Variation in periodontal referral in 2 regions in theUK

This study investigated the periodontal referral patterns of general dental practitioners (GDPs) in Northern Ireland (NI) and North West England (NWE). A questionnaire dealing with periodontal referral was sent to all 520 GDPs registered in NI and to 274 GDPs in NWE. A usable return was made by 355 (68%) in NI and 189 (70%) in NWE. The NI dentists made significantly more periodontal referrals (median 5, range 0-80) in the year preceding the survey than those in NWE (median 2, range 0-50), p<0.001. Distance was the only factor significantly related to the referral rate in both regions with those who practised more than 25 miles from a specialist referring significantly fewer patients in both regions. In NI, there was a trend towards increased periodontal referral by GDPs who had attended more postgraduate courses; however, in NWE, this was not the case. The GDPs in NWE were significantly less likely than those in NI to refer patients with medical conditions. It is concluded that there is considerable variation in periodontal referral both within and between the 2 regions studied. It is further concluded that in many cases, non-disease factors, such as the accessibility of the specialist service, have powerful effects on the decisions made by dentists and patients in these regions (NI and NWE) in relation to periodontal referral. Much of the variance in referral in North West England, as in Northern Ireland, remains unexplained.     

云南省五岁儿童乳牙龋病调查分析

目的：了解云南省５岁儿童乳牙龋齿患病情况。方法：随机抽取云南省三个城市三个农村的２１３２名５岁常住儿童,采用第二次全国口腔健康流行病学调查标准调查龋齿患病情况。结果：云南省５岁儿童乳牙患龋率为７５．７５％,龋均为４．４４,充填率仅为６．５７％,仅占构成比的４．３９％。结论：云南省５岁儿童乳牙龋齿患病率高,充填率低。儿童龋病防治应注重两个方面：１．加强对家长和教师的幼儿口腔卫生保健知识及方法的宣传。     

Experience in using moradol in osteoplastic operations in oral surgery

Osteoplastic operations on the jaws were carried out in 19 patients aged 14-64 under moradol anesthesia. The mean length of the operation was 3 hours. The authors come to a conclusion that moradol in a dose of 0.3 mg/kg b. w. ensures adequate anesthesia, with a high level of analgesia persisting in the immediate postoperative period.     

Mast cells in masseter muscle in experimental bruxism in man

Three human subjects performed tooth grinding for 25 min, and after 20 h biopsies of the right and left masseter muscles were examined for their contents of mast cells. In comparison with specimens from a control group of three subjects, there was an increase of degranulating mast cells in muscles that had performed bruxism.     

Changes in cyclooxygenase metabolities in experimental periodontitis in Macaca mulatta

The four principal metabolites of cyclooxygenase (CO) were examined during the progression of experimental periodontitis in the rhesus monkey Macaca mulatta. Thirty-two monkeys were divided in four disease-matched groups. Three groups were treated with flurbiprofen, a potent CO inhibitor, at either 0.027, 0.27 or 7.1 mg/kg/day delivered systemically by a subcutaneously-implanted osmotic mini-pump. We have previously described the findings indicating that flurbiprofen treatment significantly retarded clinical attachment loss (ALOSS), redness and radiographic bone loss (BLOSS). This investigation focuses on the changes in CO metabolites which occur during disease progression of ligature-induced periodontitis and on the dose-response relationship of flurbiprofen, as it relates to disease inhibition and the suppression of ARA metabolites within the crevicular fluid (CF). In untreated animals there was a statistically significant 3-fold increase in CF levels of prostaglandin E2 (PGE2) and thromboxane B2 (TxB2) at 3 months, as compared to baseline, which positively correlated with increases in redness, bleeding, ALOSS and BLOSS. CF-PGE2 and TxB2 levels reached a 6-fold peak at 6 months and returned to baseline by 12 months. Flurbiprofen (Fb) prevented the 3-month rise in TxB2, but did not affect the increase in PGE2. At 6 months, Fb administration caused a dose-dependent inhibition of both PGE2 and TxB2. Probit analysis of the dose-response data revealed that the concentration of Fb which caused a 50% inhibition of CF-TxB2 level (the IC50 value for TxB2 synthesis) was approximately two logs lower than the IC50 value for PGE2 synthesis, i.e. TxA2-IC50 = 0.013 vs. PGE2-IC50 = 1.35 mg flurbiprofen/kg/d. The slopes of the PGE2 and TxB2 inhibition curves were identical, consistent with a similar mechanism or singular enzyme for the site of action of Fb inhibition of CO activity. However, the kinetics and sensitivity of Fb inhibition were significantly different for the CO activity responsible for TxB2 and PGE2 synthesis, perhaps due to different compartmentalization of CO within different cell types.     

