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In-Utero Treatment Reverses Cleft Palate in Mice

Dentistry Today — Wed, 01 Nov 2017 04:00:00 +0000

Researchers at University of Utah Health clarified a molecular pathway responsible for the formation of cleft palate and identified a new treatment to reverse this defect in mouse pups in-utero. These findings, published on September 5 in the journal Development, offer a new way to think about cleft development and could potentially yield treatments to prevent this common birth defect in people. Rena D’Souza, DDS, PhD, and her team revealed how the interplay between 2 genes, PAX 9 and Wnt genes, at a critical window of development is needed for the palatal shelves to grow and fuse in the midline. “For the first time, we can show the involvement of the Wnt pathway during palate fusion,” she said. Like people born with a cleft palate, the 2 sides of the palate fail to fuse in mice lacking the gene PAX9. At the molecular level, D’Souza found another abnormality. The mice missing this gene had an increase in 2 genes, called Dkk1 and Dkk2, that block the Wnt signaling pathway. D’Souza attempted to rectify that change by administering a pharmacological Wnt-based treatment that inhibited Dkk (WAY-262611) intravenously during a critical window of the pups’ gestation, when palate formation is initiated and ongoing. Treatment restored palate fusion in all of the pups tested. The drug works by blocking the Dkk genes and restoring the Wnt pathway. The researchers found no adverse health effects after monitoring the mother mice and their pups exposed to the treatment for 18 months. Future work is necessary to investigate if it is safe and effective to deliver a drug to human babies in-utero or directly to newborns with palate defects.

(Source: National Institute of Dental and Craniofacial Research, September 13, 2017)

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A New Treatment and Caries Prevention for Sensitive Teeth

Dentistry Today — Wed, 01 Nov 2017 04:00:00 +0000

Tooth sensitivity can be treated, but many current approaches don’t last long. New research reported in the journal ACS Applied Materials & Interfaces describes the development of a new material with an extract from green tea that could treat tooth sensitivity and also help prevent caries in these susceptible patients. Plugging dentinal tubules with the mineral nanohydroxyapatite is a long-standing approach to treating sensitivity, but the material doesn’t stand up well to regular brushing, grinding, erosion or acid produced by caries-causing bacteria. Cui Huang and colleagues wanted to tackle sensitivity and beat the bacteria at the same time. The researchers encapsulated nanohydroxyapatite and a green tea polyphenol—epigallocatechin-3-gallate, or EGCG—in silica nanoparticles, which can stand up to acid and wear and tear. EGCG has been shown in previous studies to fight Streptococcus mutans, which forms biofilms that cause caries. Testing on extracted wisdom teeth showed that the material plugged the dentinal tubules, released EGCG for at least 96 hours, stood up to tooth erosion and brushing, and prevented biofilm formation. Based on these findings, the researchers say the material could indeed be a good candidate for combating tooth sensitivity and caries.

(Source: American Chemical Society. “An end to cavities for people with sensitive teeth?” ScienceDaily, August 2, 2017)

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Supervised Tooth Brushing and Caries Incidence

Dentistry Today — Wed, 01 Nov 2017 04:00:00 +0000

The anticaries effect of supervised tooth brushing, irrespective of the effect of fluoride toothpaste, has not yet been clearly determined. The objective of a study by Pires dos Santos et al was to assess the effects of supervised tooth brushing on caries incidence in children and adolescents. A systematic review of controlled trials was performed, retrieving 2,046 records; 112 were read in full and independently assessed by 2 reviewers, who collected data regarding characteristics of participants, interventions, outcomes, length of follow-up and risk of bias. Four trials were included and none of them had low risk of bias. They were all carried out in schools, but there was great variation regarding children’s age, fluoride content of the toothpaste, baseline caries levels, and the way caries incidence was reported. Among the 4 trials, 2 found statistically significant differences favoring supervised tooth brushing, but information about the magnitude and/or the precision of the effect estimate was lacking, and in one trial, clustering effect was not taken into consideration. No meta-analysis was performed due to the clinical heterogeneity among the included studies and differences in the reporting of data. The study concluded that there is no conclusive evidence regarding the effectiveness of supervised tooth brushing on caries incidence.

