Abstract
Objective
To compare the accuracy of periodontal examination at 6‐sites full‐mouth protocol with clinical and radiographic partial‐mouth recording protocols (PRPs) to diagnose periodontitis ...considering new 2018 case definition.
Methods
Periodontitis was diagnosed by full‐mouth assessment of clinical attachment level (CAL) at 6‐sites (
n
= 8529) according to 2018 case definition (standard reference). Three clinical and radiographic PRPs were considered: (i) 4 interproximal sites of all teeth (4‐sites, full‐mouth); (ii) 6‐sites on Community Periodontal Index of Treatment Needs (CPITN) teeth (6‐sites, CPITN teeth); (iii) 4‐sites on CPITN teeth (4‐sites, CPITN teeth); (iv) radiographic examination on interproximal sites of all teeth (rM‐D, full‐mouth); and (v) radiographic examination on interproximal sites of CPITN teeth (rM‐D, CPITN teeth) using Image J®. Sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), accuracy, and Κappa (
k
) were estimated (
α
= 0.05).
Results
The 4‐sites, full‐mouth protocol showed 100% sensitivity and NPV, 79.87% PPV, low specificity (38.32%), 69.30% accuracy, and poor agreement (
k
= 0.468). 6‐sites and 4‐sites CPITN teeth protocols showed 100% PPV and specificity, sensitivity and NPV of >60%, accuracy of >80%, and good agreement (
k
> 0.65). All clinical PRPs outperformed radiographic protocols.
Conclusion
Clinical PRPs using index teeth are highly accurate in diagnosing periodontitis considering 2018 case definition.
Aim
To investigate pathways between unhealthy and healthy dietary patterns and periodontitis in adolescents (18–19 years of age).
Materials and Methods
This population‐based study (n = 2515) modelled ...direct and mediated pathways (via biofilm and obesity) from patterns of healthy diet (fruits, fibre, vegetables, and dairy) and unhealthy diet (sugars, snacks, and salty/fast foods) with initial periodontitis (bleeding on probing BoP, probing depth PD ≥ 4 mm, clinical attachment loss CAL ≥ 4 mm), moderate periodontitis (BoP, PD ≥ 5 mm, and CAL ≥ 5 mm), and European Federation of Periodontology and the American Academy of Periodontology (EFP‐AAP) periodontitis definitions, adjusting for sex, socio‐economic status, smoking, and alcohol, through structural equation modelling (α = 5%).
Results
Higher values of healthy diet were associated with lower values of initial periodontitis (standardized coefficient SC = −0.160; p < .001), moderate periodontitis (SC = −0.202; p < .001), and EFP‐AAP periodontitis (p < .05). A higher value of unhealthy diet was associated with higher values of initial periodontitis (SC = 0.134; p = .005) and moderate periodontitis (SC = 0.180; p < .001). Biofilm mediated the association between higher values of unhealthy diet and all periodontal outcomes (p < .05).
Conclusions
Our findings suggest that both healthy and unhealthy dietary patterns may contribute to reduced or increased extent and severity of periodontitis by local and systemic mechanisms, preceding the effect of other established causes such as smoking and obesity, in younger population.
Objective
Mechanisms underlying the oral outcomes in sickle cell anemia (HbSS) have been less explored. This study aimed to investigate the association of morbimortality indicators and hydroxyurea ...use with adaptive pulp and jaw bone trabecular changes in HbSS.
Methods
This cross‐sectional study included 123 individuals with HbSS. The exposures were the morbimortality indicators of HbSS (number of vaso‐occlusive crises, organ damage, hemoglobin level, and leukocyte count) and the use of hydroxyurea for HbSS treatment. The outcomes were adaptive pulp and jaw bone trabecular changes confirmed by radiographic examination. Associations were estimated by Poisson regression in crude and adjusted analyses for sex, skin color, socioeconomic class, and age.
