Search

Abstract Oral bacteria are known to be associated with perioperative complications during hospitalization. However, no presented reports have clarified the relationship of oral bacterial number with medical costs for inpatients. The Diagnosis Procedure Combination (DPC) database system used in Japan provides clinical information regarding acute hospital patients. The present study was conducted to determine the association of oral bacterial numbers in individual patients treated at a single institution with length of hospital stay and medical costs using DPC data. A total of 2369 patients referred by the medical department to the dental department at Hiroshima University Hospital were divided into the low (n = 2060) and high (n = 309) oral bacterial number groups. Length of hospital stay and medical costs were compared between the groups, as well as the associations of number of oral bacteria with Charlson comorbidity index (CCI)-related diseases in regard to mortality and disease severity. There was no significant difference in hospital stay length between the low (24.3 ± 24.2 days) and high (22.8 ± 20.1 days) oral bacterial number groups. On the other hand, the daily hospital medical cost in the high group was significantly greater (US$1456.2 ± 1505.7 vs. US$1185.7 ± 1128.6, P

Abstract Objectives For people, it is challenging to be conscious of the appropriate toothbrushing time to maintain good oral health in daily life. The aim of this study was to preliminarily examine the utility of an application (app) that combines a toothbrushing timer and information on toothbrushes. Materials and Methods We developed the “Toothbrushing Timer with Information on Toothbrushes” app to help users ensure appropriate toothbrushing time and learn about the beneficial characteristics of toothbrushes. A total of 18 participants were registered for the study. At baseline (T0) and after 1 month (T1) of app usage, study participants answered a digital questionnaire that comprised three questions on oral health practice, self‐efficacy in oral hygiene, and quality of life related to oral health (Oral Health Impact Profile‐14 [OHIP‐14]). Results Five participants were excluded from the analysis as they did not answer the digital questionnaire. Finally, 13 participants completed the survey with a follow‐up of 1 month. The 13 participants were grouped into health professionals (n = 8) and non‐health professionals (n = 5). The total scores for oral health practice and self‐efficacy related to oral hygiene increased after a month of app usage in health professional and non‐health professional groups. However, there were no significant differences between T0 and T1 in either group. The total score of OHIP‐14 was lower at T1 than at T0 in both groups. Therefore, participants showed better oral health practice, self‐efficacy in oral hygiene, and quality of life related to oral health at T1 compared with that at T0. Conclusions Our app showed positive results for the users and is useful in maintaining and promoting oral health awareness and practice. However, our pilot study lacks sufficient power and did not yield significant differences. Therefore, high‐quality clinical trials with larger sample sizes are warranted for further improvement and evaluation.

Abstract Purpose Several studies have found associations between periodontitis and various types of cancer. Since the site of head and neck cancer (HNC) has contiguity or proximity to the oral cavity, it may be particularly influenced by oral inflammation. This study aimed to determine whether HNC patients have poor oral health as compared to those with other types of cancer. Methods This study retrospectively examined oral environmental factors including periodontal inflamed surface area (PISA), a new periodontal inflammatory parameter. A total of 1030 cancer patients were divided into the HNC (n = 142) and other cancer (n = 888) groups. Furthermore, the HNC group was divided into high (n = 71) and low (n = 71) PISA subgroups, and independent risk factors affecting a high PISA value were investigated. Results Multivariate logistic regression analysis showed that number of missing teeth (odds ratio 1.72, 95% CI 1.15–2.56, P

Abstract Febrile neutropenia (FN) is an infectious complication that develops during chemotherapy. Although the oral cavity can be an important infection route, it is unknown whether the oral environment is associated with FN. The present study examined the relationship between the oral environment using periodontal inflamed surface area (PISA), a new periodontal disease parameter, and FN in hematologic cancer patients undergoing chemotherapy. In this retrospective cohort study, 157 patients were divided into FN onset during chemotherapy (n = 75) and the FN negative groups (n = 82). The associations of risk factors related to the intraoral environment were assessed. Logistic regression analysis showed that types of blood cancer (odds ratio 1.98; P

