Infectious Complications of Dental and Periodontal Diseases in the Elderly Population

Total Page:16

File Type:pdf, Size:1020Kb

Infectious Complications of Dental and Periodontal Diseases in the Elderly Population INVITED ARTICLE AGING AND INFECTIOUS DISEASES Thomas T. Yoshikawa, Section Editor Infectious Complications of Dental and Periodontal Diseases in the Elderly Population Kenneth Shay Geriatrics and Extended Care Service Line, Veterans Integrated Services Network 11, Geriatric Research Education and Clinical Center and Dental Service, Ann Arbor Downloaded from https://academic.oup.com/cid/article/34/9/1215/463157 by guest on 02 October 2021 Veterans Affairs Healthcare System, and University of Michigan School of Dentistry, Ann Arbor Retention of teeth into advanced age makes caries and periodontitis lifelong concerns. Dental caries occurs when acidic metabolites of oral streptococci dissolve enamel and dentin. Dissolution progresses to cavitation and, if untreated, to bacterial invasion of dental pulp, whereby oral bacteria access the bloodstream. Oral organisms have been linked to infections of the endocardium, meninges, mediastinum, vertebrae, hepatobiliary system, and prosthetic joints. Periodontitis is a pathogen- specific, lytic inflammatory reaction to dental plaque that degrades the tooth attachment. Periodontal disease is more severe and less readily controlled in people with diabetes; impaired glycemic control may exacerbate host response. Aspiration of oropharyngeal (including periodontal) pathogens is the dominant cause of nursing home–acquired pneumonia; factors reflecting poor oral health strongly correlate with increased risk of developing aspiration pneumonia. Bloodborne peri- odontopathic organisms may play a role in atherosclerosis. Daily oral hygiene practice and receipt of regular dental care are cost-effective means for minimizing morbidity of oral infections and their nonoral sequelae. More than 300 individual cultivable species of microbes have growing importance in the elderly population. In 1957, nearly been identified in the human mouth [1], with an estimated 1014 70% of the US population aged 175 years had no natural teeth. individual microscopic organisms occupying the mouth and or- Due to water and dentifrice fluoridation, preventive dental be- opharynx at a time [2]. The most prevalent oral infectious dis- haviors, and an expanded dental profession, !35% of Americans eases, caries and periodontal disease, are historically the province aged 175 years now are missing all teeth [9]. This extends the of dentists for diagnosis and treatment. However, the effect of likelihood of risk for dental and periodontal disease into a time these oral diseases often extends systemically, particularly in older in life often marked by impaired self-care. This article will discuss adults. Hematogenous seeding from an oral source is a dominant the pathophysiology and, particularly, the systemic consequences cause of bacterial endocarditis [3] and is implicated in late pros- of these 2 oral infections in elderly people. thetic joint infection (LPJI) [4]. Periodontal disease impairs gly- cemic control in people with diabetes [5], and poorly controlled MICROECOLOGIC NICHES OF THE MOUTH diabetes may exacerbate periodontal disease [6]. Aspiration of oropharyngeal secretions is the predominant cause of nosocomial The mouth offers multiple microbiologic environments, several pneumonia in elderly persons [7]. Periodontopathic bacteria in of which involve the teeth. Tooth surfaces most apparent in the bloodstream have been linked to atherosclerosis, coronary the mouth are covered by enamel, an acellular material that is artery disease, and stroke [8]. ∼95% calcium hydroxyphosphate (hydroxyapatite) microcrys- This review focuses on caries and periodontal disease and their tals and 5% organic material [10]. Biting surfaces of teeth are marked by grooves and fissures that shelter bacterial colonies, Received 5 October 2001; revised 18 December 2001; electronically published 2 April although these irregularities in aged teeth have commonly been 2002. obliterated through years of chewing or dental restoration. The Reprints or correspondence: Dr. Kenneth Shay, Geriatrics and Extended Care Service Line, Veterans Integrated Services Network 11, PO Box 134002, Ann Arbor, MI 48113-4002 sides of teeth that contact one another represent a second mi- ([email protected]). croenvironment. This