Oral Human Papillomavirus Infection and Oral Lesions in HIV-Positive and HIV-Negative Dental Patients.

We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4(+) T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/mm(3); OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4(+) T-cell counts.

Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

INTRODUCTION: Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. METHODS: Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). RESULTS: The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P <0.05). The mean United States weighted PAR scores were 32.2 (SD, 15.0) for patients with osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P <0.05). The average modified DI scores were 29.8 (SD, 20.2) for the osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P <0.05). Group differences were greatest for lateral open bite (osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. CONCLUSIONS: Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta.

Brazilian dental students' intentions and motivations towards their professional career.

Investigating career motivations and intentions of dental students provides a better understanding of their role in society and contributes to the debate on dental education and practices. This study describes the profile, career choice motivations, and career intentions of Brazilian dental students and evaluates factors related to these choices. A cross-sectional study was carried out among dental students from three Brazilian public universities (N=915), with a response rate of 83.7 percent. Students (N=766) responded to a self-administered questionnaire about sociodemographic factors, reasons for choosing dentistry as a career, and future career intentions. Job conception was found to be the main reason for choosing dentistry as a profession. Most students intended to become specialists and work in both the public and private sectors simultaneously. Female students (OR 2.23, 95 percent CI=1.62-3.08), low-income students (OR 1.86, 95 percent CI=1.10-3.13), and students beginning their program (OR 1.87, 95 percent CI=1.22-2.85) were more likely to work in the public and private sectors simultaneously than other types of students. This study suggests that choice of career and career plans are influenced by factors related to the students' characteristics and their conception of the profession. The opportunity to combine private and public dental practice may be viewed as a way to achieve income and job security.

Effect of sample storage time on detection of hybridization signals in Checkerboard DNA-DNA hybridization.

Long-term sample storage can affect the intensity of the hybridization signals provided by molecular diagnostic methods that use chemiluminescent detection. The aim of this study was to evaluate the effect of different storage times on the hybridization signals of 13 bacterial species detected by the Checkerboard DNA-DNA hybridization method using whole-genomic DNA probes. Ninety-six subgingival biofilm samples were collected from 36 healthy subjects, and the intensity of hybridization signals was evaluated at 4 different time periods: (1) immediately after collecting (n = 24) and (2) after storage at -20 °C for 6 months (n = 24), (3) for 12 months (n = 24), and (4) for 24 months (n = 24). The intensity of hybridization signals obtained from groups 1 and 2 were significantly higher than in the other groups (p < 0.001). No differences were found between groups 1 and 2 (p > 0.05). The Checkerboard DNA-DNA hybridization method was suitable to detect hybridization signals from all groups evaluated, and the intensity of signals decreased significantly after long periods of sample storage.

Bacterial leakage along the implant-abutment interface: culture and DNA Checkerboard hybridization analyses.

OBJECTIVE: Bacterial species have been found harboring the internal surface of dental implants as consequence of their failed connections. The aim of the present study was to compare the detection frequency of bacterial leakage from human saliva through the implant-abutment interface, under non-loading conditions, using either DNA Checkerboard or culture method. MATERIALS AND METHODS: Thirty dental implants with hexagonal platforms were connected to pre-machined abutments according to the manufacturers' specifications. The assemblies were individually incubated in human saliva under anaerobic conditions for 7 days at 37°C. Afterward, contents from the inner parts of the implants were collected and evaluated with either DNA Checkerboard (s = 15) or culture (n = 15). Subsequently, identification and quantitation of bacterial species from saliva and implants were carried out for the group evaluated with the DNA Checkerboard method. RESULTS: Both DNA Checkerboard and culture showed positive signals of bacterial leakage in 6 of the 15 evaluated samples. Capnocytophaga gingivalis and Streptococcus mutans were the most frequently detected species harboring the internal surface of the implants followed by Veillonella parvula. CONCLUSION: Occurrence of bacterial leakage along the implant-abutment interface is comparably detected with both DNA Checkerboard hybridization and conventional culture methods.

