4^th Asia Pacific Congress & Expo on Dental and Oral Health July 27-29, 2015 Brisbane, Australia

Ken Southward graduated from the University of Toronto Dental School in 1971. Dr. Southward achieved the Fellowship level in the Academy of General Dentistry. He maintained a preventively oriented dental practice in Ontario, Canada for 43 years. He has published articles on nutrition, periodontal disease and the systemic process of dental caries.

The links of oral and systemic diseases are continuing to emerge. While periodontal disease has been linked to many systemic diseases through the process of uncontrolled inflammation, the same paradigm has only recently been applied to dental caries. Southward’s systemic theory shows the caries process starting in the hypothalamus part of the brain. Through the endocrine system, signals are sent to the parotid glands. Like the pancreas, the parotid glands have both an endocrine and exocrine function. The endocrine part of the parotid gland secretes parotid hormone, which stimulates a centrifugal fluid flow through the tooth. This dentinal fluid flow both cleanses and nourishes the tooth from the inside. A high sugar diet elevates blood glucose levels. This causes the brain to signal for a halt or reverse of the dentinal flow. This allows oral acids to be absorbed by the tooth. Figuratively, a healthy tooth sweats and an unhealthy tooth acts more like a sponge. These acids irritate the dentin and pulp of the tooth, which responds with an inflammatory response. When inflammation can no longer be controlled, tissue breakdown occurs in a process similar periodontal disease. It is the body’s own enzymes rather than acid that causes caries in the dentin. Antioxidants have been shown to preserve the dentinal fluid flow, even in elevated sugar diets. Vitamin K2 may preserve the centrifugal fluid flow moderated by the endocrine system. It may also influence salivary ph in the exocrine function of all salivary glands.

Masakatsu Fukuda had completed his Ph.D at the age of 31 years from Nihon University and postdoctoral studies from International Agency for Research on Cancer (IARC; Lyon, France). He is a junior associate professor of Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry. He has published more than 40 papers in reputed journals.

Mangosteen, scientific name Garcinia mangostana, is a tree found in South East Asia, and pericarps of the fruit have been used in folk medicine for the treatment of many human illnesses such as skin and wound infections, and inflammatory diseases. Mangosteen fruit rinds contain high concentration of xanthones. -Mangostin, and -mangostin are the main xanthones isolated from G. mangostana. Xanthone extracts from G. mangostana have been reported with chemoprevention effects against the chemically induced colon cancer via the reduction of c-myc expression, suppression of tumor growth and metastasis in a mouse model of mammary cancer, and a recent report showed the inhibition of prostate cancer growth by -mangostin, the main constituent of the G. mangostana xanthones. However, it is unclear whether -mangostin induces cell death to oral cancer. Then, this study examined the impact of -mangostin against oral squamous cell carcinoma. At first, we analyzed the expression of c-myc in 5 human oral suquamous cell carcinoma (HOSCC) cells. The expression level of c-myc mRNA was maximum in SAS cells, while on the other hand, it was minimum in HSC-4 cells. Hence, SAS cells were treated with -mangostin. The-mangostin slightly induced cell death to SAS cells, but not strongly. Synergistic effects by the combined treatment of -mangostin and anti-cancer drugs were reported. Then, we attempted to evaluate the synergistic effect on cell growth when cytokine, TNF related apoptosis inducing Ligand (TRAIL), was used with -mangostin (total 10 ng/ml and 30 μM). As the result, cell death was clearly induced to SAS cells. It was demonstrated that the combined treatment of -mangostin and TRAIL in SAS cells led to apoptosis via the activation of caspases-9, -3/7. Furthermore, this apoptosis was induced by G1 cell cycle arrest in SAS cells. These data suggested that the combination therapy by -mangostin and TRAIL might be a great useful with a tremendous amount of potential as an anti-oral cancer drug.

