The present study was carried out to evaluate the effect of type 2 diabetes mellitus (DM) and smoking on periodontal parameters and on the levels of salivary matrix metalloproteinase (MMP-8). One hundred and twenty five subjects were divided into five groups: group 1, systemically and periodontally healthy subjects (n = 25); group 2, systemically healthy subjects but with chronic periodontitis (n = 25); group 3, subjects with type 2 DM and chronic periodontitis (n = 25); group 4, smokers with chronic periodontitis (n = 25); group 5, diabetic-smokers with chronic periodontitis (n = 25). MMP-8 level in saliva was estimated by enzyme linked immunosorbent assay (ELISA) using Quantikine human total MMP-8 immunoassay kit. The result showed that the clinical periodontal parameters and the mean levels of the salivary MMP-8 were significantly higher for diabetic-smokers than other study groups. A highly significant positive correlation (r) between MMP-8 and periodontal parameters was also observed in diabetic-smoker patients. The findings suggest that diabetic-smokers have increased periodontal breakdown and are associated with an increased extent and severity of periodontitis. (J Oral Sci 58, 1-6, 2016)

This cross-sectional study investigated the characteristics and prevalence of orofacial pain, and its associations with sociodemographic characteristics, in 319 university students: 188 second-year students in the Medical Faculty and 131 students in the Faculty of Technical Sciences at the University of Kosovska Mitrovica. A specially designed questionnaire was used to assess the prevalence and characteristics of pain. Among the 319 students, 101 (32%) reported previous orofacial pain, and pain was more frequent among women (P < 0.05). Logistic regression revealed that gender was an important predictor of pain and that the risk for pain development among women was 1.8 times that among men. Place of residence and relationship status were not associated with frequency of orofacial pain. The regions with the highest pain prevalences were the temporal region (7%; 95% confidence interval, 4-10%) and the region around the eye (6%; 95% confidence interval, 4-9%). The first episode of orofacial pain was less than 3 months previously in 59% of the participants, and 39% of students had sought professional medical help. (J Oral Sci 58, 7-13, 2016)

Submental tracheal intubation is a technique for use in patients with maxillofacial trauma. The purpose of this retrospective study was to evaluate the efficacy and complications of this technique compared with tracheostomy. Twenty-five patients underwent submental tracheal intubation since 2001. Submental tracheal intubation was performed in cases needing intermaxillary fixation complicated by a nasal pyramid or anterior skull base fracture. No severe perioperative or long-term complications were noted. Intra- and postoperative complications were observed in three patients. In one case, the tube was accidentally dislodged into the right main bronchus during submental tracheal intubation. Two patients developed skin infections. Submental scarring was undetectable, except for one patient with slight scarring. Submental tracheal intubation avoids the complications associated with tracheostomy and the difficulty of nasal intubation during intubation and surgery. Therefore, submental tracheal intubation is useful in the intraoperative management of patients with complex maxillofacial trauma. (J Oral Sci 58, 23-28, 2016)

As part of our ongoing investigation of risk and predictive factors associated with temporomandibular disorders, we used magnetic resonance imaging (MRI) to identify risk factors for sideways disk displacement of the temporomandibular joint in 26 patients with MRI-confirmed unilateral pure sideways disk displacement (medial or lateral disk displacement) and normal positioning of the contralateral temporomandibular joint. Coronal morphologic harmonization between the condyle and fossa, angle between the axis of the ramus and condyle, and angle between the lateral pterygoid muscle (LPM) and condyle were evaluated. Only angle of the LPM related to the condyle was significantly correlated with mediolateral disk position; the angles of joints with medial, normal, and lateral disk positions were 70.2°, 66.7°, and 60.1°, respectively. These results suggest that a greater angle of the inferior head of the LPM to the axis of the condyle on axial MRI images may cause medial disk displacement, while a smaller angle may result in lateral disk displacement. (J Oral Sci 58, 29-34, 2016)