Abstract Objective Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a member of the carcinoembryonic antigen family. Although its expression has been found in chronic oral inflammatory epithelium, this study aimed to know whether CEACAM1 in oral keratinocytes participates in host immune response against Candida albicans . Methodology We investigated CEACAM1 expression in oral keratinocytes induced by C. albicans as well as by Candida cell wall component β-glucan particles (β-GPs). Furthermore, the effects of CEACAM1 on β-GPs-induced heme oxygenase-1 (HO-1) expression and its related signals were examined. Results Fluorescence staining showed CEACAM1 expression in oral keratinocytes (RT7) cells, whereas quantitative reverse transcription (RT)-PCR indicated that both live and heat-killed C. albicans increased CEACAM1 mRNA expression in RT7 cells. Examinations using quantitative RT-PCR and western blotting indicated that CEACAM1 expression was also increased by β-GPs derived from C. albicans . Specific siRNA for CEACAM1 decreased HO-1 expression induced by β-GPs from C. albicans as well as the budding yeast microorganism Saccharomyces cerevisiae . Moreover, knockdown of CEACAM1 decreased β-GPs-induced ROS activity in the early phase and translocation of Nrf2 into the nucleus. Conclusion CEACAM1 in oral keratinocytes may have a critical role in regulation of HO-1 for host immune defense during Candida infection.

Abstract Objectives This study aimed to clarify the relationship between physical performance and oral function in older women participating in community‐based physical and oral exercise programs. Material and methods We included 163 older women (mean age: 77.4 ± 8.6 years) who participated in weekly health programs in Takehara City, Hiroshima Prefecture, Japan, from August to December 2018. Physical fitness was assessed using a handgrip strength test, a timed up and go test, a one‐leg standing time with eyes open test, and a 30‐s chair stand test (CS‐30). Tongue pressure, oral diadochokinesis, and dysphagia risk assessment for the community‐dwelling elderly were used to assess oral function. Results Participants were divided into women aged 65–74 years (younger group) and those aged ≥75 years (older group). There was no significant difference in oral function measures between the groups. A significant correlation was found between CS‐30 and oral diadochokinesis for /pa/, /ta/, and /ka/ (Spearman's rank correlation; /pa/: r = .234, p = .009; /ta/: r = .299, p = .001; and /ka/: r = .283, p = .002) in the older group. Multivariable analysis revealed a significant positive relationship between CS‐30 and /ta/ repetition in the older group (p = .016). Conclusions Oral function (i.e., tongue motor function) may be associated with physical performance (i.e., lower leg muscle strength) in women aged ≥75 years. Further study is necessary to clarify sex differences in oral function deterioration.

Background: The associations between oral human herpesvirus-6 (HHV-6) and HHV-7, periodontal conditions, and lifestyle-related diseases, such as hypertension, diabetes, and dyslipidemia, have not been fully investigated in older adults. Methods: Seventy-four older patients who visited Hiroshima University Hospital were enrolled. Tongue swab samples were employed, and a real-time polymerase chain reaction was performed to detect HHV-6 and HHV-7 DNA. Dental plaque accumulation, probing pocket depth, and bleeding on probing (BOP) (i.e., a sign of periodontal inflammation) were examined. The periodontal inflamed surface area (PISA) value (i.e., an indicator of the severity of periodontitis) was also examined. Results: Of the 74 participants, one participant (1.4%) was HHV-6 DNA-positive and 36 participants (48.6%) were HHV-7 DNA-positive. A significant association between HHV-7 DNA and probing depth was found (p = 0.04). The HHV-7 DNA-positive participants had a higher positive rate of a ≥6-mm periodontal pocket with BOP (25.0%) than the HHV-7 DNA-negative participants (7.9%). Additionally, the HHV-7 DNA-positive participants had a higher PISA value than the HHV-7 DNA-negative participants. However, there was no significant association between HHV-7 and the PISA value (p = 0.82). No significant association was found between HHV-7 and lifestyle-related diseases (p > 0.05). Conclusions: Oral HHV-7 infection is associated with a deep periodontal pocket.

