The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand

Thai children have been shown to accumulate large amounts of dental calculus. The purpose of this study was to examine the relationship of calculus to caries and gingivitis, and salivary conditions which may contribute to calculus accumulation. Four-hundred and thirty-nine (439) children from 18 schools in Chiang Mai were selected for this study. The children were given oral examinations to determine calculus index (CI); decayed, missing, and filled surfaces (DMFS); decayed, missing, and filled teeth (DMFT); gingival index (GI); and plaque index (PI). Children with mean CI scores > or =1 (206) were assigned to the calculus group; the 233 children with mean CI scores of <1 to the noncalculus group. Saliva was collected from 60 randomly-selected children in each group. Unstimulated and stimulated whole saliva and stimulated parotid saliva were assessed for flow rate, pH, and buffer capacity using 2 methods. Results showed that calculus status was not significantly associated with caries, but that there was a high association between gingivitis and plaque status with calculus accumulation (P < 0.001). There were no significant differences in saliva flow rate, pH, or buffer capacity between calculus and noncalculus groups. The lack of association between calculus status and caries indicated these 2 conditions have different etiologies and suggests the importance of plaque and calculus prevention programs, in addition to caries control efforts, to maintain oral health of Thai children.     

Anticalculus and antiplaque activity of 8-hydroxyquinoline sulfate

The effect of 8-hydroxyquinoline sulfate on the formation of artificial calculi, rat calculus, and dog plaque plus its ability to remove dog plaque were studied. Several chemically related agents were also evaluated for their anticalculus effects. The most effective anticalculus agent was 8-hydroxyquinoline sulfate. At concentrations of 4 or 5%, swabbed over molar teeth, it was essentially equally effective in retarding the formation of rat calculus. Significant (1% level) reduction occurred with concentration as low as 3% in rats. When used so as to mimic mouthrinse use, 4% 8-hydroxyquinoline sulfate also significantly (5% level) reduced formation of calculus in rats. All rats showed normal behavioral and weight-gain patterns. Visual evaluation of oral tissues in the swabbing tests plus visual and histopathological evaluation of oral tissues in the mouthrinse procedure showed 8-hydroxyquinoline sulfate had no irritating or toxic effects. In dogs, the teeth treated with 4% 8-hydroxyquinoline sulfate nine times during a five-day period had 93.7 to 98.4% less buccal plaque than vehicle-treated teeth. The antiplaque effect was considerable in both canines and fourth premolars. In older dogs, teeth treated with 4% 8-hydroxyquinoline sulfate 15 times during a ten-day period had 33 to 46.1% less plaque than when treated with the vehicle. The effect was considerable on canines but slight on fourth premolars. In older dogs after 24 treatments during a 15-day period, 4% 8-hydroxyquinoline sulfate removed 25 to 57.5% of established plaque whereas the vehicle removed 2.5 to 22.5%. Again, 8-hydroxyquinoline sulfate was more effective on canine buccal plaque. These results show that 8-hydroxyquinoline sulfate is an effective anticalculus and antiplaque agent that is nontoxic to animal oral tissue. The results also indicate that the dog is a suitable animal model for the evaluation of antiplaque agents.     

Effect of three months' frequent use of sugar-free chewing gum with and without urea on calculus formation

