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Periodontal disease symptom treatment and prevention
DENTAL SCIENCE, MATERIALS AND TECHNOLOGY PERIODONTAL DISEASE: SYMPTOMS, TREATMENT AND PREVENTION No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or by any means The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services DENTAL SCIENCE, MATERIALS AND TECHNOLOGY Additional books in this series can be found on Nova‘s website under the Series tab Additional E-books in this series can be found on Nova‘s website under the E-books tab DENTAL SCIENCE, MATERIALS AND TECHNOLOGY PERIODONTAL DISEASE: SYMPTOMS, TREATMENT AND PREVENTION SHO L YAMAMOTO EDITOR Nova Biomedical Books New York Copyright © 2011 by Nova Science Publishers, Inc All rights reserved No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works Independent verification should be sought for any data, advice or recommendations contained in this book In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services If legal or any other expert assistance is required, the services of a competent person should be sought FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS Additional color graphics may be available in the e-book version of this book Library of Congress Cataloging-in-Publication Data Periodontal disease : symptoms, treatment, and prevention / editor, Sho L Yamamoto p ; cm Includes bibliographical references and index ISBN 978-1-61122-112-1 (eBook) Periodontal disease I Yamamoto, Sho L [DNLM: Periodontal Diseases WU 240] RK361.P453 2010 617.6'32 dc22 2010033087 New York Contents Preface vii Chapter I Aesthetic Periodontal Therapy – Root Coverage A L Dumitrescu, Liviu Zetu and Silvia Teslaru Chapter II Periodontal Diseases in Children and Adolescents: Clinical Features and Molecular Biological Analyses Kazuhiko Nakano, Atsuo Amano and Takashi Ooshima Chapter III Biomechanics of Rehabilitating the Perioprosthetic Patient Petros Koidis and Manda Marianthi Chapter IV Biomarkers of Periodontal Disease: Past, Present and Future Challenges Fionnuala T Lundy Chapter V Inflammatory Mediators and Oxidative Stress in Periodontal Disease Luigi F Rodella, Paolo Brunamonti Binello, Barbara Buffoli, Davide Merigo and Mauro Labanca Chapter VI Tobacco: A Risk Factor for Periodontal Disease Nouf Al-Shibani, Nawaf Labban, Eman Allam, and L Jack Windsor Chapter VII A Novel Cytodiagnostic Fluorescence Assay for the Diagnosis of Periodontitis Marco Giannelli, Lucia Formigli and Daniele Bani Chapter VIII The Healthy Periodontium, the Diseased Periodontium Leena Palomo and Nabil Bissada Chapter IX Clinical Effects of 2% Chlorhexidine Gel on Patients Undergoing Orthodontic Treatment Abdolreza Jamilian, Mahmood Ghasemi Dariush Gholami and Bita Kaveh 31 67 93 107 121 137 153 205 vi Chapter X Contents Periodontal Disease and Systemic Diseases: Interrelationships and Interactions Giuseppe Pizzo, Rosario Guiglia and Giuseppina Campisi Chapter XI Obesity Revised Ayse Basak Cinar Chapter XII Invasion of Host Cells by Porphyromonas Gingivalisin Polymicrobial Infection Atsushi Saito, Satoru Inagaki, Eitoyo Kokubu, Ryuta Kimizuka and Kazuyuki Ishihara Chapter XIII HMGB1: A Novel Inflammatory Mediator in Chronic Periodontitis Yoko Morimoto-Yamashita, Masayuki Tokuda, Kiyoshi Kikuchi, Ikuro Maruyama, Mitsuo Torii, and Ko-ichi Kawahara 215 247 257 273 Chapter XIV Risk Factors for Chronic Periodontal Diseases Daniela da Silva Feitosa, Mauro Pedrine Santamaria, Márcio Zaffalon Casati, Enilson Antonio Sallum, Francisco Humberto Nociti Júnior and Sérgio de Toledo 287 Chapter XV The Role of Antimicrobial Peptides in Periodontal Disease Suttichai Krisanaprakornkit and Sakornrat Khongkhunthian 321 Index 353 Preface Periodontal disease is a chronic bacterial infection characterized by persistent inflammation, connective tissue breakdown and alveolar bone destruction The chronic inflammation associated with periodontal disease represents the host response to bacterial plaque, mediated by the environment in which the response occurs This book presents topical research data in the study of periodontal disease, including aesthetic periodontal therapy and root coverage techniques; clinical features of periodontal diseases in children and adolescents; biomechanics and the perioprosthetic patient; maternal periodontitis and perinatal outcomes; identifying patients with enhanced disease susceptibility in periodontal disease; and inflammatory mediators and oxidative stress in periodontal disease Chapter I - Aesthetic considerations have influenced the management of dental maladies in varying degrees for many years For many years the goals of periodontal surgery have been determined by functional aspects only During recent years periodontal surgery has shifted its focus from achieving more functional goals toward a combination of both good functional and esthetic results While accomplishing the best possible functional result, esthetics should not only be maintained, but also enhanced Sometimes the esthetic outcome is the only important factor and function becomes secondary (e.g treatment of recessions or the creation of papillae) Predictability becomes the key word in this type of periodontal surgery Patient awareness and expectations have increased recently to the point that less than optimal esthetics is no longer an acceptable outcome Periodontal plastic surgery would accordingly be defined as ―surgical procedures performed to prevent or correct anatomic, developmental, traumatic or disease induced defects in the gingiva, alveolar mucosa or bone‖ The present chapter is presenting and discussing the clinical outcomes of several root coverage techniques: pedicle soft tissue grafts, rotational flaps, coronally advanced flap, semilunar flap, free soft tissue graft, nonsubmerged grafts, submerged grafts etc Chapter II - The clinical features of periodontal diseases in children and adolescents differ from those in adults Periodontitis is extremely rare in children, except those complicated with certain kinds of systemic diseases, whereas gingivitis is commonly encountered Childhood gingivitis can be reversed by professional mechanical tooth cleaning in combination with tooth brushing instruction On the other hand, gingivitis becomes increasingly prevalent with age through the adolescent period, and early diagnosis and appropriate interventions are necessary to prevent the onset of marginal periodontitis during adolescence Since most children with periodontitis possess a background of abnormal immune responses, they have a lower likelihood of good prognosis,even though diligent interventions are performed Other types of periodontal diseases include gingival recession, viii Sho L Yamamoto which is mainly caused by traumatic occlusion, and gingival overgrowth, which has a hereditary