Paula Pesonen

Macrophages modulate migration and invasion of human tongue squamous cell carcinoma.

Oral tongue squamous cell carcinoma (OTSCC) has a high mortality rate and the incidence is rising worldwide. Despite advances in treatment, the disease lacks specific prognostic markers and treatment modality. The spreading of OTSCC is dependent on the tumor microenvironment and involves tumor-associated macrophages (TAMs). Although the presence of TAMs is associated with poor prognosis in OTSCC, the specific mechanisms underlying this are still unknown. The aim here was to investigate the effect of macrophages (Mfs) on HSC-3 tongue carcinoma cells and NF-kappaB activity. We polarized THP-1 cells to M1 (inflammatory), M2 (TAM-like) and R848 (imidazoquinoline-treated) type Mfs. We then investigated the effect of Mfs on HSC-3 cell migration and NF-kappaB activity, cytokine production and invasion using several different in vitro migration models, a human 3D tissue invasion model, antibody arrays, confocal microscopy, immunohistochemistry and a mouse invasion model. We found that in co-culture studies all types of Mfs fused with HSC-3 cells, a process which was partially due to efferocytosis. HSC-3 cells induced expression of epidermal growth factor and transforming growth factor-beta in co-cultures with M2 Mfs. Direct cell-cell contact between M2 Mfs and HSC-3 cells induced migration and invasion of HSC-3 cells while M1 Mfs reduced HSC-3 cell invasion. M2 Mfs had an excess of NF-kappaB p50 subunit and a lack of p65 subunits both in the presence and absence of HSC-3 cells, indicating dysregulation and pro-tumorigenic NF-kappaB activation. TAM-like cells were abundantly present in close vicinity to carcinoma cells in OTSCC patient samples. We conclude that M2 Mfs/TAMs have an important role in OTSCC regulating adhesion, migration, invasion and cytokine production of carcinoma cells favouring tumor growth. These results demonstrate that OTSCC patients could benefit from therapies targeting TAMs, polarizing TAM-like M2 Mfs to inflammatory macrophages and modulating NF-kappaB activity.

Self-reported oral health and associated factors in the North Finland 1966 birth cohort at the age of 31

BackgroundThe Northern Finland 1966 birth cohort (NFBC 1966) is an epidemiological study where the participants have been controlled since pregnancy both in field tests and using questionnaires. This study aimed to evaluate cross-sectionally the association of self-reported oral symptoms (dental caries and bleeding of gums) with sociodemographic and health behavior factors among the subjects.MethodsOf the 11,541 original members of the cohort, 8,690 (75%) responded to the questionnaire on oral health (dental decay, gingival bleeding and self-estimated dental treatment need) and sociodemographic factors, general health and health behavior. Cross-tabulation and chi-squared tests as well as multiple logistic regression analysis were used to analyze the association between the outcome and explanatory variables.ResultsThe study group was equally distributed between the genders. One third of the subjects reported having dental decay, one fourth gingival bleeding and a half a dental treatment need. As compared to women, men reported significantly more frequently symptoms (p < 0.05). Logistic regression analysis revealed low tooth brushing frequency increasing the odds most for all oral symptoms ((OR 1.57 (1.39–1.78) for dental decay, 1.94 (1.68-2.24) for gingival bleeding and 1.42 (1.26-1.61) for dental treatment need). Frequent smoking was associated with dental decay (OR 1.63 (1.44–1.84)) and treatment need OR (1.39 (1.23–1.56)), whereas poor general health (OR 1.71 (1.48–1.96)) and high BMI (OR 1.19 (1.03–1.36)) both were associated with gingival bleeding.ConclusionsMales with single marital status, BMI over 25, poor general health and poor oral health behaviors are at risk for self-reported poor oral health and dental treatment need.

Outcome of a Community-Based Oral Health Promotion Project on Primary Schoolchildren's Oral Hygiene Habits.