Studies on the relationship between gum-chewing and calculus formation have produced contradictory results, and it is not clear whether frequent use of chewing gum promotes or inhibits calculus formation. Also, little is known about whether the addition of a small amount of urea to the chewing gum influences calculus formation. The aim of this investigation was to study the effect of sugar-free chewing gum--with and without urea--on calculus formation and some associated clinical variables. Three three-month periods were studied in a double-blind, crossover design, during which the subjects: (1) chewed 5 pieces/day of a sugar-free, urea-containing chewing gum (20 mg urea/piece); (2) chewed 5 pieces/day of a sugar-free, non-urea-containing gum; or (3) performed no gum-chewing. Twenty-nine persons, all calculus-formers, participated. They were scored for calculus at mesio-lingual, lingual, and disto-lingual sites on the 6 anterior mandibular teeth according to the Volpe-Manhold index. Plaque and gingival bleeding index, stimulated salivary secretion rate and buffer capacity, resting plaque pH, mutans streptococci in saliva and plaque, and lactobacilli in saliva were also determined. No differences in calculus formation were found among the 3 periods. The resting plaque pH was higher after the period with urea-containing gum than after the period with non-urea-containing gum and the no-gum period (p < 0.05). A slight increase in stimulated salivary secretion rate was found after the 2 gum periods (p < 0.05). The plaque and gingival bleeding indices decreased, while resting plaque pH and salivary buffer capacity increased throughout the entire study (p < 0.05). No significant differences in prevalence of the acidogenic micro-organisms were found among the test periods. The main conclusion from this study is that three months' frequent use of sugar-free chewing gum--with or without urea--neither promotes nor inhibits calculus formation.     

Modulation of the expression on constitutive rat hepatic cytochrome P450 isozymes by 5-fluorouracil

BACKGROUND and OBJECTIVE: The purpose of this study was to compare morphologic changes following C02 laser or manual curette treatment of calculus-ladened tooth root surfaces. STUDY DESIGN/MATERIALS and METHODS: Laser treatment consisted of repeated single passes with a 6 Watt focused beam at 20 pulses per second, a pulse length of 0.01 second, and a manufacturer's laser efficiency rating of 86% (i.e., the amount of total power delivered through the aperture). The rate of beam passage over the target surface was controlled at 4 mm/second using an 0.8 mm diameter tip. The calculated energy density was 240 J/cm2 for each pass of the beam. Scaled and root planed surfaces were treated with a standardized force of 600 grams using new curettes. Specimens were evaluated by scanning electron microscopy. RESULTS: Laser-induced surface changes included charring, meltdown and resolidification of calculus mineral, and ablation of microbial plaque. Laser-treated specimens also exhibited residual calculus and microbial plaque deposits in areas directly adjacent to the beam path. Scaled and root planed surfaces featured smooth and/or scale like smear layers and islands of residual calculus and microbial plaque. CONCLUSIONS: The rough surface topography resulting from laser treatment and residual calculus and microbial plaque deposits indicates that C02 laser treatment of exposed root surfaces is, at best, an adjunct to traditional methods of therapy.     

Factors determining the outcome of scaling and root planing

Scaling and root planing are the predominant and recognized forms of periodontal therapy. They have been known for centuries, and have been investigated with increasing intensity since the turn of the century. Scaling and root planing aim at therapeutic changes of the "hard tissue lesion" at the root surface, in order to render it biologically acceptable to cells capable of attaching to it. Two major components of these root surface alterations are calculus and cementum alterations. Numerous studies have shown that scaling and root planing effectively removes subgingival deposits, and that this removal is seldom complete in deeper pockets. Even though beneficial clinical effects of scaling and root planing have been shown, it is unlikely that the full potential of healing is utilized today due to technical shortcomings. Several studies have shown that the design and dimensions of curets as used today are not optimal. These instruments are for many situations too big, subject to rapid dulling, and produce a smear layer. Chemical agents have been used to remove this layer with limited success. The therapist is a virtually unknown factor in the system of delivering scaling and root planing. A recent study showed that scaling and root planing forces used by different therapists on similar root surfaces varied by factors greater than 10. In addition, higher forces were shown to remove significantly more root substance. Apparently there is a large subjective component included in the delivery of scaling and root planing therapy. Even though scaling and root planing have been shown to be effective therapeutic procedures, many aspects require more research.     