background and is associated with specific medication such as antiepilepticphenytoin In addition, cases with a rapid loss of gingival attachment and alveolar bone due to mechanical injury at the periodontal sulcus, termed ―acute periodontitis,‖ are also encountered Furthermore, an unintentional attachment loss, when materials such as small plastic tubes being fitted to the teeth are inserted, is a unique type of periodontitis in young children It should be noted that periodontitis associated with anatomical anomalies, which are derived from fragile periodontal attachment, is also encountered Considering the etiology of periodontitis, it is important to identify periodontitis-related bacterial species, since the disease is generally known to be caused by specific bacteria However, most of those belong to the obligate anaerobic group, and it is difficult and timeconsuming to isolate them On the other hand, recent developments in molecular biological techniques have enabled rapid identification of species using bacterial DNA extracted from various kinds of clinical specimens Such approaches not require isolation of viable bacteria and even small amounts of DNA can be detected using PCR techniques With such modern techniques, the author have evaluated the distribution of periodontal bacterial species in children, changes of species in the same subjects over a long interval, combinations of species simultaneously detected, and mother-to-child transmission In addition, the distributions of bacterial species in children with Down‘s syndrome and other developmental disabilities have been analyzed The authors‘ results have provided valuable information regarding bacterial profiles in clinical specimens, which should lead to further beneficial methods for clinical use in the near future Chapter III - In advanced perioprosthetic cases where the periodontium‘s integrity is severely compromised and the dental barrier‘s function is extremely disrupted, the biomechanical response to the extrinsic mechanical stimuli of the system including the prosthetic restoration supported by the biological tissues is quite altered The differentiated altered experience of the functional loading due to the lowered periodontium‘s threshold along with the apical shift of the system fulcrum due to the periodontium‘s structure reduction require a modified design of the restoration‘s metal framework as a critical factor in the system‘s survival in order to secure the expected longevity of both the restorative and biological structures, capturing the failure initiation of either progressive tissular or technical collapse So, the purpose of the present study was to: a analyze the way by which the periodontium reacts to the developing forces and how its integrity is related to the experience of the stress field on the perioprosthetic patient; b determine the parameters defining the tooth prognosis in the perioprosthetic patient and how the restoration type is involved; c report the clinical significance of tooth splinting by cantilever cross arch fixed partial denture applied on the perioprosthetic patient and the way it is related to the response of the reduced periodontium and finally d investigate the clinical significance of the specific design of the metal framework in cantilever cross-arch fixed partial dentures via a theoretical finite element model Chapter IV - Periodontal disease is a chronic bacterial infection characterised by persistent inflammation, connective tissue breakdown and alveolar bone destruction The chronic inflammation associated with periodontal disease represents the host response to bacterial plaque, mediated by the environment in which the response occurs Periodontitis is both site-specific and episodic in nature and thus biomarker development could prove Preface ix invaluable in identifying sites with active disease, predicting sites that may develop disease, monitoring response to therapy or identifying patients with enhanced disease susceptibility In periodontal disease gingival crevicular fluid (GCF) flows from the gingival microcirculation into the periodontal pockets and the volume increases in proportion to the severity of the local inflammatory process The study of GCF samples, from defined sites of chronic periodontal inflammation, allows non-invasive access to an inflammatory exudate that could be used for biomarker discovery GCF contains proteins synthesised and secreted in the inflamed gingival tissues and carried by the GCF to the gingival crevice/pocket Here, they are augmented by proteins released from bacteria and host cells, particularly polymorphonuclear leukocytes (PMNs), present in the periodontal pocket The constituents of GCF are therefore derived from a number of sources including microbial plaque, host inflammatory cells, serum and tissue breakdown products Saliva has also been studied in the search for biomarkers of periodontal disease Saliva is a more complex fluid, comprising glandular secretions, components of GCF, components of serum and also particles (including bacteria) from a variety of oral and airway sources Although saliva has the advantage of being easily collected, its biochemical complexity may hinder detection of biomarkers specific for periodontal disease Furthermore the fact that saliva bathes the whole mouth negates the use of salivary biomarkers for site-specific identification or monitoring of periodontal disease Despite an impressive list of possibilities, biomarkers have yet to reach routine clinical use as reasonable predictors of periodontal status This chapter reviews the analysis of GCF and saliva for monitoring periodontal health and disease Potentially important biomarkers of disease in both GCF and saliva are highlighted and their merits are described in further detail Putative biomarkers from both host and bacterial sources are considered and the use of multiple biomarkers is discussed Following the technological revolution in both genomic and proteomic analysis over the last decade it is tempting to speculate that the next decade could bring much waited progress in the field of biomarker identification and application in the field of periodontal disease Chapter V - Periodontal disease represents today the main cause of teeth loss after the third decade of life About 60% of dental extractions are due to etiopathogenetic periodontal factors After 35 years, the frequency of marginal periodontal disease varies from 80% to 100% of world population, depending on statistical method used and the demographic areas considered, showing a similar frequency in both sexes, slightly higher in female Two important and interrelated factors are involved in its physiopathological progression: 1) the activation of immune system and the release of inflammatory mediators, such as