Sonoelastographic Assessment of the Gender-related Changes of Achilles the Tendon

ABSTRACT Objective: To assess the gender-related differences in the elasticity and thickness of the Achilles tendon among healthy young participants. Methods: A total of 48 volunteers, who were healthy adults between the ages of 20 and 25 years, were included in this study. The metabolic equivalent (MET) scores, tendon thickness and shear wave velocities (SWVs) were compared between the males and females. Results: The median age of the males was 24 years and that of the females was 23 years. The mean body mass index (BMI) score was 22.22 ± 1.92 kg/m2 among the males and 21.84 ± 2.29 kg/m2 among the females. The median MET score of both the males and the females was 4. The median SWV was found to be 4.76 m/s in the males and 4.77 m/s in the females. There was no statistically significant difference in age, BMI, MET scores and SWV values between the males and the females (p = 0.349, p = 0.537, p = 0.923 and p = 0.578, respectively). The mean thickness of the Achilles tendon was found to be statistically significantly higher in the males than in the females (4.47 ± 0.41 mm and 4.03 ± 0.44 mm, respectively) (p = 0.001). Conclusion: The effect of gender on the Achilles tendon's elastic property is not a significant covariate in the young, healthy sample. Muscle strength may play a more important role in the Achilles tendon's injury rather than in tendon's elasticity.

Association among tenascin-C and NT-proBNP levels and arrhythmia prevalence in heart failure.

PURPOSE: Tenascin-C (TN-C) and amino-terminal fragment of the B-type natriuretic peptide (NT-proBNP) are the important predictors in prognosis of heart failure (HF). The aim of this study was to analyze the relationship of TN-C and NT-proBNP levels with the frequency and severity of ventricular arrhythmia. MATERIALS AND METHODS: Our study included 107 HF patients with EF < 45%. According to Holter analysis, the patients were divided into two groups as malignant arrhythmia group (n=29) with Lown Class 4a and 4b arrhythmia and benign arrhythmia group(n=78) with Lown Class 0-3b arrhythmia. The groups were compared with respect to levels of TN-C and NT-proBNP. The relationship of TN-C and NT-proBNP levels with frequency of ventricular premature beat (VPB) was also analyzed. FINDINGS: NT-proBNP (5042.1±1626 versus 1417.1±1711.6 pg/ml) and TN-C (1089±348.6 versus 758.5±423.9 ng/ml) levels were significantly higher in the malignant arrhythmia group than that of the benign arrhythmia group (p.

Dental caries experience among Albanian pre-school children: a national survey.

OBJECTIVE: To determine the dental caries experience and treatment needs among 5-year-olds in Albania. RESEARCH DESIGN: This cross sectional study was conducted in 2015 by using a cluster sampling technique. The dmft was used to assess dental caries experience and caries prevalence as percentages of children with dmf⟩0. Caries treatment needs were assessed with dt/dmft x 100, missing teeth with mt/dmft x 100 and ft /dmft x 100 as the Care Index. PARTICIPANTS: 2,039 five-year-olds, from 17 districts of Albania were selected . Children's residency was divided into 3 main regions (South, West, Central and North). METHOD: WHO 2013 diagnostic criteria were used and dental caries was recorded at cavity level d3. RESULTS:: The mean age was 5.4 (SD 0.5) years. The caries prevalence (dmf⟩0) was 84.1%. The prevalence of children without cavitated lesions (d=0) was 20.1%. The mean dmft index was 4.41 (SD 3.83). The caries treatment needs were 84% (SD 26%). CONCLUSIONS: The Albanian 5-year-olds assessed in this survey had a high dental caries experience and untreated cavities in the primary dentition. The national health authorities should introduce preventive programs and improved dental care access for this age group.

LONGER CECUM INSERTION TIME AND MORE INADEQUATE COLONIC PREPARATION IN PATIENTS WITH ACROMEGALY: IS A DIFFERENT COLONOSCOPY PREPARATION NEEDED?

