Journal of Oral Diseases The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Malignant Transformation Rate in Patients Presenting Oral Epithelial Dysplasia: Systematic Review and Meta-Analysis Wed, 04 Nov 2015 13:43:41 +0000 Objective. To perform a systematic review and meta-analysis on studies that assess malignant transformation rates (MTR) of oral epithelial dysplasia. Materials and Methods. This review was planned and conducted in accordance with the meta-analysis of observational studies in epidemiology (MOOSE) guidelines. PubMed, EMBASE, Google Scholar, and Cochrane databases were screened to identify observational studies. Quality assessments were completed by two reviewers independently using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Pooled-malignant transformation rate (MTR) in person years, subgroup, sensitivity, and publication bias analysis were calculated using STATA 13.0 and Comprehensive Meta-Analysis software. Results. Sixteen observational cohort studies were identified with a total of 3708 participants from Asia, North America, and Europe. Analysis showed a MTR of 10.5% (pooled-MTR: 10.5, 95% CI: 3.7 to 17.3; fixed effect model, %; -value = 2.389; ) among patients with histologically confirmed oral epithelia dysplasia undergoing long-term follow-up. Higher MTR in person year were seen among the sever dysplastic cases (pooled-MTR: 14.4%, 95% CI: 5.3% to 23.5%), studies published in Europe (pooled-MTR: 12.6%, 95% CI: 8.0% to 24.3%), and retrospective studies (pooled-MTR: 11.0%, 95% CI: 2.2% to 19.9%). Conclusion. These studies show that oral epithelial dysplasia has a significant high rate of transformation to cancer. Jaffer A. Shariff and Athanasios I. Zavras Copyright © 2015 Jaffer A. Shariff and Athanasios I. Zavras. All rights reserved. Malocclusion Characteristics as Risk Factors for Temporomandibular Disorders: Lessons Learned from a Meta-Analysis Wed, 19 Aug 2015 10:06:53 +0000 The objective of this meta-analysis was to evaluate the association of various malocclusion characteristics with temporomandibular disorders (TMDs). Two reviewers identified articles through database searches of MEDLINE (Ovid) and LILACS and hand searches of major orthodontic journals and selected references. Random-effects models were used to calculate weighted pooled odds ratio (OR) estimates of malocclusion exposures. Six articles qualified for inclusion in the final quantitative analysis. Our study found that static occlusal factors had no significant association with TMD. Of the dynamic occlusal factors assessed, only the absence of canine guidance, laterotrusive interferences, and retruded contact position to maximal intercuspation slide length ≥2 mm demonstrated significant ORs. These results should be viewed with caution, as reporting biases were difficult to assess, and heterogeneity estimates may have been underestimated due to the limited number of studies within each comparison. TMD is a term that encompasses a broad group of dysfunctions, and meta-analyses should only synthesize studies with similar diagnostic criteria. At the present, there is a paucity of studies available that could be properly synthesized to answer the research question posed. Individual studies have too much variability among their methods, and researchers need to clearly define and state their TMD factor definition. Claudia L. Cruz, Kevin C. Lee, Jae Hyun Park, and Athanasios I. Zavras Copyright © 2015 Claudia L. Cruz et al. All rights reserved. Oral Hygiene Status, Periodontal Status, and Periodontal Treatment Needs among Institutionalized Intellectually Disabled Subjects in Kolhapur District, Maharashtra, India Sun, 07 Dec 2014 09:43:55 +0000 The aim of the study was to determine influence of intellectually disability (ID) on oral hygiene status (OHS), periodontal status (PS), and periodontal treatment needs (PTNs) and investigate the association of these clinical parameters with various sociodemographic and clinical variables among multicentric institutionalized ID subjects aged 5–55 years in Kolhapur district, Maharashtra, India. This descriptive cross-sectional study was conducted by both questionnaire and clinical examination. OHS, PS, and PTNs of these subjects were assessed by recording Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index of Treatment Needs, respectively. Analysis of variance and multiple logistic and stepwise linear regression analysis were used for statistical analysis. Of the 576 subjects examined, the mean age of the subjects was 17.50 ± 7.4 years. Subjects with profound level of ID had the highest mean OHI-S, PS, and PTNs scores of 4.47 ± 1.04, 2.84 ± 0.78, and 2.25 ± 0.44, respectively, as compared with other ID groups (). The present study signified that ID subjects had poor OHS and PS with the highest PTNs and were influenced by age (), degree of ID (), SES, location, institution type, and parent’s level education. The present study underlines a considerable need for