Role of NADH/NADPH oxidase-derived H2O2 in angiotensin II-induced vascular hypertrophy

The Maillard reaction between sugar and protein has been postulated as the cause for the browning and arrestment of caries lesions. This reaction has been implicated as the cause for decreased degradability of collagen in vivo. The aim of the present study was to verify the occurrence of the reaction in vivo. Carious and sound dentin samples were taken from extracted human teeth and analyzed for the fluorescence characteristic of the Maillard reaction and oxidation and, by HPLC, for Maillard products. In addition, physiological cross-links were analyzed by HPLC. Oxidation- and Maillard reaction-related fluorescence increased in collagenase digests from carious dentin. Advanced Maillard products (carboxymethyllysine and pentosidine) increased, whereas furosine, a marker for the initial reaction, was not observed consistently. This implies no direct addition of sugars to protein, but rather the addi-tion of smaller metabolites and glycoxidation products. In addition, the physiological cross-links hydroxylysinonorleucine and dihydroxylysinonorleucine decreased in carious dentin. Also for hydroxylysylpyridinoline, a decrease was observed, but not consistently. In conclusion, the caries process modifies amino acids in dentin collagen, which can lead to increased resistance against proteolysis and ultimately to caries arrestment.     

Greater concentration of dietary sucrose decreases dentin formation and increases the area of dentinal caries in growing rats

The effect of increasing dietary sucrose concentration on dentin formation and dentinal caries progression was studied. Weanling Wistar rats received 15, 30 or 43 g/100 g sucrose in a diet; for reference, another group was fed a nonpurified diet. At the onset, tetracycline was injected to mark the dentin formed during the experiment. After 6 wk, lower molars were sectioned sagittally; the areas and thicknesses of the dentin formation during the experiment and dentinal caries lesions were quantified separately in the first and second molars. Feeding the 43% sucrose diet resulted in a significantly lower dentin formation than in other diet groups (P < 0.05). The differences obtained from the area measurements were supported by thickness measurements. In the first molar, the 43% sucrose diet resulted in a significantly greater area of dentinal caries than in the other sucrose groups. The number and severity of caries lesions clearly increased as the concentration of sucrose in the diet increased (r = 0.5, P < 0.05 and r = 0.6, P < 0.05, respectively). This study suggests that the increase in the concentration of sucrose in the diet reduces dentin formation and increases the area of dentinal caries as well as the number and severity of caries lesions; the critical sucrose concentration appears to be between 30 and 43 g/100 g.     

Comparison between Er:YAG laser and conventional technique for root caries treatment in vitro

Effective ablation of dental hard tissues by means of the erbium-doped:yttrium-aluminum garnet (Er:YAG) laser has been reported recently, and its application to caries removal and cavity preparation has been expected. However, few studies have investigated the capability of the Er:YAG laser to treat caries. In the present study, the effectiveness of caries removal by using an Er:YAG laser in vitro was compared with that of conventional mechanical treatment. Thirty-one extracted human teeth with root caries were used. Half of the caries in each tooth was treated with the Er:YAG laser, and the other was removed with a conventional bur or was left untreated as a control. Laser treatment was performed by means of a combination of contact and non-contact irradiation modes with cooling water spray, with a new fiber delivery and contact probe system. Conventional bur treatment was conducted by means of a low-speed micromotor. Measurements of the time required for caries removal, histopathological observations of decalcified serial sections, scanning electron microscope (SEM) observations, and hardness measurements of the treated cavity-floor dentin were performed for each treatment. Due to the careful irradiation technique, a longer treatment time was required for the complete removal of carious dentin by the Er:YAG laser. However, the Er:YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the bur treatment. In addition, a lower degree of vibration was noted with the Er:YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin surface. Our results show that the Er:YAG laser system is promising as a new technical modality for caries treatment.     