Apatite cement (AC), which has excellent osteoconductive ability, and alpha-tricalcium phosphate (α-TCP), which can be used for bone replacement, are useful bone substitute materials. The objective of this study was to clarify the physical properties and antimicrobial release ability of antibiotic-loaded AC/α-TCP composites in vitro. Gentamicin-loaded, rapid setting AC/α-TCP composites were prepared in 2 mixing ratios (10:3 and 10:6). The cement paste of AC/α-TCP composites was prepared in a plastic mold and dried in a thermostatic chamber at 37 °C and 100% relative humidity for 24 h. A diametral tensile strength test, powder X-ray diffraction analysis, and gentamicin release test were performed. The diametral tensile strengths of the AC/α-TCP composites were significantly less than that of AC alone. Powder X-ray diffraction patterns exhibited the characteristic peaks of hydroxyapatite in the AC/α-TCP composites and gentamicin-loaded AC/α-TCP composites. The concentration of the released gentamicin was maintained above the minimum inhibitory concentration of Staphylococcus aureus until Day 30 in both the gentamicin-loaded AC/α-TCP composites (10:3 and 10:6). Our results suggest that a gentamicin-loaded AC/α-TCP composite has potential as a drug delivery system. Further study is essential to investigate the antimicrobial activity and safety of the gentamicin-loaded AC/α-TCP composites in animal models.

Abstract Objective There is limited evidence about the most appropriate way to improve physical and oral function in older people. The aim of this study was to clarify the effectiveness of a long‐term care prevention program combining physical exercise, oral health instruction, and nutritional guidance among community‐dwelling older people. Materials and methods We included 43 older people aged at least 65 years (seven men and 23 women; mean age 75.3 years) in Bungotakada City, Japan. The 3‐month program involved a weekly intervention. Physical and oral function was investigated on the first day of the program (i.e., baseline) and at the end of the program (i.e., after 3 months). Physical function was examined using measures such as handgrip strength, timed up‐and‐go test, and one‐leg standing time with eyes open. An oral diadochokinesis test was used to assess oral function. Results Mean maximum handgrip strength increased significantly in older people aged ≤74 years (younger participants) and those aged ≥75 years (older participants) after 3 months compared with the baseline. The timed up‐and‐go test duration was significantly lower in older participants after the program. Repetition of the monosyllables pa and ka and the repetitive saliva swallowing test was significantly improved in both groups. The dysphagia risk assessment for the community‐dwelling elderly score was significantly lower in younger participants after 3 months. Conclusion Participation in a 3‐month program combining physical exercise, oral health instruction, and nutritional guidance may contribute to improvement or maintenance of oral and physical function in older people.

The low-affinity nerve growth factor receptor p75 is a stratified epithelial stem/progenitor marker of human epithelia. We found OM-1, a human squamous cell carcinoma (SCC) cell line, showed distinct cells with p75 cluster, especially located at the center of a growing colony in a monolayer culture. A cell with p75 cluster was surrounded by cytokeratin 14- and cytokeratin 13-expressing cells that settled at the outer margin of the colony. OM-1 cells were also capable of forming tumor spheres in a cell suspension culture, an ability which was attenuated by the inhibition of p75-signaling. Intriguingly, we also found a p75-negative cell population from a growing culture of OM-1 that re-committed to become p75-clustering cells. These results indicated the possibility that SCC with epithelial multi-layering capacity can exploit the p75-dependent stratified epithelial progenitor property for the cancer stemness.

Summary: Resolution of dysbiosis following treatment for periodontal disease and tobacco dependence has been reported in longitudinal intervention studies. In the present report, we evaluated the biological findings regarding the effect of smoking on the periodontal microbiome. A standardized electronic search was conducted using MEDLINE; overall, 1099 papers were extracted. Studies that addressed the relationship between tobacco and periodontal pathogens were included. Finally, 42 papers were deemed appropriate for the present review. Functional changes in periodontal pathogens exposed to nicotine and cigarette smoke extract support the clinical findings regarding dysbiosis of the subgingival microbiome. Dysbiosis of the periodontal microbiome was presented in smokers regardless of their periodontal condition (healthy, gingivitis, or periodontitis) and remained significant only in smokers even after the resolution of experimentally-induced gingivitis and following reduction of clinical signs of periodontitis with non-surgical periodontal treatment and over 3 months post-therapy. Based on these findings, smoking cessation in periodontitis patients is beneficial for promoting a health-compatible subgingival microbial community. To maximize the benefits of these interventions in dental settings, further studies on periodontal microbiome are needed to elucidate the impact of tobacco intervention on preventing recurrence of periodontal destruction in the susceptible subjects. Keywords: Smoking, Smoking cessation, Nicotine, Oral microorganism, Periodontal disease

