A cross-sectional analysis of the prevalence of dental anxiety and its relation to the oral health-related quality of life in patients with dental treatment needs at a university clinic in Switzerland

doi: 10.1111/j.1741‐2358.2011.00465.x A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland Objectives: The aim of this observational, cross‐sectional study was to analyse the relationship between dental anxiety (DA) and health‐related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. Methods: The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health‐related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. Results: No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. Conclusion: This cross‐sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.     

Pulp sensibility test in elderly patients

doi: 10.1111/j.1741‐2358.2012.00623.x
Pulp sensibility test in elderly patients Background: The ageing process transforms the histological composition of the dental pulp and may affect the response to pulp sensibility tests. Objectives: The aim of this study was to assess the influence of age on pulp response time and on pain intensity. Material and methods: Fifty elderly patients and 50 young patients were selected. Different classes of teeth were evaluated. The pulp sensibility test was performed with a refrigerant spray. The pulp response time was measured in seconds and the pain intensity was assessed by visual analogue scale. Results: The Spearman coefficient was calculated and detect a positive correlation between age and pulp response time for maxillary incisors, premolars, mandibular incisors, and mean (p < 0.05). On the contrary, there was a negative correlation between age and pain intensity for maxillary incisors, mandibular incisors, and mean (p < 0.05). Also, the results of elderly and young groups were compared by Mann–Whitney test. Significant difference was noted regarding the pulp response time for maxillary incisors, premolars, mandibular incisors, and mean (p < 0.05). Significant difference was detected regarding the pain intensity for mandibular incisors only (p < 0.05). Conclusions: Pulp response time increases when people get older while pain intensity decreases. There were variations among the classes of teeth.     

Knowledge and attitude of elderly persons towards dental implants

doi: 10.1111/j.1741‐2358.2011.00586.x Knowledge and attitude of elderly persons towards dental implants Background: Despite their unrivalled place in restorative treatment, dental implants are still scarcely used in elderly patients. Introduction: The aim of this survey was therefore to identify potential barriers for accepting an implant treatment. Materials and methods: Participants were recruited from a geriatric hospital, two long‐term‐care facilities and a private clinic. The final study sample comprised 92 persons, 61 women and 31 men with an average age of 81.2 ± 8.0 years. In a semi‐structured interview, the participants’ knowledge of implants and attitude towards a hypothetical treatment with dental implants were evaluated. Results: Twenty‐seven participants had never heard of dental implants, and another 13 participants could not describe them. The strongest apprehensions against implants were cost, lack of perceived necessity and old age. Univariate and multiple linear regression analysis identified being women, type and quality of denture, having little knowledge on implants and being hospitalised as the risk factors for refusing implants. However, old age as such was not associated with a negative attitude. Conclusion: The acceptance of dental implants in the elderly population might be increased by providing further information and promoting oral health in general. Regardless of the age, dental implants should be placed when patients are still in good health and live independently.     

Correlation between residual ridge resorption and radiomorphometric indices

doi: 10.1111/j.1741‐2358.2011.00514.x Correlation between residual ridge resorption and radiomorphometric indices Objectives: The study evaluated the relationship between residual ridge resorption (RRR) and radiomorphometric indices, including mandibular cortical index (MCI), mandibular cortical width (MCW) and panoramic mandibular index (PMI), along with demographic factors. Material and methods: Panoramic radiographs of 1863 patients over 20 years of age were assessed. Gender, age and dental status of each patient were recorded. Relationships between RRR and demographic factors and radiomorphometric indices were evaluated using chi‐square and Fisher’s exact tests with level of significance of p = 0.05. Results: Residual ridge resorption was not affected by gender (p > 0.05), but was more frequently seen in patients over the age of 50 compared with those below 49 years of age (p < 0.001). RRR was significantly associated with edentulism (p < 0.001) and with severe erosions of endosteal margin of mandible (p < 0.05). RRR was more frequently seen in patients with PMI below 0.30 (p < 0.001) and with MCW below 3 mm in 50‐ to 69‐year‐old age group (p < 0.001). Conclusions: Patients younger than 50 years of age who demonstrate severe erosions of endosteal margin of mandible and have MCW < 3 mm and PMI < 0.30 appear to be suitable candidates for early implant placement or for maintaining roots or natural teeth to preserve bone, regardless of gender.     

