U M E Chikte

Publications of U M E Chikte

• Bisphosphonate-related osteonecrosis of the jaw.

  Authors: L Feller, N H Wood, R A G Khammissa, U M E Chikte, M Bouckaert, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 02/2011; 66(1):30-2.

  Bisphosphonates are agents commonly used in the treatment of osteoporosis, and in the management of metastatic bone disease, and of hypercalcaemia of malignancy. Any oral surgical procedure orBisphosphonates are agents commonly used in the treatment of osteoporosis, and in the management of metastatic bone disease, and of hypercalcaemia of malignancy. Any oral surgical procedure or traumatic event exposing bone to bacterial infection may precipitate osteonecrosis of the jaw in subjects who have been treated with bisphosphonates which suppress bone turnover and inhibit the angiogenesis associated with healing. New guidelines for the treatment of bisphosphonate-related osteonecrosis of the jaw are emerging, but hitherto treatment has been empirically conservative.

• Oral cancer-associated paraneoplastic syndromes.

  Authors: L Feller, N H Wood, R A G Khammissa, U M E Chikte, R Essop, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 10/2010; 65(9):424-6.

  Paraneoplastic syndromes are cancer-associated endocrinological, haematological, dermatological or neurological disorders, which are directly related neither to the physical effects of the tumourParaneoplastic syndromes are cancer-associated endocrinological, haematological, dermatological or neurological disorders, which are directly related neither to the physical effects of the tumour mass, nor to invasion by the primary tumour, nor to metastasis of the tumour; nor are they associated either with the side-effects of anticancer treatment or with any of the complications of cancer. These syndromes are brought about by the ectopic production of biological mediators by the malignant tumour cells, or by immunological responses to the malignancy. Certain cancers are typically associated with specific paraneoplastic disorders. Though uncommonly, oral carcinomata have reportedly been associated with paraneoplastic pemphigus, humoral hypercalcaemia of malignancy, syndrome of inappropriate antidiuretic hormone, and paraneoplastic leukocytosis syndrome.

• Chemotherapy- and radiotherapy-induced oral mucositis: pathobiology, epidemiology and management.

  Authors: L Feller, R Essop, N H Wood, R A G Khammissa, U M E Chikte, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 09/2010; 65(8):372-4.

  Oral mucositis is a debilitating complication of anticancer treatment, characterised by erythematous, atrophic, erosive or ulcerative lesions. Oral mucositis is almost always painful, affects eating,Oral mucositis is a debilitating complication of anticancer treatment, characterised by erythematous, atrophic, erosive or ulcerative lesions. Oral mucositis is almost always painful, affects eating, sleeping, and speech and affects the physiological and social well-being of the patient. The pathophysiology of the condition is not well understood. Guidelines to the treatment of oral mucositis are often contradictory so that there is no evidence based standard treatment protocol. Therefore the treatment is empiric. This paper offers a brief review of current knowledge of the pathophysiology and treatment of oral mucositis.

• A short account of cancer--specifically in relation to squamous cell carcinoma.

  Authors: L Feller, M Bouckaert, U M E Chikte, N H Wood, R A G Khammissa, R Meyerov, J Lenner

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 08/2010; 65(7):322-4.

  Cancer is the outcome of a complex multifactorial process of cytogenetic and epigenetic changes that affect cell cycle progression, apoptosis, DNA repair mechanisms and cell differentiation. CancerCancer is the outcome of a complex multifactorial process of cytogenetic and epigenetic changes that affect cell cycle progression, apoptosis, DNA repair mechanisms and cell differentiation. Cancer cells have the capacity to evade the immune system, to invade tissues and to metastasize. Cancer is treated by surgery, chemotherapy and radiotherapy, each as single treatment modalities or more often in combination. Failure of treatment to cure a patient of cancer may be owing to the fact that radiotherapy and chemotherapy can eradicate transit-amplifying cells which are characterized by uncontrolled proliferation and prolonged survival; but cannot eradicate all cancer stem cells that divide slowly, have a relatively unlimited self-renewal capacity and express anti-apoptotic genes; and also owing to the fact that surgery cannot always eliminate occult fields of pre-cancerization.

• HPV modulation of host immune responses.

