Single nucleotide polymorphisms in long noncoding RNA, ANRIL, are not associated with severe periodontitis but with adverse cardiovascular events among patients with cardiovascular disease.

BACKGROUND AND OBJECTIVE: Biological plausibility of an association between severe periodontitis and cardiovascular disease (CVD) has been proven. Genetic characteristics play an important role in both complex inflammatory diseases. Polymorphisms (single nucleotide polymorphisms [SNPs]) in the long noncoding RNA, antisense noncoding RNA in the INK4 locus (ANRIL), were shown to play a leading role in both diseases. The primary objectives of the study were to assess, among cardiovascular (CV angiographically proven ≥50% stenosis of a main coronary artery) patients, the impact of ANRIL SNPs rs133049 and rs3217992 on the severity of periodontitis and the previous history of coronary events, as well as on the occurrence of further adverse CV events. MATERIAL AND METHODS: The prevalence of severe periodontitis was analyzed in 1002 CV patients. ANRIL SNPs rs133049 and rs3217992 were genotyped. The prognostic value of both ANRIL SNPs for combined CV endpoint (stroke/transient ischemic attack [TIA], myocardial infarction, death from a CV-related event, death from stroke) was evaluated after a 3-year follow-up period. Hazard ratios (HRs) were adjusted for established CV risk factors applying Cox regression. RESULTS: ANRIL SNPs rs133049 and rs3217992 were not associated with severe periodontitis or history of CVD in CV patients. In the Kaplan-Meier survival curve including the log rank-test (P = .036) and Cox regression (hazard ratio = 1.684, P = .009) the AA genotype of rs3217992 was shown to be an independent predictor for adverse CV events after 3 years of follow-up. CONCLUSION: SNPs in ANRIL are not risk modulators for severe periodontitis and history of CVD in CV patients. The AA genotype of ANRIL SNPs rs3217992 possesses prognostic power for further CV events within 3 years of follow-up.

Use of floss/interdental brushes is associated with lower risk for new cardiovascular events among patients with coronary heart disease.

BACKGROUND AND OBJECTIVE: Periodontitis has been found to be associated with coronary heart disease (CHD) and stroke. However, only little is known about whether periodontitis and associated confounders are associated with new cardiovascular events among patients with CHD. MATERIAL AND METHODS: A total of 942 inpatients with CHD were examined regarding periodontitis, oral care habits, bacteria in the subgingival biofilm and the expression of interleukin-(IL)-6 c. (coding DNA)-174 genotypes (rs 1800793) to determine whether these confounders are associated with new cardiovascular events within a 1-year follow-up period. Adjusted hazard ratios (HR) with respect of age, gender, smoking, body mass index, use of aids for interdental hygiene, plaque index, occurrence of severe periodontitis and further internal diseases such as diabetes, hypertension, dyslipoproteinemia, number of missing teeth, serological parameters and IL-6 genotypes were generated with Cox regression. RESULTS: In all, 941 cardiovascular patients completed the 1-year follow up and 7.3% of the patients achieved the primary endpoint (myocardial infarction: 2.1%, stroke/transient ischemic attack: 1.8%, cardiovascular deaths: 3.4%). Patients who reported practicing interdental cleaning were younger, less likely to be male or to have severe periodontitis, had a reduced tobacco exposure, had fewer missing teeth, less indices for plaque and bleeding on probing and a significant decreased adjusted risk for new cardiovascular events (HR = 0.2, CI 0.06-0.6, p = 0.01) than those patients with CHD who did not report practicing interdental cleaning. We did not obtain significant increased HR for patients with severe periodontitis (HR = 1.2, CI 0.7-2.1, p = 0.53), carriers of the IL-6 genotypes GC or CC (HR = 1.4, CI 0.8-2.5, p = 0.24) and did not find a significant association between the number of detected various oral species and the incidence of the combined endpoint (HR = 0.9, CI 0.8-1.01, p = 0.07). CONCLUSIONS: These findings suggest that flossing and brushing of interdental spaces might reduce the risk for new cardiovascular events among patients with CHD. The hypothesis that interdental cleaning per se reduces the risk of new cardiovascular events should be examined in an interventional study.

