[show abstract][hide abstract] ABSTRACT: OBJECTIVES: This is a 36 month birth-cohort study examining rampant early childhood caries (ECC) among American Indian children from a Northern Plains Tribal community. Regular oral exams, plaque samples, and caregiver interview questionnaires serve as a rich analytical source for ECC investigation. This paper reports on the prevalence of caries, as well as dmfs and its composition over the 36 month time course. METHODS: A total of 239 mother-child dyads participated in a longitudinal study of early childhood caries (ECC) and risk factors. Surface-specific exams for frank decay and non-cavitated white spot lesions occurred at baseline (approximately one month of age (±30 days) and target ages of 4, 8, 12, 16, 22, 28, and 36 months. RESULTS: Decay was first seen in seven teeth (6 maxillary incisors and 1 mandibular incisor) from five children at 8 months. The progression of caries prevalence was: 2.1% (N = 233, 8 mos), 14.9% (N = 235, 12mos), 31.8% (N = 233, 16 mos), 49.6% (N = 234, 22 mos), 69.2% (N = 227, 28 mos), and 80.2% (N = 232, 36 mos). Mean dmfs and its composition (D=decayed, M=missing, F=filled) were: 0.03 (8 mos: 100%
[show abstract][hide abstract] ABSTRACT: Dental implant abutments are fundamental prosthetic components within dentistry that require optimal biocompatibility. The primary aim of this cross-sectional study was to preliminarily assess differences in the pro-inflammatory cytokine and bone metabolism mediator protein expression in the peri-implant crevicular fluid (PICF) adjacent to transmucosal abutments.
Abutments were fabricated from either titanium or zirconia in patients previously receiving single-tooth implant therapy. All subjects sampled in this study had an identical implant system and implant-abutment connection. Participants (n = 46) had an average time of clinical function for 22 months (6.2-72.8 months, ±SD 17 months) and received a clinical and radiographic examination of the implant site at the time of PICF sampling using a paper strip-based sampling technique. Cytokine, chemokine, and bone metabolism mediator quantities (picograms/30 s) were determined using a commercial 22-multiplexed fluorescent bead-based immunoassay instrument. A total of 19 pro-inflammatory cytokines and seven bone metabolism mediators were evaluated.
Multivariable analyses provided no evidence of a group (titanium or zirconia), gender, or age effect with regard to the expression of pro-inflammatory mediators evaluated. Significant (P = 0.022) differences were observed for the bone mediator leptin, with titanium abutments demonstrating significantly elevated levels in comparison with zirconia. Osteopontin demonstrated a significant (P = 0.0044) correlation with age of the subjects.
No significant differences in pro-inflammatory cytokine or bone metabolism mediator profiles were observed biochemically, with the exception of leptin, for the abutment biomaterials of titanium or zirconia The molecular PICF findings support the observed clinical biocompatibility of both titanium and zirconia abutments.
Clinical Oral Implants Research 01/2014; · 3.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: Gene therapy using non-viral vectors that are safe and efficient in transfecting target cells is an effective approach to overcome the shortcomings of protein delivery of growth factors. The objective of this study was to develop and test a non-viral gene delivery system for bone regeneration utilizing a collagen scaffold to deliver polyethylenimine (PEI)-plasmid DNA (pDNA) [encoding platelet derived growth factor-B (PDGF-B)] complexes. The PEI-pPDGF-B complexes were fabricated at amine (N) to phosphate (P) ratio of 10 and characterized for size, surface charge, and in vitro cytotoxicity and transfection efficacy in human bone marrow stromal cells (BMSCs). The influence of the complex-loaded collagen scaffold on cellular attachment and recruitment was evaluated in vitro using microscopy techniques. The in vivo regenerative capacity of the gene delivery system was assessed in 5 mm diameter critical-sized calvarial defects in Fisher 344 rats. The complexes were ∼100 nm in size with a positive surface charge. Complexes prepared at an N/P ratio of 10 displayed low cytotoxicity as assessed by a cell viability assay. Confocal microscopy revealed significant proliferation of BMSCs on complex-loaded collagen scaffolds compared to empty scaffolds. In vivo studies showed significantly higher new bone volume/total volume (BV/TV) % in calvarial defects treated with the complex-activated scaffolds following 4 weeks of implantation (14- and 44-fold higher) when compared to empty defects or empty scaffolds, respectively. Together, these findings suggest that non-viral PDGF-B gene-activated scaffolds are effective for bone regeneration and are an attractive gene delivery system with significant potential for clinical translation.
