The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery.

An objective method to recognize patient psychology using heart rate variability (HRV) has recently been developed and is increasingly being used in medical practice. This study compared the potential of this new method with the use of conventional surveys measuring anxiety levels in patients undergoing impacted third molar (ITM) surgery. Patient anxiety was examined before treatment in 64 adults who required ITM surgery, using two methods: measurement of HRV and conventional questionnaire surveys (state section of the State-Trait Anxiety Inventory (STAI-S) and Dental Fear Survey (DFS)). Both methods were assessed for their respective abilities to determine the impact of personal background, the amount of information provided, and the surgical procedure on patient psychology. Questionnaires and HRV yielded the same finding: dental experience was the single background factor that correlated with patient anxiety; the other factors remain unclear. The STAI-S showed a significant relationship between the information provided to the patient and their anxiety level, while the DFS and HRV did not. In addition, HRV demonstrated its ability to assess the effects of the surgical procedure on patient psychology. HRV demonstrated great potential as an objective method for evaluating patient stress, especially for providing real-time information on the patient's status.

Administration of osteocalcin accelerates orthodontic tooth movement induced by a closed coil spring in rats.

The effect of local administration of osteocalcin (OC) on experimental tooth movement was examined in the rat. The maxillary first molar was first moved mesially with an initial tipping force of 30 g with a closed-coil spring anchored to the incisor for 10 days (n = 48). Three experimental groups (n = 8) were injected with purified rat OC at doses of 0.1, 1, and 10 micrograms, respectively. The injection into the palatal bifurcation site of the first molar was repeated daily. The control groups (n = 8) were injected with rat serum albumin (10 micrograms), phosphate buffered saline (PBS), or were not injected. Tooth movement was evaluated daily by measuring the inter-cuspal distance between the first and the second molars on a precise plaster model. The cumulative tooth movement (mm) in the 1-microgram OC-injected groups was significantly more than that in all of the control groups on day 9. The rate of tooth movement (mm/day) showed periodical elevation, with high values on days 1, 4, 7, and 9. Acceleration of tooth movement by OC was significant in the early experimental period. Subsequently, acceleration of early tooth movement by OC was histologically evaluated (n = 40). Each of four animals from the control (PBS, n = 20) and the experimental (1 microgram OC, n = 20) groups was killed daily up to 5 days. A significantly larger number of osteoclasts accumulated on the mesial alveolar bone surface in the 1-microgram OC-injected group on day 3 than that observed in control group. These results suggest that administration of OC accelerates orthodontic tooth movement due to enhancement of osteoclastogenesis on the pressure side, primarily in the early experimental period.

[A survey of awareness among new patients at the department of oral diagnosis and general dentistry].

The purpose of this study is to know the outline of clinical statistics of new patients at the Clinic for Initial Diagnosis/Emergency, Dental Hospital, Tokyo Medical and Dental University. We examined 1,001 new patients who visited our hospital from 19 October to 8 December 1995. The results were obtained as follows: 1. Our subjects were 1,001 patients, males were 357(35.7%) and females 644(64.3%). The ratio of male to female was 1:1.8. 2. Concerning age distribution, the majorities were in their twenties and fifties in order. 3. 71.5% of patients said it took less than one hour for them to come to our hospital. 4. The rate of introduced patients was 5.5% of all the new patients.

Patient-dentist relationship.

The scope of the review has been confined to behavioral researches published mainly in the past two decades especially on patient-dentist relationship, dental anxiety, communication and patients' satisfaction. In summary, it is concluded that there is not so much progress during the periodin the field of behavioral dentistry. Consequently, several recommendations are suggested for a future study of behavioral dentistry.

[Study on oral health status and health behavior of workers at government office].

The purpose of this study was to investigate the oral health status and health behavior of the adult population in the workplace. In 1998, oral health examination of 388 workers (male: 287, female: 101) at a government office was performed. A questionnaire was administered to obtain data regarding oral symptoms and health behavior. The results were as follows: Overall, 48% needed treatment for dental caries, 44% needed calculus removal, and 23% needed treatment for periodontal disease. Although there were no oral health complaints, 20% had early caries, 40% had dental calculus, and 19% had periodontitis. Compared to males, more females brushed their teeth, had home dentists (44%) and received more regular dental health check-ups at least once a year (48%). For males, those with home dentists had higher FT and DMFT in the twenties and thirties. There was no relationship between oral health status and regular check-ups in both males and females. The results revealed that receiving regular dental check-ups from home dentists was not popular in Japan. Further, the role of home dentists is not preventive oriented. It was concluded that it is necessary to provide regular oral health examination and health promotion programs for adult population at the workplace in Japan.

[New curriculum of behavioral dentistry].

Faculty of Dentistry, Tokyo Medical and Dental University first introduced New Curriculum of Behavioral Dentistry in Japan. This curriculum has been established in consideration of the current social environments and dental clinical practice in our country, in addition to reference to Curriculum Guidelines in the USA. When students' impressions and assessments on the courses were researched and analyzed, the majority were found to be satisfied with this curriculum although several problems to be solved were also presented at the same time, such as timing of derivering lectures.