IL-1β, IL-6 and TNF-α, which could overflow into the blood system and induce a systemic inflammatory response; 2) the production of oxygen radicals and their related metabolites A recent focus of the dental research is the individuation of biomarkers, which can be easily used as diagnostic tools Among them, metalloproteinases (MMPs) and heat shock proteins (HSPs) could provide potential biomarkers, which could be useful for evaluating both the periodontitis development and the incidence of the related cardiovascular diseases Recent studies, in fact, have shown a direct correlation between periodontal and cardiovascular diseases: in particular, both diseases have systemic and local causes, and the constant bacterial contamination of oral cavity could be linked not only to periodontopathy but also to the development of cardiovascular diseases 364 Index hypoglycemia, 277 hypoplasia, 231 hypothalamic, 295 hypothalamic-pituitary-adrenal axis, 295 hypothalamus, 295 hypothesis, 53, 72, 125, 222, 225, 232, 236, 242, 266, 295, 299 I iatrogenic, xiii, 112, 233, 287 ideal, 6, 95, 109, 110, 195, 198, 252 identical twins, 244 identification, viii, ix, xiii, 5, 32, 48, 55, 68, 94, 96, 113, 139, 149, 170, 180, 219, 288, 289, 302, 311 idiopathic, 218 IFN, 328 IgG, 301 iliac crest, 195 image, 77, 175, 201, 262, 264 image files, 201 images, 48, 144, 145, 146, 147, 175, 201, 203, 261 immersion, 140, 261 immobilization, 73 immune cells, 333 immune defense, 164 immune function, 99, 181, 186 immune regulation, 336 immune response, vii, xii, xiii, 31, 44, 57, 60, 114, 122, 125, 134, 166, 178, 187, 224, 240, 257, 268, 279, 281, 295, 299, 300, 302, 310, 322, 328, 331, 334, 338, 344, 346, 348, 349, 350, 351 immune system, ix, xiii, 107, 108, 112, 113, 134, 135, 178, 275, 294, 295, 310, 321, 337 immunity, xiii, 181, 239, 269, 283, 299, 322, 325, 331, 332, 333, 343, 345, 348, 350, 351 immunocompetence, 316 immunocompromised, 222 immunodeficiency, 44 immunogenetics, 224 immunoglobulin, 261, 277, 333 immunoglobulin G, 333 immunoglobulin superfamily, 277 immunoglobulins, 98, 103 immunohistochemical, 339 immunohistochemistry, 278, 285 immunolocalization, 116 immunomodulation, 335 immunomodulator, 334 immunoregulation, 317 immunostimulatory, 333, 341 immunotherapy, 240 impacts, xi, 247 implant placement, 26, 124, 197, 198 implant planning, 203 implants, x, 2, 5, 29, 90, 92, 121, 124, 133, 173, 195, 198, 199, 200, 203, 309 improvements, 14 in situ, 347 in situ hybridization, 150, 347 in utero, 237 in vitro, xiii, 56, 100, 106, 125, 126, 129, 133, 134, 150, 266, 271, 277, 281, 284, 286, 287, 294, 316, 319, 326, 329, 330, 335, 336, 338, 339, 341, 350 in vivo, 91, 100, 119, 281, 315, 326, 329, 338, 341 inactive, 302 incidence, ix, 35, 37, 84, 108, 113, 122, 149, 179, 181, 188, 189, 223, 224, 226, 227, 234, 244, 246, 292, 293, 295 incisor, 39, 40, 42, 44, 45, 62, 79, 84, 156 incisors, 38, 41, 43, 44, 45, 168 inclusion, 306 income, 231, 292 independence, 271 Indians, 226, 296 indication, 291 indicators, 289, 292, 303, 305, 307, 308, 310, 311 indices, 309 individuals, 58, 59, 63, 97, 99, 103, 106, 123, 156, 163, 168, 181, 183, 191, 211, 217, 219, 223, 224, 226, 229, 231, 248, 250, 251, 275, 288, 289, 290, 291, 292, 293, 296, 298, 299, 300, 302, 303, 304, 306, 311, 314, 325, 326 individuation, ix, x, 107, 108, 114 inducer, 328 induction, 119, 126, 258, 270, 275, 285, 302, 327, 332, 336, 343, 345, 348 industrialization, 249 industrialized countries, 108, 113 infants, 32, 36, 42, 221 infarction, 113, 117, 119, 138, 218, 277, 279, 285 infection, vii, viii, xi, xii, xiii, 8, 41, 63, 93, 98, 99, 106, 112, 113, 114, 115, 118, 131, 148, 150, 168, 169, 170, 200, 215, 216, 217, 218, 220, 221, 222, 223, 225, 226, 228, 229, 230, 231, 232, 234, 235, 236, 237, 238, 239, 241, 242, 243, 257, 258, 259, 260, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 274, 275, 279, 293, 302, 319, 322, 328 infections, 316, 337, 338, 348 infectious, 306, 327, 338, 339 Index infectious disease, 306, 338 inflamed sites, 96, 173 inflammatory, xii, xiii, 287, 288, 289, 290, 292, 294, 297, 299, 300, 301, 302, 316, 321, 322, 324, 325, 327, 331, 336, 337, 338, 339, 342, 343, 345, 347, 349, 351 inflammatory bowel disease, 218 inflammatory cells, ix, 93, 96, 108, 162, 165, 224, 227, 275 inflammatory disease, xii, 113, 114, 116, 138, 166, 190, 223, 246, 273, 274, 275, 277, 278, 280, 281, 282, 287, 288, 336, 339, 345 inflammatory mediators, vii, ix, x, xi, 96, 97, 98, 107, 108, 113, 115, 138, 165, 186, 215, 216, 220, 221, 227, 229, 232, 234, 283, 286, 299, 301 inflammatory response, 292, 300, 302, 347 inflammatory responses, 275, 277, 281, 282 information sharing, 252 informed consent, 139 inhalation, 293, 309 inheritance, 182 inherited, 289 inhibition, xii, 129, 134, 135, 191, 260, 265, 267, 268, 273, 275, 281, 286, 334 inhibitor, 125, 260, 265, 268, 285, 323, 327, 334, 335, 345, 348 inhibitors, 290, 329, 331 inhibitory, 317, 318, 329, 351 initiation, viii, xii, 41, 44, 47, 67, 71, 85, 97, 117, 148, 223, 280, 281, 287, 288, 289, 293, 300, 302 injections, 207 injure, 171 injuries, 41 injury, viii, 3, 16, 32, 44, 88, 89, 108, 113, 115, 218, 279 innate immunity, xiii, 299, 322, 325, 331, 343, 345, 348, 350 Innovation, 321, 339 inoculum, 260 insects, xiii, 321 insertion, 8, 42, 44, 173, 207 insight, 339 insulin, 185, 186, 226, 227, 228, 229, 241, 243, 249, 255, 296, 310, 312, 317, 324 insulin dependent diabetes, 317 insulin resistance, 185, 186, 226, 228, 229, 241, 243, 296 insulin sensitivity, 186, 228 insulin-like growth factor, 324 integration, 14, 323 365 integrity, viii, 67, 77, 85, 143, 154, 174, 348 interaction, 299, 301, 302, 343 interactions, 329 intercellular adhesion molecule, 332 interdependence, 71 interface, 13, 116 interferon, 98, 117, 220 interferon-γ, 98 interleukin, 294, 297, 298, 300, 305, 309, 310, 311, 312, 313, 315, 332, 341, 343, 351 interleukin-1, 294, 297, 298, 300, 305, 309, 310, 311, 312, 315, 351 interleukin-6, 294, 297, 298, 309, 310, 313, 343 interleukin-8, 98, 148, 294, 332, 341, 351 internalization, 261, 264, 267 intervention, 21, 38, 94, 102, 180, 186, 235, 248, 251, 255, 256 intestine, 323, 326, 345 intima, 246 intracellular signaling, 327, 339 intron, 326 inversion, 236 investment, xi, 247 ionization, 325, 326 ions, 187, 327 Iran, 205 Ireland, 93 irradiation, 88 irrigation, 41, 44, 45, 168, 169, 206, 210, 213, 214 ischemia, 234 isolation, viii, 32, 33, 46, 47, 53, 207, 277 issues, xii, 28, 37, 39, 68, 71, 72, 73, 76, 82, 83, 87, 88, 98, 100, 109, 123, 129, 138, 151, 220, 223, 229, 231, 257, 258, 269, 288, 290, 300, 317, 322, 325, 335, 338, 342 Italy, 107, 137, 139, 143, 215 J Japan, 31, 36, 140, 244, 257, 259, 261, 281 Japanese, 301, 311, 312 Japanese women, 188, 243 JNK, 327 joint destruction, 238 joints, 91, 103 Jordan, 181 Jun, 327 Jung, 336, 345 366 Index