bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Pressure Replica Technique for In Vitro Imaging of Pore Morphologies in Teeth
Authors: Uchtmann H. , Wilkie D.
Published: January 2009

The presence of a natural pore morphology is an essential factor in chemical and mechanical stability of teeth. Common histological methods give only an insufficient picture of the three-dimensional pore distribution in sound or carious teeth. This paper describes a new technique to obtain complete images of the pore structure in teeth or other biological hard tissues. Whole extracted human teeth from orthodontic therapy are mechanically cleaned and organic remnants removed chemically. After being (partly) dried, the teeth are penetrated by a freshly prepared and colored (rhodamine B dye) two-component epoxy resin. The resin is pressed into the pores and cavities of the teeth with pressures of up to 2000 bar in a high-pressure vessel by means of a manually driven piston screw pump for pressure generation. The resin fills all hollow spaces of the tooth down to sizes below 0.1 μm. The pulp and the root canals are cast in massive forms of the hardened epoxy resin, giving an exact replica of the natural structure. The penetrated samples in the form of whole, intact teeth are investigated microscopically so that the pore morphology of the tooth surface, including carious defects, can be examined. The structure of the pores extending into the interior of the tooth can be made visible by dissolution of the hard tissue-for example, in acid solutions. Micro-cavities filled with the resin are observed in thin, ground, and polished cross- and longitudinal sections cut from the teeth. The colored resin induces a high contrast to the dental apatite material. In fluorescence microscopy, only the resin structures are visible.
The Use of Immunohistochemistry in Understanding the Structure and Function of the Extracellular Matrix of Dental Tissues
Authors: Hall R.C. , Embery G.
Published: January 2009

The availability of monoclonal and polyclonal antibodies directed toward the recognition of epitopes in a variety of extracellular matrix components of the dentition represents a powerful tool in the investigation of the structure and biology of dental tissues in health and disease. The immunolocalization of both whole molecule structures and specific regions of molecules has the potential to yield information on tooth development, the effects of aging, changes in tooth structure during the initiation and progression of the caries process, together with the response of the tooth to restorative treatment. This review reports on current research to elucidate the role of extracellular matrices of enamel, dentin, cementum, and bone. Attention is directed at the use of antibodies toward the small leucine-rich proteoglycans such as decorin and biglycan, in addition to their glycosaminoglycan chains. Antibodies are also being developed toward dental tissue-specific macromolecules such as phosphophoryn and amelogenin; the use of these antibodies will increase our understanding of the role of these macromolecules in mineralized tissues.
In Vitro Studies of Laser Fluorescence for Detection and Quantification of Mineral Loss From Dental Caries
Authors: Hall A.F. , Deschepper E. , Ando M. , Stookey G.K.
Published: January 2009

Laser fluorescence (LF) is thought to be a quantitative technique for the measurement of mineral loss from dental caries. These studies aimed to demonstrate the quantitative nature of LF, by means of transverse microradiography (TMR), in addition to the possible use of LF on small specimens suitable for in situ studies. Studies also aimed to determine the ability of LF to detect caries adjacent to amalgam restorations. The results demonstrated reasonable correlation between both the histological depth and mineral loss measured by TMR compared with the % change in mean fluorescence radiance measured by LF (r = 0.70 and 0.83, respectively). Studies with small specimens demonstrated that in vitro remineralization could be observed with LF for comparison of the demineralized specimen with an undemineralized reference. ANOVA showed significant mineral gain (p < 0.0001). The detection and quantification of mineral loss adjacent to amalgam restorations may have potential for the management of recurrent caries. Studies have demonstrated that LF can detect such mineral loss, and, with refinement of the image analysis system, LF was capable of detecting remineralization. Remineralization of such lesions is controversial, but it is suggested that LF may have a role in secondary caries management.
Raman Spectroscopy in Dental Research: A Short Review of Recent Studies
Authors: Tsuda H. , Arends J.
Published: January 2009

The Raman spectroscopic technique enables us to obtain vibrational (IR and far-IR) spectra of minerals by analyzing scattered light caused by (visible or near-visible) monochromatic laser excitation. The method possesses several advantages over IR absorption, including simple sample preparation, easy spectral/band analysis, and linear-response to mineral/chemical concentrations. In micro-Raman spectrometer systems, samples are positioned under an optical microscope, and specimens can be scanned with a lateral resolution (- 1 mm). In this paper, recent applications of micro-Raman spectroscopy and near-infrared Fourier transform Raman spectroscopy in the study of dental hard tissues and of calculus are reviewed. Special attention is given to mineral components in enamel, dentin, and calculus, and to calcium fluoride formed in/on enamel. The results from the use of an Ar+-laser/grating-based micro-Raman spectrometer show that: CaF2 formed in/on enamel by APF treatment is detectable and different from pure CaF2; and with the technique, the crystallite orientation in enamel can be determined. A Raman spectrometer based on Fourier transform and a diode-laser-pumped Nd:YAG laser (1.06 mm) can be used to obtain fluorescence-free Raman signals from biological materials, and identification of mineral components present in dental calculus is possible.
New Electrochemical Techniques for Probing Phase Transfer Dynamics at Dental Interfaces in Vitro
Authors: Unwin P.R. , Macpherson J.V. , Beeston M.A. , Evans N.J. , Littlewood D. , Hughes N.P.
Published: January 2009

