Dental implants occasionally entail complications: Six to fifteen
percent of patients develop an inflammatory response in the years after
receiving a dental implant. This is caused by bacteria destroying the
soft tissue and the bone around the implant in the worst case.
In future, patients will benefit from a quick and affordable method
assessing whether they carry such bacteria: using a chewing gum based
diagnostic test developed by a pharmaceutical research team at the
Julius-Maximilians-Universität (JMU) Würzburg in Bavaria, Germany.
In practice, the test works as follows: If there is an inflammation
in the oral cavity, a bittering agent is released while chewing the gum.
Patients can then visit their dentist who confirms the diagnosis and
treats the disease. This type of early detection aims at preventing
serious complications such as bone loss.
"Anyone can use this new diagnostic tool anywhere and anytime
without any technical equipment," Professor Lorenz Meinel says; he is
the head of the JMU Chair for Drug Formulation and Delivery. He
developed the new diagnostic tool with Dr. Jennifer Ritzer and her team;
the invention is currently featured in an article in the journal Nature Communications.
Enzymes release bitter taste
The scientific background: In the presence of inflammatory
conditions, specific protein-degrading enzymes are activated in the
mouth. In just five minutes, these enzymes also break down a special
ingredient of the chewing gum, thereby releasing a bittering agent that
could not be tasted before.
Meinel's team provided the proof that this principle actually works.
First studies using the saliva of patients were conducted at Merli
Dental Clinic in Rimini.
Company establishment planned
To launch the chewing gum into the market, Meinel's team plans to
set up a company. The professor assumes that it will take two to three
years until the gum is commercially available.
Chewing gum rapid tests for other medical applications are presently
under development. "We hope to be able to diagnose other diseases with
our "anyone, anywhere, anytime" diagnostics to identify and adress these
diseases as early as possible," Meinel explains.
Tuesday, August 15, 2017
Monday, August 14, 2017
High sugar consumption gives rise to dental treatment costs in the billions
For their work the researchers evaluated representative data on the prevalence of caries, inflammation of the gums (parodontitis) and tooth loss, corresponding costs of treatment and the disease burden, as well as data on sugar consumption, in 168 countries for the year 2010. On the basis of this data they calculated the share of total costs attributable to excessive consumption of sugar. In addition to white household sugar, the researchers also focused their attention, in the analysis, to "hidden" sugar that is contained in many processed products, such as soft drinks, ketchup, ice cream and frozen foods, as well as breads, cakes and pastries.
"The data shows a clear correlation between the consumption of sugar and the incidence of caries, parodontitis and, as a result, tooth loss," said the lead author of the study, Dr Toni Meier from the Institute of Agricultural and Nutritional Sciences at the MLU. "For every additional 25 grams of sugar consumed per person and day - which amounts to roughly eight sugar-cubes or a glass of sweetened lemonade - the costs of dental treatment in high-income countries increase on average by 100 US dollars (75 euros) per person and year."
In Germany, the average daily sugar consumption lies between 90 and 110 grams per person. The costs of treatment amount to 281 US dollars (210 euros) per person and year. This puts Germany in the group of countries with the highest costs of treatment per person and year. Other countries "in the group" are Switzerland (402 US dollars, 300 euros), Denmark (238 US dollars, 178 euros) and the USA (185 US dollars, 138 euros). "If the target of 50 grams of sugar per person and day set by the World Health Organization could be reached, this would result in savings in the costs of treatment within Germany of 150 euros (201 US dollars) per person and year. Extrapolating this figure to the federal level shows annual potential savings of approximately 12 billion euros, or 16 billion US dollars," added Meier. A low-sugar diet is becoming increasingly difficult, however, since almost all processed products in the supermarket contain large quantities of added sugars.
The highest levels of sugar-related dental illness were observed by the researchers in Guatemala, Mauretania and Mexico. "Newly industrialised countries such as India, Brazil and Mexico, but also Pakistan and Egypt, could avoid an excessive burden of illness and of health care costs by anchoring the topic in their health and nutritional policies at an early stage," said the co-author of the study and nutrition scientist, Professor Gabriele Stangl of the MLU. This objective could be achieved by way of educational campaigns or by special taxation on high-calorie food. Such a sugar tax was introduced in Mexico in 2014 and already after one year was proving to be effective: the consumption of sugar-sweetened beverages had decreased by five percent. In the second year this decrease even doubled to ten percent.
