Effect of irrigation and stainless steel drills on dental implant bed heat generation.

The objective of this study is assessing the influence of the use of different drill types and external irrigation on heat generation in the bone. In-vitro study to compare two different sequences for implant-bed preparation by means of two stainless steels: precipitation-hardening stainless steel (AISI 420B) (K drills), and martensitic stainless steel (AISI 440) (S drills). Besides, the drilled sequences were realized without irrigation, and with external irrigation by means of normal saline solution at room temperature. The study was realized on bovine ribs using: K without irrigation (KSI) and with irrigation (KCI) and S without irrigation (SSI) and with irrigation (SCI) with five drills for each system. Each drill was used 100 times. Bone temperature was measured with a thermocouple immediately after drilled. Average bone temperature with irrigation was for K drills 17.58±3.32 °C and for S drills 16.66±1.30 °C. Average bone temperature without irrigation was for K drills 23.58±2.94 °C and for S drills 19.41±2.27 °C. Statistically significant differences were found between K without irrigation versus S with irrigation and K with irrigation (p<0.05, Bonferroni correction). Lower temperature variation coefficient throughout the 50 measurements was observed in irrigated groups (K=5.6%, S=5.1% vs. without irrigation groups K=9.4%, S=9.3%). The first K drill generated more heat than the remaining drills. No significant differences were detected among temperature values in any of the analyzed drill groups. Unlike irrigation, drill use and type were observed to have no significant impact on heat generation. The stainless steel AISI 420B presents better mechanical properties and corrosion resistance than AISI440.

Confirmation of oxidative stress and fatty acid disturbances in two further Papillon-Lefèvre syndrome families with identification of a new mutation.

BACKGROUND: We have previously reported oxidative and fatty acids disturbances in one Papillon-Lefèvre syndrome (PLS) family. This Mendelian condition characterized by palmar plantar keratosis and severe aggressive periodontitis, is caused by mutations in the cathepsin C (CTSC) gene. In this study, we have analysed two further unrelated PLS families to confirm this association. METHODS: Mutations were identified by direct sequencing of CTSC. Biochemical analyses were performed in probands and their relatives in order to determine plasma levels of vitamin E, CoQ10 , lipid hydroperoxides (HP) and fatty acid patterns. RESULTS: Pathogenic CTSC mutations were identified in both families including a new mutation (c504C>G). Both probands showed low levels of vitamin E and CoQ10 , and high levels of lipid HP, and also very low levels of docohexaenoic acid. CONCLUSIONS: The previously reported oxidative and fatty acids disturbances were confirmed as a feature of this condition in two further families. There are low levels of antioxidant markers and high levels of oxidative markers, in addition of low levels of some anti-inflammatory fatty acids in persons suffering PLS and some of their relatives.

Comparative analysis of 2 resonance frequency measurement devices: Osstell Mentor and Osstell ISQ.

OBJECTIVE: Comparing reliability of Osstell Mentor and Osstell ISQ in implant stability measurement, and assessing whether their measurements are comparable. MATERIALS AND METHOD: Implant stability was measured with both devices on 58 implants in 15 patients. Six measurements were completed with each device with 2 different transducers (3 measurements with each transducer), that is, 12 measurements for each implant. RESULTS: Mean implant stability quotient (ISQ) value with Osstell ISQ was 72.59, 72.47, and 73.17 in the first measurements, respectively. With Osstell Mentor, the results were 72.43, 72.60, and 73.26, respectively; mean ranges were 3.37, 3.60, and 3.75, respectively. However, mean value with Osstell ISQ and Osstell Mentor was 72.87 and 72.04, respectively. The intraclass correlation coefficient was 0.98. This means an almost perfect degree of concordance between both devices. CONCLUSIONS: Resonance frequency analysis systems in Osstell Mentor and Osstell ISQ show almost perfect reproducibility and repeatability.

Periodontitis is associated with altered plasma fatty acids and cardiovascular risk markers.

BACKGROUND AND AIMS: In periodontitis it has been found that some perturbation exists in lipid biomarkers, such as increased serum total cholesterol and low-density lipoprotein cholesterol. Nevertheless, the relationship between fatty acids and periodontitis has been demonstrated only in a few studies and remains controversial. The aim of this investigation was to explore the effects of periodontitis on a cluster of traditional and novel cardiovascular risk factors such as plasma-lipids profile, types of plasma fatty acids, adhesion molecules and systemic inflammatory markers. METHODS AND RESULTS: At a university dental school, 56 patients all over 35 years old were enrolled and invited to participate in the study. Total plasma fatty acids, saturated, n-6 polyunsaturated and monounsaturated fatty acids, peroxidability index, soluble VCAM, TNF-alpha, cholesterol, triacylglycerols, and VLDL-c were significantly higher in the periodontitis group compared to the non-periodontitis group. CONCLUSIONS: This close association found between plasma triacylglycerols, LDL-c, saturated fatty acids, polyunsaturated fatty acids, total amount of fatty acids and coenzyme Q(10) with some periodontal data such as periodontal probing depth, recession of the gingival margin and clinical attachment level (Pearson correlation between 0.3 and 0.6), leads to the conclusion that there is an inter-relationship between periodontitis, plasma fatty acids profile and the increase in metabolic risk factors for cardiovascular diseases.

