Search

This report describes the use of a novel model of multispecies biofilms to stimulate profiles of cytokines/chemokines from oral epithelial cells that contribute to local inflammation in the periodontium. Streptococcus gordonii (Sg) /S. oralis (So) /S. sanguinis (Ss) and Sg/ Fusobacterium nucleatum (Fn) /Porphyromonas gingivalis (Pg) biofilms elicited significantly elevated levels of IL-1α and showed synergistic stimulatory activity compared with an additive effect of the 3 individual bacteria. Only the Sg/ Actinomyces naeslundii (An)/Fn multispecies biofilms elicited IL-6 levels above those of control. IL-8 was a primary response to the Sg/An/Fn biofilms, albeit the level was not enhanced compared with a predicted composite level from the monospecies challenges. These results represent some of the first data documenting alterations in profiles of oral epithelial cell responses to multispecies biofilms.

"Diabetes and Oral Disease: Implications for Health Professionals" was a one-day conference convened by the Columbia University College of Dental Medicine, the Columbia University College of Physicians and Surgeons, and the New York Academy of Sciences on May 4, 2011 in New York City. The program included an examination of the bidirectional relationship between oral disease and diabetes and the interprofessional working relationships for the care of people who have diabetes. The overall goal of the conference was to promote discussion among the healthcare professions who treat people with diabetes, encourage improved communication and collaboration among them, and, ultimately, improve patient management of the oral and overall effects of diabetes. Attracting over 150 members of the medical and dental professions from eight different countries, the conference included speakers from academia and government and was divided into four sessions. This report summarizes the scientific presentations of the event.

WLBU2 is a peptide antibiotic designed for broad antimicrobial activity, including bacteria associated with periodontal disease. Although periodontitis is associated with various systemic conditions, ranging from cardiovascular disease to preterm birth, local therapy is needed to treat the source of infection. Biodegradable polymers are often used to control locally the amount and rate of delivery of drugs. In the present study, a bioerodible association polymer comprising cellulose acetate phthalate (CAP) and Pluronic ® F-127 (PF-127) was explored for its interaction with WLBU2. The intrinsic antimicrobial activity of CAP/PF-127 and the combined effects of the polymer and WLBU2 were examined using Streptococcus gordonii , a species involved in early colonisation of tooth surfaces. The polymer blend alone had dose-dependent bacteriostatic properties, resulting in a ≥2log decrease in colonies at the highest concentrations tested, possibly due to the hydrophobicity of CAP disrupting the surface of bacteria. When WLBU2 was combined with CAP/PF-127, an apparent binding of peptide to polymer significantly decreased the activity compared with free WLBU2, which functions like other cationic peptides by destabilising the bacterial membrane. Formulation with sucrose as an excipient, which reduced the interaction between WLBU2 and polymer, restored the bactericidal activity of the peptide antibiotic as reflected by a >3log decrease in S. gordonii . WLBU2 can be locally delivered using CAP/PF-127 as a release vehicle, with the peptide's bactericidal activity dominating the polymer's bacteriostatic effect.

Over the past two decades, interest in dentistry in the United States has shown a steady period of growth. There were 12,210 individuals who applied to the 2009 entering class of U.S. dental schools. The number of first-time enrollees was 4,871, the highest figure since 1990. Men continue to comprise the majority of applicants and enrollees; however, the percentages of women continue to increase. While the 2009 underrepresented minority applicants comprised 12 percent of both the applicant and first-time enrollee pools, the percentage of underrepresented minority enrollees of underrepresented minority applicants decreased from 2008. Seventy-one percent of enrollees earned a baccalaureate degree in biological science or chemistry/physical science. Regardless of major fields of study, the percent rates of enrollment generally exceeded 32 percent.

