Primary apical periodontitis correlates to elevated levels of interleukin-8 in a Swedish population: A report from the PAROKRANK study.

AIM: To explore associations between root filled teeth, primary and secondary apical periodontitis, and levels of inflammatory markers in blood from patients with a first myocardial infarction and matched controls. METHODOLOGY: Between May 2010 and February 2014, 805 patients with a first myocardial infarction and 805 controls, matched for sex, age, and postal code area, were recruited to the multicentre case-control study PAROKRANK (periodontitis and its relation to coronary artery disease). All participants underwent a physical and oral examination, as well as blood sampling. Using panoramic radiography, root filled teeth, primary apical periodontitis, and secondary apical periodontitis were assessed by three independent observers. Blood samples were analysed with enzyme-linked immunosorbent assay method for the following inflammatory markers: interleukin-1ß (IL-1ß), IL-2, IL-6, IL-8, IL-12p70, tumour necrosis factor-α, and high-sensitivity C-reactive protein (hsCRP). Additionally, white blood cell count and plasma-fibrinogen were analysed. Associations between endodontic variables and the levels of inflammatory markers were statistically analysed with Mann-Whitney U-test and Spearman correlation, adjusted for confounding effects of baseline factors (sex, age, myocardial infarction, current smoking, diabetes, family history of cardiovascular disease, education, marital status, and periodontal disease). RESULTS: Mean age of the cohort was 62 years, and 81% were males. Root fillings were present in 8.4% of the 39 978 examined teeth and were associated with higher levels of hsCRP, fibrinogen, and leukocyte count, but lower levels of IL-2 and IL-12p70. After adjusting for confounders, root filled teeth remained associated with higher levels of fibrinogen, but lower levels of IL-1ß, IL-2, IL-6, and IL-12p70. Primary apical periodontitis was found in 1.2% of non-root filled teeth and associated with higher levels of IL-8 (correlation 0.06, p = .025). Secondary apical periodontitis was found in 29.6% of root filled teeth but did not relate to the levels of any of the inflammatory markers. CONCLUSIONS: This study supports the notion that inflammation at the periapex is more than a local process and that systemic influences cannot be disregarded. Whether the observed alterations in plasma levels of inflammatory markers have any dismal effects on systemic health is presently unknown but, considering the present results, in demand of further investigation.

Is cone-beam computed tomography (CBCT) an alternative to plain radiography in assessments of dental disease? A study of method agreement in a medically compromised patient population.

OBJECTIVES: Poor oral health and dental infections can jeopardize medical treatment and be life-threatening. Due to this, patients with head and neck malignancies, generalized tumor spread, organ transplant, or severe infection are referred for a clinical oral and radiographic examination. The aim of this study was to compare the diagnostic agreement of three radiographic modalities: intraoral radiographs (IO), panoramic radiographs (PX), and cone beam computed tomography (CBCT) for diagnosis of dental diseases. MATERIALS AND METHODS: Three hundred patients were examined with IO, PX, and CBCT. Periapical lesions, marginal bone level, and caries lesions were diagnosed separately by four oral radiologists. All observers also assessed six teeth in 30 randomly selected patients at two different occasions. Kappa values and percent agreement were calculated. RESULTS: The highest Kappa value and percent agreement were for diagnosing periapical lesions (0.76, 97.7%), and for the assessment of marginal bone level, it varied between 0.58 and 0.60 (87.8-89.3%). In CBCT, only 44.4% of all teeth were assessable for caries (Kappa 0.68, 93.4%). The intra-observer agreement, for all modalities and diagnoses, showed Kappa values between 0.5 and 0.93 and inter-observer agreement varied from 0.51 to 0.87. CONCLUSIONS: CBCT was an alternative to IO in diagnosing periapical lesions. Both modalities found the same healthy teeth in 93.8%. All modalities were performed equally regarding marginal bone level. In caries diagnosis, artifacts were the major cause of fallout for CBCT. CLINICAL RELEVANCE: Intraoral radiography is the first-hand choice for diagnosing dental disease. For some rare cases where intraoral imaging is not possible, a dedicated panoramic image and/or CBCT examination is an alternative.

