Database: EMBASE <: international biomedical and pharmaceutical literature, 1988 - May 2000. [Trial access until 3/2001. Feedback welcome to medical.library@umich.edu] Search Strategy (You Saved Citations 1-292 From Set 53): ----------------------------------------------------------------------------- 1 "Root caries"/ 1483 2 ("root" adj3 (carie: or lesion:)).mp. 382 3 exp Tooth root/ 302 4 ((tooth or teeth or enamel or dentin) adj5 ("root" or apex 613 or apices)).mp. 5 ((amelocemental or cemental or cementum) adj5 (carie: or 21 lesion:)).mp. 6 Dental cementum/ 120 7 or/1-6 2448 8 exp Tooth demineralization/ 7492 9 demineralization.mp. 879 10 caries.mp. 1798 11 caires.mp. 0 12 craies.mp. 0 13 careis.mp. 1 14 carise.mp. 0 15 (teeth adj3 cavit:).mp. 32 16 (tooth adj3 cavit:).mp. 97 17 (dental adj3 cavit:).mp. 85 18 (dentin adj3 cavit:).mp. 19 19 (enamel adj3 cavit:).mp. 10 20 (teeth adj3 decay:).mp. 58 21 (tooth adj3 decay:).mp. 58 22 (dental adj3 decay:).mp. 47 23 (dentin adj3 decay:).mp. 0 24 (enamel adj3 decay:).mp. 1 25 (active adj decay).mp. 5 26 (rampant adj3 decay:).mp. 4 27 (recurrent adj3 decay:).mp. 5 28 (white adj spot:).mp. 231 29 carious.mp. 109 30 cariology.ti,ab. 2 31 (non-cavitated adj3 lesion:).mp. 0 32 (noncavitated adj3 lesion:).mp. 1 33 Tooth remineralization/ 788 34 (dental adj3 fissure:).mp. 14 35 (tooth adj3 fissure:).mp. 8 36 (teeth adj3 fissure:).mp. 1 37 caries-free.mp. 29 38 cariesfree.mp. 0 39 Cariogenic agents/ 3 40 precavit:.mp. 2 41 (filled adj3 teeth).mp. 45 42 (filled adj3 tooth).mp. 9 43 (oral adj fissure:).mp. 17 44 (tooth adj3 remineraliz:).mp. 1 45 (teeth adj3 remineraliz:).mp. 5 46 dft.mp. 542 47 dfs.mp. 980 48 dmf:.mp. 1235 49 cariogeni:.mp. 164 50 or/8-49 12313 51 7 and 50 1698 52 limit 51 to (human and english language) 1124 53 limit 52 to (adult < 18 to 64 years > or aged < 65+ years >) 292 54 from 53 keep 1-292 292 *************************** <1> UI - 2000164426 AU - Sawa Y AU - Phillips A AU - Hollard J AU - Yoshida S AU - Braithwaite MW IN - Y. Sawa, Department of Oral Anatomy I, Hokkaido University, School of Dentistry, N13 N7 Kita-ku, Sapporo 060-8586; Japan. E-Mail: sawa@den.hokudai.ac.jp. TI - Impairment of osteocalcin production in senescent periodontal ligament fibroblasts. SO - Tissue & Cell Vol 32(2) (pp 198-204), 2000. AB - Osteocalcin production of senescent periodontal ligament fibroblasts (PDLF) with the expression of senescence-associated beta-galactosidase (SA-beta-Gal) was investigated on clones from 50-80 years old donors (n=20) with teeth extracted due to periodontitis and dental caries, and from 15-19 year old donors (n=20) with normal teeth extracted for orthodontic reasons. Immunohistochemically, the nonsenescent PDLF in all cultures in passage 2 showed strong reactivity with anti-osteocalcin. The reactive intensity of PDLF (passage 2, PD 3.0) was significantly stronger in 50-80 year old donor group than in 15-19 year old donor group, suggesting that osteocalcin production of PDLF cultured in early passage is larger in cells from adult population than in cells from adolescent population. In PDLF cultures in passage 2 from 50-80 year old donor, two types of senescent cells were found: one with strong reactivity to anti-osteocalcin and the other with little detectable reactivity. The culture consisted of senescent PDLF (passage 8, PD 14.8) did not include cells which have a detectable reactivity with anti-osteocalcin immunohistochemically and the reactive intensity was significantly weaker in the senescent culture than in the culture in passage 2 by ELISA. This suggests that the production potential of osteocalcin is impaired in PDLF with aging in culture. Further, the reactive intensity with anti-osteocalcin of PDLF in passage 2 deprived of serum for 48 h was 6% of that of cells cultured with serum and the reaction increased after serum stimulation, suggesting that the osteocalcin production in PDLF in early passage is implicated in mitogenic stimulation. (C) 2000 Harcourt Publishers Ltd. [References: 16] <2> UI - 2000164422 AU - Sawa Y AU - Phillips A AU - Hollard J AU - Yoshida S AU - Braithwaite MW IN - Y. Sawa, Department of Oral Anatomy I, Hokkaido University, School of Dentistry, N13 W7 Kita-ku, Sapporo 060-8586; Japan. E-Mail: sawa@den.hokudai.ac.jp. TI - The in vitro life-span of human periodontal ligament fibroblasts. SO - Tissue & Cell Vol 32(2) (pp 163-170), 2000. AB - The in vitro life-span of human periodontal ligament fibroblasts (PDLF) was studied on clones from periodontium of teeth extracted due to periodontitis and dental caries (69 clones/192 individuals, aged 20-80 years) and from periodontium of teeth extracted for orthodontic reasons (23 clones/26 individuals, aged 15-19 years). In the primary cultures the ratio of the number of cells expressing senescence-associated beta-galactosidase (SA-beta-Gal) to the total number of cells is significantly larger in PDLF (92 clones; 11.1+/-4.9%) than in human gingival fibroblasts (GF) (10 clones; 0.5+/-0.1%). The finite population doubling numbers (PD) of PDLF are not age-matched and the mean PD of PDLF (7.1+/-2.9) is significantly smaller than GF (28.5+/-3.2), IMR-90 (human lung fibroblasts, 5 clones; 44.3+/-2.2), and human osteoblasts (5 clones; 19.7+/-1.4). Comparing the ratio of the number of SA-beta-Gal positive cells to the total number of cells in primary culture, and the finite PD in PDLF cultures: 1) the ratio of 15-19 years old donor group is significantly smaller than in the other donor groups (20-29, 30-39, 40-49, 50-59 and 60-80 years old) and 2) there were no statistically significant differences among the 20-29, 30-39, 40-49 and 50-59 year old donor groups, and the 30-39, 40-49, 50-59 and 60-80 year old donor groups. These findings suggest that the in vitro life-span of PDLF is shorter than other fibroblasts in the connective tissues and that PDLF may undergo senescence in adult clones without relation to donor's age. There may be more aged fibroblasts in periodontium than in other tissues, such as gingiva and lung. (C) 2000 Harcourt Publishers Ltd. [References: 29] <3> UI - 2000160042 AU - Merrick J AU - Shapira J IN - Prof. J. Merrick, Division for the Mentally Retarded, Ministry of Labour/Social Affairs, The Hebrew Univ.-Hadassah Faculty, Box 1260, IL-91012 Jerusalem; Israel. E-Mail: jmerrick@aquanet.co.il. TI - Dental concerns in Down syndrome. SO - International Journal of Adolescent Medicine & Health Vol 12(1) (pp 75-79), 2000. AB - Persons with Down syndrome (DS) have several cranial and oral cavity abnormalities resulting in dental disease. Two dental studies from Israel with a preadolescent (aged 8-13 years) and adult population (aged 20-48 years) of Down syndrome are reviewed. The studies used control groups of healthy and non-Down syndrome children and adults with mental retardation. All in all 84% of the children and 33% of the adults with DS were caries free. Periodontal treatment needs of the DS and non-Down adults were higher that the healthy group of persons and the DS adult group showed periodontal treatment needs three times greater than the DS children. It is recommended to start dental visits for persons with DS between the age of 18-24 months and to continue at least twice every year. [References: 3] <4> UI - 2000123144 AU - Al-Saleh I AU - Al-Doush I IN - I. Al-Saleh, Biological Medical Research Dept., King Faisal Specialist Hospital, PO Box 3354, Riyadh 11211; Saudi Arabia. TI - Urinary fluoride levels in Saudi individuals drinking tap and bottled water. SO - International Journal of Environmental Health Research Vol 10(1) (pp 21-26), 2000. AB - The fluoride concentration in the urine samples of 130 Saudi individuals aged 16-70 years old living in Riyadh was determined using a fluoride-specific electrode (0.9262 +/- 0.703 mug ml-1, 0.16-4.68 mug ml-1). There were differences in the urinary fluoride levels of the subjects. About 45.5% of the subjects had urinary fluoride less than 0.7 mug ml-1. Conversely, 22.3% of the screened subjects had urinary fluoride levels higher than 1.2 mug ml-1; this could increase the risk of dental and skeletal fluorosis. Since drinking water is considered to be the major source of fluoride, it was measured in 88 drinking water samples. Significant correlation between fluoride in urine and drinking water was found (r = 0.4341, p = 0.0237). Bottled water had significantly higher fluoride content (0.5205 +/- 0.322 mug ml-1) than tap drinking water (0.1046 +/- 0.0447 mug ml-1). About 67% of the screened water samples had low fluoride concentrations (< 0.3 mug ml-1) which is far below the recommended level for caries control. [References: 27] <5> UI - 2000106251 AU - Greenway SE AU - Greenway FL IN - Dr. F.L. Greenway, Pennington Biomedical Res. Center, 6400 Perkins Road, Baton Rouge, LA 70808-4124; United States. E-Mail: greenwfl@pbrc.edu. TI - Root surface caries: A complication of the jejunoileal bypass. SO - Obesity Surgery Vol 10(1) (pp 33-36), 2000. AB - Background: A patient developed root surface caries and loss of teeth following the jejunoileal (JI) bypass. We attempted to confirm the association of root surface caries with the JI bypass and explore the mechanisms by which it occurs. Methods: The number of root surface caries per year after, and an equal period of time before, a JI bypass was determined in 18 patients. These 18 patients and 5 normal controls gave stimulated saliva samples for measurement of chloride, bicarbonate and pH. 4 JI bypass patients and 4 normal controls gave timed stimulated saliva samples for measurements of volume. Results: 7 of 18 JI bypass patients had >0.5 root surface caries per year after the operation but none before (p<.01). Salivary chloride was > 12 meq/l in 3 of the 18 JI bypass patients but in none of 5 controls (p<.05). The salivary pH and bicarbonate were 6.38+/-0.48 vs 6.92 +/- 0.21 and 2.81+/-2.1 meq/l vs 5.8+/-1.2 meq/l in the JI bypass group and the control group respectively (p<.05). The stimulated saliva was 2.3+/-1.2 vs 4.5+/-1.4 cc/min in the JI bypass group and control group, respectively (p<.02). Conclusions: Root surface caries are more frequent after JI bypass. This may be due to decreased saliva flow and a reduced salivary buffering capacity. [References: 20] <6> UI - 2000093247 AU - Taweechaisupapong S AU - Wongkham S AU - Chareonsuk S AU - Suparee S AU - Srilalai P AU - Chaiyarak S IN - S. Taweechaisupapong, Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002; Thailand. TI - Selective activity of Streblus asper on Mutans streptococci. SO - Journal of Ethnopharmacology Vol 70(1) (pp 73-79), 2000. AB - The purpose of this in vivo one group time series design and single blind study was to determine the antimicrobial effectiveness of a mouthrinse containing Streblus asper leaf extract on Streptococcus mutans and total salivary bacteria following single 60 s rinse. Changing in salivary pH and buffer capacity during the experimental period were also measured. Thirty human subjects participated in this study. At each experimental session, a pretest saliva sample was taken. After giving the pretest samples, the subjects rinsed with S. asper leaf extract or distilled water control for 60 s, then the post-test saliva samples were collected at 0, 0.5, 1, 3, 5 and 6 h. The samples were used to determine the numbers of S. mutans and total salivary bacteria. The results indicated that S. asper leaf extract significantly reduced S. mutans counts compared with distilled water. However, the mean difference from baseline of total salivary bacterial counts was not significantly different between rinsing with S. asper leaf extract and distilled water. Moreover, S. asper leaf extract showed no effects in modifying the salivary pH and buffer capacity. It is concluded that of mouthrinse containing S. asper leaf extract can reduce S. mutans without changing an oral ecology. Copyright (C) 2000 Elsevier Science Ireland Ltd. [References: 31] <7> UI - 2000065111 AU - Bacon W AU - Hall RK AU - Roset J-P AU - Boukari A AU - Tenenbaum H AU - Walter B IN - Prof. W. Bacon, Dept. Orthopedie Dento-Faciale, Universite Louis Pasteur, 1 Place de l'Hopital, F-67000 Strasbourg; France. E-Mail: william.bacon@chru.strasbourg.fr. TI - GAPO syndrome: A new case of this rare syndrome and a review of the relative importance of different phenotypic features in diagnosis. SO - Journal of Craniofacial Genetics & Developmental Biology Vol 19(4) (pp 189-200), 1999. AB - The case of GAPO syndrome reported here is the 24th recorded case, 23 cases having been published previously. The 29-year-old male under discussion presents all the typical features of the syndrome, having short stature, dysmorphic craniofacial features, total alopecia and pseudoanodontia. Orally, the erupted primary dentition was extremely worn and on radiographic examination, the second mandibular molars were found to be unerupted, together with the entire permanent dentition. Cephalometry revealed the absence of facial pneumatisation, a deficient cranial base with diminished upper face height and maxillary and mandibular hypoplasia with a prognathic skeletal pattern. Histological examination of an extracted primary incisor and its surrounding root bone revealed extensive ankylosis. This paper describes in detail the clinical findings and reviews, and discusses previously published cases in relation to the present one. As with prior cases, parental consanguinity was present in the pedigree. [References: 30] <8> UI - 2000052164 AU - Cumella S AU - Ransford N AU - Lyons J AU - Burnham H IN - S. Cumella, Univ. Birmingham School Medicine, Division of Neuroscience, Queen Elizabeth Psychiatric Hospital, Birmingham B15 2QZ; United Kingdom. E-Mail: S.Cumella@bham.ac.uk. TI - Needs for oral care among people with intellectual disability not in contact with Community Dental Services. SO - Journal of Intellectual Disability Research Vol 44(1) (pp 45-52), 2000. AB - Previous research has found an unmet need for oral care among people with intellectual disability. The key factors which have been indicated are low expectations, fear of treatment, lack of awareness among carers and problems in accessing dental services. The withdrawal of many general dental practitioners (GDPs) from the National Health Service (NHS) may have exacerbated the latter problem in the UK. The