High levels of heavy metal accumulation in dental calculus of smokers: a pilot inductively coupled plasma mass spectrometry study.

BACKGROUND AND OBJECTIVE: Various trace elements, including toxic heavy metals, may exist in dental calculus. However, the effect of environmental factors on heavy metal composition of dental calculus is unknown. Smoking is a major environmental source for chronic toxic heavy metal exposition. The aim of this study is to compare toxic heavy metal accumulation levels in supragingival dental calculus of smokers and non-smokers. MATERIAL AND METHODS: A total of 29 supragingival dental calculus samples were obtained from non-smoker (n = 14) and smoker (n = 15) individuals. Subjects with a probability of occupational exposure were excluded from the study. Samples were analyzed by inductively coupled plasma mass spectrometry in terms of 26 metals and metalloids, including toxic heavy metals. RESULTS: Toxic heavy metals, arsenic (p < 0.05), cadmium (p < 0.05), lead (p < 0.01), manganese (p < 0.01) and vanadium (p < 0.01) levels were significantly higher in smokers than non-smokers. The levels of other examined elements were similar in both groups (p > 0.05). CONCLUSION: Within the limitations of this study, it can be concluded that the elementary composition of dental calculus may be affected by environmental factors such as tobacco smoke. Therefore, dental calculus may be utilized as a non-invasive diagnostic biological material for monitoring chronic oral heavy metal exposition. However, further studies are required to evaluate its diagnostic potential.

Assessment of alveolar bone levels from bitewing, periapical and panoramic radiographs in periodontitis patients / Evaluación de los niveles de hueso alveolar a partir de radiografías interproximales, periapicales y panorámicas en pacientes con periodontitis

The aim of this study was to determine the relationship between loss of radiographic crestal bone height in panoramic, bitewing and periapical radiography and to probe the attachment loss after periodontal treatment. Radiographic and probing measurements were made at baseline and after one year. The population in the study consisted of 21 individuals, 13 females and 8 males, ages 18-59 [mean 35.7] years. A total of 42 interproximal intra-bony defects of 21 mandibular first molar teeth, treatments of which were planned by subgingival curettage procedures, were selected from among 21 subjects who had signed consent forms. Measurements of the distance between the cemento-enamel junction and the alveolar crest were compared with probing crestal bone level and radiographic measurements before and one year after the procedures. The results of probing pocket depths level before and one year after subgingival curettage were different with the mean average being 1.18 ± 1.51 mm. These changes were statistically significant (p < 0.05). Bitewing radiography showed the highest accuracy among radiographic methods in the assessment of the crestal bone level mean average 0.22 ± 0.87 mm (p < 0.05). There was only a slight mean difference compared to panoramic radiography but this was statistically insignificant, mean average 0.20 ± 1.35 mm (p > 0.05), and the periapical radiography had the lowest accuracy of radiographic methods, changed mean average -0.14 ± 1.19.mm (p > 0.05). In summary, we can say that both bitewing and panoramic radiography are preferred to periapical images for crestal bone assesment.

El objetivo de este estudio fue determinar la relación entre la pérdida de altura radiográfica de hueso crestal en radiografías panorámicas interproximales y periapicales, e investigar la pérdida de inserción tras el tratamiento periodontal. Las mediciones radiográficas y de sondeo fueron realizadas en la situación inicial y luego de un año. La población bajo estudio consistió en 21 individuos, 13 hembras y 8 varones, con edades 18-59 [media 35.7] (años). Un total de 42 defectos intraóseos interproximales de 21 primeros molares mandibulares, cuyos tratamientos fueron planeados mediante procedimientos de curetaje subgingival, fueron seleccionados de entre 21 sujetos que habían firmado su consentimiento. Las mediciones de la distancia entre la unión cemento-esmalte y la cresta alveolar, fueron comparadas sondeando el nivel de hueso crestal y recurriendo a mediciones radiográficas, antes y después (un año más tarde) de los procedimientos. Los resultados del sondeo del nivel de profundidad de la bolsa antes y después del curetaje subgingival, fueron diferentes, siendo la media promedio 1.18 ± 1.51 mm. Estos cambios fueron estadísticamente significativos (p < 0.05). La radiografía inter-proximal mostró la mayor exactitud entre los métodos radiográficos de evaluación del nivel óseo crestal, para una media promedio de 0.22 ± 0.87 mm (p < 0.05). Hubo sólo una ligera diferencia media en comparación con la radiografía panorámica, pero fue estadísticamente insignificante, siendo la media promedio 0.20 ± 1.35 mm (p > 0.05). En cambio, la radiografía periapical resultó ser la de más baja precisión entre los métodos radiográficos, para un cambio en la media promedio de -0.14 ± 1.19.mm (p > 0.05). En resumen, puede decirse que tanto la radiografía interproximal como la panorámica tienen preferencia por sobre las imágenes periapicales a la hora de la evaluación del hueso crestal.

Assessment of alveolar bone levels from bitewing, periapical and panoramic radiographs in periodontitis patients.