Oral biofilms comprise complex multispecies consortia aided by specific inter- and intraspecies interactions occurring among commensals and pathogenic bacterial species. Oral biofilms are primary initiating factors of periodontal disease, although complex multifactorial biological influences, including host cell responses, contribute to the individual outcome of the disease. To provide a system to study initial stages of interaction between oral biofilms and the host cells that contribute to the disease process, we developed a novel in vitro model system to grow biofilms on rigid gas-permeable contact lenses (RGPLs), which enable oxygen to permeate through the lens material. Bacterial species belonging to early- and late-colonizing groups were successfully established as single- or three-species biofilms, with each group comprising Streptococcus gordonii , Streptococcus oralis , and Streptococcus sanguinis ; S. gordonii , Actinomyces naeslundii , and Fusobacterium nucleatum ; or S. gordonii , F. nucleatum , and Porphyromonas gingivalis . Quantification of biofilm numbers by quantitative PCR (qPCR) revealed substantial differences in the magnitude of bacterial numbers in single-species and multispecies biofilms. We evaluated cell-permeable conventional nucleic acid stains acridine orange, hexidium iodide, and Hoechst 33258 and novel SYTO red, blue, and green fluorochromes for their effect on bacterial viability and fluorescence yield to allow visualization of the aggregates of individual bacterial species by confocal laser scanning microscopy (CLSM). Substantial differences in the quantity and distribution of the species in the multispecies biofilms were identified. The specific features of these biofilms may help us better understand the role of various bacteria in local challenge of oral tissues.

In this reflection article, Dr. Karen Novak, a mid-career faculty member at a U.S. dental school, identifies important messages and insights she gained from a series of twenty-one articles about the future of dental education published in the Journal of Dental Education from October 2005 to February 2009. This article addresses four questions: 1) What influence have these articles had on an academic dentist’s perspectives about her role and priorities as a dental school faculty member and her own career plans and future directions? 2) What are the key messages in these articles for other dental educators who are at similar places in their careers? 3) What additional topics concerning the future of academic dentistry should be covered in future articles? and 4) What issues and priorities should receive the most attention from academic dentistry in the next decade? The American Dental Education Association’s Commission on Change and Innovation in Dental Education (ADEA CCI) was established to provide a mechanism for stakeholders in academic dentistry to meet and consider future directions in the education of the nation’s dental workforce. Along with ADEA, these stakeholders included dental schools, the American Dental Association (ADA) Board of Trustees, the Commission on Dental Accreditation (CODA), the ADA Council on Dental Education and Licensure (CDEL), the Joint Commission on National Dental Examinations (JCNDE), the dental licensure community, the ADA Foundation, and advanced dental education programs. The ADEA CCI was created to build consensus within the dental community for innovative changes in the education of general dentists. One outcome of this process was a series of articles intended to raise awareness and stimulate dialogue about issues and forces shaping the future of dental education. Collectively, this series of articles is known as the Perspectives and Reflections in Dental Education (PRIDE) series to acknowledge the commitment of the academic dental community to reflect on current practices and future directions and also to represent the pride of dental school faculty members in their educational responsibilities and accomplishments.

A recent clinical trial (Obstetrics and Periodontal Therapy [OPT] Study) demonstrated that periodontal therapy during pregnancy improved periodontal outcomes but failed to impact preterm birth. The present study evaluated seven target bacteria, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia (previously T. forsythensis), Prevotella intermedia, Campylobacter rectus, and Fusobacterium nucleatum, in subgingival dental plaque of pregnant women in the OPT Study and their association with birth outcomes.Pregnant women were randomly assigned to receive periodontal treatment before 21 weeks' gestation or after delivery. Subgingival plaque was sampled at baseline (13 to 16 weeks; 6 days of gestation) and at 29 to 32 weeks. We analyzed subgingival plaque samples from women who experienced fetal loss, delivered a live preterm infant (preterm women), or delivered a full-term infant (full-term women). Samples were analyzed using quantitative polymerase chain reaction. Associations between preterm birth and bacterial counts and percentages were tested using multiple linear regression.No significant differences were observed at baseline between preterm and full-term women for any measured bacterial species or group of species, after accounting for multiple comparisons. Changes in bacterial counts and proportions during pregnancy also were not associated with birth outcomes. In full-term and preterm women, periodontal therapy significantly reduced (P0.01) counts of all target species except for A. actinomycetemcomitans.In pregnant women with periodontitis, non-surgical periodontal therapy significantly reduced levels of periodontal pathogens. Baseline levels of selected periodontal pathogens or changes in these bacteria resulting from therapy were not associated with preterm birth.