Results
The vaso‐occlusive crises (mean ratio (MR) = 3.5, p = 0.045), lower hemoglobin (MR = 2.4, p = 0.037), and higher leukocyte count (MR = 2.17, p = 0.036) were risk factors, while the use of hydroxyurea was inversely associated with adaptive pulp changes (MR = 0.23, p = 0.024). The vaso‐occlusive crises were associated with jaw bone trabecular changes (MR = 1.33, p = 0.02).
Conclusion
Adaptive pulp changes may be a potential clinical marker of chronic vasculopathy in HbSS. The use of hydroxyurea may reduce the frequency of adaptive pulp changes.
Aim
To evaluate the association between low bone mineral density (BMD) and severe periodontitis at the end of the second decade of life.
Materials and methods
This population‐based study analysed ...2032 youngers (18–19 years old) of the RPS cohort. BMD of lumbar spine (BMD‐LS) and of the whole body (BMD‐WB) were assessed by dual x‐ray emission densitometry. Low BMD‐LS (Z‐score ≤ −2) and low BMD‐WB (Z‐score ≤ −1.5) were correlated with severe periodontitis. The extent of periodontal disease was also evaluated as the following outcomes: proportions of teeth affected by clinical attachment loss ≥5 mm and probing depth ≥5 mm. Multivariate models by sex, education, family income, risk of alcohol dependence, smoking, plaque, bleeding index, and body mass index were estimated through logistic regression (binary outcomes) and Poisson regression (continuous outcomes).
Results
The prevalence of severe periodontitis was 10.97%. Low BMD‐LS (odds ratio OR = 2.08, confidence interval CI = 1.12–3.85, p = .01) and low BMD‐WB (OR = 1.34, CI = 1.001–1.81, p = .04) were associated with severe periodontitis in the final multivariate models. Low BMD‐LS and BMD‐WB were also associated with a greater extent of periodontitis (p < .05).
Conclusions
Low BMD was found to be associated with the severity and extent of periodontitis in adolescents. Adolescents at peak bone mass age presenting low BMD are more likely to be affected by severe periodontitis.
Endothelial progenitor cells (EPCs) improve survival and reduce organ failure in cecal ligation and puncture-induced sepsis; however, expanded EPCs may represent an even better approach for vascular ...repair. To date, no study has compared the effects of non-expanded EPCs (EPC-NEXP) with those of expanded EPCs (EPC-EXP) and mesenchymal stromal cells of human (MSC-HUMAN) and mouse (MSC-MICE) origin in experimental sepsis. One day after cecal ligation and puncture sepsis induction, BALB/c mice were randomized to receive saline, EPC-EXP, EPC-NEXP, MSC-HUMAN or MSC-MICE (1 × 10(5)) intravenously. EPC-EXP, EPC-NEXP, MSC-HUMAN, and MSC-MICE displayed differences in phenotypic characterization. On days 1 and 3, cecal ligation and puncture mice showed decreased survival rate, and increased elastance, diffuse alveolar damage, and levels of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α, vascular endothelial growth factor, and platelet-derived growth factor in lung tissue. EPC-EXP and MSC-HUMAN had reduced elastance, diffuse alveolar damage, and platelet-derived growth factor compared to no-cell treatment. Tumor necrosis factor-α levels decreased in the EPC-EXP, MSC-HUMAN, and MSC-MICE groups. IL-1β levels decreased in the EPC-EXP group, while IL-10 decreased in the MSC-MICE. IL-6 levels decreased both in the EPC-EXP and MSC-MICE groups. Vascular endothelial growth factor levels were reduced regardless of therapy. In conclusion, EPC-EXP and MSC-HUMAN yielded better lung function and reduced histologic damage in septic mice.
Background
This study was conducted to investigate the biological factors underlying the association between pulp necrosis (PN) in subjects with permanent teeth with intact crowns and sickle cell ...anemia (SCA).
