Proximal contact loss between implant-supported FDPs and teeth occurred frequently and increased continuously over the follow-up period. The proximal contact loss significantly affected food impaction, but not the periodontal/peri-implant tissue conditions. Proximal contact loss should be carefully monitored during follow-up examinations in relation to food impaction.

Background Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in patients hospitalized in intensive care units. Recent studies suggest that dental plaque biofilms serve as a reservoir for respiratory pathogens. The goal of this study was to determine the genetic relationship between strains of respiratory pathogens first isolated from the oral cavity and later isolated from bronchoalveolar lavage fluid from the same patient undergoing mechanical ventilation with suspected VAP. Methods Plaque and tracheal secretion samples were obtained on the day of hospital admission and every other day thereafter until discharge from the intensive care unit from 100 patients who underwent mechanical ventilation. Bronchoalveolar lavage was performed for 30 patients with suspected VAP. Pulse-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of strains obtained from oral, tracheal, and bronchoalveolar lavage samples. Results Isolates of Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter species, and enteric species recovered from plaque from most patients were indistinguishable from isolates recovered from bronchoalveolar lavage fluid (i.e., had >95% similarity of pulse-field gel electrophoresis patterns). Nearly one-half of the Pseudomonas strains showed identical genetic profiles between patients, which suggested a common environmental source of infection. Conclusions Respiratory pathogens isolated from the lung are often genetically indistinguishable from strains of the same species isolated from the oral cavity in patients who receive mechanical ventilation who are admitted to the hospital from the community. Thus, dental plaque serves as an important reservoir for respiratory pathogens in patients who undergo mechanical ventilation. Trial registration ClinicalTrials.gov identifier: NCT00123123

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bProteins in human saliva are thought to modulate bacterial colonization of the oral cavity. Yet, information is sparse on how salivary proteins interact with systemic pathogens that transiently or permanently colonize the oral environment. Staphylococcus aureus is a pathogen that frequently colonizes the oral cavity and can cause respiratory disease in hospitalized patients at risk. Here, we investigated salivary protein binding to this organism upon exposure to saliva as a first step toward understanding the mechanism by which the organism can colonize the oral cavity of vulnerable patients. By using fluorescently labeled saliva and proteomic techniques, we demonstrated selective binding of major salivary components by S. aureus to include DMBT1 gp-340 , mucin-7, secretory component, immunoglobulin A, immunoglobulin G, S100-A9, and lysozyme C. Biofilm-grown S. aureus strains bound fewer salivary components than in the planctonic state, particularly less salivary immunoglobulins. A corresponding adhesive component on the S. aureus surface responsible for binding salivary immunoglobulins was identified as staphylococcal protein A (SpA). However, SpA did not mediate binding of nonimmunoglobulin components, including mucin-7, indicating the involvement of additional bacterial surface adhesive components. These findings demonstrate that a limited number of salivary proteins, many of which are associated with various aspects of host defense, selectively bind to S. aureus and lead us to propose a possible role of saliva in colonization of the human mouth by this pathogen. Saliva plays a key role in host defense against invading pathogens (1-4). Among the more than 2,000 proteins and peptides found in saliva (5), many exhibit direct antimicrobial activity (6). Others can bind to bacteria to facilitate either their colonization on oral surfaces or their clearance from the oral cavity through agglutination (7,8). It has been suggested that systemic pathogens can be killed, inactivated, or agglutinated by salivary components and, thus, become cleared from the oral cavity through swallowing, thereby preventing them from colonizing the oral cavity of healthy individuals (2, 9). Thus, binding of salivary proteins to pathogens is thought to play an important role in preventing systemic infections. In hospitalized patients, the protective and antimicrobial functions of saliva, which play a crucial role in host defense against invading pathogens (1-3), are frequently impaired by reduction of salivary flow or lack of salivary secretion (9-11). Under such conditions of dry mouth and poor oral hygiene, the normal commensal oral microflora shifts to a community that harbors a higher number of pathogens (12, 13).Among the various systemic pathogens in the oral cavity, attention has been given to Staphylococcus aureus (14, 15), since both endocarditis and pneumonia have been related to oral colonization by this organism (16,17). Studies have shown the occurrence of S. aureus in oral biofilm and saliva of healthy individuals (18), bu...

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The aim of this study was to investigate the effect of fluoride gel treatment on the bond strength between titanium alloys and composite resin, and the effect of NaF solution on the bond strength of titanium alloys. Five titanium alloys and one Co-Cr-Mo alloy were tested. Surface of the alloys were treated with three different methods; SiC polishing paper (No. 2000), sandblasting (50-microm Al2O3), and commercially available acidulated phosphate fluoride gel (F-=1.23%, pH 3.0). After treatment, surfaces of alloy were analyzed by SEM/EDXA. A cylindrical gelatin capsule was filled with a light-curable composite resin. The composite resin capsule was placed on the alloy surface after the application of bonding agent, and the composite resin was light cured for 30 s in four different directions. Shear bond strength was measured with the use of an Instron. Fluoride gel did not affect the surface properties of Co-Cr-Mo alloy and Ni-Ti alloy, but other titanium alloys were strongly affected. Alloys treated with the fluoride gel showed similar bond strengths to the alloys treated with sandblasting. Shear bond strength did not show a significant difference (p<0.05) regardless of treatment time (5, 10, and 20 min) of fluoride gel. After the ultrasonic cleaning subsequent to the fluoride-gel treatment, residues of fluoride ion or any other titanium-fluoride complexes were not detected. NaF solution did not reduce the shear bond strength of titanium alloys. To enhance the bond strength of composite resin to titanium alloys, fluoride-gel treatment may be used as an alternative technique to the sandblasting treatment.

Candida albicans often resides in the oral cavity of healthy humans as a harmless commensal organism. This opportunistic fungus can cause significant disease in critically ill patients, such as those undergoing mechanical ventilation in the intensive care unit (ICU) having compromised local airway defense mechanisms. The goal of this study was to determine the intra- and inter-patient genetic relationship between strains of C. albicans recovered from dental plaque, tracheal secretions, and the lower airway by bronchoalveolar lavage of patients undergoing mechanical ventilation. Three pulsed-field gel electrophoresis (PFGE) typing methods were used to determine the genetic relatedness of the C. albicans strains, including electrophoretic karyotyping (EK) and restriction endonuclease analysis of the genome using SfiI (REAG-S) and BssHII (REAG-B). The C. albicans isolates from dental plaque and tracheo-bronchial sites from the same patient were genetically indistinguishable and retained over time, whereas strains from different patients usually separated into different genotypes. Among the three methods, REAG-B proved to be the most discriminatory method to differentiate isolates. The finding of genetically similar strains from the oral and tracheo-bronchial sites from the same patient supports the notion that the oral cavity may serve as an important source for C. albicans spread to the trachea and lung of mechanically ventilated patients.

In recent years, international relationships in dentistry have grown stronger through journals, books, academies, seminars, researcher exchanges and so forth. Korea and Japan are neighbours in East Asia. However, no comparison of the dental education systems of the two countries has been published. Therefore, the authors have provided the present comparison to promote mutual understanding and to familiarise dentists around the world with dental education in these two countries. The number of dentists, life expectancy at birth, and number of decayed, missing, and filled teeth (DMFT) at age 12 years in Korea and Japan are summarised.