A Comprehensive Evaluation of the Virulence of Oral Flora

The oral cavity is inhabited by more than 700 species of commensal bacteria. Several have been identified as pathogens of oral diseases, dental caries, and periodontal diseases. However, the lack of information concerning the interaction between pathogens and the remaining commensal bacteria has made it difficult to understand the precise etiologies of oral diseases. We need to identify the comprehensive species found in individual oral flora and compare these results with corresponding oral health conditions. In this chapter, the authors delineate the previous attempts to identify oral commensal bacterial flora and discuss the potential capability of modern molecular genetic technologies such as terminal restriction fragment length polymorphism, DNA microarray and pyrosequencing analyses utilizing bioinformatics.

Automated Telephone Services in Dentist Appointment Management

Reservation of health care service appointments has traditionally been performed through telephone. This takes a lot of time and resources at both ends of the transaction, and can be error-prone. Especially dentist appointments are standard as compared to many other health service provision activities, and are thus a natural candidate for rationalization through modern information technology. Appointments can of course be made through the Internet, but using phones, especially mobile phones, adds flexibility to the performing of the transaction. In this article we take a look how the middle-sized Finnish city of Lahti has taken a comprehensive approach to develop new innovative services in dentist appointment management.

The Use of Three-Dimensional Reconstructions in the Diagnosis of Impacted Teeth

Numerous efforts have been made towards three-dimensional (3D) radiographic imaging in all fields of dentistry, ranging from oral surgery to orthodontics. Although computerized tomography (CT) has been available for quite some time now, its use in dentistry has always been limited because of cost, access, and dose considerations. In orthodontics, diagnosis and treatment planning has been based traditionally on 2D imaging, mainly cephalometric and panoramic radiographs. The introduction of cone-beam computed tomography (CBCT) represented a true revolution in dento-maxillofacial radiology, and a shift from 2D to 3D data acquisition, image reconstruction, and visualization. Therefore, CBCT has now been introduced in different areas of orthodontic diagnostic procedures and treatment planning: Evaluation of cleft palate patients, airway and soft tissue analysis, temporomandibular joint morphology assessment, diagnosis of bony asymmetry, localization of impacted teeth and detection of resorption of adjacent teeth. This book chapter gives an overview of the current literature regarding the present use of CBCT in the localization of impacted teeth for orthodontic purposes. The potential, advantages and disadvantages in the diagnosis of impacted teeth will be discussed, also using case examples from the clinical practice.

Meta-Analysis Approach for the Identification of Molecular Networks Related to Infections of the Oral Cavity

Chronic periodontitis is the most common infection of the oral cavity. Understanding how and why bacteria enter host cells, and how barrier cells respond to limit their impact, provides a biological basis of infection in the mixed bacterial-human ecosystem of the oral cavity. In addition, elucidation of the underlying shared pathogenic mechanisms of complex diseases like diabetes and oral infections can lead to new insight into the involvement of genes in increased susceptibility of patients with oral infections to complex systemic diseases and vice versa. Transcriptional profiling, statistical and ontology tools are used to uncover and dissect genes and pathways of human gingival epithelial cells that are modulated upon interaction with the periodontal pathogens. Affymetrix microarrays are applied to search the gene expression underlying infection with oral bacteria and identify distinct classes of up- and down-regulated genes during this process. The developed meta-analysis approach can help to extract sets of genes related to oral infection and interaction networks by integrating and combining quantitative gene expression data using statistical approaches. By means of overrepresentation analysis, the authors discovered molecular networks related to immune systems responses.

Imaging in Periodontology

Periodontal disease is the most common oral disorder in the elderly population. Early detection of bony and soft tissue support changes is therefore crucial in relation to the prevention of tooth loss and/or the patient’s general health. Unfortunately, the current diagnostic tools for accurate assessment of this periodontal status have shown several limitations. Most image analysis tools are based on 2D images, while bone remodelling is a 3D process. At present, Cone Beam Computed Tomography (CBCT) has become a powerful diagnostic tool in dentistry. This chapter will bring an overview of 2D and 3D visualization methods of the periodontal tissues and their pathologic manifestations like infrabony craters and furcation involvements. The diagnostic use of 2D radiographic projections, image filtering and subtraction will be compared to the use of 3D cross-sections and the image analysis tools for 3D visualization and/or follow-up of bony changes.

Finite Element Analysis and Its Application in Oral Surgery Research

The Finite Element Method (FEM) is a widely applied mathematical model that permit us to know the biomechanical behavior of the human mandible in various clinical situations under physiological and standardized trauma conditions. The three-dimensional FEM provides to simulate force systems applied and allows analysis of the response of the jawbone to the loads in 3D space. Clinical extrapolations from FEM may not give absolute values but they will provide detailed description of biomechanical pattern and a prediction of regional stresses distribution. This virtual modeling is useful to choose the most efficient localization and design of miniplate osteosynthesis and to test new biomaterials.

Accuracy of the First Integrated Cone-Beam System for Computer Aided Implantology

The aim of the chapter is to give a complete survey of Computer Aided Surgery (CAS) systems in dental implantology from the different 3D visualization technologies to the different available approaches for implant planning data transfer to the corresponding anatomical patient´s sites. Focus will be on the illumination of advantages and disadvantages for the different systems components. Further on, the diagnostic value, radiation dosages to the patient, availability and costs as well as the transfer accuracy results for the investigated system will be discussed.

Time-Sequencing and Force-Mapping with Integrated Electromyography to Measure Occlusal Parameters

Computerized Occlusal Analysis technology records, and quickly displays for clinical interpretation, tooth contact timing sequences of .003 second increments, and each tooth contacts’ fluctuating force levels which occur during functional jaw movements. These measurements are recorded intraorally with an ultra-thin, mylar-encased sensor that is connected to a computer via a USB interface. This sensor is placed between a patients’ teeth during functional jaw movements to record changing tooth-tooth interactions. The displayed occlusal data aids in the examination and treatment of occlusal abnormalities on natural teeth, dental prostheses, and dental implant prostheses. The software can be linked to an Electromyography software program that simultaneously records the electromyographic potential of 8 head and neck muscles. This combination of dynamic tooth contact force and time data, and functional muscular data, affords a dentist detailed, precise, and unparalleled diagnostic and treatment information, with which to address many differing clinical occlusal pathologies.

Selective Laser Melting in Dentistry

Although casting is currently the first choice to produce metallic frame work selective laser melting (SLM) has established. Based on a CAD/CAM system the digital data of the frame work are transferred to the production machine. The three dimensional data set of the transferred in to numerous quasi 2-dimensional data. Each of these data sets represents a single slice, which is then produced. Due to the production process complex geometries and outstanding mechanical and chemical properites can be realized. Advantageously is also the large number of simultaneously fabricated parts, which makes this method very economic.

HPV Detection and Genotyping Using the Luminex xMAP Technology

The Human Papillomavirus (HPV) is playing an important role in oral cancer. The molecular detection of HPV is based on the fact that the viral DNA is present in all the epithelial layers of the affected tissue and it can be detected easily with PCR or Real-Time PCR. The major disadvantage of PCR is that it cannot provide genotype information and the Real-Time PCR can only detect very few types in a multiplex assay. Although the HPV typing assays are capable of typing a relatively large spectrum of HPV genotypes, they cannot be automated or deployed in a high-throughput platform. The bead-based technology (Luminex suspension array technology) provides a rapid and cost-effective method to simultaneously detect different HPV genotypes.