Methods
This cohort study included 140 subjects: 125 without PN and 15 with PN. A theoretical model was built to explore the following biological factors involved in the association between PN and SCA, namely (a) increased number of sickle cell crises in the previous year (No. SCCs/year), (b) low percentage of blood oxygen saturation (SpO2) in the body, and (c) comorbidities (CoMs). The theoretical model for testing associations was analyzed by structural equation modeling.
Results
PN was associated with CoMs (SFL = 1.115; p = .032) but not with No. SCCs/year (SFL = .127; p = .596) or body SpO2 (SFL = −.102; p = .485). The prevalence rates of osteoarticular lesions (p = .009) and death
(p<.001) were significantly higher in subjects with PN than in those without.
Conclusions
Comorbidities, primarily osteoarticular lesions, are associated with PN in permanent teeth with intact crowns of patients with SCA. PN can be considered an indicator of the lethality of SCA.
We hypothesized whether propofol or active propofol component (2,6‐diisopropylphenol DIPPH and lipid excipient LIP‐EXC) separately may alter inflammatory mediators expressed by macrophages and ...neutrophils in lean and obese rats. Male Wistar rats (n = 10) were randomly assigned to receive a standard (lean) or obesity‐inducing diet (obese) for 12 weeks. Animals were euthanized, and alveolar macrophages and neutrophils from lean and obese animals were exposed to propofol (50 µM), active propofol component (50 µM, 2,6‐DIPPH), and lipid excipient (soybean oil, purified egg phospholipid, and glycerol) for 1 h. The primary outcome was IL‐6 expression after propofol and its components exposure by alveolar macrophages extracted from bronchoalveolar lavage fluid. The secondary outcomes were the production of mediators released by macrophages from adipose tissue, and neutrophils from lung and adipose tissues, and neutrophil migration. IL‐6 increased after the exposure to both propofol (median interquartile range 4.141.95–5.20; p = .04) and its active component (2,6‐DIPPH) (4.091.67–5.91; p = .04) in alveolar macrophages from obese animals. However, only 2,6‐DIPPH increased IL‐10 expression (7.596.28–12.95; p = .001) in adipose tissue‐derived macrophages. Additionally, 2,6‐DIPPH increased C‐X‐C chemokine receptor 2 and 4 (CXCR2 and CXCR4, respectively) in lung (10.088.23–29.01; p = .02; 1.551.49–3.43; p = .02) and adipose tissues (8.784.15–11.57; p = .03; 2.862.17–3.71; p = .01), as well as improved lung‐derived neutrophil migration (28.00−3.42 to 45.07; p = .001). In obesity, the active component of propofol affected both the M1 and M2 markers as well as neutrophils in both alveolar and adipose tissue cells, suggesting that lipid excipient may hinder the effects of active propofol.
In obesity, the active component of propofol affected M1 and M2 alveolar macrophages from adipose tissue differently. In neutrophils from lung and adipose tissue, only the active propofol component increased chemokine receptors, suggesting that lipid excipient may hinder the effects of active propofol.
Objectives
This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation paths.
Setting and ...Sample Population
Children evaluated at birth (T1), between 12 and 24 months (T2), and between 24 and 36 months (T3) were included. Two hundred and seventeen children who participated in T1 and T2 were randomly selected to perform the occlusion examination.
Materials and Methods
This is a prospective cohort study (BRISA). The theoretical model was tested by structural equation modelling (SEM), estimating standardized coefficients (Coeff.) (α = 0.05). The primary exposure was APO—a latent variable manifested from three health problems at birth: low birthweight (LBW), pre‐term birth (PTB) and intrauterine growth restriction (IUGR), evaluated in T1. The outcomes were four different occlusal traits assessed in T3: overjet, anterior and posterior crossbite, and crowding. Each outcome's direct and indirect effects were tested, mediated by growth, breathing, breastfeeding, and pacifier use.
