Dental Research in Review

Dental Research in Review
February 29, 2012
Keynote Speaker for Dental Research in Review Day Feb 29th, 2012, 1:15 to 2:15 PM
Dr Jane Weintraub
An “Outlier’s” Research Path: Integrating Population Science, Clinical Practice and
Health Policy to Improve Oral Health
Dr Jane Weintraub is the Dean and Alumni Distinguished Professor at the School of Dentistry and Adjunct Professor
at the School of Public Health, UNC. Her vast academic and professional background includes leading the UCSF
Center to Address Disparities in Children‘s Oral Health, known as CAN DO. After its first seven-year cycle of
funding, this National Institutes of Health-funded center received an additional seven years of funding totaling $24.4
million representing the largest research grant in the UCSF School of Dentistry‘s history. Her accolades and
accomplishments span the Public Health and Dental arenas through her leadership as a past president of both the
American Association of Public Health Dentistry and the International Association of Dental Research‘s behavioral
sciences and health services research group. She was one of the scientific editors and contributing authors for the first
Surgeon General‘s Report on Oral Health. In 2009 she received the International Association of Dental Research‘s H.
Trendley Dean Distinguished Scientist Award for her work in oral epidemiology and dental public health, and in 2010
she received the American Dental Association‘s Norton M. Ross Award for Excellence in Clinical Research.
Location: Medical Biomolecular Research Building (MBRB) room G202- Walking directions: From Manning
Drive walk into Thurston-Bowles building, take the elevator to the second floor and walk out to an outdoor courtyard
with tables. Walk straight through the courtyard. You are looking at the MBRB, a tall brick building with a curved,
two-story patio, silver wall sconces, and a round planter near the entrance. The MBRB is connected to the
Neuroscience Research Building.
Dental Research in Review Schedule of Events
Time
Activity and Location
7:00AM-7:15AM
Poster Set-Up
(3rd- & 4th-Floor Tarrson lobbies)
All Presenters
7:15AM
Dean’s Welcome Breakfast
( 464 Brauer)
7:45AM
Dean’s Welcome and Opening Remarks
(464 Brauer )
8:00AM-10:00AM
Poster Sessions
(3rd & 4th Floor Tarrson lobbies)
General Viewing, Judging and Vendor Tables
8:30 to 9:30
Presentations of Research Centers and Labs
Student Lab, 3rd Floor Brauer
10:15AM-11:45AM
Oral Sessions
(Old Dental 3180, Brauer 464 & Old Dental 150)
General Viewing and Judging
12:00PM-1:00PM
Lunch and Learn
1:10PM
Raffle MBRB G202
1:15PM-2:15PM
Keynote Address: An “Outliers” Research Path: Integrating Population Science, Clinical
Practice and Health Policy to improve Oral Health (MBRB G202). Dr. Jane Weintraub, DDS,
MPH, Dean and Alumni Distinguished Professor at The University of North Carolina at Chapel
Hill School of Dentistry
2:30PM-5:00PM
Oral Sessions
(Old Dental 3180, Brauer 464 & Old Dental 150)
General Viewing and Judging
March 7th, 2012
5:30 PM–7:00PM
Awards Presentations at the Recovery Room
Sponsored by the Dental Foundation of North Carolina
Drs. Weintraub/Beck/Khan/SRG/NCAADR/Research Advisors
Presentation of Research Centers and laboratories
8:30 to 9:30 AM
Poster
Presenter (Lab/Center)
Room
Training Program for the Next Generation
of Oral Health Researchers (NextGen)
Dr. Jim Beck (NextGen)
Distinguished Professor, Associate
Dean, Department of Dental
Ecology
3rd Floor
Tarrson
Lobby
Bio-Inspired Engineering for Craniofacial
Tissue Regeneration
Dr. Ching-Chang Ko (Ko Lab)
Associate Professor,
Department of Orthodontics
3rd Floor
Student Lab
Dose- and Time-Effects of Genipin, a
Natural Cross-Linker, on Dentin Collagen
Dr. Hideaki Nagaoka (Yamauchi
Lab)
Postdoctoral Research Associate,
Dental Research
3rd Floor
Student Lab
Oral/Table Clinic
Presenter (Lab/Center)
Room
Exploring the science behind human tooth
eruption—from ‗how to move teeth‘ to
‗how teeth move‘
Dr. Sylvia Frazier-Bowers
(Frazier-Bowers Lab)
Associate Professor, Department of
Orthodontics
3rd Floor
Student Lab
Matrix changes in cartilage with aging
Dr. Masahiko Terajima (Yamauchi
Lab)
Postdoctoral Research Associate,
Dental Research
3rd Floor
Student Lab
Molecular genetics of tooth formation
Dr. Timothy Wright (Wright Lab)
Distinguished Professor,
Department of Pediatric Dentistry
3rd Floor
Student Lab
Center for Neurosensory Disorders:
Portraits in Time
Dr. Samantha Segall (CNSD),
Post-Doctoral Fellow, CNSD
3rd Floor
Student Lab
Lunch and Learn
12-1 PM, Preregistration required
Title
Presenter
Fostering Creative Research—
Lunchtime Ruminations Over How
to Generate Good Ideas for
Meaningful Scientific Research
Dr. Steven Offenbacher
150 Old Dental
Distinguished Professor and Chair
Building
Department of Periodontology & Director of
COSD
Zirconia: Advances in
Adhesion/Cementation
Dr. Jeffrey Piascik
Adjunct Assistant Professor
Department of Operative Dentistry & RTI
International, Center for Materials and
Electronic Technologies
464 Brauer
COMT Modulation of Pain
Sensitivity: Molecular Genetic and
Receptor Mechanisms
Dr. Andrea Neely
Assistant Professor
Department of Endodontics & CNSD
475 Brauer
Using NHANES (National Health
and Nutrition Examination Survey)
Data
Dr. Anne Sanders
Assistant Professor
Department of Dental Ecology
344 Brauer
An Update on Caries and Related
Risk Factors: From Genetic to
Neighborhood Effects
Dr. Kimon Divaris
Postdoctoral Research Fellow
Dental Research
353 Brauer
―What to Tell Your Patient‘s About Dr. John Ludlow
Radiation Risk‖
Professor
Department of Diagnostics Sciences &
General Dentistry
Room
3180 Old
Dental
Building
Poster Session 1
8AM-10AM, Third Floor Tarrson Hall Lobby
#
Presenter
Department
1
Roopwant Kaur
Operative Dentistry
Immediate bond strengths to Gluma Power Gel-treated dentin
2
Hiroko Nagaoka
Operative Dentistry
3
Hideaki Nagaoka
Operative Dentistry
4
Silvia Amaya-Pajares
Operative Dentistry
5
Abdel-ghany Alsaidi
Periodontology
6
Sheng Zhong
Endodontics
7
Heather Hendricks
Orthodontics
8
Lauren Katz
Pediatric Dentistry
9
Heather Zimmerman
Pediatric Dentistry
Genipin-induced Cross-Linking and Dentin Bond Strengths
in Human Teeth
Dose- and Time-Effects of Genipin, a Natural Cross-Linker,
on Dentin Collagen
Inhibition of the Polymerization of PVS in the New LatexFree Dentistry
miRNA profiles of human gingival fibroblasts infected with
cytomegalovirus
Lipopolysaccharide induced changes in microRNA
expression
A novel PTH1R mutation causes eruption failure in
deciduous dentition
Characterization of Phenotype and Col11a1 Expression in
Cleft Palate Mice
Prevalence of interfrontal bones in inbred and F1 mice
10 Sodsi Wirojchanasak
Oral Biology
11 Christine Kim
Oral Biology
12 Folabomi Oladosu
CNSD/ Endodontics
13 Cortney Winkle
CNSD/Endodontics
14 Shad Smith
CNSD/Endodontics
15 Brittney Ciszek
CNSD/Endodontics
16 Carolina Meloto
17 Ning Yu
CNSD/
Endodontics
Oral Biology
18 Michael Stella
Periodontology
19 Ayesha Swarn
Operative Dentistry
20 Kristi Erickson
Operative Dentistry
Title
NF kappa B Haploinsufficiency Affects Osteogenesis During
BMP2-Induced Bone Regeneration
An inhibitory domain in SPLUNC1 inhibits the epithelial
sodium channel and restores airway surface liquid height in
cystic fibrosis airway epithelia
Increased MOR-1K Expression Levels are Associated with
Opioid-induced Hyperalgesia.
Catechol-O-Methyltransferase- and Stress- Dependent Pain
Sensitivity In Mast Cell Deficient Mice
Candidate Gene Association Analysis of Onset TMJD in
OPPERA, a Large Population-based Cohort Study
Chronic Catechol-O-methyltransferase-Dependent Pain: A
peripheral contribution
Characterizing a novel COMT isoform: Expression levels
and enzymatic activity
Diabetes-Related Gene Expression Patterns in Different
Stages of Periodontal Inflammation
Effect of Periodontal Therapy on Markers of Kidney Damage
in Patients with Chronic Kidney Disease.
Clinical Salivary pH Vs. Laboratory Buffering Capacity: A
Comparison
The Titratable Acidity and pH of Malted Beverages: Their
Potential Erosive Effect on Dental Erosion.
Poster Session 2
8AM-10AM, Fourth Floor Tarrson Hall Lobby
#
21
Presenter
Edward Givens
Department
Prosthodontics
22
Bashir Hosseini
Endodontics
23
Prosthodontics
24
Gustavoa
Mendonca
Daniela Mendonca
25
26
Xi Chen
Shenan Bradshaw
Dental Ecology
OMFS
27
Eric Draper
Oral Maxillofacial
Surgery
28
Chance Powell
Pediatric
Dentistry
29
Li Qian
Periodontology
30
Thatsanee
Saladyanant
Oral Biology
31
Oral Pathology
32
33
34
Raquel BurgerCalderon
Lin Lin
Russell Mack
Christopher Dibble
35
Nayoung Lee
Orthodontics
36
Orthodontics
37
Carroll Ann
Trotman
Qun Tang
38
Thomas Pardue
Prosthodontics
39
Crystal Cox
Orthodontics
Prosthodontics
Oral Biology
Prosthodontics
Oral Biology
Dental Hygeine
Title
Immediate placement & provisionalization of implants placed into
sites with periradicular infection: Influence of antibiotics on
implant survival rates.
Antibiotic use in Conjunction with Immediate Implant Placement to
Replace teeth with Apical Pathology Associated with Endodontic
Origin
The role of RHO signalling in implant surfaces with nanoscale level
features
The effects of desferrioxamine on gene expression for different
implant surfaces
Self-Rated oral health in older adults in the last year of life
Quality of Life Outcomes, Pericoronitis Symptoms, and Third
Molar Removal
The Association Between Removal of Premolars with Orthodontic
Treatment and the Angulation of Developing Third Molars Over
Time
Correlation between body mass index and the number of decayed,
missing, filled primary teeth in children who received dental
treatment under general anesthesia
Substance P regulates LPS-induced MAP-K and NF-kB activation
The Human Papillomavirus Type 16 E5 Oncoprotein Modulates
Signal Transduction and Innate Immune Response in Oral
Keratinocytes
Corroborating a Potential Link between BK virus and HIVassociated Salivary Gland Disease.
Cloning,, expression and purification of Tubby protein
Proteomic Analysis for Cerebral Cavernous Malformations
The RhoA-Rho kinase-LIM kinase-Cofilin Signaling Pathway is
Dysregulated in Cerebral Cavernous Malformation Disease
Automatic Design of Landmarks in the Circumoral Region for
Patients with Cleft Lip
Effects of Primary Lip Surgery on Facial Soft Tissue Dynamics-A
Pilot Study.
Three Intraoral Radiographic Receptor-Positioning Systems: A
Comparative Study
Sustained Tolerance of CPAP using MAS supported nasal pillows
In vivo evaluation of force decay properties of NiTi closed coil
springs and comparison with matched in vitro analysis.
Oral Session 1
10:15 AM-12:00 AM, Room 150 Old Dental Bldg
#
40
Presenter
George Soung
Department
Oral
Maxillofacial
Surgery
Time
Title
10:15 Prevalence of Third Molars with Caries Experience or
Periodontal Pathology in Young Adults
41
Paul Carruth
Endodontics
10:30 Vertical Root Fracture Detection Using High Resolution
CBCT
42
Clark Morris
Pediatric
Dentistry
10:45 Caregiver Attitudes and acceptance of Childhood
Overweight and Obesity Counseling in the Dental Office.
43
Orthodontics
11:00 Impact of Orthognathic Surgery on Oral Health QOL
44
Taneisha
Livingston
Afsar Naqvi
Periodontology
11:15 Purified LPS from the Periodontal Pathogens
Aggregatibacter actinomycetemcomitans and
Porphyromonas gingivalis induce Convergent/Divergent
miRNA Expression
45
Shijia Hu
Oral Biology
11:30 Effect of Fluoride on Regulation of Parathyroid Hormone
46
William Seaman
Dental Ecology
11:45 Partially-Differentiated Oral Keratinocytes Support In
Vitro Production of Wild-type HPV16 Originating from
an Oral Cancer.
Oral Session 2
10:15 AM-12:00 AM, Room 3180 Old Dental Bldg
#
47
Presenter
C. Marshall Long
Department
Pediatric
Dentistry
Time
10:15
48
Maura Slack
Orthodontics
10:30
49
Viviana Ruiz
Dental
Hygiene
10:45
50
Allison Cavenaugh
11:00
51
Travis Hicks
52
Steven Richardson
Pediatric
Dentistry
Pediatric
Dentistry
Endodontics
53
Uvoh Onoriobe
NC Oral
Health
Section
11:30
10:15
11:15
Title
The Age One Dental Visit: Knowledge, Attitudes, and
Behaviors of North Carolina Dentists Regarding
Physician Guidelines
Tooth Whitening Procedures and Orthodontic Treatment:
A Survey of Orthodontists
Infant and Toddler Oral Health: A Survey of Attitudes
and Practice Behaviors of North Carolina Dental
Hygienists.
Economic Turmoil and Craniofacial Care: The Impact of
a National Recession on Children with Cleft Lip/Palate
Knowledge and Practice of Eating Disorders Among a
Group of Adolescent Dental Patients
Access to Endodontic Care in North Carolina Public
Health and Medicaid Settings
Caries and Fluorosis Impacts on Oral Health-Related
Quality of Life
Oral Session 3
10:15 AM-12:00 AM, Room 464 Bauer
# Presenter
54 Shaoping Zhang
Department
Periodontology
55 Alice Wu
Periodontology
56 Andre Paes
Periodontology
57 Jonathan Reside
Periodontology
58 Kerry Dove
Pediatric Dentistry
59 Jake Philips
Oral &
Maxillofacial
Radiology
Time
Title
10:15 RIP2 Kinase Modulates PGE2 Production in Periodontal
disease
10:30 Investigation of the mRNA Expression Level of FGF-2
Gene in Periodontal Tissues as Determinants of Healing
Response after Implant Surgery
10:45 Bacterial Evaluation of Periodontal Diseases in an
Induced Model of Inflammation
11:00 In vivo Assessment of Bone Healing Following
Piezotome® Ultrasonic Instrumentation
10:15 Children, Crowding, Caries: Is there a Connection?
11:15 Comparative Dosimetry of Nomad® Pro Handheld and
Wall-mounted X-ray Sources
Oral Session 4
2:30 AM-4:00 PM, Room 150 Old Dental Bldg
#
60
Presenter
Nuha Ahmad
Time
2:30
62
Cynthia
Lambert
Matthew Larson
Department
Dental
Hygeine
Dental
Hygeine
Orthodontics
61
63
Jocelyn Beville
Orthodontics
3:15
64
Gibson McCall
Orthodontics
3:30
2:45
3:00
Title
Obstructive Sleep Apnea in Association with Periodontal
Disease
Correlation of Perceived Stress and HPA Axis Reactivity in
Temporomandibular Disorder: A Case Control Study
A Novel Biomechanical Model Assessing Orthodontic
Continuous Archwire Activation
Three Dimensional Analysis of Bone Anchored Maxillary
Protraction in Growing Class II Patients
The Efficacy of Temporary Skeletal Anchorage versus
Maxillary Osteotomy in Treatment of Anterior Open Bite
Oral Session 5
2:30 AM-4:00 PM, Room 3180 Old Dental Bldg
#
Name
Department
Time
Title
65
Tom Brown
Endodontics
2:30
66
Linda Chan
Endodontics
2:45
67
Cristina Maresca
Endodontics
3:00
68
Johnah Galicia
Endodontics
3:15
69
Hsin Chen
Endodontics
3:30
Comparison of Torsional and Cyclic Fatigue Failure in
Rotary Nickel Titanium Instruments Manufactured
with M-Wire Blue and Conventional Superelastic N
Analysis of microRNA Expression in Periapical
Lesions of Endodontic Origin.
Utilization of Blended Learning to Teach Preclinical
Endodontics: Pilot Study
Genome-wide Gene Expression Profile of Inflamed
Dental Pulp in Humans: Implications in Clinical
Diagnosis and Symptoms of Pulpitis.