Nam-Hee, Kim has completed her PhD from Seoul National University, Social Dentistry. She is the Associate Professor of Department of Dental Hygiene, Wonju College of Medicine, Yonsei University. She has published more than 12 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Research Objective: Education level is known as a determinant factor that not only affects individuals’ health related knowledge, attitude, and behavior, but also each individual’s socio-economic status and income level. It was necessary to evaluate how each individual’s education level determined in the past affects their current oral health status. The aim of this study was to examine relative disparity in tooth loss over three years based on education level of middle age and elderly Koreans. Study Design: This study is a longitudinal study which analyzed data over the last three years from Korean Genomic Rural Cohort Study, which is conducted by Korea Centers for Disease Control and Prevention (KCDC). Education level (‘lower than elementary school’, ‘middle school’, ‘higher than high school’) was set as the independent variable while the dependent variable was presence of tooth loss. Descriptive analysis and cross-analysis were carried out using SPSS 20.0 and the relative disparity was calculated via relative index of inequality (RII) using Health Disparities Calculator (HD Calc, version 1.2.4). Population Studied: A total of 603 subjects aged from 40 to 75 years were selected. The data were collected via one-on-one interviews comprised of questionnaires and oral examinations from April 2010 to August 2014. Principal Findings: Results showed that the percent of individuals who have lost one or more teeth over the last three years in this population was 45.94% (p=0.001). The percent of the lowest education with one or more teeth lost was 16% greater compared to the highest education. When the subjects were analyzed by dividing them into two groups; middle–aged (40-64) and young-old (65-75), a statistically significant difference was detected in the middle-aged (p<0.05). The relative index of inequality (RII) based on such differences was 0.597 which implied that the probability of tooth loss was greater which education level was lower. The relative disparity in terms of tooth loss was greater in the middle-aged as the RII of the middle-aged was 0.603 while that of the young-old was 0.200. The RII of the men was 0.127 and the RII of the middle-aged men and young-old men were 0.024 and -0.035, respectively. In contrast, the RII of the women was 1.032 and the RII of the middle-aged women and young-old women were 0.995 and 0.760, respectively. Conclusions: A relative disparity in terms of tooth loss was detected in the middle-aged population based on their education levels, and the degree of disparity was the greatest in middle-aged women. Implications for Policy or Practice: The majority of middle-aged women in rural areas of Korea are housewives. Studies show that many of these women tend to suffer from depression and sense of isolation as they are often excluded from social activities which in turn, deprive them from numerous social benefits. Thus, health and welfare policy that would eliminate health disparities in middle-aged women is necessary in order to overcome disparity issues regarding tooth loss related to education levels of such middle-aged women populations.

I am currently attached to the Department of Oral Biology and Biomedical Sciences in the Faculty of Dentistry, involved in teaching oral sciences to preclinical dental students. I am also involved in the supervision of post graduate students on Master and Doctorate programs. My main research interests include oral biology, bio film studies, anti-plaque agents and mechanisms, and tissue culture techniques for research in antitumour and wound healing activities.

Background: The apatite crystals of the enamel receives continuous challenges on its integrity as it is expose to the fluctuating environment in the oral cavity. The ebb and flow phases of demineralisation and remineralisation of the hard tissue is under the influence of pH and physicochemical factors. Sports drinks that are often carbonated and acidic may incur detrimental effect on the structure of the enamel. Objective: The study evaluated the erosive effect of sports drinks (SD) on the enamel tissue. Properties of SD which included pH, titratable acidity and calcium content were also determined. Methods: Non-carious extracted teeth were collected and sterilised. Each tooth was then covered with a layer of nail varnish, leaving a window of exposed enamel with surface area of 30 mm2. The tooth specimens were then distributed amongst six test groups, each with three exposed enamel windows. Each test group were tested against each of five sports drinks; ReviveTM, ExcelTM, 100PlusTM, Isotonic H2OTM and GatoradeTM for assessment of calcium released upon exposures. Mineral water served as control in the study. The weight of tooth specimens over 7-day periodic exposures to SD was monitored. Demineralisation rate and weight loss were determined to indicate the erosive effect of SD. Results: pH of all SD was recorded very acidic within the range of pH 3.02-3.45. GatoradeTM exhibited the lowest titratable acidity (p<0.05). Calcium content in IsotonicTM and 100PlusTM was 3-fold higher than in GatoradeTM and ReviveTM. The release of calcium ions from the enamel surface was fastest following exposure to 100PlusTM (2.00 µg/min) and lowest when exposed to GatoradeTM (0.33 µg/min). Weight loss was observed after a 7-day periodic exposure to ExcelTM, IsotonicTM and GatoradeTM. Interestingly, this effect was not observed with ReviveTM and 100PlusTM. Conclusion: There is no doubt that acidic nature of sports drinks has potential in causing dental erosion with in vitro studies supporting this notion. However despite the low acidity, added ions such as calcium into SD formulation tends to reduce the erosiveness of SD and encourages remineralisation of the enamel tissue instead of demineralisation. Since SD are widely used by the public in preference to carbonated beverages, oral health educators should reinforce important practices to SD users such as to decrease the time that the drinks remain in the mouth, use drinking straws and encourage drinking plain mineral water instead to avoid dehydration during sports activities.

Dr. Farrukh Faraz is the Associate Professor at Maulana Azad Institute of Dental Sciences. He did his graduation in Dental Surgery in year 1997 and subsequently obtained MDS in Periodontis in July 2002. He has been a merit scholarship holder and has been awarded a number of merit certificates during the graduation as well as post-graduation.

