Dental Calculus Research Articles

Does using the sociodental approach in oral health care influence use of dental services and oral health of adolescents living in deprived communities? a one-year follow up study

BackgroundOral health needs assessment is important for oral health care planning. This study compared dental treatment needs between normative and sociodental needs. We also longitudinally examined the relationships of baseline sociodental needs measures and socioeconomic status with one-year follow up measures of use of dental services, dental caries, filled teeth, and oral health-related quality of life (OHRQoL).MethodsA prospective study was conducted with 12-year-old adolescents from public schools in deprived communities in the city of Manaus, Brazil. Validated questionnaires were used to collect adolescents’ sex and socioeconomic status, OHRQoL (CPQ11 − 14) and behaviours (sugar intake, frequency of toothbrushing, regular use of fluoridated toothpaste and pattern of dental attendance). Normative need was assessed according to decayed teeth, clinical consequences of untreated dental caries, malocclusion, dental trauma, and dental calculus. The relationships between variables were tested thorough Structural equation modelling.ResultsOverall 95.5% of adolescents had normative dental treatment needs. Of these, 9.4% were classified as high level of propensity. Higher normative/impact need and greater propensity-related need directly predicted use of dental services at one-year follow up. The latter mediated the association of normative/impact need and propensity-related need with incidence of dental caries and filled teeth. Normative/impact need and use of dental services were directly associated with filled teeth at one-year follow up. Poor OHRQoL at one-year follow-up was directly predicted by higher normative/impact need at baseline and less filled teeth at one-year follow up. Greater socioeconomic status was directly associated with better propensity-related need. Socioeconomic status indirectly predicted incidence of dental caries and filled teeth via propensity-related need and use of dental services.ConclusionsSociodental needs measures were related to use of dental services, dental caries, filled teeth and OHRQoL after one year among adolescents living in deprived communities. Adolescents with dental needs treatment priorities according to the sociodental approach had more filled teeth via use of dental services. Dental services utilisation did not attenuate the impact of normative and impact-related need on dental caries incidence and poor OHRQoL after one year. Our findings suggest the importance of developing oral health promotion and enhancing access to dental care to improve oral health of adolescents living in deprived communities.

Biochemical and Microbiological Aspects of the Oral Cavity of Children and Young People with Neurological Impairment and Oropharyngeal Dysphagia.

The components and the salivary flow have a direct influence on the composition of the oral microbiota of children and young people with oropharyngeal dysphagia, and studies have already demonstrated the excessive accumulation of supragingival dental calculus in individuals with enteral nutrition. This study aimed to compare the oral hygiene, biochemical, and microbiological aspects of the oral cavity of children and young people with neurological impairment and oropharyngeal dysphagia. Forty children and young people with neurological impairment and oropharyngeal dysphagia were enrolled and divided into two groups: group I, encompassing 20 participants fed via gastrostomy; and group II, encompassing 20 participants fed via the oral route. Oral hygiene and salivary pH and flow were assessed, and a polymerase chain reaction was performed to evaluate the messenger RNA expressions of Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola. In groups I and II, the mean Oral Hygiene Index-Simplified scores were 4 and 2, respectively, showing a significant difference; the mean Calculus Index scores were 2 and 0, respectively, showing a significant difference; and the mean pH was 7.5 and 6.0, respectively, showing a significant difference. Bacterial analysis indicated no association between the two groups. It can be concluded that children and young people who use gastrostomy had a poorer oral hygiene, greater dental calculus deposition, and higher salivary pH. The saliva of patients in both groups contained Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola.

Ultra-high performance liquid chromatography high-resolution mass spectrometry for metabolomic analysis of dental calculus from Duke Alessandro Farnese and Maria D’Aviz

Dental calculus is a valuable resource for the reconstruction of dietary habits and oral microbiome of past populations. In 2020 the remains of Duke Alessandro Farnese and his wife Maria D’Aviz were exhumed to get novel insights into the causes of death. This study aimed to investigate the dental calculus metabolome of the noble couple by untargeted metabolomics. The pulverized samples were decalcified in a water-formic acid mixture, extracted using methanol/acetonitrile and analyzed by ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-HRMS) using a reversed-phase separation followed by electrospray ionization and full scan in positive and negative ion mode. Waters Synapt-G2-Si High-Definition hybrid quadrupole time-of-flight mass spectrometer was used. Significant features were then identified using MSE acquisition mode, recording information on exact mass precursor and fragment ions within the same run. This approach, together with data pre-treatment and multivariate statistical analysis allowed for the identification of compounds able to differentiate between the investigated samples. More than 200 metabolites were identified, being fatty acids, alcohols, aldehydes, phosphatidylcholines, phosphatidylglycerols, ceramides and phosphatidylserines the most abundant classes. Metabolites deriving from food, bacteria and fungi were also determined, providing information on the habits and oral health status of the couple.