[show abstract][hide abstract] ABSTRACT: Lauric acid (C12:0) and sapienic acid (C16:1Δ6) derived from human sebaceous triglycerides are potent antimicrobials found at the human skin surface. Long-chain bases (sphingosine, dihydrosphingosine and 6-hydroxysphingosine) are also potent and broad-acting antimicrobials normally present at the skin surface. These antimicrobials are generated through the action of ceramidases on ceramides from the stratum corneum. These natural antimicrobials are thought to be part of the innate immune system of the skin. Exogenously providing these lipids to the skin may provide a new therapeutic option, or could potentially provide prophylaxis in people at risk of infection. This article is part of a Special Issue entitled The Important Role of Lipids in the Epidermis and their Role in the Formation and Maintenance of the Cutaneous Barrier.
Biochimica et Biophysica Acta 08/2013; · 4.66 Impact Factor
[show abstract][hide abstract] ABSTRACT: Oral mucosal and salivary lipids exhibit potent antimicrobial activity for a variety of Gram-positive and Gram-negative bacteria; however, little is known about their spectrum of antimicrobial activity or mechanisms of action against oral bacteria. In this study, we examine the activity of two fatty acids and three sphingoid bases against Porphyromonas gingivalis, an important colonizer of the oral cavity implicated in periodontitis. Minimal inhibitory concentrations, minimal bactericidal concentrations, and kill kinetics revealed variable, but potent, activity of oral mucosal and salivary lipids against P. gingivalis, indicating that lipid structure may be an important determinant in lipid mechanisms of activity against bacteria, although specific components of bacterial membranes are also likely important. Electron micrographs showed ultrastructural damage induced by sapienic acid and phytosphingosine and confirmed disruption of the bacterial plasma membrane. This information, coupled with the association of treatment lipids with P. gingivalis lipids revealed via thin layer chromatography, suggests that the plasma membrane is a likely target of lipid antibacterial activity. Utilizing a combination of two-dimensional in-gel electrophoresis and Western blot followed by mass spectroscopy and N-terminus degradation sequencing we also show that treatment with sapienic acid induces upregulation of a set of proteins comprising a unique P. gingivalis stress response, including proteins important in fatty acid biosynthesis, metabolism and energy production, protein processing, cell adhesion and virulence. Prophylactic or therapeutic lipid treatments may be beneficial for intervention of infection by supplementing the natural immune function of endogenous lipids on mucosal surfaces.International Journal of Oral Science (2013) 5, doi:10.1038/ijos.2013.28; published online 19 July 2013.
International Journal of Oral Science 07/2013; · 2.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: Class III malocclusion is characterized by a composite of dentoskeletal patterns that lead to the forward positioning of the mandibular teeth in relation to the maxillary teeth and a concave profile. Environmental and genetic factors are associated with this condition, which affects 1% of the population in the United States and imposes significant esthetic and functional burdens on affected persons. The purpose of this study was to capture the phenotypic variation in a large sample of white adults with Class III malocclusion using multivariate reduction methods.
Sixty-three lateral cephalometric variables were measured from the pretreatment records of 292 white subjects with Class II malocclusion (126 male, 166 female; ages, 16-57 years). Principal component analysis and cluster analysis were used to capture the phenotypic variation and identify the most homogeneous groups of subjects to reduce genetic heterogeneity.
Principal component analysis resulted in 6 principal components that accounted for 81.2% of the variation. The first 3 components represented variation in mandibular horizontal and vertical positions, maxillary horizontal position, and mandibular incisor angulation. The cluster model identified 5 distinct subphenotypes of Class III malocclusion.
A spectrum of phenotypic definitions was obtained replicating results of previous studies and supporting the validity of these phenotypic measures in future research of the genetic and environmental etiologies of Class III malocclusion.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 07/2013; 144(1):32-42. · 1.33 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by self-determination theory (SDT), demonstrated greater changes in behavior concerning their children's oral health than mothers exposed to a neutral message delivered by brochure.
Data were collected at baseline, one- and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires regarding their child's dietary/oral hygiene habits. Chi-square, Wilcoxon Signed Rank, Mann-Whitney, and McNemar tests were used to analyze data (P<0.05).
