Association between xerostomia, oral and general health, and obesity in adults. A cross-sectional pilot study.

BACKGROUND: The objective of this study was to analyse the association between oral and general health variables and obesity indicators with the sensation of dry mouth or xerostomia as evaluated on the Xerostomia Inventory (XI). MATERIAL AND METHODS: A total of 354 randomly selected subjects participated in this cross-sectional pilot study and completed an anonymous questionnaire. Anthropometric, clinical, and xerostomic variables were evaluated. Kruskal-Wallis, ANOVA and Bonferroni test were used for multiple comparisons. ROC curves and multinomial logistic regression were used to determine the (OR) risk of xerostomia. RESULTS: A total of 30.7 % of respondents reported xerostomia based on XI. The dry mouth question, the XI taken as a "gold standard", showed a diagnostic sensitivity of 70.37 %, and a specificity of 83.27 % (AUC=0.768, p<0.001). Logistical regression showed the highest xerostomia OR was associated to patients with bad self-perceived health, 6.31 (CI 95% 2.89-13.80, p<0.001). In the model adjusted for tooth mobility, bone or respiratory diseases, and the consumption of anxiolytics and antidepressants, the OR was 3.46 (CI 95% 1.47-8.18, p=0.005). CONCLUSIONS: a high prevalence of xerostomia was found in this cross-sectional pilot study, which was significantly more frequent in women, and increased with age. Xerostomia was associated to several systemic diseases, psychological conditions, and oral functional disorders such as tooth mobility. These preliminary results can serve as the basis for developing guidelines for the application of innovative measures designed to improve the quality of life of individuals with xerostomia.

[Self-assessment of opinions, habits and oral health status by pregnant women in the south of Galicia, Spain]. / Evaluación propia en mujeres gestantes al respecto de opiniones, hábitos y estado de su salud oral en una población del sur de Galicia.

An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems.

Anatomical variations of the greater palatine canal in cone-beam computed tomography.

PURPOSE: To analyze anatomical variations of the greater palatine canal (GPC) using cone beam computed tomography (CBCT) images. METHODS: This study included 110 CBCTs. Axial slices were used to determine the shape of GPC and the number of lesser palatine foramina (LPF). Sagittal slices were used to assess the shape of the GPC and the number of lesser palatine canals (LPCs). RESULTS: The most prevalent axial and sagittal GPC shapes were oval (46.36%) and hourglass (23.64%). Most GPCs presented one LPF (47.27%) and one LPC (90.91%). CONCLUSIONS: GPC anatomy is highly variable. CBCT is a useful tool for evaluating the anatomical variations of GPC.

Morphometric study of the greater palatine canal: cone-beam computed tomography.

PURPOSE: To analyze greater palatine canal (GPC) dimensions using cone-beam computed tomography (CBCT) images, and to evaluate the position of the greater palatine foramen (GPF) with respect to various landmarks selected in relation to dental status. METHODS: This study included 150 CBCTs. Axial slices were used to determine the position and dimensions of the GPF. Sagittal slices were used to assess GPC length. Reference lines were established to evaluate the GPC diameter in sagittal and coronal slices. RESULTS: From the 77 GPF analyzed, 76 were located on level 2. Average posterior GPF distance was 6.59 ± 3.27 mm on right side and 7.35 ± 3.40 mm on left side. Several measurements to determine the position and dimensions of the GPF presented significant values (p ≤ 0.05). GPC length was 12.31 ± 1.96 mm on right side and 12.52 ± 2.15 mm on left side, statistically significant differences were detected between genders only on right canal (p ≤ 0.004). Sagittal and coronal reference lines presented significantly higher values for men except for the S3 (p < 0.062) and C1 (p < 0.067) in the left GPC. CONCLUSIONS: CBCT is a useful tool for evaluating GPC morphometrically in the three anatomical slices. The sagittal nasal plane and posterior nasal plane are two intraoral anatomical landmarks for the location of the GPF. Their scant variability allows accurate identification of GPFs in both dentate as well as edentulous patients.

Morphometric differences of nasopalatine canal based on 3D classifications: descriptive analysis on CBCT.