The aim of this study was to evaluate the effect of a school-based intervention project conducted in a mid-sized Finnish city, Laukaa on schoolchildrens oral health behavior. Material and Methods. In the intervention, all children received dental education and some of the 7–12-year-old schoolchildren received individual tooth brushing instructions by a dental nurse in 2009-2010. Parents were present at the instruction sessions. In 2009 and 2010, all the children answered a questionnaire or an oral hygienist on their oral health behavior without identification. Results. Tooth brushing frequency increased significantly among the schoolchildren between the years 2009 (61.2%) and 2010 (65%) (P < 0.05); more so among younger children (7–10-year-olds) compared to the older ones (11-12-year-olds). The 2010 results showed a slight trend of decreasing tooth brushing frequency by age both among girls and boys. Younger children got significantly more often parental help or reminding. The girls brushed their teeth significantly more frequently (71.9%) than boys (57.0%). Conclusions. Our findings indicate that oral health intervention can be beneficial on health behavior especially for children at low grades. All children, 11 to 12 years of age, especially boys, need continuous health promotion.

Root resorptions related to ectopic and normal eruption of maxillary canine teeth – A 3D study

Abstract Objective. To assess the incidence and severity of root resorption of maxillary incisors caused by ectopically and normally erupting maxillary canines and to analyse factors influencing root resorption of incisors using cone beam computed tomography. Subjects and methods. The study sample comprised 59 patients with a total of 80 canines. Forty-six of the canines, in 37 patients, were defined as ectopic and 34 canines, in 22 patients, were defined as normal. The severity of root resorptions were analysed according to studies by Ericson and Kurol. Multiple logistics regression was used to evaluate the association between various factors and root resorptions. Results. The prevalence of root resorptions was significantly higher in the ectopic canine group, 11.0% of the central incisors and 67.6% of the lateral incisors in comparison to 0% and 36.2% in the normal erupting group. Most resorptions were defined as ‘slight’ and were located in the middle third of the root. There was a statistically significant relationship between canines located mesial to the midline of the lateral incisor and root resorption on the maxillary incisors. Conclusion. The present results show that root resorption of maxillary lateral incisors was common in patients referred to CBCT imaging due to maxillary canine eruption disturbances. Although significantly more frequent in patients with ectopically erupting canines, lateral incisor resorption was also found in association with approximately every third of the normally erupting canines. The best predictor for root resorption seemed to be location of the canine mesial in relation to the midline of the lateral incisor root.

Prevalence of Temporomandibular Disorders in the Northern Finland Birth Cohort 1966

AIMS To investigate the prevalence of temporomandibular disorders (TMD) in the 46-year-old cohort subjects from the Northern Finland Birth Cohort 1966 (NFBC 1966). METHODS Altogether, 1,962 subjects (1,050 women, 912 men) participated in a clinical medical and dental examination and responded to questionnaires in 2012 to 2013. The stomatognathic examination was performed according to a modified protocol of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pearsons chi-square test and Fishers exact test were used to analyze the signs of TMD between genders, and logistic regression models were used to analyze the relationship between self-reported pain associated with TMD and modified DC/TMD protocol (P < .05). RESULTS Of the subjects available for analyses, 18.5% responded positively to the self-reported screening question for pain related to TMD. The most common signs of TMD were clicking in the temporomandibular joint (TMJ) (26.2%) and palpation pain in the masticatory muscles (11.2%). Women had signs of TMD more often than men (P < .05). The most common diagnosis was disc displacement with reduction (7.0%). Myalgia, arthralgia, disc displacement with reduction, and degenerative joint disease diagnoses were statistically significantly more common in women than in men (P < .05). The prevalence of TMD signs among the cohort subjects was 34.2%. CONCLUSION The most common sign of TMD was clicking in the TMJ and the most common TMD diagnosis was disc displacement with reduction. The prevalence of TMD signs among the examined cohort subjects was 34.2%. TMD was diagnosed in women more often than in men. The results are comparable with other corresponding population-based studies in adults.