(Source: International Journal of Paediatric Dentistry, September 21, 2017)

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Influence of Implant Diameter Replacing Single Molars

Dentistry Today — Wed, 01 Nov 2017 04:00:00 +0000

A study by Mendonca et al, published in JOMI, the official journal of the Academy of Osseointegration, evaluated the influence of implant diameter on marginal bone remodeling around dental implants replacing single molars. The follow-up period was 3 to 6 years. Patients who received dental implants with an external hexagon platform in healed sites to support a single metal-ceramic crown in the molar region were recalled to the office. The implantation sites and implant length information were recorded, and the implants were divided according to the implant diameter: regular (RP) or wide (WP). Each implant was assessed by digital periapical radiography, using a sensor holder for the paralleling technique. The marginal bone remodeling was determined as the distance from the implant platform to the first bone-to-implant contact, and the known implant length was used to calibrate the images in the computer software. The follow-up measurements were compared with those obtained from the radiograph taken at the time of prosthetic loading to determine the late bone remodeling. The independent t test was used to compare data. The study evaluated a total of 67 implants from 46 patients with a mean follow-up period of 4.5 ± 1.0 years. The RP group comprised 36 implants from 29 patients (mean age: 58.3 ± 10.6 years), while 31 implants from 17 patients (mean age: 56.9 ± 11.5 years) were included in the WP group. The RP group presented lower survival rates (86.1%) than the WP group (100.0%). Similar marginal bone loss (P < .05) was identified for the RP and WP groups (1.35 ± 0.96 mm and 1.06 ± 0.70 mm, respectively). The study concluded that although wide-diameter implants exhibited lower incidence of failures, the bone levels were similar after the prosthetic loading around regular- and wide-diameter implants supporting single molar crowns.

(Source: JOMI, Vol. 32, Issue 5, Sept/Oct 2017)

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Long-Term Outcomes of Narrow Diameter Implants in Posterior Jaws

Dentistry Today — Sun, 01 Oct 2017 18:51:18 +0000

A study published in Clinical Oral Implants Research evaluated patients who had received fixed dental prostheses supported by narrow-diameter implants (NDIs) in the posterior jaws. This study was designed as a retrospective cohort study with a mean follow-up time of 10.1 years (SD: 2.5 years).
Patients receiving NDIs in the posterior jaw were reviewed for implant survival, hardware complication, modified plaque index, peri-implant probing depth, percentage of bleeding on probing (BOP%), marginal bone loss (MBL), and patient satisfaction.
Log-rank test and t test were used to detect the influence of implant location and restoration type. The study found that 67 patients with 98 NDIs were included (premolar site: 81, molar site: 17, single crowns: 33, splinted restorations: 65).
The overall implant survival rates were 96.9% at implant level and 97.0% at patient level. Veneer chipping was the most common hardware complication. The veneer chipping rates were 19.4% at patient level and 18.4% at implant level.
All patients showed acceptable oral hygiene. Thus, the average MBL was 1.19 mm at implant level and 1.15 mm at patient level. Eight implants (8.5%) and 6 patients (9.2%) were diagnosed with peri-implantitis. Fifty-eight patients (89.2%) were satisfied with the aesthetics of the restorations, while 55 patients (84.6%) were satisfied with the function of the restorations.
The study concluded that narrow diameter implants could be a predictable treatment option in the long term. High survival rates, high patient satisfaction, acceptable complication rates, and MBL could be achieved.
Further long-term studies are needed to evaluate the predictability of NDIs in molar sites.