aims of the present study were: (1) to assess the extent of unmet clinical needs in a group of adults with intellectual disability living in the community who were not in contact with the Community Dental Service (CDS); and (2) to explore their perceptions of teeth and contact with dentists to identify how oral care can be improved. Interviews were completed with subjects and/or carers and a dental examination was completed. There were higher levels of untreated caries (decay), and gingival or periodontal (gum) problems among the sample than in either the general population, or in a previous survey of CDS users at day centres and residential facilities. The subjects were largely unaware of dental problems, and used the appearance and absence of pain to judge the condition of their teeth. They depended greatly on their carers for decision-making and support with regard to visiting the dentist and tooth-brushing. Carers requested training in oral care and the use of dental services, and support in dealing with clients who have problems tolerating tooth-brushing. The subjects had experienced a wide variation in the treatment provided by dentists, but had not found it difficult to access a dentist despite recent reductions in the availability of NHS dental care. They expressed a particular need for a good relationship with their dentist and for their dentist to have personal skills in relating to people with an intellectual disability. Dental screening checks and oral care training for carers should be made easily available. Care plans should include tooth-brushing and dietary issues for all clients who have their own natural teeth. There are significant training issues for dentists in developing personal skills in total communication, disability awareness and attitudes which value people with intellectual disability. [References: 16] <9> UI - 2000047432 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Dr. P.S. Frame, Tri-County Family Medicine, 23 Park Avenue, Cohocton, NY 14826; United States. TI - Preventive dentistry: Practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. SO - American Journal of Preventive Medicine Vol 18(2) (pp 159-162), 2000. AB - Introduction: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. Results: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Conclusions: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low- risk populations. (C) 2000 American Journal of Preventive Medicine. [References: 16] <10> UI - 2000046925 AU - Preston AJ AU - Punekar S AU - Gosney MA IN - A.J. Preston, Dept. of Clinical Dental Sciences, University of Liverpool, Liverpool L3 5PS; United Kingdom. TI - Oral care of elderly patients: Nurses' knowledge and views. SO - Postgraduate Medical Journal Vol 76(892) (pp 89-91), 2000. AB - It is important that healthcare professionals caring for the elderly in hospitals have a core knowledge of the orodental care requirements of their patients. The aim of this study was to determine the knowledge and views of nurses working on acute and rehabilitation care of the elderly wards about orodental care. One hundred nurses and healthcare assistants took part in this questionnaire study of which 58 were qualified nurses and 70 had been employed on care of the elderly wards for two or more years. Although the majority of the respondents were registered with a dentist and attended regularly, 40 did have 'some anxiety' about visiting their dentist. Approximately half of the study population regularly gave advice to their patients about dental care but their knowledge of and reasons for providing oral care and advice was often incorrect. The group's understanding of the availability of dental treatment provided by the National Health Service was also often inaccurate. It was concluded that a better core knowledge of the orodental care of older patients is required by all healthcare professionals who care for this group. It is also important that individuals in whom anxiety is associated with their own dental experience do not neglect to give orodental health advice to their patients. [References: 14] <11> UI - 2000040562 AU - Gales MA AU - Nguyen T-M IN - Dr. M.A. Gales, Department of Pharmacy, INTEGRIS, Baptist Medical Center, 3300 Northwest Expressway, Oklahoma City, OK 73112; United States. TI - Sorbitol compared with xylitol in prevention of dental caries. SO - Annals of Pharmacotherapy Vol 34(1) (pp 98-100), 2000. AB - OBJECTIVE: To summarize published data on the comparative efficacy of sorbitol and xylitol for prevention of dental caries. DATA SOURCES: Published double-blind comparative trials, using sorbitol and xylitol products, identified by MEDLINE (January 1966-December 1998) and International Pharmaceutical Abstracts (January 1970-December 1998) searches. DATA SYNTHESIS: Clinical trials generally used sorbitol and xylitol gums, which patients chewed three to five times daily for 20-40 months. Xylitol was superior to sorbitol in two longer, secondary dentition trials (30-63% reductions), but not in two primary dentition trials. CONCLUSIONS: The data suggest that xylitol-containing gums may provide superior efficacy in reducing caries rates in high-risk populations. [References: 16] <12> UI - 2000006714 AU - Vivien-Castioni N AU - Gurny R AU - Baehni P AU - Kaltsatos V IN - Dr. N. Vivien-Castioni, School of Dental Medicine, University of Geneva, Faculty of Medicine, 19 rue Barthelemy-Menn, 1211 Geneva 4; Switzerland. E-Mail: nathalie.viviencastioni@medecine.unige.ch. TI - Salivary fluoride concentrations following applications of bioadhesive tablets and mouthrinses. SO - European Journal of Pharmaceutics & Biopharmaceutics Vol 49(1) (pp 27-33), 2000. AB - Presence of elevated fluoride concentration in saliva is important for the prevention of caries. In the present study, we developed an intra-oral bioadhesive tablet aimed at delivering F- in the mouth over a prolonged period of time. Various tablet formulations were tested in vivo for their tolerance and adhesiveness. Two formulations were selected for further studies on salivary fluoride clearance. For comparison, mouthrinses with increasing F- concentrations were also examined. Results indicate that a bioadhesive tablet located on the upper gingiva is able to sustain salivary F- concentrations for about 10 h without major side effects. Mouthrinses with high F- concentration were able to prolong salivary fluoride retention for more than 6 h. [References: 28] <13> UI - 2000011078 AU - Brennan DS AU - Spencer AJ IN - E-Mail: aihw.dsru@dentistry.adelaide.edu.au. TI - Variation in dental service provision among adult migrant public-funded patients. SO - AUST NEW ZEALAND J PUBLIC HEALTH, Vol 23(6) (pp 639-642), 1999. AB - Objective: To examine type of care, oral health status and service patterns by country of birth and language. Methods: A random sample of public-funded patients (n = 6109) was surveyed in 1995-96. Results: Emergency care was highest among overseas-born patients who spoke a non-English language at home; edentulism was highest among Australian-born/English only patients; while a higher percentage of Australian-born persons were in the periodontal health category (chi2; p < 0.05). Differences in caries experience were generally small (ANOVA; p < 0.05). Service provision varied by country of birth/language after controlling for socio-demographic characteristics, type of care, and oral health status in six service areas (logistic regression; p < 0.05). Conclusions: Service patterns may reflect behavioural and cultural factors of patients or providers operating independently of socio-demographic and oral health status variables. Implications: Variation and potential inequality in service patterns related to cultural factors existed within a group of disadvantaged patients. [References: 20] <14> UI - 1999403721 AU - Mickenautsch S AU - Rudolph MJ AU - Ogunbodede EO AU - Chikte UME IN - Prof. M.J. Rudolph, Department of Community Dentistry, Univ. Witwatersrand, Johannesburg, Private Bag 15, Braamfontein 2017; South Africa. TI - Oral health among Liberian refugees in Ghana. SO - East African Medical Journal Vol 76(4) (pp 206-211), 1999. AB - Objective: To promote community involvement in the provision of oral health services. Design: The project consisted of a four-week training course in oral health for selected refugees, an oral health survey based on WHO guidelines and conducted by the refugees themselves and the provision of oral health care services to the community by the trained refugees. Setting: Liberian refugee camp, Gomoa Buduburam in Ghana. Subjects: Liberian refugees of all ages. Interventions: Twelve refugees were given short term training in oral health. In the oral health survey, 196 refugees were clinically examined for dental caries, periodontal disease and malocclusion. Main outcome measures: DMFT (for dental caries), CPITN (for periodontal disease), and malocclusion scores for selected subjects. Also clinical services rendered. Results: Oral health survey revealed a mean age (+/- SD) of 25.7 (+/- 9.5) years. Only thirty nine (19.9%) of the subjects were caries-free, and total DMFT was 2.5 +/- 2.2. Based on the CPITN, 107 (54.6%) required oral hygiene instructions (OHI), and 41 (20.9%) required prophylactic scaling with OHI. Forty four (22.5%) of the subjects had normal occlusion and 152 (77.5%) mild to severe malocclusion. Periodontal (75.5%), prosthetic (52.5%) interventions and extractions (34.2%) constituted the bulk of the treatment needs required. Clinical treatment was rendered by the trained refugees to 846 patients over a twelve month period. Conclusion: Relief programmes for refugees should emphasise a primary health care approach, focusing on prevention, based on appropriate technology, and promoting involvement by the refugee community in the provision of services. [References: 15] <15> UI - 1999390858 AU - Ramon-Fluixa C AU - Bagan-Sebastian JV AU - Milian-Masanet MA AU - Scully C IN - Prof. J.V. Bagan-Sebastian, Hospital General Universitario, Servicio de Estomatologia, Avda. Tres Cruces, s/n., 46014-Valencia; Spain. TI - Periodontal status in patients with oral lichen planus: A study of 90 cases. SO - Oral Diseases Vol 5(4) (pp 303-306), 1999. AB - OBJECTIVE: This study was carried out to relate periodontal status to the oral lesions in patients with oral lichen planus (OLP). MATERIALS AND METHODS: Periodontal status was evaluated in 90 patients with OLP and in 52 controls, in terms of the plaque index (PII), simplified calculus index (CIS) and periodontal disease index (PDI). RESULTS: No significant differences were observed between the two groups as regards the different periodontal indices. The plaque and calculus indices were higher in the more extensive forms of OLP (P = 0.02 and P = 0.012, respectively), and in the presence of gingival involvement (P = 0.004 and P = 0.04). A significant association was also observed between the presence of atrophic-erosive lesions and increased periodontal deterioration (P = 0.037). CONCLUSIONS: Increased plaque and calculus deposits are associated to a significantly higher incidence of atrophic-erosive gingival lesions in patients with OLP. [References: 53] <16> UI - 1999384778 AU - Acton RT AU - Dasanayake AP AU - Harrison RA AU - Li Y AU - Roseman JM AU - Go RCP AU - Wiener H AU - Caufield PW IN - Dr. R.T. Acton, Immunogenetics Program, University of Alabama, PAB 221, 1025 18th Street South, Birmingham, AL 35294-4400; United States. E-Mail: Acton@iprsh.igpmd.uab.edu. TI - Associations of MHC genes with levels of caries-inducing organisms and caries severity in African-American women. SO - Human Immunology Vol 60(10) (pp 984-989), 1999. AB - The aim of this investigation was to evaluate the relationship between MHC alleles at the HLA-DRB1, DQB1 and TNFa microsatellite loci and levels of oral bacteria that play a role in the etiology of dental caries, and the DMFS index in 186 AA primparous women. The average age of the cohort was 20.8 +/- 3.7 years. The median DMFS index was 9 (range 0-68). High levels of S. mutans were positively associated with DRB1*3 and DRB1*4 presence (p <= 0.005). DRB1*8 was positively associated with higher levels of S. mutans as a percentage of total Streptococci (p = 0.04). DRB1*1 was positively associated with high levels L. casei (p = 0.04). DQB1 alleles were not observed associated with oral bacterial levels. TNFa allele 103 was negatively associated (p = 0.04), and TNFa 117 was positively associated (p = 0.007), with high levels of L. acidophilus. No significant associations were observed between any DRB1, DQB1 or TNFa allele and the DMFS index. These results support an hypothesis of an association between host HLA class II and TNFa genetic profile and colonization of S. mutans, L. casei, and L. acidophilus thought to be pathogens involved in the etiology of dental caries. [References: 21] <17> UI - 1999369108 AU - Fiske J IN - Dr. J. Fiske, Guys, Kings St. Thomas Dental Inst., Guy's Hospital Site, King's College, London; United Kingdom. TI - The National Diet and Nutrition Survey: People aged 65 years and over. Volume 2: Report of the oral health survey. SO - Journal of Human Nutrition & Dietetics Vol 12(5) (pp 467-468), 1999. <18> UI - 1999349216 AU - Cederlund A AU - Lindskog S AU - Blomlof J IN - A. Cederlund, Department of Basic Oral Sciences, Oral Pathology Unit, PO Box 4064, S-141 04 Huddinge; Sweden. E-Mail: andreas.cederlund@ofa.ki.se. TI - Effect of a chemo-mechanical caries removal system (Carisolv(TM)) on dentin topography of non-carious dentin. SO - Acta Odontologica Scandinavica Vol 57(4) (pp 185-189), 1999. AB - The purpose of the present study was to examine the morphology of healthy dentin surfaces after treatment with Carisolv(TM) followed by conditioning with phosphoric acid and EDTA, since surface morphology may be of interest for dentin bonding. Another purpose was to evaluate the effect of treatment with Carisolv(TM) on healthy non-carious dentin surfaces with exposed collagen fibers. Scanning electron microscopy was utilized to carry out a detailed morphological examination of the dentin surfaces with regard to presence or absence of both smear layer and collagen fibers. Twelve premolars extracted for orthodontic reasons from young adults were used. The two enchants appeared to have