Browsing by Subject "periodontal disease"
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Item Assessing Effectiveness of an Audiovisual Educational Tool for Improving Dental Students' Probing Depth Consistency(Wiley, 2019-04) Prabhu, Srividya; John, Vanchit; Blanchard, Steven; Eckert, George J.; Hamada, Yusuke; Periodontology, School of DentistryDental students often underestimate their probing depth (PD) measurements, which emphasizes the need for effective and novel methods for teaching proper probing technique. The aim of this study was to evaluate the efficacy of audiovisual learning aids, recorded from the point of view of examiners, for improvement in PD agreement in dental students. In 2017‐18, 22 third‐year dental students were randomized into test and control groups. Each student and a single blinded faculty examiner performed PD measurements on a minimum of three patients. The test group viewed a video demonstrating proper probing technique, while the control group received only probing technique instruction from prior lectures. All measurements, the periodontal diagnoses, and the total time taken to complete PD measurements were recorded. A survey of student attitudes about the audiovisual tool was conducted after the intervention; all 22 students completed the survey. A total of 11,426 PD sites were measured. The test group had 10% greater accuracy in PD sites=4 mm. The control group had a minor but statistically significant increase in accuracy for 2 mm PD sites. For all incorrect measurements at sites PD≥4, the students tended to underestimate the PD. Tooth type, site location around tooth, and diagnosis had no significant effect on PD measurement agreement. No significant difference between groups was found for the proportions of gingivitis and periodontitis patients or for examination time. This study found that use of the audiovisual learning aid “Calibrated Periodontal Training Video” improved the students' probing depth accuracy for sites with PD of 4 mm.Item Assessment of the Calibration of Periodontal Diagnosis and Treatment Planning Among Dental Students at Three Dental Schools(American Dental Education Association, 2015-01) Lane, Brittany A.; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J.; Blanchard, Steven; John, Vanchit; Department of Periodontics and Allied Dental Programs, IU School of DentistryCalibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.Item Developing Automated Computer Algorithms to Track Periodontal Disease Change from Longitudinal Electronic Dental Records(MDPI, 2023-03-08) Patel, Jay S.; Kumar, Krishna; Zai, Ahad; Shin, Daniel; Willis, Lisa; Thyvalikakath, Thankam P.Objective: To develop two automated computer algorithms to extract information from clinical notes, and to generate three cohorts of patients (disease improvement, disease progression, and no disease change) to track periodontal disease (PD) change over time using longitudinal electronic dental records (EDR). Methods: We conducted a retrospective study of 28,908 patients who received a comprehensive oral evaluation between 1 January 2009, and 31 December 2014, at Indiana University School of Dentistry (IUSD) clinics. We utilized various Python libraries, such as Pandas, TensorFlow, and PyTorch, and a natural language tool kit to develop and test computer algorithms. We tested the performance through a manual review process by generating a confusion matrix. We calculated precision, recall, sensitivity, specificity, and accuracy to evaluate the performances of the algorithms. Finally, we evaluated the density of longitudinal EDR data for the following follow-up times: (1) None; (2) Up to 5 years; (3) > 5 and ≤ 10 years; and (4) >10 and ≤ 15 years. Results: Thirty-four percent (n = 9954) of the study cohort had up to five years of follow-up visits, with an average of 2.78 visits with periodontal charting information. For clinician-documented diagnoses from clinical notes, 42% of patients (n = 5562) had at least two PD diagnoses to determine their disease change. In this cohort, with clinician-documented diagnoses, 72% percent of patients (n = 3919) did not have a disease status change between their first and last visits, 669 (13%) patients’ disease status progressed, and 589 (11%) patients’ disease improved. Conclusions: This study demonstrated the feasibility of utilizing longitudinal EDR data to track disease changes over 15 years during the observation study period. We