Phase transfer reactions such as dissolution, precipitation, sorption, and desorption are important in a wide range of processes on dental hard tissue surfaces. An overview is provided of several new complementary electrochemical techniques which are capable of probing the dynamics of such processes at solid/liquid interfaces from millimeter- to nanometer-length scales, with a variable time resolution down to the sub-millisecond level. Techniques considered include channel flow methods with electrochemical detection, which allow reactions at solid/liquid interfaces to be studied under well-defined and calculable mass transport regimes. Scanning electrochemical microscopy allows the chemical activity of interfaces to be mapped at higher spatial and temporal resolutions. This technique, which utilizes a scanning ultramicroelectrode, has been used extensively for the study of dissolution processes of ionic crystals, as well as in imaging the action of fluid-flow-blocking agents on dentin surfaces, which act via precipitation. So that interfaces at the nanometer level can be probed, an integrated electrochemical-atomic force microscope has been developed which enables the local solution conditions to be controlled electrochemically while topographical changes are mapped simultaneously.
Potential Application of Low-Dose Doxycycline to Treat Periodontitis in Post-Menopausal Women
Authors: Payne J.B. , Reinhardt R.A.
Published: January 2009

The purpose of this paper is two-fold: (1) to review the evidence that osteoporosis and post-menopausal estrogen deficiency are associated with progressive alveolar bone loss and an elevated risk of tooth loss; and (2) to propose the use of tetracyclines, specifically low-dose doxycycline (LDD) (and, perhaps in the future, the chemically modified tetracyclines), to mitigate alveolar bone loss in post-menopausal osteoporotic/osteopenic women. Design concepts for a randomized clinical trial to study the effects of LDD on progressive alveolar bone loss in this patient population are reviewed. Since osteoporosis affects over 20 million people in the United States, progressive alveolar bone loss in this patient group represents a potentially significant public health problem unique from common adult periodontitis. Stopping progressive alveolar bone loss is essential to prevent both tooth loss and micro-architectural deterioration of alveolar bone.
Doxycycline Inhibits Collagen Synthesis by Differentiated Articular Chondrocytes
Authors: Tekoppele J.M. , Beekman B. , Verzijl N. , Koopman J.L. , Degroot J. , Bank R.A.
Published: January 2009

Doxycycline (DOX) profoundly inhibited collagen synthesis by differentiated articular chondrocytes. At 25 μM, the rate of collagen synthesis was suppressed by more than 50% without affecting cell proliferation (DNA levels) and general protein synthesis (35S-Met and 35S-Cys incorporation). Steady-state mRNA levels of type II collagen were also reduced, indicating that DOX may have an effect at the transcriptional level of type II collagen. The IC50 value of DOX to downregulate collagen synthesis (17 μM) is close to DOX levels attained in vivo (< 10 μM), and it is more than ten-fold lower than the IC50 values to inhibit the activity of most matrix metalloproteinases (MMPs). As such, these findings support the hypothesis that the reduced severity of OA observed in the dog anterior cruciate ligament model resulting from prophylactic treatment with DOX may involve mechanisms other than MMP inhibition alone. Our findings suggest that prevention of changes in the chondrocyte phenotype may be involved in the beneficial effect of doxycycline in experimental osteoarthritis. for differentiated chondrocytes in early stages of osteoarthritis exhibit elevated collagen synthesis.
Effect of Minocycline on Osteoporosis
Authors: Williams S. , Wakisaka A. , Zeng Q.Q. , Barnes J. , Seyedin S. , Martin G. , Wechter W.J. , Liang C.T.
Published: January 2009

The effect of oral minocycline on osteopenia in ovariectomized (OVX) old rats was examined in this study. Rats were divided into 4 groups: sham-operated, OVX followed by treatment with vehicle, minocycline, or 17β-estradiol. The treatment was initiated one day after OVX and proceeded for 8 wks. OVX reduced bone mineral density (BMD) in the whole femur and in the femoral regions that are enriched in trabecular bone. Treatment with minocycline or estrogen prevented a decrease in BMD. Femoral trabecular bone area, trabecular number, and trabecular thickness were reduced, and trabecular separation was increased by OVX. Treatment with minocycline or estrogen abolished the detrimental effects induced by OVX. OVX also reduced indices that reflect the interconnectivity of trabecular bone, and the loss of trabecular connectivity was prevented by treatment with minocycline or estrogen. Based on the levels of urinary pyridinoline, we showed that the effect of estrogen, but not minocycline, was primarily through its inhibitory effect on bone resorption. Analysis of bone turnover activity suggests that OVX increased parameters associated with bone resorption (eroded surface) and formation (osteoid surface, mineralizing surface, mineral apposition rate, and bone formation rate). Treatment with minocycline reduced bone resorption modestly and stimulated bone formation substantially. In contrast, treatment with estrogen drastically reduced parameters associated with both bone resorption and formation. We have concluded that oral minocycline can effectively prevent the decrease in BMD and trabecular bone through its dual effects on bone resorption and formation.
Long-Term Therapy with a New Chemically Modified Tetracycline (CMT-8) Inhibits Bone Loss in Femurs of Ovariectomized Rats
Authors: Sasaki T. , Ramamurthy N.S. , Golub L.M.
Published: January 2009

