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Introduction: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs)., Methods: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05)., Results: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses., Conclusions: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success., (Copyright© 2024 Dennis Barber Ltd.)

We aimed to characterize the association between air pollutants exposure and periodontal diseases outpatient visits and to explore the interactions between ambient air pollutants and meteorological factors. The outpatient visits data of several large stomatological and general hospitals in Hefei during 2015-2020 were collected to explore the relationship between daily air pollutants exposure and periodontal diseases by combining Poisson's generalized linear model (GLMs) and distributed lag nonlinear model (DLNMs). Subgroup analysis was performed to identify the vulnerability of different populations to air pollutants exposure. The interaction between air pollutants and meteorological factors was verified in both multiplicative and additive interaction models. An interquartile range (IQR) increased in nitrogen dioxide (NO 2 ) concentration was associated with the greatest lag-specific relative risk (RR) of gingivitis at lag 3 days (RR = 1.087, 95% CI 1.008-1.173). Fine particulate matter (PM 2.5 ) exposure also increased the risk of periodontitis at the day of exposure (RR = 1.049, 95% CI 1.004-1.096). Elderly patients with gingivitis and periodontitis were both vulnerable to PM 2.5 exposure. The interaction analyses showed that exposure to high levels of NO 2 at low temperatures was related to an increased risk of gingivitis, while exposure to high levels of NO 2 and PM 2.5 may also increase the risk of gingivitis and periodontitis in the high-humidity environment, respectively. This study supported that NO 2 and PM 2.5 exposure increased the risk of gingivitis and periodontitis outpatient visits, respectively. Besides, the adverse effects of air pollutants exposure on periodontal diseases may vary depending on ambient temperature and humidity., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases., Methods: This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters., Results: 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [- 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters., Conclusions: The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

Nowadays, air pollution which is dominated by fine particulate matter with aerodynamic diameter less than or equal to 2.5 µm resulting from rapid industrialization and urbanization combined with population explosion has become more and more severe problem to mankind and the whole planet because of its diversity of deleterious effects. The latest data estimated that exposure to fine particulate matter, or PM2.5, contributes to approximately 4 million deaths worldwide due to cardiopulmonary conditions such as heart disease and stroke, respiratory infections, chronic lung disease and lung cancer. During recent years, there has been growing concern about the adverse effects of this global threat on oral health which is one of key components of general health and quality of life. Although a few studies have reported such possible association, the findings are still far from conclusion. Moreover, the underlying mechanisms remain unclear. To our knowledge, the analysis of literature regarding this scope has yet been published. Thus, current work systematically assesses existing evidences on the potential association between exposure to PM2.5 and the development of various oral diseases as well as figures out the plausible paradigm of PM2.5-induced damages in the oral cavity through its toxic chemical constituents along with its ability to induce oxidative stress via reactive oxygen species production. This might partially provide the clues for new research ideas and progression in the field of oral health., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Tobacco practice in relation with oral diseases is a foremost cause for the global oral disease burden and is accountable for up to 50% of all periodontitis cases among adults. The present cross-sectional study was undertaken to evaluate the local effects of various types of smokeless tobacco on periodontal health in tobacco pouch keratosis (TPK) patients in Mangalore city in the state of Karnataka., Materials and Methods: A total of 345 TPK patients were evaluated of which all were smokeless tobacco users. All the patients were clinically examined for different clinical periodontal parameters such as stains, gingival recession (GR), periodontal pocket, furcation involvement, and mobility and local effects of various types of smokeless tobacco on periodontal health in TPK sites were recorded., Results: The prevalence of GR was of 87.5%. Haathichaap was the most common smokeless tobacco used (35.9%) closely followed by nonpackaged type (loose tobacco) (19.4%). This was followed by Madhu (14.2%). Likewise, periodontal parameters were observed more in these patients in decreasing order., Conclusion: The results of the present study agree strongly with other smokeless tobacco user studies in terms of the strong association between GR and smokeless tobacco placement. The present cross-sectional study indicates that TPK lesions are positively associated with periodontal diseases. It is important to raise awareness of both oral cancer and periodontal risks and inform about its possible health consequences thereby working towards an improvement of oral and general health and related quality of life in these patients., Competing Interests: None

Background: In order to identify potential activities against periodontal diseases, eighteen dihydrochalcones and structurally related compounds were tested in an established biological in vitro cell model of periodontal inflammation using human gingival fibroblasts (HGF-1 cells). Methods: Subsequently to co-incubation of HGF-1 cells with a bacterial endotoxin ( Porphyromonas gingivalis lipopolysaccharide, pg LPS) and each individual dihydrochalcone in a concentration range of 1 µM to 100 µM, gene expression of interleukin-8 (IL-8) was determined by qPCR and cellular interleukin-8 (IL-8) release by ELISA. Results : Structure-activity analysis based on the dihydrochalcone backbone and various substitution patterns at its aromatic ring revealed moieties 2',4,4',6'-tetrahydroxy 3-methoxydihydrochalcone ( 7 ) to be the most effective anti-inflammatory compound, reducing the pg LPS-induced IL-8 release concentration between 1 µM and 100 µM up to 94%. In general, a 2,4,6-trihydroxy substitution at the A-ring and concomitant vanilloyl (4-hydroxy-3-methoxy) pattern at the B-ring revealed to be preferable for IL-8 release inhibition. Furthermore, the introduction of an electronegative atom in the A,B-linker chain led to an increased anti-inflammatory activity, shown by the potency of 4-hydroxybenzoic acid N -vanillylamide ( 13 ). Conclusions: Our data may be feasible to be used for further lead structure designs for the development of potent anti-inflammatory additives in oral care products.

Purpose: Crevicular fluid was used to assess interleukin-17 (IL-17) and vascular endothelial growth factor (VEGF) in cancer patients receiving zoledronic acid and/or bevacizumab. The markers were also assessed in the serum., Methods: Twenty-five patients were included and comprised three groups: patients who received zoledronic acid (n = 9), patients who received bevacizumab (n = 9), and patients who received zoledronic acid combined with bevacizumab (n = 5). One patient received zoledronic acid and everolimus and another received zoledronic acid, bevacizumab, and temsirolimus. IL-17 and VEGF were measured by standard quantitative ELISA kits and assessed in two study points., Results: Twenty-four patients maintained good periodontal health; one had asymptomatic osteonecrosis of the jaw. First assessment: 44 samples were collected; 21 from serum and 23 from crevicular fluid. Second assessment, 6 months later: 11 samples were collected; 6 from serum and 5 from crevicular fluid. IL-17 was detected in all samples, in serum and crevicular fluid, and remained unchanged at both time points. Serum VEGF in patients with bevacizumab alone or combined with zoledronic acid was significantly lower compared with that of patients who received zoledronic acid alone. VEGF was not detected in the crevicular fluid., Conclusions: Crevicular fluid might be an easy, non-invasive means to assess IL-17. The stable values of IL-17 in crevicular fluid and serum and the lack of VEGF in the crevicular fluid could be related to the good periodontal health of our patients. Further studies are needed to assess IL-17 and VEGF in the crevicular fluid in patients with and without periodontal disease.

