value of exposure (kinetics and dose) of orthodontic patients to metal ions released from orthodontic appliances can be assessed by hair mineral analysis. The content of Cr was statistically significantly higher during the treatment than before the beginning of therapy.

The prevalence of abnormal echocardiographic findings in a sample of urban adult population.

BACKGROUND: Echocardiography has emerged as the test of choice for the evaluation of cardiac diseases. AIM: To assess the prevalence of a spectrum of cardiac abnormalities detected by echocardiography in a representative sample of an urban adult population. METHODS: Transthoracic echocardiography was performed in a random sample of 511 men (47%) and women (53%) aged 48-76 years selected from population registers in Krakow. Body surface area (BSA) was used to adjust echocardiographic parameters for variations in body size. Disease history and cardiovascular risk factors were assessed in all patients. RESULTS: Men smoked more frequently than women and had higher blood pressure and triglycerides and lower high density lipoprotein cholesterol. The most common finding was increased left ventricular (LV) end-diastolic diameter (EDd) (37%), followed by mitral (32%), aortic (24%), or tricuspid (17%) regurgitations, LV posterior wall (24.1%) and interventricular septum (17.5%) thickening, increased indexed LVEDd (23%), increased left atrial diameter (LAd; 15.7%), reduced LV ejection fraction (LVEF; 15.3%), segmental wall motion abnormalities (13.9%), increased indexed LAd (8.8%), dilation of the ascending aorta (8%), enlargement of the right ventricle (RV) (2%) and elevation of RV systolic pressure (0.6%). When adjusted for main cardiovascular risk factors and the presence of coronary artery disease, male sex was associated with a higher prevalence of enlargement of LV (LVEDd/BSA): OR = 1.8 (1.1-2.9), dilation of ascending aorta (aortic diameter/BSA): OR = 2.7 (1.3-5.8), and LA (LA/BSA) = OR 2.7 (1.3-5.6), as well as a decrease of LVEF: OR = 3.6 (1.9-6.5). CONCLUSIONS: Approximately a quarter of urban adults aged 48 to 76 can be expected to have some abnormalities on echocardiographic examination. Some of these abnormalities such as aortic dilation, LA enlargement, LV enlargement and decreased LVEF are more frequently found in males than in females, even after adjustment for BSA, main cardiovascular disease risk factors, and the presence of coronary artery disease. The use of raw instead of indexed LAd and LVEDd over estimates the prevalence of LA and LV enlargement.

Relationship between occlusal force distribution and the activity of masseter and anterior temporalis muscles in asymptomatic young adults.

UNLABELLED: Healthy subjects have a prevalent side on which they display higher-muscle activity during clenching. The relationship between symmetry of masseter muscle (MM) and anterior temporalis (TA) muscle activities and occlusion has been evaluated on the basis of physiological parameters. The aim of the present study was to investigate whether the symmetry of surface EMG (sEMG) activity in asymptomatic young adults is related to symmetry of occlusal contacts. MATERIAL: The study population consisted of seventy-two 18-year-old subjects with no temporomandibular disorder (TMD) symptoms. METHOD: All the participants underwent an sEMG recording with an 8-channel electromyograph (BioEMG III). A T-Scan III evolution 7.01 device was used to analyze the occlusal contact points. RESULTS: The correlation between the activity of right (R) and left (L) TA and the percentage of occlusal contacts was assessed, but no significant differences were found between the RMM and LMM muscles. The differences in the medium values of sEMG between males and females were not statistically significant. Equilibrated muscular activity between RTA and LTA occurred when occlusal contacts reached the percentage of 65% on the left side. CONCLUSION: The symmetry of sEMG activity in asymptomatic young adults is not related to symmetry of occlusal contacts.

Mycological analysis of the oral cavity of patients using acrylic removable dentures.