The effect of a new non-antimicrobial analog of tetracycline (CMT-8) on bone loss in ovariectomized (OVX) rats was examined. Three-month-old female rats were ovariectomized, and one week later, were distributed into 3 groups: sham-operated non-OVX controls, vehicle-treated OVX controls, and CMT-8-treated OVX rats. After 145 days of daily CMT-8 administration, the intact femurs were dissected and examined by several histological and histomorphometric techniques. OVX significantly (p < 0.01) decreased trabecular bone volume by 53.4% in the metaphyses compared with sham-operated controls. CMT-8 therapy produced a significant (p < 0.05) inhibition of trabecular bone loss and also induced bone formation in the OVX rats. Of interest, the newly synthesized bone in the CMT-treated OVX rats was found to increase the "connectivity" of the trabecular "struts" by bridging the adjacent longitudinal bone trabeculae, forming dense, platelike bone trabeculae. These results strongly suggest that long-term CMT-8 therapy effectively inhibits bone loss after OVX, not only by inhibiting bone resorption but also by inducing new bone formation in the trabecular areas of long bones.
Osseoperception: Sensory Function and Proprioception
Authors: Klineberg I. , Murray G.
Published: January 2009

Tooth loss and its replacement have significant functional and psychosocial consequences. The removal of intra-dental and periodontal mechanoreception accompanying tooth loss changes the fine proprioceptive control of jaw function and influences the precision of magnitude, direction, and rate of occlusal load application. With the loss of all teeth, complete denture restoration is a compromise replacement which only partially restores function. Implant-supported prostheses restore jaw function more appropriately, with improved psychophysiological discriminatory ability and oral stereognosis. Osseoperception is defined as depending on central influences from corollary discharge from cortico-motor commands to jaw muscles, and contributions from peripheral mechanoreceptors in orofacial and temporomandibular tissues. The processing of central influences is considered with the recognition of the plasticity of neuromotor mechanisms that occurs to accommodate the loss of dental and periodontal inputs.
Influence of Inflammatory Reactions Vs. Occlusal Loading On Peri-Implant Marginal Bone Level
Authors: Van Steenberghe D. , Naert I. , Jacobs R. , Quirynen M.
Published: January 2009

Plaque accumulation on abutments or implant surfaces induces an inflammatory reaction in the gingiva/alveolar mucosa just as around teeth. The longevity of oral implants can be jeopardized by either peri-implantitis and/or an occlusal overload. In the partially edentulous patient in whom pockets around teeth act as a reservoir for the colonization of the pockets around implants, the risk for inflammatory reactions of the peri-implant soft tissues seems especially more plausible than in the fully edentulous patient. This is especially true for implants with a very rough surface (e.g., plasma-sprayed), because of the positive relationship between surface roughness and supra- as well as subgingival plaque formation. Several medium-term (from 5 to 10 years) clinical studies support this hypothesis, through the observation of ongoing bone loss and subsequent decreasing success/survival percentages. Occlusal overload increases the risk for microfractures at the implant-bone interface in two-stage implants, which can result in significant marginal bone loss and even failure. There is ample evidence that occlusal factors are related to marginal angular defects around two-stage implants.
Clinical Experiences with Dental Implants
Authors: Henry Patrick J.
Published: January 2009

The clinical utilization of dental impants has accelerated in recent years, and new applications continue to emerge. Concomitantly, alternative implant systems have introduced conceptually different approaches to treatment using altered protocols. The purpose of this paper is to address some of the background issues pertinent to the long-term success, survival, safety, and effectiveness of these devices. The requirements for clinical acceptance of implants are controlled initially by regulatory bodies; however, the dentist eventually must make a decision on which type of implant should be used in clinical practice. This clinical decision-making process should involve the strategy of using an evidence-based approach to ensure quality of care and reduction of liability for negligent care. This is particularly the case when treatment is undertaken in identified high-risk categories. While short- to medium-term data have been accumulated on the success rates of several implant systems, it is apparent that long-term data comparing and contrasting the various advantages and disadvantages of different systems do not exist, and adequate criteria applicable to the collective clinical experience need to be defined. Expanding areas of application are dependent on continuous improvements in implant hardware, surgical protocol development, and rationalized osteopromotive and site installation augmentation technology. Many treatment endeavors are still largely at the pilot study level of development, and long-term prospective clinical trials on large numbers of patients are required to document results adequately and to elucidate the most likely productive areas for future investigation.
Biomechanical and Functional Behavior of Implants
Authors: Stanford Clark M.
Published: January 2009

