Quintessence International, 05/2003

This article reviews the clinical characteristics of the numerous local and systemic conditions that frequently involve the tongue and presents classifications based on their appearance and common locations that can aid dentists in their early recognition and clinical diagnosis.

Objective: The aim of this study was to examine the levels of periodontal disease and dental caries in individuals on renal dialysis in a Jordanian population. Method and materials: A total of 47 individuals (mean age = 42.9 years, standard deviation [SD] 12.5) were examined for plaque deposits, gingivitis, periodontitis, and dental caries using the Silness and Löe plaque index (PII), Löe and Silness gingival index (GI), probing pocket depth (PPD), and decayed, missing, or filled teeth (DMFT), respectively. Gingival recession also was recorded using the distance from the cementoenamel junction to the gingival margin. Patients were categorized into three subgroups based on their renal dialysis histories: on dialysis for less than 1 year; on dialysis for 1 to 3 years; or on dialysis longer than 3 years. Results: There were no statistically significant differences in PII, GI, PPD, and gingival recession among the three subgroups examined. The GI revealed that 55% scored more than 2, indicating moderate to severe gingivitis. None of the individuals in this study displayed an absence of gingival inflammation. DMFT index showed that there were statistically significant differences between subjects on renal dialysis for less than 1 year and subjects on dialysis for 1 to 3 years and more than 3 years. The group DMFT index mean was 8.5 (SD 2.88). Conclusion: Gingival and dental diseases are prevalent in the renal dialysis population. The dental community's awareness of the implication of poor oral health within this population should be elevated and daily oral health maintenance should be reinforced by the dialysis team.

Objective: The purpose of this study was to evaluate the fracture resistance and the mode of failure of endodontically treated teeth restored with four post-and-core systems. Method and materials: Forty intact human incisors were randomly divided into four groups. Teeth from each group received endodontic therapy and one of four post-and-core systems: serrated, parallel-sided, cast post and core; serrated, parallel-sided, prefabricated post and resin-composite core; carbon-fiber-reinforced (CFC) post and resin-composite core; and ceramic post and resin-composite core. A full-coverage metal crown was fabricated and cemented onto each tooth. Each specimen was subjected to a compressive load at a 45-degree angle to its axis until failure. The failure load was recorded and compared statistically. The mode of failure of the specimens was analyzed. Results: There was no significant difference in the failure loads among groups. More catastrophic root fracture was detected in the group restored with ceramic posts and resin-composite cores. Conclusion: The fracture resistance of endodontically treated teeth restored with these four post-and-core systems could be accepted clinically. Unfavorable tooth fracture was shown in all groups.

Objective: The aim of this study was to investigate the caries prevalence of children living in either low- or high-fluoride areas and to relate caries experience to the severity of dental fluorosis. Method and materials: A total of 278 12- to 14-year-old schoolchildren, 149 in a low-fluoride area (LFA) and 129 in a high-fluoride area (HFA), were included in the study. The naturally occurring fluoride concentrations in the drinking water were 0.30 to 0.40 ppm in the LFA, 1.42 to 1.54 ppm in the HFA1, and 1.55 to 1.66 ppm in the HFA2. Dental caries was recorded with the World Health Organization criteria, and dental fluorosis was measured using the Tooth Surface Index of Fluorosis. Results: The percentages of children who had an average TSIF ¡Ý 1 were 0%, 29%, and 77% in the LFA, HFA1, and HFA2, respectively. The mean decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled permanent surfaces (DMFS) were 0.84 ¡À 0.98 and 1.58 ¡À 2.24 in LFA, 1.30 ¡À 1.46 and 1.78 ¡À 2.52 in HFA1, and 1.26 ¡À 1.42 and 1.97 ¡À 2.60 in HFA2, respectively. There was no significant difference in caries prevalence among children living in low- and high-fluoride areas when evaluated with an analysis of covariance model, including the frequency of toothbrushing. Toothbrushing frequency had a significant effect on the decayed teeth, decayed surfaces, DMFT, and DMFS. In high-fluoride areas, there was no relationship between caries prevalence and severity of fluorosis. Conclusion: Increasing water fluoride levels were associated with higher prevalence and severity of dental fluorosis and had no influence on caries experience in children with poor oral hygiene.

Objective: There are concerns about the possible pathologic effects of relatively long-term exposure of oral tissues to bleaching agents. The purpose of the present study was to investigate the cytotoxic effects of various bleaching agents on mouse mammary carcinoma FM3A cell line. Method and materials: FM3A cell line obtained from European Collection of Animal Cell Cultures was used in cell culture assay. Exponentially growing cells were seeded in 1 x 10⁵ cells/mL in 5 mL of RPMI 1640 medium supplemented with 10% fetal calf serum and antibiotics in each well of a six-well plate. PowerGel was applied onto the cell culture medium and incubated for 24 hours at 37°C in a 5% carbon dioxide atmosphere after light curing. Opalescence PF gel was left on cell culture medium for 24 hours at the same conditions. After 24-hour incubation, the cells were collected by trypsinization and counted with a hemocytometer. For cell viability, trypane blue exclusion assay was used. The cytotoxicity of PowerGel and Opalescence PF were determined by evaluation of cell growth and viability in comparison to untreated controls (cell growth = 100%). The data were submitted to statistical analysis (One-way analysis of variance, Dunnett's t test). Results: Cell growth after 24 hours was significantly reduced (P = .000) in comparison to the control group. The cell growth in the Opalescence PF gel group also was reduced (P < .05). It was found that both gels affected cell viability. Conclusion: PowerGel and Opalescence PF showed a cytotoxic effect on cell growth in FM3A cell line.

Objective: This study investigated the effects of thermocycling on the retention of glass-fiber and resin posts. Method and materials: Forty premolar and canine tooth roots were embedded in acrylic blocks shaped to fit into a retention device. The roots were randomly assigned to two groups of 20 to receive either Lightposts or Luscent Anchors which were cemented into 9-mm-deep post spaces, with Panavia F resin cement. Each group was randomly divided into two equal subgroups: one for thermocycling, and the other to serve as a control. The thermocycled specimens were cycled 3'000 times between water baths at 5°C and 55°C, with a dwell time of 60 seconds in each. Control specimens were stored at 37°C. The tensile force required to dislodge each post from its root was recorded and the data analyzed using Student's t tests. Results: There were no significant differences in the forces required to cause post-retention failure between the control and thermocycled specimens. Lightposts were significantly more retentive than Luscent Anchors without thermocycling, but this distinction was not apparent in the thermocycled groups. Conclusion: Glass-fiber and resin posts cemented with resin cement offer acceptable levels of retention and are not susceptible to reduced retention from thermocycling. Thermocycling should be given less emphasis in tests for the retention of root canal posts cemented with resin cements.

The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4'310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.

Parkinson's disease is an idiopathic, slowly progressive disorder of the central nervous system characterized by resting tremor, muscular rigidity, slow and decreased movement (bradykinesia), and postural instability. In the United States, Parkinson's disease is the fourth most common neurodegenerative disorder in the elderly, affecting an estimated half a million people. Oral health care providers can expect to be called upon to care for patients with this progressively debilitating disease. To provide competent care to patients with Parkinson's disease, clinicians must understand the disease, its treatment, and its impact on the patient's ability to undergo and respond to dental care.