K kappa, 313, 327, 351 kappa B, 313, 327, 351 keratin, 154, 156, 225 keratinocyte, 33, 133, 335, 336, 340, 348, 350 keratinocytes, 124, 133, 154, 324, 326, 328, 332, 336, 337, 341, 342, 343, 345, 346, 349 keratosis, 350 ketoacidosis, 226 kidney, 217, 219, 231, 245, 326, 349 kill, 125, 280 killer cells, 301, 324 killing, 340, 344 kinase, 327, 332, 336, 340, 341 kinases, 324 kinetics, 332 L labeling, 261, 263 lactation, 139 lactoferrin, 120, 124 lactose, 267, 271 lamellar, 327, 348 Langerhans cells, 325, 347 laser, 325, 326 latency, 310 Latin America, 291 lead, viii, xi, xii, 2, 24, 32, 40, 44, 103, 111, 112, 113, 115, 125, 129, 168, 178, 219, 224, 229, 247, 248, 250, 251, 273, 281, 288, 290, 303, 349 leisure, 248 lending, 8, 16 leptin, 186 lesions, xii, 34, 35, 36, 37, 41, 45, 62, 63, 68, 111, 117, 138, 139, 162, 163, 164, 168, 169, 170, 174, 177, 178, 194, 217, 224, 258, 273, 274, 275, 277, 279, 282, 303, 304, 308, 316, 325, 337, 341, 347 leucine, 270 leukemia, 189, 233, 337, 340 leukocyte, 300, 313, 317 leukocytes, 301, 309, 311, 345, 350 leukoplakia, 328, 336, 339, 347 lichen, 163, 328, 336, 339, 347 lichen planus, 163, 328, 336, 339, 347 life course, xi, 247 life expectancy, 161, 181 lifestyle, 289, 294 lifestyle changes, 250 lifestyles, 299 lifetime, 180, 182, 183, 290 ligament, 13, 37, 71, 84, 94, 97, 100, 101, 104, 111, 114, 125, 133, 134, 154, 158, 164, 191, 219, 290, 308, 317 ligand, xii, 273, 274, 280, 298, 313 ligature-induced periodontitis, 293, 296, 298, 314 light, 11, 62, 140, 164, 292, 329 likelihood, xiii, 287, 289, 307 limitation, 329 limitations, 301, 336 lipid peroxidation, 113, 117 lipids, 112, 297, 327 lipopolysaccharide, 294, 318, 327, 340, 341, 351 liver, 233, 234 liver disease, 233 local anesthesia, 15, 40, 140 local conditions, 111 localization, 114, 118, 151, 235, 279, 327, 346 loci, 230, 302 locus, 224 logistics, 255 longevity, viii, 67, 83, 243, 290 longitudinal studies, 289, 298, 299, 300, 302, 303 longitudinal study, 28, 63, 87, 90, 105, 164, 184, 188, 288, 296, 298, 303, 308, 310, 317, 319 low birthweight, 237 low risk, 305, 306 low-density, 347 low-density lipoprotein, 347 low-density lipoprotein receptor, 347 LPS, 327, 331 lumen, 185, 324 lung, 333, 336, 339, 340, 343, 344, 346 lung abscess, 218 lupus, 163 lymph, 158, 169 lymphadenopathy, 169 lymphocyte, 340 lymphocytes, 96, 111, 138, 162, 164, 178, 267, 275, 301, 325, 331, 333, 343 lymphoid, 164, 166 lymphoma, 350 lysine, 101, 225, 277 lysis, 72, 260 lysosome, 99 Index M macrophage, 297, 331, 343 macrophage inflammatory protein (MIP), 331 macrophages, xii, 96, 97, 99, 111, 162, 164, 227, 273, 274, 275, 277, 282, 284, 285, 301, 333, 343 magnesium, 232 magnitude, 84, 92, 111 mainstream smoke, 122 maintenance, 289, 313 major histocompatibility complex (MHC), 300, 319 majority, 13, 14, 55, 72, 96, 97, 154, 156, 158, 223, 225, 250, 301, 302 malaise, 169 males, 291, 303 mammalian cells, 284 mammals, xiii, 114, 321, 323 man, 86, 115, 181, 212, 283, 313, 314, 315 management, vii, 1, 2, 6, 13, 28, 63, 85, 91, 97, 116, 130, 173, 199, 206, 209, 230, 231, 235, 241, 247, 250, 251, 252, 255, 256, 289, 296, 304 mandible, 77, 92, 192, 232 mandibular, 309, 312 manipulation, 13, 23 manners, 332, 333, 334 mapping, 346 markers, 53, 86, 96, 97, 101, 102, 103, 104, 105, 106, 113, 116, 118, 120, 150, 234, 241, 242, 289, 299, 301 marrow, 158, 195, 340 Mars, 325, 346 Marx, 196, 197 mass, 177, 219, 224, 231, 240, 248, 254, 255, 267, 297, 325, 326, 327, 345 mass spectrometry, 325, 326 mast cell, 301, 324, 332, 333, 336, 340, 342, 343, 347 mast cells, 96, 162, 301, 324, 332, 333, 340, 343, 347 materials, viii, 14, 32, 42, 79, 83, 194 matrix, 6, 9, 14, 15, 18, 20, 24, 25, 27, 40, 95, 97, 99, 100, 101, 103, 104, 114, 116, 117, 119, 123, 125, 132, 134, 177, 180, 185, 194, 195, 197, 221, 227, 269, 275, 300, 312, 316, 325, 332 matrix metalloproteinase, 99, 103, 114, 116, 117, 119, 123, 134, 180, 221, 275, 312, 332 matter, 16, 129 maxilla, 23, 198 maxillary incisors, 62 maxillary sinus, 198 367 MCP, 331, 332 MCP-1, 331, 332 measurement, 5, 80, 81, 82, 97, 99, 102, 146, 170, 172, 174, 240 measurements, 5, 14, 94, 95, 96, 98, 100, 102, 139, 171, 172, 207, 251, 254, 292, 298, 299 measures, 288 mechanical engineering, 92 mechanical stress, 115 media, 125, 127, 129, 246 median, 16, 325 mediation, 280 mediators, 297, 299, 301, 341 medical, xi, 40, 118, 168, 215, 216, 217, 224, 230, 235, 237, 274, 306, 310 medical care, 224 medical history, 306 medical science, 237 medication, viii, 31, 32, 39, 41, 49, 139, 161, 169, 189, 207, 224 medicine, xi, xii, 95, 201, 215, 216, 217, 225, 235, 236, 238, 243, 246, 274, 275 medulla, 295 melatonin, 112 mellitus, xiii, 185, 226, 227, 233, 240, 241, 254, 287, 296, 305, 314, 317 membranes, 13, 14, 18, 20, 27, 115, 143, 194, 199, 221, 323, 331, 343 memory, 333 men, 289, 291, 304, 310, 315 menadione, 259, 260, 261 meningitis, 218 menopause, 187, 188, 231, 232, 233 menstruation, 233 mental impairment, 244 mental retardation, 58 meta-analysis, 14, 22, 24, 84, 149, 150, 211, 237, 238, 241, 246, 255, 286, 297, 300, 314, 317 metabolic, 229, 233, 243, 256 metabolic disorder, 227, 296 metabolic disturbances, 248 metabolic syndrome, xi, 186, 215, 217, 219, 236, 243 metabolism, 103, 184, 240, 243, 271, 298 metabolites, ix, 101, 107, 108 metabolized, 124 metalloproteinase, 99, 103, 114, 116, 117, 119, 134, 300, 312, 332 metals, 129 metastasis, 114 368 Index meter, 72, 73 metformin, 186 methanol, 259, 265, 266 methicillin-resistant, 323 methodology, 77, 130, 181, 248 methylcellulose, 207 Mexican, 291 mice, 268, 271, 277, 282, 284, 313, 335, 350 microbial, xiii, 287, 288, 289, 294, 299, 302, 311, 315, 316, 321, 322, 323, 327, 329, 331, 337, 338, 344, 346 microbial communities, 63, 64 microbiota, 65, 118, 148, 184, 191, 297, 317 microcirculation, ix, 93, 94 microflora, 293, 318 micrograms, 324 microorganisms, xii, xiii, 112, 113, 210, 216, 218, 219, 223, 228, 235, 257, 258, 266, 267, 288, 294, 302, 321, 322, 324, 327, 328, 329, 330, 332, 337, 338, 345 microscope, 140, 143, 177, 261 microscopy, 148, 151, 261, 263, 264 migration, 5, 94, 98, 135, 138, 162, 164, 174, 178, 219, 279, 288, 332, 335, 336, 348, 350 military, 295, 311 mimicry, xi, 215, 220 mineralization, 101, 102, 292 minimum inhibitory concentrations, 329 Ministry of Education, 339 Minneapolis, 47 minority, 310 Mississippi, 339 mitochondrial DNA, 116 mitogen, 135, 269, 285, 324, 345 mitogen-activated protein kinase, 345 mitogenic, 347 mitosis, 336 MMP, 99, 100, 102, 114, 116, 119, 125, 127, 129, 301, 315, 316, 317 MMP-2, 100, 119, 125, 129, 301 MMP-3, 100, 114, 301 MMP-9, 99, 100, 102, 116, 127 MMPs, ix, 100, 107, 114, 123, 125, 126, 129, 275, 281, 301 mobility, 303, 306 modalities, 339 modality, 304 modeling, 92 models, xii, xiii, 68, 77, 78, 79, 81, 82, 84, 180, 217, 252, 257, 266, 270, 