DNA base composition of Allium genomes with different chromosome numbers

The aim of the present study was to analyze the fatty acid content of carious and sound human dentin. Gas chromatography and gas chromatography-mass spectrometry revealed the presence of fatty acids of C10-C18 size in the carious dentin, whereas fatty acids of C16 size were present in minute amounts in three samples of the corresponding sound dentine controls. No fatty acids were detected in the other sound dentin control samples. The source of fatty acids was considered to be microorganisms invading the dentin during the progression of the caries lesion. The presence of bacterial fatty acids in carious dentin may serve as a marker for the pathological process and thus contribute to the understanding of the mechanisms involved.     

Catecholamines, stress, and disease: a psychobiological perspective

White demineralized areas after the removal of orthodontic appliances remain a problem for clinicians and patients. The main objective of this study is to assess clinical photography as a method for the evaluation of caries and white spots and the in vivo study of remineralization of carious lesions. The secondary objective was to compare the effect of different levels of both experimental and commercial fluoride solutions on the remineralization of enamel carious lesions. White spot lesions were created with an acid solution on extracted permanent human teeth, and the lesions were remineralized in remineralizing solutions with or without fluoride ions. The changes in the enamel surface during the demineralization and the remineralization processes were recorded with a 35 mm clinical camera. Photographs were taken of the experimentally created white spots, the samples were sectioned for microradiography testing, and the actual mineral contents of the white spot lesions were calculated from the microradiographs. The enamel lesions were further analyzed by powder x-ray diffraction to confirm whether fluoride was incorporated into the lesions during the remineralization period. From this experiment it can be concluded: (1) clinical photography as currently practiced is not an adequate method of monitoring the remineralization of white spots with large lesion depths and (2) the experimental solution that contains 50 ppm fluoride had a higher efficacy for remineralization than the control solution or the commercial mouth rinse, which contained 225 ppm fluoride.     

Peer approaches for increasing HIV awareness on a college campus

PURPOSE: To compare the accuracy of clinical examination performed with bitewing radiographs or clinical examination using tooth separation to identify carious lesion activity. MATERIALS AND METHODS: 320 surfaces from 40 bitewing radiographs were examined for approximal caries on the maxillary and mandibular primary molars of 20 patients 3-10 years old. The patients were divided into three groups: (1) Absence of the permanent first molar; (2) Partial eruption of the permanent first molar; and (3) Full eruption of the permanent first molar. Two examiners evaluated the radiographs using a megascope, a magnifying glass (x2), and an amplifying image screen. Approximal radiolucencies were identified on 72 surfaces. Following the radiographic examinations, the two examiners performed conventional clinical inspection using a No. 4 dental mirror, a No. 5 dental explorer, and an air-water syringe, with artificial light and relative isolation. The separation method was performed with elastic bands, which were removed after 24 hours, and the clinical examination conducted as in the non-separation group. RESULTS: The correlation between the extension of interproximal radiolucent lesions in primary dentition and their clinical diagnoses following separation of the teeth, was similar to findings on literature evaluating the permanent dentition. On radiographic findings for enamel lesions, white spots predominated both in the inner (100%) and in the outer (94%) half of enamel upon clinical examination with separation of teeth. For radiolucent lesions in dentin, on the other hand, cavities predominated over white spot lesions (84%). In Groups 1 and 2 (young primary), white spots occurred in cases where the radiolucent lesions reached the dentin (15% and 25%), similar to findings for young permanent teeth. Clinical diagnosis performed with the mechanical separation of teeth cannot be considered conclusive for the primary dentition.     

"Carious" and "noncarious" lesions of the hard dental tissues. Ultrastructural (SEM) and microanalytical (EDS) analyses of teeth from the 3rd century B.C

The study was carried out on 80 teeth (70 of permanent dentition and 10 of primary one) of mandibular and maxillary bones. The teeth owned to subjects lived in the III c.b.C. in Sicily, and they were found in Naxos necropolis. The teeth were examined as far as carious and non carious lesions, then they were prepared for instrumental analyses by Scanning Electron Microscopy (SEM) and Energy dispersed X ray spectrometry (EDS). To an objective examination of the sample no caries were detected in the teeth sample apart one tooth, on the other hand there was an extensive occlusal abrasion, from a macroscopic point of view there were no difference as far teeth morphology. SEM examination pointed out all around dentinal tubules a circle of sclerotic dentin as reaction to occlusal wear. The amelocemental junction showed from a ultramicroscopic point of view an overlap of cementum onto enamel. EDS analysis pointed out a higher P concentration on the crown versus the root in all the teeth of the sample.     

