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.

[Investigation of efficiency of antiseptic composition containing silver treatment of prosthodontic and orthodontic stomatitis]

Results of clinical research of local application antiseptic composition containing silver for treatment of prosthodontic and orthodontic stomatitis (gingivitis, stomatitis, periodontitis, mucositis). The specified antiseptic preparation pad estimated efficiency in treatment of the common health condition of patients, complaints of patients and the data of clinical observation.

In vitro evaluation of artificial ageing on surface properties and early Candida albicans adhesion to prosthetic resins

OBJECTIVE

The aim of this in vitro study was to examine potential changes and influences of prosthetic resin surface properties on Candida albicans adhesion after surface treatment or artificial ageing.

MATERIALS AND METHODS

Standardized specimens of a denture base resin and a veneering composite were prepared, polished, and randomly subjected to different surface roughness treatments or artificial ageing protocols (storage in ethanol or artificial saliva for 7/90 d, thermocycling). Surface roughness (Ra) and surface free energy were determined prior and after each treatment. Specimens were incubated with phosphate buffered saline or whole saliva for 2 h at 37 degrees C, and later with Candida albicans suspension (2.5 h, 37 degrees C). Adherent viable fungi were quantified using a bioluminescence assay.

RESULTS

Artifical ageing did not affect substratum surface roughness, yet slight increases in substratum surface free energy and significant increases in Candida albicans adhesion were observed. Saliva coating marginally influenced Candida albicans adherence to reference and surface treated specimens, yet more pronounced differences in Candida albicans adhesion between the various artificially aged specimens were found.

CONCLUSION

No correlation between substratum surface roughness or surface free energy and Candida albicans adhesion could be established.

[Saliva pH and galvanic current ways in mouth tissues and liquids]

In the group of 290 human having metal artificial limbs in an oral cavity, decrease in average value pH the mixed saliva in comparison with the persons who are not having metal inclusions was due to increase of percent of persons with sour reaction of saliva. Thus the degree of decrease the mixed saliva pH did not depend up on size of galvanic currents and presence of galvanic symptoms. The hypothesis was put forward, that decrease of saliva pH and development of galvanism was connected with local changes in a biofilm contacting to metal artificial prosthetic devices. Galvanic currents extended both on a surface of oral mucous membrane and in tissue. Clinical symptoms of galvanism we more expressed when galvanic currents flow manly in oral tissue.

Communication: a case against underocclusion

Hypo-occlusion is another term for underocclusion. This condition is often caused during crown-and-bridge procedures where an incorrect mounting of opposing dental casts, the injudicious polishing of the occlusal surface of a cast restoration, or the intended placement of an occlusal shim prior to the casting will guarantee a close occlusal contact--one that doesn't make contact. Hypo-occlusion may also take place during routine restorative work where the clinical operator "ditches" the restoration for assumed longevity. Implant specialists often advocate to the restorative dentist that their implants should be constructed with no lateral interferences and with a light centric contact or one that is just underocclusal contact. What exactly does this mean?

A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part II: fixed dental prostheses

OBJECTIVES

The objective of this systematic review was to assess the 5-year survival rates and incidences of complications of all-ceramic fixed dental prostheses (FDPs) and to compare them with those of metal-ceramic FDPs.

METHODS

An electronic MEDLINE and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all-ceramic and metal-ceramic reconstructions with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions.

RESULTS

The search provided 3473 titles for single crowns and FDPs and resulted in 100 abstracts for all-ceramic FDPs. Full-text analysis was performed for 39 articles, resulting in nine studies of ceramic FDPs that met the inclusion criteria. The data on survival and complication rates of metal-ceramic FDPs were obtained from a previous systematic review of Tan et al. (2004) and the updated version from the same authors (Pjetursson et al. 2007). In Poisson regression meta-analysis, the 5-year survival of metal-ceramic FDPs was significantly (P<0.0001) higher with 94.4% [95 confidence interval (CI): 91.1-96.5%] than the survival of all-ceramic FDPs, being 88.6% (95 CI: 78.3-94.2%). The frequencies of material fractures (framework and veneering material) were significantly (P<0.0001) higher for all-ceramic FDPs (6.5% and 13.6%) compared with those of metal-ceramic FDPs (1.6% and 2.9%). Other technical complications like loss of retention and biological complications like caries and loss of pulp vitality were similar for the two types of reconstructions over the 5-year observation period.

