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Oral Environment (oral + environment)
Selected AbstractsPulpal responses to bacterial contamination following dentin bridging beneath hard-setting calcium hydroxide and self-etching adhesive resin systemDENTAL TRAUMATOLOGY, Issue 2 2008Yuichi Kitasako Class V cavities were prepared on 30 monkey teeth, and the pulps were exposed with a carbide bur through the cavity floor. Each exposed pulp was capped with either DY or 2V. The cavities were restored with a hybrid resin composite. The resin composite was removed at 180 days after capping, and then cavities were left open to the oral environment for 2 weeks to obtain bacteria contamination DY (BDY) and 2V (B2V; n = 10). A non-bacterial-contaminated group capped with DY was used as control. After bacterial challenges, inflammatory cell infiltration, incidence and differentiation of dentin bridges were evaluated histologically. There were significant differences in the presence of inflammatory cell infiltration among all groups (P < 0.05). No moderate or severe inflammatory reaction was found in Group DY. Group BDY showed moderate or severe inflammatory cell infiltration in 50%, and showed four necrotic specimens. Although no statistically significant difference was found in the formation and differentiation of dentin bridges among all groups, tunnel defects in dentin bridges were detected in 70% (DY), 80% (BDY), and 50% (B2V). Group B2V showed a significantly lower presence of inflammatory cell infiltration than Group BDY (P < 0.05). Bonding agent is supposed to seal the exposure site, and the remaining bonding agent on the cavities was effective as the barrier in the dentin bridges after bacterial challenges. [source] Physicochemical evaluation of silica-glass fiber reinforced polymers for prosthodontic applicationsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2005Gökçe Meriç This investigation was designed to formulate silica-glass fiber reinforced polymeric materials. Fused silica-glass fibers were chosen for the study. They were heat-treated at various temperatures (500°C, 800°C and 1100°C), silanized, sized and incorporated in two modified resin mixtures (A and B). The flexural properties in dry and wet conditions were tested and statistically analyzed, and the content of residual methyl methacrylate (MMA) monomer, dimensional changes with temperature, water sorption and solubility were determined. Woven fibers [36.9% (wt/wt)], heat-treated at 500°C, gave the highest strength values for the polymeric composites (an ultimate transverse strength of 200 Mpa and a flexural modulus of 10 GPa) compared with the fibers heat-treated at other temperatures. There was no statistically significant difference in the measured flexural properties between resins A and B regarding fiber treatment and water storage time. These fiber composites had a small quantity of residual MMA content [0.37 ± 0.007% (wt/wt)] and very low water solubility, indicating good biocompatibility. It was suggested that silica-glass fibers could be used for reinforcement as a result of their anticipated good qualities in aqueous environments, such as the oral environment. [source] Adhesive bonding of titanium nitride-plated stainless steel for magnetic attachmentsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2001Yohsuke Taira The purpose of this study was to evaluate adhesive bonding of resin to titanium nitride ion-plated stainless steel in order for magnetic attachments to survive in the oral environment. Two primers, Cesead II Opaque Primer (CPII) and Metal Primer II (MPII), and one bonding agent, Super-Bond C&B (SB), were used. The surfaces of stainless steel disks were ground and then plated with titanium nitride. After the primer and SB resin were applied, a self-curing resin was bonded to the metal surfaces. Shear bond strengths were determined after 24 h of water storage and after 2,000 thermocycles. Titanium nitride ion-plated stainless steel showed bond strength comparable to the non-plated material. After thermocycling, all specimens of the group no primer/no SB were debonded. The bond strengths of groups CPII/no SB, MPII/no SB and no primer/SB were significantly lower bond strengths than groups CPII/SB and MPII/SB. An appropriate combination of primer and bonding agent should be selected when bonding a magnetic attachment to the denture base. [source] The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formationINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2006W. T. Felippe Abstract Aim, To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA. Methodology, Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide,propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%. Results, Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters. Conclusions, Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls. [source] The effect of the renewal of calcium hydroxide paste on the apexification and periapical healing of teeth