PURPOSE: To investigate whether there is a difference between acromegalic and non-acromegalic cases in terms of bowel preparation and colonoscopic intervention. METHODS: Patients with controlled and uncontrolled acromegaly and as a control group (CG) patients without acromegaly between January 2010 and March 2014 were included. Groups were compared regarding adequacy of bowel preparation, cecal insertion time (CIT) and colonoscopy results. RESULTS: Fifty-nine patients with acromegaly (controlled n=30, uncontrolled n=29) and 73 age and gender matched volunteers without acromegaly were evaluated. CIT in cases with controlled, uncontrolled acromegaly cases and in CG was 5.33 [4.00-6.00], 7.00 [4.91-11.31], and 3.10 [2.35-4.65] minutes, respectively (p<0.001). Cases in CG had shorter CIT compared to controlled and uncontrolled acromegaly cases ( p=0.014 and p<0.001, respectively). There was no significant difference regarding CIT between controlled and uncontrolled acromegaly cases (p=0.247). Six (20%) of controlled acromegaly patients, 10 (35%) of uncontrolled acromegaly patients and three (4%) of CG had inadequate bowel cleansing (p<0.001). Although statistically insignificant, cases with inadequate bowel cleansing had tendency towards having prolonged CIT in comparison to cases with adequate bowel cleansing (6.00 [3.87-9.00] and 4.16 [2.95-5.70] minutes, respectively, p=0.07). CONCLUSION: Inadequate bowel cleansing is one of the main problems encountered during colonoscopic investigation/surveillance in acromegalic patients. Therefore, a different protocol for colonoscopy preparation may be needed for these cases.

Engineered Protein Polymer-Gold Nanoparticle Hybrid Materials for Small Molecule Delivery.

We have fabricated protein polymer-gold nanoparticle (P-GNP) nanocomposites that exhibit enhanced binding and delivery properties of the small hydrophobic molecule drug, curcumin, to the model breast cancer cell line, MCF-7. These hybrid biomaterials are constructed via in situ GNP templated-synthesis with genetically engineered histidine tags. The P-GNP nanocomposites exhibit enhanced small molecule loading, sustained release and increased uptake by MCF-7 cells. When compared to the proteins polymers alone, the P-GNPs demonstrate a greater than 7-fold increase in curcumin binding, a nearly 50% slower release profile and more than 2-fold increase in cellular uptake of curcumin. These results suggest that P-GNP nanocomposites serve as promising candidates for drug delivery vehicles.

Prevalence and aetiology of Molar-Incisor Hypomineralisation among children aged 8-10 years in Tirana, Albania.

AIM: Molar incisor hypomineralisation (MIH) describes the clinical appearance of enamel hypomineralisation of systemic origin affecting one or more permanent first molars (PFMs) that are frequently associated with affected incisors. The aim of this study was to investigate the prevalence and aetiology of MIH in children living in Tirana, Albania. DESIGN: The study was conducted at the Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, and Tirana Dental Public Health Service. A total of 1,575 school children aged 8-10 years were examined by 7 calibrated examiners (dentists) (kappa: 0.86). The Weerheijm criteria were used for the diagnosis of demarcated opacities, post-eruption breakdown, atypical restorations, and extracted PFMs due to MIH. RESULTS: Prevalence of MIH was found to be 14% (n=227). In the 227 children with MIH, tooth 36 was the most affected PFM, and tooth 46 the least affected. Tooth 21 was the most affected incisor and tooth 32 the least affected incisor by MIH. MIH(+) children had significanly more childhood diseases in the first 3 years of life (p=0.006). Among the children who used antibiotics, MIH(+) cases were 1.41 (1.06-1.87) times higher than in children who did not usedantibiotics, MIH(-) cases. CONCLUSION: MIH was found to be common among 8-10 year-old Tirana children.

Early Colonization of Lactobacillus reuteri after Exposure to Probiotics.

UNLABELLED: The aim of the present in vivo animal study is to investigate the ability of L. reuteri to colonize the oral flora during infancy. STUDY DESIGN: Twenty four rats, aged 1 month, which were pre-analyzed for mutans streptococci and L. reuteri absence in their saliva, were randomly divided into 3 groups. The control group was infected with S. mutans ATCC 25175 at the 2nd month, three times a day for 14 days. S. mutans counts were determined with microbiological saliva analyzes obtained by standard methods of oral swabbing at 3rd, 4th and 5th months. The second group, Probiotic I group, was also infected with S. mutans at the 2nd month, and further infected with L. reuteri ATCC 55730 (1×10(8)),5 drops per day for 25 days, at the 3rd month. S. mutans and L. reuteri counts were determined at the 3rd, 4th and 5th months. Plates were incubated anaerobically at 37°C for 48 h, after which colonies were confirmed as L. Reuteri. RESULTS: Regarding intragroup analysis, S. mutans counts of the Control group increased steadily during the 3rd. and 4th. months, and a statistically significant (p<0.05) reduction was registered at the 5. month. S. mutans counts of the Probiotic I group increased steadily during the 3rd. and 4th. months, and again a statistically significant (p<0.05) reduction, parallel with the Control group, was registered at the 5th. month. In the Probiotic II group, S. mutans counts started at a higher level than the Control group and there was a statistically significant (p<0.05) reduction of S. mutans at the 5th. month. CONCLUSION: It may be concluded that, L. reuteri promised a better colonization as a 'first colonisation strain'.

