Associations between self-reported physical activity and oral health: a cross-sectional analysis in 17,777 Spanish adults

Background The aim of this study was to assess the association between levels of physical activity and oral health in adults residing in Spain.Methods Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 adults aged ≥15 years; 52.0% females). The International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Oral health was self-reported through eight variables. Covariates included were sex, age, marital status, education, obesity, smoking and alcohol consumption.Results Dental caries (19.8% vs 27.8%), dental extraction (72.7% vs 75.4%), gingival bleeding (15.5% vs 19.1%), tooth movement (4.3% vs 5.9%) and missing tooth (57.9% vs 62.5%) were statistically significantly less frequent in the sufficient than insufficient physical activity group, whereas dental filling (74.2% vs 70.9%), dental material (36.6% vs 34.8%) and no missing tooth and no material (28.2% vs 25.1%) were statistically significantly more common. After adjustment, there was a negative relationship between physical activity and dental caries (OR = 0.72; 95%CI = 0.66-0.78), gingival bleeding (OR = 0.79; 95%CI = 0.72-0.86), tooth movement (OR = 0.83; 95%CI = 0.71-0.96) and missing tooth (OR = 0.91; 95%CI = 0.85-0.98). In contrast, physical activity was positively associated with dental material (OR = 1.16; 95%CI = 1.07-1.25).Conclusions Participation in physical activity is favourably associated with some but not all self-reported oral health correlates.

Molecular inflammation and oxidative stress are shared mechanisms involved in both myocardial infarction and periodontitis

BACKGROUND AND OBJECTIVE

Our aims were to improve the understanding of the pathogenic relationship between cardiovascular diseases and periodontitis and to generate new perspectives in the prevention and treatment of acute myocardial infarction (AMI) and periodontitis. The present study evaluates possible differences in inflammation, oxidative stress, and autophagy markers among subject suffering AMI, periodontitis, or both, to explore possible common pathogenic mechanisms.

MATERIAL AND METHODS

A total of 260 subjects were enrolled in the study: 106 subjects that survived to a first AMI (AMI group) and 154 subjects had no cardiac events in their clinical record (control group). A questionnaire was used to assess age, height, weight, blood pressure, and heart rate. The clinical probing depth, clinical attachment loss, number of remaining teeth, and average number of sites with bleeding on probing were assessed. Lipid peroxidation and protein levels of phosphorylated AMP-activated protein kinase (p-AMPK) and microtubule-associated proteins 1A/1B-light chain 3-II (LC3-II) were determined in isolated peripheral blood mononuclear cells by thiobarbituric acid reactive substances (TBARS) assay and Western blot, respectively. Plasma levels of interleukin-1β were determined using a commercial ELISA kit. All the obtained variables were compared between subjects suffering an AMI with or without periodontitis and control subject periodontal healthy or with periodontitis.

RESULTS

A higher proportion of subjects suffering AMI + periodontitis than only AMI (without periodontitis) was found. Higher levels of TBARS were found in subjects with periodontitis than in subjects without periodontitis in both AMI and control subjects. Positive correlations between IL-1β levels and TBARS and between IL-1β levels and LC3-II were found only in control subjects.

CONCLUSION

Results from the present study are consistent with the suggestion of periodontitis as a potential risk factor for AMI. Periodontitis association with circulating lipid peroxides in both AMI and control subjects were found. The absence of differences in IL-1β levels between AMI subjects (only AMI vs AMI + periodontitis) suggests that oxidative stress could be the main pathogenic link between AMI and periodontitis.

Use of medicines associated with dry mouth and dental visits in an Australian cohort

BACKGROUND

Poor recognition of medicine-induced dry mouth can have a number of adverse effects, including difficulties with speech, chewing and swallowing dry foods, gum disease, dental caries and oral candidosis. This study examined the prevalence of use of medicines that cause dry mouth and claims for dental services funded by the Department of Veterans' Affairs (DVA) in an Australian cohort.

METHODS

We used the DVA administrative health claims data to identify persons using medicines that can cause dry mouth at 1st of September 2016 and determine their DVA dental claims in the subsequent year. Results were stratified by gender, residence in community or residential aged cared facility and number of medicines.

RESULTS

We identified 50 679 persons using medicines known to cause dry mouth. Of these, 72.6% were taking only one medicine that may cause dry mouth, and 21.6% were taking two. Less than half (46.2%) of all people taking at least one of these medicines had a dental claim in the following year. A smaller proportion of women (35.9%) made claims than men (56.9%), χ²  = 2248.77, P < 0.0001.

CONCLUSIONS

Targeted interventions raising awareness of the relationship between some medicines and dry mouth, and the importance of dental visits are warranted.

Dental mesenchymal stem cells and neuro-regeneration: a focus on spinal cord injury

Regenerative medicine is a branch of translational research that aims to reestablish irreparably damaged tissues and organs by stimulating the body's own repair mechanisms via the implantation of stem cells differentiated into specialized cell types. A rich source of adult stem cells is located inside the tooth and is represented by human dental pulp stem cells, or hDPSCs. These cells are characterized by a high proliferative rate, have self-renewal and multi-lineage differentiation properties and are often used for tissue engineering and regenerative medicine. The present review will provide an overview of hDPSCs and related features with a special focus on their potential applications in regenerative medicine of the nervous system, such as, for example, after spinal cord injury. Recent advances in the identification and characterization of dental stem cells and in dental tissue engineering strategies suggest that bioengineering approaches may successfully be used to regenerate districts of the central nervous system, previously considered irreparable.