Background: Adjunctive treatment modalities are often required to supplement mechanical periodontal therapy as it often fails to debride completely the deeper pockets and furcations. Photodynamic Therapy (PDT), “the light induced inactivation of cells, microorganisms or molecules” has been used as an antimicrobial periodontal treatment on the concept of generating singlet oxygen and free radicals that are cytotoxic to microorganisms, by activating a photosensitizer agent using diode laser. This paper describes a clinical study to evaluate the benefits of using PDT along with Scaling and Root Planing(SRP) compared to SRP alone. Aim: To find out the clinical outcome of photodynamic therapy when used along with conventional non-surgical treatment of localized deep periodontal pockets. Materials & Methods: Thirty patients with periodontal pockets of ≥6 mm in at least two non-adjacent teeth were included in the study. One of the teeth received PDT after full mouth SRP, while another served as control. Plaque Index, Modified Sulcular Bleeding Index, Probing Pocket depth and Clinical Attachment Level were recorded at baseline, after 1 month and 3 months postoperatively. Results: Significant improvement was observed in both groups in terms of all recorded parameters 3 months postoperatively. At 1 month interval, the inter-group difference was significant in terms of modified Sulcular bleeding index, and Probing Depth which decreased more at sites treated with PDT compared to the test sites. Conclusion: Antimicrobial PDT used along with SRP results in a significant higher reduction in bleeding scores, and pocket depth reduction compared with SRP alone.

Background: It may be an important prospective clinical use for the manufacturing of porous implants for clinical situations, such as cases of limited available bone height, poor bone quality.The small segment of porous implant allowed an effective osseointegration, due to increased contact area provided by its surface configuration. Objective: Fabrication of porous titanium implants by powder technology ,as well as the observation of removal torque values of porous titanium implants compared to smooth titanium implants and to investigate the biocompatibility of these porous implants Material and methods: Twenty four porous titanium implants (3.2mm in diameter and 8mm in length) were manufactured by powder technology using commercially pure titanium powder of ≤75um particles size, with polyvinyl alcohol powder of 212-300um particle size ,as a space holder, by volume ratio (70:30)% respectively .The mixed powder was compacted using punch and die set -specially designed for this study –under 20 bar then sintering at 900 oC by the use of argon gas . Twenty four smooth titanium implants were prepared of (3.2mm in diameter and 8mm in length) by lathing of commercially pure titanium rod as a control group.The implants were examined by X-ray diffraction (XRD) and also the microstructure was investigated by scanning electrone microscope (SEM), as well as estimation of porosity percentage . For each tibia of the 24 white New Zealand rabbits ,one implant of each type ( one poros in right , and the smooth in left tibia), through surgical procedure carried under serial condition with antibiotic cover . Mechanical test was performed to evaluate the bone-implant interface, after ( 2 and 6weeks) healing periods . The implants were divided as follow : 40 implants in 20 rabbits ( were divided into 20 porous and 20 smooth implants ) were used for the measurement of torque removal amount required to remove implants from bone. The remaining 4 animals received 8 implants these four porous and four smooth implants were divided to two groups 2 rabbits were selected for each histological examination period ( 2 , 6) weeks Result: Porous implants were obtained successfully by powder technology with 52% porosity and pore size 210um 17±. The porous implant showed significantly higher removal torque values when compared to smooth implants at the two different intervals of examination (2,6 weeks) , this proved to be statistically highly significant, also a highly significant difference was noticed for the means of the torque removal values in the same group at different implantation period . In addition , histological analysis confirmed new bone formation in contact with implant , as well as improvement of bone in response to porous titanium implants compared to those produced by smooth implants , with no evidence of clinical or histological features of inflammatory reaction with both . Conclusion : Powder technology seemed to be particularly advantageous in fabrication of porous titanium implant with interconnected porous structure with pore size(210±17um) and 52% porosity .Porous implant show a biocompatibility and increasing bone ingrowth compared with the smooth type represented by higher removal torque values and supported by histological analysis and for both healing periods (2,6 )weeks .

Aim: The purpose of this study was to conduct epidemiological research of the oral health conditions and needs of public school children who study in fluoridated and non-fluoridated areas of Brasilia, the capital of Brazil. Methods: The sample was selected based on the evaluation of the clinical cards of 562 children, from ages 6 to 17. For this research, we classified the children based on their treatment needs according to priorities 01, 02 and 03. The clinical cards were divided into two groups according to the addresses of the schools. Group 1 (G1) corresponds to rural schools with less fluoridated water. Group 2 (G2) corresponds to urban schools with fluoridated water. The analyses utilized the following tests: Fisher’s Exact Test, Student T-Test and Pearson’s Chi-Square Test. Results: In G1, 62.7% (n=103) of the children present Priority 1 treatment need, 27.5% (n=103) present priority 2 and just 9.8% (n=17) present Priority 3. In G2, 36.2% (n=143) present Priority 1, 25.7% (n=102) present priority 2 and 38.1% (n=152) present Priority 3. The value of (P) was 0.001, which shows a statistically significant difference between the two groups. In G1, the children from 6 to 9 years showed an average of 3.76 teeth; in G2, the average was about 1.67 teeth per child. The value of (P) was 0.001, which shows a highly significant difference. The values of (P) for the other ages were 0.007 and 0.634, respectively, showing no significant difference. Conclusions: We show that the children who do not use fluoridated water (G1) have worse oral health conditions. These results show the necessity of improving the fluoridated water supply in Brazil.