Browsing by Subject "313 Dentistry"

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  • Gu, Ying; Lee, Hsi-Ming; Napolitano, Nicole; Clemens, McKenzie; Zhang, Yazhou; Sorsa, Timo; Zhang, Yu; Johnson, Francis; Golub, Lorne M. (2013)
  • Wilkman, Tommy; Apajalahti, Satu; Wilkman, Erika; Törnwall, Jyrki; Lassus, Patrik (2017)
    Purpose: The aim of the present study was to compare the resorption of the bone in the free scapular, free iliac crest, and free fibular microvascular flaps in mandibular reconstruction over time. Patients and Methods: In the present retrospective study, we analyzed 186 consecutive patients with scapular, fibular, or deep circumflex iliac artery (DCIA) osseous free microvascular flaps in mandibular reconstruction. We followed up the patients clinically and using multislice computed tomography (MSCT) with volume analyses of the bone. The volume of the bone was analyzed against time. Results: A total of 38 patients fulfilled the study criteria. Resorption of the osseous flaps was found to continue for several years. At 2 years, the volume loss was 14% for the scapula, 3% for the DCIA, and 1% for the fibula. Three-dimensional (3D) volume analysis of the MSCT scans showed more resorption than 2-dimensional analyses of the radiographs. Postoperative radiation therapy, patient age, and patient gender did not correlate with bone resorption. Conclusions: After microvascular mandibular reconstruction, the volume reduction over time is the least in the fibula and the greatest in scapula, with that of the DCIA in between. The volume reduction continues for several years in all of these. For assessment of the volume reduction of osseal reconstruction, a 3D volume analysis is more reliable than height by width measurements. (C) 2016 American Association of Oral and Maxillofacial Surgeons
  • Kallio, Jouko; Kauppila, Timo; Lasse, Suominen; Heikkinen, Anna Maria (2017)
  • Nieminen, Mikko Tapani; Novak-Frazer, Lily; Rautemaa, Vilma; Rajendran, Ranjith; Sorsa, Timo; Ramage, Gordon; Bowyer, Paul; Rautemaa-Richardson, Riina (2014)
  • Stape, Thiago Henrique Scarabello; Seseogullari-Dirihan, Roda; Tjäderhane, Leo; Abunas, Gabriel; Marcondes Martins, Luis Roberto; Tezvergil-Mutluay, Arzu (2018)
    In dentistry, the wet-bonding approach relies on water to maintain demineralized collagen expanded for proper resin infiltration; nevertheless, hydrolytic instability of the resin-dentin interface is inevitable with current bonding techniques. Considering dimethyl sulfoxide's (DMSO) ability to "biomodify" collagen and precipitate enzymes, the aim was to test whether the use of DMSO would permit adequate resin bonding to H3PO4-etched dehydrated dentin and assess its impact on collagen degradation by host-derived enzymes. Etched dentin surfaces from extracted sound human molars were randomly bonded in wet or dry conditions using aqueous or ethanolic DMSO solutions as pretreatments and bonding resins with or without DMSO. Bonded teeth were sectioned into resin-dentin slabs for confocal in situ zymography and beams for microtensile bond strength test. Demineralized powdered dentin was incubated in the tested DMSO -media and a hydroxyproline assay evaluated dissolution of collagen peptides. Zymography was performed on protein extracts obtained from dry and wet H3PO4-ecthed dentin powder treated with the DMSO- media. The correlative biochemical analysis demonstrated that reduction of water content during dentin hybridization by the innovative dry-bonding approaches with DMSO is effective to inactivate host-derived MMP-2 and MMP-9 and thus reduce collagen degradation while simultaneously optimizing resin-dentin bonding.