Variables affecting the fit of zirconia fixed partial dentures: A systematic review

STATEMENT OF PROBLEM

Different parameters affect the marginal and internal fit of zirconia fixed partial dentures (FPDs) on natural teeth. Determining a way to optimize these restorations is essential.

PURPOSE

The purpose of this systematic review was to determine the variables affecting the marginal fit and internal accuracy of zirconia FPDs on natural teeth.

MATERIAL AND METHODS

An electronic search was conducted by 2 independent reviewers by using the MEDLINE, Cochrane, Web of Science, and Scopus databases, as well as Google Scholar, for studies published up to July 2018, and a manual search was conducted from the reference lists of related articles. Eligibility criteria included articles in English published in peer-reviewed journals that assessed the marginal and/or internal adaptation of zirconia FPDs on teeth with 3 or more units, with at least 1 of the experimental groups being frameworks or FPDs fabricated from zirconia. Risk of bias was assessed with the aid of the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

The search provided 418 records, with 41 fulfilling the inclusion criteria. The selected studies showed considerable heterogeneity regarding materials, state of sintering, manufacturer and computer-aided design and computer-aided manufacturing (CAD-CAM) system, experimental methodology, sample size, and span length. Of the included articles, 36 were in vitro studies and 5 were clinical studies, most of which exhibited high-performance and detection biases. CAD-CAM systems provided more precise marginal and internal fit than CAM systems. An increase of framework span length to 6 or more units decreased both marginal and internal fit. The reported marginal gap tended to increase after the veneering process. The introduction of a conventional impression into an otherwise digital workflow seems to have a negative effect on the marginal fit.

CONCLUSIONS

The accuracy of zirconia FPDs or frameworks is considerably influenced by the processing procedure used and the choice of CAD-CAM system.

Salivary Gland Diseases

A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur in salivary glands. The most common problem is painful blockage of ducts by stones that prevents drainage of saliva. Sialadenitis can be due to either infectious or noninfectious factors. Bacterial or viral infections are the most common causes of acute sialadenitis. Staphylococcus is the usual bacterial cause, whereas paramyxovirus (mumps) is the common viral cause. Eighty percent of salivary tumors are benign, whereas about 20% are malignant. Most tumors occur in the parotid gland and on the hard palate. Classifications, imaging, and suggested treatment are described.

An updated systematic review and meta-analysis about the safety and efficacy of infliximab biosimilar, CT-P13, for patients with inflammatory bowel disease

OBJECTIVE

We aimed to evaluate the efficacy and safety of infliximab biosimilar, CT-P13, for patients with inflammatory bowel disease.

METHODS

We searched PubMed, Scopus, Ovid, and Web of Science for relevant clinical trials discussing CT-P31 administration for IBD patients either naïve to biological therapy or switched from IFX therapy. Data of the rates of clinical response, clinical remission, and adverse events were extracted and pooled in a random effect model meta-analysis using CMA version 2.

RESULTS

Thirty-two studies with a total of 3464 IBD patients treated with CT-P13 were identified. The pooled rates of clinical response among Crohn's disease (CD) and ulcerative colitis (UC) at 8-14 weeks were 0.81 (95% CI = 0.72 to 0.87) and 0.68 (95% CI = 0.63 to 0.72), respectively, and at 48-63 weeks were 0.69 (95% CI = 0.48 to 0.85) and 0.54 (95% CI = 0.45 to 0.63) respectively. After switching from IFX to CT-P13, the pooled rates of sustained clinical response among CD and UC at 30-32 weeks were 0.84 (95% CI = 0.57 to 0.96) and 0.96 (95% CI = 0.58 to 0.99), respectively, and at 48-63 weeks were 0.51 (95% CI = 0.22 to 0.79) and 0.83 (95% CI = 0.19 to 0.99) respectively. Moreover, adverse events were reported (CD = 0.10, 95% CI 0.04 to 0.22; UC = 0.18, 95% CI 0.05 to 0.15).

CONCLUSION

CT-P13 is effective and well tolerated in short and long-term periods. Switching to CT-P13 is recommended for the management of IBD.

Developmental dental anomalies assessed by panoramic radiographs in a Greek orthodontic population sample

PURPOSE

To assess developmental dental anomalies on panoramic radiographs in a Greek orthodontic population.

MATERIALS AND METHODS

The sample consisted of 1200 panoramic radiographs that have been taken as part of routine orthodontic treatment planning in children and adolescents. The following exclusion criteria were applied: systemic disorders such as syndromes or clefts, previous jaw surgery and poor quality of the radiograph. Dental anomalies were classified as anomalies of tooth shape, size, eruption-, position- or number anomalies or root alterations.

