Reiko Yamanaka

Short-Term Effects of Non-Surgical Periodontal Treatment on Plasma Level of Reactive Oxygen Metabolites in Patients With Chronic Periodontitis

BACKGROUND Elevated levels of blood reactive oxygen species (ROS) are associated with the severity of periodontitis. Therefore, improvement of periodontitis may result in a decrease in blood ROS. However, it is unclear how periodontal treatment affects blood ROS. Recently, reactive oxygen metabolites (ROMs) were recognized as a useful measure of blood ROS. The aim of this longitudinal study was to investigate the effect of non-surgical periodontal treatment on plasma ROMs in patients with chronic periodontitis. METHODS Nineteen subjects with chronic periodontitis (mean age: 46.8 years) were monitored at baseline (prior to scaling and root planing) and 1 and 2 months after therapy. Dental health parameters were evaluated, and plasma was obtained at these time points from patients and controls (19 subjects without periodontitis; mean age: 45.3 years). The plasma ROM level was determined using a spectrophotometric technique. RESULTS At baseline, patients with chronic periodontitis had higher plasma ROM level (441.8 +/- 71.1 Carratelli units) than the control subjects (324.4 +/- 34.0 Carratelli units; P <0.01). Probing depth, clinical attachment level, and bleeding on probing in patients with chronic periodontitis showed a significant improvement 2 months after non-surgical periodontal treatment, and this was accompanied by a significant reduction in plasma ROM level (P <0.01). CONCLUSIONS In patients with chronic periodontitis, non-surgical periodontal treatment was effective at improving clinical parameters and reducing plasma ROMs. The improvement in chronic periodontitis by non-surgical periodontal treatment might offer clinical benefits by decreasing blood ROS.

Relationship between periodontitis and hepatic abnormalities in young adults.

Abstract Objective. Obesity has been implicated as a risk factor for periodontitis and non-alcoholic fatty liver disease (NAFLD). In NAFLD, elevated alanine aminotransferase (ALT) is associated with obesity. Although a possible interrelationship between liver function and periodontitis has been reported among the middle-aged population, the correlation in young adults is little known. This study was designed to investigate the relationship between ALT and the presence of periodontitis in university students in Japan. Material and methods. Medical and oral health data were collected in a cross-sectional examination conducted by the Health Service Center of Okayama University. Systemically healthy, non-smoking students aged 18 and 19 years old (n = 2225) were included. The protocol of the United States National Health and Nutrition Examination Survey was applied. Subjects with probing pocket depth ≥ 4 mm were defined as having periodontitis. Logistic regression analysis was used to estimate the association between ALT, body mass index and periodontitis. Results. The number of subjects with periodontitis was 104 (4.7%). In males, having periodontitis was significantly associated with an increased level of ALT (≥ 41 IU/l) in logistic regression analysis (adjusted odds ratio 2.3; 95% confidence interval 1.0–5.2; p < 0.05). However, there was no significant association between periodontitis and ALT in female students. Conclusions. Elevated ALT could be a potential risk indicator for periodontitis among young males. Monitoring hepatic abnormalities to prevent periodontitis must be better understood, even in the young adult population.

Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults

BackgroundTo investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan.MethodsA personal interview survey was conducted on first-year university students (n = 1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender.ResultsAmong the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319), pain in the TMJ only (Group II, n = 21), difficulty in mouth opening only (Group III, n = 18), clicking and pain (Group IV, n = 29), clicking and difficulty in mouth opening (Group V, n = 48), difficulty in mouth opening and pain (Group VI, n = 11), and combination of three symptoms (Group VII, n = 97). The control group (n = 1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR = 12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only.ConclusionsTMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

Relation of dietary preference to bite force and occlusal contact area in Japanese children

The purpose of this study was to examine the relationship of dietary preference to bite force and occlusal contact area in Japanese elementary school children. A total of 348 children, aged 7-12 years, from two public elementary schools located in Okayama Prefecture, Japan, participated in the study. Clinical examination included decayed, missing and filled teeth (dmft and DMFT), and total numbers of deciduous and permanent teeth. Bite force and occlusal contact area were measured using a pressure-detecting sheet. Dietary preference was assessed using a questionnaire in which the answers were given in like/dislike form. Mann-Whitney U-test and multiple logistic regression analysis were applied to analyse the data. In multiple logistic regression analysis after adjustment for age, gender and total number of teeth present, children who liked cabbage and celery showed significantly higher bite force (P = 0.05 and P < 0.01, respectively) than those who disliked these. Children who liked cabbage and celery also showed higher occlusal contact area (P < 0.05 and P < 0.01, respectively) than those who disliked these. The Japanese elementary school children who liked hard foods such as cabbage and celery showed higher bite force and higher occlusal contact area than those who disliked these foods. A positive attitude towards harder food items might contribute to healthy development of the masticatory apparatus.

Validity of a Questionnaire for Periodontitis Screening of Japanese Employees

Validity of a Questionnaire for Periodontitis Screening of Japanese Employees: Tatsuo Yamamoto, et al. Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

Relationship between acetaldehyde concentration in mouth air and tongue coating volume.

