[Improvement of oral health care in geriatric care by training of nurses and nursing assistants for the elderly]

Because oral health among residents of German nursing homes is inadequate, this intervention study evaluated the effects of dental training for nurses and nursing assistants (RN and RA) in homes for the elderly on their assessment of oral health in residents and, as a consequence, on the status of residents' oral health. 53 residents and the RNs and RAs from three homes for the elderly participated in this study. The nursing staff received training in dental health care. As primary outcome, the competence in performing the Brief Oral Health Examination (BOHSE) was measured at baseline date and four months after training. Additional outcome measures were dental and denture hygiene in residents, functional status of dentures, and treatment needs. Dental training was shown to improve the nursing staff's competences in oral health assessment in tendency. Residents' oral hygiene improved significantly, whereas no relevant effects on hygiene and functional status of dentures were registered. The need for dental treatment turned out to be considerable at both measurements. Modifications in test tools with identification of dental treatment needs seem to be indicated in order to improve cooperation between nursing staff and dentists in homes for the elderly.

Kinetics of fluoride bioavailability in supernatant saliva and salivary sediment

The assessment of the fluoride kinetics in whole saliva as well as in the different salivary phases (supernatant saliva and sediment) is essential for the understanding of fluoride bioavailability.

OBJECTIVES

To assess the fluoride content, provided by sodium fluoride and amine fluoride, in the supernatant saliva and in salivary sediment.

METHODS

Seven trained volunteers were randomly attributed to 2 groups in a cross-over design and brushed their teeth in the morning for 3 min with a product containing either sodium fluoride or amine fluoride. Saliva was collected before, immediately after tooth brushing and 30, 120, and 360 min later and measured. The samples were centrifuged 10 min at 3024 × g. Fluoride content of the supernatant saliva and of the sediment was analysed using a fluoride sensitive electrode. All subjects repeated the study cycles 2 times, and statistical analyses were made using the nonparametric sign test for related samples, the Wilcoxon-Mann-Whitney-test for independent samples.

RESULTS

There was a significant increase in fluoride immediately after tooth brushing in both groups in saliva and sediment. The distribution of fluoride between salivary sediment and supernatant saliva (ratio) varied considerably at the different collection times: decreased from 17.87 in baseline samples of saliva to 0.07 immediately and to 0.86 half an hour after tooth brushing in the sodium fluoride group and from 14.33 to 2.85 and to 3.09 in the amine fluoride group. Furthermore after 120 min and after 360 min after tooth brushing the ratio increased from 17.6 to 31.6 in the sodium fluoride group and from 20.5 to 25.76 in the amine fluoride group. No difference was found in the sediment-supernatant saliva ratio between the sodium fluoride and the amine fluoride groups 360 min after tooth brushing.

CONCLUSION

For the assessment of fluoride kinetics in whole saliva it is necessary to pay attention to at least four factors: fluoride formulation, time after fluoride application, fluoride concentration in supernatant saliva and fluoride concentration in salivary sediment. This study was approved by the Ethical Committee of the University of Witten/Herdecke permission 21/2008.

Measurement of separate cosmic-ray electron and positron spectra with the fermi large area telescope

We measured separate cosmic-ray electron and positron spectra with the Fermi Large Area Telescope. Because the instrument does not have an onboard magnet, we distinguish the two species by exploiting Earth's shadow, which is offset in opposite directions for opposite charges due to Earth's magnetic field. We estimate and subtract the cosmic-ray proton background using two different methods that produce consistent results. We report the electron-only spectrum, the positron-only spectrum, and the positron fraction between 20 and 200 GeV. We confirm that the fraction rises with energy in the 20-100 GeV range. The three new spectral points between 100 and 200 GeV are consistent with a fraction that is continuing to rise with energy.

Constraining dark matter models from a combined analysis of Milky Way satellites with the Fermi Large Area Telescope

Satellite galaxies of the Milky Way are among the most promising targets for dark matter searches in gamma rays. We present a search for dark matter consisting of weakly interacting massive particles, applying a joint likelihood analysis to 10 satellite galaxies with 24 months of data of the Fermi Large Area Telescope. No dark matter signal is detected. Including the uncertainty in the dark matter distribution, robust upper limits are placed on dark matter annihilation cross sections. The 95% confidence level upper limits range from about 10(-26)  cm3  s(-1) at 5 GeV to about 5×10(-23)   cm3  s(-1) at 1 TeV, depending on the dark matter annihilation final state. For the first time, using gamma rays, we are able to rule out models with the most generic cross section (∼3×10(-26)  cm3  s(-1) for a purely s-wave cross section), without assuming additional boost factors.