The ability to achieve a long-term stable implant interface is not a significant clinical issue when sufficient uni- or bi-cortical stabilization is available. Clinical outcomes studies suggest that the higher-risk implants are those placed in compromised cortical bone (thin, porous, etc.) in anatomic sites with minimal existing trabecular bone (characterized as type IV bone). In establishing and maintaining an implant interface in such an environment, one needs to consider the impact of masticatory forces. These forces, in turn, have the potential to create localized changes in interfacial stiffness through the viscoelastic properties of bone. Changes in these properties will alter the communication between osteocytes and osteoblasts, leading to an increase in new bone growth, a maintenance of established bone, or a loss (potentially catastrophic) of either cortical or trabecular bone. Therefore, a key to understanding the biomechanical and functional behavior at an implant interface is to control the extent of anticipated modeling and remodeling behavior through an optimal implant design combined with a thorough understanding of how tissues respond to the mechanically active environment.
Responses of Bone Cells to Biomechanical Forces in Vitro
Authors: Burger E.H. , Klein-Nulend J.
Published: January 2009

In this paper, we review recent studies of the mechanism by which mechanical loading of bone is transduced into cellular signals of bone adaptation. Current biomechanical theory and in vivo as well as in vitro experiments agree that the three-dimensional network of osteocytes and bone-lining cells provides the cellular basis for mechanosensing in bone, leading to adaptive bone (re)modeling. They also agree that flow of interstitial fluid through the lacunar-canalicular porosity of bone, as a result of mechanical loading, most likely provides the stimulus for mechanosensing, and informs the bone cellular network about the adequacy of the existing bone structure. Important signaling molecules involved in in vivo adaptive bone formation, as well as in in vitro cellular response to fluid flow, are nitric oxide and prostaglandins. The expression of key enzymes for nitric oxide and prostaglandin production in bone cells is altered by fluid shear stress in vitro. Together, these studies have increased our understanding of the cell biology underlying Wolff's Law. This may lead to new strategies for combating disuse-related osteoporosis, and may also be of use in understanding and predicting the long-term integration of bone-replacing implants.
Modular Production and the New Division of Labour Within Europe
Authors: Frigant Vincent , Layan Jean-Bernard
Published: January 2009

This article focuses on the emergence of a new international division of labour in the auto parts industry. Its first section examines the hypothesis that the shift to modular production offers a chance to modify value chain geography inasmuch as modularity causes new opportunities and constraints in geographic proximity terms. An analytical matrix is provided and applied to New Accession Countries, with special consideration being given to French suppliers' circumstances due to the requirement that host country characteristics and company specificities be analysed simultaneously. The second section tests this matrix using statistical data and culminates in a case-study. It will be demonstrated that New Accession Countries are being integrated with the rest of the Continent, due to firms' ongoing search for location-related advantages and because of a tightening/easing interaction that is associated with proximity constraints.
Euro Commentary: Regional Differences in the Growth Patterns of Knowledge-Intensive Business Services
Authors: González-López Manuel
Published: January 2009

This article aims to analyse the regional dynamics of knowledge-intensive business services (KIBS), an activity usually associated with the so-called knowledge-based economy (KBE). As will be seen later, most of the studies of this sector refer to central and metropolitan regions but little has been said about the characteristics and nature of its growth in other regions.A study of the Spanish case has been made which tries to identify specific patterns of KIBS development in different kinds of regions. The results obtained indicate that KIBS interregional trade decisively shapes KIBS regional growth in such a way that, on the one hand, it contributes to the concentration of these activities in metropolitan and well-developed regions and, on the other hand, it makes KIBS growth in less developed regions (LDRs) externally dependent.
Biomechanics of the Mandible
Authors: van Eijden T.M.
Published: January 2009

In this review the biomechanical behavior of the mandibular bone tissue, and of the mandibular bone as a whole, in response to external loading is discussed. A survey is given of the determinants of mandibular stiffness and strength, including the mechanical properties and distribution of bone tissue and the size and shape of the mandible. Mandibular deformations, stresses, and strains that occur during static biting and chewing are reviewed. During biting and the powerstroke of mastication, a combination of sagittal bending, corpus rotation, and transverse bending occurs. The result is a complex pattern of stresses and strains (compressive, tensile, shear, torsional) in the mandible. To be able to resist forces and bending and torsional moments, not only the material properties of the mandible but also its geometrical design is of importance. This is reflected by variables like polar and maximum and minimum moments of inertia and the relative amount and distribution of bone tissue. In the longitudinal direction, the mandible is stiffer than in transverse directions, and the vertical cross-sectional dimension of the mandible is larger than its transverse dimension. These features enhance the resistance of the mandible to the relatively large vertical shear forces and bending moments that come into play in the sagittal plane.
Human Papillomavirus Infections in Children: the Potential Role of Maternal Transmission
Authors: Syrjanen Stina , Puranen Mirja
Published: January 2009