High conservation of the dental plaque microbiome across populations with differing subsistence strategies and levels of market integration.

Industrialization-including urbanization, participation in the global food chain and consumption of heavily processed foods-is thought to drive substantial shifts in the human microbiome. While diet strongly influences stool microbiome composition, the influence of diet on the oral microbiome is largely speculative. Multiple ecologically distinct surfaces in the mouth, each harbouring a unique microbial community, pose a challenge to assessing changes in the oral microbiome in the context of industrialization, as the results depend on the oral site under study. Here, we investigated whether microbial communities of dental plaque, the dense biofilm on non-shedding tooth surfaces, are distinctly different across populations with dissimilar subsistence strategies and degree of industrialized market integration. Using a metagenomic approach, we compared the dental plaque microbiomes of Baka foragers and Nzime subsistence agriculturalists in Cameroon (n = 46) with the dental plaque and calculus microbiomes of highly industrialized populations in North America and Europe (n = 38). We found that differences in microbial taxonomic composition between populations were minimal, with high conservation of abundant microbial taxa and no significant differences in microbial diversity related to dietary practices. Instead, we find that the major source of variation in dental plaque microbial species composition is related to tooth location and oxygen availability, which may be influenced by toothbrushing or other dental hygiene measures. Our results support that dental plaque, in contrast to the stool microbiome, maintains an inherent stability against ecological perturbations in the oral environment.

Natural products from reconstructed bacterial genomes of the Middle and Upper Paleolithic.

Major advances over the past decade in the field of ancient DNA are providing access to past paleogenomic diversity, but the diverse functions and biosynthetic capabilities of this growing paleome remain largely elusive. We investigated the dental calculus of 12 Neanderthals and 52 anatomically modern humans ranging from 100,000 years ago to the present and reconstructed 459 bacterial metagenome-assembled genomes. We identified a biosynthetic gene cluster shared by seven Middle and Upper Paleolithic individuals that allows for the heterologous production of a class of previously unknown metabolites that we name "paleofurans." This paleobiotechnological approach demonstrates that viable biosynthetic machinery can be produced from the preserved genetic material of ancient organisms, allowing access to natural products from the Pleistocene and providing a promising area for natural product exploration.

Oral health status of students with visual or hearing impairments in Northeast China

BackgroundVisual or hearing impairments in students seriously affect their quality of life. The aim of this study was to identify oral hygiene status and its influencing factors on visual or hearing impairments in students in Northeast China.MethodsThis study was conducted in May 2022. A total of 118 visually impaired students and 56 hearing impaired students from Northeast China were included in this study via census. Oral examinations and questionnaire-based surveys of students and their teachers were conducted. The oral examinations included caries experience, prevalence of gingival bleeding and dental calculus. The questionnaires included three parts: Social demographics (residence, sex and race) and parents’ educational level; Oral hygiene habits and medical treatment behaviors; Knowledge and attitudes towards oral health care. This questionnaire was selected from the Fourth China National Oral Health Survey and the reliability and validity of the questionnaire were previously tested. T tests, one-way ANOVA, χ2 tests and multivariate logistic analyses were conducted to evaluate the differences and dependent variables of dental caries.ResultsThe prevalence of dental caries in visually impaired and hearing impaired students were 66.10% and 66.07%. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in visually impaired students were 2.71 ± 3.06, 52.08% and 59.38%, respectively. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in hearing impaired students were 2.57 ± 2.83, 17.86% and 42.86%, respectively. The results of the multivariate logistic analysis showed that fluoride use and parents’ educational background had an impact on the caries experience of visually impaired students. The daily toothbrushing frequency and parents’ educational background had an impact on the caries experience of hearing impaired students.ConclusionsThe oral health situation of students with visual or hearing impairments remains severe. It is still necessary to promote oral and general health in this population.

Impact of Noisy Labels on Dental Deep Learning-Calculus Detection on Bitewing Radiographs.