CONCLUSION

Based on the present systematic review of all-ceramic FDPs, significantly lower survival rates at 5 years were seen compared with metal-ceramic FDPs. The most frequent reason for failure of FDPs made out of glass-ceramics or glass-infiltrated ceramics was fracture of the reconstruction (framework and veneering ceramic). However, when zirconia was used as framework material, the reasons for failure were primarily biological and technical complications other than framework fracture.

Ante's (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support

BACKGROUND

In subjects suffering from generalized severe periodontitis, only a few teeth may be treated and used as abutments for fixed dental prostheses (FDPs).

OBJECTIVE

To systematically review the impact of severely reduced, but healthy periodontal tissue support on the survival rate and complications of FDPs after a mean follow-up time of at least 5 years.

SEARCH STRATEGY

Publications considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. The search was performed in duplicate and was limited to human studies published in the dental literature from 1966 up to and including September 2006. Only publications in English, in peer-reviewed journals, were considered. Abstracts were excluded.

SELECTION CRITERIA

Prospective and retrospective cohort studies were included. The primary outcome measure included survival rates of FDPs and abutment teeth, whereas biological and technical complications of FDPs and abutment teeth represented secondary outcome measures.

DATA ANALYSIS

Summary estimates of survival rates and of biological and technical complications were calculated after 5 and 10 years.

RESULTS

The search provided 860 titles of which six publications were included. A total of 579 FDPs were incorporated and followed up to 25 years. Meta-analysis yielded an estimated FDP survival rate of 96.4% [95% confidence interval (95% CI): 94.6-97.6%] after five and of 92.9% (95% CI: 89.5-95.3%) after 10 years, respectively. After 10 years, the estimated rate of abutment teeth without endodontic complications amounted to 93% (95% CI: 62.6-98.9%). The 10-year estimated rate of caries-free abutment teeth was 98.1% (95% CI: 88.2-99.7%). FDPs without loss of retention were estimated to occur in 95.4% (95% CI: 92.6-97.2%) of cases after 10 years.

CONCLUSIONS

These results showed that (i) masticatory function could be established and maintained in subjects receiving FDPs on abutment teeth with severely reduced but healthy periodontal tissue support and (ii) FDPs survival rates compared favourably with those of FDPs incorporated in subjects without severely periodontally compromised dentitions.

Dental treatment and risk of variant CJD--a case control study

OBJECTIVE

Knowledge of risk factors for variant CJD (vCJD) remains limited, but transmission of prion proteins via re-useable medical devices, including dental instruments, or enhanced susceptibility following trauma to the oral cavity is a concern. This study aimed to identify whether previous dental treatment is a risk factor for development of vCJD.

DESIGN

Case control study.

METHODS

Risk factor questionnaires completed by interview with relatives of 130 vCJD patients and with relatives of 66 community and 53 hospital controls were examined by a dental surgeon. Responses regarding dental treatments were analysed.

RESULTS

We did not find a statistically significant excess of risk of vCJD associated with dental treatments with the exception of extractions in an unmatched analysis of vCJD cases with community controls (p = 0.02). However, this result may be explained by multiple testing.

CONCLUSIONS

This is the first published study to date to examine potential links between vCJD and dental treatment. There was no convincing evidence found of an increased risk of variant CJD associated with reported dental treatment. However, the power of the study is restricted by the number of vCJD cases to date and does not preclude the possibility that some cases have resulted from secondary transmission via dental procedures. Due to the limitations of the data available, more detailed analyses of dental records are required to fully exclude the possibility of transmission via dental treatment.

