Faculty Bibliography

OBJECTIVE: Studies on salivary flow rates in human beings have mainly been carried out with adults. The purpose of this study was to determine the unstimulated salivary flow rates of children 4 to 7 years old. In addition, the relative contributions of the variables age, gender, race, height, body weight, dentition status, use of prescription medication, and health status (information obtained from parents) to the unstimulated salivary flow rates of children were also studied. STUDY DESIGN: Data were obtained from children (n = 447) at 2 sites in the United States (site 1, southeast Michigan; site 2, northern Michigan) and at 5 sites in Brazil (site 3, Porto Alegre; site 4, Sao Paulo; site 5, Belem; and sites 6 and 7, sites in Rio de Janeiro). In northern Michigan (site 2) the participants were cognitively or developmentally disabled, or both. In Rio de Janeiro (site 7), a group of 8- to 12-year-olds served as a control group. Saliva samples were collected for 3 minutes between 9 AM and noon in the spring or summer, and the saliva rate was determined gravimetrically. Data were analyzed by analysis of variance, bivariate analysis, and regression analysis. RESULTS: The secretion rates at the 7 sites were (in milliliters per minute) 0.19 +/- 0.15, 0.23 +/- 0.28, 0.34 +/- 0.23, 0.48 +/- 0.37, 0.25 +/- 0.27, 0.37 +/- 0.28, and 0.61 +/- 0.34, respectively. There were significant differences among sites (P <.0001). The older group (site 7) had flow rates that were significantly higher than the flow rates of any other group. In addition, children from Michigan (sites 1 and 2) had significantly lower rates than most groups of children in Brazil. Girls had lower unstimulated salivary flow rates than boys did at all the sites, but the differences were not statistically significant. Race was shown not to affect the flow rates. The use of any prescription medication by children in the previous 3 months was associated with lower salivary flow rates than were found in children not using prescription medication. Children who were in good health and who had no previous medical conditions had higher flow rates--but not significantly so. Higher flow rates occurred in children with mixed dentition than in children with primary dentition, although again the differences were not statistically significant. Regression analysis revealed weight to be of significance in explaining the variability of the unstimulated salivary flow rates at 2 sites, height at 1 site, the use of prescription medication at 2 sites, and age at 1 site. CONCLUSIONS: The unstimulated salivary flow rates in children in the northern United States are comparable with those reported for Japanese children, whereas the flow rates of children in Brazil are comparable with those reported for North American and European adults. In addition, none of the demographic variables/parameters tested contributed consistently to the variability of the unstimulated salivary flow rates in children at the 7 sites assessed in this study

BACKGROUND: Chlorhexidine, a cationic anti-microbial agent, prevents gingivitis by inhibiting plaque accumulation. Gingivitis is the most predominant form of periodontal disease in children and adolescents. The purpose of this study was to determine the effects of a chlorhexidine varnish on the gingival status of adolescents. METHODS: The subjects of this study were 10-15 years old adolescents randomly divided into a control (C) and a treatment (T) group, n = 53 and n = 57, respectively. After restoration of all caries lesions, a prophylaxis was given to both C and T groups. A 10 percent chlorhexidine varnish was applied to the entire dentition of T subjects at BL; and one week and three months thereafter. One calibrated examiner determined blindly the Gingival Index (GI) of all subjects. RESULTS: The average percentage of sites per subject with GI scores of 2 or 3 at BL, and after three and six months for the T group were, respectively, 3.68 +/- 7.13, 0.71 +/- 2.43 and 0.16 +/- 0.62. The corresponding values for the C group were 2.11 +/- 3.68, 1.27 +/- 2.94 and 1.59 +/- 5.20. Profile analysis revealed that over a 6-month period subjects of T group had significantly fewer sites with GI scores 2 and 3 than subjects in the C group (p = 0.025). CONCLUSIONS: It is concluded that the professional application of a chlorhexidine varnish significantly improved the gingival health of adolescents over a 6-month period

