Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia.

(1) Background: The aim of this study was to assess oral health in children following dental treatment under general anaesthesia and to obtain information about oral health measures in both the children and their parents. (2) Methods: Children were scheduled for regular dental re-examination one to six years after dental treatment under general anaesthesia. Scores for mixed dmft/DMFT, the plaque control record (PCR), and the gingival bleeding index (GBI) were determined. Information about children's/parents' oral hygiene habits and frequency of dental visits was obtained. Scores for mixed dmft/DMFT as assessed before dental treatment under general anaesthesia/at re-examination were compared (Wilcoxon test). (3) Results: From the 134 parents initially contacted, 35 attended regular dental control visits (response rate: 26%) with their children (median age 6 years). Of the 35 children (20 female, 15 male), 18 (51.4%) were healthy and 17 (48.6%) had a pre-existing condition. Mixed dmft/DMFT scores determined at the recall visit differed significantly from the earlier visit (p = 0.006). Children had 1.74 ± 3.64 teeth newly affected by caries. Four children (11.4%) needed dental treatment under general anaesthesia again. Oral hygiene was mediocre (median PCR: 32%). The GBI was high (median: 14%). Children with a high PCR also had a high GBI. (4) Conclusions: Children who had received dental treatment under general anaesthesia still had a high caries risk. Further prophylaxis programs are necessary to prevent caries and further use of general anaesthesia.

Efficacy of a Toothpaste Based on Microcrystalline Hydroxyapatite on Children with Hypersensitivity Caused by MIH: A Randomised Controlled Trial.

PURPOSE: Hypersensitivity is a frequent complaint in children with molar incisor hypomineralisation (MIH). This double-blind randomised controlled trial aimed to evaluate non-inferiority in hypersensitivity relief of a toothpaste containing microcrystalline hydroxyapatite compared to amine fluoride in children with MIH. MATERIALS AND METHODS: Children were randomised into 2 groups: either hydroxyapatite (intervention) or amine fluoride toothpaste (control). The primary endpoint was pain sensation in response to tactile stimulus (Wong-Baker FACES Pain Rating Scale) 56 days after randomisation and analysed by mixed effects linear regression analysis. Non-inferiority was inferred if the upper limit of the one-sided 95% confidence interval (CI) of the difference between intervention and control group was below the non-inferiority margin of 1 in the ITT (intention-to-treat) and PP (per protocol) population. RESULTS: Twenty-one children were randomised and 14 children finished the study per protocol. In the ITT population, hydroxyapatite was non-inferior to amine fluoride (mean difference: -0.75 95%CI [-∞;0.49]). In the PP population, non-inferiority could not be shown (-0.62 [-∞;1.08]). CONCLUSIONS: Overall non-inferiority in hypersensitivity relief of a toothpaste containing hydroxyapatite compared to amine fluoride could not be shown. However, the hydroxyapatite group tended to be less hypersensitive in both populations. Attrition of the PP population due to the COVID-19 pandemic led to loss of statistical power.

Effects of adjunctive light-activated disinfection and probiotics on clinical and microbiological parameters in periodontal treatment: a randomized, controlled, clinical pilot study.

OBJECTIVES: The aim of this pilot study was to evaluate the clinical and microbiological outcomes of light-activated disinfection (LAD) alone or combined with probiotics as an adjunct to non-surgical periodontal treatment. MATERIALS AND METHODS: In this single-blinded, randomized, controlled clinical pilot study, 48 patients (28 females and 20 males) with untreated periodontitis (stages II and III, grade B) were included. Using a parallel-group design, patients were randomly assigned into 3 groups to receive subgingival debridement (SD) alone (group 1, n = 16), SD with LAD (group 2, n = 16), or SD with LAD plus probiotic treatment (group 3, n = 16). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), gingiva-index simplified (GIs), plaque-control record (PCR), and subgingival microbiological samples were analyzed at baseline, 3 months, and 6 months of follow-up. RESULTS: All treatment modalities demonstrated clinical improvements in PPD and CAL at 6 months compared to baseline but without a statistical significant difference between the groups. The combination of SD + LAD + probiotic treatment (group 3) demonstrated significantly greater reductions in BOP, GIs, and red complex bacteria P. gingivalis and T. forsythia compared with other groups at 6 months (p < 0.05). CONCLUSIONS: A single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone. The combination of SD + LAD + probiotic treatment in group 3 led to further improvements of the inflammatory parameters. CLINICAL RELEVANCE: The additional use of probiotics in periodontal treatment can be a useful approach to support inflammation and infection control of periodontal tissues. Further studies are necessary to determine the extent of added benefit for this treatment approach.