Significantly more positive changes were observed for dietary/oral hygiene behaviors among the intervention group mothers at one- and six-month follow-ups than for the controls. Significantly fewer mothers in the intervention group shared dining ware with their child at both one- (P=0.0046) and six-month follow-ups (P<0.0001); this practice was decreased only at six-months for the control group mothers (P=0.05). Restricting consideration only to mothers who were not checking for white spot lesions at baseline, a significantly greater proportion of mothers in the intervention group performed this behavior at six-months (P=0.0044).
Data provided evidence of the effectiveness of the SDT videotaped oral health message relative to a neutral brochure.
[show abstract][hide abstract] ABSTRACT: ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Genome-wide association scan for childhood caries implicates novel genes. Shaffer JR, Wang X, Feingold E, Lee M, Begum F, Weeks DE, et al. J Dent Res. 2011;90(12):1457-62. REVIEWER: Deborah V. Dawson, PhD, ScM PURPOSE/QUESTION: To identify associations between genetic loci and the presence of childhood caries SOURCE OF FUNDING: NIH grants and contracts. Additional governmental and nonprofit support provided by Danish National Research Foundation, Danish Pharmacists' Fund, Egmont Foundation, March of Dimes, Augustinus Foundation, and Health Fund of the Danish Health Insurance Societies TYPE OF STUDY/DESIGN: Cohort study LEVEL OF EVIDENCE: Level 2: Limited-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE: Not applicable.
The journal of evidence-based dental practice 12/2012; 12(4):225-7.
[show abstract][hide abstract] ABSTRACT: This study investigated the frequency of Iowa dentists' provision of in-office and out-of-office dental care for people who are homebound, as well as comparing the practice and educational characteristics among dentists who did and did not provide care for patients who were homebound. The authors mailed a survey form to all licensed dentists on the Iowa State Health Professional license database (n = 1,168), excluding pediatric dentists and orthodontists. A second mailing was sent to all nonrespondents four months later, resulting in 638 returned forms for a 54.6% response rate. The questionnaire included two outcome responses associated with the treatment in the dentist's office or in the patient's home for patients who are homebound. About 40% of Iowa dentists reported providing care in the office to patients who are homebound, but care outside of the office was provided by fewer dentists (6%) who had more years of practice experience. These results suggest an increased sense of professional or community responsibility among these older Iowa dentists. Education efforts may increase homebound care and more involvement of younger dentists.
[show abstract][hide abstract] ABSTRACT: Sphingoid bases found in the outer layers of the skin exhibit antimicrobial activity against gram-positive and gram-negative bacteria. We investigated the uptake of several sphingoid bases by Escherichia coli and Staphylococcus aureus, and assessed subsequent ultrastructural damage. E. coli and S. aureus were incubated with D-sphingosine, dihydrosphingosine, or phytosphingosine at ten times their MIC for 0.5 and 4 h, respectively, to kill 50% of viable bacteria. Treated bacterial cells were immediately prepared for SEM, TEM, and analyzed for lipid content by QTLC. E. coli and S. aureus treated with sphingoid bases were distorted and their surfaces were concave and rugate. Significant differences were observed in the visual surface area relative to controls for both E. coli and S. aureus when treated with dihydrosphingosine and sphingosine (p < 0.0001) but not phytosphingosine. While sphingoid base-treated S. aureus exhibited disruption and loss of cell wall and membrane, E. coli cytoplasmic membranes appeared intact and the outer envelope uncompromised. Both E. coli and S. aureus cells contained unique internal inclusion bodies, likely associated with cell death. QTLC demonstrated extensive uptake of sphingoid bases by the bacteria. Hence, sphingoid bases induce both extracellular and intracellular damage and cause intracellular inclusions that may reflect lipid uptake.
Skin pharmacology and physiology 10/2012; 26(1):36-44. · 2.89 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objectives: This paper reports the prevalence and severity of caries in a group of 16-month-old American Indian children. Methods: The study is an ongoing longitudinal study of risk factors for caries in children from a Northern Plains Tribal community. Children were examined for caries and risk factor data collected at approximately 1, 4, 8, 12, and 16 months of age. Surface-specific caries data were collected and the presence of precavitated "white spot" lesions was recorded at the subject level. Results: The mean age was 15.4 months for the sample of 232 children. Caries prevalence was 31.9 percent, while an additional 29.3 percent had white spot lesions only. Mean dmfs was 1.57, and ranged from 0 to 44 surfaces. Nearly 3 percent of all erupted tooth surfaces were affected and maxillary central incisors had the highest prevalence of caries (22 percent). Conclusions: Among the very youngest children, dental caries prevalence was very high among these American Indian children.
