Ill-fitting prosthesis is associated with an increased risk of elevated blood pressures

OBJECTIVE

Previous studies focused on the benefits of adequate prosthodontic treatment, while few studies have investigated the prosthodontic-related risks to health. As a modifiable oral health indicator, the association of ill-fitting prosthesis (IFP) with hypertension has not been fully explored.

METHODS

This cross-sectional study involved 158,659 adults in Beijing (2009-2017) receiving intra-oral examinations and blood pressure measurements. Logistic regression models were applied to assess the association of IFP with the prevalence of hypertension, systolic blood pressure (SBP) ≧ 140 mmHg and diastolic blood pressure (DBP) ≧ 90 mmHg, as well as subgroup analyses by different fixed IFP subgroups (according to involved teeth number) and removable IFP subgroup. We further investigated effect modifications among stratified populations.

RESULTS

158,659 individuals were included for analysis, 346 (26.86%) in IFP group and 27,380 (17.40%) in non-IFP group (p < 0.001) were hypertensive. After adjustment of sex, age, obesity, dyslipidaemia, diabetes, hsCRP, family history of CVD, self-reported smoking, self-reported drinking and WC, ORs of hypertension, SBP ≧ 140 mmHg and DBP ≧ 90 mmHg were 1.330 (95% CI: 1.162-1.522), 1.277 (95% CI: 1.098-1.486) and 1.376 (95% CI: 1.186-1.596), respectively (p < 0.05). Furthermore, after full adjustment, the number of involved teeth showed a significant incremental trend with hypertension risk in the population with and without IFP (p for trend <0.001). The IFP-blood pressure associations were more pronounced in females, 18-60 years, non-obese and diabetic participants.

CONCLUSION

As a modifiable oral indicator, IFP was significantly associated with a higher risk of hypertension.

A Rare Laryngeal Foreign Body Case: Postcricoid Total Dental Prosthesis

In this case report, 60-year-old patient who aspirated total dental prosthesis into the postcricoid region was presented with patient's history, clinical findings, radiologic examinations and surgical treatment with comparison of literature data. To our literature knowledge, this is the first total dental prosthesis detected in postcricoid region. This was unusual because it did not cause any respiratory disorders such as laryngospasm and asphyxia, although it led to mucosal abrasions in a wide area of esophageus. Laryngoscope, 134:2331-2334, 2024.

Dental prosthesis use is associated with higher protein intake among older adults with tooth loss

BACKGROUND

Tooth loss is associated with reduced protein intake, which leads to sarcopenia and frailty in older adults.

OBJECTIVE

To evaluate the protective effect of dental prostheses on decreased protein intake in older adults with tooth loss.

METHODS

This cross-sectional study was based on a self-reported questionnaire targeting older adults. Data were obtained from the Iwanuma Survey of the Japan Gerontological Evaluation Study. We used % energy intake (%E) of total protein as the outcome and the use of dental prostheses and number of remaining teeth as explanatory variables. We estimated the controlled direct effects of tooth loss by fixing the use/non-use of dental prostheses based on a causal mediation analysis, including possible confounders.

RESULTS

Among 2095 participants, the mean age was 81.1 years (1SD = 5.1), and 43.9% were men. The average protein intake was 17.4%E (1SD = 3.4) of the total energy intake. Among participants with ≥20, 10-19 and 0-9 remaining teeth, the average protein intake was 17.7%E, 17.2%E/17.4%E and 17.0%E/15.4%E (with/without a dental prosthesis), respectively. Compared to participants with ≥20 remaining teeth, those with 10-19 remaining teeth without a dental prosthesis did not have a significantly different total protein intake (p > .05). Among those with 0-9 remaining teeth without a dental prosthesis, total protein intake was significantly low (-2.31%, p < .001); however, the use of dental prostheses mitigated the association by 79.4% (p < .001).

CONCLUSION

Our results suggest that prosthodontic treatment could contribute to maintaining protein intake in older adults with severe tooth loss.