Combining chemical agents and techniques to remove intrinsic stains from vital teeth

Hydrochloric acid, hydrogen peroxide, and carbamide peroxide are chemical agents currently used to remove a variety of intrinsic stains from vital teeth. Because none of these agents is effective in treating all tooth discolorations, approaches that use combinations of the agents can be helpful in extending the range of their effectiveness. Selection of the appropriate chemical stain removing agent is discussed and situations in which a combination of agents and techniques have proved to be more successful than a single agent approach are described.     

Muscle power and shoulder joint function after removal of the latissimus dorsi muscle

Understanding the functional dynamics of the oral cavity helps researchers design methods to predict clinical outcomes. Most information about the oral cavities of companion animals must be drawn from animal studies designed to understand human oral disease and from human studies. Based upon functional criteria for any animal or experimental research study, supragingival plaque and calculus can be assessed within four to six weeks. Although longer studies may be more appealing, such study designs may compromise the oral soft tissue health of the animals and are complicated by oral cavity dynamics. Thus, they are less sensitive and predictive of longer term clinical outcomes. Additional research is necessary to relate tooth surface accumulation phenomena with oral soft tissue health.     

Indications for carotid endarterectomy in patients with symptoms: when, where?

Carotid endarterectomy (CEA) is one of the most commonly used surgical methods in the treatment of cerebral stroke with both therapeutic and also prophylactic implications. CEA has been used in surgical practice for 40 years. At the beginning it was very popular and was widely used. Later, the opposite extreme was reached, and its therapeutic efficacy was denied unjustifiably. However, at the beginning of the ninetieth three large controlled studies were completed (North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial and Veterans Administrations Symptomatic Trial) and the results of these trials were the basis for establishing the solid criteria for the surgical procedure in some groups of symptomatic patients with stenosis of the internal carotid artery. Thus, CEA was in again. In accordance with the attitudes of the American Association Ad Hoc Committee (1995), evidenced indications for CEA in patients with symptomatic stenosis of the internal carotid artery (in the group with surgical risk less than 6%) include (a) single or recurrent episodes of TIA in the last 6 months, "crescendo" TIA combined with carotid stenosis > 70% with or without plaque ulceration, with or without antiplatelet therapy, and (b) mild stroke in last 6 months with carotid stenosis > 70% with or without plaque ulceration, with or without antiplatelet therapy. The authors report their experience and results of a six-month pilot study of 301 patients, of whom 248 were operated on for symptomatic carotid stenosis with low combined perioperative morbidity and mortality (0.6%). Also, indications for surgical reconstruction of carotid and coronary arteries in patients with marked signs of atherosclerosis in both arterial systems are discussed.     

Vulnerable plaque: pathobiology and clinical implications

PURPOSE: To review the pathobiology and clinical implications of vulnerable coronary atherosclerotic plaques and to discuss the identification of vulnerable plaques and mechanisms of plaque stabilization. DATA SOURCES: English-language articles in the MEDLINE database that were published from 1966 to the present, identified by using the terms atherosclerotic plaque, myocardial revascularization, and plaque stabilization. Selected references cited in identified articles were reviewed. STUDY SELECTION: Experimental, clinical, and basic research studies related to coronary atherosclerotic plaques. DATA SYNTHESIS: Rupture at the site of a vulnerable atherosclerotic plaque is the most frequent cause of acute coronary syndromes. Typically, such plaque does not cause high-grade stenosis and has a large lipid core and a thin fibrous cap that is often infiltrated by inflammatory cells. Mechanical stresses contribute to plaque vulnerability, and certain triggers may cause plaque disruption directly. The most important consequence of plaque rupture is thrombosis. No method reliably identifies plaques prone to rupture. The reduction of coronary events by lipid-lowering agents despite only modest luminal changes suggests that these agents have a plaque-stabilizing effect. Surgical or percutaneous revascularization does not address the basic biology of coronary atherosclerosis and therefore may have little effect on plaque vulnerability. CONCLUSIONS: Improved understanding of the biology of atheromatous plaques has led to the concept of plaque vulnerability. Identification and stabilization of vulnerable plaques are important new directions in the treatment of coronary atherosclerosis. The relative benefits of aggressive medical therapy aimed at plaque stabilization should be compared with those of revascularization in the management of chronic coronary artery disease.     

