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Journal Cover   Current Oral Health Reports
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Online) 2196-3002
   Published by Springer-Verlag Homepage  [2302 journals]
  • Photodynamic and Tissue Tolerable Plasma Therapies as Alternatives to
           Antimicrobials to Control Pathogenic Biofilms
    • Abstract: Abstract The need for novel antimicrobial techniques has become critical for a number of reasons, including the emergence of resistant strains because of excessive prescription and misuse of antibiotics. The mouth is colonized by a large number of microorganisms. When these microorganisms are organized as biofilms they can contribute to chronic diseases in the human population, such as dental caries, candidiasis, and periodontal disease. Hence, alternative antimicrobial approaches have risen to facilitate the treatment of these diseases. As novel therapies, photodynamic antimicrobial chemotherapy and tissue-tolerable plasma are promising methods that offer the possibility of microbial decontamination with decreased odds for the traditional side effects. Thus, the present review aims to offer an overview and future directions of these new approaches to control pathogenic oral biofilms.
      PubDate: 2015-01-11
  • The Biofilm Community: Rebels with a Cause
    • Abstract: Abstract Oral biofilms are some of the most complex and diverse ecosystems developed by successive colonization of more than 600 bacterial taxa. Development starts with the attachment of early colonizers such as Actinomyces species and oral streptococci on the acquired pellicle and tooth enamel. These bacteria not only adhere to the tooth’s surface, but also interact with each other and lay foundation for attachment of bridging colonizers such as Fusobacterium nucleatum followed by late colonizers including the red complex species Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, the founders of periodontal disease. As the biofilm progresses from supragingival sites to subgingival sites, the environment changes from aerobic to anaerobic, thus favoring the growth of mainly Gram-negative obligate anaerobes while restricting the growth of the early Gram-positive facultative aerobes. Microbes present at the supragingival level are mainly related to gingivitis and root caries, whereas subgingival species advance the destruction of teeth supporting tissues, and thus cause periodontitis. This review summarizes our present understanding and recent developments on the characteristic features of supra- and subgingival biofilms, interaction between different genera and species of bacteria constituting these biofilms, and draws our attention to the role of some of the recently discovered members of the oral community.
      PubDate: 2015-01-07
  • Is Citrullination the Missing Link between Periodontal Disease and
           Rheumatoid Arthritis?
    • Abstract: Abstract Connections between periodontitis (PD) and rheumatoid arthritis (RA) are suggested by an increased prevalence of PD in RA, shared environmental and genetic risk factors, and correlating levels of severity when the two diseases occur together. Here, we compare and contrast the results from numerous studies documenting this association, and highlight the involvement of citrullination in the development of autoimmunity leading to the destructive pathology that characterizes RA. The contribution of citrullination to RA may occur in at least three distinct phases: (i) the initial breakdown of tolerance leading to autoimmunity; (ii) the maturation of the citrulline specificity of the autoantibody response; and (iii) the pro-inflammatory effect of citrullinated proteins themselves in established disease. We conclude that citrullination is more than a ‘missing link’; rather, it is an active process in the evolution of low levels of autoimmunity found in PD into the pathogenic anti-citrullinated protein response specific to RA.
      PubDate: 2015-01-06
  • Rheumatoid Arthritis and Periodontal Disease: A Rheumatologist's
    • Abstract: Abstract Despite advances in our understanding of the inflammatory events that underlie rheumatoid arthritis (RA), which have led to targeted therapies that more effectively control the condition, the etiology of RA is not fully understood. With the discovery that serum antibodies to citrullinated peptides (ACPA) are highly specific for RA and that Porphyromonas gingivalis, the major pathogen responsible for periodontitis (PD), contains the enzyme responsible for the citrullination of peptides, a plausible explanation for observations of increased incidence and severity of PD in RA patients and an appreciation of pathogenic similarities between the two conditions has emerged. Studies of the effect of RA treatment on the severity of PD have been limited and conflicting, especially with respect to anti-TNF agents, but indicate the potential for IL-6 as a therapeutic target for both conditions. PD treatment appears to improve clinical and laboratory evidence of RA disease activity, and the response of RA to anti-TNF therapy is abrogated by the presence of PD. Thus, evaluation and treatment of PD can be recommended for all RA patients.
      PubDate: 2014-12-28
  • Microbiology of Oral Biofilm-Dependent Diseases: Have We Made Significant
           Progress to Understand and Treat These Diseases?