  Authors: L Feller, N H Wood, R A G Khammissa, U M E Chikte, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 07/2010; 65(6):266-8.

  Host immune responses to HPV are generally low-level because the virus, being confined to basal epithelial cells is shielded from the circulating immune cells during initial stages of infection. InHost immune responses to HPV are generally low-level because the virus, being confined to basal epithelial cells is shielded from the circulating immune cells during initial stages of infection. In this location there is only a limited expression of viral proteins. Other factors contributing to the low level of host immunity are that HPV infection is non-lytic (does not cause death of the infected cell); that a functionally active immune response is generated only at later stages of HPV infection, in post-mitotic suprabasal keratinocytes where all viral genes are expressed; and that only in suprabasal keratinocytes has the HPV DNA been sufficiently amplified to be detected by the host immune-surveillance cells. In addition to the natural low-level immune responses towards HPV, HPV also employs several mechanisms to down-regulate innate and cell-mediated immunity, thus facilitating host immune evasion and persistent infection. The environment, lifestyle, the genetic make-up of the host, and the viral genomic characteristics can also influence the persistence of HPV infection, and consequential diseases. Persistent infection with high-risk HPV is associated with increased risk of developing HPV-mediated premalignancy and malignancy. It is not clear if the natural humoral immune response as opposed to vaccination is effective in eliminating primary HPV infection or in preventing progression of infection; but after initial infection, the host develops HPV-specific T cell immune responses that appear to be capable of clearing established infection, of protecting against progression of early HPV-associated intraepithelial neoplastic lesions to squamous cell carcinoma, and of preventing reinfection.

• The pathobiology and mechanisms of infection of HPV.

  Authors: N H Wood, R A G Khammissa, U M E Chikte, R Meyerov, J Lemmer, L Feller

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 04/2010; 65(3):124-6.

  There are more than 120 types of low-risk and high-risk human papillomaviruses, all of which are epitheliotropic. HPV infection may be latent, or active in a subclinical form or a symptomatic form,There are more than 120 types of low-risk and high-risk human papillomaviruses, all of which are epitheliotropic. HPV infection may be latent, or active in a subclinical form or a symptomatic form, the latter manifesting as benign or malignant neoplasms. In basal cells with non-productive HPV infection some early HPV proteins are expressed independently of cell maturation: the productive cycle of HPV replication depends upon specific cellular factors of the maturation of the infected keratinocytes. In HPV-mediated oncogenesis, the combined pathobiological effects of E6 and E7 oncoproteins of high-risk HPV culminate in cellular genomic instability and transformation of persistently infected cells, that progress to the development of a malignant phenotype. In this article we provide insights into the stages of HPV infection, and into the viral genomic organization and replicative cycle.

• Salt fluoridation: a meta-analysis of its efficacy for caries prevention.

  Authors: V Yengopal, U M E Chikte, S Mickenautsch, L B Oliveira, A Bhayat

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 03/2010; 65(2):60-4, 66-7.

  The aim of this meta-analysis was to assess the caries preventive effect of Salt fluoridation (SF) in the permanent dentition in children. THE OBJECTIVES WERE TO COMPARE: (1) the caries preventiveThe aim of this meta-analysis was to assess the caries preventive effect of Salt fluoridation (SF) in the permanent dentition in children. THE OBJECTIVES WERE TO COMPARE: (1) the caries preventive effects of SF versus no exposure in different age cohorts (6-8; 9-12; and 13-15 years old); (2) SF versus other community based interventions (milk or water fluoridation [WF]). 9 English and 2 non-English databases were searched for papers that reported on the caries preventive effect of groups (with controls) that were exposed to SF in the form of mean DMFT scores with standard deviations. Differences in exposed and nonexposed groups were computed on the basis of weighted mean differences (WMDs) with 95% confidence intervals (CIs). For 6-8 year olds, the pooled reduction in DMFT scores was -0.98 [95% CI: -1.68 to -0.29]; for 9-12 year olds, it was -2.13 [95% CI: -2.55 to -1.70] and for the 13-15 year old groups, -4.22 [95% CI: -6.84 to -1.55]. All the analyses favoured the SF groups (p <0.001). For SF versus WF, there was no difference (-0.11 reduction [95% CI: -0.29 to +0.07]). Within limitations, the pooled estimates of the WMDs for the different age cohorts favoured SF versus no exposure.