Oxidative stress markers in oral lichen planus.

Oral lichen planus (OLP) is a relatively common disorder whose cause is still unknown. Oral cancer is preceded in most cases by pre malignant lesions-leukoplasia, submucous fibrosis and lichen planus. Free radicals and reactive oxygen species play important roles in both pathogenesis of lichen planus and carcinogenesis. Thus monitoring systemic and saliva compounds important for the antioxidant defence (oxidative balance) could be important for the clinician's treatment strategy. Thorough medical management and early active treatment are necessary to improve symptoms and might also be a relevant prevention strategy from squamous cell carcinoma risk, although data to fully support this statement still need investigation. The principal aim of this study was to determine the systemic uric acid, GGT, and albumin levels as well as the levels of uric acid and albumin in 20 patients diagnosed with lichen planus and 20 controls. Extensive medline search failed to reveal any study of this type. Our results showed a significant decrease of saliva (p < 0.005) uric acid and an increase in serum gamma glutamyl transpherase (GGT) (p < 0.01) as well as in the total antioxidant capacity of saliva in patient group with respect to the control one. The preliminary conclusion of our study is that uric acid, the most important salivary antioxidant and GGT could be considered in the future as useful markers of oxidative stress for elaboration of treatment strategy and monitoring.

Nifedipine and cyclosporin affect fibroblast calcium and gingiva.

It has been stated that cyclosporin and nifedipine produce gingival overgrowth. However, the specific pathogenic mechanism remains uncertain. We used an experimental rat model to test the hypothesis that changes in collagen metabolism and numbers of gingival blood vessels are not mediated by intracellular calcium concentration (ratiometric Fura-2 AM measurement) in gingival fibroblasts. In the cyclosporin group, both width (364.2 +/- 67.5 mum) and microvessel density (number of vessels/mm(2), stained with anti-CD34 antibody) (41.6 +/- 5.1) of gingiva were statistically different when compared with those in the control group (width = 184.3 +/- 35.2 mum, microvessel density = 19.6 +/- 2.4). The nifedipine group showed the highest content of collagen (proportion of total stroma occupied by collagen, stained with Picro-Mallory) (nifedipine group = 66.3 +/- 9.4, cyclosporin group = 55.2 +/- 7.9, control group = 30.1 +/- 10.2). Freshly cultured fibroblasts from the cyclosporin group exhibited higher ratiometric values of fluorescence than did both the control and nifedipine groups (p = 0.03). Our results support the hypothesis that changes in gingival collagen metabolism are not mediated by calcium intracellular oscillations.

The relationship between insulin resistance and periodontitis is not affected by Mediterranean diet in a Spanish population.

OBJETIVE: To examine the insulin resistance measured by surrogate indices in subjects with and without periodontitis and to find out any correlation among dietary intake with insulin resistance. DESIGN: Fifty-five patients were recruited to participate in this cross-sectional study. Insulin resistance measured by the homoeostasis model assessment (HOMA-IR) and the quantitative insulin sensitivity check index moreover glycaemia, creatinine, uric acid, high density lipoproteins, low density lipoproteins, very low density lipoproteins and triglycerides among others. True periodontal disease was elucidated through the examination of probing pocket depth, clinical attachment level, recession of the gingival margin and gingival bleeding. The statistical analyses used were the student's T-test for independent variables, Kolmogorov-Smirnov if variations were homogeneous; if not, the Mann-Whitney U Test was applied instead. Correlations between variables were assessed using Pearson's correlation coefficients. True periodontal disease was confirmed through the greater values of probing pocket depth, clinical attachment level, gingival margin and gingival bleeding in the periodontitis group in comparison with non-periodontitis group. RESULTS: Insulin resistance was evidenced by the greater values of HOMA-IR as well as by the lower quantitative insulin sensitivity check index values in the periodontitis group. Fasting insulin, glucose, uric acid, creatinine, low density lipoproteins, triglycerides and very low density lipoprotein levels were significant higher in periodontitis group. Pearson's correlations did not show any association among diet data and insulin resistance parameters in periodontitis patients. CONCLUSION: A putative systemic relationship between insulin resistance and periodontitis exists but it does not seem conceivable any effect of diet over such relationship.