The aim of this study is to clarify the deflection, splaying, and abrasion of single tufts of polybutylene terephthalate (PBT) toothbrushes after use. A single-center randomized controlled trial is performed. The changes in deflection, bristle splaying, and abrasion are investigated for the middle single tuft of the top line (top–middle tuft) and the middle single tuft of the bottom line (bottom–middle tuft) of PBT toothbrushes with medium stiffness after 1 month, 2 months, and 3 months of use by 34 participants. A soft-material bending-resistance tester is used to assess the deflection of the single tufts. The deflection value of the top–middle tuft significantly increased after 1 month of use compared with the baseline. In contrast, the deflection of the bottom–middle tuft significantly increased after 3 months of use compared with the baseline and after 1 month and 2 months of use. Importantly, the change in deflection was distinctly different between the top– and bottom–middle tufts. The bristle splaying of both tufts significantly increased after use, but a significant change in bristle abrasion was not found. The bending stiffness of the top tuft of a PBT toothbrush may decrease more rapidly than that of the bottom tuft with use.

Abstract Objective This study aimed to clarify the association between oral human cytomegalovirus (HCMV) and periodontitis in Japanese adults. Methodology In total, 190 patients (75 men and 115 women; mean age, 70.2 years) who visited Hiroshima University Hospital between March 2018 and May 2020 were included. Oral rinse samples were taken to examine the presence of HCMV DNA using real-time polymerase chain reaction (PCR). P. gingivalis was detected by semi-quantitative PCR analysis. Results HCMV DNA was present in nine of 190 patients (4.7%). There were significant associations between HCMV presence and the presence of ≥4-mm-deep periodontal pockets with bleeding on probing (BOP) (P

Background and Objectives: Candida albicans can be detected in subgingival sites of patients with periodontitis. However, the association between oral Candida albicans and periodontitis has not been fully elucidated in Japanese adults. The aim of this study is to clarify the relationship between oral Candida albicans infection/co-infection of oral C. albicans and Porphyromonas gingivalis and periodontitis among middle-aged and older Japanese people. Materials and Methods: Eighty-six patients (mean age 70.4 years) who visited the Hiroshima University Hospital from April to September 2021 were investigated in this study. Oral swab samples were collected from the tongue surface. C. albicans and P. gingivalis DNA was detected by real-time PCR using specific DNA primer sets. C. albicans-positive participants were classified into two groups according to the presence or absence of intron insertion of C. albicans DNA by PCR analysis. Results: C. albicans was detected in 22 (25.6%) of the 86 patients. Patients in their 80s recorded a higher C. albicans-positive rate (35.3%) compared with other participants. However, there was no significant association between the C. albicans positivity rate and clinical parameters such as sex, age, systemic disease, denture use, or oral health status. Of the 22 C. albicans-positive participants, 10 participants (45.5%) had C. albicans with intron insertion; 70% of participants who had C. albicans with intron insertion exhibited ≥6 mm probing depth. C. albicans/P. gingivalis co-infection was found in 12 patients (14%). Importantly, binomial logistic regression analysis revealed that C. albicans/P. gingivalis co-infection was significantly associated with ≥6 mm periodontal pockets with bleeding on probing (p = 0.02). Conclusions: Co-infection of C. albicans and P. gingivalis is involved in active periodontitis in middle-aged and older people.

Abstract Background The effectiveness of an oral hygiene program for children living in a children’s home has been reported. However, to the best of our knowledge, no studies have evaluated the possible effects of self-checking of oral health among children residing in a children’s home. The objective of this study was to examine if self-checking using plaque disclosing solution improves oral hygiene in schoolchildren living in a children’s home. Methods We enrolled nine schoolchildren (six girls) without untreated decayed teeth living in a children’s home in Japan. This preliminary study was designed as a 5-month program comprising group and individual instructions and self-checking using plaque disclosing solution. Paired t-test and Wilcoxon signed-rank test were used for statistical analysis to evaluate the change of Plaque Control Record (PCR) and Patient Hygiene Performance (PHP). Results The mean PCR significantly decreased to 38.7% after 3 months of self-checking using disclosing solution compared with that before self-checking (i.e., at 1 month) (60.7%) (P