• HIV-associated Kaposi sarcoma in African children.

  Authors: L Feller, R A G Khammissa, T S Gugushe, U M E Chikte, N H Wood, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 02/2010; 65(1):20-2.

  HIV-associated Kaposi sarcoma (HIV-KS) is common in African countries where HIV infection is pandemic and anti-retroviral medication is not readily available. Human herpesvirus-8 (HHV-8), which isHIV-associated Kaposi sarcoma (HIV-KS) is common in African countries where HIV infection is pandemic and anti-retroviral medication is not readily available. Human herpesvirus-8 (HHV-8), which is the essential, but not the sole aetiological factor in KS, is endemic in sub-Saharan Africa and is substantially more prevalent in HIV-seropositive than in HIV-seronegative subjects. In children in sub-Saharan Africa, KS, whether it be HIV-KS or African endemic KS is much more prevalent than any other epidemiological forms of KS. In addition, in sub-Saharan children oral KS is common, and the life-expectancy of HIV-seropositive children with KS is short. Since generalized systemic KS is frequently associated with oral HIV-KS, it is advisable to introduce systemic cytotoxic chemotherapy early in the course of oral HIV-KS. Although the introduction of highly active antiretroviral therapy (HAART) brought about a decline in the incidence of HIV-KS worldwide, HIV-KS remains a significant problem in sub-Saharan Africa where the prevalence of HHV-8 infection is high and access to HAART is limited.

• Tuberculosis part 4: Control of Mycobacterium tuberculosis transmission in dental care facilities.

  Authors: L Feller, N H Wood, U M E Chikte, R A G Khammissa, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 10/2009; 64(9):408-10.

  The risk of transmission of Mycobacterium tuberculosis (Mtb) in oral healthcare facilities is probably low, but the consequences if it occurs, are grave. The greatest risk of exposure to MtbThe risk of transmission of Mycobacterium tuberculosis (Mtb) in oral healthcare facilities is probably low, but the consequences if it occurs, are grave. The greatest risk of exposure to Mtb transmission is associated with treating dental patients from communities with a high prevalence of tuberculosis (TB) and HIV disease because these patients may have active TB but be unaware of their status. The risk of Mtb transmission in the dental surgery is heightened by dental treatment with ultrasonic and air operated high speed instruments that generate aerosols. This article offers recommendations for the necessary components of an effective Mtb infection control programme.

• Tuberculosis part 3: HIV-tuberculosis co-infection.

  Authors: L Feller, N H Wood, U M E Chikte, R A G Khammissa, R Meyerov, J Lemmer

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 09/2009; 64(8):352-4.

  Tuberculosis is the most common opportunistic infection in HIV-seropositive persons. Tuberculosis may occur at any stage of HIV disease but the prevalence of TB increases with the progressiveTuberculosis is the most common opportunistic infection in HIV-seropositive persons. Tuberculosis may occur at any stage of HIV disease but the prevalence of TB increases with the progressive diminution of CD4+ T cell numbers. There is a synergistic relationship between tuberculosis and HIV infection as each accelerates the progression of the other.

• The Relationships between Two Different Drinking Water Fluoride Levels, Dental Fluorosis and Bone Mineral Density of Children.

  Authors: S R Grobler, A J Louw, U M E Chikte, R J Rossouw, T J van W Kotze

  The open dentistry journal. 02/2009; 3:48-54.

  This field study included the whole population of children aged 10-15 years (77 from a 0.19 mg/L F area; 89 from a 3.00 mg/L F area), with similar nutritional, dietary habits and similar ethnic andThis field study included the whole population of children aged 10-15 years (77 from a 0.19 mg/L F area; 89 from a 3.00 mg/L F area), with similar nutritional, dietary habits and similar ethnic and socioeconomic status. The fluoride concentration in the drinking water, the bone mineral content, the bone density and the degree of dental fluorosis were determined. The left radius was measured for bone width, bone mineral content, and bone mineral density. The mean fluorosis score was 1.3 in the low fluoride area and 3,6 in the high fluoride area. More than half the children in the low fluoride area had no fluorosis (scores 0 and 1) while only 5% in the high fluoride area had none. Severe fluorosis (30%) was only observed in the high fluoride area. The Wilcoxon Rank Sum Test indicated that fluorosis levels differed significantly (p < 0.05) between the two areas. No relationships were found between dental fluorosis and bone width or between fluorosis and bone mineral density in the two areas (Spearment Rank correlations). A significant increase in bone width was found with age but no differences amongst and boys and girls. A significant positive correlation was found in the high fluoride area between bone mineral density over age. In the 12-13 and 13-14 year age groups in the high fluoride area, girls had higher bone mineral densities. However, a significant negative correlation (p<0.02) was found for the low fluoride area (0.19 mg/L F) over age.