produced two distinctly different surfaces. Etching with phosphoric acid following Carisolv(TM) treatment resulted in a porous dentin surface, while EDTA etching without prior Carisolv(TM) treatment appeared to have unrecovered an intact collagen network. In contrast, the surfaces treated with Carisolv(TM) prior to EDTA etching displayed smooth intertubular surfaces with only occasional fibers. Apparently, the ability of EDTA to expose collagen in the dentin surface is counteracted or inhibited by the Carisolv(TM) treatment. Furthermore, it cannot be excluded that the Carisolv(TM) treatment in itself may have dissolved collagen fibers. Since most bonding systems claim bonding to the collagenous component of dentin, the question arises which of the etched surfaces is preferable and to what degree the collagenous component contributes to bonding strength. Furthermore studies are thus needed to evaluate the micromechanical retention of a restoration to the different surfaces described in the present study. [References: 20] <19> UI - 1999325421 AU - Mojon P AU - Budtz-Jorgensen E AU - Rapin C-H IN - P. Mojon, Div. Gerodontol. Rem. Prosthodontics, Section of Dental Medicine, University of Geneva, 19 rue Barthelemy-Menn, 1205 Geneva; Switzerland. E-Mail: Philippe.Mojon@medecine.unige.ch. TI - Relationship between oral health and nutrition in very old people. SO - Age & Ageing Vol 28(5) (pp 463-468), 1999. AB - Objective: to evaluate the relationship between oral health status and nutritional deficiency. Design: cross-sectional clinical study. Subjects: 324 institutionalized frail older adults (mean age 85). Measurements: structured oral examination including an evaluation of mucosa, periodontal state, caries prevalence and denture quality. The nutritional status was assessed using serum albumin concentration and the body mass index. Physical dependence was assessed using the Barthel index. To identify oral health disorders associated with markers of malnutrition we performed the Pearson chi2 test separately for edentulous and dentate patients. Subjects: With at least one of the identified oral disorders were classified as having compromised oral functional status. Results: about two-thirds of the subjects were functionally dependent and half had either a body mass index < 21 kg/m2 or serum albumin < 33 g/l. Among the edentulous, wearing dentures with defective bases or not wearing dentures at all were the factors most associated with malnutrition. In dentate subjects, corresponding identifiers were the number of occluding pairs of teeth (five or fewer, either natural or prosthetic), the number of retained roots (four or more), and the presence of mobile teeth. According to these criteria, 31% of the subjects had a compromised oral functional status. This was more frequently found in dependent subjects (37%) than semi-dependent subjects (18%; odds ratio, 2.6; 95% confidence interval, 1.4-4.8). Those with compromised oral functional status had a significantly lower body mass index and serum albumin concentration. Conclusion: specific detrimental oral conditions are associated with nutritional deficiency in very old people. [References: 39] <20> UI - 1999325412 AU - Walls AWG IN - A.W.G. Walls, Department of Restorative Dentistry, The Dental School, Framlington Place, Newcastle upon Tyne NE2 4BW; United Kingdom. E-Mail: a.w.g.walls@newcastle.ac.uk. TI - Oral health and nutrition. SO - Age & Ageing Vol 28(5) (pp 419-420), 1999. <21> UI - 1999285288 AU - Sgan-Cohen HD AU - Horev T AU - Zusman SP AU - Katz J AU - Eldad A IN - H.D. Sgan-Cohen, Department of Community Dentistry, School of Dental Medicine, Hebrew University-Hadassah, P.O. Box 12272, Jerusalem 91120; Israel. TI - The prevalence and treatment of dental caries among Israeli permanent force military personnel. SO - Military Medicine Vol 164(8) (pp 562-565), 1999. AB - A survey was conducted to determine dental caries prevalence and treatment among 1,095 25- to 44-year-old permanent force Israeli military personnel. Caries experience, by decayed, missing, and filled permanent teeth (DMFT), was 11.66, with an average of 1.37 untreated caries, 2.40 extracted teeth, and 7.90 treated teeth. Caries was positively associated with age (p < 0.001). Females demonstrated statistically higher DMFT levels than males (p = 0.009). Negative associations were detected for education levels and untreated and extracted components (p < 0.001), and a positive association was detected for the treated caries component (p < 0.001). Permanent military personnel treated by private dentists exhibited 17.6% untreated caries, compared with 9.4% among personnel treated in the army. Officers had lower levels of untreated caries (8.6%) than others (13.3%). Among the present population, 77% had attended a dental clinic in the preceding 2 years. Permanent force personnel are offered free, comprehensive, and accessible dental treatment. The data emphasize a need for further dental health education. [References: 19] <22> UI - 1999251597 AU - Astor FC AU - Hanft KL AU - Ciocon JO IN - Dr. F.C. Astor, Department of Otolaryngology, Cleveland Clinic Florida, 3000 W. Cypress Creek Rd., Ft. Lauderdale, FL 33309; United States. TI - Xerostomia: A prevalent condition in the elderly. SO - Ear, Nose, & Throat Journal Vol 78(7) (pp 476-479), 1999. AB - Although xerostomia is associated with aging, studies have determined that salivary gland function is well preserved in the healthy geriatric population. Therefore, dry mouth is probably not a condition of aging, but most likely one of systemic or extrinsic origin. Saliva seems to undergo chemical changes with aging. As the amount of ptyalin decreases and mucin increases, saliva can become thick and viscous and present problems for the elderly. One of the most prevalent causes of xerostomia is medication. Anticholinergics, such as psychotropic agents and antihistamines, and diuretics can dry the oral mucosa. Chronic mouth breathing, radiation therapy, dehydration, and autoimmune diseases, such as Sjogren's, can also diminish salivation, as can systemic illness such as diabetes mellitus, nephritis, and thyroid dysfunction. Xerostomia can lead to dysgeusia, glossodynia, sialadenitis, cracking and fissuring of the oral mucosa, and halitosis. Oral dryness can affect denture retention, mastication, and swallowing. Dry mouth symptom can be treated with hydration and sialagogues or with artificial saliva substitutes. Because patients are at risk for dental caries, they should be referred to a dentist for preventive care. In patients with Sjogren's syndrome and in those who have undergone radiation therapy, pilocarpine has been used recently with good results. [References: 20] <23> UI - 1999214955 AU - Vanheusden AJ AU - Goffinet G AU - Zahedi S AU - Nusgens B AU - Lapiere CM AU - Rompen EH IN - Dr. E.H. Rompen, Institute of Dentistry, University of Liege, 78 Bd. de la Constitution, B-4020 Liege; Belgium. TI - In vitros stimulation of human gingival epithelial cell attachment to dentin by surface conditioning. SO - Journal of Periodontology Vol 70(6) (pp 594-603), 1999. AB - Background: Chemical root conditioning is widely used to improve the outcome of regenerative periodontal therapies by favoring the attachment of the regenerated periodontal structures. Although the effect of root conditioning on periodontal mesenchymal cells is well documented, very little is known about its potential effect on the re-formation of the junctional epithelium, a crucial event for the protection of the wound. The goal of the present study was to test in vitro the consequences of dentin conditioning with citric acid or minocycline on the attachment kinetics and morphology of human gingival keratinocytes (HGK). Methods: The attachment kinetics of HGK to samples of powdered human dentin (particle size 44 to 76 mum) were examined by use of 3H-labeled cells. The morphology of attached epithelial cells was then determined by scanning electron microscopy (SEM). Results: When the initial adhesion kinetics of cells on untreated dentin were tested, the percentage of attached HGK proved to be dependent on the number of plated cells and the time of incubation (from 0 to 12 hours). Conditioning the dentin by 3% critic acid or by minocycline-HCl (at 0.01, 0.1, or 2.5%) significantly increased (P < 0.005) keratinocyte attachment beyond 6 hours, without notable differences between the 2 substances at any concentration. The attachment kinetics of HGK preincubated for 24 hours by 10 mug/ml minocyline-HCl on untreated dentin was found to be similar to that observed for non-preincubated cells. These results are in agreement with the SEM observations: indeed, the surface conditioning of dentin significantly modified the morphology of attached HGK, whereas the preincubation of these cells with minocyline-HCl did not. Conclusions: These results suggest that minocycline-HCl does not exert a direct effect on human gingival epithelial cells. In contrast, conditioning the dentin by citric acid or by minocycline stimulates the attachment of HGK, which could lead to a rapid periodontal healing by favoring the re-formation of a junctional epithelium. [References: 76] <24> UI - 1999181942 AU - Simons D AU - Kidd EAM AU - Beighton D IN - D. Simons, West Herts Community Dental Services, Dental Department, Principal Health Centre, St Albans, Herts AL1 3LA; United Kingdom. TI - Oral health of elderly occupants in residential homes. SO - Lancet Vol 353(9166) (pp 1761), 1999. <25> UI - 1999175049 AU - Koba K AU - Kimura Y AU - Matsumoto K AU - Gomyoh H AU - Komi S AU - Harada S AU - Tsuzuki N AU - Shimada Y IN - Dr. K. Matsumoto, Department of Endodontics, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515; Japan. E-Mail: koukichi@hp.dent.showa-u.ac.jp. TI - A clinical study on the effects of pulsed Nd:YAG laser irradiation at root canals immediately after pulpectomy and shaping. SO - Journal of Clinical Laser Medicine & Surgery Vol 17(2) (pp 53-56), 1999. AB - Objective: The effects of pulsed Nd:YAG laser irradiation for the treatment of root canals immediately after pulpectomy and shaping with regard to improvement of symptoms were evaluated clinically. Summary Background Data: The effects of pulsed Nd:YAG laser irradiation for the treatment of root canals were experimentally investigated using an animal model, but not under clinical conditions. Materials and Methods: Thirty-eight teeth from 29 patients were diagnosed as normal or irreversible pulpitis were used. After extirpation of pulp and shaping using a step-back technique and cleansing with 5% sodium hypochlorite (NaOCl) and 3% hydrogen peroxide (H2O2), laser irradiation was applied at 1 W and 15 pps for 1 second in 23 teeth (laser- treated group). Root canals were then obturated with gutta-percha points and sealer by the lateral condensation method. The condition of the obturations was confirmed radiographically. The control teeth were treated in the same way, but without laser irradiation. Occurrence of spontaneous pain was recorded 1 day after treatment and occurrence of percussion pain was recorded 1, 2, and 3 weeks after treatment. Results: Effective ratio, which was the ratio of the number of 'none' teeth to total teeth number in the laser- treated group, was higher than that in the control group, but there was no significant difference between 2 groups with regard to spontaneous and percussion pain (p > 0.05). Conclusion: These results suggest that the clinical application of pulsed Nd:YAG laser might be advantageous for the one-visit treatment of root canals immediately after pulpectomy shaping and to reduce postoperative pain. [References: 29] <26> UI - 1999130183 AU - Toljanic JA AU - Bedard J-F AU - Larson RA AU - Fox JP IN - J.A. Toljanic, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637; United States. TI - A prospective pilot study to evaluate a new dental assessment and treatment paradigm for patients scheduled to undergo intensive chemotherapy for cancer. SO - Cancer Vol 85(8) (pp 1843-1848), 1999. AB - BACKGROUND. Patients scheduled to receive chemotherapy frequently undergo pretherapy dental treatment to eliminate potential sources of odontogenic infection. A prospective study was conducted to assess a new protocol emphasizing minimal pretherapy dental treatment. METHODS. Forty- eight consecutive patients diagnosed with solid or hematologic neoplasms underwent dental examination prior to intensive chemotherapy. All chronic dental pathology was scored as either mild-to-moderate or severe based on the likelihood of conversion to an acute state during chemotherapy. No pretherapy dental treatment was given to patients with chronic dental disease. Intertherapy dental complications and the overall impact on chemotherapy outcomes were assessed. RESULTS. Thirty-eight patients (79%) were diagnosed with pretherapy chronic dental pathology. Twenty-one of these patients (44% of the total population) were identified as having severe pathology and considered at risk for acute intertherapy dental complications. Two patients (4%) experienced acute intertherapy episodes, each presenting as oral abscesses. In both cases, resolution was achieved with antibiotics without interruption of chemotherapy. Oncologic treatment outcomes for all patients were judged to be unaffected by either the presence of chronic pretherapy dental disease or acute intertherapy exacerbations of these disease states. CONCLUSIONS. These results demonstrate that patients with chronic dental pathology can safely proceed with chemotherapy without dental intervention, as conversion of chronic dental disease to an acute state during chemotherapy occurs infrequently. If intertherapy dental infections do arise, they can be managed effectively without interrupting therapy or adversely affecting oncologic treatment outcomes. [References: 14] <27> UI - 1999157249 AU - Ship JA IN - J.A. Ship, Associate Professor/Vice Chair, Department of Oral Medicine, Univ. Michigan School of Dentistry, 1011 N. University, Ann Arbor, MI 48109-1078; United States. E-Mail: jship@umich.edu. TI - The influence of aging on oral health and consequences for taste and smell. SO - Physiology & Behavior Vol 66(2) (pp 209-215), 1999. AB - Oral diseases that are commonly seen in older adults can impair chemosensory function. Many