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Objectives: Familial adenomatous polyposis (FAP) is a hereditable disorder characterized by early and unremitting development of intestinal polyps and extraintestinal manifestations requiring multidisciplinary surveillance. Herein we describe a multicenter cross-sectional analysis of the dento-osseous radiographic findings of patients with FAP from North and South America., Study Design: Groups I and II included individuals with FAP diagnosed by standard clinical criteria. Patients were paired with age- and sex-matched participants without FAP. Panoramic radiograph of both cohorts, including children and adults, were analyzed., Results: Of 114 panoramic radiographs, 38 were from patients with FAP, composed of group I (n = 22) and group II (n = 16), and 76 were from matched control participants. Evaluators had excellent agreement on key findings (intraclass correlation coefficient = 0.89). The prevalence of osseous anomalies was higher in adults (75%) than in children (65.4%). Dental anomalies were also higher in children with FAP with a prevalence of 15.4%., Conclusions: We describe important and significant differences in the prevalence of dento-osseous anomalies in children compared with adult patients with FAP. These findings warrant careful consideration and may influence multidisciplinary management of the condition. Conversely, the presence of these abnormalities in pediatric dental patients even if not diagnosed with FAP should be borne in mind as possibly indicating de novo or unrecognized disease., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Vitamin A metabolites play important roles in T cell activation and differentiation. A conventional model of RARα function relies upon retinoic acid (RA)-liganded RARα binding to specific DNA motifs to regulate gene expression in the nucleus. However, this genomic function fails to explain many of the biological responses of the RA-RARα axis on T cells. We generated a mouse line where RARα is over-expressed in T cells to probe RARα function with unprecedented sensitivity. Using this model together with mice specifically lacking RARα in T cells, we found that RARα is required for prompt exit from metabolic quiescence in resting T cells upon T cell activation. The positive effect of RARα on metabolism is mediated through PI3K and subsequent activation of the Akt and mTOR signaling pathway. This largely non-genomic function of RARα is surprisingly ligand-independent and controls the differentiation of effector and regulatory T cell subsets.

Familial adenomatous polyposis patients often present with non-malignant extra-intestinal manifestations which include dental anomalies that may be evident prior to the appearance of the colonic adenomas. The aims of this study were to describe the prevalence and type of dental anomalies and the relationships between gene mutations and dental anomalies in these patients. Twenty-two pediatric familial adenomatous polyposis patients and 46 controls, who were age and gender matched participated. Familial adenomatous polyposis patient's had a dental examination with panoramic radiograph and medical record review for age at diagnosis, the presence of the adenomatous polyposis coli gene mutation, and determination of other extra-intestinal manifestations on the body. The control group was identified from a retrospective chart review and selected if there was a current panoramic radiograph. The only significant difference between familial adenomatous polyposis patients and controls were the presence of jaw osteomas and sclerosis (p = .0001). Patients with a mutation in, or upstream of codon 1309 had a higher frequency of osteomas (77.8%) and jaw-bone sclerosis (44.4%), and 77% of these had at least one dental anomaly. This preliminary study showed an association between a genetic variant at, or upstream of codon 1309, and radiographic dental anomalies.

Objectives: To compare the effect of a stannous fluoride dentifrice versus a triclosan-containing dentifrice on the reduction of plaque using in vitro and clinical models., Methods: Both investigations evaluated a novel 0.454% stabilized stannous fluoride dentifrice (Crest® Pro-Health™ smooth formula) versus a sodium fluoride/triclosan positive control dentifrice (Colgate® Total®). The in vitro evaluation utilized the Plaque Glycolysis and Regrowth Model (PGRM), wherein the metabolic effects (acid production/glycolysis inhibition) of the dentifrices were assessed on plaque biofilms grown on glass rods after three days growth and a single dentifrice treatment. Treatments were evaluated via analysis of variance, Student's t-test. The clinical trial was a four-week, single-center, randomized and controlled, double-blind, parallel group study, where 120 adults were randomized to one of the two dentifrices for use at home according to manufacturer's instructions. Plaque was evaluated at baseline and Week 4 with the Rustogi Modified Navy Plaque Index (RMNPI). Statistical analyses were via analysis of covariance., Results: In vitro PGRM: The stannous fluoride dentifrice provided 43.3% glycolysis inhibition compared to 27.5% for the triclosan control, and the pH decrease associated with acid production was significantly less for stannous fluoride (0.87) versus triclosan (1.11); p < 0.05. Clinical trial: One hundred eighteen (118) subjects completed the study with fully evaluable data. Both dentifrice groups demonstrated statistically significant (p < 0.0001) reductions in plaque at Week 4 compared with baseline, with the stannous fluoride dentifrice producing a significantly lower adjusted mean Week 4 plaque score (p < 0.0001) versus the triclosan positive control for whole mouth plaque (23.1% lower) and interproximal plaque (43.5% lower). Both dentifrices were well-tolerated., Conclusions: The stabilized stannous fluoride dentifrice provided statistically significant reductions in plaque glycolysis in vitro and plaque growth in vivo compared to the triclosan dentifrice. Results for both studies were consistent., Competing Interests: Dr. He, Dr. Zsiska, Dr. Schneiderman, Ms. Eusebio, and Ms. Farmer are employees of Procter & Gamble. The study was supported by Procter & Gamble.