with incomplete root formationINTERNATIONAL ENDODONTIC JOURNAL, Issue 7 2005M. C. S. Felippe Abstract Aim, To evaluate the influence of renewing calcium hydroxide paste on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals. Methodology, Forty premolars from four 6-month-old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedströem files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of one premolar in each dog were left empty (group 4-control), and those of the other nine teeth in each animal were filled with a calcium hydroxide-propylene glycol paste. All teeth were restored with reinforced zinc oxide cement (IRM) or IRM and amalgam (group 4). The paste was renewed and the teeth restored again 1 week later. Then, the nine teeth in each animal were divided into three experimental groups: group 1 , paste not changed; group 2 , paste renewed every 4 weeks for 5 months; and group 3 , paste renewed after 3 months had elapsed. The teeth were restored with IRM and amalgam (groups 1 and 3) or IRM (group 2). The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate six parameters: apical calcified tissue barrier, inflammatory reaction, bone and root resorption, paste extrusion and microorganisms. Results of experimental groups were analysed by Kruskal,Wallis nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%. Results, Significant differences (P < 0.05) were found in relation to the presence of bone resorption and paste in the periradicular area, the formation of a calcified tissue barrier at the apex, and the intensity of the apical inflammatory reaction. Bone resorption was more evident in group 1 (medicament not changed), and the presence of paste in the periodontal tissues was more common in groups 2 and 3. Renewal of the paste reduced the intensity of the inflammatory reaction (groups 2 and 3), but the formation of apical calcified tissue was more noticeable in the teeth where the paste had not been renewed. Conclusions, Replacement of calcium hydroxide paste was not necessary for apexification to occur, however, it did reduce significantly the intensity of the inflammatory process. Monthly renewal of calcium hydroxide paste reduced significantly the occurrence of apexification. [source] Amylase and cyclic amp receptor protein expression in human diabetic parotid glandsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2010Monica Piras J Oral Pathol Med (2010) 39: 715,721 Background:, Salivary dysfunction and oral disorders have been described in both type 1 and type 2 diabetes mellitus. However, the cellular and molecular consequences of diabetes on oral tissues remain to be ascertained. The purpose of this investigation was to study, by means of electron microscopy, the morphologic and molecular changes that occur in salivary glands during diabetes. Methods:, Biopsy samples of parotid glands were excised from non-diabetic and diabetic (type 1 and type 2) consenting patients and processed by standard methods for routine morphology and electron microscopic immunogold labeling. Specific antibodies were used to determine and quantify the expression of secretory proteins (alphaamylase and the regulatory subunit of type II protein kinase A). Results:, Morphologic changes in the diabetic samples included increased numbers of secretory granules, and alterations in internal granule structure. Quantitative analysis of immunogold labeling showed that labeling densities were variable among the parotid gland samples. In type 1 diabetes amylase expression was greater than in non-diabetic glands, whereas in type 2 diabetes it was not significantly changed. Expression of type II regulatory subunits was slightly, although not significantly, increased in acinar secretory granules of type 1 diabetic samples and was unchanged in type 2 diabetic samples. Conclusions:, Our data show that diabetes elicits specific changes in secretory protein expression in human salivary glands, thus contributing to the altered oral environment and oral disease associated with diabetes. [source] Abrasion resistance of titanium nitride coatings formed on titanium by ion-beam-assisted depositionJOURNAL OF ORAL REHABILITATION, Issue 2 2005T. SAWASE summary, To improve the physical properties of the pure titanium surface, thin titanium nitride (TiN) films were deposited by means of ion-beam-assisted deposition. Film structure was confirmed as TiN by X-ray diffraction analysis. Surface hardness and abrasion resistance were significantly improved on TiN-coated specimens. Five combinations of oral hygiene instruments and materials were applied to the specimens as simulations of the oral environment. Treatment with the metal scaler and ultrasonic scaler severely changed the surface features and significantly increased the surface roughness parameters on pure titanium controls, whereas only small scratches and dull undulations were seen on the TiN-coated specimens. Profilometric tracings and scanning electron micrographs demonstrated the improved