The objectives of this study were to evaluate the effects of applying 0.50% chlorhexidine (CHX) gel using the dental drug delivery system (3DS) on salivary Streptococcus mutans (S. mutans) and on the surface topography of metal and ceramic orthodontic brackets. The study involved 20 orthodontic patients with high levels of salivary S. mutans. The patients were treated with professional mechanical tooth cleaning followed by application of 0.50% CHX using individual trays (3DS). Salivary S. mutans levels were repeatedly measured 1, 2, 4, and 8 weeks post-treatment. In vitro study utilized forty ceramic and metallic brackets that were immersed in 0.50% CHX gel for 10 min, whereas another untreated forty brackets served as controls. The frictional resistances of stainless steel wires to the brackets before and after CHX treatment were recorded using a universal testing machine. Scanning electron microscopy was used to compare changes in the surface topography of brackets. Statistical analyses were used to determine the effect of CHX on bacterial count and to evaluate the effect of CHX on frictional resistance. According to the results of this study, S. mutans levels were reduced significantly (P < 0.05). There were no significant changes in the frictional resistance and surface topography of brackets before or after application of CHX. (J Oral Sci 58, 35-42, 2016)

Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disease with a varied clinical presentation. The present clinical study was carried out to clarify the demographic and clinical profile of 108 patients with OLP. The patients were identified based on the diagnostic criteria proposed by van der Meij et al. (2003) modified from the WHO (1978) clinical and histopathologic definition of OLP. Information such as age, gender, clinical presentation and type of OLP, site of involvement, symptoms, extraoral involvement, history of systemic disease, familial occurrence and risk factors like chewing and smoking tobacco, chewing betel quid, alcohol consumption were obtained. Mean age of OLP patients was 45.4 years, and among the identified patients, 70.4% were females. The most frequent clinical type was the reticular form (80.6%). The OLP lesions were symptomatic in 77.8% of the patients. The buccal mucosa was the most affected site (87.9%) and multiple oral lesions were observed in 41.7% of the patients. Among the OLP patients, 36.1% and 4.7% reported chewing tobacco and smoking tobacco, respectively. Histopathologically, epithelial dysplasia was seen in two cases. The chronic nature of OLP warrants patient education, psychological support and long-term follow up. (J Oral Sci 58, 43-47, 2016)

A prospective cohort study was designed to measure marginal bone level changes at 36-month follow-up and to evaluate the influence of biologically relevant, anatomic and stress-related variables. STROBE guidelines were followed. Totally, 748 implants were inserted into 350 patients. Standardized periapical radiographs were taken at 2- (stage-two surgery), 12-, 24-, and 36-month follow-ups. Descriptive statistics were used and inter- and intra-examiner reliability were determined. A mixed-model was used to evaluate predictor variables. Statistical analysis was performed at implant level (statistical significance: P < 0.05). A total of 34 (4.5%) implants failed; of the 34 implants, 6 were early failures (0.8%) and 28 were late failures (3.7%). A total of 576 implants reached 36-month follow-up (mean follow-up: 25.58 months; SD: 10.32). Mean marginal bone remodeling was −0.56 mm. (SD: 1.30; range: −6.80 ± 3.65). A statistically significant, higher marginal bone loss was found for subcrestal implants and subcrestal implants inserted into the maxilla, for implants inserted into patients aged over 50 years, and for early-delayed implants inserted into patients aged over 50 years. In conclusion, a low, mean crestal bone loss at 36-month follow-up was recorded but implant positioning in the apico-occlusal dimension was found to be the most significant variable that influenced bone loss. (J Oral Sci 58, 49-57, 2016)