prevention and treatment of periodontal disease among ID subjects in India. Nilima S. Kadam, Rahul Patil, Abhijit N. Gurav, Yojana Patil, Abhijeet Shete, Ritam Naik Tari, Dhanashree Agarwal, D. T. Shirke, and Prashant Jadhav Copyright © 2014 Nilima S. Kadam et al. All rights reserved. Clinical Relevance of the Advanced Microbiologic and Biochemical Investigations in Periodontal Diagnosis: A Critical Analysis Mon, 17 Nov 2014 00:00:00 +0000 New approaches to periodontal diagnosis, including advanced microbiologic, biochemical, and genetic tests, have been shown to provide the clinician with the information not available by traditional means. The purpose of a diagnostic test is to confirm, exclude, classify, or monitor disease to guide treatment. Their clinical value depends on whether the information they provide leads to improved patient outcomes. This can be assessed by randomized trials, which compare patient outcomes from the new diagnostic test versus the old test strategy. Being nonmandatory for marketing approval, such trials are not always feasible because of large sample sizes requirements. So, many diagnostic tests enter the practice without being critically analysed for any additional benefits. Effective diagnosis is just as essential as the selection of effective treatments for the success of periodontal therapy. So, the current paper aims to focus on the practical utility of this rapidly emerging plethora of periodontal diagnostic tools, emphasizing the critical issues surrounding the clinical application of microbiologic and biochemical investigations, employed for periodontal diagnosis. Vishakha Grover, Anoop Kapoor, Ranjan Malhotra, and Gagandeep Kaur Copyright © 2014 Vishakha Grover et al. All rights reserved. Enamel Carious Lesion Development in Response to Sucrose and Fluoride Concentrations and to Time of Biofilm Formation: An Artificial-Mouth Study Mon, 15 Sep 2014 05:04:33 +0000 The aim of this study was to evaluate both sucrose and fluoride concentrations and time of biofilm formation on enamel carious lesions induced by an in vitro artificial-mouth caries model. For Study 1, biofilms formed by streptococci and lactobacilli were grown on the surface of human enamel slabs and exposed to artificial saliva containing 0.50 or 0.75 ppmF (22.5 h/d) and broth containing 3 or 5% sucrose (30 min; 3x/d) over 5 d. In Study 2, biofilms were grown in the presence of 0.75 ppmF and 3% sucrose over 3 and 9 days. Counts of viable cells on biofilms, lesion depth (LD), and the integrated mineral loss (IML) on enamel specimens were assessed at the end of the tested conditions. Counts of total viable cells and L. casei were affected by sucrose and fluoride concentrations as well as by time of biofilm formation. Enamel carious lesions were shallower and IML was lower in the presence of 0.75 ppmF than in the presence of 0.50 ppmF . No significant effect of sucrose concentrations was found with respect to LD and IML . Additionally, deeper lesions and higher IML were found after 9 d of biofilm formation . Distinct sucrose concentrations did not affect enamel carious lesion development. The severity of enamel demineralization was reduced by the presence of the higher fluoride concentration. Additionally, an increase in the time of biofilm formation produced greater demineralization. Our results also suggest that the present model is suitable for studying aspects related to caries lesion development. Rodrigo Alex Arthur, Eduardo Kazuo Kohara, Robert Aaron Waeiss, George J. Eckert, Domenick Zero, and Masatoshi Ando Copyright © 2014 Rodrigo Alex Arthur et al. All rights reserved. Correlation of Anxiety Levels between Temporomandibular Disorder Patients and Normal Subjects Sun, 14 Sep 2014 05:55:47 +0000 Background. Temporomandibular disorders (TMDs) are among the common musculoskeletal conditions affecting the individual. Anxiety plays an important role in the pathogenesis of TMD. Modern lifestyle and work environment bring to focus the role of anxiety in everyday life which is changing the demographics of diseases like TMD. This study compared the anxiety scores between TMD patients and normal subjects. Material and Methods. 505 individuals were included in the study who were divided into group 1 with 255 individuals presenting with signs and symptoms of TMD and group 2 with 250 normal individuals as controls. Hospital anxiety depression scale was used to calculate the anxiety scores. Fischer’s t test was used to compare the anxiety scores between the two groups. Results. 80% of individuals in group 2 and 44% in group 1 individuals had normal anxiety scores. 45% of the individuals in group 1 and 19% in group 2 had borderline anxiety scores. 