Background/aim: Microbial tetracycline (TC) pastes have been employed to treat oral bacterial infection. In the present study, we investigated the kinetic radical-scavenging and pro-/anti-inflammatory activity of TC with or without visible light irradiation (VLI)., Materials and Methods: The radical-scavenging activity of TC and minocycline (MC) was determined by differential scanning calorimetry (DSC). The stoichiometric factor (n) and the rate constant of inhibition and propagation (k inh /k p ) were determined. The levels of cyclooxygenase-2 (Cox2), tumor necrosis factor-α (Tnfα) or nitric oxide synthase 2 (Nos2) mRNA in RAW264.7 cells stimulated with lipopolysaccharide (LPS) were investigated using real-time reverse transcriptase-polymerase chain reaction., Results: The n and k inh /k p values for 1 mM TC in 2,2'-azobisisobutyronitrile and benzoyl peroxide systems were 0.1-0.2 and 119-250, respectively, whereas the corresponding values for quercetin (QU) and resveratrol (RE) were 2-4 and 7-15, respectively. In RAW264.7 cells stimulated with LPS, Cox2 and Tnfα mRNA were over-expressed in the presence of TC. MC down-regulated only the expression of Cox2 by about 50% in LPS-stimulated cells. The anti-inflammatory activity determined on the basis of Cox2 inhibition declined in the order QU>RE>MC>TC. Upon application of VLI, only TC down-regulated the expression of LPS-stimulated Cox2 and Tnfα mRNA. After exposure to VLI, TC, but not MC, markedly up-regulated hemoxygenase-1 (Ho-1) expression., Conclusion: TC is a chain-breaking antioxidant with a large k inh Upon activation by VLI, TC may undergo degradation and its degradation products affect pleiotropic mediators such as Cox2, Tnfα and Ho-1. TC may be useful as a local photodynamic therapy for periodontal diseases., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Purpose: To determine the prevalence of professionally reported oral side effects of chemotherapy and the self-reported oral side effects and whether both prevalences could be related to the periodontal risk of the patients., Methods: A cross-sectional study with patients undergoing chemotherapy treatment was carried out. Demographic, oral hygiene habits, and cancer-related data were collected while the patient was receiving the chemotherapy infusion. Patient's oral status, measured according to the oral-assessment guide for patients in hospital environments, patient-related outcomes (PROMs), measured by a visual analogue scale, and patient's periodontal risk were analyzed using validated questionnaires. Data was reported in means and standard deviations (SD) in quantitative variables and in counts, prevalence, and 95% confidence intervals (CI) in qualitative variables. ANOVA test and chi-squared tests were used to compare oral side effects among different periodontal risk groups., Results: Three hundred sixty-nine patients were included in the study. The prevalence of professionally reported oral side effects was 86.99% (95% confidence interval CI 83.54%; 90.44%). The prevalence of self-reported oral side effects was 89.70% (95% CI 86.59; 92.82). The most common oral side effects were xerostomia (73.4%), dysgeusia (61.8%), and dry lips (54.2%). More oral alterations were found in patients with worse periodontal risk (p < 0.001)., Conclusions: The prevalence of oral side effects (professional or self-reported) is higher than 85% in patients undergoing chemotherapy. This prevalence increases as the risk of developing periodontal disease does.

Background: Oral contraceptives pills (OCPs) are common and a convenient form of contraception. The use of hormonal contraceptives by women has been considered to influence gingival and periodontal disease progression., Aim: This study was conducted to assess the effect of oral contraceptive pills on the periodontal health., Materials and Method: A cross-sectional comparative study was conducted among 200 females aged 18 years and above of Jaipur city. The study subjects were divided into two groups i.e. contraceptive users and non-contraceptive users, each group consisted 100 females. Data was collected using Modified WHO Performa (1997). Periodontal status was examined using Community Periodontal Index (CPI) and Loss of Attachment (LOA). Chi-square test and one sample t-test was used for statistical analysis and P value was set (p< 0.05) as significant., Results: Mean CPI score in subjects and non-contraceptive users was 2.34+ 0.81 and 1.16+ 0.89 respectively. Mean LOA score in each group was 0.28+ 0.45 and 0.19+ 0.50 respectively., Conclusion: Oral Contraceptive pills had adverse effects on periodontal health.

Periodontitis, an inflammatory disease of the gingival tissue, triggered by microbial-derived elements, such as lipopolysaccharide (LPS), collapses the periodontal tissues and resorbs the alveolar bone. This study evaluated the inhibitory effects of standardized Boesenbergia pandurata extract (BPE) and panduratin A (PAN) on periodontitis-induced inflammation and alveolar bone loss. Sprague-Dawley rats with LPS-induced periodontitis were orally administered BPE (50 and 200 mg/kg/day) and PAN (20 mg/kg/day) for 8 days. Histological analysis revealed that BPE- and PAN-administered groups showed decreased cell infiltration and alveolar bone resorption. Furthermore, the BPE and PAN significantly alleviated the mRNA and protein expression levels of nuclear factor kappa B (NF-κB), interleukin-1β, matrix metalloproteinase (MMP)-2, and MMP-8. BPE and PAN also inhibited the expression of nuclear factor of activated T cells, cytoplasmic 1, c-Fos, and ostoclastogenesis-related enzymes, including cathepsin K and tartrate-resistant acid phosphatase (ALP). BPE and PAN not only upregulated the osteoblastogenesis-associated markers, such as collagen type I (COL1A1) and ALP, but also increased the ratio of osteoprotegerin to receptor activator of NF-κB ligand. Collectively, BPE and PAN efficiently prevent destruction of periodontal tissues and stimulating the loss of alveolar bone tissues, strongly indicative of their potential as natural antiperiodontitis agents.