We have recently demonstrated that extracorporeal shock-wave therapy (ESWT) is effective in promoting the healing of dermal wounds and in regenerating alveolar bone lost through periodontal disease. The objective of the present study was to determine any antibacterial effect of ESWT on oral bacteria. Monoculture suspensions of 6 bacterial species were treated with 100 to 500 pulses of ESWT at energy flux densities (EFD) of 0.12 mJ/mm2, 0.22 mJ/mm2, and 0.3 mJ/mm2. Following treatment, aliquots were plated for viability determination and compared with untreated controls. ESWT showed a significant microbicidal effect for Streptococcus mutans and an unencapsulated strain of Porphyromonas gingivalis following as few as 100 pulses at 0.3 mJ/mm2 (p ≤ 0.001). In addition, a significant disruption of bacterial aggregates was observed at lower EFDs. No significant reduction in viability was observed for all other bacteria at EFDs and pulses tested (p > 0.05). These findings suggest that low-energy ESWT may be bactericidal for selected oral bacteria.

Background and Objective: Dietary manipulation, including caloric restriction, has been shown to impact host response capabilities significantly, particularly in association with aging. This investigation compared systemic inflammatory and immune-response molecules in rhesus monkeys (Macaca mulatta). Material and Methods: Monkeys on continuous long-term calorie-restricted diets and a matched group of animals on a control ad libitum diet, were examined for systemic response profiles including the effects of both gender and aging. Results: The results demonstrated that haptoglobin and α1-antiglycoprotein levels were elevated in the serum of male monkeys. Serum IgG responses to Campylobacter rectus, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were significantly elevated in female monkeys. While only the antibody to Fusobacterium nucleatum was significantly affected by the calorie-restricted diet in female monkeys, antibody levels to Prevotella intermedia, C. rectus and Treponema denticola demonstrated a similar trend. Conclusion: In this investigation, only certain serum antibody levels were influenced by the age of male animals, which was seemingly related to increasing clinical disease in this gender. More generally, analytes were modulated by gender and/or diet in this oral model system of mucosal microbial challenge.

Low-calorie diets are commonplace for reducing body weight. However, no information is available on the effects of a reduced-calorie diet on periodontal inflammation and disease. The purpose of this study was to evaluate the clinical effects of a long-term calorie-restriction (CR) diet on periodontitis in an animal model of periodontitis.Periodontitis was induced in 55 young, healthy, adult rhesus monkeys (Macaca mulatta) by tying 2.0 silk ligatures at the gingival margins of maxillary premolar/molar teeth. Animals on a CR diet (30% CR; N = 23) were compared to ad libitum diet controls (N = 32). Clinical measures, including the plaque index (PI), probing depth (PD), clinical attachment level (CAL), modified gingival index (GI), and bleeding on probing (BOP) were recorded at baseline and 1, 2, and 3 months after ligature placement.Significant effects of CR were observed on the development of inflammation and the progression of periodontal destruction in this model. Compared to controls, CR resulted in a significant reduction in ligature-induced GI (P0.0001), BOP (P0.0015), PD (P0.0016), and CAL (P0.0038). Periodontal destruction, as measured by CAL, progressed significantly more slowly in the CR animals than in the controls (P0.001).These clinical findings are consistent with available evidence that CR has anti-inflammatory effects. Moreover, these experimental findings are the first observations, to the best of our knowledge, that CR dampens the inflammatory response and reduces active periodontal breakdown associated with an acute microbial challenge.