The del/del genotype of the nuclear factor-kappaB -94ATTG polymorphism and its relation to aggressive periodontitis.

BACKGROUND AND OBJECTIVE: Periodontitis is influenced by specific host-dependent immune responses. Periodontopathogens induce innate immune responses, amongst others, via toll-like receptor 2 (TLR2), resulting in activation of the nuclear transcription factor nuclear factor-kappaB (NF-kappaB). The aim of this case-control study was to evaluate links between genetic variants of these genes and chronic/aggressive periodontitis in a multivariate model. MATERIAL AND METHODS: A total of 141 patients with periodontitis (63 with chronic periodontitis and 78 with aggressive periodontitis) and 81 controls without periodontitis were included in the study. Polymorphisms in TLR2 (Arg677Trp, Arg753Gln) and in NF-kappaB (-94ins/delATTG) were determined by restriction fragment length polymorphism and fragment length analyses, respectively. Subgingival bacterial colonization was evaluated using a PCR/DNA probe test (micro-Ident). RESULTS: Although there was no association of the TLR2 polymorphism Arg753Gln with periodontitis, heterozygous carriers (Arg/Gln) were at a higher risk for colonization with bacteria of the 'red complex' (corrected p-value = 0.042). The del/del genotype of the NF-kappaB polymorphism was associated with aggressive periodontitis considering age, gender, smoking and approximal plaque index as potential confounders (odds ratio = 2.81, p = 0.035, 95% confidence interval: 1.08-7.33). del/del carriers had a higher risk for subgingival colonization with Aggregatibacter actinomycetemcomitans (odds ratio = 2.36, p = 0.030, 95% confidence interval: 1.09-5.1; adjusted for age, gender, smoking and pocket depth(bacteria)). CONCLUSIONS: The del/del genotype of NF-kappaB was shown to be associated with the occurrence of aggressive periodontitis.

Interleukin-2 -330 and 166 gene polymorphisms in relation to aggressive or chronic periodontitis and the presence of periodontopathic bacteria.

BACKGROUND AND OBJECTIVE: As a pro-inflammatory cytokine, interleukin-2 mediates the activation, growth and differentiation of T and B lymphocytes and natural killer cells. Promoter polymorphisms of the interleukin-2 gene have been associated with altered interleukin-2 production or identified as prognostic markers for various infectious diseases. Therefore, the aim of this study was to evaluate two polymorphisms at positions -330 T/G and 166 G/T in patients with generalized chronic periodontitis (n = 58) or generalized aggressive periodontitis (n = 73) in comparison with periodontitis-free controls (n = 69). MATERIAL AND METHODS: Both interleukin-2 polymorphisms were analyzed using the polymerase chain reaction with sequence-specific primers. Distributions of single alleles, genotypes and haplotypes were calculated using the chi-square test. Risk factor analyses were carried out by logistic regression with respect to established cofactors for periodontitis. The presence of subgingival bacteria in an individual were analyzed using a molecular biological method (the micro-Ident test). RESULTS: The interleukin-2 genotype -330 TG occurred less frequently in patients with chronic periodontitis (25.9% vs. 49.3%). Moreover, this genotype decreased the adjusted odds ratio for chronic periodontitis (odds ratio = 0.394), whereas the interleukin-2 genotype 166 TT and the haplotype combination interleukin-2 -330,166 TT : TT were associated with an increased adjusted odds ratio (odds ratio = 2.82 or 2.97). For the latter interleukin-2 combination, a positive association for the subgingival presence of Porphyromonas gingivalis (81.3% vs. 59.5%) and bacteria of the 'red complex' (78.1% vs. 56.0%) was shown. CONCLUSION: The interleukin-2 genotypes -330 TG and 166 TT, as well as the combination genotype interleukin-2 TT : TT, could be putative prognostic factors for chronic periodontitis.

Oral health-related quality of life in patients seeking care for dentin hypersensitivity.