Background. The problems of fungal infections in edentulous have been discussed in literature. Findings show that oral mycosis has an influence on the mycosis of oesophageal mucosa. Based on this we started to follow from 2007 in patients who wear dentures mycological examination, to evaluate changes of yeasts numbers, the sensitivity to antibiotics and determine the impact of types of prosthesis, time of using, gender and age of patients. 1230 patients who were wearing dentures participated in the retrospective study. The material for mycological examination was sampled as a smear from the palate. After the mycological identification of Candida species and assessment of growth, the susceptibility testing with Fluconazole and Nystatin was made. The number of 23 Candida species was diagnosed microbiologically in five years. C. albicans and C. glabrata were increasing in number-from 33,7% to 46,9% and 6,7% to 14,0%, respectively. There was a significant statistical difference between yeasts growth and gender (P = 0, 017 < 0.05). The conclusion is that a large percentage of persons wearing removable denture has been affected by Candida species and that could lead to the mycosis of farther gastrointestinal tract sections. The mycological examination before treatment, especially in patients using acrylic denture, appears to be necessary.

Knowledge of a patient-dependant phase of acute myocardial infarction in Polish adults: the role of physician's advice.

BACKGROUND: Effective management of acute myocardial infarction (AMI) is limited by patient delay in calling an ambulance. We aimed to assess knowledge related to a patient-dependant phase of AMI and its determinants in adults. METHODS: Questionnaire survey was conducted among a random sample of 942 men (48%) and women (52%) aged 63.50 ± 6.50 selected from population registers in Cracow (Poland). Questions from the Behavioral Risk Factor Surveillance System were used to assess knowledge of AMI symptoms. The respondents were further asked about the first thing they would do in response to AMI symptoms, the emergency phone number and whether a doctor advised them about AMI. RESULTS: All suggested AMI symptoms were recognized by 51 (5.4%) respondents. More persons would call an ambulance in response to AMI symptoms in another person than if they appear in themselves (87.4% vs. 74.4%, P = 0.02). Only 644 (68%) participants knew the emergency phone number and 104 (11%) were advised about AMI by their doctors. Such advice was associated with higher rates of knowledge of AMI symptoms and the emergency phone number but not with a declaration of the appropriate reaction to AMI symptoms. Participants after AMI did not represent better knowledge of a patient-dependant phase of AMI but paradoxically less frequently than other persons declared calling an ambulance in response to AMI symptoms. CONCLUSION: Improvement in knowledge and attitudes related to a patient-dependant phase of AMI is needed in adults even if they experienced AMI before. A routine advice from a doctor may contribute significantly to this improvement.

Periodontitis affects neurological deficit in acute stroke.

BACKGROUND AND PURPOSE: Periodontitis is an independent risk factor for ischaemic stroke, but its influence on stroke severity has not been investigated yet. We studied the association of advanced periodontitis or edentulousness with neurological deficit on admission and short-term outcome of stroke patients. METHODS: The study included 169 patients with ischaemic stroke. The neurological deficit on admission was evaluated using the NIH stroke scale (NIHSS). The outcome at discharge was assessed using the modified Rankin scale (mRS) and the Barthel Index (BI). The clinical attachement level (CAL), the distance between cemento-enamel junction and the probed base of periodontal pocket, was recorded for each tooth at six sites. Advanced periodontitis was defined as CAL≥6mm in at least one measured site. RESULTS: Patients with advanced periodontitis or edentulousness were older than those with no or mild periodontitis (71.4years vs. 60.1; p<0.001), had greater neurological deficit on admission (8.9 vs. 5.7; p=0.01) and worse outcome at hospital discharge measured in the mRS (2.2 vs. 1.4; p=0.009). The presence of advanced periodontitis or edentulousness was independent risk factor for greater NIHSS on admission (p=0.025), after adjusting for age, gender and the studied risk factors. The logistic regression model, however, showed that stroke severity on admission but not advanced periodontitis or edentulousness, affected the outcome of stroke patients. CONCLUSIONS: Advanced periodontitis or edentulousness in patients with ischaemic stroke is associated with greater neurological deficit on admission.