Quantitative PCR (qPCR) has recently been used to quantify microorganisms in complex communities, includ- ing dental plaque biofilms. However, there is variability in the qPCR protocols being used. This study was designed to evaluate the validity of two of these variables with the intent of developing a more standardized qPCR protocol. The two variables evaluated were (1) the use of DNA content versus actual cell counts to estimate bacterial numbers in mixed plaque samples and (2) the effectiveness of three different universal primers versus species specific primers in amplifying specific target pathogens in these samples. Results lead to the development of a standardized protocol that was shown to be highly reproducible as demonstrated by low coefficients of variation. The results also confirmed that this standardized qPCR protocol can be used as a sensitive method for quantifying specific bacterial species in human plaque samples. Key Word: qPCR, oral bacteria, biofilms.

Intercultural competence is an important component of the doctor-patient relationship in the multicultural climate evolving in the United States. We hypothesized that 1) exposure to racial and ethnic diversity in the student body, faculty, staff, and patient population in dental school and 2) a dental school curriculum that includes presentations on issues concerning racial and ethnic diversity will contribute to students9 feeling more competent and confident to enter the multicultural work environment that is rapidly developing in the United States. A Likert-type scale questionnaire was administered to 627 fourth-year dental students enrolled in seven dental schools representing geographically diverse regions of the United States. Of these, 376 questionnaires were returned for a response rate of 60 percent. Results indicated that both the perception of diversity in the school environment and the presentation of diversity-specific content in the curriculum had moderately positive and significant correlations with the students9 perception of their competency or ability to serve and work with diverse populations. The respective Pearson correlation coefficients for diversity in the school environment and diversity curriculum were .497 (p

Weber's "Institutional Ethics Audit" model was designed as a tool for assessment of an organization's effort to institutionalize ethics into its operations. In this model, the overall ethical environment of an organization is evaluated through an assessment of its 1) ethical cultures, 2) ethics policy, 3) enforcement mechanisms, and 4) ethical training. Assessment of these components allows the organization to be placed along a continuum that spans aethical firms, compliance firms, emerging firms, and integrity firms. This paper presents the conceptual framework for this model. We propose that application of this model to academic institutions, including dental schools, could provide appropriate information to improve the ethical climate of the institution.

Recent dental school surveys have indicated a slight decrease in the overall number of dental school applicants. As a result, competition for the most highly qualified students is increasing among dental schools. A number of factors may contribute to an applicant9s decision on where to matriculate, such as tuition costs, cost of living in an area, location of the dental school, reputation, availability of financial aid, and the school9s facilities. Identifying the reasons why students choose to attend a specific school may be an important first step in formulating a strategic plan for recruitment. As a result, a survey was sent to all students (250) interviewed at the University of Pittsburgh School of Dental Medicine for the 2000-01 admissions cycle. The results of this survey were compared to a similar survey sent following the 1994-95 admissions cycle. In addition, the results of the University of Pittsburgh surveys were compared to a similar survey conducted by a different northeastern dental school. The factors rated most important in 1994-95 were reputation, facilities, and location, in order. In 2000-01, location, curriculum, tuition, and reputation were rated the most important factors, in order. This information may assist admissions officers in formulating an effective recruitment strategy for the most highly qualified applicants.

