Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals

Objective: The 10‐year incidence of dental caries was related to some associated factors in a random sample of 65, 75 and 85‐year‐old inhabitants of Gothenburg. Subjects: Of the 208 persons examined at baseline, 102 (49%) participated in the follow‐up examination; 56, 37 and nine, respectively, in the different age groups. For the purpose of time‐trend comparisons, a new random sample of 98 individuals aged 55 years was examined. Results: Ninety‐five per cent of the participants had developed one or more carious lesions during the 10‐year period and the incidence of coronal and root caries increased with age. In the 65‐year‐olds, 9% of the root surfaces had decayed during the period, compared with 25% in the 85‐year‐olds. Secondary caries predominated over primary caries and prosthetic crowns accounted for 70% of the restored tooth surfaces. Twenty per cent of the individuals were daily smokers and 61% were taking drugs with hyposalivatory side‐effects. The mean saliva secretion rates were lower in the older groups compared with the ‘younger’ ones. The overall salivary counts of mutans streptococci and lactobacilli had increased during the period and the values were highest in the oldest age groups. Salivary levels of lactobacilli and mutans streptococci, number of teeth, daily numbers of cigarettes and drugs and oral hygiene were the best predictors of the incidence of caries. Conclusion: The findings indicate that there is an increased risk of dental caries with age owing to unfavourable caries‐related factors.     

Relationship of cariogenic bacteria levels with periodontal status and root surface caries in elderly Japanese

Objective: The relationship of the levels of cariogenic bacterial species with periodontal status and decayed root surfaces was investigated in elderly Japanese subjects. Methods: Three hundred and sixty‐eight individuals (each 75 years old) were examined for periodontal status (pocket depth, attachment loss), root surface caries and salivary levels of mutans streptococci (MS) and lactobacilli (LB). Results: Values >4 mm of attachment loss (rAL4) and for average attachment loss (aAL) of sites measured were significantly higher in subjects with LB than those without. Multiple regression analysis also showed a correlation between aAL and rAL4 values with the presence of LB (aAL p = 0.003; rAL4 p = 0.002). Further, multiple regression analysis of interacting factors regarding decayed root surfaces showed that LB carriers had a greater incidence of decayed root surface caries (p = 0.003), while MS and LB levels were correlated to the number of decayed root surfaces (LB p = 0.010; MS p = 0.026). Conclusion: Our results indicate that considerable attachment loss elevates the possibility of having LB, thus increasing the risk of root surface caries. It was also found that LB and MS measurements may be useful indicators of decayed root surfaces in elderly individuals with attachment loss.     

Development and evaluation of two root caries controlling programmes for home-based frail people older than 75 years

Objectives: (i) Initially, to devise and examine the validity of a system for determining lesion activity on root surfaces, and (ii) compare the effectiveness of two preventive programmes in controlling root caries in elderly people using the devised system. Materials and methods: (i) Four clinical variables: texture, contour, location and colour of root caries lesions were selected to evaluate lesion activity. The intraexaminer reproducibility of the scoring system was assessed on 28 elderly patients. The accuracy was assessed on 10 of these persons using an impression material (Clinpro, 3M ESPE). (ii) Of total, 215 homebound 75+ year olds were randomly assigned to one of three groups: group 1, once a month a dental hygienist brushed the teeth of the participants and applied Duraphat vanish to active root caries lesions. The participants in groups 2 and 3 received 5000 and 1450 ppm F‐toothpaste, respectively, to use twice a day. This study included an interview, a baseline examination and a final follow‐up examination after 8 months. Results: (i) Intraexaminer reproducibility of the root caries scoring system was 0.86 (Kappa). The sensitivity and specificity was 0.86 and 0.81. (ii) Data from those 189 (88%) who completed the study disclosed that there were no inter‐group differences at the baseline examination concerning relevant conditions. At the end of the study, the root caries status of participants in groups 1 and 2 had improved significantly when compared with group 3 (p < 0.02). No significant difference was observed between groups 1 and 2 (p = 0.14). Conclusion: The data suggest that the root caries scoring system is reliable. Both the intervention programmes controlled root caries development; the hygienist in eight of 10 persons, the 5000 ppm F‐toothpaste in seven of 10. In contrast, five of 10 participants who only brushed with 1450 ppm F‐toothpaste had root caries progression.     