In the present study we have mimicked, in vitro, an inflammatory process using Lipopolysaccharide derived from Porphyromonas Gingivalis (LPS-G) and human Periodontal Ligament Stem Cells induced to endothelial differentiation (e-hPDLSCs). The research project has been organized into the three following steps: i) induction of hPDLSCs toward endothelial differentiation; ii) evaluation of the molecular signaling pathway involved in the response to the LPS-G, and iii) functional response evaluation of the living construct constituted by porcine decellularized valve/e-hPDLSCs treated with LPS-G. Obtained results showed that 5 μg/ml LPS-G stimulus provokes: a slowdown of cell growth starting from 24 hr and the release of IL6, IL8, and MCP1 molecules. Signaling network analyzed showed the activation of TLR4/ NFkB/ERK1/2/p-ERK1/2 signaling mediated by MyD88 in LPS-G stimulated e-hPDLSCs, moreover a time course put in evidence a nuclear traslocation of ERK1/2 and p-ERK1/2 in differentiated samples. Following, the ability of e-hPDLSCs to expand and colonize the decellularized porcine heart valves was appraised at ultrastructural level. Considering that, the Reactive Oxygen Species (ROS) play an important role in the progression and development of cardiovascular disease (CVD), in LPS-G living construct model e-hPDLSCs/decellularized porcine heart valves (dPHV), ROS production was assessed. Time lapse experiments evidenced that LPS-G provokes in e-hPDLSCs a rapid and sustained increase in ROS generation, negligible on undifferentiated cells. From obtained data, by multiparametric analyses, a reasonable conclusion may be that the inflammation process activated by LPS-G can affect endothelial cells and could represent in vivo a possible pathological and predictor state of CVD., (© 2018 Wiley Periodicals, Inc.)

The aim of this study was to evaluate the associations between cigarette use and five salivary oxidative stress biomarkers, copper-zinc superoxide dismutase (Cu/Zn SOD), manganese superoxide dismutase (MnSOD), catalase, thioredoxin-1 (TRX1), and peroxiredoxin-2 (PRX2), to assess the effectiveness of non-surgical periodontal therapy., Materials and Methods: This is an observational study,167 patients diagnosed with periodontitis were recruited. Both saliva samples and clinical measurements (plaque index (PI), bleeding on probing (BOP), and pocket depth (PD)) were taken at baseline and after completing non-surgical periodontal therapy. The Levels of salivary biomarkers were determined using a MILLIPLEX ® MAP Human Oxidative Stress Magnetic Bead Panel kit. The overall reductions in PI and BOP were 31.56% and 42.16%, respectively. BOP reduction after treatment in female or male non-smokers was significantly higher than in male former smokers (p < 0.05). After completing non-surgical periodontal therapy, Cu/ZnSOD, MnSOD, catalase, and Prx2 significantly decreased. There was a significant interaction between smoking status and ΔCu/ZnSOD on PI and a significant interaction between smoking status and ΔCatalase on BOP., Conclusions: Cigarette smoking interferes with redox homeostasis in the body, alters antioxidants levels, and influences the periodontal disease activity.

Objective: This study evaluated the effect of an experimental carcinogenic, 4-Nitroquinoline 1-oxide (4NQO), in the spontaneous alveolar bone loss (ABL) in an animal model., Design: Twenty-two male Wistar rats were included in this study. They were randomly divided into two groups: the control group (n = 10) received food and water ad libitum, and the test group (n = 12) receive the same food; however, 25 ppm of 4NQO was diluted in the drinking water. All animals were euthanized after 20 weeks, and the tongues were removed and analyzed macroscopically to determine the presence of oral mucosal lesions. All specimens were paraffin-embedded and histological sections were obtained. The microscopic analysis was based on routine procedure (haematoxylin and eosin stain). The analysis of spontaneous ABL was performed by a calibrated examiner using standardized photographs and imaging software. Differences in spontaneous ABL were assessed among the three resulting groups: control, 4NQO with oral squamous cell carcinoma (OSCC), and 4NQO without OSCC., Results: In the 4NQO-treated group, nine animals developed OSCC. The animals in the 4NQO with OSCC group presented significantly more spontaneous ABL (0.65 ± 0.21 mm) than the control group (0.34 ± 0.05) (p < 0.001). The animals in the 4NQO without OSCC group showed a mean spontaneous ABL of 0.47 ± 0.13 mm, which was not statistically significant different when compared to the control group (p = 0.096)., Conclusions: It was concluded that the presence of OSCC enhanced spontaneous ABL in Wistar rats when compared to control animals. Additionally, it was shown that, solely, administration of 4NQO may not be considered responsible for alveolar bone destruction., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Khat or qat (Catha edulis) is a plant that grows in East Africa and southern Arabia. The leaves and twigs of this small tree are chewed by several millions of people worldwide for their stimulating amphetamine-like effects. The reported prevalence of khat chewing in Europe and the USA is on the rise, especially with global migration. Long-term khat chewing has several detrimental general and oral health effects. The aim of the present study was to review the current literature regarding khat use and its association with oral and dental diseases, with particular emphasis on its link with oral keratotic white lesions and oral cancer. We searched the literature to identify all relevant articles. Studies showed that khat is associated with several oral and dental conditions, including keratotic white lesions, mucosal pigmentation, periodontal disease, tooth loss, plasma cell stomatitis, and xerostomia. There are limited data on the incidence of dental caries among khat chewers. The evidence that khat chewing is a risk factor for oral cancer is still weak, and is mainly based on anecdotal case reports and uncontrolled studies., (© 2017 John Wiley & Sons Australia, Ltd.)