Background: Gastroesophageal reflux disease (GERD) affects 15-25% of children and adolescents in the United States. The diagnosis of GERD in children is complex as reported symptoms or symptom profiles have been found to be unreliable. Frequently, the diagnosis must be confirmed by objective tests such as pH monitoring or histological evidence of esophagitis on an esophageal biopsy. Dental erosion has been shown to be associated with GERD as an atypical complication and has the potential to be a marker of GERD. The purposes of this study were to compare the frequency and patterns of dental erosion in children and adolescents with and without histologic esophagitis., Methods: Twenty-five subjects were recruited from patients scheduled for an upper gastrointestinal endoscopy. Information regarding potential GERD symptoms, food habits, and dental hygiene habits were obtained. Intra-oral photographs were taken, and a dental exam for erosion was performed. The results of a standard biopsy taken from the lower third of the esophagus during an endoscopy were used to divide subjects into either the control group or the GERD group (i.e. those with histologic esophagitis)., Results: Twenty-two subjects yielded 586 evaluable teeth. No significant difference was found between frequency or erosion patterns of those with and without histologic esophagitis. Dental erosions were more frequent in primary teeth., Conclusions: Dental erosions do not appear to be associated with histologic esophagitis indicative of GERD.

Purpose: To evaluate the dental stain removal efficacy of two commercially-available manual toothbrushes., Methods: This was a randomized, examiner-blind, parallel-group, two treatment clinical trial of 2 weeks duration. Subjects qualifying for the study had a mean Modified Lobene Stain Index of ≥ 1.5 on at least two anterior teeth. Subjects were randomly allocated to one of two groups, receiving a test manual toothbrush (Oral-B 3D White Radiant) or a positive control (PC) manual brush to be used for 1 minute, twice daily for 2 weeks with a standard, anti-cavity fluoride dentifrice. Subjects were given written and verbal instructions, and the first use was supervised at the baseline visit. Stain was measured at baseline and after 2 weeks of product use. Stain measurements were conducted using the Modified Lobene Stain Index (MLSI) and the Interproximal Modified Lobene Stain Index (IMLSI)., Results: Use of the two manual brushes resulted in statistically significant reductions of surface stain relative to baseline after 2 weeks of use. The mean MLSI composite stain reductions versus baseline were 1.37 for White Radiant and 0.87 for PC (P < 0.001 for both). Using the IMLSI, the mean stain reductions for composite, gingival and interproximal regions were 1.68, 1.20 and 1.68 for White Radiant (P < 0.001) and 1.25, 0.97 and 1.43 for PC (P ≤ 0.002). ANCOVA yielded statistically significant between group differences, with greater composite stain removal observed for White Radiant using both indices (P ≤ 0.025).

Background: This study examined attitudes about research, knowledge of the research process, reasons for and satisfaction with participation in a dental clinical trial as a function of demographic characteristics., Materials and Methods: 180 adults were invited to complete a 47-item survey at the completion of a 10-week dental product study at a Midwestern academic dental center. Seven demographic items included gender, race/ethnicity, age, education, household income, location of usual dental care, and dental insurance. Forty items assessed: attitudes about research; knowledge of the research process; perception of the study team; perceived risks/benefits; health perceptions; and general satisfaction with the study., Results: 176 participants completed the questionnaire for a 98% response rate. African Americans were more likely to attribute Fate/God as more important to their health and their willingness to participate in research than whites, and more likely to report non-supportive social norms when compared to whites and other groups. Individuals in the 45-59 age group were less likely to attribute financial reimbursement as a motivator for their participation in research compared to all other age groups. Individuals with less education rated Fate/God attitudes as important to their research participation, reported lower autonomy for participation, and reported less supportive social norms compared to those with some college education. Participants in the four income categories showed significant differences in reasons for participation and desire for free care., Conclusion: Motivations for participation of a Midwestern population of research subjects are dependent on age, ethnicity, belief in Fate/God, education, social norms and income.

