Early Dental Caries and Their Associated International Classifications of Disease Morbidity: A 16-Year Population Study

Objective: The study objective was to examine the relationship between dental caries diagnosed before the age of four and ICD diseases over a 16-year period. Methods: The sample of approximately 33,531 (48% female) individuals having a total of 2,864,790 physician diagnoses over 16 years comprised a the cohort two groups, one with (2.7% of the sample) and one without dental caries (dependent variable) that were under the age of four years in the first two years of the sample data. Categories of dental caries and associated gingivitis and periodontal disease were based on the International Classification of Disease (ICD Version 9) diagnostic codes 521-523. The sample was described. Odds ratios comparing those with and without dental caries and the main ICD classes were calculated. Additionally, the ratio of each ICD diagnosis frequency comparing the cohort groups were calculated and represented the diagnoses assigned over the first 15 physician visits. Results: Males had proportionally more dental caries diagnosed. Diagnoses were made predominantly by general practitioners. Within the dental caries cohort group, associated ICD diagnoses were over-represented in both odds ratios and within individual ICD diagnoses on the first diagnosis and over the first 15 diagnoses in time. Conclusion: Dental caries diagnosed in very young children before the age of four are associated with multi-morbidity over subsequent years. Sex differences and patterns of associated morbidity may contribute to a better understanding of early life vulnerability to dental caries and their sequelae.

Surgical Ciliated Cyst of the Maxilla: A Case-Series of Three Cases

The surgical ciliated cyst is an iatrogenic lesion occurring after surgeries in which the Schneiderian membrane has been exposed, such as in orthognathic surgery or maxillary sinus procedures. This lesion has been infrequently documented in western countries. In this case series, we present three cases of surgical ciliated cysts of the maxilla.

Comparison of Two Protocols for the Treatment of Class 2 Malocclusion

Purpose: The purpose of this study was to compare the outcomes of the treatment with the twin block and modified twin block appliances in growing patients with Class 2 malocclusion. Materials and Methods: A cephalometric analysis was performed in 51 patients. The twin block sample consisted of 23 patients, 10-girls and 13-boys (mean age 10.46±0.71 years at the start of treatment, T1, and 12.84±0.78 years at the end of active treatment, T2). The modified twin block sample consisted of 28 patients, 18 girls and 15 boys (mean age 11.78±0.91 years at T1, and 13.32±0.56 years at T2). The twin block activators were used during the day, except for eating time, and the modified ones were used only at night. Duration of the treatment was 16-20 months. The changes from T2 to T1 and the differences between the groups were compared with the analysis of variance. Results: SNB angle in the twin block group showed 1.25±1.39 degrees change and in the modified twin block group, it exhibited 3.69±1.01 degrees change. Overjet in the group with twin block decreased 4.58±1.59 mm, and in the group with modified twin block it decreased 4.43±1.41 mm. In the modified twin block group, there was more retrusion of upper incisors in comparison with the twin block group. Accordingly, under the effect of modified twin block, retrusion of the upper lip was observed. Conclusion: Through modifying the twin block appliance, it is possible to ensure the comfort of the patients by reducing the daily usage, to reposition the mandibula forward and to correct overjet and sagittal dento-skeletal relationships without increasing facial height and to improve positions of upper incisors and lips.

The Effect of Three Polishing Systems on the Surface Rugosity of One Composite Resin

Direct restorations in composite resin require superficial rugosity appropriate to guarantee a surface free of biofilm buildup, which interferes with the durability of the restoration, its properties and the aesthetic aspect. Thus, it is relevant to know the behaviour of the finishing and polishing systems. The in vitro study aimed to compare the polishing efficiency of three different polishing systems in promoting the surface smoothness of a nanocomposite resin. Sixty specimens of the nanocomposite resin Filtek Z350 XT (3M) were made, randomly divided into three groups (n=20), according to the tested polishing systems: Enhance (Dentsply), DFL Polishers, and Sof-Lex Spiral (3M). The surface rugosity of the samples was measured by means of the rugosimeter equipment. The data were analysed through statistical tests: ANOVA two-way and post-hoc Tukey. The results indicated Sof-Lex (3M) polishing discs as the ones with the lowest average surface rugosity (0.13µm), presenting statistically significant results (p<0.05); followed by the abrasive rubbers of the DFL system (0.17 µm) and the Enhance system (Dentsply), which showed greater average surface rugosity (0.30 µm). The lowest surface rugosity of the composite resin evaluated in this study (Z350 XT- 3M) was obtained after polishing with the multi-step system (Sof-Lex), from the same manufacturer.

