Hui-Chieh Yu

Changes in prevalence of precancerous oral submucous fibrosis from 1996 to 2013 in Taiwan: A nationwide population-based retrospective study

BACKGROUND/PURPOSE Oral submucous fibrosis (OSF) has been regarded as a precancerous condition. Research examining the prevalence of OSF could be the first step in preventing or reducing malignant transformation. In this study, we probed a nationwide registered database to assess the prevalence, gender distribution, age, income, and urbanization status of OSF patients in Taiwan. METHODS A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Ministry of Health and Welfare, Taiwan. We identified dental visit patients diagnosed with OSF during the period between January 1, 1996 and December 31, 2013. In addition, demographic characteristics were analyzed by multivariate Poisson regression. RESULTS The prevalence of OSF increased significantly from 8.3 (per 105) in 1996 to 16.2 (per 105) in 2013 (p < 0.0001). Men had a significantly higher OSF prevalence than women (p < 0.001). The mean age of patients with OSF increased from 1996 to 2013. Individuals living in rural areas had a higher risk of OSF compared with those living in urban areas [relative risk (RR), 1.10; 95% confidence interval (CI), 1.07-1.13]. The higher income group had a lower risk of OSF compared with the lower income group (RR, 0.76; 95% CI, 0.73-0.80). CONCLUSION This large-scale government-centered survey demonstrates that the prevalence of OSF in Taiwan significantly increased from 1996 to 2013. The prevalence was higher among men than among women.

Trends in the prevalence of diagnosed temporomandibular disorder from 2004 to 2013 using a Nationwide health insurance database in Taiwan

Background/purpose Temporomandibular disorder (TMD) is defined as various clinical signs and symptoms involving the masticatory muscles, the temporomandibular joint and associated structures. The aim of this study was to investigate the prevalence of diagnosed TMD in Taiwan using a National Health Insurance Research Database from 2004 to 2013. Materials and methods A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance from 2004 to 2013. The diagnosis of TMDs was identified in accordance with the International Classification of Disease, Ninth revision (ICD-9-CM 524.6). The relative risk of TMD from 2004 to 2013 after adjusting for year, age, and gender was evaluated by logistic regression analysis. Results The prevalence of TMD increased significantly from 14 (per 104) to 26 (per 104) over the past 10 year period [odds ratio (OR), 1.07; 95% confidence interval (CI), 1.04–1.09]. The mean age with TMD from 2004 to 2013 was 52.31 ± 17.15 years and 45.12 ± 17.32 years, respectively. The female group had a higher risk of TMD than the male group (OR, 1.70; 95% CI, 1.49–1.94). Conclusion Taken together, the estimated prevalence of TMD significantly increased from 2004 to 2013 in Taiwan. In addition, the risk for TMD was higher among women than among men.

Increased risk of periodontitis in patients with psoriatic disease: a nationwide population-based retrospective cohort study

Aims Periodontitis and psoriatic disease, including psoriasis (PS) and psoriatic arthritis (PsA), share the common risk factors and co-morbidities. However, the risk of periodontitis in patients with psoriatic disease still needs further investigation. This study was a nationwide population-based retrospective cohort study assessing the risk of periodontitis from psoriatic disease exposure. Materials and Methods Patients with newly diagnosed psoriatic disease from 2003 to 2012 were identified from the Taiwanese National Health Insurance Research Database. The 1:4 ratio propensity score matched controls were selected from no psoriatic disease participations. The subsequent risk of periodontitis was evaluated in exposure and comparison groups. Multiple Cox proportional hazard models were used for the estimation. Results A total of 3,487 psoriatic disease patients and 13,948 controls were identified. Incidence rate of periodontitis was higher in patients with PsA. The adjusted hazard ratio (aHRs) for moderate/severe periodontitis were 0.85 (95% CI [0.65–1.11]) in PS group and 1.66 (95% CI [0.99–2.78]) in PsA group. The aHRs of PsA were increased over time, aHRs was changed from 0.65 (0–11 months from index date) to 1.34 (≥12 months from index date) in all types of periodontitis and from 1.09 to 1.79 in moderate/severe periodontitis group, respectively. Conclusions The increased risk of periodontitis was observed, especially the association between PsA and moderate/severe periodontitis. The patients with psoriatic disease should receive regular periodontal evaluation.