Nine contiguous genes encoding a potential type IV secretion system have been identified in the chromosome of Actinobacillus actinomycetemcomitans strain VT747 and on a plasmid (pVT745) in strain VT745. Seven of these genes encode predicted proteins that share significant homology with type IV secretion proteins in Bordetella pertussis (ptl operon), Brucella melitensis biovar suis and Agrobacterium tumefaciens (virB operons), where they are involved in protein secretion, pathogen intracellular survival and multiplication, and DNA transport, respectively. Results of previous studies have demonstrated that pVT745 is a conjugative plasmid and that a secondary plasmid, pMMB67, can be mobilized from strain VT745. Given these results, it was hypothesized that (1) the type IV secretion genes on pVT745 are responsible for these two functions and (2) the type IV VT747 chromosomal genes also play a role in the transport of DNA. Wild-type and mutant strains of VT745 were evaluated for their conjugative abilities. Wild-type mating efficiency was 10(-6) transconjugants per donor, while the mutant strain yielded no transconjugants. Wild-type VT745 harbouring a co-resident plasmid, pMMB67, mobilized pMMB67 at a frequency of 10(-6), while VT747 was unable to mobilize this plasmid. These results support the hypothesis that the plasmid-encoded type IV secretion system on pVT745 is involved in DNA transport. However, the chromosomally encoded secretion system may not play a role in DNA transport in strain VT747. While the precise function of these chromosomal genes in strain VT747 has not been determined, Northern blot analyses demonstrated that these genes are expressed in both ACT: actinomycetemcomitans strains VT745 and VT747.

A 25.1-kb plasmid, pVT745, was isolated from Actinobacillus actinomycetemcomitans strain VT745. This plasmid hybridized under stringent conditions to chromosomal DNA from 15 A. actinomycetemcomitans isolates obtained from geographically diverse regions of the United States. Southern blot analyses of HincII-digested A. actinomycetemcomitans genomic DNA revealed five strain-specific patterns of hybridization, which clearly indicated that intact pVT745 was not inserted into any of the genomes. Plasmid pVT745 was digested with BamHI and PstI into three, non-overlapping fragments of approximately 7.0, 8.0, and 10.0 kb. The fragments were cloned in Escherichia coli on the low copy number vector pGB2. Although these three fragments exhibited no cross-hybridization, genomic DNA from isolates representing each of the strain-specific patterns hybridized with two or three of the cloned fragments. The results suggest that two or more unique sequences within pVT745 also may be present in genomic DNA obtained from various strains of A. actinomycetemcomitans.

Anin vitromodel of bacterial biofilms on rigid gas-permeable contact lenses (RGPLs) was developed to challenge oral epithelial cells. This novel model provided seminal data on oral biofilm-host cell interactions, and with selected bacteria, the biofilms were more effective than their planktonic counterparts at stimulating host cell responses.

Over the past two decades, interest in dentistry in the United States has shown a steady period of growth. There were 12,210 individuals who applied to the 2009 entering class of U.S. dental schools. The number of first-time enrollees was 4,871, the highest figure since 1990. Men continue to comprise the majority of applicants and enrollees; however, the percentages of women continue to increase. While the 2009 underrepresented minority applicants comprised 12 percent of both the applicant and first-time enrollee pools, the percentage of underrepresented minority enrollees of underrepresented minority applicants decreased from 2008. Seventy-one percent of enrollees earned a baccalaureate degree in biological science or chemistry/physical science. Regardless of major fields of study, the percent rates of enrollment generally exceeded 32 percent.

Oral bacterial biofilms trigger chronic inflammatory responses in the host that can result in the tissue destructive events of periodontitis. However, the characteristics of the capacity of specific host cell types to respond to these biofilms remain ill-defined. This report describes the use of a novel model of bacterial biofilms to stimulate oral epithelial cells and profile select cytokines and chemokines that contribute to the local inflammatory environment in the periodontium. Monoinfection biofilms were developed with Streptococcus sanguinis, Streptococcus oralis, Streptococcus gordonii, Actinomyces naeslundii, Fusobacterium nucleatum, and Porphyromonas gingivalis on rigid gas-permeable contact lenses. Biofilms, as well as planktonic cultures of these same bacterial species, were incubated under anaerobic conditions with a human oral epithelial cell line, OKF4, for up to 24 h. Gro-1α, IL1α, IL-6, IL-8, TGFα, Fractalkine, MIP-1α, and IP-10 were shown to be produced in response to a range of the planktonic or biofilm forms of these species. P. gingivalis biofilms significantly inhibited the production of all of these cytokines and chemokines, except MIP-1α. Generally, the biofilms of all species inhibited Gro-1α, TGFα, and Fractalkine production, while F. nucleatum biofilms stimulated significant increases in IL-1α, IL-6, IL-8, and IP-10. A. naeslundii biofilms induced elevated levels of IL-6, IL-8 and IP-10. The oral streptococcal species in biofilms or planktonic forms were poor stimulants for any of these mediators from the epithelial cells. The results of these studies demonstrate that oral bacteria in biofilms elicit a substantially different profile of responses compared to planktonic bacteria of the same species. Moreover, certain oral species are highly stimulatory when in biofilms and interact with host cell receptors to trigger pathways of responses that appear quite divergent from individual bacteria.