Supervised deep learning requires labelled data. On medical images, data is often labelled inconsistently (e.g., too large) with varying accuracies. We aimed to assess the impact of such label noise on dental calculus detection on bitewing radiographs. On 2584 bitewings calculus was accurately labeled using bounding boxes (BBs) and artificially increased and decreased stepwise, resulting in 30 consistently and 9 inconsistently noisy datasets. An object detection network (YOLOv5) was trained on each dataset and evaluated on noisy and accurate test data. Training on accurately labeled data yielded an mAP50: 0.77 (SD: 0.01). When trained on consistently too small BBs model performance significantly decreased on accurate and noisy test data. Model performance trained on consistently too large BBs decreased immediately on accurate test data (e.g., 200% BBs: mAP50: 0.24; SD: 0.05; p < 0.05), but only after drastically increasing BBs on noisy test data (e.g., 70,000%: mAP50: 0.75; SD: 0.01; p < 0.05). Models trained on inconsistent BB sizes showed a significant decrease of performance when deviating 20% or more from the original when tested on noisy data (mAP50: 0.74; SD: 0.02; p < 0.05), or 30% or more when tested on accurate data (mAP50: 0.76; SD: 0.01; p < 0.05). In conclusion, accurate predictions need accurate labeled data in the training process. Testing on noisy data may disguise the effects of noisy training data. Researchers should be aware of the relevance of accurately annotated data, especially when testing model performances.

Paleoproteomic evidence reveals dairying supported prehistoric occupation of the highland Tibetan Plateau.

The extreme environments of the Tibetan Plateau offer considerable challenges to human survival, demanding novel adaptations. While the role of biological and agricultural adaptations in enabling early human colonization of the plateau has been widely discussed, the contribution of pastoralism is less well understood, especially the dairy pastoralism that has historically been central to Tibetan diets. Here, we analyze ancient proteins from the dental calculus (n=40) of all human individuals with sufficient calculus preservation from the interior plateau. Our paleoproteomic results demonstrate that dairy pastoralism began on the highland plateau by ~3500 years ago. Patterns of milk protein recovery point to the importance of dairy for individuals who lived in agriculturally poor regions above 3700 m above sea level. Our study suggests that dairy was a critical cultural adaptation that supported expansion of early pastoralists into the region's vast, non-arable highlands, opening the Tibetan Plateau up to widespread, permanent human occupation.

Association Between Kidney Stone and Dental Calculus in a Saudi Population: A Cross-Sectional Study.

To investigate the correlation between dental calculus and kidney stones, and to identify the risk factors associated with the presence of these conditions. This study was carried out at the medical city, King Saud University, Riyadh, Saudi Arabia between 2020 and 2021. The study included 141 participants (70 with kidney stones and 71 with controls). The dental plaque and calculus indices were used to record plaque and calculus scores, respectively. All information was statistically investigated and the level of significance was set at p<0.05. The plaque and calculus indices were significantly higher in the control group when compared to the kidney stone group (p<0.05). A weak positive correlation between age and the calculus index in the kidney stone group was revealed (r=0.31, p=0.01). However, only within the age group 36-55, the results showed that the control group had a significantly higher calculus index than that of the kidney stone group (p=0.02). The married patients with kidney stones scored a significantly higher plaque index than the unmarried patients (p=0.03). The dental plaque and calculus indices were lower in the kidney stone group than those of the non-kidney stone group. Therefore, the clinical observation of dental plaque and calculus may not be indicators of kidney stones. However, within the kidney stone group, elderly and married patients could be at a higher risk for developing dental calculus and plaque, respectively.

Changes in Oral Health Behavior According to Dental Calculus Removal Health Insurance in Korea

Periodontal disease is a chronic disease that is increasing year by year. Korea also recognizes the seriousness of periodontal disease and has been applying preventive scaling in the National Health Insurance since 2013 to prevent it. Studies confirming the effectiveness of such insurance coverage are very scarce. Therefore, this study intended to confirm the effect of such policy by comparing and analyzing the oral health characteristics and oral health behavior of the South Koreans before and after the scaling insurance. For all the analyses, complex sampling analysis with the stratification variable, clustering variable, and weight was applied. For a total of 40,945 people, the demographic characteristics, oral health characteristics, dental clinic use, brushing, and use of oral care supplies were compared through chi-square tests. Scaling insurance showed a positive effect (p < 0.05) on the unemployed and elderly people, who had lost their previous economic status; on smoking and willingness to quit smoking as well as on consultation on drinking problems; on dental-clinic use and oral examination in terms of utilization of dental clinics; and on brushing after lunch, before breakfast, and before sleeping. The study results showed that the scaling rate was universalized, and there was a positive effect on willingness to quit smoking and undergo oral examination. An active reimbursement policy for oral health education is needed, however, if a substantial change in oral health behavior is to be achieved.

