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Sugar Restriction for Caries Prevention: Amount and Frequency. Which Is More Important?

The World Health Organization guideline to use less sugar may be an opportunity and support for dentistry in its goal to get the message of using less sugar across to the public. Two ways (with all the combinations of these) to achieve a reduction of sugar consumption are the reduction of the amount of sugar in products or the reduction of the frequency of consumption of sugar-containing products. Which sugar-reducing strategy is best for caries prevention? To answer this question, this manuscript discusses the shape of the dose-response association between sugar intake and caries, the influence of fluoridated toothpaste on the association of sugar intake and caries and the relative contribution of frequency and amount of sugar intake to caries levels. The results suggest that when fluoride is appropriately used, the relation between sugar consumption and caries is very low or absent. The high correlation between amount and frequency hampers the decision related to which of both is of more importance, but frequency (and stickiness) fits better in our understanding of the caries process. Reducing the amount without reducing the frequency does not seem to be an effective caries preventive approach in contrast to the reciprocity. Goals set in terms of frequency may also be more tangible for patients to follow than goals set in amount. Yet, in sessions of dietary counselling to prevent dental caries, the counsellor should not forget the importance of quality tooth brushing with fluoride toothpaste.

By |2018-09-26T00:33:55+00:00January 1st, 2018|Other|

Synergism in aluminum and mercury neurotoxicity.

Aluminum and mercury are common neurotoxic contaminants in our environment – from the air we breathe to the water that we drink to the foods that we eat. It is remarkable that to date neither of these two well-established environmental neurotoxins (i.e. those having a general toxicity towards brain cells) and genotoxins (those agents which exhibit directed toxicity toward the genetic apparatus) have been critically studied, nor have their neurotoxicities been evaluated in human neurobiology or in cells of the human central nervous system (CNS). In this paper we report the effects of added aluminum [sulfate; Al₂(SO₄)₃] and/or mercury [sulfate; HgSO4] to human neuronal-glial (HNG) cells in primary co-culture using the evolution of the pro-inflammatory transcription factor NF-kB (p50/p65) complex as a critical indicator for the onset of inflammatory neurodegeneration and pathogenic inflammatory signaling. As indexed by significant induction of the NF-kB (p50/p65) complex the results indicate: (i) a notable increase in pro-inflammatory signaling imparted by each of these two environmental neurotoxins toward HNG cells in the ambient 20-200 nM range; and (ii) a significant synergism in the neurotoxicity when aluminum (sulfate) and mercury (sulfate) were added together. This is the first report on the neurotoxic effects of aluminum sulfate and/or mercury sulfate on the initiation of inflammatory signaling in human brain cells in primary culture. The effects aluminum+mercury together on other neurologically important signaling molecules or the effects of other combinations of common environmental metallic neurotoxins to human neurobiology currently remain not well understood but certainly warrant additional investigation and further study in laboratory animals, in human primary tissue cultures of CNS cells, and in other neurobiologically realistic experimental test systems.

By |2018-08-04T00:19:00+00:00January 1st, 2018|Mercury|

A longitudinal ecological study of seasonal influenza deaths in relation to climate conditions in the United States from 1999 through 2011.

Introduction: Influenza is an acute respiratory disease with significant annual global morbidity/mortality. Influenza transmission occurs in distinct seasonal patterns suggesting an importance of climate conditions on disease pathogenesis. This hypothesis-testing study evaluated microenvironment conditions within different demographic/geographical groups on seasonal influenza deaths in the United States.

Materials and methods:The United States Centers for Disease Control and Prevention (CDC) Wonder online computer interface was utilized to integrate and analyze potential correlations in data generated from 1999 through 2011 for climate conditions of mean daily sunlight (KJ/m2), mean daily maximum air temperature (oC), mean daily minimum air temperature (oC), and mean daily precipitation (mm) from the North America Land Data Assimilation System (NLDAS) database and on influenza mortality (ICD-10 codes:J09, J10, or J11) from the Underlying Cause of Death database.