Foreign body in the airway: unusual cause of acute dyspnoe after cardiac surgery

We report on a 68-year-old male who presented with acute onset of dyspnoea and cough. After coronary artery bypass grafting and mitral valve repair with an annuloplasty ring, postoperative recovery was initially uneventful. On the 6th postoperative day, he came back to intensive care unit due to acute dyspnoea. Fig. 1 demonstrates chest x-ray. We identified the foreign body as a dental prosthesis (Fig. 2). Removal from the right bronchial tree was successful using a flexible bronchoscope under local anesthesia; intubation was not required. This procedure was safe and well tolerated by the patient. Clinical presentation of adult foreign body aspiration are often nonspecific. Chest x-ray is very helpful for identification and localization of foreign bodies in the airway. Extraction can be performed with flexible or rigid bronchoscopy. For the removal, biopsy forceps, Fogarty balloon catheter, alligator forceps or wire baskets are effective.

Candida albicans, Staphylococcus aureus and Streptococcus mutans colonization in patients wearing dental prosthesis

BACKGROUND

Denture stomatitis is associated to Candida albicans, different bacteria and other co-factors such as an acid pH, a carbohydrate ingestion increase, different systemic illnesses and pharmacological treatments.

OBJECTIVE

The aim of this study was to determine Candida albicans, Staphylococcus aureus and Streptococcus mutans prevalence in the mucous membrane and prosthesis of patients with and without atrophic denture stomatitis and its relationship with other potential clinical co-factors.

STUDY DESIGN

Saliva was collected from 105 patients (62 female and 43 male) wearing dental prosthesis in order to measure their pH. Oral samples of the mucous membrane and the internal surface of dental prosthesis were taken with sterile cotton to proceed with the microbiological study. The identification of the isolated microorganisms was performed using conventional microbiological methods.

RESULTS

Diabetes and Hypertension were the most frequent systemic illnesses. High carbohydrate ingestion was observed in numerous patients. Atrophic denture stomatitis was reported in 50 patients and the pH average in saliva was of 5.2. The presence of C albicans, S. aureus and S. mutans in the mucous membrane and prosthesis was of 51.4%, 52.4% and 67.6%, respectively. C. albicans was isolated in 66.7% from the prosthesis, whereas S. aureus and S. mutans were isolated in 49.5% of those same prosthesis. C. albicans was isolated in 86% of the patients with atrophic denture stomatitis and S. aureus was isolated in a similar percentage (84% of patients). The isolation of S. mutans was less frequent, and it was observed in 16% of the oral samples of these patients.

CONCLUSIONS

C. albicans, S. aureus and S. mutans frequently colonize the oral mucous of patients wearing dental prosthesis. This illness-bearing condition is more frequent in patients with denture stomatitis, even though dental prosthesis colonization is lower than in the oral mucous.

Assessment of risk factors for oral leukoplakia in West Virginia

OBJECTIVE

To assess risk factors associated with oral leukoplakia in a US population with high use of smoked tobacco and smokeless tobacco.

METHODS

The RJ Gorlin Leukoplakia Tissue Registry was used to identify individuals with oral leukoplakia in West Virginia, USA. This case-control study consisted of 90 cases with oral leukoplakia and 78 controls with periapical cysts. Univariate-univariable (one dependent variable and one independent variable) and univariate-multivariable (one dependent variable and multiple independent variables) logistic regression modeling quantified the association between oral leukoplakia and potential explanatory variables.