Effect of Bi2MoO6 Morphology on Adsorption and Visible-Light-Driven Degradation of 2,4-Dichlorophenoxyacetic Acid.

The development of highly efficient and stable visible-light-driven photocatalysts for the removal of herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) from water is still a challenge. In this work, Bi2MoO6 (BMO) materials with different morphology were successfully prepared via a simple hydrothermal method by altering the solvent. The morphology of the BMO material is mainly influenced by the solvent used in the synthesis (H2O, ethanol, and ethylene glycol or their mixtures) and to a lesser extent by subsequent thermal annealing. BMO with aggregated spheres and nanoplate-like structures hydrothermally synthesized in ethylene glycol (EG) and subsequently calcined at 400 °C (BMO-400 (EG)) showed the highest adsorption capacity and photocatalytic activity compared to other synthesized morphologies. Complete degradation of 2,4-D on BMO upon irradiation with a blue light-emitting diode (LED, λmax = 467 nm) was reached within 150 min, resulting in 2,4-dichlorophenol (2,4-DCP) as the main degradation product. Holes (h+) and superoxide radicals (⋅O2-) are assumed to be the reactive species observed for the rapid conversion of 2,4-D to 2,4-DCP. The addition of H2O2 to the reaction mixture not only accelerates the degradation of 2,4-DCP but also significantly reduces the total organic carbon (TOC) content, indicating that hydroxyl radicals are crucial for the rapid mineralization of 2,4-D. Under optimal conditions, the TOC value was reduced by 84.5% within 180 min using BMO-400 (EG) and H2O2. The improved degradation performance of BMO-400 (EG) can be attributed to its particular morphology leading to lower charge transfer resistance, higher electron-hole separation, and larger specific surface area.

Fundamentals of Unanticipated Efficiency of Gd2O3-based Catalysts in Oxidative Coupling of Methane.

Improving the selectivity in the oxidative coupling of methane to ethane/ethylene poses a significant challenge for commercialization. The required improvements are hampered by the uncertainties associated with the reaction mechanism due to its complexity. Herein, we report about 90 % selectivity to the target products at 11 % methane conversion over Gd2O3-based catalysts at 700 °C using N2O as the oxidant. Sophisticated kinetic studies have suggested the nature of adsorbed oxygen species and their binding strength as key parameters for undesired methane oxidation to carbon oxides. These descriptors can be controlled by a metal oxide promoter for Gd2O3.

Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study.

INTRODUCTION: Prospective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study. METHODS: Eight-hundred five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 and 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately 8 years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and nonfatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the log-rank test and Cox proportional hazards regression adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis. RESULTS: In total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root-filled tooth increased the risk of a future event. After adjustment, the number of remaining teeth and non-root-filled teeth decreased the risk of future events, whereas a higher Decayed, Missing and Filled Teeth score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. A higher Decayed, Missing and Filled Teeth score and decayed teeth increased the risk of all-cause mortality. CONCLUSIONS: Tooth loss is a strong indicator of an increased risk for future cardiovascular events. Root-filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.

"I Feel Like I Have Lost Part Of My Identity" - A Qualitative Study Exploring The Impact Of Chronic Ankle Instability.

Introduction: Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. . Study Design: Qualitative study. Methods: Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. . Results: Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). . Conclusion: The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. . Level of Evidence: Not applicable.

Cobalt nanoparticle-catalysed N-alkylation of amides with alcohols.

A protocol for efficient N-alkylation of benzamides with alcohols in the presence of cobalt-nanocatalysts is described. Key to the success of this general methodology is the use of highly dispersed cobalt nanoparticles supported on carbon, which are obtained from the pyrolysis of cobalt(ii) acetate and o-phenylenediamine as a ligand at suitable temperatures. The catalytic material shows a broad substrate scope and good tolerance to functional groups. Apart from the synthesis of a variety of secondary amides (>45 products), the catalyst allows for the conversion of more challenging aliphatic alcohols and amides, including biobased and macromolecular amides. The practical applicability of the catalyst is underlined by the successful recycling and reusability.