Objective Oral biofilm formation and progression on the surface of the tooth can lead to advanced oral disease such as gingivitis. The purpose of this randomized, controlled, double-blinded study was to evaluate the effects of a novel dental gel on oral plaque biofilm using multimodal imaging techniques. Materials and Methods Twenty-five subjects with moderate gingival inflammation (Löe and Silness Gingival Index ≥ 2) and pocket depths <4 were randomly assigned to brush twice daily for 21 days with the test or the control dental gel. In vivo multimodality in situ imaging was performed over a 3-week period using in vivo Optical Coherence Tomography (OCT) and Non-Linear Optical microscopy (NLOM). Plaque levels, gingival inflammation and gingival bleeding were also charted on days 0, 7, 14, and 21 using standard clinical indices. Results After 3 weeks, OCT and NLOM images showed a macroscopic break-up of the plaque layer and smaller, fragmented residual deposits in the test group with no apparent changes in the pellicle. Biofilm was also reduced in the control group, but to a lesser degree with regard to thickness, continuity and surface area. Paralleling these imaging results, clinical indices were significantly improved in both groups (P <0.05) and significantly lower in the test group (P <0.05). Conclusion Both dental gels reduced oral biofilm with the test gel showing greater efficacy (P <0.05) as determined by clinical and imaging parameters.
Background and Objectives Few studies have been published that evaluate the usefulness of different caries-diagnostic modalities in general dental practice. The goal of this study was to compare the results of screening for coronal dental caries in a general dental practice using clinical observations, radiographs, laser fluorescence (DIAGNOdent™) (LF), and optical coherence tomography (OCT). Diagnostic agreement between OCT and LF versus standard clinical techniques for detecting caries was determined in 40 subjects. Study Designs/Materials and Methods Forty patients with >1 coronal carious lesion as determined by prescreening using clinical examination and radiographs were enrolled in this study. Subjects with gross caries were excluded. Subsequently each patient underwent a full detailed dental examination by an experienced clinician, using visual examination and radiographs according to standard clinical practice. The coronal surfaces of a total of 932 teeth were examined and charted. Teeth were then photographed, rediagnosed using the LF system, and imaged using OCT. Two blinded pre-standardized examiners reviewed radiographic and OCT images and assigned caries status. Results Based on manufacturer’s cutoff values, sensitivity and specificity for coronal caries using LF technique (i) on unaltered tooth surfaces were 73.7% and 94.1%, respectively and (ii) in previously restored or sealed teeth, they were 19.2% and 95.8%, respectively. LF technique was unable to assess tissue health underneath sealants and restorations. Clinician agreement (kappa [k]) regarding caries diagnosis using OCT imaging was overall 0.834 (SE = 0.034). Sensitivity and specificity for caries using OCT technique (i) on unaltered tooth surfaces approximated 74.1% and 95.7%, respectively and, (ii) in previously restored or sealed teeth, they approximated 76.0% and 95.6%, respectively. Although OCT was able to detect lesions beneath many resin restorations and sealants, results varied considerably between materials. OCT imaging was unable to detect caries when caries was >2 mm below the tooth surface. Conclusion These findings support the usefulness of LF for primary caries detection, and the clinical utility of OCT for early caries detection and monitoring under dental resin restorations and sealants.
Objective Electronic cigarettes have given rise to a new, largely unregulated market within the smoking industry. While generally supposed to be less harmful than traditional tobacco smoke, awareness of the biological effects of electronic cigarette liquid is still scarce. Our objective was to determine the impact of electronic cigarette flavoring and nicotine on gingival squamous cell carcinoma invasion, RAGE expression, and the elaboration of pro‐inflammatory molecules. Methods and Materials Gingival and tongue squamous cell carcinoma cells were exposed to Red Hot or Green Apple flavored electronic cigarette flavoring with or without nicotine. Immunofluorescence determined RAGE expression. Real‐time cellular invasion was assessed using a RTCA DP instrument. Culture medium was assayed for cytokine secretion. Results Compared to controls we observed: increased cell invasion in gingival cells with Red Hot electronic cigarette flavoring and decreased cell invasion with Green Apple; decreased cell invasion in tongue cells treated with Red Hot electronic cigarette flavoring and no differences in invasion with Green Apple; flavor and nicotine dependent increases in RAGE expression; and differential expression of IL‐1α, IL‐8, and MMP‐13. Conclusion We conclude that electronic cigarette flavoring and nicotine orchestrate differential regulation of oral squamous cell carcinoma (OSCC) cell invasion and inflammatory effects. This study provides an important initial step in dissecting RAGE‐mediated mechanisms of cancerous invasion and molecular avenues employed by OSCC.
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