Non-invasive management of superficial root caries lesions in disabled and infirm patients

In disabled and infirm patients with limited, if any, capacity for independent oral self‐care, it is difficult to control progression of root caries lesions. Objective: To evaluate the effect of non‐restorative cariostatic treatment on progression of active superficial root caries lesions (n =56). Design: Pilot study. Setting: Department of Cariology, Institute of Odontology, Karolinska Institutet, Huddinge. Subjects: 15 physically‐dependent patients. Intervention: The patients were allotted to one of the following groups. Group 1, professional tooth cleaning and application of tap water flavoured with eucalyptus oil; Group 2, professional tooth cleaning and application of Cervitec, (1% chlorhexidine in thymol‐containing varnish), Group 3, professional tooth cleaning and application of Cervitec and Fluor Protector (varnish containing 0.1% fluoride). Every three months for 18 months, each subject received the treatment twice within a 10‐day interval. Measurements: The status of the 56 root caries lesions was evaluated every six months using a root caries index based on visual and tactile criteria. The examiners were blind to which treatment group the patients belonged. Results: In most subjects (14 out of 15), progression of root caries lesions was arrested. No statistically significant differences could be demonstrated between the three treatment groups. However, regardless of treatment regimen, there was a statistically significant difference between the greater number of subjects exhibiting no progression of root caries lesions and those with lesion progression, at 6 (p=0.022), 12 (p=0.006) and 18 months (p<0.001). Conclusion: This pilot study suggests that in disabled and infirm patients regular professional tooth cleaning with a fluoride containing paste, with or without supplementary varnishing with chlorhexidine‐thymol and/or fluoride can prevent further progression of existing superficial root caries lesions.     

Indicators for root caries in Danish persons with recently diagnosed Alzheimer's disease

doi: 10.1111/j.1741‐2358.2011.00560.x
Indicators for root caries in Danish persons with recently diagnosed Alzheimer’s disease Objective: To identify indicators of root caries among persons with newly diagnosed Alzheimer’s disease (AD). Background: Few studies have investigated dental caries in older adults with AD. Previously we found that persons with AD had significantly more root caries compared to persons with dementia other than AD. Methods: Participants were recruited from two university hospital clinics in Copenhagen, Denmark. A team of neurologists/geriatricians carried out the diagnostic screening. The study included an interview, oral examination and medical records. Results: We evaluated potential indicators of root decay across subjects with 3+ decayed surfaces vs. <3 decayed surfaces. Variables associated with increased odds of root caries were age over 80 years, 2+ decayed coronal surfaces and 5+ filled root surfaces. Among the social variables, living with someone was associated with a nearly 70% reduction in the odds of having 3+ surfaces of untreated caries. Discussion: Root caries is highly prevalent among individuals with new AD and there is still a strong need for active assessment of and attention to oral problems in persons with AD. Our findings document that recently diagnosed AD cases with multiple coronal caries lesions are at elevated risk of having more root caries. Also persons 81+ years and those with multiple root fillings are more likely to have numerous untreated root lesions.     

A longitudinal study of the relationship between diet intake and dental caries and periodontal disease in elderly Japanese subjects

Objective: We hypothesise that a difference in nutrition influences dental caries and periodontal disease. There are few previous studies especially longitudinal ones which have evaluated this hypothesis. This study investigated the relationship between nutritional intake, including milk and milk products (MMP), and dental disease, controlling for several confounding factors. Material and methods: A group of 600 subjects aged 70, randomly selected for this study, included approximately the same number of male and female subjects. The number of teeth on which root caries had occurred or where there was a periodontal event over a 6‐year period was measured. To determine quantitative food intake at baseline, a semi‐quantitative food frequency questionnaire was used during face‐to‐face interviews by dieticians. The stepwise method of multiple linear regression analysis was used to identify independent predictors of the number of root caries or periodontal disease events during the 6 years. Intake of the six food groups includes (i) fish, shellfish, meat, beans and eggs; (ii) MMP; (iii) dark green and yellow vegetables (DYV); (iv) other vegetables and fruits; (v) cereals, nuts and seeds, sugar and sweeteners, confectioneries (CNSC) and (vi) fats and oils. The alcohol, gender and anthropometric evaluation including measurements of weight and height for the calculation of body mass index, educational level, the number of family members and the number of remaining teeth were used as independent variables. Results: According to stepwise multiple regression analysis, two variables (quantity of MMP, and gender) were negatively associated with the number of root caries events during the 6 years. The standardised coefficients were ?0.14 (p = 0.035) and ?0.17 (p = 0.007) respectively. In addition, DYV were negatively, and three other variables (CNSC; alcohol; and the number of remaining teeth at baseline) were positively associated with the number of periodontal disease events during the 6 years. The standardised coefficients were ?0.16 (p = 0.001), 0.11 (p = 0.042), 0.10 (p = 0.041) and 0.58 (p < 0.001) respectively. Conclusion: Our results suggest that the intake of MMP in this elderly population correlated with root caries events. In addition, intake of vegetables negatively correlated, and intake of ‘CNSC’ positively correlated with periodontal disease events.     