Temporal and site-specific expression of transforming growth factor-beta4 in human endometrium

Orthodontic treatment with fixed appliances increases the caries risk in young persons. The aim of this study was to apply a new caries diagnostic method, quantitative laser fluorescence, for longitudinal in vivo quantification of changes in incipient enamel lesions related to fixed orthodontic appliances. Seven young patients with active caries lesions disclosed at removal of the orthodontic brackets and bands were enrolled in the study. Caries preventive measures were intensified, including dietary advice, oral hygiene instructions, and the regular use of a fluoride dentifrice. The caries lesions were monitored with the quantitative laser fluorescence method after removal of the brackets and once a month thereafter. For each lesion, three quantities were measured: lesion area (mm2), mean fluorescence loss (%) over the lesion, and maximum loss of fluorescence (%) in the lesion. During a 1-year follow-up period, the areas of the lesions decreased and the enamel fluorescence lost was partly regained indicating that a remineralization process had occurred. It was concluded that quantitative laser fluorescence seems suitable for in vivo monitoring of mineral changes in incipient enamel lesions, and useful for the evaluation of preventive measures in caries prone persons, such as orthodontic patients.     

Effects of ArF:excimer laser irradiation on human enamel and dentin

Round enamel and dentin surfaces of sound and carious extracted human teeth were irradiated by an ArF:excimer laser for up to 180 sec. Thermographic measurements indicated that the temperature rise due to heat accumulation caused by laser irradiation on these enamel and dentin surfaces was up to 19 degrees C (10 HZ with 540 J/cm2), and the temperature returned to the preirradiation value within 10 sec after the irradiation was stopped. Under light microscopy, no carbonization was evident on these surfaces, and a simple recess was formed by abrasion or vaporization in the irradiated regions. In the secondary SEM, uniformly distributed fine pores and prism structures appeared slightly on the enamel surfaces. Between the peritubular and the intertubular dentin, there appeared a distinct difference in the dissolved area. The laser almost completely removed carious regions of the enamel and the dentin, and penetration extended beyond the carious regions. In the backscattered electron SEM, highly mineralized layers were observed on the enamel and dentin surfaces dissolved by the laser.     

Effects of xylitol and carbohydrate diets on dental caries, dentine formation and mineralization in young rats

Female Wistar rats were weaned at the age of 3 weeks and fed for 7 weeks either a high-sucrose diet, a non-cariogenic raw potato-starch diet, a high-sucrose diet with 5% xylitol supplement, a raw potato-starch diet with 5% xylitol supplement or a non-cariogenic, commercial, powdered rat food (Ewos R3) for reference. A low xylitol concentration reduced the progression and severity of carious lesions but did not affect dentine apposition or the width of predentine in rats fed high-carbohydrate diets. Widening of the predentine zone in rats fed a high-sucrose diet might reflect disturbed mineralization, which could not be explained by serum ionized calcium or phosphate ion levels and which could not be corrected by low xylitol concentrations. It is concluded that the reduced area of dentinal carious lesions after low xylitol supplementation is not dependent on dentine formation or mineralization, but rather on direct effects in the mouth.     