abrasion resistance of the TiN-coated specimens. [source] The effect of thermocycling and dentine pre-treatment on the durability of the bond between composite resin and dentineJOURNAL OF ORAL REHABILITATION, Issue 5 2004M. S. Huang Summary, The high bond strength between restorative resin and dentine plays an important role in long-term performance of restorations in the oral environment. A variety of treatment techniques have been described to enhance the bond strength of composite resin to dentine. Unfortunately, few studies have reported available bond durability of adhesive resins to dentine. The purpose of this research was to study the shear bond strength of composite resin to dentine pre-treated with phosphoric acid, self-etching agent or Nd:YAP laser irradiation. The durability of bond strength between resin and dentine stored in the artificial saliva thermocycling between 5 and 55 °C was also evaluated. The scanning electron microscope was used to assess the treated-dentine surfaces. The mean value of the shear bond strength in the acid-etching group (18·2 ± 4·9 MPa) was the highest among the three dentine treatments (self-etching system: 12·6 ±3·0 MPa, Nd:YAP laser: 13·4 ± 3·3 MPa) prior to thermocycling. After thermocycling, shear strength values of all treated dentines decreased with increasing number of the cycles. When subjected to 3000 thermocycles, the mean bond strengths of these pre-treated samples to composite resin became 9·1 ± 1·4, 7·8 ± 1·8, and 8·1 ± 1·7 MPa for acid-etching, self-etching and laser-irradiation, respectively, with a significant reduction of 38,50%. [source] Oral mucosal versus cutaneous sensory testing: a review of the literatureJOURNAL OF ORAL REHABILITATION, Issue 10 2002R. Jacobs summary, The innervation of skin and oral mucosa plays a major physiological role in exteroception. It also has a clinical interest as illustrated by sensory changes after neurosurgical procedures. These sensory changes often rely only on the patients' subjective reports, although objective assessments are possible. This review compares the neurophysiological features of the trigeminal sensory pathways with those of cutaneous sensory innervation. In this review, three receptor groups will be discussed: mechanoreceptors, thermoreceptors and nociceptors. Differences between receptors in the glabrous skin, the hairy skin and the oral mucosa will be highlighted. Sensory testing devices have been developed to quantify psychophysiological parameters such as the threshold level for receptor activation upon mechanical stimulation, but such devices have been merely developed to determine the threshold of skin receptors (tactile, thermal). Later on, some have been adapted to suit the particularities of the oral environment. This review attempts to compare the available literature on test devices for oral versus cutaneous tactile function. It summarizes what is common or rather particular to the devices used to study either cutaneous or oral receptors. [source] Environmental damage and occlusal contact area wear of composite restorativesJOURNAL OF ORAL REHABILITATION, Issue 1 2002A. U. J. Yap The chemical environment is one aspect of the oral environment, which could have an appreciable influence on the in-vivo degradation of composite resins. The resin matrix can be softened and fillers constituents can be leached out when composites are exposed to certain chemicals/food-simulating liquids (FSLs). A reciprocal compression sliding wear device was used to study the effects of the chemical environment on occlusal contact area (OCA) wear of four composite restoratives (Silux Plus, Z100, Ariston pHc and Surefil). The effects of FSL on hardness was also investigated and correlated to wear. Thirty-six hardness/wear specimens of each material were made and stored in artificial saliva at 37 °C for 24 h. The specimens were then divided into six groups of six specimens and stored in the following FSL for 1 week at 37 °C: distilled water (W), 0·02 N citric acid (C), 0·02 N lactic acid (L), heptane (H) and 75,25% ethanol,water solution (E). Conditioning in artificial saliva (S) was used as control. After conditioning, the specimens were wear tested at 20 MPa contact stress against SS304 counter-bodies in the respective FSL/artificial saliva up to 20 000 cycles. Wear depth (lm, n=6) was measured using profilometry. Change in hardness (,KHN, Knoop hardness number) was determined by microhardness testing pre- and post-conditioning. Results of statistical analyses (ANOVA/Scheffe's at significance level 0·05) of wear data were as follows: Silux , S, W > L, H, E and C, L > H; Z100 , S, W > all other mediums and E > H; Ariston , all other mediums > H; Surefil , W, C > S, L, H, E (> indicates significantly more wear). With the exception of Surefil, the greatest wear was observed with conditioning and wear testing in water. This ranged from 93·18 ± 21·96 lm for Z100 to 31·43 ± 2·80 lm for Surefil. For all materials, conditioning in heptane