Mutational analysis of Csc1/Vps4p: involvement of endosome in regulation of autophagy in yeast

The present study was performed to test the tendency for plaque and calculus build-up along the wire of different types of bonded orthodontic canine-to-canine retainers, whether the presence of such retainers causes any damage to the teeth involved, the failure rate of the retainers, and any changes in incisor alignment during a 3-year period of retention. The four test groups received either retainers made of thick plain wire bonded only to the canines (n = 11); thick spiral wire bonded only to the canines (n = 13); thin, flexible spiral wire bonded to each tooth (n = 11); or removable retainers (n = 14). Accumulation of plaque and calculus along the gingival margin, gingival inflammation and probing attachment level were scored in lingual areas from canine to canine at the time of fixed appliance removal and again 3 years after retainer insertion. Incisor irregularity was measured on plaster models made at the same time periods. Accumulation of plaque and calculus and development of caries along the wire were scored at follow-up. Retainer failures were recorded whenever they occurred. The results revealed no intergroup differences in changes between baseline and follow-up examinations or status along the retainer wire for any of the variables. Gingival inflammation and plaque accumulation were scored less frequently after 3 years in retention than at the time of debonding. No signs of caries were seen adjacent to the wire. Failures were observed of one, four and three of the fixed retainer types, respectively. These patients showed a greater increase in incisor irregularity than the other patients.     

A six-month clinical evaluation of the Dentrust toothbrush

Clinical study guidelines have been established by the American Dental Association for assessing plaque and gingivitis reductions with chemotherapeutic agents. Two six-month studies are required. While the toothbrush is also instrumental in plaque and gingivitis reduction, there are currently no study requirements by the ADA for manual brush efficacy. It was thought to apply the long-term efficacy requirements for chemotherapeutic agents to two manual toothbrushes to assess their efficacy for comparative purposes. Forty-eight subjects using the Dentrust toothbrush and forty-five subjects using the Oral-B toothbrush completed a six-month study to assess safety, plaque removal and gingivitis reduction. The subjects were randomly assigned to use either the newly designed (three sided) Dentrust toothbrush or the traditional flat-headed toothbrush. The subjects took their respective toothbrushes home following a baseline evaluation, and were subsequently assessed at three and six months by the same examiners with the same indices in this single-blind trial. There were no significant differences between the two groups on plaque removal during the study. At six months, the Dentrust group removed a significant amount of both buccal and lingual plaque and the flat-headed toothbrush removed a significant amount of buccal plaque only. On gingivitis the groups had no significant differences at baseline; however, by six months the Dentrust group was significantly better than the flat-headed toothbrush on gingivitis reduction. Long-term use of the Dentrust toothbrush can be said to significantly contribute to gingival health overall, and especially in the hard to reach lingual areas compared to long-term use of a traditional flat-head toothbrush.     

Calculus deposits and bone loss on the teeth of Romano-British and eighteenth-century Londoners

The relation between dental calculus and periodontal disease is not clear but it is generally recognized that calculus is a significant pathogenetic factor. Skeletal material has previously been used to study some aspects of chronic adult periodontitis but few studies have quantified the extent of calculus in ancient populations and its relation to changes in alveolar bone height. This study records the presence and extent of calculus and its relation to alveolar bone loss in a Romano-British and eighteenth-century London population. There were significant differences in calculus deposition in the two populations but this appeared to have little effect on changes in alveolar bone contour. It is suggested that the amount of calculus may be related to diet but that changes in alveolar bone height seem to be independently controlled.     

alpha2-Adrenoceptor antagonists reverse the 5-HT2 receptor antagonist suppression of head-twitch behavior in mice

Reference ranges are used in preclinical drug safety studies to screen experimental data for atypical values. The methods used most often to construct sample reference ranges are essentially large sample methods and may flag too few "atypical" values. It is better to generate finite sample reference ranges by modifying existing methods used for constructing tolerance intervals. We define validity and efficiency for reference ranges and discuss the validity and efficiency of the methods described. A finite sample distribution-free method emerges as the clear winner.     