Liaison teams have been developed in order to ensure that national initiatives identified in the American Dental Education Association's Commission on Change and Innovation (ADEA CCI) are implemented at the level of individual schools. Teams of four faculty members each have been identified at 43 United States and Canadian schools. These teams receive training at ADEA annual meeting and at summer institutes. Representative projects from three schools are described.

In this reflection article, Dr. Karen Novak, a mid-career faculty member at a U.S. dental school, identifies important messages and insights she gained from a series of twenty-one articles about the future of dental education published in the Journal of Dental Education from October 2005 to February 2009. This article addresses four questions: 1) What influence have these articles had on an academic dentist's perspectives about her role and priorities as a dental school faculty member and her own career plans and future directions? 2) What are the key messages in these articles for other dental educators who are at similar places in their careers? 3) What additional topics concerning the future of academic dentistry should be covered in future articles? and 4) What issues and priorities should receive the most attention from academic dentistry in the next decade? The American Dental Education Association's Commission on Change and Innovation in Dental Education (ADEA CCI) was established to provide a mechanism for stakeholders in academic dentistry to meet and consider future directions in the education of the nation's dental workforce. Along with ADEA, these stakeholders included dental schools, the American Dental Association (ADA) Board of Trustees, the Commission on Dental Accreditation (CODA), the ADA Council on Dental Education and Licensure (CDEL), the Joint Commission on National Dental Examinations (JCNDE), the dental licensure community, the ADA Foundation, and advanced dental education programs. The ADEA CCI was created to build consensus within the dental community for innovative changes in the education of general dentists. One outcome of this process was a series of articles intended to raise awareness and stimulate dialogue about issues and forces shaping the future of dental education. Collectively, this series of articles is known as the Perspectives and Reflections in Dental Education (PRIDE) series to acknowledge the commitment of the academic dental community to reflect on current practices and future directions and also to represent the pride of dental school faculty members in their educational responsibilities and accomplishments.

Dietary caloric restriction (CR) has been found to reduce systemic markers of inflammation and may attenuate the effects of chronic inflammatory conditions. The purpose of this study was to examine the effects of long-term CR on naturally occurring chronic inflammatory periodontal disease in a nonhuman primate model.The effects of long-term CR on extent and severity of naturally occurring chronic periodontal disease, local inflammatory and immune responses, and periodontal microbiology, were evaluated in a cohort of 81 (35 female and 46 male; 13-40 y of age) rhesus monkeys (Macaca mulatta) with no previous exposure to routine oral hygiene. CR monkeys had been subjected to 30% CR for 13-17 y relative to control-fed (CON) animals starting at 3-5 y of age.Same sex CR and CON monkeys exhibited similar levels of plaque, calculus, and bleeding on probing. Among CON animals, males showed significantly greater periodontal breakdown, as reflected by higher mean clinical attachment level and periodontal probing depth scores, than females. CR males exhibited significantly less periodontal pocketing, lower IgG antibody response, and lower IL-8 and ss-glucuronidase levels compared to CON males, whereas CR females showed a lower IgG antibody response but comparable clinical parameters and inflammatory marker levels relative to CON females. Long-term CR had no demonstrable effect on the periodontal microbiota.Males demonstrated greater risk for naturally occurring periodontal disease than females. Long-term CR may differentially reduce the production of local inflammatory mediators and risk for inflammatory periodontal disease among males but not females.

