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Objectives: Craniofacial microsomia (CFM) is a congenital condition that typically involves hypoplasia of the ear and jaw. It is often associated with adverse effects such as hearing loss and sleep‐disordered breathing. There is little research on its etiology. Methods: We conducted a case–control study from maternal interview data collected from mothers of infants with and without CFM. The study included 108 children with and 84 children without CFM. Logistic regression with adjustment for demographic factors was used to evaluate associations between maternal exposures of interest and risk for CFM overall, as well as for different phenotypic sub‐groups of children on the CFM spectrum. Results: We found a statistically significant association between diabetes mellitus (DM) and CFM (OR 4.01, 95% CI 1.6–10.5). The association was slightly attenuated after adjustment for BMI. Higher parity was also associated with increased risk for CFM (OR 2.0, 95% CI 1.0–4.0). Vitamin A consumption and/or liver consumption was associated with a 70% lower risk compared with non‐users (OR 0.3, 95% 0.1–0.8). Maternal age at the time of pregnancy was not associated with CFM. Conclusions: These analyses contribute evidence linking maternal DM with an elevated risk of having an infant with CFM, which is consistent with previous research and adds to the body of knowledge about the strength of this association. Further study is warranted to understand the potential mechanisms underlying the effect of DM in the developing embryo. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate whether insulin resistance (IR) predicts the risk of oral inflammation, assessed as the number of sites with bleeding on probing (BOP) and number of teeth with probing pocket depths (PPD) ≥ 4 mm and BOP.Methods: Data on 870 overweight/obese diabetes free adults, aged 40-65 years from the San Juan Overweight Adults Longitudinal Study over a three-year period, was analyzed. Baseline IR, assessed using the Homeostasis Model Assessment of IR (HOMA-IR) index, was divided into tertiles. BOP was assessed at buccal and lingual sites, and PPD at six sites per tooth. Negative binomial regression was used to estimate the risk ratios (RRs) for oral inflammation adjusted for baseline age, gender, smoking status, alcohol intake, education, physical activity, waist circumference, mean plaque index, and baseline number of sites with BOP, or number of teeth with PPD≥4 mm and BOP. The potential impact of tertiles of serum TNF-α and adiponectin on the IR-oral inflammation association was also assessed in a subsample of 597 participants.Results: Participants in the highest HOMA-IR tertile at baseline had significantly higher numbers of sites with BOP [RR = 1.19, 95% confidence interval (CI): 1.03-1.36] and number of teeth with PPD ≥ 4 mm and BOP (RR = 1.39, 95% CI: 1.09-1.78) at follow-up, compared with individuals in the lower two HOMA-IR tertiles. Neither TNF-α nor adiponectin confounded the associations.Conclusion: IR significantly predicts gingival/periodontal inflammation in this population. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The purpose of this study was to determine whether restoration emergence angle was associated with peri‐implantitis. Materials and Methods: A data set consisting of 96 patients with 225 implants (mean follow‐up: 10.9 years) was utilized. Implants were divided into bone‐level and tissue‐level groups, and radiographs were analysed to determine the restoration emergence angles, as well as restoration profiles (convex or concave). Peri‐implantitis was diagnosed based on probing depth and radiographic bone loss. Associations between peri‐implantitis and emergence angles/profiles were assessed using generalized estimating equations. Results: Eighty‐three patients with 168 implants met inclusion criteria. The prevalence of peri‐implantitis was significantly greater in the bone‐level group when the emergence angle was >30 degrees compared to an angle ≤30 degrees (31.3% versus 15.1%, p = .04). In the tissue‐level group, no such correlation was found. For bone‐level implants, when a convex profile was combined with an angle of >30 degrees, the prevalence of peri‐implantitis was 37.8% with a statistically significant interaction between emergence angle and profile (p = .003). Conclusions: Emergence angle of >30 degrees is a significant risk indicator for peri‐implantitis and convex profile creates an additional risk for bone‐level implants, but not for tissue‐level implants. [ABSTRACT FROM AUTHOR]

Background Craniofacial microsomia (CFM) is a congenital condition with wide phenotypic variability, including hypoplasia of the mandible and external ear. We assembled a cohort of children with facial features within the CFM spectrum and children without known craniofacial anomalies. We sought to develop a standardized approach to assess and describe the facial characteristics of the study cohort, using multiple sources of information gathered over the course of this longitudinal study and to create case subgroups with shared phenotypic features. Methods Participants were enrolled between 1996 and 2002. We classified the facial phenotype from photographs, ratings using a modified version of the Orbital, Ear, Mandible, Nerve, Soft tissue (OMENS) pictorial system, data from medical record abstraction, and health history questionnaires. Results The participant sample included 142 cases and 290 