Matrix metalloproteinases (MMPs) and tumor-associated macrophages (TAMs) play important roles in tumor growth. The present study investigated the expression levels of MMP2 and MMP9 in relation to the distribution of TAMs in the primary and metastatic regions of oral squamous cell carcinoma. Twenty-nine cases of oral squamous cell carcinoma (OSCC) with regional lymph node metastasis were selected from available documents in the archives of the Department of Pathology, Nihon University School of Dentistry. Four-micrometer-thick sections were prepared from the primary and metastatic regions. Each section was subjected to immunohistochemical staining using anti-MMP2, anti-MMP9, and anti-CD68 antibodies. The distribution and localization of MMPs and TAMs were compared between primary and metastatic regions. The expression levels of both MMPs were higher in the metastatic regions of lingual and gingival cancers. Statistically significant differences were observed in both T1 and T2 cases. In contrast to the higher expression of MMPs in metastatic regions, a higher number of TAMs were distributed in the primary regions. From these results, MMP expression levels and the numbers of TAMs were expected to have an inverse relationship between the primary and metastatic regions of OSCC. (J Oral Sci 58, 59-65, 2016)

The aims of this study were to determine the incidence of malignant salivary gland tumors (MSGTs) in a specific in Spanish Mediterranean population, evaluate oncological outcomes, and identify prognostic factors for survival. Overall survival and disease-free survival rates were calculated for 23 patients with MSGTs who were treated in our department during 2004-2012. In the recruitment population of the reference hospital, annual incidence per 100,000 inhabitants was estimated, with corresponding 95% confidence intervals (CIs). The mean annual incidence of MSGTs was 0.91 new cases per 100,000 inhabitants (95% CI, 0.14-2.83). The most common histological type was squamous cell carcinoma (34.8%). Overall survival ranged from 2 to 120 months (mean 70.5 months). The 5-year overall survival rate was 52.5%, and the 5-year disease-free survival rate was 50%. The mean disease-free interval was 73.9 months (95% CI 47.1-100.7). Metastatic spread, tumor stage, perineural invasion, a submaxillary location, tumor size, histological grade, positive lymph node status, and presence of positive surgical resection margins were the most important factors in patient survival. Our results are consistent with those of other studies in relation to disease incidence but differ somewhat with respect to histological type. (J Oral Sci 58, 67-73, 2016)

Developmental dental anomalies have been associated with different malocclusions in various populations. This study verified this association in Brazilian non-syndromic orthodontic patients. The prevalence of dental anomalies was evaluated by examining 2,052 pretreatment records of orthodontic patients. Panoramic radiographs, study designs, intraoral photographs and medical history were collected in order to identify hypodontia, hyperdontia, microdontia, macrodontia, taurodontism, transposition, impaction, and ectopia. Epidemiological data and classification of malocclusion were also obtained. Data were analyzed using chi-square and Fisherʼs exact test (P < 0.05), and the prevalence ratio was obtained from cases that had a significant association between anomaly and malocclusion. The results showed that 27.4% of the patients evaluated had some dental anomaly, and most of them were white women aged 11-20 years. Ectopia, microdontia, impaction, and hypodontia were more prevalent in patients with Class I malocclusion. Macrodontia was the only anomaly associated with Class II division 1. Impaction was associated with Class III malocclusion, at a 1.84-times higher prevalence. In conclusion, impaction was correlated with Class I malocclusion; macrodontia showed association with Class II division 1; and impaction and ectopia were associated with Class III malocclusion in Brazilian orthodontic patients. (J Oral Sci 58, 75-81, 2016)

The oropharyngeal area can be a source of halitosis. However, the relationship between healthy tonsillar microbiota and halitosis is poorly understood. We conducted a pilot clinical study to clarify the effect of gargling with an antiseptic agent on tonsillar microbiota in patients with halitosis. Twenty-nine halitosis patients who did not have otolaryngologic disease or periodontitis were assigned randomly to one of three groups: benzethonium chloride (BZC) gargle; placebo gargle; no gargle. Concentrations of volatile sulfur compounds (VSCs) in mouth air, the organoleptic score (ORS) and tongue-coating score (TCS) were measured before and after testing. Tonsillar microbiota were assessed by detection of periodontal pathogens, and profiling with terminal-restriction fragment length polymorphism (T-RFLP) analysis and sequencing of 16SrRNA clone libraries for taxonomic assignment. Gargling with BZC reduced the concentrations of methyl mercaptan and hydrogen sulfide and the ORS, but did not affect the TCS or prevalence of periodontal pathogens. T-RFLP analyses and 16SrRNA clone sequencing showed a tendency for some candidate species to decrease in the test group. Although gargling of the oropharyngeal area with an antiseptic agent can reduce oral malodor, it appears that tonsillar microbiota are not influenced greatly. (J Oral Sci 58, 83-91, 2016)

