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The attitude of nursing staff to the denture care of in-patients in hospital following the introduction of written guidelines on denture care was assessed together with the need for further guidelines. A survey in the form of a questionnaire was carried out on 100 nursing staff in a general hospital. The topics covered included usefulness of the guidelines and denture hygiene and general denture care procedures on the ward together with aspects of general denture care included in the nurse training programme. There was a 66% response rate. The results highlighted that the introduction of written guidelines were helpful to the nursing staff but additional training was requested. A computer-aided learning (CAL) programme on denture care aimed specifically at nursing was then developed. A total of 81 nursing staff were surveyed following the introduction of the CAL programme. The results demonstrated that the CAL programme was well received by 100% of the staff surveyed. Further work is to be undertaken on the development of an oral-health educational programme for nursing staff. [ABSTRACT FROM AUTHOR]

Objectives: To determine the success, survival, peri-implant health and prosthetic complications in head and neck cancer patients receiving oral rehabilitation utilising dental implants between 2008 and the present day., Materials and Methods: Service evaluation. Survival Group: Retrospective review of records to determine implant survival and prosthetic complications. Success Group: Examination to determine implant success and health., Results: Survival Group: 260 implants in 81 individuals, median follow up 49.2 months. 89.3% implant survival at 96 months, no further failures up to 133 months. 40.9% individuals required repair or remake of prosthesis by 72 months - mostly denture re-lines. Success group: 164 implants in 48 individuals, median follow up 56 months. Peri-implant mucositis detected in 22% of fixtures (37.5% individuals); peri-implantitis in 12.8% (25% individuals); 33.3% fixtures exhibiting periimplantitis at 120 months. Previous smoking significantly associated with development of peri-implantitis (HR 2.372, p=0.032, 95CI:1.232, 93.317). Compromised survival (e.g. peri-implantitis), absolute (not in mouth) or clinical failure estimated to occur in 28.1% fixtures at 101 months, mostly due to peri-implantitis., Conclusions: There is a large burden of ongoing care in this cohort, requiring interventions to improve peri-implant health and maintain complex prostheses. Oral rehabilitation and ongoing maintenance in this cohort is complex and multi-disciplinary., (Copyright© 2023 Dennis Barber Ltd.)

Objective: Clinical manifestations of Gram-negative bacteria mediated diseases can be influenced by how the host senses their major microbe-associated molecular pattern, the cell wall lipopolysaccharide (LPS). Keystone periodontal pathogens can produce a heterogeneous population of LPS molecules, with strikingly different host-microbiome interactions and immune outcomes., Design: Structure-function correlations of salivary LPS extracts in patients with periodontitis before and after periodontal treatment and healthy volunteers were analysed by comparing its lipid A and carbohydrate chain chemical structure and evaluating its endotoxin activity and inflammatory potential., Results: Salivary LPS extracts from periodontitis patients were characterised by high m/z lipid A mass-spectrometry peaks, corresponding to over-acylated and phosphorylated lipid A ions and by a combination of rough and smooth LPS carbohydrate moieties. In contrast, gingival health was defined by the predominance of low m/z lipid A peaks, consistent with under-acylated and hypo-phosphorylated lipid A molecular signatures, with long and intermediate carbohydrate chains as determined by silver staining. Total, diseased salivary LPS extracts were stronger inducers of the recombinant factor C assay and triggered significantly higher levels of TNF-α, IL-8 and IP-10 production in THP-1 cells, compared to almost immunosilent healthy samples. Interestingly, salivary LPS architecture, endotoxin activity, and inflammatory potential were well conserved after periodontal therapy and showed similarities to diseased samples., Conclusions: This study sheds new light on molecular pathogenic mechanisms of oral dysbiotic communities and indicates that the regulation of LPS chemical structure is an important mechanism that drives oral bacteria-host immune system interactions into either a symbiotic or pathogenic relationship., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives: Regulation of lipopolysaccharide (LPS) chemical composition, particularly its lipid A domain, is an important, naturally occurring mechanism that drives bacteria-host immune system interactions into either a symbiotic or pathogenic relationship. Members of the subgingival oral microbiota can critically modulate host immuno-inflammatory responses by synthesizing different LPS isoforms. The objectives of this study were to analyze subgingival lipid A profiles and endotoxin activities in periodontal health and disease and to evaluate the use of the recombinant factor C assay as a new, lipid A-based biosensor for personalized, point-of-care periodontal therapy., Materials and Methods: Subgingival plaque samples were collected from healthy individuals and chronic periodontitis patients before and after periodontal therapy. Chemical composition of subgingival lipid A moieties was determined by ESI-Mass Spectrometry. Endotoxin activity of subgingival LPS extracts was assessed using the recombinant factor C assay, and their inflammatory potential was examined in THP-1-derived macrophages by measuring TNF-α and IL-8 production., Results: Characteristic lipid A molecular signatures, corresponding to over-acylated, bi-phosphorylated lipid A isoforms, were observed in diseased samples. Healthy and post-treatment samples were characterized by lower m/z peaks, related to under-acylated, hypo-phosphorylated lipid A structures. Endotoxin activity levels and inflammatory potentials of subgingival LPS extracts from periodontitis patients were significantly higher compared to healthy and post-treatment samples., Conclusions: This is the first study to consider structure-function-clinical implications of different lipid A isoforms present in the subgingival niche and sheds new light on molecular pathogenic mechanisms of subgingival biofilm communities., Clinical Relevance: Subgingival endotoxin activity (determined by lipid A chemical composition) could be a reliable, bacterially derived biomarker and a risk assessment tool for personalized periodontal care.

