Chinese Journal of Dental Research, 01/2012

Saliva reflects the physiologic state of the body, including emotional, endocrinal, nutritional and metabolic variations, and so can be used to monitor both oral and systemic health. In the past decade, salivary diagnostic approaches have been developed to monitor oral and systemic diseases. Along with these exciting scientific advancements, there is an emerging need to move salivary diagnostics out of the lab and into clinical practice. Point-of-care (POC) technologies specifically developed for salivary diagnostics can provide rapid, simple, low-cost and accurate measurements directly from saliva. To further transform salivary diagnostics into clinical reality, an integrated platform-based POC application is necessary, which includes sample processing, detection, a user-friendly interface and medical information technology. This review presents the requirements for POC platforms in salivary diagnostics and describes current applications of POC platforms for monitoring medical conditions using saliva. By advancing POC platforms for salivary diagnostics, dentists are anticipated to engage in chairside screening of medical conditions. Keywords: salivary diagnostics, point-of-care devices

Trauma is the predominant causal factor for temporomandibular joint (TMJ) ankylosis. However, the relationship between condylar fracture and TMJ ankylosis is complicated. It is believed that post-traumatic TMJ ankylosis arises from TMJ intracapsular changes, including damaged cartilage, displaced or disrupted discs, haematoma formation and subsequent fibrosis and calcification in the joint. In this review, the relationship between TMJ ankylosis and condylar fracture is discussed based on clinical characteristics and animal studies. The management of TMJ ankylosis is also reviewed and discussed. Keywords: temporomandibular joint, ankylosis, condylar fracture

Objective: To explore the use of the contralateral full-thickness retroangular island flap for reconstructing midfacial through-and-through defects. Methods: Full-thickness retroangular flaps raised from the contralateral infraorbital region were used to reconstruct midfacial through-and-through defects in eight patients following the resection of skin cancers. The defects ranged in size from 4.5 × 5.5 cm to 6.0 × 8.0 cm (mean 5.78 × 6.06 cm). The skin and mucosa in the full-thickness flaps ranged in size from 3.0 × 9.0 cm to 4.0 × 12.0 cm (mean 3.50 × 10.25 cm) and from 2.0 × 2.0 cm to 2.5 × 3.0 cm (mean 2.19 × 2.69 cm), respectively. Results: All the flaps survived and no complications occurred. The patients were followed for an average of 9.0 months (range 6-13 months). The vascularity of the flaps was good and the colour and texture matches were excellent. Cosmetic and functional outcomes were satisfactory in all patients. Conclusion: The contralateral full-thickness retroangular island flap containing the angular vessels in the pedicle is technically simple to use and is a good alternative for the reconstruction of moderate to large midfacial through-and-through defects. Keywords: retroangular flap, orbitonasolabial flap, nasolabial flap, cheek defect

Objective: To evaluate the relationships between clinical periodontal parameters and levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and lipid profile markers in subjects with or without hyperlipidaemia. Methods: Forty chronic periodontitis (CP) subjects with hyperlipidaemia (CP/HPL group), 40 systemically healthy CP subjects (CP group) and 20 systemically and periodontally healthy subjects (control group) were enrolled. The clinical periodontal parameters, the serum concentrations of Lp-PLA2, lipid profiles including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and white blood cell (WBC) counts were determined and compared between different groups. Linear regression analysis was performed to identify the contributing factors of Lp-PLA2. Results: Serum Lp-PLA2 level in the CP/HPL group and the CP group was significantly higher than in the healthy group. TC and TG levels in the CP/HPL group were higher than in the CP and control groups. No difference was observed for levels HDL-c and LDL-c and WBC counts among the groups. Linear regression analysis showed that the serum level of Lp-PLA2 was positively associated with bleeding on probing and WBC counts. Conclusion: Elevated level of Lp-PLA2 is associated with periodontal inflammation, indicating that periodontal treatment could reduce the risk of cardiovascular disease in CP subjects with hyperlipidaemia. Keywords: periodontitis, hyperlipidaemia, lipoprotein-associated phospholipase A2

Objective: To evaluate the translucency characteristics of new flowable bulk-filling resin composites at various thicknesses. Experimental short fibre-reinforced composite was also tested. Methods: Two new brands of flowable bulk composites (Venus Bulk Fill and SureFil SDR Flow), experimental short fibre-reinforced resin composite (FC) and, as control, conventional flow (Filtek Supreme Flow XT A3) and universal (Filtek Universal Supreme XTE A3B) resin composites were investigated. Translucency parameter was calculated for various thicknesses of composite (1, 2, 3, 4, 5 and 6 mm) over white and black backgrounds using spectrophotometry to determine the CIELAB values of each specimen. Data were statistically analysed with analysis of variance. Results: Translucency values significantly correlated with thickness of resin composite specimens (P 0.05). For the new types of flowable bulk-filling material, translucency was observed for thicknesses up to 5 to 6 mm, whereas for experimental FC composite, the effect was observed up to 4 to 5 mm, and for control flow and universal filling composites, up to 2 to 3 mm. Conclusion: New flowable bulk-filling resin composites have less masking ability than conventional universal filling resin composite materials, which should be taken into account when optimum colour match and aesthetic results are to be achieved. Keywords: translucency, flowable resin composite, universal resin composite