Cytomorphometric Analysis of Inflammation Dynamics in the Periodontium Following the Use of Fixed Dental Prostheses

Cytomorphometry is used in the sampling of biological materials and diagnostic procedures. The use of cytological studies in periodontal diseases is not well described in the literature. Our study aimed to quantitatively assess the inflammation dynamics using cytomorphometric analysis of the periodontium before and after the use of fixed dental prostheses. Following ethics approval, a total of 105 subjects were divided in 3 groups as gingivitis (n = 23), periodontitis (n = 58), and healthy periodontium (control) (n = 24). The fixed dental prostheses (crowns and fixed partial dentures) were fabricated from cobalt-chrome metal-ceramic prostheses using the conventional method (C/M-CoCr), cobalt-chrome metal-ceramic prostheses by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (C/C-CoCr), and zirconia-based ceramic prostheses by the CAD/CAM technique (C/C-Zr) among subjects with gingivitis and periodontitis. The gingival crevicular fluid (GCF) was obtained from subjects before and after the use of the prostheses. The total count of epithelial cells and the connective tissue cells or polymorphonuclear neutrophils (PMNs) in GCF were studied using cytomorphometric analysis. The Statistical Package Tor the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA) was used to analyze the results and the significance level was set at p = 0.05. The data for before and after the use of the prostheses were compared using independent t-Tests. Similarly, the results after the use of prostheses in gingivitis, periodontitis, and control in each type of prostheses were compared using One-way ANOVA with post hoc using Scheffe. The total epithelial cells and the PMNs were determined along with the epithelium/leukocyte index. Regardless of the prostheses type used, no significant change in the parameters was identified among patients with a healthy periodontium, before and after prosthetic treatment. In all study groups, a statistically increase (p value < 0.05) was observed in the oral epithelial cell counts and a statistically decrease (p < 0.05) in the PMNs count following the use of the fixed prostheses. Data on cytomorphometric analysis could enable the selection of the most appropriate prostheses for use in patients with periodontal pathologies. When choosing prostheses, changes in the composition of GCF could be considered as a useful criterion for their use.

DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF 59 PATIENTS WITH LIP CANCER AT A TERTIARY UNIVERSITY HOSPITAL IN TURKEY - A SINGLE-CENTER EXPERIENCE

The aim of this study is to evaluate the general demographic and clinical features, and our treatment outcomes in our patients with lip cancers, during the last 15 years. This study was conducted as a retrospective chart-review, and included a total of 59 patients with lip cancer, who were diagnosed, treated, and followed-up at the otorhinolaryngology department of Ankara University, Faculty of Medicine, Ibn-i Sina Hospital between 2000 to 2015. 91.5% of cases were male with a mean age of 61.2 years, 39% were farmers, 87% were smoking, 40.7% had dental prosthesis and 67.8% had poor oral hygiene. 93.2% of the cases had lower-lip tumors and 72.9% had stage 1 tumors. Postoperative pathological assessments revealed well-differentiated squamous-cell carcinoma in 58.3% of cases. Neck dissection was performed in 52.5% of patients. Five-year survival rate was 96.1% and 10-yeat survival was 72.1%. Patients with and without neck dissection had similar survival rates. Lip cancers are frequent cancers, and constitute a significant health problem regarding functional and esthetic roles of the mouth region. Early-diagnosis provides effective treatment, but advanced cases require complex resection and reconstruction techniques. Neck dissection in early-diagnosed cases did not contributed to survival in our cases.

Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses. A systematic review and meta-analysis

OBJECTIVES

To evaluate the implant failure, marginal bone loss (MBL), and other biological or technical complications of restorations supported by tilted and straight implants after at least 3 years in function.

METHODS

Electronic and manual searches were performed in MEDLINE, Embase, Web of Science, and OpenGrey to identify clinical studies published up to December 2017. After duplicate study selection and data extraction, the risk of bias was assessed with the ROBINS-I tool. Random-effects meta-analyses of relative risks (RRs) or mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by subgroup/sensitivity analyses and application of the GRADE approach.

RESULTS

A total of 17 nonrandomized studies (eight prospective/nine retrospective) were included. The number of implants of the overall systematic review was 7,568 implants placed in 1,849 patients supporting either full-arch or partial implant prostheses. No difference in the failure of tilted and straight implants was seen (eight studies; 4,436 implants; RR = 0.95; 95% CI = 0.70 to 1.28; p = 0.74), with the quality of evidence being very low due to bias and imprecision. Likewise, no difference in MBL was seen between tilted and straight implants (16 studies; 5,293 implants; MD = 0.03 mm; 95% CI = -0.03 to 0.10 mm; p = 0.32), with the quality of evidence being very low due to bias and inconsistency. Contradictory results regarding implant survival were found from prospective and retrospective studies, which could indicate bias from the latter.