E-cigarette-derived inhaled nicotine may contribute to the pathogenesis of periodontal and pulmonary diseases in particular via lung inflammation, injurious, and dysregulated repair responses. Nicotine is shown to have antiproliferative properties and affects fibroblasts in vitro, which may interfere in tissue myofibroblast differentiation in e-cig users. This will affect the ability to heal wounds by decreasing wound contraction. In periodontics, direct exposure to e-vapor has been shown to produce harmful effects in periodontal ligament and gingival fibroblasts in culture. This is due to the generation of reactive oxygen species/aldehydes/carbonyls from e-cig aerosol, leading to protein carbonylation of extracellular matrix and DNA adducts/damage. A limited number of studies regarding the effects of e-cig in oral and lung health are available. However, no reports are available to directly link the deleterious effects on e-cigs, inhaled nicotine, and flavorings aerosol on periodontal and pulmonary health in particular to identify the risk of oral diseases by e-cigarettes and nicotine aerosols. This mini-review summarizes the recent perspectives on e-cigarettes including inhaled nicotine effects on several pathophysiological events, such as oxidative stress, DNA damage, innate host response, inflammation, cellular senescence, profibrogenic and dysregulated repair, leading to lung remodeling, oral submucous fibrosis, and periodontal diseases., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Data sourcesMedline (PubMed), Embase, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases and a manual search of the Journal of Dental Research, Journal of Clinical Periodontology, Journal of Periodontology and the International Journal of Periodontics and Restorative Dentistry from January 2014 to February 2015.Study selectionProspective, retrospective, randomised or not, case-controlled or case series trials showing the incidence or recurrence of peri-implant disease plus or minus PIMT over more than six months.Data extraction and synthesisThree reviewers independently selected studies and abstracted data with two reviewers assessing study quality using the Newcastle-Ottawa Scale (NOS). A multivariate binomial regression was used to examine the data.ResultsThirteen studies were included with ten contributing to the meta-analysis. The average quality assessment score (NOS) was 5.3 out of a possible nine, only one paper achieved eight. At patient level mucositis ranged from 18.5-74.2% and peri-implantitis from 8-28%, with significant effects being seen for treatment (z= -14.36, p<0.001). Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. For peri-implantitis there were also significant effects of treatment (z = -16.63, p<0.001). Increased peri-implantitis was observed for patients with a history of periodontal disease. (z=3.76, p<0.001). Implants under PIMT have 0.958 the incident event compared to those with no PIMT.ConclusionsWithin the limitations of the present systematic review it can be concluded that implant therapy must not be limited to placement and restoration of dental implants, but to the implementation of PIMT to potentially prevent biological complications and heighten the long-term success rate. Although it must be tailored to a patients risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of five to six months. Additionally, it must be stressed that even in the establishment of PIMT, biological complications might occur. Hence, patient-, clinical-, and implant-related factors must be thoroughly explored.

The field of special care dentistry is rapidly gaining recognition as a service that should be provided to the persons with physical, mental or intellectual disabilities by general practitioner, pediatric or geriatric dentists as well as dental hygienists. Because the oral healthcare and dental treatments are given in the narrow space of oral cavity and also accompanying technical difficulties with high risk of injury, the special needs patients are treated under being controlled their behavior or body motion by applying psychological, physical or pharmacological techniques. Those persons also manifest specific oral signs and symptoms such as dental caries, periodontal diseases as well as high incidence of dental hypoplasia, oro-facial trauma or drug-induced gingival overgrowth. The children with developmental disorders especially such as autism spectrum disorder(ASD), attention-deficit/hyperactivity disorder(AD/HD), or specific learning disorder(LD), and those with medical care needs at all times are also increasing relatively in Japan with declining birthrate. Those children have specific dental problems and require the special oral healthcare. This article presents the current status of oral healthcare for the persons with special needs.

Waterpipe tobacco smoking (WTS, also known as hookah, shisha, narghile, and many other names) involves passing tobacco smoke through water prior to inhalation by the consumer. As the number of waterpipe smokers is rising rapidly, there is growing concern over the use of WTS, particularly as there has been a widely held misconception that WTS is free from health hazards. In reality, it is associated with a variety of adverse health outcomes on both a short- and long-term basis. Hence, it is desirable to develop advanced techniques for surveillance, intervention, and regulatory/policy frameworks specific to the production and use of waterpipe tobacco. This review is written to survey the types and extent of pollutants released from its use and their potential health risks. A review of the present regulation guidelines is also included., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Consumption of carbonated beverages was reported to be associated with obesity and other adverse health consequences. This study was performed to assess the relationship between the consumption of carbonated beverages and periodontal disease using nationally representative data.The data from the Korea National Health and Nutrition Examination Survey conducted between 2008 and 2010 were used; the analysis in this study was confined to a total of 5517 respondents >19 years old who had no missing values for the consumption of carbonated beverages or outcome variables. The community periodontal index greater than or equal to code 3 was defined as periodontal disease.The odds ratios of the percentage of individuals with periodontal treatment needs tended to increase with the consumption of carbonated beverages. Adjusted odds ratios and their 95% confidence intervals adjusted for various factors including age, sex, body mass index, smoking, drinking, exercise, metabolic syndrome, frequency of tooth brushing per day, use of secondary oral products, dental checkup within a year, consumption of coffee of the individuals with the consumption of carbonated beverages once or less per month, once or less per week and twice or more per week were 1.109(0.804,1.528), 1.404(1.035,1.906), and 1.466(1.059,2.029), respectively. A subgroup analysis revealed that in individuals with body mass index < 25 or waist circumference < 90 cm for males or < 80 cm for females, the prevalence of periodontal disease increased with higher consumption of carbonated beverages (P for trend < 0.05).Consumption of carbonated beverages was positively associated with the risk of periodontal disease in Korean adults. In a subgroup analysis, the individuals consuming carbonated beverages with body mass index < 25 or waist circumference < 90 cm for males or < 80 cm for females were more likely to have periodontal disease. Consumption of carbonated beverages may be considered to be an independent risk indicator for periodontal disease and periodontal health of nonobese individuals may benefit from reduction of carbonated beverage consumption.

Cigarette smoking is a major lifestyle-related risk factor for periodontal diseases. However, the pathophysiological role of cigarette smoking in periodontal disease has yet to be fully elucidated. Here we report that the systemic administration of cigarette smoke condensate or nicotine, which is the major ingredient of cigarette smoke, augmented alveolar bone loss. Concomitantly, the number of osteoclasts in periodontal tissues increased and the expression of receptor activator of nuclear factor κB ligand was upregulated at the ligated side in mice with periodontitis. Nicotine also attenuated alveolar bone repair after ligature removal. These observations highlight the destruction of periodontal tissue by smoking and the unfavorable clinical course of periodontal disease in patients with a cigarette smoking habit. The present study demonstrates that periodontal disease models are useful for elucidating the pathogenesis of cigarette smoking-related periodontal diseases.