RESULTS

The age range of the subjects (536 males and 664 females) was 7-17 years with a mean age of 11.78 years. The prevalence of dental anomalies was assessed with a Chi-squared test. The intraobserver agreement was evaluated by calculating Cohen's [Formula: see text]. Among the 1200 digital panoramic radiographs examined, a total of 224 (18.67%) presented dental anomalies, 92 (7.67%) males and 132 (16.67%) females. Moreover, 203 patients (16.92%) had 1 dental anomaly, whereas 19 (1.58%) and 2 (0.17%) patients had 2 or more than 2 dental anomalies, respectively. Oligodontia was the most prevalent dental anomaly and was presented in 6.4% of the subjects, while supernumerary teeth were detected in 1% of the patients.

CONCLUSIONS

A significant number of orthodontic patients had at least one DDA. The most common DDA in this sample was oligodontia followed by impaction and supernumerary teeth. Comparison to our data with other studies revealed variation in their prevalence suggesting genetic and environmental influences.

The advances in nerve tissue engineering: From fabrication of nerve conduit to in vivo nerve regeneration assays

Peripheral nerve damage is a common clinical complication of traumatic injury occurring after accident, tumorous outgrowth, or surgical side effects. Although the new methods and biomaterials have been improved recently, regeneration of peripheral nerve gaps is still a challenge. These injuries affect the quality of life of the patients negatively. In the recent years, many efforts have been made to develop innovative nerve tissue engineering approaches aiming to improve peripheral nerve treatment following nerve injuries. Herein, we will not only outline what we know about the peripheral nerve regeneration but also offer our insight regarding the types of nerve conduits, their fabrication process, and factors associated with conduits as well as types of animal and nerve models for evaluating conduit function. Finally, nerve regeneration in a rat sciatic nerve injury model by nerve conduits has been considered, and the main aspects that may affect the preclinical outcome have been discussed.

Angina bullosa hemorrhagica

Angina bullosa hemorrhagica (ABH) is a term used to describe acute, subepithelial oral mucosal blisters filled with blood without any systemic disorder or hemostatic defect. The diagnosis of ABH is largely clinical, and includes elimination of other diseases at histology. We present a 24-year-old patient suffering from ABH with some clinical peculiarities. Recognition of ABH is of great importance to dermatologists, to avoid misdiagnosis.

Regenerative Endodontic Treatment of Bilateral Necrotic Immature Permanent Maxillary Central Incisors with Platelet-rich Plasma versus Blood Clot: A Split Mouth Double-blinded Randomized Controlled Trial

AIM

Clinical and radiographic assessment of the regenerative potential of bilateral immature permanent maxillary central incisors with necrotic pulps using blood clot (BC) and platelet-rich plasma (PRP) scaffolds.

TRIAL DESIGN

This is a split mouth double-blinded parallel randomized controlled clinical trial.

SUBJECTS AND METHODS

Randomization and blinding: the study started with 15 patients with bilateral maxillary immature permanent central incisors with necrotic pulp. The two upper bilateral central incisors were randomly assigned to either the control (BC scaffold) group I or examined (PRP scaffold) group II. Participant: 13 patients aged 8-14 years fulfilled the study requirements. A follow-up was done for 3, 6, 9, and 12 months. Standardized radiographs were collected during the follow-up period, and radiographic changes were measured using Image J software. Primary outcome measured were clinical: pain, mobility, swelling, and sinus/fistula. Radiographic outcome included increased root length and increase in root thickness. Secondary outcomes were clinical: discoloration and sensibility test. Radiographic outcome included an increase in bone density measurements and a decrease in apical diameter. Standardized radiographs were collected during the follow-up period, and radiographic changes were measured using Image J software.

RESULTS

All 26 treated teeth survived during the 12-month follow-up period with 100% success rate. PRP-treated teeth showed a statistically significant increase in radiographic root length, width, periapical bone density, and a decrease in apical diameter when compared with BC. At the end of 12 months, all treated teeth did not respond to the sensibility test. BC displayed a significantly higher amount of crown discoloration compared to the PRP group.

CONCLUSION

For necrotic immature teeth, regenerative endodontic treatment using PRP is a desirable alternative to BC and shows excellent 12-months prognosis.

HOW TO CITE THIS ARTICLE

Rizk HM, AL-Deen MSS, et al. Regenerative Endodontic Treatment of Bilateral Necrotic Immature Permanent Maxillary Central Incisors with Platelet-rich Plasma versus Blood Clot: A Split Mouth Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2019;12(4):332-339.

Artificial Saliva: Challenges and Future Perspectives for the Treatment of Xerostomia

The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.

Avaliação do manchamento e da rugosidade superficial de materiais restauradores diretos após diferentes sistemas de polimento: estudo in vitro