RESULTS

Unadjusted measures of association indicate that those with oral leukoplakia were more likely to be older [odds ratio of crude: OR(Crude) = 2.72; 95% confidence interval (CI): 1.45-5.11], more likely to currently use smokeless tobacco (OR(Crude) = 3.16; 95% CI: 1.10-9.07), and more likely to currently use snuff (OR(Crude) = 8.32; 95% CI: 1.83-37.80). Individuals currently using smokeless tobacco or currently using snuff were more likely to have oral leukoplakia [adjusted odds ratio, OR(Adj) = 9.21 and 30.08; 95% CI: 1.49-57.00 and 2.67-338.48, respectively], after simultaneously adjusting for age, gender, currently using smoked tobacco, currently using alcohol daily, and dental prostheses use.

CONCLUSIONS

Generalizability is an issue when studying risk factors associated with oral leukoplakia because of geographical variations in the composition of smokeless tobacco (i.e. betel, lime, ash, and N-nitrosamines) and cultural variations in the use of tobacco (i.e. reverse smoking). Snuff was the main smokeless tobacco product currently used in West Virginia, and was strongly associated with oral leukoplakia, after adjusting for potential explanatory variables.

Aneurysm of the distal facial artery from a penetrating oral prosthesis

We report a 94-year-old male who died of pneumonia. During the routine dissection of the head and neck for a gross anatomy course at our institution a mass was noted in the region of the right cheek. Macroscopic and microscopic observation of this mass revealed an aneurysm of the facial artery. A traumatic defect was noted at the apex of the aneurysmal wall related to an intraoral prosthetic clasp that had penetrated the buccinator muscle. Traumatic aneurysms of the face have been caused by blunt trauma to the jaw with or without fracture, surgical manipulation around the teeth and jaw, and following missile injury. Some have described compression of neighboring structures such as cranial nerves and other blood vessels with resultant compromise. We believe our case to be the first report of a facial artery aneurysm in a cadaver and we are unaware of other reports from the literature describing the production of a facial artery aneurysm from a puncture of an intraoral prosthesis through the medially placed buccinator muscle. Although seemingly rare, health care professionals should make efforts to ensure that oral prostheses do not develop sharp or irregular edges that could potentially perforate the lateral oral cavity with potential perforation of the overlying vasculature.

An amalgam tattoo on the oral mucosa related to a dental prosthesis

A 60-year-old woman presented with a pigmented lesion on the upper left gingival mucosa of 2 years duration. The lesion was in an area where a dental metallic prosthesis had been inserted into a nearby tooth several years earlier. A biopsy of the affected mucosa showed aggregates of pigmented granules varying in size in the dermis, extracellular matrix and within macrophages; these did not stain with melanin stains. The diagnosis was consistent with an amalgam tattoo.

Bone level change at implant-supported fixed partial dentures with and without cantilever extension after 5 years in function

OBJECTIVE

The aim of this study was to retrospectively analyze whether the inclusion of cantilever extensions increased the amount of marginal bone loss at free-standing, implant-supported, fixed partial dentures (FPDs) over a 5-year period of functional loading.

MATERIAL AND METHODS

The patient material comprised 45 periodontally treated, partially dentate patients with a total of 50 free-standing FPDs supported by implants of the Astra Tech System. Following FPD placement (baseline) the patients were enrolled in an individually designed supportive care program. A set of criteria was collected at baseline to characterize the FPDs. The primary outcome variable was change in peri-implant bone level from the time of FPD placement to the 5-year follow-up examination. The comparison between FPDs with and without cantilevers was performed at three levels: FPD level, implant level, and surface level. Bivariate analysis was performed by the use of the Mann-Whitney U-test and stepwise regression analysis was utilized to evaluate the potential influence of confounding factors on the change in peri-implant bone level.

RESULTS

The overall mean marginal bone loss for the implant-supported FPDs after 5 years in function was 0.4 mm (SD, 0.76). The bone level change at FPDs placed in the maxilla was significantly greater than that for FPDs in the mandible (0.6 versus 0.2 mm; p<0.05). No statistically significant differences were found with regard to peri-implant bone level change over the 5 years between FPDs with and without cantilevers at any of the levels of comparisons. The multivariate analysis revealed that the variables jaw of treatment and smoking had a significant influence on peri-implant bone level change on the FPD level, but not on the implant or surface levels. The model explained only 10% of the observed variance in the bone level change.

