Caries risk assessment.

Caries remains the most common chronic disease affecting both children and adults in the United States. High rates of primary and secondary caries in at-risk populations result in significant lifetime costs. Dental providers should be skilled in assessing an individual patient's risk for dental caries so that effective and minimally invasive preventive strategies can be employed to address the etiology of dental caries. Validated assessment strategies, such as the caries risk assessment model, allow dental providers to implement a systematic and evidence-based approach to astutely assess and record changes in the caries risk status of patients in an effort to prevent disease.

Sensitization of fear learning to mild unconditional stimuli in male and female rats.

Stress-enhanced fear learning (SEFL) refers to the long-lasting nonassociative sensitization produced by intense stress (e.g., repeated and unpredictable footshock) that results in increased fear learning to a mild conditioning regimen (e.g., one shock). SEFL experiments suggest that one component of posttraumatic behavior is inappropriately strong fear conditioning occurring to relatively mild stressors. Past reports of SEFL have used the same intensity (1 mA) of footshock to cause both the sensitization and conditioning of new fear. SEFL would be a particularly problematic component of posttrauma behavior if intense stress results in substantial fear conditioning under conditions that would not normally support conditioning. Therefore, we determined if SEFL occurred when the conditioning shock was substantially milder than the SEFL-inducing shock. The results indicate that exposure to a sensitizing regimen of shock can convert a mild footshock that normally does not support measurable levels of fear conditioning into one that causes substantial learned fear. Moreover, as the intensity of single footshock increases, so does the capacity of the prior stressor to contribute to the sensitization of fear responses. Consistent with prior studies, males acquired and retained a greater level of fear conditioning than female rats, however the level of sensitization did not differ between sexes.

Narrow-Diameter versus Standard-Diameter Implants and Their Effect on the Need for Guided Bone Regeneration: A Virtual Three-Dimensional Study.

PURPOSE: Narrow-diameter implants (NDIs) are proven treatment options for completely edentulous patients with severely resorbed alveolar ridges. The aim of this study was to evaluate virtually whether or not the implant diameter affects the need for ridge augmentation in edentulous patients, using a 3D planning software program. MATERIALS AND METHODS: Existing cone beam CT scans of 200 outpatients (100 maxillae, 100 mandibles) were selected, and treatment was planned in a virtual 3D planning software program with either 3.3 mm-diameter implants (test group) or 4.1 mm-diameter implants (control group). Statistical analysis was performed. RESULTS: A total of 1,760 implants were virtually planned (880 implants each for test and control groups). Overall, significantly associated with the absence or need for ridge augmentation as compared with need for ridge augmentation (p < .0001). Use of the 3.3 mm-diameter implants increased the odds ratio for ridge augmentation being unnecessary by 2.2 (95% confidence interval) relative to the 4.1 mm-diameter implants. CONCLUSIONS: Use of NDIs was able to provide a statistically significant reduction in need for bone grafting among completely edentulous patients. More clinical longitudinal studies are necessary to confirm the long-term success of their use.

Implant-prosthodontic classification of the edentulous jaw for treatment planning with fixed rehabilitations.

PURPOSE: This study aimed to develop a classification of edentulous jaws for use as a diagnostic tool during implant-prosthodontic treatment planning. MATERIALS AND METHODS: The morphology of 200 fully edentulous alveolar ridges (100 maxillae, 100 mandibles) was assessed with cone beam computed tomography. Generic implants (length: 8 mm; diameter: 4.1 mm) were used. To develop the classification system, the feasibility of virtually placing the implants without vertical ridge augmentation was considered. Potential implant sites were evaluated in terms of ridge width and described as either type A (no horizontal augmentation required) or type B (horizontal augmentation required). A descriptive statistical analysis of subjects' age, sex, and arch classification was performed. RESULTS: In total, 880 implants were virtually planned. Based on alveolar ridge height, four arch patterns were identified (C1 to C4), providing a basis for prosthodontic planning with either removable or fixed implant-supported restorations. The frequencies of each category were as follows: C3 (n = 62, 62%), C4 (n = 16, 16%), C2 (n = 12, 12%), and C1 (n = 10, 10%) for the maxilla and C3 (n = 36, 36%), C4 (n = 31, 31%), C1 (n = 24, 24%), and C2 (n = 9, 9%) for the mandible. CONCLUSION: The proposed classification of the edentulous arch represents a useful tool for communication between clinicians when planning implant-supported rehabilitations.

Amnesia for early life stress does not preclude the adult development of posttraumatic stress disorder symptoms in rats.

BACKGROUND: Traumatic experience can result in life-long changes in the ability to cope with future stressors and emotionally salient events. These experiences, particularly during early development, are a significant risk factor for later life anxiety disorders such as posttraumatic stress disorder (PTSD). However, because traumatic experience typically results in strong episodic memories, it is not known whether such long-term memories are necessary for particular features of PTSD, such as enhanced fear and anxiety. Here, we used a fear conditioning procedure in juvenile rats before maturation of the neural systems supporting declarative memory to assess the necessity of early memory to the later life development of PTSD-related symptoms. METHODS: Nineteen-day old rats were exposed to unpredictable and inescapable footshocks, and fear memory for the shock context was assessed during adulthood. Thereafter, adult animals were either exposed to single-trial fear conditioning or elevated plus maze or sacrificed for basal diurnal corticosterone and quantification of neuronal glucocorticoid and neuropeptide Y receptors. RESULTS: Early trauma exposed rats displayed stereotypic footshock reactivity, yet by adulthood, hippocampus-dependent contextual fear-related memory was absent. However, adult rats showed sensitized fear learning, aberrant basal circadian fluctuations of corticosterone, increased amygdalar glucocorticoid receptors, decreased time spent in the open arm of an elevated plus maze, and an odor aversion associated with early-life footshocks. CONCLUSIONS: These results suggest that traumatic experience during developmental periods of hippocampal immaturity can promote lifelong changes in symptoms and neuropathology associated with human PTSD, even if there is no explicit memory of the early trauma.