    • Abstract: Abstract The oral microbiome plays a crucial role in the establishment and maintenance of oral health. Major disturbances in the interactions between this microbiome, the microenvironment, and the host may lead to the development of oral diseases. A large proportion of infectious diseases that affect humans are caused by organisms living in biofilms. This is also the case for oral infections such as dental caries, periodontal diseases, and endodontic and fungal infections. In this review, new concepts regarding the role of the oral biofilm in the etiopathogenesis of these diseases are presented, and a more ecological view of pathogenic communities as causative agents of oral diseases is discussed. We believe that a better understanding of oral biofilm physiology and ecology will provide insight for the development of new cost-effective diagnostic tools, as well as preventive and therapeutic strategies for the management of these infections.
      PubDate: 2014-12-24
  • The Link Between Periodontitis and Rheumatoid Arthritis: A
           Periodontist’s Perspective
    • Abstract: Abstract In this review, we critically evaluate the case–control studies examining the relationship between rheumatoid arthritis (RA) and periodontitis, two common chronic inflammatory diseases with a similar host-mediated pathogenesis. We review the “two-hit” periodontitis model that our group previously proposed, in which we elucidate how a systemic disease such as RA can potentially exacerbate or initiate periodontitis. Furthermore, we discuss adjunctive host modulation therapy, originally developed for periodontitis (i.e., subantimicrobial-dose doxycycline alone or in combination with an anti-inflammatory agent), to simultaneously mitigate RA and periodontitis. Finally, we review studies describing periodontal treatment effects on both RA disease activity measures and systemic inflammation. Current evidence suggests that an association exists between periodontitis and RA. Well-designed multicenter longitudinal clinical trials and studies with sufficient sample sizes are needed to ascertain the temporal relationship between these two diseases and whether periodontal treatment can reduce the severity of RA or prevent its onset.
      PubDate: 2014-12-24
  • Host Responses in the Link Between Periodontitis and Rheumatoid Arthritis
    • Abstract: Abstract Periodontitis and rheumatoid arthritis (RA) are common chronic inflammatory conditions and share many clinical and pathologic features. There is evidence to suggest that similar profiles of cytokine genotypes and their coding proteins are involved in the pathogenesis of periodontitis and RA. In particular, constitutive overproduction of pro-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), has been implicated to play a pathologic role in the two inflammatory diseases. Results from studies with animal and human subjects have suggested an improvement of periodontal inflammatory condition after treatment with TNF-α inhibitors. Likewise, IL-6 receptor inhibition therapy has been suggested to have an effect on control of periodontal inflammation in patients with RA. In the present review, we provide an overview of studies showing the pathological role of cytokines in the linkage between periodontitis and RA, and further summarize the current studies assessing the effect of cytokine targeted therapy on periodontal condition.
      PubDate: 2014-12-24
  • Progress in the Identification of Genetic Factors in Periodontitis
    • Abstract: Abstract The susceptibility to periodontitis is determined by a complex interplay between bacteria, the immune system, and life-style factors, and is mainly regulated by genes. The genetic factors contributing to the pathogenesis of periodontitis are still not fully defined. The aim of the present review is to summarize and discuss the status of replicated candidate gene and genome-wide association studies (GWAS) in aggressive and chronic periodontitis. Currently, 3 susceptibility genes, namely GLT6D1, ANRIL, and COX-2, have repeatedly been associated with periodontitis in cohorts of sufficient size. Most of the associations have been reported in aggressive periodontitis. Single nucleotide polymorphisms (SNPs) within ANRIL and COX-2 seem to also be associated with chronic periodontitis. Further, SNPs within the IL-10 gene have shown suggestive associations with aggressive periodontitis, and SNPs within DEFB1 with aggressive and chronic periodontitis. Probably, the identified SNPs are “genetic markers” and not causative variants for aggressive and chronic periodontitis.
      PubDate: 2014-10-18
  • Diagnosis, Prevalence, and Treatment of Halitosis
    • Abstract: Abstract Halitosis affects a large part of the population. Many of those that are affected suffer from this problem for a long time before they visit a professional halitosis clinic. Further, halitosis creates social and psychological disadvantages. Although halitosis has multifactorial origins, in nine out of ten cases the source can be found within the oral cavity. The most frequent intra-oral causes are tongue coating, gingivitis, and periodontitis, or a combination of these. A general dental practitioner is often faced with patients suffering from halitosis in her/his dental practice and therefore should be able to manage it. Using standardized strategies, a high level of treatment success can be achieved. In the literature, several methods to determine halitosis and various possibilities for treatment are described. The present review summarizes diagnostics, prevalence, and current treatments of oral halitosis.