Oral health of children and adolescents with or without attention deficit hyperactivity disorder (ADHD) living in residential care in rural Rhineland-Palatinate, Germany.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is defined as childhood neurobehavioural disorder. Due to short attention span, oral hygiene and dental treatment of such individuals can be challenging. Aim of this study was to evaluate the oral health of children and adolescents with and without ADHD living in residential care in rural Rhineland-Palatinate, Germany. METHODS: Included in the study were 79 participants (male/female:58/21, age 9-15 years) living in residential care: 34 participants with ADHD and 45 participants without ADHD (control). Oral examination included the following parameters decayed, missing, filled teeth in the primary dentition (dmft), decayed, missing, filled surfaces/teeth in the secondary dentition (DMFS/DMFT), approximal plaque index (API), bruxism and orthodontic treatment. Additionally, oral hygiene, last dental visit and treatment performed, and dietary habits were assessed by questionnaire. RESULTS: There were no significant differences in dmft, API, bruxism and oral hygiene habits between groups. However, participants with ADHD tended to have higher DMFS/DMFT values than the control group. Ongoing orthodontic treatment was found more often in the control group. The ADHD group tended to consume acidic/sugary beverages and sweet snacks more often than the controls. Different treatments (control visit/prophylaxis, dental therapy, orthodontic treatment) were performed at the last dental visit in the two groups. CONCLUSIONS: Within the limitations of this study, oral health was similar in children and adolescents with or without ADHD from the same residential care setting. Parents/guardians need instructions for better supervision of oral hygiene and dietary habits to improve the poor oral health of children with or without ADHD.

The world's longest human tooth extracted / Der längste extrahierte menschliche Zahn der Welt

A patient with an abscess of the canine fossa starting from the tooth 13 turned up at the dental office. Such an abscess requires immediate and consistent surgical intervention to avoid potential lethal complications for the patient. The highlying swelling reaching the infraorbital area was quite impressive in this case. The panoramic radiograph that was taken (Fig. 1) revealed a canine of considerable radiographic length. The upper canines of the human have the greatest mean length of all the teeth of the human dentition. A conservative tooth treatment can cause problems just as a surgical tooth preservation in the context of a root tip resection would. An alio loco trepanation and root canal preparation had previously been unsuccessful. The instrumen-tation of the tooth was impossible for the colleague due to its canal length. The difficult access to the root tip as well as the degree of destruction on the palatal side and the abscess spoke in this case against a resection and for the extraction of the tooth. After surgical removal and measurement of the tooth, it was confirmed that with 37.2 mm this was the longest tooth ever extracted by a human being.

One-year Clinical Performance of Flowable Bulk-fill Composite vs Conventional Compomer Restorations in Primary Molars.

PURPOSE: To evaluate the clinical performance of a flowable bulk-fill composite vs a compomer in Class II cavities of primary molars. MATERIALS AND METHODS: In a clinical study, 100 restorations were placed in two randomly assigned comparable Class II cavities in 32 children (aged 6.7 ± 1.2 years) with at least one bulk-fill composite (Venus Bulk Fill, Heraeus Kulzer) and one compomer (Dyract eXtra, Dentsply). After caries excavation, the adhesive Scotchbond Universal (3M Oral Care) was applied in self-etching mode. According to the manufacturer's instructions, Venus Bulk Fill was used for the entire Class II cavity of primary molars without a cover layer. After visible-light curing, both restorations were finished and polished. Both restorative materials were evaluated at baseline and after one year, including esthetic, functional, and biological parameters, using the FDI criteria. The Mann-Whitney U-test was used to determine the difference in the complete scores at baseline and after one year (p < 0.05). RESULTS: After one year, 99 restorations were reevaluated; one tooth had exfoliated physiologically. Concerning the esthetic parameters, Dyract eXtra showed slightly higher scores than Venus Bulk Fill. Both materials showed similar scores regarding functional and biological parameters. No severe postoperative sensitivities or side-effects were reported. There was no statistically significant difference between the performance of Venus Bulk Fill and Dyract eXtra for primary molars. CONCLUSION: The flowable bulk-fill composite Venus Bulk Fill can be considered as an alternative material for clinical use in primary teeth, but longer-term studies might still be needed.

