What every dental practitioner should know about how to examine patients with dental implants.

Dental implants are a common treatment modality provided in both primary and secondary care settings. It is increasingly common for a general dental practitioner to see patients with implant-retained restorations. This article suggests an implant safety checklist for general dental practitioners to help them examine an implant-retained prosthesis.

An Investigation into the Effects of Outer Membrane Vesicles and Lipopolysaccharide of Porphyromonas gingivalis on Blood-Brain Barrier Integrity, Permeability, and Disruption of Scaffolding Proteins in a Human in vitro Model.

Background: The effects of the key pathogens and virulence factors associated with gum disease such as Porphyromonas gingivalis (P. gingivalis) on the central nervous system is of great interest with respect to development of neuropathologies and hence therapeutics and preventative strategies. Chronic infections and associated inflammation are known to weaken the first line of defense for the brain, the blood-brain barrier (BBB).

Do Periodontal Pathogens or Associated Virulence Factors Have a Deleterious Effect on the Blood-Brain Barrier, Contributing to Alzheimer's Disease?

The central nervous system (CNS) is protected by a highly selective barrier, the blood-brain barrier (BBB), that regulates the exchange and homeostasis of bloodborne molecules, excluding xenobiotics. This barrier forms the first line of defense by prohibiting pathogens from crossing to the CNS. Aging and chronic exposure of the BBB to pathogens renders it permeable, and this may give rise to pathology in the CNS such as Alzheimer's disease (AD).

Is titanium alloy Ti-6Al-4 V cytotoxic to gingival fibroblasts-A systematic review.

Objectives: Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent.

Diagnostic Biomarkers for Alzheimer's Disease Using Non-Invasive Specimens.

Studies in the field of Alzheimer's disease (AD) have shown the emergence of biomarkers in biologic fluids that hold great promise for the diagnosis of the disease. A diagnosis of AD at a presymptomatic or early stage may be the key for a successful treatment, with clinical trials currently investigating this. It is anticipated that preventative and therapeutic strategies may be stage-dependent, which means that they have a better chance of success at a very early stage-before critical neurons are lost.

T-cells expressing a chimeric-PD1-Dap10-CD3zeta receptor reduce tumour burden in multiple murine syngeneic models of solid cancer.

Adoptive transfer of T-cells is a promising therapy for many cancers. To enhance tumour recognition by T-cells, chimeric antigen receptors (CARs) consisting of signalling domains fused to receptors that recognize tumour-associated antigens can be expressed in T-cells. While CAR T-cells have shown clinical success for treating haematopoietic malignancies, using CAR T-cells to treat solid tumours remains a challenge.

Does articaine, rather than lidocaine, increase the risk of nerve damage when administered for inferior alveolar nerve blocks in patients undergoing local anaesthesia for dental treatment? A mini systematic review of the literature.

Aims: This mini systematic review seeks to analyse the available literature and determine if a 4% articaine solution poses a greater risk of inferior alveolar and/or lingual nerve damage compared to that of 2% lidocaine, when administered for an inferior alveolar nerve block.

Results: After a mini systematic review of the published literature, seven suitable studies were identified: one double-blind random controlled trial (DBRCT) and six retrospective cohort studies. The DBRCT and two of the cohort studies concluded that 4% articaine poses no greater risk of nerve damage.

In their own words: investigating the preparedness of final year dental students in the UK for independent general dental practice.

Introduction: There is relatively little data on the preparedness of UK dental graduates for independent general dental practice. Two recent studies have indicated that graduates appear well prepared, but although quantifying the level of preparedness, they provide limited understanding of the underlying factors contributing to preparedness. This study aims to more deeply understand the contributing factors leading to assertions of graduate preparedness using focus groups of final year dental students, and semi-structured interviews of senior faculty members.

The /Host Interactome Shows Enrichment in GWASdb Genes Related to Alzheimer's Disease, Diabetes and Cardiovascular Diseases.

Periodontal disease is of established etiology in which polymicrobial synergistic ecology has become dysbiotic under the influence of . Following breakdown of the host's protective oral tissue barriers, migrates to developing inflammatory pathologies that associate with Alzheimer's disease (AD). Periodontal disease is a risk factor for cardiovascular disorders (CVD), type II diabetes mellitus (T2DM), AD and other chronic diseases, whilst T2DM exacerbates periodontitis.

Exploring the Association between Alzheimer's Disease, Oral Health, Microbial Endocrinology and Nutrition.

Longitudinal monitoring of patients suggests a causal link between chronic periodontitis and the development of Alzheimer's disease (AD). However, the explanation of how periodontitis can lead to dementia remains unclear. A working hypothesis links extrinsic inflammation as a secondary cause of AD.

Periodontitis, Microbiomes and their Role in Alzheimer's Disease.

As far back as the eighteenth and early nineteenth centuries, microbial infections were responsible for vast numbers of deaths. The trend reversed with the introduction of antibiotics coinciding with longer life. Increased life expectancy however, accompanied the emergence of age related chronic inflammatory states including the sporadic form of Alzheimer's disease (AD).

How prepared are foundation dentists in England and Wales for independent general dental practice?

Introduction The Graduate Assessment of Preparedness for Practice (GAPP) questionnaire has been shown to be valid and reliable in assessing the preparedness of foundation dentists (FDs) for independent general dental practice (GDP). In this study it is used to establish preparedness at six weeks of dental foundation training (DFT) across England and Wales.Method GAPP questionnaires were sent to all FDs and ESs in England and Wales in mid-September 2012.

Cerebral Oxidative Stress and Microvasculature Defects in TNF-α Expressing Transgenic and Porphyromonas gingivalis-Infected ApoE-/- Mice.