PURPOSE: This descriptive retrospective study analyzed differences among sagittal, coronal and axial NC groups based on the dimensions of nasopalatine canal (NC), buccal bone plate (BBP) and palatal bone plate (PBP) to canal. METHODS: Measurements were made on 224 CBCTs for NC, BBP and PBP on the three anatomic planes at three levels: level 1, when the incisive foramen is completely closed on the axial plane; level 2, at the midpoint of NC length (NCL) on the sagittal plane; and level 3, at the foramina of Stenson on the sagittal plane. ANOVA tests with post hoc tests were used. The intraclass correlation coefficient and Kappa test were used for evaluating the intraobserver agreement. RESULTS: Regarding coronal classification, these significant differences were found: BBP length (BL)level 1 was lower for the two parallel canals group; PBP length (PL)level 1 was lower for single canal group; and NCL was lower for Y-type canal group. Regarding axial classification, these significant differences were found: LPlevel 1 was lower for 3.1-3 group; PBP width (PW)level 3 was the greatest for 3.1-3; and LPlevel 3 was lower for 1.1. CONCLUSIONS: Presurgical evaluation with CBCT in premaxillae region should include analysis on coronal and axial planes and not only on sagittal plane seeing as morphometric differences were found on coronal and axial planes. Following the morphological coronal classification, two parallel canals presented a higher NCL, a higher LP and a lower LV at inferior edge of alveolar ridge.

Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography.

OBJECTIVES: To examine the presence and morphologic characteristics of bifid mandibular canals (BMCs) and retromolar foramens (RFs) using cone beam CT (CBCT) and to determine their visualization on panoramic radiographs (PANs). METHODS: A sample of 225 CBCT examinations was analysed for the presence of BMCs, as well as length, height, diameter and angle. The diameter of the RF was also determined. Subsequently, corresponding PANs were analysed to determine whether the BMCs and RFs were visible or not. RESULTS: The BMCs were observed on CBCT in 83 out of the 225 patients (36.8%). With respect to gender, statistically significant differences were found in the number of BMCs. There were also significant differences in anatomical characteristics of the types of BMCs. Only 37.8% of the BMCs and 32.5% of the RFs identified on CBCT were also visible on PANs. The diameter had a significant effect on the capability of PANs to visualize BMCs and RFs (B = 0.791, p = 0.035; B = 1.900, p = 0.017, respectively). CONCLUSIONS: PANs are unable to sufficiently identify BMCs and RFs. The diameter of these anatomical landmarks represents a relevant factor for visualization on PANs. Pre-operative images using only PANs may lead to underestimation of the presence of BMCs and to surgical complications and anaesthetic failures, which could have been avoided. For true determination of BMCs, a CBCT device should be considered better than a PAN.

Three-dimensional study of nasopalatine canal morphology: a descriptive retrospective analysis using cone-beam computed tomography.

PURPOSE: For dental implant treatment planning and placement, a precise anatomic description of the nasopalatine canal (NC) is necessary. This descriptive retrospective study evaluated dimensions of the NC and buccal bone plate (BBP) and the tridimensional association of the anatomic variants of NC, using cone-beam computed tomography (CBCT). METHODS: This study included 230 CBCTs. Sagittal slices were used for measurements of the NC and BBP and to evaluate shape and direction-course of the NC. Coronal slices were used to assess NC shape and axial slices to assess number of incisive foramina and foramina of Stenson. RESULTS: Mean NC length was 12.34 ± 2.79 mm, statistically significant differences were detected between genders (p < 0.001). Mean BBP length was 20.87 ± 3.68 mm, statistically significant differences were found for the dental status (p < 0.001) and mean BBP width was 6.83 ± 1.28 mm, significant differences were detected between genders (p < 0.001). Mean nasopalatine angle was 73.33° ± 8.11°, significant differences were found in sagittal and coronal classifications. The most prevalent canal was: cylindrical sagittal shape (48.2 %); slanted-straight direction-course (57.6 %); Ya-type coronal shape (42.4 %); and one foramen incisive with two Stenson's foramina (1-2) (50.9 %). Sagittal shape was associated with sagittal direction-course (p < 0.001). Coronal shape was associated with axial classification (p < 0.001). CONCLUSIONS: The NC anatomy is highly variable. Gender is related to the NC length and BBP width, while dental status is related to BBP length. There was an association between the different sagittal classifications of the NC and between the coronal shape and axial classification.

The expression of ENa(+)C and ASIC2 proteins in Pacinian corpuscles is differently regulated by TrkB and its ligands BDNF and NT-4.