Country and gender differences in the motivation of dental students-An international comparison.

PURPOSE: The objective of this study, conducted in Germany, Finland and Turkey, was to identify whether motivations to study dentistry varied by country, gender or year of study. METHODS: The multicentre pilot study was conducted in English language in 2014. Participants (n = 469 dental students) were either in the first or last year of study. The response rate was 91%. RESULTS: The sample comprised 63% females and 37% males, reflecting the common gender distribution in dental education. A total of 236 first year students (50.3%) and 233 final year students (49.7%) took part in the study. The participants were aged 21-25 years and of 15 different nationalities, mostly from Turkey, Germany and Finland. Considering who motivated them most to become a dentist, the most common answer was "self-motivated" (49.5%). 23.4% of the students stated having been motivated by a "family member or friend, who is a dentist," while 24.3% said they had been motivated by a "family member or friend, who is not a dentist." -Very few students (2.8%) recorded having been motivated by a "high school or college counsellor." Motivations for choosing dentistry as a career included "ability to help people," "self-employment," "income potential," "working with hands" and "status and prestige," all of which were rated as highly important. "Time management" and "career variety" were rated as moderately important. Significant statistical differences were observed by country and gender. For the German students, a dental relative was significantly more often relevant than for the Finnish and Turkish students, who were more often influenced by family members or friends not working in the dental field. "Time management" seemed to be significantly more important to female than to male students. CONCLUSION: In line with a feminisation of the workforce in dentistry, a well-structured working environment and well-thought-out time management may play an increased role in future work force planning (Gender dentistry: International vergleichende Studie zu Karrierewahl und Spezialisierungswünschen von Zahnmedizinstudenten. Ulm: Universität Ulm).

Visible Light Curing Devices - Irradiance and Use in 302 German Dental Offices.

PURPOSE: To determine the irradiance delivered by visible-light curing (VLC) units and obtain information about the exposure times and the maintenance protocols used by dentists. MATERIALS AND METHODS: The irradiance (mW/cm2) delivered by 526 VLCs from 302 dental offices from the Rhine-Main area, Germany, was measured using an integrating sphere (IS) and a MARC patient simulator (M-PS); additional information was gathered using a survey. RESULTS: Irradiance was measured from 117 standard quartz-tungsten-halogen (QTH), 5 high-power QTH, 2 LED 1st-generation, 333 LED 2nd-generation, 61 LED 3rd-generation, and 8 plasma-arc curing (PAC) units. Depending on the measurement method, 8% (IS) or 11% (M-PS) of the VLCs delivered < 400 mW/cm2. Depending on the VLC, the shortest exposure times required to deliver a radiant exposure of 16 J/cm2 ranged from 7 to 294 s. The number of exposure cycles used by dentists when light curing a restoration ranged from 1 to 14. The shortest total exposure time used by dentists on a restoration was 5 s, the maximum was 200 s, and the median was 20 s. Of the 526 VLCs, 41% had intact, undamaged light tips. Only half of the dental offices checked the irradiance from their VLCs regularly, 97% disinfected the VLC, and 86% used eye protection. CONCLUSION: Approximately 10% of the VLCs delivered < 400 mW/cm2 and 14% of the dental offices used no form of eye protection. To achieve sufficient light curing of RBC restorations, more awareness about the VLCs used in the dental office is required.

Dental age assessment in 6- to 14-year old German children: comparison of Cameriere and Demirjian methods.