Objectives: Our three academic institutions, Indiana University, Northwestern Memorial Hospital, and Wake Forest, were among the first in the United States to implement the Beckman Coulter AU5822 series chemistry analyzers. We undertook this post-hoc multi-center study by merging our data to determine performance characteristics and the impact of methodology changes on analyte measurement., Design and Methods: We independently completed performance validation studies including precision, linearity/analytical measurement range, method comparison, and reference range verification. Complete data sets were available from at least one institution for 66 analytes with the following groups: 51 from all three institutions, and 15 from 1 or 2 institutions for a total sample size of 12,064., Results: Precision was similar among institutions. Coefficients of variation (CV) were <10% for 97%. Analytes with CVs >10% included direct bilirubin and digoxin. All analytes exhibited linearity over the analytical measurement range. Method comparison data showed slopes between 0.900-1.100 for 87.9% of the analytes. Slopes for amylase, tobramycin and urine amylase were <0.8; the slope for lipase was >1.5, due to known methodology or standardization differences. Consequently, reference ranges of amylase, urine amylase and lipase required only minor or no modification., Conclusion: The four AU5822 analyzers independently evaluated at three sites showed consistent precision, linearity, and correlation results. Since installations, the test results had been well received by clinicians from all three institutions., (Copyright © 2015. Published by Elsevier Inc.)

This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

Batrachochytrium dendrobatidis ( Bd ), a chytrid fungus, is a causative agent of chytridiomycosis and amphibian population declines worldwide. The sequenced genome of Bd provides information necessary for studying the fungus and its molecular biology. Fluorescent microscopy is a technique used to image targeted molecules in live or fixed organisms to understand cellular trafficking and localization, but the use of fluorescent microscopy with Bd has not yet been demonstrated. Two fluorescent stains were tested for their use in live-cell imaging of Bd , i.e., the cell wall-specific fluorophore Solophenyl Flavine 7GFE and the DNA-specific fluorophore DRAQ5. These specific staining patterns were observed in live cultures of Bd when visualized with laser-scanning confocal microscopy.

Both experimental and retrospective studies suggest a link between parafunctions and pain in temporomandibular disorder (TMD) patients. To investigate the role of parafunctions in TMD, experience sampling methodology was used as a prospective test of the hypothesis that patients with TMD have higher levels of tooth contact and tension than non-TMD controls. Three groups of TMD patients and a group of normal controls carried pagers for one week, were contacted approximately every two hours by an automated calling system, and completed questionnaires assessing tooth contact, tension, and pain at each contact. Results showed that tooth contact was much more frequent among normal controls than is commonly presumed. Patients with myofascial pain with/without arthralgia reported more frequent contact, higher intensity contact, and more tension than patients with disk displacement or normal controls. Increased masticatory muscle activity responsible for tooth contact and tension may be an important mechanism in the etiology and maintenance of the myofascial pain and arthralgia of TMD.

Background: The purpose of this study was to determine the total root surface area of extracted teeth by computerized image analysis and the amount of remaining attachment area assuming various amounts of bone loss due to periodontal disease., Methods: One hundred fifty extracted mandibular teeth were evaluated, and measured from cusp tip to the cemento-enamel junction (CEJ), CEJ to root apex, and cusp tip to root apex. The fulcrum point of the tooth was also measured, along with the total root surface area of attachment and total surface area of attachment remaining following simulation of attachment loss in 2 mm increments. Measurements were made on 80 teeth on one proximal surface and either the buccal or lingual surface and multiplied by a factor of 2. Measurements on 70 teeth were made on all 4 root surfaces to predict the accuracy of measuring only 2 surfaces to determine root surface area. Images of the tooth surfaces were obtained by video camera and converted to computer image with measurement of the surface areas., Results: The total root surface area for the mandibular cuspids and first and second bicuspids was 275.88 mm2, 251.45 mm2, and 271.81 mm2, respectively. The 2-sided and 4-sided measurements for the mandibular first bicuspid were 252.55 mm2 and 247.02 mm2, respectively (P>0.05)., Conclusions: This study found the total root surface area to be greater than that in most previous studies. Increasing attachment loss is related to decreasing root surface area; however, this relationship is not directly proportional. No statistical difference was found between measuring 4 surfaces versus only 2 surfaces.