Dental calculus as a useful tool for public health evidence in past populations: The case of two individuals from Begho-Ghana (10th–19th C. AD)

Dental calculus as a useful tool for public health evidence in past populations: The case of two individuals from Begho-Ghana (10th–19th C. AD)

A state-of-the-art approach for dental diagnosis using machine learning assessment

In the modern era, intelligent systems are playing a vital role in day-to-day human life-related applications. It is not only giving solutions to handling health-care applications for dental treatments. In this context, artificial intelligence-based machine learning (ML) algorithms are used for experimenting with the trained data sets that progress the relevances in decision-making. A specific practice The “Internet of Dental Things” is a ground-breaking method to accomplish the avoidance and supervision of periodontal diseases, dental caries, oral cancers, and other dental diseases. Various ML algorithms such as convolutional neural network, K-nearest neighbor, and random Forest are used for anticipating nodal status and tumor grade in oropharyngeal and oral cavity squamous cell carcinoma. The ML algorithms help with diagnosis, assistive systems, and monitoring toward decision-making and contribute to the pursuit of suggesting an exact dental treatment. It is helpful in diagnosing tooth loss, cracked teeth, periodontitis, dental fluorosis, dental caries, dental calculus, dental plaque, and periodontal disease. The suggestions given by the intelligent system render accuracy, precision, specificity, sensitivity, confusion matrix, recall, and F1-Score to strengthen the decision-making and contribute to the pursuit of offering an exact treatment.

Comparative evaluation of conventional and diode laser-assisted gingival curettage in shallow suprabony periodontal pocket – Three months follow-up of a randomized clinical trial

Background: Chronic periodontitis is one of the most common forms of periodontal disease in adults. The primary goal of periodontal therapy is to remove dental plaque and bacteria to restore and maintain gingival tissue health. Subgingival scaling, root planning, and curettages are aimed at removing dental plaque, calculus, and necrotic cementum. Aim and Objectives: The main aim of our present randomized control clinical trial was to evaluate the clinical effectiveness of diode lasers compared to conventional curettage using hand instruments in patients with chronic periodontitis having shallow suprabony pockets. In addition, the pain sensation during conventional and laser-assisted curettage was compared during the procedure using Visual Analog Scale. Materials and method: Subjects with shallow pockets were divided into two groups and treated with either conventional curettage (Control group) with hand instrument or with diode laser (Test group). The data obtained were fed into Microsoft Excel 2000 package, and statistical analysis was carried out using SPSS software version 20.0 for Windows. Results: The control group elicited a reduction in probing pocket depth (PPD) from baseline to 1 month after treatment (6.60 ± 0.99 vs. 3.87 ± 0.64, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 2.43 ± 0.50, which was also statistically significant (P &lt; 0.05). The reduction between the 1 and 3 months after treatment (3.87 ± 0.64 vs. 2.43 ± 0.46, respectively), was also statistically significant (P &lt; 0.05). The test group elicited a reduction in PPD from baseline to 1 month after treatment (6.80 ± 0.86 vs. 4.00 ± 0.76, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 3.53 ± 0.48, which was also statistically significant (P &lt; 0.05). There was a marginal reduction of postoperative scores between the 1 and 3 months after treatment (4.00 ± 0.76 vs. 3.53 ± 0.48, respectively), which was nonsignificant (P = 0.53). The mean PPD at baseline between Control group versus Test group (6.60 ± 0.99 vs. 6.80 ± 0.86, respectively) was nonsignificant (P = 0.56). The PPD at 1 month also revealed nonsignificant reduction, i.e. Control group versus Test group (3.87 ± 0.64 vs. 4.00 ± 0.76, P = 0.60). The postoperative reduction of PPD at 3 months was statistically significant (P &lt; 0.05), i.e. Control group versus Test group (2.43 ± 0.46 vs. 3.53 ± 0.48). Conclusion: Within the limit of our study, it can be proved that both hand instrument-guided curettage and laser-assisted curettage can effectively reduce shallow pockets to a healthy gingival sulcus.

Oral metagenomes from Native American Ancestors reveal distinct microbial lineages in the pre-contact era.