(Source: Clinical Oral Implants Research, August 28, 2017)

Diabetes Report Released by CDC

Dentistry Today — Sun, 01 Oct 2017 18:50:57 +0000

More than 100 million US adults are now living with diabetes or prediabetes, according to a new report released by the Centers for Disease Control and Prevention (CDC). As of 2015, 30.3 million Americans—9.4% of the US population—have diabetes. Another 84.1 million have prediabetes, a condition that if not treated often leads to type 2 diabetes within 5 years. Diabetes was the seventh leading cause of death in the US in 2015. People with diabetes are at increased risk of serious health complications including premature death, vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet, or legs. In 2015, an estimated 1.5 million new cases of diabetes were diagnosed among people ages 18 and older. Nearly one in 4 adults living with diabetes—7.2 million Americans—didn’t know they had the condition.
Only 11.6% of adults with prediabetes knew they had it. Rates of diagnosed diabetes increased with age; among adults ages 18 to 44 years, 4% had diabetes; among those ages 45 to 64 years, 17% had diabetes; among those ages 65 years and older, 25% had diabetes. Rates of diagnosed diabetes were higher among American Indians/Alaska Natives (15.1%), non-Hispanic blacks (12.7%), and Hispanics (12.1%), compared to Asians (8.0%) and non-Hispanic whites (7.4%). Diabetes’ prevalence varied significantly by education. Among US adults with less than a high school education, 12.6% had diabetes; among those with a high school education, 9.5% had diabetes; and among those with more than a high school education, 7.2% had diabetes. More men (36.6%) had prediabetes than women (29.3%). Rates were similar among women and men across racial/ethnic groups or educational levels. The southern and Appalachian areas of the US had the highest rates of diagnosed diabetes and of new diabetes cases.

(Source: CDC, July 18, 2017)

Chewing Gum Rapid Test for Inflammation

Dentistry Today — Sun, 01 Oct 2017 18:49:00 +0000

Six percent to 15% of patients develop an inflammatory response in the years after receiving a dental implant. In the worst cases, this is caused by bacteria destroying the soft tissue and the bone around the implant. In the future, patients will benefit from a quick and affordable method of assessing whether they carry such bacteria using a chewing gum-based diagnostic test developed by a pharmaceutical research team at the Julius-Maximilians-Universität (JMU) Würzburg in Bavaria, Germany.
In practice, the test works as follows: In the presence of inflammatory conditions, specific protein-degrading enzymes are activated in the mouth. In just 5 minutes, these enzymes also break down a special ingredient of the chewing gum, thereby releasing a bittering agent that could not be tasted before. Patients can then visit their dentist who confirms the diagnosis and treats the disease. This type of early detection aims at preventing serious complications such as bone loss.
“Anyone can use this new diagnostic tool anywhere and anytime without any technical equipment,” says Professor Lorenz Meinel, head of the JMU Chair for Drug Formulation and Delivery. He developed the new diagnostic tool with Dr. Jennifer Ritzer and her team; the invention is currently featured in an article in the journal, Nature Communication.
Meinel’s team provided the proof that this principle actually works. First studies using the saliva of patients were conducted at Merli Dental Clinic in Rimini.
To launch the chewing gum into the market, Meinel’s team plans to set up a company. The professor assumes that it will take 2 to 3 years until the gum is commercially available.
Chewing gum rapid tests for other medical applications are presently under development.
“We hope to be able to diagnose other diseases with our ‘anyone, anywhere, anytime’ diagnostics to identify and address these diseases as early as possible,” Meinel explains.

(Source: JMU. “Chewing gum rapid test for inflammation.” ScienceDaily, August 16, 2017)

Oral Device Helps the Blind

siteground — Tue, 11 Aug 2015 13:54:27 +0000

The US Food and Drug Administration (FDA) has allowed marketing of a new device that when used along with other assistive devices, like a cane or guide dog, can help blind people in orientation, mobility, and object recognition by processing visual images with their tongues.

The BrainPort V100 is a battery-powered system that includes a video camera mounted on a pair of glasses and a small, flat, intraoral device containing a series of electrodes that the user holds against his or her tongue. Software converts the image captured by the video camera into electrical signals that are then sent to the intraoral device and perceived as vibrations or tingling on the user’s tongue. With training and experience, the user learns to interpret the signals to determine the location, position, size, and shape of objects, and to determine if objects are moving or stationary.