To date, more than 100 types of human papillomavirus (HPV) have been identified. In the past 20 years, there has been an increasing interest in HPVs because of their potential role in the pathogenesis of malignant tumors. HPV infections are known to affect predominantly adult, sexually active age groups, whereas skin warts, at various anatomic sites, are usually associated with younger individuals. The modes of viral transmission in children remain controversial, including perinatal transmission, auto- and hetero-inoculation, sexual abuse, and, possibly, indirect transmission via fomites. Recent studies on perinatal infection with HPV have been inconclusive. It is still unclear how frequently perinatal infection progresses to clinical lesions, whether genital, laryngeal, or oral. Conflicting reports have been published on the prevalence of HPV infections in children. The current consensus is, however, that newborn babies can be exposed to cervical HPV infection of the mother. The detection rate of HPV DNA in oral swabs of newborn babies varies from 4% to 87%. The concordance of HPV types detected in newborn babies and their mothers is in the range of 57% to 69%, indicating that the infants might acquire the HPV infection post-natally from a variety of sources. HPV antibodies have been detected in 10% to 57% of the children, and there is usually no correlation between seropositivity and the detection of HPV DNA in either the oral or the genital mucosa. There is also evidence that transmission in utero or post-natal acquisition is possible. The mode of in utero transmission remains unknown, but theoretically the virus could be acquired hematogenously, by semen at fertilization, or as an ascending infection in the mother. The understanding of viral transmission routes is important, particularly because several vaccination programs are being planned worldwide. The serologic response to HPV detected in different populations of young women or women at risk of cervical cancer might be due to genital infections, but the possibility that HPV infection has been acquired earlier in life through the oral mucosa or respiratory tract cannot be ruled out.
Osteopontin
Authors: Sodek J. , Ganss B. , McKee M.D.
Published: January 2009

Osteopontin (OPN) is a highly phosphorylated sialoprotein that is a prominent component of the mineralized extracellular matrices of bones and teeth. OPN is characterized by the presence of a polyaspartic acid sequence and sites of Ser/Thr phosphorylation that mediate hydroxyapatite binding, and a highly conserved RGD motif that mediates cell attachment/signaling. Expression of OPN in a variety of tissues indicates a multiplicity of functions that involve one or more of these conserved motifs. While the lack of a clear phenotype in OPN "knockout" mice has not established a definitive role for OPN in any tissue, recent studies have provided some novel and intriguing insights into the versatility of this enigmatic protein in diverse biological events, including developmental processes, wound healing, immunological responses, tumorigenesis, bone resorption, and calcification. The ability of OPN to stimulate cell activity through multiple receptors linked to several interactive signaling pathways can account for much of the functional diversity. In this review, we discuss the structural features of OPN I hat relate to its function in the formation, remodeling, and maintenance of bones and teeth.
Molecular Signaling and Pulpal Nerve Development
Authors: Fried K. , Nosrat C. , Lillesaar C. , Hildebrand C.
Published: January 2009

The purpose of this review is to discuss molecular factors influencing nerve growth to teeth. The establishment of a sensory pulpal innervation occurs concurrently with tooth development. Epithelial/mesenchymal interactions initiate the tooth primordium and change it into a complex organ. The initial events seem to be controlled by the epithelium, and subsequently, the mesenchyme acquires odontogenic properties. As yet, no single initiating epithelial or mesenchymal factor has been identified. Axons reach the jaws before tooth formation and form terminals near odontogenic sites. In some species, local axons have an initiating function in odontogenesis, but it is not known if this is also the case with mammals. In diphyodont mammals, the primary dentition is replaced by a permanent dentition, which involves a profound remodeling of terminal pulpal axons. The molecular signals underlying this remodeling remain unknown. Due to the senescent deterioration of the dentition, the target area of tooth nerves shrinks with age, and these nerves show marked pathological-like changes. Nerve growth factor and possibly also brain-derived neurotrophic factor seem to be important in the formation of a sensory pulpal innervation. Neurotrophin-3 and -4/5 are probably not involved. In addition, glial cell line-derived neurotrophic factor, but not neurturin, seems to be involved in the control of pulpal axon growth. A variety of other growth factors may also influence developing tooth nerves. Many major extracellular matrix molecules, which can influence growing axons, are present in developing teeth. It is likely that these molecules influence the growing pulpal axons.
Food Starches and Dental Caries
Authors: Lingstrom P. , van Houte J. , Kashket S.
Published: January 2009