Metastasizing Ameloblastoma: A Systematic Review in Search of Clinicopathological Predictors

Introduction: Ameloblastoma is a benign odontogenic tumor that is aggressive and localised in nature, listed as the first or second most prevalent odontogenic tumor and rarely tends to metastasis, but when it does, it receives the definition adopted by the WHO in 2017 of metastasizing ameloblastoma. Materials and Methods: This systematic review of clinical case reports of metastasizing ameloblastoma from the last 10 years, collected from PubMed, ScienceDirect and Cochrane digital databases, aims to search for association between clinical/pathological and/or molecular parameters of ameloblastoma and its metastatic potential. Results: The targeted search yielded 14 publications with a total of 18 clinical cases, which showed a mean age for diagnosis of metastasizing ameloblastoma of 46 years, with no gender predilection and a high probability of occurrence in the yellow Asian race, favouring a pattern of distant dissemination. The highest frequency of metastasis was associated with mandibular primary lesions diagnosed in young patients, and the most frequently found variant was the multicystic solid type, follicular subtype; distant metastasis was the predominant form of presentation, with the lungs being the main target. Conclusion: At the moment, there is nothing that can predict metastatic potential in ameloblastoma. More standardised studies exploring the molecular terrain are needed, as this is a key and understudied factor.

Periodontitis and Other Risk Factor for Coronary Artery Disease among Adults: A Case Control Study in Delhi, India

Background: Periodontitis is an extension of inflammation to the supporting tissue of the tooth. Prevalence varies worldwide with a higher prevalence in Asian countries and in India as reported. Literature reports that the sub-gingival microflora and the continuous latent endotoxemia originating from the periodontal pockets is a risk factor for the damage to vascular endothelial integrity, platelet function and blood coagulation leading to periodontal disease playing a role in etiopathogenesis of coronary artery disease and cerebrovascular disease. Aim: To study periodontitis and other risk factor that correlates with CAD among the adult urban population. Settings & Design: Clinic based case control study carried out in medicine and dental outpatient departments (OPD) of Hamdard Institute of Medical Sciences & Research and associated HAH Centenary Hospital, New Delhi. Minimum sample size was calculated to be 140. A 1:3 case to control ratio was taken. Methods & Materials: Periodontal Index (Russell Index) was utilized in our study to grade periodontal health status. Statistical Analysis: The data was analysed using SPSS 21.0 version. Categorical variables were tested for significance using Chi square test and multiple logistic regression was used for predicting the probability of cases with cardiac problems having periodontitis. Results: 30 (21.4%) participants were recruited as cases and 110 (78.6%) as controls. Among the cases the Mean Russell score for case was 3.98 ± 0.70 and control group was 3.11 ± 0.68, respectively. Among the total subjects 76.4% showed a RI score of ≥3 indicative of established destructive and terminal periodontal disease and 23.5% constituted the beginning of destructive periodontal disease. Conclusion: Severity of periodontitis was noted in cases as compared to controls. Findings suggest the relationship between CAD and periodontal disease.

Quantitative Assessment of Microbial Contamination and Patterns of Public Behaviour with Used Toothbrushes: Implications of Storage and Replacement

Introduction: Toothbrushes can readily become contaminated with microbes during use and storage. They present a potential hazard of cross-contamination and subsequent infection. Aims: To investigate the nature and level of microbial contamination of used toothbrushes and influence of participant lifestyle. Methods and Results: 103 used toothbrushes were donated, and microbial contents were determined by microbial culture and identification. 97% of toothbrushes revealed contamination. The microbial loads ranged from 0-1010 cfu/brush with median values of around 107, with Candida isolated in the highest levels. 90% of toothbrushes were stored in bathrooms presumably exposed to environmental contamination and 72% revealed the presence of enteric bacteria including Klebsiella, Serratia and Enterobacter. 50% of participants kept toothbrushes for >3 months and 40% retained toothbrushes for 4-6 months; microbial loads were fully established during the first three months of use and did not increase further with prolonged use. Only 57% of participants brushed their teeth twice a day and 41% brushed once a day. Conclusion: Used toothbrushes are heavily contaminated and the presence of potentially pathogenic microorganisms constitutes a potential health risk. Significance and Impact of Study: There is an under-recognised risk of cross-contamination/infection, especially when multiple users store toothbrushes in close contact. Guidance on toothbrush age, brushing frequency and storage is not being followed. Further education is required to improve public awareness.