"To be able to reduce the burden of nutrition-related illnesses, a balanced mix of educational work and food-policy initiatives, along with innovative technological solutions, are needed," said the co-author of the study, Dr Katja Riedel, joint coordinator of the NatLifE 2020 innovative alliance and program manager of system-products nutrition at BRAIN AG. The alliance co-financed by the German Federal Ministry of Education and Research aims, with the help of biotechnology and the understanding of biological systems, to develop a new generation of sustainably produced and biological active substances for foods and cosmetics and thereby to make a contribution towards improving human nutrition, health and well-being.
Monday, August 7, 2017
Man loses feeling in legs after long-term denture fixative use
The man was referred to a neurology clinic after developing numbness, pain and weakness in his legs. The symptoms, which had lasted for more than six months, stopped him from leaving the house.
An MRI (magnetic resonance imaging) scan revealed spinal cord abnormalities and after several tests he was diagnosed with copper deficiency myelopathy (CDM).
CMD is a neurological disorder which can cause loss of feeling and numbness in the arms and legs.
The man explained that he had been using 2-4 tubes of denture fixative that contained zinc every week for the past 15 years because of his ill-fitting false teeth.
Excess zinc intake can interfere with the absorption of copper, leading to neurological problems, in rare cases.
The man was advised to stop using the fixative and given copper supplements to treat his symptoms. But he didn't recover completely, and the doctors warn that irreversible nerve damage may be a consequence of a delayed diagnosis of CDM.
Wednesday, August 2, 2017
An end to cavities for people with sensitive teeth?
Tooth sensitivity commonly occurs when the protective layers of teeth are worn away, revealing a bony tissue called dentin. This tissue contains microscopic hollow tubes that, when exposed, allow hot and cold liquids and food to contact the underlying nerve endings in the teeth, causing pain. Unprotected dentin is also vulnerable to cavity formation. Plugging these tubes with a mineral called nanohydroxyapatite is a long-standing approach to treating sensitivity. But the material doesn't stand up well to regular brushing, grinding, erosion or acid produced by cavity-causing bacteria. Cui Huang and colleagues wanted to tackle sensitivity and beat the bacteria at the same time.
The researchers encapsulated nanohydroxyapatite and a green tea polyphenol -- epigallocatechin-3-gallate, or EGCG -- in silica nanoparticles, which can stand up to acid and wear and tear. EGCG has been shown in previous studies to fight Streptococcus mutans, which forms biofilms that cause cavities. Testing on extracted wisdom teeth showed that the material plugged the dentin tubules, released EGCG for at least 96 hours, stood up to tooth erosion and brushing and prevented biofilm formation. It also showed low toxicity. Based on these findings, the researchers say the mate
Tuesday, August 1, 2017
History of gum disease increases cancer risk in older women
Postmenopausal women who have a history of gum
disease also have a higher risk of cancer, according to a new study of
more than 65,000 women.
The study, led by researchers at the University at Buffalo, is the first national study of its kind involving U.S. women, and the first to focus specifically on older women. It's also the first study to find an association between periodontal disease and gallbladder cancer risk in women or men. The findings were published today (Aug. 1) in the journal Cancer Epidemiology, Biomarkers & Prevention.
"This study is the first national study focused on women, particularly older women," said Jean Wactawski-Wende, the study's senior author.
"Our study was sufficiently large and detailed enough to examine not just overall risk of cancer among older women with periodontal disease, but also to provide useful information on a number of cancer-specific sites," added Wactawski-Wende, dean of UB's School of Public Health and Health Professions and a professor of epidemiology and environmental health.
The study included 65,869 postmenopausal women enrolled in the Women's Health Initiative, an ongoing national prospective study designed to investigate factors affecting disease and death risk in older American women. The average age of the participants was 68, and most were non-Hispanic white women.
As part of a follow-up health questionnaire, participants were asked "Has a dentist or dental hygienist ever told you that you had periodontal or gum disease?"
Women who reported a history of gum disease had a 14 percent increased risk of overall cancer. Of the 7,149 cancers that occurred in the study participants, the majority -- or 2,416 -- were breast cancer.
