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Simple Summary: Domestic rabbits are one of the most commonly kept pets with a hypselodontic type of dentition, possessing teeth that grow throughout the animal's life. These animals often show signs of disease in the stomatognathic system. Dental disease can also affect the function of other organs and systems. The most common clinical signs of dental disease in domestic rabbits are the following: lack of appetite, weight loss, apathy, and difficulty chewing and swallowing food. These clinical signs are non-specific, and, therefore, a definitive diagnosis usually requires additional methods, such as an X-ray examination, a CT scan, MRI, and endoscopic examination. The most common dental disease found in this study's animals was malocclusion secondary to abnormal clinical crown abrasion and abnormal tooth growth. In domestic rabbits, osteomyelitis is a common complication of dental abscesses. Computed tomography is an invaluable diagnostic method in the diagnosis of dental disease and secondary diseases of the head area, such as inflammation of the nasal cavities or otitis media, in pet rabbits. Domestic rabbits have teeth that grow throughout the animal's life and are prone to disease. Clinical signs of dental disease in domestic rabbits are non-specific, and, therefore, a definitive diagnosis usually requires additional methods. This study was carried out on a group of 105 domestic rabbits aged 3 to 9 years. In total, 90 domestic rabbits with dental disease visible on CT images and other secondary diseases of the head area qualified for this study. Malocclusion was found in 57 (63.3%). Retrograde elongation of the tooth apices in the mandible was present in 39 (43.3%), and it was present in the maxilla in 48 (53%). Clinical tooth crowns were overgrown in 39 (43%). Dental abscesses were present in 54 (63%). Secondary to the presence of a dental abscess, osteomyelitis was found in 43 (79% of the animals with a dental abscess). Dental inflammatory resorption was found in 36 (40%). Secondary to dental disease, nasal cavity inflammation was found in 18 (20%). Otitis media was present in six (6.7%). The most common dental disease found in this study's animals was malocclusion secondary to abnormal clinical crown abrasion and abnormal tooth growth. In domestic rabbits, osteomyelitis is a common complication of dental abscesses. Computed tomography is an invaluable diagnostic method in the diagnosis of dental disease and secondary diseases of the head area, such as inflammation of the nasal cavities or otitis media, in pet rabbits. [ABSTRACT FROM AUTHOR]

Summary : Periodontal disease and increased missing teeth were associated with incident vertebral fractures. In contrast, professional dental cleaning and frequent tooth brushing, was associated with a lower risk of vertebral fracture. Better oral hygiene care attenuated the risk associated with dental diseases. Purpose: To investigate the association between oral health and the risk of vertebral fractures. Methods: We included 2,532,253 individuals aged ≥40 years who underwent the Korean National Health Insurance Service health examinations in 2008 and followed up until December 31, 2017. We performed multivariable Cox proportional hazard regression analyses to evaluate the association between dental diseases and oral hygiene care and the risk of vertebral fractures. Results: Over the 9.3-year median follow-up, 1.46% (n = 36,857) experienced vertebral fractures. Individuals with dental diseases had a higher risk of vertebral fracture than those without (hazard ratio [HR] 1.04, 95% confidence interval [CI]: 1.02–1.07 for periodontal diseases; 1.02, 1.00–1.05 for dental caries; 1.12, 1.05–1.20 for ≥15 missing teeth). Good oral hygiene care was associated with a lower vertebral fracture risk (HR 0.89, 95% CI: 0.86–0.91 for ≥1 time/year [vs. <1 time/year] of professional dental cleaning; 0.90, 0.87–0.93 for ≥2 times/day [vs. 0–1 time/day] of toothbrushing). The combined dental diseases was significantly associated with an increased vertebral fracture risk, whereas combined oral hygiene care was associated with further risk reduction. Better oral hygiene care reduced vertebral fracture risk associated with dental diseases (all P <0.001). Conclusion: Periodontal disease, dental caries, and an increased number of missing teeth were independently associated with higher risks for vertebral fractures. Conversely, improved oral hygiene care, such as personal dental cleaning and frequent tooth brushing, may modify vertebral fracture risks associated with dental disease. [ABSTRACT FROM AUTHOR]

Objective: Cell pyroptosis is implicated in progressive bone loss in dental inflammatory diseases. We induced caspase‐3/Gasdermin E (GSDME)‐mediated pyroptosis in osteoblast‐like cells and evaluated the effects on osteogenesis. Materials and Methods: Osteoblast‐like cells were treated with various concentrations of sodium butyrate (NaB) to identify the most appropriate for inducing caspase‐3/GSDME‐mediated pyroptosis. Cells were divided into control, NaB and NaB+Ac‐DEVD‐CHO (specific caspase‐3 inhibitor) groups. Pyroptosis level was evaluated by immunofluorescence, morphological observation, flow cytometry, lactate dehydrogenase (LDH) release assays, mRNA and protein levels of pyroptosis‐related markers. Then, inflammation level, osteoprotegerin (OPG) and receptor activator of nuclear factor‐κB ligand (RANKL) expression and osteogenic function were detected. Results: Treatment with 10 mM NaB increased caspase‐3 expression, GSDME cleavage, LDH release and the number of pyroptotic cells, with morphologic changes, indicating GSDME‐mediated pyroptosis induction. The pyroptosis‐related changes were abolished by caspase‐3 inhibition. Caspase‐3/GSDME‐mediated pyroptosis triggered the expression of inflammatory cytokines and RANKL, downregulated alkaline phosphatase (ALP) activity, mineralisation level, mRNA and protein levels of multiple osteogenic markers. These effects were partly reversed by Ac‐DEVD‐CHO. Conclusion: Caspase‐3/GSDME‐mediated pyroptosis induced by NaB activated the inflammatory response, reduced osteogenic differentiation and disturbed OPG/RANKL axis, leading to osteogenic dysfunction in osteoblast‐like cells. [ABSTRACT FROM AUTHOR]

Introduction: The occurrence of dental emergencies, now termed as dental disease nonbattle injuries (D-DNBIs), has long been an impacting factor on militaries' operational effectiveness. Owing to D-DNBIs contributing to low morale, the removal of personnel from duty, causing logistical hardships, and requiring deployable dental teams to operate in theater, there remains a significant benefit in the reduction in the occurrence of D-DNBIs. No study to date has reviewed D-DNBI rates specific to a modern military, and insight into whether militaries are seeing improvements in their dental preparedness remains to be gained.Materials and Methods: A scoping review was conducted in accordance with the guidelines set out by Joanna Briggs Institute. Databases searched included SCOPUS, PubMed, OVID, and DOSS. Six hundred and one articles were initially screened, and six articles were included in the final review.Results: A D-DNBI rate of 172 per 1,000 members per year was reported across the coalition, with the U.S., UK, and French militaries reporting on their dental experience. Both the French data and one UK study reported significantly higher D-DNBIs than their U.S. counterparts, who described 124 D-DNBIs per 1,000 members per year. A significant proportion of these D-DNBIs were reported to be "preventable," which raises questions on the efficacy of garrison healthcare services. Dental disease nonbattle injury rates appear to be largely consistent with what was first reported decades ago, and there remains ongoing and significant value in expeditionary dental services providing supportive healthcare for any deployed military personnel.Conclusion: Rates of D-DNBIs appear to be stable with what was historically reported when an international coalition is considered, with national variation. There remains a significant number of D- DNBIs which require dental treatment within the operational theater, and further efficiencies can be gained from predeployment treatment of "preventable" D-DNBIs. [ABSTRACT FROM AUTHOR]