Results and discussion:Significant inverse correlations between the climate conditions of temperature, sunlight, and precipitation and seasonal influenza death rate were observed. Similar effects were observed among males and females, but when the data were separated by race and urbanization status significant differences were observed.

Conclusion: This study highlights key factors that can help shape public health policy to deal with seasonal influenza in the United States and beyond.

By |2018-08-07T00:11:23+00:00January 1st, 2018|Other|

Long term changes in health complaints after removal of amalgam restorations.

MATERIALS AND METHODS:
Patients previously referred to a specialty unit for health complaints attributed to amalgam restorations were included in the study. The 20 participants who were allocated to the treatment group had all amalgam restorations removed and replaced with other dental restorative materials. Intensity of health complaints was calculated from questionnaire data and personality variables were measured by MMPI-2.

RESULTS:
At the follow-up five years after the amalgam removal was completed, intensity of general health complaints was significantly reduced (p=.001), but the symptom load was still high. The reduction was significantly correlated with concentration of mercury in urine at pre-treatment. There were no significant correlations with personality variables.

CONCLUSIONS:
Removal of amalgam restorations was followed by a long term reduction of general health complaints, which was associated with mercury concentration in urine before amalgam removal. Additional studies are needed to confirm the potential mechanisms for the observed reduction.

Concerns about environmental mercury toxicity: do we forget something else?

We have read the article by Eunhee Ha and co-authors (2016) entitled “Current progress on understanding the impact of mer-cury on human health” with great interest (http://dx.doi.org/10. 1016/j.envres.2016.06.042). The authors addressed the significant concern of mercury (Hg) pollution and its impact on human health by conducting a critical review of the scientific literature on the topic reported since January of 2012. We are however surprised to find that one landmark paper is missing (Woods et al., 2012). The group, working at the Department of Environmental and Occu-pational Health Sciences, University of Washington, Seattle, has published several reports showing associations between Hg toxi-city and genetic polymorphism, as pointed out by Ha et al. (2016).

By |2018-07-18T23:56:11+00:00January 1st, 2017|Mercury|

Neurologic Complications of Medical Disease [presentation].

Excess zinc ingestion is a well-recognized cause of copper deficiency. Zinc causes an upregulation of metallothionein production in the enterocytes. Metallothionein is an intracellular ligand and copper has a higher affinity for metallothionein than zinc. Copper displaces zinc from metallothionein, binds preferentially to the metallothionein, remains in the enterocytes, and is lost in the stools as the intestinal cells are sloughed off. […] Total hip arthroplasty may be complicated by corrosion and disassembly of the components. Metallosis is a very rare complication of arthroplasty. It refers to chronic infiltration of metallic wear debris into the periprosthetic bony and soft tissues.10 Reactive chronic inflammatory changes are seen. Wear debris can rarely cause systemic intoxication by prosthetic metallic materials, mostly by cobalt-chromium. […] Gadolinium is a lanthanide metal with paramagnetic properties that make it an excellent contrast agent to improve the utility of MRI. Two complications related to use of gadolinium-based contrast agents have been recognized (both in patients with underlying renal disease): nephrotoxicity and nephrogenic systemic fibrosis.15

By |2018-08-08T23:47:27+00:00January 1st, 2017|Mercury, Other|

Could night-guards be used as a simple method to detect leached-elements from dental restorations intra-orally? A study on amalgam restorations.