The polymicrobial dysbiotic subgingival biofilm microbes associated with periodontal disease appear to contribute to developing pathologies in distal body sites, including the brain. This study examined oxidative stress, in the form of increased protein carbonylation and oxidative protein damage, in the tumor necrosis factor-α (TNF-α) transgenic mouse that models inflammatory TNF-α excess during bacterial infection; and in the apolipoprotein knockout (ApoE-/-) mouse brains, following Porphyromonas gingivalis gingival monoinfection. Following 2,4-dinitrophenylhydrazine derivatization, carbonyl groups were detected in frontal lobe brain tissue lysates by immunoblotting and immunohistochemical analysis of fixed tissue sections from the frontotemporal lobe and the hippocampus.

Oral flora in acute stroke patients: A prospective exploratory observational study.

Objective: To describe the bacterial profile of the oral flora during the first 2 weeks following a stroke, examining changes in the condition of the oral cavity and infections.

Background: Dysphagia is common after a stroke and can lead to aspiration pneumonia. Oral flora changes associated with stroke have been implicated as a possible source of bacteria that can cause systemic infections.

Prospective, longitudinal assessment of quality of life in patients with cancer of the head and neck and their primary carers.

Cancer of the head and neck has profound psychosocial and physical effects on patients, so quality of life (QoL) is an essential consideration-not only is it of importance to the patient but it also provides a subjective measure of the success of treatment. However, we know of little work about its influence on carers. The aim of this study was to assess the impact of the diagnosis and treatment on the QoL of patients and their carers from baseline (preoperatively) to three months postoperatively.

Can Better Management of Periodontal Disease Delay the Onset and Progression of Alzheimer's Disease?

A risk factor relationship exists between periodontal disease and Alzheimer's disease (AD) via tooth loss, and improved memory following dental intervention. This links the microbial contribution from indigenous oral periodontal pathogens to the manifestation of chronic conditions, such as AD. Here, we use Porphyromonas gingivalis infection to illustrate its effect on mental health.

Chronic infection accelerates the occurrence of age-related granules in ApoE mice brains.

This study explored the origin of age-related granules in the apolipoprotein E gene knockout (ApoE) B6 background mice brains following chronic gingival infection with for 24 weeks. Intracerebral localization of was detected by fluorescence hybridization (FISH) and its protease by immunohistochemistry. The age-related granules were observed by periodic acid-Schiff (PAS), silver impregnation, and immunostaining.

Developing an ecologically relevant heterogeneous biofilm model for dental-unit waterlines.

This study monitored the biodiversity of microbes cultured from a heterogeneous biofilm which had formed on the lumen of a section of dental waterline tubing over a period of 910 days. By day 2 bacterial counts on the outlet-water showed that contamination of the system had occurred. After 14 days, a biofilm comparable to that of clinical waterlines, consisting of bacteria, fungi and amoebae had formed.

Porphyromonas gingivalis-stimulated macrophage subsets exhibit differential induction and responsiveness to interleukin-10.

Objectives: Oral mucosal macrophages (Mϕs) determine immune responses; maintaining tolerance whilst retaining the capacity to activate defences against pathogens. Mϕ responses are determined by two distinct subsets; pro-inflammatory M1- and anti-inflammatory/regulatory M2-Mϕs. Tolerance induction is driven by M2 Mϕs, whereas M1-like Mϕs predominate in inflammation, such as that exhibited in chronic Porphyromonas gingivalis (PG) periodontal infection.

Real-world effectiveness of anti-TNF switching in psoriatic arthritis: a systematic review of the literature.

Anti-tumor necrosis factors (Anti-TNFs) are a class of biologic disease-modifying anti-rheumatic drugs indicated for the treatment of moderate-to-severe psoriatic arthritis (PsA). Refractory patients are commonly managed by switching from one anti-TNF to another. To assess the evidence on the effectiveness of anti-TNF cycling in PsA patients, a systematic review of the literature was conducted.

The development and piloting of the graduate assessment of preparedness for practice (GAPP) questionnaire.

Introduction Most new dental graduates in the UK begin their professional career following a year in dental foundation training (DFT). There has been little investigation of how prepared they feel for independent general dental practice across all four domains of the General Dental Council's curriculum 'Preparing for practice'. This paper describes the development of the Graduate Assessment of Preparedness for Practice (GAPP) questionnaire to address this.

Apolipoprotein E Related Co-Morbidities and Alzheimer's Disease.

The primary goal of advancement in clinical services is to provide a health care system that enhances an individual's quality of life. Incidence of diabetes mellitus, cardiovascular disease, and associated dementia coupled with the advancing age of the population, have led to an increase in the worldwide challenge to the healthcare system. In order to overcome these challenges, prior knowledge of common, reliable risk factors and their effectors is essential.

Risk Assessment for the Spread of Serratia marcescens Within Dental-Unit Waterline Systems Using Vermamoeba vermiformis.

Vermamoeba vermiformis is associated with the biofilm ecology of dental-unit waterlines (DUWLs). This study investigated whether V. vermiformis is able to act as a vector for potentially pathogenic bacteria and so aid their dispersal within DUWL systems.

Porphyromonas gingivalis Periodontal Infection and Its Putative Links with Alzheimer's Disease.

Periodontal disease (PD) and Alzheimer's disease (AD) are inflammatory conditions affecting the global adult population. In the pathogenesis of PD, subgingival complex bacterial biofilm induces inflammation that leads to connective tissue degradation and alveolar bone resorption around the teeth. In health, junctional epithelium seals the gingiva to the tooth enamel, thus preventing bacteria from entering the gingivae.