Background: Preoperative dental screening before cardiac valve surgery is widely accepted but its required scope remains unclear. This study evaluates two preoperative dental screening (PDS) approaches, a focused approach (FocA) and a comprehensive approach (CompA), to compare postsurgical 90-day mortality.Methods: Retrospective cohort analysis was performed on all patients who underwent valve surgery at Brigham and Women's Hospital with FocA and Massachusetts General Hospital with CompA of PDS approach from January 2009 to December 2016. Patients with intravenous drug abuse and systemic infections were excluded. Univariate, multivariable, and subgroup analysis was performed.Results: A total of 1835 patients were included in the study. With FocA 96% of patients (1097/1143) received dental clearance in a single encounter with 3.3% receiving radiographs and undergoing dental extractions. With CompA 35.5% of patients (245/692) received dental clearance in a single encounter, 94.2% received radiographs, and 21.8% underwent dental extractions. There was no significant difference in 90-day mortality when comparing both PDS approach (10% vs 8.4%, P = .257). This remained unchanged in a multivariable model after adjusting for risk factors (odds ratio:1.32 [95%CI:0.91-1.93] [P = .14]). Reoperation due to infection was less in FocA (0.5%) vs CompA (2.6) (P < .001) and postoperative septicemia was increased in the FocA (1.7%) cohort when compared to the CompA (0.7%) (P < .001) patients.Conclusions: There was no difference in post valve surgery 90-day mortality between patients who underwent a FocA vs CompA of PDS. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy of different concentrations of essential oils combined with calcium hydroxide against Enterococcus faecalis. Thirteen experimental groups were formed: NC (negative control); PC (positive control); GC (growth control); SC (sterilization control); RO (Rosmarinus officinalis); ROH (calcium hydroxide + RO); ZO (Zingiber officinale); ZOH (calcium hydroxide + ZO); AB (Citrus aurantium bergamia); ABH (calcium hydroxide + AB); CO (Copaifera officinalis); COH (calcium hydroxide + CO); DWH (calcium hydroxide and distilled water). After reconstitution of the E. faecalis strain, microdilution testing was performed to define the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The data were tabulated in an Excel spreadsheet, and the MIC and MBC were calculated in accordance with the Bacteriological Analytical Handbook. MICs in the range of 0 to 100 mg/ml were only observed in the ROH group. The RO, ROH, AB, ZO, and ZOH presented absolute data for MBC. Bacterial growth was detected in the DWH group at all concentrations tested. The combination of the essential oils tested here with calcium hydroxide appears promising as an intracanal medication in endodontic treatment because of its effectiveness against Enterococcus faecalis. Essential oils are important in endodontic therapy since calcium hydroxide, the gold standard intracanal medication, is not effective against E. faecalis. [ABSTRACT FROM AUTHOR]

In this study, the authors analyzed patterns, trends, and correlates of hospital inpatient admissions for nontraumatic dental conditions (NTDCs) in Florida for the calendar years 2006 through 2016. The study was a retrospective analysis of hospital inpatient admissions for NTDCs throughout Florida. The authors derived data from a database maintained by the Florida Agency for Health Care Administration, the state's primary health policy and planning entity. There were 26,659 hospital inpatient admissions for NTDCs during the 11-year period. The number of admissions increased from 1,808 in 2006 to 3,542 in 2016, and total charges increased from $46.1 million to $166.5 million. The most common diagnosis was periapical abscess without sinus. Emergency departments were the most frequent source of admission. Hospital inpatient admissions for NTDCs are a growing challenge in Florida. If trends continue, hospital inpatient admissions for NTDCs will place an increasing burden on the state's health care system. Increasing numbers of hospital inpatient admissions for NTDCs are largely a consequence of using emergency departments to address dental-related conditions. This growing dental public health concern has major implications for health care resources and outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescents and young adults are at high risk for opioid misuse after exposure from medical treatment. However, the epidemiology of opioid prescribing among outpatient adolescents and young adults remains poorly described. We aimed to characterize opioid prescribing in adolescents and young adults receiving care in emergency departments (EDs) and outpatient clinics. METHODS: We analyzed National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey data from 2005 to 2015. We included visits to EDs and outpatient clinics for adolescents (13-17 years old) and young adults (18-22 years old). Rates of opioid prescribing were calculated with 95% confidence intervals (CIs), and linear trends over time were examined with logistic regression models. RESULTS: Nearly 57 million visits (5.7%; 95% CI 5.4% to 6.0%) by adolescents and young adults were associated with an opioid prescription. The rate of opioid prescribing was 14.9% (95% CI 14.4% to 15.6%) for ED visits and 2.8% (95% CI 2.5% to 3.1%) for outpatient clinic visits. There was a small but significant decrease in the rate of opioid prescriptions among ED visits (odds ratio 0.96; 95% CI 0.95 to 0.98); no change was seen for outpatient clinic visits. Among ED visits, opioid-prescribing rates were highest among adolescents and young adults with dental disorders (59.7% and 57.9%, respectively), followed by adolescents with clavicle (47.0%) and ankle fractures (38.1%). CONCLUSIONS: Rates of opioid prescribing in EDs and outpatient clinics remain high for adolescents and young adults, especially for certain emergency conditions. These findings inform targeted educational campaigns aiming to ensure judicious use of opioids in this highrisk population. [ABSTRACT FROM AUTHOR]

Purpose: More attention has been focused on the long-term side effects of treatment protocols since impressive advances in childhood cancer treatment have resulted in a growing population of patients. The purpose of this study was to investigate the disturbances of dento-facial development in children who were long-term survivors of childhood malignancies.Methods: Fifty-three children (mean age, 10 years + 4 months) in long-term remission underwent oral/dental and radiographic examinations after completion of therapy. Crown and root malformations, gingival/periodontal status, enamel defects, discolorations, decayed and unerupted teeth, premature apexifications, agenesis, maximal interincisal opening and lateral movement of jaws, and soft tissue abnormalities were noted. Caries were evaluated by the decayed-missing-filled teeth (DMFT) index. Forty healthy children (mean age, 12 years + 4 months) belonging to the same age group and socioeconomic community were served as controls. All participants in the study were evaluated in terms of craniofacial development.Results: The data of the study showed that higher prevalence of root malformation, unerupted teeth, and enamel hypoplasia were detected as a consequence of childhood cancer and/or antineoplastic therapy. Although no differences of craniofacial growth and development were observed between groups (P > 0.05), plaque and gingival index scores were statistically higher in the study group (P < 0.05).Conclusion: A range of variations in dental structures is recognized as a side effect of childhood cancer therapy in long-term survivors of pediatric malignancies that may affect their quality of life. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of all rare diseases occur with orofacial manifestations. Symptoms and manifestations of relevance to orthodontists represent a considerable proportion of these diseases and require appropriate strategies for their treatment. This article provides an overview of the orthodontically relevant manifestations of rare diseases.Material and Methods: Overall, 3,639 rare diseases listed at the Orphanet, OMIM or Pubmed database were evaluated for orofacial manifestations. All rare diseases which were indicated with at least one orofacial manifestation were recorded in a database for rare diseases with orofacial manifestations called "ROMSE," which was developed by the authors. All the rare diseases were analysed with regard to orthodontically relevant orofacial manifestations, such as dysgnathia, changes in the number of teeth, failures of eruption, pathologies of bone metabolism or orofacial clefts. For all rare diseases with orthodontic relevance, an exact analysis was undertaken.Results: The orthodontically relevant orofacial manifestation termed dysgnathia is described in 151 of 535 identified rare diseases (28.2%). In these 151 rare diseases, 15 different subforms of dysgnathia, in the sense of skeletal misdevelopments of the jaws but without dental abnormalities, were described. Also changes in the number of teeth (17.9%), orofacial clefts (27.6%), failures of eruption (8.4%) and pathologies of the bone (2.1%) were described.Conclusions: Orthodontics play an important role in the diagnosis and treatment of orofacial manifestations in rare diseases. Databases such as ROMSE are a first step toward providing valid information in publicly accessible databases. [ABSTRACT FROM AUTHOR]