11% of group 1 individuals and <1% of group 2 individuals demonstrated high anxiety scores. These results were statistically significant. Conclusion. Individuals with TMD exhibited higher levels of anxiety scores whereas significant number of control subjects exhibited normal anxiety scores. Subhash Vasudeva, Asha Iyengar, and Nagesh Seetaramaiah Copyright © 2014 Subhash Vasudeva et al. All rights reserved. Impact of an Oral Health Education Workshop on Parents’ Oral Health Knowledge, Attitude, and Perceived Behavioral Control among African Immigrants Mon, 23 Jun 2014 08:27:46 +0000 Purpose. To evaluate the impact of an educational workshop on parental knowledge, attitude, and perceived behavioral control regarding their child’s oral health. Materials and Methods. A one-time oral health education workshop including audio/visual and hands-on components was conducted by a trained dentist and bilingual community workers in community locations. Participants were African parents of children who had lived in Canada for less than ten years. The impact of the workshop was evaluated by a questionnaire developed based on the theory of planned behavior. Results. A total of 105 parents participated in this study. Participants were mainly mothers (mean age years) who came to Canada as refugee (77.1%) and had below high school education (70%). Paired t-test showed a significant difference in participants’ knowledge of caries, preventive measures, and benefits of regular dental visits after the workshop (P valu). A significant improvement was also found in parental attitudes toward preventive measures and their perceived behavioral control (). Parents’ intention to take their child to a dentist within six months significantly altered after the workshop (P valu). Conclusions. A one-time hands-on training was effective in improving parental knowledge, attitude, perceived behavioral control, and intention with respect to their child’s oral health and preventive dental visits in African immigrants. Maryam Amin, Pawan Nyachhyon, Maryam Elyasi, and Muhammed Al-Nuaimi Copyright © 2014 Maryam Amin et al. All rights reserved. Reliability of Pederson Scale in Surgical Extraction of Impacted Lower Third Molars: Proposal of New Scale Thu, 12 Jun 2014 12:33:49 +0000 The aim of this study was to evaluate the clinical reliability of the Pederson index in preoperative assessment of the difficulty of surgical removal of impacted mandibular third molars. Pederson index was found to be unreliable predictor of true difficulty with low sensitivity and specificity. A new index (Kharma scale), which takes into consideration the anatomical form of tooth roots, is proposed and evaluated both pre- and postoperatively. The results of the evaluation indicate that the new estimating index is more reliable and accurate measure than Pederson scale. Mohamed Yasser Kharma, Salah Sakka, Ghassan Aws, Basel Tarakji, and Mohammed Zakaria Nassani Copyright © 2014 Mohamed Yasser Kharma et al. All rights reserved. Salivary Melatonin and the Severity of Attachment Loss: A Case-Control Study Mon, 09 Jun 2014 13:00:53 +0000 Background. Melatonin (MT: N-acetyl-5-methoxytryptamine) is a neuroendocrine hormone secreted mainly by the pineal gland in the brain. MT is produced with a circadian rhythm characterized by elevated blood levels during the night. In healthy individuals, maximal secretion of MT occurs between midnight and 2:00 am, whereas the minimal production occurs during the day. MT can be determined by repeated measurement of plasma or salivary MT or urine sulfatoxy-melatonin. Melatonin has powerful antioxidant effects, has an immunomodulatory role, stimulates the synthesis of type I collagen fibers, and promotes bone formation. Melatonin is also secreted in the saliva, although its role in the mouth is not known well. The purpose of this study was to examine the correlation between salivary melatonin level and periodontal diseases. Methods. Fifty subjects by mean age of years were equally divided into 5 groups: 10 healthy subjects, 10 subjects with gingivitis, 10 subjects with localized moderate chronic periodontitis, 10 subjects with generalized moderate chronic periodontitis, and 10 subjects with generalized severe chronic periodontitis. Saliva samples were collected from all the subjects and melatonin levels were determined using an enzyme-linked immunosorbent assay. Two-way and one-way ANOVA and Tukey test were used to analyze relationships among variables. Results. Healthy subjects had significantly higher salivary melatonin level ( pg/mL) compared to patients with gingivitis ( pg/mL) (). The difference between salivary melatonin level in patients with gingivitis and periodontitis was significant (). Level of melatonin in patients with generalized severe chronic periodontitis ( pg/mL) was significantly lower than that in other groups (). Conclusions. This study determined that salivary melatonin level in patients with periodontal diseases is lower than that in healthy subjects. Consequently we conclude that there is a negative correlation between melatonin level and the severity of disease, suggesting that melatonin might have a protective role against periodontal diseases, although further research is required