Journal of Public Health Dentistry 09/2012; · 1.21 Impact Factor
[show abstract][hide abstract] ABSTRACT: This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population. More than three-quarters (76.1%) of the respondents reported using at least one CAM treatment in the past 12 months; 93.3% reported using at least one CAM treatment at some time in their lives. High rates of chiropractic use were found in this population. Tooth pain was the most frequently reported dental condition motivating CAM use. About 10% of dental school clinic patients use topical oral herbal and/or natural products to treat dental conditions, most frequently for preventive/oral health reasons or for tooth pain.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to consider the impact of surface defects on quantitative light-induced fluorescence (QLF) and micro-digital-photography (MDP) measures, in relationship to lesion depth.
Simulated enamel carious lesions were developed on 45 extracted human teeth. Images of each tooth were captured with both QLF and MDP. The teeth were sectioned and lesion depth was measured with polarized light microscopy (PLM). Pearson correlations were computed using data from the 27 lesions which did not have surface loss, and then separately based upon the 18 lesions which did display surface loss. MDP variables ΔR and ΔX measure reflected light, whereas QLF variables ΔF and ΔQ measure fluorescence.
A strong correlation was identified between lesion depth and ΔF (r=-0.765, p<0.0001), and ΔQ (r=-0.827, p<0.0001) on intact lesions while a weak but suggestive, although non-significant, correlation was identified between average lesion depth and ΔR (r=0.369, p=0.059) and ΔX (r=0.595, p=0.0011). However, the corresponding correlation was not statistically significant, when lesions with surface loss were considered for QLF and MDP measures.
QLF measures ΔF and ΔQ were strongly correlated with lesion depth in lab-simulated lesions with no surface loss, but not among lesions with surface defects. The two MDP-associated measures, ΔR and ΔX, could not be said to differ significantly when lesions with and without surface defects were compared with lesion depth. Because intact lesions can be remineralized, accurate assessment of their status is imperative for caries treatment.
Dental caries is still widely prevalent today. We now know that with early stage detection, remineralization can be accomplished. Being able to identify dental caries in its reversible stage (before physical surface loss) is paramount for the clinician to be able to treat the disease non-invasively.
Journal of dentistry 08/2012; 40(11):955-61. · 2.00 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objectives: The objective of this study is to assess relationships between the presence or absence of mutans streptococci (MS) and other covariates in children aged 12-49 months. Methods: Data were analyzed using baseline information from 411 children enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC) who participated in a psychoeducational study in Iowa. Children were assessed for MS using a semiquantitative method (RODAC plates). Dental examinations using d(1) d(2) .(3) criteria and presence of visible plaque on incisors and molars were completed. Mothers completed a series of detailed questionnaires regarding their child's oral health, their socioeconomic status, their child's dietary/oral hygiene habits, and beverage consumption, among other behaviors. Bivariate relationships with the presence of MS were assessed and followed by multivariable modeling using logistic regression (alpha = 0.05). Results: MS was present in 144 children (35 percent). Bivariate relationships with MS presence were identified for multiple covariates that included demographic characteristics, type of beverage consumption, dental caries, and plaque measures. Multivariate logistic regression modeling suggested that MS presence in children was positively associated with nonwhite race of the child, number of teeth present, presence of cavitated lesions, proportion of teeth with plaque, and lower levels of maternal education. Conclusions: The presence of MS was associated with greater caries and plaque scores and with low maternal education and nonwhite racial background.