CONCLUSIONS

Within the limitations of the present systematic review, no effect of implant inclination on implant survival or peri-implant bone loss was found.

Are fibre posts associated with the occurrence of prosthetic complications?

Data sourcesThe Pubmed, Evidence-Based Dentistry, BMJ Clinical Evidence, EmbaseDynamed, and www.opengrey.eu databases and manual search of reference lists.Study selectionRandomised clinical trials (RCTs) were accepted if they had: participants with no periodontal disease and teeth restored with SCs or FDPs and compared fibre posts and other prosthetic systems and evaluated the prosthetic complications with a minimum observational period of 36 months.Data extraction and synthesisTitles and abstracts were evaluated independently by two reviewers, any disagreement was discussed with a third reviewer. The agreement for the two reviewers was 97%. The quality and the risk of bias of the studies included was assessed following the Cochrane Handbook considering the domains of randomisation, sample size, inclusion and exclusion criteria, follow-up achieved, blinding, withdrawing and groups' compatibility for quality assessment, and for the risk of bias the domains evaluated were allocation concealment, blinding of outcome assessor and follow-up.ResultsThe database search yielded 4,230 records; after duplications removal, 3,670 records were reviewed independently by the authors, and four articles were chosen to include in the systematic review.The most frequently reported failures in the available studies were as follows: fibre post debonding, loss of retention of single crowns and marginal gaps. Less frequently, chippings and fractures were recorded in SCs. No studies about complications related to FDPs were found.The failure rate ranged from 0 to 28.2%.ConclusionsA correlation between the failure rates of fibre posts and the type of prosthetic restoration (SCs or FDPs ) cannot be found. Further RCTs are required to achieve evidence-based conclusions, particularly about the use of fibre posts with FDPs.

[Influence of basic dental materials on indicators of free radical oxidation and antioxidant blood`s potential of white rats (experimental study)]

OBJECTIVE

Introduction: Basic materials used in the clinic of orthopedic dentistry are high-polymer compounds and have a number of positive properties in certain conditions. The main group of materials for manufacturing of removable dentures is acrylic plastics of hot polymerization. However, such materials can sometimes cause a number of complications. Using removable prostheses, which are made of acrylic plastics can cause the development of an allergic or toxic-chemical reaction of tissues of the prosthetic bed. The question of improving the quality of removable prosthesis is one of the most important problems for many years because of reactions of people's organism they can cause. This aim is achieved by development of new basic dental materials and improvements at various stages of the process of manufacturing removable plate prostheses. The aim: To investigate the possible adverse effect of various groups of basic dental materials on some hematological parameters of white male rats in the Wistar line.

PATIENTS AND METHODS

Materials and methods: Experiments were performed on 20 white male Wistar rats weighing 160-200 grams. The choice of this species was based on the literature data on the use of white rats in the study of the biological effects of plastics, solvents, dyes, and others. Freshly made samples of the studied materials were used in experiments, because the maximum allocation of monomer occurs in the first 7 days after polymerization. Euthanasia of animals was performed 7 days after surgical intervention under hexenal anesthesia by blood transfusion from the right ventricle. The object of the study was the venous blood of experimental animals.

RESULTS

Results: On the seventh day after substrate samples of basic materials Ftorax, Deflex Acrylato and Vertex ThermoSens intramuscularly into the anterior abdominal wall, white laboratory rats did not have results, such as some unnormal reaction of the animal's organism. A slight increase in the value of the index of spontaneous hemolysis of erythrocytes (5.8±0.5%) in the group of animals, which was sampled with the material "Ftorax" in comparison with the control group (4.6±0.3%), has no statistically significant difference. Similarly, there is no significant increase in the accumulation of TBC-reactants in this group to a value of 4.48±0.28 μmol/l compared with the group of pseudo-operated animals (3.02±0.41 μmol/l), which is not statistically significant. Thus, it can be stated that according to the parameters of free radical oxidation, the biological reaction of the animal organism to the incorporation of the aforementioned materials was not revealed.

CONCLUSION

Conclusions: The results of the study of the biological effect of basic dental plastics on white rats by stacking samples of investigated material into the anterior abdominal wall evaluated by free radical oxidation and activity of antioxidant enzymes did not reveal statistically significant differences comparing with the control group of animals.