BACKGROUND: The aim of the study was to compare two frequently used dental age estimation methods for accuracy. METHODS: A total of 479 panoramic radiographs in age groups 6-14 years from a German population were evaluated. The dental age of 268 boys and 211 girls was assessed by means of the method of Demirjian (1973) and Cameriere (2006) and compared with their actual chronological age. RESULTS: Demirjan's method showed an overestimation of dental age compared to chronological age in all age groups for boys (mean difference -0.16, p = 0.010, range -0.35 to 0.09), age group 9 showed an underestimation. Using the same method for girls (mean difference -0.18, p = 0.008, range -0.45 to 0.13), an overestimation could also be shown in all age groups except for age groups 8 and 13. Results for Cameriere's method showed for boys (mean difference 0.07, p = 0.314, range -1.38 to 3.83) in age groups 6 to 11 an overestimation, but in age groups 12 to14 an underestimation. The results for girls (mean difference 0.08, p = 0.480, range -1.55 to 4.51) showed an overestimation for age groups from 6 to 10, and an underestimation in age groups 11 to 14. CONCLUSIONS: The comparison shows an advantage of Demirjian's method for both genders. While Cameriere's method showed a higher inaccuracy in all age groups, Demirjian's method showed more appropriate results for dental age estimation of the investigated German population. To avoid errors in forensic age estimation and to prevent misidentifications for defendants in criminal processes, further studies of more precise methods for age estimation for the German population are required.

Effect of thermocycling with or without 1 year of water storage on retentive strengths of luting cements for zirconia crowns.

STATEMENT OF PROBLEM: Bond stability between zirconia crowns and luting cement and between cement and dentin is a main concern; however, only limited evidence is available as to its longevity. PURPOSE: The purpose of this in vitro study was to measure the retentive strengths of 7 self-adhesive cements (RelyX Unicem Aplicap, RelyX Unicem Clicker, RelyX Unicem 2 Automix, iCEM, Maxcem Elite, Bifix SE, SpeedCem), 2 adhesive cements with self-etch primers (Panavia 21, SEcure), 1 glass ionomer cement (Ketac Cem), 1 resin-modified glass ionomer cement (Meron Plus), and 1 zinc phosphate cement for luting zirconia crowns (LAVA) to extracted teeth after thermocycling with or without 1 year of water storage. MATERIAL AND METHODS: Two-hundred-forty extracted human molars (2 treatments; n=10 per cement) were prepared in a standardized manner. All cements were used according to the manufacturers' recommendations. The intaglios of the crowns were treated with airborne-particle abrasion. After thermocycling (×5000, 5°C/55°C) with or without 1 year of water storage, the cemented ceramic crowns were removed by using a Zwick universal testing device. Statistical analyses were done with the Wilcoxon rank sum and the 2-independent-samples Kolmogorov-Smirnov test. RESULTS: Median retentive strengths [MPa] for specimens thermocycled only/thermocycled with 1 year of water storage were as follows: Panavia 21: 1.7/2.5, SEcure: 3.0/3.0, RelyX Unicem Aplicap: 3.1/3.4, RelyX Unicem Clicker: 4.1/4.2, RelyX Unicem 2 Automix: 3.8/3.1, iCEM: 2.3/2.7, Maxcem Elite: 3.0/3.2, Bifix SE: 1.7/1.7, SpeedCem: 1.3/1.6, Meron Plus: 3.1/2.7, Ketac Cem: 1.4/1.4, and zinc phosphate cement: 1.1/1.6. Statistically significant differences were found only among specimens thermocycled only or thermocycled with 1-year water storage (P<.001). CONCLUSIONS: Significant differences in retentive strengths were observed among cements after thermocycling only or thermocycling with 1 year of water storage, but not for the effect of the additional 1 year of water storage.

Survey of midwives' knowledge of caries prevention in perinatal care.