contact area, which is surrounded by Clinical Infectious Diseases 2002;34:1215–23 ᮊ 2002 by the Infectious Diseases Society of America. All rights reserved. tooth structure and gingiva, is sheltered from food debris and 1058-4838/2002/3409-0009$03.00 oral hygiene and shelters adherent bacteria. AGING AND INFECTIOUS DISEASES • CID 2002:34 (1 May) • 1215 Near the gingiva, the tooth surface abruptly changes from DENTAL CARIES: PATHOGENESIS acellular enamel into cementum, which is cellular tissue that AND LOCAL SEQUELAE is nearly 30% organic [11]. Initially, after a tooth’s eruption, the cemento-enamel junction is covered by gingiva; accumu- Dental caries is initiated by the nonhemolytic viridans strep- lated disease, trauma, and maturation expose it. In time, tooth- tococci [2], termed “mutans streptococci,” most commonly brushing and professional cleanings remove cementum and Streptococcus mutans and Streptococcus sobrinus. These organ- expose underlying dentin. Dentin is also ∼30% organic and isms are not present in newborns but appear as primary den- cellular. The tooth surface adjacent to the gingiva is a distinct tition erupts. DNA analysis confirms that transmission occurs microenvironment constantly bathed in plasma ultrafiltrate usually from mother to child, probably through shared food (“sulcular fluid”) seeping out of the sulcus between the gingiva implements [19]. The organisms thrive on sucrose, which they and the tooth. In the absence of gingival or periodontal disease, convert into organic acids and sticky polysugar (dextrans), the tooth-gingiva attachment is 1–3 mm from where the tooth which adheres the organisms to tooth surfaces [20]. Oral sites emerges from soft tissue (figure 1). The sulcular or subgingival that are not regularly disturbed, such as fissures and contact Downloaded from https://academic.oup.com/cid/article/34/9/1215/463157 by guest on 02 October 2021 microenvironment offers a continuum of conditions: the sulcus areas, thereby become susceptible to dental decay. entrance supports aerobic organisms; regions at increasing Tooth structure is in chemical equilibrium with saliva under depth are associated first with facultative species, then with neutral pH. Increasing acidity to pH 5.4 by exposing plaque to anaerobic species, that build adherent multispecies colonies sugar causes a net efflux of calcium and phosphorus from the (plaque) on the tooth [12]. enamel into saliva [21]. Initially, crystals of surface hydroxyapatite Another ecologic niche, saliva, is partially removed (and re- dissolve, leaving behind an organic matrix of the sparse inter- newed) continuously. Saliva is a variable and complex solution crystalline material. When neutrality is reestablished through sal- of water, glycoprotein, and organic and inorganic ions. Under ivary dilution and buffering, hydroxyapatite reforms on the ma- normal circumstances, saliva protects the oral cavity and its trix. However, an undisturbed plaque colony limits the effects contents [13]. Through chemical buffer systems (predomi- of saliva, even as colonies maintain a low pH at the underlying nantly bicarbonate), saliva maintains oral pH at nearly neutral tooth surface. When dissolution has proceeded to the point that values. Long-chain glycoproteins, enzymes, statins, and im- the matrix collapses, a cavity forms. When cavitation extends munoglobulins temper microbial growth. Calcium and phos- through the enamel to the dentin, the caries process shifts as phate in solution maintain equilibrium between the soluble proteolytic organisms, particularly Lactobacillus species, exploit tooth structure and saliva [14]. Diminished salivary flow and the more organic substrate [20]. modified saliva composition allow oral pH to decrease, dis- Older people frequently have dentin exposed near the gin- turbing the equilibrium between tooth structure and oral fluids, giva, and root caries initiates there. Root caries is started by and permitting uninhibited microbial growth [15]. Flow from mutans streptococci, and there is early involvement of prote- parotid [16], submandibular [17], and minor salivary glands olytic Actinomyces species, including Actinomyces viscosus, Ac- remains largely unaffected in healthy persons, regardless of age. tinomyces odontolyticus, and Actinomyces naeslundii. Root caries It has been reported that a reduced flow rate can potentially is relatively uncommon before the age of 30 years, but it rapidly