Background-The CXC chemokine receptor 4 (CXCR4) and its ligand, stromal cell-derived factor-1 (SDF-1α or CXC chemokine ligand 12) are involved in the trafficking of leukocytes into and out of extravascular tissues. The purpose of this study was to determine whether SDF-1α secreted by host cells plays a role in recruiting inflammatory cells into the periodontia during local inflammation.
Background
Aromatase inhibitor (AI) use results in low estrogen levels which in turn affect bone mineral density (BMD). Periodontitis, alveolar bone loss, and tooth loss are associated with low BMD. The goal of this study was to assess the prevalence of periodontitis, perceived oral health, and evaluate salivary biomarkers in postmenopausal women who are early stage (I-IIIA) breast cancer (BCa) survivors and receive adjuvant AI therapy.
Methods
Participants included 58 postmenopausal women; 29 with BCa on AIs and 29 controls without BCa diagnoses. Baseline periodontal status was assessed with: (1) periodontal pocket depth (PD); (2) bleeding on probing (BOP); and (3) attachment loss (AL). Demographic and dental utilization information was gathered by questionnaire. Linear regression modeling was used to analyze the outcomes.
Results
No differences in mean PD or the number of teeth were found. The AI group had significantly more sites with BOP (27.8 vs. 16.7; p = 0.02), higher worst-site AL (5.2 mm vs. 4.0 mm; p < 0.01) and more sites with dental calculus than did controls (18.2 vs. 6.4; p < 0.001). Linear regression adjusted for income, tobacco use, and dental insurance, and previous radiation and chemotherapy exposure demonstrated AI use increased CAL over 2 mm (95% CI: 0.46 -3.92). Median salivary osteocalcin and Tumor Necrosis Factor levels were significantly higher in the BCa group than the control group.
Conclusions
This first investigation of the periodontal status of women initiating adjuvant AI therapy identifies this population as having an increased risk for periodontitis (NCT1272570).
This analysis failed to validate the theory that earlier high- or current low-dose OC use is associated with increased levels of gingivitis or periodontitis and suggests an important reexamination of the perceived association between OC use and periodontal diseases.
Many graduating dentists leave dental school feeling that they are not prepared to start and run a dental practice. The aim of this pilot study was to explore the knowledge and perceptions dental graduates have in the area of practice management. A twenty-item survey was mailed in the fall of 2008 to nearly half of the University of Michigan dental school alumni who had graduated between the years of 1997 and 2007. Respondents were asked about their demographics, practice characteristics, and perceptions of knowledge/experience regarding practice management skills at the present time as well as at graduation. Data were analyzed using descriptive and inferential statistics. The majority of respondents were general practitioners (84 percent) aged thirty to thirty-nine practicing between six and ten years with practice incomes reported to be greater than $300,000 per year (79 percent). Most dentists reported being either an owner or co-owner of the practice (57 percent), and 33 percent reported being an associate in the practice. Upon graduation, 7 percent of the respondents felt that they had a strong knowledge of accounting or human resource issues; this perception increased to 47 percent at the present time. Similarly, less than 6 percent of respondents felt they understood issues pertaining to dental insurance upon graduation; this perception increased to 68 percent after having spent time in the workforce. In contrast to the large increase in knowledge/experience in business aspects of dentistry that had accrued since graduation, most alumni reported only a 7 percent increase in their knowledge of the legal aspects of dental practice. Results from this study indicate that interventions are needed to increase graduating dentists' knowledge of practice management and close the gap between their knowledge and its application in real life. The majority of alumni believed there is a need to improve the curriculum focused on these aspects of dental practice.
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