In vitro antioxidant activities of antioxidant-enriched toothpastes.

Several forms of periodontal diseases (PD) are often associated with modified phagocytosing leukocytes and contemporary free radical production. Host antioxidant defenses could benefit from toothpastes used as adjuncts to counteract plaque-associated bacteria. The aim of the present study was to determine possible antioxidant activity (AA) of 12 differently antioxidant-enriched toothpastes, regardless of their efficacy as antimicrobial agents. Toothpastes were enriched alternatively with sodium ascorbyl phosphate, alpha-tocopherol acetate, pycnogenol, allantoin and methyl salycilate or a mixture of these. AA was tested in a cell-free system with a ABTS-decolorization assay improved by means of a flow injection analysis device. Comet assay, using NCTC 2544 keratinocytes, was performed to test if it was possible to identify any protection against in vitro DNA fragmentation provoked by a challenge with H(2)O(2) in cultures pre-incubated with toothpaste extracts. Only toothpastes containing sodium ascorbyl phosphate displayed clear AA with I(50) values ranging between 50 and 80 mg of toothpaste/ml water. COMET analysis of cells challenged with H(2)O(2) in presence of toothpaste extracts revealed a limited protection exerted by sodium ascorbyl phosphate. The results described herein indicate that toothpastes containing sodium ascorbyl phosphate possess AA. All the data were obtained in systems in vitro and the demonstration of in vivo AA is desirable. These findings could be useful in the treatment and maintenance of some forms of PD and should be considered when arranging new toothpaste formulations.

A morphometric study of the secretory granules of the granular duct in the submaxillary gland of the rat following stimulation with noradrenaline and isoproterenol.

In the present work, we carry out a morphometric analysis, at ultrastructural level, of the secretory granules of the granular undulated duct of the submaxillary gland of the rat, under basal conditions (Control Group or I), following stimulation for 10 minutes with 2 mg/100 g weight of Isoproterenol (Group II), and following stimulation with 2 gammas/100 g weight of Noradrenalin for the same time as in the former case. It is seen that in general, Noradrenalin produces the appearance of a greater number of small granules than does Isoproterenol or the control group; and that Isoproterenol induces the presence of larger-sized granules than does Noradrenalin.

Effect of cigarette smoking on periodontal status of healthy young adults.

BACKGROUND: It has been shown that tobacco is a significant risk factor for periodontal disease; however, there have been few studies on young populations where problems of general health can be discounted. The purpose of this study was to examine the influence of tobacco consumption on the periodontal condition of a young, healthy population. METHODS: The study population consisted of 304 young Caucasian males (average age 19.38 +/- 0.72 years) entering the Armed Forces. All the subjects completed a self-administered questionnaire on age, oral hygiene habits, previous dental examinations, and quantity and length of tobacco use. The periodontal examination consisted of the plaque index (PI); periodontal bleeding index (PBI); probing depth (PD); and clinical attachment level (CAL). One- and 2-way ANOVA was used to compare data recorded between smokers and non-smokers. RESULTS: Forty-six percent of subjects reported that they brushed their teeth at least once a day, but only 13% visited a dentist at least once a year. Over half (53%) were habitual smokers, 43% smoking between 5 and 20 cigarettes per day; 39% of the smokers had been smoking for less than 5 years. Mean PI was 31.24 +/- 14.88 (27.19 +/- 15.93 for smokers and 35.78 +/- 12.17 for non-smokers), with significant differences between non-smokers and those who smoked 5 to 20 cigarettes per day (26.85 +/- 16.11, P<0.0001). Mean PBI was 42.29 +/- 8.43 (non-smokers 44.67 +/- 6.53 and smokers 40.17 +/- 9.46). Significant differences were found between the PBI of the non-smokers and of those who smoked 5 to 20 cigarettes per day (39.90 +/- 9.64, P <0.0001). There were also differences in the PBI between those who brushed their teeth once (40.53 +/- 9.61) and twice (44.86 +/- 5.9) a day (P<0.0001). Mean PD was 1.62 +/- 0.43 mm (non-smokers 1.56 +/- 0.36 and smokers 1.68 +/- 0.49). Deeper probing depths were recorded among smokers than among non-smokers, with statistically significant differences (P<0.049); statistically significant differences were also found between those who attended (1.49 +/- 0.50) and those who did not attend (1.65 +/- 0.42) regular dental check-ups (P<0.031). Mean CAL 1.75 +/- 0.41 (non-smokers 1.64 +/- 0.32 and smokers 1.82 +/- 0.44). CONCLUSIONS: It may be concluded that, even at such an early age, tobacco consumption affects the periodontal health. It is necessary to inform young smokers of the risk of tobacco use regarding periodontal health.