provided detailed steps and computer algorithms to clean and preprocess the EDR data and generated three cohorts of patients. This information can now be utilized for studying clinical courses using artificial intelligence and machine learning methods.Item Effect of epigallocatechin gallate on nicotinetreated Fusobacterium nucleatum biofilm(Office of the Vice Chancellor for Research, 2016-04-08) Kaur, Mandeep; Dhami, Amarjeet; Gregory, Richard L.Abstract Tea polyphenols such as epigallocatechin gallate (EGCG) have exhibited antimicrobial properties. Fusobacterium nucleatum is an oral bacterium that is associated with periodontal diseases. Biofilm adheres to the enamel surfaces of our teeth as plaque. Biofilm formation in the oral cavity leads to many complications such as caries and periodontal diseases. Those who smoke tend to have increased risk of periodontal diseases and F. nucleatum biofilm formation. The objective of this research was to determine the effects of EGCG (0.25 mg/ml) and varying concentrations of nicotine (0-32 mg/ml) on F. nucleatum biofilm. The study was conducted by treating F. nucleatum biofilm with various concentrations of nicotine (0-32 mg/ml) and EGCG. Biofilm formation was measured using a crystal violet dye staining assay and a spectrophotometer. Biofilm formation of F. nucleatum with EGCG and nicotine exhibited a significant decrease in biofilm formation at low concentrations of nicotine (0-4 mg/ml). EGCG alone without nicotine significantly reduces F. nucleatum biofilm formation. EGCG can be added to dental treatments such as toothpaste and mouthwash for those who smoke. Periodontal diseases lead to many health problems in other parts of the body, therefore it is important to find ways to decrease biofilm formation of F. nucleatum.Item Effect of Nicotine on Planktonic and Biofilm Growth Phases of an Experiment(Office of the Vice Chancellor for Research, 2014-04-11) Gupta, Vinayak; Gregory, Richard L.Tobacco and cigarette smoke increase the risk of periodontal disease, one of the most widespread human diseases. It has been established that Porphormonas gingivalis, a gram negative anaerobic bacterium, is one of the main causative agents of periodontal disease. Prior research indicates that P. gingivalis binds to Fusobacterium nucleatum in oral biofilms. It is not yet understood if nicotine, a major component of cigarette smoke, affects the growth of bacteria differently if added in the planktonic phase, defined as the primary subculture from agar to broth before the start of a biofilm formation experiment, or the biofilm phase, defined as the secondary subculture from broth culture to a microtiter plate. Therefore, the main objective of this study is to understand this methodological difference. F. nucleatum and P. gingivalis were both grown in anaerobic GasPak containers on blood agar plates. The media for primary subculture consisted of a Brain Heart Infusion (BBL) broth supplemented with 5 g/L yeast extract and 5% vitamin K & hemin serum at 37oC. F. nucleatum was subcultured in the absence of nicotine and plated on a 96 well plate to establish biofilm. P. gingivalis was subcultured in varying concentrations of nicotine and subcultured on top of the F. nucleate biofilm. Biofilm mass was analyzed using the crystal violet technique and samples were measured in a spectrophotometer at 490 nm. The results demonstrated a statistically significant increase in biofilm formation when P. gingivalis was subjected to a higher nicotine concentration in the planktonic phase in comparison to a lower nicotine concentration in the biofilm phase. This data suggests a nicotine assisted activation of receptors on the surface of P. gingivalis specific for binding to F. nucleatum. Further testing on the receptors through a biotinylation assay will confirm the results.Item Effects of Caffeine on Fusobacterium nucleatum biofilm treated with Nicotine(Office of the Vice Chancellor for Research, 2016-04-08) Dhami, Amarjeet; Kaur, Mandeep; Gregory, Richard L.Abstract: Fusobacterium nucleatum is a subgingival bacteria that is associated with periodontal disease. In general, smokers tend to have a higher risk of periodontal disease and increased cavities along with greater chance of atherosclerosis, which can cause blockage leading to a heart attack or stroke. The objective of this study was to determine the effects of caffeine on F. nucleatum biofilm formation treated with various concentrations