Tooth loss and dental caries in community-dwelling older adults in northern Manhattan

doi: 10.1111/j.1741‐2358.2011.00502.x Tooth loss and dental caries in community‐dwelling older adults in northern Manhattan Objective: To examine tooth loss and dental caries by sociodemographic characteristics from community‐based oral health examinations conducted by dentists in northern Manhattan. Background: The ElderSmile programme of the Columbia University College of Dental Medicine serves older adults with varying functional capacities across settings. This report is focused on relatively mobile, socially engaged participants who live in the impoverished communities of Harlem and Washington Heights/Inwood in northern Manhattan, New York City. Materials and Methods: Self‐reported sociodemographic characteristics and health and health care information were provided by community‐dwelling ElderSmile participants aged 65 years and older who took part in community‐based oral health education and completed a screening questionnaire. Oral health examinations were conducted by trained dentists in partnering prevention centres among ElderSmile participants who agreed to be clinically screened (90.8%). Results: The dental caries experience of ElderSmile participants varied significantly by sociodemographic predictors and smoking history. After adjustment in a multivariable logistic regression model, older age, non‐Hispanic Black and Hispanic race/ethnicity, and a history of current or former smoking were important predictors of edentulism. Conclusion: Provision of oral health screenings in community‐based settings may result in opportunities to intervene before oral disease is severe, leading to improved oral health for older adults.     

Localization of transforming growth factor beta receptor II interacting protein-1 in bone and teeth: implications in matrix mineralization

Transforming growth factor beta receptor II (TGFβR-II) interacting protein 1 (TRIP-1) is a WD-40 protein that binds to the cytoplasmic domain of the TGF-β type II receptor in a kinase-dependent manner. To investigate the role of TRIP-1 in mineralized tissues, we examined its pattern of expression in cartilage, bone, and teeth and analyzed the relationship between TRIP-1 overexpression and mineralized matrix formation. Results demonstrate that TRIP-1 was predominantly expressed by osteoblasts, odontoblasts, and chondrocytes in these tissues. Interestingly, TRIP-1 was also localized in the extracellular matrix of bone and at the mineralization front in dentin, suggesting that TRIP-1 is secreted by nonclassical secretory mechanisms, as it is devoid of a signal peptide. In vitro nucleation studies demonstrate a role for TRIP-1 in nucleating calcium phosphate polymorphs. Overexpression of TRIP-1 favored osteoblast differentiation of undifferentiated mesenchymal cells with an increase in mineralized matrix formation. These data indicate an unexpected role for TRIP-1 during development of bone, teeth, and cartilage.     

Tooth morphology of Echimyidae (Rodentia,Caviomorpha): homology assessments,fossils, and evolution

Echimyidae constitute the most important radiation of caviomorph rodents in the Neotropical region, represented by 20 extant genera and several extinct species. Both in extant and fossil forms, this diversity is reflected by a significant morphological variation found in crown structures of the cheek teeth. Different hypotheses of primary homology have been proposed for these structures, which, in turn, support diverse dental evolutionary hypotheses. In this contribution we inspect the main structures (cusps and lophids) of the lower deciduous teeth and molars in extinct and extant Echimyidae, and establish their topological correspondences. Comparisons with cusps and lophids of Erethizontidae are emphasized. We explore the testing of alternative primary hypotheses of lophid correspondences in a cladistic context. Following a ‘dynamic’ approach, we select the hypothesis of primary homology, which produced the more parsimonious results, and evaluate the evolutionary transformations of the dental characters analysed. In this context, the phylogenetic relationships of living Myocastor coypus (Molina, 1782) with the extinct Tramyocastor and Paramyocastor are tested. Our results indicate that pentalophodonty is the derived condition for the lower molars in Echimyidae, that trilophodonty evolved independently at least three times during the evolutionary history of these rodents, and that tetralophodonty represents the plesiomorphic condition. This study shows that dental evolution in echimyids can be better understood when occlusal structures are expressed as reliably comparable characters, and when fossils are taken into account. © 2012 The Linnean Society of London, Zoological Journal of the Linnean Society, 2012, 164 , 451–480.     

Phylogenetic analysis,taxonomic revision,and dental ontogeny of the Cretaceous Zhelestidae (Mammalia: Eutheria)

Iphisa elegans Gray, 1851 is a ground‐dwelling lizard widespread over Amazonia that displays a broadly conserved external morphology over its range. This wide geographical distribution and conservation of body form contrasts with the expected poor dispersal ability of the species, the tumultuous past of Amazonia, and the previously documented prevalence of cryptic species in widespread terrestrial organisms in this region. Here we investigate this homogeneity by examining hemipenial morphology and conducting phylogenetic analyses of mitochondrial (CYTB) and nuclear (C‐MOS) DNA sequence data from 49 individuals sampled across Amazonia. We detected remarkable variation in hemipenial morphology within this species, with multiple cases of sympatric occurrence of distinct hemipenial morphotypes. Phylogenetic analyses revealed highly divergent lineages corroborating the patterns suggested by the hemipenial morphotypes, including co‐occurrence of different lineages. The degrees of genetic and morphological distinctness, as well as instances of sympatry among mtDNA lineages/morphotypes without nuDNA allele sharing, suggest that I. elegans is a complex of cryptic species. An extensive and integrative taxonomic revision of the I. elegans complex throughout its wide geographical range is needed. © 2012 The Linnean Society of London, Zoological Journal of the Linnean Society, 2012, 166 , 361–376.