Objective: The use of methamphetamine (MA), a highly addictive stimulant, is rapidly increasing, with MA being widely abused as the scene drug "Crystal Meth" (CM). CM has been associated with severe oral health effects, resulting in so-called "Meth mouth". This term appeared for the first time in 2005 in the literature and describes the final complex of symptoms including rampant caries, periodontal diseases and excessive tooth wear. The aim of this study was to investigate the effects of chronic CM abuse on teeth and intraoral tissue with respect to potential symptoms of Meth mouth., Materials and Methods: In cooperation with two centres for addiction medicine, we performed clinical intraoral investigations in 100 chronic CM users and 100 matched-pair controls. We undertook a caries and periodontal examination by using the clinical parameters DMF-T/DMF-S, bleeding on probing index (BOP) and periodontal screening index (PSI) and tested individual oral hygiene by using approximal space plaque index (API). All clinical data were analysed by the t test for independent samples., Results: We found significantly larger numbers of caries (p < 0.001) and higher levels of gingival bleeding (p < 0.001) and periodontal disease (p < 0.001) among CM users. Oral hygiene was significantly lower in CM users (p < 0.024)., Conclusion: Chronic CM use can lead to extensive potential damage within the intraoral cavity. When CM is used over a long period of time and in the absence of treatment, clinical symptoms in terms of Meth mouth syndrome cannot be excluded., Clinical Relevance: Based on our results, we recommend a specific prevention and therapeutic concept including educational campaigns for MA users and specialized dental care for CM patients.

Background: The authors used a large community sample of methamphetamine (MA) users to verify the patterns and severity of dental disease and establish a hierarchy of caries susceptibility by tooth type and tooth surface., Methods: Using a stratified sampling approach, 571 MA users received comprehensive oral examinations and psychosocial assessments. Three calibrated dentists characterized dental and periodontal disease by using National Health and Nutrition Examination Survey protocols. The authors also collected data on substance use history and other attributes linked to dental disease., Results: On all dental outcome measures, MA users evidenced high dental and periodontal disease, with older (≥ 30 years) and moderate or heavy MA users disproportionately affected. Women had higher rates of tooth loss and caries, as well as a greater prevalence of anterior caries. Current cigarette smokers were more likely to manifest 5 or more anterior surfaces with untreated caries and 3 or more teeth with root caries. Nearly 3% were edentulous, and a significant percentage (40%) indicated embarrassment with their dental appearance., Conclusions: MA users have high rates of dental and periodontal disease and manifest a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease. Women and current cigarette smokers are affected disproportionately. The intraoral patterns and hierarchy of caries susceptibility in MA users are distinctive., Practical Implications: The prevalence and patterns of dental and periodontal disease could be used to alert dentists to possible covert MA use and to plan treatment. Concerns about dental appearance have potential as triggers for behavioral interventions., (Copyright © 2015 American Dental Association. All rights reserved.)

Background: The aim of this study was to assess the effects of chronic alcohol consumption on periodontitis development in rats., Methods: Periodontal disease was experimentally induced by lipopolysaccharide (LPS; 2 mg/ml) injections into the gingival tissue around first upper and lower molar's neck, and into the interdental space between first and second molars. This protocol was repeated for 6 weeks on days 1, 3, and 5 of each week. Chronic alcohol consumption was induced by 20% ethanol (EtOH) as the only liquid source during 4 months., Results: Chronic alcohol consumption by itself increased alveolar bone loss and biological mediators of periodontal disease such as prostaglandin E2 (PGE2 ) content on gingival tissue, and inducible nitric oxide synthase activity plus PGE2 content in submandibular gland. Unexpectedly, alcohol consumption did not increase the damage evoked by the proved model of LPS injections for periodontitis induction., Conclusions: Results suggest 20% alcohol consumption during 4 months generates differential effects on oral health of rats, depending on its pathophysiological state: It would exacerbate the inflammatory condition when periodontal damage is absent, but it would not when damage is installed., (Copyright © 2014 by the Research Society on Alcoholism.)

A 54-year-old female was referred for management of a large amalgam tattoo involving the alveolar mucosa between teeth #6 and #9. The lesion had been present for over 20 years following endodontic treatment of teeth #7 and #8. A two-stage surgical approach was used to remove the pigmentation, beginning with removal of amalgam fragments from the underlying bone and placement of a subepithelial connective tissue graft and acellular dermal matrix to increase soft tissue thickness subadjacent to the amalgam. Following 7 weeks of healing, gingivoplasty was performed to remove the overlying pigmented tissue. At the 21-month follow-up appointment, the patient exhibited naturally appearing soft tissue with no evidence of amalgam tattoo.

The parameters of oral bacterioscopy and homeostasis were studied in patients with periodontal diseases. The shift of pH towards the acid values, increased content of total protein were determined. Analysis of oral fluid showed increase in level of ionized calcium, nitrate anion, and decreased content of magnesium and ammonium cations. The increased overall number of bacteria in patients with periodontal diseases was seen, especially due to gram-negative bacteria.

Background: The deleterious effects of chewing betel quid (BQ) with or without tobacco on periodontal health are poorly addressed. The aim of this study was to investigate the severity and extent of periodontal disease among individuals chewing BQ with and without tobacco., Methods: One hundred twenty individuals (70 BQ chewers: 35 with tobacco and 35 without tobacco) and 50 control individuals (non-chewers) were included in this study. Sociodemographic data and information regarding BQ chewing habit were collected using a questionnaire. Plaque index, bleeding on probing and probing pocket depth were measured. Numbers of missing teeth were recorded and marginal bone loss was measured on panoramic radiographs. Statistical analyses were performed using 1-way analysis of variance and Bonferroni post hoc test., Results: The socioeconomic status of subjects in the control group was significantly higher as compared with those chewing BQ either with or without tobacco. Plaque index, bleeding on probing and probing pocket depth were greater in subjects chewing BQ with tobacco than in those chewing BQ without tobacco and the controls. Subjects chewing BQ with tobacco had fewer teeth than those chewing BQ without tobacco and the controls. Marginal bone loss was higher in subjects chewing BQ with tobacco than in those chewing BQ without tobacco and the controls., Conclusions: The severity of periodontal disease is enhanced in subjects chewing BQ with tobacco as compared with those chewing BQ without tobacco. Subjects with a low socioeconomic status and poor education are significantly more likely than others to develop periodontal disease.