Development of New Biomimetic Cement (Gemosil®)
as an Alternative to Mineral Trioxide Aggregate for
Use in Endodontic Therapy
Oral Session 6
2:30 AM-4:00 PM, Room 464 Bauer
#
Name
Department
Time
70
Martin Evers
Oral Maxillofacial
Radiology
2:30
71
Heidi
Kohltfarber
Oral Maxillofacial
Radiology
2:45
72
Cameron Walker
3:00
73
Theresa Wang
Oral Maxillofacial
Radiology
Prosthodontics
74
Bryan Limmer
Prosthodontics
3:30
75
Jordan Olsen
Pediatric Dentistry
3:45
76
Chien Sim
Pediatric Dentistry
4:00
3:15
Title
Development and Testing of a CBCT
Educational Module for Dental Providers in the
US Navy
A Comparison of 2D versus 3D Radiography
in the Treatment Planning of Non Healing
Root Canal Treated Teeth
Effective Dose and Image Quality of CBCT
Diagnostic Imaging Scans
4-year Radiographic and Esthetic Evaluation of
Peri-Implant Tissue in Immediate Implants
Replacing Single Teeth in the Esthetic Zone
Prosthetic Complications With a Monolithic
Zirconia Implant Supported Fixed Prosthesis –
The UNC Protocol
Dynamic Finite Element Analysis of Maxillary
Incisor Trauma
Dietary Recommendations for Infants and
Toddlers Among Pediatric Dentists in North
Carolina
Abstracts
#1 Immediate bond strengths to Gluma Power Gel-treated dentin
R. Kaur1, E. J. Swift, Jr1., H. O. Heymann1, A.V. Ritter1, C. Phillips2, R. Walter1. 1Department of Operative Dentistry
and 2 Department of Orthodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC
Objectives: To evaluate the effects of Gluma Power Gel on bond strengths of etch-and-rinse and self-etch adhesives to
dentin. Methods: Occlusal surfaces of human molars were ground with 600-grit silicon carbide paper to obtain flat
dentin. For etch-and-rinse adhesive groups, dentin surfaces were conditioned with phosphoric acid prior to application
of Gluma Power Gel, Gluma Desensitizer, HemaSeal & Cide, HurriSeal, MicroPrime B, or MicroPrime G. Etch-andrinse adhesives tested were iBond Total Etch, ExciTE F, OptiBond Solo Plus, and Prime & Bond NT. The one-step
self-etch adhesives Adper Prompt L-Pop and Xeno IV also were evaluated. All materials were applied following
manufacturers‘ instructions. Venus Diamond composite build-ups were placed and specimens stored in distilled water
at 37°C. After 24 h, specimens were sectioned into beams and tested in microtensile bond strength (MTBS). Data
were analyzed using factorial analysis of variance (SAS 9.2vers). Level of significance was set at 0.05. Results: For
etch-and-rinse systems, mean MTBS ranged from 20.0 MPa when iBond Total Etch was used with Gluma Power Gel
to 46.6 MPa when ExciTE F was used with HemaSeal & Cide. These were similar to the results obtained with onestep self-etch adhesives, which had means ranging from 22.0 MPa (Adper Prompt L-Pop, control) to 37.0 MPa (Adper
Prompt L-Pop, MicroPrime G). The main factors (adhesive, desensitizer) and pairwise interaction effects were not
statistically significant (P>0.25). Conclusions: Gluma Power Gel has no adverse effect, on average, on the bonding of
the tested etch-and-rinse and self-etch adhesives to dentin. This study was supported by Heraeus Kulzer.
#2 Genipin-induced Cross-Linking and Dentin Bond Strengths in Human Teeth
H. Nagaoka1, H. Nagaoka2, R. Walter3, L.W. Boushell1, A.V.Ritter1, M. Yamauchi2. 1Department of Operative
Dentistry and 2NC Oral Health Institute, University of North Carolina,. 3Department of Preventive & Restorative,
Sciences Division of Restorative Dentistry, University of Pennsylvania
Achieving a strong and stable bond between composite resin and dentin collagen matrix remains a challenge. It has
been reported that the treatment of collagen with a natural cross-linker, genipin (GE), significantly improves the
ultimate tensile strength of dentin. However, its effect on dentin bond strength at the dentin/resin interface is not well
understood. Objectives: To evaluate the extent of GE-induced collagen cross-linking on amino acid composition and
dentin bond strength. Methods: Demineralized bovine dentin collagen was treated with 0.5% GE for 1, 4 and 12 hrs,
hydrolyzed with 6N HCl and subjected to amino acid analysis. The effect of GE-induced cross-linking on micro tensile
bond strength (MTBS) was investigated by using extracted human molars (n=12). Specimens were etched, treated with
PBS (control) or 0.5% GE for 1, 4 or 12 hrs prior to build-up with resin. Specimens were incubated at 37 °C for 24 hrs,
then processed for MTBS testing. Data were analyzed with ANOVA and Fisher‘s PLSD,and P<0.05 was considered
significant. Results: In the amino acid analyses, the contents of lysine (Lys) and hydroxylysine (Hyl) in the GE treated
group were significantly decreased in a time dependent manner. The MTBS was significantly increased in the 4 and
12 hrs GE treatment groups (58.5 ± 17.7 MPa and 44.3 ±16.8 MPa, respectively) when compared to the control (15.1 ±
8.5 MPa) (p<0.001). The MTBS of the 1hr treatment group was not significantly different than the control.
Conclusion: GE-induced cross-linking involves the Lys and Hyl residues of collagen and the 0.5% GE treatment for 4
hrs could be sufficient to exert efficient bond strength. Supported by NIH grants, DE019569 and DE020909.
#3 Dose- and Time-Effects of Genipin, a Natural Cross-Linker, on Dentin Collagen
Hideaki Nagaoka, DDS, Ph.D1, Hiroko Nagaoko, DDS2, Masahiko Terajima, DDS, Ph.D1, Andrew Burton1, Lee W
Boushell, DMD, MS2, Mitsuo Yamauchi, DDS, Ph.D1 1NC Oral Health Institute, 2Department of Operative Dentistry,
University of North Carolina at Chapel Hill, Chapel Hill, NC.
Genipin (GE) is a naturally occurring cross-linker that can stabilize collagen matrix in various tissues. Recently, it has
been shown that the GE treatment of dentin collagen improves dentin-resin bond strength. However, the optimal
conditions of GE-induced cross-linking are not well established. Objectives: To determine the effects of dose and time
of GE treatment on stability, amino acids and lysyl oxidase (LOX)-mediated cross-links of dentin collagen. Methods:
Bovine dentin was pulverized, demineralized and the insoluble collagen was collected. The samples were then treated
with 0.01%, 0.1% and 0.5% of GE for 30min, 1hr, 4hrs, 8hrs, 12hrs and 24hrs. After the treatment, an aliquot of each
sample was digested with bacterial collagenase and the digestibility was assessed by hydroxyproline analysis. The rest
of the aliquots were reduced with standardized NaB3H4, hydrolyzed with 6N HCl and subjected to amino acid and
cross-link analysis by HPLC. Results: The results demonstrated that GE-treated collagen became insoluble against
collagenase digestion in a dose- and time-dependent manner. The major amino acids that were diminished with GE
treatment were lysine and hydroxylysine residues, and the decreases were dose- and time-dependent. The cross-link
analysis showed that GE treatment generated the NaB3H4-reducible compounds but the LOX-mediated collagen
cross-links were not affected. Conclusion: The GE treatment stabilizes dentin collagen likely by forming
lysine/hydroxylsyine-based cross-links some of which are reducible with NaB3H4. Supported by NIH grant,
DE019569 and DE020909.
#4 Inhibition of the Polymerization of PVS in the New Latex-Free Dentistry
Silvia Amaya-Pajares, DDS., Alex J. Delgado, DDS, Terry E. Donovan, DDS. Dept of Operative Dentistry,
University of North Carolina
The aim of this study is to evaluate polymerization of a PVS impression material in direct and indirect contact with
different latex-free materials. The PVS inhibition of polymerization is thought to be contamination of the
chloroplatinic acid catalyst by sulfur compounds in the latex products. This inhibition is usually subtle and is limited
to the surface of the impression in contact with the contaminated tissues. The PVS material in contact with such agents
became sticky, rippled and unpolymerized, producing most of the times distorted and unacceptable Gypsum cast.
Materials and methods: The polymerization of one PVS impression material was evaluated after direct and indirect
contact with 9 brands of non-latex products and 4 brands of latex products. To test indirect inhibition, a plate was
divided in nine areas and each brand of product was rubbed on a specific area for 10 seconds and 1 minute. Samples of
the impression material were directly expressed on the plate and allowed to set for 10 minutes. To assess direct
contamination of the products, samples of the PVS material were expressed from an automatic mixing device directly
on the products. The sample was considered ―inhibited‖ if the contact surface was rippled or slippery. Results: Indirect
contamination resulted in 100% polymerization. Neoprene gloves showed 100% polymerization with both direct and
indirect contact. Conclusion: The previously negative interaction between latex products and PVS impression materials
seems to be a rare occurrence today. Improvements in PVS materials and use of non-latex materials may play a role.
Further studies should be indicated to correlate these findings.
#5 miRNA profiles of human gingival fibroblasts infected with cytomegalovirus
Abdel-ghany AlsaidiAG Alsaidi, Roger Arce and Salvador Nares. 2Department of Periodontics, University of North
Carolina at Chapel Hill, Chapel Hill, NC.
BACKGROUND AND OBJECTIVE: Human herpes-viruses are the etiological agents of many
chronic/latent/recurrent infections in humans. Among herpeviridae family members, Cytomegalovirus (CMV) has
been implicated as a co-infectious agent in the initiation and progression of periodontal disease in humans. However,
very little is known about the pathophysiology of such co-infection. A pro-inflammatory effect has been recently
demonstrated in human gingival fibroblasts (HGF) after CMV infection in vitro, which theoretically could be mediated
by viral proteins interfering with mRNA processing, including regulatory micro RNA molecules (miRNA). Moreover,
CMV-derived viral miRNA may play an important role during the co-infection process. We hypothesize that altered
expression of miRNAs after CMV infection may be linked to the pathogenesis of periodontal disease in gingival
fibroblasts.Therefore, the objective of this in vitro investigation is to study the effects of human CMV infection on the
miRNA expression profiles of HGF. MATERIAL AND METHODS: Human gingival fibroblasts will be
experimentally infected with the Towne strain of CMV and the kinetics of expression of miRNA studied at different
multiplicity of infection (MOI) and time-points. Total RNA will be isolated, and quantitative reverse transcriptionpolymerase chain reaction arrays used to analyze the relative expression levels of 80 key human miRNA linked to
inflammation. Commercially available CMV specific primers will also be used to detect the presence of miRNAs of
viral origin. ANTICIPATED RESULTS: We anticipate that the MOI will be correlated with induction/suppression of
miRNA linked to inflammation supporting a role of virally-mediated induction of inflammation on HGF. In addition,
we anticipate detecting the presence of CMV-derived miRNAs in HGF.
#6 Lipopolysaccharide induced changes in microRNA expression
Sheng Zhong DDS, MS *, Shaoping Zhang DDS†, PhD, Eric Bair PhD#, Salvador Nares DDS, PhD†, and Asma A.
Khan BDS, PhD*# * Department of Endodontics, †Department of Periodontics, #Center for Neurosensory Disorders,
School of Dentistry, University of North Carolina, Chapel Hill
microRNAs (miRs) have emerged as important regulators of the immune response. We have previously identified
downregulation of miR-152 and miR-128 expression in inflamed human pulps extirpated from carious teeth as
compared to normal pulps collected from non-carious teeth. The purpose of this study is to investigate the effect of
lipopolysaccharide (LPS) on global miR expression profiles inclusive of miR-152 and miR-128 in human
macrophages. We hypothesize that challenge of these cells with LPS will induce changes in expression of microRNAs
linked to host defense. CD14 positive monocytes were isolated from human buffy coats by magnetic sorting and
induced towards a macrophage lineage. The macrophages were then challenged with ultrapure LPS from Escherichia
coli 0111:B4 (InvivoGen, San Diego, California) at concentrations of 0.5ng/µl to 500ng/µl, while control cultures
remained unchallenged. After 1-8 hours, total RNA was extracted, and microRNA levels assayed by NanoString
technology (Seattle, WA). Data were analyzed using 2- way ANOVA. LPS altered expression of miR-152 and miR128 in a time and dose-dependent manner. These results provide evidence that miRs are responsive to LPS and are
linked to the host response against pulpal infection. This suggests a yet unrecognized role of miRs, including miR152
and miR128, in the pathogenesis of E.coli infection and pulpal/periapical pathology. In conclusion, the results of this
study suggest that microRNAs are involved in regulating the pulpal and periapical response to infection.
#7 A novel PTH1R mutation causes eruption failure in deciduous dentition
H.M. Hendricks and S. Frazier-Bowers, Department of Orthodontics, University of North Carolina, Chapel Hill, NC
Mutations in the PTH1R gene have been associated with the non-syndromic craniofacial phenotype, primary failure of
eruption (PFE), which is marked by clinical eruption failure of secondary teeth in the absence of mechanical
obstruction. The recent finding that mutations in the PTH1R gene cause PFE confirms the genetic basis of eruption but
also suggests the etiology eruption disorders. To date, 4 coding and 3 splice-site mutations have been identified as
causative of PFE in families. Clinical diagnosis of PFE versus ankylosis is challenging; recent phenotypic studies have
shown a broad spectrum of clinical characteristics. Objective: The objective of our study is to expand the definition of
the clinical presentation of PFE and test the hypothesis that eruption failure resulting from a genetic mutation includes
a broad clinical spectrum. Methods: Study participants (N=27) were characterized phenotypically based on the
following criteria: intra- versus supra-osseous eruption failure, uni- or bilateral affection, and Type I versus Type II
presentation. Direct sequencing of PCR products was carried out to analyze the coding region and intron-exon
boundary of the PTH1R gene in affected individuals. Results: Phenotypic analysis revealed that 100% of affected
individuals included an infraoccluded permanent first molar; bilateral eruption failure occurred in 63% of cases. Of the
individuals analyzed genetically, one nuclear family segregated a novel 1094 del G mutation in the coding region of
PTH1R. The corresponding phenotypic presentation of the proband revealed a uni-lateral supra-osseous affection with
infra-occluded primary and permanent first molars in upper and lower right quadrants. The proband also presented
with a mild skeletal class III malocclusion. Conclusions: The identification of the PTH1R 1094 del G frame shift
mutation confirms association of PTH1R with eruption failure of permanent and primary dentition. This work is
supported by an AADR student fellowship and NIH RR00046.
#8 Characterization of Phenotype and Col11a1 Expression in Cleft Palate Mice
LH Katz1, V. Hoglund2, P. Overbeek3, K. Ryan1 and E. Everett1.
1
Pediatric Dentistry, 2 Curriculum in Genetics & Molecular Biology UNC, Chapel Hill, NC ; 3 Molecular and Cellular
Biology, Baylor College of Medicine, Houston, TX
Objectives: Cleft palate (CP) is a common birth defect occurring in 1 in 2000 live births. CP can be isolated or
associated with a recognized syndrome. This study investigated a transgene (Tg) insertion mouse line (OVE1226b)
which demonstrates CP, limb dysplasia, and craniofacial dysmorphology as an autosomal recessive trait. Localization
of the Tg complex and characterization of the phenotype of CP embryos were goals of this study. Methods: A BAC
OVE1226b Tg/+ genomic library was constructed and screened by PCR using primers specific for the Tg element
(TYBS minigene). Skeletal staining, microCT, craniofacial measurements, and RT-PCR were performed on late
gestation (17.5 & 18.5dpc) embryos (wildtype, Tg/+, and Tg/Tg). Results: A BAC clone was identified and endsequencing performed. One end contained sequence from the Tg complex and the other an intergenic region
approximately 180kb from the 3‘ end of Col11a1. CP embryos exhibit micrognathia, tongue protrusion, U-shaped
cleft, and rhizomelic shortening of the limbs. Comparing 17.5dpc CP and wildtype embryos no significant differences
were observed for tip of nose to eye, tip of nose to pinna, overall head or crown to rump lengths. For 18.5dpc CP and
wildtype embryos significant differences were observed for tip of nose to eye (p<0.001), tip of nose to pinna
(p=0.001). No significant differences were observed for overall head or crown to rump lengths. Skeletal clearing and
microCT demonstrate reduced skeletal mineralization. Humeri BMD were less in CP embryos compared to wildtype at
17.5dpc p <0.001 and 18.5dpc p=0.014. RT-PCR of Col11a1 gene expression showed 62-fold downregulation
comparing CP to wildtype (p=0.007). Conclusions: The OVE1226b line recapitulates phenotypic and molecular
features paralleling those seen in cho/cho (chrondrodysplasia) mice carrying a mutation in Col11a1. COL11A1
mutations are associated with fibrochondrogenesis, Stickler type II, Marshall syndrome, and some cases of Robin
sequence. (NIH/NIDCR DE015180 and institutional funds)
#9 Prevalence of interfrontal bones in inbred and F1 mice
H. Zimmerman, K. Avanesyan, E. Everett, Pediatric Dentistry, University of North Carolina, Chapel Hill, NC
Objectives: The interfrontal bone (IF) is a minor skeletal trait in mice. When present the IF bone resides between the
frontal bones along the interfrontal (metopic) suture. IF is considered a quasi-continuous trait and genetic and
environmental factors play roles in its development. The mechanism(s) underlying IF bone development are poorly
understood and may involve de novo secondary ossification centers, induction by the interfrontal suture or dura. We
sought to survey inbred strains of mice and selected F1 crosses the prevalence of IF. Methods: Archived mouse skulls
from a Mouse Phenome Project (MPP) and discarded mouse heads from the Collaborative Cross (CC) Projectwere
available for this study. In total 25 inbred strains and 17 F1 crosses (generated between pairs of CC founder lines)
were investigated. A total of 931 (10-12 wks old) mice representing nearly equal numbers of males and females were
phenotyped. Frozen CC mouse heads were cleaned, bleached, dried, and preserved using polyurethane. This
processing had been performed previously with MPP skulls. Skulls were viewed dorsally and the IF measured using a
zoom stereomicroscope equipped with a calibrated reticle. Triplicate direct measurements of maximum IF widths and
lengths were collected. Descriptive statistics and comparison of means (ANOVA) were performed. Differences were
considered significant when p < 0.05. Results: Six of the 25 inbred strains lacked IF. Prevalence of IF in the
remaining strains ranged from 5.0 to 98.3%. Nine of 17 F1 crosses lacked IF and the prevalence of IF in the remaining
F1 crosses ranged from 1.7 to 61.5%. Comparing males and females among inbred and F1 crosses showed no
significant differences between the sexes. Conclusion: Strain dependent differences in IF will facilitate investigation of
genetic and environmental factors contributing to IF development. (Acknowledge the Mouse Phenome Project and
Collaborative Cross Consortium for access to skulls)
#10 NFκB Haploinsufficiency Affects Osteogenesis During BMP2-induced Bone Regeneration
Sodsi Wirojchanasak, A.S. Baldwin, L.F. Cooper Oral Biology Program and Department of Prosthodontics, University
of North Carolina, Chapel Hill, NC
Inflammatory regulation is a significant factor that determines bone regeneration outcome. The transcription factor
NFκB regulates various cellular activities corresponding to inflammation. Its role in bone development was identified
through osteoblastogenesis control yet no in vivo study has determined in perspective of bone regeneration. Objective:
The purpose of this study was to define the influence of NFκB p65 on osteoblastic activities during BMP2-induced
bone formation. Methods: In vivo bone formation was stimulated by subcutaneous implantation of 5-mm collagen
scaffolds with/without 1 ug of recombinant human bone morphogenetic protein (rhBMP2; Medtronic, Minneapolis,
MN) into p65fl/+, p65fl/+Osx-Cre and Osx-Cre mice at 5-7 weeks old. The scaffolds were harvested at 2 and 5 weeks
after implantation (n=3-5/group/condition). Bone formation potential was analyzed by analyses the retrieved scaffolds
using microcomputed tomography, real-time PCR for osteoblastic markers, histological and immunohistochemical
stainings. Results: The scaffolds with rhBMP2 from p65fl/+Osx-Cre mice had markedly smaller amount of calcified
tissue at both two and five weeks postimplantation as demonstrated via histological staining. Quantification by
microCT indicated significantly lower mineralized tissue volume than p65fl/+controls (2 weeks p65fl/+Osx-Cre
1.44+0.68% vs p65fl/+11.73+3.36%; 5 weeks p65fl/+Osx-Cre 3.00+1.71% vs p65fl/+16.96+5.54%; p<0.05). Steady
state levels of osteoblast-specific mRNA were lower in p65flox/+Osx-Cre mice: Runx2 2.64 vs 3.11; Osx 19.53 vs
94.27; Alp 124.61 vs 520.95; Bsp 664.56 vs 11386.21; Ocn 55.57 vs 2009.33 folds (p<0.05 except Runx2 p=0.18).