Quantitative evaluation of hyaline articular cartilage T2 maps of knee and determine the relationship of cartilage T2 values with age, gender, articular changes.

OBJECTIVE: To identify changes in knee joint cartilage transverse relaxation values depending on the patient's age and gender and to investigate the relationship between knee joint pathologies and the transverse relaxation time. PATIENTS AND METHODS: Knee MRI images of 107 symptomatic patients with various pathologic knee conditions were analyzed retrospectively. T2 values were measured at patellar cartilage, posteromedial and posterolateral femoral cartilage adjacent to the central horn of posterior meniscus. 963 measurements were done for 107 knees MRI. Relationship of T2 values with seven features including subarticular bone marrow edema, subarticular cysts, marginal osteophytes, anterior-posterior cruciate and collateral ligament tears, posterior medial and posterior lateral meniscal tears, synovial thickening and effusion were analyzed. T2 values in all three compartments were evaluated according to age and gender. RESULTS: A T2 value increase correlated with age was present in all three compartments measured in the subgroup with no knee joint pathology and in all patient groups. According to the ROC curve, an increase showing a statistically significant difference was present in the patient group aged over 40 compared to the patient group aged 40 and below in all patient groups. There is a statistically difference at T2 values with and without subarticular cysts, marginal osteophytes, synovial thickening and effusion. T2 relaxation time showed a statistically significant increase in the patients with a medial meniscus tear compared to those without a tear and no statistically significant difference was found in T2 relaxation times of patients with and without a posterior lateral meniscus tear. CONCLUSIONS: T2 cartilage mapping on MRI provides opportunity to exhibit biochemical and structural changes related with cartilage extracellular matrix without using invasive diagnostic methods.

The prevalence of gastroesophageal reflux disease among hospital employees.

Quantitative estimate of the actual prevalence of the gastroesophageal reflux disease (GERD) is difficult to obtain because most of the patients with heartburn have intermittent symptoms. The aim of this study was to assess the frequency of typical and atypical symptoms suggesting GERD to investigate the association of habits and social conditions reported to lead to reflux in the employees of hospital. A total of 2037 collected forms were assessed. The prevalence of GERD was found to be 21.7% (442). The prevalence of symptoms other than heartburn in employees with and without GERD symptoms were 6.6% versus 3.4% (P < 0.05) for asthma, 27.6% versus 8.3% (P < 0.001) for night cough, 50% versus 19.5% (P < 0.001) for noncardiac chest pain. Dyspeptic complaints were found to be significantly higher among GERD patients (P < 0.001). By multiple logistic regression analysis, female gender (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.03-1.60, P = 0.027), non-steroidal anti-inflammatory drug medication (OR 1.29, 95% CI 1.03-1.60, P = 0.021) and body mass index over 30 (OR 2.26, 95% CI 1.60-3.18, P < 0.001) were independent risk factors associated with GERD symptoms. GERD is a common health problem in Turkey, and its prevalence is similar to that of Western populations with different symptom profiles. Female gender, non-steroidal anti-inflammatory drug, and body mass index >30 kg/m(2) were independent risk factors associated with GERD symptoms. Age, alcohol, coffee, tea, and tobacco smoking do not seem to be risk factors for reflux.

Role of 'student-to-student local analgesia administration' on undergraduate students' opinions regarding 'pain-free local analgesia technique' in children.