Until recently many physicians in the United States including obstetrician gynecologists have been relatively unconcerned with oral health. During most physical examinations, the oral cavity is given only a rudimentary examination. With the recognition of the oral-systemic health care link, physicians have been keenly interested in the findings from their dental colleagues in periodontal medicine which have convincingly linked periodontal disease with such diverse systemic health complications as aging, Alzheimer disease, cardiovascular disease, diabetes, and also pregnancy complications including low birth weight, preterm delivery, preeclampsia, and early pregnancy loss. Intervention trials designed to improve oral health during pregnancy have proven to be safe; however, the outcomes have been inconsistent. Further studies will be required to determine the nature of the association and the optimal timing and efficacy of intervention.

Objectives: The authors hypothesized that women with a history of gestational diabetes mellitus (GDM) during pregnancy would exhibit more severe periodontal disease than controls without a history of diabetes during pregnancy. Methods: Data from NHANES III provided information for 4,244 women ages 20–59. One hundred and thirteen had a history of GDM (GDM+), while 4,131 had no history of diabetes before or during their pregnancies (GDM-). Women were further classified by the presence or absence of diabetes mellitus (DM+ or OM-) at the time of their NHANES 111 examination. Periodontal disease (PO) was defined as one or more teeth with one or more sites with probing depth ≤4mm, loss of affachment ≤2mm, and bleeding on probing. Results: The PD prevalence among women who were GDM+DM- was 9.0% and 4.8% for those who were GDM-DM-. PD prevalence for women who were GDM+DM+ was 30.5% and 11.6% for GDM-DM+ subjects, respectively. A logistic regression model, controlling for age, calculus, smoking, and income estimated women who were GDM+DM+ were more likely to have periodontal disease than women who were GDM-DM- and women who were GDM-DM+. The GDM+DM- group also tended to be more likely to have PD than the GDM-DM- and GDM-DM+ groups. However, the odds ratios were not statistically significant. Conclusions: These results support the hypothesis that women with gestational diabetes mellitus (GDM) during pregnancy may be at greater risk for developing more severe periodontal disease than pregnant women without GDM.

The purpose of this study was to characterize the patient population utilization of a dental home as grouped by: (1) age; (2) sex; and (3) payment method.A retrospective chart review of 1,020 patients, who initially presented for an emergency visit, was performed. From the original data pool, 2 groups were delineated: (1) those patients who returned for comprehensive dental care; and (2) those who did not return for comprehensive dental care.Patients with private dental insurance or Medicaid dental benefits were statistically more likely to return for comprehensive oral health care than those with no form of dental insurance. Younger patients (or =3 years of age) were least likely to return for comprehensive dental care.Socioeconomic factors play a crucial role in care-seeking behaviors. These obstacles are often a barrier to preventive and comprehensive oral health care.

Intercultural competence is an important component of the doctor-patient relationship in the multicultural climate evolving in the United States. We hypothesized that 1) exposure to racial and ethnic diversity in the student body, faculty, staff, and patient population in dental school and 2) a dental school curriculum that includes presentations on issues concerning racial and ethnic diversity will contribute to students' feeling more competent and confident to enter the multicultural work environment that is rapidly developing in the United States. A Likert-type scale questionnaire was administered to 627 fourth-year dental students enrolled in seven dental schools representing geographically diverse regions of the United States. Of these, 376 questionnaires were returned for a response rate of 60 percent. Results indicated that both the perception of diversity in the school environment and the presentation of diversity-specific content in the curriculum had moderately positive and significant correlations with the students' perception of their competency or ability to serve and work with diverse populations. The respective Pearson correlation coefficients for diversity in the school environment and diversity curriculum were .497 (p.001) and .459 (p.001). These results support the hypotheses that diversity exposure and training in the dental school environment are important for dental students entering a multicultural workplace.