Pacinian corpuscles are innervated by large myelinated Aalpha-beta axons from the large- and intermediate-sized sensory neurons of dorsal root ganglia. These neurons express different members of the degenerin/epithelial Na(+) channel (DEG/ENa(+)C) superfamily of proteins with putative mechanosensory properties, whose expression is regulated by the TrkB-BDNF system. Thus, we hypothesized that BDNF and/or NT-4 signalling through activation of TrkB may regulate the expression of molecules supposed to be necessary for the mechanosensory function of Pacinian corpuscles. To test this hypothesis we analyzed the expression and distribution of ENa(+)C subunits and acid-sensing ion channel 2 (ASIC2) in Pacinian corpuscles from 25 days old mice deficient in TrkB, BDNF and NT-4. Pacinian corpuscles in these animals are normal in number, structure, and expression of several immunohistochemical markers. Using immunohistochemistry we observed that the beta-ENa(+)C and gamma-ENa(+)C subunits, but not the alpha-ENa(+)C subunit, were expressed in wild-type animals, and they were always found in the central axon. ASIC2 immunoreactivity was found in both the central axon and the inner core cells. The absence of TrkB or BDNF abolished expression of beta-ENa(+)C and ASIC2, whereas expression of gamma-ENa(+)C did not change. Expression of beta-ENa(+)C and gamma-ENa(+)C subunits in NT-4 deficient mice was found in the axons but also in the inner core cells whereas levels of expression of ASIC2 were increased in these animals. This study suggests that expression in Pacianian corpuscles of some potential mechanosensory proteins is regulated by BDNF, NT-4 and TrkB.

Effects of psychological stress and alprazolam on development of oral candidiasis in rats.

Psychological stress has been found to suppress cell-mediated immune responses that are important in limiting the proliferation of Candida albicans. Since anxiolytic drugs can restore cellular immunity in rodents exposed to stress conditions, we designed experiments conducted to evaluate the effects of alprazolam (1 mg/kg of body weight/day), a central benzodiazepine anxiolytic agonist, on the development of oral candidiasis in Sprague-Dawley rats exposed to a chronic auditory stressor. Animals were submitted to surgical hyposalivation in order to facilitate the establishment and persistence of C. albicans infection. Application of stress and treatment with drugs (placebo or alprazolam) were initiated 7 days before C. albicans inoculation and lasted until the end of the experiments (day 15 postinoculation). Establishment of C. albicans infection was evaluated by swabbing the inoculated oral cavity with a sterile cotton applicator on days 2 and 15 after inoculation, followed by plating on YEPD (yeast extract-peptone-dextrose) agar. Tissue injury was determined by the quantification of the number and type (normal or abnormal) of papillae on the dorsal tongue per microscopic field. A semiquantitative scale was devised to assess the degree of colonization of the epithelium by fungal hyphae. Our results show that stress exacerbates C. albicans infection of the tongues of rats. Significant increases in Candida counts, the percentage of the tongue's surface covered with clinical lesions, the percentage of abnormal papillae, and the colonization of the epithelium by fungal hyphae were found in stressed rats compared to those found in the unstressed rats. Treatment with alprazolam significantly reversed these adverse effects of stress, showing that, besides the psychopharmacological properties of this anxiolytic drug against stress, it has consequences for Candida infection.

Effects of amphetamine on development of oral candidiasis in rats.

Experiments were conducted to evaluate the effects of amphetamine (0. 4 mg/kg of body weight/day) on the development of oral candidiasis in Sprague-Dawley rats. Animals were submitted to surgical hyposalivation in order to facilitate the establishment and persistence of Candida albicans infection. Treatment with drugs (placebo or amphetamine) was initiated 7 days before C. albicans inoculation and lasted until the end of the experiments, day 15 postinoculation. Establishment of C. albicans infection was evaluated by swabbing the inoculated oral cavity with a sterile cotton applicator on days 2 and 15 after inoculation, followed by plating on YEPD (yeast extract-peptone-dextrose) agar. Tissue injury was determined by the quantification of the number and type (normal or abnormal) of papillae on the dorsal tongue per microscopic field. A semiquantitative scale was devised to assess the degree of colonization of the epithelium by fungal hyphae. Our results show that amphetamine exacerbates C. albicans infection of the tongues of rats. Significant increases in Candida counts, the percentage of the tongue's surface covered with clinical lesions, the percentage of abnormal papillae, and the colonization of the epithelium by fungal hyphae were found in amphetamine-treated rats compared to those found in the rats injected with a placebo. The last two parameters increased in rats treated with the placebo compared to the parameters of the untreated control rats.

Modifications of clinical methodology in Class I restoration with composite resins.

This work describes modifications of clinical methodology for the use of composite resins (changes in the isolation of the operating field, in the preparation of the cavities to be occluded and in the way the resin is applied), and relates them to studies of the fine structure of dental enamel and of the adverse side-effects of resins.