Caries extreme groups among adolescents, leaving organised dental care in G?teborg, Sweden

The aim was--in a longitudinal respect--to study whether 15-year-old children, in caries-free groups, and groups with high frequency of carious lesions, had a stable caries development from 15 to 19 years of age, when they left the organised Public Dental Care. Caries index values were analysed for the period 1986/7-1990/1 for patients born 1971-72 and residing in G?teborg. The groups of caries-free children seemed to be stable in their dental health in about 60-70% according to the prevalence indices used; and about 80% according to the incidence index DS-a. The caries prevalence index mean values of the 15-year-old patient groups with high frequencies of lesions showed between 1.5 to 3.5 percentile units higher mean values when the individuals were 19 years of age. However, the corresponding caries incidence index values were as low as half the size, indicating a possible treatment effect of the caries prevention programme used. Related to the DFS-a index, the 20% groups with the highest caries index values were registered for about 80% of all approximal lesions, of special interest for dental care costs.     

Oral hygiene as a risk indicator of enamel and dentin caries

Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. OBJECTIVES: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. METHODS: The study was conducted in Goa, India. Data came from a cross-sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self-administered questionnaire to their parents. The cavitated and non-cavitated criteria were used to score for caries, and the Silness-Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean+/-s for dmfs, enamel and dentin lesions were 4.20+/-5.10, 2.59+/-2.89 and 1.61+/-3.30 respectively, and the mean plaque score was 1.00+/-0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries-oral hygiene association seen is explored further.     

A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women

Using annual bite-wing radiographs, the incidence and progression of approximal caries (4d-7m) were assessed longitudinally in teenagers and adolescents whose treatment had been based on remineralizing rather than restorative strategies. A closed cohort of 536 children initially was followed from 11 to 22 years of age. The scoring system was: 0 = no visible radiolucency; 1-2 = radiolucency in the enamel up to the enamel-dentin border; 3 = radiolucency with a broken enamel-dentin border but with no obvious progression in the dentin; 4 = radiolucency with obvious spread in the outer half of the dentin, and 5 = radiolucency in the inner half of the dentin. Caries rates were estimated as the number of new lesions/100 tooth surface-years, and the Kaplan-Meier estimate was used to calculate the cumulative survival time of each approximal surface. Three events were used: the transitions from states 0 to 2, 2 to 4 and 3 to 4. The results showed a considerable variation between the surfaces in both caries rates and survival time. For all surfaces combined, the median caries rate from state 0 to 2 was 3.9 new lesions/100 tooth surface-years; from state 2 to 4, the rate was 5.4, and from state 3 to 4 it was 20.3. Of the sound surfaces (state 0), 75% survived 6.3 years without reaching state 2. Given state 2, 75% survived 4.8 years without reaching the outer half of the dentin (state 4), while given a lesion at the enamel-dentin border (state 3), 75% survived 1.3 years without doing the same. The median survival time of lesions from state 3 to 4 was 3.1 years. The group with DMFSappr>1 at the age of 11-12 years had a risk of new approximal enamel lesions (state 0-2) that was 2.5 times greater than that of the group with DMFSappr = 0-1.     

Arrest of root surface caries in situ

This study tests the hypothesis that daily oral hygiene combined with topical fluoride arrests active root-surface caries lesions without changing the mineral content of the lesions. Therefore, changes in mineral content and distribution were studied in root surfaces during caries lesion development and subsequent arrest of lesion progression in situ. In 18 subjects, lesions were developed during 3 months in sound root-surface specimens inserted into lower partial dentures. After 3 months, ground sections were prepared from each lesion prior to re-insertion of the specimens into the dentures. In addition, one sound root specimen was added per subject. During the following 3 months, half of the subjects cleaned both sound and carious specimens once a day with an 1100-ppm fluoride toothpaste, and the specimens were treated twice with 2% NaF for 2 min in situ. The other half of the subjects continued the experiment without cleaning. During the initial three-month period, all specimens developed subsurface lesions extending 187 to 583 microm into the dentin. Lesion depth increased somewhat in both experimental groups during the following 3 months (P > or = 0.1). There was a non-significant increase in mineral loss in the plaque-covered specimens (P = 0.08). However, the total mineral content of specimens subjected to plaque removal and topical fluoride did not change. This treatment resulted in an increased mineral content in the surface layer (P < 0.01) and formation of a zone of higher mineral content within the body of the lesion. The sound root surfaces which had been cleaned for a three-month period showed mineral uptake in the surface layer, occasionally associated with subsurface demineralization extending 20 to 70 microm into the tissue. The mineral loss of these specimens was significantly smaller than that of plaque-covered surfaces (P < 0.001). It is concluded that daily plaque removal and topical fluoride use influence the distribution of mineral in sound and carious root surfaces and may arrest lesion progression without affecting the total mineral content.     