Weber's "Institutional Ethics Audit" model was designed as a tool for assessment of an organization's effort to institutionalize ethics into its operations. In this model, the overall ethical environment of an organization is evaluated through an assessment of its 1) ethical cultures, 2) ethics policy, 3) enforcement mechanisms, and 4) ethical training. Assessment of these components allows the organization to be placed along a continuum that spans aethical firms, compliance firms, emerging firms, and integrity firms. This paper presents the conceptual framework for this model. We propose that application of this model to academic institutions, including dental schools, could provide appropriate information to improve the ethical climate of the institution.

Recent dental school surveys have indicated a slight decrease in the overall number of dental school applicants. As a result, competition for the most highly qualified students is increasing among dental schools. A number of factors may contribute to an applicant's decision on where to matriculate, such as tuition costs, cost of living in an area, location of the dental school, reputation, availability of financial aid, and the school's facilities. Identifying the reasons why students choose to attend a specific school may be an important first step in formulating a strategic plan for recruitment. As a result, a survey was sent to all students (250) interviewed at the University of Pittsburgh School of Dental Medicine for the 2000-01 admissions cycle. The results of this survey were compared to a similar survey sent following the 1994-95 admissions cycle. In addition, the results of the University of Pittsburgh surveys were compared to a similar survey conducted by a different northeastern dental school. The factors rated most important in 1994-95 were reputation, facilities, and location, in order. In 2000-01, location, curriculum, tuition, and reputation were rated the most important factors, in order. This information may assist admissions officers in formulating an effective recruitment strategy for the most highly qualified applicants.

Results of Southern blot analyses and polymerase chain reaction revealed that the Gram-negative pathogen, Actinobacillus actinomycetemcomitans, harbored DNA homologous to the secA gene of Escherichia coli. In E. coli, the secA gene product is essential for translocation of proteins across the inner membrane via the Sec system. This A. actinomycetemcomitans secA homolog was cloned and its nucleotide sequence determined. Amino acid sequence analysis of the cloned gene revealed significant homology to the SecA pro- teins of Haemophilus influenzae, E. coli, Caulobacter crescentus and Bacillus subtilis. Although the cloned gene did not complement a temperature sensitive mutation in the E. coli secA gene, strains harboring the cloned gene did produce a protein that cross-reacted with anti-SecA antibody. In addition, the cloned gene did restore sensitivity to sodium azide in an E. coli azideR mutant. These data support the hypothesis that A. actinomycetemcomitans may use a system similar to the Sec system of E. coli to transport proteins across the cytoplasmic membrane, but suggest that the A. actinomycetemcomitans gene product may require gen- era-specific Sec proteins to complement some Sec mutations in E. coli.

expression of OLFM4, Muc1, Muc2 and IL8 was measured by quantitative RT-PCR in 200 ileal and colonic biopsies of patients with active/inactive IBD and controls. OLFM4 immunostaining was performed in formalin fixed or carnoy-fixed and paraffin-embedded tissue. The mRNA levels of the major antimicrobial peptides in mice (Cryptidin-1, mBD1, mBD2), as well as mMuc1 and mMuc2 were measured in OLFM4 knock-out mice compared to wild type controls. The effect of bacterial stimulation with different apathogenic bacteria on OLFM4 expression was determined using the mucin producing colon carcinoma cell line LS174T in the presence and absence of DBZ, a gamma-secretase inhibitor blocking the Notch pathway.Results:As expected, IL8 expressionwas significantly augmented in inflamed biopsies with comparable levels in the active IBD subgroups. OLFM4 mRNAwas significantly induced in colonic inflamed vs. noninflamed Crohn′s disease (CD, 3.6-fold, p 0.0001) and colonic (2.3-fold, p