The periodontal inflamed surface area (PISA) has been proposed for assessment of the total periodontal inflammatory status in people with periodontitis. This study was performed to investigate the associations of periodontopathic bacteria and candida with PISA in older people. We enrolled 100 patients aged ≥ 60 years who visited Hiroshima University Hospital. PISA and periodontal epithelial surface area (PESA) were calculated in each patient. Oral rinse samples were collected for DNA extraction. Periodontopathic bacteria and candida were detected by polymerase chain reaction. The mean values of PISA and PESA were significantly greater in T.forsythia-positive patients than in T.forsythia-negative patients. T.forsythia/C. albicans double-positive patients exhibited significantly greater PISA values than did non-double-positive patients. Additionally, PISA values were significantly greater in T. forsythia//T. denticola/C. albicans triple-positive patients than in T. forsythia//T. denticola/C. albicans non-triple-positive patients (p = 0.02). Propensity score-matching was performed between periodontopathic bacteria-positive and -negative patients using propensity scores generated from clinical factors. Importantly, T.forsythia/T. denticola double-positive patients exhibited significantly greater PISA values than non-double-positive patients among 72 propensity score-matched patients. Our preliminary results highlight the importance of the presence of T.forsythia and T. denticola for periodontal inflammation severity in older Japanese people.

Background: The aim of this prospective cohort study was to clarify changes in physical and oral function in older adults after completing a 3-month health program combining physical and oral exercise, oral health instruction, and nutritional guidance. Methods: Subjects were 34 women aged at least 70 years (mean age 79.2 years) in Bungotakada City, Oita Prefecture, Japan. Physical and oral function was investigated on the first day (baseline), at the end of the program, and 6 and 12 months after completing the health program. Physical function was measured using handgrip strength test, timed up and go (TUG) test and one-leg standing time test. Oral diadochokinesis test and repetitive saliva swallowing test (RSST) were employed to assess oral function. Results: TUG scores were significantly lower at 6 and 12 months than at baseline in participants aged ≥70 and /pa/, /ta/, and /ka/ was improved at the end of program in participants aged ≥70 and

Objective Human papillomavirus (HPV) infection is a major risk factor for cervical cancer and may also be related to development of oral cancer. The objective of this study was to provide updated information regarding association between oral HPV prevalence and smoking in people without oral cancer. Methods We systematically reviewed 29 studies which reported the prevalence of oral HPV infection that included 22,756 subjects (age range 2-89 years) and were published from January 2012 to June 2015. Additionally, we investigated oral HPV16 prevalence by PCR using type specific primer in 256 patients who visited Hiroshima University Hospital from 2014 to 2018. The study design was approved by the Ethical Committee of Hiroshima University. Results The prevalence of overall HPV was considerably higher in males who had sex with males (12.2%) as compared to heterosexual men (4.7%) and women (2.9%). A meta-analysis revealed a significant statistical association of sexual behavior and smoking with oral HPV infection (OR = 1.90, 95% CI = 1.51-2.39, P

ABSTRACT Objective Biocompatible materials such as interconnected porous hydroxyapatite ceramics (IP-CHA) loaded with osteogenic cells and bioactive agents are part of an evolving concept for overcoming craniofacial defects by use of artificial bone tissue regeneration. Amongst the bioactive agents, melatonin (MEL) and basic fibroblast growth factor (FGF-2) have been independently reported to induce osteoblastic activity. The present in vitro study was undertaken to examine the relationship between these two bioactive agents and their combinatory effects on osteoblastic activity and mineralization in vitro. Material and Methods Mouse preosteoblast cells (MC3T3-E1) were seeded and cultured within cylindrical type of IP-CHA block (ø 4x7 mm) by vacuum-assisted method. The IP-CHA/MC3T3 composites were subjected to FGF-2 and/or MEL. The proliferation assay, alkaline phosphatase enzyme activity (ALP), mRNA expressions of late bone markers, namely Osteocalcin (OCN) and Osteopontin (OPN), and Alizarin Red staining were examined over a period of 7 days. Results FGF-2 mainly enhanced the proliferation of MC3T3-E1 cells within the IP-CHA constructs. MEL mainly induced the mRNA expression of late bone markers (OCN and OPN) and showed increased ALP activity of MC3T3 cells cultured within IP-CHA construct. Moreover, the combination of FGF-2 and MEL showed increased osteogenic activity within the IP-CHA construct in terms of cell proliferation, upregulated expressions of OCN and OPN, increased ALP activity and mineralization with Alizarin Red. The synergy of the proliferative potential of FGF-2 and the differentiation potential of MEL showed increased osteogenic activity in MC3T3-E1 cells cultured within IP-CHA constructs. Conclusion These findings indicate that the combination of FGF-2 and MEL may be utilized with biocompatible materials to attain augmented osteogenic activity and mineralization.