• Patterns of tooth surface loss among winemakers.

  Authors: U M E Chikte, S Naidoo, T J v W Kolze, S R Grobler

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 11/2005; 60(9):370-4.

  There are a few documented case studies on the adverse effect of wine on both dental hard and soft tissues. Professional wine tasting could present some degree of increased risk to dental erosion.There are a few documented case studies on the adverse effect of wine on both dental hard and soft tissues. Professional wine tasting could present some degree of increased risk to dental erosion. Alcoholic beverages with a low pH may cause erosion, particularly if the attack is of long duration, and repeated over time. The purpose of this study was to compare the prevalence and severity of tooth surface loss between winemakers (exposed) and their spouses (non-exposed). Utilising a cross-sectional, comparative study design, a clinical examination was conducted to assess caries status; the presence and severity of tooth surface loss; staining (presence or absence); fluorosis and prosthetic status. The salivary flow rate, buffering capacity and pH were also measured. Thirty-six persons, twenty-one winemakers and fifteen of their spouses participated in the study. It was possible to show that there was a difference in terms of the prevalence and severity of tooth surface loss between the teeth of winemakers and those who are not winemakers. The occurrence of tooth surface loss amongst winemakers was highly likely due to frequent exposure of their teeth to wine. Frequent exposure of the teeth to wine, as occurs among wine tasters, is deleterious to enamel, and constitutes an occupational hazard. Erosion is an occupational risk for wine tasters.

• Evidence based healthcare--a method for practitioner's to improve clinical practice.

  Authors: V Yengopal, U M E Chikte

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 03/2003; 58(1):34-9.

• One-year evaluation of atraumatic restorative treatment and minimum intervention techniques on primary teeth.

  Authors: A J Louw, I Sarvan, U M E Chikte, E Honkala

  SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 10/2002; 57(9):366-71.

  Atraumatic restorative treatment (ART) and minimal intervention treatment (MIT) techniques were evaluated under field conditions in 5 regions of the Western Cape Province of South Africa, whereAtraumatic restorative treatment (ART) and minimal intervention treatment (MIT) techniques were evaluated under field conditions in 5 regions of the Western Cape Province of South Africa, where caries prevalence exceeds 60% and remains mostly untreated. The purpose of the study was to compare and evaluate results of ART and MIT techniques in the primary dentition of 6-9 year-old schoolchildren using glass-ionomer (GI) (Fuji IX) and compomer (Dyract AP) materials. At baseline 401 children were treated, and 1,119 restorations placed by 5 calibrated dentists, 53% with ART (using hand instruments only) and 47% with MIT (minimal use of slow hand-piece) techniques. Evaluations were done with a CPI periodontal probe to measure marginal defects and to detect decay. A pain assessment for the restoration procedures indicated that 80% of subjects experienced no pain, 18% discomfort and slight pain, and 2% required local anaesthetic. After one year 90.5% of subjects and 80% of restorations were followed up (11.1% lost as a result of exfoliation); of these restorations 86% were clinically acceptable (84.1% of the ART and 88% of the MIT). With the art technique 82.7% of GI restorations and 85.6%, of compomer restorations were acceptable. With the MIT technique 86.5% of GI restorations and 89.9% of compomer restorations were acceptable. Success of restorations per region varied significantly: regions 1 and 2-90%, region 3-80%, region 4-70% and region 5-95%. There were no significant statistical differences in respect of materials or methods employed. ART and MIT techniques were well accepted as complementary caries approaches by operators. One-year results show that ART and MIT techniques were successful, substantiating its use for the primary dentition in areas with high caries prevalence. Longer-term assessments are required.