Objectives: The purpose of this research was to evaluate the periodontal inflamed surface area (PISA) in persons with clinically severe obesity with or without diabetes. The PISA is thought of as the main contributor to any systemic inflammatory burden posed by periodontitis. The aforementioned disease is a chronic inflammatory condition characterized by a shift in the microbiological ecology and an increase in the inflammatory host response. This condition may affect more than teeth and their supporting structure. A relationship is thought to exist between periodontitis and systemic health; thus, periodontitis is thought to be a risk factor for various disorders such as diabetes. Methods: This study analyzed the baseline data of individuals participating in a prospective study investigating whether diabetes alters the subgingival microbial composition and/or bacteria RNA expression by comparing bacteria obtained from patients with and without diabetes both before and after bariatric surgery. Patients from Temple University’s Hospital Bariatric Surgery Program were selected based on inclusion and exclusion criteria for the parent study and analyzed in the present study. Medical data including BMI, HbA1c and fasting glucose were obtained. Following the dental examination, the periodontal epithelial surface area (PESA) affected by bleeding on probing (BOP) was quantified. PESA and PISA for each patient was calculated (Neese et al., 2008). Statistical analysis comparing non-diabetics and diabetics was performed using the non-parametric Mann-Whitney U Test. Results: Of the 8 participants, 25% were diabetic and 75% were non-diabetic. The mean PESA was 1785.20 ± 728.18 mm2 and 1544.80 ± 204.73 mm2 in patients with and without diabetes, respectively. The mean PISA was 875.10 ± 653.50 mm2 and 568.78 ± 181.38 mm2 in patients with and without diabetes, respectively. While both PESA and PISA were higher among those with diabetes, the differences did not reach statistical significance. Conclusions: These findings suggest that the inflammatory burden posed by periodontitis is greater in diabetics with obesity compared to non-diabetics with obesity. A larger sample size would be required to have appropriate statistical power to confirm the present findings. Such a study would provide a better understanding of the underlying systemic implications of periodontitis in diabetic and non-diabetic persons with clinically severe obesity. / Oral Biology

Objective: Prior to the advent of bonded orthodontic appliances each tooth was fitted with a band made from stainless steel. Traditionally they were cemented to the tooth with a zinc phosphate cement. This acted more as a luting agent then adding to the actual adherence of the band to the tooth. In addition, often times the cement would wash out and upon the band removal white spot lesions and or carious lesions were present. The development of glass monomer cements had a traumatic improvement over both the adhesion to the tooth and a diminishing of white spot lesions in part due to the release of fluoride. Since the advent of the acid-etch technique and the bonding of orthodontic brackets directly to the enamel various bonding adhesives were developed. The first and most popular bonding resins were chemical curing bonding systems. The general class of self-adhesive and/or self-etching orthodontic adhesives are of several types, including resin-modified cements, such as resin-modified glass ionomer cements, that exhibit self-adhesive properties to enamel, as well as self-etching primers that combine the conditioning and priming agents into one acidic, polymerizable composition for application to the tooth surface, and do not require separate etching and rinsing steps. Not only do resin modified glass ionomers have the benefit of chemically bonding to a clean and un-etched enamel surface, but these self-adhesive cements also release significant and continuous levels of fluoride ion. Recently investigators have explored adding antimicrobial agents in addition to fluoride in orthodontic adhesives. One such approach has been the addition of ZnO powder, a known compound with anti-microbial properties, to an orthodontic resin modified glass ionomer adhesive. It should also be noted that zinc ions and compounds have been shown to positively influence enamel remineralization and enhance apatite formation. The objective of this research is to evaluate the effect of the addition of an antimicrobial agent, zinc oxide powder, on selected mechanical properties of a resin modified glass ionomer orthodontic adhesive. Methods: A resin modified glass ionomer (Fuji Ortho LC), in its two-component, powder/liquid format were utilized in this study. Control specimens, according to manufacturer's directions for use, were prepared for both diametral tensile and microhardness testing with be prepared. Using the powder component provided in the marketed product; powder blends containing both 10 and 20 percent Zinc Oxide (by weight) will be added to the RMGI powder, and thoroughly mixed and blended to create a uniform powder blend. The mechanical testing will be performed on 8-10 disc specimens, approximately 6.2 mm diameter by 3.1 mm in height, using a standardized mixing and molds for each material. The specimens will be tested using the Instron 5569 testing machine at a crosshead speed of 0.75 mm/minute for DTS until failure occurs. Data was recorded in Newton’s (N) force. The microhardness testing was performed on 12 disc specimens, approximately 6.2 mm diameter by 3.1 mm in height, using a standardized mixing and molds for each material. A CSM microindentation testing device was used to measure theVickers microhardness. The surface morphological evaluation of the specimens both control and experimental will be examined at 50 X magnification for comparison of surface characteristics and morphology. One-way ANOVA for comparison of time- and material-specific mean Vickers microhardness values and post hoc pair-wise comparisons was employed to assess statistically significant differences in the mean values (p<0.05). Results: The diametral tensile strength test of all specimens including the modified control and experimental showed incremental decreases in the DTS as compared to the control mixed as per the manufacturer’s specifications. The Vickers values illustrated minimal variation of Vickers microhardness for the control and experimental group. The surface morphological evaluation illustrated various differences between the control, modified control and the Zinc Oxide formulations. Conclusions: Alterations in the liquid powder ration of the orthodontic resin modified glass ionomer adhesive resulted in a reduction of the DTS. The addition of both 10% and 20% zinc oxide powder also resulted in a significant reduction of the DTS as compared to the manufacturers mix proportions of liquid and powder. The Vickers microhardness did not illustrate a significant alteration in any of the specimens. The addition of both 10% and 20% zinc oxide powder to the mixture reduced the modulus and stiffness as compared to both of the control groups. Lastly, the morphology of the experimental samples with the zinc oxide showed a more irregular surface at the fracture site. / Oral Biology

