Periodontal disease in adults with untreated congenital growth hormone deficiency: a case-control study

P>Aim The aim of this study was to investigate the possible associations between isolated growth hormone deficiency (IGHD) and periodontal attachment loss (PAL) in adults affected by congenital IGHD. Materials and methods Forty-five previously identified IGHD subjects were eligible for this study. The final study sample comprised 32 cases (gender:20M/12F; age:44.8 +/- 17.5) matched for age, gender, diabetes, smoking status and income to 32 controls (non-IGHD subjects). Participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured, written questionnaire. Periodontitis was defined as proximal PAL >= 5 mm affecting >= 30% of teeth. Results No significant differences were observed in the percentage of sites with visible plaque between IGHD and non-IGHD subjects (59.4% versus 46.9%, p=0.32). IGHD subjects had significant less supragingival calculus (31.3% versus 59.4%, p=0.02) and more bleeding on probing (71.9% versus 18.8%, p < 0.01) than controls. PAL >= 5 mm was significantly more prevalent (100% versus 71.9%, p < 0.01) and affected more teeth (30.5% versus 6.7%, p < 0.01) in cases than in controls. After adjusting for supragingival calculus, IGHD cases had a higher likelihood of having periodontitis than controls (OR=17.4-17.8, 95% CI=2.3-134.9, p=0.004-0.005). Conclusion Congenital IGHD subjects have a greater chance of having PAL.

Tooth loss prevalence and risk indicators in an isolated population of Brazil

Objective. The aim of this study was to assess the prevalence, extent, and risk indicators of tooth loss in an isolated population of Brazil. Material and methods. Two-hundred-and-forty-two subjects, ranging in age from 14 to 82 years (mean 36.2 years), were identified by census in an isolated population of Brazil. All consenting subjects received a full-mouth clinical (DFT index and information about missing teeth) and periodontal examination of 6 sites per tooth. Furthermore, they were interviewed using a structured written questionnaire in order to gather information about demographic, environmental, and biological variables. Results. Of the 200 subjects (80% response rate), 19 (9.5%) were edentulous, 90% had lost at least one tooth, and 39% had lost more than 8 teeth. The mean number of teeth lost was 9.5 (95% CI = 8.2-10.8). First mandibular molars were the most commonly missing teeth. In a multiple logistic regression analysis based on a theoretical hierarchical model of tooth loss, having more than 8 teeth lost was strongly associated with adult age (OR = 18.3-17.3, 95% CIs = 4.8-69.7 and 4.0-75.1) and female gender (OR = 5.9, 95% CI = 1.9-18.2) in the final model. Conclusions. Tooth loss was highly prevalent and extensive in this isolated population. Demographic and behavioral factors played an important role in tooth loss prevalence in this population.

Comparison of two cellular harvesting methods for primary human oral culture of keratinocytes

The possibility of obtaining transplantable oral epithelia opens new perspectives for oral treatments. Most of them are surgical, resulting in mucosal failures. As reconstructive material this in vitro epithelia would be also useful for other parts of the human body. Many researchers still use controversial methods; therefore it was evaluated and compared the efficiency of the enzymatic and direct explant methods to obtain oral keratinocytes. To this project oral epithelia fragments were used. This work compared: time needed for cell obtainment, best cell amount, life-span and epithelia forming cell capacity. The results showed the possibility to obtain keratinocytes from a small oral fragment and we could verify the advantages and peculiar restrictions. We concluded that under our conditions the enzymatic method showed the best results: in the cells obtaining time needed, cell amount and life-span. Both methods showed the same capacity to form in vitro epithelia.