controls. The average age was 13.5 years (standard deviation, 1.3 years; range, 11.1-17.1 years). Sixty-one percent of cases were male, 74% were white non-Hispanic. Among cases, the most common features were microtia (66%) and mandibular hypoplasia (50%). Case subgroups with meaningful group definitions included: (1) microtia without other CFM-related features ( n = 24), (2) microtia with mandibular hypoplasia ( n = 46), (3) other combinations of CFM- related facial features ( n = 51), and (4) atypical features ( n = 21). Conclusion We developed a standardized approach for integrating multiple data sources to phenotype individuals with CFM, and created subgroups based on clinically-meaningful, shared characteristics. We hope that this system can be used to explore associations between phenotype and clinical outcomes of children with CFM and to identify the etiology of CFM. Birth Defects Research (Part A) 106:915-926, 2016.© 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The clinical presentation of microtia varies widely from minimal morphological abnormalities to complete absence of the ear. In this study we sought to identify and characterize sub-groups of microtia using a statistical and a clinical approach. Photographs of 86 ears were classified in relation to all the external ear components. We used cluster analysis and rater's clinical opinion to identify groups with similar phenotypes in two separate analyses. We used Cramer's Phi coefficient of association to assess the similarity among the clinician's groupings as well as among the statistical sub-phenotypic groups and each of the clinician's groupings. The cluster analysis initially divided the 86 ears into a more and a less severe group. The less severe group included two sub-groups that included ears classified as normal and a group that had very few anomalous components. The group of 48 more affected ears all had abnormalities of the helix crus; antihelix-stem, -superior crus and -inferior crus; and antitragus. These were further divided into 4 sub-phenotypes. There was a moderate degree of association among the raters' groupings (Cramer's Phi: 0.64 to 0.73). The statistical and clinical groupings had a lower degree of association (Cramer's Phi: 0.49 to 0.58). Using standardized characterization of structural abnormalities of the ear we identified six distinct phenotypic groups; correlations with clinicians' groupings were moderate. These clusters may represent groups of ear malformations associated with the same etiology, similar time of insult or target cell population during embryonic development. The results will help inform investigations on etiology. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Long-term studies worldwide indicate that peri-implant inflammation is a frequent finding and that the prevalence of peri-implantitis correlates with loading time. Implant loss, although less frequent, has serious oral health and economic consequences. An understanding of predictive factors for peri-implant disease and implant loss would help providers and patients make informed decisions. Methods: A cross-sectional study was performed on 96 patients with 225 implants that were placed between 1998 and 2003. Implant placement data were collected from patient records, and patients presented for a clinical and radio-graphic follow-up examination. Implant status and periodontal status were determined, the data were analyzed to determine the prevalence of peri-implant disease or implant loss, and a predictive model was tested. Results: The mean follow-up time for the patients was 10.9 years. The implant survival rate was 91.6%. Peri-implant mucositis was found in 33% of the implants and 48% of the patients, and peri-implantitis occurred in 16% of the implants and 26% of the patients. Individuals with peri-implantitis were twice as likely to report a problem with an implant as individuals with healthy implants. Peri-implantitis is associated with younger ages and diabetes at the time of placement and with periodontal status at the time of follow-up. Implant loss is associated with diabetes, immediate placement, and larger-diameter implants. Conclusions: One in four patients and one in six implants have peri-implantitis after 11 years. The data suggest that periodontal and diabetes status of the patient may be useful for predicting implant outcomes. [ABSTRACT FROM AUTHOR]

The Elements of Morphology Standard Terminology working group published standardized definitions for external ear morphology. The primary objective of our study was to use these descriptions to evaluate the interrater reliability for specific features associated with microtia. We invited six raters from three different subspecialities to rate 100 ear photographs on 32 features. We calculated overall and within specialty and professional experience intraclass correlation coefficients (ICC) and 95% confidence intervals. A total of 600 possible observations were recorded for each feature. The overall interrater reliability ranged from 0.04 (95% CI: 0.00-0.14) for the width of the antihelix inferior crus to 0.93 (95% CI: 0.91-0.95) for the presence of the inferior crux of the antihelix. The reliability for quantitative characteristics such as length or width of an ear structure was generally lower than the reliability for qualitative characteristics (e.g., presence or absence of an ear structure). Categories with very poor interrater reliability included anti-helix inferior crux width (0.04, 95% CI: 0.00-0.14), crux helix extension (0.17, 95% CI 0.00-0.37), and shape of the incisura (0.14, 95% CI: 0.01-0.27). There were no significant differences in reliability estimates by specialty or professional experience for most variables. Our study showed that it is feasible to systematically characterize many of structures of the ear that are affected in microtia. We incorporated these descriptions into a standardized phenotypic assessment tool (PAT-Microtia) that might be used in multicenter research studies to identify sub-phenotypes for future studies of microtia. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Supragingivally applied glycine powder air polishing (SupraGPAP) has been shown to remove biofilms in shallow periodontal pockets. This study assesses efficacy and safety of subgingivally applied glycine powder air polishing (SubGPAP) in moderate-to-deep periodontal pockets. Methods: Patients with chronic periodontitis and intraoral Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia who completed initial therapy were randomly assigned to receive SubGPAP in periodontal pockets with probing depths of 4 to 9 mm, SupraGPAP in all other shallow periodontal sites, and at mucous membranes followed by removal of calculus using curets (full-mouth GPAP) or scaling and root planing followed by coronal polishing (SRP). Patients rinsed with 0.12% chlorhexidine gluconate after debridement, and twice daily, for 2 weeks. Results: All 30 patients enrolled completed the baseline, day 10, and day 90 visits. SubGPAP resulted in significantly lower total viable bacterial counts in moderate-to-deep pockets when compared to SRP immediately after debridement and at day 10 (P <0.05). Total P. gingivalis counts in the oral cavity were significantly reduced after full-mouth GPAP compared to SRP at day 90 (P<0.05). Patients' comfort levels were high for both treatments. There were no adverse events related to full-mouth GPAP. Conclusions: The results indicate that SubGPAP is more efficacious in removing subgingival biofilm in moderate-to-deep periodontal pockets than SRP. Furthermore, full-mouth GPAP may result in a beneficial shift of the oral microbiota and appears to be well tolerated. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine whether routine surgeon consultation with medicine specialists and multidisciplinary care conferences-potentially modifiable hospital characteristics-are associated with lower 1-year mortality in older adults with hip and lower extremity injuries. DESIGN: Retrospective cohort study. SETTING: Oregon hospitals. PARTICIPANTS: Two thousand five hundred thirty-eight Medicare recipients aged 67 and older hospitalized in Oregon hospitals in 2002 with hip or lower extremity injuries. MEASUREMENTS: Demographic, injury, comorbidity, and survival information were gathered from Medicare records for 2000 to 2003. All Oregon hospitals with a qualifying case were surveyed using a structured telephone interview to collect information about routine surgeon consultations and multidisciplinary care conferences for older adult orthopedic patients. Multivariable generalized estimating equation models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between hospital characteristics and mortality. RESULTS: After adjusting for age, injury severity, comorbid conditions, trauma center status, and hospital annual volume of patients with hip fracture, the relative odds of dying in the year after injury for inpatients treated in settings with routine surgeon consultation with medical staff was 0.69 (95% CI 0.57-0.83) compared with patients not treated in such settings. Inpatient treatment in settings with routine multidisciplinary care conferences did not significantly affect the relative odds of dying in the year after injury (OR=1.06, 95% CI=0.89-1.26). CONCLUSION: Routine consultation by attending orthopedic surgeons with medicine or primary care specialists for Medicare inpatients is associated with better survival 1 year after injury. [ABSTRACT FROM AUTHOR]

A generalized linear mixed model is an increasingly popular choice for the modelling of correlated, non-normal responses in a regression setting. A number of methods are currently available for fitting a generalized linear mixed model including Monte-Carlo Markov-Chain maximum likelihood algorithms, approximate maximum likelihood (PQL), iterative bias correction, and others. Of interest in this paper is to compare the parameter estimation of the various methods in the modelling of a count data set, the incidence of polio in the USA over the period 1970-1983, using a longlinear generalized linear mixed model with an autoregressive correlation structure. Despite the fact that all of these methods are considered valid modelling techniques, we find that parameter estimates and standard errors differ substantially between analyses, particularly in the estimation of the parameters describing the random effects distribution. A small simulation study is helpful in understanding some of these differences. The methods lead to reasonably similar predictions for future observations, with small differences observed in some monthly counts. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims To use a novel social epidemic probability model to investigate longitudinally the extent to which parents’ and older siblings’ smoking predict children's smoking transitions. Design Parents’ and older siblings’ smoking status was assessed when children were in 3rd grade (baseline). Three smoking transitions were assessed over the period of child/adolescent smoking acquisition (up to 12th grade): (1) transition from never smoking to trying smoking, (2) transition from trying to monthly smoking and (3) transition from monthly to daily smoking. Setting Forty Washington State school districts participating in the long term Hutchinson Smoking Prevention Project (HSPP). Participants and measurements Participants were the 5520 families for whom data on both parents’ and older siblings’ baseline smoking status, as well as on children's smoking transitions, were available. Findings The probability that a smoking parent influenced their child to make the first transition to trying smoking was 32% (95% CI: 27%, 36%); to make the second transition from trying to monthly smoking, 15% (95% CI: 10%, 19%); and to make the third transition from monthly to daily smoking, 28% (95% CI: 21%, 34%). The probability that an older sibling influenced a child to make the first transition to trying smoking was 29% (95% CI: 17%, 39%); to make the second transition from trying to monthly smoking, 0% (95% CI: 0%, 8%); and to make the third transition from monthly to daily smoking, 20% (95% CI: 4%, 33%). Conclusions In contrast to previous research, the results provide new evidence suggesting that family smoking influences both initiation and escalation of children's smoking. Results also quantify, in terms of probabilities, the importance of parents’ and older siblings’ smoking on children's three major smoking transitions. Parents’ smoking, as well as older siblings’ smoking, are important behaviors to target in preventing adolescents from making smoking transitions. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims The first prospective investigation of the extent to which parentalsmoking cessation predicts their children's daily smoking. Design Parental smoking status was assessed when children were aged8/9 years and children's smoking status was assessedat age 17/18 years. Setting Twenty Washington State school districts in the control groupof the Hutchinson Smoking Prevention Project. Participants and measurements Questionnaire data were gathered on 3012 children (49% femaleand 91% Caucasian) and both of their parents in a cohort witha 95% retention rate. Findings When both parents quit smoking, children's odds of dailysmoking were reduced by 39% (95% CI = 15%,56%) compared to when both parents were current smokers.Furthermore, when both parents never smoked then children’sodds of daily smoking were reduced by 71% (95% CI = 62%,78%). Conclusions Parental smoking cessation is associated with reduced risk oftheir children's daily smoking. Parents who quit stillplace children at substantially higher risk compared to parentswho never smoked. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to identify baseline factors associated with future caries development in older adults (age 60+) during a 3-year study period. Poisson regression analysis was used to determine the association between potential risk factors and disease incidence. The significant factors associated with high coronal caries incidence rates were high baseline root DMFS (P<0.001), high counts of mutans streptococci and lactobacilli (P=0.036), male gender (P=0.007), and Asian ethnicity (P=0.002). These factors had small to moderate effects on incidence rates, with relative risk values of approximately 1.2 to 2. The significant factors associated with higher disease incidence on root surfaces were baseline coronal DMFS (marginally significant, P=0.078), high bacterial counts (P=0.002), and Asian ethnicity (P=0.009). The predictive value of the models was low for both coronal and root caries. This result may be because this population had a higher than usual caries incidence rate, making discrimination among these caries-active individuals difficult. The current study affirmed the value of baseline DMFS and salivary variables to modeling caries incidence and introduced ethnicity as variable useful for the study of dental caries in older adults. [ABSTRACT FROM AUTHOR]

The methods currently used to evaluate the risk of developmental defects in humans from exposure to potential toxic agents do not reflect biological processes in extrapolating estimated risks to low doses and from test species to humans. We develop a mathematical model to describe aspects of the dynamic process of organogenesis, based on branching process models of cell kinetics. The biological information that can be incorporated into the model includes timing and rates of dynamic cell processes such as differentiation, migration, growth, and replication. The dose-response models produced can explain patterns of malformation rates as a function of both dose and time of exposure, resulting in improvements in risk assessment and understanding of the underlying mechanistic processes. To illustrate the use of the model, we apply it to the prediction of the effects of methylmercury on brain development in rats. [ABSTRACT FROM AUTHOR]

Presents views of J.B. Bricker et al on comments made by three different study groups on their study to find a relationship between parental smoking cessation and children's smoking. Methods by which parents can prevent initiation of smoking in their children; Investigation of parental practice that discourages their children from smoking; Discussion of the relevance of three important etiological factors of smoking.