  • Räisänen, Ismo T.; Heikkinen, Anna Maria; Pakbaznejad Esmaeili, Elmira; Tervahartiala, Taina; Pajukanta, Riitta; Silbereisen, Angelika; Bostanci, Nagihan; Sorsa, Timo (2019)
    Background This cross-sectional study aims to investigate if a point-of-care (PoC) test of active matrix metalloproteinase-8 (aMMP-8) predicts levels of inflammation amplifier triggering receptor expressed on myeloid cells-1 (TREM-1) and its putative ligand the neutrophil peptidoglycan recognition protein 1 (PGLYRP1) in saliva. Methods Forty-seven adolescents, aged 15 to 17 years, were tested with aMMP-8 PoC test, which was followed by a full-mouth clinical examination of the assessment of periodontal, mucosal, and oral health. TREM-1 and PGLYRP1 levels were analyzed by ELISA. The immunofluorometric assay (IFMA) specific for aMMP-8 was used as the reference method. Results Fourteen saliva samples out of a total of 47 showed positivity for aMMP-8 PoC test. Both the TREM-1 and the aMMP-8 (IFMA) levels were significantly elevated among the aMMP-8 PoC test positives compared with the PoC test negatives (P <0.05). Moreover, aMMP-8 levels assessed by IFMA showed a strong positive correlation with TREM-1 levels in saliva (r = 0.777, P <0.001). The number of sites with a probing depth of >= 4 mm was significantly lower among the adolescents that had a negative aMMP-8 PoC test result, and TREM-1 levels <75 pg/mL (P <0.05). In contrast, adolescents with a positive aMMP-8 PoC test result (i.e., elevated aMMP-8 levels) together with elevated TREM-1 levels had a significantly higher number of periodontal pockets with >= 4 mm (P <0.001). Conclusion The present study validated usability of aMMP-8 PoC test for predicting "proinflammatory" salivary profile and periodontal health status in adolescents.
  • Haapaniemi, Aaro; Mäkitie, Antti; Kekolahti, Pekka; Ryynänen, Olli-Pekka (2019)
  • Kormi, Eeva; Snall, Johanna; Tornwall, Jyrki; Thoren, Hanna (2016)
    Purpose: The aim of the study was to clarify the use of perioperative glucocorticoids (GCs) in association with oral and maxillofacial surgical procedures. Materials and Methods: We conducted a survey of consultant oral and maxillofacial surgeons (OMSs) working in tertiary and secondary referral hospitals in Finland. Results: The administration of GCs is common among OMSs (85.2% of respondents), especially in association with orthognathic surgery (100% of respondents) and facial fractures (43.5%). All OMSs who administered GCs reported that they reduce swelling. The next most common reasons for administering GCs were established practice (43.5%) and pain reduction (39.1%). The regimens differed widely from a 5-mg single dose to a 116-mg total dose of dexamethasone equivalent. Conclusions: GCs are widely administered by OMSs, especially in major surgery. The literature shows some benefits of their use in dental and orthognathic operations, and their use seems rather safe. Proof of efficacy remains to be determined for other major maxillofacial surgical procedures; thus further studies are needed. (C) 2016 American Association of Oral and Maxillofacial Surgeons
  • Vehkalahti, Miira M; Swanljung, Outi (2020)
    Objectives To assess occurrence and its variation over time of serious accidental perforations during endodontic treatment and the fate of perforated teeth by tooth type and characteristics of patients and dentists. Materials and methods Data, based on patient documents on healthcare malpractice claims, comprised all endodontic injuries (n = 970) verified by the Patient Insurance Centre in Finland in 2002-2006 and 2011-2013. Two specialists in endodontics scrutinized the documents. Accidental perforations were recorded by location (tooth type, chamber/canals) and dichotomized as avoidable (could have been avoided by following good clinical practice) or unavoidable (normal treatment-related risks). Fate of perforation cases was recorded as treatment discontinued, root canal(s) filled, or tooth extracted. Background information included patients' and dentists' sex and age and the service sector. Statistical evaluation used Chi-square tests. Results Serious accidental perforations comprised 29% of all verified injuries. Most perforations were judged as avoidable: 93% in patients aged below 35 years, 87% when located in the pulp chamber or in molars (84%); 70% of all perforations and 75% of those in molars resulted in tooth extraction. The overall rate of serious accidental perforations was 17.6 cases per 100,000 endodontic patients per year. Conclusions The rate of serious accidental perforations increased over time. The majority was in molars and resulted in tooth extraction.