Current adjuvant treatment modalities for breast cancer that express the estrogen receptor or progesterone receptor include adjuvant anti-estrogen therapies, and tamoxifen and aromatase inhibitors. Bone, including the jaw, is an endocrine-sensitive organ, as are other oral structures. This review examines the potential links between adjuvant anti-estrogen treatments in postmenopausal women with hormone receptor positive breast cancer and oral health. A search of PubMed, EMBASE, CENTRAL, and the Web of Knowledge was conducted using combinations of key terms "breast," "cancer," "neoplasm," "Tamoxifen," "Aromatase Inhibitor," "chemotherapy," "hormone therapy," "alveolar bone loss," "postmenopausal bone loss," "estrogen," "SERM," "hormone replacement therapy," and "quality of life." We selected articles published in peer-reviewed journals in the English. The authors found no studies reporting on periodontal diseases, alveolar bone loss, oral health, or oral health-related quality of life in association with anti-estrogen breast cancer treatments in postmenopausal women. Periodontal diseases, alveolar bone density, tooth loss, and conditions of the soft tissues of the mouth have all been associated with menopausal status supporting the hypothesis that the soft tissues and bone of the oral cavity could be negatively affected by anti-estrogen therapy. As a conclusion, the impact of adjuvant endocrine breast cancer therapy on the oral health of postmenopausal women is undefined. The structures of the oral cavity are influenced by estrogen; therefore, anti-estrogen therapies may carry the risk of oral toxicities. Oral health care for breast cancer patients is an important but understudied aspect of cancer survivorship.

Unlabelled: Most studies investigating the impact of oral contraceptives have been performed some years ago, when the level of sexual hormones was greater than the actual formulations., Objective: The aim of this study was to evaluate the effects of current combined oral contraceptives (COC) on periodontal tissues, correlating the clinical parameters examined with the total duration of continuous oral contraceptive intake., Material and Methods: Twenty-five women (19-35 years old) taking combined oral contraceptives for at least 1 year were included in the test group. The control group was composed by 25 patients at the same age range reporting no use of hormone-based contraceptive methods. Clinical parameters investigated included pocket probing depth (PD), clinical attachment level (CAL), sulcular bleeding index (SBI) and plaque index (Pl.I). Data were statistically evaluated by unpaired t test, Pearson's correlation test and Spearman's correlation test., Results: The test group showed increased PD (2.228±0.011 x 2.154±0.012; p<0.0001) and SBI (0.229±0.006 x 0.148±0.005, p<0.0001) than controls. No significant differences between groups were found in CAL (0.435±0.01 x 0.412±0.01; p=0.11). The control group showed greater Pl.I than the test group (0.206±0.007 x 0.303±0.008; p<0.0001). No correlation between the duration of oral contraceptive intake, age and periodontal parameters was observed., Conclusions: These findings suggest that the use of currently available combined oral contraceptives can influence the periodontal conditions of the patients, independently of the level of plaque accumulation or total duration of medication intake, resulting in increased gingival inflammation.

Purpose: Oral complications are frequent and troublesome symptoms for those undergoing chemotherapy for cancer. Several antineoplastic agents are proved to have stomatotoxic potential, among them 5-fluorouracil (5-FU). The aim of the present study was to evaluate the oral status and patient experiences during chemotherapy with 5-FU for colorectal cancer., Methods: Twenty-eight patients treated with 5-day 5-FU plus leucovorin entered this study. Positive data about oral symptoms were taken by anamnesis. Mucositis severity index, gingival index, plaque index, probing pocket depth and bleeding on probing have been used to assess oral mucosa and periodontal status of the patients. Patients were examined prior to chemotherapy and 14 days after the start of the chemotherapy cycle., Results: Mild to moderate subjective complaints concerning oral cavity were reported by 17.9% of patients before and 39.2% of patients after chemotherapy. Clinical examination revealed oral mucosa damage in 10.7% and 35.7% of patients, with mean mucositis score of 0.14 and 0.54 before and after chemotherapy, respectively. Although mean values of all periodontal indices were elevated after chemotherapy, only increase in gingival index was statistically significant (p=0.035). Mucositis was significantly correlated with oral pain (p=0.00), xerostomia (p=0.00), and plaque index (p=0.077), while the correlation between mucositis and the rest of the examined parameters was not significant., Conclusion: Oral complications were not highly expressed in this study. Although 5-FU is considered to exert significant stomatotoxic effect, severe mucositis was far less common in this study compared to studies reported elsewhere.

Background and Objectives: Khat, or qat (Catha edulis), is a shrub indigenous to Yemen and certain parts of eastern Africa. Chewing the leaves, which have sympathomimetic and euphoric effects, is a popular habit in numerous countries including the Yemenite population in Israel. Khat has potentially significant toxic effects; however, its oral effects have been only sporadically examined and some changes suggested. The aim of this study was to assess the association between habitual Khat use and oral/dental pigmentation, gingival health, and reports of oral dryness., Study Design: Forty-seven Yemenite Israeli individuals >30 years old, who chewed Khat at least twice a week for over 3 years, and 55 control subjects were studied. All individuals underwent standard clinical oral examinations for color changes and gingival health., Results: White changes were significantly more prevalent in the khat chewers, identified primarily at the chewing site (83% vs. 16%). The difference in the prevalence of oral mucosal pigmentation between nonchewing nonsmoking (66.7%) and the khat-chewing (100%) groups was highly significant. The mean gingival index and the depth of periodontal pockets of the khat-chewing subjects were significantly reduced at the chewing side compared with the nonchewing side. Increased gingival recession was recorded on the khat-chewing side. Discoloration of the teeth adjacent to the site of chewing was recorded. Oral dryness occurring 30 minutes after initiating the khat-chewing session was reported by khat users., Conclusion: Khat chewing may result in a number of changes in the oral mucosa and the dentition. The mechanical and chemical irritation may result in the development of mucosal white lesions and dark pigmentation. Khat chewing may reduce aspects related to risk of gingival and periodontal inflammation, but it appears to be associated with attachment loss at the site of chewing., (Copyright 2010 Mosby, Inc. All rights reserved.)

Many cell types possess the essential components for a non-neuronal cholinergic system. These components include acetylcholine, choline acetyltransferase, acetylcholinesterase (AChE) and nicotinic acetylcholine receptors. Studies have indicated that AChE may be crucial for various types of apoptosis and that tobacco smoking augments the severity of periodontal disease. We hypothesize that there is a non-neuronal cholinergic system in periodontal tissue that is activated by excess nicotine, which increases expression of AChE, thus increasing apoptosis of periodontal cells. If so, the introduction of an AChE inhibitor should decrease periodontal cell apoptosis, lessening periodontal disease.