The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) impairment in patients seeking care for their hypersensitive teeth in comparison with general population subjects and to investigate the influence of gender and age on OHRQoL in these populations. Study participants were 656 patients without removable prosthodontics who sought treatment for their hypersensitive teeth in German dental offices. These patients were asked to complete the German form of the Oral Health Impact Profile (OHIP-G) prior to treatment. The sum of OHIP-G item responses (OHIP-G49, 0-196) characterized the OHRQoL impairment. Patients' OHIP summary scores were compared with those in a sample of the German general population (n = 1541). The influence of population (patients vs. general population subjects), gender and age was investigated using a multivariable linear regression model. Age presented a curvilinear association with OHRQoL, with lower OHIP scores associated with younger and older adults and higher OHIP scores (indicating impaired OHRQoL) associated with middle-aged adults in both the patient and general populations. Gender influence depended on the population, i.e. female general population subjects had lower OHIP scores than male general population subjects and female patients had higher OHIP scores than male patients. Mean OHIP summary scores indicated that patients with hypersensitive teeth reported considerably more impaired OHRQoL (approximately 22 OHIP units) than subjects in the general population. The present study suggests that the oral condition of hypersensitive teeth is significantly associated with impaired OHRQoL.

The interleukin-10 promoter haplotype ATA is a putative risk factor for aggressive periodontitis.

BACKGROUND AND OBJECTIVE: Interleukin-10 has been described as an anti-inflammatory cytokine and a B-cell proliferation factor. Promoter polymorphisms of the interleukin-10 gene have been associated with altered interleukin-10 expression. Therefore, the aim of this study was to evaluate three polymorphisms at positions -1082G>A, -819C>T and -590C>A in patients with generalized chronic periodontitis (n = 27) and generalized aggressive periodontitis (n = 32) in comparison with periodontitis-free controls (n = 34). MATERIAL AND METHODS: Interleukin-10 promoter polymorphisms were analyzed by polymerase chain reaction with sequence-specific primers (PCR-SSP). Distributions of single alleles, genotypes and haplotypes were calculated by the chi-square test. Risk factor analyses were carried out by logistic regression. Subgingival bacteria were subjected to molecular biological analyses using the micro-Ident test. RESULTS: The combination ATA/ATA was found only in patients with aggressive periodontitis (15.6 vs. 0.0%, p = 0.023). Taking into account age, gender, smoking and plaque level, an increased odds ratio (3.7, p = 0.04) for aggressive periodontitis was shown for subjects with the haplotype ATA. Prevotella intermedia was found to be decreased in ACC- positive (41.3 vs. 66.7%, p = 0.022), ATA-positive (33.3 vs. 57.1%, p = 0.032) and ACC/ATA-positive (20.0 vs. 55.9%, p = 0.002) individuals. In GCC/GCC-positive subjects, P. intermedia occurred more frequently (86.7 vs. 42.3%, p = 0.002). CONCLUSION: The haplotype ATA, which is known as a 'low interleukin-10 producer' is a putative risk indicator for generalized aggressive periodontitis.

Impact of genetic variants of CD14 and TLR4 on subgingival periodontopathogens.

CD14 and toll-like receptor 4 (TLR4) are involved in host's immune response to bacterial pathogens including periodontal bacteria. Functional important gene polymorphisms are described for both genes. The aim of this study was to evaluate links between genetic polymorphisms of CD14 and TLR4 and risk markers of periodontitis in a multivariate model. One hundred and thirty-three periodontitis patients (chronic: n = 60, aggressive: n = 73) and 80 healthy controls without periodontitis were included in the study. Polymorphisms in CD14 c.-159C>T and in TLR4 Asp299Gly, Thr399Ile were determined by restriction fragment length polymorphism analyses. The clinical investigation included smoking status, plaque and bleeding indexes, pocket depth and attachment loss. Subgingival bacterial colonization was analysed molecularbiologically using the micro-Ident test. Prevotella intermedia occurred less frequently in individuals positive for the TT genotype of CD14 in bivariate analysis (odds ratio = 0.36%, confidence interval: 0.14-0.91, P = 0.045). In binary logistic regression analyses, the occurrence of this bacterium was significantly decreased in TT carriers (odds ratio = 0.31%, confidence interval: 0.81-0.12, P = 0.017) considering age, smoking and maximum clinical attachment loss at microbial test site as confounding factors. However, no significant association with chronic and or aggressive periodontitis and polymorphisms in CD14 and TLR4 could be proven. Although the CD14 c.-159C>T polymorphism could be shown to be associated with subgingival colonization with P. intermedia, there is no evidence that CD14 and TLR4 polymorphisms investigated are independent risk factors for chronic or aggressive periodontitis in German periodontitis patients.