Artificial caries formation around fluoride-releasing restorations in roots

Secondary caries is one of the most important factors leading to replacement of dental restorations. This investigation assessed the capacity of fluoride-releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in the buccal and lingual surfaces of 30 extracted premolars. The six materials used were: glass-ionomer cement (Fuji), glass-ionomer cement with silver particles added (Ketac-silver), fluoride-containing composite resin (Tetric), composite resin (Silux plus), fluoride-containing amalgam (Fluor-Alloy) and high-copper amalgam (Dispersalloy). After 5 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that repair with glass-ionomer materials of a carious lesion may be of great importance in the prevention of secondary caries around the restorations in roots.     

Cytomorphology of tyrosine-rich crystalloids in fine needle aspirates of salivary gland adenomas

OBJECTIVE: To evaluate the presence of tyrosine-rich crystalloids (TRC) in fine needle aspiration (FNA) specimens of pleomorphic adenomas of salivary gland. STUDY DESIGN: FNA specimens from 12 patients were reviewed, and the percentage of cases showing TRC was established. The staining properties of the TRC were evaluated as well as spontaneous fluorescence under ultraviolet (UV) light. RESULTS: Of the 12 pleomorphic adenomas, 4 showed TRC (30%) in the smears. Among the eight cytologically negative cases there were two that showed a few TRCs on histology. All positive cases were from African American patients. TRC stained weakly with Papanicolaou stain. TRC were deep blue with Diff-Quik. They fluoresced under UV light. CONCLUSION: TRC could be detected in FNA specimens. They were best seen under UV light. The Papanicolaou technique stained TRC very pale, making them difficult to see. Diff-Quik stained TRC dark blue, mimicking deposits of dye. The amount of TRC in histology paralleled the detection rate in cytology.     

Research with families in palliative care: conceptual and methodological challenges

The aims of the present study were to investigate the ability of 3 experienced clinicians to detect occlusal carious lesions, assess their depth, diagnose their activity and define a logical management for each lesion. The material consisted of 35 third molars scheduled for extraction or surgical removal making it possible to validate the accuracy of the clinical recordings histologically. Examinations were carried out at baseline and after 4 months in order to monitor lesion progression. At the first visit a radiograph was taken; the number of filled surfaces was counted and the oral hygiene assessed generally and by disclosing occlusal plaque of the tooth under examination. After cleaning the occlusal surface caries was recorded in a selected investigation site using a visual ranked caries scoring system, as well as an electrical conductance recording (ECM). Apart from counting fillings and taking new radiographs the same procedure was performed at the second visit, which then was followed by extraction of the tooth. After sectioning the tooth lesion depth was recorded, and lesion activity, based on acid production, was assessed using methyl red dye. Lesion activity was also judged by means of polarized light microscopic examinations of the sections. Results showed strong relationships between the visual, ECM and radiographic assessments and both lesion depth and lesion activity. In contrast, all other parameters were poorly related to lesion activity. Changes in visual assessments and in conductance readings from first to second examination were poorly associated with lesion activity. In conclusion, clinicians are able to detect lesions, predict activity and severity and define a logical management of occlusal caries on the basis of a single examination.     

