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The GOSLON/5-year-old scoring systems have been used in various national and international studies. This study aims to identify the range of Modified Huddart and Bodenham (MHB) scores, which correlate with each GOSLON and 5-year-old category and thereby create a new scoring system that allows comparison with historical data. Two hundred and eighty-three unilateral cleft lip and palate study models from England and Scotland that had all been previously scored using the 5-year-old and GOSLON indices by calibrated examiners were scored using MHB on two separate occasions a month apart by two examiners. Reliability analysis using intraclass correlation and Bland Altman plots were performed. Ordinal regression was used to define the categories of MHB that correspond to the 5-year-old and GOSLON categories. The results revealed a high level of repeatability for both the 5 and the 10 year old models. The MHB scale was grouped into the five categories of the GOSLON and 5-year-old indices with more precision for the 5 year than the 10 year scores. In conclusion, there was high intra-examiner and inter-examiner agreement using the MHB scoring system. It also correlates well with the 5-year-old and GOSLON indices and has been shown to be a much more sensitive scoring system.

This corrects the article on p. e1001333 in vol. 7. [This corrects the article on p. e1001333 in vol. 7.].

Previous studies reported an inverse relationship between body mass index (BMI) and upper aerodigestive tract (UADT) cancers. Examining change in BMI over time may clarify these previous observations. We used data from 2, 048 cases and 2, 173 hospital- and population-based controls from ten European countries (alcohol-related cancers and genetic susceptibility in Europe study) to investigate the relationship with BMI and adult change in BMI on UADT cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI at three time intervals and BMI change on UADT cancer development, adjusting for center, age, sex, education, fruit and vegetable intake, smoking and alcohol consumption. We found an inverse relationship between UADT cancers and BMI at time of interview and 2 years before interview. No association was found with BMI at 30 years of age. Regarding BMI change between age 30 and 2 years before interview, BMI decrease (BMI change

Background: Sequence variants located at 15q25 have been associated with lung cancer and propensity to smoke. We recently reported an association between rs16969968 and risk of upper aerodigestive tract (UADT) cancers (oral cavity, oropharynx, hypopharynx, larynx, and esophagus) in women (OR = 1.24, P = 0.003) with little effect in men (OR = 1.04, P = 0.35). Methods: In a coordinated genotyping study within the International Head and Neck Cancer Epidemiology (INHANCE) consortium, we have sought to replicate these findings in an additional 4,604 cases and 6,239 controls from 10 independent UADT cancer case–control studies. Results: rs16969968 was again associated with UADT cancers in women (OR = 1.21, 95% CI = 1.08–1.36, P = 0.001) and a similar lack of observed effect in men [OR = 1.02, 95% CI = 0.95–1.09, P = 0.66; P-heterogeneity (Phet) = 0.01]. In a pooled analysis of the original and current studies, totaling 8,572 UADT cancer cases and 11,558 controls, the association was observed among females (OR = 1.22, 95% CI = 1.12–1.34, P = 7 × 10−6) but not males (OR = 1.02, 95% CI = 0.97–1.08, P = 0.35; Phet = 6 × 10−4). There was little evidence for a sex difference in the association between this variant and cigarettes smoked per day, with male and female rs16969968 variant carriers smoking approximately the same amount more in the 11,991 ever smokers in the pooled analysis of the 14 studies (Phet = 0.86). Conclusions: This study has confirmed a sex difference in the association between the 15q25 variant rs16969968 and UADT cancers. Impact: Further research is warranted to elucidate the mechanisms underlying these observations. Cancer Epidemiol Biomarkers Prev; 20(4); 658–64. ©2011 AACR.

Previous studies reported an inverse relationship between body mass index (BMI) and upper aerodigestive tract (UADT) cancers. Examining change in BMI over time may clarify these previous observations. We used data from 2,048 cases and 2,173 hospital- and population-based controls from ten European countries (alcohol-related cancers and genetic susceptibility in Europe study) to investigate the relationship with BMI and adult change in BMI on UADT cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI at three time intervals and BMI change on UADT cancer development, adjusting for center, age, sex, education, fruit and vegetable intake, smoking and alcohol consumption. We found an inverse relationship between UADT cancers and BMI at time of interview and 2 years before interview. No association was found with BMI at 30 years of age. Regarding BMI change between age 30 and 2 years before interview, BMI decrease (BMI change = + 5%) was inversely associated with UADT cancers (OR = 0.74; 95% CI = 0.62, 0.89). BMI gain remained inversely associated across all subsites except for esophageal cancer. When stratified by smoking or by drinking, association with BMI gain was detected only in drinkers and smokers. In conclusion, BMI gain is inversely associated with UADT cancers. These findings may be influenced by smoking and/or drinking behaviors and/or the development of preclinical UADT cancers and should be corroborated in studies of a prospective nature.

Tobacco and alcohol are major risk factors for upper aerodigestive tract (UADT) cancer and significant variation is observed in UADT cancer rates across Europe. We have estimated the proportion of UADT cancer burden explained by tobacco and alcohol and how this varies with the incidence rates across Europe, cancer sub-site, gender and age. This should help estimate the minimum residual burden of other risk factors to UADT cancer, including human papillomavirus. We analysed 1981 UADT cancer cases and 1993 controls from the ARCAGE multicentre study. We estimated the population attributable risk (PAR) of tobacco alone, alcohol alone and their joint effect. Tobacco and alcohol together explained 73% of UADT cancer burden of which nearly 29% was explained by smoking alone, less than 1% due to alcohol on its own and 44% by the joint effect of tobacco and alcohol. Tobacco and alcohol together explained a larger proportion of hypopharyngeal/laryngeal cancer (PAR=85%) than oropharyngeal (PAR=74%), esophageal (PAR=67%) and oral cancer (PAR=61%). Tobacco and alcohol together explain only about half of the total UADT cancer burden among women. Geographically, tobacco and alcohol explained a larger proportion of UADT cancer in central (PAR=84%) than southern (PAR=72%) and western Europe (PAR=67%). While the majority of the UADT cancers in Europe are due to tobacco or the joint effect of tobacco and alcohol, our results support a significant role for other risk factors in particular, for oral and oropharyngeal cancers and also for UADT cancers in southern and western Europe.