Correlation of microhardness and wear in differently eroded bovine dental enamel.

The purpose of the study was to compare the microhardness data of differently eroded enamel surfaces with the wear caused by toothbrushing. Sixty bovine enamel specimens were polished and prepared for microhardness determination. The polished surfaces were covered with tape except for a 1.3 x 10.0 mm window. Fifteen specimens each were stored in an erosive beverage (Sprite Light) for either 1, 5 or 15 min. Each specimen was immersed in 10 ml of the beverage. The remaining 15 specimens were not eroded. Interferometrical analysis revealed that substance loss after 15 min of erosion was negligibly low (about 75 mm). In all specimens Vickers microhardness determinations were conducted on eroded (= final hardness) and non-eroded (= initial hardness) enamel surfaces. The specimens were subsequently submitted to toothbrushing abrasion using a slurry consisting of 1 g non-fluoridated dentifrice in 5 ml artificial saliva. The total amount of tooth wear due to erosion and subsequent abrasion was profilometrically evaluated. Statistical analysis revealed a significant decrease in hardness and a significant increase in wear with increasing time of storage in the erosive beverage. Overall regression analysis yielded a statistically significant correlation between both initial and final hardness and the amount of tooth wear. The correlation of abrasion and final hardness could be described by a quadratic mathematical function. It is concluded that the susceptibility of eroded enamel to toothbrushing abrasion can be correlated with Vickers microhardness values, thereby suggesting an overproportionate increase of abrasion with decreasing hardness values.

Comparison of the bond strength of selected adhesive dental systems to cortical bone under in vitro conditions.

The study was performed to compare the tensile bond strength attained between composite and bone and between bone and bone using two different adhesive systems (Clearfil New Bond and Histoacryl) in vitro. Sixty porcine bone specimens with a total thickness of 4.0 mm (+/- 0.5 mm) and a cortical layer of 1.5 mm (+/- 0.2 mm) were obtained under standardised conditions. Ten specimens each were assigned to four experimental groups: group A: Clearfil New Bond (bone-composite); group B: Clearfil New Bond (bone-bone); group C: Histoacryl (bone-composite); group D: Histoacryl (bone-bone). The tensile bond strength of the adhesive agents mentioned above was measured 15 min after application and also after light-curing of the composite filling material (Tetric Ceram, colour A2; groups A and C) using a universal testing machine. The tensile bond strength measured was as follows: group A 8.00 MPa (+/- 1.36 MPa), group B 6.39 MPa (+/- 2.05 MPa), group C 5.22 MPa (+/- 1.96 MPa), and group D 1.95 MPa (+/- 0.49 MPa). Tensile bond strength was significantly increased in group A compared to groups C and D (P < 0.05, Tukey's test). The values in group D were significantly reduced compared to all other groups (P < 0.05, Tukey's test). Despite the limitations of an in vitro investigation, it can be concluded that adhesive systems might be a useful alternative in bone bonding. The use of dentin adhesives seemed to produce higher bond strength to bone than that attained with the cyanoacrylate adhesive.

Influence of two dentin bonding systems on the demineralization of the root surface.

It has been assumed that dentin adhesives can prevent root surface caries. The aim of this study was to determine the caries-protective effect of two different dentin bonding systems on the demineralization of root surfaces in vitro. The root surfaces of 60 freshly extracted caries-free human molars were thoroughly cleaned and polished, thereby removing the cementum. The teeth were then coated with acid-resistant nail varnish, exposing two rectangular windows of 6 mm2 each. One window served as an untreated control, while the other window was treated with a dentin bonding system. The specimens were distributed among the following experimental groups--Group 1: Syntac, Heliobond (no air thinning); Group 2: Syntac, Heliobond (as recommended); Group 3: Syntac, without Heliobond; Group 4: Prime & Bond 2.0 (no air drying); Group 5: Prime & Bond 2.0 (as recommended); Group 6: Prime & Bond 2.0 (dentin pretreated with 36% phosphoric acid). Subsequently, all specimens were demineralized for 6 days with acidified gel (HEC, pH 4.8, 37 degrees C). From each tooth, three dentinal slabs were cut perpendicular to the polished surface of the windows. The slabs were ground to a thickness of 80 microns and imbibed with water. The depth of the respective demineralized areas was determined using a polarized light microscope. All control specimens exhibited lesions with a mean depth of 67 microns. In Groups 2, 3, and 5 the lesion depth was reduced significantly, while in Groups 1, 4, and 6 no lesions could be detected. It was concluded that the demineralization of the root surface can be impeded by application of the dentin adhesives tested.