Results
There was no direct association between APO and any of the outcomes: overjet (Coeff. = −0.163, P = .241), anterior crossbite (Coeff. = −0.696, P = .065), posterior crossbite (Coeff. = −0.087, P = .589) and crowding (Coeff. = 0.400, P = .423). The indirect (total and specifics) effects tested also showed no association (P > .05). However, APO was associated with lower child growth in all models; breastfeeding was associated with higher child growth in all models, and pacifier use was associated with overjet (Coeff. = 0.184, P < .001) and posterior crossbite (Coeff. = 0.373, P = .011).
Conclusion
APO was not a risk factor for overjet, crossbite and crowding in an early stage of the primary dentition by direct and indirect pathways. However, growth has been lower in children with APO and higher in children breastfed. Also, the harmful effects of using a pacifier in dental occlusion are highlighted.
Purpose. To evaluate the mineral ion loss of root dentine after treatment with 2% chlorhexidine solution (CHX) and to compare its yield and flexural strength (fs) after exposure to calcium hydroxide ...Ca(OH)2. Materials and Methods. Dentine bars (DB) were made from 90 roots of bovine incisors and randomized into three groups: GControl: distilled/deionized water (DDW), GNaOCl: 2.5% sodium hypochlorite + 17% EDTA, and GCHX: CHX + DDW. The release of phosphate (PO4) and calcium (Ca) ions was measured by spectrophotometry. The DB were exposed to Ca(OH)2 paste for 0, 30, 90, and 180 days. DB were subjected to the three-point bending test to obtain yield and fs values. The fracture patterns were evaluated (20x). Data were analyzed using Kruskal-Wallis and Dunn’s post hoc tests or one- and two-way ANOVA followed by Tukey’s post hoc test (α=0.05). Results. GCHX showed lower PO43- and Ca2+ ionic release than GNaOCl (p<0.001). For yield and fs, GCHX>GNaOCl in all periods (p<0.001), except for yield strength values on 90 days (p=0.791). A larger frequency of vertical fractures was observed in GNaOCl and that of oblique fractures in GCHX (p<0.05). Conclusions. CHX prevented PO43- and Ca2+ loss and showed a tendency to preserve the yield and fs of root dentine over time following exposure to Ca(OH)2 paste.
Association between Sickle Cell Anemia and Pulp Necrosis Costa, Cyrene Piazera Silva, DDS, MS; Thomaz, Erika Bárbara Abreu Fonseca, DDS, MS, PhD; Souza, Soraia de Fátima Carvalho, DDS, MS, PhD
Journal of endodontics,
02/2013, Letnik:
39, Številka:
2
Journal Article
Recenzirano
Abstract Introduction The purpose of this study was to evaluate the association between sickle cell anemia (SCA) and pulp necrosis (PN). Methods One hundred thirteen individuals with SCA (ie, the ...exposed group) from the Supervision of Hematology and Hemotherapy of Maranhão (HEMOMAR), Maranhão, Brazil, and 226 individuals without SCA, the sickle cell trait, or other diseases (ie, the nonexposed group) were enrolled in this study. All participants were over 16 years old and had at least 1 clinically intact permanent tooth. Patients with SCA and a history of lower alveolar nerve paresthesia and those who had suffered from vasoocclusive crises within the previous 6 months were excluded. PN of clinically intact permanent teeth without a history of orofacial trauma was diagnosed using the cold thermal test (CTT) and pulse oximetry adapted for dentistry (POD). Poisson regression was used to estimate the associations ( P < .05). Results In an unadjusted analysis, the occurrence of PN in clinically intact permanent teeth was 8.33 times higher in the exposed group than in the nonexposed group ( P < .001). This association remained significant after adjusting for a history of orofacial trauma and folic acid use for the CTT and POD evaluations. Conclusions In conclusion, SCA is a potential risk factor for PN in clinically intact permanent tooth.
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