Design and Progress of Oral Health Examinations in the Tohoku Medical Megabank Project.

In order to assess the long-term impact of the Great East Japan Earthquake on the oral health of disaster victims and to evaluate gene-environmental interactions in the development of major oral diseases and oral-systemic associations, the oral part of two large-scale genome cohort studies by the Tohoku Medical Megabank Organization (ToMMo), including the Community-based cohort (CommCohort) study and the Birth and Three-Generation cohort (BirThree) study, have been conducted. The study population comprised 32,185 subjects, including 16,886 participants in the CommCohort study and 15,299 participants in the BirThree cohort study, recruited from 2013 to 2017. The oral studies consist of a questionnaire regarding oral hygiene behavior, clinical examinations by dentists, and oral plaque and saliva sampling for microbiome analyses, which were carried out at seven community support centers in Miyagi prefecture. The median age of all participants was 55.0 years, and 66.1% of participants were women. Almost all participants reported that they brushed their teeth more than once a day. The median number of present teeth was 27.0, and the decayed, missing and filled tooth number was 16.0, with a significant difference according to age and sex. The median periodontal pocket and clinical attachment level was 2.48 mm and 4.00 mm, respectively. Periodontal parameters increased significantly according to age, except for the accumulation of dental calculus. The oral part of these extensive cross-sectional studies provides a unique and important platform for future studies on oral health and diseases that elicit through interactions with systemic diseases, lifestyles, life events and genetic backgrounds, and contributes to researches clarifying the long-term effects of disasters on oral health.

From manual periodontal probing to digital 3-D imaging to endoscopic capillaroscopy: Recent advances in periodontal disease diagnosis.

Deepened periodontal pockets exert a significant pathological burden on the host and its immune system, particularly in a patient with generalized moderate to severe periodontitis. This burden is extensive and longitudinal, occurring over decades of disease development. Considerable diagnostic and prognostic successes in this regard have come from efforts to measure the depths of the pockets and their contents, including level of inflammatory mediators, cellular exudates and microbes; however, the current standard of care for measuring these pockets, periodontal probing, is an analog technology in a digital age. Measurements obtained by probing are variable, operator dependent and influenced by site-specific factors. Despite these limitations, manual probing is still the standard of care for periodontal diagnostics globally. However, it is becoming increasingly clear that this technology needs to be updated to be compatible with the digital technologies currently being used to image other orofacial structures, such as maxillary sinuses, alveolar bone, nerve foramina and endodontic canals in 3 dimensions. This review aims to summarize the existing technology, as well as new imaging strategies that could be utilized for accurate evaluation of periodontal pocket dimensions.

Noninvasive diagnostic adjuncts for the evaluation of potentially premalignant oral epithelial lesions: current limitations and future directions.

Potentially premalignant oral epithelial lesions (PPOELs) are a group of clinically suspicious conditions, of which a small percentage will undergo malignant transformation. PPOELs are suboptimally diagnosed and managed under the current standard of care. Dysplasia is the most well-established marker to distinguish high-risk PPOELs from low-risk PPOELs, and performing a biopsy to establish dysplasia is the diagnostic gold standard. However, a biopsy is limited by morbidity, resource requirements, and the potential for underdiagnosis. Diagnostic adjuncts may help clinicians better evaluate PPOELs before definitive biopsy, but existing adjuncts, such as toluidine blue, acetowhitening, and autofluorescence imaging, have poor accuracy and are not generally recommended. Recently, in vivo microscopy technologies, such as high-resolution microendoscopy, optical coherence tomography, reflectance confocal microscopy, and multiphoton imaging, have shown promise for improving PPOEL patient care. These technologies allow clinicians to visualize many of the same microscopic features used for histopathologic assessment at the point of care.

Impacto de condições bucais na qualidade de vida de indivíduos portadores de lúpus eritematoso sistêmico / Impact of systemic lupus erythematosus on oral health - related quality of life