CONCLUSION

The study failed to demonstrate that the presence of cantilever extensions in an FPD had an effect on peri-implant bone loss.

Aspiration and ingestion in dental practice: a 10-year institutional review

BACKGROUND

This article is an institutional retrospective review of incidents involving aspiration and ingestion of dental foreign objects at a large multidisciplinary dental educational facility. It was undertaken to determine which dental procedures were more likely to involve aspiration or ingestion, as well as to evaluate the outcome of these adverse incidents.

METHODS

The inclusion criteria involved all patients who were documented to have experienced loss of dental instruments or material behind the posterior pharynx during a 10-year consecutive period. The dental and medical records of these patients were analyzed, and the outcomes of the adverse events fell into three categories: aspiration, ingestion, or neither aspirated nor ingested. The authors also noted the type of dental instrument and the specialty or area of dentistry in which this event occurred.

RESULTS

There were 36 documented cases. Twenty-five of these were instances of ingestion and one was an aspiration. In 10 cases, aspiration and ingestion were ruled out through radiographic examination or the object was retrieved from the patient's mouth.

CONCLUSIONS

Fixed prosthodontic therapy had the highest number of incidents of adverse outcomes. Ingestion was a more prevalent outcome than aspiration. Dental procedures involving single-tooth cast or prefabricated restorations involving cementation have a higher likelihood of aspiration.

CLINICAL IMPLICATIONS

The implications for clinical practice include the recognition of risk that dental therapy demands in regard to the airway and posterior pharynx, documentation and follow-up of adverse outcomes, and the use of preventive measures such as rubber dams or gauze throat screens or floss ligatures.

Pattern of tooth loss in recipients of free dental treatment at the University Hospital of Amman, Jordan

The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients <or=40 years of age whereas periodontal extractions were predominant for the above 40-year-old group. In addition, the most frequently extracted teeth, due to caries, were lower first and second molars while lower incisors were most commonly extracted for periodontal disease. Premolars were extracted for orthodontic reasons, upper incisors for trauma, third molars for eruption problems and canines for pre-prosthetic reasons. In conclusion, dental caries was the main reason for removal of teeth in adults attending the University of Jordan free dental casualty clinic. Therefore, in order to reduce the rate of dental extractions in this sector of the Jordanian population, efforts should focus on prevention and treatment of caries. Efforts should also be made to change the values and beliefs of this sector towards the importance of natural dentition.

Effects of machined/turned, TiO2-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction: A study on isolated rat sciatic nerves

The purpose of this study was to explore the clinical relevance of the effects of machined/turned, TiO(2)-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction. Isolated rat sciatic nerves were placed between two suction electrodes in a pyrex bath containing a tyrode solution. Evoked compound action potentials (cAPs) of the nerves were recorded before and after contact with the implants. The mandibular incisors of randomly selected animals were extracted and changes in cAP amplitudes were used as controls. The differences in final cAP values of Astra Tech implants and rat natural teeth were insignificant (P < 0.05), whereas the differences between other groups were significant (P < 0.05). Machined/turned-surface implants did not cause any change in cAPs. A slight decrease in cAPs was observed for TiO(2)-blasted and sandblasted/acid-etched implants, and the natural teeth. The reductions of cAPs in latter groups were not 50% after an application time of 300 min. The cAP changes of nerves contacting TiO(2)-blasted and sandblasted/acid-etched oral implants fall within physiologic limits in vitro. Machined/turned, TiO(2)-blasted, and sandblasted/acid-etched titanium implant surfaces do not lead to irreversible neurotoxic effects.