Recent research on calculus

This paper discusses the different types of calcium phosphate in calculus and the role of plaque pH in controlling calcium phosphate precipitation (calculus) or dissolution (caries). There is great site-specificity of deposition of supragingival but not subgingival calculus, with highest amounts of the former being present on the lingual aspects of the mandibular anterior teeth. This may be because the plaque there is most alkaline as that region has the highest salivary film velocity and the lowest salivary sugar concentration during consumption of sugar-containing food and drinks. The importance of calculus removal for good gingival health is emphasised.     

Eyeglass MEDRETE: practical considerations (a user''s guide)

Humans are exposed to a variety of potential developmental toxicants. This fact, combined with the knowledge that human development can be disrupted by "environmental" agents, has led to the development of methods designed to identify potential developmental toxicants. Currently, the principal method used to screen drugs and chemicals that are potential human developmental toxicants is the segment II study (i.e., a study in which prospective drugs and chemicals are tested in pregnant animals). Because of the cost and time involved in such studies and the pressure to reduce the number of animals used in such testing, alternative methods for developmental toxicity testing have been sought. This has resulted in a number of in vitro tests whose aim is to screen large numbers of agents quickly and inexpensively. Although numerous in vitro tests of developmental toxicity have been developed during the last 15 years, no one system or combination of tests have been validated for the purpose intended. Nonetheless, two systems--the limb bud/CNS micromass, and the chick embryo neural retina cell culture (CERC)--continue to be advanced as viable in vitro developmental toxicology tests. The purpose of this commentary is to evaluate the prospects for the development of an in vitro test system(s) that can screen the universe of drugs and chemicals and reliably identify those that require further study and those that do not. The conclusion of this investigator is that the prospects for validating such in vitro tests are not promising. This conclusion is based primarily on the lack of basic knowledge regarding the relevance of end points assayed in the micromass and CERC test systems to those end points known or thought to be critical for normal development.     

Plaque mineralisation in vitro

Dental calculus is plaque mineralised by deposition of calcium and phosphate resulting from interactions between the oral microbial plaque flora and components of oral fluids. An artificial-mouth microcosm dental plaque culture system has been developed to study aspects of plaque mineralisation, including pH control. Five plaques were grown from saliva under simulated oral conditions in a mucin-containing medium, and sucrose was applied to mimic meals. The plaques were mineralised with a urea-based, calcium-phosphate-monofluorophosphate-urea (CPMU) mineralising solution. Alkaline pH oscillations were generated by the plaques in response to CPMU applications, and an acidic oscillation followed sucrose applications. Plaque mineralisation by the CPMU procedure was almost totally dependent on the urea present in the mineralising solution, but total mineralisation also increased as the resting pH increased as a result of urea in the medium. Following four CPMU applications with a sucrose application every 12 hours improved plaque viability and mineralisation. The plaque mineral formed resembled a carbonated hydroxyapatite; other potential calcium phosphate minerals were undetectable except for calcium carbonate. A wide range of mineral deposition patterns in plaque were seen by electron microscopy.     