"There is increasing evidence that periodontal disease may be linked to an increased cancer risk and this association warrants further investigation," said the paper's first author, Ngozi Nwizu, who worked on the research while completing her residency in oral and maxillofacial pathology in UB's School of Dental Medicine and her doctorate in pathology (cancer epidemiology) at UB's Roswell Park Cancer Institute Graduate Division. Nwizu is now an assistant professor of oral and maxillofacial pathology at the University of Texas Health Science Center at Houston.
The risk associated with periodontal disease was highest for esophageal cancer, the researchers reported. "The esophagus is in close proximity to the oral cavity, and so periodontal pathogens may more easily gain access to and infect the esophageal mucosa and promote cancer risk at that site," Wactawski-Wende said.
Gallbladder cancer risk also was high in women who reported a history of gum disease. "Chronic inflammation has also been implicated in gallbladder cancer, but there has been no data on the association between periodontal disease and gallbladder risk. Ours is the first study to report on such an association," Nwizu said.
The esophageal and gallbladder cancer findings are significant, Nwizu said. "Esophageal cancer ranks among the most deadly cancers and its etiology is not well known, but chronic inflammation has been implicated," she said.
"Certain periodontal bacteria have been shown to promote inflammation even in tiny amounts, and these bacteria have been isolated from many organ systems and some cancers including esophageal cancers. It is important to establish if periodontal disease is an important risk of esophageal cancer, so that appropriate preventive measures can be promoted."
Periodontal disease also was associated with total cancer risk among former and current smokers.
The findings for this particular age group are significant because they offer a window into disease in a population of Americans that continues to increase as people live longer lives.
"The elderly are more disproportionately affected by periodontal disease than other age groups, and for most types of cancers, the process of carcinogenesis usually occurs over many years," said Nwizu. "So the adverse effects of periodontal disease are more likely to be seen among postmenopausal women, simply because of their older age."
The study, led by researchers at the University at Buffalo, is the first national study of its kind involving U.S. women, and the first to focus specifically on older women. It's also the first study to find an association between periodontal disease and gallbladder cancer risk in women or men. The findings were published today (Aug. 1) in the journal Cancer Epidemiology, Biomarkers & Prevention.
"This study is the first national study focused on women, particularly older women," said Jean Wactawski-Wende, the study's senior author.
"Our study was sufficiently large and detailed enough to examine not just overall risk of cancer among older women with periodontal disease, but also to provide useful information on a number of cancer-specific sites," added Wactawski-Wende, dean of UB's School of Public Health and Health Professions and a professor of epidemiology and environmental health.
The study included 65,869 postmenopausal women enrolled in the Women's Health Initiative, an ongoing national prospective study designed to investigate factors affecting disease and death risk in older American women. The average age of the participants was 68, and most were non-Hispanic white women.
As part of a follow-up health questionnaire, participants were asked "Has a dentist or dental hygienist ever told you that you had periodontal or gum disease?"
Women who reported a history of gum disease had a 14 percent increased risk of overall cancer. Of the 7,149 cancers that occurred in the study participants, the majority -- or 2,416 -- were breast cancer.
"There is increasing evidence that periodontal disease may be linked to an increased cancer risk and this association warrants further investigation," said the paper's first author, Ngozi Nwizu, who worked on the research while completing her residency in oral and maxillofacial pathology in UB's School of Dental Medicine and her doctorate in pathology (cancer epidemiology) at UB's Roswell Park Cancer Institute Graduate Division. Nwizu is now an assistant professor of oral and maxillofacial pathology at the University of Texas Health Science Center at Houston.
The risk associated with periodontal disease was highest for esophageal cancer, the researchers reported. "The esophagus is in close proximity to the oral cavity, and so periodontal pathogens may more easily gain access to and infect the esophageal mucosa and promote cancer risk at that site," Wactawski-Wende said.
Gallbladder cancer risk also was high in women who reported a history of gum disease. "Chronic inflammation has also been implicated in gallbladder cancer, but there has been no data on the association between periodontal disease and gallbladder risk. Ours is the first study to report on such an association," Nwizu said.
The esophageal and gallbladder cancer findings are significant, Nwizu said. "Esophageal cancer ranks among the most deadly cancers and its etiology is not well known, but chronic inflammation has been implicated," she said.