Objective Acetaldehyde is the first metabolite of ethanol and is produced in the epithelium by mucosal ALDH, while higher levels are derived from microbial oxidation of ethanol by oral microflora such as Candida species. However, it is uncertain whether acetaldehyde concentration in human breath is related to oral condition or local production of acetaldehyde by oral microflora. The aim of this pilot study was to investigate the relationship between physiological acetaldehyde concentration and oral condition in healthy volunteers. Material and Methods Sixty-five volunteers (51 males and 14 females, aged from 20 to 87 years old) participated in the present study. Acetaldehyde concentration in mouth air was measured using a portable monitor. Oral examination, detection of oral Candida species and assessment of alcohol sensitivity were performed. Results Acetaldehyde concentration [median (25%, 75%)] in mouth air was 170.7 (73.5, 306.3) ppb. Acetaldehyde concentration in participants with a tongue coating status score of 3 was significantly higher than in those with a score of 1 (p<0.017). After removing tongue coating, acetaldehyde concentration decreased significantly (p<0.05). Acetaldehyde concentration was not correlated with other clinical parameters, presence of Candida species, smoking status or alcohol sensitivity. Conclusion Physiological acetaldehyde concentration in mouth air was associated with tongue coating volume.

Effects of mechanical stimulation by a powered toothbrush on the healing of periodontal tissue in a rat model of periodontal disease

BACKGROUND AND OBJECTIVE Elimination of pathogens is the main aim of periodontal treatment; however, modulation of the host immune response should also be considered. This study aimed to evaluate the effects of mechanical stimulation on periodontal healing in rats. MATERIAL AND METHODS Before starting the experiment, lipopolysaccharide and proteases were applied once a day, for 4 wk, to both maxillary first molars of 30 rats to induce periodontal disease, and the application was stopped at the end of the 4-wk period. The experiment started immediately following this pretreatment. In the experiment, the left palatal gingiva was stimulated once daily using a powered toothbrush and the right gingiva served as a control (no mechanical stimulation). Pathological changes, and proliferation and cell death in periodontal tissues, were evaluated histometrically and immunohistochemically at baseline (0 wk), and at 1 and 3 wk of stimulation. RESULTS The control showed a reduction of polymorphonuclear leukocyte infiltration in connective tissue and an increase in the numbers of gingival and periodontal ligament fibroblasts. Mechanical stimulation reduced polymorphonuclear leukocyte infiltration and the area of destroyed collagen in connective tissue, and increased the number of gingival fibroblasts; however, it had no effect on alveolar bone and root resorption or on the number of periodontal ligament fibroblasts. CONCLUSION Mechanical stimulation accelerated the healing of gingival inflammation by reducing the infiltration of polymorphonuclear leukocytes and enhancing fibroblast proliferation and collagen synthesis.

Relationship Between Serum Albumin Concentration and Periodontal Condition in Patients With Head and Neck Cancer

BACKGROUND Serum albumin concentration is known to be an independent predictor of survival in head and neck cancer. The previous studies suggested relationships between serum albumin concentration and oral health status in populations without serious systemic disorders. However, these relationships remain unclear in patients with head and neck cancer. The purpose of this study is to investigate the relationship between serum albumin concentration and oral health status in patients with head and neck cancer. METHODS Fifty individuals diagnosed with primary head and neck cancer, 25 individuals with normal serum albumin concentration (≥3.85 g/dL), and 25 age- and sex-matched individuals with lower serum albumin concentration (<3.85 g/dL) were analyzed. General status, including cancer stage, body mass index, drinking and smoking habits, and biochemical serum markers, were evaluated. Oral health status, including periodontal condition and occlusion tooth pairs, were also evaluated. RESULTS Mean clinical attachment level (CAL) and C-reactive protein in the lower serum albumin concentration group were greater than those in the normal serum albumin concentration group (P = 0.009 and P = 0.002, respectively). However, there were no significant differences in any other oral and/or serum parameters between the two serum albumin groups. A logistic regression model showed that mean CAL was significantly associated with high or low levels of serum albumin concentration (odds ratio = 9.752; 95% confidence interval = 1.702 to 55.861; P = 0.011). CONCLUSIONS This study suggests an association between periodontal disease and serum albumin concentration in patients with head and neck cancer. Longitudinal studies are necessary to examine the causal relationship between serum albumin concentration and periodontal condition.

Detection of Identical Isolates of Enterococcus faecalis from the Blood and Oral Mucosa in a Patient with Infective Endocarditis

The detection of infective endocarditis (IE) of oral origin has been previously discussed. However, there are few reports confirming this infection using molecular biological techniques. We herein describe the case of a 67-year-old man who developed IE. Blood culture samples and strains obtained from the gingival and buccal mucosa showed 100% identity to Enterococcus faecalis JCM 5803 on sequencing of 16S rRNA gene fragments. A random amplification of polymorphic DNA (RAPD) analysis showed the same pattern for these samples, thus confirming the identity of E. faecalis isolates in the blood and oral mucosa. Our observations provide novel information regarding the level of identity between IE pathogens and oral bacteria.

Perioperative management center (Perio) for neurosurgical patients

Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7–14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 ± 0.3 days), compared to that in the non-PERIO group (4.7 ± 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.