[The reactions of lipid's free radical oxidation, hemocoagulant properties of oral fluid in patients with galvanic currents in the mouth]

OBJECTIVE

Introduction: Oral manifestation of galvanic currents due to the presence of two and more dissimilar metals in dental restorations is rather important in prosthodontics. The aim of our study was to assess the reactions lipid's free radical oxidation and hemocoagulant properties of oral fluid in patients with disorders in oral cavity due to galvanic currents.

PATIENTS AND METHODS

Materials and methods: The study had got some groups. The first one consisted of 7 healthy patients without dental prosthesis. The other one included 22 patients with dental prosthesis and they were suffered from short circuiting due dissimilar metallic restorations in oral cavity. This group we were divided into two groups: the second one - for 7 patients were produced metal ceramic fixed dental prosthesis, the third one - for 15 patients were produced whole casted fixed dental prosthesis and pressing brazed fixed dental prosthesis. To assess the process of lipid's free radical oxidation of oral fluid we studied kinetic concentration of malone dialdehyde, activity level of superoxide dismutase and catalase. Also we found out hemocoagulant activity data of oral fluid: thrombin time, prothrombin time, fibrinolytic activity, recalcification time.

RESULTS

Results: In our study we observed increasing of lipid's free radical oxidation in patients of the second and third groups, which led to increasing malone dialdehyde data in third group compared with second group. In patients of second and third groups was recorded the increasing of the CAT activity in the oral fluid. Also there is the in fact decreasing in hemocoagulant properties of oral fluid, such as reducing in recalcification time, increasing in prothrombin time in the second and especially in the third groups of patients. It was marked the significant increasing of fibrinolytic activity of oral fluid in the second and third group of patients.

CONCLUSION

Conclusions: The oral manifestation of electrochemical interactions due to presence of dissimilar metallic restorations led to shift in oral cavity's homeostasis. This statement we can verify with results of our study. In patients with oral manifestation of galvanic currents were observed the increasing in activity of the reactions of lipid's free radical oxidation in oral fluid, changes in antioxidative enzymes and in local homeostasis of oral fluid.

Current concepts of oral and maxillofacial rehabilitation and treatment in aviation

Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

FACTORS RELATED TO ORAL CANDIDIASIS IN ELDERLY USERS AND NON-USERS OF REMOVABLE DENTAL PROSTHESES

This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p < 0.05, OR = 4.3). The most common etiological agent was Candida albicans (37 isolates), with 23 (62.2%) in the denture group and 14 (37.8%) (control group). Among patients who presented clinical manifestations of oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.

[STUDY OF COLONIZATION PROCESSES AND PERSISTENCE OF MICROORGANISMS IN ARTIFICIAL MATERIALS FOR MEDICAL USE]

AIM

Study processes of microbial colonization and persistence of microorganisms in polymer materials for medical use.

MATERIALS AND METHODS

Samples (1 x 1 cm plates) of polymer plastics for production of removable dental prosthesis based on polyurethane and acryl were used, that were incubated with clinical isolates of Pseudomonas aeuruginosa, Staphylococcus aureus in Luria-Bertani broth nutrient media for 24, 48 hours and 7, 14 days and for 1, 5 and 3 months at a temperature of 37 degrees C. Dynamics of interaction process of microorganisms with polymer materials were studied using scanning electron microscope Quanta 200 3D (FEI Company, USA). The samples were fixated after incubation with 10% of neutral formaldehyde, dehydration with alcohols or acetone, typical for SEM, was not carried out, that allowed to conserve the native structure of the samples, including exo-cell matrix of biofilms.

RESULTS

Electron-microscopical data on stages of interaction of bacteria with the surface of medical plastics were obtained. Biofilms were shown to be formed on abiotic surfaces and biodestructive changes of plastics appeared. A question on the possibility of prolonged persistence of pathogenic for human microorganisms in artificial prosthesis is discussed.

CONCLUSION

The developed experimental model of formation of biofilm on abiotic surfaces could be the basis for carrying out studies directed on the fight with biofilms, by using SEM.

