Relationship between acetaldehyde concentration in mouth air and tongue coating volume

Objective Acetaldehyde is the first metabolite of ethanol and is produced in the epithelium by mucosal ALDH, while higher levels are derived from microbial oxidation of ethanol by oral microflora such as Candida species. However, it is uncertain whether acetaldehyde concentration in human breath is related to oral condition or local production of acetaldehyde by oral microflora. The aim of this pilot study was to investigate the relationship between physiological acetaldehyde concentration and oral condition in healthy volunteers. Material and Methods Sixty-five volunteers (51 males and 14 females, aged from 20 to 87 years old) participated in the present study. Acetaldehyde concentration in mouth air was measured using a portable monitor. Oral examination, detection of oral Candida species and assessment of alcohol sensitivity were performed. Results Acetaldehyde concentration [median (25%, 75%)] in mouth air was 170.7 (73.5, 306.3) ppb. Acetaldehyde concentration in participants with a tongue coating status score of 3 was significantly higher than in those with a score of 1 (

Bone Augmentation Using Novel Unidirectional Porous Hydroxyapatite with Bone Morphogenetic Protein-2 on Rat Skull

Unidirectional porous hydroxyapatite (UDPHAp) is a material whose microstructure consists of cross-sectional oval pores with a pore diameter in the range of 100-300 mu m that penetrate through the material. UDPHAp has proven suitable for osteogenesis and angiogenesis. The present study was designed to evaluate the osteogenic effect of a newly developed UDPHAp as a carrier of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a rat onlay graft model. UDPHAp was implanted beneath the calvarial periosteum of rats to simulate alveolar bone augmentation in a clinical condition. At 2 weeks after implantation, UDPHAp with rhBMP-2 resulted in active bone formation, and the augmented bone was connected directly with the original bone, whereas commercialized porous hydroxyapatite (PHAp) with rhBMP-2 showed little bone formation. These results suggest that UDPHAp in this model is suitable for onlay graft and is an effective biomaterial for the rhBMP-2 delivery system

In vivo Evaluation of a Novel Chitosan/HAp Composite Biomaterial as a Carrier of rhBMP-2

We developed a porous chitosan/hydroxyapatite (HAp) composite, in which the HAp nanocrystals align along the chitosan molecules, and examined the biocompatibility, osteoinductive activity, and the ability to act as a carrier of recombinant human bone morphogenetic protein-2 (rhBMP-2) of this novel biomaterial. The composite was subcutaneously implanted into the backs of 11-week-old SD rats, with or without rhBMP-2 (5μg). At 2 and 8 weeks after the implantation, the composite was explanted for morphohistological evaluation. In the presence of rhBMP-2, ectopic bone formation was found at 2 weeks and maturation of the newly formed bone around the composite at 8 weeks. Chitosan/HAp composite alone caused little inflammation, and new blood vessel growth and multinucleated giant cells were found around the composite, accompanied with roughening of the surface due to degradation at 2 weeks; however, neither cartilage nor bone formation was found around the composite. With rhBMP-2, the bioabsorption of the composite was accelerated as the rhBMP-2-induced bone matured. Histomorphometrical analysis showed that the mean value of the composite areas with rhBMP-2 was significantly smaller than that without rhBMT-2 at 2 and 8 weeks after the implantation. These results suggested that the novel chitosan/HAp composite was an effective bioabsorbable material as a carrier of rhBMP-2

Oral management for a patient with trismus accompanied by Isaacs’ syndrome: a case report

Abstract Background Isaacs’ syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings include cramps, fasciculations, and myokymia; however, there are few reports of dental treatment for trismus. Case presentation A patient with trismus due to Isaacs’ syndrome experienced swelling and pain in the gingiva surrounding his right lower first molar. He was diagnosed with chronic apical periodontitis by a dentist near his home. However, the patient was informed that dental treatment and medication could not be administered because of the presence of Isaacs’ syndrome, and he visited the Geriatric Dentistry and Perioperative Oral Care Center at Kyushu University Hospital 2 weeks later. The patient’s painless mouth-opening distance (between incisors) was 20 mm at that time, and medication, including amoxicillin capsules and acetaminophen, was administered because the dental extraction forceps or endodontic instruments were difficult to insert into the oral cavity for treatment. Two months after his initial visit, the patient visited us complaining of pain in the same area. However, he had recently undergone plasmapheresis treatment in neurology to alleviate limited mouth opening and systemic myalgia, resulting in a pain-free mouth-opening distance of approximately 35 mm. During this temporary period in which he had no restriction in mouth opening, we performed tooth extraction and bridge restoration on the mandibular right first molar and created an oral appliance for sleep bruxism. Conclusions Plasmapheresis therapy transiently reduced trismus, rendering dental interventions feasible, albeit temporarily. This case report underscores the importance of close collaboration between neurologists and dentists who encounter similar cases while furnishing valuable insights to inform dental treatment planning

