Anterior shoulder anatomy and subcoracoid impingement: An anatomical study.

OBJECTIVE: The aim of our study was to describe the anatomy of the anterior shoulder, specifically structures potentially involved in subscapularis tears pathophysiology and also to identify structures at risk during surgical approaches of this area. MATERIALS AND METHODS: We designed an observational, experimental study based on cadaveric models. Dissection was performed and several structures of the anterior shoulder were characterized including the subscapularis, coracoid morphology, the coracoacromial ligament, coraco-humeral distance, and the axillary and musculocutaneous nerves. RESULTS: Our sample included 16 shoulders. The coracoacromial ligament presented two bands in 37.5%, and these variants were significantly wider and thinner, and were associated with inferior coraco-humeral distance in internal rotation. The subscapularis footprint was longer and the coracoid process was bigger in male specimens, and the median coracoid angle was 122°, corresponding to a Leite-Torres type I. The Subscapularis showed a median thickness of 0.7cm, while the coraco-humeral distance in our sample ranged from 0.30cm in internal rotation to 0.85cm in external rotation. Neurologic relevant structures were at least more than 2.55cm from the coracoid tip. CONCLUSIONS: This is the first paper to explore the eventual relationship between the presence of a double band coracoacromial ligament variant and subcoracoid impingement. Also, to our knowledge, this is the first cadaveric model study to postulate a possible anatomic base for subcoracoid impingement, as the SS myotendinous junction thickness was found to be greater than the coraco-humeral distance in neutral position and in IR.

Helicobacter pylori identification: a diagnostic/confirmatory method for evaluation.

The Helicobacter pylori extra gastric reservoir is probably the oral cavity. In order to evaluate the presence of this bacterium in patients with periodontitis and suspicious microbial cultures, saliva was collected from these and non-periodontitis subjects. PCRs targeting 16S rRNA gene and a 860 bp specific region were performed, and digested with the restriction enzyme DdeI. We observed that the PCR-RFLP approach augments the accuracy from 26.2 % (16/61), found in the PCR-based results, to 42.6 % (26/61), which is an excellent indicator for the establishment of this low-cost procedure as a diagnostic/confirmatory method for H. pylori evaluation.

Cariogenic bacteria and dental health status in adolescents: the role of oral health behaviours.

AIM: To evaluate the association between dental health status and levels of cariogenic bacteria in teenagers and the influence of behaviours and socio-demographic background on levels of bacteria. MATERIALS AND METHODS: Study design: A cross-sectional population-based sample of 13-year-old adolescents (112 females and 78 males, total 190) was examined. The number of decayed, missing and filled surfaces (DMFS), plaque and hygiene index were recorded according to the WHO criteria. The saliva samples were collected in a sterile container and then analysed by culture on Mitis Salivarius Bacitracin (MSB) agar for mutans Streptococci and on Man Rogosa Sharp (MRS) agar for Lactobacilli. The levels of bacteria were expressed as the number of colonies forming units per millilitre of saliva (CFU/ml). Associations between levels of mutans Streptococci and Lactobacilli and dental health were estimated by odds ratio (OR) and 95% confidence interval (95% CI) using unconditional logistic regression. RESULTS: No mutans Streptococci were detected in 53.2% of the adolescents but 22.6% presented ≥ 10³ CFU/ml. For Lactobacilli, these values were, respectively 43.7% and 34.7%. After adjustment for gender and social class, the OR (95% CI) for DMFS >5 was 8.66 (3.57-21.02) if mutans Streptococci ≥ 10³ CFU and 2.11 (0.96-4.64) if Lactobacilli ≥ 10³ CFU. CONCLUSION: This data allow us to conclude that hygiene habits and dental visits are not associated with high levels of cariogenic bacteria, but high scores of DMFS were found in adolescents with high levels of mutans Streptococci and lower parents' education.

Relationship between dental and periodontal health status and the salivary microbiome: bacterial diversity, co-occurrence networks and predictive models.

The present study used 16S rRNA gene amplicon sequencing to assess the impact on salivary microbiome of different grades of dental and periodontal disease and the combination of both (hereinafter referred to as oral disease), in terms of bacterial diversity, co-occurrence network patterns and predictive models. Our scale of overall oral health was used to produce a convenience sample of 81 patients from 270 who were initially recruited. Saliva samples were collected from each participant. Sequencing was performed in Illumina MiSeq with 2 × 300 bp reads, while the raw reads were processed according to the Mothur pipeline. The statistical analysis of the 16S rDNA sequencing data at the species level was conducted using the phyloseq, DESeq2, Microbiome, SpiecEasi, igraph, MixOmics packages. The simultaneous presence of dental and periodontal pathology has a potentiating effect on the richness and diversity of the salivary microbiota. The structure of the bacterial community in oral health differs from that present in dental, periodontal or oral disease, especially in high grades. Supragingival dental parameters influence the microbiota's abundance more than subgingival periodontal parameters, with the former making a greater contribution to the impact that oral health has on the salivary microbiome. The possible keystone OTUs are different in the oral health and disease, and even these vary between dental and periodontal disease: half of them belongs to the core microbiome and are independent of the abundance parameters. The salivary microbiome, involving a considerable number of OTUs, shows an excellent discriminatory potential for distinguishing different grades of dental, periodontal or oral disease; considering the number of predictive OTUs, the best model is that which predicts the combined dental and periodontal status.

Prevalence and severity of dental caries in schoolchildren of Porto, Portugal.

OBJECTIVES: To measure the prevalence and severity of dental caries in adolescents of the city of Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental caries experience. METHODS: A sample of 700 thirteen-year-old schoolchildren was examined. Results from the dental examination were linked to anthropometric information and to data supplied by two structured questionnaires assessing nutritional factors, socio-demographic characteristics and behaviour related to health promotion. Dental caries was measured using the DMFT index, and two dichotomous outcomes, one assessing the prevalence of dental caries (DMFT > 0); the other assessing the prevalence of a high level of dental caries (DMFT > or = 4). RESULTS: Consuming soft drinks derived from cola (irrespective of sugared or diet) two or more times per week, attending a public school, being female and having parents with low educational attainment were identified as risk factors both for having dental caries and for having a high level of dental caries. CONCLUSION: Caries levels were positively associated with frequency of intake of sweetened foods and drinks.