accompany use of the majority of medications commonly pre- increases in incidence in the succeeding decades of life. In scribed for older people [15]; saliva composition and flow are contrast, the attack rate of enamel caries remains stable commonly deleteriously altered in elderly individuals [18]. throughout a person’s life [22]. Figure 1. Schematic representation (not to scale) of selected dental and periodontal structures in healthy persons 1216 • CID 2002:34 (1 May) • AGING AND INFECTIOUS DISEASES Without dental treatment, natural progression of caries fol- Bacterial endocarditis is the most common of these condi- lows 1 of 2 paths. In younger people, tooth pulp begins to be tions. Approximately 27% of cultured cases of bacterial en- affected when caries invades dentin [23]. Dental pulp consists docarditis are caused by mutans streptococci [30]. A link be- of capillaries, nerves,
Recommended publications
  • The Anachoretic Effect of Periapical Tissues Following Overinstrumentation of the Radicular Foramen
    Loyola University Chicago Loyola eCommons Master's Theses Theses and Dissertations 1974 The Anachoretic Effect of Periapical Tissues Following Overinstrumentation of the Radicular Foramen Peter Joseph Lio Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_theses Recommended Citation Lio, Peter Joseph, "The Anachoretic Effect of Periapical Tissues Following Overinstrumentation of the Radicular Foramen" (1974). Master's Theses. 2665. https://ecommons.luc.edu/luc_theses/2665 This Thesis is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 1974 Peter Joseph Lio THE ANACHORETIC EFFECT OF PERIAPICAL TISSUES FOLLOWING OVERINSTRUMENTATION OF THE RADICULAR FORAMEN BY PETER J. LIO, B.S., D.D.S. A Thesis Submitted to the Faculty of the Graduate School of Loyola University in Partial Fulfillment of the Requirements for the Degree of Master of Science MAY 1974 library - bvcb lfriverdy Medical Center DEDICATION To my loving parents, Carmelo and Rose, whose devotion, loyalty, and personal sacrifice are unending, I dedicate this thesis. ii ACKNOWLEDGEMENTS To Dr. Franklin S. Weine for his genuine interest, professional assistance, and warm, personal friendship throughout my entire graduate education. To Dr. Marshall H. Smulson, an everlasting flame of high educa­ tional standards. To Dr. John V. Madonia and Dr. Robert Pollock for their unselfish assistance as advisors. iii AUTOBIOGRAPHY Peter Joseph Lio was born in Chicago, Illinois, on November 14, 1944, to Carmelo M.
    [Show full text]
  • Glossary for Narrative Writing
    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
    [Show full text]
  • June 18, 2013 8:30 Am – 11:30 Am
    Tuesday – June 18, 2013 8:30 am – 11:30 am Poster Abstracts – Tuesday, June 18, 2013 #1 ORAL LESIONS AS THE PRESENTING MANIFESTATION OF CROHN'S DISEASE V Woo, E Herschaft, J Wang U of Nevada, Las Vegas Crohn’s disease (CD) is an immune-mediated disorder of the gastrointestinal tract which together with ulcerative colitis, comprise the two major types of inflammatory bowel disease (IBD). The underlying etiology has been attributed to defects in mucosal immunity and the intestinal epithelial barrier in a genetically susceptible host, resulting in an inappropriate inflammatory response to intestinal microbes. The lesions of CD can affect any region of the alimentary tract as well as extraintestinal sites such as the skin, joints and eyes. The most common presenting symptoms are periumbilical pain and diarrhea associated with fevers, malaise and anemia. Oral involvement has been termed oral CD and may manifest as lip swelling, cobblestoned mucosa, mucogingivitis and linear ulcerations and fissures. Oral lesions may precede gastrointestinal involvement and can serve as early markers of CD. We describe a 6-year-old male who presented for evaluation of multifocal gingival erythema and swellings. His medical history was unremarkable for gastrointestinal disorders or distress. Histopathologic examination showed multiple well-formed granulomas that were negative for special stains and foreign body material. A diagnosis of granulomatous gingivitis was rendered. The patient was advised to seek consultation with a pediatric gastroenterologist and following colonoscopy, was diagnosed with early stage CD. Timely recognition of the oral manifestations of CD is critical because only a minority of patients will continue to exhibit CD-specific oral lesions at follow-up.