Background: Indigenous youth have higher rates of chronic health conditions interfering with healthy development, including high rates of ear, dental, chest and musculoskeletal pain, as well as headache, arthritis and mental health issues. This study explores differences in pain-related diagnoses in First Nations and non-First Nations children.Methods: Data from a study population of age- and sex-matched First Nations and non-First Nations children and youth were accessed from a specific region of Atlantic Canada. The primary objective of the study was to compare diagnosis rates of painful conditions and specialist visits between cohorts. The secondary objective was to determine whether there were correlations between early physical pain exposure and pain in adolescence (physical and mental health).Results: Although ear- and throat-related diagnoses were more likely in the First Nations group than in the non-First Nations group (ear 67.3% v. 56.8%, p < 0.001; throat 89.3% v. 78.8%, p < 0.001, respectively), children in the First Nations group were less likely to see a relevant specialist (ear 11.8% v. 15.5%, p < 0.001; throat 12.7% v. 16.1%, p < 0.001, respectively). First Nations newborns were more likely to experience an admission to the neonatal intensive care unit (NICU) than non-First Nations newborns (24.4% v. 18.4%, p < 0.001, respectively). Non-First Nations newborns experiencing an NICU admission were more likely to receive a mental health diagnosis in adolescence, but the same was not found with the First Nations group (3.4% v. 5.7%, p < 0.03, respectively). First Nations children with a diagnosis of an ear or urinary tract infection in early childhood were almost twice as likely to have a diagnosis of headache or abdominal pain as adolescents (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1-3.0, and OR 1.7, 95% CI 1.2-2.3, respectively).Interpretation: First Nations children were diagnosed with more pain than non-First Nations children, but did not access specific specialists or mental health services, and were not diagnosed with mental health conditions, at the same rate as their non-First Nations counterparts. Discrepancies in pain-related diagnoses and treatment are evident in these specific comparative cohorts. Community-based health care access and treatment inquiries are required to determine ways to improve care delivery for common childhood conditions that affect health and development. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic.Material and Methods: Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83-0.94), whereas specificity was low (0.41-0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96).Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present. [ABSTRACT FROM AUTHOR]

Introduction: Patients diagnosed with head and neck tumors, are treated by surgery, radiation therapy (RT), chemotherapy (CT) or a combination thereof. The goal is to describe the management protocol for patients subjected to radiation therapy (RT) and to study their long-term oral health status.Materials and Methods: A retrospective study was performed in a sample of 50 patients. We analyzed the oral health status and all the variables included applying the adapted protocol of pre-RT.Results: Prior to RT, 84% of patients required scaling and 32% conservative treatment. Around 74% of patients required at least one exodontia. The mean of exodontias for patients presenting Grade 3 of oral hygiene was 6.50 per person (p<0.0001). The pre-RT study of possible candida infection showed that 78% of patients were negative for this infection. The mean resting saliva production was 39.10 (SD: 23.30; range: 13-145), with a stimulated value of 64.78 (SD: 33.92; range: 16-200).Conclusions: All patients should be protocoled to ensure that they present optimal oral conditions prior to initiating RT treatment. [ABSTRACT FROM AUTHOR]

Background: The number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published. Objective: To provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues. Methods: A literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list. Results: The searches yielded 549 unique articles, of which 36 were included for critical appraisal and data extraction. The included studies suggest that older people with dementia had high scores for gingival bleeding, periodontitis, plaque, and assistance for oral care. In addition, candidiasis, stomatitis, and reduced salivary flow were frequently present in older people with dementia. Conclusions: The studies included in the current systematic review suggest that older people with dementia have high levels of plaque and many oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, stomatitis, mucosal lesions, and reduced salivary flow. Scientific rationale for study: With the aging of the population, a higher prevalence of dementia and an increase in oral health problems can be expected. It is of interest to have an overview of the prevalence of oral problems in people with dementia. Principal findings: Older people with dementia have multiple oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, mucosal lesions, and reduced salivary flow. Practical implications: The oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular professional dental care to people with dementia. [ABSTRACT FROM AUTHOR]

Oral diseases, especially oral cancers, are becoming serious health problems in humans. To image vasculatures and structures simultaneously in the human oral cavity which are tightly associated with various oral diseases, we develop a dual-modality portable optical resolution photoacoustic microscopy (ORPAM) and optical coherence tomography (OCT) system. This system utilizes a new rotary scanning mechanism and a compact design of the imaging head, making it portable and free of translation of the imaging interface or samples. Through the phantom experiments, both modalities yield high lateral resolutions of 8.1 µm (ORPAM) and 8.56 µm (OCT), respectively. The axial resolutions are measured to be 116.5 µm for ORPAM and 6.1 µm for OCT. In vivo imaging of a mouse ear was carried out to evaluate the performance of the system in biological tissues. In addition, in vivo oral imaging of a healthy human lip and monitoring recovery progress of a lip ulcer demonstrate the clinical potential of this system. [ABSTRACT FROM AUTHOR]

Background. Antibiotic prescribing practices among general dentists and dental specialists in the United States remains poorly understood. The purpose of this study was to compare prescribing practices across dental specialties, evaluate the duration of antibiotics dentists prescribed, and determine variation in antibiotic selection among dentists. Methods. The authors performed a retrospective cross-sectional analysis of dental care provider specialties linked to deidentified antibiotic claims data from a large pharmacy benefits manager during the 2015 calendar year. Results. As a group, general dentists and dental specialists were responsible for more than 2.9 million antibiotic prescriptions, higher than levels for several other medical and allied health care provider specialties. Antibiotic treatment duration generally was prolonged and commonly included broad-spectrum agents, such as amoxicillin clavulanate and clindamycin. Although amoxicillin was the most commonly prescribed antibiotic among all dental specialties, there was substantial variation among other antibiotics each specialty selected. The most common antibiotic treatment durations were 7 and 10 days. Conclusions. This study's results demonstrate that dentists frequently prescribe antibiotics for prolonged periods and often use broad-spectrum antibiotics. Further studies are necessary to evaluate the appropriateness of these antibiotic prescribing patterns. Practical Implications. The clinically significant variation in antibiotic selection and treatment duration identified among all dental specialties in this study population implies that further research and guidance into the treatment of dental infections is necessary to improve and standardize antibiotic prescribing practices. [ABSTRACT FROM AUTHOR]