Background: Primary stability is an important prognostic factor for dental implant therapy. In the present study, we evaluate the relationship between implant stability evaluation findings by the use of an implant stability quotient (ISQ), an index for primary stability, and a morphological evaluation of bone by preoperative computed tomography (CT). Subjects and methods: We analyzed 98 patients who underwent implant placement surgery in this retrospective study. For all 247 implants, the correlations of the ISQ value with cortical bone thickness, cortical bone CT value, cancellous bone CT value, insertion torque value, implant diameter, and implant length were examined. Results: 1. Factors affecting ISQ values in all cases: It was revealed that there were significant associations between the cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis. 2. It was revealed that there was a significant correlation between cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis in the upper jaw. 3. It was indicated that there was a significant association between cortical bone thickness and implant diameter with ISQ by multiple regression analysis in the lower jaw. Conclusion: We concluded that analysis of the correlation of the ISQ value with cortical bone thickness and values obtained in preoperative CT imaging were useful preoperative evaluations for obtaining implant stability.

We previously reported that polybutylene terephthalate (PBT) toothbrushes become less effective for plaque removal after two months of use. However, it remains unknown how the bristle stiffness of PBT toothbrushes changes after several months of use. We performed a single-center randomized controlled trial to evaluate the bristle stiffness and bristle splaying of soft and medium manual toothbrushes among dental and medical students of Hiroshima University. Subjects were 80 participants who met the criteria. Participants were randomly assigned to the soft toothbrush group (n = 40) or the medium toothbrush group (n = 40). We collected toothbrushes immediately after first use (T0), after one month of use (T1), after two months of use (T2), and after three months of use (T3). Bristle stiffness was measured according to the International Organization for Standardization (ISO) 22254. The mean bristle stiffness (N/cm2) of soft and medium toothbrushes was significantly lower at T2 and T3 than at T0 (T2 vs. T0, soft; 3.63 vs. 3.89, P < 0.01 and medium; 4.33 vs. 4.52, P < 0.05, respectively, and T3 vs. T0, 3.62 vs. 3.89, p < 0.01 and 4.18 vs. 4.52, p < 0.001, respectively). Bristle stiffness was significantly reduced in soft and medium PBT toothbrushes after two months of use.

The aim of this study was to clarify the association between oral Candida detection and the dependency status of older people. This study included 31 older people aged ≥70 years who had a certified need for long-term care or support and received care in a local day care center; it also included 27 independent older patients aged ≥70 years who visited Hiroshima University Hospital. Oral Candida was detected by a polymerase chain reaction using swab samples from the tongue surface. Oral moisture was significantly reduced in dependent older people, compared with independent older people (p = 0.003). There was a weak negative relationship between numbers of bacteria and levels of oral moisture (Spearman’s rank correlation coefficient; R = −0.29, p = 0.01). Dependent older people exhibited a significantly higher rate of Candida albicans detection (35.5%) compared with independent older people (11.1%). Dependent older people also exhibited a higher rate of concurrent detection of both C. albicans and Candida glabrata (32.3%) compared with independent older people (11.1%), but this difference was not statistically significant. Thus, dependent older people may be more susceptible to oral C. albicans infection, compared with independent older people. Good oral hygiene is necessary to prevent oral Candida infection in dependent older people.

Abstract Objective The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. Material and Methods We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method. Results The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7. Conclusions Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teeth.

AbstractObjective The objective of this study was to clarify significant risk factors for postoperative complications in the oral cavity in patients who underwent oral surgery, excluding those with oral cancer.Material and Methods This study reviewed the records of 324 patients who underwent mildly to moderately invasive oral surgery (e.g., impacted tooth extraction, cyst excision, fixation of mandibular and maxillary fractures, osteotomy, resection of a benign tumor, sinus lifting, bone grafting, removal of a sialolith, among others) under general anesthesia or intravenous sedation from 2012 to 2014 at the Department of Oral and Maxillofacial Reconstructive Surgery, Hiroshima University Hospital.Results Univariate analysis showed a statistical relationship between postoperative complications (i.e., surgical site infection, anastomotic leak) and diabetes (p=0.033), preoperative serum albumin level (p=0.009), and operation duration (p=0.0093). Furthermore, preoperative serum albumin level (