Endodontic therapy in a postirradiated child: review of the literature and report of a case.

Exodontia of extremely carious teeth leads to a significant risk of osteoradionecrosis in patients who have undergone radiotherapy. In these patients, endodontic treatment could be an alternative. Successful root canal therapy in a girl who had been irradiated for head and neck neoplasms is reported. The results indicated that use of calcium hydroxide to obturate the root canals is a viable method of postirradiation endodontics in primary teeth.

Clinical performance of a self-etching and a total-etch adhesive system - 2-year results.

The purpose of this controlled prospective clinical study was to compare the clinical performance of the self-etching adhesive system AdheSE and the established total-etch adhesive system Excite in classes I and II cavities for a period of 2 years. Fifty patients participated in this study. Each received two restorations, one with AdheSE, one with Excite by one calibrated, non-blinded operator. The resin composite used to restore the teeth was Tetric Ceram HB. One calibrated, blinded clinician re-evaluated the restorations at baseline, after 6, 12 and 24 months after placement using the modified Ryge criteria. For this, vitality, post-operative sensitivity, visible marginal irregularity, marginal discolouration, secondary caries, surface texture, anatomic form and filling defect were considered. After 2 years, 67 restorations were reviewed in 34 patients. None of the teeth showed signs of secondary caries. Two teeth, one of each group, had to receive endodontic treatment because of pulp inflammation. All other teeth remained vital. Slight marginal discolourations were observed in six AdheSE restorations and three Excite restorations. These restorations were scored as Beta. After 2 years, an overall clinical success rate, summing up all the Alpha and Beta scores, of 97% was found, viewing both adhesive systems together. Statistic analysis using log-rank test showed no statistic differences in the overall survival rate between the two materials tested within the observation period. It can be concluded that both adhesive systems tested demonstrated very good clinical performance in the restoration of classes I and II cavities at the end of 2 years.

[The correlation among pulp chamber, tooth length and tooth width in different age groups]. / Untersuchungen über die Korrelation zwischen Pulparaum, Zahnlänge und Zahnbreite.

Computing the quotients of pulp chamber length/tooth length and pulp chamber width/tooth width for canines and lower premolars on orthopantomograms of subjects aged between 19 and 65 years led to the following result: significant reduction in length quotient and highly significant reduction in width quotient with increasing age. The reduction in width was considerably greater than in length.

[Flexural strength tests of repaired amalgam specimen]. / Prüfung der Biegefestigkeit reparierter Amalgamprüfkörper.

Test results of four types of alloys: Flexural strength declined significantly with increasing age of the specimen, however, differently for the tested alloys. The increase in mercury content of the repair amalgam did not influence flexural strength. The combination of materials with each other demonstrated that none of the amalgams was particularly suitable as a repair amalgam.

Permeability of dentine after Nd:YAG laser treatment: an in vitro study.