An epidemiologic examination was carried out to reveal the prevalence of the periodontal diseases and oral pigmentation in patients with Yusho in 2008. The results obtained were as follows. 1) Yusho patients complained of tooth pain and periodontal diseases such as gingival swelling, gingival bleeding, but not of oral pigmentation. 2) 116 patients out of 148 patients with Yusho, who were measured periodontal pocket depth according to Ramfjord' methods, had at least one tooth with periodontal pocket deeper than 3 mm. Similarly, 399 teeth out of a total 710 examined teeth showed a periodontal pocket with more than 3 mm in depth. However, it was determined that 74 teeth had a periodontal pocket deeper than 4 mm. 3) Oral pigmentation was observed in 91 patients out of 155 patients with Yusho. In this study, gingival pigmentation was most predominant among oral pigmentation. The prevalence of oral pigmentation in male patients seemed to be somewhat higher than that in female patients. In addition, the prevalence of oral pigmentation tended to be higher in younger patients than in elder patients. Pigmentation of the buccal mucosa, lip or palate, however, was observed only in patients beyond the age of fifty. These results indicated that PCB-related compounds may be responsible for the higher prevalence of both periodontal diseases and oral pigmentation.

Background: Periodontal disease is a complex, multifactorial, chronic inflammatory disease that involves degradation of periodontal structures, including alveolar bone. Cadmium adversely affects bone remodeling, and it is therefore possible that environmental Cd exposure may be a risk factor for periodontal-disease-related bone loss., Objective: We examined the relationship between environmental Cd exposure and periodontal disease in U.S. adults., Methods: We analyzed cross-sectional data from the third National Health and Nutrition Examination Survey (NHANES III). We defined periodontal disease as clinical attachment loss of at least 4 mm in > 10% of sites examined. We used multivariable-adjusted logistic regression analyses to estimate the association between creatinine-corrected urinary Cd levels and periodontal disease., Results: Of the 11,412 participants included in this study, 15.4% had periodontal disease. The age-adjusted geometric mean urine Cd concentration (micrograms per gram creatinine) was significantly higher among participants with periodontal disease [0.50; 95% confidence interval (CI), 0.45-0.56] than among those without periodontal disease (0.30; 95% CI, 0.28-0.31). Multivariable-adjusted analyses, which included extensive adjustments for tobacco exposure, showed that a 3-fold increase in creatinine-corrected urinary Cd concentrations [corresponding to an increment from the 25th (0.18 microg/g) to the 75th (0.63 microg/g) percentile] was associated with 54% greater odds of prevalent periodontal disease (odds ratio = 1.54; 95% CI, 1.26-1.87). We observed similar results among the subset of participants who had limited exposure to tobacco, but only after removing six influential observations., Conclusion: Environmental Cd exposure was associated with higher odds of periodontal disease.

Background: This study investigated the possible association of nifedipine (NIF) intake and diabetes mellitus (DM) with periodontal destruction., Methods: A group of Chinese subjects (N = 1,083, age: 63 +/- 8.7 years) were screened. Three hundred fifty-eight non-smokers with hypertension were selected for the study and were grouped based on DM status as non-DM and DM groups, DM(-) and DM(+) respectively. NIF(+) and NIF(-) indicated NIF intake or not. The groups were further divided: NIF(-)/DM(-) (n = 135); NIF(+)/DM(-) (n = 108); NIF(-)/DM(+) (n = 64); and NIF(+)/DM(+) (n = 51). The periodontal conditions in anterior teeth were assessed using plaque index, sulcus bleeding index, clinical attachment loss (AL), probing depth (PD), and the number of missing teeth., Results: Using analysis of covariance, NIF intake was associated with mean PD and extent of PD > or =4 mm in the non-DM and DM groups. The subjects in the NIF(+)/DM(+) subgroup showed greater mean AL and percentage of sites with AL > or =5 mm and AL > or =7 mm than those in NIF(-)/DM(+) subgroup, whereas no significant difference existed between subjects in NIF(-)/DM(-) and NIF(+)/DM(-) subgroups. The NIF(+)/DM(+) subgroup exhibited a greater percentage of sites with AL > or =5 mm (35.5%) compared to the other three subgroups (24.7% for NIF[-]/DM[-], P = 0.004; 25.0% for NIF[+]/DM[-], P = 0.007; and 25.2% for NIF[-]/DM[+], P = 0.016). Logistic regression analysis showed that the NIF(+)/DM(+) subgroup had a significantly higher risk for having >10% of sites with AL > or =5 mm compared to the NIF(-)/DM(-) subgroup (odds ratio [OR] = 2.9; 95% confidence interval [CI]: 1.2 to 7.4; P = 0.022), the NIF(+)/DM(-) subgroup (OR = 3.1; 95% CI: 1.2 to 8.1; P = 0.020), and the NIF(-)/DM(+) subgroup (OR = 5.1; CI: 1.8 to 14.3; P = 0.002)., Conclusion: NIF intake may increase the risk for periodontal destruction in patients with type 2 DM.

During this experimental study with 6 week-old rats the rate of alveolar bone resorption increased with the balanced diet and drinking water containing 50 mg/l NaF, which is similar to the group of rats observed in case of periodontitis model with the same diet and supplemented with ammonium chloride 5 mg/kg. The mineral complex (Mg-sulfat, Zn-sulfat, Mr-sulfat, Na-citrat) 300 mg/kg possessing a pronounced anti acidosis effect when added to the same balanced diet and sodium fluoride in drinking water with the same concentration prevents resorption processes in the alveolar bone and reduces toxicity action of fluorides on the alveolar and pelvic bones by decreasing metabolic acidosis in the bone tissue.

The aim of this study was to evaluate the periodontal health status of lead-exposed apprentices and to search the correlation between clinical periodontal parameters and either blood lead or oxidative stress/damage indices in erythrocytes. Sixty male subjects were recruited for this study (30 apprentices and 30 controls). The periodontal health status was determined with gingival index, plaque index, gingival bleeding time index, probing depth, and clinical attachment level records. Additionally, blood lead level and indices of oxidative stress (glutathione peroxidase, superoxide dismutase), catalase activities and damage (malondialdehyde concentration) in erythrocytes were determined. The results showed that lead level was significantly higher in apprentices than in controls (P < 0.05). None of the clinical periodontal parameters and oxidative stress/damage indices were significantly different between the groups (P > 0.05). Significant correlation between plaque index and catalase, probing depth and superoxide dismutase, clinical attachment level and superoxide dismutase, and clinical attachment level and malondialdehyde in apprentices group (P < 0.05), and gingival bleeding time index and glutathione peroxidase in control group were found (P < 0.05). In multiple regression analysis, there were statistically significant associations between gingival index and working status, family income and either probing depth or clinical attachment level (P < 0.05). The results of this study showed significant association between the clinical periodontal parameters and oxidative stress/damage indices in apprentices indirectly exposed to low levels of lead.