Estimated prevalence of the GYS-1 mutation in healthy Austrian Haflingers

The aim of this study was to determine the occurrence and frequency of a mutation in the gene coding for skeletal muscle glycogen synthase type 1 (GYS-1), which is the cause of equine polysaccharide storage myopathy (PSSM) type 1 in a population of 50 Haflingers. GYS-1 genotyping of 50 Haflingers was performed with a validated restriction fragment length polymorphism (RFLP) assay. The second aim was to compare resting and post-exercise muscle enzyme activities as well as parameters of glucose metabolism in blood between horses with and without the mutation. Nine of the 50 Haflingers were identified to be heterozygous for the mutation (HR). None was homozygous (HH). The estimated HR prevalence was 18 per cent in this herd. Mean aspartate aminotransferase (AST) activity at rest and mean creatine kinase and AST activity after exercise were significantly higher in HR compared with RR (homozygote normal) horses. No significant differences could be found in the other parameters.

Influence of individual saliva secretion on fluoride bioavailability

The aim of this preliminary investigation was to compare the individual saliva secretion rate with the fluoride bioavailability in saliva after using sodium fluoride and amine fluoride.

METHODS

To assess oral fluoride kinetics 10 highly trained volunteers brushed their teeth with one of the formulations and saliva was collected. The amount of saliva was measured, and the fluoride content was determined. Data underwent statistical analysis using the Mann-Whitney-U test and Pearson correlation. The ex vivo experiment I included individual saliva collection of the same volunteers. Then the oral hygiene products were solved in equal amounts of whole saliva (ex-vivo experiment II), and the fluoride content was measured. Finally, both products were dispersed in distilled water (ex-vivo experiment III) to calculate the dissociation of both products in water.

RESULTS

In vivo results of fluoride content after 3 min. tooth brushing demonstrated a negative correlation with saliva secretion: for NaF r = -0.695 (p<0.01) and for amine fluoride r = -0.446 (p<0.01). The in-vitro experiment I resulted for NaF in 251.7±22.4 µg/g fluoride and for amine fluoride in 171.7±14.4 µg/g.

CONCLUSIONS

Fluoride bioavailability of saliva after exposure to NaF was higher compared to amine fluoride. The individual secretion rate changes the fluoride content and normal secretors keep the fluoride availability longer.

Collaboration of a model osteoporosis prevention and management program in a faith community

This article describes the collaborative efforts of a parish nurse, family nurse practitioner, and a registered dietitian in a faith-based setting to address the women's health issue of osteoporosis. A model for education and treatment including lifestyle changes, nutrition, and pharmacological therapies is discussed. The whole person perspective of prevention and management for women with this chronic disease is explored. Implications for practice and education for women across the life span are described.

Effects of Bleaching Agents on Human Enamel Light Reflectance

In dental bleaching, the micromorphological alterations of hard tissues have been well investigated, but little is known about the optical changes involved. The results of the current study showed that enamel, irrespective of maturation, is subjected to a shift in reflectance towards blue within the color space and enhanced reflection. This effect was demonstrated in different bleaching agent concentrations and protocols.

Effects of low-magnitude, high-frequency mechanical stimulation in the rat osteopenia model

SUMMARY

In this study, short-term, whole-body vertical vibration at 90 Hz improved trabecular bone quality. There was an improvement of bone quality and density in both osteoporotic and control rats. This treatment may therefore be an attractive option for the treatment of osteoporosis.

INTRODUCTION

Aside from pharmacological treatment options, physical exercise is known to augment bone mass. In this study, the effects of whole-body vertical vibration (WBVV) on bone quality and density were evaluated using an osteoporotic rat model.

METHODS

Sixty female Sprague Dawley rats were ovariectomized (C) or sham (SHAM) operated at the age of 3 months. After 3 months, both groups were divided into two subgroups that received either WBVV at 90 Hz for 35 days or no treatment. After sacrificing the rats, we evaluated vertebral bone strength, histomorphometric parameters, and bone mineral density (BMD).

RESULTS

Treatment with WBVV resulted in improved biomechanical properties. The yield load after WBVV was significantly enhanced. According to yield load and Young's modulus, the treated OVX rats reached the level of the untreated SHAM animals. In all measured histomorphometric parameters, WBVV significantly improved bone density. Treatment with WBVV demonstrated greater effects on the trabecular bone compared to the cortical bone. The ash-BMD index showed significant differences between treated and untreated rats.

CONCLUSION

Using WBVV as a non-pharmacological supportive treatment option for osteoporosis demonstrated an enhancement of bone strength and bone mass. This procedure may be an attractive option for the treatment of osteoporosis.