      PubDate: 2014-09-30
  • Is Periodontitis Prevalence Declining' A Review of the Current
    • Abstract: Abstract In recent decades, a decline in caries has led to retention of more teeth in industrialised countries. However, it is unknown, if such a trend also exists for periodontitis. Thus, the aim of this article is to review the evidence for global trends in the change in the prevalence of periodontitis over the last 20 years. Because evaluations of disease trends and comparisons of those between-trend studies are complicated by several methodological aspects, we also comprehensively discuss these issues. In total, ten studies provided data on trends in periodontal diseases with varying degrees of methodological bias. All studies consistently reported declining trends of periodontal parameters. However, methodological issues partly restricted interpretability of trend studies. Nevertheless, this review supports the assumption that periodontal disease prevalence is declining, though to varying degrees, but we will probably face higher treatment demands in the future because the number of teeth within subjects as well the number of elderly subjects within populations is increasing.
      PubDate: 2014-09-26
  • Natural History of Periodontitis
    • Abstract: Abstract Prospective studies have been conducted around the world to investigate the natural progression of periodontitis. Eight populations, with at least five years of observation, have been investigated in Norway, Sri Lanka, China, Indonesia, Australia, Germany, New Zealand, and Brazil. The findings from each population were based on the assessments of clinical periodontal parameters, microbiological samplings, socioeconomic status, tobacco use, and daily oral hygiene. Periodontitis was not commonly seen in the younger cohorts. With increasing age, however, the prevalence and severity of periodontitis rose significantly, although there was substantial variance within this general finding among individual cohorts. While the accumulation of plaque and subgingival calculus appears to be primarily accountable for the onset and progression of periodontitis, it is also necessary to consider the individual’s susceptibility and their response to the exposure of common risk factors such as smoking, as well as their socioeconomic status, in order to understand the natural progression of the disease.
      PubDate: 2014-09-23
  • Subgingival Distribution of Microorganisms
    • Abstract: Abstract Composition of subgingival microbiotas has long been seen as being of primary importance in the etiology of periodontal diseases. Development of advanced molecular methods has improved our knowledge about the role of traditional periodontal pathogens as well as resulted in the recovery of novel pathogen candidates. Detection rates of these microorganisms vary considerably between geographical regions but also between ethnic groups within a country. We have gathered information of various types of microorganisms inhabiting subgingival sites of individuals living in different parts of the world for the present review, the purpose of which is to highlight the potential impact of geography and ethnicity on subgingival findings, especially in chronic periodontitis.
      PubDate: 2014-09-20
  • Definition and Prevalence of Peri-Implantitis
    • Abstract: Abstract This narrative review focuses on the current understanding of the definition and prevalence of peri-implantitis. A MEDLINE (PubMed) search over the past 3 years was performed using keywords related to the definition and prevalence of peri-implantitis. Additional literature retrieved from reference lists, review articles, and consensus reports were used. Definition of peri-implantitis is heterogeneous due to the various thresholds of bone loss and pocket depths used, creating a discrepancy in the prevalence figures. The prevalence of peri-implant mucositis varied between 19 and 65 %, whereas the prevalence of peri-implantitis ranged from 10 to 40 %. A consensus has been reached that the definition of peri-implantitis should be clinical signs of inflammation (bleeding on probing) and/or suppuration, in combination with progressive bone loss. In addition, we strongly recommend that measurement of the bone loss in relation to the implant length would further classify the case as mild, moderate, or severe peri-implantitis.
      PubDate: 2014-09-14
  • Microstructural Features of Current Resin Composite Materials
    • Abstract: Abstract Dental resin composites have become the primary choice of most practitioners for the direct restoration of teeth owing to their esthetics and properties, both of which are highly dependent upon the microstructure of the materials. The type, size, amount, and distribution of the reinforcing fillers are all critical determinants of the optical and physical properties of the composite. The chemistry of the resin monomers and the quality of the highly cross-linked network formed during the polymerization reaction significantly influences these properties. Finally, the transfer of stress from the weaker resin matrix to the stronger and stiffer reinforcing fillers is accomplished by ensuring a strong interfacial linkage between the two phases, typically via a silane coupling agent. Recent work characterizing and describing the influence of the microstructure of dental composites on their properties and performance are reviewed in this manuscript.