A non-contact electromagnetic vibration device (NEVD) was previously developed to monitor the condition of periodontal tissues by assessing mechanical parameters. This system requires placement of an accelerometer on the target tooth, to detect vibration. Using experimental tooth models, we evaluated the performance of an NEVD system with a laser displacement sensor (LDS), which does not need an accelerometer. Simulated teeth (polyacetal rods) were submerged at various depths in simulated bone (polyurethane or polyurethane foam) containing simulated periodontal ligament (tissue conditioner). Then, mechanical parameters (resonant frequency, elastic modulus, and viscosity coefficient) were assessed using the NEVD with the following detection methods: Group 1, measurement with an accelerometer; Group 2, measurement with an LDS in the presence of the accelerometer; and Group 3, measurement with an LDS in the absence of the accelerometer. Statistical analyses were performed using nonparametric methods (n = 5) (P < 0.05). The three mechanical parameters significantly increased with increasing depth. In addition, the mechanical parameters significantly differed between the polyurethane and polyurethane foam models. Although Groups 1 and 2 did not significantly differ, most all mechanical parameters in Group 3 were significantly larger and more distinguishable than those in Groups 1 and 2. The LDS was more accurate in measuring mechanical parameters and better able to differentiate periodontal tissue conditions. (J Oral Sci 58, 93-99, 2016)

MicroRNAs (miRNAs) are small non-coding RNAs that regulate post-transcriptional expression by translational inhibition or mRNA degradation. miRNAs bind to target mRNAs through partial complementarity, and can regulate many genes. In the present study, we investigated the effects of miR-223 on the expression of inflammatory cytokines in human gingival fibroblasts (HGF). To determine the effects of miR-223 on the expressions of interleukin-1β (IL-1β) and IL-6, HGF were stimulated by IL-1β (1 ng/mL) or tumor necrosis factor-α (TNF-α; 10 ng/mL) and transfected with a miR-223 expression plasmid. Levels of mRNA for IL-1β, IL-6, inhibitor of kappa-B kinase α (IKKα) and mitogen-activated protein kinase phosphatase-5 (MKP-5) were measured by real-time PCR, and levels IL-1β, IL-6 and IKKα protein were determined by enzyme-linked immunosorbent assay and Western blotting. Expression of IL-1β and IL-6 mRNAs was induced by IL-1β and TNF-α and further increased by miR-223 overexpression. IL-1β and TNF-α induced the expression of IL-1β and IL-6 mRNAs, and this was reduced by miR-223 inhibitor. Overexpression of miR-223 decreased the levels of IKKα protein and MKP-5 mRNA in HGF. These findings indicate that miR-223 might control the inflammatory response via IKKα and MKP-5 in periodontal tissue. (J Oral Sci 58, 101-108, 2016)

Our study aimed to examine facial asymmetry in patients with unilateral cleft lip and palates (UCLP) using cone-beam computed tomography (CBCT) and explore the factors responsible for lower facial asymmetry in these individuals. The experimental group included 21 adolescent patients with non-syndromic UCLP while the control group comprised 14 patients without any facial cleft defects. The maxillofacial regions of the patients in the two groups were scanned using CBCT, and the Mimics 10.01 software was used to analyze the images. Multiple linear stepwise regression analysis was used to explore the factors related to the deviation of the pogonion point (Pog). Comparison of the two groups showed that the position of the lateral point of the pyriform aperture and the length of the mandibular body exhibited significant asymmetry (P < 0.05). Pog in the UCLP group deviated to the cleft side (1.24 ± 2.28 mm), and was related to B6L(R) to Sagittal plane, CdL(R) to Sagittal plane, and U6L(R) to LS plane. We concluded that significant differences between the cleft and non-cleft sides existed only around the cleft, and not in the deeper regions of the maxillary complex. Functional adaption may be the main reason responsible for chin deviation in UCLP individuals. (J Oral Sci 58, 109-115, 2016)