Bsp immunostaining indicated reduced active osteoblasts in the mineralized scaffolds of p65fl/+Osx-Cre mice in
compared with p65fl/+ controls (n=3). Conclusion: Lack of p65 single allele significantly retarded in vivo bone
formation in BMP2-delivery system in regard to osteoblast differentiation control. Mice with NFκB p65
haploinsufficiency had reduced size of newly formed bone with fewer osteoblasts and lower bone-related gene
expression levels. This study provides basic knowledge concerning inflammatory regulation that impacts clinical
outcome of bone tissue regeneration. Supported by NIH Grant#RO1 DE016986-01A2
#11 An inhibitory domain in SPLUNC1 inhibits the epithelial sodium channel and restores airway surface
liquid height in cystic fibrosis airway epithelia
Seul Ki 'Christine' Kim; Robert Tarran; Carey Hobbs; Sompop Bencharit; Nikolay Dokholyan; Pradeep Kota;
Elizabeth. Cystic Fibrosis/Plumonary Research and Treatment Center, UNC; School of Dentistry, UNC School of
Medicine, Department of Computational and Experimental Biophysics, UNC
Objectives: Epithelial sodium channel (ENaC) regulates the mucociliary clearance and the volume of airway surface
liquid (ASL). ENaC hyperactivity decreases ASL volume and dehydrates mucus leading to chronic lung infection
(common in cystic fibrosis, CF), while short, palate lung and nasal epithelial clone 1 (SPLUNC1) negatively regulates
ENaC. We identified SPLUNC1 inhibitory domain on ENaC and elucidated its functionality in ASL volume regulation
using in vivo model and structural homology modeling. Methods: Xenopus oocytes were injected with aßγ-ENaC
cRNAs in the presence or absence of MTSET. Two electrode voltage clamp method measured the relative ENaC
current with or without SPLUNC1 or the peptide G22-A39 treatment. The peptide pull-down assay was performed on
HEK293T cells transfected with HA/V5-tagged human aßγ-ENaC subunits cDNAs. G22-A39 effecting normal and CF
primary human bronchial epithelial cell (HBEC) mucosal surface were measured by confocal microscope.Discrete
Molecular Dynamic (DMD) simulation generated SPLUNC model based on the structure of bactericidal/permeabilityincreasing protein (BPI). Results: The relative ENaC current decreased ~60% with =15% of SPLUNC1. G22-A39
treatment showed similar result regardless of its concentration. Within G22-A39 treatment, MTSET presence increased
relative ENaC current. Compared to the basal, G22-A39 treatment decreased the current both in the presence and
absence of MTSET. Western blots showed exclusive interaction of G22-A39 and ß-ENaC. ASL height increased by
~two-fold on CF HBEC after G22-A39 treatment. Conclusion: SPLUNC1 inhibitory domain for ENaC is identified as
G22-A39. SPLUNC1 and G22-A39 inhibited Xenopus oocytes ENaC activity. G22-A39 prevented ASL
hyperabsorption in CF HBECs. SPLUNC model suggests that the N-terminal residues (G22-A39) functions
independent of the main globular domain. Supported by the NIH/NHLBI and a UNC bridge fund
#12 Increased MOR-1K Expression Levels are Associated with Opioid-induced Hyperalgesia.
Oladosu, M.S. Conrad, D. Prustik, J. Gauthier, G. Slade, L. Diatchenko, A.G. Neely Center of Neurosensory
Disorders, School of Dentistry, UNC; Curriculum of Neurobiology, Department of Neuroscience, University of Illinois
at Urbana-Champaign, Urbana, IL 61801
Objective: Opioids commonly used in the treatment of acute and chronic pain have been reported to produce a
paradoxical opioid induced hyperalgesia (OIH) in a subset of the population. Recent evidence indicates a potential role
for MOR-1K, an alternative splice variant of MOR-1, in OIH. Unlike its parent receptor MOR-1 that mediates opioid
induced analgesia (OIA) via cellular inhibition, MOR-1K facilitates cellular excitation upon activation. Because of its
opposing cellular effects, we hypothesized that MOR-1K contributes to OIH in genetically-susceptible individuals. We
tested our hypothesis by evaluating pain and related activity profiles as well as MOR-1K gene expression within the
central nervous system in genetically diverse strains of mice. Methods: Following handling and habituation,
C57BL/6J, CXBK, and 129SV/EV mice were evaluated for behavioral responses to mechanical and thermal stimuli as
well as locomotor activity (n= 16/group). Mice then received subcutaneous injections of vehicle or escalating amounts
of morphine over four days (10, 20, 20, and 40 mg/kg). Pain behavior and locomotor activity were re-evaluated on
days 1-7. In separate groups of mice, tissue was collected from discrete brain regions on days 1, 4, and 5 to measure
MOR-1K gene expression using RT-PCR (n= 16/group). Results: The three mouse strains exhibited divergent OIA and
OIH behavioral profiles. C57BL/6J mice displayed both OIA and OIH, 129SV/EV mice displayed only OIA, and
CXBK mice displayed only OIH. MOR-1K gene expression paralleled pain behavior in the two most extreme strains,
such that 129SV/EV mice exhibiting decreased expression during OIA and CXBK mice exhibited increased expression
during OIH. The three strains showed no differences in locomotor activity. Conclusions: Our findings suggest MOR1K contributes to OIH. With further research, MOR-1K could be exploited as a target for development of antagonists
that reduce or prevent OIH. Supported by NIH/NINDS R01 NS072205
#13 Catechol-O-Methyltransferase- and Stress- Dependent Pain Sensitivity In Mast Cell Deficient Mice
C. Winkle1, B. Ciszek1, S.Segall1, B.Koller2, L. Diatchenko1, A.Neely1 Center for Neurosensory Disorders, School of
Dentistry1, Dept. of Genetics, School of Medicine2, University of North Carolina, Chapel Hill NC
Objectives: While mechanisms underlying chronic pain conditions are poorly understood, they are associated with
genetic factors resulting in reduced Catechol-O-methyltransferase (COMT) activity, and environmental factors
producing high stress levels. Literature suggests that both reduced COMT and high stress may contribute to chronic
pain by increasing levels of pro-inflammatory cytokines, produced in large part by mast cells. In the present study, we
sought to examine the relationship between COMT activity, stress and mast cells in a mouse model. We hypothesized
that reduced COMT and high stress would interact to increase pain sensitivity and that mast cell deficient (Wsh -/-)
mice would show reduced COMT- and stress-dependent pain sensitivity compared to wild type controls. Methods:
Baseline measurements for mechanical and thermal pain sensitivity as well as locomotor activity were obtained from
30 eight week old C57BL/6J (Jackson) and Wsh -/- (Koller) mice. Mice were exposed to a 3 day forced or sham swim
stress paradigm followed by intraperitoneal injections of the COMT inhibitor OR486 (30mg/kg) or vehicle. Behavior
was reassessed at 1,2, and 3 hours. Results: Both C57BL/6J and Wsh -/- mice exhibited increased mechanical and
thermal pain sensitivity following forced versus sham swim. In C57BL/6J mice, COMT inhibition similarly increased
mechanical and thermal pain sensitivity following sham swim and potentiated pain sensitivity following forced swim.
In Wsh -/- mice COMT inhibition had no effect. No differences in locomotion were observed. Conclusions: We
provide the first demonstration that COMT inhibition and stress interact to produce additive effects on mechanical and
thermal pain sensitivity. Furthermore, we show that mast cells mediate COMT-dependent but not stress-dependent
pain. Together these findings suggest that gene-environment interactions that influence COMT and stress pathways
contribute to chronic pain and implicate mast cells as targets for chronic pain treatment. Support: NIH/NINDS RO1
NS072205
#14 Candidate Gene Association Analysis of Onset TMJD in OPPERA, a Large Population-based Cohort Study
Smith SB1, Slade G1, Bair E1, Miller V1, Fillingim RB2, Greenspan J3, Orbach R4 , Dubner R3 , Knott C5, Maixner W1,
Diatchenko L1. 1Center for Neurosensory Disorders, School of Dentistry, UNC; 2University of Florida, Gainesville,
Fl; 3University of Maryland, Baltimore, MD; 4SUNY Buffalo, NY; 5 Battelle, INC.
Objectives: Temporomandibular joint disease (TMJD) is a multifactorial syndrome, resulting from both environmental
and genetic factors. Genetic predisposition to the development of TMJD is likely highly polygenic, with many genes
of small individual impact influencing pro-nociceptive pathways related to pain amplification and psychological
distress. In this study, we used a large candidate gene panel to look for genetic variants statistically associated with an
increase in TMJD incidence in a large population-based sample. Methods: Initially healthy subjects recruited into the
OPPERA cohort (n=2424) were followed for up to five years and monitored for the development orofacial pain
symptoms. DNA from subjects‘ donated blood was genotyped using a dedicated Affymetrix microarray chip
comprised of 3295 single-nucleotide polymorphisms (SNPs), representing about 350 genes known to influence
psychological and nociceptive pathways. Allelic frequency differences between onset TMJD cases and pain-free
subjects were assessed using a Cox proportional hazards model in GenABEL. Results: A total of 228 subjects
developed examiner-verified TMJD during the follow-up period. Although no SNPs exceeded a multiple-testing
corrected threshold for significance, a number of genes showed suggestive association with onset TMJD. Top genes
include those encoding the cytokines VEGFA and CCL5, a member of the EGF receptor family of tyrosine kinases
ERBB2, the ephrin B2 receptor EPHB2, the melanocortin-4 receptor MCR4, and the dopamine D2 receptor DRD2.
Conclusion: Several genes known to influence nociceptive and inflammatory pathways were suggestively associated
with the development of TMJD. These results need to be confirmed in independent cohorts. Supported by NIH
DE017018, DE016155, DE007333, DE00366, NS45685, AR/AI-44564, AR-30701, AR/AI-4403, AA000301,
G192BR-C4.
#15 Chronic Catechol-O-methyltransferase-Dependent Pain: A peripheral contribution
Ciszek B, Neely A. Center for Neurosensory Disorders, School of Dentistry, University of North Carolina
Objectives: Genetic and pharmacologic alterations resulting in reduced catechol-O-methyltransferase (COMT) activity
are associated with increased pain sensitivity and likelihood of developing chronic pain disorders. Studies have shown
that COMT-dependent pain is mediated via ß2 and ß3-adrenergic receptors (ARs). As ß2 and ß3ARs are located in
peripheral, spinal and central nervous system regions where they could potentially drive pain transmission, it is
important to determine the site of action whereby ß-adrenergic systems drive persistent COMT-dependent pain. Our
study evaluated the contribution of peripheral ß-adrenergic systems in a sustained COMT-inhibition model. We
hypothesized that peripheral ß2/3-adrengeric systems contribute to persistent pain following sustained COMT
inhibition. This hypothesis was tested by measuring evoked and non-evoked pain behaviors in adrenalectomized rats
(lacking peripheral epinephrine) receiving sustained systemic administration of COMT inhibitor. Methods:
Adrenalectomized and normal Sprague-Dawley rats were implanted with Alzet osmotic pumps that delivered the
COMT inhibitor OR486 (15mg/kg/day) or vehicle over a 2-week period. Prior to and on days 1, 3, 5, 7, 9, 11 and 13
following implantation; evoked and non-evoked behaviors were assessed. Evoked behaviors included responses to
punctuated mechanical stimuli and thermal heat. Non-evoked behaviors included weight, core body temperature, grip
strength and locomotion. Effects of sustained drug administration on these behaviors were compared between
adrenalectomized and normal rats. Results: As predicted, normal rats receiving sustained OR486 treatment exhibited
increased mechanical and thermal pain sensitivity compared to those receiving vehicle. In contrast, adrenalectomized
rats showed a blunted response to sustained OR486 treatment. These findings demonstrate a peripheral contribution to
COMT-dependent pain sensitivity. Conclusion: Eliminating peripheral adrenomedullary input may alleviate pain by
reducing catecholamine levels and subsequent release of mediators that sensitize nociceptors. Demonstrating that
persistent COMT-dependent pain is mediated peripherally is a vital step in determining the best way to treat chronic
pain. Supported by NIH/NINDS R01-NS072205 to A.N.
#16 Characterizing a novel COMT Isoform: Expression levels and enzymatic activity
Meloto, Carolina Beraldo1; Segall, Samantha K1, Gauthier, Josee1, Park, Hee-Jin2; Diatchenko, Luda1
1
Center for Neurosensory Disorders, 2Biology Undergraduate, University of North Carolina at Chapel Hill
Our human association studies have linked a single nucleotide polymorphism (SNP – rs165774) located at the 3‘
untranslated region (UTR) of an alternatively spliced catechol-O-methyltransferase (COMT) mRNA (BC5555) to
temporomandibular disorder (TMD). This mRNA codes for a COMT isoform truncated at the C-terminus, which we
hypothesize may display alternative binding affinities to COMT substrates. Objectives: The aim of this project is to
characterize this isoform by expressing the truncated enzyme in different cell-based systems, and comparing its
enzymatic activity to the major isoforms of COMT. Methods: Four different cell lines (HEK293, H4, 3T3, and Be2C)
were transfected with either a major or a truncated isoform of the membrane-bound (MB) or soluble (S) version of the
enzyme, or with empty vector. Quantitative PCR was used to control for transcript expression levels of the different
COMT isoforms. Enzymatic activity of the truncated isoforms was compared to the major isoforms activity for both
catechol and norepinephrine. Results: Truncated isoforms of COMT were consistently less expressed in all cell lines,
suggesting additional regulation of corresponding mRNA amount at the level of mRNA stability. Unexpectedly, in
spite of the lower level of truncated COMT mRNAs, enzymatic activity of truncated S-COMT isoform, but not MBCOMT isoform, showed much higher efficiency in metabolizing norepinephrine in all four cell lines in comparison
with major isoform. For catechol, enzymatic activity of both truncated S- and MB-COMT variants was lower in all cell
lines, in line with the corresponding mRNA levels. Conclusions: (i) COMT truncated isoforms are less stable than
wild-type isoforms; (ii) truncated S-COMT isoform is more efficient in metabolizing the biological catecholamine
norepinephrine. These observations suggest that SNP rs165774 may have functional effect on the truncated COMT
expression level and consequently enzymatic activity and thus contribute to painful TMD. Acknowledgements:
CAPES 0968/11-0, NIDCR grant U01-DE017018, NINDS PO1-NS045685.
#17 Diabetes-Related Gene Expression Patterns in Different Stages of Periodontal Inflammation
Ning Yu, Silvana Barros, Shaoping Zhang, Steven Offenbacher, School of Dentistry, Center for Oral and Systemic
Diseases, University of North Carolina at Chapel Hill
Objectives: We conducted a pilot study to examine whether insulin regulated genes are differentially expressed in
gingival biopsy samples comparing gingivitis and periodontitis to health, and whether obesity modified this expression
pattern. Methods: Total RNA was extracted from gingival biopsy samples collected from 21 patients: 7 periodontal
healthy patients, 7 experimental gingivitis patients, and 7 periodontitis patients, each group with 4 non-obese
(BMI<30) and 3 obese (BMI>30) subjects. Diabetes-related gene expression patterns were evaluated using a PCR
arrays panel (SABiosciencesTM) to examine 84 candidate genes involved with insulin resistance and glucose
metabolism. Non-obese subjects with healthy periodontium were regarded as the referent group for statistical analysis
not adjusting for multiple comparisons. Results: In non-obese gingivitis patients, 15 genes (CEBPA, DUSP4, HMOX1,
IGFBP5, IRS1, MAPK14, PARP1, PIK3R1, PTPN1, PYGL, STX4, STXBP1, STXBP2, TRIB3, VAMP3) were
significantly up-regulated (P<0.05), while 3 genes (NFKB1, TNF, TNFRSF1A) were significantly down-regulated
(P<0.05). In obese gingivitis patients, 6 genes (CEBPA, G6PD, HMOX1, PARP1, STXBP1, STXBP2) were
significantly up-regulated (P<0.05), while 2 genes (NFKB1, TNFRSF1A) were significantly down-regulated (P<0.05).
Similar expression patterns were observed in periodontitis subjects, but none of them reached statistical significance,
irrespective of obesity status. Conclusion: Preliminary findings suggest that acute periodontal inflammation may be
associated with tissue metabolism changes which mimic insulin resistance and which can be modulated by obesity
status, but these changes are not evident in periodontitis. These pilot studies allow us to infer that acute gingival
inflammation may induce localized changes which modify tissue insulin/glucose metabolism. Additionally, larger
studies to confirm these findings may provide insight into understanding the association between periodontal disease
and diabetes.Supported by NIH R01DE021052-01,R0225747.
#18 Effect of Periodontal Therapy on Markers of Kidney Damage in Patients with Chronic Kidney Disease.