PURPOSE: To assess midwives' knowledge about oral health and early caries prevention during perinatal care for mothers and babies. STUDY DESIGN AND METHODS: A survey developed by the investigators was conducted among midwives to assess their knowledge about caries etiology, their attitude toward their role in early caries prevention, and prophylactic measures recommended during pregnancy, and after birth, for their babies. Self-administered questionnaires were sent to 180 midwives in hospitals and 323 midwives from a midwives' association in Hesse, Germany. RESULTS: Response rates were 46% (83/180) and 56% (181/323); a total of 264 questionnaires were evaluated. Most midwives were familiar with the term Early Childhood Caries (ECC), over 90% knew the role of acidic bacteria, carbohydrates, and insufficient oral hygiene in caries etiology. A vast majority of the midwives considered caries prophylaxis as essential, and saw this topic as part of their core area of competence. Only 60% informed the pregnant women in their care about pregnancy gingivitis. Almost all midwives gave recommendations about caries prophylaxis. The risk for developing ECC was explained to the pregnant women and mothers/parents by 92% of the midwives. Recommendations concerning regular dental visits for small children were given by 80% of the midwives. CLINICAL IMPLICATIONS: The time-intensive medical care of families through advanced practice nurses or midwives offers opportunities for better education about caries prophylaxis. A consensus of all the involved healthcare professional groups, including dentists, obstetricians, advanced practice nurses, midwives, pediatric nurses, and pediatricians, is needed to provide uniform recommendations for prophylaxis and prevention of ECC.

Hearing assessment in dental practitioners and other academic professionals from an urban setting.

INTRODUCTION: Extended exposure to high-speed handpieces and other noise-intensive devices might put dentists at risk for possible hearing impairment. The aim of this study was to determine the hearing ability of dentists and other scientists for comparison. METHODS: After approval by the ethics committee, 115 subjects (dentists and other academic professionals as controls) of both genders were enrolled in the study. Exclusion criteria were colds, ear-blockages or abnormal hearing-thresholds. An audiometric determination (Oscilla USB audiometer, AudioConsole 3, Inmedico A/S, Denmark) was performed in the frequency range of 125 Hz to 8 kHz for both ears. Anamnestic data and number of years in the profession were assessed using a questionnaire. Differences between groups were analyzed with the Mann-Whitney-U-test. RESULTS: Data from 53 dentists and 55 other academic professionals (69.4% male, 30.6% female) with a mean age of 51.7 ± 9.6 years and similar gender distributions in both groups were analyzed. The audiometric tests for the right and left air conduction showed that the hearing of dentists tended to be slightly more impaired than in the control subjects. For the frequencies 3 kHz and 4 kHz these differences were statistically significant for both ears. In contrast, no significant differences were found in this range for bone conduction. CONCLUSIONS: Hearing impairment in dentists was slightly higher than in controls. Although other factors like environmental noise exposure were comparable for both groups, occupational exposure to high-speed handpieces and other noisy devices can be an additional burden for the hearing.

Clinical parameters and aMMP-8-concentrations in gingival crevicular fluid in pregnancy gingivitis.

BACKGROUND: During pregnancy hormonal changes may increase the risk for developing gingivitis. The aim of this study was to evaluate the signs of gingival inflammation and the enzyme activity of matrix metalloproteinase-8 (aMMP-8) in the gingival crevicular fluid of pregnant women. METHODS: After approval by the ethics commission, a total of 40 volunteers participated in the study; group 1 (n = 20, age: 32 +/- 4 years) with pregnant women, and group 2 (n = 20, age: 30 +/- 10 years) with age-matched non-pregnant women as controls. After obtaining anamnestic data, the dental examination included assessment of oral hygiene, gingival inflammation, probing pocket depth, and recession. Gingival crevicular fluid was collected from both groups. A quantitative determination of aMMP-8 concentrations in the gingival crevicular fluid samples was performed. RESULTS: The aMMP-8 values of group 1 were higher (median 6.25 ng/mL aMMP-8 eluate) compared with group 2 (median 3.88 ng/mL aMMP-8 eluate), but the difference was not statistically significant (p = 0.265). Group 1 showed significantly increased probing pocket depths (p = 0.001). Gingival inflammation was present in 80% of the pregnant women, but only in 40% of the control subjects. CONCLUSIONS: It was shown that during pregnancy changes related to periodontal health could be observed. Higher aMMP-8 values, elevated probing pocket depths, and an increase of gingival inflammation could be detected in comparison with non-pregnant women.