AIM: To examine the role of 'student-to-student local analgesia administration' on undergraduate dental students' opinions regarding pain-free local analgesia techniques in children. METHODS: Grade 3 (n:29), Grade 4 (n:59) and Grade 5 students (n:28) of Yeditepe University, School of Dentistry, Istanbul, Turkey participated in the study. Informed consent and ethical approval were obtained. Students' opinions were evaluated by means of a short survey administered before and after educational activities. Activities were provided in a didactic manner (theoretical, practical and clinical stages) and lasted for 6 months. Theoretical lectures on 'pain-free local analgesia techniques in children' were given to all classes. In the practical stage, 3rd and 4th grade students were paired and performed infiltration analgesia on each other according to the lectured technique. In the final clinical stage, 4th and 5th grade students were supervised, whilst administering the technique on children during their clinical training. RESULTS: Before the activities, only 40% of students believed in the possibility of pain-free local analgesia in children, whereas after the educational activities, the percentage had risen to 68% (P = 0.0001). A significant difference was observed between the opinions of 4th grade students who attended the practical stage and 5th grade students who did not. CONCLUSION: The role of 'student-to-student local analgesia administration' was found to be significant in changing undergraduate students' opinions about pain-free dental injections in children.

Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction.

BACKGROUND: We aimed to examine the association between plasminogen activator inhibitor-1 (PAI-1) genetic polymorphism and early spontaneous recanalization in patients presenting with acute ST-elevation myocardial infarction. METHODS: Patients admitted to our emergency department with ST-elevation myocardial infarction in the first 6 h of symptom onset were included. An immediate primary percutaneous coronary intervention was performed. Patients were grouped according to the initial patency of the infarct-related artery (IRA) as follows: total occlusion (TO) group [Thrombolysis in Myocardial Infarction (TIMI) 0-1 flow in the IRA], partial recanalization group (TIMI 2 flow in the IRA), and complete recanalization (CR) group (TIMI 3 flow in the IRA). PAI-1 4G/5G polymorphism was detected using the real-time PCR method. RESULTS: There were 107 patients in the TO group, 30 patients in the partial recanalization group, and 45 patients in the CR group. When we evaluated degrees of patency according to the PAI-1 genotype, TO of the IRA was the highest in patients with the PAI 4G/4G genotype (PAI-1 4G/4G: 66.7%, PAI-1 4G/5G: 65.9%, PAI-1 5G/5G: 40.4%) and CR of the IRA was the highest in patients with the PAI 5G/5G genotype (PAI-1 5G/5G: 38.5%, PAI-1 4G/5G: 19.8%, PAI-1 4G/4G: 17.9%). The distribution of genotypes in different degrees of patency of IRA was statistically significant (P=0.029). In logistic regression analysis, the PAI-1 5G/5G genotype was associated independently with the spontaneous CR of the IRA (odds ratio: 2.875, 95% confidence interval [1.059-7.086], P=0.038). CONCLUSION: Patients with the PAI-1 5G/5G genotype seem to be luckier than others in terms of early spontaneous recanalization of the IRA. Further prospective studies with large patient populations are required for more precise results.

PAI-1 4G/5G gene polymorphism is associated with angiographic patency in ST-elevation myocardial infarction patients treated with thrombolytic therapy.

BACKGROUND: In this study, we examined the relationship between PAI-1 4G/5G polymorphism and patency of the infarct-related artery after thrombolysis in patients with ST-elevation myocardial infarction (STEMI). METHODS: Acute STEMI patients who received thrombolytic therapy within first 12 h were included in our study. The PAI-1 4G/5G promoter region insertion/deletion polymorphism was studied from venous blood samples. Patients with the PAI-1 4G/5G gene polymorphism were included in group 1 and the others were included in group 2. Coronary angiography was performed in all patients in the first 24 h after receiving thrombolytic therapy. Thrombolysis in myocardial infarction (TIMI) 0-1 flow in the infarct-related artery was considered as 'no flow', TIMI 2 flow as 'slow flow', and TIMI 3 flow as 'normal flow'. RESULTS: A total of 61 patients were included in our study. Thirty patients (49.2%) were positive for the PAI-1 4G/5G gene polymorphism, whereas 31 of them (50.8%) were in the control group. There were significantly more patients with 'no flow' (14 vs. 6; P=0.02) and less patients with 'normal flow' (8 vs. 19; P=0.02) in group 1. In addition, time to thrombolytic therapy (TTT) was maximum in the 'no flow' group and minimum in the 'normal flow' group (P=0.005). In the logistic regression analysis, TTT (odds ratio: 0.9898; 95% confidence interval: 0.982-0.997; P=0.004) and the PAI-1 4G/5G gene polymorphism (odds ratio: 4.621; 95% confidence interval: 1.399-15.268; P<0.01) were found to be independently associated with post-thrombolytic 'no flow'. CONCLUSION: The PAI-1 4G/5G gene polymorphism and TTT are associated independently with 'no flow' after thrombolysis in patients with STEMI.