The aim of our study is evaluating occupational exposure in a factory named "Poligrafico Zecca dello Stato" in Foggia. The workers had a occupational disease "chlorine related parodontal disease" indemnified by INAIL (Italian Occupational Assurance). The study demonstrated the workers have been indemnified worked as engineer, drying and electrolysis process employed. The study showed that the workers indemnified without legal action were different in respect of workers that take legal action, because the last showed, paradoxically, a chlorine occupational exposure. The explanation of this paradox might be the production cycle non acknowledge by operators.

The distinguishable films composed of poly(vinyl alcohol) (PVA) and carboxymethyl-chitosan (CMCS) were prepared by blending/casting method, and loaded with ornidazole (OD) as local drug delivery system. In vitro test, the blend films showed pH-responsive swelling behavior and moderate drug release action, and also exhibited a little antimicrobial activity against E. coli and S. aureus strains. Those characteristics of CMCS/PVA blend films were essentially governed by the weight ratio of CMCS and PVA. Increasing the content of PVA in blend film would decrease swelling and decelerated the drug release. However, increasing the content of CMCS would enhance the antimicrobial activity. The biocompatibility and bioactivity of the blend film were also evaluated using rabbit blood and Wister rats. This blend drug system was of no hemolysis, no toxicity to rat periodontia and no cytotoxicity to the rat muscle. After subcutaneously implanting the blend drug films in Wister rat, the systems kept a good retention at the application site and maintained high drug concentration in long time (5 days) which was longer than the period of drug released in vitro (160 min).

Background: The purpose of this study was to histomorphometrically evaluate the response of periodontal tissues covering Class V resin restorations in dogs., Methods: After raising a mucoperiosteal flap, bony defects measuring 5 x 5 mm were created on the buccal aspect of the canines of five dogs followed by cavity preparations on the root surface measuring 3 x 3 x 1 mm. Before repositioning the flap to cover the bone defect, the cavities were restored with composite resin (CR) or resin-modified glass ionomer cement (RMGIC) or were left unrestored as control (C). The dogs were euthanized 90 days after surgery. Specimens comprising the tooth and periodontal tissues were removed, processed routinely, cut into longitudinal serial sections in the buccolingual direction, and stained with hematoxylin and eosin (H&E) or Masson's trichrome. The most central sections were selected for histomorphometric analysis., Results: Histomorphometric analysis revealed apical migration of epithelial tissue onto the restorative materials (RMGIC and CR). The C group presented significantly longer connective tissue attachment (P <0.05) than the RMGIC and CR groups and significantly higher bone regeneration (P <0.05) compared to the RMGIC group. Histologically, the cervical third (CT) of all groups had the most marked chronic inflammatory infiltrate., Conclusions: Within the limits of this study, it can be concluded that the restorative materials used exhibit biocompatibility; however, both materials interfered with the development of new bone and the connective tissue attachment process.

Healthcare professionals should be aware that systemic bone conditions impact the periodontium. Bisphosphonate drugs used for systemic bone loss affect the maxilla and mandible. Alveolar bone loss in periodontitis and skeletal bone loss share common mechanisms. At present, bisphosphonates are in wide use for prevention and treatment of osteoporosis, Paget's disease and metastatic bone conditions. This therapy is linked to a negative side effect called osteonecrosis of the jaws. At the same time, bisphosphonate therapy is also reported to be beneficial to the periodontium. In fact, periodontal therapy using bisphosphonates to modulate host response to bacterial insult may develop into a potential strategy in populations in which periodontal therapy is not convenient. Unlocking the full potential of bisphosphonates involves understanding the mechanisms of action of different classes of bisphosphonates, limiting unwanted side effects and expanding its indications. Developing bisphosphonates to slow the progression of periodontal disease depends on identifying an effective dosage regimen and delivery system that would reach the target site in the periodontium, while limiting unwanted side effects.

Epilepsy, which is characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 200,000 Canadians at any one time. Dentists with a thorough knowledge of seizure disorders and the medications used to treat them can provide necessary dental and oral health care to these patients. In this review, we summarize current knowledge of epilepsy, seizures and antiepileptic drugs and provide information on dental-related issues, as well as guidelines for the management of an acute seizure in the dental office.

Objective: We investigated the risk of periodontal disease and tooth loss, associated with habits of smoking and alcohol consumption, in a longitudinal study., Subjects and Methods: The subjects were 1332 Japanese males, 30-59 yr of age, who were free from periodontal disease at the baseline check-up, and who underwent a second check-up 4 yr later. Periodontal disease was diagnosed using the community periodontal index score, based on the clinical probing of pocket depth (> or = 4 mm). Smoking and alcohol consumption patterns were evaluated using a self-administered questionnaire., Results: A dose-response relationship was observed between the amount of smoking and the incidence of periodontal disease in each age group. The overall odds ratios (95% confidence intervals), adjusted for age and alcohol, were 1.51 (0.95-2.22), 1.58 (1.13-2.22) and 2.81 (1.96-4.03), among smokers consuming 1-19, 20 or 21 or more cigarettes per day, respectively, with a significant linear trend (p < 0.0001). A similar association was found between smoking and tooth loss, except for the 50-59-yr-old age group. The adjusted odds ratios were 1.26 (0.60-2.64), 2.01 (1.21-2.32) and 2.06 (1.23-3.48), respectively. A significant linear trend between smoking and tooth loss was also observed (p = 0.01). Ex-smokers showed no significant difference compared with nonsmokers. We also found a significant linear trend between alcohol consumption and tooth loss among 30-39-yr-old subjects, while no relationship was observed between alcohol consumption and periodontal disease., Conclusion: Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.

During periodontal infections, bacterial lipopolysaccharides (LPS) from Gram negative bacteria, along with other bacterial products, drive alveolar bone destruction. Tissue destruction occurs through both direct and indirect pathways. In the indirect pathway, LPS induce the secretion of proinflammatory cytokines, which in turn provokes a cascade of reactions leading to osteoclasts activation. In the direct pathway, LPS stimulate osteoblasts, osteoclasts precursors and osteoclasts, with an inflammatory cytokines independent manner. In this paper, the mechanisms involved in these two pathways are reviewed.