Association between dental diseases and oral hygiene care and the risk of vertebral fracture: a nationwide cohort study.

Periodontal disease and increased missing teeth were associated with incident vertebral fractures. In contrast, professional dental cleaning and frequent tooth brushing, was associated with a lower risk of vertebral fracture. Better oral hygiene care attenuated the risk associated with dental diseases. PURPOSE: To investigate the association between oral health and the risk of vertebral fractures. METHODS: We included 2,532,253 individuals aged ≥40 years who underwent the Korean National Health Insurance Service health examinations in 2008 and followed up until December 31, 2017. We performed multivariable Cox proportional hazard regression analyses to evaluate the association between dental diseases and oral hygiene care and the risk of vertebral fractures. RESULTS: Over the 9.3-year median follow-up, 1.46% (n = 36,857) experienced vertebral fractures. Individuals with dental diseases had a higher risk of vertebral fracture than those without (hazard ratio [HR] 1.04, 95% confidence interval [CI]: 1.02-1.07 for periodontal diseases; 1.02, 1.00-1.05 for dental caries; 1.12, 1.05-1.20 for ≥15 missing teeth). Good oral hygiene care was associated with a lower vertebral fracture risk (HR 0.89, 95% CI: 0.86-0.91 for ≥1 time/year [vs. <1 time/year] of professional dental cleaning; 0.90, 0.87-0.93 for ≥2 times/day [vs. 0-1 time/day] of toothbrushing). The combined dental diseases was significantly associated with an increased vertebral fracture risk, whereas combined oral hygiene care was associated with further risk reduction. Better oral hygiene care reduced vertebral fracture risk associated with dental diseases (all P <0.001). CONCLUSION: Periodontal disease, dental caries, and an increased number of missing teeth were independently associated with higher risks for vertebral fractures. Conversely, improved oral hygiene care, such as personal dental cleaning and frequent tooth brushing, may modify vertebral fracture risks associated with dental disease.

The effect of loading time on marginal bone change of implants immediately placed after extraction: a retrospective study.

BACKGROUND: The purpose of this study is to compare and analyze the treatment outcomes between two groups which are both immediately placed implant cases, one is immediate loading, and the other is conventional loading group. METHODS: Medical records of the patients who underwent implant treatment which were immediately placed after tooth extraction were analyzed. Demographic data were collected and by using periapical or panoramic radiographic image, marginal bone level and distant crestal bone level were measured. Marginal bone change over time was analyzed and compared between immediate loading group and conventional loading group. RESULTS: A total of 71 patients, 112 immediately placed implants after tooth extraction were initially involved. Measuring was done with implants which had not failed (81). 10 implants were had failed and removed. The others were excluded because of follow-up loss, absence of radiographic image, etc. Demographic data were collected, and measured values were averaged at each follow-up and showed in linear graphs. CONCLUSIONS: In case of immediate implantation of dental implant after extraction, loading time could affect marginal bone level or biological width of the implant. Immediate loading group showed 0.92 mm (mean value) more bone loss compared to conventional loading group at bone-implant contact points 24 months after implantation. At distant crestal points, there was no noticeable difference in bone change pattern between two groups.

Therapeutic effects of sialendoscopy for diagnosis and treatment of hyposalivation patients: a retrospective study.

BACKGROUND: Hyposalivation is disease with multiple symptoms. This disease is hard to be diagnosed and to be treated, and there are not enough clinical protocols to cure the disease. In this study, we propose our own treatment protocols which aim not only to cure the disease but also to care for the disease-related symptoms. METHODS: At the 1st visit, we collect patient-related information. This procedure includes an intraoral exam, patient history taking, VAS value and unstimulated whole saliva (UWS) measurement, and salivary buffer test. Following the interview and oral examination, objective results are obtained by radiological image, CT, and sialoscintigraphy. At the 2nd visit, we analyze radiographic images including neck CT and salivary scintigraphy. These images can allow accurate diagnosis and help the patients to better understand the current condition. Depending on the severity of symptoms and patient's discomfort, we try a surgical approach at the 3rd visit, sialendoscopy. RESULTS: With treatment, we can manage the discomfort of patients in daily life. The VAS value of hyposalivation patients dropped gradually with the trial of sialendoscopy. In the case of Sjogren's syndrome patients, the treatment efficacy has been decreased with low reactivity of treatment. The true meaning of this treatment is in not only curing the disease, but also caring for the disrupted patients. Overall, the amount of UWS increased with the progress after the procedure. Especially in the lower UWS at the 1st visit, there was a more significant increase after the procedure. CONCLUSION: Although many factors that cause hyposalivation have not been identified, the efficacy of sialendoscopy to relieve discomfort in hyposalivation patients has been observed. However, treatment was more difficult and complicated in the group of patients with systemic disease. This study will not only present a treatment protocol for hyposalivation patients, but also consider methods for diagnosing more precisely and improving treatment efficacy. Hyposalivation is a curable and manageable disease in some cases, so interpretation between the clinician and the patient is important.

Effect of arthrocentesis on the clinical outcome of various treatment methods for temporomandibular joint disorders.

BACKGROUND: We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. RESULTS: We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). CONCLUSION: The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

Preliminary study on the efficacy of xerostomia treatment with sialocentesis targeting thyroid disease patients given radioiodine therapy.

BACKGROUND: Radioiodine therapy has been widely used for thyroid disease patients, but hyposalivation and xerostomia may occur in 10~30% of patients. Sialocentesis is a procedure that removes inflammatory substances in the salivary duct and expands the duct for the secretion and delivery of saliva. In this study, thyroid disease patients treated with radioactive iodine were selected among the patients with xerostomia who visited the hospital, and the effect of sialocentesis was compared and analyzed. And then, comparison between the radioiodine therapy-experienced group and the non-radioiodine therapy-experienced group was conducted. RESULTS: In this study, we studied xerostomia patients who underwent radioiodine therapy due to thyroid diseases and who underwent sialocentesis at the Korea University Anam Hospital. Sialocentesis is conducted by one surgeon. The study also compares the clinical symptoms before and after the surgery. After the procedure, the discomfort due to xerostomia was reduced, and the symptom was improved effectively. CONCLUSIONS: The results of this study showed that sialocentesis has a clinical effect in the treatment of xerostomia, which is a side effect of radioiodine therapy. In addition, the possibility of further clinical application of sialocentesis in the future is found.

Sialolithotomy of the submandibular duct using sialendoscopy.

BACKGROUND: Conventionally, indirect radiography has been used to diagnose salivary gland diseases. However, with the development of sialendoscopy, diagnosis and treatment of salivary gland diseases have become more effective. Herein, we report a case of sialolithotomy treated with sialendoscopy and compare it with the existing methods through a literature review. CASE PRESENTATION: Two patients with a foreign body sensation under the tongue and dry mouth visited the Anam Hospital, Korea University. Radiographic examination revealed salivary stones inside the right Wharton duct, and the patients underwent sialolithotomy under local or general anaesthesia. The stones were totally removed, and there were no postoperative complications such as bleeding or pain. CONCLUSION: The development of sialendoscopy has enabled better definitive diagnosis of salivary gland diseases compared with the conventional methods; better treatment outcomes can be obtained when sialendoscopy is used in appropriate cases.