Relationship between root elongation rate and diameter and duration of growth of lateral roots of maize

The objective of this work was to describe the relationship between elongation rate and diameter of maize roots and to estimate the length and growth duration of lateral roots of maize. Diameters and elongation rates of roots were measuredin situ on plants grown 5 weeks in small rhizotrons under greenhouse conditions. At the end of the experimental period the roots were harvested and diameters of axile and lateral roots were measured. The frequency distribution of diameters of harvested roots was bimodal with a minimum at 0.6 mm; 97% of axile roots were larger than this value and 98% of the lateral roots were smaller. Root elongation per day increased as diameter increased but the slope of the relationship with lateral roots was about 2.5 times that with axile roots when separate linear regressions were fitted to the two populations. The length of lateral roots found on axillary roots between the base and about 30 cm from the apex was approximately 2.2 cm. All of the data was consistent with the hypothesis that the lateral roots grew for about 2.5 days and then ceased growing. The axillary roots continued to grow throughout the experimental period at a rate of about 3 cm day⁻¹. Contribution from the Department of Agronomy, New York State College of Agriculture and Life Sciences, Cornell University, Ithaca, NY 14853. Agronomy paper No. 1661. This research is part of the program of the Center for Root-Soil Research.     

Concentration of selected elements in the roots and crowns of both primary and permanent teeth with caries disease

We examined the differences between the concentrations of chemical elements in caries-changed primary teeth and permanent ones with a division into the root and the crown. The study comprised 27 children aged from 4 to 11 yr and 36 adults aged from 36 to 71 yr. We examined the elements with the total reflection X-ray fluorescence method. The lowest concentrations of calcium, manganese, strontium, lead, and copper were in the roots of primary teeth compared to the roots of permanent ones. The calcium, nickel, zinc, lead, and copper concentrations were significantly higher in the roots of primary teeth than in the roots of permanent teeth. However, the zinc concentration was higher both in the root and crown of primary teeth than in permanent teeth. On the basis of our investigations, we can conclude that the content of some elements (manganese, copper, strontium, and lead) is higher in caries permanent teeth than in primary ones. The nickel and zinc concentrations are higher in the teeth of the children than the adults. However, the content of other elements (calcium, chromium, iron) is similar in both kinds of teeth.     

Longitudinal Relationship between Elapsed Time in the Action Stages of Change and Weight Loss

Objective: The objective of this study was to examine the longitudinal relationship between the elapsed time in the action and maintenance stages of change for multiple target behaviors and weight loss or gain. Research Methods and Procedures: The research design was a prospective cohort study of overweight and obese primary care patients randomized to an obesity management intervention based on the Transtheoretical Model and a chronic disease paradigm. The target behaviors included increased planned exercise and usual physical activity, decreased dietary fat, increased fruit and vegetable consumption, and increased dietary portion control. The participants were 329 middle‐aged men and women with elevated body mass indices recruited from 15 primary care practices in Northeastern Ohio; 28% of the participants were African Americans. The main outcomes were weight loss (5% or more) or weight gain (5% or more) after 18 or 24 months of follow‐up. Results: There were significant (p < 0.05) longitudinal relationships between the number of periods (0 to 4) in action or maintenance for each of the five target behaviors, or a composite score taken across the five target behaviors, and weight loss. In all cases, there was a significant (p < 0.05) stepped (graded) relationship between the time in action or maintenance and weight loss (or gain). Discussion: The data support the concept of applying the Transtheoretical Model to the problem of managing obesity in primary care settings. The remaining challenge is to identify those factors that reliably move patients into the action and maintenance stages for long periods.     