to validate this hypothesis. Leila Golpasand-Hagh, Faramarz Zakavi, Arash Daraeighadikolaei, Akram Ahangarpour, Sara Hajati, and Arsham Daraeighadikolaei Copyright © 2014 Leila Golpasand-Hagh et al. All rights reserved. Saliva: A Cutting Edge in Diagnostic Procedures Mon, 26 May 2014 00:00:00 +0000 The ability to monitor the health and disease status of the patient through saliva is a highly desirable goal for the health professionals. Considering the microconcentration of salivary constituents, saliva is explored to be diagnostic tool as it also meets the demands for an inexpensive, noninvasive and easy to use screening method. The incorporation of salivary diagnostics into clinical practice is gaining reality and will be of diagnostic value in the prospective future. The investigative use of saliva is not being applied only in dental health but also in various other systemic disorders. The advent of molecular techniques is gaining attention and this has triggered its application as a specific and sensitive biomarker in proteomics, genomics, and transcriptomics. This review discusses the basics of salivary diagnostics, expectoration techniques, and its application in various local and systemic disorders. Senthamil Sindhu and Nithya Jagannathan Copyright © 2014 Senthamil Sindhu and Nithya Jagannathan. All rights reserved. Global Research Trends on Early-Life Feeding Practices and Early Childhood Caries: A Systematic Review Mon, 19 May 2014 05:43:07 +0000 Objective. To describe the epidemiologic literature related to early-life feeding practices and early childhood caries (ECC) with regard to publication attributes and trends in these attributes over time. Methods. Systematic literature review including electronic and manual searches (in BIOSIS, CINAHL, Cochrane Library, LILACS, MEDLINE, Web of Science, and WHOLIS), covering the years 1990–2013. Attributes of publications meeting a priori inclusion criteria were abstracted and organized by global region and trends over time. Attributes included country of origin and study design of included publications and age and caries prevalence of the populations studied. Results. 244 publications drawn from 196 independent study populations were included. The number of publications and the countries represented increased over time, although some world regions remained underrepresented. Most publications were cross-sectional (75%); while this percentage remained fairly constant over time, the percentage of studies to account for confounding factors increased. Publications varied with respect to the caries experience and age range of children included in each study. Conclusions. Publication productivity regarding feeding practices and ECC research has grown, but this growth has not been evenly distributed globally. Individual publication attributes (i.e., methods and context) can differ significantly and should be considered when interpreting and synthesizing the literature. Benjamin W. Chaffee and Ashley Cheng Copyright © 2014 Benjamin W. Chaffee and Ashley Cheng. All rights reserved. Variable Selection Method in Prediction Models: Application in Periodontology Tue, 04 Feb 2014 13:30:51 +0000 The aim of this study, applied in the field of periodontal diseases, was first to analyze the fatty acid levels in two groups of patients and then to propose a method for selecting the most relevant predictors. Two groups of patients, 29 with moderate or severe periodontitis and 27 who served as controls, were clinically examined, and their fatty acids in serum were measured by gas chromatography. The levels of these 12 fatty acids were the variables of the analysis. Logistic regression, together with the area under the receiver operating characteristic (ROC) curves, allowed determining a composite score which led to a subset of the most relevant covariables. The fatty acid levels differed significantly between the 2 groups in multivariate analysis () and the best logistic model was obtained with only 3 predictive variables: arachidonic acid, linoleic acid, and DHA. Fatty acid levels in serum of patients were significantly different according to the presence of moderate or severe periodontitis. By taking into account the comparison of ROC curves, our approach could optimize the choice of variables in multivariate analyses and could better fit it with diagnosis and prognosis of oral diseases in dental research. Paul Tramini, Jean-Christophe Chazel, Isabelle Calas-Bennasar, Philippe Gibert, and Nicolas Molinari Copyright © 2014 Paul Tramini et al. All rights reserved. Talon Cusp: A Prevalence Study of Its Types in Permanent Dentition and Report of a Rare Case of Its Association with Fusion in Mandibular Incisor Tue, 21 Jan 2014 09:14:51 +0000 Purpose. The data on various types of talon cusp, a rare developmental anomaly that occurs predominantly on palatal surfaces of maxillary incisors with varied prevalence in different populations, is scarce. Thus, the purpose of study was to evaluate prevalence of various types of talon cusp and its association with sex predilection, site, and other dental anomalies and complications. Subjects and Methods. A cross-sectional prevalence study for various types of talon cusp was conducted in 5200 patients selected randomly. Hattab’s classification criterion was used for diagnosis of types of talon cusp. The clinical diagnosis was confirmed with radiograph. Results. The prevalence of talon cusp was found to be 0.02% (1 in 430 cases). 