Journal of Public Health Dentistry 04/2012; · 1.21 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objectives: To evaluate the impact of two approaches to 3D image superimposition on the reliability of soft tissue facial landmark selection as measured by the intraclass correlation coefficient. Methods: 3D stereophotogrammetric images of 15 subjects were landmarked by a calibrated rater using 3dMd software (Atlanta, GA) for 22 standard anthropometric soft tissue landmarks; a second landmarking was performed by the same rater within two weeks of the first. The dual landmark coordinates were then exported for intra-rater reliability assessments using intraclass correlation coefficients (ICCs) for each dimension of each landmark. Reliability was initially determined without superimposition, then following superimposition using one of two methods. Method 1: the landmark subnasale (SN) was translated to the origin for each landmarking of each subject. Method 2: a mean form was calculated from the two landmark configurations. The centroid of this mean form was translated to the origin for each subject for both measures. The impact of superimposition was assessed by comparison of ICCs and Euclidean distances between duplicate landmark measurements. Results: Without superimposition, reliability was excellent. The ICC ranged from 0.9971 to 1.0000 (p<0.0001). Subnasale (SN) translation decreased reliability for all 22 landmarks except for the Z coordinate of Gnathion (ICC = +0.001). The ICC ranged from 0.6789 to 0.9996 (p<0.0001). This translation changed the distance between the repeated measures, changed within-landmark variances and prevented reliability assessment for subnasale. Mean form centroid translation decreased reliability to a lesser extent for all 22 landmarks except for one coordinate in right tragion, left tragion and gnathion respectively. The ICC values ranged from 0.8326 to 0.9999 (p<0.0001). This translation did not change Euclidean distances, did not alter within-landmark variances and did not prevent reliability assessment for subnasale. Conclusion: Failure to superimpose facial landmark configurations can overestimate the reliability of landmark selection in 3D stereophotogrammetric techniques.
[show abstract][hide abstract] ABSTRACT: There is growing evidence that the role of lipids in innate immunity is more important than previously realized. How lipids interact with bacteria to achieve a level of protection, however, is still poorly understood. To begin to address the mechanisms of antibacterial activity, we determined MICs and minimum bactericidal concentrations (MBCs) of lipids common to the skin and oral cavity--the sphingoid bases D-sphingosine, phytosphingosine, and dihydrosphingosine and the fatty acids sapienic acid and lauric acid--against four Gram-negative bacteria and seven Gram-positive bacteria. Exact Kruskal-Wallis tests of these values showed differences among lipid treatments (P < 0.0001) for each bacterial species except Serratia marcescens and Pseudomonas aeruginosa. D-sphingosine (MBC range, 0.3 to 19.6 μg/ml), dihydrosphingosine (MBC range, 0.6 to 39.1 μg/ml), and phytosphingosine (MBC range, 3.3 to 62.5 μg/ml) were active against all bacteria except S. marcescens and P. aeruginosa (MBC > 500 μg/ml). Sapienic acid (MBC range, 31.3 to 375.0 μg/ml) was active against Streptococcus sanguinis, Streptococcus mitis, and Fusobacterium nucleatum but not active against Escherichia coli, Staphylococcus aureus, S. marcescens, P. aeruginosa, Corynebacterium bovis, Corynebacterium striatum, and Corynebacterium jeikeium (MBC > 500 μg/ml). Lauric acid (MBC range, 6.8 to 375.0 μg/ml) was active against all bacteria except E. coli, S. marcescens, and P. aeruginosa (MBC > 500 μg/ml). Complete killing was achieved as early as 0.5 h for some lipids but took as long as 24 h for others. Hence, sphingoid bases and fatty acids have different antibacterial activities and may have potential for prophylactic or therapeutic intervention in infection.
Antimicrobial Agents and Chemotherapy 12/2011; 56(3):1157-61. · 4.57 Impact Factor
[show abstract][hide abstract] ABSTRACT: The objective of this study was to assess the perceived oral health-related quality of life (OHQoL) of adolescents affected with one of the ectodermal dysplasias (EDs). Data were collected from 2003 to 2007 in a cross-sectional study of a convenience sample of individuals affected by ED (n = 35) using the Child Perceptions Questionnaire (CPQ11-14) for children and the Parent-Caregiver Perceptions Questionnaire for their caregivers. The main findings of this study were that individuals who were affected with ED in the older age group (15- to 19-year-olds) perceived more functional problems than younger individuals (11- to 14-year-olds) (p= .04). Females with ED (n = 13) perceived more emotional problems than males (n = 22; p= .01). Although caregivers tended to report slightly higher OHQoL scores (indicating worse OHQoL), no significant differences were observed between children's and parents' total OHQoL and individual domains' median scores (p > .05). Thus, the perceptions of oral health and well-being may vary by age and gender for children who have ED. Caution is warranted concerning using parents as proxies for their children when assessing the child's OHQoL.