  • Räisänen, Ismo T.; Sorsa, Timo; van der Schoor, Gerrit-Jan; Tervahartiala, Taina; van der Schoor, Peter; Gieselmann, Dirk-Rolf; Heikkinen, Anna Maria (2019)
    This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. A total of 47 adolescents (30 boys/17 girls) aged 15-17 were first tested with the aMMP-8 PoC test, followed by a full-mouth evaluation of clinical parameters of oral health including periodontal, oral mucosal, and caries assessment. A periodontist performed these clinical examinations. The aMMP-8 PoC test result had much stronger association with subclinical periodontitis than the BOP 20% test (2.8-5.3 times stronger in terms of odds ratio). The aMMP-8 PoC test had >= 2 times higher sensitivity than the BOP 20% test with, generally, the same specificity. Further, the aMMP-8 PoC test had generally better accuracy and lower false negative percentages. The aMMP-8 PoC test seemed to be more effective than the conventional BOP test in detecting subclinical periodontitis/pre-periodontitis in adolescents reducing the risk of their undertreatment. However, the sample size may be a limiting factor, and more studies are needed to confirm our results for both adolescents and adults.
  • Sorsa, Timo; Alassiri, Saeed; Grigoriadis, Andreas; Räisänen, Ismo T.; Pärnänen, Pirjo; Nwhator, Solomon O.; Gieselmann, Dirk-Rolf; Sakellari, Dimitra (2020)
    The aim of this study was to investigate the utility of incorporating active matrix metalloproteinase-8 (aMMP-8) as a biomarker into the new periodontitis classification system (stage/grade) presented in 2018. This study included 150 Greek adults aged 25-78, of whom 74 were men and 76 women. Participants were tested with an aMMP-8 point-of-care mouthrinse test, after which a full-mouth clinical examination was performed to assess their periodontal and oral health. The aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal-Wallis test and Dunn-Bonferroni test for pairwise post-hoc comparisons; p <0.01 and p <0.05, respectively). Furthermore, aMMP-8 levels were less correlated with plaque levels than bleeding on probing (BOP) (Spearman's rho = 0.269, p <0.001; Spearman's rho = 0.586, p <0.001); respectively). Thus, aMMP-8 was more robust to the confounding effects of oral hygiene than traditional periodontal parameter bleeding on probing. The aMMP-8 point-of-care mouthrinse test can be utilized as an adjunctive and preventive diagnostic tool to identify periodontal disease, classified by stage and grade, and ongoing periodontal breakdown chairside in clinical practice in only 5 min. Overall, integrating aMMP-8 into the new periodontitis classification system seems beneficial.
  • Hernández, Marcela; Baeza, Mauricio; Räisänen, Ismo T.; Contreras, Johanna; Tervahartiala, Taina; Chaparro, Alejandra; Sorsa, Timo; Hernández-Ríos, Patricia (2021)
    Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients.