resulted in the least wear. This ranged from 8·9 ± 2·2 ,m for Ariston to 16·5 ± 5·9 lm for Silux. The effects of the different FSL on OCA wear were material dependent. No correlation was observed between ,KHN and wear. [source] Solubility properties of human tooth mineral and pathogenesis of dental cariesORAL DISEASES, Issue 5 2004T Aoba Dental research over the last century has advanced our understanding of the etiology and pathogenesis of caries lesions. Increasing knowledge of the dynamic demineralization/remineralization processes has led to the current consensus that bacteria-mediated tooth destruction can be arrested or even to some degree reversed by adopting fluoride and other preventive measures without using restorative materials. Our experimental approach provided new insight into the stoichiometries and solubility properties of human enamel and dentin mineral. The determination of the solubility product constant on the basis of the stoichiometric model (Ca)5·x(Mg)q(Na)u(HPO4)v(CO3)w(PO4)3·y(OH,F)1·z, verifies the difference in their solubility properties, supporting the phase transformation between tooth mineral and calcium phosphates in a wide range of fluid compositions as found in the oral environment. Further refinement of the stoichiometry and solubility parameters is essential to assess quantitatively the driving force for de- and remineralization of enamel and dentin in the oral fluid environment. Prediction of the effects of a combination of inhibitors and accelerator(s) on remineralization kinetics is also required. In order to develop devices efficient for optimizing remineralization in the lesion body, it is a critical question how, and to what extent, fluoride can compensate for the activity of any inhibitors in the mineralizing media. [source] Introduction of agriculture and its effects on women's oral healthAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010James T. Watson This study explores the dynamic relationship between the introduction of agriculture and its effects on women's oral health by testing the hypothesis that female reproductive physiology contributes to an oral environment more susceptible to chronic oral disease and that, in a population undergoing the foraging to farming transition, females will exhibit a higher prevalence of oral pathology than males. This is tested by comparing the presence, location, and severity of caries lesions and antemortem tooth loss across groups of reproductive aged and postreproductive females (n = 71) against corresponding groups of males (n = 71) in an Early Agricultural period (1600 B.C.,A.D. 200) skeletal sample from northwest Mexico. Caries rates did not differ by sex across age groups in the sample; however, females were found to exhibit significantly more antemortem tooth loss than males (P > 0.01). Differences were initially minimal but increased by age cohort until postreproductive females experienced a considerable amount of tooth loss, during a life stage when the accumulation of bodily insults likely contributed to dental exfoliation. Higher caries rates in females are often cited as the result of gender differences and dietary disparities in agricultural communities. In an early farming community, with diets being relatively equal, women were found to experience similar caries expression but greater tooth loss. We believe this differential pattern of oral pathology provides new evidence in support of theinterpretation that women's oral health is impacted by effects relating to reproductive biology. Am. J. Hum. Biol. 2010. © 2009 Wiley-Liss, Inc. [source] Identification of the human salivary cystatin complex by the coupling of high-performance liquid chromatography and ion-trap mass spectrometryPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 4 2003Alessandro Lupi Abstract Human salivary cystatins, five major (S, S1, S2, SA, SN) and two minor (C and D), are multifunctional proteins playing a different role in the oral environment. Salivary cystatin SN is able to effectively inhibit lysosomal cathepsins B, C, H and L and cystatin SA inhibits cathepsins C and L in vitro. These activities suggest, particularly for cystatin SN, an important role in the control of proteolytic events in vivo. Differently, cystatins S are involved, together with statherin, in the mineral balance of the tooth. Due to their distinct role, a reliable method for identification and quantification of the different cystatins, as well as of possible truncated and derived forms, could be helpful for the assessment of the status of the oral cavity. To this purpose high-performance liquid chromatography electrospray ionization mass spectrometry (HPLC-ESI MS) was applied to the analysis of human saliva obtained from healthy subjects. All known salivary cystatins, with the exception of cystatin C, were detected. Strong evidence was also obtained for the presence in saliva of post-translational modified isoforms of cystatins, which may be related to donor