Previous molecular epidemiological studies on head and neck cancer have examined various single nucleotide polymorphisms (SNPs), but there are very few documented associations. In the International head and neck cancer epidemiology (INHANCE) consortium, we evaluated associations between SNPs in the metabolism, cell cycle, and DNA repair pathways and the risk of head and neck cancer. We analyzed individual-level pooled data from 14 European, North American, Central American, and Asia case-control studies (5,915 head and neck cancer cases and 10,644 controls) participating in the INHANCE consortium. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for SNP effects, adjusting for age, sex, race, and country. We observed an association between head and neck cancer risk and MGMT Leu84Phe heterozygotes (OR = 0.79, 95% CI = 0.68-0.93), XRCC1 Arg194Trp homozygotes Arg/Arg (OR = 2.3, 95% CI = 1.1-4.7), ADH1B Arg48His homozygotes Arg/Arg (OR = 2.7, 95% CI = 1.9-4.0), ADH1C Ile350Val homozygotes Ile/Ile (OR = 1.2, 95% CI = 1.1-1.4), and the GSTM1 null genotype (OR = 1.1, 95% CI = 1.0-1.2). Among these results, MGMT Leu84Phe, ADH1B Arg48His, ADH1C Ile350Arg, and the GSTM1 null genotype had fairly low false positive report probabilities (

Genome-wide association studies (GWAS) have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT) cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p≤5×10−7). Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10−8) located near DNA repair related genes HEL308 and FAM175A (or Abraxas) and a 12q24 variant (rs4767364, p = 2×10−8) located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2) gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5×10−8; rs1229984-ADH1B, p = 7×10−9; and rs698-ADH1C, p = 0.02). These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility., Author Summary We have used a two-phased study approach to identify common genetic variation involved in susceptibility to upper aero-digestive tract cancer. Using Illumina HumanHap300 beadchips, 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls, were genotyped for a panel 317,000 genetic variants that represent the majority of common genetic in the human genome. The 19 top-ranked variants were then studied in an additional series of 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies. Five variants were significantly associated with UADT cancer risk after the completion of both stages, including three residing within the alcohol dehydrogenase genes (ADH1B, ADH1C, ADH7) that have been previously described. Two additional variants were found, one near the ALDH2 gene and a second variant located in HEL308, a DNA repair gene. These results implicate two variants 4q21 and 12q24 and further highlight three ADH variants UADT cancer susceptibility.

Background Temporomandibular disorders (TMD) are a group of disorders affecting the temporomandibular joints and the muscles of mastication. TMDs are treated with a wide range of drugs. The extent to which the use of these drugs is based upon evidence is unknown. Objectives To assess the effectiveness of pharmacological interventions both alone and in combination with non-pharmacological therapy in relieving pain in patients with chronic TMD. Search methods Electronic searches of the Cochrane Oral Health Group's Trials Register (2 August 2010), CENTRAL (The Cochrane Library 2010, Issue 3), MEDLINE via OVID (1950 to 2 August 2010), EMBASE via OVID (1980 to 2 August 2010) and CINAHL via EBSCO (1981 to 2 August 2010) were conducted. Reference lists of articles and previous reviews were scanned for relevant articles and authors were contacted for further information where appropriate. Selection criteria Randomised controlled trials (RCTs) in which a pharmacological agent was compared with placebo for the management of pain in patients with TMD. Parenteral routes of administration were excluded. Data collection and analysis Duplicate data extraction and assessment of risk of bias in included studies was performed. Main results Eleven studies were included with a total of 496 participants. The primary outcome of most of the studies was pain. The risk of bias in the included studies was variable. Whilst four studies showed significant pain relief for the active treatment, three were of poor quality. Most adverse effects were mild to moderate in severity. Four studies reported withdrawals due to severe adverse reactions, but insufficient information was provided regarding the trial groups from which the withdrawals occurred. No meta-analysis was conducted due to lack of similarities across the included studies. Authors' conclusions There is insufficient evidence to support or not support the effectiveness of the reported drugs for the management of pain due to TMD. There is a need for high quality RCTs to derive evidence of the effectiveness of pharmacological interventions to treat pain associated with TMD.

Objectives The purpose of this study was to determine the pattern of mouthwash use and to investigate the associated factors in general population. Material and Methods An Adult Dental Health Survey was conducted on 3,022 residents of Grampian region of Scotland (adjusted participation rate 58.2%). Participants received a questionnaire consisting of questions on oral health and behavioural factors. Results The majority of participants (38.1%) have never used mouthwash, 17.5% used mouthwash less than once a month, 19.4% used mouthwash once every few days and 25.1% used mouthwash daily. Prevalence of use decreased with age (P < 0.001). Woman were more likely to use mouthwash than men (P = 0.004). Mouthwash use decreased with decrease in the level of deprivation (P < 0.001). Never-smokers were less likely to use mouthwash (40.3%) compared to smokers (53.1%) or those who stopped smoking (46.5%) (P < 0.001). Mouthwash was used by smaller proportion of people drinking alcohol on daily basis (36.6%), than by abstainers (42.2%) (P = 0.012). There was a positive relationship between flossing or brushing pattern and mouthwash use (P < 0.001). There was statistically significant relationship between mouthwash use and reasons for the last dental visit (P = 0.009). When compared to healthy individuals, mouthwash was used by higher proportion of people reporting that they had gum disease (P = 0.001), ulcers (P = 0.001), oral infections or swelling (P = 0.002) or other problems (P = 0.025). Conclusions Mouthwash use in general population is associated with socio-demographic, health and behavioural factors.

Objective. To determine whether the report of pain is influenced by meteorological conditions. Methods. A population-based study (Epidemiology of Functional Disorders) was conducted in North West England. Subjects were mailed a questionnaire that enquired about pain on the day of completion ('any pain') and chronic widespread pain (CWP) as defined by the ACR, as well as about the potential mediating factors, sleep quality, exercise and mood, between the weather and pain. Hourly information on sunshine, precipitation, air temperature and pressure was available from a local weather station. Analysis of relationships was done by Cox regression and described as prevalence ratios (PRs) with 95% CIs. Results. Between January 2005 and December 2006, questionnaires from 2491 subjects were returned: 42% of the subjects reported 'any pain' on the day of completion, whereas 15% of the subjects had CWP. For both 'any pain' and CWP, the PR was the highest in winter (46.1 and 22.2%, respectively) followed by autumn (45.4 and 17.9%, respectively) and spring (41.9 and 14.7%, respectively) and lowest in summer (35.6 and 9.5%, respectively). Persons were less likely to report pain on days with >5.8 h of sunshine (any pain: PR = 0.87, 95% CI 0.82, 0.93; CWP: PR = 0.56; 95% CI 0.38, 0.84) and with average temperature of >17.5 degrees C (any pain: PR = 0.74, 95% CI 0.66, 0.83; CWP: PR = 0.40; 95% CI 0.34, 0.48). These relationships were partly explained by persons reporting taking more exercise and having better sleep quality and a more positive mood on days with sunshine and higher temperatures. Conclusions. Although a strong relationship between lack of sunshine, lower temperatures and pain reporting has been demonstrated, pain is not an inevitable consequence of such climatic conditions.