Clinical comparison of gluma and Er:YAG laser treatment of cervically exposed hypersensitive dentin.

PURPOSE: To compare the desensitizing effects of a glutaraldehyde-based desensitizing system (Gluma) and an Er:YAG laser treatment on cervically exposed hypersensitive dentin. METHODS: A total of 22 subjects (mean age: 39 +/- 13.7 years; 15 females, 7 males) suffering from cervical dentin hypersensitivity was included in a prospective, split-mouth clinical study. The teeth were treated on one side of the mouth with the glutaraldehyde-based desensitizing system and on the other side with the Er:YAG laser. Sensitivity perception was recorded before treatment (baseline), during and immediately after treatment, after 1 week, 1 month, 3 months and 6 months. The subjects were asked to rate the sensitivity experienced during air stimulation by placing a mark on a visual analogue scale (VAS). RESULTS: Both techniques showed an effective reduction of cervical dentin hypersensitivity. The subjects experienced equal improvements compared to their status before and 6 months after treatment with both methods (P<0.001).

A prospective clinical trial on the influence of a triamcinolone/demeclocycline and a calcium hydroxide based temporary cement on pain perception.

INTRODUCTION: The aim of this clinical trial was to compare the degree of short term post-operative irritation after application of a triamcinolone/demeclocycyline based or a calcium hydroxide based provisional cement. METHODS: A total of 109 patients (55 female and 54 male; mean age: 51 ± 14 years) with primary or secondary dentinal caries were randomly assigned to the two treatment groups of this biomedical clinical trial (phase III). Selection criteria were good systemic health and treated teeth, which were vital and showed no symptoms of pulpitis. Up to three teeth were prepared for indirect metallic restorations, and the provisional restorations were cemented with a triamcinolone/demeclocycyline (Ledermix) or a calcium hydroxide (Provicol) based material. The intensity of post-operative pain experienced was documented according to the VAS (4, 12, 20, 24, and 82 h) and compared to VAS baseline. RESULTS: A total of 159 teeth were treated (Ledermix: 83 teeth, Provicol: 76 teeth). The minor irritation of the teeth, experienced prior to treatment, was similar in both groups; however, 4 h after treatment this value was significantly higher in the Provicol group than in the Ledermix group (p < 0.005, t-test). After 12 h, the difference was no longer significant. The number of patients taking analgesics for post-treatment pain was higher in the Provicol group (n = 11/53) than in the Ledermix group (n = 3/56). CONCLUSIONS: The patients had no long term post-operative pain experience in both groups. However, within the first hours after cementation the sensation of pain was considerably higher in the Provicol group than in the Ledermix group.

The effect of Parodontax® on the MMP-8 concentration in gingivitis patients.

The aim of the study was to evaluate the efficacy of Parodontax® (GlaxoSmith-Kline, Bühl, Germany) on the signs gingival inflammation and the enzyme activity of matrix metalloproteinase-8 (aMMP-8) in the gingival crevicular fluid. After approval by the ethics commission, a total of 50 volunteers participated in the study; group 1 (n = 25, age: 43 ± 12 years) with moderate gingivitis (BOP +) and group 2 (n = 25, age: 29 ± 11 years) with clinically healthy gingival conditions (BOP -). After obtaining anamnestic data, the dental examination included assessment of oral hygiene (Quigley & Hein 1962), gingival inflammation (Saxer & Mühlemann 1975), probing pocket depth and clinical attachment level. Gingival crevicular fluid was collected from both groups. A quantitative assessment of aMMP-8 in the gingival crevicular fluid samples was performed (DentoAnalyzer, Dentognostics GmbH, Jena, Germany). Study participants were instructed to use only Parodontax®. After three weeks, all parameters were measured again. The aMMP-8 values of group 1 were significantly reduced after the use of Parodontax® toothpaste and mouthwash (p < 0.001; baseline median 41.25 ± 38.16 ng/ml, final post-treatment median 7.73 ± 7.58 ng/ml aMMP-8 eluate; group 2: baseline median 3.75 ± 3.16 ng/ml, final post-treatment median 3.73 ± 1.54 ng/ml aMMP-8 eluate). Gingival inflammation and plaque accumulation were reduced. It was shown that Parodontax® was effective in reducing the enzymatic activity of inflammation.