Copper hypersensitivity: dermatologic aspects--an overview

Reports of immune hypersensitivity reactions of both the immediate and the delayed type following cutaneous or systemic exposure to copper are reviewed here in an endeavor to draw a comprehensive profile of the immunogenic potential of that metal and its compounds. The immunotoxic potential of the metal is also briefly reviewed. In principle, as noted for other transition metals, the electropositive copper ion is potentially immunogenic because of its ability to diffuse through biological membranes, forming complexes when in contact with tissue protein. Based on the results of the predictive guinea pig test and the local lymph node assay (LLNA), copper has a low sensitization potential. Reports of immune reactions to copper include immunologic contact urticaria (ICU), allergic contact dermatitis (ACD), systemic allergic reactions (SAR) and contact stomatitis (STO), but considering the widespread use of copper intrauterine devices (IUDs) and the importance of copper in coinage, items of personal adornment and industry, unambiguous reports of sensitization to the metal are extremely rare, and even fewer are the cases that appear clinically relevant. Most reports of immune reactions to copper describe systemic exposure as a cause--predominantly to intrauterine devices and to prosthetic materials in dentistry--implicitly excluding the induction of hypersensitivity from contact with the skin as a risk factor.

Gerodontic nutrition and dietary counseling for prosthodontic patients

The older dental patient can be at risk of poor nutrition for a variety of reasons including physiologic, oral, psychosocial, functional, and medical factors. Any decline in the ability to eat increases the risk of malnutrition. Oral impairments can affect diet and nutrition because of chances in the ability and desire to taste, bite, chew, and swallow foods. The dental team must be aware of these potential detrimental effects of dental treatment and provide counteractive dietary guidance. Problems vary with the patient and the dental condition, so suggestions must be tailored to meet the patient's specific needs. Caregivers should: Screen patients to determine whether there are risk factors that could compromise nutrition. Provide diet guidance to prepare patients for any changes in eating ability. Promote diet adequacy by suggesting appropriate choices from each food group in the Food Guide Pyramid. Consult with and refer clients to a registered dietitian whenever possible.

Assessment of cytogenetic damage in lymphocytes and in exfoliated nasal cells of dental laboratory technicians exposed to chromium, cobalt, and nickel

Dental laboratory technicians may be exposed to metal alloys that are used in the production of crowns, bridges and removable partial dentures. These alloys consist of 35-65% cobalt, 20-30% chromium, 0-30% nickel, and small amounts of molybdenum, silica, beryllium, boron and carbon. The aim of this study was to assess whether dental technicians are occupationally exposed to chromium, cobalt and nickel, by analyzing urinary excretion levels of these metals and to investigate the genotoxic effects of occupational exposure associated with dental prostheses production operations by analyzing cytokinesis-blocked micronucleus (CB-MN) frequencies in peripheral lymphocytes and micronucleus (MN) frequencies in exfoliated nasal cells from 27 dental laboratory technicians and 15 control subjects. The differences in the urinary excretion of metals between technicians and controls were statistically significant. The mean (+/-S.D.) CB-MN frequencies ( per thousand ) in peripheral lymphocytes were 4.00 (+/-2.98) among the dental technicians and 1.40 (+/-1.30) among the controls, a statistically significant difference (P<0.005). The mean (+/-S.D.) MN frequencies ( per thousand ) in nasal cells were 3.50 (+/-1.80) among the dental technicians and 1.19 (+/-0.53) among the controls, which was also a statistically significant difference (P<0.005). There was a significant correlation between duration of exposure and MN frequencies in lymphocytes (r=0.642, P<0.01), but not in nasal cells of technicians. Our data reveal that in vivo exposure to chromium, nickel and cobalt metals is evident and that this occupational exposure may contribute to the observed genotoxic damage in two types of cells, e.g. lymphocytes and exfoliated nasal cells. However, it cannot be determined which compound(s) are responsible for the genotoxic damage observed in this study.