Objectives The aim of the current study was to investigate whether there was a relationship between a history of third molar removal and the prevalence of orofacial pain in a sample of the general population. Material and methods A survey was conducted in South East Cheshire, United Kingdom (81% participation rate). Information was collected using postal questionnaires (n = 1510) and dental records (n = 809). Results Participants who reported third molar extractions were more likely to report orofacial pain (RR = 1.29; 95% confidence interval [CI] 1.01 - 1.65). Participants with a more recent history of extractions (< 8 years ago) as recorded in dental records were more likely to report orofacial pain compared to those who had all third molar present (RR = 1.91; 95% CI 1.10 - 3.32). Conclusions This research suggests that self-reported third molar removal is linked to self-reported orofacial pain, however evidence from one study is not sufficient to give an unequivocal answer.

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1, 796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.

Background The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption. Objective To determine the contribution of lifestyle factors to the etiology of UADT cancers occurring in those aged less than 50 years. Methods A case-control study was conducted in 10 European countries. Cases were cancers of the oral cavity and pharynx, larynx and esophagus, and hospital or population controls were age and sex matched. Results There were 356 cases younger than 50 years and 419 controls. Risk was strongly related to current smoking [odds ratio (OR) 5.5 95%; confidence interval (CI) (3.3, 9.2)], and risk increased with number of pack-years smoked. Risk was also related to alcohol consumption for both current (OR 1.8; 0.97, 3.3) and past (OR 3.4; 1.6, 7.4) drinkers, and risk increased with number of drink-years. Persons frequently consuming fruits and vegetables were at significantly reduced risk. Conclusions Risk factors already identified as being important for UADT cancers in adults are also important influences on risk in younger adults. The implication of these results is that the public health message in preventing UADT cancers remains the same to young and old alike.

Background: Genetic variants in 15q25 have been identified as potential risk markers for lung cancer (LC), but controversy exists as to whether this is a direct association, or whether the 15q variant is simply a proxy for increased exposure to tobacco carcinogens. Methods: We performed a detailed analysis of one 15q single nucleotide polymorphism (SNP) (rs16969968) with smoking behaviour and cancer risk in a total of 17 300 subjects from five LC studies and four upper aerodigestive tract (UADT) cancer studies. Results: Subjects with one minor allele smoked on average 0.3 cigarettes per day (CPD) more, whereas subjects with the homozygous minor AA genotype smoked on average 1.2 CPD more than subjects with a GG genotype (P20 CPD) [odds ratio (OR)=1.13, 95% confidence interval (CI) 0.96-1.34, P=0.13 for heterozygotes and 1.81, 95% CI 1.39-2.35 for homozygotes, P

Introduction In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year – more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet. Patients and methods A multicentre case–control study with 2198 cases of UADT cancer and 2141 controls from hospital and population sources was undertaken involving 14 centres from 10 countries. Personal interviews collected information on demographics, lifetime occupation history, smoking, alcohol consumption and diet. Socioeconomic status was measured by education, occupational social class and unemployment. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. Results When controlling for age, sex and centre significantly increased risks for UADT cancer were observed for those with low versus high educational attainment OR = 1.98 (95% CI 1.67, 2.36). Similarly, for occupational socioeconomic indicators – comparing the lowest versus highest International Socio-Economic Index (ISEI) quartile for the longest occupation gave OR = 1.60 (1.28, 2.00); and for unemployment OR = 1.64 (1.24, 2.17). Statistical significance remained for low education when adjusting for smoking, alcohol and diet behaviours OR = 1.29 (1.06, 1.57) in the multivariate analysis. Inequalities were observed only among men but not among women and were greater among those in the British Isles and Eastern European countries than in Southern and Central/Northern European countries. Associations were broadly consistent for subsite and source of controls (hospital and community). Conclusion Socioeconomic inequalities for UADT cancers are only observed among men and are not totally explained by smoking, alcohol drinking and diet.

There is suggestive, but inconclusive, evidence that dietary factors may affect risk of cancers of the upper aerodigestive tract (UADT). In the context of the alcohol-related cancers and genetic susceptibility in Europe study, we have examined the association of dietary factors with UADT cancer risk. We have analyzed data from 2, 304 patients with UADT cancer and 2, 227 control subjects recruited in 14 centers in 10 European countries. Dietary data were collected through a semi-quantitative food frequency questionnaire that also assessed preferred temperature of hot beverages. Statistical analyses were conducted through multiple logistic regression controlling for potential confounding variables, including alcohol intake and smoking habits. Consumption of red meat (OR per increasing tertile = 1.14, 95% CI: 1.05-1.25), but not poultry, was significantly associated with increased UADT cancer risk and the association was somewhat stronger for esophageal cancer. Consumption of fruits (OR per increasing tertile = 0.68, 95% CI: 0.62-0.75) and vegetables (OR per increasing tertile = 0.73, 95% CI: 0.66-0.81) as well as of olive oil (OR for above versus below median = 0.78, 95% CI 0.67-0.90) and tea (OR for above versus below median = 0.83, 95% CI 0.69-0.98) were significantly associated with reduced risk of UADT cancer. There was no indication that an increase in tea or coffee temperature was associated with increased risk of UADT overall or cancer of the esophagus ; in fact, the association was, if anything, inverse. In conclusion, the results of this large multicentric study indicate that diet plays an important role in the etiology of UADT cancer.

Introduction: Several important issues for the established association between tobacco smoking and upper aerodigestive tract (UADT) cancer risks include the associations with smoking by cancer subsite, by type of tobacco, and among never alcohol drinkers and the associations with involuntary smoking among nonsmokers. Our aim was to examine these specific issues in a large-scale case-control study in Europe. Methods: Analysis was done on 2,103 UADT squamous cell carcinoma cases and 2,221 controls in the Alcohol-Related Cancers and Genetic Susceptibility in Europe project, a multicenter case-control study in 10 European countries. Unconditional logistic regression was done to obtain odds ratios (OR) and 95% confidence intervals (95% CI). Results: Compared with never tobacco smoking, current smoking was associated with UADT cancer risks (OR, 6.72; 95% CI, 5.45-8.30 for overall; OR, 5.83; 95% CI, 4.50-7.54 for oral cavity and oropharynx; OR, 12.19; 95% CI, 8.29-17.92 for hypopharynx and larynx; and OR, 4.17; 95% CI, 2.45-7.10 for esophagus). Among never drinkers, dose-response relationships with tobacco smoking pack-years were observed for hypopharyngeal and laryngeal cancers (Ptrend = 0.010) but not for oral cavity and oropharyngeal cancers (Ptrend = 0.282). Among never smokers, ever exposure to involuntary smoking was associated with an increased risk of UADT cancers (OR, 1.60; 95% CI, 1.04-2.46). Conclusion: Our results corroborate that tobacco smoking may play a stronger role in the development of hypopharyngeal and laryngeal cancers than that of oral cavity and oropharyngeal cancers among never drinkers and that involuntary smoking is an important risk factor for UADT cancers. Public health interventions to reduce involuntary smoking exposure could help reduce UADT cancer incidence. (Cancer Epidemiol Biomarkers Prev 2009;18(12):3353–61)