O presente estudo teve o objetivo de avaliar o impacto de condições bucais na qualidade de vida de indivíduos portadores de Lupus Eritematoso Sistêmico (LES). Foi realizado um estudo transversal, através do qual foram avaliados 75 pacientes portadores de LES em tratamento no Serviço de Reumatologia do Hospital das Clínicas da UFMG. A amostra foi constituída também por um grupo controle composto por 78 indivíduos, que segundo o autorrelato, não apresentavam nenhuma doença sistêmica. A qualidade de vida relacionada à saúde bucal (QVRSB) destes indivíduos foi avaliada através da versão brasileira do questionário Oral Health Impact Profile (OHIP-49). Todos os participantes foram submetidos à exame odontológico, tendo sido obtidos índice CPO-D; parâmetros periodontais e medidas referentes à sialometria. Foram coletadas também variáveis sociodemográficas, hábitos de higiene bucal. Indivíduos do grupo LES foram avaliados com relação à atividade da doença (SLEDAI) e os danos (SLICC/SDI) causados pela mesma. Através do teste qui-quadrado, o grupo LES e o grupo controle foram comparados de acordo com as variáveis independentes avaliadas. O teste não paramétrico Mann-Whitney foi usado para comparar a QVRSB de indivíduos do grupo LES e indivíduos do grupo controle. Dentro do grupo LES, o teste Mann-Whitney também foi utilizado para avaliar a QVRSB de indivíduos entre as diferentes categorias de SLEDAI e SLICC/SDI. Para o escore total do OHIP, o nível de significância foi estabelecido em (p<0,05). Para as sub-escalas aplicou-se a correção de Bonferroni e o nível de significância foi estabelecido em (p<0,007). Finalmente, análise de regressão linear foi realizada para a comparação da QVRSB dos dois grupos. Valores de (p<0,05) foram considerados de significância estatística. Os resultados demonstraram que indivíduos do grupo LES apresentaram um maior impacto negativo das condições bucais na qualidade de vida quando comparados aos indivíduos do grupo controle (p=0,011). A condição bucal determinante do impacto negativo foi o uso de prótese (p<0,05). No grupo LES, também foi observado que indivíduos com um dano moderado apresentaram QVRSB deteriorada quando comparados a indivíduos sem dano (p=0,043). O conhecimento do impacto das condições bucais na qualidade de vida de indivíduos portadores de LES pode ser útil para aprimorar o tratamento multidisciplinar deste grupo de pacientes

The present cross sectional study aimed to evaluate the impact of oralconditions on the quality of life of individuals with Systemic Lupus Erythematosus (SLE). A sample of 75 patients with SLE under surveillance at the Department of Rheumatology of the Federal University of Minas Gerais was evaluated. The study also included a control group of 78 individuals, who, according to self-report, did not present any disease..Individuals' oral health-related quality of life (OHRQoL) wasevaluated through the Brazilian version of the questionnaire Oral Health Impact Profile (OHIP-49). All the participants were submitted to dental examination. Dental caries was assessed by means of the DMFT index and the periodontal condition was evaluated through criteria previously established that considered probing depth. Measures of sialometry, sociodemographic characteristics, and oral hygiene habits were also collected. Individuals of the SLE group were evaluated in terms of disease activity (SLEDAI) and disease damage (SLICC/SDI). The responses to categorical questions for each group were compared using the Chi-square test. The responses to continuous variables for each group were compared using Mann-Whitney test. The Mann-Whitney test was also used to evaluate differences in the subscale and overall OHIP scores between the SLE group and the Control group and between the different SLEDAI and SLICC/SDI categories in the SLE group. For the overall score, the level of significance was set at p<0.05. For the subscales, the Bonferroni correction was used and p values <0.007 were considered statistically significant. The results demonstrated that individuals of the SLE group presented a higher negative impact of the oral conditions on the quality of life when compared with the individuals of the control group (p=0,011). The determinant of the negative impact was prosthesis wearing (p<0,05). In the SLE group, it was also observed that individuals with a moderate damage presented worse OHRQoL when compared with individuals without damage (p=0,043). Awareness of the impact of oral conditions on the quality of life of individuals with SLE may be useful to improve the multidisciplinary treatment of this group of patients

Clinical and sociodemographic predictors of oral pain and eating problems among adult and senior Spaniards in the national survey performed in 2010