Time-dependent Activation of ERK1/2 in Nerve Terminals of the Dentin-Pulp Complex following Bradykinin Treatment

The extracellular signal-regulated kinases 1 and 2 (ERK1/2) have been implicated in the inflammation-dependent sensitization of nociceptors, and the inflammatory mediator bradykinin (BK) led to a reduced threshold in the nociceptor terminals, activating intracellular signaling by phosphorylating receptors and ion channels. The effects of BK on the non-transcriptional modulation of the ERK1/2 in the peripheral nociceptor terminals, including in nerve endings of the dentin-pulp complex, are unknown. The time-dependent effects of BK (10−7 M) on the ERK1/2 phosphorylation in nerve terminals of the dentin-pulp complex were investigated by quantitative and double immunolabeling with organ bath experiments. In nerve terminals, total and p-ERK1/2 were detected. In comparison with the controls, the numbers of p-ERK1/2-positive nerve endings increased after 1 and 3 min and decreased after 10 min of BK treatment. Analysis of the data indicates that BK induces phosphorylation-mediated local activation of ERK1/2 in nerve terminals modulating nociception in the dentin-pulp complex.

[Caries risk assessment - are saliva tests as well as microbiological and clinical test procedures worthwhile?]

The recent representative survey has proven once more that people in Germany are affected by caries to a very different extent. Since caries can be prevented by risk-adjusted preventive programs, it would be helpful to have a possibility to determine the individual caries risk before cavities occur. Determination of a relative risk, risk screening and risk diagnosis are different levels of caries risk assessment. The present article provides information about which caries risk assessment options are available for different populations. A relative risk can be determined by the detection of Mutants Streptococci in caries-free 2-5-year-old children. With Dentoprog, a valid instrument for caries risk screening is available for 6-12-year-old school children. With respect to all other patients, a quantitative risk diagnosis can be roughly performed using the Cariogram which is based on the assessment of multiple risk parameters. The conclusion is that several options for caries risk assessment for different age groups are available. Nevertheless, there is no solution to how often a patient should appear for prevention in a dental office nor which preventive measures have to be taken to keep him/her healthy. Therefore it seems reasonable to roughly determine the recall frequency on the basis of the respective risk assessment and to adjust this frequency over time after the evaluation of disease progression.

Long-term Survival of Cerec Restorations: A 10-year Study

Class I and II CAD-CAM ceramic restorations can be considered durable alternatives to direct and laboratory-fabricated restorations.

Evaluation of dentin abrasion during professional tooth cleaning in an in vitro model

OBJECTIVES

Professional tooth cleaning (PTC) may lead to loss of exposed dentin. The aim of the present study was to determine the absolute loss of dentin during PTC using various product combinations with an in vitro model.

MATERIAL AND METHODS

Dentin specimens (72) were randomly assigned to nine groups. In four groups each, prophy brushes and prophy cups were used in combination with four different abrasives (calcium pyrophosphate, pumice, Hawe cleanic, Nupro coarse). In the ninth group, a rubber cup with embedded fluoride and abrasives was used (pasteless prophy cup). The treatment time was 37 s. Surface loss was determined by profilometry.

RESULTS

The surface loss in the nine groups was as following: (1) brush/calcium pyrophosphate: 6.18 microm (a); (2) brush/pumice: 5.51 microm; (3) brush/Nupro coarse: 10.10 microm (b); (4) brush/Hawe cleanic: 1.88 (a, b); (5) prophy cup/calcium pyrophosphate 2.07 (c); (6) prophy cup/pumice: 6.07 microm; (7) prophy cup/Nupro coarse: 5.93 microm (c); (8) prophy cup/Hawe cleanic: 4.93 microm (c); (9) pasteless prophy cup: 11.86 microm (c). Groups with the same letter in parentheses are statistically significant different at p<0.05. In a pooled analysis, no statistically significant difference between brushes and prophy cups was found.

CONCLUSION

In the present study, the surface loss of about eight PTC procedures was simulated. Hence, the dentin loss ranged between 0.24 and 1.48 microm per PTC. Therefore, PTC does not seem to be a main factor in dentin loss.

Microhardness changes in dentine after neonatal capsaicin application

AIM

To determine if desensitization of the nociceptive innervation in the dental pulp has an effect on odontoblast function in the rat.

METHODOLOGY

Neonatal systemic application of capsaicin was used to selectively eliminate nociceptive innervation. 12 capsaicin-treated rats were intravitally perfused at 150 days of life with 4% formaldehyde and jaws were prepared for Vicker's microhardness (VMH) measurement. As a control, 12 rats were injected with vehicle on the 3rd day of life and intravital perfusion was carried out exactly as those used for the experimental group. Immunohistological labeling of CGRP was carried out in both groups to assure the efficiency of desensitization in the experimental group. The VMH was measured in the incisors of each animal for a quantitative analysis of dentine quality.

RESULTS

Vicker's microhardness was significantly higher in the control rats compared with the capsaicin-treated rats (P < 0.001).

CONCLUSIONS

Neonatal systemic application of capsaicin produces changes in the quality of dentine in the rat over time and therefore it is suggestive that selective elimination of the nociceptive innervation in pulpal tissue may effect odontoblast function.