Prevalence of dental erosion in Greek minority school children in Istanbul.

AIM: To evaluate the prevalence and aetiology of dental erosion in Greek minority school children living in Istanbul (Turkey). METHODS: The present study was initiated in four Greek minority elementary schools in Istanbul where a total of 83 children (46 girls, 37 boys) between ages 7-14 years old were examined. Children were categorised into 7-11 and 12-14 ages groups. Data were obtained by clinical examination, questionnaire and standard data records. All tooth surfaces were examined, dental erosion was recorded per tooth and classified according to the index of Lussi et al. [1996] RESULTS: In the 7-11 yrs old group, 47.4% (n:18) of the children exhibited dental erosion while in 12-14 yrs old group, 52.6% (n:20) of the children exhibited dental erosion. There were no statitistical differences between age, gender groups and findings of dental erosion (p>0.05). However prevalence of dental erosion in 12-14 yrs old was twice that of the 7-11 years old children. In general, an unusual drinking pattern of slow swallowing of beverages significantly affected the prevalence of dental erosion (p=0.03). CONCLUSION: Multiple regression analysis revealed no relationship between dental erosion and related erosive sources such as medical conditions, brushing habits, swimming, and the consumption of acidic fruit juices and beverages (p>0.05). However it should be noted that the sample size in the current study was small.

Viability of fibroblasts in a novel probiotic storage media.

A number of storage media have been investigated as to their ability to maintain the viability of the periodontal ligament (PDL) cells and thus to permit longer extra-alveolar periods prior to replantation of avulsed teeth. The aim of the present in vitro study was to evaluate the number of viable PDL cells of avulsed teeth treated by Hank's Balanced Salt Solutions (HBSS), saline, a novel probiotic solution and milk. Thirty-six freshly extracted single-rooted human teeth with closed apices were divided into one of the four experimental groups and two control groups (N = 6 each). The positive and negative controls corresponded to 0 min and an 8-h dry time respectively. Following extraction, the coronal 3 mm of PDL tissue was scraped with a #15 scalpel to remove cells that might have been damaged. The experimental teeth were dried for 30 min followed by a 45 min immersion in one of the four experimental media. Each experimental tooth, after drying and soaking, was incubated for 30 min with a 2.5 ml solution of 0.2 mg ml(-1) of collagenase CLS II and a 2.4 mg ml(-1) solution of dispase grade II in phosphate buffer saline (PBS). The cells were then labelled with 0.4% Trypan blue for determination of viability. The teeth stored in positive control demonstrated the highest number of viable PDL cells followed in rank order by HBSS, saline, Lactobacillus reuteri solution and milk. There was no significant difference in the number of viable PDL cells between HBSS, milk, L. reuteri solution and saline. Within the parameters of this study, it appears that probiotic may be able to maintain PDL cell viability as HBSS, milk, or saline.

Short communication: preferences of dentist's attire in a group of Istanbul school children related with dental anxiety.

AIM: This was to assess children's preferences for each of four different kinds of dental attire and to consider the relationship between children's preferences and levels of dental anxiety. METHODS: A group of 827 children aged 9-14 years looked at anonymised photographs and were asked to say which of four dental attires they would prefer their dentists to wear "if they had been to a dental clinic". Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used to evaluate the children's anxiety level. RESULTS: Formal attire was the first preference for 45.6 % of the children (n: 377), followed by the child-friendly attire with a preference of 30.5% (n:144). There were 350 children (42.3%) who were diagnosed as anxious (CFSS-DS > or = 32) and 477 children (57.7%) were diagnosed as non-anxious (CFSS-DS <32). Anxious children were found to prefer the formal attire significantly less than non-anxious ones (p=0.010). CONCLUSIONS: The popular view that children are fearful of white coats was not found in this survey. More children were observed to prefer the formal attire. However, the concept of "child-friendly" attire might be more appropriate for anxious children and enhance an easy first communication with them.

The prevalence and aetiology of molar-incisor hypomineralisation in a group of children in Istanbul.