Background. No evidence-based guidelines exist for preventive dental care before radiation therapy (RT) in patients with head and neck cancer (HNC). An ongoing multicenter, prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), is addressing this knowledge gap. The authors evaluated the level of dental disease before RT in the OraRad cohort, factors associated with dental disease, and dental treatment recommendations made before RT. Methods. As part of OraRad, the authors assessed caries, periodontal disease, dental recommendations, and dental interventions performed before RT. Results. Baseline measures were reported for 356 participants (77% men) with mean (standard deviation) age of 59.9 (11.0) years. Measures included mean number of teeth (22.9), participants with at least 1 tooth with caries (37.2%), and participants with at least 1 tooth with probing depth 5 millimeters or greater (47.4%). Factors associated with less extensive dental disease before RT included having at least a high school diploma, having dental insurance, history of routine dental care, and a smaller tumor size (T1 or T2). Based on the dental examination before RT, 163 (49.5%) participants had dental treatment recommended before RT, with extractions recommended most frequently. Conclusion. Many patients with HNC require dental treatment before RT; more than one-third require extractions. Practical Implications. Most patients have some level of dental disease at the start of RT, indicating the importance of dental evaluation before RT. By observing dental outcomes after RT, OraRad has the potential to determine the best dental treatment recommendations for patients with HNC. [ABSTRACT FROM AUTHOR]

Background One of the requirements of laryngoscopy is to determine which head position will result in optimal visualization. Our hypothesis was that parameters derived from magnetic resonance imaging (MRI) can help quantify the effect of age on airway modifications due to head extension during development. Method In children undergoing planned MRI, additional sequences on the upper airways were performed: one in a near-neutral position, the other with the head extended at 35°. The axis of the face, the pharynx, the larynx, the trachea, and the line of glottic visualization were determined. The following angles were calculated: the Visu-Lar angle, formed by the line of glottic visualization and the laryngeal axis, and the Phar-Lar angle, formed by the pharyngeal and laryngeal axes. Results One hundred and fifty-five patients (1 to 222 months of age [25–145] months) were included and 54% were under general anaesthesia. Age had no effect on the variation in the Visu-Lar angle, which diminished as a function of head extension, nor on the variation in the Phar-Lar angle, which was minimal in the neutral position. During extension, anatomical axes rotated similarly, and the visualization axis rotated the most, followed by the pharyngeal and laryngeal axes. These results were not correlated with general anaesthesia. Conclusion Regardless of age, head extension diminished the Visu-Lar angle, and increased the Phar-Lar angle. This study supports that, as in adults, head extension is probably the key factor for good visualization conditions during laryngoscopy on children, but clinical data is needed to confirm this result. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health.Data Sources: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases.Study Design: Empirical analyses and structured panel reviews.Methods: Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs).Principal Findings: ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated.Conclusions: The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research. [ABSTRACT FROM AUTHOR]

Thirty-two skeletons from burial ground Bakheri chala were analysed macroscopically and X-ray for pathological conditions such as trepanation, traumatic injuries, infectious disease and dental pathology. This study has shown that average age at death was relatively high. Trepanation with rectangular sawing for the first time found in the Armenia at two individuals. Trauma to the skull was common, which suggests a high level of inter-personal violence. We here report a case of decapitation. Bakheri chala site showed a high frequency of auditory exostosis. The dental pathology conditions of this population were numerous. Agriculture introduced people to carbohydrates, or sugars, which affect the teeth and cause dental caries. The staple diet of ancient population from Shnogh river consisted of wine, bread, vegetables, and fruits. Males do show a slightly higher rate of wear than females possibly suggesting a greater proportion of bread in the diet of males. [ABSTRACT FROM AUTHOR]

Introduction: Proper cooperation between patient and dentist is of great help to make a good oral impression. However, patients are frequently confused when information is given through traditional verbal description. The present study compared the effectiveness of the multimedia information delivery ways with the traditional verbal manner on patients' understanding level in oral impression taking.Methods: The recruited 191 participating patients were randomly assigned to the control group (the verbal group) and two intervention groups (the video group and the picture group) according to the information delivery manner. After intervention, the patients' understanding degree was measured by questionnaire and performance evaluation of behavior feedback on the provided information quantitatively. Also, patients' self-assessment of satisfaction was interviewed by telephone. All data was analyzed by SPSS 14.0 software, and p≤0.05 was set as significant difference in advance.Results: One-Way ANOVA and Chi-square showed there were no statistically significant differences in the mean age, gender composition, and educational level among the three groups (P>0.05). In both questionnaire assessment and performance evaluation, One-Way ANOVA followed by LSD indicate that the video group gained a higher score than the verbal group or the picture group (P<0.05). The questionnaire score in the picture group is significantly higher than in the control group (P<0.05), but no significant difference was shown between these two groups in patients' performance evaluation (P>0.05). Higher percentage of satisfaction was reported by patients in the two multimedia groups than that in the control group.Discussion: Oral impression taking is a consecutive process that requires action cooperation between dentists and patients simultaneously. This particularity makes it more suitable for multimedia delivery. The delivery of tailored information using multimedia in this study was favored by most patients and could improve the degree of patient understanding of the oral impression taking procedures. [ABSTRACT FROM AUTHOR]

The objective of this systematic review is to identify current computer-assisted technologies used for managing patients with a need to re-establish craniofacial appearance, subjective discomfort and stomatognathic function, and the extent of their clinical documentation. Electronic search strategies were used for locating clinical studies in MEDLINE through PubMed and in the Cochrane library, and in the grey literature through searches on Google Scholar. The searches for commercial digital products for use in oral rehabilitation resulted in identifying 225 products per November 2016, used for patient diagnostics, communication and therapy purposes, and for other computer-assisted applications in context with oral rehabilitation. About one-third of these products were described in about 350 papers reporting from clinical human studies. The great majority of digital products for use in oral rehabilitation has no clinical documentation at all, while the products from a distinct minority of manufacturers have frequently appeared in more or less scientific reports. Moore's law apply also to digital dentistry, which predicts that the capacity of microprocessors will continue to become faster and with lower cost per performance unit, and innovative software programs will harness these improvements in performance. The net effect is the noticeable short product life cycle of digital products developed for use in oral rehabilitation and often lack of supportive clinical documentation. Nonetheless, clinicians must request clinically meaningful information about new digital products to assess net benefits for the patients or the dental professionals and not accept only technological verbiage as a basis for product purchases. [ABSTRACT FROM AUTHOR]