The purpose of this investigation was to determine the effects of Nd:YAG laser treatment on the permeability of dentine. Forty dentine discs were prepared by horizontal sectioning through the middle coronal third of freshly extracted non-carious third molars. After the removal of the pulp the discs were finished with 600 grit and divided into three test groups and one control group (n = 10). For the test group three different laser power settings were chosen: test group A: 3 x 60 sec, 60 mJ; test group B: 3 x 60 sec, 90 mJ; test group C: 3 x 60 sec, 120 mJ. No laser treatment was performed on the control group. In a two-chamber system the filtration rate of dentine tubules from an exactly defined area of the specimens was measured using a radioactive Ringer solution under a pressure of 30 cm H2O. Permeability measurements were carried out three times prior to lasing, three times immediately following laser treatment and six times after the application of phosphoric acid. Analysis of variance showed a significant influence of the Nd:YAG laser treatment on the permeability of dentine (P < 0.001). The mean quotient of non-treated control vs. lased dentine was 2.19 +/- 0.86 for the 60 mJ beam, 1.49 +/- 0.88 for the 90 mJ beam, and 2.04 +/- 2.17 for the 120 mJ beam. Etching the lased surfaces had a statistically significant influence on the permeability of the dentine only in the 60 mJ group (P < 0.001). The data show that the Nd:YAG laser treatment often increases the permeability of smear layer covered dentine but moderates the increase of permeability after etching the surface with phosphoric acid.

[A standardized reproducible technique to induce traumatic edema in the rat paw]. / Ein Versuchsmodell zur Erzeugung traumatischer Odeme mit konstant hoher Volumenausbeute am Beispiel des Rattenpfotentestes.

A standardized reproducible technique is reported for inducing traumatic edema in the rat paw showing considerable swelling volume and low tissue damage. The edema is measured volumetrically subsequent to squashing the rat paw under standardized conditions in a wringing-machine with two wooden rollers. The technique is compared with other methods.

[The influence of dentin conditioning on permeability of dentin]. / Der Einfluss der Dentinkonditionierung auf die Dentinpermeabilität.

In this study the influence of four different pretreatments showed significant differences on the permeability of cut dentin. On the average the application of 25% polyacrylic acid increased the permeability by approximately 10 percent, the application of 34% polyacrylic acid by 30 percent. The treatment with 0.1% chlorhexidin-digluconate produced no change of permeability. Calciumhydroxide suspension reduced the permeability by 15 percent and diminished the increase caused by phosphoric acid significantly.

[Examination of shear strength of repaired composite specimen]. / Prüfung der Scherfestigkeit reparierter Kompositprüfkörper.

The test of the shearstrength of two composite-inlay-materials and two posterior composites exhibited a statistically significant less bond-strength of repaired specimen compaired with unrepaired control-groups, whereas each material showed different results. The indirect-inlay-system proved to have the lowest bondstrength after repairing. The combination of the two posterior composites as well as the two inlay-systems with each other showed that none of these materials was convincing as a repairing material.

Marginal leakage in class II-restorations after use of ceramic-inserts luted with different materials.

The efficiency of using prefabricated ceramic inlays to prevent microleakage has been discussed in different investigations. The purpose of this study was to evaluate the marginal microleakage of a new glass ceramic inlay system in combination with two different composite luting materials and one polyacid-modified composite, respectively. Standardized class II cavities (n = 60) were filled with (1) Empress inlays fixed with a highly viscous luting composite as a control group, and with glass ceramic inlays (Cerana) in combination with (2) a highly viscous luting composite, (3) a low-viscous luting composite and (4) a polyacid-modified composite, respectively. After thermocycling the marginal quality was analysed with scanning electron microscopy, and the dye penetration along the cavity walls was measured. The use of the Cerana inlays with a polyacid-modified composite resin did not reveal a good marginal adaptation. However, the combination of the Cerana and the Empress inlays with the highly viscous composite exhibited a comparable marginal fit. Within the limitations of an in vitro study it is concluded that the combination of the new glass ceramic inlays with a polyacid-modified composite cannot be recommended for clinical use.

Marginal fit of restorations before and after cementation in vivo.

Triturated luting cements provide convenient clinical handling. This study clinically evaluated the influence of two trituration capsule cement systems on the marginal fit of inner copings for telescoping crowns. Using a randomized parallel design, one coping was cemented using zinc phosphate cement (Phosphacap) and one using a glass-ionomer cement (Ketac-Cem Maxicap) for each of 12 patients. A blind examination of the marginal fit of the restorations was made before and after cementation using the replica technique and a scanning electron microscope. The mean marginal discrepancies for all cast copings were approximately 30 microns (median 23 microns) before cementation. They increased significantly after cementation to 86 microns (median 63 microns) in the zinc phosphate cement copings but to only to 47 microns (median 44 microns) in the glass-ionomer cement copings.