Cancers of the upper aerodigestive tract (UADT) include malignant tumors of the oral cavity, pharynx, larynx, and esophagus and account for 6.4% of all new cancers in Europe. In the context of a multicenter case-control study conducted in 14 centers within 10 European countries and comprising 1,511 cases and 1,457 controls (ARCAGE study), 115 single nucleotide polymorphisms (SNP) from 62 a priori–selected genes were studied in relation to UADT cancer. We found 11 SNPs that were statistically associated with UADT cancers overall (5.75 expected). Considering the possibility of false-positive results, we focused on SNPs in CYP2A6, MDM2, tumor necrosis factor (TNF), and gene amplified in squamous cell carcinoma 1 (GASC1), for which low P values for trend (P trend < 0.01) were observed in the main effects analyses of UADT cancer overall or by subsite. The rare variant of CYP2A6 −47A>C (rs28399433), a phase I metabolism gene, was associated with reduced UADT cancer risk (P trend = 0.01). Three SNPs in the MDM2 gene, involved in cell cycle control, were associated with UADT cancer. MDM2 IVS5+1285A>G (rs3730536) showed a strong codominant effect (P trend = 0.007). The rare variants of two SNPs in the TNF gene were associated with a decreased risk; for TNF IVS1+123G>A (rs1800610), the P trend was 0.007. Variants in two SNPs of GASC1 were found to be strongly associated with increased UADT cancer risk (for both, P trend = 0.008). This study is the largest genetic epidemiologic study on UADT cancers in Europe. Our analysis points to potentially relevant genes in various pathways. [Cancer Res 2009;69(7):2956–65]

Alcohol is an important risk factor for upper aerodigestive cancers and is principally metabolized by alcohol dehydrogenase (ADH) enzymes. We have investigated six ADH genetic variants in over 3,800 aerodigestive cancer cases and 5,200 controls from three individual studies. Gene variants rs1229984 (ADH1B) and rs1573496 (ADH7) were significantly protective against aerodigestive cancer in each individual study and overall (P = 10-10 and 10 -9, respectively). These effects became more apparent with increasing alcohol consumption (P for trend = 0.0002 and 0.065, respectively). Both gene effects were independent of each other, implying that multiple ADH genes may be involved in upper aerodigestive cancer etiology. © 2008 Nature Publishing Group.

Background and Aims Our group previously published retrospective analyses of 12 months of admissions to the Grampian Regional Infectious Diseases Unit from 1980-81 and from 1991. This study aimed to collect data in 2001 and to compare annual admission numbers, diagnoses, duration of stay and outcome in 1980-81, 1991 and 2001. Methods Data on all admissions was collected prospectively throughout 2001. This was compared with the previously published data. Results Total admissions rose from 605 in 1980-81 to 900 in 1991 and to 1152 in 2001. Sixty one percent of admissions in 1980-81 were confirmed as having infection compared to 72% in 1991 and to 83% in 2001. The most common reason for admission in 2001 was skin and soft tissue infection, but this was only the ninth commonest reason in 1981. Mean length of stay fell from 9.6 days in 1980-81 to 7.4 days in1991 and to 5.5 days in 2001. The mortality rate fell from 3.1% in 1981 and 1991 to 1.0% in 2001. Conclusions This study demonstrates significant changes in type, number and outcome of admissions to a regional infection unit. We discuss possible reasons for these changes.

Aim: Although asthma is defined as a chronic inflammatory disease, inflammation is rarely assessed. The fraction of exhaled nitric oxide (FeNO) is a biomarker of airways inflammation. We assessed the feasibility of FeNO monitoring in general practice. Methods: Prospective observational study of volunteers attending primary care asthma clinics. Consenting subjects were seen at their own surgery for 2-weekly reviews over 12 weeks, with assessment of FeNO, lung function, symptoms and health status. Results: 22 adults and 15 children provided informed consent. Two subjects were unable to perform the FeNO expiratory manoeuvre. In the remaining subjects, measurements conforming to highest ERS/ATS recommendations were made on 211 of 236 occasions, and on 21 further occasions acceptable readings were made. Acceptability was high to subjects and staff. Correlations between FeNO readings and other parameters were weak and non-significant except for statistically significant correlation between longitudinal FeNO changes and changes in lung function (r= -0.33, p

Introduction The aims of this study were to assess whether early Twin-block appliance treatment improves the attractiveness of Class II profiles and to determine the orofacial features of a profile that most influence the perception of attractiveness. Methods Silhouetted profiles of 20 treated patients and 20 untreated controls randomly selected from 174 subjects (ages, 8-10 years) of a randomized, controlled trial into the effectiveness of early Class II treatment were assessed by 30 children (ages, 10-11 years) and 24 teaching staff using a 5-point Likert scale. Independent samples t tests were used to compare attractiveness ratings between the treated and untreated groups. Linear regression was used to determine the features defining attractiveness. Results Early orthodontic treatment resulted in improved perceptions of facial profile attractiveness. Profiles were likely to be rated as attractive if the overjet was smaller (P = 0.001) and no teeth showed (P Conclusions Profile silhouettes of children who had received early orthodontic treatment for Class II malocclusion were perceived to be more attractive by peers than those of children who did not receive treatment.

To compare the clinical failure rates of bonded first molar tubes with those of cemented bands during fixed appliance therapy.Prospective randomized controlled clinical trial.Two UK hospital orthodontic clinics, February 2001-December 2004.Hospital waiting list patients needing fixed appliances (n = 110).Patients were randomly allocated to two groups. Experimental group patients (n = 55) received single first molar tubes (n = 181) bonded with a no-mix chemically cured composite (Rely-A-Bond) after a 30-second etch. Control group patients (n = 55) were treated with bands (n = 186) cemented with Intact glass ionomer cement (GIC). First-time failures were recorded together with the time of failure. All patients were followed to the end or discontinuation of treatment.First-time failures: bands = 18.8%; bonds = 33.7 %. Bonded tubes were more likely to fail [RR 2.4; 95% CI (1.4, 4.1)] compared with bands. Experimental group patients also had more bracket failures (P = 0.009), when analysed at patient level.First molar tubes bonded with Rely-A-Bond composite showed a significantly higher first-time failure rate than bands cemented with Intact GIC.