Objectives: The ball-tipped World Health Organization (WHO) periodontal probe is widely employed to measure periodontal probing depths, and to detect dental calculus and overhanging margins of dental restorations, in epidemiologic surveys of periodontal status in population groups. However, the ability of the WHO probe to reliably identify subgingival dental calculus on tooth root surfaces has received little attention. This study assessed, using an in vitro typodont model system, the ability of a WHO periodontal probe, as compared to an ODU 11/12 dental explorer, to accurately detect the presence of subgingival dental calculus. Methods: Three typodont models of the human oral cavity, comprised of white plastic teeth emerging from pink silicone gingival and palatal soft tissues, and presenting a total of 108 subgingival sites on mandibular posterior plastic teeth, of which 57 (52.8%) had artificial dental calculus deposits, were mounted in manikin phantom heads with simulated soft tiss / Oral Biology

Objectives: To study the effect of the recombinant human bone morphogenetic protein-2 (rhBMP-2) on sinus volumetric and histometric changes after sinus floor augmentation compared to a conventional approach utilizing other bone grafting materials, such as autografts, allografts, and xenografts. Materials and methods: A search of 3 electronic databases, including PubMed/MEDLINE, EMBASE, Cochran Library Central, and a hand search for peer- reviewed journal relevant articles were performed. Relevant articles that were published between the years of 1999-2019 were included in the search. Human clinical trials with data on comparison of sinus volumetric and histometric outcomes with and without the use of rhBMP-2 in sinus grafting procedures, with 10 or more augmentation sites in each study group, and with a follow-up period of at least 3 months, were included. Variables such as the primary outcome (vertical bone level gain) and the secondary outcome (including implant survival rate, bone density, and the histological parametrics) that were recorded for each study was compared and analyzed. Results: Seven randomized controlled trials (RCTs) were included. The two approaches (conventional bone grafting compared to bone morphogenic proteins (BMPs)) demonstrated comparable effectiveness for both clinical and histomorphometric measures. Conclusions: This systematic review revealed that the use of rhBMP-2 in maxillary sinus floor augmentation achieved similar clinical and histometric outcomes when compared to conventional sinus grafting procedures after a healing period of at least 3 months or longer. Currently, the concentration and amount of rhBMP-2 utilized to gain bone formation in maxillary sinus floor augmentation remains unclear and will need further clinical studies completed. / Oral Biology

As orthodontics integrates more digital imagery it has become necessary to reconfigure and adapt the Coben analysis. In its original paper-based form, it is exceedingly time consuming. The objective of this project was to: 1.) Create a novel method for analyzing radiographic cephalometric images in a digital manner using the Coben analysis. 2.) Compare the original norms and standard deviations to the measurements taken on today's patients. 3.) Address any changes in the norms due to secular trends. In the present study 279 digital cephalometric radiographs were separated into 3 age groups by sex. The breakdown is as follows: 53 males age 7-10 with a median age of 8.17 years, 43 females age 7-10 with a median age of 8.67 years, 45 males age 11-14 with a median age of 11.58 years, 50 females age 11-14 with a median age of 11.52 years, 41 males age 15-18 with a median age of 16.08 years and 47 females with a median age of 16.33 years. The cephalometric radiographs were digitally traced using Coben analysis standards to compare to the original Coben analysis norms and assess any differences in secular trends. Based on the results collected, the following conclusions were drawn: 1. As evidenced by the larger standard deviations in the current study compared to the original study, more individual variation exists among the facial skeletal components that form a Class I occlusion than previously thought. 2. We recommend 3.8° should be used for the S-N angle mean in males age 11-14 and 2.9° for females age 11-14 as opposed to the 7° suggested by the original study 3. The hand tracing method previously employed uses graph paper with the coordinate system enlarged 8% to compensate for the 8% enlargement of the radiographic film. This is no longer necessary when tracing a digital cephalometric radiograph. 4. The distance from basion to articulare in this study is consistently within one standard deviation of the original study's measurements for males and females. This distance appears stable for research purposes. 5. The Coben analysis linear and proportional measurements need not be adjusted due to the vast array of variables present in any population which include, but are not limited to, variation in comparative sample populations, genetics, polymorphisms, or endocrine disrupting chemicals. / Oral Biology

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