Association of self-perceived periodontal status with oral hygiene, probing depth and alveolar bone level among young adults.

The literature regarding self-reported dental/oral health data suggests that certain self-reported information is valid. The objective of this study was to show whether self-perceived periodontal conditions can predict actual periodontal status measured by probing depth and radiographic bone level. Participants completed a questionnaire regarding systemic health, education, smoking status, oral hygiene habits and self-perception of their own periodontal status using a visual analog scale (VAS); they were examined clinically and radiographically. More than two-thirds self-perceived their periodontal status as between 5 and 8 (out of 10). Smoking was related to radiographic bone loss, but not to the number of sites with PD > or = 5mm. Periodontal self-assessment correlated with the number of sites with PD > or = 5mm (p = 0.013), the number of sites with radiographic bone loss > or = 3 mm (p = 0.045), as well as with plaque index (p = 0.003) and daily flossing (p = 0.022). For a cutoff of 5 in the VAS score, sensitivity of 84% and specificity of 22% were found for high PD and sensitivity of 85% and specificity of 24% for bone loss.

Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum.

INTRODUCTION: Both chronic periodontal disease (CPD) and erectile dysfunction (ED) are associated with cardiovascular disease and its risk factors, including smoking and diabetes mellitus. However, the association between ED and CPD has never been studied. AIM: To study the association between ED and CPD. MAIN OUTCOME MEASURES. Prevalence of ED, prevalence of CPD, ED severity. METHODS: The study population consisted of 305 men who filled the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect ED and assess its severity, and underwent a pair of standardized posterior dental bitewing radiographs in order to detect CPD. SHIM questionnaire scores 21 or less represented ED. Alveolar bone loss of >or=6 mm represented CPD. RESULTS: The mean age of included men was 39.5 +/- 6.7 years. Overall, 70 (22.9%) men had ED and 13 (4.3%) had CPD. CPD was significantly more prevalent among men with mild ED (P = 0.004) and moderate to severe ED (P = 0.007) in comparison to men without ED. CONCLUSIONS: ED might be associated with CPD. These preliminary findings are consistent with theories that associate these conditions with systemic inflammation, endothelial dysfunction, and atherosclerosis.

Hidden occlusal caries: challenge for the dentist.

Hidden occlusal caries was defined 20 years ago as a dentinal caries lesion near the occlusal surface of the tooth, visible on a radiograph, where in visual examination the occlusal enamel is seen intact or minimally perforated. Hidden caries present the dentist with challenges in prevention, diagnosis, treatment planning, patient education and research. This article describes these challenges and offers solutions. In trying to prevent the formation of hidden caries lesions, the dentist should consider using fissure sealants, which have already proved to be an efficient way of preventing fissure caries. Diagnosing hidden caries is a challenge for the dentist, who is used to detecting fissure caries solely by visual examination and probing, because, by definition, hidden caries should be diagnosed by radiographs. However, in order to diagnose occlusal carious lesions accurately, the practitioner must look for them on radiographs. In cases of inconclusive radiographic examinations and a stained fissure, an operative diagnosis approach should be employed. In treating hidden caries, the dentist should consider, according to clinical and radiographic examinations, an observation-only approach or a preventive resin restoration. The dentist should become familiar with this type of carious lesion and learn how to prevent, diagnose and treat it.

An unusual lateral luxation of an upper incisor owing to long-term boxing without protection.

This case report describes a lateral luxation of an upper incisor in a 19-year-old non-professional boxer. The tooth displacement gradually worsened over several months because the boxer received repeated blows to the head without using a mouthguard. Being a chronic dental trauma, rather than an acute lateral luxation, this case had several unique features: the labial plate of the alveolar bone was penetrated, the root apex was free in the vestibulum, the tooth was mobile (second degree) and radiographs revealed bone resorption. This case emphasized the need for a mouthguard to be used even with amateur boxing. The dental practitioner should educate his sportsmen-patients of the risk of sport-related dental trauma and the benefit of a mouthguard.

Analysis of factors related to extraction of endodontically treated teeth.

BACKGROUND: Endodontic therapy is a predictable treatment, resulting in up to 97% retention rate for the treated teeth. However, about 3% of endodontically treated teeth require further treatment, including extraction of the tooth. STUDY DESIGN: This retrospective study analyzed all endodontically treated permanent teeth that were extracted in a multidisciplinary clinic in 2006-2007 (n = 547). Associations among the extractions' indications and the patients' gender, education, and smoking status, as well as tooth type and coronal restoration, were investigated. RESULTS: Of the 547 endodontically treated teeth that were subjected to extraction, mandibular (44.6%) and maxillary (20.5%) first molars were the most common. Fifteen percent of the extracted teeth were restored with a crown, whereas 57.4% of the extracted teeth did not have a permanent coronal restoration. The reasons for extraction were nonrestorable caries (61.4%), endodontic failure (12.1%), vertical root fracture (8.8%), iatrogenic perforation (8.8%), periodontal disease (4.6%), unrestorable cusp fracture (2.4%), orthodontic (1.3%), and prosthetic (0.2%) considerations and dental trauma (0.5%). Periodontitis was more prevalent among current smokers than among nonsmokers (P < .05). Gender and education had no influence on the extraction of the tooth. Vertical root fracture was more prevalent in mandibular than in maxillary first molars (P < .05). Caries was more prevalent in unrestored teeth than coronally restored or crowned teeth (P = .001). Endodontic failure and VRF were more prevalent in restored than in unrestored teeth (P < .05). CONCLUSIONS: The most common extracted tooth profile was the mandibular first molar without permanent coronal restoration, which was lost due to caries destruction. Endodontically treated teeth were prone to extraction mainly due to nonrestorable carious destruction and to a lesser extent to endodontic-related reasons such as endodontic failure, VRF, or iatrogenic perforation.