A questionnaire containing 20 questions was sent to 127 members of the Association for Those Injured by Electricity and Visual Display Units in northern Sweden, of whom 103 (81%) answered. The questionnaire consisted of questions about age, sex, and place of work. Furthermore, the members were asked to state: 1) their general and oral symptoms; 2) whether they thought that dental amalgam and other types of dental filling materials had affected their symptoms; 3) whether they were replacing or had replaced their amalgam fillings and, if so, what effect it had had on their symptoms; 4) whether they had been medically examined; and 5) whether they were or had been sick-listed for their complaints. Of those who answered the questionnaire, 79% were women (mean age 45 yr) and 21% men (mean age 42 yr). Sixty percent worked in offices. In 82%, the symptoms had started at work. The mean duration of the symptoms was 5.2 yr. The symptoms were aggravated mostly in "electric environment in general" and in "office with computers". Skin complaints, fatigue, and eye symptoms were the most common general symptoms. Sixty-five percent mentioned that they had oral symptoms. Gustatory disturbances, burning mouth, and temporomandibular joint (TMJ) dysfunction were the most common oral symptoms. Fifty-six percent considered that dental amalgam and 24% that other dental materials affected the symptoms. Twenty-one percent were in the process of replacing the amalgam fillings; 40% had already done so. After replacement, 37% had noticed a decrease of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
The buffering capacity and flow rate of stimulated whole saliva were assessed in 150. persons, 20-24 yr of age. The associations were assessed between the buffer value and the flow rate, some dietary factors, tobacco habits, use of oral contraceptives, and some demographic variables. The results demonstrate that a low flow rate may predict a low buffer value but not a high value. Flow rate accounted for the largest part of the buffering variation but morning and afternoon saliva sampling, female gender, food consumption between meals, and smoking seem to have contributed to low buffering values. Snuff-taking habits, oral contraceptives, and protein consumption between meals were not associated with the buffering capacity.
Bone mineral density (BMD) was measured in five different regions of the mandible of 77 postmenopausal women. These women were also classified according to the remaining, clinically determined alveolar height in the edentulous distal regions of the mandible. The duration of edentulousness in the maxilla and in the mandible was determined anamnestically. All subjects were edentulous in the maxilla, and 42 were also edentulous in the mandible. The other 35 women had teeth only in region d35-d45. This study shows that after extraction of the last teeth in the mandible, the BMD of the cortical bone is not lowered, but that the BMD of the trabecular portion is lowered more by mechanical stress caused by the remaining natural teeth than by maxillary dentures. This feature becomes apparent when duration of edentulousness in the maxilla is compared with the BMD values of different regions in the mandible.
For study of the enamel-protective effect of chlorhexidine-fluoride applications, the labial surfaces of pieces of bovine incisors were treated with 0.2% chlorhexidine gluconate solution, with Duraphat fluoride varnish, or with both of the above agents, while one group was treated with distilled water and one was left as an untreated control. Furthermore, a placebo varnish was used in the chlorhexidine- and distilled-water-treated groups; all the varnishes were removed after 24 h. The enamel slabs were mounted pairwise in an artificial mouth to form approximal contacts. The teeth were continuously rinsed with a common pool of artificial saliva to which was added 3% sucrose, and which was infected on the first day with Streptococcus mutans, "Ingbritt". The saliva was renewed daily and the incubation at 37 degrees C lasted for 10 days. The appreciable softening found in the distilled-water- and placebo-varnish-treated group tended to be prevented by the chlorhexidine and even more by the fluoride treatment, while the chlorhexidine-fluoride treatment prevented enamel softening completely. The saliva, infected only on the first day, and renewed daily, tended to become more acidified toward the end of the experimental period, obviously because the fermenting organisms had infected the surfaces of the model and formed plaque-like coatings on the enamel.
Five amalgam-bearing patients, with clinically and histologically confirmed oral lichenoid lesions, were tested by applying 0.5% Hg in petrolatum for 10 min to clinically normal mucosa. Control sites were exposed to petrolatum only. Four amalgam-bearing patients with no clinical evidence of oral lichenoid lesions served as controls; they were subjected to similar Hg and petrolatum exposure. After 24 h, biopsies were taken and immunocytochemically analyzed with monoclonal antibodies to lymphoid and nonlymphoid cells. No distinct differences could be detected between the Hg-exposed areas of the lichen patients and those of the nonlichen patients. Furthermore, normal mucosa exposed to petrolatum only showed a staining pattern in the lichen patients which was no different from the nonlichen patients. The findings are discussed with respect to possible mechanisms of development of lichen-like lesions in oral mucosa.