M. Stella, M. Wehmeyer, S. Barros, S. Offenbacher, A. Kshirsagar, Departments of Periodontology and Nephrology
and Hypertension, University of North Carolina, Chapel Hill, NC
Objectives: To determine the effect of periodontal therapy on serum levels of inflammatory markers in chronic kidney
disease (CKD) patients. Methods: 51 patients with at least three months history of dialysis and moderate or severe
chronic periodontitis were recruited from six dialysis clinics. Subjects had at least twelve teeth, of which at least two
had clinical attachment loss of at least 6mm and probing depths of at least 5mm. All subjects were clinically examined
and treated with extractions, scaling and root planing, and locally delivered antibiotics. Serum samples were obtained
from CKD patients before and six months after therapy. Inflammatory markers were analyzed by multiplexing and
levels were compared before and after therapy. Results: Mean neutrophil gelatinase-assoviated lipocalin (NGAL)
serum value did not change from baseline to post-treatment (from 1271.2±120.7ng/mL to 1427.4±135.7ng/mL,
p=.218). Conclusion: NGAL is an inhibitor of MMP-9 and has been seen to indicate acute kidney damage. In this
study, we found no changes in serum markers of inflammation following periodontal treatment. There was no
significant change in NGAL levels after treatment. Non-surgical periodontal therapy in this population did result in an
improvement in periodontal condition (change in PD or BOP). However, there was no net change in systemic markers
of inflammation in CKD patients. Previous studies had shown no reduction in IL-6 or increase in serum albumin.
Acknowledgements: This project was supported in part by grants M01RR00046 and UL1RR025747 from the National
Center for Research Resources, National Institutes of Health and by OraPharma, Inc.
#19 Clinical Salivary pH Vs. Laboratory Buffering Capacity: A Comparison
A. Swarn R.S. Eidson, T. Donovan and A.V. Ritter- Operative Dentistry R.R. Arnold and E.V. Simmons- Diagnostic
Sciences & General Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
Objectives: Measurement of salivary pH chairside can provide useful information to practitioners in managing a
patient with high caries risk. Increased salivary buffering capacity has been thought to increase defense against acid
attack. The purpose of this pilot study was to determine the association between a chairside salivary pH test and the
buffering capacity of stimulated mixed saliva collected at the same visit. Methods: The sample consisted of 15 subjects
(53% females, 22-53 years of age) who are enrolled in a caries management study. For each subject, salivary pH was
measured chairside and the buffering capacity in the laboratory. Chairside salivary pH was measured by placing
pHion Diagnostic pH Test Strips (pHion Balance, Scottsdale, AZ) in the buccal vestibule for 15 seconds. The color
transition of the strips was read as numerical scores in increments of 0.25. At the same appointment, stimulated saliva
samples were collected for 5 minutes and transported on ice to the laboratory for determination of buffering capacity.
The saliva was diluted four-fold in 0.005N HCl and the final pH determined after ten minutes. All samples were
collected at the same time of the day for each subject. Values were categorized as High or Low, based on enamel
demineralization thresholds for both tests. Data was analyzed using Chi-Square statistics. Results: The pH values for
the CS ranged from 4.75 to 6.75 while for LS they ranged from 4.0 to 6.10. There is a statistically significant
association (p=0.046) between the chairside and the laboratory salivary pH tests used. Conclusions: The chairside
salivary pH test used (pHion Diagnostic pH Test Strips) is positively associated with a laboratory salivary buffering
capacity test when used as an adjunct tool for caries risk assessment. Supported in part by Oral Biotech.
#20 The Titratable Acidity and pH of Malted Beverages: Their Potential Erosive Effect on Dental Erosion.
Fernando Astorga DDS, Kristi Erickson, DMD, Terry Donovan, DDS, Department of Operative Dentistry, University
of North Carolina at Chapel Hill, Chapel Hill, NC.
Objective: The objective of this study was to measure the pH and titratable acidity of commercially available malt
beverages. Titratable acidity is a key factor in determining the erosive potential of a beverage. The hypothesis tested
is that there is no significant difference in the pH and titratable acidity of the samples and the control. Methods:
Three samples from each of six different commercially available malt beverages were analyzed for their initial pH and
titratable acidity. pH was measured with a Jenco pH Vision 6072, standardized and sloped prior to calibration with
standard buffers of pH 4.0 and 7.0. 100mL of each drink were titrated three times with 1M sodium hydroxide (NaOH)
added in .5mL increments, until the pH of 7 was reached. A positive control of orange juice was used. Results:
Preliminary data demonstrates average initial pH was lowest for Smirnoff Ice Original and highest for orange juice.
The titratable acidity to pH 5.5 was greatest for the control, orange juice and lowest for Mike‘s Hard Lemonade.
Conclusion: Initial pH does not appear to be related to buffering capacity and an increased titratable acidity (buffering
capacity) suggests more erosive potential of the beverage. By maintaining a lower pH for a greater time various
beverages have an increased potential in causing dental erosion.
#21 Immediate placement and provisionalization of implants placed into sites with periradicular infection:
Influence of antibiotics on implant survival rates.
Edward Givens JR, DDS1, Sompop Bencharit, DDS, MS1, PhD, Ceib Phillips, MPH2, PHD, Don Tyndall, DDS, MPH,
PHD3
1
Department of Prosthodontics, 2 Department of Orthodontics, 3 Department of Radiology, University of North
Carolina at Chapel Hill, Chapel Hill, NC
Objectives: The primary goal of this prospective controlled clinical trial is to evaluate the influence of pre- and
postoperative antibiotic therapy on the rate of success of implants placed and non-occlusally loaded into sites with
periradicular infections. Methods: A total of 20 subjects are planned for enrollment into the study. For those who
meet inclusion, prior to extraction, both a pre-operative PVS impression and small-volume CBCT image are acquired.
Upon extraction of the tooth, the site is curetted and irrigated with sterile saline and 0.12% chlorohexidine solutions.
The appropriate length and diameter implant (Zimmer TSV implant system) is then placed. A screw-retained
provisional is inserted and adjusted such that no contacts exist in MIP or excursive movements. The subject returns for
follow-up visits at week 1 and 4, then 6 and 12 months post-implant placement. PVS impressions are taken at the 6
and 12 month visits. A final CBCT scan is made at the 12 month follow-up. Solid casts are made from the
impressions, and scanned. Data acquired from the scanned images will be used to evaluate changes in dimension of
the interdental papilla as well as the keratinzed gingival facial to the implant. Results: 14 subjects have been enrolled
to date. Of these, one implant has failed to integrate. The remaining implants appear to have integrated, and have
been restored with a permanent restoration. Final data analysis will be conducted once all follow-up visits have been
completed. Conclusion: Within the limitations of this study, it appears that pre- and post-operative antibiotic use does
not have a positive effect on the outcome of implants placed into sites with periradicular infection. Further studies
with larger sample sizes are needed to confirm these preliminary results.
#22 Antibiotic use in Conjunction with Immediate Implant Placement to Replace teeth with Apical Pathology
Associated with Endodontic Origin
Bashir Hosseini1, Asma Khan1, Derek Duggan1 and Sompop Bencharit2
1
Department of Endodontics, 2 Department of Prosthodontics, University of North Carolina at Chapel Hill
Objectives: In cases where the restorability of a tooth has a poor prognosis, it is in the best interest of the patient to
consider implant therapy. However, in teeth that have developed apical pathology, this creates a concern for immediate
implant therapy as this may compromise the outcome of treatment. Immediate implants were contraindicated in site
with pathology but recent trends have moved away from this concept. Lately, the potential benefit of systemic
antibiotic therapy to manage surgical complications after implant placement in sites with pathology has been a subject
of debate. The objective of the proposed study is to explore the use of antibiotics in improving the outcome of
immediate implant placement following extraction of teeth with apical periodontitis. Methods: Informed consent will
be obtained from patients (N=30) who meet our inclusion criteria which include but are not limited to: patients that
have a premolar, canine or incisor that has developed apical periodontitis with poor restorative prognosis. They will
receive Amoxicillin or a placebo one hour prior to and for one week after extraction of their affected tooth and
immediate placement of Zimmer implants. The implant will be immediately temporized but taken out of occlusion.
Pain, discomfort, and level of healing will be evaluated at follow-up appointments scheduled at 1, 2, 4 and 8 week
post-treatment. CBCT and impressions taken at the follow up appointments will be used to evaluate bone and soft
tissue healing. Results: We expect to see that antibiotic coverage will not make a clinical difference in the treatment
outcome, long term prognosis, healing, or bone to implant integration. Conclusion: As there are currently no clear
guidelines on this topic, and with the growing risk of antibiotic resistant bacterial strains, this study will provide
relevant information on the effect of antibiotic coverage for immediate implant surgery
#23 The Role of RHO Signalling in Implant Surfaces with Nanoscale level Features
Gustavo Mendonçaa, Daniela B.S. Mendonçaa, Danilo Maldonado e Duartea, Ruiwei Lianga,b, Lyndon F. Coopera
a
Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, b Oral Biology Program, University of
North Carolina at Chapel Hill, NC
Surface topography can dramatically affect bone formation in the process of osseointegration. A prevalent hypothesis
is that surface topography influences osseointegration by direct cell-implant surface interactions. It is presently
unknown how nanofeatures superimposed onto endosseous dental implant surfaces affect adherent cell behavior. The
general goal of this study is to determine how specific nanoscale topographic modifications of titanium surfaces
influence adherent osteoprogenitor cell behavior. This study considered the role of intracellular proteins that regulate
cell shape and contribute to gene regulation in adhesion-dependent ways. Specifically, RhoA functions in concert with
its main effectors ROCK (Rho-associated coiled-coil forming protein kinase) to regulate adhesion-associated cell
signaling. We hypothesize that superimposition of nanotopography on implant surfaces alters RhoA/ROCK signaling
and consequently influences the osseointegration process. The use of surface technologies in control of robust bone
formation offers many clinical advantages for treatment of patients. This study defined RhoA/ROCK signaling effects
during mesenchymal stem cells differentiation in topography-dependent modulation of osteoblastic differentiation and
demonstrated that RhoA/ROCK signaling of adherent cells is specifically modulated by nanoscale surface features of
titanium implant surfaces. Defining how nanofeatures cue osteoinduction and osteogenesis will permit further clinical
control of the processes central to osseointegration and control of other implantable devices.
#24 The effects of desferrioxamine on gene expression for different implant surfaces
Daniela B.S. Mendonça, Gustavo Mendonça, Lyndon F. Cooper
Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel
Hill, NC
Desferrioxamine (DFO) is a drug used for iron chelation therapy and acts as a hypoxia-mimetic agent, blocking the
degradation and inducing the accumulation of HIF-Inducible F
related to hypoxia. The aim of this study was to investigate the effects of DFO on implant surfaces on osteoblastrelated gene expression. Methods: Human fetal osteoblasts (hFOBs) were grown on titanium disks (20x1mm) with
machined (S), micron- (R) or nanostructured (N) surfaces immersed in DFO solution overnight. Real Time PCR was
used to measure the mRNA levels of Runx2, Osx, HIFtransfected with an HRE (Hypoxia Responsive Element)-driven luciferase reporter plasmid and seeded on disks.
Results: After 1d Runx2 mRNA showed an up-regulation for R and N surfaces in DFO, compared to S of 7.0- and 5.8fold, respectively. A 10.7-fold induction was noted for N surfaces after 3d. Osx was up-regulated by 7.2- for N while a
5.2- and 2.4-fold induction was noted for R and S disks immersed in DFO after 1d. After 3d, N group showed a 44.6fold induction. For HIF-1α, a 2.2- and 2.5-fold increase was observed for R and N DFO disks after 1d and a 4.1- and
24.5-fold induction could be observed after 3d, respectively. For VEGF, an up-regulation of 4.6 was observed for both
R and N surfaces after 1d. After 3d, a 3.3- and 21.4-fold increase was observed for R and N disks, respectively. The
luciferase assay showed higher HIF20.0-, 17.6- and 14.0-fold induction in HIFobserved. Conclusions: Results suggest a synergistic effect of DFO and nanotopography in stimulating osteoblastrelated gene expression.
#25 Self-Rated oral health in older adults in the last year of life
Xi Chen, Dental Ecology Naorungroj, Supawadee, Operative Dentistry Christian Douglas, Biostatistics University of
North Carolina at Chapel Hill, Chapel Hill, NC
Objective: Self-rated health, physical function and cognition remarkably decline at the end of life. However, how selfrated oral health changes at the end of life remains unknown. This study was to examine self-rated oral health and
dentally-related behaviors among community-dwelling elders in the last year of life. Method: This study was based
on the national death index and the data of the Piedmont 65+ Dental study, a longitudinal study based on 810 dentate
community-dwelling older adults aged 65 and above. The participants were retrospectively categorized into two
groups, being in the last year of life (end-of-life group) and not being in the last year of life (control group).
Participants were surveyed at baseline, 18, 36, 60 and 84 months regarding their socio-demographics, self-rated oral
health, dental care pattern, oral hygiene practice and systemic health. Generalized linear models for repeated outcomes
were used to compare the two groups‘ characteristics.
Results: After adjusting for socio-demographics, the end-oflife group was more likely to rate their overall oral health (OR=2.94, 95% CI: 1.32, 6.54) and body health (OR=2.35,
95% CI: 1.13, 4.91) as bad than the control group. End-of-life participants were also more likely to dislike their mouth
appearance (OR=2.27, 95% CI: 1.07, 4.83) and face appearance (OR=1.12, 95% CI: 0.33, 3.83), and rate their ability
to taste (OR=7.24, 95% CI: 2.65, 19.77) or smell (OR=2.98, 95% CI: 1.09, 8.15) as bad. Compared to control group,
end-of-life group were more likely to receive medical care in the past 6 months and be hospitalized in the past 24
months. There was no difference in dental care patterns and oral hygiene practice, but end-of-life participants tended to
be more likely to request assistance in brushing teeth than the controls (OR=55.04, 95% CI: 11.7, 258.84).
Conclusion: Self-rated oral health significantly declines in the last year of life.
#26 Quality of Life Outcomes, Pericoronitis Symptoms, and Third Molar Removal
Bradshaw S*, Phero J, Faulk J*, Blakey G*, Phillips C#, White R*
*Department of Oral and Maxillofacial Surgery; # Department of Orthodontics, University of North Carolina
Objectives: Assess the impact of 3rd molar removal on quality of life in subjects with mild symptoms of pericoronitis.
Methods: 60 Subjects with pericoronitis affecting at least 1 mandibular 3rd molar were recruited for an IRB-approved
study between 2006 and 2011, with follow-up at least three months after 3rd molar removal. Inclusion criteria were
ASA I-II, 18-35 years of age, with minor symptoms of pericoronitis affecting at least one mandibular 3rd molar.
Subjects with major symptoms of pericoronitis, generalized periodontal disease, BMI >29, taking antibiotics, or using
tobacco were excluded. Clinical, demographic, and QOL data were collected at enrollment. Gross debris was then
removed from the symptomatic 3rd molar sites. No attempt was made to mechanically remove all non-sheddable
biofilm. No antibiotics were prescribed. Subjects were recalled and QOL data colleted at least three months after 3rd
molar removal: a condition-specific QOL instrument with 3 domains (lifestyle, function, and pain) and the Gracely
Scale. Results: Median age was 21.9 years (IQ 20.2-24.7 years). Median post-surgery follow-up was 7.7 months (IQR
6.0-12.4 mo.). The percent of subjects reporting worst pain as severe decreased from 32% at enrollment to 3% postsurgery. Subjects responding none for worst pain increased 10% to 78%. Fifteen percent of subjects reported pain
intensity as ―nothing‖, ―faint‖ or ―very weak‖ at enrollment increasing to 96% post-surgery. A third of subjects
reported the unpleasantness of pain as ―neutral‖, ―slightly unpleasant‖, or ―slightly annoying‖ at enrollment increasing
to 96% post-surgery. Twenty two percent and 18% of subjects at enrollment, but less than 2% post-surgery, reported
―quite a bit‖ or ―lots of difficulty‖ with eating desired foods and chewing foods. Conclusions: Removal of 3rd molars
positively influenced quality of life outcomes in subjects who presented with minor symptoms of pericoronitis of at
least 1 mandibular 3rd molar. Supported in part by grants from: NIH GCRC RR00046, Oral and Maxillofacial
Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, Dental Foundation of North Carolina
#27 The Association Between Removal of Premolars with Orthodontic Treatment and the Angulation of
Developing Third Molars Over Time
Eric Draper Skvara M, Draper E, Russell B, Proffit W, Phillips C, White R The University of North Carolina School
of Dentistry, Oral and Maxillofacial Surgery and Orthodontics, Chapel Hill NC
Purpose: Assess changes in 3rd molar angulation over the time course of orthodontic treatment in subjects having
either 1st or 2nd mandibular premolars removed. Methods: In an IRB approved retrospective analyses the differences
in mandibular 3rd molar angulation over time were compared to the vertical axis of adjacent 2nd molars. Subjects for
review were selected beginning with recently treated patients with available records to include 25 subjects each in both
the 1st and 2nd premolar groups. Demographic data: age at the start of treatment, gender, and ethnicity were
recorded. Study subjects were treated between 1996 and 2011. Clinical data: change in angulation during treatment
was calculated for each mandibular 3rd molar. A decrease in 3rd molar angulation signified a more vertical position;
this was considered favorable. Conversely, an increase in angulation was considered unfavorable. Angulation data
from subjects was assessed by descriptive and Chi Square statistics. Significance was set at P<0.05. Results: Mean
angulation for mandibular 3rd molars at the start of treatment before removal of premolars was not significantly
different: 1st premolar group 35.5 degrees (SD 15.2) and 2nd premolar group 34.7 degrees (SD 13.4). Also, mean
angulation for 3rd molars at the start of orthodontic treatment was not significantly different by anatomic side.
Similarly, mean angulation for mandibular 3rd molars did not differ significantly at the end of orthodontic treatment:
1st premolar group 33.5 degrees (SD 15.2) and 2nd premolar group 30.4 degrees (SD 18.7). However, 3rd molar
angulation was more favorable in 69% of the patients with 2nd premolar removal as compared to only 38% of the
patients with 1st premolar removal. Conclusions: Although the results were not statistically significant, mandibular
3rd molars tended to be more vertical if 2nd premolars were removed as compared to removal of 1st premolars.