habits. Cystatin SN and cystatins S, S1 and S2 were well separated by HPLC-ESI MS coupling from other components and thus this approach can be successfully applied to their quantification. [source] Activity-based mass spectrometric characterization of proteases and inhibitors in human salivaPROTEOMICS - CLINICAL APPLICATIONS, Issue 7 2009Xiuli Sun Abstract Proteases present in oral fluid effectively modulate the structure and function of some salivary proteins and have been implicated in tissue destruction in oral disease. To identify the proteases operating in the oral environment, proteins in pooled whole saliva supernatant were separated by anion-exchange chromatography and individual fractions were analyzed for proteolytic activity by zymography using salivary histatins as the enzyme substrates. Protein bands displaying proteolytic activity were particularly prominent in the 50,75,kDa region. Individual bands were excised, in-gel trypsinized and subjected to LC/ESI-MS/MS. The data obtained were searched against human, oral microbial and protease databases. A total of 13 proteases were identified all of which were of mammalian origin. Proteases detected in multiple fractions with cleavage specificities toward arginine and lysine residues, were lactotransferrin, kallikrein-1, and human airway trypsin-like protease. Unexpectedly, ten protease inhibitors were co-identified suggesting they were associated with the proteases in the same fractions. The inhibitors found most frequently were alpha-2-macroglobulin-like protein 1, alpha-1-antitrypsin, and leukocyte elastase inhibitor. Regulation of oral fluid proteolysis is highly important given that an inbalance in such activities has been correlated to a variety of pathological conditions including oral cancer. [source] Xerostomia: an update for cliniciansAUSTRALIAN DENTAL JOURNAL, Issue 3 2010MS Hopcraft Abstract Saliva plays an important protective role in the oral environment, and reductions in saliva quantity are known to increase the risk of oral diseases. Importantly, xerostomia or the perception of a dry mouth is now being recognized as an important risk factor for dental diseases. Furthermore, the subjective sensation of a dry mouth is a debilitating condition in itself that impacts on the quality of life of sufferers. With approximately 1 in 5 people reporting some form of dry mouth, and an increasing prevalence in the elderly, it is important for clinicians to have a thorough understanding of this problem. The aim of this paper is to review some of the literature relating to xerostomia in order to provide an evidence based update for clinicians. [source] Clinical assessment and management of the oral environment in the oncology patientAUSTRALIAN DENTAL JOURNAL, Issue 2010LJ Walsh Abstract The dental care of oncology patients is an important component of general dental practice. Oncology patients have additional requirements for their outpatient care in the dental office. Intense involvement of the general dental practitioner in the patient's overall plan of care is essential so that appropriate preventive and therapeutic strategies are followed prior to chemotherapy, radiation and other medical treatments. This paper provides an overview of the role of the dental practitioner in the pre-treatment workup and post-treatment maintenance of oncology patients, and discusses the complications which occur during the intensive and in-hospital phases of care, in the context of approaches that show promise for reducing or preventing these. The role of the general dental practitioner in the maintenance of oral health for the remainder of the patient's life is stressed, with evidence-based recommendations given for optimal use of home care products which support oral health and improve quality-of-life. [source] Influence of changing the chewing region on mandibular movementAUSTRALIAN DENTAL JOURNAL, Issue 1 2009K Hashii Abstract Background:, In the shortened dental arch condition, little is known of how patients adapt their jaw function during mastication to the new oral environment. This study aimed to investigate the changes in mandibular movements when the chewing region was changed from the first molar to the first premolar. Methods:, Thirty clinical residents with natural dentitions were recruited. The subjects were asked to chew a piece of beef jerky using either the first molar or the first premolar on the preferred chewing side. Three-dimensional trajectories of lower incisors and both condyles were analysed using a jaw movement tracking device with six degrees of freedom during the period between the onset and offset of electromyographic bursts from the masseter and anterior temporal muscles. Results:, The closing angle of the lower incisors for first premolar chewing was narrower in comparison with that for first molar chewing (p < 0.05). The lengths of the condylar trajectories and the maximum velocities of the condylar movement for first premolar chewing were smaller