Background: The number of Acute Dental Infections (ADI) presenting for emergency department (ED) care are steadily increasing. Outpatient Parenteral Antibiotic Therapy (OPAT) programs are increasingly utilized as an alternative cost-effective approach to the management of serious infectious diseases but their role in the management of severe ADI is not established. This study aims to address this knowledge gap through evaluation of ADI referrals to a regional OPAT program in a large Canadian center.Methods: All adult ED and OPAT program ADI referrals from four acute care adult hospitals in Calgary, Alberta, were quantified using ICD diagnosis codes in a regional reporting system. Citywide OPAT program referrals were prospectively enrolled over a five-month period from February to June 2014. Participants completed a questionnaire and OPAT medical records were reviewed upon completion of care.Results: Of 704 adults presenting to acute care facilities with dental infections during the study period 343 (49%) were referred to OPAT for ADI treatment and 110 were included in the study. Participant mean age was 44 years, 55% were women, and a majority of participants had dental insurance (65%), had seen a dentist in the past six months (65%) and reported prior dental infections (77%), 36% reporting the current ADI as a recurrence. Median length of parenteral antibiotic therapy was 3 days, average total course of antibiotics was 15-days, with a cumulative 1326 antibiotic days over the study period. There was no difference in total duration of antibiotics between broad and narrow spectrum regimes. Conservative cost estimate of OPAT care was $120,096, a cost savings of $597,434 (83%) compared with hospitalization.Conclusions: ADI represent a common preventable cause of recurrent morbidity. Although OPAT programs may offer short-term cost savings compared with hospitalization, risks associated with extended antibiotic exposures and delayed definitive dental management must also be gauged. [ABSTRACT FROM AUTHOR]

The aim of this article is to add to the literature on the sociology of oral health and dentistry by presenting the relevance of status passage to the study of complete tooth loss. The article reports on an analysis of data taken from participants residing in the Nelson region of New Zealand. In total the data include interviews from 20 participants, all of whom had their remaining natural teeth removed before 1960. In total, 12 women and eight men were interviewed. All were from a European background with an age range of 71 to 101 years. Following a narrative approach, participants were interviewed on the nature of the social factors that resulted in complete tooth loss by starting with their family history and then focusing on the factors and events leading up to their total tooth loss. Data were analysed using the methods and techniques of grounded theory. This article provides an outline of the importance of scheduling, prescribing, social factors, 'compound awareness contexts' and reversibility to the status passage into complete tooth loss. We conclude by arguing that the theory of status passage may enable a detailed analysis of the 'time-space extensionality' of trajectories into complete tooth loss. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of repeated topical application of oral capsaicin gel in two different concentrations for relief of burning/stinging sensations in patients with burning mouth syndrome (BMS).Material and Methods: This randomized double-blind cross-over study included 22 female patients with BMS. The patients were randomized for topical application of either 0.01% or 0.025% oral capsaicin gel on the dorsal part of tongue three times daily for 14 days, followed by 14 days wash-out period, and finally treatment with the other concentration of oral gel three times daily for 14 days. A visual analogue scale (VAS) was used to assess the severity of pain five times during the intervention period.Results: 18 patients completed the intervention. Their VAS score at baseline was 5.5 ± 0.6 cm (mean ± SD). Treatment with the two concentrations of capsaicin gels significantly improved the burning/stinging symptoms assessed on VAS compared with baseline (p = 0.002). There was no statistically significant difference between the two concentrations of the gels on relieving symptoms. Four patients dropped out during the intervention period due to gastrointestinal side-effects.Conclusions: Topical capsaicin might be an alternative for the short-term treatment of BMS. However, further studies are needed to investigate especially the gastro-intestinal side-effects which may limit its long-term use. [ABSTRACT FROM AUTHOR]

Objective: The aim of this review was to provide a systematic overview including a quality assessment of studies about oral health and orofacial pain in older people with dementia, compared to older people without dementia. Methods: A systematic literature search was performed in PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. The quality assessment of the included articles was performed using the Newcastle-Ottawa Scale (NOS). Results: The search yielded 527 articles, of which 37 were included for the quality assessment and quantitative overview. The median NOS score of the included studies was 5, and the mean was 4.9 (SD 2.2). The heterogeneity between the studies was considered too large to perform a meta-analysis. An equivalent prevalence of orofacial pain, number of teeth present, decayed missing filled teeth index, edentulousness percentage, and denture use was found for both groups. However, the presence of caries and retained roots was higher in older people with dementia than in those without. Conclusions: Older people with dementia have worse oral health, with more retained roots and coronal and root caries, when compared to older people without dementia. Little research focused on orofacial pain in older people with dementia. Clinical relevance: The current state of oral health in older people with dementia could be improved with oral care education of caretakers and regular professional dental care. [ABSTRACT FROM AUTHOR]

The increasing prevalence and severity of oral disease in South Africa and the resultant effect on quality of life remain of major concern. However, to aid in the relief thereof a variety of over-the-counter (OTC) locally acting mouth and throat preparations are available. The use of these preparations broadly include the symptomatic relief of painful, inflamed and irritated mouths and throats due to various causes, use in dental procedures and the treatment of fungal infections. [ABSTRACT FROM AUTHOR]

Early detection of the most prevalent oral disease worldwide, i.e., dental caries, still remains as one of the major challenges in dentistry. The current dental standard of care relies on caries detection methods, such as visual inspection and x-ray radiography, which lack the sufficient specificity and sensitivity to detect caries at early stages of formation when they can be healed. We report on the feasibility of early caries detection in a clinically and commercially viable thermophotonic imaging system. The system incorporates intensity-modulated laser light along with a low-cost long-wavelength infrared (LWIR; 8 to 14 μm) camera, providing diagnostic contrast based on the enhanced light absorption of early caries. The LWIR camera is highly suitable for integration into clinical platforms because of its low weight and cost. In addition, through theoretical modeling, we show that LWIR detection enhances the diagnostic contrast due to the minimal LWIR transmittance of enamel and suppression of the masking effect of the direct thermal Planck emission. Diagnostic performance of the system and its detection threshold are experimentally evaluated by monitoring the inception and progression of artificially induced occlusal and smooth surface caries. The results are suggestive of the suitability of the developed LWIR system for detecting early dental caries. [ABSTRACT FROM AUTHOR]

Introduction: Maximal opening of mouth is described as the greatest distance between incisal edge of maxillary central incisor to the incisal edge of mandibular central incisor, when the mouth is opened as wide as possible painlessly or as the inter incisal distance plus the overbite. Clinical measurement of normal range of Maximum Mouth Opening (MMO) in children is an important diagnostic criterion for evaluation of stomatognathic system, especially for those with temporomandibular and neurogenic dysfunctions. Aim: To determine the correlation of maximal mouth opening with age, sex, height, body weight and different facial types. Materials and Methods: The study was a cross-sectional study which was conducted on 434 children, who were randomly divided into three groups based on their age: Group I- children of age 6 to 8 years, Group II- children of age 8.1 to 10 years, Group III- children of age 10.1 to 12 years. For each child, the examiner took three readings of MMO in millimeters (mm) and the mean of the three readings was considered. Age, sex, standing height, body weight and facial type of each child were also recorded simultaneously. Pearson correlation was used to determine the relationship between the different parameters. p-value <0.05 was the bench mark for statistical significance in the analysis. Descriptive and inferential analysis was done for the data using SPSS version 20.0. (SPSS 20, inc.; Chicago). Results: The estimated average MMO measured for girls and boys in the age range of 6-8 years, with a total sample size of 139, was 41.14 ± 4.29 mm and 42.16 ± 3.98mm respectively in euryprosopic face type. In leptoproscopic face type, it was 42.12 ± 4.54mm and 43.76 ± 3.80 mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 41.77 ± 4.09mm and 42.51 ± 3.95 mm in girls and boys respectively. The estimated average MMO measured for girls and boys in the age range of 8.1-10 years, with a total sample size of 143, was 44.42+4.69mm and 43.30 ± 4.11 mm in euryprosopic face type. In leptoproscopic face type, it was 43.02 ± 3.92mm and 46.29 ±3.09mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 42.50 ±4.32 and 42.80 ± 5.16 mm in girls and boys respectively. The estimated average MMO measured for girls and boys in the age range of 10.1-12 years, with a total sample size of 152, was 44.63 ± 5.28 mm and 45.80 ± 5.18 mm respectively in euryprosopic face type. In leptoproscopic face type, it was 45.76 ± 4.98 mm and 46.28 ± 4.68 mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 45.32 ± 5.80 mm and 46.03 ± 5.86 mm in girls and boys respectively. Conclusion: There was a significant difference in MMO between males and females; with males having higher values in all age groups. MMO is seen to increase with age in a statistically significant manner. Significantly increased value of MMO was observed in leptoproscopic face type in comparison to euryproscopic and mesoproscopic face type for each age group. [ABSTRACT FROM AUTHOR]