Aspirin and other NSAIDs are widely used as analgesics and preventative agents for vascular events. Research evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. Data on the chemo preventative role of these drugs on the mortality in patients with upper aerodigestive tract cancer (UADT) are insufficient. The aim of this study was to investigate the effect of aspirin and other NSAIDs prescriptions after cancer diagnosis on the survival in UADT cancer patients. Patients with UADT cancer (oral cavity, oropharynx, hypopharynx, larynx or esophagus) were identified from the Primary Care Clinical Informatics Unit (PCCIU) database which contains information from a sample of general medical practices in Scotland, United Kingdom. Cox regression was used for statistical data analysis. There were 2,392 cases of UADT cancer diagnosed between 1996 and 2010 from 131 general medical practices. The mean age of patients was 66 years (SD 12), and most were male (63%). Median survival in head and neck cancer (HNC) patients was 94 months, while median survival in oesophageal cancer patients was 10 months. For HNC, improved survival was observed with aspirin prescription (ever vs never Hazard Ration (HR) = 0.5 95% Confidence Interval (CI) 0.4, 0.7) and other NSAIDs prescription (ever vs never HR = 0.7 95% CI 0.6, 0.9), however there was no association with COX-2 prescriptions. For oesophageal cancer patients, improved survival was observed with aspirin prescriptions (ever vs never HR = 0.5 95% CI 0.5, 0.6), Cox-2 prescriptions (HR = 0.8 95% CI 0.6, 0.9) and other NSAIDs (HR = 0.7 95% CI 0.6, 0.8). Conclusion: Aspirin and other NSAIDs prescriptions after diagnosis may reduce all-cause mortality in UADT cancer patients. Citation Format: Tatiana V. Macfarlane. Aspirin and other non-steroidal anti-inflammatory drug prescriptions after diagnosis and upper aerodigestive tract cancer survival. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2822. doi:10.1158/1538-7445.AM2015-2822

Introduction: The purpose of this study was to validate the child perception questionnaire (CPQ11-14) with a sample of schoolchildren in Greater Manchester, United Kingdom. Methods: We made a longitudinal survey of children from 1999 to 2002, using the index of orthodontic treatment need (IOTN) at baseline when the children were 11 to 12 years old, the CPQ11-14, and their uptake of orthodontic treatment 3 years later. Results: CPQ11-14 scores corresponded to differences in IOTN scores. These were related to the child's emotional and social well-being. Regression analysis showed that CPQ11-14 scores were higher for girls, for higher grades of the dental health component of the IOTN, and for children who thought that their teeth needed straightening. Conclusions: CPQ11-14 has acceptable reliability and validity, and is likely to be a useful measure for orthodontic trials. The impact of malocclusion on a child's quality of life might be substantial. © 2006 American Association of Orthodontists.

OBJECTIVE: To design and validate a self-administered instrument for assessing orofacial pain related disability in the general population. METHODS: The 32-item questionnaire was developed by open-ended interviews with patients attending dental hospital clinics and was subsequently tested on 171 community subjects with self-reported orofacial pain and 48 dental hospital patients. RESULTS: Construct validity of the instrument was demonstrated in three ways. First, levels of reported disability were greater in dental hospital patients than for community subjects reporting orofacial pain. Secondly, the instrument was able to detect differences in disability levels reported by community subjects who did and did not consult with a healthcare professional and those who had acute and chronic pain. Thirdly, amongst community subjects with pain, disability scores increased with higher pain intensity, pain duration and were greater amongst subjects who had sought a consultation. Results of factor analysis identified two constructs: physical and psychosocial disabilities, associated with orofacial pain. The Cronbach's alpha score was 0.78 and 0.92 for the physical and psychosocial constructs, respectively, and this along with item correlation values between 0.43 and 0.80 confirmed the internal consistency. CONCLUSION: We have therefore designed a valid instrument for assessing the impact of painful orofacial conditions in both community and clinic settings.

We conducted a randomised double-blind placebo-controlled single-centre study to compare the effect of preoperative ibuprofen 600 mg, diclofenac 100 mg, paracetamol 1 g with codeine 60 mg or placebo (Vitamin C 50 mg) tablets for relief of postoperative pain in 119 patients who had day case operations under general anaesthesia for removal of impacted third molars. Patients were given the tablets 1 h before operation. Pain was assessed using visual analogue scales and verbal rating scales preoperatively at 15 and 30 min and 1 and 3 h postoperatively. After they had gone home, patients were contacted by telephone at 6 and 24 h postoperatively to find out whether they had any adverse effects from the analgesics. There was no significant difference in the extent of postoperative pain among the four groups, but the placebo group had significantly shorter times before their first request for postoperative analgesics (median 17 min, range 14-90) than the diclofenac group (median 32, range 15-150). Preoperative analgesics at the stated doses are effective in providing immediate postoperative pain control after operations on third molars. There were, however, some side-effects including nausea, vomiting, headaches, and gastrointestinal discomfort, but there were no significant differences among the active analgesic groups with respect to adverse events either shortly after operation or at 6 or 24 h.

The objective of this study was to evaluate the abrasion resistance and surface roughness of two injection-molded poly(methylmethacrylate) denture base materials (SR-Ivocap 'Plus', Ipsyl 60 RV), and also one compression-molded material (Trevalon). A fourth group of specimens (prepared from Trevalon using the injection-molding procedure) was compared to the compression-molded specimens.Ten specimens were prepared according to manufacturers' instructions. An experiment involving toothbrush and dentifrice abrasion was performed on all specimens from each of the materials and the cumulative percentage weight-loss was calculated after 100,000 brush strokes. A series of surface roughness profile measurements were also obtained from each specimen within the groups. The data were analysed by using the Kolmogorov-Smirnov test. A level of significance of 0.017 was set in order to adjust for multiple comparisons between the three sets of materials.There was found to be no statistically significant difference between the three groups of materials in terms of percentage weight-loss, and no statistically significant difference between the Trevalon specimens when injection-molded or compression-molded. In terms of surface roughness, however, SR-Ivocap 'Plus' recorded the lowest surface roughness profile of the three groups. It was found that there was a statistically significant difference (P0.017) between this material and Ipsyl RV 60 (producing the highest roughness), and compression-molded Trevalon. Furthermore, there was found to be no statistically significant difference between injection-molded and compression-molded specimens of Trevalon with regard to surface texture.From a clinical standpoint, the surface roughness results suggest SR-Ivocap 'Plus' to be the material most likely to produce the least suitable substrate for the accumulation of denture plaque.