Eight adult periodontitis (AP) patients were studied immunohistochemically to determine the presence of matrix metalloproteinases (MMPs) MMP-1, MMP-3, and MMP-8 in the marginal gingival and gingival granulation tissue specimens obtained from periodontal flap surgery after scaling and root planing. Clinically healthy gingival tissue specimens obtained from impacted third-molar extraction operations served as controls. MMP-type-specific antisera were applied by the avidin-biotin-peroxidase complex staining method. Moderate immunoreactivity for neutrophil collagenase (MMP-8) was found both in the AP patients' marginal gingival connective tissue and in gingival granulation tissue specimens. Immunoreactivity for fibroblast-type collagenase (MMP-1) and stromelysin-1 (MMP-3) was detected only in the AP patients' gingival granulation tissue specimens. In the control specimens, no immunoreactivity for the MMPs could be detected. For the first time, this finding demonstrates immunohistochemically the presence of MMP-8 in human inflamed gingiva in situ, and further highlights the importance of MMP-8 in periodontal tissue destruction, evidently during the acute phase(s) of the disease. However, our results confirm and extend previous studies indicating that other types of MMPs from resident gingival cell sources also seem to participate in the chronic and destructive course of periodontal inflammation.
This study introduces a strategy to identify and produce sequences useful as genetic markers, or native genetic probes for DNA-DNA hybridization in bacterial strains where the genetics is not well described. Actinobacillus actinomy-cetemcomitans (A.a.) was used as an example. Fifty ng genomic DNA from A.a. ATCC 33384 and Haemophilus aphrophilus ATCC 33389 was amplified in a thermocycler using a single 10-mer primer. The PCR products were separated by electrophoresis on a 1% submarine agarose gel containing ethidium bromide and visualized by UV illumination, and the strain-specific amplitypes were compared. DNA from two bands, 0.9 and 4 kb, unique for the A.a. strain, was cut out, amplified under high stringency with the same primer and labeled by replacing 33.3 microM dTTP with digoxigenin-labeled dUTP in the reaction mixture. The labeled probe was then repeatedly used for hybridization to DNA from various A.a., H. aphrophilus, and other bacterial strains of the Pasteurellaceae family. The results showed that the 0.9-kb probe detected all A.a. tested, and distinguished it from other closely related bacterial species. We conclude that the described strategy is useful for identifying and selecting genetic sequences useful as genetic markers in A.a.
The keratin pattern in oral epithelia is related to the type of terminal differentiation observed morphologically (keratinization/nonkeratinization) and to the presence or absence of epithelial dysplasia. Furthermore, it has been suggested recently that inflammatory phenomena influence the keratin expression in human gingiva. The aim of the present study was to describe the keratin pattern in oral lichen planus (OLP) lesions, which are well known to be characterized by hyperkeratinization and severe inflammatory changes, in order to elucidate the role of inflammation in keratin expression of oral epithelia. Tissue sections were stained with antikeratin antibodies directed to groups of keratins (AE1 and AE2) and to single keratin proteins (Nos. 5, 8, 13, and 19). The keratin pattern in OLP lesions differed in some respects from that of leukoplakias and frictional keratoses as characterized in previous studies. No consistent patterns for use in a diagnostic context were found. However, the changes in OLP lesions did not mimic those previously described in inflamed gingival specimens and in oral epithelial dysplasias. Thus, the results encourage further studies on the potential diagnostic use of keratin expression in premalignant oral lesions. Furthermore, the study suggests that the inflammatory reaction seen in OLP lesions does not influence keratin expression in a way comparable with the suggested influence of inflammation in gingival specimens.
Excessive fluoride (F) in drinking water should be removed, but simple, inexpensive methods of fluoride removal are not readily available. This study examines the F--binding capacity of clay and clayware, especially the effect of the firing temperature on the F--binding process. A series of pots were made from ordinary potter's clay and fired at 500-1000 degrees C. Likewise, small clay bricks were fired and then crushed and sieved. NaF solutions containing 10 mg/l F- (10 ppm F-) were prepared. Suitable aliquots of the solutions were poured into clay pots or exposed to powdered clayware. Samples were taken at storage periods of 30 min to 20 days and analyzed for F- by ion-selective electrodes. The rate and capacity of F--binding in the clayware varied with the firing temperature. Clay fired at approximately 600 degrees C was most effective. Temperatures over 700 degrees C caused a decline in F--binding, and pottery fired at 900 degrees C and above seemed unable to remove F- from water. Pots fired at 500 degrees C or less cracked in water. The findings indicate that clayware, fired at an optimal temperature, may be of practical value for partial defluoridation of drinking water.
