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PubMed1997

Effect of an enzymatic rinse on salivary levels of Streptococcus mutans and lactobacilli in periodontally treated patients.

Root surface caries is prevalent in patients with both treated and untreated periodontal disease. The major etiologic factor has been identified as microbial plaque. In periodontally treated patients, significantly higher root caries prevalence and incidence have been found in patients with high levels of Streptococcus mutans and Lactobacilli in saliva. Reducing the levels of S. mutans and Lactobacilli in saliva may lower the risk of root caries development. The purpose of this investigation was to determine the effect of an oral enzymatic rinse on the salivary counts of S. mutans and Lactobacilli in periodontally treated patients. Fifteen adult subjects participated in a double-blind, cross-over designed clinical trial. Each subject had previously undergone comprehensive periodontal therapy and had been maintained on a regular program of supportive periodontal therapy. Paraffin-stimulated whole saliva was collected from each participant. Each subject was then randomly given either the enzymatic rinse product or a control rinse and instructed to rinse with one tablespoonful twice a day for 2 weeks, after which saliva samples were taken. After a washout period, salivary samples were again taken, and the subjects received the alternate rinse product. Two weeks later, final salivary samples were taken. The salivary samples were serially diluted and incubated aerobically on selective culture media. S. mutans and Lactobacilli were counted on the basis of colonial morphology. Pretreatment and posttreatment salivary counts of S. mutans and Lactobacilli were analyzed using the Wilcoxon matched-pairs signed-rank test at the 5% level of significance. Analysis of data revealed that neither the test nor the control rinse significantly lowered salivary counts of either species in the sample population.

Adult↗
PubMed1987

The effects of cheese snacks on caries in desalivated rats.

Rats that had had their submandibular/sublingual glands removed surgically, and their parotid ducts tied, developed fewer and less severe caries lesions on coronal and root surfaces when fed cheese snacks in addition to a cariogenic diet than when fed additional cariogenic snacks or no additional snacks. The effects of cheese snacks were particularly dramatic on root-surface caries. These observations may be relevant for elderly humans who are most likely to develop root surface caries. Populations of Streptococcus mutans did not differ among the groups. Actinomyces viscosus was not detected at the end of the experiment in any of the groups. The results of this study demonstrate that cheese exerts a protective effect against coronal and root-surface caries in rats with a severely limited salivary function.

Animals↗
PubMed1996

Detection of anaerobic odontogenic infections by fluorine-18 fluoromisonidazole.

Odontogenic infections are a potential risk for patients who receive cervicofacial radiotherapy and should be treated before irradiation. Anaerobic microbial infections are the most common causes. This study assessed the value of the hypoxic imaging agent fluorine-18 fluoromisonidazole (FMISO) in detecting anaerobic odontogenic infections. Positron emission tomography (PET) imaging was performed at 2 h after injection of 370 MBq (10 mCi) of FMISO in 26 nasopharyngeal carcinoma patients and six controls with healthy teeth. Tomograms were interpreted visually to identify hypoxic foci in the jaw. All patients received thorough dental examinations as a pre-radiotherapy work-up. Fifty-one sites of periodontitis, 15 periodontal abscesses, 14 sites of dental caries with root canal infection, 23 sites of dental caries without root canal infection, and seven necrotic pulps were found by dental examination. Anaerobic pathogens were isolated from 12 patients. Increased uptake of FMISO was found at 45 out of 51 sites of periodontitis, all 15 sites of periodontal abscess, all 14 sites of dental caries with root canal infection, all seven sites of necrotic pulp and 15 sites of dental caries without obvious evidence of active root canal infection. No abnormal uptake was seen in the healthy teeth of patients or in the six controls. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of FMISO PET scan in detecting odontogenic infections were 93%, 97%, 84%, 99% and 96%, respectively. 18F-fluoride ion bone scan done in three patients showed that 18F-fluoride ion plays no role in the demonstration of anaerobic odontogenic infection. FMISO PET scan is a sensitive method for the detection of anaerobic odontogenic infections, and may play a complementary role in the evaluation of the dental condition of patients with head and neck tumours prior to radiation therapy.

Bacteria, Anaerobic↗
PubMed1993

The association of mutans streptococci and non-mutans streptococci capable of acidogenesis at a low pH with dental caries on enamel and root surfaces.

Coronal dental plaque from each of 12 caries-positive subjects (Group I) was pooled from "white spot" tooth surface areas and, separately, from sound surface areas; sound surface areas in each of 18 caries-free subjects (Group II) were sampled similarly. Two samples, one consisting of material from a root-surface lesion and another of plaque from a sound root-surface area, were obtained from each of another 10 subjects (Group III). The samples from Groups I and II were evaluated for: (1) pH-lowering potential in vitro with dispersed plaque suspensions, excess glucose supply, and a 60-minute test; (2) the levels of mutans streptococci (MS) and lactobacilli; and (3) the distribution of the predominant non-mutans streptococci (non-MS) according to their final pH in glucose broth; only microbial analysis was done for the Group III samples. The levels of the MS were generally positively associated with caries. A weaker positive association was found for the levels of those non-MS capable of acidogenesis at low pH (final pH < 4.4). The latter generally far outnumbered the MS in all types of samples. The levels of lactobacilli were nearly always very low. The pH-lowering potential (final pH and pH drop rate) was higher for plaque from "white spot" areas than for plaque from sound surface areas (Group I). The samples from caries-free subjects (Group II), however, exhibited a pH-lowering potential which was not significantly different from that of both types of samples from the caries-active subjects (Group I).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1980

Comparison of selective broth and plating methods for isolation of Streptococcus mutans from root surface dental plaques.