Schneiderian membrane repair with platelet-rich fibrin during maxillary sinus augmentation with simultaneous implant placement

Maxillary sinus augmentation is used to gain adequate bone volume for the placement of dental implants in edentulous posterior maxilla. Schneiderian membrane perforation is one of the most common complications associated with maxillary sinus augmentation procedures. Choukroun’s platelet-rich fibrin (PRF) protocol is a simple and free technique that allows one to obtain fibrin clots and membranes enriched with platelets and growth factors, after starting from an anticoagulant-free blood harvest. The clinical applications of PRF have already been described in periodontal regeneration surgery, sinus augmentation, and bisphosphonate-related osteonecrosis of the jaw. This report is the first to provide a quick and simplified option for the repair of Schneiderian membrane perforation with PRF during maxillary sinus augmentation with simultaneous implant placement. A 62-year-old man, who has had diabetes mellitus for 10 years, had atrophy of the left maxillary posterior

Patients with chronic periodontitis present increased risk for primary Sjögren syndrome: a nationwide population-based cohort study

Many reports have mentioned the association between chronic periodontitis (CP) and primary Sjögren syndrome (pSS). However, no cohort study has been performed for the risk of pSS in patients with CP. In this study, we evaluated the risk of pSS from CP exposure in a nationwide population-based cohort study in Taiwan. We studied the claims data of Taiwanese population from 2001 to 2012. We identified 76,765 patients with CP from the National Health Insurance Database in Taiwan. We also selected 76,765 controls that were randomly frequency matched by age, sex, and index year from the general population. We analyzed the risk of pSS by using Cox proportional hazards regression models including sex, age, and comorbidities. In this study, 76,765 patients with CP (mean age: 40.8 years) and 76,765 controls (mean age: 41.0 years) were followed-up for 8.54 and 8.49 years, respectively. A total of 869 cases of pSS were identified in CP cohort and 483 cases in non-CP cohort. Multivariate Cox regression analysis indicated that the incidence rate of pSS was significantly higher in CP cohort than those who in non-CP cohort (adjusted HR: 1.79, 95% CI [1.60–2.00]). Taken together, this nationwide retrospective cohort study demonstrated that the risk of pSS was significantly higher in patients with CP than in the general population. The association between CP and pSS was significant in the female group.

Time trend in the prevalence of oral lichen planus based on Taiwanese National Health Insurance Research Database 1996–2013

Background/Purpose Oral lichen planus (OLP) is a common chronic inflammatory disease characterized by a T cell-mediated immune response against epithelial cells. The epidemiological survey of OLP in Taiwanese population was scarce. In this study, we investigated the time trend of prevalence stratified by gender, age, urbanization, and income of OLP based on National Health Insurance Research Database (NHIRD). Materials and methods We studied the claims data of Taiwanese population from NHIRD 1996 to 2013. Patients with the diagnosis of OLP based on the International Classification of Diseases, Ninth Clinical Modification (ICD-9-CM) code: 697.0 were recruited in this study. Demographic characteristics were analyzed by multi-variate Poisson regression. Results The prevalence of OLP increased significantly from 1.3 (per 105) in 1996 to 12.8 (per 105) in 2013 (p for trend < 0.001). The prevalence was higher among female than male (RR: 2.13; 95% CI: 2.07–2.18, p < 0.001). The subjects living in suburban area had a lower risk of OLP than those living in urban area (RR: 0.80; 95% CI: 0.78–0.82, p < 0.001). The higher income group had higher risk of OLP compared with the lower income group (RR, 2.27; 95% CI, 2.17–2.36, p < 0.001). Conclusion The prevalence of OLP in Taiwan significantly increased over the past 18 years. The mean age with OLP was shown in an increased pattern. In addition, OLP occurs more frequently in women than in men.

Effects of fibroblast growth factor-2 on cell proliferation of cementoblasts

Background/purpose Fibroblast growth factor (FGF)-2 is known as a signaling molecule that induces tissue regeneration. Little is known about the effect of FGF-2 on cementoblasts for periodontal and periapical regeneration. The aim of this study was to investigate the effects of FGF-2 on murine immortalized cementoblast cell line (OCCM.30). Materials and methods Cell growth and proliferation was judged by using alamar blue reduction assay. Flow cytometry analysis was used to evaluate Stro-1 positive cells expression with or without FGF-2. Western blot was used to evaluate the expression of phosphorylated serine–threonine kinase Akt (p-Akt) and extracellular signal-regulated protein kinase (p-ERK) in cementoblasts. Results FGF-2 was found to increase cell growth in a dose-dependent manner (P < 0.05). The concentration of 10 ng/mL FGF-2 enhanced cell proliferation in a time-dependent manner (P < 0.05). In addition, 10 ng/mL FGF-2 significantly increased the number of Stro-1 positive cells in the first 24 hours (P < 0.05). Moreover, 10 ng/mL FGF-2 was found to upregulate p-Akt and p-ERK in a time-dependent manner (P < 0.05). Conclusion Taken together, FGF-2 could increase cementoblast growth, proliferation, and Stro-1 positive cells. These enhancements are associated with the upregulation of p-Akt and p-ERK expression. The application of FGF-2 may provide benefit for periodontal and periapical regeneration during the early phase of wound healing.