Resumo Introdução Com o avanço estético e tecnológico dos compósitos restauradores diretos, a procura pela Odontologia Éstética tem aumentado. Objetivo Avaliar o manchamento e a rugosidade superficial dos compósitos Filtek Z350 (3M ESPE) e Filtek Bulk Fill (3M ESPE), polidos por diferentes sistemas: Disco SofLex e Disco SofLex diamantado espiral (ambos da 3M ESPE), após exposição repetitiva ao café. Material e método Neste estudo in vitro, um total de 80 discos de resina foi confeccionado, com 40 espécimes para cada compósito avaliado. Os espécimes foram ainda subdivididos em grupos (n=10) de acordo com o método de polimento ‒ SofLex e SofLex diamantado ‒ e a solução de armazenamento ‒ água deionizada (controle) e café (experimental). Após 24 horas de armazenamento em água deionizada, foi realizada a avaliação de cor e rugosidade inicial, bem como a execução dos protocolos de polimento testados. Posteriormente, os espécimes foram expostos ao processo de manchamento em café e água deionizada durante 42 dias. Após esse período, a cor e a rugosidade foram reavaliadas. Resultado A análise estatística paramétrica evidenciou que o manchamento superficial foi influenciado significativamente pelos fatores compósito e solução, mas não pelo fator polidor ou ainda por qualquer interação entre os fatores. Para o fator compósito, Filtek Z350 exibiu maior manchamento, e para o fator solução, foi observado maior manchamento para o café. Já na análise de rugosidade, não houve diferenças significativas. Conclusão Independentemente do sistema de polimento, a solução experimental de café alterou a cor de ambos os compósitos avaliados e verificou-se que a rugosidade não foi alterada.

Enhanced expression of IL-34 in an inflammatory cyst of the submandibular gland: a case report

Background

Cysts of the salivary glands are common lesions that occur in the context of various etiologies. Although the diagnostic importance of cysts in salivary gland diseases has been well studied, molecular mechanisms that control the related pathological process remain largely unknown. IL-34 is a novel cytokine that was discovered recently as a tissue-specific ligand of colony stimulating factor-1 receptor. Since its discovery, accumulating evidence has revealed emerging roles of IL-34 in various pathological conditions and has been suggested to correlate remarkably with inflammation. In this study, we report a medical case of an inflammatory cyst within the submandibular gland, through which evaluating the possible involvement of IL-34 in salivary gland disorders.

Case presentation

A 37-year-old male patient suffered from a sudden swelling in the right submandibular region, started initially small and had gradually increased in size to reach 3–4 cm in 1 week, accompanied by pain and local fever. Ultrasonography and MRI imaging revealed the existence of a well-defined cystic lesion with sharp borders measuring 39.8 mm × 19.7 mm within the right submandibular gland. The cyst was removed surgically, and the diagnostic decision was determined based on histopathological observations as an inflammatory cyst in the submandibular gland. Sections were generated from different regions of the surgically resected inflammatory cyst and used to examine IL-34 expression by immunohistochemistry compared to normal salivary gland tissues. Immunohistochemical staining showed enhanced expression of IL-34 in the ductal epithelial cells and endothelial cells of blood vessels, with a tendency to be accompanied with high infiltration of immune cells, which suggests a possible involvement of IL-34 in the pathogenesis of salivary gland inflammation.

Conclusions

In this report, we introduce interesting findings of enhanced IL-34 expression in a case of an inflamed submandibular gland. Our findings emphasize the pathological roles of IL-34 as an inflammation amplifier and angiogenic enhancer in inflammatory conditions, such as in salivary gland disorders.

Electronic supplementary material

The online version of this article (10.1186/s41232-018-0069-6) contains supplementary material, which is available to authorized users.

Avaliação do efeito cromático em resinas compostas nanoparticuladas submetidas a solução café

Resumo Introdução Em uma sociedade de alta competitividade social, os padrões estéticos estão cada vez mais refinados e, dentro destes, a concepção e o desejo de se ter o sorriso perfeito aumentaram consideravelmente a busca pelos tratamentos dentários e, consequentemente, o desenvolvimento de materiais que possam propiciar tais resultados. O sucesso clínico de uma restauração engloba sua longevidade, do ponto de vista funcional, incluindo ausência de infiltrações, e sua função estética, por meio da manutenção de coloração e lisura superficial adequada. Objetivo O presente trabalho busca analisar a alteração de cor de duas marcas de compósitos odontológicos nanoparticulados ‒ Z350 e Bulk Fill (3M ESPE) ‒ e dois sistemas de polimento ‒ Disco SofLex e Disco SofLex espiral emborrachado (3M ESPE) ‒, com as subdivisões em grupos controle (água destilada) e experimental (café), em um período de 21 dias. Material e método Os espécimes foram confeccionados de modo padronizado e armazenados por sete dias em água deionizada a 37 °C, em estufa para análise da cor inicial, seguido do armazenamento nas respectivas soluções para a análise cromática, ao final do período de estudo, sendo ambas as análises realizadas através de espectrofotômetro (CM-700d, Konica Minolta, Osaka, Japão) e escala ΔE CIELAB. Resultado Observou-se que ambas as resinas tiveram sua coloração alterada na presença do café, entretanto a resina Z350 apresentou maiores variações em comparação à Bulk Fill. Conclusão Apesar de a solução corante café ser capaz de promover mudança de cor nas resinas estudadas, os sistemas de polimento, isoladamente, não apresentam efeito final sobre a alteração cromática desses materiais restauradores.

Success rates and factors associated with failure of temporary anchorage devices: A prospective clinical trial

AIM

The objective of the present study was to investigate success rates and associated factors affecting temporary anchorage device (TAD) failure in different biomechanical applications.

