The historical development of dentistry in Hong Kong

Dentistry in Hong Kong during this century has advanced from an informal streetside practice to a discipline that now serves the community by way of registered oral health care personnel. Throughout the years, public attitudes towards dental care have also changed: from a palliative approach involving the extraction of teeth when pain arose, to the prevention of dental disease even at the formative stage of dentition through water fluoridation, regular therapeutic care, and oral health maintenance. The education and professionalisation of practitioners has evolved from apprenticeship to the establishment of a structured university curriculum and postgraduate specialist training of international standards.published_or_final_versio

Oral health status of southern Chinese following head and neck irradiation therapy for nasopharyngeal carcinoma

Objective: To investigate the oral health status of patients with nasopharyngeal carcinoma (NPC) after completion of radiotherapy. Methods: Thirty-three NPC patients (mean age 53 ± 10 years) who had completed head and neck radiotherapy (3.6 ± 3.1 years post-operation) were examined. Dental caries, periodontal status and oral mucosal lesions were recorded. Stimulated whole saliva (SWS) flow rate, pH, buffer capacity and carriage rate of carcinogenic micro-organisms were assessed. Jaw opening was measured. Results: Xerostomia was present in all patients, while 42% had candidiasis and 21% had limited jaw opening. The mean number of teeth present was 22, mean DMFT was 8.0, mean number of untreated root caries lesions was 1.4. Both saliva pH and buffering capacity were low while Streptococcus mutans and Lactobacillus spp. carriage were high. 52% of the patients had no dental care following radiotherapy. Although few patients expressed direct dissatisfaction, perceived level of information and of post-operative dental care was insufficient. Conclusions: Post-irradiated NPC patients constitute a high-risk group for dental root caries and oral candidiasis. The carriage rate of Streptococcus mutans and Lactobacillus spp. in this NPC patient group was the highest among findings of other similar studies. This may be related to the inadequacy of dental care after radiotherapy. Head and neck radiotherapy was not associated with periodontal disease. © 1998 Elsevier Science Ltd. All rights reserved.postprin

Are periodontal diseases risk factors for certain systemic disorders - What matters to medical practitioners?

Objective. To review recent data on the nature and pathobiology of periodontal infections and to elaborate how periodontal infections might increase susceptibility to some important systemic diseases and conditions. Data sources. Medline literature search and websites of the American Academy of Periodontology and American Medical Association. Study selection. Literature and data on periodontal diseases and their links to systemic diseases. Data extraction. Review of relevant information and data. Data synthesis. Periodontal diseases, including gingivitis and periodontitis, are among the most common infections of humans. They are induced by bacteria and bacterial products of dental plaque and are characterised by inflammatory destruction of tooth-supporting connective tissues and alveolar bone. A growing body of scientific evidence has shown that severe periodontitis may enhance susceptibility to certain important systemic diseases and conditions, for example, cardiovascular disease, diabetes mellitus, adverse pregnancy outcomes, and pulmonary infections. The clinical implications of the emerging specialty of periodontal medicine for dental and medical practitioners are postulated. Conclusions. Periodontal diseases may be risk factors for cardiovascular disease, diabetes mellitus, adverse pregnancy outcomes, and pulmonary infections. Dental and medical practitioners should be aware of the clinical implications of these inter-relationships and treat affected patients in collaboration for better oral and general health.published_or_final_versio

Oral microbiological and physiopathological status of post irradiated nasopharyngeal carcinoma patients

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Intra-oral colonization of coliform bacteria in irradiated, dentate, xerostomic individuals

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A novel patient with an attenuated Costello syndrome phenotype due to an HRAS mutation affecting codon 146-Literature review and update

De novo germline mutations in HRAS cause Costello syndrome, with >95% of the mutations causing Costello syndrome affecting amino acid position 12 (p.Gly12) or 13 (p.Gly13). We report on a patient with de novo missense mutation causing an amino acid change at codon 146 of HRAS, c.436G > C:p.Ala146Pro, who presented with subtle dysmorphic features, failure to thrive, global developmental delay, and hypertrophic obstructive cardiomyopathy. Mutations affecting codon 146 are observed in <1% of patients with Costello syndrome. From literature search, there were only two other patients reported with mutations involving the same location. We summarized and updated their findings, and discussed evidence to show that these patients with less obvious signs of Costello syndrome may not necessarily run a more benign clinical course.postprin

Periodontal status in mothers with or without spontaneous preterm births

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A preliminary investigation on periodontal disease and rheumatoid arthritis

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Diagnostic value of whole-exome sequencing in Chinese pediatric-onset neuromuscular patients

BACKGROUND: Neuromuscular disorders (NMDs) comprise a group of heterogeneous genetic diseases with a broad spectrum of overlapping the clinical presentations that makes diagnosis challenging. Notably, the recent introduction of whole-exome sequencing (WES) is introducing rapid changes on the genetic diagnosis of NMDs. We aimed to investigate the diagnostic value of WES for pediatric-onset NMDs. METHODS: We applied integrated diagnostic approach and performed WES in 50 Chinese subjects (30 males, 20 females) with undiagnosed pediatric-onset NMDs despite previous specific tests. The patients were categorized in four subgroups according to phenotyping and investigation findings. Variants on NMDs gene list and open exome analysis for those with initial negative findings were identified. RESULTS: WES identified causative variants in ACTA1 (n = 2), POMT1, COL6A1 (n = 2), MTMR2, LMNA, SELENON, DNM2, TGFB1, MPZ, IGHMBP2, and LAMA2 in 13 patients. Two subjects have variants of uncertain significance (VUSs) in TTN and SCN11A, unlikely to be pathogenic due to incompatible phenotypes. The mean interval time from symptom onset to genetic diagnosis was 10.4 years (range from 1 month to 33 years). The overall diagnostic yield of WES in our cohort was 26%. Open exome analysis was necessary to identify the pathogenic variant in TGFB1 that caused skeletal dysplasia with neuromuscular presentation. CONCLUSION: Our study shows a clear role of WES in the pathway of integrated diagnostic approach to shorten the diagnostic odyssey in patients with rare NMDs