stomatological conditions are preventable and treatable, yet unmanaged, they can cause significant morbidity and a diminished quality of life. Importantly, many oral diseases are not necessarily an inevitable consequence of growing old, and are frequently attributed to systemic diseases and their treatment. Although gustation may undergo mild age-related decrements, olfaction declines dramatically with greater age. The oral-facial region is intimately involved in the sensations of taste and smell, and diseases affecting this region in an older person could adversely affect an already compromised chemosensory system. Older adults with impaired taste and/or smell should be thoroughly evaluated for oral and pharyngeal diseases. It is reasonable to expect that a healthy adult can grow older with good oral health and function, and can continue to experience the hedonic pleasures of taste and smell associated with eating and drinking. Copyright (C) 1999 Elsevier Science Inc. [References: 72] <28> UI - 1999148844 AU - Fontana G AU - Lapolla A AU - Sanzari M AU - Piva E AU - Mussap M AU - De Toni S AU - Plebani M AU - Fusetti F AU - Fedele D IN - Prof. D. Fedele, Department of Internal Medicine, Servizio di Diabetologia, Osp. Geriatrico, Via Vendramini 7, I-35187 Padova; Italy. TI - An immunological evaluation of type II diabetic patients with periodontal disease. SO - Journal of Diabetes & its Complications Vol 13(1) (pp 23-30), 1999. AB - Peridontal disease is a frequent complication of diabetes, and diabetic subjects often exhibit decreased immune response with increased susceptibility to infection. We evaluated the possible relationship between immune response and periodontal disease in 40 type II diabetic patients, mean (+/- SD) age 59 +/- 8 years and mean disease duration 17 +/- 4 years, with good metabolic control (mean fasting plasma glucose, 10.5 +/- 3.8 mM/L, mean HbA(1c) 8.1 +/- 1.66%), and in 40 age and gender-matched controls. Interproximal alveolar bone loss (ABL), as the percentage of bone loss from the cement enamel junction (CEJ) to the apex, was measured with a modified Schei ruler at the deepest point on the mesial/distal surface of the teeth, except third molars, on a panoramic radiograph. Immunological evaluation involved study of NADPH neutrophil superoxide production, neutrophil chemotaxis, lymphocyte subpopulations, immunoglobulins and complement. Diabetic patients showed significant differences compared with controls regarding ABL (30.6 +/- 14.7% versus 17.6 +/- 4.3%; p < 0.0001) and the T- helper/T-suppressor ratio (2.3 +/- 1.0% versus 1.8 +/- 0.8%; p < 0.05). Other parameters of cell-mediated immunity and humoral immune response did not show any significant variations. No correlation between immunological and radiographic analysis parameters were found. Further studies are needed to verify the exact role played by immunological factors in type II diabetic patients with periodontal disease. [References: 51] <29> UI - 1999137305 AU - Tenenbaum H AU - Dahan M AU - Soell M IN - Prof. H. Tenenbaum, Department of Periodontology, Dental Faculty, 1, Place de l'Hopital, 67000 Strasbourg; France. TI - Effectiveness of a sanguinarine regimen after scaling and root planing. SO - Journal of Periodontology Vol 70(3) (pp 307-311), 1999. AB - Background: A variety of chemical agents have been evaluated relative to their abilities to inhibit dental plaque and to improve gingival health. Chlorhexidine gluconate is the best known and most widely used member of these agents, but its long-term use is compromised by different side effects, especially extrinsic tooth and tongue staining. Another agent, sanguinarine, which is currently used in both a mouthrinse and toothpaste, leads in some cases only to a transient burning sensation and could be used on a long-term basis. The purpose of this 14-week controlled clinical trial was to assess the effectiveness of a toothpaste and oral rinse containing sanguinaria extract after scaling, root planing and a chlorhexidine regimen. Methods: Sixty patients diagnosed as having adult periodontitis received initial periodontal therapy including scaling and root planing, followed by a 2-week oral care regimen which included rinsing with 0.2% chlorhexidine gluconate oral rinse. Upon completion of this 2-week initial therapy phase, patients were randomly assigned to either sanguinarine toothpaste and oral rinse or to control toothpaste and oral rinse without sanguinarine. Plaque (modified Quigley-Hein index) and gingivitis (gingival index) were measured prior to periodontal therapy, at the end of the chlorhexidine phase (2 weeks), and after 8 and 14 weeks. Results: Sanguinarine-containing toothpaste and oral rinse significantly inhibited the redevelopment of gingivitis through the 12 weeks following the chlorhexidine phase compared to the control toothpaste and rinse. Patients in the test group had 26% fewer bleeding sites at 8 weeks, and 32% fewer at 14 weeks, than the control group. Conclusions: Our results support the combined use of chlorhexidine mouthrinse for a short term (2 weeks) followed by sanguinaria mouthrinse and toothpaste up to 3 months in order to optimize the effectiveness of chlorhexidine without side effects. Further studies on the long-term effect of this combination should be established. [References: 23] <30> UI - 1999134152 AU - Drinovec J AU - Bagar-Povse M AU - Bohar F IN - Dr. J. Drinovec, RADENSKA Radenci, Raziskovalna enota, Zdravilisko naselje 14, 1252 Radenci; Slovenia. TI - Is fluoride effectively absorbed from mineral water?. SO - FORSCH KOMPLEMENTARMED, Vol 6(1) (pp 43-44), 1999. AB - The absorption of fluoride from mineral water (containing 1.608 mg/l of fluoride) was studied in 17 healthy volunteers, 9 males and 8 females. The plasma and 24-hour urine concentrations of fluoride were determined at the beginning of the study, after 7 days of drinking mineral water Radin, and after 7 days of drinking the fluoride-rich mineral water Miral. Drinking of the mineral water Miral statistically significantly increased the plasma and urine concentrations of fluoride. [References: 3] <31> UI - 1999118275 AU - Nathoo N AU - Nadvi SS AU - Van Dellen JR AU - Ciric I AU - Adams CBT AU - Wagner FC Jr IN - N. Nathoo, Department of Neurosurgery, Wentworth Hospital, P/Bag JACOBS 4026, Durban, Natal; South Africa. TI - Cranial extradural empyema in the era of computed tomography: A review of 82 cases. SO - Neurosurgery Vol 44(4) (pp 748-754), 1999. AB - OBJECTIVE: Intracranial suppurative disorders (abscesses and empyemas) continue to be common neurosurgical emergencies in South Africa. Cranial extradural empyema (EDE) occurs less frequently than its subdural counterpart but remains a potentially devastating disease process. We present our 15- year experience with this condition in the era of computed tomography. METHODS: Of the 4623 patients with intracranial sepsis who were admitted to the neurosurgical unit at Wentworth Hospital (Durban, South Africa) during a 15-year period (1983-1997), 76 patients with EDEs were identified. An additional six patients who were identified from our outpatient records were treated nonsurgically. Analyses were performed with respect to clinical, radiological, bacteriological, surgical, and outcome data. All information for this study was obtained from the computerized databank for the unit. Statistical analyses of the related pre- and postoperative clinical data were performed. RESULTS: The 76 patients with EDEs accounted for 1.6% of the total number of patients admitted for treatment of intracranial sepsis during the study period. Thirteen patients (15.8%) had infratentorial pus collections. Male patients predominated by a ratio of 2:1, and 66 patients were between the ages of 6 and 20 years (mean age, 16.56 +/- 9.87 yr). The origins of the sepsis were paranasal sinusitis for 53 patients (64.6%), mastoiditis for 16 patients, trauma for 5 patients, dental caries for 1 patient, and miscellaneous causes for 7 patients. The most common clinical presenting features were fever, neck stiffness, and periorbital edema. Surgery was performed in the form of burrholes for 21 patients, small craniectomies for 39 patients, and craniotomies for 5 patients. The additional five patients, while having drainage of their infected paranasal sinuses, had simultaneous drainage of their extradural pus collections by the ear, nose, and throat surgeon. The majority of patients (81 patients) experienced good outcomes (Glasgow Outcome Scale scores of 4 or 5). A single patient died after surgery (mortality rate, 1.22%). CONCLUSION: EDEs occur less frequently than subdural empyemas and are associated with better prognoses. Surgical drainage (burrholes), simultaneous eradication of the source of sepsis, and high-dose intravenous antibiotic therapy remain the mainstays of treatment. Selective nonsurgical management of small EDEs is possible, provided the source of sepsis is surgically eradicated. It is our opinion that EDE is a disease that should be managed without morbidity or death. [References: 20] <32> UI - 1999120242 AU - Bourgeois D AU - Berger P AU - Hescot P AU - Leclercq MH AU - Doury J IN - D. Bourgeois, Lab. of Res. in Oral Health EA 1885, WHO Collaborating Centre, Faculty of Dentistry, 69372 Lyon Cedex 08; France. TI - Oral health status in 65-74 years old adults in France, 1995. SO - Revue d Epidemiologie et de Sante Publique Vol 47(1) (pp 55-59), 1999. AB - Background: A study was carried out to assess the oral health status of the non-institutionalized population aged 65-74 years and living in the Rhone-Alpes region, France, in 1995. Methods: The representative sample was composed of 603 subjects comprised of 41.5% of men of which 24.5% lived in rural areas i.e. less than 2,000 inhabitants and 75.5% of urban areas. The quota sample used was stratified by socio-economic status, residence and gender. Oral health was defined by dentate status, D (Decayed), M (Missing), F (Filled) components and DMFT components. Carious lesions, fillings, missing teeth were recorded using the World Health Organization criteria. An indicator of treatment need the ratio of decayed teeth over decayed and filled teeth D/D+F was used. Results: The DMFT index at 65-74 years for the French population was 23.3 +/- 4.0. The dental condition of the study group in the Rhones-Alpes region of France appears satisfactory considering the low percentage of untreated decayed teeth at 65-74 years old (17.4%) and the low rate of edentate people (16.3%). Gender, location and socio-economic variables in relation to the dental status were discussed. Conclusion: The relatively good oral health status of the senior citizens and the low rate of need for treatment of dental decay together with the level of oral care available provided a solid base for further development of a qualitative national dental care system. [References: 13] <33> UI - 1999113772 AU - Liang H AU - Wang Y AU - Wang Q AU - Ruan M-S IN - H. Liang, Department Applied Chemistry, College Chemical Engineering, Xi'an Jiaotong University, 710049 Xi'an; China. TI - Hydrophobic interaction chromatography and capillary zone electrophoresis to explore the correlation between the isoenzymes of salivary alpha-amylase and dental caries. SO - Journal of Chromatography. B, Biomedical Sciences & Applications Vol 724(2) (pp 381-388), 1999. AB - High-performance hydrophobic interaction chromatography (HIC) and capillary zone electrophoresis (CZE) were utilized in an effort to find the correlation between the composition of some isoenzymes of human salivary alpha-amylase (HSA) and dental caries. The mixture of more than three isoenzymes of HSA, fractionated from human parotid saliva with HIC, was further separated by CZE at the optimum pH 6.50. The composition and relative quantity of these isoenzymes were compared between two groups of individuals with different caries-susceptibility. It is found that the present frequency of peak II on CZE in the caries-free group was higher than that in the caries-active group and the relative quantities of peak III and peak IV showed remarkable differences (p<0.05) between the two groups. These results may indicate that the composition of HSA isoenzymes is related to the occurrence of dental caries. However, more work should be done to further affirm this correlation between the isoenzymes of salivary alpha-amylase and dental caries. Copyright (C) 1999 Elsevier Science B.V. [References: 31] <34> UI - 1999112278 AU - Finsterer J IN - Dr. J. Finsterer, Postfach 348, 1180 Wien; Austria. TI - High-altitude illness induced by tooth root infection. SO - Postgraduate Medical Journal Vol 75(882) (pp 227-228), 1999. AB - High-altitude illness may occur after recent pulmonary infection, but high-altitude illness after root canal therapy has not been described previously. A 44-year-old man is presented who skied to a 3333 m high peak in the Eastern Alps one day after he had undergone root canal therapy because of a tooth root infection. After 4 hours above 3000 m severe symptoms of high-altitude illness, including pulmonary oedema, developed. His condition improved after immediate descent. The next day he presented with local and general signs of infection which were successfully treated with gingival incisions and antibiotics. In conclusion, acute tooth root infection and root canal therapy may induce high-altitude illness at an altitude just above 3000 m. [References: 6] <35> UI - 1999069638 AU - Streckfus CF AU - Parsell DE AU - Streckfus JE AU - Pennington W AU - Johnson RB IN - C.F. Streckfus, Department of Research, Univ. of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505; United States. TI - Relationship between oral alveolar bone loss and aging among African-American and Caucasian individuals. SO - Gerontology Vol 45(2) (pp 110-114), 1999. AB - Background: The periodontal attachment apparatus consists of the periodontal ligament, alveolar bone, cementum and supra-crestal connective tissue. They are interdependent and provide protection and support to the dentition. It is theorized that the integrity of the periodontal apparatus can be maintained throughout life by exercising comprehensive oral hygiene practices and routine dental care. Additionally, it appears to be unaffected by aging. As a consequence, the