METHODS

A total of 180 TADs were used as a part of 82 patients' treatment plan (24 males and 58 females); their mean age was 21.41 years. Three types of TADs were used: 50 (3M ESPE, Neuss, Germany), 56 (Bone screw; Jeil Medical, Seoul, Korea), and 74 (Morelli, Sorocaba, Brazil). Eight maxillary and four mandibular sites were selected for insertion. Three different lengths (6, 8, and 10 mm) and three different diameters (1.5, 1.6, and 1.8 mm) were used. The force levels were set at 50, 100, 150, 200, and 250 g. Patient-, implant-, and operator-dependent factors were evaluated throughout the 266 days of function. Qualitative variables were described by proportions and percentages and analyzed using χ² test.

RESULTS

The overall success rate was 82.2%. The higher age group showed a significantly higher success rate. Oral hygiene showed a statistically-significant (P ˂ .05) difference between both success and failure groups. All other patient-related factors showed no significant differences. Regarding force levels used, the highest success rate was in 250 g and the lowest was in 100 g. There were no significant differences between both groups regarding other implant- and operator-related factors.

CONCLUSIONS

Temporary anchorage devices have a good success rate and are beneficial to be integrated in orthodontic treatment planning. Patient age, oral hygiene, and force level are the most significant factors affecting TAD success.

Surface Characterization and Cell Adhesion of Different Zirconia Treatments: An in vitro Study

AIM

The aim of this study was to characterize the surface of zirconia subjected to different treatments and evaluate its effect on cell adhesion and proliferation.

MATERIALS AND METHODS

A total of 80 zirconia disks were divided into four groups (n = 20) according to the surface treatments used: group I: as-sintered (AS), no surface treatment applied; group II: abrasion treatment applied using Rocatec (ROC; 3M ESPE) system with silica-coated alumina powder of grit size 110 μm; group III: erbium, chromium:yttrium, scandium, gallium, garnet (Er, Cr:YSGG) laser (LAS; BIOLASE) was used at a frequency of 20 Hz and output power of 3 W; and group IV: specimens were subjected to the selective infiltration etching (SIE) technique. Surface characterization was evaluated for the different groups (roughness, hardness, and morphology), and cell behavior (adhesion and proliferation) was tested (a = 0.05).

RESULTS

The ROC group reported a significant increase in surface roughness (2.201 ± 0.352) and Vickers hardness (1758 ± 16.6) compared with the other surface treatments. The SIE surface-treated group reported a significantly higher number of cells (64.5 ± 2.6 and 53.5 ± 2.2 respectively) compared with the other surface-treated groups.

CONCLUSION

The SIE is a promising surface treatment for zirconia that significantly enhances cell adhesion and osseointegration.

CLINICAL SIGNIFICANCE

The SIE treatment of zirconia implants may help in a faster and better osseointegration.

Comparative radiopacity of conventional and full-contour Y-TZP ceramics

The purpose of this study was to evaluate the radiopacity of different yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramics used in the fabrication of fixed dental prostheses. Disk-shaped specimens (N=120, n=30 per group) were fabricated with thicknesses of 0.3, 0.5, and 1 mm from the following four Y-TZP ceramics: Cercon ht (Degudent) (CZ), Prettau (Zirkonzahn) (ZZ), Alliance (Kuraray Noritake Dental) (NA), and Ice Zirkon (Zirkonzahn) (ICE). The optical densities of each material were measured from radiographic images, and each material (N=1) were characterized by using XRD and SEM. The results were analyzed with oneway analysis of variance and the Tukey-Kramer test (α=0.05). In the case of the ICE and NA specimens, the radiopacity significantly differed with thickness (p<0.05). However, the radiopacities of 0.5- and 0.3-mm-thick CZ and ZZ specimens were not significantly different (p>0.05). Full-contour Y-TZP materials have higher radiopacities than those of the conventional Y-TZP materials in decreased thicknesses.

Effect of grinding and polishing on roughness and strength of zirconia

STATEMENT OF PROBLEM

The clinical applications of high-translucency monolithic zirconia restorations have increased. Chairside and laboratory adjustments of these restorations are inevitable, which may lead to increased roughness and reduced strength. The influence of grinding and polishing on high-translucency zirconia has not been investigated.

PURPOSE

The purpose of this in vitro study was to compare the roughness averages (Ra) of ground and polished zirconia and investigate whether roughness influenced strength after aging.

MATERIAL AND METHODS

High-translucency zirconia disks were milled, sintered, and glazed according to the manufacturer's recommendations. Specimens were randomized to 4 equal groups. Group G received only grinding; groups GPB and GPK received grinding and polishing with different polishing systems; and group C was the (unground) control group. All specimens were subjected to hydrothermal aging in an autoclave at 134°C at 200 kPa for 3 hours. Roughness average was measured using a 3-dimensional (3D) optical interferometer at baseline (Ra1), after grinding and polishing (Ra2), and after aging (Ra3). A biaxial flexural strength test was performed at a rate of 0.5 mm/min. Statistical analyses were performed using commercial software (α=.05).