Background: Innate immune response by oral mucosal cells may be the first line of host defense against viral infection. Retinoic acid-inducible gene-I (RIG-I) recognizes viral dsRNA in the cytoplasm, and RIG-I-mediated signaling regulates antiviral type I IFN, and inflammatory chemokine production. Here, we tested the hypothesis that oral mucosal cell participation in host defense against viral infection via RIG-I. Methods: RIG-I expression was detected in immortalized oral keratinocytes (RT7), oral fibroblasts (GT1) using and RT-PCR and immunohistochemistry. RT7 and GT1 were exposed to dsRNA virus mimic Poly I:C-LMW/LyoVec (PLV). Expression of IFN-β and CXCL10 via RIG-I was examined by Real-time RT-PCR and ELISA. Phosphorylation of IRF3 and STAT1 were detected by western blotting. Results: RT7 and GT1 constitutively expressed RIG-I in the cytoplasm. Furthermore, PLV increased IFN-β and CXCL10 productions in both RT7 and GT1 via RIG-I concurrent with phosphorylation of IRF3 and STAT1. PLV-induced CXCL10 production was attenuated by neutralization of IFN-β and blocking of IFN-α/β receptor (IFNAR), indicating primal IFN-β production via the RIG-I-IRF3 axis, which eventually induces CXCL10 production via the IFNAR -STAT1 axis. Conclusion: We propose that RIG-I in oral keratinocytes and fibroblasts may cumulatively develop host-defense mechanisms against viral infection in oral mucosa.

ABSTRACT Objective The objective of this study was to clarify differences regarding HPV16 infection and gene amplification between the oral cavity and oropharynx in healthy individuals. Material and Methods The subjects were 94 healthy asymptomatic individuals (41 males, 53 females; mean age 58.6 years, range 16-97 years) who visited the Department of Oral and Maxillofacial Reconstructive Surgery of the Hiroshima University Hospital from 2014 to 2015. Oral epithelial cells were collected from oral rinse and pharynx gargle samples and placed in saline. The human endogenous retrovirus gene ERV3-1 was used as a reference to estimate the number of human cells in each sample. DNA samples were extracted from approximately 10,000 human cells and tested for HPV16 DNA by PCR using a type-specific primer. Similarly, we analyzed the HPV16 viral copy number in HPV16-positive cases using real-time PCR to examine genomic amplification. Results The percentage of HPV16-positive cases was higher in the gargle (28.7%) as compared to the rinse (16.0%) samples. In the oral rinse samples, males (26.8%) showed a significantly higher rate of HPV16 than females (7.5%) (P=0.021). Importantly, in older subjects (aged 60-89 years), gargle samples showed a significantly higher rate of HPV16 (33.3%) than oral rinse samples (13.7%) (P=0.034). The average number of viral copies was approximately 8 times higher in the gargle than in the oral rinse samples (0.16±0.27 vs. 1.35±1.26 copy numbers per cell), a significant difference (P

Aim: Current studies indicate that oral human papillomavirus (HPV) and candida infection may increase the risk of developing oral cancer. The objective of this study was to investigate the risk factors for HPV16/18 and candida infection in the oral cavity in Japanese people without oral cancer or premalignant lesions. Methods: We targeted 181 Japanese patients (mean age 59.8 years, range 20-- 89 years) who visited Hiroshima University Hospital. None of the patients had oral cancer or oral potentially malignant disorder. Oral rinse samples were collected after mouth rinsing. Real-time polymerase chain reaction (PCR) was performed using typespecific primers to detect HPV16/18 DNA and Candida albicans/Candida glabrata DNA. Results: Of the 181 participants, 20 participants (11.0%) were HPV16 DNA positive and three participants (1.7%) were HPV18 DNA positive. Smoker had significant higher positive rates of HPV16 DNA than nonsmoker (P = 0.03). Additionally, binomial logistic regression analysis revealed that smoking was significantly associated with HPV16 DNA (odds ratio 4.11, P = 0.01). Six participants (3.3%) showed coinfection with HPV16 and C. albicans. No significant association was found between HPV16/18 and C. albicans/C. glabrata. Logistic regression analysis revealed that denture use was significantly associated with C. glabrata (odds ratio 5.09, P = 0.003). Conclusions: Tobacco smoke is an important risk factor for oral HPV16 infection. Co-infection with oral HPV16 and C. albicans can be found in people without oral cancer. Our results highlight the importance of not smoking and regularly cleaning dentures to prevent co-infection with HPV and candida. [ABSTRACT FROM AUTHOR]