Middle ear findings and need for ventilation tubes among pediatric cleft lip and palate patients in northern Finland.

PURPOSE Middle ear problems are common in cleft patients. This study aimed to determine the need for ventilation tubes (VTs) and complications such as tympanic perforation and cholesteatoma. MATERIAL AND METHODS Data of 156 children with clefts managed in northern Finland spanning 15 years from 1997 to 2011 were collected from 6 hospitals. The following were recorded: birth date, gender, cleft type, surgery timing, surgery type, number of tube insertions, tube material, middle ear findings, and tube placement timing. Clefts were divided into 4 groups: cleft palate (CP), cleft lip and palate (CLP), cleft lip (CL), and submucous cleft palate. The prevalence of middle ear findings was reported. RESULTS Mucous secretion was noted in 96.8% of CLP patients, 69.2% of CP patients, and 13.0% of CL patients. In all, 82.7% of study group had 1 or more VTs placed during follow-up. All CLP patients required more than 1 VT placement. A total of 94.5% of CP patients required VTs compared to 13.0% of CL patients. In the presence of residual oral nasal fistula, the mean number of tube insertions was 5.3. The prevalence of tympanic perforations in clefts was 35.9% and cholesteatoma in 2.6% of patients. CONCLUSIONS CLP and isolated CP patients have frequent middle ear infections requiring multiple VT placements.

Influence of Intrinsic Factors on Erosive Tooth Wear in a Large-Scale Epidemiological Study

Objective: To assess the influence of self-reported intrinsic factors [gastroesophageal reflux disease (GERD), long-term alcoholism, long-term heavy use of alcohol and multiple pregnancies] on erosive tooth wear in a middle-aged cohort sample. Materials and Methods: Of the total Northern Finland Birth Cohort (NFBC 1966), a convenience sample (n = 3,181) was invited for an oral health examination in 2012-2013, of which 1,962 participated, comprising the final study group. Erosive tooth wear was assessed by sextants using the Basic Erosive Wear Examination Index (BEWE, 0-18). Clinical data were supplemented by questionnaires conducted in 1997/1998 and 2012/2013. The participants were divided into severe (BEWE sum ≥9) and no-to-moderate (BEWE sum 0-8) erosive wear groups, and the logistic regression model was applied. Results: Selected intrinsic factors were quite rare in this cohort sample and explained only 5.9% of the difference in the prevalence and severity of erosive wear. Daily symptoms of GERD [odds ratio (OR) 3.8, confidence interval (CI) 1.2-12.0] and hyposalivation (OR 3.8, CI 1.2-11.8) were the strongest risk indicators for severe erosive wear. Additionally, variables associated with an elevated risk for severe erosive wear were diagnosed alcoholism at any point (OR 2.5, CI 0.7-9.7) and self-reported heavy use of alcohol in both questionnaires (OR 2.0, CI 0.6-6.2). Even low-dose long-term consumption of alcohol was associated with erosive wear. Conclusions: In this cohort sample, intrinsic factors such as GERD or alcoholism alone are relatively uncommon causes of erosive tooth wear. The role of long-term use of alcohol in the erosion process may be bigger than presumed.

Dental treatment need and dental general anesthetics among preschool-age children with cleft lip and palate in northern Finland

Cleft lip and palate incidence is high in northern Finland. This study aimed to investigate the proportion of children in need of restorative dental treatment among cleft lip and palate patients in northern Finland, as well as their need for dental treatment under general anesthesia. The records of 183 cleft lip and palate patients, treated in Oulu University Hospital from 1997 to 2013, were reviewed. Data on dental caries were analyzed in association with cleft type, considering also the presence of syndromes. The frequency of dental general anesthetic (DGA) use, and of treatments, were also analyzed. Dental treatment need was most frequently observed, in this rather limited study population, in patients with the most severe deformities, namely bilateral cleft lip and palate, of whom 60% had caries. Among the study population, 11.5% (n = 21) had a syndrome. Of those, 57.1% had dental caries at the age of 3 or 6 yr, and only four could be treated without a DGA. Dental treatment under general anesthesia was performed in 14.8% of cleft patients without a syndrome, but in 38.1% of those with a syndrome. General anaesthesia is required for the provision of dental care more often in cleft (17.5%) than in non-cleft (0.2%) patients, and especially for those with a syndrome.