    [Show full text]
  • International Journal of Medical and Biomedical Studies (IJMBS)
    || ISSN(online): 2589-8698 || ISSN(print): 2589-868X || International Journal of Medical and Biomedical Studies Available Online at www.ijmbs.info PubMed (National Library of Medicine ID: 101738825) Index Copernicus Value 2018: 75.71 Review Article Volume 4, Issue 2; February: 2020; Page No. 274-278 RELATIONSHIP BETWEEN ALZHEIMER’S DISEASE & PERIODONTITIS -A LITERATURE REVIEW Nivetha K1, Ayswarya V Vummidi2, Paavai Ilango3*, Abirami T4, Arulpari Mahalingam5, Vineela Katam Reddy6, Angel Infant R7, Meenambal A8 1Intern, Department of Periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India 2MDS, Senior lecturer, Department of Periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India 3*MDS, Professor and Head, Department of Periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India 4MDS, Senior lecturer, Department of Periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India 5MDS, Professor, Department of Pedodontics, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India 6MDS, Professor, Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Pondicherry, Tamil Nadu, India 7BDS, Tutor, Department of Periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India 8BDS, Tutor, Department of periodontology, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India Article Info: Received 07 February 2020; Accepted 27 February 2020 DOI: https://doi.org/10.32553/ijmbs.v4i2.999 Corresponding author: Dr. Paavai Ilango Conflict of interest: No conflict of interest. Abstract Periodontitis is the microbial infection often causing inflammation of the gingiva, bone loss and tooth mobility. Apart from periodontitis, periodontal bacteria like Porphyromonas gingivalis, Spirochetes, Treponema denticola are known to cause systemic diseases such as cardiovascular diseases, preterm low birth weight infants, Alzheimer’s diseases etc.
    [Show full text]
  • Structural Changes in the Oral Microbiome of the Adolescent
    www.nature.com/scientificreports OPEN Structural changes in the oral microbiome of the adolescent patients with moderate or severe dental fuorosis Qian Wang1,2, Xuelan Chen1,4, Huan Hu2, Xiaoyuan Wei3, Xiaofan Wang3, Zehui Peng4, Rui Ma4, Qian Zhao4, Jiangchao Zhao3*, Jianguo Liu1* & Feilong Deng1,2,3* Dental fuorosis is a very prevalent endemic disease. Although oral microbiome has been reported to correlate with diferent oral diseases, there appears to be an absence of research recognizing any relationship between the severity of dental fuorosis and the oral microbiome. To this end, we investigated the changes in oral microbial community structure and identifed bacterial species associated with moderate and severe dental fuorosis. Salivary samples of 42 individuals, assigned into Healthy (N = 9), Mild (N = 14) and Moderate/Severe (M&S, N = 19), were investigated using the V4 region of 16S rRNA gene. The oral microbial community structure based on Bray Curtis and Weighted Unifrac were signifcantly changed in the M&S group compared with both of Healthy and Mild. As the predominant phyla, Firmicutes and Bacteroidetes showed variation in the relative abundance among groups. The Firmicutes/Bacteroidetes (F/B) ratio was signifcantly higher in the M&S group. LEfSe analysis was used to identify diferentially represented taxa at the species level. Several genera such as Streptococcus mitis, Gemella parahaemolysans, Lactococcus lactis, and Fusobacterium nucleatum, were signifcantly more abundant in patients with moderate/severe dental fuorosis, while Prevotella melaninogenica and Schaalia odontolytica were enriched in the Healthy group. In conclusion, our study indicates oral microbiome shift in patients with moderate/severe dental fuorosis.