and slower, respectively, in comparison with those for first molar chewing (both sides; p < 0.01). Conclusions:, The mandibular movement during mastication might be changed to adapt the premolar chewing because of a loss of posterior occlusal supports. [source] A new paradigm for operative dentistryAUSTRALIAN DENTAL JOURNAL, Issue 4 2007GJ Mount Abstract It is over 100 years since GV Black gathered together most of the knowledge then current on the caries process and set clear parameters for the discipline of operative dentistry. His four-volume treatise set standards that were relevant for the times and, in fact, were so well described that they remained dominant in this discipline until quite recently. However, over the last 50 years there has been great progress in scientific method and in knowledge of the common diseases of the oral environment, including the caries process, so maybe it is time for change. The term "paradigm" describes a philosophy of science, a generally accepted model of how ideas relate to one another, forming a conceptual framework within which scientific research is carried out. Black defined the paradigm within which further research was to be conducted during the following years and the profession accepted his lead. However, it is not expected that the parameters of a profession should remain unchanged over a substantial period so it is suggested that the dental profession should, at this time, recognize a new paradigm. Improvements in scientific method have led to a better understanding of the oral environment, resulting in extensive changes for this profession. It is suggested that the standards set by Black should be now consigned to history and an entirely new paradigm adopted. First, the profession must recognize that dental caries is a bacterial disease and its primary efforts should be directed towards identification and elimination of the disease prior to initiating repair of the damage that it has caused. Preservation of natural tooth structure is then the next responsibility. There should be maximum use made of preventive strategies, including remineralization, followed by minimal intervention cavity designs and the use of bioactive restorative materials to restore the lesions. The profession should be prepared to move on. [source] An overview of the dental pulp: its functions and responses to injuryAUSTRALIAN DENTAL JOURNAL, Issue 2007C. Yu Abstract The dental pulp is a unique tissue and its importance in the long-term prognosis of the tooth is often ignored by clinicians. It is unique in that it resides in a rigid chamber which provides strong mechanical support and protection from the microbial rich oral environment. If this rigid shell loses its structural integrity, the pulp is under the threat of the adverse stimuli from the mouth, such as caries, cracks, fractures and open restoration margins, all of which provide pathways for micro-organisms and their toxins to enter the pulp. The pulp initially responds to irritation by becoming inflamed and, if left untreated, this will progress to pulp necrosis and infection. The inflammation will also spread to the surrounding alveolar bone and cause periapical pathosis. The magnitude of pulp-related problems should not be underestimated since their most serious consequence is oral sepsis, which can be life threatening, and hence correct diagnosis and management are essential. Clinicians must have a thorough understanding of the physiological and pathological features of the dental pulp as well as the biological consequences of treatment interventions. [source] Long-term bio-degradation of cross-linked and non-cross-linked collagen barriers in human guided bone regenerationCLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2008Haim Tal Abstract: Objective: This double-blind study clinically and histologically evaluated long-term barrier bio-durability of cross-linked and non-cross-linked collagen membranes (CLM and NCLM) in sites treated by guided bone regeneration procedures. Materials and methods: In 52 patients, 52 bony defects were randomly assigned to treatment with either a CLM or a NCLM. Post-surgical spontaneous membrane exposures were recorded. Before implant placement, full-thickness standard soft tissue discs were retrieved wherever suitable for histologic examination. Results: Spontaneous membrane exposure was observed in 13 (50%) CLM sites and in six (23.1%) NCLM sites (P<0.05). Clinical healing at exposed sites lasted 2,4 weeks. CLM were histologically intact in all non-perforated sites, were interrupted in five perforated sites, and undetected in four. NCLMs were undetected in all 18 specimens examined. In three non-perforated CLM sites, bone apposition and ossification at or within the membrane was observed. Conclusions: CLMs were more resistant to tissue degradation than NCLMs, and maintained integrity during the study. Neither membrane was resistant to degradation when exposed to the oral environment. CLMs were