The aim of this study was to determine the relationship between loss of radiographic crestal bone height in panoramic, bitewing and periapical radiography and to probe the attachment loss after periodontal treatment. Radiographic and probing measurements were made at baseline and after one year The population in the study consisted of 21 individuals, 13 females and 8 males, ages 18-59 [mean 35.7] years. A total of 42 interproximal intra-bony defects of 21 mandibular first molar teeth, treatments of which were planned by subgingival curettage procedures, were selected from among 21 subjects who had signed consent forms. Measurements of the distance between the cemento-enamel junction and the alveolar crest were compared with probing crestal bone level and radiographic measurements before and one year after the procedures. The results of probing pocket depths level before and one year after subgingival curettage were different with the mean average being 1.18 +/- 1.51 mm. These changes were statistically significant (p < 0.05). Bitewing radiography showed the highest accuracy among radiographic methods in the assessment of the crestal bone level mean average 0.22 +/- 0.87 mm (p < 0.05). There was only a slight mean difference compared to panoramic radiography but this was statistically insignificant, mean average 0.20 +/-1.35 mm (p > 0.05), and the periapical radiography had the lowest accuracy of radiographic methods, changed mean average -0.14 +/- 1.19 mm (p > 0.05). In summary, we can say that both bitewing and panoramic radiography are preferred to periapical images for crestal bone assessment.

Assessment of mandibular bone mineral density in patients with type 2 diabetes mellitus.

OBJECTIVES: To assess mandibular bone mineral density in patients with type 2 diabetes mellitus using panoramic radiographs. METHODS: Nineteen patients with type 2 diabetes mellitus and 17 control subjects participated in the study. Bone mineral density measurements were performed on the panoramic radiographs with the help of a five-step copper stepwedge phantom, attached to each film cassette, which was calibrated before hand by dual energy X-ray absorptiometry (DXA). The analysis was performed on digitized images by dedicated software (Scion Image). The accuracy of the measurement technique was also evaluated by cross-calibration with a DXA phantom. RESULTS: Mean mandibular bone mineral density (g cm(-2)) was 1.53+/-0.27 in women and 1.52+/-0.29 in men with type 2 diabetes. In age and gender matched control subjects the values were 1.56+/-0.28 and 1.46+/-0.23 in women and in men, respectively. No statistically significant difference was observed between groups in mandibular bone mineral density. CONCLUSIONS: The present study showed that bone mineral density of the mandible does not seem to be affected in patients with type 2 diabetes mellitus. We also observed that a panoramic radiograph could serve for accurate mandibular bone density determination, when calibrated well with the DXA method.

Blood pressure, heart rate and temperature variability during periodontal surgery

The aim of the present study is to investigate changes in blood pressure, pulse rate and temperature before and after periodontal surgery. The study included 127 normal healthy patients (43 males, 84 females) with age range 9 to 65 years (mean age: 26 +/- 12 years) who underwent periodontal surgery. After administration of a local anaesthetic agent (Ultracain DS) containing 0.06 mg adrenaline, the blood pressure, pulse rate, and temperature were measured. Based on the type of operation, the patients were divided into four groups. Statistically significant changes (as decreasing) in all parameters were observed (blood pressure: systolic 111.3 +/- 20.1, diastolic 67.7 +/- 13.1, pulse rate: 87.8 +/- 14.9, temperature: 36.3 +/- 0.3 ) but these changes were significantly decreased after operations (blood pressure: systolic 105.9 +/- 19. 7, diastolic 62.6 +/- 11.3, pulse rate: 84.01 +/- 13.1, temperature: 36.2 +/- 0.3). And without age group differentiation in all parameters, statistically significant decreases were found among females (p < or = 0. 05).

Gingival fibromatosis, short stature, border-line IQ, facial dysmorphism and hepatomegaly.

Gingival fibromatosis, short stature, border-line IQ, facial dysmorphism and hepatomegaly: Gingival fibromatosis is a rare and benign disorder. The enlarged gingivae are firm and may interfere with speech, closure of the lips, and mastication. We report a thirteen years old girl, with gingival fibromatosis referred to the periodontics clinics. Full mouth gingivectomy and gingivoplasty were performed. Medical investigation showed short stature, low-borderline IQ, facial dysmorphism, and hepatomegaly. Histological analysis revealed hyperplasia in the epithelial area and fibrotic appearance of gingival connective tissue with dense collagen fibre clusters. Pedigree analysis confirmed that mode of inheritance is autosomal recessive. According to the combination of clinical findings, this case report may represent a previously unreported syndrome.

Blood pressure, heart rate and temperature variability during periodontal surgery.

The aim of the present study is to investigate changes in blood pressure, pulse rate and temperature before and after periodontal surgery. The study included 127 normal healthy patients (43 males, 84 females) with age range 9 to 65 years (mean age: 26 +/- 12 years) who underwent periodontal surgery. After administration of a local anaesthetic agent (Ultracain DS) containing 0.06 mg adrenaline, the blood pressure, pulse rate, and temperature were measured. Based on the type of operation, the patients were divided into four groups. Statistically significant changes (as decreasing) in all parameters were observed (blood pressure: systolic 111.3 +/- 20.1, diastolic 67.7 +/- 13.1, pulse rate: 87.8 +/- 14.9, temperature: 36.3 +/- 0.3 ) but these changes were significantly decreased after operations (blood pressure: systolic 105.9 +/- 19. 7, diastolic 62.6 +/- 11.3, pulse rate: 84.01 +/- 13.1, temperature: 36.2 +/- 0.3). And without age group differentiation in all parameters, statistically significant decreases were found among females (p < or = 0. 05).