of nicotine (0-32 mg/ml). Nicotine is found in cigarettes and this experiment examined if caffeine will inhibit the growth of biofilm with nicotine. Various concentrations of nicotine were used ranging from 0-32 mg/ml. Total absorbance was measured using a spectrophotometer and revealed that caffeine at a concentration of 8 mg/ml significantly inhibited the formation of biofilm at nicotine concentrations of 0.25-8 mg/ml. Biofilm formation was significantly higher when caffeine was not present. Biofilm is commonly found in the mouth and is responsible for biofilm production on teeth leading to dental plaque deposits which become tarter. Simply brushing will not remove tarter and if left untreated it can cause periodontal gum disease. Caffeine-containing beverages may be beneficial in preventing F. nucleatum biofilm formation in smokers.Item Heterogeneity of Human Gingival Fibroblasts in Tobaccostimulated Collagen Degradation(Office of the Vice Chancellor for Research, 2010-04-09) ZHANG, W.; FANG, M.; SONG, F.; WINDSOR, L. J.Matrix metalloproteinases (MMPs) are a large family of zinc-dependent endopeptidases and their activity is modulated by tissue inhibitors of metalloproteinases (TIMPs). Smoking is a risk factor for periodontal disease. Cigarette smoke condensate (CSC) is the particulate matter of cigarette smoke. Human gingival fibroblasts (HGFs) are one of major cellular components in periodontal tissue. CSC can increase collagen degradation of HGFs by enhancing and altering the localization of MMPs. Previous clinical studies also showed that some smoking people even with very high dental plaque index still had good periodontal status and did not develop periodontal disease. Objectives: The aim of this study was to investigate the heterogeneity of HGFs to CSC-stimulated collagen degradation and to start examining its mechanisms. Methods: Eleven HGF cell lines were established from healthy gingival tissue from patients undergoing crown-lengthening surgery. HGFs were seeded as single colony (75,000 cells/well) in 6-well Type I collagen coated plates and exposed to 100 µg/ml CSC (Murty Pharmaceuticals, Lexington, KY) diluted in serum-free media with/without a MMPs inhibitor (GM6001, 100 nM, Chemicon, Temecla, CA) for 3 days. HGFs were seeded with serum free media alone as controls. The mRNA levels of multiple MMPs/TIMPs were measured by reverse transcriptionpolymerase chain reaction. Results: CSC increased collagen degradation in 7 HGF cell lines (CSC-susceptible HGFs), but not in 4 HGF cell lines (CSC-unsusceptible HGFs). GM6001 inhibited CSC-stimulated collagen degradation in all of CSC-susceptible HGFs. The mRNA levels of MMP-1, MMP-2, MMP-3, MMP-14, TIMP-1, and TIMP-2 increased 2.5, 1.3, 3.9, 2.0, 1.6, and 1.3 fold, respectively, in the CSC-susceptible HGFs. However, expression of MMPs/TIMPs basically didn’t change in the CSC-unsusceptible HGFs, except for MMP-3 which increased 1.4 fold. Conclusions: Heterogeneity of HGFs existed in regard to the CSC-stimulated collagen degradation and the altered expression of the MMPs/TIMPs may be responsible for this heterogeneity. This project was supported by the IUPUI Tobacco Cessation and Biobehavioral Center.Item Impact of Continuing Education on Clinicians' Self- Reported Knowledge of Tobacco Dependence and Tobacco Control Interventions(JScholar, 2018-10-20) Romito, Laura M.; Coan, Lorinda; Department of Biomedical and Applied Sciences, School of DentistryPurpose: To assess a tobacco cessation continuing education (CE) program for Indiana dental and medical providers. Methods: A 26-item immediate post-CE survey and a 19-item 3-month follow-up survey assessed changes in participants’ self-reported knowledge of tobacco dependence and tobacco control interventions. De-identified data were analyzed using descriptive statistics, Spearman correlation coefficients, and Mantel- Haenszel chi-square tests. Results: Participants totaled 252 across 6 programs statewide. Immediate post-CE course survey response was 98.4% (N=248): dental assistants (2%), dental hygienists (83%), dentists (8.5%), and other healthcare professionals (6.45%). Participants reported less knowledge before than immediately after CE (p< .0001) and 3 months after (p<.0001). Reported knowledge at 3 months was less than after CE (p< .002). Participants reported on their intention to apply program communication strategies (99%), implement brief tobacco interventions (85%), and refer