Sucrose and starches are the predominant dietary carbohydrates in modern societies. While the causal relationship between sucrose and dental caries development is indisputable, the relationship between food starch and dental caries continues to be debated and is the topic of this review. The current view of dental caries etiology suggests that in-depth evaluation of the starch-caries relationship requires the consideration of several critical cariogenic determinants: (1) the intensity (i.e., the amount and frequency) of exposure of tooth surfaces to both sugars and starches, (2) the bioavailability of the starches, (3) the nature of the microbial flora of dental plaque, (4) the pH-lowering capacity of dental plaque, and (5) the flow rate of saliva. Studies of caries in animals, human plaque pH response, and enamel/dentin demineralization leave no doubt that processed food starches in modern human diets possess a significant cariogenic potential. However, the available studies with humans do not provide unequivocal data on their actual cariogenicity. In this regard, we found it helpful to distinguish between two types of situations. The first, exemplified by our forebears, people in developing countries, and special subject groups in more modern countries, is characterized by starch consumption in combination with a low sugar intake, an eating frequency which is essentially limited to two or three meals per day, and a low-to-negligible caries activity. The second, exemplified by people in the more modern societies, e.g., urban populations, is characterized by starch consumption in combination with significantly increased sugar consumption, an eating frequency of three or more times per day, and a significantly elevated caries activity. It is in the first situation that food starches do not appear to be particularly caries-inducive. However, their contribution to caries development in the second situation is uncertain and requires further clarification. Although food starches do not appear to be particularly caries inducive in the first situation, the possibility cannot be excluded that they contribute significantly to caries activity in modern human populations. The commonly used term "dietary starch content" is misleading, since it represents a large array of single manufactured and processed foods of widely varying composition and potential cariogenicity. Hence, increased focus on the cariogenicity of single starchy foods is warranted. Other aspects of starchy foods consumption, deserving greater attention, include the bioavailability of starches in processed foods, their retentive properties, also in relation to sugars present (starches as co-cariogens), their consumption frequency, the effect of hyposalivation on their cariogenicity, and their impact on root caries. The starch-caries issue is a very complex problem, and much remains uncertain. More focused studies are needed. At present, it appears premature to consider or promote food starches in modern diets as safe for teeth.
Evidence for Bacterial Causation of Adverse Pulpal Responses in Resin-Based Dental Restorations
Authors: Bergenholtz G.
Published: January 2009

The widespread use of resin and resin-monomers for bonding of dental restorations to dentin has occurred because of a fundamental shift in the view that injury to the pulp is induced by restorative procedures. While, for many years, the toxic effects of restorative materials were thought to be of crucial importance in the development of adverse pulpal responses the key role of bacterial leakage at the restoration-tooth interface is now well-recognized. Consequently, if optimal conditions for the preservation of pulpal health are to be ensured, dental restorations should provide an impervious seal against the surrounding tooth structure. However, polymerization shrinkage and contraction stresses induced during setting, as well as a variety of technical difficulties encountered during the clinical operation, often produce less than perfect results. Therefore, modern restorative procedures involving resin and resin-bonded restoratives must still rely on the ability of the pulp to cope with the injurious elements to which it may be exposed during and after the procedure. This review examines factors that may govern the pulp's response to restorative procedures that involve adhesive technologies. An assessment is made of the risks involved as far as the continued vital function of the pulp is concerned. It is concluded that an intact, although thin, wall of primary dentin often enables the pulp to overcome both toxic material effects and the influences of bacterial leakage. In contrast, the pulp may not do equally well following capping of open exposures with resin composites. A dearth of controlled clinical studies in this area of dentistry calls for confirmation that pulpal health prevails over the long term following the use of total-etch and resin-bonding techniques.
Regulation of Mandibular Postures: Mechanisms and Clinical Implications
Authors: Woda A. , Pionchon P. , Palla S.
Published: January 2009

This review argues that (1) the habitual mandibular position is constantly variable and so cannot be considered as a craniomandibular reference point, (2) there is no unique centric relation, (3) mandibular posture greatly depends on head posture, (4) clinical evaluation of the occlusal vertical dimension is mostly empirical, and (5) neither the vertical dimension at rest nor the centric relation can be determined by means of existing instrument-based clinical methods. However, some physiological conditions exist that facilitate the recording of craniomandibular position.
Regulation of Mandibular Growth and Morphogenesis
Authors: Mina Mina
Published: January 2009

The development of the vertebrate face is a dynamic process that starts with the formation of facial processes/prominences. Facial processes are small buds made up of mesenchymal masses enclosed by an epithelial layer that surround the primitive mouth. The 2 maxillary processes, the 2 lateral nasal processes, and the frontonasal processes form the upper jaw. The lower jaw is formed by the 2 mandibular processes. Although the question of the embryonic origin of facial structures has received considerable attention, the mechanisms that control differential growth of the facial processes and patterning of skeletal tissues within these structures have been difficult to study and still are not well-understood. This has been partially due to the lack of readily identifiable morphologically discrete regions in the developing face that regulate patterning of the face. Nonetheless, in recent years there has been significant progress in the understanding of the signaling network controlling the patterning and development of the face (for review, see Richman et al., 1991; Francis-West et al., 1998). This review focuses on current understanding of the processes and signaling molecules that are involved in the formation of the mandibular arch.
Synthetic Hammerhead Ribozymes as Tools in Gene Expression
Authors: lyngstadaas S. Petter
Published: January 2009