BACKGROUND: Pain and chewing difficulties have been identified as the strongest predictors of oral disadvantage. The aim of this study is to analyze and quantify the sociodemographic, behavioural and clinical factors modulating the oral pain and eating difficulties reported by Spanish adults and elderly Spanish people in the last National Oral Health Survey performed in 2010. MATERIAL AND METHODS: Data concerning pain and chewing difficulties were acquired on a Likert scale format from a representative sample of the Spanish general population with ages between 35-44 years (n=391) and 65-74 years (n=405). Risk factors were identified using bivariate analysis, after which the crude association between risk factors (sociodemographic, behavioural and clinical) and outcome variables (pain and eating problems) was assessed by adjusted odds ratios, calculated by means of multivariate logistic regression. RESULTS: Eating problems and oral pain were mainly associated with prosthetic and caries treatment needs as clinical predictors, but female sex was also seen to be a relevant and significant risk factor for suffering pain and eating restrictions. Paradoxically, after taking into account all the aforementioned predictors, the adults had an almost two fold higher risk of reporting pain or eating difficulties than the elderly subjects. CONCLUSIONS: In agreement with the results from the last national oral health survey, prosthetic and caries treatment needs should be considered key factors in determining the oral well-being of the Spanish population. In sociodemographic terms, the women and adults were seen to be at a significantly higher risk of suffering pain and eating restrictions

Trends in dental service provision in Australia: 1983-1984 to 2009-2010.

OBJECTIVE: To investigate time trends in dental service provision. METHODS: A random sample of Australian dentists was surveyed by mailed questionnaires in 1983-1984, 1993-1994, 2003-2004, and 2009-2010 (response rates 67-76%). The service rate per visit was collected from a log of services. RESULTS: The rate of service provision per visit [rate ratio (RR)] increased from 1983-1984 to 2009-2010 for the service areas of diagnostic (RR=1.8; 1.6-1.9), preventive (RR=1.9; 1.6-2.1), endodontic (RR=2.1; 1.7-2.6), and crown and bridge (RR=2.9; 2.3-3.8), whereas prosthodontic services decreased (RR=0.7; 0.6-0.9). CONCLUSIONS: The profile of services provided by dentists changed over the study period to include less emphasis on replacement of teeth and more on diagnosis, prevention, and retention of natural dentitions.

Prevalência de hipomineralização molar-incisivo e fatores associados em escolares de um município do sudeste brasileiro / Prevalence of molar incisor hypomineralization and associated factors among schoolchildren from a city in southeastern Brazil

Estudos no mundo todo têm investigado os potenciais fatores envolvidos na ocorrência da hipomineralização molar-incisivo (HMI), porém os resultados relatados são variados e inconclusivos. Desta forma, os objetivos deste estudo foram verificar a prevalência de HMI em um grupo de escolares de oito e nove anos de idade e investigar os possíveis fatores associados. Um estudo transversal foi realizado com uma amostra de base populacional. A amostra aleatória, estratificada entre escolas públicas e privadas, foi composta por 1.181 escolares residentes em Lavras, Minas Gerais, Brasil. Previamente ao estudo principal, um estudo piloto foi desenvolvido para testar a metodologia. Os dados foram coletados através de exame clínico e questionários autoaplicáveis respondidos pelas mães. As mães responderam a um questionário autoaplicável contendo questões abrangendo características pré-natais, perinatais e saúde da criança nos quatro primeiros anos de vida e a outro sobre características socioeconômicas e demográficas. A HMI foi diagnosticada a partir dos critérios da Academia Europeia de Odontopediatria. Por meio do exame bucal, avaliou-se também a cárie dentária nas dentições decídua e permanente, de acordo com as recomendações da Organização Mundial de Saúde (OMS) e os defeitos de desenvolvimento de esmalte (DDE) nos segundos molares decíduos utilizando o Developmental Defects of enamel Index (DDE index). Os exames bucais foram realizados por um único examinador previamente calibrado. A análise estatística incluiu descrição dos dados, testes bivariados e modelos de regressão de Poisson com variância robusta (p<0.05, IC95%). Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (CAAE 10659812.0.0000.5149). A prevalência de HMI foi de 20,4%. Observou-se maior frequência de HMI entre as crianças com cárie na dentição permanente (RP: 2,67; IC95%: 1,98-3,61), DDE nos segundos molares decíduos (RP: 2,54; IC95%: 1,87- 3,45) e que tiveram asma e/ou bronquite até os quatro anos de idade (RP: 1,93; IC95%: 1,45-2,56). Conclui-se que a prevalência de HMI foi alta na amostra estudada. A HMI foi mais frequente em crianças com experiência de cárie na dentição permanente, com presença de DDE nos segundos molares decíduos e 10 naquelas que tiveram asma e/ou bronquite até os quatro anos de idade, mesmo após controle para os fatores potencialmente associados