Dietary and oral hygiene habits of active athletes and adolescents attending ordinary junior high schools

BACKGROUND Active sports require sufficient energy intake. How do young athletes meet this need? The aim of this study was to investigate self-reported health and oral behaviors of young athletes and to compare them with a population-based sample of ordinary adolescents. DESIGN A computer-based questionnaire on oral hygiene habits and dietary habits was conducted in two junior high schools with special classes for athletes in 2011. Adolescents of similar age (n=1230) attending ordinary classes had responded the same questionnaire earlier in the city of Oulu (in 2004) and in Kajaani, Finland (in 2006-2007). Answers to individual questions as well as sum scores of the answers were analyzed. The answers of the athletes and ordinary adolescents were analyzed by gender using cross-tabulation and chi-square testing. RESULTS The mean sum score of the athletes indicated their more favorable health behavior compared with the other adolescents. They also ate more frequently the four daily than the others; in addition, they ate the school lunch as an entity which it was intended. However, the athlete boys consumed more fizzy/soft drinks and ate chocolate more often than the rest. The athletes also brushed their teeth more frequently than ordinary adolescents. Oral health behavior of the girls was better than that of the boys. CONCLUSIONS Health behavior of the young athletes is better than that of other adolescents. Continuous oral health education should be targeted to all adolescents; growing boys should be target group of information on healthy sources of energy.

GWAS Identifies New Loci for Painful Temporomandibular Disorder: Hispanic Community Health Study/Study of Latinos:

Temporomandibular disorder (TMD) is a musculoskeletal condition characterized by pain and reduced function in the temporomandibular joint and/or associated masticatory musculature. Prevalence in the United States is 5% and twice as high among women as men. We conducted a discovery genome-wide association study (GWAS) of TMD in 10,153 participants (769 cases, 9,384 controls) of the US Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The most promising single-nucleotide polymorphisms (SNPs) were tested in meta-analysis of 4 independent cohorts. One replication cohort was from the United States, and the others were from Germany, Finland, and Brazil, totaling 1,911 TMD cases and 6,903 controls. A locus near the sarcoglycan alpha (SGCA), rs4794106, was suggestive in the discovery analysis (P = 2.6 × 106) and replicated (i.e., 1-tailed P = 0.016) in the Brazilian cohort. In the discovery cohort, sex-stratified analysis identified 2 additional genome-wide significant loci in females. One lying upstream of the relaxin/insulin-like family peptide receptor 2 (RXP2) (chromosome 13, rs60249166, odds ratio [OR] = 0.65, P = 3.6 × 10−8) was replicated among females in the meta-analysis (1-tailed P = 0.052). The other (chromosome 17, rs1531554, OR = 0.68, P = 2.9 × 10−8) was replicated among females (1-tailed P = 0.002), as well as replicated in meta-analysis of both sexes (1-tailed P = 0.021). A novel locus at genome-wide level of significance (rs73460075, OR = 0.56, P = 3.8 × 10−8) in the intron of the dystrophin gene DMD (X chromosome), and a suggestive locus on chromosome 7 (rs73271865, P = 2.9 × 10−7) upstream of the Sp4 Transcription Factor (SP4) gene were identified in the discovery cohort, but neither of these was replicated. The SGCA gene encodes SGCA, which is involved in the cellular structure of muscle fibers and, along with DMD, forms part of the dystrophin-glycoprotein complex. Functional annotation suggested that several of these variants reside in loci that regulate processes relevant to TMD pathobiologic processes.