BACKGROUND: Bonding of orthodontic brackets to teeth is important to enable effective and efficient treatment with fixed appliances. The problem is bracket failure during treatment which increases operator chairside time and lengthens treatment time. A prolonged treatment is likely to increase the oral health risks of orthodontic treatment with fixed appliances one of which is irreversible enamel decalcification. This is an update of the Cochrane Review first published in 2003. A new full search was conducted on 26 September 2017 but no new studies were identified. We have only updated the search methods section in this new version. The conclusions of this Cochrane Review remain the same. OBJECTIVES: To evaluate the effects of different orthodontic adhesives for bonding. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 26 September 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 8) in the Cochrane Library (searched 26 September 2017), MEDLINE Ovid (1946 to 26 September 2017), and Embase Ovid (1980 to 26 September 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing two different adhesive groups. Participants were patients with fixed orthodontic appliances. The interventions were adhesives that bonded stainless steel brackets to all teeth except the molars. The primary outcome was debond or bracket failure. DATA COLLECTION AND ANALYSIS: Data were recorded on decalcification as a secondary outcome, if present. Information regarding methods, participants, interventions, outcome measures and results were extracted in duplicate by pairs of review authors. Since the data were not presented in a form that was amenable to meta‐analysis, the results of the review are presented in narrative form only. MAIN RESULTS: Three trials satisfied the inclusion criteria. A chemical cured composite was compared with a light cured composite (one trial), a conventional glass ionomer cement (one trial) and a polyacid‐modified resin composite (compomer) (one trial). The quality of the trial reports was generally poor. AUTHORS' CONCLUSIONS: There is no clear evidence on which to make a clinical decision of the type of orthodontic adhesive to use.

The aim of this retrospective study was to determine the type of healing which occurred in root-fractured permanent incisor teeth in children. The objectives were to determine whether gender, age, stage of root development or location of the fracture affected the healing type. The method involved careful scrutiny of clinical records and radiographs of children who attended a unit of paediatric dentistry in a dental hospital. Relevant information was entered onto a data collection sheet. The results were tabulated and analysed by the chi2-tests using the SPSS statistical package. The results are based on 34 root-fractured teeth in 33 children aged 8-15 years. Root development was incomplete in 27 of the root-fractured teeth and complete in seven teeth. A good healing outcome was seen in 27 (79.4%) of the teeth and poor healing in 7 (20.6%). The only factor which was found to be statistically significantly related to healing was the stage of root development. It can be concluded that root-fractured teeth with immature roots have a better chance of showing good healing than teeth with mature roots.

Background: While previous studies on tobacco and alcohol and the risk of upper aerodigestive tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and/or alcohol, studies on addiction to tobacco itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is a risk factor for UADT SCC risk in the multicenter case-control study (ARCAGE) in Western Europe independent of tobacco smoking or alcohol drinking intensity or duration. Methods: The analyses included 1,905 ever smoking UADT SCC cases (871 oral cavity/oropharynx, 814 hypopharynx/larynx, 127 esophagus, and 93 overlapping oral cavity/pharynx) and 1,489 ever smoking controls. The addiction variables included first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden, and cigarettes per day. Odds ratios (OR) and 95% confidence intervals (95% CI) for UADT cancers with addiction variables were estimated with unconditional logistic regression, adjusting for center, age, sex, education level, alcohol consumption, and tobacco smoking. Results: Among current smokers, 76.47% of cases were categorized in the highest addiction level, whereas 54.69% of controls were in that category. The participants who smoked their first cigarette within 5 minutes of waking up were two times more likely to develop UADT SCC (OR = 2.22, 95% CI 1.57–3.15) than those who smoked 60 minutes after waking up. A higher modified Fagerstram score, reflecting greater tobacco addiction, was associated with an increased risk of UADT SCC among current smokers, but not among former smokers. Conclusion: We observed that time to first cigarette after waking up was associated with UADT SCC risk, regardless of heavy smoking or alcohol drinking behaviors. These results are consistent with residual effect of smoking that was not captured by the questionnaire responses alone.

Objectives To evaluate the effect of issuing a patient reminder plus a confirmation slip on the attendance of orthodontic new patients. Setting Department of Orthodontics, University Dental Hospital of Manchester. Design A randomised controlled trial. Method New patients were randomly allocated to: Outcome measures Patient attendance at the clinic. Results A total of 232 patients were entered into the study between June 18, 2001 and August 29, 2001. These were randomly allocated to 115 (49.8%) in the reminder group and 116 (50.2%) in the no reminder group. If the patient received a reminder and returned the confirmation they were less likely to fail the appointment than if they did not receive a reminder (OR 0.4, 95% CI 0.2 to 0.96) There was an effect of social deprivation, if the patients lived in an area of high social deprivation they were 2.7 (95% CI 1.1 to 6.5) times more likely to fail to attend an appointment than people who were more affluent. Conclusions The use of postal reminders for orthodontic consultation appointments appears to result in a useful increase of appointments that are kept or cancelled in advance.

Statement of Problem. Little evidence is available on the length of time that adhesive should be allowed to dry before irreversible hydrocolloid impression making. Purpose. This study investigated the effect of adhesive drying times on the bond strengths of 2 irreversible hydrocolloid impression materials to 2 "custom" tray materials. Material and Methods. A total of 1632 specimens were tested: 816 in tensile tests and 816 in tests of the shear bond strength (megapascals) of 2 irreversible hydrocolloid impression materials to an autopolymerizing and a visible light-polymerizing acrylic resin tray material. In the first part of the investigation, a single coat of adhesive was applied to specimen plates that simulated the custom impression tray surface; in the second part, a second coat of adhesive was applied after the irreversible hydrocolloid was removed, and the effect of this second coating on bond strength was examined. In both parts, the adhesive was allowed to dry for a range of times (0 to 8 minutes at 30-second intervals, for a total of 17 time periods) before the addition of the impression material. The specimen plates were placed in a humidor and separated in a universal testing machine operated at a crosshead speed of 100 mm/min with 0- to 5-kN load cell. Data from each of the 1632 specimens were collected and evaluated with analysis of variance, regression analysis, and t tests ( P Results. Significant differences in mean bond strengths were found between specimens with a 4-minute adhesive drying time (0.179 MPa tensile, 0.068 MPa shear) and specimens with a 0-minute drying time (0.065 MPa tensile, 0.015 MPa shear). Any period over 4 minutes produced no significant difference. The mean bond strengths of the single-coated specimens were 0.179 MPa (tensile) and 0.076 MPa (shear). These values were significantly greater than those for specimens with a second adhesive layer (0.136 MPa tensile, 0.035 MPa shear) over all time periods. Mean tensile bond strengths (0.158 MPa) were consistently higher than shear bond strengths (0.056 MPa) for all combinations of tray material, adhesive application, and time. Conclusion. Within the limitations of this study, the results suggest that adhesive applied to the autopolymerized and light-polymerized custom tray materials tested should be allowed to dry for at least 4 minutes before irreversible hydrocolloid is applied. Better results were obtained when the adhesive layer from a failed irreversible hydrocolloid impression was removed and replaced rather than overlaid with an additional adhesive coating. (J Prosthet Dent 2002;88:423-30.)

