Oral health status of low-income, middle-aged to elderly Hong Kong Chinese with type 2 diabetes mellitus.

PURPOSE: To study oral health conditions, diabetic medical complications and their association in type 2 diabetes mellitus (DM). MATERIALS AND METHODS: Cross-sectional survey of 364 type 2 DM patients (63.6 +/- 10.1 years, 54% female) and 161 controls (64.1 +/- 10.6 years, 53% female) with or without essential hypertension, predominantly low-income, attending a hospital were recruited. Periodontal disease (Community Periodontal Index [CPI]) and dental status (decayed, missing and filled teeth [DMFT]) were recorded. Fasting plasma glucose and, for DM patients, HbA1C and DM complications were recorded on enrolment and follow up, respectively. RESULTS: Many DM subjects had fair diabetic control. Both groups (control/DM) had poor oral health: DMFT = 14.5/16.8, CPI 4 = 36%/50%, (P < 0.02) while DM subjects had less DT(adjusted) = 2.1/1.4 (P < 0.01). Of the follow-up DM individuals, 294 (81%) had medical complication(s). Regression analyses showed association between advanced periodontal attachment loss (ALoss) and age, male gender, smoking and DM; MT and DMFT were associated with age, female gender, smoking, DM and hypertension. ALoss and DMFT were not associated with DM complications. CONCLUSIONS: The oral health of the surveyed Chinese subjects was poor. Type 2 DM subjects were affected more by ALoss and MT but less DT. Subjects with hypertension had higher odds for MT.

Genetic polymorphisms and plasma levels of transforming growth factor-beta(1) in Chinese patients with tuberculosis in Hong Kong.

Susceptibility to tuberculosis (TB) may be affected by host genetic factors. Elevated levels of transforming growth factor-beta 1 (TGF-beta(1)) were found in plasma of patients with active TB compared with those of healthy contacts. To investigate the association of TGF-beta(1) gene polymorphisms (C-509T and T869C) and plasma levels with the risk of TB in Hong Kong Chinese adults, a case-control study was carried out on 174 active TB patients and 174 healthy controls matched for age, gender and smoking. Blood samples from 180 blood donors served as another control group. Genotyping was carried out on genomic DNA using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Plasma TGF-beta(1) was measured by commercially available ELISA kit. We found no differences in the distribution of genotypes or alleles of TGF-beta(1) gene polymorphisms at C-509T and T869C between patients and either group of healthy controls. Patients with TB had elevated plasma TGF-beta(1) levels compared with healthy controls irrespective of their genotypes (p<0.001). In conclusion, TGF-beta(1) gene polymorphism at C-509T and T869C is not associated with TB susceptibility in Hong Kong Chinese adults, but elevated plasma TGF-beta(1) levels suggests that this cytokine may play a role in the pathogenesis of tuberculosis.

Color stability of provisional prosthodontic materials.

STATEMENT OF PROBLEM: Discoloration of provisional prosthodontic materials may result in patient dissatisfaction and additional expense for replacement. PURPOSE: The purpose of this study was to determine the color stability of 5 provisional prosthodontic materials before and after immersion in distilled water or coffee for 20 days or exposure to ultraviolet (UV) light for 24 hours. MATERIAL AND METHODS: A total of 105 disc-shaped specimens (20+/-0.1 mm by 1+/-0.05 mm) were fabricated with 5 provisional prosthodontic materials: polyethyl methacrylate resins (Trim II), polymethyl methacrylate resins (Duralay; Alike), and bis-acryl methacrylate resin (Luxatemp; Integrity), according to manufacturers' instructions (n=21). Seven specimens of each material were randomly selected and immersed individually in distilled water (60 degrees C) or coffee (37 degrees C) for 20 days or exposed to UV irradiation for 24 hours, respectively. Color was measured as CIE L*a*b* with a colorimeter before and after the immersion or UV exposure. Color change (Delta E) was calculated and data were analyzed with 1-way ANOVA and the Tukey multiple comparisons test (alpha=.05). RESULTS: For specimens immersed in water, the color change of bis-acryl-methacrylate-based provisional materials (Integrity and Luxatemp) was significantly less than that of 3 methyl/ethyl methacrylate-based provisional materials (Trim II, Alike, and Duralay) (P<.002). After immersion in coffee, the 3 methyl/ethyl methacrylate-based provisional materials exhibited significantly less color change compared to the 2 bis-acryl methacrylate-based provisional materials (P<.0001). After ultraviolet irradiation, 2 bis-acryl methacrylate-based provisional materials showed significantly less color change than any of the 3 methyl/ethyl methacrylate-based provisional materials (P<.0001). CONCLUSION: Luxatemp and Integrity (bis-acryl-methacrylate-based resins) demonstrated acceptable color stability and were the most color-stable provisional prosthodontic materials tested compared to the methyl/ethyl methacrylate-based resins.

Fractured dens evaginatus and unusual periapical radiolucency.

Dens evaginatus (DE) is not uncommon. It can affect the premolars of people of oriental ethnicity, and it can lead to different clinical problems. This article describes the diagnosis and management of a patient presenting with a fractured tubercle of DE and an unusual buccal abscess in relation to periapical radiolucency extending around the mandibular second premolar and first molar.

Threshold contrast ratio and masking ability of porcelain veneers with high-density alumina cores.

PURPOSE: The purposes of this study were to: (1) investigate the correlation between the color difference of bilayer porcelain veneers over white and black backgrounds (deltaE1) and their opacity (contrast ratios); (2) determine whether there is a recommendable threshold contrast ratio above which the color difference is clinically acceptable (when deltaE < or = 5); and (3) compare the ability of porcelain veneers to mask a color change from white to black backgrounds (deltaE1) and their ability to mask a color change from white to clinically discolored teeth (deltaE2). MATERIALS AND METHODS: Forty-four maxillary anterior teeth of eight patients with severe tetracycline discoloration were prepared for bilayer porcelain veneers in shade A2 porcelain. The cores were 0.25 mm thick. The color (CIE L*a*b*) and reflectance (Y) of the midbuccal region of each veneer were measured over white and black backgrounds using a colorimeter under artificial daylight. The veneers were bonded to discolored teeth, and their color was measured after 1 week. RESULTS: The mean color difference deltaE1 was 10.6 (SD 2.6). The mean contrast ratio was 0.75 (SD 0.1). There was a close and statistically significant correlation between deltaE1 and contrast ratio. The determined threshold contrast ratio was 0.91. The mean color difference deltaE2 was 11.6 (SD 5.5). A paired t test showed no difference between deltaE1 and deltaE2. CONCLUSION: There was a significant correlation between the masking ability of veneers (deltaE1) and their opacity (contrast ratio). There was no significant difference in the ability of the porcelain veneers in masking a color change from white to black backgrounds compared to their ability to mask the color change from white to the discolored teeth.

Assessment of endodontically treated teeth adjacent to proposed implant sites.

Many partially dentate dentitions are now being restored using dental implants; but assessment of endodontically treated teeth adjacent to the proposed implant sites has seldom been reported. Assessment criteria are given for sound- and endodontically compromised teeth to ensure adequate preimplant preventive and restorative treatment and to minimize the chances of failure of dental implants adjacent to these teeth. Cases are used to illustrate pitfalls in the treatment planning process.