Objective: To investigate the effect of dehydration time on tooth colour measurement in vitro using colourimetry. Methods: Ten extracted human maxillary central incisors were used. L*a*b* values at the centre of the labial surface of each tooth were measured using a colourimeter. The first measurement was performed after removal of excess water. The second and third measurements were performed after the teeth had dried at room temperature for 2 h and 4 h, respectively. The colour differences (ΔE) between dehydration time points were calculated. Repeated oneway ANOVA was performed for colour values at different dehydration time points. Pairwise comparison of group means (Student t test) was used to examine the differences between ΔE and 1.5ΔE (α = 0.05). Results: There were statistically significant changes in the L* values after 2 h and 4 h dehydration as well as between each ΔE and 1.5ΔE. Neither 2 h nor 4h dehydration resulted in change of a* value or b* value. Conclusion: Dehydration time affected colour measurement using a colourimeter; the teeth become lighter after dehydration for 2 h or longer. Keywords: colour measurement, dehydration, tooth, colour difference, colourimeter

Objective: To compare the wear resistance and surface roughness of nanofiller-containing composites and microhybrid composites after simulated wear. Methods: Five microhybrid composites and five nanofiller-containing resin composites were included in the study. Six cylindrical specimens with a diameter of 10 mm and a thickness of 6 mm for each material were prepared. The volume loss, vertical loss and the surface roughness (Ra) were determined after 800 cycles of simulated chewing motion. One specimen of each material was analysed by scanning electron microscopy (SEM) to compare the morphology of the wear surfaces. The microhybrid composites group and nanofiller-containing composites group were tested using the Mann-Whitney U test with a significance level of α = 0.05. Results: For all microhybrid composites, the average wear volume loss and vertical loss were 56.44 mm3 and 730.6 µm, respectively, while the average wear losses of nanofiller-containing composites were 40.15 mm3 and 528.17 µm, respectively. The nanofiller containing composite GNH400N showed the least roughness (Ra = 0.346 ± 0.076 µm), while the conventional microhybrid composite Ceramage showed the highest roughness (Ra = 0.699 ± 0.214 µm). However, wear resistance and surface roughness for the two groups showed no statistical difference. SEM micrographs of the nanofiller-containing composites after wear testing showed smoother and more uniform wear surfaces than for the microhybrid composites. Conclusion: Nanofillers did not significantly influence the wear resistance of resin composites, but might improve the surface roughness of resin composites. Keywords: composite, microhybrid filler, nanofiller, roughness, wear

Objective: To evaluate the anti-plaque and anti-gingivitis properties of Acacia arabicacontaining toothpaste in an adult population. Methods: Sixty subjects with gingivitis were randomly assigned to a test group (Acacia arabica-containing toothpaste) or control group (regular toothpaste). An analysis of plaque index (PI), gingival index (GI) and bleeding on probing index (BOP%) were carried out at baseline and after 28 days followed by a washout period. After the washout period, the test and control groups were crossed over and the assessments were repeated. Results: Reductions in PI, GI and BOP% were observed in the test group compared with the control group. Conclusion: Brushing with Acacia arabica-containing toothpaste may help inhibit gingivitis. It can be recommended for daily oral hygiene procedures. Keywords: Acacia arabica, dentifrice, plaque, gingivitis

Nodular fasciitis is a benign fibroblastic proliferate lesion that is thought to be a response of tissue to injury. It usually presents as a rapidly growing subcutaneous mass. Upper extremities are most commonly affected, followed by the head and neck region. The clinical behaviour and histological presentation mimic those of malignant tumours, thus the lesion is easily misdiagnosed. The authors report here three cases of orofacial nodular fasciitis and review the literature focused on the diagnosis of the disease. Patient one had a history of trauma. The physical examination, radiographic features and findings in surgery were suggestive of a malignant tumour. The final diagnosis of nodular fasciitis was made through the immunohistochemical pathology. The other two patients had no history of trauma, but presented typical clinical and pathological features of nodular fasciitis. It is essential that dentists are aware of the distinctions between nodular fasciitis and malignant tumours in order to limit overtreatment and treatment-related morbidity. Keywords: nodular fasciitis, orofacial region

Aggressive periodontitis comprises a group of rare, often severe, rapidly progressive forms of periodontitis mostly characterised by an early age of clinical manifestation and a distinctive tendency for cases to aggregate in families. This case report presents a 16-year-old female patient with clinical and radiographic evidence of severe attachment loss, whose mother was also a patient with severe periodontal destruction. The girl was diagnosed with generalised aggressive periodontitis and received full-mouth scaling and root planing, bone graft surgeries and guided tissue regeneration on intrabony defects mesial of the mandibular first molars. Microbiological and immunological tests were performed on five selected sites before and at 2 months after initial therapy. Clinical and radiographic findings reported up to 4 years postoperatively indicated good effects and stability of treatment outcome. Keywords: aggressive periodontitis, periodontal initial therapy, bone graft surgery, guided tissue regeneration