277, 286, 288, 289, 304, 307 modification, 10, 12, 15, 112, 225, 256, 306 modifications, 8, 20, 75, 83, 102, 148, 273, 302, 321 modulation, 294 moisture, 207 molecular biology, 239, 328 molecular mass, 326, 327, 345 molecular mimicry, xi, 215, 220 molecular structure, 323 molecular weight, 101, 114 molecules, xiii, 100, 108, 112, 114, 158, 220, 230, 258, 269, 279, 280, 281, 300, 322, 323, 327, 331, 336, 339 monitoring, ix, 28, 50, 61, 93, 94, 99, 109, 110, 139, 143, 312 monocyte, 294, 297, 331, 333, 340, 348 monocyte chemoattractant protein, 269, 331 monocytes, 301, 324, 331, 341, 342 monolayer, 261 mononuclear cell, 316, 332 morbidity, 8, 23, 220, 222, 223, 231, 296 Morocco, 311 morphogenesis, 114 morphology, 4, 8, 26, 33, 36, 156, 161, 174, 192, 259, 261 mortality, 116, 220, 222, 244, 296 Moses, 27 motivation, 22, 210, 222 motor skills, 230 mouth, 290, 306 mRNA, 326, 327, 328, 332, 333, 334, 336, 337, 345, 347 mRNAs, 325, 343 mucin, 336, 339 mucosa, vii, 1, 2, 4, 5, 8, 9, 12, 15, 16, 17, 24, 27, 29, 122, 124, 144, 154, 173, 200, 222, 224, 322, 325, 326, 327, 346, 350 mucosal barrier, 302 mucous membrane, 169, 294 multicellular organisms, 351 multiple alleles, 302 multiple factors, 111 mumps, 226 muscular dystrophy, 233, 277 mutagenesis, 229 mutant, 56, 267 mutations, 338, 350 myasthenia gravis, 226 myeloid, 337, 340, 351 myeloid cells, 351 myeloperoxidase, 325 Index myocardial infarction, 113, 117, 119, 138, 218 myocardial ischemia, 234 myocarditis, 218 myofibroblasts, 125 N National Institutes of Health, 245 natural, 301, 314, 324, 327, 337, 343 natural compound, 281, 282 natural killer, 301, 324 natural killer cell, 301, 324 neck, 306 necrosis, 75, 97, 98, 111, 119, 120, 169, 189, 220, 221, 285, 298, 300, 309, 311, 347 negative consequences, xii, 247 negative effects, 235 neglect, 109, 230, 275 neonatal, 343 neoplasia, 316 nephritis, 216 nephropathy, 184, 228 nerve, 97, 198, 230, 244, 295 nerve fibers, 295 nervous system, 230, 295 neuralgia, 218 neurodegeneration, 290 neurodegenerative diseases, xi, 215, 217, 219 neurodegenerative disorders, 243 neuroendocrine, 294, 295 neuroinflammation, 245 neurokinin, 105 neuronal cells, 285 neuropathy, 184, 199, 227, 228 neuropeptides, 98 neutral, 99 neutropenia, xiii, 44, 178, 232, 322, 338 neutrophil, xiii, 294, 297, 314, 321, 322, 323, 324, 325, 326, 330, 332, 333, 336, 338, 339, 341, 342, 346, 347, 348, 351 neutrophils, 125, 126, 127, 134, 162, 191, 227, 277, 294, 297, 323, 324, 325, 328, 331, 333, 338, 341, 342, 343, 345, 347, 349, 350 New England, 246 nicotine, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 133, 134, 135, 293, 294, 309, 314, 318 Nielsen, 314 nitrate, 229, 242 nitric oxide, 277, 331, 341 nitrogen, 125 369 nitrosamines, 129, 229, 242 nitroso compounds, 242 nodes, 85 non-enzymatic, 297 non-institutionalized, 181 nonsmokers, 16, 22, 122, 123, 124, 292, 293, 294 non-surgical therapy, 124, 191, 192 norepinephrine, 295 normal, xiii, 297, 298, 309, 311, 312, 321, 324, 325, 326, 328, 331, 337, 340, 347 North America, 188, 235, 238, 244, 308 Northern Ireland, 93 Norway, 1, 86 NSAIDs, 225 N-terminal, 327 nuclear, 298, 327 nuclei, 278, 340 nucleic acid, 143, 277 nucleus, 276, 277, 278, 279 null, 268 numerical tool, 77 nursing, 243 nursing home, 243 nutrient, 248, 249, 271 nutrients, 36, 177 nutrition, 169, 242, 254 nutritional assessment, 186 nutritional status, 244 O obesity, xi, 116, 186, 226, 228, 229, 231, 247, 248, 249, 250, 251, 254, 255 objective criteria, 109 obstruction, 222 occlusion, viii, 31, 32, 39, 71, 72, 74, 75, 87, 88, 89, 90, 179, 274, 283 odds ratio, 292 oedema, 140 oil, 143, 207, 261 older adults, 319 oligomerization, 119 open spaces, 178 optical density, 261 oral, xiii, 288, 290, 291, 294, 295, 296, 298, 302, 304, 308, 310, 311, 312, 314, 316, 318, 321, 322, 324, 325, 326, 327, 328, 329, 330, 336, 338, 339, 342, 343, 345, 346, 347 370 Index oral cavity, ix, xiii, 33, 36, 46, 52, 97, 108, 112, 122, 125, 126, 130, 154, 170, 216, 223, 229, 242, 244, 258, 321, 322, 323, 324, 325, 328, 329 oral diseases, xi, 222, 243, 247, 250, 251, 254, 338 oral health, xi, xii, xiii, 59, 111, 188, 210, 215, 216, 218, 230, 238, 240, 243, 244, 247, 248, 250, 251, 252, 254, 255, 281, 286, 304, 310, 314, 321 oral hygiene, 288, 291, 295, 296, 308 oral squamous cell carcinoma, 325 organ, 189, 226, 245 organism, 54, 266, 294, 302 organs, 113, 223, 324, 325 orthodontic treatment, xi, 3, 29, 139, 206, 207, 211, 212, 213, 214 osteoblasts, 298, 315 osteoclastogenesis, 225, 317, 318 osteoclasts, 298, 300, 315 osteogenesis, 233 osteomyelitis, 218 osteonectin, 102 osteopenia, 297, 298, 312, 316, 318 osteoporosis, xi, xiii, 131, 189, 190, 215, 217, 219, 225, 232, 236, 245, 275, 287, 290, 297, 298, 311, 312, 316 outpatients, 251 ovariectomized, 298 ovariectomized rat, 298 ovariectomy, 317 overlap, 158 overweight, xi, 247, 248, 249 oxidation, 230, 297 oxidative, 294, 316 oxidative damage, 115, 229, 230 oxidative stress, vii, x, 108, 111, 112, 113, 114, 116, 118, 119, 120, 229, 243 oxygen, ix, 101, 107, 108, 112, 115, 116, 125, 129, 134, 135, 177, 180, 191 P pain, 36, 37, 41, 45, 168, 169, 170, 199, 224 pain management, 168 pairing, 326 palate, 15, 20 pancreas, 226, 228, 249, 326, 349 pancreatic, 296 pancreatic cancer, xi, 215, 217, 219, 228, 229, 241, 242, 286 pancreatitis, 226, 229, 241 pandemic, xi, xii, 247, 250 paradigm shift, 6, 220 parallel, xi, 9, 11, 73, 75, 200, 215, 293 parallelism, 75 paralysis, 328, 342 parameter, 305, 306, 312 parasite, 138 parasites, 222 parents, 45, 54, 55, 65, 210 participants, 186, 295 passive, 293, 295 pathogenesis, xi, 65, 66, 68, 71, 94, 115, 118, 119, 138, 183, 215, 224, 234, 235, 237, 239, 258, 266, 275, 278, 279, 280, 282, 290, 294, 307, 315, 322, 329, 330, 337, 338, 339 pathogenic, 303, 311, 330, 342, 349 pathogens, xi, xii, xiii, 41, 46, 55, 57, 63, 64, 99, 102, 106, 112, 115, 118, 123, 125, 131, 132, 133, 134, 138, 148, 150, 164, 183, 189, 190, 200, 215, 218, 219, 221, 222, 223, 225, 227, 228, 230, 234, 236, 237, 257, 258, 259, 262, 267, 268, 278, 279, 281, 294, 297, 300, 302, 319, 322, 328, 329, 330, 331, 338 pathology, 41, 108, 111, 192, 235, 236, 243 pathophysiological, 229, 258 pathophysiology, xi, 138, 215, 216, 227, 230, 281, 282 pathways, 113, 129, 135, 218, 224, 230, 260, 285, 327, 332, 336, 339, 341, 345, 349, 351 patient care, 304 patients, xiii, 287, 289, 290, 291, 293, 295, 296, 297, 298, 300, 302, 304, 306, 309, 310, 311, 312, 313, 314, 315, 317, 322, 325, 337, 338, 340, 347, 348, 351 pattern recognition, 302 PCR, viii, 32, 33, 46, 47, 48, 49, 51, 54, 56, 57, 58, 60, 63, 139, 239, 258, 285, 333 PDL, 84, 158, 161, 168, 170, 171, 174, 191, 194, 199, 200 pellicle, 177 pemphigus, 163 peptidase, 104 peptide, xiii, 98, 105, 225, 321, 322, 323, 324, 325, 326, 327, 328, 331, 336, 339, 340, 341, 342, 343, 344, 345, 346, 