Age-related changes in anthropometric measurements in the craniofacial regions and in height in Down's syndrome

This cross-sectional study analyzed age-related changes in normal and abnormal measurements of the head and face in three age categories in 115 Down's syndrome patients 1 to 36 years old. The frequency of normal measurements significantly surpassed that of abnormal ones in each category. Clinically, the key task was to ascertain differences between the youngest and oldest patients. In age group 1 (1 to 5 years), normal measurements in three of the six craniofacial regions were significantly more frequent than abnormal ones. In age group 2 (6 to 15 years) the percentage of normal measurements significantly increased, influenced by higher growth rates in the period of maturation, which coincided with this category. In age group 3 (16 to 36 years) the percentage of normal measurements significantly increased in the head and ear but decreased in the other regions, significantly in the orbits. The frequency of both optimal and severely abnormal measurements changed significantly from age group 1 to 3 in only five measurements each, with no consistency in the direction of results. Abnormal measurements qualified as stigmata and were recorded in 40% (10 of 25) in five regions: three in the face; two in each of the head, orbits, and ears; and one in the nose. Marked epicanthi covering the endocanthion decreased from 35.0% in age group 1 to 8.7% in group 3. In age group 1, the frequency of normal body height (20.7%) in both sexes was significantly less than subnormal (70.3%) but significantly decreased in age group 2. Mean height in group 3 was enough to rule out short stature as a stigmata of Down's syndrome. The study was limited by small numbers, particularly in the variations of normal and abnormal, but the trend toward normality after maturation suggests that reconstructive surgery should be delayed until this time.     

Trends in socioeconomic disparities in oral health in Brazil and Sweden

Celeste RK, Nadanovsky P, Fritzell J. Trends in socioeconomic disparities in oral health in Brazil and Sweden. Community Dent Oral Epidemiol 2011; 39: 204–212. © 2010 John Wiley & Sons A/S Abstract – Objectives: To describe the dynamics of trends in socioeconomic disparities in oral health in Brazil and Sweden among adults, to assess whether trends follow expected patterns according to the inverse equity hypothesis. Methods: In Sweden, we obtained nationally representative data for the years 1968, 1974, 1981, 1991 and 2000, and in Brazil, for 16 state capitals in 1986 and in 2002. Trends in the prevalence of ‘edentulism’ and of ‘teeth in good conditions’ were described in two groups aged 35–44 with lower and higher economic standards, respectively. Results: There was an annual decline in disparities in ‘edentulism’ of 0.4 percentage points (pp) (95% CI = 0.2–0.7) in Brazil and 0.7pp (95% CI = 0.5–0.9) in Sweden, as a result of improvements in both income groups. Concerning ‘teeth in good conditions’, in Brazil, there was improvement only in the higher income group and absolute disparities have increased (0.5pp annually), while in Sweden, there was a nonsignificant decrease (0.3pp annually) with improvements in both groups. Since 1991 in Sweden and in 2002 in Brazil, our measures of socioeconomic disparities in ‘edentulism’ were not statistically significant. Trends did not differ by sex or dental visit. Conclusions: Despite improvements in both income groups and a decrease in disparities in ‘edentulism’, the poorer group in Brazil has seen no improvement in ‘teeth in good conditions’ and disparities have increased. It appears that Brazil and Sweden reflect different stages of trend for ‘teeth in good conditions’ and the same stages for ‘edentulism’, represented by the inverse equity hypothesis.     

Dental erosion in deciduous teeth--an in vivo and in vitro study

OBJECTIVE: The aims of this study were to report on severe dental erosion and its associated etiological factors in deciduous teeth of Saudi children (n=16, X macro=6.5 years, R=5--8) in vivo, and to confirm (or reject) the clinical diagnosis by scanning electron microscopy (SEM). Another aim was to study progression of erosion in vitro using extracted healthy deciduous and permanent teeth. METHOD: For the in vivo study, a questionnaire and clinical examination was completed, medical history obtained and exfoliated eroded teeth (n=8) examined by SEM. For the in vitro study, enamel specimens were prepared from Saudi (n=21) and Finnish (n=19) deciduous teeth as well as Finnish permanent teeth (n=20), immersed in 2% citric acid for 5--30 min, microhardness measurements performed, and the specimens studied by SEM. RESULTS: The in vivo investigation showed that high intake of acidic drinks and fruits, upper respiratory tract problems and frequent medications may constitute possible etiological and/or aggravating factors for severe dental erosion in Saudi children. Deciduous tooth enamel was softer than permanent tooth enamel. SEM showed no clear differences in the ultrastructure of the enamel specimens amongst the three groups. The clinical diagnosis of severe dental erosion in those cases studied was reliable as verified by SEM. CONCLUSIONS: The presence of dental erosion in children is likely to be associated with a number of general health and dietary factors but is also aggravated by the relatively more rapid progression of erosion in the deciduous teeth.