The influence of general health and socio-cultural variables on the periodontal condition of pregnant women.

BACKGROUND: There has been speculation as to whether hormonal changes during pregnancy or pre-existing conditions of general, oral, and dental health and socio-cultural background have a greater impact on the development of periodontal disease during pregnancy. METHODS: This study evaluates the periodontal status of 130 pregnant women (plaque index, bleeding index, probing depth, and clinical attachment level) and its relationship to demographic (age, professional level, education, and urban or rural residence) and clinical variables (gestation period, previous pregnancy, health status, previous live births, previous periodontal maintenance). The hospital in which the study was conducted was selected during a prior pilot study. All records were compiled by the same trained examiner with a calibrated manual probe. Statistical tests used were ANOVA and ANCOVA. RESULTS: Results showed a mean plaque index of 58.7+/-2.79%, which increased with statistical significance when the professional level was lower (P <0.014), education was lower (P <0.01), previous periodontal maintenance was less frequent (P <0.00001) and patients lived in rural areas (P <0.0003). The mean bleeding index was 68.8+/-2.44% and was significant in relation to lower professional level (P <0.025), less frequent previous periodontal maintenance (P <0.029), and an urban residence (P <0.0011). A mean clinical attachment level of 0.84+/-0.65 mm was observed and was related significantly with age (26 to 30 years) (P <0.001) and the third trimester of gestation period (P <0.0025). The mean probing depth was 1.71+/-0.3 mm, which related significantly with age (36 to 42 years) (P <0.0002), lower professional level (P <0.0013), rural residence (P <0.0025), 2 or more previous live births (P <0.0001), and non-attendance for previous periodontal maintenance (P <0.0023). Using ANCOVA testing and adjusting by age, the differences relating to previous live births disappeared. CONCLUSIONS: Gingivitis due to accumulation of plaque was the most characteristic periodontal condition in this sample and was related to professional level, level of education, and previous periodontal maintenance. These results illustrate the importance of establishing periodontal preventive measures for pregnant women, even though their demographic and clinical characteristics do not differ from those of the general population.

Elevated hydroperoxide levels and antioxidant patterns in Papillon-Lefèvre syndrome.

BACKGROUND: Since it has been found that reactive oxygen species seem to be involved in the pathogenesis of both periodontitis and hyperkeratotic syndromes, we studied a group of patients belonging to 3 generations of a family with different degrees of severity of Papillon-Lefèvre syndrome (PLS) to ascertain whether altered concentrations of the most important hydrophobic and hydrophilic plasma antioxidants as well as products of oxidative damage are present in PLS. METHODS: Coenzyme Q (CoQ), vitamin E, glutathione (GSH), and uric acid were evaluated by high-performance liquid chromatography (HPLC) (supplied with electrochemical detector) techniques and hydroperoxides by a spectrophotometric method. RESULTS: GSH and uric acid were in the range of reference values; CoQ was very low in both the child of the third generation and his mother, and these 2 subjects had the highest hydroperoxide levels. The child also had extremely low values of vitamin E. In general, all family members showed abnormally high hydroperoxide levels, with the exception of those members who are phenotypically healthy. CONCLUSIONS: Since the subjects with the lowest hydroperoxide contents are phenotypically healthy, whereas the affected individuals presented lower antioxidant levels and very high hydroperoxide concentrations, it has been suggested that a specific antioxidant therapy could be a promising approach in treating some PLS subjects. Moreover, unexpected manifestations of heterozygosity in the child of the third generation were also detected.

Craniofacial and oral manifestations of trichorhinophalangeal syndrome type I (Giedion's syndrome): a case report.

A case of trichorhinophalangeal syndrome type I (Giedion's syndrome) is presented and discussed. Pathologic alterations, including oral and facial manifestations, and the clinical history of this unusual condition are described. The case is compared with others reported in the literature.

Clinical assessment of gingival size among patients treated with diltiazem.