The diagnostic efficacies of three panoramic-based indices were compared with classification of bone mineral density by dual-energy x-ray absorptiometry. The panoramic indices were 1) cortical bone height, 2) an ordinal classification, and 3) the Panoramic Mandibular Index. The results indicate that panoramic dental radiographs should not be used to assess the patient's status regarding osteoporosis, although the means of the variables in different mineral density groups of skeleton may differ significantly
Rosin is a ubiquitous contact sensitizer which may be present in dental materials such as periodontal dressings, impression materials, cements, and cavity varnishes When a hypersensitive person is exposed to a sensitizer, allergic contact dermatitis/stomatitis may develop, most commonly after direct skin/mucosa contact with the sensitizer. However, widespread dermatitis may develop after systemic administration of the sensitizer, and this paper reports the case of a rosin-hypersensitive man who developed widespread eczematous dermatitis after dental treatment with a rosin-containing product.
Analysis and treatment of dental and medical factors that can cause burning mouth were performed in 25 consecutive patients according to a treatment protocol. The effect of the dental and medical treatment on the burning mouth was evaluated. The sick leave profile was presented. Apart from burning mouth symptoms, the patients reported several oral and general symptoms, such as gustatory changes, xerostomia, back and joint muscle pain, headache, and dizziness. The most common dental diagnoses were temporomandibular joint, masticatory, and tongue muscle dysfunction and lesions in the oral mucosa. The most common medical diagnoses were low serum iron and hypersensitive reaction to mercury. None of the patients tested exceeded the limit of 100 nmol Hg/l urine. Replacement of amalgam fillings was the most common dental therapy, followed by treatment of dysfunction in the masticatory system. Iron replacement was the most frequent medical treatment. The patients had over 50% more days per year sick leave than an age- and sex-matched normal population. A follow-up found that the burning mouth had disappeared in 32% of the patients. This study confirms the opinion that burning mouth is multicausal. Hypersensitive reaction to mercury was more frequent than expected, but replacement of amalgam fillings relieved burning mouth in only two of five such patients, and one of these two patients had hypersensitive reactions to both mercury and gold. One reason that so many patients continued to have burning mouth might have been neglect of dental, medical, or both diagnoses. Another reason might be that assessment of the psychologic status of the patients and psychologic treatment when indicated were not done.
The aim of the present investigation was to determine the mineral distribution in the enamel of teeth with amelogenesis imperfecta (AI) by quantitative microradiography. A further aim was to correlate the findings to clinical manifestations and inheritance patterns for AI. Included in the study were a total of 29 teeth with AI, 28 primary and one permanent, and seven unaffected teeth, five primary and two permanent. Quantitative microradiography was applied to sagittally ground sections, 70-90 microns, of the teeth. The mineral content of the enamel, expressed as percentage by volume, was lower in most of the teeth with AI than in the unaffected teeth. The largest range for the mineral distribution was found in the enamel of the variants clinically characterized by hypomineralization. These teeth showed a mineral distribution pattern that reflected an extremely low mineral content in the bulk of the enamel. In the AI teeth clinically characterized by hypoplasia, the mineral distribution pattern was similar to that of the unaffected teeth, although with larger local variations in mineral content. Apart from the teeth connected with X-linked inheritance, no differences were found among teeth with similar clinical variants connected with different inheritance patterns.
The purpose of the present investigation was to determine, in patients with oral mucosal lesions of lichenoid character, whether it is possible with epicutaneous patch tests, to detect those who will react favorably to removal of amalgam. Of 48 patients, 19 (39.6%) showed positive patch test reactions to 1% mercury ammonium chloride, and 29 (60.4%) showed negative test results. The observation period varied from 3 months to 3 yr (mean value 1.5 yr). After treatment, 94.7% of the positive group and 86.2% of the negative group showed regression of lesions. Reactions exceeding the contact zone between amalgam restorations and lesions showed positive patch test results in 21% of the cases, as compared with 47% among those with lesions restricted to the contact areas; 85.7 and 93.9%, respectively, showed regression after removal of amalgam restorations. The results of the present study indicate that removal of amalgam usually affects the lesions favorably and that epicutaneous patch tests are of little prognostic value in patients with oral mucosal lesions of lichenoid character.
Longitudinal microradiography has been used to determine inhibiting effects of aluminum (III), Al, and fluoride on mineral loss from slices of bovine enamel exposed to a demineralizing solution 4 h daily for 35 days. Inhibitor treatment was 5 min four times daily. For the remaining time, the samples were immersed in a neutral calcium phosphate solution which allowed neither remineralization nor demineralization. This study indicates that a 1-mM (27 ppm) solution of Al in a 0.1-M lactate solution, pH 5, has an inhibitory effect on the in vitro demineralization of bovine enamel. Application of this solution alternating with 20 mM (380 ppm) fluoride gave the same total inhibition as treatment with 20 mM fluoride alone.
Root surface texture after scaling with hand instruments, ultrasonic scalers (Amdent 830 and Cavi-Med 2000), and a sonic scaler (Titan-S) was assessed in vitro. The experimental material consisted of 48 extracted human teeth divided into six groups. Root surface texture was assessed with scanning electron microscopy (SEM). Hand and sonic instrumentation produced large grooves and removed cementum evident at a magnification of x 70, while the root surface alterations after ultrasonic instrumentation were not detectable below a magnification of x 500. The working principle of each scaling instrument in relation to its effect on the root surface was discussed.