Limited studies have focused on how European contact and colonialism impacted Native American oral microbiomes, specifically, the diversity of commensal or opportunistically pathogenic oral microbes, which may be associated with oral diseases. Here, we studied the oral microbiomes of pre-contact Wichita Ancestors, in partnership with the Descendant community, The Wichita and Affiliated Tribes, Oklahoma, USA. Skeletal remains of 28 Wichita Ancestors from 20 archeological sites (dating approximately to 1250-1450 CE) were paleopathologically assessed for presence of dental calculus and oral disease. DNA was extracted from calculus, and partial uracil deglycosylase-treated double-stranded DNA libraries were shotgun-sequenced using Illumina technology. DNA preservation was assessed, the microbial community was taxonomically profiled, and phylogenomic analyzes were conducted. Paleopathological analysis revealed signs of oral diseases such as caries and periodontitis. Calculus samples from 26 Ancestors yielded oral microbiomes with minimal extraneous contamination. Anaerolineaceae bacterium oral taxon 439 was found to be the most abundant bacterial species. Several Ancestors showed high abundance of bacteria typically associated with periodontitis such as Tannerella forsythia and Treponema denticola. Phylogenomic analyzes of Anaerolineaceae bacterium oral taxon 439 and T. forsythia revealed biogeographic structuring; strains present in the Wichita Ancestors clustered with strains from other pre-contact Native Americans and were distinct from European and/or post-contact American strains. We present the largest oral metagenome dataset from a pre-contact Native American population and demonstrate the presence of distinct lineages of oral microbes specific to the pre-contact Americas.

Permafrost preservation reveals proteomic evidence for yak milk consumption in the 13th century

Domesticated yaks endure as iconic symbols of high-altitude frozen landscapes, where herding communities depend on their high-fat milk, transport, dung, and natural fibers. While there is established proteomic evidence for ancient consumption of ruminant and horse milk in the mountains and steppes of northern Eurasia, yak dairy products have yet to be detected. Yak domestication and the species’ dispersal from Tibet into the mountainous zones to the north are also poorly resolved due to a paucity of zooarchaeological data. To examine the potential of paleoproteomics to shed light on domesticated yak in Mongolia, we analyzed human dental calculus from Mongol era elite individuals recovered from permafrost burials in Khovsgol province, where people continue to herd yak to this day. We report the first evidence for yak dairy consumption, linked to local resource control. In addition, we confirm a large diversity of recovered whey, curd, tissue, and blood proteins, likely reflecting the excellent preservation conditions found at permafrost sites.

Oral Health of Sambaqui Groups in Saquarema, Brazil

This article presents differences and similarities in dietary practices of fisher-gatherer groups excavated from two sambaquis (shell-mound archaeological sites) in Saquarema, Rio de Janeiro state, Brazil. We analyzed the buccal apparatus of 35 individuals excavated from Sambaqui da Beirada, dated from 5437 to 3440 years cal BP, and Sambaqui do Moa, dated from 4770 to 3199 years cal BP. Our oral health analysis of 852 alveoli and 704 teeth assessed the frequency and degree of teeth wear and the prevalence and frequency of caries, linear enamel hypoplasia, calculus, periapical cavities, and antemortem teeth loss. We applied the chi-square test and Fisher exact test to test statistical significance. Severe tooth wear, the absence of caries, a high frequency and prevalence of dental calculus, and a low prevalence of linear enamel hypoplasia were found in both sites, although periapical cavities and antemortem teeth loss indexes varied greatly. Despite a superficial homogeneity, the results point to variation in the physiopathological processes that occurred at both sites, including differences related to age and sex. These oral health-related results, together with other archaeological data from both sambaquis, showcase the expected cultural differences stemming from dietary practices.

The subsistence strategies of Qin humans in the Guanzhong Plain before the establishment of Qin Empire: A combined stable isotope and archaeobotanical approach

The turbulent stage before the unification of China under the first Empire, the Qin Dynasty (221–207 BC), witnessed remarkable changes in economic livelihood and social conditions. This study aims to investigate the subsistence strategies of humans living in the Guanzhong Plain during the Late Qin State (350–221 BC) by using carbon and nitrogen isotope analysis on animal and human bone collagen, as well as starch grain analysis of human dental calculus, from Podi cemetery, Shannxi Province, China. We argue that Podi humans likely relied on a mixed subsistence strategy based on animal husbandry practices and diverse crop agricultural pattern which consist of millet, soybean, wheat, and probably supplemented by hunting and gathering (Job's tears, nuts and tubers) economy. Combined with bioarcheological studies on Qin humans, we infer that previously traditional animal husbandry economy was still being practiced in the Qin period along with the inclusion of a newly introduced agricultural economy.

Effect of phosphoproteins on intracellular calcification of bacteria.