Histological Evidences of Autograft of Dentin/Cementum Granules into Unhealed Socket at 5 Months after Tooth Extraction for Implant Placement

The aim of this clinical case study was to observe biopsy tissues at 5 months after an autograft of a partially demineralized dentin/cementum matrix (pDDM) into a tooth-extracted socket exhibiting healing failure. A 66-year-old female presented with healing failure in the cavity for 2 months after the extraction (#36). Initial X-ray photos showed a clear remainder of lamina dura (#36), a residual root (#37), and a horizontal impaction (#38). The vital tooth (#38) was selected for pDDM. The third molar crushed by electric mill was decalcified in 1.0 L of 2.0% HNO3 for 20 min and rinsed in cold distilled water. The pDDM granules (size: 0.5–2.0 mm) were grafted immediately into the treated socket. X-ray views just after pDDM graft showed radio-opaque granules. At 5 months after pDDM graft, the surface of regenerated bone was harmonized with the mandibular line, and bone-like radio-opacity was found in the graft region. The biopsy tissue (diameter: 3.0 mm) at 5 months after pDDM graft showed that mature bone was interconnected with the remaining pDDM. The novel histological evidence highlighted that newly formed bone was connected directly with both dentin-area and cementum-area matrix of pDDM. We concluded that pDDM contributed to the regeneration of bone in the unhealed socket, and this regeneration prepared the socket for implant placement. Autogenous pDDM could be immediately recycled as an innovative biomaterial for local bone regeneration

地域自立高齢者の口腔の主観的健康感と医療費との関係

Objectives: The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods: Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results: A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion: The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.掲載誌情報：Gerodontology. Vol.29(2), pp. e246-e252, June 2012.doi: 10.1111/j.1741-2358.2011.00459.x

Aberrant Expression of HOX Genes in Oral Dysplasia and Squamous Cell Carcinoma Tissues

Human HOX genes consist of 39 genes and encode transcription factors that function as master developmental regulators. We hypothesized that the misexpression of HOX genes was associated with carcinogenesis and malignant progression. The expression levels of 39 HOX genes in 31 human oral squamous cell carcinoma (SCC), 11 dysplasia, and 10 normal mucosa tissues were quantified by the real-time RT-PCR method. The expression levels of 18 HOX genes in the SCC tissues were significantly higher than those in the normal mucosa tissues. The dysplasia tissues showed higher expression of HOXA2, A3, B3, and D10 than normal mucosa tissues whereas they showed lower expression of HOXA1, B7, B9, and C8 than SCC. The SCC with lymph node metastasis showed high expression of HOXC6 compared to the SCC without it. These results suggest that misexpressions of particular HOX genes are implicated in the development of oral dysplasia and SCC

A Cross-Sectional Study of Age-Related Changes in Oral Function in Healthy Japanese Individuals

Background: Oral function deterioration is related to a variety of factors, including aging, decline in activities of daily living, malnutrition, and cognitive decline. This cross-sectional study examined the effects of aging on oral function in healthy individuals. Methods: A retrospective study was conducted on 175 healthy, independent patients aged 40–89 years, without dementia and with ≥20 teeth, who visited a local dental clinic in Japan. Patients were compared with 92 university students aged 20–29 years. The seven criteria proposed by the Japanese Society of Gerodontology to diagnose “oral hypofunction” were observed and statistically analyzed. Results: Compared with those in the control group, the degree of tongue coating was increased in the group aged over 80 years, occlusal force was decreased in the group aged 70–79 years, tongue motor function was decreased in the groups aged 60–69 years and older, and tongue pressure was decreased in the groups aged 70–79 years and older. Conclusions: Healthy, independent individuals maintained several oral function criteria across aging, including oral mucosal wetness, occlusal force, lip motor function, masticatory function, and swallowing function. Tongue motor function and tongue pressure decreased with aging, indicating that these may be rehabilitation targets