    [Show full text]
  • Abfraction Myth Or Reality
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 13, Issue 2 Ver. III. (Feb. 2014), PP 70-73 www.iosrjournals.org Abfraction Myth or Reality Dr Pragya Tripathi, Dr Deepak Chopra, Dr Sukhchain Bagga Sr Lecturer Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Reader Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Reader Dept of Periodontics, Inderprastha Dental College, Sahibabad, Ghaziabad (UP) India. Abstract: Abfraction is the loss of tooth structure at the cervical region from heavy occlusal forces. It is described as one of the causes of lesions found along the cervical margins of teeth. This article critically reviews the literature in favour and against the theory of abfraction. From the literature there is little direct evidence supporting the theory of abfraction, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear. I. Introduction Abfraction is the micro structural loss of tooth substance in areas of stress concentration. This occurs most commonly in the cervical region of teeth, where flexure may lead to a breaking away of the thin layer of enamel rods, as well as micro fracture of cementum and dentin1. Since the publication of one of the text books for dentistry by anatomist and physiologist John Hunter in 1778, the definitions and classifications of the terms “attrition”, “abrasion” and “erosion” have been in a state of confusion. Furthermore, the more recent introduction of the terms “abfraction” to designate stress induced non carious lesions have not resolved this dilemma fully2.
    [Show full text]
  • Study of Root Canal Anatomy in Human Permanent Teeth
    Brazilian Dental Journal (2015) 26(5): 530-536 ISSN 0103-6440 http://dx.doi.org/10.1590/0103-6440201302448 1Department of Stomatologic Study of Root Canal Anatomy in Human Sciences, UFG - Federal University of Goiás, Goiânia, GO, Brazil Permanent Teeth in A Subpopulation 2Department of Radiology, School of Dentistry, UNIC - University of Brazil’s Center Region Using Cone- of Cuiabá, Cuiabá, MT, Brazil 3Department of Restorative Dentistry, School of Dentistry of Ribeirão Beam Computed Tomography - Part 1 Preto, USP - University of São Paulo, Ribeirão Preto, SP, Brazil Carlos Estrela1, Mike R. Bueno2, Gabriela S. Couto1, Luiz Eduardo G Rabelo1, Correspondence: Prof. Dr. Carlos 1 3 3 Estrela, Praça Universitária s/n, Setor Ana Helena G. Alencar , Ricardo Gariba Silva ,Jesus Djalma Pécora ,Manoel Universitário, 74605-220 Goiânia, 3 Damião Sousa-Neto GO, Brasil. Tel.: +55-62-3209-6254. e-mail: [email protected] The aim of this study was to evaluate the frequency of roots, root canals and apical foramina in human permanent teeth using cone beam computed tomography (CBCT). CBCT images of 1,400 teeth from database previously evaluated were used to determine the frequency of number of roots, root canals and apical foramina. All teeth were evaluated by preview of the planes sagittal, axial, and coronal. Navigation in axial slices of 0.1 mm/0.1 mm followed the coronal to apical direction, as well as the apical to coronal direction. Two examiners assessed all CBCT images. Statistical data were analyzed including frequency distribution and cross-tabulation. The highest frequency of four root canals and four apical foramina was found in maxillary first molars (76%, 33%, respectively), followed by maxillary second molars (41%, 25%, respectively).