#28 Correlation between body mass index and the number of decayed, missing, filled primary teeth in children
who received dental treatment under general anesthesia
Chance Powell1, Ceib L. Phillips2, Michael W. Roberts1, 1Department of Pediatric Dentistry. 2Department of
Orthodontics, School of Dentistry, UNC
Objectives: The purpose and aim of this study was determine if there was a significant correlation between calculated
body mass index and the frequency of decayed, missing, and filled teeth from a retrospective cohort of children in the
age range of 3 to 5 years. Methods and materials: Data was collected from children between the ages 3-5 years who
received dental treatment in the operating room at the University of North Carolina at Chapel Hill Hospitals (UNCCH) between 2007 and 2008. The children included in this study had been previously diagnosed with carious primary
teeth by faculty of the Department of Pediatric Dentistry, UNC School of Dentistry. The diagnosis was confirmed by
an intra-operative oral examination including full mouth dental radiographs. The study included only those 215
children with an American Society of Anesthesiologist (ASA) I or II physical status. The dmft score for each patient in
our study was obtained by reviewing their intraoperative School of Dentistry‘s dental records including dental
radiographs. Biostatistic information was grouped according to age, BMI, gender, ASA classification and dmft to
determine statistical correlation. Results: Controlling for age, race, and gender multiple linear regression models
showed that was a significant association between BMI and dmft for race and gender. In regards to the dentition, the
overweight children had a statistically significant (p= 0.001) higher dental caries prevalence value than did normal or
underweight children. Conclusions: The significance of this outcome has great dental application. Along with other
risk factors associated with high BMI such as diabetes and cardiovascular disease, dental caries can be identified early
and managed with proper nutrition and diet counseling.
#29 Substance P regulates LPS-induced MAP-K and NF-kB activation
Li Qian, Patrick Flood Department of Periodontology and the Comprehensive Center for Inflammatory Disorders,
University of North Carolina, Chapel Hill, NC
Objective: Substance P (SP) is an endogenous neuropeptide that triggers various biological effects in both the nervous
and immune systems, the release of SP from nerve or immune cells has been reported to associate with the
inflammatory status of a variety of pain and inflammatory disorders, including periodontal disease (PD). It has been
also found in high concentrations in the gingival crevicular fluid from sites with periodontal destruction. Increasing
evidence has demonstrated that inflammation induced by Porphyromonas gingivalis (Pg), the key periodontal
pathogens, is the fundamental process contributing to periodontal disease (PD). Methods: using primary macrophage
and macrophage cell line RAW264.7, LPS from both E.coli (Ecoli-LPS) and Pg (Pg-LPS), we investigated the role of
SP in regulating macrophage-mediated inflammatory responses. Results: we observed that macrophage cell line and
primary macrophage response differently to Ecoli-LPS and Pg-LPS stimulation, and synergistic effects when both SP
and LPS were used at their optimal concentrations. We also found that low doses of substance P synergized with
Ecoli-LPS in enhancing the mRNA expression of pro-inflammatory mediators, including TNFα, IL-1β, and iNOS, and
also synergized LPS-induced activation of NF-kb and MAPK pathway by measuring the phosphorylation level of p65,
ikk, ikBa, JNK, p38, and ERK. The signal pathway involved in the regulatory role of SP in Pg-LPS-mediated
inflammation is currently under investigation. Conclusion: SP play an important role in regulating macrophagemediated inflammatory responses, potentially through the activation of NF-kb and MAPK signaling pathway.
#30 The Human Papillomavirus Type 16 E5 Oncoprotein Modulates Signal Transduction and Innate Immune
Response in Oral Keratinocytes
Thatsanee Saladyanant, William Todd Seaman, Webster-Cyriaque Jennifer.
Immunology and Dental Ecology, University of North Carolina at Chapel Hill
Department of Microbiology and
Human Papillomaviruses (HPVs) cause most cervical cancers and 20 to 50% of oral cancers. HPV-16 and HPV-18 are
high risk viruses associated with cancer development whereas low risk viruses, HPV-6 and HPV-11, are associated
with benign disease and with the development of oral warts. The early HPV oncogenes, E6/ E7 play a major role in
tumorigenesis by abrogating the normal function of cell cycle regulators. The E5 protein enhances the immortalization
ability of E6/E7 and induces cell transformation and endoplasmic reticulum stress in human keratinocytes. Objectives:
We have generated and tested HPV mutant E5 to clarify the ability and mechanism of E5 to enhance proliferation
associated pathway and innate immunity in oral keratinocytes which are not well characterized. Methods: We
constructed HPV-16 virus with a deleted E5 gene and HA-tag overexpression vectors encoded HPV-16 E5 and HPV 6
E5 genes. The HA-tag was used to detect E5 in transfected oral keratinocytes. We overexpressed E5 in human oral
keratinocytes then used immunoblotting to identify signal transduction molecules that were modulated. Results: The
expression of p-p38 MAPK, p-ERK1/2, p-MEK1/2 but not p-AKT in HPV-16 E5 overexpressing cells was enhanced
compared to vector alone, to an HPV-16 virus with E5 deleted and to HPV-6 E5 overexpressing cells. Luciferase
reporter assay demonstrated the higher interferon promoter activity and RT-PCR detected enhanced expression of IFN
regulated genes ISG 54 and 2,5 OAS in HPV-16 E5 overexpressing cells.
Conclusion: We have developed
important reagents to dissect the role of HPV E5 in oral HPV pathogenesis in future studies. We have determined that
low risk virus was not able to activate key signaling pathways (mek1/2, erk 1/2, p38) nor able to activate the interferon
response. As such, both of these activities may be important to oral tumorigenesis. The AKT pathway may not be
important to oral tumorigenesis.
#31 Characterizing HIV Salivary Gland Disease-derived BK virus in vitro
Burger-Calderon, Raquel*. Jeffers, Liesl PHD*. Houston, KaiulaniI*. Webster-Cyriaque, Jennifer*®. *Microbiology
and immunology Dept, UNC School of Medicine. ®UNC School of Dentistry
Background: We have consistently detected BK virus (BKV) in HIV-associated salivary gland disease (HIVSGD).
Objective: To assess the role of BKV in HIVSGD. Methods: We 1) measured BKV load in the throatwash (TW) of
HIVSGD patients, 2) characterized the non-coding control region (NCCR) and replication capabilities of HIVSGDderived virus from saliva or affected glands in vitro. TW DNA was isolated and the BK viral load (VL) of 20 HIVSGD
and 9 control patients determined via real time (RT) PCR (n=29). The NCCR of 13 HIVSGD patients were sequenced
and compared to 3 control strains. Transcription factor binding sites (TFBS) were predicted via PROMO. We
transfected human submandibular salivary gland (HSG) and Vero cells with cloned patient-derived and control BKVs,
measured VP1/Tag expression and viral production via RT PCR and Southern Blot (SB). Vero and HSG cells were
infected with resulting virions. Results: Pearson correlation analysis revealed a strong relationship between BKV VL
and HIVSGD and weaker correlates between BKV and HIV-VL, CD4 counts, antiretroviral treatment and age. All
HIVSGD-derived BKV NCCRs revealed a potential signature block sequence (OPQPQQS). Spearman-Rank-Sum test
analysis of the O block revealed a positive correlation between predicted total C/EBP-beta/p300 TFBS and increasing
BKV VL (p=0.04). HIVSGD-derived viruses and control BKV productively infected HSG cells in vitro, confirmed by
viral gene expression, the presence of encapsulated virions in supernatant and de novo infection of Vero and HSG
cells. Conclusion: Consistent links 1) between increased oral BKV shedding and HIVSGD, 2) between increased oral
BKV shedding and significant TFBS within the signature NCCR and 3) detection of a signature HIVSGD-NCCR
corroborate BKV as the etiological agent of HIVSGD. Further, wild-type oral isolates have not previously been
characterized in vitro and we have established an HIVSGD in vitro model that supports permissive replication of
patient-derived and laboratory strain BKV.
#32 Cloning, expression and purification of Tubby protein
Lin Lin1, Kasturi Puranam2 and Glenn K Matsushima1, 2, 3, 4
1
Curriculum in Oral Biology, School of Dentistry, 2UNC Neuroscience Center; 3Department of Microbiology and
Immunology; 4Program for Molecular Biology & Biotechnology, School of Medicine, UNC
Objective: Tyro-3, Axl, and Mertk constitute the TAM family of receptor kinases which regulate the clearance of
apoptotic cells. The known ligands for these receptors are GAS6 and Protein S. Recently Tubby has been identified as
a specific ligand to the Mertk receptor. It was identified as eat-me signals by ORF phage display and was found to be
an unconventional secreted protein lacking a signal peptide sequence. In this project, our objective is to produce tubby
protein that can be used to study signal transduction through Mertk. Materials and Methods: Tubby plasmid was
transformed into One Shot® INVaF‘ competent cells. After propagation and cloning of bacteria, colonies containing
tubby cDNA were identified by restriction enzyme analysis. Positive colonies were selected and sufficient quantities
of plasmid were obtained for transfection and expression in HEK293 cells. Using anti-FLAG® M2 affinity agarose
gel, tubby protein was purified and corroborated using Western blot analysis. Results: We have successfully cloned,
expressed and purified tubby protein. Future studies will use the tubby protein to examine signal transduction through
Mertk.
Acknowledgments: Supported by NMSS RG4293
#33 Proteomic Analysis for Cerebral Cavernous Malformations
1. C. Mack, Dental Research, UNC, Chapel Hill, 2. C. Dibble, Pharmacology, UNC, Chapel Hill, NC 3. S. Schwartz,
David H. Murdock Research Institute, Kannapolis, NC 4. J. Carlson, David H. Murdock Research Institute,
Kannapolis, NC 5. S. Bencharit, Prosthodontics, UNC
Objectives: Cerebral cavernous malformation (CCM) is a vascular anomaly which predisposes affected individuals to
hemorrhagic stroke. The etiology of CCM has been traced to three genetic mutations. These CCM genes, Krit1
(CCM1), OSM (CCM2), and PDCD10 (CCM3), interact as a protein complex within the cell. The loss of expression of
each CCM gene results in disruption of in vivo endothelial tube formation as well as reduction in actin fiber formation.
However, the global effects of CCM gene knockdown are unknown. There lies the additional question of whether any
of these knockdowns will reveal novel signaling pathways related to the in vitro and clinical phenotypes. Here we used
a proteomic approach to define the signaling pathways involved in CCM. Methods: Using mouse endothelial stem
cells (MEES), we examined the global proteomic effects of the loss of each CCM gene expression. Label-free
differential protein expression analysis using multidimensional liquid chromatography/tandem mass spectrometry (2DLC-MS/MS) was applied to examine the expressed proteomic profile for each knockdown cell-line (CCM1, CCM2,
and CCM3) compared to mock shRNA and no shRNA control cell-lines. Those differentially expressed proteins were
identified (ANOVA; p<0.05) and principle component analysis (PCA) as well as cluster analysis were used to analyze
identified proteins. Results: 122 proteins were found to be differentially expressed amongst the five cell-lines. PCA
and cluster analysis results demonstrate the effects of individual CCM knockdown and suggests a unique proteomic
profile for each cell line. In each of the three CCM knockdown cell-lines, overexpression of cytoskeletal proteins is the
most common. Conclusions: The results suggest that these CCM genes play essential role in cytoskeletal development
and that proteomic analysis is proven to be a useful tool for future examination of CCM-related signaling pathways.
Supported by NIH, 1R21HL092338-01.
#34 The RhoA-Rho kinase-LIM kinase-Cofilin Signaling Pathway is Dysregulated in Cerebral Cavernous
Malformation Disease
Dibble CF, Borikova AL, Feinberg NN, Johnson GL, and Bencharit S
Medicine and Department of Prosthodontics, School of Dentistry, UNC
Department of Pharmacology, School of
Cerebral Cavernous Malformations (CCM) are vascular lesions that can cause seizures and strokes. CCM disease
occurs when there is bi-allelic loss in endothelial cells in one of three genes: ccm1, -2, or -3. The CCM proteins
regulate degradation of the small GTPase RhoA and thus cytoskeletal dynamics. Recentwork showed that loss of CCM
proteins is associated with an increase in RhoA-Rho Kinase (ROCK)-Myosin Light Chain 2 (MLC2) signaling. ROCK
also affects the cytoskeleton through the LIM Kinase (LIMK)-cofilin pathway. Here, we show that phospho-LIMK and
phospho-cofilin are increased with loss of the CCM proteins in human and mouse endothelial cells. Significantly,
phospho-cofilin is significantly increased in the endothelial monolayer of surgically resected lesions from familial
ccm1, -2, and -3 mutation carriers. Knockdown of LIMK1 normalizes phospho-cofilin levels in CCM knockdown
endothelial cells and rescues tube formation and invasion defects seen in CCM knockdown endothelial cells. LIMK1
knockdown rescues tube formation to similar levels seen with small molecule ROCK inhibition, indicating that the
LIMK-cofilin axis is a major ROCK effector pathway dysregulated in CCM. Additionally, we construct the first
simulatedmodel of tube formation, which suggests that a major reason for the defective CCM knockdown tube
formation phenotype is an inability to maintain stable intercellular contacts. These findings, for the first time, define
the role of the CCM proteins in regulating LIMK-cofilin control of the actin cytoskeleton in endothelial cells, and
define elevated phospho-cofilin as a biomarker for CCM. These data suggest that both arms of the ROCK cytoskeletal
regulatory network, cofilin and MLC2, are dysregulated with loss of the CCM proteins, cumulatively resulting in
increased actin stability and contributing to thepathophysiology associated with CCM disease.
#35 Automatic Design of Landmarks in the Circumoral Region for Patients with Cleft Lip
Nayoung Lee, PostDoc, University of North Carolina at Chapel Hill; Chuck Heaston, Vice President, Operations &
Customer Service, 3dMD; Carroll-Ann Trotman, Professor and Associate Dean for the Office of Academic Affairs,
University of Maryland Dental School and Adjunct Professor, University of North Carolina at Chapel Hill
Objectives: Analyses of facial soft tissue shape and movement change is based on landmark changes during different
facial animation/movements. Generally, landmark identification is performed manually; however, manual
identification is inconvenient and requires much time and effort. Therefore, the aim of this study was to develop
software to automatically identify landmarks on the circumoral region. Methods: The study sample consisted of
participants recruited from the University of North Carolina School of Dentistry Orthodontic, Pedodontic, and
Craniofacial Clinics. The participants were patients with repaired cleft lip and palate (CL/P) and non-cleft ‗control‘
subjects. Landmarks were positioned on the lip boundary and circumoral region of participants as follows. A
horizontal center line, defined as a line through the right and left commissures (mouth corners), was first identified.
The center line then was evenly divided into 6 areas by 5 points equidistant between the right and left commissures.
Then, 5 points on the upper lip and 5 points on the lower lip, orthogonal to each of the 5 points on the center line, were
defined as landmarks. Landmarks on the upper circumoral region then were defined using points 1 cm orthogonally
distant from landmarks on the upper lip and using points 2 cm orthogonally distant from the landmarks along the lower
lip.
Results: Software was developed to automatically register landmarks in the circumoral region. For this
approach, the lip boundary landmarks were positioned differently for the various facial animation/movements.
Conclusion: The newly-developed software can be used for comparative analyses of shape and movement between
patients with CL/P and non-cleft subjects. Future work will be focused on the development of a robust and automatic
facial landmark extraction. Supported by NIDCR GRANT DE013814, DE019742.
#36 Effects of Primary Lip Surgery on Facial Soft Tissue Dynamics—A Pilot Study.
Carroll Ann Trotman, Department of Orthodontics, UNC Julian J. Faraway, Statistic Department, University of Bath
Objective: Babies born with a cleft of the lip/palate (CL/P) have an obvious facial disability. The initial or primary
surgical repair of the lip aims to rehabilitate the facial form and function; however, with growth many babies remain
with both a facial disfigurement and impairment in movement. Therefore, the objective of this study was to determine
the facial functional (movement) changes in babies before and after primary lip repair.
Methods: 15 babies with
unrepaired CL/P and 15 non-cleft ‗control‘ babies were recruited from the University of North Carolina Craniofacial,
Pediatric Plastic Surgery, and Pediatric Dentistry Clinics. The babies with CL/P were followed longitudinally for 4
months and had three-dimensional (3D) movement tests conducted before and 4 months after primary lip repair. The
non-cleft babies were tested at similar times. A Motion Analysis system was used to track 14 specific facial landmarks
during spontaneous and elicited behaviors. Statistics. Changes in inter-landmark distances were computed during the
behaviors. A model of the form log(measure) ~ action + visit*cleftgroup was considered where action=behavior type,
visit = before/after surgery, and cleftgroup = CL/P versus non-cleft). Other exploratory models also were computed.
Results: Apart from the upper lip, facial movements were similar for both groups of babies. Over the 4-month period,
there was a 16% increase in range of movements for both groups. For certain behaviors the babies with CL/P had
decreased movement compared with the non-cleft controls. Babies with CL/P demonstrated a decrease in the range of
movement over the 4-months while control babies demonstrated an improvement. For babies with CL/P, asymmetry
in movement is reduced after surgery.
Conclusion: Babies with CL/P have a significant impairment in facial
function that worsens with age despite surgical repair of the lip. Supported by NIH DE013814, DE019742.
#37 Three Intraoral Radiographic Receptor-Positioning Systems: A Comparative Study
Q Tang*, SM Mauriello, E Platin, JB Ludlow. University of North Carolina, School of Dentistry.
Objectives: The purpose of this study was to compare the number and types of technique errors and diagnostic quality
of radiographs exposed using the XCP® (standard), XCP-ORA™ (modified), and XCP®/JADRAD™ Dental X-ray
shield (standard/shield) systems. Methods: Senior dental hygiene students (n=29) exposed up to three patient intraoral
full mouth series (FMX). A randomized block study design was used to assign students to one of six study groups.
Each group was assigned an alternating sequence of device use. (After the procedure, the student operator completed a
six-item survey regarding the use of the device. At study completion, each post-study five-item survey was
administered to students who completed using all three study devices. Examiner reliability was 0.87 (intra-class
correlation). Data were analyzed using one-way ANOVA. The primary outcome was the percentage of any error per
FMX. Results: Sixty FMXs were exposed by 25 operators (86% of the senior students). The mean (SD) percent of any
technique error for the standard, modified, and standard/shield devices was 18.4(8.1), 17.5(7.2), and 15.4(6.6)
respectively (p=0.43). There was no statistically significant difference among the three systems used. Error types
varied per device with cone cut errors having the lower mean 15.8(8.4), using the standard/shield compared to the
highest mean, 25.1(4.0), using the modified device. The modified device had the lowest mean of vertical errors
4.2(4.2) compared to the highest using the standard/shield 8.7(6.5). The mean for horizontal errors ranged from
5.9(4.4) with the standard/shield to the highest 11.2(5.2) with the modified device. The percentage average of packet
placement errors was similar among all devices. From the post study survey, 50% of subjects who completed
radiographs with all three study devices preferred the modified device. Conclusions: No statistical difference in
technique errors was found among the three devices tested. Although fewer horizontal and cone centering errors
occurred when using the XCP®/JADRAD™, students preferred using the XCP-ORA™.