347, 348, 349, 350, 351 peptide synthesis, 326 peptides, xiii, 148, 151, 300, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 336, 337, 338, 339, 340, 341, 342, 343, 345, 346, 347, 348, 349, 350, 351 performance, 77 Index perinatal, vii, 44 periodontist, 180 periodontium, 290, 297, 325, 331, 339 peripheral blood, 134, 241, 316, 332, 342 peripheral blood mononuclear cell, 316, 332 peripheral neuropathy, 227 permanent molars, x, 38, 205, 207 permeability, 185, 189, 227, 327 permeabilization, 344 permission, 265, 333, 334, 335 permit, 9, 10, 198, 217, 293 pernicious anemia, 226 peroxidation, 112, 113, 117 peroxide, 294 personal history, 226 pertussis, 347 phagocytic, 302 phagocytosis, 112, 126, 163, 190, 227, 232, 294, 297, 301, 313, 324, 328, 332, 345 pharmacological treatment, 250 pharmacology, 285 pharynx, 242 phenol, 129 phenotype, 178, 220, 227, 297, 299 phenotypes, 27, 45, 150 phenylalanine, 126 phenytoin, viii, 31, 40, 61, 164 pheochromocytoma, 226 Philadelphia, 177, 179, 213 phorbol, 327, 340 phosphate, 140, 260, 332 phospholipase C, 333, 347 phospholipids, 98 phosphorus, 232 phosphorylation, 119, 335, 340 photographs, 39, 40, 41, 45, 198 physical activity, 225, 248, 249 physical exercise, 247, 251 physical inactivity, 249 physical properties, 14 physiological, 291, 294 physiology, x, 153 pig, 345, 348 pigmentation, 206 pilosebaceous unit, 341 pilot study, 185, 212, 256, 318 pituitary, 295 placebo, x, 205, 206, 207, 209, 213 placenta, 326, 328 planning, 294, 303, 307 371 plants, xiii, 321 plasma, 340, 343, 346, 349 plasma cells, 162, 164, 178 plasma membrane, 140, 145, 343 plasminogen, 129 platelet aggregation, 220 platelets, 246 plausibility, 217, 295 play, xiii, 297, 299, 307, 310, 321, 322, 325, 330, 331 playing, 258 pneumococcus, 235 pneumonia, 222, 223, 237, 238 polarization, 342 policy, 252 policy makers, 252 polio, 233 polydipsia, 226, 249 polymerase, 33, 63, 132 polymerase chain reaction, 33, 63, 132 polymorphism, 244, 300, 301, 305, 315, 316, 317 polymorphisms, 112, 118, 230, 245, 299, 300, 301, 309, 310, 311, 312, 313, 314, 315, 317, 318 polymorphonuclear, 309, 313 polypeptide, 98, 101 polypeptides, 267, 349 polyphenols, 281 polysaccharide, 177 polyuria, 226, 249 poor, 295, 297, 312, 327 population, ix, 4, 76, 83, 86, 90, 107, 108, 131, 143, 161, 181, 182, 188, 210, 222, 223, 226, 231, 238, 242, 243, 288, 292, 294, 296, 299, 301, 304, 310, 312, 317, 318, 325 population group, 76, 83 pore, 323 porosity, 232, 234, 240 positive correlation, 51, 139, 144, 147, 295, 298 positive feedback, 333 positive relationship, 275 postmenopausal, 297, 298, 311, 315, 316, 318 postmenopausal women, 231, 240, 245, 297, 316, 318 poverty, 231 PRC, 304 precancerous lesions, 325, 347 predictability, 8, 17, 86, 158, 194, 195, 309 predictors, 289, 302, 304, 306, 307 predisposing factors, 291, 308 prednisone, 232 preeclampsia, 237 372 Index pregnancy, xi, 61, 139, 174, 187, 188, 216, 218, 221, 226, 233, 237 premature death, 223 premolars, xi, 17, 77, 206 preparation, 5, 75, 195, 260, 261 preservation, 22, 69, 124, 156, 198 preterm delivery, xi, 215, 217, 237 preterm infants, 221 prevention, xi, xii, 2, 184, 223, 228, 231, 238, 245, 247, 251, 252, 254, 280, 281, 288, 304, 307, 331 primary function, 73 primary teeth, 33, 37, 39, 44 primate, 349 priming, 191 principles, 23, 26, 77, 90, 105, 110, 116, 118 private practice, 149, 207 probability, 9, 24, 91, 95, 103, 302, 304, 306, 307 probe, x, 5, 25, 26, 35, 104, 139, 149, 170, 172, 173, 200, 205, 207 production, 294, 295, 296, 297, 300, 311, 318, 322, 328, 333, 336, 337, 341, 343, 347, 348 professionals, 68, 216, 217, 252 professions, 339 progesterone, 187, 277 prognosis, vii, viii, 22, 31, 45, 67, 68, 75, 76, 83, 86, 87, 90, 92, 96, 97, 150, 161, 164, 166, 180, 219, 304, 306, 310, 338 prognostic factors, 289, 304, 313 prognostic value, 303, 314 program, 289, 306 progressive neurodegenerative disorder, 230 proinflammatory, 296, 348 pro-inflammatory, xiii, 98, 112, 138, 221, 224, 227, 234, 277, 281, 286, 294 prokaryotes, 114 proliferation, 112, 124, 125, 127, 128, 129, 133, 148, 164, 181, 185, 220, 227, 229, 290, 332, 335, 336, 339, 344, 348, 349 promoter, 312, 315, 317 prophylaxis, 183 prostaglandin, 331, 333, 341, 347, 348 prostaglandins, 187 prostate, 326 prostate gland, 326 prosthesis, 76, 83, 85, 199, 200 proteases, 99, 100, 104, 126, 302, 331 protection, xii, 11, 13, 18, 26, 99, 134, 173, 188, 223, 257, 259, 264, 267, 294 protective role, 325, 338 protein, 317, 324, 326, 327, 331, 334, 337, 342, 347, 348, 349, 351 protein family, 351 protein kinases, 265 protein synthesis, 265 proteinase, 151, 225, 324, 345, 348, 349 proteins, ix, 6, 24, 27, 93, 96, 103, 108, 113, 114, 115, 116, 117, 119, 132, 177, 185, 186, 191, 194, 196, 225, 277, 282, 284, 297, 311, 325, 341, 342 proteoglycans, 100, 105, 106 proteolysis, 99 proteolytic enzyme, 324 prototype, 260, 262 pseudomonas, 330, 344 pseudomonas aeruginosa, 223, 266, 270, 330, 344 psoriasis, 163, 337, 348 psoriatic, 326, 337 psoriatic arthritis, 239 psychiatric disorders, 230 psychiatry, 244 psychopathology, 22 psychosocial factors, 251 psychotropic medications, 230 puberty, 32, 168, 187 public, 296, 297 public health, 113, 130, 220, 296, 297 pulmonary diseases, 216, 222 pulp, xi, 215, 231, 306, 336, 349 pulp cells, 349 purification, 277 pus, 35 pyogenic, 41, 187 pyorrhea, 71 Q quality of life, xi, 247, 248, 251, 252 quantification, 95 questionnaire, 295 R race, xiii, 2, 112, 122, 135, 181, 183, 219, 231, 287, 291, 292, 316 racial groups, 291 radiation, 128, 139, 201, 204, 306 radicals, ix, 107, 108, 115, 118, 191 radiography, 174, 201 random, 290 Index range, 290, 295, 296, 298, 331, 334, 335, 338 RANKL, 298, 309, 313 rat, 293, 296, 298, 317, 341 rats, 293, 298, 309, 310, 314, 315, 317, 332, 343, 348 reactants, 234 reactions, 48, 59, 218, 230, 295 reactive groups, 261 reactive oxygen, 101, 112, 115, 125, 129, 135, 275 reactivity, xi, 134, 215, 220 reading, 339 real time, 139 reality, 76, 77 recall, 51, 102, 109, 110, 212 receptors, xii, 126, 222, 227, 266, 273, 274, 277, 280, 282, 284, 297, 298, 301, 302, 311, 314, 327, 331, 332, 339, 350 recession, vii, x, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 22, 24, 25, 26, 27, 28, 29, 31, 32, 39, 111, 121, 122, 132, 138, 150, 171, 172, 173, 174, 181, 182, 195, 197, 219, 288, 292, 308 recognition, 62, 268, 300, 302 recommendations, 261 reconstruction, 2, 13, 90, 91, 201 recovery, 41, 43, 60, 294, 346 recurrence, x, xiii, 40, 121, 138, 184, 185, 280, 287, 289, 297, 302, 305, 313 regenerate, 129 regeneration, 5, 13, 14, 18, 20, 22, 24, 25, 28, 58, 89, 101, 119, 124, 132, 184, 192, 193, 194, 197, 199, 280, 290, 291, 336 regression, 72, 186, 306 regression analysis, 72 regression model, 306 regular, 289 regulation, 298, 313, 315, 322, 324, 327, 328, 332, 333, 334, 336, 337, 