Gingival crevicular fluid MMP-8-concentrations in patients after acute myocardial infarction.

BACKGROUND: The aim of this study was to determine the presence of matrix metalloproteinase-8 in the gingival crevicular fluid (GCF) of patients after acute myocardial infarction (AMI). METHODS: A total of 48 GCF samples from 20 AMI patients, hospitalized at the Department of Cardiology and Angiology of the Johannes Gutenberg University Mainz, were investigated. Besides the myocardial infarction all patients suffered from chronic periodontal disease. Fifty-one GCF samples from 20 healthy age matched individuals with similar periodontal conditions served as controls. The dental examination included the assessment of oral hygiene, gingival inflammation, probing pocket depth, clinical attachment level and X-ray examination. The study was only carried out after the positive consent of the regional ethic commission. A quantitative assessment of aMMP-8 levels in the gingival crevicular fluid was performed with the help of the DentoAnalyzer (Dentognostics GmbH, Jena, Germany), utilising an immunological procedure. RESULTS: The aMMP-8 concentrations found in the gingival crevicular fluid of the AMI patients significantly differed (p = 0.001; mean value 30.33 ± 41.99 ng/ml aMMP-8) from the control group (mean value 10.0 ± 10.7 ng/ml aMMP-8). These findings suggest that periodontal inflammation in AMI patients might be associated with higher MMP-8-values compared to the healthy controls. CONCLUSIONS: The acute myocardial infarction seems to influence the degree of periodontal inflammation, thus the measurement of the gingival crevicular fluid MMP8 levels seems to be a helpful biochemical test to obtain information about the severity of the periodontal disease.

In vitro functional responses of isolated human vaginal tissue to selective phosphodiesterase inhibitors.

Only little is known as to the significance of the cyclic nucleotide-mediated signal transduction in the control of the function of human vaginal smooth musculature. Recently, the presence of the phosphodiesterase (PDE) isoenzymes 4 (cAMP-PDE) and 5 (cGMP-PDE) in the human vagina was reported. Thus, it was the aim of the study to elucidate the effects of some PDE inhibitors on the tension induced by endothelin 1 (ET-1), as well as on levels of cGMP and cAMP in isolated human vaginal wall tissue. Using the organ bath technique, the ability of norepinephrine (NE), carbachol, serotonin (5-HT), oxytocin and ET-1 to contract isolated vaginal wall muscle strips was evaluated. In another set-up, the effects of the PDE4 inhibitor rolipram and PDE5 inhibitors sildenafil and vardenafil (1 nM-10 microM) on the tension induced by 0.1 microM ET-1 of human vaginal wall tissue strips were investigated. In order to measure drug effects on tissue levels of cGMP and cAMP, vaginal tissue was exposed to different concentrations (0.1, 1 and 10 microM) of the compounds and the accumulation of cyclic nucleotides was determined. The adenylyl cyclase stimulating agents forskolin and nitric oxide donor sodium nitroprusside (SNP) (0.01, 0.1 and 1 microM) were used as reference compounds. While NE, carbachol and oxytocin failed to contract the vaginal tissue, ET-1 and, to a certain degree, 5-HT elicited contractile responses of the isolated strip preparations. The tension induced by 0.1 microM ET-1 was dose-dependently reversed by the drugs. The rank order of efficacy was sildenafil > forskolin > rolipram >or= vardenafil > SNP. Rmax values ranged from 24% (SNP) to 50% (sildenafil). With sildenafil being the only exception, none of the compounds reached an EC50 value. The relaxing effects of the drugs were paralleled by a fourfold to tenfold increase in tissue levels of cGMP and/or cAMP. Our results demonstrate that PDE inhibitors can relax human vaginal tissue and increase levels of cyclic nucleoside monophosphates. The findings with regard to the PDE5 inhibitors may indicate that the NO-cGMP pathway is, to a certain degree, involved in the control of vaginal smooth muscle tone. This might be of significance with regard to the pharmacological treatment of disorders connected with female sexual arousal and the ability to achieve orgasm.