investigators performed a study to determine the effects of chronological aging on alveolar bone loss. Objective: The present study was conducted to determine the relationship between oral alveolar bone loss, oral hygiene, and aging among African-American and Caucasian populations. Methods: The population consisted of 229 individuals. There were 131 men and 98 women. With respect to race there were 89 African-Americans and 140 Caucasians. Oral examinations, oral hygiene and missing teeth determinations and bitewing radiographs were performed on all the individuals. Radiographs were digitized and measurements were made from the cementum/enamel junction to the alveolar bone crest. Measurements were made for both the maxillary and mandibular jaws. Results: The results of the study showed a significant multiple linear regression model relationship between oral bone loss and aging. Oral hygiene was a factor, but contributed only slightly to the overall model. Race, gender and the number of missing teeth were not significant variables in the overall model. Conclusion: The results of this study suggest age-related alveolar bone loss. [References: 20] <36> UI - 1999045617 AU - Childers NK AU - Tong G AU - Mitchell S AU - Kirk K AU - Russell MW AU - Michalek SM IN - N.K. Childers, Department of Pediatric Dentistry, School of Dentistry, University of Alabama, Birmingham, AL 35294-0007; United States. E-Mail: nkc@uab.edu. TI - A controlled clinical study of the effect of nasal immunization with a Streptococcus mutans antigen alone or incorporated into liposomes on induction of immune responses. SO - Infection & Immunity Vol 67(2) (pp 618-623), 1999. AB - Recent attention to mucosal immunization strategies has been focused on the nasal route for vaccine delivery. This study was designed to determine the effectiveness of a liposome-protein vaccine compared to that of a protein-only vaccine in inducing immune responses in humans. Healthy subjects were randomly assigned to two groups and immunized intranasally with a crude antigen preparation rich in glucosyltransferase (C-GTF) from Streptococcus mutans, alone or in liposomes. Parotid saliva, nasal wash, and serum were collected prior to and at weekly intervals following immunization and were analyzed for anti-C-GTF activity by enzyme, linked immunosorbent assay. The levels of immunoglobulin A (IgA) anti-C-GTF activity in the nasal wash from both groups after immunization increased to a mean peak of fivefold over the baseline level on day 28. Salivary IgA anti-C-GTF responses were induced to a lesser extent. IgG and IgA anti-C-GTF responses in serum were detected on day 14. The IgA responses were predominantly of the IgA1 subclass. These results show that C-GTF vaccines were more effective in inducing a local secretory IgA antibody response than a salivary or serum response when they were given intranasally. The IgA1 anti-C-GTF response in nasal wash samples for liposomal antigen versus antigen only was the only response which was significantly different (P < 0.04). This suggests that the form of the antigen affects the magnitude of the local mucosal response but not that of a disseminated response. These results provide evidence for the effective use of a nasal protein vaccine in humans for the induction of mucosal and systemic responses. [References: 49] <37> UI - 1999042249 AU - Youssefzadeh S AU - Gahleitner A AU - Dorffner R AU - Bernhart T AU - Kainberger FM IN - Dr. S. Youssefzadeh, Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna; Austria. TI - Dental vertical root fractures: Value of CT in detection. SO - Radiology Vol 210(2) (pp 545-549), 1999. AB - PURPOSE: To determine the value of computed tomography (CT) in the diagnosis of dental vertical root fractures relative to the value of conventional dental radiography. MATERIALS AND METHODS: Thirty-seven patients with 42 teeth in which vertical root fracture was clinically suspected underwent dental radiography and axal CT. Two radiologists evaluated the images independently and by consensus for a fracture line. The results were compared with intraoperative findings. RESULTS: Twenty-eight of the 42 teeth were proved intraoperatively to be fractured. The sensitivity and specificity averaged for the two reviewers in the assessment of vertical fractures were 23% and 70%, respectively, with dental radiography and 100% and 100%, respectively, with CT. Consensus reading showed sensitivities of 25% for dental radiography and 75% for CT. Eight (reviewer A) or nine (reviewer B) false-negative CT findings were encountered in cases in which metallic artifacts obscured parts of the root and in cases in which the root was very small in diameter. Interobserver agreement was 95% for dental radiography an 93% for CT. CONCLUSION: CT is superior to dental radiography in the detection of dental vertical root fractures. [References: 14] <38> UI - 1999039544 AU - Almstahl A AU - Kroneld U AU - Tarkowski A AU - Wikstrom M IN - A. Almstahl, Department of Oral Microbiology, Institute of Odontology, Box 450, Medicinaregatan 12A, 405 30 Goteborg; Sweden. E-Mail: Annica.Almstahl@odontologi.gu.se. TI - Oral microbial flora in Sjogren's syndrome. SO - Journal of Rheumatology Vol 26(1) (pp 110-114), 1999. AB - Objective. To study presence of microorganisms associated with caries, gingivitis, oral opportunistic infections, and extent of hyposalivation in dentate patients with primary and secondary Sjogren's syndrome (SS). Methods. An oral clinical examination was performed. The salivary flow was measured and a rinsing sample analyzed for presence of specific microorganisms. The results were compared to those of healthy controls matched for sex, age, and number of teeth. Results. In patients with undetectable salivary flow at rest, mean number and proportion of mutans streptococci and lactobacilli showed a tendency to be increased, as well as the frequency of Candida. They also displayed an increased proportion of filled surfaces. In contrast, gingivitis and the numbers of microorganisms associated with gingivitis were comparable to those found in the healthy controls. Conclusion. Patients with SS and severe hyposalivation harbor oral flora associated with the development of caries and frequent presence of retention sites, indicating a need for efficient preventive dental care. [References: 32] <39> UI - 1999034126 AU - Furhoff A-K AU - Tomson Y AU - Ilie M AU - Bagedahl-Strindlund M AU - Larsson KS AU - Sandborgh-Englund G AU - Torstenson B AU - Wretlind K IN - Dr. A.-K. Furhoff, Family Medicine Stockholm, Division of Dental Toxicology, Karolinska Institute, Huddinge; Sweden. TI - A multidisciplinary clinical study of patients suffering from illness associated with release of mercury from dental restorations: Medical and odontological aspects. SO - Scandinavian Journal of Primary Health Care Vol 16(4) (pp 247-252), 1998. AB - Objective- To describe medical and odontological aspects of patients who believed their illness was caused by mercury in dental fillings. Design- Comparison of self-reported and assessed medical and odontological variables. Setting - The School of Dentistry, Karolinska Institute. Subjects - Sixty- seven patients, referred for suspected side-effects of mercury in dental fillings, and 64 matched controls. Main outcome measures- Incidence of medical and odontological diagnoses, own perception of health, and incidence of self-reported symptoms. Results - Three quarters of the patients were women. The mean age was 49 years. Thirty-seven patients (55%) and 47 controls (73%) (NS) showed no sign of somatic disease. Half of the patients felt ill or very ill at the time of the examination. Patients reported twice as many symptoms as the controls during a 3-month period. Patients reported a higher prevalence of very low resting saliva secretion rate, and a higher number of decayed tooth surfaces and of instances of temporomandibular joint dysfunction. Conclusion - Patients' feelings of ill-health were more likely related to psychiatric than somatic diagnoses. This study underlines the importance of making an overall diagnosis, including both mental and somatic disorders, especially in unclear cases and in self-diagnosed illnesses. [References: 17] <40> UI - 1999005255 AU - Epstein JB AU - Emerton S AU - Kolbinson DA AU - Le ND AU - Phillips N AU - Stevenson- Moore P AU - Osoba D IN - J.B. Epstein, Department of Dentistry, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC V5Z 4E6; Canada. TI - Quality of life and oral function following radiotherapy for head and neck cancer. SO - Head & Neck Vol 21(1) (pp 1-11), 1999. AB - Background. Multiple oral complaints occur following radiotherapy for oropharyngeal cancer, but the frequency and severity of symptoms of dysfunction and discomfort are not well understood. The purpose of this investigation was to assess the quality of life, oral function, and oral symptoms following radiotherapy. Methods. A general quality of life survey (the European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire QLQ-C30), with an added oral symptom and function scale was mailed to 100 patients more than 6 months following radiotherapy. Results. Sixty-five patients responded. Difficulty chewing or eating was reported by 43% of respondents. Dry mouth was reported by 91.8%, change in taste by 75.4%, dysphagia by 63.1%, altered speech by 50.8%, difficulty with dentures by 48.5%, and increased tooth decay by 38.5% of dentate patients. Pain was common (58.4%) and interfered with daily activities in 30.8%. Mood complaints were reported by approximately half the patients. Interference of the physical condition social activities was reported by 60%. The frequency of oral side effects correlated with radiation treatment fields and dose. Conclusion. Oral complications following radiotherapy for head and neck cancer are common and affect quality of life. Use of a general function scale such as the EORTC questionnaire with the addition of disease/site specific scales may provide useful data on outcome of therapy and upon the complications associated with therapy and impact upon the quality of life. [References: 34] <41> UI - 1999002422 AU - Szymanska J AU - Fetkowska-Mielnik K IN - Dr. J. Szymanska, Department of Paedodontics, Medical Academy, Staszica 11, 20-081 Lublin; Poland. TI - Aspects of dental health in adult rural population in Poland. SO - ANN AGRIC ENVIRON MED, Vol 5(2) (pp 103-108), 1998. AB - Using the literature on the subject, an assessment was made of the state of the oral health in rural population: dental state, periodontal diseases, state and needs for prosthetic rehabilitation. The articles presents possible causes of this state of things. [References: 32] <42> UI - 1998418358 AU - Yoshiba N AU - Yoshiba K AU - Iwaku M AU - Ozawa H IN - Dr. N. Yoshiba, Dept. of Operative Dent./Endodontics, Niigata Univ. School of Dentistry, Gakkocho-dori-2, Niigata 951-8514; Japan. E-Mail: yoshiba@dent.niigata-u.ac.jp. TI - Immunohistochemical localizations of class II antigens and nerve fibers in human carious teeth: HLA-DR immunoreactivity in Schwann cells. SO - Archives of Histology & Cytology Vol 61(4) (pp 343-352), 1998. AB - Nerve fibers and class II major histocompatibility complex (MHC) antigen-expressing dendritic cells have been known to gather in the dental pulp beneath carious lesions. Significant functional interactions presumably occur between the neural and immune elements. The present study analyzed the morphological relationship between class II-expressing cells and nerve fibers in fuman carious teeth, visualized by a HLA-DR monoclonal antibody and a protein gene product 9.5 (PGP 9.5) polyclonal antibody; a confocal laser scanning microscope (CLSM) and an electron microscope were used. In pulps affected by early caries, HLA-DR-positive dendritic cells aggregated mainly in the cell-free zone associated with bundles of PGP 9.5-immunoreactive nerve fibers. In pulps affected by advanced caries, the accumulated HLA-DR-positive cells and PGP 9.5-immunoreactive nerve fibers showed close association with each other especially beneath the odontoblast layer: the cells even embraced the nerve fibers. Intriguingly, class II molecules were recognized not only in dendritic cells but also in the Schwann cells of non-myelinated nerves in the pulp. Using immunoelectron microscopy, class II molecules were localized on the surface of the non-myelinating Schwann cells and also within some vesicles, whereas myelinating Schwann cells lacked this immunoreactivity. PGP 9.5-immunoreactive nerve fibers were also observed densely in the odontoblast layer, and CLSM revealed an intimate association of the nerve fibers and dendritic cells. The immunoreactivity for HLA-DR in Schwann cells depended upon the severity of the carious lesion. Class II-expressing Schwann cells are suggested to function as antigen-presenting cells in addition to dendritic cells. [References: 40] <43> UI - 1998389862 AU - Dolan TA AU - Peek CW AU - Stuck AE AU - Beck JC IN - T.A. Dolan, University of Florida, College of Dentistry, JHMHC Box 100405, Gainesville, FL 32610-0405; United States. E-Mail: tdolan@dental.ufl.edu. TI - Functional health and dental service use among older adults. SO - Journals of Gerontology Series A-Biological Sciences & Medical Sciences Vol 53(6) (pp M413-M418), 1998. AB - Background. Although socioeconomic barriers to receiving adequate dental care have been well documented, physical frailty as a risk factor for not visiting the dentist has not been fully explored. This study prospectively examines the relationship between functional health and dental service use, taking into account sociodemographic characteristics, general and dental health status, and prior dental utilization behavior. Methods. Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults age 75+ years living in Santa Monica, CA, collected between 1988 and 1993, were analyzed. A series of discrete- time proportional hazards models were used to assess the effects of functional status, sociodemographic characteristics, and general health and dental health measures on dental service use. Results. Functional status was negatively associated with dental service use, and the conditional probability of a first visit to the dentist after baseline decreased over time. When additional measures of general health, dental health, and socioeconomic status were introduced, the effect of functional status was mitigated but remained significant. In the most fully specified model, which took dental visitation behavior prior to the beginning of the study into account, the effect of functional limitation remained significant. Conclusions. Even in this relatively well-educated group of older persons with higher than average dental service use, impaired functional status was associated with lower levels of dental service use over time. [References: 23] <44> UI - 1998390285 AU - Dostalova T AU - Jelinkova H AU - Kucerova H AU - Krejsa O AU - Hamal K AU - Kubelka J AU - Prochazka S IN - Dr. T. Dostalova, Institute of Dental Research, Vinohradsku 48, 120 60 Prague 2; Czech Republic. E-Mail: dostalova@vus.cz. TI - Noncontact Er:YAG laser ablation: Clinical evaluation. SO - Journal of Clinical Laser Medicine & Surgery Vol 16(5) (pp 273-282), 1998. AB - Objective: The aim of this study is to evaluate the quality of laser ablation in comparison with the classical drilling preparation. Methods: For the experiment, the Er:YAG laser drilling machine was used. The system had a laser head, water cooler, and power supply with automatic control. Spot size of 300-350 mum was used for the preparation. Repetition rate of 1-4 Hz, and pulse energies of 100-400 mJ with water spray were chosen. Cavity shape in comparison with classical drill, time of preparation, and influence of cavity shape on filling materials retention in accordance with the U.S. Public Health Service System were used. The evaluation criteria for noncontact Er:YAG ablation were done. Results: The cavity shape is irregular, but spot surface has larger area and microretentive appearance. Caries of enamel and dentin were treated with a noncontact preparation. It was possible to remove the old insufficient fillings, except for amalgam or metal alloys. The average number of pulses was 111.22 (SE 67.57). Vibrations of microexplosions during preparation were felt by patients on 14 cavities; however, nobody felt unpleasant pain. The qualities of filling materials in laser cavities were very stable; however, cavo surface margin discoloration of 82-86% of Alfa rating could be a problem. Changes of the color and anatomic form of the tooth were observed in 4-8%. Conclusions: In comparison with the classical treatment, it could be said that the retention and quality of filling materials is the same or very similar. [References: 24] <45> UI - 1998346085 AU - Bourgeois D AU - Nihtila A AU - Mersel A IN - Dr. D. Bourgeois, Oral Health Programme, Division of Noncommunicable Diseases, World Health Organization, 1211 Geneva 27; Switzerland. TI - Prevalence of caries and edentulousness among 65-74-year-olds in Europe. SO - BULL WHOO, Vol 76(4) (pp 413-417), 1998. AB - Reviewed in this article are epidemiological studies included in the WHO Global Oral Data Bank for noninstitutionalized European adults aged 65-74 years for the period 1986-96. Edentulous percentages, decayed, missing, filled teeth (DMFT) index, and data on the mean number of teeth are presented. At least one representative study had been carried out in 48% of the countries, with the quantity of information from countries with developed market economies being similar to that from countries with economies in transition. The proportion of 65-74-year-olds who were edentulous varied from 12.8% to 69.6%, the mean number of teeth ranged from 15.1 to 3.8, and the DMFT index from 22.2 to 30.2. The observed disparities in the oral health status among older European adults suggest that it may be possible to develop and implement oral health policies that take into account geographical and socioeconomic differences in populations. [References: 15] <46> UI - 1998310680 AU - Abusbeih G AU - Nickle HH IN - Dr. H.H. Nickle, 3006 S. Maryland Parkway, Las Vegas, NV 89109; United States. TI - Meningococcal endocarditis due to dental caries in a previously healthy adult. SO - Infectious Diseases in Clinical Practice Vol 7(7) (pp 353-357), 1998. <47> UI - 1998293672 AU - Shen E-C AU - Fu E IN - Dr. E.-C. Shen, Dental Department, 804 Military General Hospital, 195 Hsin Hai Rd Sec. 2, Taipei; Taiwan. TI - Carious lesions in the heroin addicted patient. A case report. SO - Journal of Periodontology Vol 69(8) (pp 938-940), 1998. AB - Heroin abuse is destroying the health of many individuals in our society. Much of the information that has appeared in the literature has concerned itself with the general health of addicts; the oral health status of these individuals has not been studied to the same extent. This report will present and discuss the management of a case involving the effects of long-term heroin abuse on the dentition. [References: 6] <48> UI - 1998299757 AU - Beli N AU - Bentham P IN - P. Bentham, Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ; United Kingdom. TI - Nature and extent of dental pathology and complications arising in patients receiving ECT. SO - Psychiatric Bulletin Vol 22(9) (pp 562-565), 1998. AB - This study aimed to describe the prevalence of dental pathology in patients receiving electroconvulsive therapy and to prospectively determine the incidence of dental complications arising during treatment. Of 30 subjects, 93% complained of a dry mouth and 83% were taking drugs with anticholinergic properties. A third wore dentures and the dentate population had a mean of 15 decayed, missing or filled teeth. Oral hygiene and periodontal condition was poor with one-third requiring scaling and 30% complex periodontal treatment. Temporomandibular pain followed 44% of treatments, and minor buccal lesions occurred in 22%. Greater emphasis must be placed on dental care, and guidelines are suggested to improve practice. [References: 8] <49> UI - 1998263964 AU - Lie T AU - Bruun G AU - Boe OE IN - Dr. T. Lie, Kuwait University, Faculty of Dentistry, Periodont./Dental Public Hlth. Dept., P.O. Box 24923, Safat 13110; Kuwait. E-Mail: tryggve@hsc.kuniv.edu.kw. TI - Effects of topical metronidazole and tetracycline in treatment of adult periodontitis. SO - Journal of Periodontology Vol 69(7) (pp 819-827), 1998. AB - THE PRESENT STUDY WAS PERFORMED to assess and compare the clinical healing and the microbiological findings following local application of metronidazole or tetracycline to augment subgingival scaling in previously untreated adult periodontitis sites. Eighteen patients with moderate to severe adult periodontitis at single-rooted teeth were selected. In each patient, 3 interproximal sites having comparable root anatomy, probing depth <=5 mm and bleeding on probing were randomly assigned to 1 of 3 treatment groups: 1) two sessions of subgingival scaling and root planing; 2) similar to 1, with each treatment supplemented with a 25% metronidazole sustained release gel; 3) similar to 1 with each treatment supplemented with a 3% tetracycline ointment. The treatments were performed by 1 operator and the clinical variables probing depth, attachment level, and bleeding on probing were evaluated at baseline, 3 months and 6 months by a second blinded examiner. The microbiological findings were evaluated using a commercial test kit. The average probing depth reduction for the 3 groups at 6 months was 1.5 mm and the average gain of clinical attachment was 0.8 mm. There were no significant differences between the effects following topical application of the metronidazole gel or the tetracycline ointment. Scaling and root planning alone appeared as effective as the drug augmented regimens, although there was a weak but non-significant tendency for better results in sites with the antibiotic drugs. Actinobacillus actinomycetemcomitans was generally not detected; Prevotella intermedia was not significantly reduced, the Porphyromonas gingivalis was significantly reduced in all treatment groups. It was concluded that the augmentative effect of the metronidazole gel and the tetracycline ointment was comparable but small compared to scaling and root planning alone. The clinical importance of such small augmentation effects should be further evaluated. [References: 36] <50> UI - 1998263960 AU - Ng VW-K AU - Bissada NF IN - Dr. N.F. Bissada, Case Western Reserve University, School of Dentistry, 10900 Euclid Avenue, Cleveland, OH 44106-4905; United States. TI - Clinical evaluation of systemic doxycycline and ibuprofen administration as an adjunctive treatment for adult periodontitis. SO - Journal of Periodontology Vol 69(7) (pp 772-776), 1998. AB - THE OBJECTIVE OF THIS STUDY was to compare the efficacy of a systemic antibiotic (doxycycline) and a no-steroidal anti-inflammatory drug (ibuprofen), administered either separately or combined, as an adjunctive treatment of scaling/root planing (SRP). Thirty-two subjects diagnosed with generalized moderate adult periodontitis and having at least 2 teeth with <=5 mm probing depth were randomly divided into 4 groups. Each group was treated with oral doxycycline and/or ibuprofen for 6 weeks as follows: group 1, doxycycline 200 mg the first day followed by 100 mg per day; group 2, ibuprofen 800 mg per day; group 3, doxycycline plus ibuprofen scheduled as in groups 1 and 2; group 4, one placebo capsule/day (control). A split mouth design was utilized in each subject such that half of the teeth received one session of scaling/root planing (SRP), while the other half received no SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) using a customized acrylic stent were recorded at baseline and at 3, 6, 12, and 24 weeks following SRP. Analysis using ANOVA and Student t-test showed statistical significance (P<=0.05) from baseline data in: 1) gains of 0.4 mm and 0.5 mm of CAL for groups 1 and 3, respectively; 2) reduction of 0.7 mm PD for group 3; 3) reduction of 0.4 and 0.1 GI scores for groups 1 and 3, respectively; and 4) gain of 0.5 mm CAL and reductions of 0.4 mm PD and 0.2 GI score for the SRP group when compared to the no SRP group at 24 weeks. It may be concluded that the adjunctive use of systemic doxycycline alone or in combination with ibuprofen results in a statistically significant, yet modest clinical, improvement beyond that obtained by scaling/root planing. [References: 17] <51> UI - 1998237113 AU - Paul T AU - Brandt RS IN - Dr. T. Paul, Riyadh Armed Forces Hospital, P.O. Box 7897, Riyadh 11159; Saudi Arabia. TI - Oral and dental health status of children with cleft lip and/or palate. SO - Cleft Palate-Craniofacial Journal Vol 35(4) (pp 329-332), 1998. AB - Objective: To ascertain the oral and dental health status of children with cleft lip and/or palate. Design: Oral and dental examinations were carried out on 114 selected children with cleft lip and/or palate, using standard criteria and indices. Setting: These children were examined at two cleft palate clinics in the United Kingdom. Patients: All children examined were between the ages of 3 and 18 years. Results: Sixty one (53.5%) of the subjects exhibited no evidence of previous caries experience, but as many as 20% exhibited active decay. The mean caries experience in the deciduous dentition (dmfs) was 2.3, and that in the permanent dentition (DMFS) was 0.9. Caries experience of the Caucasian children of the sample was lower (mean dmfs 1.9) than that of the Asian children (mean dmfs 5.5). The mean simplified debris index of the sample was 0.9, and the mean gingival bleeding index was 0.4. Children with cleft lip and palate had generally poorer oral and gingival health than those with isolated clefts of the lip or palate. Conclusion: Twenty percent of the sample had active decay. These children had poor oral health in the surgically repaired anterior segment. [References: 12] <52> UI - 1998250099 AU - Kurien M AU - Mathew J AU - Job A AU - Zachariah N IN - M. Kurien, Department of ENT, Christian Medical College, Vellore, Tamil Nadu; India. TI - Ludwig's angina. SO - Clinical Otolaryngology & Allied Sciences Vol 22(3) (pp 263-265), 1997. AB - A 13 year review of patients diagnosed to have Ludwig's angina admitted to the Christian Medical College and Hospital, Vellore, India, between March 1982 and April 1995 is presented. The patients were either admitted to the ENT or paediatric surgical units. There were 41 patients, 24% bring children and 76% adults. The clinical profile and outcome of these two groups were compared. In the paediatric group, none had dental caries while in the adult group, 52% had associated dental caries. In children, 70% were controlled with conservative medical management unlike the adults of whom 81% needed incision and drainage. Tracheostomy was necessary in 10% of the children and in 52% of the adults. The mortality was 10% in both groups. [References: 12] <53> UI - 1998221265 AU - Nash MM AU - Zaltzman JS IN - Dr. J.S. Zaltzman, St. Michael's Hospital, Renal Transplant Office, 61 Queen Street East, Toronto, Ont. M5C 2T2; Canada. TI - Efficacy of Azithromycin in the treatment of cyclosporine-induced gingival hyperplasia in renal transplant recipients. SO - Transplantation Vol 65(12) (pp 1611-1615), 1998. AB - Background. Gingival hyperplasia (GH) is a common side effect of cyclosporine. Azithromycin (Zithromax; AZI) is a macrolide antibiotic reported in case studies to reduce cyclosporine-induced gingival hyperplasia (CIGH) in renal transplant recipients (RTR). Methods. The efficacy of AZI to treat CIGH in RTR was examined in a double-blind, randomized crossover trial. Patients (n=17) with CIGH were randomized to receive AZI and a matching placebo in alternate order for 5 days, separated by a 2-week washout period. Follow-up visits were conducted at week 6 and week 12. Changes in GH were evaluated by measuring the clinical gingival sulcus depths, tooth length, and the length of the interdental papillae to the cementurn-enamel junction of two teeth in each of the four quadrants. Results. Significant improvements were observed in all three types of periodontal measurements, representing reductions of gingival tissue above the medial aspect of the tooth, of the gingival sulcus depth, and of the length of the interdental papillae. Patients reported an improvement in gum bleeding. AZI was well tolerated, and 67% of the patients reported that the treatment was at least somewhat useful. Conclusions. AZI should be