The purpose of this study was to access current medication usage by HIV/AIDS patients and its effects on dental caries and on unstimulated salivary flow rates. Thirty females and 127 males (mean age = 39.6 +/- 7.4 years), of whom 46% were White/Non-Hispanic, 39% African-American, and 15% Hispanic, were examined and interviewed at the Bering Dental Clinic, Houston, Texas. The mean time in years after seroconversion was 5.4 +/- 4.1. Calibrated examiners performed dental caries examination (DMFS) with dental explorers and bitewing radiographs. Interviews were carried out with pretested questionnaires, and medication usage was assessed by illustrative examples of HIV/AIDS medications. Salivary flow rates were determined gravimetrically (mL/min). Bivariate analysis and analysis of variance (ANOVA) were used to analyze the data. Because there were no race or gender effects on dental caries outcome variables or salivary flow rates, separate logistic regression models for medication usage were generated, which were adjusted for age and CD4+ cell counts. Patients who, currently, were receiving antiretroviral therapy (ART) had a lower occurrence of dental caries than patients not taking these medications. An unexpected finding in the lower caries rate group was a decrease in salivary flow rates, which was a probable oral side effect of ART. It appears from this cross-sectional study that systemic medication for the management of HIV disease has no significant detrimental effect on the dentition

OBJECTIVE: Very little information exists on minor salivary gland output (MSGO) in health and disease. We investigated the minor salivary gland output of elderly subjects with different medical backgrounds and the relationship of that output with life practices, demographic variables, complaints of dry mouth, medication usage, functional status, medical treatments, and dental and medical variables.Study Design: MSGO was measured with a special moisture-detecting paper on the lip, cheek, and palate, which comprised the total MSGO. A parsimonious linear regression model was developed to determine which of the many measured variables influenced the MSGO. RESULTS: There were significant differences in MSGO between the recruitment sites, with the non-Veteran Affairs (VA) Independent Living participants having significantly lower MSGO than the VA groups. A secretion rate for MSGO based on median values from all subjects of <4.6 microL/min was categorized as being low, whereas a secretion rate for MSGO >/=4.6 microL/min was categorized as high. A regression model was used to examine variables that could be associated with MSGO variability. The results show that being older, a woman, a current smoker, and having a complaint of dry mouth were associated with lower MSGO rates. CONCLUSIONS: An association between subjective complaints of dry mouth and a decrease in MSGO measured objectively was demonstrated in this elderly population. Furthermore, age and sex effects on MSGO were also demonstrated

Chemometrics has been shown quite efficient to uncover relationships between chemical composition of a sample and its geographical origin. Forty propolis samples originated from the the South and South East of Brazil were analyzed by HPLC and 18 compounds of interest were studied which included: caffeic, p-coumaric and ferulic acids, and some of their derivatives, pinobanksin, a derivative of kaempferol and five phenolic compounds (assigned as 3-prenyl4-hydroxycinnamic acid (PHCA); 2,2-dimethyl-6-carboxyethnyl-2H-1-benzopyran (DCBE); 3,5-diprenyl-4-hydroxycinnamic acid (DHCA); compound E (still unknown) and 6-propenoic-2,2-dimethyl-8-prenyl-2H-1-benzopyran acid (DPB). Principal Component Analysis (PCA) indicated three different groups of propolis samples, having the same typical chromatogram, evaluated by HPLC. Samples from the South East group were rich in derivatives of kaempferol. Samples from the South group I had a high content of DPB compound, but a low concentration of kaempferol derivatives and of DCBEN compound. Samples from the South group II were characterized by a high concentration of DCBEN, DHCA, p-coumaric and DPB compounds. Therefore, the identification of new compounds in Brazilian propolis can give, useful information about the plant sources of a given geographic region