#38 SUSTAINED TOLERANCE OF CPAP USING MAS SUPPORTED NASAL PILLOWS
Boota A. (1), White J.R. (2), Pardue T. (3), Essick G. (3) 1) Palmetto Pulmonary and Critical Care Associates, PA,
St. Francis Hospital, Greenville, SC, USA 2) White and Siachos, Greenville, SC, USA 3) University of North
Carolina School of Dentistry, Chapel Hill, NC, USA
Introduction: Recently, we demonstrated that CPAP tolerance can be improved using a mandibular advancement splint
(MAS) to physically support and stabilize the position of nasal pillows (2011 AADSM abstract). However, it was
unknown whether patients‘ lack of complaints and adherence to therapy would persist beyond the initial trial period.
Methods: Data were available for nine CPAP-intolerant patients (mean age=57.1yrs, BMI=29-33.8) treated with
hybrid therapy. Patients were fitted with a MAS that advanced the jaw 71% of maximum protrusion. A metal rod was
secured facially to the upper component to provide support and positional stability for nasal pillows (TAP-PAP
chairside, Airway Management Inc., Dallas, Tx). PSG: Lab sleep data were obtained from patients‘ initial diagnostic
and CPAP titration studies, and final PAP titration with MAS. CPAP Tolerance: Using a 13-item checklist, patients
reported reasons for intolerance to conventional CPAP, and to PAP combined with MAS at the start of treatment and
10.1 (range 5-13.6) months later. Results: Mean AHI was 61.3 events/hr (range 10-108) prior to any treatment, 5
events/hr (range 0-20.7) at optimum CPAP of 11.5 cmH2O (10-16) without MAS, and 1.8 events/hr (0-6.1) at
optimum CPAP of 9.9 cmH2O (9-15) with MAS. Each patient reported 2-6 reasons associated with intolerance to
conventional CPAP: Most commonly ‗can‘t keep in place‘ (77.8% patients), ‗unconsciously remove‘ (56.6%), ‗mask
uncomfortable‘ (44.4%), ‗mask leaks‘ (44.4%). During the initial trial period of hybrid therapy, only two patients
reported a single negative experience: ‗unconsciously remove‘, ‗pull of hose applies force to teeth‘. 10.1 months later,
patients reported only two negative experiences (both related to MAS) and using the hybrid therapy 6.6 nights/week
for 7.4 hrs/night, on average. Mean ESS remained low at 3.6. Conclusions: Adherence to CPAP therapy can be
improved and maintained using hybrid therapy, which proves to be as efficacious as conventional CPAP.
#39 In vivo evaluation of force decay properties of NiTi closed coil springs and comparison with matched in
vitro analysis.
Crystal Cox, Ching-Chang Ko, Tung Nguyen, UNC Department of Orthodontics
Nickel-titanium (NiTi) closed coil springs are purported to deliver constant forces over extended working times. In
vivo studies supporting this claim are limited. Objectives: Evaluate changes in force decay properties of NiTi closed
coil springs after clinical use. Methods: Pseudoelastic force-deflection curves for 30 NiTi coil springs (used intraorally) and 15 matched laboratory control springs (simulated intra-oral conditions - artificial saliva, 37 ˚C ) were
generated pre- and post-retrieval via Dynamic Mechanical Analysis (DMA) and Instron testing, respectively, to
evaluate amount of force loss and hysteresis change following 4, 8, or 12 weeks of working time (n=10 per group).
Effect of the oral environment and clinical use on force properties was evaluated by comparing in vivo and in vitro
data. Results: Preliminary clinical data show a statistically significant force loss over 12 weeks (mean= -48.48gms,
P<0.001) and up to a 12% decrease in hysteresis (p=0.005). A statistically significant decrease in force levels between
4 weeks and 8 weeks of use (mean = -21.90gms, p = 0.04) was also found. Conclusions: NiTi closed coil springs do
not deliver constant forces and lose elastic energy when used intra-orally.
#40 Prevalence of Third Molars with Caries Experience or Periodontal Pathology in Young Adults
GEORGE Y. SOUNG PRESENTING ON BEHALF OF: RACHEL N. GARAAS, DMD, ELDA L. FISHER, DMD, MD,
GRAHAM H. WILSON, BS, CEIB PHILLIPS, PHD, MPH, DANIEL A. SHUGARS, DDS, PHD, MPH, GEORGE H.
BLAKEY, DDS, ROBERT D. MARCIANI, DMD, AND RAYMOND P. WHITE, JR., DDS, PHD
Purpose: We assessed the prevalence of caries experience and periodontal pathology on asymptomatic third molars in
young adults. Subjects and Methods: Healthy subjects with 4 asymptomatic third molars were enrolled in an
institutional review board-approved study during a 5-year period. Full mouth periodontal probing, 6 sites per tooth,
was the measure of clinical periodontal status. The presence or absence of occlusal caries experience (carious lesions
or restorations, including sealants) on third molars and on any surface of the first and second molars were assessed
using a visual-tactile examination and panoramic radiographs. The primary outcome measures were at least 1
periodontal probing depth of at least 4 mm versus none and caries experience versus no caries experience. Results:
The data were analyzed from 409 subjects, who averaged 25 years old. More subjects were female (53%) and white
(76%). More subjects had at least 1 periodontal probing depth of 4 mm or deeper on a third molar (55%) than on the
distal of a second molar (46%). These findings were more likely to be detected around a third molar in subjects with all
third molars at the occlusal plane (72%) than in subjects with at least one third molar below (33%). Overall, fewer
subjects were affected by third molar caries experience than first or second molars (24% vs 73%, respectively). Of the
subset of subjects with all four third molars at the occlusal plane, 26% were affected by both third molar periodontal
pathology and caries experience and 16% were caries and periodontal pathology free. Conclusions: In these crosssectional analyses, periodontal pathology was detected more frequently on third molars than on first and second molars
and caries experience was detected more frequently on first and second molars than on third molars. Supported By:
Oral and Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, and Dental
Foundation of North Carolina.
#41 Vertical Root Fracture Detection Using High Resolution CBCT
PAUL CARRUTH, ERIC RIVERA1, DDS, MS; CEIB PHILLIPS2, PHD, MPH; JOHN LUDLOW3, DDS, MS; DONALD
TYNDALL, DDS, PHD, MSPH3; DEBORAH PRICE2
1
Department of Endodontics, 2Department of Orthodontics, 3 Radiology, School of Dentistry, UNC
Objectives: To determine if there is a statistically significant increase in accuracy of vertical root fracture (VRF)
detection utilizing high resolution, small field of view cone beam computed tomography (CBCT) compared to
conventional periapical radiography. Methods: This study utilized three dry skulls consisting of fifty-one root canal
treated premolars and molars. Twenty-one of these teeth were randomly selected and fractured using the Monaghan
method. Conventional periapical radiographs as well as CBCT scans using the Kodak 9000 unit were taken of each
skull. The skulls were covered on the facial and lingual surfaces with ½ inch of wax for soft tissue simulation. The PA
images and CBCT volumes were randomized and assessed by three calibrated expert observers who evaluated VRF
presence using a five point rating scale (fracture definitely present, fracture probably present, unsure, fracture probably
not present, and fracture definitely not present). Results: Descriptive analysis of the observer‘s evaluations indicate the
following: Truly correct responses were identified by Observer 1 17.65% with PA and 39.22 % with CBCT, by
Observer 2 9.8% with PA and 37.25% with CBCT, and by Observer 3 41.18% with PA and 47.06% with CBCT. For
Observer 1, 4 out of 9 correct PA responses were, for the same tooth, incorrect with CBCT and 15 out of 20 CBCT
correct responses were incorrect with PA. In the same manner, for Observer 2, 4 out of 5 PA responses were solely
correct and 18 out of 19 CBCT responses were solely correct. For Observer 3, 10 out of 21 PA responses were solely
correct and 13 out of 24 CBCT responses were solely correct. Conclusion: Each observer more correctly identified
vertical root fractures that were truly present with the Kodak 9000 CBCT volumes than PA images.
#42 Caregiver attitudes and acceptance of childhood overweight and obesity counseling in the dental office.
Clark Morris1, Tina Tran3, Wesley Rich3, Melinda Beck2, Raymond Tseng 1,2,3 1Dept. of Pediatric Dentistry, School of
Dentistry, 2Dept. Of Nutrition, Gillings School of Global Public Health University of North Carolina, Chapel Hill, NC,
USA; 3Dept. of Public Health, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA.
Objectives: Childhood overweight and obesity (ow/ob) affect over 33% of children and adolescents. Effective
diagnosis and treatment requires collaboration among pediatric healthcare providers, including dentists who see
children. Dentists are willing to engage in ow/ob prevention services, but no study has assessed whether parents are
willing to accept diagnostic and counseling services from these providers. The objective of this study was to assess
parental comfort level and attitudes about addressing childhood ow/ob in the dental office. Methods: Caregivers
whose children presented for new patient or recall visits in a pediatric dental private practice were surveyed. Likert
scales and dichotomous questions assessed parental comfort level with different healthcare providers discussing child
ow/ob, and perceived difficulty of sustaining ow/ob-associated lifestyle changes for 3 or 6 months. Bivariate analysis
was performed with Chi-square tests to identify significant associations. P< 0.05 was considered to be statistically
significant. Results: Physicians discussed BMI percentile at only 30% of well child visits. Private insurance,
completion of a college degree, and believing children would not outgrow obesity were significantly associated with
parental acceptance of weight counseling. A significant majority of parents felt that addressing child weight in the
dental office was appropriate, and were just as comfortable talking with dentists as they were with physicians. ―Having
breakfast everyday‖ and ―having fruits/vegetables at least once per day‖ were rated as easier goals than brushing twice
per day. For all lifestyle changes, there was no difference in reported difficulty for sustaining changes for 3 or 6
months. Conclusion: Child weight discussions occur infrequently, highlighting an opportunity for dentists to be
involved. Parents believe that discussing a child‘s weight in the dental office is appropriate, and are comfortable
engaging in such discussions. This study provides a starting point for promoting lifestyle changes to address childhood
ow/ob in the dental office.
#43 Impact of Orthognathic Surgery on Oral Health QOL
Taneisha Livingston1, Dr. Ceib Phillips1, Dr. George Blakey, III2
1
Department of Orthodontics 2Department of Oral and Maxillofacial Surgery, School of Dentistry, UNC
Objectives: To assess self-reported changes in oral health related quality of life(OHQOL) and to evaluate the effect of
type of surgery, gender, and age on these changes in patients having orthognathic surgery for a dentofacial deformity.
Methods: Between July 2003 and July 2010, 189 patients completed the 14-item Short Form Oral Health Impact
Profile (OHIP-14) before orthognathic surgery, 6 weeks after surgery and at the completion of orthodontics as part of
an IRB approved prospective study. Subjects with a congenital syndrome, acute trauma, or ASA III or IV were
excluded. Repeated measures analysis of variance was used to analyze the changes for the overall OHIP score (range
0 to 56). Higher scores indicate a worse oral health quality of life. Results: 65% of the subjects were female; average
age was 19. 40% had both a maxillary and mandibular ostetotomy; 36% maxillary only; and 24% mandibular only.
Before surgery, the most frequently reported items as occurring very often because of problems related to teeth or
mouth were ―being self-conscious‖, uncomfortable eating any foods‖, and ―embarrassed‖ (28,13, and 14%
respectively). A substantial improvement in the overall score, on average, occurred by 1 year(P<0.0001). Older
subjects reported worse OHQOL before surgery and at 1 year after surgery than younger subjects(P<0.0001). Average
OHQOL scores were significantly different among the surgery types (P<0.0001). Patients who had a 2 jaw procedure
reported the worst OHQOL before surgery and patients with a mandibular procedure (single or two jaw) had slightly
worse scores, on average, at 1 year than those who had a maxillary procedure only. Conclusions: Significant
improvement in overall oral health QOL occurred by 1 year after surgery. The type of surgery and the age of the
patient at surgery had a significant effect on the change from pre-surgery to post-treatment. Supported in part by NIH
NIDCR R01 DE 005215
#44 Purified LPS from the periodontal pathogens Aggregatibacter actinomycetemcomitans and Porphyromonas
gingivalis induce convergent/divergent miRNA expression
AFSAR RAZA NAQVI1, JEZROM SELF-FORDHAM1, ASMA KHAN2, SALVADOR NARES1 1Department of Periodontology,
2
Department of Endodontics, University of North Carolina, Chapel Hill, NC
Background: Macrophages recognize pathogen-associated molecular patterns (PAMPs) through Toll-like receptors
(TLRs) and mobilize transcriptional programs aimed at host defense. MicroRNAs (miRNA) are small, ~21nucleotide,
single-stranded, non-coding RNAs that regulate diverse biological processes, including inflammation and immunity.
However, little is known about the role of these key mediators in the host response against periodontal pathogens. Here
we dissect the early mechanisms underlying effector-specific responses by comparing the miRNA profiles of
macrophages challenged with LPS from periodontal pathogens recognized by TRL4 or TLR2. Methods and Materials:
Macrophages were differentiated from the monocytic cell line THP-1 and challenged for 4 hours with 100ng/µl
purified LPS from Aggregatibacter actinomycetemcomitans, Y4 serotype B, Porphyromonas gingivalis, strain 33277
(Pg), and Pg grown in cigarette smoke extract at a concentration of 4000 ng nicotine equivalents/ml. miRNA profiles
were interrogated using Nanostring technology and expression confirmed by RT-PCR. mRNA targets for differentially
expressed miRNAs were identified using PUBMED and miRWalk. Candidate mRNAs were selected if identified as
miRNA targets in at least 5/8 databases and linked to immunity/inflammation by GO Biological Process.
mRNA/miRNA interactions were confirmed using a dual luciferase assay. Results: Our results show that of the 653
human miRNA probes approximately 200 (~30%) miRNAs were responsive to LPS. We identified
convergent/divergent expression profiles including a ―core‖ response of 11 upregulated and 20 down-regulated
miRNAs common to the three LPS‘s as well as LPS-specific miRNA expression. Our dual-luciferase assays confirmed
targeting of thrombospondin1 (THBS1), a potent activator of TGF-ß and macrophage chemoattractant by LPSresponsive let-7f. Our data indicates that LPS from periodontal pathogens induces convergent/divergent miRNA
expression in human macrophages and identify key targets linked to inflammation and immunity. We also confirm let7f targeting of THBS1. These pathogen-effector responsive miRNAs will be useful in our understanding of hostpathogen interactions that may be exploited therapeutically. Funded by NIH 1R01DE021052-01A1.
#45 Effect of fluoride on regulation of parathyroid hormone
S. HU1, PURANIK. CP1, MARTINEZ-MIER A2, E. T. EVERETT3, 1 Oral Biology Curriculum, UNC,
University 3 Department of Pediatric Dentistry, University of North Carolina, Chapel Hill, NC
2
Indiana
Objective: We have reported that 3-weeks of fluoride (F) exposure in C3H/HeJ mice leads to increased osteoclast
potential with increases in serum osteoclast markers (iPTH, sRANKL, and TRAP5B). In order to better understand
immediate/early events leading to this response we subjected mice to single oro-gastric F dose. We hypothesize that F
ingestion leads to an immediate decrease in serum calcium (Ca) thereby stimulating intact parathyroid hormone (iPTH)
secretion initiating osteoclastogenesis. Methods: Fifty-two, 3 week-old, C3H/HeJ mice were acclimated on a constant
nutrition diet for one week (Test Diet#5861, F: 0ppm, Ca: 0.61%, phosphorus (Pi): 0.57%, vitamin D3: 2.2IU/g,
energy: 4.09kcal/g) and 0ppm F was provided ad libitum in the drinking water. Single 100ppm F water dose
(0.1mg/10g) was given by oro-gastric gavage and mice were euthanized at 0.5, 1, 3, 6, 12 or 24hrs. Sera, parathyroid
complexes (PTC) and humerii were collected. Sera were subjected to Ca (total and ionized), F, Pi, and iPTH
determinations. RNA was extracted from tissues. Real-time PCR was performed to interrogate expression of (Pth,
Casr, Klotho, Fgfrl, Vdr, Pthlh, Fgf23, Tnfs1 and Pth1r) genes in the parathyroid-kidney-bone axis. Results were
compared to control (0ppm F) oro-gastric gavage group harvested at 0hr. Results: There were no significant
differences in serum Ca (ionized and total) and Pi between test and control groups. Serum F was significantly higher at
0.5hr (p<0.05) and 1hr (p<0.005) groups as compared to control. Serum iPTH at 24hr was significantly lower
(p=0.013) than controls. For PTC, expression of Pth (p=0.03) and Klotho (p=0.02) genes was significantly upregulated
at 24hrs. There was no change in Fgf23 and Tnfs11 gene expression at 24hrs in the humerii. Conclusion: The data did
not support the hypothesis. A single F dose leads to decrease in serum iPTH secretion without any changes in Ca.
(Supported by NIH R01 DE018104)
#46 Partially-differentiated oral keratinocytes support in vitro production of wild-type HPV16 originating from
an oral cancer.
William Seaman1, Department of Dental Ecology, Lineberger Cancer Center
Xiaoying Yin Lineberger
Comprehensive Cancer Center Marion Couch, Lineberger Comprehensive Cancer Center Vicki Madden, Pathology
and Laboratory Medicine Jennifer Webster-Cyriaque, Department of Dental Ecology and Department of Microbiology
and immunology
Objectives: The causal relationship between human papillomavirus (HPV) and cervical cancer is well established.
While recent studies show an association between oral HPV infection and oral cancer, the role HPV plays in oral
malignancies is less understood. We sought to develop a model for oral keratinocyte infection by HPV16 in vitro.