AIM: To our knowledge, the prevalence and aetiology of molar-incisor hypomineralisation has not been discussed nor investigated in Turkish children in Istanbul. Therefore the aim of the present study is to investigate the prevalence and aetiology of MIH in a group of children in Istanbul. DESIGN: Between April and July 2007, a retrospective clinical study was initiated at the Dept. of Paediatric Dentistry, School of Dentistry, Yeditepe University, Istanbul, Turkey. A total of 147 children aged 7-9 years visiting our clinic were examined by two calibrated paediatric dentists (kappa: 0.89). The examiners used the criteria for the diagnosis of demarcated opacities, post-eruption breakdown, atypical restorations, and extracted PFMs due to MIH developed by Weerheijm et al. RESULTS: In the present study, prevalence of MIH was 14.9%. Of the 22 children affected with MIH, 17 (77.2%) had only demarcated opacities, but no breakdown or atypical restorations. Regarding diseases in the first 3 years of life, 55% of MIH and 19.4% of non-MIH children had a disease history. 27% of MIH children had suffered from upper and lower respiratory tract infections including bronchitis. This was significantly different from non-MIH children (p<0.001). CONCLUSION: MIH was common among a group of 7-9 years old children, Istanbul.

Anti-Scl-70 antibodies in autoimmune hypothyroidism.

The relationship between autoimmune thyroiditis and systemic sclerosis is controversial. Data exist on the presence of thyroid autoantibodies in patients with systemic sclerosis but, as far as we could ascertain, anti-Scl-70 antibodies, which are highly specific for systemic sclerosis, have not been investigated in autoimmune hypothyroidism. This study compares the presence of anti-Scl-70 in females with autoimmune hypothyroidism (n = 24) and in healthy age-matched female controls (n = 26). Free thyroxine levels were similar in both groups. Thyroid stimulating hormone (TSH), antithyroid peroxidase (anti-TPO), antithyroglobulin (anti-Tg) and index values for anti-Scl-70 levels were significantly higher in patients with autoimmune hypothyroidism compared with controls, although the anti-Scl-70 test was negative in both groups. Anti-TPO, anti-Tg and TSH significantly correlated with anti-Scl-70. In conclusion, autoimmune hypothyroidism seems to be associated with a higher index level of anti-Scl-70, yet a negative anti-Scl-70 antibody test. This suggests that autoimmune hypothyroidism might have common aetiological factors with systemic sclerosis.

Prevalence of dental caries and tooth wear in a Byzantine population (13th c. A.D.) from northwest Turkey.

Dental caries and wear are important conditions to record in archaeological collections. Reconstruction of the life of ancient peoples can be accomplished by studying their dental remains. The aim of the present paper was to determine the frequency, distribution, and characteristics of dental caries, dental wear and related diet in the mediaeval Byzantine population of Iznik in northwest Turkey. The analysed sample consisted of the dental remains of 56 individuals with the total of 280 teeth. The majority (261 or 93.2%) of the teeth belonged to the permanent dentition. The frequency of antemortem tooth loss in the sample was 6.5% and the frequency of caries was 6.8%. The most frequent recorded caries were mesial (3.3%), followed by buccal (3%). The frequency of dental wear was rather high (84.2%) exhibiting presence of dentin clusters mostly. This finding is consistent with the hypothesis of caries attrition competition based on the assumption that a beneficial effect of tooth wear is to avoid development of caries. High wear in the archaeological population can be linked to the fact that the cumulative effects of attrition as a result of the Byzantine diet.

Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli.

The aim was to evaluate the effect of xylitol and probiotic chewing gums on salivary mutans streptococci (MS) and lactobacilli (LB). The material consisted of 80 healthy young adults (21-24 years) who volunteered after informed consent. They were assigned by random into one of four parallel study groups: A, probiotic gum group; B, xylitol gum group; C, probiotic + xylitol gum group; and D, placebo gum group. The gums were taken three times daily after meals, and the intervention period was 3 weeks. The probiotic gums contained two strains of Lactobacilli reuteri (ATCC 55730 at a dose of 1 x 10(8) CFU/gum and ATCC PTA 5289 at a dose of 1 x 10(8) CFU/gum), and each pellet of the xylitol gum contained approximately 1.0 g xylitol as single sweetener. Pretreatment and posttreatment samples of stimulated whole saliva were collected and quantified for MS and LB with chair-side kits. A statistically significant reduction (p < 0.05) of salivary MS was displayed in group A and B after the intervention when compared with baseline. A similar but nonsignificant tendency was seen in group C. No alterations of salivary LB was demonstrated in any group. In conclusion, daily chewing on gums containing probiotic bacteria or xylitol reduced the levels of salivary MS in a significant way. However, a combination of probiotic and xylitol gums did not seem to enhance this effect.