patients to local cessation resources (95%), Indiana Quitline (96%). Follow-up survey response rate was 54% (N=136). Participants reported active engagement in tobacco interventions (48%, 78), applying CE communication strategies (85%, 109), and implementing brief interventions (71%, 90). Participants reported referring few patients to local or state quitline counselors. Conclusion:Tobacco dependence CE may enhance health care practitioners’ knowledge and willingness to integrate tobacco interventions in their healthcare settings but it does not ensure a change in clinical tobacco control interventionsItem INTERACTIONS OF HUMAN GINGIVAL FIBROBLASTS WITH TOBACCO TREATED PORPHYROMONAS GINGIVALIS(Office of the Vice Chancellor for Research, 2012-04-13) Lanier, Branden; Al-Shibani, Nouf Khider; Windsor, L. Jack; Gregory, RichardPorphyromonas gingivalis (P. gingivalis) and tobacco are risk factors for periodontal disease. The objective of this study was to determine the effects that tobacco treated P. gingivalis cells have on human gingival fibroblasts (HGFs). The study was conducted to examine the effects that cigarette smoke condensate (CSC), nicotine, and dissolvable smokeless tobacco (DST) strips treated P. gingivalis has on cell cytotoxicity and the expression of cy-tokines and growth factors from HGFs. The P. gingivalis was grown at 37°C and then the cells and supernatant were separated. P. gingivalis cells were then washed and killed. The concentration of protein in the cell pellet and supernatant were determined by protein assay using the Bradford method. The lowest non-toxic levels of the cell pellet and supernatant will be used to treat the HGFs for 72 hours and then cytotoxicity was determined by lactate dehydrogenase (LDH) assays. The cytokine/growth factor expression will be determined by antibody protein arrays. The protein assays showed that the tobacco products reduced the protein amounts as compared to untreated bacteria. The results should show an increase in cytotoxicity with increasing protein concentrations, along with increased pro-inflammatory cyto-kine/growth factors expression by the HGFs treated with tobacco treated P. gingivalis compared to P. gingivalis that was not treated with tobacco prod-ucts. A better understanding of the detrimental effects that tobacco has on the underlining causes of periodontal disease can advance the quest of con-trolling the disease. This study was funded by the Indiana University–Purdue University Indianapolis Multidisci-plinary Undergraduate Research Institute (MURI).Item Nicotine Regulates Streptococcus mutans Extracellular Polysaccharide and Related Protein Expression(Office of the Vice Chancellor for Research, 2013-04-05) Huang, Ruijie; Li, Mingyun; Gregory, Richard L.Streptococcus mutans, a gram-positive facultatively anaerobic bacterium, is considered as the primary contributor to caries due to its high acidogenicity and aciduricity. Smoking is one of the risk factors of periodontal disease and dental caries. Nicotine is one of the alkaloid pharmacologically active agents in tobacco. Previous studies indicated nicotine stimulated S. mutans biofilm formation and metabolism. However, the detailed mechanism is still unknown. Thus, the aim of this study is to investigate how nicotine facilitates S. mutans biofilm formation focused on extracellular polysaccharide synthesis. S. mutans UA159 (ATCC 700610) was used in the present study. Confocal laser scanning microscopy (CLSM) was used to investigate the effect of 0, 1, 2 and 4 mg/ml nicotine on 24 h S. mutans biofilm extracellular polysaccharide (EPS) expression (red fluorescentlabeled) and nucleic acid expression (green fluorescent-labeled). Western blot assays were used to investigate the effect of 0, 1, 2 and 4 mg/ml nicotine on the expression of glucosyltransferase (Gtfs), glucan-binding protein A (Gbp-A) and Gbp-B in 24 h S. mutans biofilm cells. CLSM results indicated nicotine increased both EPS and nucleic acid, and the ratio of EPS/nucleic acid was also increased. It implied EPS synthesis in single S. mutans cells was stimulated by nicotine treatment. Biofilm thickness was thicker in nicotine-treated groups than the non-treated group. Western blot assay results indicated that nicotine stimulated GtfC, Gbp-A and Gbp-B expression, but decreased GtfB expression. In conclusion, nicotine stimulates S. mutans cell proliferation and EPS synthesis partially by increasing GtfC, Gbp-A and Gbp-B.