A plasmid containing the human metallothionein II gene can function as an antibody-assisted electrophoretic biosensor for heavy metals

Different forms of heavy metals affect biochemical systems in characteristic ways that cannot be detected with typical metal analysis methods like atomic absorption spectrometry. Further, using living systems to analyze interaction of heavy metals with biochemical systems can be laborious and unreliable. To generate a reliable easy-to-use biologically-based biosensor system, the entire human metallothionein-II (MT-II) gene was incorporated into a plasmid (pUC57-MT) easily replicated in Escherichia coli. In this system, a commercial polyclonal antibody raised against human metal-responsive transcription factor-1 protein (MTF-1 protein) could modify the electrophoretic migration patterns (i.e. cause specific decreases in agarose gel electrophoretic mobility) of the plasmid in the presence or absence of heavy metals other than zinc (Zn). In the study here, heavy metals, MTF-1 protein, and polyclonal anti-MTF-1 antibody were used to assess pUC57-MT plasmid antibody-assisted electrophoretic mobility. Anti-MTF-1 antibody bound both MTF-1 protein and pUC57-MT plasmid in a non-competitive fashion such that it could be used to differentiate specific heavy metal binding. The results showed that antibody-inhibited plasmid migration was heavy metal level-dependent. Zinc caused a unique mobility shift pattern opposite to that of other metals tested, i.e. Zn blocked the antibody ability to inhibit plasmid migration, despite a greatly increased affinity for DNA by the antibody when Zn was present. The Zn effect was reversed/modified by adding MTF-1 protein. Additionally, antibody inhibition of plasmid mobility was resistant to heat pre-treatment and trypsinization, indicating absence of residual DNA extraction-resistant bacterial DNA binding proteins. DNA binding by anti-DNA antibodies may be commonly enhanced by xenobiotic heavy metals and elevated levels of Zn, thus making them potentially effective tools for assessment of heavy metal bioavailability in aqueous solutions and fluid obtained from metal implant sites.

[Development and substantiation of complex approach to determination of individual intolerance and hypersensitivity to dental materials]

The aim of research was to define the most simple, objective and affordable test for determination of individual compatibility for dental materials before placement of prostheses in the oral cavity. After series of provocative and laboratory tests it was found that the most convenient is the muco-gingival test. Also found that absolutely all materials, including ceramics, can cause individual intolerance with more or less severe clinical symptoms.

Oral colonisation and infection by Candida sp. in diabetic and non-diabetic patients with chronic kidney disease on dialysis

INTRODUCTION

Oral candidiasis (OC) is a common opportunistic infection in immunocompromised patients. Species identification is sometimes important for treatment. objective: to determine the prevalence of different Candida species colonising or infecting the oral mucosa (OM) of diabetic (DM) and non-diabetic (non-DM) chronic kidney disease patients, comparing both groups and exploring potential risk factors.

METHODS

56 DM and 80 non-DM patients on chronic dialysis were examined. OM swabs were cultured on Sabouraud dextrose agar plates. Candida species were identified with API® galleries. OC was confirmed by exfoliative cytology. Statistical associations were analysed using χ2, Fisher's exact test (ET), and multiple logistic regression.

RESULTS

Candida prevalence was 43.4%: 53.6% DM and 36.3% non-DM, (p=.045). The species identified were C. albicans 74.6%, C. glabrata 22.0%, C. tropicalis 15.2%, C. parapsilosis 3.4 %, C. kefyr 3.4% and C. famata 1.7% without difference between groups. DM patients had a higher xerostomia prevalence (p=.002) and lower salivary flow (p=.008) and lower serum albumin (p=.018). 16.9% of patients had OC, 23.2% DM compared with 12.5% non-DM, (p=.101). The following were associated with the presence of Candida in the OM: the use of dental prostheses (odds ratio [OR] 25.6, 95% confidence interval [CI] 2.5 to 253, P=.001), xerostomia (OR 9.6, 95% CI 2.4 to 38.1, P=.001) and low serum albumin values (OR 0.41, 95% CI 0.22 to 0.98, P=.044).

CONCLUSIONS

The presence of Candida sp. in the OM was associated with dental prostheses, xerostomia and low serum albumin.

[Contact wear related to single- and multi-unit dental prostheses]

Occlusal surfaces of teeth and restorations wear by repeated antagonistic contact. Two-body wear is the result of direct contact between occlusal surfaces. In cases of three-body wear, food is found between antagonistic teeth. Contact wear is expressed predominantly by abrasion and material fatigue. Erosion is a type of wear which does not involve direct antagonistic contact. Qualitative methods exist for registering occlusal tooth wear. Wear of restorations can be measured using casts. An obvious method for comparing rates of wear of restorative materials is laboratory research. This method has demonstrated that the wear rates of composite and enamel are similar. Cast metals and in particular ceramic wear less than enamel. The relation between oral factors and the rate of tooth wear is not always clear. Wellpolished surfaces of restorations wear less quickly and have less effect on the wearing of antagonistic teeth than rougher restoration surfaces.