Objective: To compare oral health parameters in perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected youth (PHEU). Methods: In a cross-sectional substudy within the Pediatric HIV/AIDS Cohort Study, participants were examined for number of decayed teeth (DT), Decayed, Missing, and Filled Teeth (DMFT), oral mucosal disease, and periodontal disease (PD). Covariates for oral health parameters were examined using zero-inflated negative binomial regression and ordinal logistic regression models. Results: Eleven sites enrolled 209 PHIV and 126 PHEU. Higher DT scores were observed in participants who were PHIV [Adjusted Mean Ratio (aMR) = 1.7 (95% CI 1.2–2.5)], female [aMR = 1.4 (1.0–1.9)], had no source of regular dental care [aMR = 2.3 (1.5–3.4)], and had a high frequency of meals/snacks [≥5 /day vs 0–3, aMR = 1.9 (1.1–3.1)] and juice/soda [≥5 /day vs 0–3, aMR = 1.6 (1.1–2.4)]. Higher DMFT scores were observed in participants who were older [≥19, aMR = 1.9 (1.2–2.9)], had biological parent as caregiver [aMR = 1.2 (1.0–1.3)], had a high frequency of juice/soda [≥5 /day vs 0–3, aMR = 1.4 (1.1–1.7)] and a low saliva flow rate [mL/min, aMR = 0.8 per unit higher (0.6–1.0)]. Eighty percent had PD; no differences were seen by HIV status using the patient-based classifications of health, gingivitis or mild, moderate, or severe periodontitis. No associations were observed of CD4 count and viral load with oral health outcomes after adjustment. Conclusions: Oral health was poor in PHIV and PHEU youth. This was dismaying since most HIV infected children in the U.S. are carefully followed at medical health care clinics. This data underscore the need for regular dental care. As PHIV youth were at higher risk for cavities, it will be important to better understand this relationship in order to develop targeted interventions. [ABSTRACT FROM AUTHOR]

Although diver's mouth syndrome (DMS) has long been recognized by scuba divers, little attention has been paid to the influence of wearing a scuba diving mouthpiece on the stomatognathic system. In this review, DMS-related stomatognathic events (DMS-SE) while wearing a mouthpiece, the relationship between components of the mouthpiece and those events, and design considerations to reduce the risk of those events are discussed based on evidence from 32 articles concerning scuba diving mouthpieces. Forward movement of the mandible, loss of molar occlusal support, and continuous jaw clenching while wearing a mouthpiece are considered to be pathogenic for DMS-SE. Several experimental studies have suggested a relationship between incidence of those events and the design of mouthpiece components such as the connector, labial flange, platform, and occlusal rug, and the possibility of reducing risk of those events through design customization of these components. Improvement of the shape of commercially available mouthpieces and creation of custom-made mouthpieces may thus contribute to the prevention and treatment of DMS-SE and the provision of a comfortable diving environment. [ABSTRACT FROM AUTHOR]

Purpose. We evaluated the intra- and interrater agreement and test-retest reliability of analyst derivation of swallow function variables based on repeated high resolution manometry with impedance measurements. Methods. Five subjects swallowed 10×10 mL saline on two occasions one week apart producing a database of 100 swallows. Swallows were repeat-analysed by six observers using software. Swallow variables were indicative of contractility, intrabolus pressure, and flow timing. Results. The average intraclass correlation coefficients (ICC) for intra- and interrater comparisons of all variable means showed substantial to excellent agreement (intrarater ICC 0.85–1.00; mean interrater ICC 0.77–1.00). Test-retest results were less reliable. ICC for test-retest comparisons ranged from slight to excellent depending on the class of variable. Contractility variables differed most in terms of test-retest reliability. Amongst contractility variables, UES basal pressure showed excellent test-retest agreement (mean ICC 0.94), measures of UES postrelaxation contractile pressure showed moderate to substantial test-retest agreement (mean Interrater ICC 0.47–0.67), and test-retest agreement of pharyngeal contractile pressure ranged from slight to substantial (mean Interrater ICC 0.15–0.61). Conclusions. Test-retest reliability of HRIM measures depends on the class of variable. Measures of bolus distension pressure and flow timing appear to be more test-retest reliable than measures of contractility. [ABSTRACT FROM AUTHOR]

Background: Looking for and treating the portal of entry (POE) of infective endocarditis (IE) is important, but published research on this topic is nonexistent.Objectives: The goal of this study was to systematically search for the POEs of present and potentially new episodes of IEs.Methods: Patients were systematically seen by a stomatologist, an ear, nose, and throat specialist, and a urologist; women were systematically seen by a gynecologist; patients were seen by a dermatologist when there were cutaneous and/or mucous lesions. Colonoscopy and gastroscopy were performed if the microorganism came from the gastrointestinal tract in patients ≥50 years of age and in those with familial histories of colonic polyposis. Treatment of the POE was systematically considered.Results: The POEs of the present IE episodes were identified in 74% of the 318 included patients. The most frequent POE was cutaneous (40% of identified POEs). It was mainly (62% of cutaneous POEs) associated with health care and with intravenous drug use. The second most frequent POE was oral or dental (29%). A dental infectious focus was more often involved (59% of oral or dental POEs) than a dental procedure (12%). POEs were gastrointestinal in 23% of patients. Colonic polyps were found in one-half of the patients and colorectal adenocarcinomas in 14%. Performance was good regarding the search for an oral or dental or a colonic potential POE, which were found in 53% and 40% of patients, respectively.Conclusions: Our search for the POEs of present IEs was often successful, as was searching for an oral or dental or a gastrointestinal POE of a new IE episode. We advise the systematic performance of stomatologic examinations in patients with IE and performance of colonoscopy in patients ≥50 years of age or at high risk for colorectal cancer. [ABSTRACT FROM AUTHOR]