[Medical interview with simulated patients at behavioral science in dentistry].

The purpose of this paper is to present an outline of student's practice of interviewing simulated patients at behavioral science in dentistry. This practice was initiated as part of a newly introduced behavioral science course at our school of dentistry, to enable students to acquire communication skills, comprehensive understanding, and a proper attitude vis-à-vis patients. Students as well as instructors involved in the practice evaluated it as highly relevant for clinical education. It is concluded that the development of such practices in dental education is a prerequisite for training students to dentists oriented toward patient-centered dental practice.

Expression and localization of ferritin mRNA in ameloblasts of rat incisor.

At the maturation stage, the ameloblasts of the rat incisor incorporate iron, supplied through the bloodstream, and deposit it into the surface layer of the enamel. In this unique iron transport system, ferritin functions as a transient iron reservoir in the cells. Here the expression of ferritin mRNA and its localization in the rat enamel organ was examined. Among various tissues, the enamel organ showed the highest expression for both ferritin H- and L-chain mRNA, as quantified by reverse transcription-polymerase chain reaction. In situ hybridization using digoxigenin-labelled cRNA probes for each chain demonstrated that both ferritin H- and L-chain mRNA were abundantly expressed in presecretory and secretory ameloblasts. The intensity of the positive hybridization signal gradually decreased toward the incisal direction. Differing from the mRNA localization, ferritin protein was immunologically undetectable in presecretory or secretory ameloblasts but was found in ameloblasts at the maturation stage, into which iron is known to be incorporated from the bloodstream. Thus, the expression of ferritin mRNA precedes the protein expression in the developmental stages of rat incisor ameloblasts, and the translation of ferritin and its half-life are probably controlled by the iron entry, as has been reported for other cell types.

Effects of local administration of osteocalcin on experimental tooth movement.

The purpose of this study was to evaluate the effects of local administration of osteocalcin, a major noncollagenous bone matrix protein, on experimental tooth movement in rats. An orthodontic elastic band was inserted between the upper first and second molars, and the first molar was moved mesially. Purified osteocalcin (0 to 10 micrograms) in 20 microliters of phosphate-buffered saline was injected into the region of the root bifurcation of the first molar daily for 4 days. Tooth movement increased significantly following the injections. Histological studies revealed that the injections markedly stimulated the appearance of osteoclasts on the pressured side of the alveolar bone surface. The results suggest that osteocalcin has an additive effect on the rate of orthodontic tooth movement through the enhancement of osteoclastogenesis on the pressured side.

Conflict situation increases serotonin release in rat dorsal hippocampus: in vivo study with microdialysis and Vogel test.

The release of serotonin (5-hydroxytryptamine, 5-HT) in the dorsal hippocampus was measured using an in vivo microdialysis method in rats subjected to the Vogel type conflict test. The conflict situation significantly increased 5-HT release in the dorsal hippocampus. Midazolam (0.75 and 1.5 mg/kg i.p.) suppressed the dosage-dependently this increased 5-HT release, an inhibition closely associated with the attenuation of conflict behavior. These findings suggest that the activation of serotonergic neuronal activity in the dorsal hippocampus is linked to mediation of anxiety-related behavior.

Toxicity of camphorated phenol and camphorated parachlorophenol in dental pulp cell culture.

The toxicity of phenol, parachlorophenol, camphorated phenol, camphorated parachlorophenol, and camphor was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) colorimetric assay on established rat dental pulp cells (RPC-C2A). RPC-C2A cells at the confluent stage were incubated for 24 h in an experimental medium containing each compound at different concentrations. All tested drugs showed cytotoxicity in the MTT assay in a concentration-dependent manner. It is believed that camphor is a vehicle, and it reduces the toxicity of phenol and parachlorophenol. However, camphor itself showed cytotoxicity, and the addition of camphor increased the toxicity of phenol and parachlorophenol, reconfirming the cytotoxicity of these classical antiseptics.

Ultrastructural and biochemical studies of the effect of polychlorinated biphenyl on mouse parotid gland cells.

These effects of polychlorinated biphenyl (PCB) were examined by light and electron microscopy and biochemical analysis of lysosomal enzyme activities. Several experimental protocols with dosage schedules of either 0.2, 2.0, or 20 mg/kg of PCB were used. Typical histological changes were observed in mice given 2 mg/kg of PCB in a single injection. There were no remarkable changes until 4 days after PCB administration; marked cytoplasmic vacuolation was observed in parotid acinar cells at 7 days. The activities of lysosomal enzymes increased after the PCB injection and their maximum values appeared consistently at 4 days after the treatment; the increases were threefold for acid phosphatase, twofold for beta-glucuronidase, threefold for cathepsin D, fivefold for cathepsin H and twofold for cathepsin L. As vacuolation was preceded by a large increase in lysosomal enzyme activities and the vacuoles co-localized with lysosomes, it is suggested that an increase in these activities induced by PCB may be closely related to the development of vacuolation in the parotid acinar cells as a subacute effect of PCB.