Association of dental prosthetic condition with food consumption and the risk of malnutrition and follow-up 4-year mortality risk in elderly Taiwanese

OBJECTIVE

To determine the impact of dental prosthetic condition on food consumption, risk of malnutrition and follow-up 4-year mortality risk in elderly Taiwanese.

DESIGN AND SETTING

Analyzing the data sets of the 1999 and 2003 "Survey of Health and Living Status of the Elderly in Taiwan", a longitudinal cohort study.

PARTICIPANTS

A national probability sample of 2766 men and women 65 years of age or older.

MEASUREMENTS

Self-reported intake frequencies of major food categories, masticatory ability, food consumption, and the risk of malnutrition assessed with the Mini Nutritional Assessment (short-form) stratified by dental prosthetic condition. Cox regression was used to compare follow-up mortality risk.

RESULTS

Non-denture wearers and removable-denture wearers had poorer masticatory ability and greater nutritional risk and consumed fruits and vegetable less often compared to fixed-denture wearers. Removable-denture wearers also had lower self-perceived nutritional status and BMI compared to fixed-denture wearers. Survival analysis showed that non-denture wearers and removable-denture wearers had lower follow-up 4-year survival. Cox regression analysis showed that removable-denture wearers had increased follow-up 4-year mortality risk compared to fixed-denture wearers adjusted for sociodemographic, lifestyle and health-related factors.

CONCLUSIONS

Based on data of a national sample of a longitudinal cohort study, dental prosthetic condition is a significant factor of nutritional health in the elderly. It can affect food pattern and the risk of malnutrition and mortality of elderly persons. Dental care should be an important part of geriatric health promotion program and fixed-denture is a preferred choice over removable-denture.

Correlation of prosthetic status with the GOHAI and TMD indices

This study sought to find a correlation between the prosthetic status and TMD and between the prosthetic status and self-perception of oral health in a Brazilian elderly population (n = 400). Prosthetic status was recorded in clinical examinations, and TMD was determined by applying the Helkimo index. Self-perception of oral health was evaluated based on the Geriatric Oral Health Assessment Index (GOHAI). The most prevalent prosthetic status was edentulous using complete dentures (47.5%). Absence of subjective TMD symptoms was found in 69.5%, and of clinical TMD signs in 38.3% of the population. The average GOHAI score was 33.02 +/- 2.85. A correlation was found between prosthetic status and TMD subjective symptoms (P = 0.017), but prosthetic status and TMD objective signs were uncorrelated (P = 0.061). Prosthetic status and self-perception of oral health were positively correlated (P = 0.001).

Monitoring of selenium in oral cavity argyria - a clinical and microscopic study

OBJECTIVE

Argyria is generally classified as localized or generalized condition. Distinct pigmentation of the oral mucosa in the vicinity of amalgam fillings is often referred to as amalgam tattoos. Pigmented areas can also be associated with silver-containing corrosion products of dental alloys used for prosthetic restorations. Silver-containing electron dense particles (Ag-EDPs) are frequently found in pigmented areas. We attempted to correlate results of the elemental composition of Ag-EDPs with excerpts from health profiles of our study paticipants.

DESIGN/SETTING

Eight patients with diagnosed signs of localized argyria were investigated in this study. Biopsies from distinctly pigmented gingival areas were subjected to histological examination, electron microscopy and x-ray microanalysis.

RESULTS

Elemental composition of Ag-EDPs determined by x-ray microanalysis showed mainly silver in combination with sulfur or selenium or a combination of both chalcogens. Elemental analyzes results of Ag-EDPs were analyzed along with excerpts from the patient's clinical records. Two patients with low or undetectable selenium in the Ag-EDPs suffered from autoimmune thyroiditis, Parkinson's disease, bronchial asthma, and allergies to molds, pollen and dust.

CONCLUSIONS

We suggest that selenium in Ag-EDPs is a product of the detoxification process for Ag(+) ions in gingival tissue and that it may reflect the availability of endogenous selenium for physiological processes in the human body. Its presence or absence might thus be used as another marker of a patient's health status.