This study compared the wear characteristics of a heat-pressed lithium disilicate ceramic material opposed to feldspathic porcelain, a lithium disilicate glass ceramic, and zirconia materials. Ceramic plate specimens were prepared from feldspathic porcelain (EX-3 nA1B), lithium disilicate glass ceramics (e.max CAD MO1/C14), and zirconia (Katana KT 10) and then ground or polished. Rounded rod specimens were fabricated from heat-pressed lithium disilicate glass ceramic (e.max press LT A3) and then glazed or polished. A sliding wear testing apparatus was used for wear testing. Wear of glazed rods was greater than that of polished rods when they were abraded with ground zirconia, ground porcelain, polished porcelain, or polished lithium disilicate ceramics. For both glazed and polished rods, wear was greater when the rods were abraded with ground plates. The findings indicate that application of a polished surface rather than a glazed surface is recommended for single restorations made of heat-pressed lithium disilicate material. In addition, care must be taken when polishing opposing materials, especially those used in occlusal contact areas. (J Oral Sci 58, 117-123, 2016)

Temporomandibular joint dislocation (TMJ) is sometimes found in post-stroke patients, and most cases occurs involuntarily. This report describes a rare case of repeated, voluntary, TMJ in a 73-year-old woman with dysphagia and dysarthria. The cause of dislocation was suspected to be voluntary excessive mouth opening associated with gastroesophageal reflux-related vomiting and the desire to eject oral deposits resulting from hypoglossal and facial nerve paralyses. After an oral hygiene intervention, the frequency of TMJ dislocation decreased and finally disappeared. Thorough oral hygiene seemed to contribute to protection against TMJ dislocation. (J Oral Sci 58, 133-136, 2016)

This case report describes the clinical efficacy of treatment with basic fibroblast growth factor (FGF-2) for periodontal regeneration. A patient with aggressive periodontitis participated in a clinical trial involving administration of 0.3% FGF-2 in comparison with a placebo control. To evaluate the efficacy of FGF-2, standardized radiographs were taken before surgery and at 12, 24, and 36 weeks after FGF-2 treatment. The rate of increase in alveolar bone height was 86.9% at 36 weeks. The 6-year postoperative radiograph showed significant development of alveolar bone in comparison with the first visit. FGF-2 treatment may be effective for periodontal regeneration in cases of aggressive periodontitis. (J Oral Sci 58, 137-140, 2016)

A 28-year-old man visited our hospital with the chief complaint of trismus. Computed tomography revealed a well-defined, soft tissue tumor, 66 × 45 × 21 mm, with a distinct boundary in the inner region of the zygomatic arch. The mass contained various sizes of bone-like hard tissue, some of which adhered to the right coronoid process. A contrast-enhanced magnetic resonance image showed that the mass was composed mainly of adipose tissue. Tumorectomy was performed, and the histopathological diagnosis was osteolipoma. At 2-year follow-up, mouth opening had increased from 31 mm to 50 mm. (J Oral Sci 58, 141-144, 2016)

Low-grade cribriform cystadenocarcinoma (LGCCC) is a recently described rare tumor of the salivary gland; this tumor most frequently arises from the parotid gland. Here, we describe a case of LGCCC arising from a minor salivary gland in the buccal mucosa. A 72-year-old man had a small mass on the left buccal mucosa. The mass was completely resected, and the postoperative course was uneventful. Histopathologically, the tumor comprised a single cyst with intraductal proliferation. Based on these histopathological findings along with immunohistochemistry a diagnosis of LGCCC arising from a minor salivary gland was made. (J Oral Sci 58, 145-149, 2016)