Shear bond strength between different materials bonded with two resin cements.

BACKGROUND: The aim of this study was to compare the shear bond strength between Ni-Cr alloy specimens bonded to air-abraded Ni-Cr, bur-abraded Ni-Cr, etched ceramic and etched enamel substrates using the resin cements RelyX ARC or Enforce. MATERIALS AND METHODS: Ni-Cr specimens were made and sandblasted with Al(2)O(3) airborne-particles. Disc-shaped patterns were made for each of the four experimental substrates: Ni-Cr treated with Al(2)O(3) airborne-particles, Ni-Cr treated with diamond bur abrasion, etched enamel and etched ceramic. RESULTS: Significant differences in shear bond strength were found between the different materials and luting agents evaluated. The Ni-Cr alloy cylinders bonded to Ni-Cr surfaces sandblasted with 50 µm Al(2)O(3) particles and bonded with Enforce achieved the highest bond strength when compared with other substrates (28.9 MPa, p < 0.05). Bur-abraded metal discs had lowest values, regardless the cement used (2.9 and 6.9 MPa for RelyX and Enforce, respectively). Etched enamel and etched ceramic had similar shear bond strengths within cement groups and performed better when RelyX was used. CONCLUSIONS: Bonding Ni-Cr to Ni-Cr and ceramic may result in similar and higher bond strength when compared to Ni-Cr/enamel bonding. For metal/metal bonding, higher shear bond strength was achieved with resin cement Enforce, and for metal/ceramic and metal/enamel bonding, RelyX had higher results.

Nutritional and anthropometric analysis of edentulous patients wearing implant overdentures or conventional dentures.

As masticatory efficiency diminishes drastically in edentulous patients, several researchers have studied over the past two decades how dietary intake varies when different types of oral rehabilitation are provided. Since the use of implants to support prostheses in edentulous mandibles has been shown to significantly improve masticatory performance, the question remains as to whether this improvement will influence the nutritional status. The purose of this study was to evaluate the nutritional status of edentulous patients who randomly received either a mandibular conventional denture (CD) or an implant-supported overdenture (IP) 1 year previously. Weight, height, body composition and handgrip strength measurements were collected for analysis. Blood tests were performed to measure plasma parameters of diet intake. Participants responded to a Food Frequency Questionnaire and a Masticatory Function Questionnaire. Fifty-three people participated (58% men, 42% women; mean age = 53). Body composition indicators as well as plasma parameters were generally within normal range, and no statistically significant difference (p>0.05) was found between the groups. Patients in the CD group had significantly lower ratings for items regarding difficulty in chewing (p<0.05), but no significant difference was found for dietary intake (p>0.05). Although the CD wearers reported having more difficulty in chewing hard foods, both groups appeared to have a similar nutritional status.

Nutritional and anthropometric analysis of edentulous patients wearing implant overdentures or conventional dentures

As masticatory efficiency diminishes drastically in edentulous patients, several researchers have studied over the past two decades how dietary intake varies when different types of oral rehabilitation are provided. Since the use of implants to support prostheses in edentulous mandibles has been shown to significantly improve masticatory performance, the question remains as to whether this improvement will influence the nutritional status. The purose of this study was to evaluate the nutritional status of edentulous patients who randomly received either a mandibular conventional denture (CD) or an implant-supported overdenture (IP) 1 year previously. Weight, height, body composition and handgrip strength measurements were collected for analysis. Blood tests were performed to measure plasma parameters of diet intake. Participants responded to a Food Frequency Questionnaire and a Masticatory Function Questionnaire. Fifty-three people participated (58 percent men, 42 percent women; mean age = 53). Body composition indicators as well as plasma parameters were generally within normal range, and no statistically significant difference (p>0.05) was found between the groups. Patients in the CD group had significantly lower ratings for items regarding difficulty in chewing (p<0.05), but no significant difference was found for dietary intake (p>0.05). Although the CD wearers reported having more difficulty in chewing hard foods, both groups appeared to have a similar nutritional status.