Remineralisation study of artificial root caries lesions after fluoride treatment. An in vitro study using electric caries monitor and transversal micro-radiography

Aims: To evaluate and compare remineralisation of root caries lesions after in vitro treatment with various fluoride (F) agents using an Electric Caries Monitor (ECM) and Transversal Micro‐Radiography (TMR). Materials: Permanent human teeth were extracted and root surface specimens were sectioned, prepared (n = 35), and randomly allocated into seven different experimental groups (groups 1–7). Methods: Root surfaces were demineralised in an acidified gel (pH = 5.0) for 3 weeks followed by various F treatments and stored in a standardised remineralising solution at 37°C for 6 weeks. The root surfaces were treated twice daily with different dentifrice slurries for 2 min, either with a neutral placebo dentifrice without F (group 5); or a neutral sodium fluoride (NaF) 1400 p.p.m. F dentifrice (group 1); or a neutral 1250 p.p.m. F dentifrice (group 6); or an acid dentifrice (pH 4.7) with 1400 p.p.m. F containing amine fluoride (AmF) (groups 3 and 4) or a 1250 p.p.m. (pH 4.7) AmF dentifrice (group 6). In groups 1, 2, 5, 6, and 7, the root surfaces were additionally rinsed for 2 min with a neutral non‐F placebo solution. In groups 3 and 4, rinsing were performed for 2 min with an acid (pH 4.7) 250 p.p.m. F solution, containing 125 p.p.m. F as AmF and 125 p.p.m. F as potassium fluoride (KF), once or twice per day respectively. ECM was used to measure electrical resistance on root surfaces at baseline and after 3 and 6 weeks respectively. TMR technique was used to measure and compare root surface lesion depths and mineral loss. Results: Six weeks daily treatment with a dentifrice slurry containing AmF followed by rinsing with a combination of equal amounts of AmF and KF solution twice a day showed a statistical significant higher ECM values compared with the other groups. TMR data measuring lesion depths and mineral loss reduction supported the results of the ECM findings. Conclusions: Daily application of a dentifrice slurry containing 1400 p.p.m. F as AmF combined with twice daily rinsing with a 250 p.p.m. F solution containing equal amount of AmF and KF significantly remineralise primary root caries lesions in vitro. ECM and TMR are valuable complementary methods in order to analyse the remineralisation processes.     

Relations between root length densities and root intersections with horizontal and vertical planes using root growth modelling in 3-dimensions

The root growth simulation model of Diggle (ROOTMAP; 1988) was modified to allow the numerical output of data on root intersections with horizontal and vertical planes. ROOTMAP was used to generate two three-dimensional model structures of fibrous root systems. The lateral roots were oriented randomly (geotropism index=0) but the main axes were positively gravitropic (geotropism index=0.6). The mean density of root intersections (n, cm^-2) with the sides of a series of 5×5×5 cm cubic volumes was related approximately linearly to the root length density (L_t cm^-2) within each volume by the equation L_t=2.3n (correlation coefficient, r=0.981). This compared with the relation of L_t=2n predicted theoretically for randomly oriented lines (Melhuish and Lang, 1968). Root length density was related to the intersection density by the equation L_t=2.43n_v (r=0.940) for the vertical faces and L_t=1.88n_h (r=0.984) for the horizontal faces. L_t/n_v was greater than L_t/n_h because of the preferential vertical orientation of the main root axes. The Melhuish and Lang (1968) equation does not generally give accurate prediction of root length density from field experiment data. Under field conditions, values have been reported in the ranges of 1.4 to 16 for L_t/n_h, and 3.8 to 9 for L_t/n_v. The most likely explanation for this difference is that only a small proportion (e.g. about 20–30%) of the actual number of roots are counted using the core-break and root mapping (including the trench wall) methods, due to the practical experimental difficulties of identifying individual fine roots under field conditions. Detailed experimental studies are needed to identify what portion of the root system is recorded using these field techniques (e.g. whether the main root axes are counted while the fine lateral roots remain undetected). Three-dimensional models of root growth provide a new method of studying the relations between L_t, n_v and n_h for root systems generated stochastically according to known geometrical rules. Using these models it will be possible to determine the effects of the degree of gravitropism and of root branching on the value and on the variability of L_t/n_h and L_t/n_v. The effectiveness of the statistical corrections that have been developed to correct for non-random root orientation can also be evaluated, as can the effects of sample position.     