  • De Oliveira, Carine Ervolino; Dourado, Mauricio Rocha; Sawazaki-Calone, Iris; De Medeiros, Marcell Costa; Rossa Junior, Carlos; Cervigne, Nilva De Karla; Leon, Jorge Esquiche; Lambert, Daniel; Salo, Tuula; Graner, Edgard; Coletta, Ricardo D. (2020)
    Poor prognosis associated with the dysregulated expression of activin A in a number of malignancies has been related to with numerous aspects of tumorigenesis, including angiogenesis. The present study investigated the prognostic significance of activin A immunoexpression in blood vessels and cancer cells in a number of oral squamous cell carcinoma (OSCC) cases and appliedin vitrostrategies to determine the impact of activin A on angiogenesis. In a cohort of 95 patients with OSCC, immunoexpression of activin A in both blood vessels and tumor cells was quantified and the association with clinicopathological parameters and survival was analyzed. Effects of activin A on the tube formation, proliferation and migration of human umbilical vein endothelial cells (HUVECs) were evaluated in gain-of-function (treatment with recombinant activin A) or loss-of-function [treatment with activin A-antagonist follistatin or by stable transfection with short hairpin RNA (shRNA) targeting activin A] conditions. Conditioned medium from an OSCC cell line with shRNA-mediated depletion of activin A was also tested. The profile of pro- and anti-angiogenic factors regulated by activin A was assessed with a human angiogenesis quantitative PCR (qPCR) array. Vascular endothelial growth factor A (VEGFA) and its major isoforms were evaluated by reverse transcription-qPCR and ELISA. Activin A expression in blood vessels demonstrated an independent prognostic value in the multivariate analysis with a hazard ratio of 2.47 [95% confidence interval (CI), 1.30-4.71; P=0.006) for disease-specific survival and 2.09 (95% CI, 1.07-4.08l: P=0.03) for disease-free survival. Activin A significantly increased tubular formation of HUVECs concomitantly with an increase in proliferation. This effect was validated by reduced proliferation and tubular formation of HUVECs following inhibition of activin A by follistatin or shRNA, as well as by treatment of HUVECs with conditioned medium from activin A-depleted OSCC cells. Activin A-knockdown increased the migration of HUVECs. In addition, activin A stimulated the phosphorylation of SMAD2/3 and the expression and production of total VEGFA, significantly enhancing the expression of its pro-angiogenic isoform 121. The present fndings suggest that activin A is a predictor of the prognosis of patients with OSCC, and provide evidence that activin A, in an autocrine and paracrine manner, may contribute to OSCC angiogenesis through differential expression of the isoform 121 of VEGFA.
  • Sinha, Snehadri; Narjus-Sterba, Matilda; Tuomainen, Katja; Kaur, Sippy; Seppänen-Kaijansinkko, Riitta; Salo, Tuula; Mannerström, Bettina; Al-Samadi, Ahmed (2020)
    Mesenchymal stem cells (MSCs) are commonly isolated from bone marrow and adipose tissue. Depending on the tissue of origin, MSCs have different characteristics and physiological effects. In various cancer studies, MSCs have been found to have either tumor-promoting or tumor-inhibiting action. This study investigated the effect of adipose tissue-MSCs (AT-MSCs) and bone marrow-MSCs (BM-MSCs) on global long interspersed nuclear element-1 (LINE-1) methylation, the expression level of microenvironment remodeling genes and cell proliferation, migration and invasion of oral tongue squamous cell carcinoma (OTSCC). Additionally, we studied the effect of human tongue squamous carcinoma (HSC-3)-conditioned media on LINE-1 methylation and the expression of microenvironment remodeling genes in AT-MSCs and BM-MSCs. Conditioned media from HSC-3 or MSCs did not affect LINE-1 methylation level in either cancer cells or MSCs, respectively. In HSC-3 cells, no effect of MSCs-conditioned media was detected on the expression ofICAM1, ITGA3orMMP1. On the other hand, HSC-3-conditioned media upregulatedICAM1andMMP1expression in both types of MSCs. Co-cultures of AT-MSCs with HSC-3 did not induce proliferation, migration or invasion of the cancer cells. In conclusion, AT-MSCs, unlike BM-MSCs, seem not to participate in oral cancer progression.