RESULTS

Group G showed a significantly higher mean value of Ra3 (1.96 ±0.32 μm) than polished and glazed groups (P<.001), which showed no statistically significant difference among them (GPB, 1.12 ±0.31 µm; GPK, 0.88 ±0.31 µm; C: 0.87 ±0.25 μm) (P>.05). Compared with baseline, the roughness of groups G and GPB increased significantly after surface treatments and after aging, whereas aging did not significantly influence the roughness of groups GPK or C. Group G showed the lowest mean value of biaxial flexural strength (879.01 ±157.99 MPa), and the highest value was achieved by group C (962.40 ±113.84 MPa); no statistically significant differences were found among groups (P>.05). Additionally, no significant correlation was detected between the Ra and flexural strength of zirconia.

CONCLUSIONS

Grinding increased the roughness of zirconia restorations, whereas proper polishing resulted in smoothness comparable with glazed surfaces. The results provide no evidence that grinding and polishing affect the flexural strength of zirconia after aging.

Bone resorptive activity in symptomatic and asymptomatic apical lesions of endodontic origin

OBJECTIVES

The aim of this study is to assess the levels and diagnostic accuracy of a set of bone resorption biomarkers, including TRAP-5, RANKL, and OPG in symptomatic and asymptomatic apical lesions and controls.

MATERIALS AND METHODS

Apical tissues from symptomatic and asymptomatic apical periodontitis patients and periodontal ligaments from healthy teeth extracted for orthodontic reasons were processed for tissue homogenization and the levels of TRAP-5, RANKL, and OPG were determined by multiplex assay. Marker levels were analyzed by Kruskal Wallis test, and diagnostic accuracy was analyzed with ROC curves.

RESULTS

Higher levels of RANKL, OPG, and RANKL/OPG ratio were determined in both types of apical lesions compared to healthy periodontal ligament, whereas higher TRAP-5 levels were found only in symptomatic apical lesions (p < 0.05). OPG, RANKL, and RANKL/OPG ratio showed diagnostic potential to identify apical lesions versus healthy controls (AUC = 0.69, p < 0.05); while TRAP-5 showed a potential to discriminate symptomatic versus asymptomatic apical periodontitis (AUC = 0.71, p < 0.05) and healthy controls (AUC = 0.83, p < 0.05).

CONCLUSIONS

Apical lesions showed higher RANKL and OPG levels than healthy tissues. TRAP-5 levels were the highest in symptomatic apical lesions, suggesting that these represent a progressive state, and showed diagnostic potential.

CLINICAL RELEVANCE

Clinically symptomatic apical periodontitis might represent biologically progressive apical lesions based on TRAP5 levels. TRAP5 has diagnostic potential to identify these lesions, representing a candidate prognostic biomarker.

Composite Replacement of Amalgam Restoration Versus Freshly Cut Dentin: An In Vitro Microleakage Comparison

OBJECTIVE

The aim of this study was to evaluate the microleakage of the composite restorations when bonded to tooth structure previously restored with amalgam material compared with that of freshly cut dentin.

METHODS AND MATERIALS

Thirty intact, extracted intact human molars were mounted in autopolymerizing acrylic resin. Class II box preparations were prepared on the occluso-proximal surfaces of each tooth (4-mm bucco-lingual width and 2-mm mesio-distal depth) with the gingival cavosurface margin 1 mm above the CEJ. Each cavity was then restored using high copper amalgam restoration (Disperalloy, Dentsply) and then thermocycled for 10,000 thermal cycles. Twenty-five of the amalgam restorations were then carefully removed and replaced with Filtek Supreme Ultra Universal (3M ESPE); the remaining five were used for scanning electron microscopy and energy dispersive x-ray spectroscopy analysis. A preparation of the same dimensions was performed on the opposite surface of the tooth and restored with composite resin and thermocycled for 5000 thermal cycles. Twenty samples were randomly selected for dye penetration testing using silver nitrate staining to detect the microleakage. The specimens were analyzed with a stereomicroscope at a magnification of 20×. All of the measurements were done in micrometers; two readings were taken for each cavity at the occlusal and proximal margins. Two measurements were taken using a 0-3 scale and the percentage measurements.

RESULTS

Corrosion products were not detected in either group (fresh cut dentin and teeth previously restored with amalgam). No statistically significant difference was found between the microleakage of the two groups using a 0-3 scale at the occlusal margins (McNemar test, p=0.727) or proximal margins (Wilcoxon signed-rank test, p=0.174). No significance difference was found between the two groups using the percentage measurements and a Wilcoxon signed-rank test at either the occlusal (p=0.675) or proximal (p=0.513) margins. However, marginal microleakage was statistically significant between the proximal and occlusal margins (p<0.001).

CONCLUSION

Within the limitations of this in vitro study, no significant difference was found between the microleakage of nondiscolored dentin in teeth that were previously restored with amalgam compared with freshly cut dentin. However, marginal microleakage in the proximal surface was higher than that in the occlusal surface.