活性氧介导内皮素-1诱导的培养新生大鼠心肌细胞肥大

实验在原代培养的新生大鼠心肌细胞中进行,检测内皮素-1(endothelin-1,ET-1)及其他药物对心肌细胞活性氧(reactiveoxygen species,ROS)产生和心肌细胞肥大的作用,以探讨ROS在ET-1诱导的心肌细胞肥大信号通路中的作用及ROS与蛋白激酶C(protein kinase C,PKC)活化的关系。细胞内ROS水平用ROS敏感的荧光探针2,7-dichlorofluorescin dictate(DCF-DA)反映,心肌细胞肥大通过细胞内RNA含量、细胞内蛋白质含量、细胞表面积大小来确定。实验结果如下:单独使用ET-1后,心肌细胞内反应ROS含量的DCF-DA荧光值比对照组增加77%,反应心肌肥大的PI荧光值、细胞内蛋白质含量、细胞表面积也分别比对照组增加128%、87%和151%。ET-1合用内皮素受体A亚型(ET_A)受体拮抗剂ABT-627、PKC抑制剂CC或过氧化氢酶后,DCF-DA的增加分别减弱62%、60%和51%,同时心肌细胞肥大也被抑制,单独使用PKC激动剂佛波醇脂(PMA)也能使DCF-DA的产生比对照组增加74%。因此,在ET-1诱导心肌细胞肥大的过程中,ET-1能够使心肌细胞产生ROS和诱导ROS依赖的心肌细胞肥大,这一作用依赖于ET_A受体的激活和PKC的活化,·ROS在ET-1诱导心肌细胞肥大中起信号传递的作用。     

Identification and characterization of collagen-binding activity in Streptococcus mutans wall-associated protein: a possible implication in dental root caries and endocarditis

Streptococcus mutans is implicated in coronal and dental root decay, and in endocarditis. Comparative study of the amino acid sequence of S. mutans 47 kDa wall-associated protein A (WapA) revealed a collagen-binding domain (CBD) at the N-terminal region. Recombinant AgA (WapA truncated at the carboxyterminal end) was isolated, biotin-labeled, and analyzed by Solid Phase Binding Assay. The results showed that biotin-labeled AgA bound significantly and in a dose-dependent manner to immobilized collagen type I, and to a lesser extent to fibronectin, but not to collagen type IV or laminin. Binding of biotin-labeled S. mutans cells to collagen-coated surfaces was significantly inhibited by antibody to WapA or AgA (P<0.001). The results obtained confirmed the collagen-binding activity of CBD in AgA and WapA, and suggested that WapA may be used, not only as a vaccine against coronal and dental root caries, but also against S. mutans-mediated endocarditis.     

幽门螺杆菌感染与脑梗死复发的关系及其机制研究

目的探讨幽门螺杆菌(HP)感染与脑梗死复发的相关性及其作用机制,为抗HP治疗降低脑梗死复发率提供依据。方法对我院神经内科收治的600例初发脑梗死患者,采用碳14呼气试验来定性HP感染患者,其中HP阴性患者197例为对照组(A组),HP阳性患者403例中,203例行标准三联疗法的患者为HP阳性治疗组(B组),200例未行抗HP治疗的患者为HP阳性观察组(C组)。所有患者均采用免疫投射比浊法定量血清超敏C反应蛋白(CRP),采用荧光偏振免疫测定法定量同型半胱氨酸(HCY),并进行为期3年的随访,比较3组患者的脑梗死复发率和CRP、HCY水平。结果 3组患者中,在随访期间复发率为HP阳性观察组为38.77%,HP阳性治疗组为25.37%,HP阴性对照组为20.51%。结论 HP感染与脑梗死有相关性,可通过作用于CRP和HCY加重动脉硬化,而增加脑梗死复发率。