Features of somatisation have been shown to predict the onset of widespread body pain. This study aims to determine to what extent persons with orofacial pain syndromes share these features and to what extent they are uniquely related to oral mechanical factors. We have conducted a population-based cross-sectional survey in the South-East Cheshire area of the United Kingdom involving 2504 individuals aged 18–65 years. All participants completed a postal questionnaire which enquired about the occurrence of both orofacial pain and widespread body pain. It also enquired about potential risk factors for one or both conditions. In total, 473 subjects (23%) reported orofacial pain only, 123 (6%) widespread pain only, while 85 (4%) reported both. The number reporting both was significantly higher than would be expected if the symptoms were independent (P

To evaluate which orthodontic adhesives (a). bond orthodontic brackets to teeth more reliably and (b). are more effective at preventing decalcification.The search strategy for the literature review was carried out according to the standard Cochrane systematic review methodology. The Cochrane Clinical Trials Register and the Cochrane Oral Health Group Specialized Register were searched for randomized clinical trials and controlled clinical trials. All volumes that had not already been assessed by the Oral Health Group in the European Journal of Orthodontics, American Journal of Orthodontics, Journals of Orthodontics, and Angle Orthodontist were hand-searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review.The primary outcome measure was the failure of the orthodontic adhesive. A secondary outcome of decalcification occurring around the orthodontic bracket was also recorded, if data were available.Two randomized clinical trials and one controlled clinical trial were identified that fulfilled all the inclusion and exclusion criteria. The trials compared: (a). light- and chemically-cured composite; (b). chemically-cured composite and conventional glass ionomer cement; and (c). chemically-cured composite and light-cured compomer.Each paper was quality assessed by two people independently. A qualitative analysis of the trials in the review is presented. The data presentation, for the majority of the trials, precluded the use of suggested Cochrane Health Group statistical analysis.It is difficult to draw any conclusions from this review; however, suggestions are made for methods of improving future research involving orthodontic adhesives.

The aim of this study was to investigate objective characterisation of gait as a marker of the chronic pain of adjuvant arthritis (AA). Video recorded images of spontaneous rat ambulations were analysed to quantify various temporal and spatial parameters and compare these between the AA and control groups. Changes were also recorded after the administration of a single dose of buprenorphine (15 ?g). Individual temporal parameters were significantly reduced (velocity (P=0.05), stride length (P=0.007), single stance time (P

Questionnaires were circulated to all Fellows of the British Society of Oral and Maxillofacial Surgeons in 1999, 75% of whom replied (n = 194). There was a wide range of responses for both the timing of review appointments and the taking of radiographs. Most patients were first followed up 1 week after operation (46%), but 38% were reviewed in the second week. Five surgeons did not review patients at all and two did not review until 6 or 9 months, respectively. Nearly two-thirds routinely offered a second follow-up appointment but only 14% offered more than two, the maximum being seven. Most arranged postoperative radio-graphs but the timing ranged from immediately postoperatively to 1 year after the procedure. Less than one-third requested a second postoperative radiograph between 1 month and 1 year. The largest disparity was in the time of discharge to the general dental practitioner, which ranged from immediately to 5 years, the most popular time of discharge being at 3 months. The wide variations may reflect unnecessary recall of patients and misuse of valuable clinical time.

Purpose of study To evaluate the suitability of two non-sterile, powder-free gloves for routine use in general dental practice. Basic procedures Randomly allocated blind evaluation of two powder-free gloves by five dentists and five dental nurses in general dental practice. Each dentist and dental nurse were allocated a four-day supply of two unnamed powder-free gloves. Following glove usage a questionnaire sought their views regarding ease of donning, operator comfort, puncture and tear resistance, and tactile sensitivity. Details of procedure undertaken, time of wear and puncture and tear formation for the dentists’ gloves were also recorded. The dentists’ gloves were retained and subsequently tested for punctures and tears. Main findings In terms of ease of donning, operator discomfort, tear resistance and tactile sensitivity neither glove was ideal, however one glove was rated higher than the other. Overall, the dentists noticed only half of the punctures and tears detected in the laboratory. One glove was more prone to punctures with the other glove more liable to tear. Time worn in excess of 20 minutes and endodontic procedures were associated with a higher incidence of punctures. Principal conclusions The two powder-free gloves evaluated in this study would appear not to be suitable for routine use in general dental practice. Further developments are required before powder-free gloves of the type evaluated can be expected to receive widespread acceptance for routine use by dentists and dental nurses in general dental practice.

Purpose: Porcelain veneers are a safe and effective treatment modality for selected teeth that have poor esthetics. However, removal of porcelain veneers that have failed may be time-consuming and involve considerable removal of sound tooth structure adjacent to the veneer. The aim of this study was to evaluate a novel method of porcelain laminate veneer removal by incorporating a fluorescent dye into the luting cement that allows the practitioner to visualize the cement on the tooth and remove the veneer without causing residual damage to the adjacent tooth substance. Materials and Methods: Porcelain veneers were luted on extracted teeth with a luting cement modified with a fluorescing agent. Faculty teaching staff and final year dental undergraduates were asked to remove the veneers with the aid of a curing light to render the luting cement visible by fluorescing. They were then asked to compare the removal of comparable veneers without this visual aid and to complete a standard questionnaire. The depth of cure of the conventional and modified cements was measured using a penetrometer. Results: Results of the questionnaire indicated that the operators found removing the veneer cemented with the modified (fluorescing) cement considerably easier than removing the veneer cemented with the conventional cement. Microscopy indicated that more damage was caused to the underlying tooth during removal of conventionally cemented veneers. The incorporation of the dye into the cement reduced the depth of cure from 4.238 mm (SD = 0.025) to 3.761 mm (SD = 0.096). CLINICAL SIGNIFICANCE The fluorescent cement was considered to be superior to conventional cements in its ease of visibility, and as a consequence, veneers cemented with the fluorescing cement are easier to remove. The fluorescing dye significantly reduced the depth of cure, but this may not be clinically significant, because of the small thickness of cement employed when luting adhesive restorations. The use of such fluorescing materials may not be restricted to a luting cement for veneers but may also be incorporated into bases and lining materials so they can be visualized on removal of tooth-colored restorations, to prevent further tooth destruction.