ALX/FPR2 Modulates Anti-Inflammatory Responses in Mouse Submandibular Gland

Activation of the G-protein coupled formyl peptide receptor 2 (ALX/FPR2) by the lipid mediators lipoxin A4 and resolvin D1 (RvD1) promotes resolution of inflammation. Our previous in vitro studies indicate that RvD1 activation of ALX/FPR2 resolves cytokine-mediated inflammatory responses in mammalian cells. However, the impact of ALX/FPR2 activation on salivary gland function in vivo is unknown. The objective of this study was to determine whether submandibular glands (SMG) from ALX/FPR2(-/-) mice display enhanced inflammatory responses to lipopolysaccharides (LPS) stimulation. For these studies, C57BL/6 and ALX/FPR2(-/-) mice at age 8-12-week-old were treated with LPS by i.p for 24 h. Salivary gland structure and function were analyzed by histopathological assessment, saliva flow rate, quantitative PCR, Western blot analyses and immunofluorescence. Our results showed the following events in the ALX/FPR2(-/-) mice treated with LPS: a) upregulated inflammatory cytokines and decreased M3R (Muscarinic Acetylcholine receptor M3) and AQP5 (Aquaporin 5) protein expression, b) decreased saliva secretion, c) increased apoptosis, d) alteration of tight junction and neuronal damage. Overall, our data suggest that the loss of ALX/FPR2 results in unresolved acute inflammation and SMG dysfunction (xerostomia) in response to LPS that is similar to human salivary gland dysfunction induced by bacterial infection.

Medication Management of Jaw Lesions for Dental Patients

Most pathologic lesions of the jaws or of oral mucosa are treated successfully by surgical interventions. For treatment of the central giant cell lesion, aneurysmal bone cysts, histiocytosis of the mandible, hemangioma, odontogenic keratocyst, Paget disease, oral submucous fibrosis, and oral lichen planus, medical management consisting of intralesional injections, sclerosing agents, and systemic bisphosphonates is as successful as surgical procedures with fewer complications. Pharmacology of agents used and protocols are presented.

Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications

Zirconia (ZrO₂) based dental ceramics have been considered to be advantageous materials with adequate mechanical properties for the manufacturing of medical devices.

Regenerative endodontics--Creating new horizons

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics.

Melkersson-Rosenthal Syndrome with Orofacial Swelling and Recurrent Lower Motor Neuron Facial Nerve Palsy: A Case Report and Review of the Literature

Melkersson-Rosenthal Syndrome (MRS) is a rare otoneurologic condition, which is poorly understood and often underdiagnosed. Etiology and incidence are unclear, although infectious, inflammatory, and genetic causes have been implicated. Recurrent facial nerve palsy, facial swelling, and fissured tongue are the symptoms and signs of this condition. However, this triad is not typical in all patients as patients may present with one or more of the symptoms, which makes management of this condition difficult. Steroids may prove to be useful especially in patients who have facial nerve palsy. In this case report, we have described a 46 year-old Caucasian male who presented to the clinic for the evaluation of orofacial swelling and left facial deviation with a history of multiple treatments for recurrent lower motor neuron type facial nerve palsy.

Saliva as a diagnostic tool for oral and systemic diseases

Early disease detection is not only vital to reduce disease severity and prevent complications, but also critical to increase success rate of therapy. Saliva has been studied extensively as a potential diagnostic tool over the last decade due to its ease and non-invasive accessibility along with its abundance of biomarkers, such as genetic material and proteins. This review will update the clinician on recent advances in salivary biomarkers to diagnose autoimmune diseases (Sjogren's syndrome, cystic fibrosis), cardiovascular diseases, diabetes, HIV, oral cancer, caries and periodontal diseases. Considering their accuracy, efficacy, ease of use and cost effectiveness, salivary diagnostic tests will be available in dental offices. It is expected that the advent of sensitive and specific salivary diagnostic tools and the establishment of defined guidelines and results following rigorous testing will allow salivary diagnostics to be used as chair-side tests for several oral and systemic diseases in the near future.

Effects of Fiber-reinforced Composite Bases on Microleakage of Composite Restorations in Proximal Locations

Objectives:

The aim of this study was to evaluate the microleakage of direct restorative composite resin upon the addition of an intermediate glass fiber-reinforced composite (GFRC) layer of various fiber orientations between tooth and particulate filler composite resin (PFRC).

Materials and Methods:

Cavities were prepared both on the mesial and distal surfaces of sixty extracted human molars with one margin placed below and the other above the cementoenamel junction (CEJ). Teeth were assigned to five different groups. Four of the groups received a layer of semi-interpenetrating polymer network (semi-IPN) resin system impregnated E-glass GFRC at the bottom of the cavity: Group 1; unidirectional continuous GFRC (EVS) in buccolingual direction (EVS-BL), Group 2; EVS in mesiodistal direction (EVS-MD), Group 3; bidirectional woven GFRC (EVN), Group 4; multidirectional short GFRC (EXP-MLT), Group 5; PRFC only (control). After acid etching and priming of the cavities and insertion of GFRC layer with the adhesive resin (Scotchbond Multipurpose 3M-ESPE), the cavities were filled incrementally with PRFC (Filtek Z250, 3M-ESPE) and each layer was light cured for 20 s. After finishing and polishing, the restored teeth were water-stored for 24 h at 37 °C and then thermocycled for 6000 cycles between 5-55 °C, before immersion in 0.5 % basic fuchsin dye for 24 h. After sectioning by 3-5 sagittal cuts, each sequential section was imaged and digitally analyzed to determine the stain depth.