The activation and function of host matrix metalloproteinases in dentin matrix breakdown in caries lesions

Matrix metalloproteinases (MMPs) are a family of enzymes which, in concert, are capable of degrading collagen. We investigated whether human MMPs could participate in the degradation of dentin organic matrix after demineralization. We performed Western blot analyses using MMP-specific antibodies to identify MMPs in human dental caries lesions. Enzymography and functional activity assays, with 125I-labeled gelatin as substrate or quantitating the degradation of type I collagen, were used to determine the activity of purified and salivary gelatinolytic (MMP-2 and MMP-9) and collagenolytic (MMP-8) enzymes with and without acid-activation in pHs relevant to caries. Respective analyses were done with caries-related bacteria. We performed electron microscope analyses to assess the degradative activity of sterilized salivary host MMPs on demineralized human dentin. Human MMP-2, MMP-8, and MMP-9 were identified in demineralized dentinal lesions. The latent purified forms of these enzymes were activated at low pH (4.5), followed by neutralization, mimicking the conditions during caries progression. Incubation of human saliva at low pH followed by neutralization resulted in a four-fold increase in the gelatinolytic activity. No gelatinolytic or collagenolytic activity was observed in bacterial samples. The activated enzymes in saliva degraded demineralized dentin organic matrix in vitro. These results demonstrate the pH-dependent activation mechanism of MMPs, which may have a distinct role in different physiological and pathological conditions. They further demonstrate that host MMPs, activated by bacterial acids, have a crucial role in the destruction of dentin by caries.     

A four-year randomized controlled trial of hormone replacement and bisphosphonate, alone or in combination, in women with postmenopausal osteoporosis

The aim of this study was to investigate the extent of natural intrinsic fluorescence in carious human dentine and any correspondence of such autofluorescence (AF) to the mineral distribution within the lesion. Two investigative techniques were used, both employing the same sample set and fields in diamond-polished block surfaces of polymethylmethacrylate-embedded carious teeth. AF at emission wavelengths >515 nm, excited by 488-nm laser light, was assessed using a confocal laser scanning optical microscope (CLSM), the recordings made under standard operating conditions. The relative mineral content was assessed using digital backscattered scanning electron microscopy (20 kV BSE-SEM). The AF intensity correlated with the level of demineralisation as seen by BSE, but the depth of the lesion as seen by CLSM was significantly greater implying that the AF is not directly related to the mineral component.     

Social facilitation of eating among friends and strangers

In a series of studies to investigate the basic structural features and characteristics of the biological apatite crystals using a transmission electron microscope, we examined the ultrastructure of the human enamel, dentin, and bone crystals through the cross and longitudinal sections at near atomic resolution. Subsequently, using the same approach, we have been able to directly examine the images of the lattice imperfections in the crystal lattices of the human tooth and bone crystals, and the images of the fusion of the crystals. In this research, furthermore, using transmission and scanning electron microscopes, we examined the dissolution of the enamel crystals caused by the carious enamel from the same viewpoint. The material used for the observation of the dissolution of the enamel crystals was obtained from the region which corresponds to the middle layer of the enamel at the portion near the wall of a carious cavity caused by the fissure caries on the occlusal surface of the lower first molars. Small cubes of the materials used for the observation by transmission electron electron microscope were fixed in glutaraldehyde and osmium tetroxide and embedded in epoxy resin using the routine methods. The ultrathin sections were cut with a diamond knife without decalcification. The sections were examined with the HITACHI H-800H type transmission electron microscope operated at 200 kV. Each crystal was observed at an initial magnification of 300,000 times and at a final magnification of 10,000,000 times and over. The material used for the observation by the scanning electron microscope was the fractured surface obtained from the carious enamel. The fractured carious enamel surfaces were coated with carbon and gold and observed with the HITACHI HHS-2R type scanning electron microscope operated at 25 kV. The crystals were observed at a final magnification of 50,000 times. As a result, we have confirmed that the dissolution of the enamel crystals caused by a caries occurs in the units of "hexagonal cell". We sincerely believe that the electron micrographs shown in this report are the first to show the images of the dissolution of the enamel crystals caused by a caries at near atomic resolution.