"Certain periodontal bacteria have been shown to promote inflammation even in tiny amounts, and these bacteria have been isolated from many organ systems and some cancers including esophageal cancers. It is important to establish if periodontal disease is an important risk of esophageal cancer, so that appropriate preventive measures can be promoted."
Periodontal disease also was associated with total cancer risk among former and current smokers.
The findings for this particular age group are significant because they offer a window into disease in a population of Americans that continues to increase as people live longer lives.
"The elderly are more disproportionately affected by periodontal disease than other age groups, and for most types of cancers, the process of carcinogenesis usually occurs over many years," said Nwizu. "So the adverse effects of periodontal disease are more likely to be seen among postmenopausal women, simply because of their older age."
Wednesday, July 12, 2017
Diabetes causes shift in oral microbiome that fosters periodontitis
A new study led by University of Pennsylvania researchers has found that the oral microbiome is affected by diabetes, causing a shift to increase its pathogenicity. The research, published in the journal Cell Host & Microbe this week, not only showed that the oral microbiome of mice with diabetes shifted but that the change was associated with increased inflammation and bone loss.
"Up until now, there had been no concrete evidence that diabetes affects the oral microbiome," said Dana Graves, senior author on the new study and vice dean of scholarship and research at Penn's School of Dental Medicine. "But the studies that had been done were not rigorous."
Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome. But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes.
"My argument was that the appropriate studies just hadn't been done, so I decided, We'll do the appropriate study," Graves said.
Graves co-authored the study with Kyle Bittinger of the Children's Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet's Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases.
The researchers began by characterizing the oral microbiome of diabetic mice compared to healthy mice. They found that the diabetic mice had a similar oral microbiome to their healthy counterparts when they were sampled prior to developing high blood sugar levels, or hyperglycemia. But, once the diabetic mice were hyperglycemic, their microbiome became distinct from their normal littermates, with a less diverse community of bacteria.
The diabetic mice also had periodontitis, including a loss of bone supporting the teeth, and increased levels of IL-17, a signaling molecule important in immune response and inflammation. Increased levels of IL-17 in humans are associated with periodontal disease.
"The diabetic mice behaved similar to humans that had periodontal bone loss and increased IL-17 caused by a genetic disease," Graves said.
The findings underscored an association between changes in the oral microbiome and periodontitis but didn't prove that the microbial changes were responsible for disease. To drill in on the connection, the researchers transferred microorganisms from the diabetic mice to normal germ-free mice, animals that have been raised without being exposed to any microbes.
These recipient mice also developed bone loss. A micro-CT scan revealed they had 42 percent less bone than mice that had received a microbial transfer from normal mice. Markers of inflammation also went up in the recipients of the diabetic oral microbiome.
"We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome," said Graves.
With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice.
The findings "demonstrate unequivocally" that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.
Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene.
"Diabetes is one of the systemic disease that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control," he said. "And good oral hygiene can take the risk even further down."
Friday, July 7, 2017
New dental materials developed to stop degradation of demineralized dentin
A: Demineralized dentin with a number of collagen fibres, that if not preserved and remineralized, these can be degraded by the action of the dentinal proteolytic enzymes. B: Dentin treated with resin with fluoride-containing bioactive glass, which presents mineral precipitations – signs of remineralization.
Credit: Image courtesy of Asociación RUVID
Salvatore Sauro, Professor of dental
biomaterials and minimally invasive dentistry at CEU Cardenal Herrera
University, in Spain, has collaborated with several researchers from
Finland, Brazil, Belgium, Germany and the UK on the development of
innovative dental biomaterials for the regeneration of dental hard
tissues.
Bacterial plaque causes tooth decay due to acids produced by
different bacteria species; this has trigged an intense research
activity for the development of novel restorative biomaterials with
protective and self-healing remineralizing properties. In this new
study, Salvatore Sauro, a professor of CEU Cardenal Herrera University
(Spain) specialized in the development of innovative dental
biomaterials, has collaborated with several researchers from Finland,
Brazil, Belgium, Germany and the United Kingdom in order to accomplish
this target. Indeed, this international group of research generated two
new dental restorative biomaterials containing bioactive glasses, and
assessed their effectiveness in reducing the enzymatic auto-degradation
of collagen fibres and evoking their remineralization.