    [Show full text]
  • A Guide to the Clinical Management of Attrition
    Tooth Wear Themed Issue PRACTICE A guide to the clinical management of attrition J. S. Rees*1 and S. Somi2 Key points Discusses aetiology of attrition. Discusses signs and symptoms of attrition. Discusses clinical management of attrition including adhesive and conventional techniques. Attrition is an enigmatic condition often found in older individuals and often as a result of bruxism which can take place as a result of either day bruxism, night bruxism or both. Various studies and systemic reviews clearly shown that tooth wear is an age-related phenomena and the last Adult Dental Health Survey showed that 15% of participants showed moderate wear and 3% severe wear with 80% of patients over 50 years of age showing signs of wear. This review examines current theories around the aetiological factors contributing to attrition together with the clinical management of attrition focusing on minimal intervention where possible. Introduction Attrition is formally defined as the loss of tooth substance caused by tooth-to-tooth contact so although it is predominantly seen occlusally, attrition can also occur interproximally as lateral movement of the teeth produces broader 1 interproximal contacts over time (Fig. 1). Fig. 1 Examples of attrition Typically, this type of wear is seen as marked wear facets with complimentary wear facets being seen in the upper and lower jaws. In very general a canine guided occlusion to a group function Symptoms terms, patients often tend to brux in an anterior/ type occlusion, once wear of the canines allows • Tooth grinding at night posterior direction or in a lateral direction. If contact of the posterior teeth in lateral excursion.
    [Show full text]
  • Periodontal Inflammation and Infections: Systemic Implications Ms
    Original Periodontal Inflammation and Infections: Systemic Implications Ms. Rashmi 1, Dr. Sudarsan Sabitha 2, Dr. Arunmozhi Ulaganathan 3, Dr. Ramamurthy Shanmugapriya 4, 5 Dr. Rathinasamy Kadhiresan Abstract 1 CRRI Student The emergence of PERIOMEDICINE made it explicit that a bidirectional link exists between 2 Professor & HOD periodontal diseases and systemic health. For more than 3000years now, this association is being 3 Professor investigated. Starting from the proposal of Focal infection theory, numerous paradigm shifts have 4,5 Reader been witnessed in the periodontal science. Enormous numbers of research studies supporting the Dept of Periodontics, bidirectional link are documented in the literature. However similar amount of evidence against it Sri Venkateswara Dental College also exists. This article gives and insight into the various forms of evidence in literature that have and Hospital, Chennai been documented to prove an association or causal link or otherwise between periodontal disease and systemic implication. Key Words: Evidence, Focal infection, Periodontitis, Systemic Health. Introduction extractions and tonsillectomies to such an extent that “Take care of your teeth and they’ll take care of you.” one contemporary quoted “If the craze for violent removal goes on, it will come to pass that we will have This dictum is of unknown origin, yet the relation a gutless, glandless, and toothless, and I am not sure between oral health and general health has been we may not have, thanks to false psychology and inquisitive for more than 3000 years. Hippocrates, the surgery, a witless race’’.[10] father of medicine advocated teeth extraction as means to cure arthritis. [1] At the turn of the century, with the dawn of Bacteriology, it appeared that most, if not all diseases The rise and decline of the Focal Infection might be infectious in origin.