Although studies worldwide have investigated potential factors involved in the occurrence of molar incisor hypomineralization (MIH), the findings are varied and inconclusive. Thus, the aim of this study was to determine the prevalence and investigate the factors associated with the occurence of molar incisor hypomineralization in a group of schoolchildren aged eight and nine years. A crosssectional study was conducted with a population-based sample. The random sample, stratified between public and private schools, consisted of 1181 children residents in Lavras, Minas Gerais, Brazil. Prior to the main study, a pilot study was carried out to test the methodology. Data were collected via clinical examination and selfadministered questionnaires completed by mothers. Mothers completed a selfadministered questionnaire with questions on prenatal, perinatal and postnatal aspects, and another questionnaire on socioeconomic and demographic aspects. MIH was diagnosed using the criteria of the European Academy of Pediatric Dentistry. During the clinical examination, the presence of caries in permanent and primary dentitions, according to the recommendations of the World Health Organization (WHO) and developmental defects of enamel (DDE) in the second primary molars using the Developmental Defects of enamel Index (DDE index) also were evaluated. Oral examinations were performed by a single examiner who had undergone a training exercise. Data analysis involved descriptive statistics, bivariate tests and Poisson regression with robust variance (p<0.05, IC95%). This study was approved by the Ethics Committee of the Federal University of Minas Gerais, Brazil (CAAE 10659812.0.0000.5149).The prevalence of MIH was 20.4%. MIH was more frequent among children with dental caries in permanent dentition (PR: 2,67; 95%CI: 1,98-3,61); those with DDE on the primary second molars (PR: 2,54; 95%CI: 1,87- 3,45) and those who experienced asthma and/or bronchitis in the first 4 years of life (PR: 1,93; 95%CI: 1,45-2,56). In conclusion, the prevalence of MIH was high in the present sample. The occurrence of MIH was more frequent in children with caries experience in the permanent dentition, those with enamel defects on primary second 12 molars and those who had asthma experience in the first four years of life, even after controlling for potential confounding factors

A vision for oral and maxillofacial pathology in Jamaica / Una visión de la patología oral y maxilofacial en Jamaica

Oral and maxillofacial pathology is an important bridging specialty between dentistry and medicine. This branch of dentistry is gaining special interest as a result of increasing number of oral cancer and microbial diseases. The advancements of medicine and basic medical sciences may help in directing the research in dentistry and oral and maxillofacial pathology. This paper highlights the new area and scope for oral and maxillofacial pathology in Jamaica.

La patología oral y maxilofacial es una especialidad importante que constituye un puente de enlace entre la medicina y la odontología. Esta rama de la odontología está ganando interés especial como resultado del aumento de número de casos cáncer bucal y enfermedades microbianas. Los avances de la medicina y las ciencias médicas básicas pueden ayudar a dirigir la investigación en odontología y patología oral y maxilofacial. Este trabajo pone de relieve la nueva área y el alcance de la patología oral y maxilofacial en Jamaica.

Is dentistry going to get into the salivary diagnostics game or watch from the sidelines?

What is salivary diagnostics and why should you care? Most of us dentists try to avoid or control saliva as it interferes with access, or chemical interactions in dental materials, or impression materials, or when it is simply a nuisance. Periodically, we may note reduced flow or encounter a patient with xerostomia. Correspondingly, we then manage the reduced flow in an attempt to maintain homeostasis. However, with the discovery of salivary biomarkers, saliva is taking on a new role.

Fatores determinantes da dor de dente e o impacto na vida diária de indivíduos residentes em Betim-MG/2013 / Determinants of toothache and impact on daily living among residents of betim, Brazil

O objetivo do presente estudo foi avaliar a prevalência e o impacto da dor de dente e seus fatores determinantes, em adultos de 35 a 44 anos de idade residentes no sudeste do Brasil, município de Betim-MG. O primeiro e o segundo estudo consistiram em estudos transversais com objetivo de investigar a dor de dente e seu impacto na vida diária e na qualidade de vida. Um questionário foi aplicado em uma amostra de 744 indivíduos a avaliação da cárie dentária realizada através do índice CPO-d. A dor de dente relatada nos últimos 6 meses foi o desfecho estudado. No primeiro estudo as variáveis referentes à dor de dente foram agrupadas em três dimensões: acesso aos serviços de saúde bucal, gravidade da dor de dente e limitação social/funcional. Observou-se que 68% apresentaram baixo acesso, 39,7% alta gravidade e 47,3% alto impacto da dor de dente na vida diária. Dos impactos investigados o nervosismo (87,2%) e a dificuldade para mastigar (72,6%) foram os mais freqüentes. Através da análise por correspondência foram identificados quatro grupos com perfis distintos para dor de dente e seus fatores associados. Dois grupos apresentaram maiores efeitos da dor de dente na vida diária. Um composto por indivíduos que tiveram um menor acesso aos serviços de saúde bucal (mulheres, pardas, casadas, 1º grau, baixa renda familiar)...