New automatic test for the study of platelet response to variations in osmotic pressure: application in the evaluation of the viability of platelet concentrates

Studying the osmotic resistance or swelling of platelets has often been suggested as a global test to assess the viability of those cells. A number of authors have also analysed the behaviour of platelets in hypotonic media by a variety of complementary methods (cell count, morphology, determinations of substances released, photometric measurement of aggregation induced by aggregating agents, etc). Most studies are currently based on the so-called "osmotic shock response" test, which measures according to time the light transmitted through platelet-rich plasma (PRP) after dilution in distilled water. In this study, the authors describe a new automated and reproducible test using slow dialysis to assess platelet osmotic resistance. The "Fragilimeter", a device initially described by the authors to characterise RBC fragility, has been adapted to the study of platelet osmotic behaviour. The variations in light transmission through a platelet suspension according to NaCl concentration are linked to the change in cellular volume and lysis and characterise the viability of the cells. The results obtained with normal platelets revealed the good reproducibility of the technique. The osmotic resistance is evaluated for two parameters: anticoagulant (citrate, EDTA) and cellular concentration. The test was applied to quality control of stored platelet concentrates for transfusion, prepared with different cell separators.     

Experimental models and treatment trials for cerebral infarction

Recent progress in both experimental and clinical studies of cerebral infarction is outlined, and research on delayed neuronal death and ischemic penumbra is described. Development of animal models to study clinical pathophysiology is reviewed, and our focal cerebral ischemia model which has been used for many years is introduced. With elucidation of the pathophysiology of cerebral ischemia, various pharmaceutical agents have appeared recently in the clinical setting and our experimental trials on the treatment of cerebral ischemia are also introduced. From the clinical aspect, practical methods of treatment including antiplatelet therapy are explained. Cerebrovascular dementia and its prevention are also described.     

Are prosome particles formed by the disintegration of proteasomes?

Quail reticulocyte 19S "prosome" fractions isolated on sucrose density gradients contain two kinds of particles: cylindrical proteasomes and ferritin. When samples of this fraction are prepared for electron microscopy using the one-step stain protocol described in this paper, most of the particles have a rectangular image resembling the proteasome. However, when samples are prepared for electron microscopy using the two-step stain protocol described here, there are few rectangular images. Their place is taken by round particles that resemble the prosome. Thus it appears that the round, raspberry-shaped particles called prosomes and the ring-like proteasome particles may be artifacts of specimen preparation for electron microscopy. We propose that proteasome particles may disintegrate when prepared for electron microscopy by methods such as the two-step stain protocol and that prosome particles represent the component parts of the proteasome. Furthermore, based on the enhancement of proteasome images obtained using the one-step main protocol we propose that, instead of consisting of a stack of four rings, the proteasome is constructed of three components, i.e., a spherical central particle flanked by two flat hexagonal end caps.     

Nature of geometric (Berry) potentials

Previous studies have found that the fluoride concentration of plaque growing on or adjacent to glass ionomer cement (GIC) is increased and the proportion of mutans streptococci in plaque is reduced. So far, there are only a few studies of the long-term effect of glass ionomer fillings on plaque in vivo. The aim of this study was to determine whether old GIC fillings have effects on plaque fluoride and microflora and whether this effect can be increased by topical application of fluoride on GIC fillings in vivo. The participants were 27 adults with at least 3 GIC fillings about 3 years old. Plaque was collected from sites adjacent to the GIC fillings and from the contralateral teeth, after which a 1.2% fluoride gel was applied to all teeth. Three days later, plaque was collected from the same sites as before. Stimulated saliva was also collected at both appointments. The results show that none of the patients had elevated levels of fluoride in their saliva either before or 3 days after the fluoride treatment. The fluoride concentration was 0.51 microgram/mg protein in plaque on GICs and 0.35 microgram/mg protein in plaque on contralateral teeth (p = 0.028). After the fluoride treatment, the respective fluoride concentrations were 0.59 microgram/mg and 0.75 microgram/mg (p = 0.849). No significant differences in the proportion of mutans streptococci and lactobacilli in plaque from GIC and contralateral teeth were found. The results suggest that the fluoride concentration of plaque growing on old GIC fillings is slightly increased. In this study, however, this had no significant effect on the cariogenic microflora.(ABSTRACT TRUNCATED AT 250 WORDS)