      PubDate: 2014-09-14
  • Strategies to Improve Biocompatibility of Dental Materials
    • Abstract: Abstract Adverse reactions to dental materials occur and public interest in this topic has increased during recent decades. Thus, improving the biocompatibility of dental materials is necessary and must be based on several strategies. First, a strategy for improving the administrative and technical conditions for material certification processes should be included, such as the development of in vitro tests with enhanced predictability of the generated data for use in the clinic. Second, research on material/tissue interactions must be enhanced and include mechanistic approaches, as this strategy leads to the development of new and more biocompatible materials. Research into patients and their individual exposure situation is a strategy directed at better defining risk groups. Finally, improvement of education will also lead to improved biocompatibility of dental materials.
      PubDate: 2014-09-11
  • Adhesion to Dental Ceramics
    • Abstract: Abstract All-ceramic restorations are attractive because of their long lasting esthetics and the ability to withstand the oral conditions. However, bonding to ceramics has challenged the dental community for the last few decades. The clinical success of a ceramic restoration is strongly dependent on the quality and durability of the bond between the resin cement and the restoration. This study presents the bonding mechanisms and the mechanical tests to evaluate the adhesive interfaces of resin-bonded ceramic restorations, mainly the zirconia-based restorations, which are the most popular. An adequate bond involves ceramic surface changes for mechanical retention, which can be achieved using primers, such as acids and airborne particle abrasion. Selective etching of high crystalline content ceramics mostly occurs within grain boundaries that offer little micromechanical retention and an insufficient bond to resin. The most popular surface treatment to improve adhesion to high crystalline content ceramics involves the treatment of surfaces with airborne particle abrasion and chemical bonding. Yet, there are reports on new methods to enhance the resin bond to zirconia that need further investigation. This study provides scientific evidences to guide the clinical procedures on bonding ceramic restorations.
      PubDate: 2014-09-10
  • Adhesive Materials with Bioprotective/Biopromoting Functions
    • Abstract: Abstract Esthetic restoration using resinous materials has achieved great success in the past decade.A large part of this success is attributed to the significant advances in adhesive materials. Although refinement of existing adhesive materials is still required to improve bonding reliability and reproducibility, the development of innovative adhesives with bioprotective/biopromoting functions has been recognized as an important direction for future research. Until now, significant achievements have been made in the development of adhesives that can protect the bonded interface from extrinsic bacteria- or intrinsic enzyme-induced destruction, as well as those that can promote the natural remineralization or regeneration process of the tooth tissue. In this review, the author will summarize the latest developments in these innovative bioactive adhesive materials.
      PubDate: 2014-09-06
  • Oral Mucosal Injury in Oncology Patients
    • Abstract: Abstract The field of oral mucosal injury caused by cancer therapies has strategically matured in the scientific as well as clinical realms over the past decade. Prior to the late 1990s, the condition had been viewed by many healthcare providers as an inevitable consequence of high-dose chemotherapy and other intensive therapies in oncology practice. Fortunately, expanding insights into the pathobiology as well as design strategies for clinical trials in recent years have fostered development of high-quality clinical practice guidelines as well as health professional education relative to prevention and treatment. This report is directed to analysis of this contemporary modeling. Guideline-based management recommendations that have emerged over the past year and controversies in the field are highlighted.
      PubDate: 2014-08-03
  • Understanding the Pathobiology of Oral Lichen Planus
    • Abstract: Abstract Oral lichen planus (OLP) is a relatively common chronic inflammatory disease. A consistent body of evidence suggests that OLP is a predominantly T-cell mediated disease that shares clinical and histological features with chronic graft versus host disease. A putative genetic predisposition linked to cytokine polymorphisms has been revealed and some possible etiologic factors such as amalgam and hepatitis C virus have been studied in detail. In this review, an overview on the immunopathogenesis of OLP will be provided and a putative comprehensive hypothesis will be discussed in detail. Despite significant advances, many questions still remain concerning the etiology and pathogenesis of OLP.
      PubDate: 2014-07-20
  • Interprofessional Clinical Experiences in Dental Education
    • Abstract: Abstract Interest and activity in interprofessional education (IPE) has grown substantially in recent years across the health professions, driven by the belief that more effective interprofessional collaboration among providers will contribute to realization of the Triple Aim objectives articulated by the Institute for Healthcare Improvement—better individual care experiences, better population health, and reduced per capita cost of care. In dental education, new standards from the Commission on Dental Accreditation (CODA) in 2013 require that dental schools demonstrate that graduates are competent to communicate and collaborate with other health professionals, requiring dental educators to develop IPE curricula and assessment at their institutions. One of the more challenging aspects of IPE curriculum development is to provide meaningful interprofessional clinical experiences for students. The purpose of this paper is to review selected examples of interprofessional clinical experiences involving dental students and to describe an interprofessional clinical experience implemented at the authors’ institution.
      PubDate: 2014-07-15
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