associated with a higher incidence of tissue perforations. In non-perforated sites, CLM ossification at or within the membrane was occasionally observed. [source] Do adverse effects of dental materials exist?CLINICAL ORAL IMPLANTS RESEARCH, Issue 2007What are the consequences, how can they be diagnosed, treated? Abstract Objectives: All dental biomaterials release substances into the oral environment to a varying degree. Various preclinical biocompatibility test systems have been introduced, aiming at an evaluation of the potential risks of dental materials. Potential pathogenic effects of released substances from dental materials have been demonstrated. For the biocompatibility of a biomaterial, it is not only important that minimal diffusable substances are released when it is in body contact , the material must also fulfill the function for which it has been designed. This is also very much dependent on the material properties and its handling properties. The aim of this review was to generate an overview of the present status concerning adverse reactions among patients and personnel. Materials and methods: A systematic review was performed using a defined search strategy in order to evaluate all MEDLINE-literature published between 1996 and 2006. Results: The compilation of the literature available has revealed that the majority of studies have been carried out on patients compared with personnel. Adverse reactions towards dental materials do occur, but the prevalence and incidence are difficult to obtain. The results were essentially based on cohort studies. Clinical trials, especially randomized-controlled trials, are in the minority of all studies investigated, with the exception of composite and bonding studies, where clinical trials, but not randomized-controlled trials, represent the majority of studies. Patients and personnel were treated separately in the manuscript. Amalgam studies show the lowest degree of verified material-related diagnosis. Even if objective symptoms related to adverse reactions with polymer resin-based materials have been reported, postoperative sensitivity dominates reports concerning composites/bondings. Verified occupational effects among dental personnel show a low frequency of allergy/toxic reactions. Irritative hand eczema seemed to be more common than in the general population. Conclusions: Patient- and personnel-related studies are of variable quality and can be improved. There is a need for a better description of the content of materials. A registry for adverse effects of dental materials would be useful to detect the occurrence of low-incidence events. [source] Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patientsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006Constantin Alexander Landes Abstract Objective: To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life. Patients and methods: One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up. Results: At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9±0.9; 1.4±0.9; 0.4±0.5 mM; P<0.01); Periotest® score (,2.7±2.7; ,2.4±2.2; ,3.1±3.3; P<0.2); gingival recession (0.6±0.7 mM; 0.8±0.9 mM; 0.4±0.5 mM, P<0.02); and peri-implant probing depths (3±1.2; 2.6±0.6; 3.4±1.7 mM; P<0.002). Conclusion: The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up. [source] Lipid peroxidation levels and total oxidant status in serum, saliva and gingival crevicular fluid in patients with chronic periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007Ferda Alev Akal Abstract Objectives: Increased levels of reactive oxygen species lead to oxidative stress. Recent data suggest increased lipid peroxidation (LPO) levels and oxidative stress in periodontitis. Malondialdehyde (MDA), a significant LPO product, increases in oxidative stress. In this study, MDA levels and total oxidant status (TOS) in serum, saliva and gingival crevicular fluid (GCF) were investigated in patients with chronic periodontitis (CP). Materials and Methods: Thirty-six CP patients and 28 periodontally healthy controls were included in the study. Following clinical measurements and samplings, MDA and TOS levels were measured by high-performance liquid chromatography and a novel automatic colorimetric method, respectively. Results: While the saliva and GCF MDA levels, and serum, saliva and GCF TOS values were significantly higher in the CP group than the control group (p<0.05), no significant difference in serum MDA levels was found (p>0.05). Strong positive correlations were observed between periodontal parameters and MDA and TOS levels (p<0.05). Conclusions: The results revealed that LPO significantly increased locally in the periodontal pocket/oral environment, while TOS displayed both systemic and local increases in periodontitis. The findings suggest that increased LPO and TOS may play an important role in the pathology of periodontitis, and are closely related to the clinical periodontal status. 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