Method: HPV-type specific qPCR was used to detect HPV in oral fluids from HIV-infected individuals and archived
oral cancer biopsies. The whole genome of HPV16 was amplified by PCR from clinical samples. LoxP-containing
viral genomes were used to introduce HPV16 episomes into immortalized oral keratinocytes (OKF6tert1) by Cre/loxP
recombination. HPV16 transcripts were detected by RT-qPCR. DNase-resistant viral DNA was detected in culture
media using qPCR. Transmission electron microscopy (TEM) was used to visualize viral particles in media.
Immunofluorescence (IFA) was performed to detect HPV proteins in infected cells. Results: We detected HPV16 in
15% of DNA samples prepared from paraffin-embedded oral cancer tissues obtained from a smoker/drinker
population. The entire HPV16 genome was PCR-amplified and cloned. To determine if oral keratinocytes expressing
differentiation markers could support HPV production, an HPV16 genomic clone was cotransfected with a Creexpression plasmid into cells. Recombined episomes were confirmed by PCR across the loxP junction. HPV16specific E1^E4 transcripts from transfected cells were detected using RT-qPCR, confirming viral gene expression.
Extracellular, DNase-resistant HPV16 DNA was detected by qPCR. Viral particles between 40 and 50 micron
reminiscent of VLPs were detected in the media of transfected cells by TEM. Viral proteins were detected by IFA in
OKF6tert1 and human foreskin keratinocytes after incubation with media from HPV16-tranfected cells. Conclusions:
These results indicate that OKF6tert1 cells support production of infectious HPV16 particles and may provide a system
for identifying events in lytic HPV16 infection and HPV-associated oral malignancy and disease.
#47 The Age One Dental Visit: Knowledge, Attitudes, and Behaviors of North Carolina Dentists Regarding
Physician Guidelines
C. MARSHALL LONG,DDS1, ROCIO B. QUINONEZ,DMD,MS,MPH1, R.GARY ROZIER,DDS,MPH2 JESSICA
Y. LEE,DDS,MS,PHD1,2
1
DEPARTMENT OF PEDIATRIC DENTISTRY, SCHOOL OF DENTISTRY,2DEPARTMENT OF HEALTH
POLICY AND MANAGEMENT, GILLINGS SCHOOL OF PUBLIC HEALTH
Objectives: The purpose of this study was to: (1) assess the knowledge, attitudes and behaviors of general and pediatric
dentists in North Carolina (NC) regarding physician guidelines for infant oral health; and (2) determine barriers among
these dentists in embracing these guidelines. Methods: Using a cross-sectional design, all pediatric dentists (N = 153)
and 1000 randomly selected general dentists currently practicing full-time in NC were surveyed. A 63-item
questionnaire was developed using a framework for guideline adherence recommended by Cabana et et. (1999).
Questionnaires were mailed to all participants with second and third mailings for non-respondents according to the
Dillman Method. The primary outcome was guideline compliance as indicated by acceptance of children referred for
age one dental visit by a physician Results: Response rates were 49.3% and 67.3% for general and pediatric dentists,
respectively. Awareness of the current physician infant oral health guidelines was reported by 89% of pediatric
dentists, but only 32% of general dentists. Statistical analysis is currently ongoing and results from descriptive,
bivariate and regression analyses will be reported. Discussion: This study investigates knowledge, attitudes and
opinions of NC dentists and pediatric dentists regarding physician guidelines and involvement in infant oral health.
Barriers towards accepting physician referral for the age one dental visit among this population will be described. This
information can be used to concretely identify important barriers that can lead to the development of interventions to
maximize the availability of a dental home for young children. Supported by 3M ESPE Postdoctoral Research
Fellowship and NC Dental Society.
#48 Tooth Whitening Procedures and Orthodontic Treatment: A Survey of Orthodontists
M.E. SLACK, C. PHILLIPS, P.E. ROSSOUW, E.J. SWIFT, JR.
Dentistry, University of North Carolina, Chapel Hill, NC
Departments of Orthodontics and Operative
Objectives: Esthetics is increasingly important in modern dentistry, but there are currently no published reports
regarding how whitening products or procedures are being included within contemporary orthodontic practices in the
United States. The authors conducted a study to quantitatively and qualitatively assess orthodontists‘ current whitening
practices. Methods: The authors surveyed a random sample of 3,600 American Association of Orthodontists members
via electronic and paper questionnaires. The sample was stratified and weighed by geographic region of the United
States. Results: A total of 1,182 surveys were returned and eligible for analysis. Overall 89.1 percent of respondents
reported that they had patients who requested whitening procedures within the last six months and 76.3 percent had
recommended whitening procedures to patients within their orthodontic specialty practice. Nearly one-third (32.4
percent) of respondents provided whitening procedures within their practice, while nearly two-thirds (66.4 percent) of
respondents referred patients to other providers for whitening procedures. Referrals for professional-strength
whitening strips for home use (83.1 percent) and in-office bleaching with light activation (72.5 percent) were the most
common types of whitening referrals nationwide. Conclusion: Across the country, most orthodontists encounter
patients who request whitening procedures, and their recommendation and provision of these procedures vary by
geographic region. The majority of orthodontists do recommend whitening procedures; however the proportion of
orthodontists who refer such procedures out to other providers is nearly double the proportion that provides whitening
services within their own specialty practice. Supported in part by the Procter & Gamble Co.
#49 Infant and Toddler Oral Health: A Survey of Attitudes and Practice Behaviors of North Carolina Dental
Hygienists.
VIVIANA R. RUIZ1, ROCIO B. QUINONEZ2 REBECCA S. WILDER1 CEIB. PHILLIPS3
1
Dental Ecology, 2Pediatric Dentistry, 3Department of Orthodontics
Objectives: The purpose of this study is to evaluate the knowledge, comfort, values, practice behaviors, and stage of
readiness of dental hygienists (DH) in North Carolina (NC) with respect to providing oral health care to
infants/toddlers and the barriers that prevent such care. Methods: Using a descriptive cross-sectional design, a survey
was mailed to 2000 randomly selected licensed DH practicing in NC selected from the State Board of Dental
Examiners database. Results: The response rate was 43% with the majority of respondents being female (99%). DH
reported feeling comfortable with caring for infants/toddlers (46%), but lacked knowledge in the infant/toddler‘s care
protocols. A high rate of DH‘s reported not providing care to infants/toddlers (59%), however two thirds were
contemplating providing these services and 11% reported being very likely to make these changes in the next six
months. Significant barriers included lack of continuing education opportunities, unfamiliarity with the infant oral
health guidelines, and current practice situation. Conclusion: These findings indicate that less than half of NC DH
delivers preventive oral health care services to infants/toddlers. For those not delivering these services, there is a
willingness to make changes, however, knowledge is lacking regarding oral health care for preschool age children as
well as accepted guidelines. DH would benefit from an earlier introduction to infant/toddler oral health in their
educational curriculum, access to continuing education courses, and review of national guidelines that can assist in
their willingness to provide oral care to this population.
This study was supported by an unrestricted grant from
Colgate/Palmolive Company.
# 50 Economic Turmoil and Craniofacial Care: The Impact of a National Recession on Children with Cleft
Lip/Palate
A. CAVENAUGH, R. STRAUSS, R. QUINONEZ, L. KOROLUK, V. WHITE. Departments of Pediatric Dentistry,
Orthodontics, and Dental Ecology
Objective: A modest number of studies contribute valuable but limited information regarding barriers to accessing
health care for a child with a cleft; however none to date have attempted to obtain data on the complete multifactorial
basis of these barriers. A progressive inverse relationship between financial security and health care access may have
a unique impact on the multidisciplinary care required for these patients, and can be directly studied in the context of
the recent economic recession. This study aims to provide an assessment of barriers to health care as perceived by the
parents of children with cleft lip/palate using a cross-sectional online survey accessed through AmeriFace® (an
organization that provides emotional, educational, and practical support to people with craniofacial differences and
their families). Methods: Survey link was placed on the AmeriFace® website (October 26, 2010-January 31, 2011).
A convenience sample was recruited via cleft/craniofacial advocacy websites and email through AmeriFace®.
Inclusion criteria were parents/legal guardians of a child (<18 years) with a cleft lip and/or cleft palate; had internet
access; able to read and understand English; and U.S. residents. Descriptive statistics and proportions were determined
for demographics, financial security, and perceived problems accessing care, supplemented by primary analysis of
qualitative data. Results: N=207 participants. Forty-eight percent reported income decrease/total loss due to economic
decline which they believe directly affected access to craniofacial care. Insurance premiums and co-pays/deductibles
were perceived barriers independent of the economy for 45% and 53% of respondents, respectively; however, the
recession increased the impact of these barriers for 57% and 61% of respondents, respectively. Twelve percent lost
insurance benefits entirely. Fifty-two percent considered increased transportation costs a barrier.
Conclusions:
Despite most participants being affluent, well-educated, and White, significant barriers to obtaining craniofacial care
not only exist but have progressively increased due to the recent economic recession.
#51 Knowledge and Practice of Eating Disorders Among a Group of Adolescent Dental Patients
TRAVIS M. HICKS*, DDS, JESSICA LEE, DDS, MPH, PHD* TUNG NGUYEN, DMD, MS**, MARIA LA VIA, MD***,
MICHAEL W. ROBERTS, DDS, MSCD*
* Department of Pediatric Dentistry, **Department of Orthodontics, *** Department of Psychiatry. UNC
Objectives: The purpose of this study was to look at a cohort of female adolescent patients between the ages of 12-17
years to ascertain how much they know about the eating disorders of bulimia and anorexia nervosa, determine if they
have practiced behavior consistent with bulimia and/or anorexia nervosa, and compare the individual participant‘s
personal body image to the participant‘s Body Mass Index (BMI) to determine if there is a disconnect with actual and
perceived healthy weight status. Methods: A survey instrument was self completed by 126 subjects and weight,
height, and BMI were obtained for all participants. Embedded in the survey were questions to ascertain the
participant‘s knowledge of eating disorders as well as the five ―SCOFF‖ questions, to determine if an eating disorder
may exist. Ninety-five % confidence intervals were used to determine the possibility of eating disorders in this female
adolescent population. Results: Based on the response to the SCOFF Questions, 18.25% of the sample may have an
eating disorder. Using a 95% confidence interval, it is believed that the true population of adolescent females with an
eating disorder is between 12-25%. The BMI‘s were significantly higher in the group suspected of having an eating
disorder. Of those with a suspected eating disorder, only 38% could correctly identify the definition/symptoms of
bulimia nervosa and 50% for anorexia nervosa.
Conclusion: More education should be directed at this young age
group, as it appears eating disorders are beginning at a very early age. If the at-risk individuals knew more about the
disorders and the consequences that accompany them, they may be less likely to practice the behaviors.
Supported
by AAPD/3M ESPE/Omni Fellowship
#52 Access to Endodontic Care in North Carolina Public Health and Medicaid Settings
STEVEN L RICHARDSON1, CEIB PHILLIPS2, ASMA KHAN1, ERIC RIVERA1,
1
Department of Endodontics, 2Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel
Hill
Objectives: Access to dental care is a major health policy concern, especially when specialty care is necessary. The
purpose of this study was to assess access to endodontic care for dental public health patients in North Carolina. Our
hypothesis was that dentists in public health clinics (PHC) perform fewer endodontic procedures and perceive more
barriers to care than practitioners in private practice offices that accept Medicaid (PPM). Methods: 1195 PHC or PPM
dentists were sent surveys regarding endodontic conditions encountered, endodontic treatments provided, referral
patterns, treatment techniques and dentist perspectives on barriers to care. Results: Our survey had a 45.7% response
rate. Of those responders, 78.7% report frequently (>1x/month) encountering an endodontic condition in their practice
but fewer than 35% report performing any root-canal procedure during the same time period. Chi-square analysis
showed a significant difference between PHCs and PPMs with frequency of endodontic procedures performed. PHCs
were significantly more likely to perform pulpotomy, pulpal debridement, anterior root canals and premolar root canals
(p<.05). PHCs were also significantly more likely to refer a patient for treatment (p<.001). Lack of adequate
insurance coverage was considered the greatest barrier to care with 89.2% considering it a moderate to major barrier,
followed by cost of the endodontic treatment (87.4%) and cost of the final restoration following treatment (85.5%).
PPMs were significantly more likely to consider cost and insurance a major barrier (p<.05). Conclusion: Treatment
patterns and perceptions of barriers to care are different for PHCs and PPMs in North Carolina. Acknowledgements:
Research supported by the AAE Foundation and the UNC Department of Endodontics
#53 Caries and Fluorosis Impacts on Oral Health-Related Quality of Life
Onoriobe UE1, Rozier RG2, King RS1, Cantrell JC2.
1
NC Oral Health Section; 2UNC Gillings School of Global Public Health
Objectives: To determine the impacts of dental caries and enamel fluorosis on oral health-related quality of life
(OHRQoL) in North Carolina Schoolchildren and their families. Methods: All students (n=7,686) enrolled in a
probability sample of 398 classrooms in grades K-12 in North Carolina public schools and their parents were recruited
for a one-time survey in 2003-04. Parents of children in grades K-3 and 4-12 completed the Early Childhood Oral
Health Impact Scale (ECOHIS) and the Family Impact Scale (FIS), respectively. Students in grades 4-5 (CPQ8-10)
and 6-12 (CPQ11-14) completed a Child Perception Questionnaire. All students received a clinical examination for
enamel fluorosis in anterior teeth (Dean‘s Index) and caries experience (d2-3fs, D2-3MFS) by one of 6 trained dentists.
OHRQoL (sum of impact frequency Likert scores) were analyzed by fluorosis categories (unaffected; questionablevery mild; mild-moderate-severe) and caries scores (sum of d2-3fs, D2-3MFS) descriptively and using OLS
regression, while controlling for covariates (child ever had dental injury, treatment needed, unmet demand, dental
home, age, race-ethnicity, percent poverty level, county urbanicity and parental education). Results: Clinical or
OHRQoL information was available for 6,088 children (Response Rate=79.2%). 72.4% of children were unaffected
by fluorosis, 24.0% had questionable or very mild fluorosis, and 3.4% had mild, moderate or severe fluorosis. Mean
d2-3fs and D2-3MFS scores per child were 2.1 and 1.7, respectively. CPQ8-10, CPQ11-14, ECOHIS and FIS mean
scores were 13.3, 21.4, 4.9 and 2.4, respectively. No associations were found between fluorosis categories and any
OHRQoL scales in the multivariate analysis (all P-values > 0.1). The sum of d2-3fs and D2-3MFS scores was
positively and strongly associated with ECOHIS (B=0.220; P=<.001), FIS (B=0.063; P=.001), andCPQ11-14
(B=0.239; P<.001) scores. Conclusion: The child‘s caries experience had a negative impact on OHRQoL of the child
and parent, while fluorosis prevalence or severity had no impact.Funded by Grant No. U48/CCU415769 from CDC
and D13H P15295 from HRSA.
#54 RIP2 Kinase Modulates PGE2 Production in Periodontal disease
Shaoping Zhang DDS†, PhD, Sheng Zhong DDS, MS*, Eric Bair PhD#, Salvador Nares DDS, PhD * Department of
Endodontics, †Department of Periodontics, #Center for Neurosensory Disorders, School of Dentistry, University of
North Carolina, Chapel Hill
Objectives: Levels of prostaglandin E2 (PGE2) and its processing enzyme, prostaglandin-endoperoxide synthase2/cyclooxlygenase-2 (PTGS2, or COX-2), are elevated in actively progressing periodontal lesions, but suppressed in
chronic disease. Previously we reported that epigenetic regulation may be one mechanism leading to the inhibition of
PTGS2 transcription in gingival biopsies with chronic periodontitis. In this study, we were seeking to explore a novel
mechanism related to MAPK pathway that may control the expression of PGE2 in chronic periodontitis gingival
samples. Methods: A genome-wide transcriptional analysis of gingival biopsy samples was performed using the
GeneChip Human Gene 1.0 ST Array platform. RIPK2 gene was knocked down in THP.1 cells according to
manufacture‘s protocol. Transcriptional analysis and protein production were assessed by realtime PCR and ELISA,
respectively, in THP.1 cells challenged with Porphyromonas Gingivalis. MAPK activity was evaluated by Western
blot. Results: We demonstrated that mRNA level of RIP2, a kinase that can activate MAPK pathway, is decreased in
chronic periodontitis samples in comparison to gingival health control. We also showed that pharmacological inhibitor
of RIP2 represses PGE2 secretion in THP.1 cells upon challenge by porphyromonas gingivalis, and further
demonstrate that siRNA-mediated silencing of RIP2 leads to diminished MAPK activation and PGE2 secretion in
vitro.
Conclusion: These findings provide another molecular basis for the reduced PGE2 expression in chronic
periodontal patients through decreased expression of RIP2, and further identify functional alterations in MAPKinase –
ERK/JNK-pathways as potential suppressors of inflammation in chronic periodontitis.
#55 Investigation of the mRNA Expression Level of FGF-2 Gene in Periodontal Tissues as Determinants of
Healing Response after Implant Surgery
P.S.A. WU, S. BARROS, S. OFFENBACHER. Department of Periodontology, School of Dentistry, University of North
Carolina, Chapel Hill, NC
Background: Periodontal wound healing is a complex multifactorial process involving a series of interactions of cells
and growth factors. Of significant importance to wound healing is the fibroblast-growth-factor-2(FGF-2). Previous
studies have suggested this gene may be down-regulated in diseased periodontal tissues. Aberrant gene expression in
smokers and diabetics has also been reported. However, the role of FGF-2 in periodontal wound healing has not been
fully investigated. Objectives: To determine 1)whether FGF-2 expression level is associated with wound healing after
implant surgery and, 2)whether it varies among healthy, smoking and diabetic patients. Methods: Subjects of 18-70
years, each requiring =1 implant, were recruited from UNC Department of Periodontology during September2010December2011. They were distributed into control, smoking (smoking and non-diabetic) or diabetic (diabetic and nonsmoking) groups. During the implant surgery, gingival tissue biopsies were collected at the surgical site. GCF samples
of the two closest teeth were collected within 2 weeks before surgery and at 2, 4 and 6 weeks after implant placement.