Induction of drug metabolizing enzymes by polychlorinated biphenyl in the parotid gland and relation to changes in vitamin A content and morphological changes.

The relationship between the morphological changes and vitamin A content during the development of acute toxicity induced by polychlorinated biphenyl (PCB) in mouse parotid glands was investigated. PCB was administered intraperitoneally at a single dose of 2 mg/kg. Ultrastructural studies revealed remarkable morphological changes in the rough endoplasmic reticulum, nucleus, Golgi apparatus and the secretory granules at 7 days after the administration of PCB. The activities of adenosine monophosphatase (AMPase) and alkaline phosphatase were increased 1 day after PCB administration. Then the activity of NADPH-cytochrome c reductase increased 4 days after PCB administration. Subsequently, the vitamin A content of the parotid glands significantly decreased at 7 days compared with the control. These sequential changes in enzyme activities implied that the decrease of vitamin A content in the parotid glands may be partly due to catabolism of vitamin A by increased activities of microsomal enzymes induced by PCB. In conclusion, it is suggested that PCB also induces drug metabolizing enzymes in the parotid gland cells and that the acute toxicity of PCB on this tissue may occur, at least partly, through the reduction of vitamin A not only by the secondary effect from liver impairment but also by the locally accelerated catabolism of vitamin A in the mouse parotid gland.

[Effects of microtubule inhibitors on the amelogenesis in rat incisor enamel at the maturation stage: changes of staining patterns of GBHA on the enamel surface].

We investigated the effect of microtubule inhibitors on the amelogenesis in rat incisor enamel at the maturation stage by the glyoxal bis (2-hydroxyanil) (GBHA) staining method. Several red stripes stained with GBHA appeared on the maturation enamel surface of control rats. Colchicine injection (1.3 mg/kg, s.c.) disarranged the GBHA staining stripes and increased the staining area. The ratio of the GBHA staining area to the maturation enamel surface was about 25% in the control, but this value increased about 60% at 8 and 24 hr after the colchicine injection. Lumicolchicine, which does not have the ability to disrupt microtubules, did not cause any significant changes in the enamel surface. The incorporation of 45Ca to the maturation enamel was also reduced by colchicine. Since the hypocalcemic action of microtubule inhibitors may be related to the change of the enamel surface, other drugs, sodium salicylate and sodium fluoride, that have a hypocalcemic action were tested. The staining pattern was not altered by these drugs. Therefore, the hypocalcemic action was independent of the changes of the GBHA staining pattern. These results indicated that the disruption of microtubules in the ameloblasts inhibited calcium movement in the maturation enamel, resulting in the disarrangement of the GBHA staining pattern.

A cross-sectional study on osteocalcin levels in gingival crevicular fluid from periodontal patients.

The purpose of the present study was to determine the levels of osteocalcin, a bone specific matrix protein, in gingival crevicular fluid (GCF) from periodontal disease patients and to investigate the relationship between GCF osteocalcin levels and clinical parameters. Nineteen initial visit patients, 5 patients with gingivitis and 14 patients with adult periodontitis, participated in this study. The clinical parameters including probing depth, attachment level, gingival index, and tooth mobility were recorded following careful sampling of GCF with a filter paper strip harvested for 3 minutes. Osteocalcin adsorbed on a strip was extracted in a plastic tube containing 150 microliters of 10 mM sodium phosphate buffer (pH 6.5). GCF osteocalcin was determined by a newly-developed, high sensitive enzyme immunoassay which could recognize the N-terminal 20 residue peptide. In gingivitis patients, no significant amounts of osteocalcin were detected. In periodontitis patients, on the other hand, osteocalcin levels were detected, ranging between 0 and 540 pg/tube and positively correlated with these clinical parameters (P < 0.01). Moreover, in several sites in GI = 3 group, extremely higher levels of GCF osteocalcin were detected. These results strongly suggest that in addition to the presence of GCF osteocalcin the levels of osteocalcin may reflect the degree of the periodontal inflammation at the sampled sites.

Comparison of the effect of colchicine and vinblastine on the inhibiton of dentinogenesis in rat incisors.

The quantitative effect of vinblastine, colchicine and lumicolchicine on the rate of dentine formation was determined by chronologically-labelling dentine with the lead salt of EDTA, before and after the intravenous administration of the test drug. Colchicine and vinblastine produced a dose-dependent inhibition of dentine formation. Lumicolchicine had no adverse effect. Although the log dose-response lines of colchicine and vinblastine were parallel, the effect of vinblastine was more potent. The relative potency ratio of vinblastine to colchicine was 1.25-1.70. These results suggest that both colchicine and vinblastine may act at the same site i.e. microtubules, thereby inhibiting the secretion of new dentine matrix.