Gingival overgrowth induced by nifedipine has been extensively reported. This finding, however, does not apply to gingival size changes caused by other calcium antagonists such as diltiazem. We studied the gingiva of 13 subjects with ischemic cardiopathy who had been treated with diltiazem and established two control groups: (1) a healthy group of 12 patients and (2) a group of 10 patients with ischemic cardiopathy and concomitant treatment similar to that applied to the diltiazem group except that they had not been administered any type of calcium antagonists. The size of the gingiva around the six anterior teeth was measured on plaster models of the upper and lower jaws. Significantly higher scores of the size of the gingiva were found when patients treated with diltiazem were compared with the patients in the other two groups (p < 0.05) gingiva were found when patients treated with diltiazem were compared with the patients in the other two groups (p < 0.05) and also when interproximal (p < 0.05) and vestibular (p < 0.05) sites were considered. We did not observe any significant difference in the plaque index of each group (p < 0.05); only bleeding after probing was found statistically different between the diltiazem and the nondiltiazem groups.

A clinical assessment of the effectiveness of a mouthwash based on triclosan and on Zea mays L used as supplements to brushing.

The effectiveness of a mouthwash based on triclosan in combatting plaque and gingivitis was compared with a mouthwash based on nonsaponifiable maize germ (Zea mays L). Both were used to supplement conventional mechanical oral hygiene. The study was carried out under double-blind conditions with a negative control (a placebo) and a positive control (a mouthwash based on chlorhexidine). After a period of 14 days to allow the Plaque Index and Gingival Index to standardize, the 43 subjects who formed the sample were examined weekly for 3 weeks. During the study, five subjects were excluded because they did not meet the criteria for selection for the study. Although the mouthwash based on triclosan reduced the Plaque Index by 7.3% in comparison with the placebo negative control (a less marked effect than that of chlorhexidine, which achieved an 8.43% reduction), it had scarcely any effect on the Gingival Index. The mouthwash based on Zea mays L had no beneficial action on the Plaque Index, which increased slightly, but it led to an improvement in the Gingival Index (7.17% in comparison with the placebo).

[The current status in obtaining a license for the practice of dentistry in the European Union and the United States of America]. / Estado actual de la obtención de la licencia para el ejercicio de la odontología en la Unión Europea y en los Estados Unidos de Norteamérica.

Present regulations on the issuance of dental licenses are very different between the United States of America and the European Community. Two different mechanisms attempt to arrive at the fairest possible solution: licenses controlled by either national and/or local examinations in the United States, and licensing by credentials in the European Community. Both are compared and discussed.

Periodontal status and treatment needs among Spanish hospitalized psychiatric patients.

The purpose of this study was to evaluate the periodontal status and treatment needs (by CPITN) of 565 patients hospitalized in a psychiatric facility in Seville, Spain. The results of this study showed that 31.7% of the patients were edentulous and that 68.3%% were dentate. Of the dentate subjects, 8.5% were found to have a healthy periodontium, 14.2% had bleeding on probing, 43.8% had calculus, 24.6% had shallow pockets, and 8.9% had deep pockets. The results of the study also showed that the severity of periodontal disease increased significantly with age and the length of time of hospitalization. The need for oral hygiene instruction among the dentate population was determined to be 91.5%, and the need for treatment (oral prophylaxis and scaling) was 77.3%. These findings suggest that hospitalized psychiatric patients in Spain are in dire need of preventive dentistry.

Dental health among institutionalized psychiatric patients in Spain.

This study assessed the dental health of an institutionalized psychiatric population in Spain. The study population was composed of 347 males and 218 females with a mean age of 58.0. The mean length of hospitalization was 26.1 years. The largest proportion of the patients (62%) was diagnosed as having schizophrenia. All subjects were taking psychotropic drugs, with a mean number of 2.1 medications. The sample was examined according to the WHO dental criteria. The DMFT index demonstrated the mean number of carious teeth to be 7.9; missing teeth, 17.0; and filled teeth, 0.0. The DMFT index increased significantly with the patient's age and length of hospitalization. Female and demented patients had significantly higher DMFT scores. These findings suggest that institutionalized patients with mental illness in Spain have extensive untreated dental disease.

Metabolic syndrome and periodontitis: is oxidative stress a common link?

A review of pathological mechanisms that can explain the relationship between periodontitis and cardiovascular disease (CVD) is necessary to improve the management of both conditions. Metabolic syndrome is a combination of obesity, hypertension, impaired glucose tolerance or diabetes, hyperinsulinemia, and dyslipidemia. All these have been examined in recent years in terms of their relationship to periodontitis. Reviewed data indicate an association between some of them (body mass index, high-density lipoprotein-cholesterol [HDL-C], triglycerides, high blood pressure, among others) and periodontitis. Oxidative stress may act as a potential common link to explain relationships between each component of metabolic syndrome and periodontitis. Both conditions show increased serum levels of products derived from oxidative damage, with a pro-inflammatory state likely influencing each other bidirectionally. Adipocytokines might modulate the oxidant/anti-oxidant balance in this relationship.