12 cases of talon cusp in 10 patients (60% males) were documented (2 bilateral cases and 8 unilateral). Type I talon cusp and type II talon cusp were present in five cases each (40.1%) and type III talon cusp was observed in two (16.2%) cases. Conclusion. Type I talon cusp and type II talon cusp were the most common types and permanent maxillary central incisor was the most commonly involved tooth (50%). An extremely rare case of talon cusp on a fused permanent mandibular incisor is also reported. Gaurav Sharma and Archna Nagpal Copyright © 2014 Gaurav Sharma and Archna Nagpal. All rights reserved. Apoptosis and Its Significance in Oral Diseases: An Update Mon, 30 Dec 2013 08:43:14 +0000 Apoptosis is a well defined mode of cell death which plays an imperative role in the development, regulation, and maintenance of the cell populations in multicellular organisms. Apoptosis is implicated in both health and diseases. Errors in apoptotic mechanisms have been allied to a wide range of pathologies including oral diseases. This review presents an update focused on the role and significance of apoptosis in various oral diseases ranging from reactive to benign and malignant pathologies. Megha Jain, Sowmya Kasetty, Sudheendra Udyavara Sridhara, Nitin Jain, Samar Khan, and Ami Desai Copyright © 2013 Megha Jain et al. All rights reserved. Effect of Scaling and Root Planing on Detection of Tannerella forsythia in Chronic Periodontitis Sun, 22 Dec 2013 15:14:58 +0000 Aim. This study was aimed to determine the prevalence of Tannerella forsythia in subgingival plaque samples of chronic periodontitis patients having different level of periodontal destruction and to assess the effect of scaling and root planing (SRP) on prevalence of T. forsythia. Materials and Methods. Study included 3 groups: group 1 were healthy individuals, group 2 had periodontitis with probing depth ≤ 5 mm, and group 3 had periodontitis with probing depth > 5 mm. Subjects in groups 2 and 3 exhibited both healthy and diseased periodontal sites. Prevalence of T. forsythia was determined using polymerase chain reaction. Subjects in groups 2 and 3 received SRP and were reevaluated three months after SRP. Results. T. forsythia was not detected in group 1. It was found in diseased sites in 40% and 73.33% of patients from groups 2 and 3, respectively. It was also found in healthy sites in 6.67% and 13.33% of patients from groups 2 and 3, respectively. The detection frequency of T. forsythia after SRP was 6.67% and 13.33% in groups 2 and 3, respectively. Conclusion. The results indicate a possible association between periodontal disease and presence of T. forsythia. Also, the detection frequency of T. forsythia was reduced after SRP. Ritesh B. Wadhwani, Minal S. Chaudhary, Dipti A. Tharani, and Shweta A. Chandak Copyright © 2013 Ritesh B. Wadhwani et al. All rights reserved. Clinically Classified Periodontitis and Its Association in Patients with Preexisting Coronary Heart Disease Wed, 19 Jun 2013 13:04:05 +0000 The aim of this retrospective study was to investigate possible associations between clinically classified periodontitis as determined by assessing its severity and diagnosed coronary heart disease in outpatients referred to a specialist clinic for neurosurgery treatment. A total of 2,912 individuals were clinically examined for periodontal disease experience by using probing pocket depth (PPD) and clinical attachment loss (CAL). Socioeconomic, oral health behaviour, and general health related information was collected by using a self-administered questionnaire. Statistical analysis of the questionnaire items was performed by using multivariate logistic regression analysis model. The results showed that the occurrence of hypertension (, 95% CI = 1.52–3.84), smoking (, 95% CI = 1.25–3.11), classified periodontitis (, 95% CI = 1.15–2.77), and the high level of serum C-reactive protein (, 95% CI = 1.05–2.89) were significantly associated with the presence of coronary heart disease. These observations strengthen the role of some of the traditional causative risk factors for coronary heart disease while a significant association was recorded between diagnosed coronary heart disease and clinically classified periodontitis which is considered as a risk factor for coronary heart disease. Nikolaos A. Chrysanthakopoulos and Panagiotis A. Chrysanthakopoulos Copyright © 2013 Nikolaos A. Chrysanthakopoulos and Panagiotis A. Chrysanthakopoulos. All rights reserved.