Influence of dental implantation on bone mineral density distribution: a pilot study.

PURPOSE: Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS: Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low5 and High5) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS: Edentulous patients with implants had significantly greater HSD and High5 values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High5 values significantly increased after receiving implants (P < .022). CONCLUSION: The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.

The role of peripheral nerve signaling in endometriosis.

A hallmark of endometriosis - a chronic debilitating condition whose causes are poorly understood - is neuronal innervation of lesions. Recent evidence demonstrates that the peripheral nervous system plays an important role in the pathophysiology of this disease. Sensory nerves, which surround and innervate endometriotic lesions, not only drive the chronic and debilitating pain associated with endometriosis but also contribute to a pro-growth phenotype by secreting neurotrophic factors and interacting with surrounding immune cells. The diverse array of contributions that neurons play in endometriosis indicate that it should be considered as a nerve-centric disease. This review is focused on the emerging field of exoneural biology and how it applies to the field of endometriosis, in particular the role that peripheral nerves play in driving and maintaining endometriotic lesions. A better understanding of the mechanisms of neuronal contribution to endometriosis, as well as their interactions with accompanying stromal and immune cells, will unearth novel disease-relevant pathways and targets, providing additional, more selective therapeutic horizons.

Photographic assessment of fluorosis in children from naturally fluoridated Kungsbacka and non-fluoridated Halmstad, Sweden.

OBJECTIVES: To assess levels of fluorosis and fluorosis of esthetic concern in children from a naturally fluoridated and a non-fluoridated area of Sweden, and to determine the relative contributions of fluoridated water, parental educational level, and infant oral health-related behaviors. METHODS: A parental questionnaire collected information concerning child F-supplement and F-dentifrice usage histories, and socio-economic status. Photographic examination of 1336 subjects (F=791; N-F=545) was undertaken. Fluorosis was assessed (blind to F-exposure) in a random sample (n=250) of 35 mm slides by four dental and two lay "jurors" (with 10% random repeat-viewing for inter-observer and intra-observer agreement). Four outcomes were assessed on each slide: fluorosis at any level, fluorosis of esthetic concern, acceptability of appearance, and treatment needs. Ordinal logistic regression models were used to determine significant determinants. RESULTS: For presence of fluorosis of esthetic concern, majority jury agreements (>3 of 6) were seen in only 2.3% (N-F) and 13.4% (F) pupils (p<0.001), albeit jurors unanimously scored only 13 F and 2 N-F exposed children as having esthetically unacceptable fluorosed teeth (p<0.001). The over-riding significant factor in terms of fluorosis of esthetic concern was exposure to water fluoridation in infancy in both unadjusted and adjusted models. CONCLUSIONS: The important factor in relation to fluorosis of esthetic concern was explained by exposure to fluoridated water in infancy, and was not explained by age, sex, level of parental education or early childhood oral health behaviors. However, prevalence of this condition was relatively low. These findings should inform policies on appropriate total fluoride exposure levels during infancy.

SAR study of 1-aryl-4-(phenylarylmethyl)piperazines as ligands for both dopamine D2 and serotonin 5-HT1A receptors showing varying degrees of (Ant)agonism. Selection of a potential atypical antipsychotic.

The syntheses of several 1-aryl-4-(arylpyridylmethyl)piperazines (4) and their affinities for dopamine D(2) and serotonin 5-HT(1A) receptors are described. The compounds were evaluated both in vitro and in vivo, resulting in the identification of the drug candidate SLV313 (4e) with equipotent and full D(2) receptor antagonism and 5-HT(1A) receptor agonism. Minor structural modifications in SLV313 revealed the possibility of designing compounds possessing varying degrees of partial agonism on one or both target receptors.

Prevalence of dental fluorosis in children from non-water-fluoridated Halmstad, Sweden: fluoride toothpaste use in infancy.

OBJECTIVES: To determine the prevalence and severity of dental fluorosis in children aged 7-9 years from non-water-fluoridated Halmstad, Sweden, and to relate the results to their reported fluoride exposure history during infancy. MATERIAL AND METHODS: In Spring 2002, a questionnaire distributed to a cluster random sample of 1039 parents enquired into their child's early oral health behaviors and included a "photographic toothpaste menu". The permanent upper anterior teeth (13-23) were examined clinically (+10% repeats) using a modified Thylstrup-Fejerskov Index. RESULTS: Complete data were available for 53% (n=548) of the sampled children. The prevalence offluorosis at any level was 49% (95% CI: 45-54%), and of fluorosis with esthetic concern (TF score > or =3) 4% (95% CI: 3-6%). Based on repeat observations, reliability was good (kappa = 0.82). There was no statistically significant increased risk of dental fluorosis prevalence associated with any of the fluoride exposure risk factors examined, including reported usage of (1000 ppm) fluoride toothpaste from time of first deciduous tooth eruption. CONCLUSIONS: While there were low levels of dental fluorosis of esthetic concern, half the children had some degree of dental fluorosis. The prevalence of dental fluorosis was not explained by the risk factors, including fluoride toothpaste usage as explored in this study.

An assessment of teenagers' perceptions of dental fluorosis using digital simulation and web-based testing.