This paper describes the admissions process, especially the organisation of an interviewing system. The method of application to Dental School is discussed and basic selection processes outlined. The introduction of a new interviewing system is explained and criteria for interview selection and marking defined. All interviewers received regular training; the content of training days is described together with the experience of those involved. Changes made to the interview marking system after 1 year are discussed. Criteria marked at interview were monitored against students' success in year 1 and 2 examinations. Results show that students who performed highly at interview for leadership were more likely to succeed in semester 2 of the course and in year 1 examinations overall.

To investigate the effect of midazolam and flumazenil on psychomotor function and alertness in human volunteers.Randomised, double-blind, cross over study.Intravenous flumazenil was administered to sedated and non-sedated healthy human volunteers, in doses typical of those used clinically to induce sedation with midazolam and for reversal with flumazenil. Subjective assessment of alertness and objective measures of psychomotor function using light reaction time and the Maddox wing were made over a 1 hour period.Seven males and seven females each attended four experimental sessions. Psychomotor function was impaired by midazolam but there was some individual variation to this response. All sedated subjects receiving flumazenil had significantly improved alertness and psychomotor function when compared with those subjects who received placebo. Mean alertness (P0.01) and light reaction time (P0.05) showed significant improvement and returned to baseline by 60 minutes. Stability also showed significant improvement (P0.05) but did not return to baseline by 60 minutes. There was no significant effect on psychomotor function or alertness when the antagonist flumazenil was administered in the absence of the agonist midazolam.An earlier discharge time based on subjective assessment of alertness is not advocated for patients whose intravenous midazolam sedation is reversed with flumazenil.

J.M. SHARGAWI, E.D. THEAKER, D.B. DRUCKER, T. MACFARLANE and A.J. DUXBURY.1999.Negative air ions (NAIs) are known to kill C. albicans; however, their precise mechanism of action is uncertain. Elucidation of this has been hampered by a lack of reproducibility between results obtained by different investigators. The aim of this study was to determine the influence of variation in experimental parameters on the sensitivity of C. albicans to negative air ions and the role of ozone in this process. Ten strains of C. albicans were exposed to NAIs generated at different emitter distances, exposure times, relative humidities and under aerobic and oxygen-free conditions. In further experiments, ozone levels were measured under the same conditions. The effect of NAIs on C. albicans growth was assessed by measuring the area of the zone of inhibition generated around the electrode of the ionizer. There was a significant reduction in area of zone of inhibition with increasing emitter distance (P

Introduction Temporomandibular disorder (TMD) is a common condition. Studies of TMD in relation to orthodontic treatment did not show an association, but longitudinal studies from adolescence to adulthood are lacking. The aim of this study was to investigate the relationship between orthodontic treatment and TMD with a longitudinal study design. Methods This prospective cohort study was conducted in South Wales, United Kingdom. The baseline investigation was carried out in 1981 and involved children aged 11 to 12 years (n = 1018). Follow-up investigations were done in 1984 (n = 792), 1989 (n = 456), and 2000 (n = 337). Results Overall TMD prevalence increased from the baseline (3.2%) to age 19 to 20 (17.6%) and decreased by age 30 to 31 (9.9%). TMD prevalence was higher in females at all follow-up points, except the baseline. Overall, incidences of TMD were 11.9%, 11.5%, and 6.0% at the first, second, and last follow-ups, respectively. Females were more likely to develop TMD than males (hazard ratio [HR], 2.1; 95% CI, 1.3 and 3.3), and those with high self-esteem were less likely to develop TMD (HR, 0.6; 95% CI, 0.4 and 0.8). There was no association between orthodontic treatment and new TMD onset. The incidences of persistent TMD were 20.0%, 34.9%, and 28.0% at the first, second, and last follow-ups, respectively. Females were more likely to have persistent TMD than males (HR, 2.5; 95% CI, 1.0 and 6.1). There was no association between orthodontic treatment and persistent TMD. The only significant predictors of TMD in adults aged 30 to 31 were female sex (odd ratio, 3.0; 95% CI, 1.1 and 8.2) and TMD in adolescence (odds ratio, 4.5; 95% CI, 2.0 and 10.0). Conclusions Orthodontic treatment neither causes nor prevents TMD. Female sex and TMD in adolescence were the only predictors of TMD in young adulthood.

OBJECTIVE: (i) To analyse the consistency of a group of orthodontists' treatment decisions and (ii) to identify factors that may influence this consistency. DESIGN: Cross-sectional observational study. SUBJECTS: Ten orthodontists. METHODS: The orthodontists examined 60 case vignettes and recorded their treatment decisions on two separate occasions. MAIN MEASURE: Inter- and intra-examiner agreement was evaluated with the Kappa statistic. RESULTS: The consistency within each orthodontist was moderate. However, between-orthodontist consistency was poor. CONCLUSION: It appears that there is marked variation between orthodontists in treatment planning decisions and this may reflect the lack of evidence for the effectiveness of competing treatments.

The first intron of EGFR gene contains a microsatellite sequence of 9 to 23 CA-dinucleotide repeats that is very polymorphic. Transcription of the gene is inversely proportional to number of CA-repeats. Shorter CA-dinucleotide repeats cause over expression of EGFR mRNA and protein products with increased proliferation and survival advantage to the cells. Increased EGFR expression is reported to be associated with HNC susceptibility with poorer prognosis, and polymorphism in the CA-repeats is one of the early genetic alterations in HNC. We extracted DNA from blood and saliva samples from 51 (26 cases, 25 controls) participants of Feasibility Study of Cancer of the Head and Neck, Genetics and Environment in Grampian, and analysed using PCR and ABI 3130×L Genetic Analyser. Subjects’ ages ranged from 45-84 years; mean (SD) 63.15 ± 10.46 years. The EGFR risk association with HNC was calculated based on two categories: subjects with short CA-repeats (alleles ≤ 119bp) and those with long CA-repeats (alleles >119bp). After multivariate analysis adjustment for gender, tobacco, alcohol, and diet, there was increased risk of the short CA-dinucleotide repeats for HNC (OR= 1.50, 95% CI 0.34-6.71, p = 0.6). The low statistical power is likely due to small sample size. However, the result agrees with what obtains in the literature database.