The assessment of genetic controls for sequential developmental processes such as tooth formation and biomineralization is often difficult in transgenic "knockout" models, where phenotypes reflect only the permanent eradication of a gene, and reveal little about the dynamic range of expression for the gene(s) involved. One promising strategy to overcome this problem is through the use of ribozymes, a class of metalloenzymes made entirely of ribonucleic acid (RNA), that are capable of cleaving other RNA molecules in a catalytic fashion. Their activity can be targeted against specific mRNAs by selection of unique sequences flanking a conserved catalytic motif. In synthetic ribozymes, specificity, stability, and cell permeability can be dramatically improved by the incorporation of chemically modified ribonucleotides. This review focuses on the design and application of hammerhead ribozymes, the best-known and most widely used class of RNA-based enzymes. So far, except for a few conserved structures at the catalytic core, no one particular model or superior ribozyme design has been identified. It may well be that each cell, tissue, and organism has different requirements for the uptake, activity, and stability of hammerhead ribozymes. However, designed ribozymes can be highly effective agents for timed and localized elimination of gene products. As the 3D structures of active hammerhead molecules are revealed, more effective ribozymes will be developed. Today, developments in ribozyme-mediated sequence-specific blocking of gene expression hold great promise for active RNA enzymes as tools in biomolecular research and for eliminating unwanted gene expression in human diseases.
Chemokines, a Family of Chemotactic Cytokines
Authors: Groves D.T. , Jiang Y.
Published: January 2009

Chemokines are low-molecular-weight proteins that stimulate recruitment of leukocytes. They are secondary proinflammatory mediators that are induced by primary pro-inflammatory mediators such as interleukin-I (IL-1) or tumor necrosis factor (TNF). The physiologic importance of this family of mediators is derived from their specificity. Unlike the classic leukocyte chemo-attractants, which have little specificity, members of the chemokine family induce recruitment of well-defined leukocyte subsets. Thus, chemokine expression can account for the presence of different types of leukocytes observed in various normal or pathologic states. There are two major chemokine sub-families based upon the position of cysteine residues, i . e.,CXC and CC. All members of the CXC chemokine sub-family have an intervening amino acid between the first two cysteines; members of the CC chemokine sub-family have two adjacent cysteines. As a general rule (with some notable exceptions), members of the CXC chemokines are chemotactic for neutrophils, and CC chemokines are chemotactic for monocytes and a small sub-set of lymphocytes. This review discusses the potential role of chemokines in inflammation and focuses on the two best-characterized chemokines, monocyte chemoattractant protein-1 (MCP-1 a CC chemokine, and interleukin-8 (IL-8), a member of the CXC chemokine sub-family.
A New Biological Approach To Vital Pulp Therapy
Authors: Rutherford Bruce , Fitzgerald Mark
Published: January 2009

Molecular biology is providing opportunities to develop new strategies or agents for the treatment of a wide variety of diseases. The availability of large amounts of highly purified proteins produced by recombinant DNA techniques is an obvious example. Recent evidence has implicated proteins belonging to the bone morphogenetic protein (BMP) subgroup of the transforming growth factor beta supergene family in tooth formation and dentinogenesis. It has long been known that bone and dentin contain bone morphogenetic protein activity. Recently, recombinant human BMP-2, -4, and -7 (also known as OP-1 ) have been shown to induce reparative dentin formation in experimental models of large direct pulp exposures in permanent teeth. The manner in which these agents act appears unique. New reparative dentin replaces the stimulating agents applied directly to the partially amputated pulp. Hence, the new tissue forms contiguous with, largely superficial to, and not at the expense of the remaining vital pulp tissue. This suggests a therapeutic approach permitting the induction of a predetermined and controlled amount of reparative dentin. Additionally, OP-l has been associated with the formation of reparative dentin after application to a freshly cut but intact layer of dentin. These findings may provide future clinicians with additional options for the treatment of substantially damaged or diseased vital teeth.
Does Variability in Salivary Protein Concentrations Influence Oral Microbial Ecology and Oral Health?
Authors: Rudney J.D.
Published: January 2009