  • Emingil, Gulnur; Gurkan, Ali; Tervahartiala, Taina; Hernandez, Marcela; Özgül, Semiha; Sorsa, Timo; Alassiri, Saeed A (2019)
    Objectives: The aim of the present randomized, double-blind, placebo-controlled, parallel-arm study was to examine the effectiveness of a sub-antimicrobial dose of doxycycline (SDD) in combination with nonsurgical periodontal therapy, compared to nonsurgical periodontal therapy alone, on potential gingival crevicular fluid (GCF) biomarkers of periodontal tissue catabolism related to the clinical outcomes over a 12-month period. Materials and Methods: GCF was collected and clinical parameters were recorded from 30 periodontitis patients randomized either to an SDD or placebo group. The SDD group received SDD (20 mg) b.i.d for 3 months plus scaling and root planing (SRP), while the placebo group was given placebo capsules b.i.d for 3 months plus SRP. The patients were evaluated every 3 months during the 12-month study period. At each visit, clinical parameters and GCF sampling were repeated. Matrix metalloproteinase (MMP)-8, MMP-9, MMP-13, myeloperoxidase (MPO), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase-5 (TRAP-5) were determined by IFMA and ELISA. Results: Significant improvements were observed in all clinical parameters in both groups over 12 months (p < 0.0125) while the SDD group showed significantly better reduction in gingival index (GI) and pocket depth and a gain in clinical attachment compared to the placebo group (p < 0.05). GCF MMP-8 and OPG levels significantly reduced in the SDD group compared to baseline (p < 0.05). GCF MMP-9 significantly decreased in both groups compared to baseline (p < 0.05). GCF MPO significantly decreased at 3 and 9 months in the SDD group, while it significantly decreased at 6 months in the placebo group (p < 0.05). TRAP and MMP-13 could be detected in none of the samples. Conclusions: The present results indicate that three months of adjunctive usage of SDD to nonsurgical periodontal therapy compared to nonsurgical periodontal therapy alone in periodontitis patients results in further improvement of clinical periodontal parameters and GCF markers of periodontal tissue breakdown over a 12-month period. Beneficial effects of adjunctive SDD therapy is likely to be related to the reduced levels of two major periodontitis-associated MMPs, MMP-8 and -9, and their potential oxidative activator MPO.
  • Kautto, A.; Vehkalahti, M. M.; Ventä, I. (2018)
    The purpose of this study was to assess the age of patients at the time of extraction of third molars. Our data included all routine and surgical extractions of third molars (n = 8199 teeth) performed by general and specialist dentists of the public oral health services of the city of Helsinki over the period 2013-2014. Measurements included patient's age, gender, the identified third molar, the type of anaesthesia, the method of extraction, and the diagnosis at extraction. Patients' ages ranged from 10 to 99 years. We found significant differences between younger and older age groups: third molar extractions occurred more often for women than for men below the age of 30 years (P <0.001) and vice versa for patients older than 30. Extractions were more prevalent for the upper jaw (P <0.001), and surgical extractions were more common than routine extractions (P <0.001) below the age of 40 years, but the corresponding prevalences reversed after the age of 40 years. Diagnoses at extraction differed between younger and older patients. We conclude that the treatment pattern of third molars at public health services varies greatly over a lifetime, and that a greater variety exists than had been reported previously from oral and maxillofacial units.