Risk indicators for increased probing depth in an isolated population in Brazil

Background: The aim of this study was to assess the prevalence, extent, and severity of probing depth (PD) and to investigate the associations between demographic, socioeconomic, and behavioral risk indicators and PD in a periodontally untreated and isolated population in Brazil. Methods: The target population consisted of all individuals aged >= 12 years as identified by a census. Consenting participants were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured written questionnaire. Results: Among the 214 subjects who were interviewed and clinically examined, PD >= 4 mm was observed in 54% to 83% of the subjects, depending on age, whereas the age-dependent prevalence of PD :6 mm ranged from 5% among 12- to 19-year-olds to 50% among 40- to 49-year-olds, decreasing to 40% among subjects >= 50 years of age. Multivariate analyses identified supragingival calculus (odds ratio [OR] = 5.4 to 10.3; 95% confidence intervals [CIs]: 2.5 to 11.6 and 4.0 to 26.2 for 20% to 50% and > 50% of the sites, respectively) as a risk indicator for PD A mm, whereas age :40 years (OR = 9.0; 95% CI: 1.7 to 48.5), being a moderate/heavy smoker (OR = 3.7; 95% CI: 1.4 to 10. 1), and having supragingival calculus in 20% to 50% of sites (OR = 6.8; 95% CI: 1.4 to 32.4) or in >50% of sites (OR = 15.3; 95% CI: 3.2 to 73.6) were risk indicators for PD >= 6 mm. Having undergone urgency dental treatment was a protective factor for PD A and >= 6 mm (OR = 0.4; 95% CI: 0.2 to 0.8). Conclusions: Increased PD is highly prevalent in this isolated population. Behavioral factors played a significant role as risk indicators for increased PD in this isolated population.

Direct comparison of the bond strength results of the different test methods: A critical literature review

Objective. The goal of this paper is to undertake a literature search collecting all dentin bond strength data obtained for six adhesives with four tests ( shear, microshear, tensile and microtensile) and to critically analyze the results with respect to average bond strength, coefficient of variation, mode of failure and product ranking. Method. A PubMed search was carried out for the years between 1998 and 2009 identifying publications on bond strength measurements of resin composite to dentin using four tests: shear, tensile, microshear and microtensile. The six adhesive resins were selected covering three step systems ( OptiBond FL, Scotch Bond Multi-Purpose Plus), two-step (Prime & Bond NT, Single Bond, Clear. l SE Bond) and one step (Adper Prompt L Pop). Results. Pooling results from 147 references showed an ongoing high scatter in the bond strength data regardless which adhesive and which bond test was used. Coefficients of variation remained high (20-50%) even with the microbond test. The reported modes of failure for all tests still included high number of cohesive failures. The ranking seemed to be dependant on the test used. Significance. The scatter in dentin bond strength data remains regardless which test is used confirming Finite Element Analysis predicting non-uniform stress distributions due to a number of geometrical, loading, material properties and specimens preparation variables. This reopens the question whether, an interfacial fracture mechanics approach to analyze the dentin - adhesive bond is not more appropriate for obtaining better agreement among dentin bond related papers. (C) 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Roughness of Human Enamel Surface Submitted to Different Prophylaxis Methods

The purpose of this in vitro study was to evaluate alterations in the surface roughness and micromorphology of human enamel submitted to three prophylaxis methods. Sixty-nine caries-free molars with exposed labial surfaces were divided into three groups. Group I was treated with a rotary instrument set at a low speed, rubber clip and a mixture of water and pumice; group II with a rotary instrument set at a low speed, rubber cup and prophylaxis paste Herjos-F (Vigodent S/A Industria e Comercio, Rio de Janeiro, Brazil); and group III with sodium bicarbonate spray Profi II Ceramic (Dabi A dante Indtistrias Medico Odontologicas Ltda, Ribeirao Preto, Brazil). All procedures were performed by the same operator for 10 s, and samples were rinsed and stored in distilled water. Pre and post-treatment surface evaluation was completed using a surface profilometer (Perthometer S8P Marh, Perthen, Germany) in 54 samples. In addition, the other samples were coated with gold and examined in a scanning electron microscope (SEM). The results of this study were statistically analyzed with the paired t-test (Student), the Kruskal-Wallis test and the Dunn (5%) test. The sodium bicarbonate spray led to significantly rougher surfaces than the pumice paste. The use of prophylaxis paste showed no statistically significant difference when compared with the other methods. Based on SEM analysis, the sodium bicarbonate spray presented an irregular surface with granular material and erosions. Based on this study, it can be concluded that there was an increased enamel stuface roughness when teeth were treated with sodium bicarbonate spray when compared with teeth treated with pumice paste.

Emerging technologies for the prevention of dental caries. Are current methods of prevention sufficient for the high risk patient?

Fluorides and chlorhexidine are technologies that are 65 and 40 years old, respectively. This overview argues that current methods of caries prevention are not effective for the high caries risk patient. In this review examples, arguments and recommendations are provided to address the high caries risk patient that include: failure of comprehensive chemical modalities treatments to address the high caries risk patient; ecological alteration - would this be an effective approach?; and biomaterials and oral microbiome research to address the high caries risk patient.