More than 1.2 million Americans were blind as of 2010, according to the National Institutes of Health’s National Eye Institute (NEI). The NEI forecasts that this number will rise to 2.1 million by 2030, and to 4.1 million by 2050. The FDA reviewed the data for the BrainPortV100 through the de novo premarket review pathway, a regulatory pathway for some low- to moderate-risk medical devices that are not substantially equivalent to an already legally marketed device. Clinical data supporting the safety and effectiveness of the BrainPort V100 included several assessments, such as object recognition and word identification, as well as oral health exams to determine risks associated with holding the intraoral device in the mouth. Studies showed that 69% of the 74 subjects who completed one year of training with the device were successful at the object recognition test. Some patients reported burning, stinging, or metallic taste associated with the intraoral device. There were no serious device-related adverse events.

The BrainPort V100 was developed by Wicab in Middleton, Wis.

(Source: FDA Press Announcements; June 23, 2015)

Link Between Periodontal Disease and Heart Disease

siteground — Tue, 11 Aug 2015 13:53:17 +0000

Dr. Maria Febbraio, a foundational science researcher at the University of Alberta School of Dentistry, has recently added to the existing research showing that patients with untreated periodontal disease are at higher risk of developing cardiovascular disease.

In her research, published in the scientific journal PLOS ONE, Dr. Febbraio identified a new receptor on cells that interacts with bacteria in the mouth causing periodontal disease. This new receptor, called CD36, interacts with toll-like receptors—the immune system’s early-warning sentinels against infection—to produce a protein called interleukin-1 beta (IL-1β). The IL-1β then increases inflammation, which plays a role in both periodontal disease and atherosclerosis, providing a direct link between the 2 diseases.

“Other studies established the link between periodontal disease and cardiovascular disease and showed that toll-like receptors were involved. But this study recognizes CD36 as an essential co-receptor in the inflammatory response,” says Dr. Febbraio. “Now that we have an idea of the players involved, we can try to direct therapies more specifically to avoid the unwanted side effects of medication used to treat inflammation.”

With hope to further develop the research and ultimately find a way to treat or stop the progression of heart disease by targeting these receptors, Dr. Febbraio adds, “We can specifically try to intervene in the interaction between CD36 and toll-like receptors to block the inflammatory response to the bacteria. Our studies identify CD36 as a new potential therapeutic target.”

(Source: University of Alberta; June 25, 2015)

Dental Implants Result in Better Quality of Life for Osteoporotic Women

siteground — Tue, 11 Aug 2015 13:51:48 +0000

As postmenopausal women with osteoporosis age, they are at greater risk of losing their teeth. But what treatment for tooth loss provides women with the highest degree of satisfaction in their work and social lives? A new study by Case Western Reserve University School of Dental Medicine researchers suggests dental implants may be the best route to take, according to Dr. Leena Palomo, associate professor of periodontics and corresponding author of “Dental Implant Supported Restorations Improve the Quality of Life in Osteoporotic Women.” Their findings were reported in the Journal of International Dentistry.

The research is part of a series of studies analyzing dental outcomes for women with osteoporosis. In one of the first studies to examine quality of life after treatment to replace missing teeth in osteoporotic women, the researchers surveyed 237 women about their satisfaction with replacement teeth and how it improved their lives at work and in social situations. The 23-question survey rated satisfaction with their work, health, emotional, and sexual aspects of their lives. Participants were from the Case/Cleveland Clinic Postmenopausal Wellness Collaboration, which is part of a database of health information about 900 women with osteoporosis. Osteoporotic women with one or more adjacent teeth missing (excluding wisdom teeth or third molars) were chosen for the study. The women had restoration work done that included implants (64), fixed partial denture (60), a removable denture (47), or had no restoration work done (66). Women with dental implants reported a higher overall satisfaction with their lives, said Christine DeBaz, a third-year Case Western Reserve dental student. Ms. DeBaz was lead researcher on the project and personally interviewed each participant. Fixed dentures scored next highest in satisfaction, followed by removable denture and, finally, women with no restoration work. Women with dental implants also reported the highest satisfaction in emotional and sexual areas, while those without restorations scored the lowest in those 2 areas. As health professions move to a patient-centered form of delivering dental service, understanding the patient’s outcomes for satisfaction of the treatment’s aesthetics is as important as chewing function, she said.

“We need hard data to drive our decision-making about which is best for the patient,” said Dr. Palomo.

(Source: Case Western Reserve University; June 12, 2015)