Salivary protein interactions with oral microbes in vitro include aggregation, adherence, cell-killing, inhibition of metabolism, and nutrition. Such interactions might be expected to influence oral ecology. However, inconsistent results have been obtained from in vivo tests of the hypothesis that quantitative variation in salivary protein concentrations will affect oral disease prevalence. Results may have been influenced by choices made during study design, including saliva source, stimulation status, control for flow rate, and assay methods. Salivary protein concentrations also may be subject to circadian variation. Values for saliva collected at the same time of day tend to remain consistent within subjects, but events such as stress, inflammation, infection, menstruation, or pregnancy may induce short-term changes. Long-term factors such as aging, systemic disease, or medication likewise may influence salivary protein concentrations. Such sources of variation may increase the sample size needed to find statistically significant differences. Clinical studies also must consider factors such as human population variation, strain and species differences in protein-microbe interactions, protein polymorphism, and synergistic or antagonistic interaction between proteins. Salivary proteins may form heterotypic complexes with unique effects, and different proteins may exert redundant effects. Patterns of protein-microbe interaction also may differ between oral sites. Future clinical studies must take those factors into account. Promising approaches might involve meta-analysis or multi-center studies, retrospective and prospective longitudinal designs, short-term measurement of salivary protein effects, and consideration of individual variation in multiple protein effects such as aggregation, adherence, and cell-killing.
A Critical Evaluation of Methods for Root Coverage
Authors: Goldstein M. , Brayer L. , Schwartz Z.
Published: January 2009

Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins. Although it seldom results in tooth loss, marginal tissue recession is associated with thermal and tactile sensitivity, esthetic complaints, and a tendency toward root caries. This article reviews the current surgical procedures for the coverage of exposed root surfaces, including their advantages and disadvantages. Today, the outcome of root coverage procedures is predictable, aesthetically acceptable, and, together with the use of guided tissue regeneration, at the forefront of regenerative procedures
Neural Control of Pulpal Blood Flow
Authors: Olgart L.
Published: January 2009

Blood flow of mammalian dental pulp is under both remote and local control. There is evidence for the existence of parasympathetic nerves in the pulp, but functionally the cholinergic influence is weak, and the physiological significance of this autonomic system seems to be low. The evidence for sympathetic vasoconstrictor nerves in the pulp is robust, and there is convincing support for the contention that these nerves play a physiological role, operating via release of noradrenaline and neuropeptide Y. However, there is no significant functional evidence in support of sympathetic beta-adrenoceptor-mediated vasodilation in the pulp. The local control of blood flow involves a subset of intradental sensory nerves. By virtue of their neuropeptide content, these afferent fibers cause vasodilation and inhibit sympathetic vasoconstriction in response to painful stimulation of the tooth. Such locally governed control may serve to meet immediate demands of the pulp tissue. A locally triggered reflex activation of sympathetic nerves in the pulp may modulate this control and limit its magnitude. Thus, there are competitive interactions between local and remote vascular controls which may be put out of balance in the injured and inflamed dental pulp.
Bioavailability of Components of Resin-Based Materials Which Are Applied To Teeth
Authors: Hume W.R. , Gerzina T.M.
Published: January 2009

Chemical components of many materials used in dental practice can move into the local biophase, where they can have beneficial or adverse effects. The strongest indirect evidence that components of resin-based materials used in dentistry can move into the biophase are the many reports of allergic dermatitis in dental personnel. Direct measurement of component release has shown that triethylene glycol dimethacrylate (TEGDMA), hydroxyethyl methacrylate (HEMA), and, in the case of some orthodontic cements, bis-glycidyl methacrylate and benzoyl peroxide can move into an aqueous medium from a range of resin-based materials which are applied to teeth as part of oral care. In the case of resin composite restorations, HEMA and TEGDMA are available in microgram quantities via the salivary surface in the minutes and hours after clinical placement and via dentin and pulp in the hours and days after placement. Fortunately, moderate thickness of dentin protects pulp tissue against local toxicity. There are no data which suggest that systemic toxicity is a risk with any of these materials. There are some case reports of allergic responses to the monomers in patients, but the incidence of such responses appears at present to be much lower than that in dental personnel.
Human Oral Microbial Ecology and Dental Caries and Periodontal Diseases
Authors: Liljemark W.F. , Bloomquist C.
Published: January 2009

In the human oral cavity, which is an open growth system, bacteria must first adhere to a surface in order to be able to colonize. Ability to colonize a non-shedding tooth surface is necessary prior to any odontopathic or periodontopathic process. Complex microbe-host relationships occur and must be studied before the commensal-to-pathogenic nature of the human indigenous oral flora can be understood. Medical pathogens, if present in the appropriate host, always produce specific disease. Caries and periodontal diseases are conditional diseases, requiring numbers of certain indigenous species at various sites, particularly the tooth surface. In the case of caries, the condition is related to sugar consumption. Periodontal disease/s may require certain host and environmental conditions, such as local environment or nutritional factors in gingival crevicular fluids. Nonetheless, critical numbers of certain indigenous species must be present in order for these diseases to occur. The aim of this review is to understand the acquisition of the indigenous oral flora and the development of human dental plaque. The role of the salivary pellicle and adherence of indigenous bacteria to it are critical first steps in plaque development. Bacterial interactions with saliva, nutritional factors, growth factors, and microbial physiologic processes are all involved in the overall process of microbial colonization.