Background: Several antibacterial agents have been studied as a means to produce bactericidal or bacteriostatic activity as an adjunct to mechanical treatment of periodontal disease. The primary purpose of this study was to evaluate the efficacy of tetracycline strips administered singly or in multiples in conjunction with root planing, versus root planing alone, or to an untreated control. Secondary purposes were to compare gingival crevicular fluid (GCF) volume and GCF concentrations of tetracycline in pockets treated with strips; to evaluate strip insertion time; and to compare ease of placement for single or multiple strips., Methods: Using a 4-quadrant design, 4 test teeth in 24 patients were treated with either root planing and single strip application; root planing and multiple strip application; root planing alone; or an untreated control., Results: Single and multiple strip placement resulted in a significant reduction in probing depth (P = 0.033) compared to root planing and untreated groups. The multiple strip group significantly decreased bleeding on probing (P = 0.05) compared to all other treatment groups. There was no treatment effect on GCF; however, there was a significant reduction in the GCF volume over time (P = 0.001). The time required for placement was, on average, 1.9 minutes for single strips and 3.25 minutes for multiple strips., Conclusions: Our data suggest that multiple strips are superior to a single strip in reducing bleeding on probing, and that local delivery of tetracycline is superior to root planing alone in reducing probing depth.

Background: Currently, the most commonly used lasers for dental procedures are the Nd:YAG and CO2. Studies comparing healing of osteotomy defects prepared with rotary burs to those created by laser irradiation have reported conflicting results. The purpose of this study was to evaluate and compare the histologic healing of bone in rat tibial osteotomy defects created either by a dental bur, CO2 laser with and without removal of the char layer, and Nd:YAG laser with char layer removed and with and without use of an air/water surface cooling spray., Methods: Tibial osteotomy defects were created in 4 groups of 6 rats each using the following: 1) #6 round bur with simultaneous saline irrigation; 2) CO2 laser with char layer intact; 3) CO2 laser with char layer removed; 4) Nd:YAG laser with air/water surface cooling, and char layer intact; 5) Nd:YAG laser with air/water surface cooling, and char layer removed; and 6) Nd:YAG laser without air/water surface cooling, and char layer removed. Both laser types were used at energy densities typically utilized for oral soft tissue surgery., Results: Progressive healing from day 0 through day 21 post-treatment was observed in all treatment groups. However, compared to controls treated by rotary dental bur, those specimens treated by laser, regardless of laser type, energy density, or other parameters, exhibited a delay in healing that appeared to be related to the presence of residual char in the osseous defect. Specimens treated with the Nd:YAG laser using an air/water surface coolant exhibited a decreased thickness and continuity of the char layer and yielded the only specimens with new bone formation at the surface of the laser ablation defect. In addition, the normal pattern of bone remodeling in the rat tibia appeared to have been altered by laser irradiation., Conclusions: In this animal model, laser-induced osteotomy defects, when compared to those prepared by rotary bur, exhibited a delayed healing response that appeared to be related to the presence of residual char in the osseous defect.

The clinical safety and effectiveness of a subgingivally delivered biodegradable drug delivery system containing either 10% doxycycline hyclate (DH), 5% sanguinarium chloride (SC) or no agent (VC) was evaluated in a 9-month multi-center trial. The study was a randomized parallel design with 180 patients who demonstrated moderate to severe periodontitis. All patients had at least two quadrants with a minimum of four qualifying pockets > or = 5 mm that bled on probing. Two of the qualifying pockets were required to be > or = 7 mm. At baseline and at 4 months all qualified sites were treated with the test article administered via syringe. Probing depth reduction (PDR), attachment level gain (ALG), bleeding on probing reduction (BOP), and plaque index were determined monthly. Analysis of efficacy data from the 173 efficacy-evaluable patients indicated that all treatments gave significant positive clinical changes from baseline at all subsequent timepoints. DH was superior to SC and VC in PDR at all timepoints (P < or = 0.01 to 0.001) with a maximum reduction of 2.0 mm at 5 months. For ALG, DH was superior to VC at months 2, 3, 4, 5, 6, 8, and 9 (P < or = 0.04 to 0.002) and superior to SC at months 5, 6, 7, 8, and 9 (P < or = 0.01 to 0.001) with a maximum ALG of 1.2 mm at 6 months. For BOP reduction, DH was superior to VC at all time points (P < or = 0.05) and to SC at months 3, 5, 6, 8, and 9 (P < or = 0.03). For DH, the maximum ALG in deep (> or = 7 mm) pockets was 1.7 mm and PDR 2.9 mm compared to 0.8 mm and 1.6 mm, respectively for moderate (5 to 6 mm) pockets. Test articles were applied without anesthesia and no serious adverse events occurred in the trial. The results of this study indicate that 10% doxycycline hyclate delivered in a biodegradable delivery system is an effective means of reducing the clinical signs of adult periodontitis and exhibits a benign safety profile.