Numerous factors can be considered for the etiology of temporomandibular disorders (TMD). The aim of the present study was to investigate whether the presence of both nasal septal deviation (NSD) and habitual prone sleeping posture (HPSP) predisposes TMD. We evaluated 200 subjects in 4 groups. Group I (NSD−, HPSP−/control group), Group II (NSD+, HPSP−), Group III (NSD−, HPSP+), Group IV (NSD+, HPSP+). All patients were examined according to the research diagnostic criteria to determine the presence of TMD. Group IV had the highest value for TMD incidence (44 %). Thus, we found that the presence of both NSD and HPSP parameters increased TMD incidence in Group IV compared to the control group ( p = 0.000). Additionally, Group IV showed significantly higher values than Group II ( p = 0.012) and Group III ( p = 0.039). For Group III (NSD−, HPSP+), TMD was determined higher compared to the control group ( p = 0.009). A statistically higher value of presence of TMD was determined in Group II (NSD+, HPSP−) than control group ( p = 0.029). The incidence of TMD was significantly higher in women than men ( p = 0.020). We concluded that one having an unilateral obstructive nasal septal deviation in addition to a habit of sleeping in prone position must be alert for potential TMD. [ABSTRACT FROM AUTHOR]

This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus. [ABSTRACT FROM AUTHOR]

The mesenchymal stem cells of dental pulp (DPSCs) were isolated and characterized for the first time more than a decade ago as highly clonogenic cells that were able to generate densely calcified colonies. Now, DPSCs are considered to have potential as stem cell source for orthopedic and oral maxillofacial reconstruction, and it has been suggested that they may have applications beyond the scope of the stomatognathic system. To date, most studies have shown that, regardless of their origin in third molars, incisors, or exfoliated deciduous teeth, DPSCs can generate mineralized tissue, an extracellular matrix and structures type dentin, periodontal ligament, and dental pulp, as well as other structures. Different groups worldwide have designed and evaluated new efficient protocols for the isolation, expansion, and maintenance of clinically safe human DPSCs in sufficient numbers for various therapeutics protocols and have discussed the most appropriate route of administration, the possible contraindications to their clinical use, and the parameters to be considered for monitoring their clinical efficacy and proper biological source. At present, DPSC-based therapy is promising but because most of the available evidence was obtained using nonhuman xenotransplants, it is not a mature technology. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to (1) quantify the number of intratheater dental Medical evacuations (MEDEVACs) required for French Soldiers in Mali during Operation Serval and (2) determine a Soldier's time away from their unit because of MEDEVAC, dental treatment, and return to unit.Methods: Data concerning MEDEVACs occurring during Operation Serval were recorded by the Patient Evacuation Coordination Center. MEDEVACs resulting from oral/facial/dental conditions were evaluated for the period from February 15, 2013 to May 15, 2013.Results: Fifty-four (15.7%) of the 338 MEDEVACs recorded were required to treat dental emergencies. Dental emergencies accounted for 54 (23.9%) of nonbattle injury MEDEVACs. Soldiers evacuated for dental problems were unavailable to their units an average of 10.5 days.Conclusions: French military personnel often require MEDEVAC to treat dental problems occurring in the theater of operation. Dental casualties requiring MEDEVAC are absent from their units for almost 2 weeks, which could drastically decrease their operational capacity and ability to complete their mission. Predeployment dental readiness and the presence of a dental surgeon in close proximity to deployed forces may reduce the number of MEDEVACs required and reduce the time away from the unit. [ABSTRACT FROM AUTHOR]

Purpose: to describe and characterize alterations in orofacial individuals with neurofibromatosis type 1 and to correlate these changes with clinical manifestations of neurofibromatosis type 1 and the muscular strength. Methods: the study included 24 individuals with neurofibromatosis type 1, 12 males and 12 females, aged between 14 and 50 years, matched by sex and age, with volunteers not affected by the disease. All subjects were evaluated for maximal handgrip force (Fmáx) and evaluated for orofacial motricity using the MBGR protocol. Results: the main findings of this study demonstrated that individuals with neurofibromatosis type 1 had higher prevalence of abnormal structures phonoarticulatory and significant differences (p < 0.05), when compared to the control group in relation to body posture and speech organs, mobility, muscle tone, pain on palpation and stomatognathic functions. The total score of the test also showed Spearman correlation coefficient significant at 5% over Fmáx. Conclusion: patients with neurofibromatosis type 1 had a higher prevalence of phonoarticulatory changes with significant impacts on the functions of breathing, chewing, swallowing and speaking. These alterations were correlated with the reduction of systemic muscular strength. [ABSTRACT FROM AUTHOR]

The aim of the study was to demonstrate the orthodontic treatment of malocclusions in dogs, a condition which can lead to cranio-mandibular and functional disorders of the stomatognathic system. The treatment involved the use of maxillofacialorthopaedic appliances, which type depended on the type of disorder and the degree of malocclusion. The applied treatment induced changes in the alveolar bone. Throughout the process of the treatment a great attention was paid to regular brushing off the orthodontic appliance using antiseptics for prophylactic prevention of inflammation of gingival tissue and the palate caused by food getting stuck in the spaces between the teeth. [ABSTRACT FROM AUTHOR]

Introduction For chewing to occur properly, it is necessary that all oral structures are present and of normal standard. Objectives The aim of this study is to verify the presence of oral changes in smokers and the impact of the changes on masticatory function compared with individuals who never smoked. Methods Forty-eight subjects were evaluated, split into two study groups (24 subjects each) of current tobacco users and individuals who have never smoked. The variables halitosis, presence of lesions suggestive of caries and periodontal problems, number of teeth, classification of malocclusions according to angle, standard grinding food, chewing pattern, and speed of chewing were evaluated. Results There was no statistically significant difference in tooth loss between the groups, but the smokers had more losses manifesting malocclusion. Most smokers had halitosis and lesions suggestive of caries and periodontal problems; the halitosis was associated with the latter variable. Masticatory speed was also reduced significantly in these individuals compared with the control group when associated with occlusal alterations, in addition to grinding food with the tongue. No difference was observed regarding the chewing pattern. The presence of halitosis and periodontal problems were more common in those who smoke more than 20 years. Conclusion There is an association between smoking and dental changes, which cause increased masticatory changes. [ABSTRACT FROM AUTHOR]

Experimental and non-experimental stress significantly increase masseter muscle tone, which has been linked to the symptoms and pathogenesis of several stomatognathic system diseases. Until now, the mechanism underlying this phenomenon has remained unclear. The current study was performed to determine the mechanism of the stress-induced increase in masseter muscle tone and to investigate the effect of lamotrigine on this change. Animals challenged by repeated restraint stress received either saline as a vehicle or lamotrigine in doses of 20, 30 or 40 mg/kg body weight, whereas control animals received saline without stress treatment. Masseter muscle tone was assessed using electromyography. The activity of glutamate-related metabolic enzymes (glutaminase and glutamine synthetase) in the trigeminal motor nucleus was also investigated. Our results showed an interesting phenomenon: masseter muscle activity increased concurrently with the upregulation of the glutamate concentration after stress treatment. The activities of glutaminase and glutamine synthetase in the trigeminal motor nucleus were also upregulated and downregulated, respectively, when the rats were challenged by prolonged stress. The animals treated with lamotrigine at moderate and high doses had significantly decreased masseter muscle tone compared with stressed animals treated with vehicle. These results suggested that increased glutaminase activity and decreased glutamine synthetase activity increased glutamate production and decreased glutamate decomposition, causing an increase in glutamate levels in the trigeminal motor nucleus and eventually increasing masseter muscle tone. The administration of lamotrigine at doses of 30 or 40 mg/kg body weight effectively mitigated the adverse effects of stress on masseter muscle tone via inhibition of glutamate release. [ABSTRACT FROM AUTHOR]