339, 346, 351 rehabilitation, 68, 173 rejection, 189, 231, 277 relapses, 138 relationship, 288, 292, 295, 296, 298, 312, 317, 318, 319, 337, 338 relationships, 340, 341 relativity, 69 relevance, 14, 243, 244, 349 relief, 84, 169 remodelling, 100, 104, 105 renal failure, 245 renal replacement therapy, 231 373 repair, 28, 89, 96, 101, 129, 158, 194, 279, 285, 304, 335, 336 replacement, 35, 231, 316 reproduction, 13, 133, 194 reproductive organs, 325 researchers, xiii, 96, 148, 216, 293, 295, 301, 322 resection, 193, 194 residues, 225, 350 resistance, 91, 99, 106, 148, 170, 226, 228, 229, 241, 243, 252, 296, 331 resolution, 95, 221 respiratory, 324, 327, 344 responsiveness, 300, 308 restitution, 75 restoration, viii, 16, 67, 68, 69, 73, 74, 76, 78, 81, 82, 84, 85, 177, 195, 199, 200, 201, 303 restorations, xiii, 287, 304, 306, 308, 309, 317 restorative material, 83 restrictions, 73 retardation, 58 retention loss, 74 reticulum, 327 retinopathy, 184, 228 reverse transcriptase, 332 rheumatic diseases, 223, 238, 239 rheumatoid arthritis, xi, xii, 116, 215, 217, 219, 235, 236, 238, 239, 240, 273, 274, 282 rheumatoid factor, 240 ribosomal RNA, 63 rings, 305 risk assessment, 61, 87, 118, 179, 180, 304, 305, 306, 313, 318 risk factors, x, xiii, 86, 109, 112, 113, 117, 121, 132, 164, 180, 189, 190, 219, 221, 228, 230, 231, 232, 234, 235, 242, 244, 245, 248, 250, 274, 280, 287, 289, 291, 297, 299, 300, 301, 302, 303, 304, 305, 307, 308, 309, 312, 313, 315 risk profile, 164, 305, 306 risks, 6, 149, 166, 182, 186, 188, 189, 229, 248, 254, 304, 317 RNA, 63, 333 rodent, 315 Romania, room temperature, 259 root, vii, xiii, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 44, 45, 62, 73, 75, 89, 94, 101, 108, 109, 118, 124, 125, 133, 134, 145, 158, 161, 164, 168, 172, 174, 178, 180, 190, 192, 193, 194, 195, 197, 199, 206, 374 Index 207, 210, 212, 217, 218, 280, 287, 294, 303, 304, 306 root canal treatment, 45, 62 roots, 4, 8, 21, 28, 158, 179, 193 rubber, 200 rural, 292 S safety, 76, 289 saliva, ix, xiii, 33, 46, 48, 49, 50, 51, 52, 54, 56, 64, 65, 94, 96, 100, 102, 103, 104, 113, 114, 117, 122, 123, 139, 222, 225, 230, 231, 271, 321, 322, 325, 326, 329, 338, 347, 349 salivary gland, 96, 113, 325, 326, 328, 340, 346, 347, 349 salivary glands, 96, 325, 326, 328, 340, 346, 347, 349 salt, 329, 330, 343 salt concentration, 329, 330 sample, 289, 332 saturated fat, 248, 249 scaling, 89, 101, 109, 118, 124, 168, 172, 180, 206, 207, 210, 212, 218, 280, 294 scars, 12 scatter, 201 scavenger, 333 scheduling, 87 school, 64, 255 science, 23, 77, 92, 237 sclerosis, 233 scoliosis, 233 scope, 194, 196, 252, 323, 329 scores, 299, 304, 306, 309 screening, 109, 110, 139, 252, 254 search, 301, 349 searching, 325 secrete, 98, 148, 158, 275, 284, 295 secretion, 220, 227, 229, 234, 278, 295, 315, 316, 317, 328, 340 seeding, 259 self-control, 225 self-efficacy, 252, 256 self-reports, 251 senescence, 57, 181 sensation, 210 sensitivity, 2, 48, 95, 99, 102, 103, 109, 110, 138, 146, 168, 170, 186, 228 separation, 350 sepsis, 277, 331, 343 septic shock, xii, 273, 274, 277, 278 septum, 298 series, 298 serine, 330, 345 serotonin, 232 serum, ix, 93, 96, 101, 106, 115, 116, 128, 168, 185, 224, 225, 228, 229, 231, 241, 245, 259, 260, 261, 265, 267, 298, 313, 316, 329 SES, 183 severity, xiii, 287, 288, 289, 290, 291, 292, 299, 300, 301, 303, 304, 312, 317, 318 sex, 182, 185 sex ratio, 182 sex steroid, 185 shape, 3, 68, 110, 140, 154, 156, 158, 174, 198, 264 shock, ix, 108, 114, 115, 116, 117, 118, 119, 120, 218 showing, ix, xi, 48, 56, 107, 109, 145, 148, 247, 278, 281, 329 shrinkage, 9, 16, 145, 146 sialic acid, 187 side effects, 210 signal peptide, 326, 328 signaling, 332, 340, 341, 344, 345, 346, 349 signaling pathway, 278, 332, 339, 344, 345, 349 signalling, 282 signs, 44, 45, 51, 57, 73, 88, 110, 122, 139, 145, 149, 162, 166, 168, 169, 170, 174, 179, 200, 226, 227 similarity, 299 Singapore, 240 single nucleotide polymorphism (SNP), 301, 314, 316 sinuses, 203 sinusitis, 218 sites, 288, 292, 298, 302, 303, 305, 306, 331, 346 skeleton, 234 skin, 218, 324, 325, 326, 328, 336, 337, 340, 344, 347, 348, 351 skin diseases, 337 skin disorders, 325 small intestine, 323, 326, 345 smoke, 293, 294, 309, 316 smoke exposure, 126, 134, 293, 316 smokers, 292, 293, 294, 318 smoking, x, xiii, 16, 17, 22, 69, 111, 112, 121, 122, 123, 124, 126, 127, 130, 131, 132, 133, 134, 135, 139, 164, 169, 186, 190, 191, 219, 221, 224, 231, 234, 247, 248, 249, 250, 251, 256, 283, 287, 292, 293, 294, 296, 298, 299, 301, 304, 305, 307, 308, 309, 310,묈311, 312, 313, 314, 316, 318, 319 smoking cessation, 133, 135, 169, 248, 251, 256, 283 Index smooth muscle, 220, 285, 332, 336, 347, 351 smooth muscle cells, 285, 332, 351 snacking, 254 social life, 110, 248 social support, 294 socioeconomic, xiii, 287, 291, 292, 316 socioeconomic status, xiii, 183, 221, 224, 287, 292 sodium, 27, 210, 232 software, 144, 203, 262, 264 solution, 8, 15, 143, 238, 261, 349 somatic cell, 284 species, viii, xii, 32, 33, 41, 42, 46, 47, 48, 49, 50, 51, 52, 53, 54, 56, 57, 58, 59, 60, 61, 63, 64, 65, 66, 101, 111, 112, 114, 115, 116, 125, 129, 134, 135, 150, 177, 180, 188, 219, 221, 228, 234, 258, 267, 271, 273, 274, 275, 276, 280, 294, 300, 302, 323, 329 spectrum, 293, 323, 340 speculation, 58 spermatozoa, 346 spinal cord, 233 spine, 188, 232, 298 splinting, viii, 67, 69, 73, 74, 75, 89, 91 Spring, 235 sprue, 226 SPT, 313 sputum, 222 squamous cell, 242, 325 squamous cell carcinoma, 242, 325 Sri Lanka, 288, 313 stability, 12, 13, 21, 64, 71, 74, 102, 105, 206 stabilization, 11, 13, 74, 87, 89, 323 stages, 288, 329, 337 stakeholders, 252 standard deviation, 263, 265, 297 Staphylococcus, 323, 324, 330, 346, 349 Staphylococcus aureus, 323, 324, 330, 346, 349 state, 35, 71, 73, 74, 85, 109, 158, 174, 185, 228, 229, 230, 237, 250, 280, 294, 298, 310, 326, 338 states, 98, 174, 186, 274, 331, 339 statistics, 241 sterile, 47, 140, 198, 199, 260, 266 steroids, 225 stimulus, 240 stomatitis, 36 storage, 327 strain, 294, 341, 345 strains, 329, 330 strategies, 288, 295 stratification, 245 375 streptococci, 65, 132, 347 stress, vii, viii, x, xiii, 67, 75, 76, 79, 80, 81, 82, 83, 84, 91, 92, 108, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 123, 164, 192, 219, 229, 239, 240, 243, 287, 294, 295, 296, 301, 307, 309, 314, 315, 317, 318 stressors, 294 stroke, 113, 138, 151, 233 structural characteristics, 114 structure, viii, x, xiii, 8, 67, 133, 153, 158, 200, 251, 276, 277, 299, 321, 323, 344, 348, 349 students, 293, 295, 311 style, 255 subacute, 218 subgroups, 183 substances, 293 substitutes, 18 substitution, 56, 66 substrates, 267, 270, 338, 340 subtilisin, 330, 345 subtraction, 175 success rate, 13, 76, 82, 198, 217 sucrose, 132 superimposition, 161 superoxide, 294 suppression, 126, 189, 331 surface component, 258 surgery, 