Methods: Ten upper custom-made night-guards were fabricated for patients suffering from bruxism, who had amalgam-restorations in their upper molars. The night-guards were delivered to the patients and they were instructed to wear the night-guards during when they were asleep. After six months, the night-guards were taken from the patients to be analyzed. A new unused night-guard was fabricated from the same material to be used as a control. In the used night-guards, two areas were studied: the fitting surfaces contacting the amalgam restorations and the fitting surfaces not contacting amalgam restorations. Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Analysis (EDXA) were used to examine the structural and elemental changes in the night-guards.
Results: SEM of the unused night-guard revealed a homogenous structure, and the composition was carbon and oxygen, as shown using EDXA
(C=88.9wt% and O=11.1wt%). By contrast, the fitting surfaces of the
night-guards contacting amalgam restorations showed numerous lustrous particles. Elemental analysis of these areas showed the presence of mercury and sulfur, in addition to carbon and oxygen (Hg=21.2wt%, S=2.5wt%,
C=67.1wt% and O=9.2wt%). The night-guards’ fitting surfaces not contacting amalgam restorations showed slight cracking, and the composition was carbon and oxygen (C=88.3wt% and O=11.7 wt%).
Conclusions: Analyzing fitting surfaces of night-guards contacting dental restorations, such as amalgam, could aid in understanding the nature of leached-elements from these restorations intra-orally. However, further studies about its application upon dental-restorations other than amalgam are recommended.

By |2018-08-03T23:43:05+00:00January 1st, 2017|Mercury|

Role of oral foci in systemic diseases: An update.

Background: A current research disagreement middles about a theorized connection between chronic oral infections and the progress of adverse systemic health conditions. However, the gap between general and dental medicine is quickly closing, due to significant findings supporting the association between dental infections and systemic conditions such as cardiovascular diseases, type 2 diabetes mellitus, respiratory diseases, stroke, adverse pregnancy outcomes, osteoporosis, renal diseases, and gastrointestinal diseases. Relentless efforts have brought light on numerous advances in illuminating their etiopathological links. However, the majority of data about possible role or interlink between the infection and systemic disease is available in the form of case report or summary. As case reports are not the acceptable to many indexed scientific magazines, many these findings undergo unnoticed to researchers. The currently minimal accessible data provide only an indication of the actuality.

Aim: This article highlights the Role of oral foci in systemic diseases.

Conclusion: There is need of sincere work efforts on genetic relatedness of organisms, rather than their phenotypes, sophisticated sampling, detection, and analytical techniques to create the associations. To give insight to recent apprises of different systemic diseases as a consequence of primary oral infections and the pathogenesis link. The odontogenic bacteremia is likely to cause systemic and end organ infections, but such infections can easily resist by body defenses. It is important that role of good oral health and the risks associated with poor oral health should told to the individuals.

Clinical significance: Dentists and medical practitioners should work together to provide comprehensive health care, thereby reducing the morbidity and mortality associated with oral infections.

Survival of endodontically treated roots/teeth based on periapical health and retention: a 10-year retrospective cohort study.

INTRODUCTION:

The purpose of this retrospective longitudinal cohort study was to evaluate the outcome of nonsurgical root canal treatment (NSRCT), expressed as survival for both periapical health and retention of roots/teeth, as determined by clinical evaluation, periapical film/digital radiography (PFR/DPR), and cone-beam computed tomography (CBCT) over 10 years, to determine the prognostic factors that influenced successful treatment outcomes.

METHODS:

A total of 132 teeth (208 roots) with vital pulp received NSRCT at a university clinic. Eighteen factors (preoperative, intraoperative, and postoperative) were documented from the dental records and radiographs. Periapical indices with scores ≥2 (PFR/DPR) and ≥1 (CBCT) indicated the presence of a periapical lesion. Data were analyzed using the Kaplan-Meier test and the Cox proportional hazards regression model (P < .05).

RESULTS:

The estimated 10-year overall survival rates for periapical health of roots/teeth were 89.4%/88.6% with PFR, 89.4%/89.3% with DPR, and 72.6%/69.7% with CBCT; the survival rate for root/tooth retention was 90.4%/91.6%.

CONCLUSIONS:

The long-term outcome of NSRCT expressed as survival for periapical health was different with each radiographic method. Approximately more than 90% of the roots/teeth were retained for up to 10 years. The prognostic factors for periapical health were the disinfection of gutta-percha, missed canals, age, treatment sessions, and density of root filling (voids); the age and presence of a post were for root/tooth retention.

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