Contemporary concepts in the diagnosis of periodontal disease.

Periodontitis is an inflammatory disease of bacterial origin that results in the progressive destruction of the tissues that support the teeth, specifically the gingiva, periodontal ligament, and alveolar bone. The diagnosis of periodontal disease currently relies almost exclusively on clinical parameters and traditional dental radiography. In this article, the authors review current diagnostic techniques and present new approaches and technologies that are being developed to improve assessment of this common condition.

Contemporary concepts in the diagnosis of oral cancer and precancer.

This article addresses several issues in the approach to diagnosis of oral cancer. The term oral cancer is clarified. Key aspects of the biologic basis of development of oral cancer and the known risk factors associated with the disease are summarized. The clinical presentation of oral cancers and precancerous lesions and their histopathologic correlates is discussed. The importance of conventional tissue biopsy as the prevailing gold standard for diagnosis is emphasized. Other current technologies available for detecting and diagnosing oral cancer and premalignant lesions are acknowledged, and their respective strengths and weaknesses are discussed.

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico / Idiopathic thrombocytopenic purpura: importance of the dentist in this diagnosis

Esse trabalho descreve um caso de púrpura trombocitopênica idiopática (PTI) diagnosticado durante exame odontológico de rotina. A PTI é uma desordem caracterizada pela destruição anormal das plaquetas circulantes e geralmente apresenta manifestações bucais. Dessa forma, destacamos a importância de o cirurgião-dentista estar apto a reconhecer os sinais e sintomas da PTI, principalmente mudanças bucais que não têm origem dental, possibilitando tratamento imediato. Esta patologia quando não tratada, pode ser irreversível e fatal.

Manifestações orais em pacientes pediátricos leucêmicos / Oral manifestations in pediatrics leukemic patients

A Leucemia Linfóide Aguda é o câncer mais comum em pacientes pediátricos, caracteriza-se por apresentar manifestações clínicas iniciais e decorrentes do próprio tratamento antineoplástico. O objetivo deste trabalho foi verificar a prevalência das manifestações clínicas gerais e orais relacionadas à Leucemia Linfóide Aguda bem como das complicações orais agudas da terapia antineoplástica, além de enfatizar a participação do cirurgião-dentista no acompanhamento desses pacientes. Foram examinados 16 pacientes com diagnóstico de Leucemia Linfóide Aguda que estavam em tratamento antineoplástico no Instituto de Hematologia e Hemoterapia e Casa da Criança/ NACC-JP...

Acute linfoblastic leukemia is the most common type of cancer in pediatric patients. This disease is characterized by presenting initial clinical manifestations and those stemming from antineoplasic treatment. The aim of this study was verify theprevalence of the general and oral clinical manifestations related to acute linfoblastic leukemia as well as of oral manifestations from antineoplasictherapy. In addition, this study also intended to emphasize the importance of this knowledge for dentistry professionals who treat these patients.Sixteen individuals, all patients undergoing antineoplasic treatment at Instituto de Hematologia and Hemoterapia and Casa da Criança/NACC-JP and who had been diagnosed with acute leukemia, were examined. Of the individuals studied, 75% were males, 62.5% were white, and the age varied from 3 to 17 years of age. The most common clinicalmanifestations included: fever, pallor, cervical lymphadenopathy, and bone pain. During the therapy period, oral manifestations found included: mucosite,traumatic petechia, and diffuse papillary atrophy. Dentists may provide a premature diagnosis...

Lesões estomatológicas em crianças HIV positivas e suas implicações clínicas / Stomatologic lesions in HIV infected children and their clinical implications

Lesões bucais são comuns nos pacientes pediátricos infectados pelo HIV. Estas doenças relacionam- se com o estado de saúde geral do paciente e com o seu prognóstico frente à HAART (Highly Active Antiretroviral Therapy). Este artigo teve como objetivo descrever, conforme relatos na literatura científica, as principais lesões estomatológicas associadas ao HIV presentes em pacientes pediátricos, destacando as suas formas clínicas, diagnóstico e possíveis tratamentos e, com isso auxiliar no exame intra-oral regular e acompanhamento do paciente.