Patients with severely worn dentition were interviewed and clinically examined, and only those were included who had no or minimal subjective symptoms or clinical signs of craniomandibular disorder. During a 14-month screening period, only 7 patients fulfilled the inclusion criteria; all were men. Maximal bite force was measured in the molar regions and in the incisal region. Facial morphology was evaluated from lateral cephalometric radiographs, and the form of dental arches from dental casts. Average maximal bite force in the molar region was 911 N and in the incisal region 569 N. The most characteristic findings concerning bite force were the high force levels in the incisal region and an incisal/molar bite-force ratio of 63%. The facial morphology of the patients was rectangular, with an anteriorly rotated mandible, small anterior face height, and great interincisal angle. Moreover, the form of the maxillary dental arch was more rectangular than normal. The high bite forces of these patients, especially in the incisal area, can probably be explained by strong masticatory muscles and mechanically favorable skull morphology, which in its turn has been influenced by the surrounding muscles.
The trial included 24 children (aged 2-7 yr) referred for dental treatment under general anesthesia, since conventional behavioral management methods had failed to achieve treatment acceptance. As an alternative, they received, on two separate occasions with "identical" dental treatment, conscious sedation by rectal administration of either midazolam (0.3 mg/kg body weight (bwt)) or midazolam (0.3 mg/kg bwt) plus ketamine (1.0 mg/kg bwt). This allowed a double-blind, crossover design. The aims were to assess conscious sedation, combined with local anesthesia, as an alternative to general anesthesia, and further to evaluate the effects obtained by addition of a low dose of ketamine to rectally administered midazolam. The feasibility of dental treatment was rated as excellent or good for 16 of the 24 children when premedicated with midazolam, and for 18 of the 24 children when ketamine was added to midazolam. At least some treatment could be given to all children. Verbal contact was maintained with all children throughout both treatment sessions. The children were significantly less anxious when they arrived for the second session. Amnesia and drowsiness were significantly increased when ketamine was added to midazolam. The combination also tended to be more efficient in relief of anxiety and prevention of pain, but there were large variations in the children's responses to the drugs. Midazolam significantly reduced the blood oxygen level, but not with ketamine added. For most children, both regimens proved to be appropriate as alternatives to general anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of this study was to evaluate the clinical performance of four types of tooth-colored inlays. The systems included 15 direct ceramic inlays (CEREC Vita-Blocks), 15 direct composite inlays (Brilliant D.I., Coltène), 14 indirect ceramic inlays (Vita Dur N), and 14 indirect composite inlays (Estilux) in 37 patients. The inlays were evaluated clinically 1 wk (base line) and 6 and 12 months after cementation. The clinical assessments were supported by bitewing radiographs. One Vita Dur N inlay fractured after 1 yr of service, and one Brilliant D.I. inlay had to be replaced because of secondary caries. No apparent increase in plaque accumulation or gingival inflammation could be related to treatment with inlays. At base line and throughout the observation period, the Vita Dur N inlays received the highest ratings for morphology and color match. The Brilliant D.I. inlays showed the smoothest surface texture, whereas the Estilux inlays showed the roughest texture. After 6-12 months of observation, all types of inlays showed varying degrees of disintegration of the composite luting cement. Within the observation period, all inlay systems appeared to be clinically acceptable.
An open, randomized, controlled study with two parallel treatment groups was done to evaluate the efficacy and safety of a single application of a miconazole 55 mg/g denture lacquer applied once on the mucosal denture surface, as compared with those of a commercially available miconazole 2% gel applied four times daily for 2 wk, in the treatment of Candida-associated denture stomatitis. The efficacy variables were Candida cultures on the Oricult plates taken from the palatal mucosa and the denture surface, erythema of the palatal mucosa, and smears for leukocyte migration into the palatal epithelium taken on entering the study and on days 3, 7, 14, 21, 28, and 35 after commencement of therapy. On entering the study, all patients had positive cultures of yeast in the samples from the palatal mucosa. Within the first 3 days, all gel patients and 88% of the lacquer patients had fewer than 10 colonies. The gel was statistically significantly more efficient than the lacquer on days 7 and 14. In the samples from the denture surface, all patients had more than 100 yeast colonies at inclusion and, on day 3, approximately 80% in both treatment groups had fewer than 10 colonies. From day 7 onward, the gel was statistically significantly more efficient than the lacquer. The reddening of the palatal mucosa was not statistically significantly different in the treatment groups at any of the examinations, but smears for the determination of leukocyte migration indicated that the gel was statistically significantly more efficient than the lacquer on day 7.(ABSTRACT TRUNCATED AT 250 WORDS)