Dental students are assessed using a range of methods in their final-year examinations. The aim of this study was to explore the correlations and predictive value of final-year dental students' performance on knowledge-based and clinical assessments. Examination data related to applied dental knowledge (ADK), exit case presentation (CP), and integrated structured clinical examination (ISCE) assessments for five consecutive cohorts of final-year students at one U.K. dental school from 2011-12 to 2015-16 were collated. The relationships between the scores produced by each assessment were investigated to explore the relative contributions of each to the understanding of students' abilities across the domains. The study utilized data from all 304 students: 147 (48.4%) females and 157 (51.6%) males. Significant positive correlations were found between ISCE and ADK performance (r(391)=0.42, p<0.001) as well as between ISCE and CP (r(391)=0.44, p<0.001). In addition, both ADK performance and CP performance were significant predictors (at p<0.001) of ISCE performance. This study provides important information about the relationship between these students' performance across knowledge (ADK) and clinical (ISCE and CP) domains and highlights their predictive value. Further research is required to establish if these findings can be generalized and to explore the correlations between performance of dental students before and after graduation.

Objectives: The study objectives were to assess the oral health status of a sample of UK resident Bangladeshi women tobacco-in-paan users and its relationship to participant age and number of daily paan, to determine the prevalence of oral pain at baseline and at the one-week postcessation follow-up, and to explore the relationship between oral health status and changes in self-reported oral pain at baseline and at the one-week postcessation follow-up., Methods: Interviews were conducted in Sylheti using fully structured questionnaires and an oral examination was carried out. A quit date was set and nicotine replacement therapy patches (Nicorette 15 mg, Pfizer) were supplied. Age, number of daily paan, and oral pain characteristics, including intensity, frequency, any provoking factors, and associated symptoms were recorded. Oral mucosal lesions (OMLs) and numbers of teeth decayed, missing, filled, and those with recession, abrasion, loss of attachment (LOA), and tooth wear were charted., Results: Fifty-two women took part. The mean age was 42.8 years and number of daily paan with tobacco was 13. Compared to those aged 18-39 years, those aged 40 years and older had poorer oral health. Older adults were significantly more likely to have higher numbers of teeth with recession, abrasion, and LOA greater than 3.5 mm. They were significantly more likely to have an OML at baseline. The prevalence of self-reported oral pain was 26.9 percent at baseline and 51.9 percent at one-week follow-up. Presence of an OML at baseline was a significant predictor of reports of oral pain at the one-week follow-up. Results of stepwise multiple regression analysis confirmed this finding (OR = 3.66; 95% CI = 1.06, 12.621; P = .04)., Conclusions: Reports of oral pain at follow-up during a tobacco cessation program correlate with the presence of OMLs at baseline. Further investigation of this relationship is needed. Access to appropriate dental care, as an aid to successful tobacco cessation, is indicated.