This study aimed to evaluate the effects of phosphoproteins on bacterial mineralization. Dental calculus formation is attributed to bacterial mineralization in the oral cavity; however, the influence of phosphoproteins (which are abundant in saliva) is not clear. The model bacterium Escherichia coli was suspended in a calcification solution containing casein as a model phosphoprotein. To evaluate mineralization independent of bacterial metabolism, bacteria killed by heat treatment at 70°C were compared with viable bacteria. After incubation at 37°C for 24h, the mode of calcification was observed using electron microscopy and energy dispersivex-ray spectroscopy. Solutions without casein produced precipitation in solution, which was identical to that in experiments without bacteria. In contrast, calcification solutions with 200ppm casein only produced calcium phosphate deposition intracellularly. Without heat treatment, intracellular calcification rarely occurred, even when casein was added. Thus, phosphoproteins promoted intracellular calcification of dead bacteria; this is similar to the calcification of insoluble matrices, such as collagen fibrils, promoted by acidic polymers. We concluded that intracellular calcification is caused by the collagen fibril-like behavior of dead bacteria. The promotion of intracellular calcification of dead bacteria by phosphoproteins suggested a basic principle of dental calculus formation.

Paleopathological analysis of the cranial samples from Pre-Columbian Cuba

The article presents a paleopathological analysis of two cranial samples from pre-Columbian Cuba: the Si-boney (also known as Archaic) sample consisting of 40 individuals and the Taíno sample composed of 27 indi-viduals. The Siboney are believed to have arrived to Cuba around 5000 years ago, and the Taíno inhabited the island since approximately 500 AD until decimation by the newcomers from the Old World. All the Taíno crania exhibit fronto-occipital artificial deformation. The main focus of the study is oral pathologies and bone abnormali-ties observed in the samples and how these reflect the differences between the two groups and individuals within each of them. Dental pathologies (caries, abscesses, antemortem tooth loss, and dental calculus) are more fre-quent in each sample's male and elder groups. The two samples compared together are close in the frequencies of caries, abscesses, and AMTL, while dental calculus is more frequent among the Taíno. The two cultural groups had different subsistence strategies: the Siboney were hunter-fisher-gatherers with the exception of the Canímar Abajo subgroup, for whom consumption of cultigens is proved, the Taíno were agriculturalists. In paleopathologi-cal studies, agricultural subsistence is usually associated with a higher rate of caries and lower rate of dental cal-culus. However, even after excluding individuals from Canímar Abajo from the Siboney sample, the difference in the caries rate between the two samples stayed insignificant. This could be due to carbohydrate-rich fruits that played an important role in the Archaic population’s diet. Pathological markers observed in the studied crania were classified according to Donald Ortner’s typology of bone abnormalities, which includes four major categories (abnormal bone size, abnormal bone or bone group shape, abnormal bone formation and abnormal bone destruc-tion) and subcategories within them. Such an approach focuses mainly on the appearance of the lesions rather than on their possible causes. Pathological markers seen in the samples can suggest infectious, neoplastic, my-cotic diseases, metabolic disorders. Possible antemortem traumas are infrequent in both samples. Specific to the Taíno crania is premature suture closure, which most probably is the consequence of artificial cranial deformation. In general, the analysis did not reveal significant differences in the two group's pathological statuses.

Oral hygiene and infective endocarditis: a case control study

To determine if oral hygiene is associated with infective endocarditis (IE) among those at moderate risk for IE. This is a case control study of oral hygiene among hospitalized patients with IE (cases) and outpatients with heart valve disease but without IE (controls). The primary outcome was the mean dental calculus index. Secondary outcomes included other measures of oral hygiene and periodontal disease (e.g., dental plaque, gingivitis) and categorization of blood culture bacterial species in case participants. The 62 case participants had 53% greater mean dental calculus index than the 119 control participants (0.84, 0.55, respectively; difference=0.29, 95% CI: 0.11, 0.48; P=.002) and 26% greater mean dental plaque index (0.88, 0.70, respectively; difference=0.18, 95% CI: 0.01.0.36; P=.043). Overall, cases reported fewer dentist and dental hygiene visits (P=.013) and fewer dental visits in the 12 weeks before enrollment than controls (P=.007). Common oral bacteria were identified from blood cultures in 27 of 62 cases (44%). These data provide evidence to support and strengthen current American Heart Association guidance that those at risk for IE can reduce potential sources of IE-related bacteremia by maintaining optimal oral health through regular professional dental care and oral hygiene procedures.