The Influence of Diet, Exercise and Education Level During Pregnancy on Child Cavities and Tooth Eruption

Objectives: This study’s objective was to evaluate if exercise during pregnancy, a healthy diet rich in polyunsaturated fatty acids and calcium, and the mother’s educational level influenced the dental health measures of caries risk and tooth eruption of their offspring. Methods: Women with children 6 years and younger completed questionnaires regarding PA and diet (PUFA-rich, calcium-rich (Ca) dairy foods) during pregnancy and education level prior to their child’s dental examination. T-tests were used to compare exercisers and non-exercisers; correlation and regression analyses were conducted to determine relationships and predictors of child dental health, respectively. Results: Eighty-two mother-child pairs were analysed. Exercisers had trends of increased PUFA (p=0.07) and Ca-rich dairy foods (p=0.12) to non-exercisers during pregnancy. Ca-rich dairy foods during pregnancy had positive associations with primary tooth count (p=0.004), mixed surface count (p=0.02), and tooth eruption (p=0.04). Controlling for maternal education and exercise, tooth eruption was predicted by PUFA summary and cheese consumption while dairy summary predicted primary tooth count; caries risk was predicted by maternal education; primary surface caries was associated with exercise duration. Conclusion: During pregnancy, calcium-rich dairy and PUFA-rich foods influenced child tooth eruption and thus tooth count, while exercise duration was associated with primary surface caries. Maternal education was associated with lower caries risk. Our findings support educating women on calcium intake and appropriate exercise levels during pregnancy, plus oral health counseling for their child.

Plasma Treatment Effects on Oral Candida albicans Biofilms

The objective of this study is to evaluate the plasma treatment effects on oral fungal biofilms. Candida albicans biofilms were developed on the 48-well plate to serve as a model of oral fungal biofilm. The treatment of 0.2% chlorhexidine digluconate (CHX) was used as a positive control compared with plasma treatments. The efficacy of treatments was determined by 3-(4,5-dimethylazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and confocal laser scanning microscope (CLSM). The survival percentage of Candida albicans decreased from 52% to 27% as the plasma power increased from 6mA to 8mA and plasma exposure time extended from 2 min to 10 min. Moreover, it was found that there is a synergistic effect of the combination of plasma and CHX treatments. Scanning electron microscopy (SEM) examination indicated severe cell damages resulting from plasma treatment. In conclusion, the low-temperature plasma treatment is effective in deactivating Candida albicans biofilms and thus provides a promising alternative to disinfect oral fungal biofilms.

Effect of Electrospinning Parameters on the Fiber Diameter and Morphology of PLGA Nanofibers

Background: Poly lactic-co-glycolic acid (PLGA) has been widely investigated for various biomedical applications, such as craniofacial bone regeneration, wound dressing and tissue engineering. Electrospinning is a versatile technology used to produce micro/nanoscale fibers with large specific surface area and high porosity. Purpose: The aim of the current study is to prepare PLGA nanofibers using electrospinning for guided tissue regeneration/guided bone regeneration applications. The objective of this study is to determine the appropriate electrospinning parameters such as applied voltage, flow rate, spinneret-collector distance and polymer solution concentration for preparation of PLGA fibrous membrane and their effect on the mean fiber diameter of the electrospun fibers. Method: PLGA pellets were dissolved in Hexafluoroisopropanol (HFIP) in various concentrations overnight using a bench rocker. The resulting PLGA solution was then loaded into a syringe and electrospinning was done by maintaining the other parameters constant. Similarly, various fibrous mats were collected by altering the specific electrospinning parameter inputs such as applied voltage, flow rate and spinneret-collector distance. The morphology of the fibrous mats was characterized using Scanning Electron Microscope. The mean fiber diameter was assessed using ImageJ software and the results were compared using one-way ANOVA. Results: We obtained bead-free uniform fibers with various tested solution concentrations. One-way ANOVA analysis demonstrated significant variation in mean fiber diameter of the electrospun fibers with altering applied voltage, solution concentration, flow rate and spinneret-collector distance. Conclusion: The above-mentioned electrospinning parameters and solution concentration influence the mean fiber diameter of electrospun PLGA nanofibers.