OBJECTIVES: To develop a new model to establish teenagers' perceptions of the aesthetic impact of fluorosis, in the context of overall facial appearance. This web-based model was used to compare different degrees of fluorosis at any one distance, while also comparing the same level of fluorosis at different 'distances'. METHODS: A 14-year-old subject was used as the model face. Different degrees of fluorosis were 'built-up' on this subject's teeth using digital simulation. A web-based questionnaire showed 30 photographs, displaying four levels of fluorosis, in addition to fluorosis-free, at five different 'distances'. The closest images were shown with and without retractors, while the more distant pictures showed more of the subject's face. Teenage pupils (n = 217) were then asked to grade the acceptability of the appearances and indicate if they would wish treatment for each such appearance. RESULTS: At any one distance, acceptability fell as fluorosis level increased. When the same degree of fluorosis was compared at different distances, acceptability improved as the teeth were viewed from further away. Pictures taken without retractors had higher acceptability than those taken with retractors in place. CONCLUSIONS: Teenagers can discriminate between various degrees of fluorosis. However, more distant viewing of fluorosed teeth, within the overall context of the face, improves acceptability of the appearance.

Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus fruit consumption, vitamin C, and inflammatory and thrombotic variables.

BACKGROUND AND OBJECTIVE: Tooth loss has been associated with cardiovascular disease (CVD), but the mechanisms are unclear. We evaluated the association of total tooth loss with prevalent CVD in men and women; as well as with citrus fruit consumption, plasma vitamin C, and inflammatory and thrombotic variables. METHODS: We used an age-and sex-stratified population survey, of men and women aged 25-74 years, in North Glasgow. RESULTS: Thirty-eight percent of women and 29% of men were edentulous. Total tooth loss was associated with prevalent CVD in both sexes. After adjustment for major potential confounders (age, sex, smoking, and social class), the odds ratio (95% CI) for prevalent CVD was 1.55 (1.13, 2.13) in the edentulous. Total tooth loss was also associated with low citrus fruit consumption and low plasma vitamin C levels, increased plasma C-reactive protein in men, and with increased plasma interleukin-6, fibrinogen, and factor VIII levels in women. CONCLUSION: Prevalent CVD is associated with total tooth loss. Possible mechanisms include low intake of citrus fruit, and hence, low plasma vitamin C levels, and a predisposition to low-grade inflammation and thrombosis. It may be prudent to ensure adequate vitamin C intake in people with no teeth.

A blind caries and fluorosis prevalence study of school-children in naturally fluoridated and nonfluoridated townships of Morayshire, Scotland.

OBJECTIVES: To undertake a blind caries and fluorosis prevalence study of Grade 1 (aged 5/6 yr) and Grade 4-7 (aged 8-12 yr) children from naturally water-fluoridated (1 ppm, since 1985) Burghead, Findhorn & Kinloss (F), and nearby nonfluoridated Buckie & Portessie (N-F), in rural Morayshire, Scotland. METHODS: A blind clinical (+ 10% repeats) caries study of the above townships' 5/6-yr-old lifetime (15 F; 43 N-F), and 8-12-yr-old lifetime (55 F; 136 N-F)/school-lifetime (31 F; 37 N-F) residents was undertaken following bussing of these children to a common examination site in close-by Elgin Town Hall. Initially, each child was asked about their own perception of the aesthetics of their maxillary front teeth. Fluorosis was assessed clinically using the TF Index, as well as photographically - for later blind scoring (+ 10% repeats for lifetime 8-12-yr-olds) of slides by four dental and two lay 'jurors', alongside a now-established UK 'bench-mark' mildly mottled (TFI = 2), fluorosis comparator slide, judged in previous studies to be aesthetically lay-acceptable. In addition, by parental questionnaire, information was sought concerning their child's fluoride supplement and dentifrice usage histories. RESULTS: For 5/6-yr-olds, mean primary caries scores were 96.0% less in fluoridated than nonfluoridated subjects (P < 0.01). In 8-12-yr-olds, DMFT values favoured water-fluoridated subjects; their caries-free trend was significant (P < 0.001 overall). Clinically, 33% of all lifetime F subjects and 18% of all N-F pupils had fluorosed maxillary anterior teeth (P = 0.045), but no statistically significant difference was found between the 7% F and 3% N-F subjects with TFI scores > 2 (P = 0.25). Photographically, 'jury' mottling assessment (+ 10% repeats) of projected slides resulted in at least 1 : 6 positive scores in 43.6% of F and 30.9% of N-F pupils, albeit they unanimously scored only nine F and five N-F children as having fluorosed teeth (P < 0.01). In no case did all members score TFI > 2. Dental and lay scorers rated TFI = (1/2) in only a further 9.1% and 5.5% of F subjects, respectively, compared to 0.7% and 1.5% respectively of N-F pupils. Again, TFI > 2 was scored unanimously in no child. No differences were found regarding the children's own degree of anterior tooth aesthetic nonacceptability between F (11%) and N-F (12%) prevalence (P = 0.75). Finally, only one F child had taken F supplements and, while 26 N-F had used F drops, no significant relationship was found between their usage and TFI values in the latter group (P = 0.49). Additionally, no relationship was noted between clinical TFI scores and the age at which parents stated fluoridated dentifrice toothbrushing commenced, between 0 and 24 + months of age. CONCLUSIONS: Considerable caries benefit has accrued to those Morayshire rural children who have received naturally fluoridated water (at 1 ppm) throughout their lives, as compared to their socioeconomically similar, nonfluoridated rural counterparts. Furthermore, in spite of all but two subjects claiming to have brushed regularly with fluoridated dentifrice (and no evidence of the availability of nonfluoridated toothpaste being purchasable in the five townships), only borderline mild fluorosis disadvantages have been noted clinically, and none by the subjects' own aesthetic perceptions. Finally, no evidence was found to suggest any delay in permanent tooth eruption patterns of the F subjects. It would seem appropriate therefore, that adjustment of Scots' drinking waters' natural fluoride levels to 1 ppm should be pursued to extend similar dental advantages to the vast majority of that population (both young and old) which, it is well documented, has the worst dental health of mainland UK.