considered for RTR with CIGH. [References: 15] <54> UI - 1998203417 AU - Hayes EB AU - Talbot SB AU - Matheson ES AU - Pressler HM AU - Hanna AB AU - McCarthy CA IN - Dr. E.B. Hayes, Div. of Vector-Borne Infectious Dis., Centers for Dis. Control/Prevention, PO Box 2087, Fort Collins, CO 80522; United States. TI - Health status of pediatric refugees in Portland, Me. SO - Archives of Pediatrics & Adolescent Medicine Vol 152(6) (pp 564-568), 1998. AB - Background: Ann understanding of the health conditions affecting pediatric refugees is essential to providing responsible health care for them when they arrive in the United States. Objective: To assess the health status of pediatric refugees in an area of increased refugee resettlement. Design: Retrospective medical records review. Setting: Ambulatory clinic at Main Medical Center in Portland, a community and referral hospital. Patients: One hundred thirty-two refugees and immigrants aged 2 months through 18 years who had initial health care evaluations during 1994 and 1995. Results: Sixty-six patients arrived from Africa, 22 from the former Yugoslavia, and the remainder from the former Soviet Union, Middle Asia, Southeast Asia, and Latin America. The mean age of the patients was 10 years; 56 (42%) were female. The overall health status of most of the children was good, with most having appropriate weight and height for age. Dental caries and dermatologic conditions were the most prevalent findings on physical examination. Two patients had evidence of traumatic injuries. The results of tuberculin (Mantoux) tests were positive (<=10 mm) in 45 (35.2%) of 128 children for whom results were noted, hepatitis B surface antigen was detected in 5 (4.0%) of 124 children, and hepatitis B surface antibody was detected in 26 (21.1%) of 123 children. Five (16.7%) of 30 children younger than 6 years had elevated blood lead levels, anemia was detected in 25 (19.7%) of 127 children with hematocrit results available. Stool specimens were obtained from 87 patients, of whom 38 (43.7%) had pathogenic parasites in at least 1 specimen. Conclusions: Pediatric refugees arrive in the United States with a variety of conditions that may be unfamiliar to practitioners trained in this country. The results of this study support the screening of refugees from Africa and other regions for tuberculosis, stool parasites, and hepatitis B. [References: 17] <55> UI - 1998217490 AU - Cunning DM AU - Lipke N AU - Wax MK IN - Dr. M.K. Wax, State University of New York, Department of Otolaryngology, Buffalo General Hospital, 100 High Street, Buffalo, NY 14203; United States. TI - Significance of unilateral submandibular gland excision on salivary flow in noncancer patients. SO - Laryngoscope Vol 108(6) (pp 812-815), 1998. AB - Objectives/Hypothesis: Normal salivary flow is important for maintaining good oral hygiene. Lack of normal flow predisposes to an increased incidence of dental caries and symptomatic xerostomia. The submandibular glands are responsible for 70% of resting salivary flow. Removal of the submandibular gland is most commonly performed for sialolithiasis, chronic sialoadenitis, or as part of a neck dissection. The effect of unilateral gland resection for benign disease on resting salivary flow has not been well examined in the literature. Study Design: Case controlled study involving patients who had undergone a unilateral submandibular gland resection matched with normal control subjects. Method: Stimulated and unstimulated salivary flow rates in surgical and control subjects were measured in a controlled setting. Results: Unstimulated salivary flow rates were 0.805 mL/min in the control group and 0.405 mL/min in the surgical group (P = .01). Stimulated salivary flow rates were not significantly different between the two groups (P > .05). Fifty- seven percent of patients in the surgical group and 14% in the control group had xerostomia (P < .05). Conclusion: Unilateral submandibular gland excision results in a decreased rate of resting salivary flow and an increase in subjective xerostomia. [References: 10] <56> UI - 1998213038 AU - Salvolini E AU - Di Giorgio R AU - Curatola A AU - Mazzanti L AU - Fratto G IN - Prof. L. Mazzanti, Istituto di Biochimica, Universita degli Studi di Ancona, Via Ranieri 65, 60131 Ancona; Italy. TI - Biochemical modifications of human whole saliva induced by pregnancy. SO - British Journal of Obstetrics & Gynaecology Vol 105(6) (pp 656-660), 1998. AB - Objective: To assess human unstimulated whole saliva components during pregnancy, to determine the relation, if any, between pregnancy and oral health, particularly total protein concentration, alpha-amylase activity, sialic acid content and calcium and phosphate concentrations were evaluated. Design: Cross-sectional study. Participants: Forty-five healthy primigravid women; 15 nonpregnant women acted as controls. Results: 1. A higher total protein content at 10 and 21 weeks of gestation with respect to the controls and to pregnant women at 40 weeks; 2. a higher alpha-amylase activity at 10 and 21 weeks of gestation compared with the controls and to pregnant women at 40 weeks; 3. an increased sialic acid content at 21 and 40 weeks; 4. decreased calcium and phosphorus concentrations at 21 and 40 weeks of gestation. Conclusions: Pregnancy modifies saliva composition. This could play a pivotal role in the incidence of pregnancy-induced dental caries. [References: 30] <57> UI - 1998210364 AU - Peeters FPML AU - DeVries MW AU - Vissink A IN - Dr. F.P.M.L. Peeters, Dept. of Psychiatry/Neuropsychology, Section of Social Psychiatry, Maastricht University, P.O. Box 616, 6200 MD Maastricht; Netherlands. TI - Risks for oral health with the use of antidepressants. SO - General Hospital Psychiatry Vol 20(3) (pp 150-154), 1998. AB - In this article, attention is focused on oral pathology, particularly dental caries, caused by hyposalivation as a consequence of (long-term) use of antidepressants. Changes in clinical psychiatric practice and increasing numbers of prescriptions of antidepressants in primary care and specialty care settings have made awareness of this risk even more relevant than in the past. Normat physiology of salivary glands and changes in the secretion of saliva during use of antidepressants are described. Monitoring, prevention, and treatment of hyposalivation induced by antidepressants are encouraged as an adjunct in the clinical management of depression. [References: 29] <58> UI - 1998215390 AU - Schoenberg NE AU - Gilbert GH IN - Dr. N.E. Schoenberg, Department of Behavioral Science, College of Medicine Office Building, University of Kentucky, Lexington, KY 40536-0068; United States. TI - Dietary implications of oral health decrements among African-American and White older adults. SO - Ethnicity & Health Vol 3(1-2) (pp 59-70), 1998. AB - Objective. Older African-Americans are at disproportionate risk of chronic, nutritionally-related diseases. To begin to understand factors that may contribute to the disproportionate prevalence of life-threatening illnesses among African-Americans, this study investigates ethnic differences in the prevalence of oral health decrements. Design. The Florida Dental Care Study (FDCS), a longitudinal study of changes in the oral health of 873 subjects age 45+, was used to explore a broad range of oral health status differences between African-American and White adults in the United States. The FDCS consists of clinical and self-reported measures of oral health, sociodemographic information, and other indicators of oral functional status. Results. The prevalence of oral health decrements in this sample using a broad range of clinical and self-reported measures was substantial. African-American elders were at a heightened risk of poor oral health profiles, including having fewer teeth and being more likely to have a carious surface, fractured cusp or incisal edge, severely mobile teeth and severe periodontal levels than their White counterparts. Furthermore, the African-American respondents in our sample were significantly more likely to report a lower self-rated oral health and functioning than their White counterparts. These findings persist regardless of poverty status or educational level, two factors commonly thought to confound racial differences in health outcomes. Conclusion. Our study provides evidence that the widespread prevalence of oral health decrements and accompanying functional disability among this sample of dentate older adults impacts their daily lives. Of particular concern is the oral health status of older African-Americans who may be nutritionally vulnerable due, in part, to these oral health decrements and disabilities. We suggest enhancing the access of health services in order to prevent those oral health decrements that presumably undermine adequate dietary intake. [References: 35] <59> UI - 1998215374 AU - Dewhurst SN AU - Mason C AU - Roberts GJ IN - S.N. Dewhurst, Department of Paediatric Dentistry, Eastman Dental Institute Hospital, 256 Gray's Inn Road, London WC1X 8LD; United Kingdom. TI - Emergency treatment of orodental injuries: A review. SO - British Journal of Oral & Maxillofacial Surgery Vol 36(3) (pp 165-175), 1998. AB - There has been an increase in the incidence of injuries to the incisor teeth in the primary and permanent dentitions over the last decade; one study reported that roughly 35% of 9-year-old children will have damaged their teeth in some way. Much has been written about dental injuries, and there may be confusion about the appropriate emergency treatment for different types. Classification and understanding of the types of injury are essential before diagnosis and treatment can be undertaken. Although dental injuries can occur singly, they more usually involve a combination of injuries to a tooth and its supporting structures. Prompt, accurate diagnosis and appropriate emergency treatment as outlined in this paper will greatly improve the prognosis for many dentoalveolar injuries. The aim must be to ensure that the third of the population of preteenage children who damage their teeth are not resigned to loss of an incisor in later life because of inaccurate diagnosis and poor treatment of the emergency condition. [References: 53] <60> UI - 1998208125 AU - Makinen KK AU - Olak J AU - Russak S AU - Saag M AU - Seedre T AU - Vasar R AU - Vihalemm T AU - Mikelsaar M AU - Makinen P-L IN - K.K. Makinen, Institute of Dentistry, University of Turku, 20520 Turku; Finland. TI - Polyol-combinant saliva stimulants: A 4-month pilot study in young adults. SO - Acta Odontologica Scandinavica Vol 56(2) (pp 90-94), 1998. AB - Several studies indicate that xylitol (X) consumption is associated with certain biochemical changes in dental plaque and whole saliva. In making X- containing saliva stimulants more cost-effective and palatable, manufacturers may use maltitol syrup (MS, which normally contains some sorbitol and higher polyols) or polydextrose (PD, a polysaccharide molecule with a mass >22 kDa) as bulking agents. Combinations of X with MS and PD have not been tested regarding their salivary effects. One hundred and eighty-eight young subjects (mean age, 22 years) of both sexes were divided into three groups of equal size for a 4-month study. The subjects in one group used X-MS dragees (in 7 daily episodes; 8 g X per day), while the subjects in another group used X- PD dragees in as many daily episodes (8 g X per day). Subjects in the third (comparison) group did not receive saliva stimulants. Paraffin-stimulated whole saliva samples were collected at baseline, after 2 months, and at endpoint. The usage of X-MS was associated with a significant (P < 0.05) reduction in the salivary sucrase activity. After 4 months, the activity of enzymes hydrolyzing Nalpha-benzoyl-DL-arginyl-p-nitroaniline was significantly reduced in all groups, while the levels of free sialic were reduced in group X-PD only (P < 0.05). These salivary changes most likely reflected microbial shifts in the oral cavity and suggest that information from saliva studies may be of avail when deciding which bulking agents should be used in xylitol- based saliva stimulants. [References: 19] <61> UI - 1998209298 AU - Poulton R AU - Thomson WM AU - Brown RH AU - Silva PA IN - R. Poulton, Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin; New Zealand. TI - Dental fear with and without blood-injection fear: Implications for dental health and clinical practice. SO - Behaviour Research & Therapy Vol 36(6) (pp 591-597), 1998. AB - The relation between dental, blood and injection fear and oral health was examined in 936 New Zealand 18-year-olds. Of the approximately ten percent (n = 96) of the sample who reported a dental fear, 1 in 10 also reported a fear of blood and 53% a co-morbid fear of injections. Study members with dental fear alone or co-morbid dental and blood or injection fear had significantly worse oral health (i.e. greater caries experience) than a no-fear comparison group or individuals with blood-injection fear only. Further, individuals with dental and blood or injection fear had a significantly higher level of recent tooth decay than individuals with dental fear alone. Time since last dental treatment also tended to be highest in this group. Implications for dental health and practice were discussed. [References: 12] <62> UI - 1998185222 AU - Andreana S IN - Dr. S. Andreana, Department of Periodontology, SUNY, School of Dental Medicine, Buffalo, NY 14214; United States. TI - A combined approach for treatment of developmental groove associated periodontal defect. A case report. SO - Journal of Periodontology Vol 69(5) (pp 601-607), 1998. AB - DEVELOPMENTAL GROOVES ARE NOT RARE and often appear on maxillary lateral incisors. This may represent a challenge and sometimes tooth extraction is inevitable. This case report describes a combined technique of regenerative and antimicrobial/root conditioning used to treat a maxillary lateral incisor in a 32-year-old woman. Tooth No. 10 presented a periodontal probing depth of 8 mm below the cingulum, associated with a developmental groove. The tooth was vital. After initial preparation, a palatal miniflap was raised, granulation tissue was eliminated by means of ultrasonic bactericidal curettage and radicoloplasty performed. The surface was then treated for 3 minutes with tetracycline-HCl solution (100mg/ml), and the defect filled with sterile, medical grade, calcium sulfate. Clinical measurement were retaken at 6, 12, and 18 months. The results indicated a reduction of probing depth to 2 mm, reestablishment of the lamina dura, and radiographical evidence of bone growth. This combined treatment allowed the tooth to be saved, the palatal surgical approach did not alter the esthetics of the area, and its simplicity is recommended. [References: 39] <63> UI - 1998185219 AU - Harris RJ IN - Dr. R.J. Harris, 855 West-Seventh Street, Reno, NV 89503; United States. TI - A clinical evaluation of an allograft combined with a bioabsorbable membrane versus an alloplast/allograft composite graft combined with a bioabsorbable membrane. 