Results:

All GFRC groups in dentin revealed significantly lower microleakage compared to control (p<0.05). The orientation of FRC intermediate layer did not reveal significant differences in microleakage (p>0.05). The microleakeage in enamel was not different between the groups (p>0.05).

Conclusion:

Use of intermediate GFRC layer between tooth and PFRC could provide alternative method to minimize microleakage.

Clinical Relevance:

Use of GFRC intermediate layer underneath the particulate filler composite can be used to minimize the leakeage of the restorations.

Novel zirconia surface treatments for enhanced osseointegration: laboratory characterization

Purpose. The aim of this study was to evaluate three novel surface treatments intended to improve osseointegration of zirconia implants: selective infiltration etching treatment (SIE), fusion sputtering (FS), and low pressure particle abrasion (LPPA). The effects of surface treatments on roughness, topography, hardness, and porosity of implants were also assessed. Materials and Methods. 45 zirconia discs (19 mm in diameter × 3 mm in thickness) received 3 different surface treatments: selective infiltration etching, low pressure particle abrasion with 30 µm alumina, and fusion sputtering while nontreated surface served as control. Surface roughness was evaluated quantitatively using profilometery, porosity was evaluated using mercury prosimetry, and Vickers microhardness was used to assess surface hardness. Surface topography was analyzed using scanning and atomic force microscopy (α = 0.05). Results. There were significant differences between all groups regarding surface roughness (F = 1678, P < 0.001), porosity (F = 3278, P < 0.001), and hardness (F = 1106.158, P < 0.001). Scanning and atomic force microscopy revealed a nanoporous surface characteristic of SIE, and FS resulted in the creation of surface microbeads, while LPPA resulted in limited abrasion of the surface. Conclusion. Within the limitations of the study, changes in surface characteristics and topography of zirconia implants have been observed after different surface treatment approaches. Thus possibilities for enhanced osseointegration could be additionally offered.

Interaction with ectomycorrhizal fungi and endophytic Methylobacterium affects nutrient uptake and growth of pine seedlings in vitro

Tissues of Scots pine (Pinus sylvestris L.) contain several endophytic microorganisms of which Methylobacterium extorquens DSM13060 is a dominant species throughout the year. Similar to other endophytic bacteria, M. extorquens is able to colonize host plant tissues without causing any symptoms of disease. In addition to endophytic bacteria, plants associate simultaneously with a diverse set of microorganisms. Furthermore, plant-colonizing microorganisms interact with each other in a species- or strain-specific manner. Several studies on beneficial microorganisms interacting with plants have been carried out, but few deal with interactions between different symbiotic organisms and specifically, how these interactions affect the growth and development of the host plant. Our aim was to study how the pine endophyte M. extorquens DSM13060 affects pine seedlings and how the co-inoculation with ectomycorrhizal (ECM) fungi [Suillus variegatus (SV) or Pisolithus tinctorius (PT)] alters the response of Scots pine. We determined the growth, polyamine and nutrient contents of inoculated and non-inoculated Scots pine seedlings in vitro. Our results show that M. extorquens is able to improve the growth of seedlings at the same level as the ECM fungi SV and PT do. The effect of co-inoculation using different symbiotic organisms was seen in terms of changes in growth and nutrient uptake. Inoculation using M. extorquens together with ECM fungi improved the growth of the host plant even more than single ECM inoculation. Symbiotic organisms also had a strong effect on the potassium content of the seedling. The results indicate that interaction between endophyte and ECM fungus is species dependent, leading to increased or decreased nutrient content and growth of pine seedlings.

Biodegradation of composite resin with ester linkages: identifying human salivary enzyme activity with a potential role in the esterolytic process

OBJECTIVES

The ester linkages contained within dental resin monomers (such as Bisphenol A-glycidylmethacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA)) are susceptible to hydrolytic degradation by salivary esterases, however very little is known about the specific esterase activities implicated in this process. The objective of this work was to isolate and identify the dominant proteins from saliva that are associated with the esterase activities shown to be involved in the degradation of BisGMA.

METHODS

Human whole saliva was collected and processed prior to separation in a HiPrep 16/60 Sephacryl S-200 HR column. The fraction with the highest esterase activity was further separated by an anion exchange column (Mono-Q (10/100G)). Isolated fractions were then separated by gel electrophoresis, and compared to a common bench marker esterase, cholesterol esterase (CE), and commercial albumin which has been reported to express esterase activity. Proteins suspected of containing esterase activity were analyzed by Mass Spectroscopy (MS). Commercially available proteins, similar to the salivary esterase proteins identified by MS, were used to replicate the enzymatic complexes and confirm their degradation activity with respect to BisGMA.

RESULTS

MS data suggested that the enzyme fraction with the highest esterase activity was contained among a group of proteins consisting of albumin, Zn-α2-glycoprotein, α-amylase, TALDO1 protein, transferrin, lipocalin2, and prolactin-induced protein. Studies concluded that the main esterase bands on the gels in each fraction did not overlap with CE activity, and that albumin activity emerged as a lead candidate with significant esterase activity relative to BisGMA degradation, particularly when it formed a complex with Zn-α2-glycoprotein, under slightly basic conditions.

SIGNIFICANCE

These enzyme complexes can be used as a physiologically relevant formulation to test the biostability of composite resins.