O uso de implantes para suportar próteses em pacientes edêntulos completos causa uma melhora significativa na performance mastigatória desses indivíduos. Contudo, a influência desse benefício no estado nutricional do paciente ainda não está completamente estabelecida. Esse estudo avaliou o estado nutricional de pacientes desdentados completos reabilitados com próteses totais convencionais (grupo CD) ou com próteses totais implanto-suportadas (grupo IP) na mandíbula. Foram coletados dados sobre composição corporal e uma amostra de sangue para análise. Os participantes responderam a um questionário sobre freqüência alimentar (QFA) e outro sobre habilidade mastigatória e método de preparo dos alimentos (QMF). A amostra foi composta de 53 participantes selecionados a partir de um estudo randomizado, sendo 58 por cento homens e 42 por cento mulheres, com idade média de 53 anos. Os indicadores de composição corporal se encontraram dentro da normalidade e sem diferenças significativas (p>0.05). O grupo CD obteve valores significativamente diferentes para itens do QMF sobre dificuldade de mastigar (p<0.05). Os dados do QFA e o resultado do exame de plasma estavam dentro dos níveis normais, e os valores entre os grupos foram semelhantes (p>0.05). Embora os participantes que receberam prótese total convencional tenham relatado maior dificuldade de mastigar alimentos duros, os dois grupos apresentaram estados nutricionais semelhantes.

Reduction of salivary S. aureus and mutans group streptococci by a preprocedural chlorhexidine rinse and maximal inhibitory dilutions of chlorhexidine and cetylpyridinium.

OBJECTIVES: Staphylococcus aureus and mutans group streptococci can cause, among many other diseases, infective endocarditis and postoperative infections. The reduction of the number of these microorganisms in the oral cavity prior to surgical procedures has been related to a decreased incidence of such occurrences. The aim of this study was to evaluate the effect of a single preprocedural rinse with 0.12% chlorhexidine solution (Periogard) on the salivary counts of S aureus and mutans group streptococci and determine maximal inhibitory dilutions (MID) of this and 0.05% cetylpyridinium chloride solution (Cepacol). METHOD AND MATERIALS: Saliva was collected from 60 patients before and after 30-second mouthrinses with chlorhexidine and cultured in appropriate media. The number of microorganisms was calculated based on the colony-forming units (CFUs). For the in vitro MID determination, 25 strains of S aureus were seeded in the media containing one of the sequential dilutions of both antiseptics. RESULTS: S aureus, Streptococcus mutans, and Streptococcus sobrinus were initially isolated from 45%, 63%, and 28% of the patients, respectively. After rinsing with chlorhexidine, the reductions in the CFUs were above 99% for all the studied microorganisms. In the MID determination, all isolates were inhibited with 1/20 and 1/80 dilutions of cetylpyridinium and chlorhexidine, respectively. Dose-response curves were obtained for both antiseptics. CONCLUSION: Single preprocedural chlorhexidine mouthrinse is effective in reducing salivary microorganisms to levels currently considered safe to perform invasive procedures, and it is still effective in a 1:80 dilution.

Temporomandibular disorder or Eagle's syndrome? A clinical report.

This clinical report describes the diagnosis and treatment of a patient under emotional stress with orofacial pain, headaches, and the feeling of a foreign body in the throat. An elongated styloid process at the beginning of the oral pharynx was diagnosed. Although these symptoms could be aspects of Eagle's syndrome, deflective occlusal interferences, tender muscles of mastication, and a clicking temporomandibular joint led to an evaluation for temporomandibular disorder related to malocclusion. An occlusal splint was used to confirm the diagnosis and to alleviate symptoms. Occlusal adjustments were subsequently performed. In a 10-year follow-up, the patient had no complaints.