100 consecutively treated cases. SO - Journal of Periodontology Vol 69(5) (pp 536-546), 1998. AB - THE PURPOSE OF THIS STUDY was to evaluate and compare the clinical effectiveness of 2 surgical techniques in treating periodontal defects. Both techniques involved tetracycline treatment of a root planed root, grafting the osseous defect with a bone graft, and placement of a bioabsorbable membrane. In group a, the bone graft was a mix of demineralized freeze-dried allograft, tetracycline, and porous hydroxyapatite and in group B, the bone graft was a mix of demineralized freeze-dried allograft and tetracycline. There was a statistically significant increase in recession (group A, 0.7 mm; group B, 0.6 mm), decreases in probing depth (group A, 6.1 mm; group B, 5.6 mm), and gains in attachment levels (group A, 5.4 mm; group B, 5.0 mm). There were no statistically significant differences between the results for either group. The defects associated with furcations and those that were not associated with furcations had similar results, except for the percent attachment gain. Smoking and age (<=60 years old) could not be associated with results. Defects with <=10 mm probing depths (PD) had greater PD reductions (group A, 7.7 mm; group B, 7.1) and attachment gains (group A, 6.6 mm; group B, 6.4 mm) tan the defects with probing depths less than 10 mm (probing reduction group A, 4.8 mm; group B, 4.5 mm; attachment gain group A, 4.4 mm; group b, 4.0 mm). Both surgical procedures improved the clinical situation. However, neither technique seemed to offer a statistical advantage over the other. The inclusion of porous hydroxyapatite did not improve or diminish the results. [References: 31] <64> UI - 1998111567 AU - Carrassi A AU - Sardella A AU - Rimondini L AU - Doyle RJ AU - Richards RG IN - A. Carrassi, Ist. di Scienze Biomediche S. Paolo, Via di Rudini 8, 20100 Milano; Italy. TI - In vivo early plaque colonization on smooth titanium surface. SO - Cells & Materials Vol 6(1-3) (pp 111-116), 1996. AB - Plaque development on pure titanium in a 24-hour period is described in an in vivo human model. Stents with titanium and root cementum specimens were applied to volunteers, who suspended oral hygiene procedures for 24 hours. The specimens were removed at 2, 4 and 24 hours and studied with a scanning electron microscope. A global area of 240 mum x 300 mum, composed of the sum of twelve 20 mum x 25 mum fields randomly selected, was examined for each specimen. The presence of cocci, short rods, long rods and bacterial aggregation, and bacteria density was recorded for each field. The values quoted for the global area were cumulative of those observed in the fields. At 24-hours, significantly legs bacteria was recovered from the titanium than from the corresponding root cementum specimens. The early colonizers of titanium were cocci, frequently located in the roughest part of the specimen. Visible salivary pellicle formation was delayed on the titanium compared to the cementum surface. At 24-hours, fewer rods were recovered from the titanium than from cementum surfaces. These results suggest that early plaque formation is reduced on titanium surface and that morphological irregularities are critical for bacterial adhesion and colonization. [References: 23] <65> UI - 1998190368 AU - Ali MH AU - Zayed ME IN - Dr. M.H. Ali, Department of Surgery, King Fahad Hospital, PO Box 204, Al Baha; Saudi Arabia. TI - Necrotizing fasciitis of the head and neck: Report of three cases. SO - Annals of Saudi Medicine Vol 17(6) (pp 641-645), 1997. <66> UI - 1998156992 AU - Woods II ML IN - Dr. M.L. Woods II, Royal Brisbane Hospital, Infectious Diseases Unit, Wattlebrae Herston, QLD 4029; Australia. TI - Photo quiz I. SO - Clinical Infectious Diseases Vol 26(5) (pp 1071+1220-1221), 1998. <67> UI - 1998091420 AU - Laurikainen K AU - Kuusisto P IN - K. Laurikainen, School of Public Health, University of Tampere, PO Box 607, FIN-33101 Tampere; Finland. TI - Comparison of the oral health status and salivary flow rate of asthmatic patients with those of nonasthmatic adults - Results of a pilot study. SO - Allergy Vol 53(3) (pp 316-319), 1998. AB - The oral health status and stimulated salivary flow rate of 33 adult asthmatic outpatients were compared with those of 33 nonasthmatic controls. The groups were matched by age and sex, and an adjustment for education was made in the statistical analysis. In the oral examination, a small difference in the prevalence of caries was observed when the sums of decayed, missing, and filled teeth (DMFT) were compared. The mean (SD) crude DMFT score was 20.1 (5.8) in the asthma group and 18.4 (7.6) in the control group. A statistically significant difference was seen in the amount of periodontal inflammation and in the stimulated salivary flow rate between the groups. The mean (SD) crude periodontal status index (PSI) was 52.7% (23.8%) in the asthmatics and 37.1% (20.4%) in the controls. The 95% confidence interval (95% CI) for the difference in adjusted means of PSI ranged from 0.1% to 21.9% (P=0.05). In the stimulated salivary flow rate, crude mean values were 1.0 (0.5) ml/min and 1.3 (0.5) ml/min, respectively, and the 95% CI for the difference was from 0.05 ml/min to 0.57 ml/min (P=0.01). Mucosal lesions in the oral cavity were found in 15 asthmatics (45%) and in eight controls (24%). In conclusion, the results of this study support the hypothesis that adult asthmatics have a higher risk of oral diseases than nonasthmatic subjects. [References: 17] <68> UI - 1998093612 AU - Duggal MS AU - Curzon MEJ AU - Bailey CC AU - Lewis IJ AU - Prendergast M IN - M.S. Duggal, Division of Child Dental Health, Leeds Dental Institute, Leeds; United Kingdom. TI - Dental parameters in the long term survivors of childhood cancer compared with siblings. SO - Oral Oncology Vol 33(5) (pp 348-353), 1997. AB - There have been a number of reports on the dental health of long term survivors (LTS) of childhood malignancy as compared with normal controls. However, it is usually difficult to identify a meaningful control population as most of these patients are from widely differing geographical areas and socioeconomic status. The aim of this investigation was, therefore, to study the dental health of LTS compared with siblings. 46 LTS who had siblings of a similar age were identified for the study. Both groups were examined for dental caries, gingivitis and enamel defects. There was no statistically significant difference in the mean DMFS of the test and control groups. However, the LTS had a significantly (P=0.006) higher number of decayed surfaces (1.50+/-0.30) as compared with their siblings (0.50 +/-0.20). The LTS also had a significantly higher prevalence of severe gingivitis (1.11 +/- 0.33) compared with controls (0.02 +/- 0.02). There was a significantly higher prevalence of all types of enamel defects in the LTS and fewer teeth with no enamel defect as compared with their siblings, with the mean values being 15.7+/-0.9 and 25.3 +/-0.3, respectively. It was concluded that there was a higher prevalence of untreated dental disease and developmental defects in long term survivors. [References: 13] <69> UI - 1998091525 AU - Meurman JH AU - Laine P AU - Lindqvist C AU - Teerenhovi L AU - Pyrhonen S IN - J.H. Meurman, Institute of Dentistry, University of Helsinki, Helsinki; Finland. TI - Five-year follow-up study of saliva, mutans streptococci, lactobacilli and yeast counts in lymphoma patients. SO - Oral Oncology Vol 33(6) (pp 439-443), 1997. AB - Twenty-two patients out of the 79 that were originally included were examined 5 years after beginning anticancer therapy for lymphomas. The patients' cumulative data on salivary flow rate, buffering capacity and acidogenic microbial counts were compared with respective data of 17 patients who died during the follow-up. Stimulated saliva samples had been taken at baseline and during the cytostatic treatment with combination chemotherapy, and 1 year and 5 years later. Chair-side kits were used at the hospital ward for the assessment of the study parameters. Mean saliva flow at baseline was 1.5+/-0.7 ml/min in the surviving group and 1.5+/-0.8 ml/min in the deceased. Salivary flow rates were not affected by the anticancer treatment and there was no statistically significant difference between the groups in this respect. A significant difference was observed between the groups in salivary buffering capacity values at baseline: only 32% of the survived had low buffering capacity in comparison to 69% of those who later died (P<0.02). Buffering capacity values remained low in 50% of the surviving patients 5 years later. Higher mutans streptococci and lactobacili counts were seen among the deceased than in the survived patients but mutans streptococci decreased significantly in both groups after the start of the anticancer therapy (P<0.05). The number of positive yeast counts increased consistently during the chemotherapy in both groups, being higher in the survived when compared with the deceased patients. Yeast counts remained positive 5 years later in 73% of the survived patients, while the mean mutans streptococci and lactobacilli counts decreased below baseline values. The results showed that persistently high salivary microbial counts and low buffering capacity may be linked with poor prognosis. [References: 27] <70> UI - 1998091517 AU - Meurman JH AU - Pyrhonen S AU - Teerenhovi L AU - Lindqvist C IN - J.H. Meurman, Institute of Dentistry, University of Helsinki, Helsinki University Central Hospital, Helsinki; Finland. TI - Oral sources of septicaemia in patients with malignancies. SO - Oral Oncology Vol 33(6) (pp 389-397), 1997. AB - This article reviews papers dealing with oral infections of adult septicaemia patients, searched from MEDLINE, Current Contents and Core Biomedical Collection databases from January 1966 to November 1996. Case reports were excluded. The systematic review of literature revealed that our knowledge of the topic is mostly based on very small patient material. There are no multicentre studies on the effects of various oral health treatment modes on the prevention of septicaemia of oral origin. The number of controlled and comparative studies on the efficacy of the different treatment protocols of oral infections is also small. Current recommendations in this respect are mainly empirical and not evidence based. Clinical practice guidelines are therefore urgently needed. Nevertheless, close co-operation between oncological and oral health units is emphasised because many studies have shown that the oral cavity is indeed an important source of bacteraemia. Life-threatening infections may follow if maintenance of oral health is neglected during anticancer therapy and if potential oral infection foci are left untreated before immunosuppressive therapy. [References: 67] <71> UI - 1998087579 AU - Langmore SE AU - Terpenning MS AU - Schork A AU - Chen Y AU - Murray JT AU - Lopatin D AU - Loesche WJ IN - Dr. S.E. Langmore, Audiology Speech Pathology Dep (126), VA Medical Center, 2215 Fuller Road, Ann Arhor, MI 48105; United States. TI - Predictors of aspiration pneumonia: How important is dysphagia?. SO - Dysphagia Vol 13(2) (pp 69-81), 1998. AB - Aspiration pneumonia is a major cause of morbidity and mortality among the elderly who are hospitalized or in nursing homes. Multiple risk factors for pneumonia have been identified, but no study has effectively compared the relative risk of factors in several different categories, including dysphagia. In this prospective outcomes study, 189 elderly subjects were recruited from the outpatient clinics, inpatient acute care wards, and the nursing home care center at the VA Medical Center in Ann Arbor, Michigan. They were given a variety of assessments to determine oropharyngeal and esophageal swallowing and feeding status, functional status, medical status, and oral/dental status. The subjects were followed for up to 4 years for an outcome of verified aspiration pneumonia. Bivariate analyses identified several factors as significantly associated with pneumonia. Logistic regression analyses then identified the significant predictors of aspiration pneumonia. The best predictors, in one or more groups of subjects, were dependent for feeding, dependent for oral care, number of decayed teeth, tube feeding, more than one medical diagnosis, number of medications, and smoking. The role that each of the significant predictors might play was described in relation to the pathogenesis of aspiration pneumonia. Dysphagia was concluded to be an important risk for aspiration pneumonia, but generally not sufficient to cause pneumonia unless other risk factors are present as well. A dependency upon others for feeding emerged as the dominant risk factor, with an odds ratio of 19.98 in a logistic regression model that excluded tube-fed patients. [References: 94] <72> UI - 1998071056 AU - Leal FR AU - Cohen ME AU - Forgas-Brockmann L AU - Meyer DM AU - Simecek J IN - F.R. Leal, Naval Dental Center, Great Lakes, IL 60088; United States. TI - A prospective study of sealant application in Navy recruits. SO - Military Medicine Vol 163(2) (pp 107-109), 1998. AB - A 3-year prospective study was designed to evaluate sealants in preventing the formation and progression of caries in a young adult military population. United States Navy dentists performed dental examinations on recruits being in-processed at the Naval Training Center, San Diego, California. Contralateral molar pairs (same arch) without