293, 304, 336 surgical, 297, 308, 309, 316 surgical intervention, 21 surgical removal, 216 surgical resection, 194 surgical technique, 8, 10, 11, 16, 28 surgical template, 198 surveillance, 244 survey, 86, 237, 243, 290, 291, 295 survival, viii, 52, 67, 68, 76, 86, 91, 124, 131, 191, 199, 277, 290, 303, 306, 307, 311, 314 survival rate, 303, 306 survivors, 117 susceptibility, vii, ix, xi, xiii, 35, 58, 93, 104, 115, 130, 132, 197, 215, 219, 220, 222, 224, 231, 287, 289, 297, 299, 301, 303, 304, 310, 312, 329, 337, 341, 346, 347 suspensions, 260 suture, 9, 11, 15 sweat, 325, 347 Sweden, 14, 242 swelling, 35, 37, 41, 43, 45, 110, 140, 162, 169, 170, 200, 224, 274 376 Index Switzerland, 244, 262 sympathetic nervous system, 295 symptoms, 45, 64, 72, 168, 169, 200, 224, 225, 226, 227, 249, 274, 275 syndrome, viii, xi, xiii, 32, 44, 57, 58, 61, 64, 66, 178, 184, 215, 217, 218, 219, 224, 226, 229, 232, 233, 236, 243, 322, 338, 344 synergistic, 330 synergistic effect, 270 synovial fluid, 224, 239 synovial tissue, 224 synthesis, 40, 102, 124, 125, 133, 161, 265, 284, 290, 322, 324, 326, 331, 332, 333, 336, 341, 344, 351 systemic risk, 161 T T cell, 127, 284, 300, 341, 342, 351 T lymphocytes, 96, 275, 301, 331, 343 tactics, 269 target, 118, 224, 265, 282 TCC, 47 technical support, 149 techniques, vii, viii, 1, 2, 5, 17, 18, 21, 23, 25, 26, 32, 46, 57, 60, 156, 186, 195, 252, 258, 328 technological revolution, ix, 94 technologies, 102, 103 technology, 14, 248, 298 teens, 33 telephone, 251 temperature, 115, 177, 259, 329 tension, 9, 11, 12, 17, 23, 26 testing, 168, 184, 302 testis, 326, 340 testosterone, 232 tetrachlorodibenzo-p-dioxin, 134 TGA, 47 TGF, 316 Thai, 318 Thailand, 321, 339 thapsigargin, 327 therapeutic agents, 281 therapeutic approaches, xi, xii, 215, 273, 281 therapeutic goal, 164, 167, 168, 194, 197, 280 therapeutic intervention, 94, 102 therapeutic targets, 119 therapeutics, 117, 285 thinning, 145 Thomson, 309, 316 threshold level, thresholds, 291 thrombin, 277, 284 thrombomodulin, 277, 284 thrombosis, 218 thrombus, 185 thymus, 326, 328 thyroiditis, 226 time periods, 164 TIMP, 116, 125, 129 TIMP-1, 116, 129 tissue homeostasis, 148, 337, 339 titanium, 27, 309 TLR, 347 TLR2, 280 TLR4, 280 T-lymphocytes, 333 TNF, ix, xii, 97, 98, 107, 111, 113, 184, 186, 189, 190, 191, 220, 221, 224, 225, 227, 228, 230, 240, 273, 274, 275, 277, 278, 279, 280, 281, 285, 300, 316, 317, 327, 328, 331, 333, 336, 344 TNF-alpha, 184, 240, 285, 344 TNF-α, ix, 98, 107, 113, 230, 274, 277, 281 tobacco, x, 3, 25, 121, 122, 123, 126, 127, 129, 130, 131, 132, 135, 191, 219, 242, 249, 292, 293, 294, 308, 309, 316 tobacco smoke, 132, 293, 294, 308, 309 tobacco smoking, 122, 127, 131, 219, 293, 316 toll-like, 331 tonsils, 216, 328 toothbrushing, 3, 247, 251, 256 topical anesthetic, 169 topology, 346 total cholesterol, 231 toxic, 293, 339 toxic effect, 129 toxic products, 111, 210 toxic shock syndrome, 218 toxic substances, 293 toxicology, 242 toxin, 347 trachea, 326, 328 trainees, 311 training, 96, 251 transcriptase, 332 transcription, xii, 117, 118, 273, 274, 277, 284, 327, 335, 345 transcription factor, 327, 345 transcription factors, 284 transcriptional, 351 Index transfer, 335 transformation, 73 transglutaminase, 340 transition, 288, 304 translocation, 218, 221, 238, 271 transmission, viii, 32, 53, 54, 61, 65, 71 transparency, 5, 26 transplant, 16, 189, 231, 245 transplant recipients, 245 transplantation, 226 transport, 248 trauma, 3, 21, 22, 23, 34, 71, 72, 73, 74, 87, 88, 89, 110, 176, 178, 179, 195, 198, 199, 201, 226, 233, 274, 283 traumatic events, 13 Treponema denticola, 303, 328, 330, 331, 341 trial, x, 205, 206, 207, 212, 213, 237, 238, 295 trigeminal nerve, 230 trigeminal neuralgia, 218 triggers, xii, 180, 273, 282, 301, 348 trisomy, 57 trochanter, 298 trypsin, 104, 270, 324, 343 tumor, xii, 98, 111, 119, 187, 189, 191, 220, 221, 228, 273, 274, 281, 282, 285, 286, 298, 300, 311, 347 tumor cells, 281 tumor necrosis factor, xii, 98, 111, 119, 189, 191, 220, 221, 273, 274, 282, 285, 286, 298, 300, 311, 347 tumors, 229 tumour growth, 282 Turkey, 251 turnover, 97, 99, 101, 154 twins, 61, 244, 299, 314 type diabetes, 185, 226, 227, 296, 310, 317, 318 type diabetes, xii, 116, 226, 227, 229, 241, 243, 249, 250, 255, 256, 273, 280, 285, 296, 315 type diabetes mellitus, 296 tyrosine, 105 U ulcer, 218, 335, 344 ulcerative colitis, 232 ulcers, 140 underlying mechanisms, 123 uniform, 109, 110 united, 55, 130, 182, 183, 228, 290, 291, 292, 308, 310, 312, 318 377 United States, 55, 130, 182, 183, 228, 290, 291, 292, 308, 310, 312, 318 urban, 131, 292, 310 urea, 231 urine, 226, 249 urokinase, 129, 135 urticaria, 218 USA, 2, 47, 63, 117, 139, 207, 255, 259, 261, 262, 306, 339, 340, 349 UV radiation, 128 uveitis, 218, 348 V vaccination, 339 vagina, 326 validation, 95, 315 validity, 305 valuation, 87, 255, 316 variables, 72, 77, 87, 130, 170, 274, 289, 291, 299, 306 variance, 299 variation, 299, 302, 303, 314 variations, 61, 173, 230, 299, 312, 317, 323, 338 varieties, 58 vasoactive intestinal peptide, 105 vasodilatation, 336 vasodilation, 98 vasopressin, 310 vector, 76, 305, 306 vegetables, 249, 256 vein, 127, 135, 282 vessels, 33, 122, 127, 144, 158, 164, 220, 249, 258, 322, 328, 332 viral infection, 169, 226 virulence, 290, 302, 330, 331 virus, 337, 344 viruses, 163, 222, 323, 337 vision, 249 vitamin C, 131 vitamin D, 112, 324 vitamins, 232 vitiligo, 226 vulnerability, 200 W war, 269 water, 36, 143, 149, 158, 260, 327 378 Index water permeability, 327 wavelengths, 262 weakness, 226 weight control, 249 weight loss, 225, 243, 248, 249 Weinberg, 342, 343, 345, 349 well-being, 250 wellness, 304 western blot, 125, 128 white blood cells, 148 wires, 206 women, 291, 297, 298, 312, 316, 318 wool, 207 workers, 333, 334, 335 workplace, 293 World Health Organization (WHO), xi, 247, 248, 250, 251, 254, 256, 297 worldwide, xi, 243, 247, 248, 249, 288, 296 wound healing, 14, 23, 26, 58, 114, 125, 154, 161, 184, 309, 324, 335, 341 X xenopus oocytes, 343 xenotransplantation, 277 xerostomia, 231 x-rays, 201 Y yang, 277 yeast, 259, 261, 282, 330 yield, x, 82, 83, 137, 149, 326, 338 yin, 277 young adults, 64, 131, 226, 245, 312, 316 Z zinc, 100, 125 ... of periodontal treatment on cardiovascular diseases, adverse pregnancy outcomes, diabetes mellitus, and respiratory disease Chapter XI - Obesity, diabetes and oral diseases (dental cariesand periodontal. .. chapter, basic knowledge and the clinical importance of antimicrobial peptides in periodontal disease will be discussed in detail In: Periodontal Disease: Symptoms, Treatment and Prevention ISBN 978-1-61761-739-3... periodontitis and perinatal outcomes; identifying patients with enhanced disease susceptibility in periodontal disease; and inflammatory mediators and oxidative stress in periodontal disease Chapter