The aim of the study was to evaluate the inhibition of endogenous proteolytic enzymes of dentin and the remineralization induced by two different innovative experimental resins containing bioactive glasses: one containing micro-particles of Bioglass 45S5 and the other one containing micro-particles of an experimental bioactive glass enriched with fluoride and high amount of phosphates. Their anti-degradation effects was evaluated on completely demineralized human dentin specimens after immersion in artificial saliva for a period of thirty days by means of an immunohistochemical process. The remineralization evoked by such experimental bioactive resins was also evaluated by means of infrared spectroscopy and scanning electron microscopy.
Greater effectiveness with fluoride and phosphates
According to Professor Salvatore Sauro and his co-authors, " the resin-based material containing the experimental bioactive glass enriched with fluoride and phosphates resulted to be more efficient in inhibiting the enzymatic-mediated degradation of demineralized dentine collagen, and more bioactive than the one containing Bioglass 45S5. This was mainly due to the fluoride ions as well as to the large amount of phosphates released by the material, which accelerated dentin remineralization and reduced the degradation of demineralized dentin collagen via inhibition of matrix metalloproteinases and cysteine cathepsins.
This type of experimental bioactive material would therefore be more suitable for the development of new restorative dental materials for the clinical treatment of the dental caries.
Publication in the Journal of Dental Research
Professor Sauro perform his research activity mainly at CEU Cardenal Herrera University, (Spain) as well as at King's College London (UK) where he has an honorary position as research senior lecturer. He spends most of his time in the development of minimally invasive treatments and therapeutic bioactive dental composites for the treatment and restoration of caries affected dentin, such as those tested in this study -- which seem to be able to prevent the degradation of dentin collagen and evoke the remineralization of demineralized dental tissues. In this study, Dr Salvatore Sauro collaborated with researchers from the Department of Restorative Dentistry of the University of Turku (Finland); the Faculty of Dentistry of the University of Fortaleza (Brazil); the Biomaterials Group of the University of Ghent (Belgium); the Friedrich Schiller University of Jena (Germany); and the Dental Institute of King's College London (United Kingdom), institution of which Salvatore Sauro is a Visiting Senior Lecturer.
The study is published in the Journal of Dental Research.
The aim of the study was to evaluate the inhibition of endogenous proteolytic enzymes of dentin and the remineralization induced by two different innovative experimental resins containing bioactive glasses: one containing micro-particles of Bioglass 45S5 and the other one containing micro-particles of an experimental bioactive glass enriched with fluoride and high amount of phosphates. Their anti-degradation effects was evaluated on completely demineralized human dentin specimens after immersion in artificial saliva for a period of thirty days by means of an immunohistochemical process. The remineralization evoked by such experimental bioactive resins was also evaluated by means of infrared spectroscopy and scanning electron microscopy.
Greater effectiveness with fluoride and phosphates
According to Professor Salvatore Sauro and his co-authors, " the resin-based material containing the experimental bioactive glass enriched with fluoride and phosphates resulted to be more efficient in inhibiting the enzymatic-mediated degradation of demineralized dentine collagen, and more bioactive than the one containing Bioglass 45S5. This was mainly due to the fluoride ions as well as to the large amount of phosphates released by the material, which accelerated dentin remineralization and reduced the degradation of demineralized dentin collagen via inhibition of matrix metalloproteinases and cysteine cathepsins.
This type of experimental bioactive material would therefore be more suitable for the development of new restorative dental materials for the clinical treatment of the dental caries.
Publication in the Journal of Dental Research
Professor Sauro perform his research activity mainly at CEU Cardenal Herrera University, (Spain) as well as at King's College London (UK) where he has an honorary position as research senior lecturer. He spends most of his time in the development of minimally invasive treatments and therapeutic bioactive dental composites for the treatment and restoration of caries affected dentin, such as those tested in this study -- which seem to be able to prevent the degradation of dentin collagen and evoke the remineralization of demineralized dental tissues. In this study, Dr Salvatore Sauro collaborated with researchers from the Department of Restorative Dentistry of the University of Turku (Finland); the Faculty of Dentistry of the University of Fortaleza (Brazil); the Biomaterials Group of the University of Ghent (Belgium); the Friedrich Schiller University of Jena (Germany); and the Dental Institute of King's College London (United Kingdom), institution of which Salvatore Sauro is a Visiting Senior Lecturer.
The study is published in the Journal of Dental Research.
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