  • Hiltunen, Kaija; Mäntylä, Päivi; Vehkalahti, Miira M (2021)
    Background: Population aging will likely have an impact on oral health care trends. The aim of this study was to describe age-and time-related trends in oral health care in people ages 60 and older in Public Oral Health Services (POHS) in Helsinki, Finland. Materials and methods: Material for the study comprised the electronic documentation of oral health care procedures performed on patients 60 years and older (N = 282,143) in POHS during 2007-2017. Patients were aggregated into 5-year age groups. The 5 most common treatment categories, restorations, periodontal treatment, extractions, endodontics, and prosthetics, were selected for analysis. Changes by time (calendar year) and differences by age group were shown as percentages and percentage points; corresponding trends were assessed by applying linear regression models to the data. Results: The attendance rate for these patients increased from 14.5% in 2007 to 23.1% in 2017, with the total number of visits increasing by 76.4% in the 11-year period. The average number of visits per patient decreased from 3.5 visits in 2007 to 3.0 visits in 2017. In 2007, 60.5% of patients received restorative treatment and 41.3% received periodontal care. In 2017, the corresponding figures were 55.5% and 49.8%, respectively. The older the patient, the fewer the visits and restorative, periodontal, and endodontic treatments and the greater the rate of tooth extractions and prosthetics. Conclusion: A declining age group-related trend was recognized for restorative, periodontal, and endodontic treatments. Owing to ongoing population growth, POHS will be facing huge challenges in providing treatment for all individuals seeking services. (c) 2020 The Authors. Published by Elsevier Inc. on behalf of FDI World Dental Federation. This is an open access article under the CC BY-NC-ND license (
  • Vehkalahti, Miira M; Palotie, Ulla; Valaste, Maria (2021)
    Objectives: This study assessed age-related variation in the volume and content of restorative dental care performed by private dentists for adults in Finland in 2012-2017. Methods: This retrospective register-based observational study utilized the Social Insurance database of private dental services in 2012 and 2017, including all patients. The data were aggregated into 5-year age groups for 20-89-year-olds; those aged 90+ formed one group. A patient was one who had received at least one treatment, and a restoration patient one who received at least one restoration (direct/indirect), excluding prosthetic crowns. Attendance rate was the proportion of the population treated. Volume of restorative treatment was the proportion of restoration patients among all patients using private dental services. Content of restorative treatment was described as the number of teeth receiving restoration and the size of restoration (number of surfaces restored). Correlation coefficient demonstrated associations between age groups and numbers of restorations. Results: Rate of restoration patients was 64.8 % in 2012 and 61.1 % in 2017, the rate for individuals aged under 80 years in each calendar year being smaller than in previous years. Mean number of restorations received per patient was 1.59 in 2012 and 1.42 in 2017, increasing with age (r = 0.85 in 2012; r = 0.95 in 2017). Small restorations dominated; one to two surfaces were covered in 72.3 % and 75.5 % of restorations in 2012 and 2017, respectively. Conclusions: Volume and content of restorative dental care for adults vary by age and have decreased slightly over time. Clinical significance: Restorative treatments are a prominent part of dental care for adults. This paper sheds light on the entity of restorative dental care for adults visiting private dentists. Variation in restoration volume and content is shown according to patient's age group, and changes are assessed across six years.
  • Vehkalahti, M. M.; Palotie, U.; Valaste, Maria (2020)
    Aim To evaluate age-specific aspects and changes in volume and content of endodontic treatment for adults visiting private dentists in Finland in 2012 and 2017. Methodology This study utilized register-based data of private dental care. The observation unit of the aggregated macro-level data was age group, with 5-year age groups from 20 to 24 years onwards and the oldest group combining all patients aged 90 years and over. Data from years 2012 and 2017 included all the oral health care of 2.04 million patients receiving reimbursement for treatment by private dentists; a total of 183 932 patients received at least one endodontic treatment and were analysed. The number of teeth receiving endodontic treatment was counted separately as pulp cappings, pulpotomies and root canal fillings according to number of canals filled per tooth. Statistical associations were assessed as correlation coefficients. Results The mean age of endodontic patients was 53.6 years in 2012 and 55.9 years in 2017. In both years, 38% were aged from 50 to 64 years. In 2012, 9.9%, and in 2017, 8.0% of patients received at least one endodontic treatment; the older the patients, the fewer received endodontic treatment (r = -0.9). From 2012 to 2017, numbers of all patients and treatments decreased, endodontic patients and treatments even more notably, and in all age groups. Per thousand patients in 2017, 62.1 teeth received root canal treatment and 14.9 pulp capping. Pulp capping comprised 19.2%, pulpotomies 0.8% and root canal fillings 80.0% of teeth receiving endodontic treatment. Of root filled teeth, 45.1% received filling in one canal, 17.0% in two and 37.9% in three or more canals, multi-canal options being less frequent in older patients (r = -0.94). Conclusions Endodontic treatment, received by 9% of adult patients visiting private dentists in Finland, was strongly age-dependent, showing a decreasing trend with age and time.