A random sample of sixty-two 11-15-year-old adolescents from 17 different locations in Guatemala were selected for this study. Pocket depth, Plaque Index, and bleeding upon probing were recorded from 6 randomly selected sites in each subject (a total of 372 sites). Subgingival plaque samples were subsequently collected from these sites and processed by several assays. For cost reasons, in each pair of sites different assays were performed as follows: sites #1, #2--BANA test for T. denticola, P. gingivalis, B. forsythus and screening of plaque samples with polyclonal antibodies (ELISA system) for A. actinomycetemcomitans; sites #3, #4--detection of yeasts by SAB agar; sites #5, #6--detection of Entamoeba gingivalis by the Heidenhain iron hematoxylin modified technique. A total of 66% of the children had at least one site that bled upon probing, 42% exhibited at least one site with pocket depth > 3 mm, and 79% exhibited a high Plaque Index, with the percent of sites affected being 30%, 12% and 41%, respectively. In sites #1, #2 (N = 124), the BANA test assay and A. actinomycetemcomitans tested positive in 77% and 47% of the children accounting for 59% and 31% of the sites, respectively. In sites #3, #4 (N = 124), yeasts were detected in 43% of the children and 29% of the sites. In sites #5, #6 (N = 124), Entamoeba gingivalis was detected in 21% of the children and in 11% of the sites. The risk for severe gingival inflammation and/or increased probing depth was 1.5 and 5.2 times higher if a positive BANA test or A. actinomycetemcomitans test was found in a particular site. No associations could be found for yeasts and Entamoeba gingivalis

Bite-wing radiographs are an integral part of a thorough diagnostic evaluation for interproximal caries. This study evaluates the observers' ability to assess correctly proximal carious lesion depth with two different speeds of intraoral film. Significant underestimation of lesion depths by the observers with both imaging modalities are shown, with no significant diagnostic difference between the two film types for both the presence and extent of caries

The purpose of this investigation was to determine the antimicrobial and healing potential of propolis on direct dental pulp exposures. This study used 25 adult male rats. Pulp exposures were performed and animals were allocated to propolis and calcium hydroxide (Ca(OH)2 groups. Animals were killed on days 5, 7, 10, and 14. The teeth were routinely processed for histological evaluation. Non-parametric tests were employed to analyze the data. No significant differences were found between study groups on the wound healing of the dental pulp. Both substances were comparable in exhibiting normal reorganization of the pulp and no increased vascularity, and were equally efficacious in maintaining a low inflammatory and microbial cell population as well as in stimulating the formation of reparative dentin

Six months after implant placement to restore a maxillary lateral incisor, a 55-year-old patient developed a sinus tract associated with the apical area. Radiographic examination revealed a periapical radiolucency at the apex of the implant, and a diagnosis of retrograde peri-implantitis was made. Treatment consisted of elevation of a full-thickness flap, curettage of the apical lesion, irrigation with chlorhexidine gluconate, placement of demineralized freeze-dried bone, and coverage of the site with an absorbable collagen would dressing before primary closure of the flap. The prosthesis is functioning satisfactorily 17 months after apical treatment was performed

The aim of this study was to verify the association between children and their mothers (N = 28) for periodontal clinical and microbiological measures. Periodontal clinical parameters (probing depth and bleeding on probing) were obtained from six reference teeth from each mother-child pair. In addition, subgingival plaque samples taken from the same reference teeth were collected and placed on the Perioscan test for the detection of Treponema denticola, Porphyromonas gingivalis and Bacteroides forsythus. There were statistically significant differences between children and mothers regarding probing depth; there was an overall tendency for mothers to exhibit average probing depths greater than their children. In contrast, if a child had a bleeding site, the respective site on the mother usually also bled on probing, implying that there was an association in terms of bleeding between the mother-child pairs. Similar findings were observed for the Perioscan test. It is concluded that the occurrence of bleeding and periodontal anaerobic infections (as determined by the Perioscan test) were similar in reference teeth of mother-child pairs. These data suggest that parents with periodontal disease may serve as a reservoir of periodontopathic organisms for their children