Approximately 150 sound root surfaces in 44 subjects prone to root surface caries were sampled longitudinally to determine the microbial flora associated with root caries initiation. During the first 16 months of the study, a comparison of Streptococcus mutans recovery was made by using three bacteriological media: mitis-salivarius agar (MSA), mitis-salivarius-bacitracin-sucrose agar (MSB), and a partially selective mannitol-containing broth. Total streptococcal and S. mutans populations were found to be much lower than in previous reports. MSB was more selective; S. mutans was detected in many samples when its numbers were too low for isolation on MSA. However, recovery of S. mutans was greater on MSA than on MSB for most samples yielding colonies on both media. Mannitol-containing broth used as an enrichment medium yielded the highest frequency of S. mutans isolation among the three media.

Aged↗
PubMed1996

Autotransplantation of premolars and molars in patients with tooth aplasia.

OBJECTIVES: The purpose of this study was to investigate retrospectively a group of patients who had undergone autotransplantation of teeth. METHODS: The study group comprised 29 patients who had had a total of 31 teeth autotransplanted (22 premolars and nine molars). Seventeen premolars and one molar were moved from the upper to the lower jaw. The remaining premolars and molars were moved within the same quadrant. Twenty-three teeth were transplanted in cases of agenis, two in cases of ectopic eruption, and six after loss of the first molar. The observation period varied from 3 to 16 years (average 8 years). The patients were examined clinically, and radiographs were taken of the autotransplanted teeth. In addition, the patients were asked to complete a questionnaire. RESULTS: By the end of the observation periods, four autotransplanted teeth had been extracted due to root fracture, caries, or external root resorption. In three of the patients who had lost their transplanted teeth and where no replacement had been inserted, the dentition had remained stable without tipping, rotations, or elongation. Most of the patients were happy with the autotransplantation and satisfied with the information that they had received in connection with the surgery. CONCLUSION: Although not a frequent procedure, it was concluded that autotransplantation had a good prognosis after an (average) observation period of 8 years.

Adolescent↗
PubMed2002

Application of an adjusted chi2 statistic to site-specific data in observational dental studies.

BACKGROUND: When a binary response is observed on teeth from each subject belonging to 2 or more exposure groups, application of the usual Pearson chi2 tests is invalid, since such responses within the same subject are not independent. Consequently, special statistical methods are needed to control for the correlation among teeth (sites) within the same subject. A simple adjustment to the Pearson chi2 statistic has been proposed for comparing proportions in site-specific data. However, the required assumptions for this statistic have not yet been thoroughly addressed. These assumptions are guaranteed to hold in experimental comparisons, but may be violated in some observational studies. METHOD: We investigate the conditions under which the adjusted chi2 statistic is valid and examine the performance of the adjusted chi2 statistic when these conditions are violated. RESULTS: Our simulation study shows that the adjusted chi2 statistic generally produces good empirical type I errors under the assumption of a common intracluster correlation coefficient. Even if the intracluster correlations are different, the adjusted statistic performs well when the groups have equal numbers of clusters (subjects). CONCLUSION: The discussion is illustrated using an observational study of caries on the roots of teeth.

Analysis of Variance↗
PubMed1989

Methodological and nutritional issues in assessing the oral health of aged subjects.

Despite several serious methodological difficulties in epidemiological research on the oral health of elderly subjects, sufficient data are available to conclude that the prevalence of dental diseases is high in persons aged greater than 65 y in the US. An estimated 41% are completely edentulous, and dental caries, including root-surface caries, and destructive periodontal disease are widespread. Whether nutrition is related to the oral health problems of older persons is unclear: this question has received little research attention, and the results have generally been equivocal. There is some evidence that loss of teeth may be associated with suboptimal intake of nutrients and with changes in food preference.

Aged↗
PubMed1993

Effect of sucrose concentration on the cariogenic potential of pooled plaque fluid from caries-free and caries-positive individuals.

Pooled plaque samples were obtained from (1) coronal surfaces of two groups of caries-free (CF) subjects, (2) coronal 'white-spot' surface areas of a group of caries-positive (CP) subjects, and (3) exposed, sound root surfaces of root caries-free (RCF) and root caries-positive (RCP) subjects. The plaque samples were obtained before and 3 min after a 1 min rinse with a 0.5, 1, 2, 5 and 10% sucrose solution. Plaque fluid was then isolated from each plaque sample by centrifugation and analyzed for inorganic ions, organic acids, and pH values. With increasing sucrose concentration: (1) plaque fluid pH and the degree of saturation (DS) with respect to tooth mineral decreased; (2) the pH and DS values of CP and RCP samples were consistently lower than those of CF and RCF samples, respectively; (3) plaque fluid lactic acid concentrations increased and were consistently higher in the CP and RCP samples than in the CF and RCF samples, respectively, and (4) plaque fluid lactic acid concentrations leveled off between 1 and 5% sucrose; this occurred at lower sucrose concentrations with CP and RCP samples than with CF and RCF samples, respectively. RCP samples contained consistently higher levels of mutants streptococci than RCF samples. The chemical composition of plaque fluids, following sucrose exposure, were found to correlate well with caries history. The observed differences in lactic acid concentrations in samples from CF and CP subjects are discussed with regard to differences in microbiological composition and possible differences in plaque permeability to sucrose.

Adolescent↗