Objectives: Poor oral health can have a negative impact on overall health. This is especially concerning for individuals with sickle cell disease (SCD), an inherited blood disorder that affects hemoglobin and can lead to an increased risk of infection and hyperalgesia. Because the majority of individuals with SCD have Medicaid insurance and no dental coverage, we provided free basic dental care to individuals with SCD to determine whether it decreased overall healthcare utilization.Methods: Through a contract with a private dental office, we provided free basic dental care (eg, cleanings, fillings, x-rays) to individuals with SCD. We reviewed medical records for the 12 months before and after their initial dental visit to determine whether there were any changes in acute care visits (defined as a visit to the emergency department, sickle cell infusion center, or visits to both in the same day), hospitalizations, and total days hospitalized. We conducted a negative binomial regression to determine any differences in the pre-post periods.Results: In our multivariable analysis, there was a statistically significant decrease in hospital admissions. In addition, there was a significant decrease in total days hospitalized if dental work was completed, but an increase in days hospitalized in men.Conclusions: Providing dental care to individuals with SCD who did not have dental insurance did not greatly alter acute care visits. A larger sample size may be necessary to observe an effect. [ABSTRACT FROM AUTHOR]

Introduction Möbius syndrome (MS; VI and VII palsy) is a rare disease that in Brazil has a great frequency because of the use of misoprostol during pregnancy. Objective Verify if the speech and language performance of children with MS whose mothers reported use of misoprostol (Cytotec, Pfizer, Connecticut, USA) are different from the performance of children of mothers who did not report use. Methods The stomatognathic system beyond receptive and expressive language and speech was evaluated in children with MS, and their mothers were questioned whether they used misoprostol during the pregnancy. Results During the interview, 61.11% of mothers reported that they took misoprostol during the pregnancy. Most of the subjects (83.3%) whose mothers took misoprostol presented bilateral palsy beyond bad mobility of the tongue (90.9%) and speech disorders (63.6%). Conclusion The number of mothers who took misoprostol without knowing the risk for MS was great. The lack of facial expressions and speech disorders were common characteristics of the individuals with MS, whether themothers took misoprostol during the pregnancy or not. [ABSTRACT FROM AUTHOR]

A descriptive study was conducted in 40 patients with disorders of the stomagtonathic system who visited the Physical Medicine Department of the Intermediate State Hospital of Katutura, in Windhoek (Namibia) and were referred from the specialty of maxillofacial surgery, from 2008 to 2009, in order to assess the symptoms and signs, as well as the time of improvement with the application of physical agents. Variables such as sex, age, diagnosis, symptoms and signs, sessions of therapy and final results were considered in the series. Finally it was found that in 87.5% of patients good results were obtained between sessions 5 and 10, which indicated that with this therapeutic method a satisfactory course without complications or worsening of clinical pattern is achieved. [ABSTRACT FROM AUTHOR]

Teeth loss has different causes and has devastating results to the entire stomatognathic system by affecting its main functions: masticatory function, physiognomic function and phonetic function. Through this article our aim is to underline the anatomical characteristics of the maxillary bone, the resorption mechanism at this level that is produced as a result of masticatory unit loss, the importance of the maxillary sinus, the way these characteristics are influencing the prosthetic restauration as well as the importance of immediate provisional restauration. Nowadays the temporary restauration represents an indispensable stage of treatment as this increases the patients level of trust in the practitioner, in the therapeutic act but mostly the patients comfort as well as the opportunity of a fast society reintegration. [ABSTRACT FROM AUTHOR]

Aims of the research is to analyze the advantages of various types of imaging investigations and their limitations as early diagnosis of diseases in the stomatognathic system. In the complex oral rehabilitation are situations when an investigation requires more accurate imaging and diagnostic accuracy. From an economic perspective, its higher cost will pay off in that early diagnosis and intervention on early stage lesions have lower costs than therapeutic interventions for lesions that were diagnosed only after clinical manifestations. [ABSTRACT FROM AUTHOR]

Low-level laser therapy (LLLT) has been widely used in the treatment of the stomatognathic system dysfunction; however, its biological effect remains poorly understood. This study evaluated the effect of LLLT (GaAlAs, 780 nm, 20 J/cm², 40 mW) on masseter muscle of HRS/J mice after different numbers of laser irradiations (three, six, and ten) for 20 s in alternate days. Three experimental groups were defined according to the number of laser irradiations and three control groups ( n = 5) were used. On the third day after the last irradiation, all animals were killed and the masseter muscle was removed and processed for the following analysis: (a) transmission electron microscopy, (b) zymography, (c) immunohistochemistry for vascular endothelial growth factor (VEGF) and VEGFR-2. The results showed: (a) with six laser applications, a dilation of T tubules, and sarcoplasmic reticulum cistern, increased pinocytosed vesicles in the endothelium; with ten laser applications, few pinocytic vesicles in the endothelium and condensed mitochondria. (b) Under the conditions of this study, the synthesis of other matrix metalloproteinases was not observed, only the MMP-2 and -9. (c) After ten laser irradiations, immunostaining was observed only for VEGFR-2. We conclude that after six laser applications, ultrastructural changes may facilitate the Ca transfer to cytosol and increase the fluid transport from one surface to another. The ultrastructural changes and no immunostaining for VEGF with ten applications may decrease the metabolic activity as well as damage the angiogenic process, suggesting that an effective number of laser applications may be less than ten, associating to this therapy a better cost-benefit. [ABSTRACT FROM AUTHOR]

The diagnosis of the occlusal disorders of the dento-maxillary is a delicate stage, but of great importance in establishing the functional rehabilitation of the dental arches. Occlusal disorders occur as a result of dental anomalies of number, odontal coronary lesions, dental migration, edentulous, gnatoprotetic devices improperly executed, changes of the occlusion parameters, and secondary musculoskeletal and joint disorders. The difficulty in the diagnosis, is that any trauma occurring in any component of the stomatognathic system may lead to occlusal dysfunction. Meanwhile, occlusal dysfunction can cause symptoms in all dento-maxillary structures. Recent research on the phenomenon of occlusal trauma etiology showed major difficulties in determining the exact causes and evolution of the phenomenon itself. This paper highlights the importance of usage in practice of the registration and transfer systems, also the important role of the radiological examination in detecting and highlighting the phenomenon of occlusal trauma. [ABSTRACT FROM AUTHOR]

We performed cluster analysis of stabilometry data of 129 men and 122 women at the age of 20-60 years using the following 4 methods: European stabilometry variant, Romberg test (European variant), Romberg test (American variant), and Romberg test (American Universal variant). Results of factor analysis of primary data matrix obtained during the test 'eye open-teeth clenched' attest to higher clinical significance of absolute stabilometry parameters in comparison with relative ones. The results of factor analysis revealed peculiarities of functional status of the stomatognathic system as the postural sensor and its effect on postural balance. The contribution of the functional status of the stomatognathic system into the postural balance is about 2%. [ABSTRACT FROM AUTHOR]