    [Show full text]
  • Principles of Periodontology Andrew R
    Marquette University e-Publications@Marquette School of Dentistry Faculty Research and Dentistry, School of Publications 2-1-2013 Principles of Periodontology Andrew R. Dentino Marquette University, [email protected] Seokwoo Lee Jason Mailhot Arthur F. Hefti Marquette University, [email protected] Accepted version. Periodontology 2000, Vol. 61, No. 1 (February 2013): 16-53. DOI. © 1999-2018 John Wiley & Sons, Inc. Used with permission. Marquette University e-Publications@Marquette Dentistry Faculty Research and Publications/School of Dentistry This paper is NOT THE PUBLISHED VERSION; but the author’s final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation below. Periodontology 2000, Vol. 61, No. 1 (2013): 16-53. DOI. This article is © Wiley and permission has been granted for this version to appear in e-Publications@Marquette. Wiley does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Wiley. Table of Contents Abstract ......................................................................................................................................................... 3 History ........................................................................................................................................................... 5 Early Observations .................................................................................................................................... 5 From
    [Show full text]
  • Cell Proliferation Study in Human Tooth Germs
    Cell proliferation study in human tooth germs Vanesa Pereira-Prado1, Gabriela Vigil-Bastitta2, Estefania Sicco3, Ronell Bologna-Molina4, Gabriel Tapia-Repetto5 DOI: 10.22592/ode2018n32a10 Abstract The aim of this study was to determine the expression of MCM4-5-6 in human tooth germs in the bell stage. Materials and methods: Histological samples were collected from four fetal maxillae placed in paraffin at the block archive of the Histology Department of the School of Dentistry, UdelaR. Sections were made for HE routine technique and for immunohistochemistry technique for MCM4-5-6. Results: Different regions of the enamel organ showed 100% positivity in the intermediate layer, a variation from 100% to 0% in the inner epithelium from the cervical loop to the incisal area, and 0% in the stellar reticulum as well as the outer epithelium. Conclusions: The results show and confirm the proliferative action of the different areas of the enamel organ. Keywords: MCM4, MCM5, MCM6, tooth germ, cell proliferation. 1 Molecular Pathology in Stomatology, School of Dentistry, Universidad de la República, Montevideo, Uruguay. ORCID: 0000-0001- 7747-671 2 Molecular Pathology in Stomatology, School of Dentistry, Universidad de la República, Montevideo, Uruguay. ORCID: 0000-0002- 0617-1279 3 Molecular Pathology in Stomatology, School of Dentistry, Universidad de la República, Montevideo, Uruguay. ORCID: 0000-0003- 1137-6866 4 Molecular Pathology in Stomatology, School of Dentistry, Universidad de la República, Montevideo, Uruguay. ORCID: 0000-0001- 9755-4779 5 Histology Department, School of Dentistry, Universidad de la República, Montevideo, Uruguay. ORCID: 0000-0003-4563-9142 78 Odontoestomatología. Vol. XX - Nº 32 - Diciembre 2018 Introduction that all the DNA is replicated (12), and prevents DNA from replicating more than once in the Tooth organogenesis is a process involving a same cell cycle (13).
    [Show full text]
  • Oral Health Systemic Health: What's the Evidence
    The Oral Health Systemic Health Connection: What’s the Evidence? THOMAS M. PAUMIER DDS Oral Health Systemic Health Connection Are there systemic medical conditions which cause or lead to the progression of periodontal disease or periapical pathology? Does periodontal disease or periapical pathology cause or lead to the progression or worsening of systemic medical conditions? Introduction Question 1 Question 2 Focal Infection Theory Metastatic spread of infection from the mouth as a result of transient bacteremia Metastatic injury from the effects of circulating oral bacterial toxins Metastatic inflammation caused by immune response induced by oral bacteria Bacteremia ….. Infective Endocarditis/PJI Ulcers ……. Heliobacter pylori Introduction Question 1 Question 2 Current Research Nearly one third of all recent periodontal research 57 different systemic disease conditions Bi-directional relationship Observational studies vs. Randomized Controlled Trials Association vs Causality Surrogate evidence vs. Direct evidence Methodology Introduction Question 1 Question 2 Challenges to Conducting Quality Research How to define periodontal disease Attachment loss, pocket depths, bone loss, BOP, mobility Tooth loss, edentulism (surrogate markers) Clinical exam, chart review, patient self report Length of time since diagnosed with periodontal disease Treatment protocols ….. Root planing, surgery, antibiotics Response to treatments …… maintenance, relapse, refractory cases Length of time following treatment and disease improvement Confounders Introduction Question 1 Question 2 Challenges to Conducting Quality Research COMMON RISK FACTORS FOR PERIODONTAL DISEASE AND SYSTEMIC DISEASES (confounders) Smoking Diabetes Obesity Metabolic Syndrome Age Others …… Low Ca++, Vit D, Alcohol Consumption, Osteoporosis, Stress Introduction Question 1 Question 2 Observational Studies Researchers simply watch what happens to a series of people in one group CONTROL GROUP …… like group of people who have not had intervention or treatment being studied CASE CONTROL ….
    [Show full text]