Implant stability was measured using the Osstell ISQ instrument at 4 and 6 weeks after surgery. Tissue mRNA
expression of FGF-2 was determined by quantitative PCR. Protein levels of FGF-2 will be measured in the GCF by
ELISA. Interim data was analyzed without statistical testing. Results: Twenty control, five smoking and four diabetic
subjects were recruited by December2011. Interim data analyses suggested that FGF-2 mRNA expression was downregulated by 1.92folds and 1.51folds in the periodontal tissues of smoking (fold change=0.52) and diabetic (fold
change=0.66) subjects respectively. It is hypothesized that FGF-2 expression will be up-regulated during normal
periodontal wound healing, and that this might be impaired among smokers and diabetics. Conclusion: The data
indicated that we can quantify FGF-2 mRNA expression in tissues and that there is a trend for FGF-2 down-regulation
in periodontal tissues of smoking and diabetic subjects. Findings from this study will provide preliminary data for
larger prospective clinical trials. Supported by UNC-CH Department of Periodontology.
#56 Bacterial Evaluation of Periodontal Diseases in an Induced Model of Inflammation
Paes B. da Silva, A; Barros, S; Offenbacher, S. Department of Periodontology, School of Dentistry, University of
North Carolina, Chapel Hill, NC
Objective: the advances in molecular approaches, such as the use of techniques based on the 16S rRNA could offer a
better understanding of the diversity and complexity of oral microbiota in periodontal diseases. The aim of this study
was to further characterize the specific plaque bacteria in subjects enrolled in five five biofilm-gingival interface (BGI)
groups. Methods: approximately thirty five participants were enrolled in each of the five BGI groups. Participants
abstained from brushing and flossing teeth in one maxillary and mandibular posterior sextant during a three week
period via placement of acrylic stents. After the induction of plaque accumulation (21 days), participants reinstated
normal oral hygiene. Participants were followed for four weeks after treatment and clinical parameters were recorded.
Subgingival plaque samples collected at baseline, peak of induction and resolution were analyzed by the Human Oral
Microbe Identification Microarray (HOMIM). Results: at baseline Spirochaetes are more abudant in BGI-P2, and
Synergystetes are more abundant in BGI-P2 and BGI-P3 than the other BGI groups (p=0.05). In BGI-H subjects, at the
peak of induction, a significant increase from baseline is observed in levels of Firmicutes (p=0.035), Fusobacteria
(p=0.0072), Proteobacteria (p=0.0088), and Bacteroidetes (p=0.0053), whereas at resolution phase a significant
decrease to baseline levels were detected in all except Firmicutes. In BGI-G individuals, at the peak of induction, a
significant increase is observed in the abundance of Firmicutes (p=0.0019), Fusobacteria (p=0.0017), Proteobacteria
(p=0.034), TM7 (p=0.016) and Bacteroidetes (p=0.0053), however, Firmicutes and Proteobacteria did not rebound. In
BGI-P1 group, at the peak of induction a significant increase in abundance is observed in the Proteobacteria (p=0.014),
Synergistetes (p=0.0045), and the Bacteroidetes (p=0.028), whereas at the resolution phase a significant decrease were
detected in Bacteroidetes (p=0.0052) but not the Proteobacteria and Synergistetes. In BGI-P2, a significant increase
from the baseline is observed in the Proteobacteria phylum (p=0.039), which was significantly decrease (p=0.0094) at
the resolution phase. Also, a decrease was detected in the Bacteroidetes (p=0.0052) and Spirochaetes (p=0.043) at the
resolution phase. Conclusions: in periodontal disease, bacteria in the Synegistetes and Spirochaetes phylum do not
rebound to baseline levels with the removal of the supragingival plaque. In addition bacteria in the Firmicutes do not
rebound in healthy individuals, whereas in gingivitis individuals the Proteobacteria also do not rebound during the
resolution period of this study.
#57 In vivo Assessment of Bone Healing Following Piezotome® Ultrasonic Instrumentation
RESIDE J1, ARCE R1, PADILLA E, EVERETT E2, NARES S1. 1Department of Periodontology,
2
Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC
Objectives: Piezoelectric ultrasonic instrumentation of bone is performed with regularity in a number of surgical
dental applications. To date, however, there are no studies that have simultaneously compared the in vivo genetic,
radiographic, and histological wound healing responses of bone to ultrasonic bone manipulation versus the gold
standard high speed rotary instrumentation.
Methods: Fourteen Spraque-Dawley rats underwent bilateral tibial
osteotomies (n=28) prepared in a randomized split-leg design using either high speed rotary (R), 1st generation
Piezotome® (P1), or 2nd generation Piezotome® (P2) instrumentation. After a 1 week healing period, tibias (n=12)
were resected and total RNA isolated for qRT-PCR array analysis. Sham surgeries (S) and R served as controls for
qRT-PCR. Tibia (n=8) were also processed for immunohistochemistry at 1 week. At 3 weeks, tibial samples were
processed for microCT analysis (n=16) and histology (n=16) to evaluate percentage of bone fill (%BF) and bone
mineral density (BMD).
Results: At 1 week, 3, 11, and 18 genes important in bone healing were statistically
significantly (p<0.05) downregulated following R, P1, and P2 instrumentation, respectively, relative to surgical sham
surgeries. Immunhistochemistry supported the qRT-PCR findings. Histologically, instrumentation with piezoelectric
units (P1, P2) produced osteotomy defects with smooth marginal bone relative to R. Following µCT analysis,
statistically significant differences were present in %BF and BMD between P2 and R in peripheral bone (p=0.020).
No statistically significant differences in BMD between were present in bone immediately adjacent to the osteotomy
and distant sites following P1 and P2 instrumentation. Conclusions: Compared to high speed rotary instrumentation,
genes important to wound healing are downregulated at 1 week relative to sham and rotary controls suggesting that
wound healing occurs at an accelerated rate. Downstream effects of piezoelectric instrumentation include improved
quantity and quality of peripheral bone. This project was supported by an unrestricted grant from Acteon, Inc.
#58 Children, Crowding, Caries: Is there a Connection?
DOVE KA, KEELS MA, QUINONEZ RB, ROBERTS MR, ROZIER RG
Department of Pediatric Dentistry and Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
Objectives: The purpose of this study is to investigate lack of interdental spacing of primary incisors as a clinical risk
factor for the early assessment of caries risk, primarily interproximal caries. Methods: This study is a cross-sectional,
prospective, IRB-approved study in which 203 healthy subjects between the ages of 42-60 months were collected. All
subjects had all 20 primary teeth without previous restoration. If posterior contacts were closed and the patient was
eligible for bitewing radiographs (according to the AAPD recommendations) diagnostic radiographs were obtained and
a caries risk assessment questionnaire was asked of the parents while a clinical exam was performed by a calibrated
resident/dentist. The outcome variable is the presence of interproximal caries. The explanatory variables are the
presence/absence of anterior interdental spacing as well as the risk factors in the existing AAPD Caries Risk
Assessment. Results: Odds ratios for posterior interproximal disease were calculated for the bivariate analysis.
Significant variables for this population were Hispanic race, Medicaid insurance, lack of dental home, history of
parental caries, non-fluoridated water intake, no flossing, presence of plaque and deep pit and fissures and enamel
defects on the teeth, as well as closed anterior contacts. Negative binomial regression was determined to be the best
model to use to analyze this data. The regression model determined the significant variables were the presence of
plaque and enamel defects/deep pit and fissures, and number of closed anterior contacts. All of these variables are
clinical variables. Conclusions: The AAPD Caries Risk Csessement has never been validated, but according to our
study, the clinical variables, including our own experimental variable of anterior interdental spacing were the most
significant variables in our regression model. It seems that lack of anterior interdental spacing in our study population
is associated with an increase in interproximal caries.
#59 Comparative dosimetry of Nomad® Pro handheld and wall-mounted X-ray sources
Phillips BJ1, Ludlow JB1, Platin E1, Mauriello SM2. 1Radiology, Diagnostic Sciences and General Dentistry, 2Dental
Hygiene, Dental Ecology, University of North Carolina, Chapel Hill, NC
Objectives: To compare operator and patient dosimetry during Full Mouth Survey (FMX) between the Nomad
Pro® (Aribex, Orem, UT) handheld device and the Planmeca Intra® (Planmeca USA Inc., Roselle, IL) wallmounted x-ray source.Methods: One operator exposed 14 imaging studies simulating 10 Full Mouth Series, a
total of 180 images per study, (FMX) on a RANDO phantom (The Phantom Laboratory, Salem, NY) . Seven
studies were completed using the handheld device and seven were completed using the wall-mounted x-ray source. Fspeed film settings for an average adult were used. The wall-mounted source incorporated a 7cm diameter open cone
while the hand-held device utilizes a 6cm open cone. Optical Stimulated Luminescence (OSL) dosimetry was utilized
to record operator and phantom dose (Nanodot, Landauer Inc., Glenwood, IL). Three dosimeters per area were
attached to thyroid, waist and trigger hand areas of the operator prior to each study. Dosimeters were placed within the
phantom in twenty-four predetermined anatomic locations (Ludlow et al 2008). Dosimeters were read with a MicroStar
reader (Landauer Inc., Glenwood, IL). Effective dose was derived using the 2007 ICRP calculation. Operator
exposures and phantom doses were evaluated separately using Analysis of Variance (ANOVA).Results: Mean (SD)
FMX dose was significantly less for the Nomad Pro 36µSv (8.4) than for wall-mount 98µSv (14.3) (p=0.0217). Mean
operator exposures were indistinguishable from ambient background levels (<2 µGy/study) and were not different for
handheld and wall mounted sources (p=0.2624) or dosimeter location (p=0.6815). Conclusion: Operator dose was
indistinguishable from background dose and not different for wall-mounted and Nomad Pro sources during FMX
imaging simulation. Patient dose was reduced by 63% using the hand-held device. Patient dose reduction may be
attributed to the reduced diameter of the Nomad Pro cone. The Nomad Pro is as safe to use for operators and safer to
use for patients in comparing doses with conventional wall-mounted sources using round-cones
#60 Obstructive Sleep Apnea in Association with Periodontal Disease
Nuha Ahmad1, Gregory Essick2 , Anne Sanders1, Rose Sheats3, Jennifer Brame1
1
Dental Hygeine Program, Dept of Dental Ecology, 2Dept of Prosthodontics, 3Dept of Orthodontics
Periodontitis is associated with several cardio-metabolic disorders that are co-morbid with sleep-disordered breathing.
A relationship between periodontitis and obstructive sleep apnea (OSA) is plausible, but has little research attention.
Objective: This study investigated the association between periodontitis and risk for OSA. Methods: A case-control
study was designed in which cases had moderate or severe periodontitis (32.5%) and controls had mild periodontitis or
healthy periodontal tissues (67.5%). Sixty-one (39.6%) males and 93 (60.4%) females (mean age = 61 yrs; age range =
19 to 88) were recruited from the dental hygiene preventive care clinic at the University of North Carolina, School of
Dentistry between February 2011 and April 2011. Subjects received a full mouth periodontal examination that
measured probing pocket depth and clinical attachment levels at six sites per tooth on all teeth present. Periodontal
status was determined according to the classification of the American Academy of Periodontology. Risk for OSA was
determined by the 4-item ―STOP‖ OSA screening questionnaire which assesses self-reported snoring, daytime
sleepiness, witnessed apnea during sleep, and history of hypertension. Demographic, general health and orofacial
characteristics were recorded that were considered putative predictors of either periodontitis or OSA. A multivariate
binary logistic regression was used to assess the odds of moderate or severe periodontitis according to OSA risk.
Results: Fifty subjects (32.5%) had moderate or severe periodontitis and 59 (38.3 %) subjects screened at high risk for
OSA, by providing two or more affirmative responses on the STOP questionnaire. Cases were 4.1 times more likely
(CI: 1.9, 11.4) to be at high risk for OSA than controls (P=0.007) after adjustment for potential confounders including
sex, age, smoking, diabetes and body mass index. Conclusion: A significant association was observed between
periodontitis and risk for OSA.
#61 Correlation of Perceived Stress and HPA Axis Reactivity in Temporomandibular Disorder: A Case Control
Study
C.A. LAMBERT1, A. E. SANDERS1, G. D. SLADE1, R.S. WILDER1, E.W. RUSSELL2
1
Dept of Ecology, SOD, UNC; 2Dept of Physiology & Pharmacology University of Western Ontario.
Perceived stress is associated with temporomandibular disorder (TMD). Whether levels of cortisol are also elevated in
individuals with TMD is unknown. Objectives: We hypothesized that cortisol concentration, a biomarker of
hypothalamic-pituitary-adrenal (HPA) axis reactivity, was elevated in TMD cases relative to controls, and that
perceived stress was positively correlated with cortisol concentration. Methods: This study used a case control design
in which TMD case status was determined by examiner using the TMD Research Diagnostic Criteria. Participants
(n=116) aged 18-59 years were recruited from within a 50 mile radius of the University of North Carolina at Chapel
Hill. Following examination, cases (n=45) and controls (n=71) completed the 14-item Perceived Stress Scale using a
reference interval of the past three months. Approximately 100 strands of hair were cut from the posterior vortex
segment of their scalp. The three centimeters of hair most proximal to the scalp was analyzed with a commercially
available salivary cortisol enzyme immunoassay adapted for hair cortisol. This length of hair corresponds to the last
three months of growth and thereby captures systemic HPA axis activity over time. Results: TMD cases perceived
higher levels of stress than controls over three months preceding this study (P=0.001). However, systemic cortisol
production was lower in TMD cases than in controls (P<0.001) over the corresponding three month period. The
correlation coefficient revealed a negative relationship (r= -0.188) between perceived stress and cortisol concentration
(P=0.044). In analysis stratified by case status, the relationship of perceived stress and cortisol concentration was nonsignificant for cases (P=0.169) and controls (P=0.498). Conclusions: Despite perceiving more stress, TMD cases had
lower cortisol levels than controls and the two measures of stress were not positively correlated. This study was
supported by the North Carolina Translational and Clinical Sciences Institute.
#62 A Novel Biomechanical Model Assessing Orthodontic Continuous Archwire Activation
MATTHEW LARSON, CHING-CHANG KO, GARLAND HERSHEY, ROSE SHEATS Department of Orthodontics,
University of North Carolina, Chapel Hill, NC
Objective: Orthodontic biomechanics of a continuous archwire inserted into multiple orthodontic brackets is poorly
understood. The purpose of this research was to apply a computer modeling technique known as ―birth-death‖ to
simulate insertion of an orthodontic wire and consequent transfer of forces to the dentition in an anatomically accurate
model. Methods: A digital model containing the maxillary dentition, periodontal ligament (PDL), and surrounding
bone was constructed from human computerized tomography (CT) data. Virtual brackets were placed on four teeth,
and a steel archwire (0.019‖x 0.025‖) with a 0.5 mm step bend to intrude the lateral incisor was virtually inserted into
the bracket slots. Forces applied to the dentition and surrounding structures were simulated utilizing the birth-death
technique. Results: The goal of simulating a complete bracket-wire system on accurate anatomy including multiple
teeth was achieved. Orthodontic force delivered by the wire-bracket interaction was: central incisor 19.1 N, lateral
incisor 21.9 N, and canine 19.9 N. Loading the model with equivalent point forces showed a different stress
distribution in the PDL. Conclusion: The birth-death technique proved to be a useful biomechanical simulation
method for placement of a continuous archwire in orthodontic brackets. The ability to view the stress distribution
throughout proper anatomy (e.g., PDL effects) and appliances advance understanding of orthodontic biomechanics.
#63 THREE DIMENSIONAL ANALYSIS OF BONE ANCHORED MAXILLARY PROTRACTION IN
GROWING CLASS III PATIENTS
Jocelyn Beville 1, Lucia Cevidanes, DDS, MS, PhD2 Tung Nguyen1, DDS, MS Sylvia Frazier-Bowers, DDS, MS,
PhD1 Hongtu Zhu, PhD – Biostatistics, School of Dentistry, UNC, 2 Department of Orthodontics, University of
Michigan
OBJECTIVES: To evaluate the treatment changes produced by bone anchored maxillary protraction (BAMP) on
growing Class III patients using 3D cephalometric measurements. METHODS: Cone-beam computed tomography
(CBCT) scans were taken before and after treatment with the BAMP protocol on 30 consecutively treated growing
Class III patients. Dolphin Imaging v.11.5 3D software was used to calculate linear, angular, and airway measurements
to assess the treatment changes in three planes of space. ICC was used to test landmark reliability. One-sample t-tests,
95% confidence interval, and Pearson correlations were used to evaluate the changes. RESULTS: Our results show
that the maxillary bone orthopedic effects as measured at the right and left tuberosity posteriorly and at ANS and A
point anteriorly are coupled with forward growth and response to treatment at zygomatic landmarks. The mandibular
changes showed statistically significant closure of the mandibular plane angle bilaterally (p values = 0.01 and 0.00 for
right and left sides respectively), despite individual variability with a range of -13.10 to + 4.20. Although this study
sample presented significant mandibular growth restraint, the airway volume with growth and treatment was
significantly increased (p value = 0.02). CONCLUSIONS: Short term assessment of 3D cephalometric changes with
BAMP clearly demonstrated a combination of different skeletal components of midface protraction and mandibular
growth restraint without negative effects on airway dimensions.
#64 The Efficacy of Temporary Skeletal Anchorage versus Maxillary Osteotomy in Treatment of Anterior Open
Bite
GIBSON MCCALL1, CEIB PHILLIPS1, ROSE SHEATS1 GEORGE BLAKEY2
1
Department of Orthodontics, 2Department of Oral and Maxillofacial Surgery, University of North Carolina, Chapel
Hill, NC
Objectives: To compare 2 treatment options (temporary skeletal anchorage (TSA) versus maxillary osteotomy) for
closure of an anterior open bite based on long term stability of treatment outcome. Methods: Consecutively treated
cases with an initial anterior open bite from a private practice and the graduate orthodontic clinic were selected. All
subjects were treated with maxillary posterior intrusion with use of temporary skeletal anchorage (N=33; F=26, M=7)
or a maxillary osteotomy (N=18; F=14, M=4). Cephalometric radiographs were measured and three time points, T1 –
Initial, T2 – Debond, T3 – Retention were compared. Length of follow up was 1.66±.81 yrs for the TSA group and
2.11±1.5 yrs for the surgical group. Results: All TSA patients achieved positive over bite. Relapse is seen in both
groups; however, positive over bite is maintained. Conclusions: Treatment with TSA seems to be an acceptable
treatment alternative to surgery for patients with anterior open bites.
#65 Comparison of Torsional and Cyclic Fatigue Failure in Rotary Nickel Titanium Instruments Manufactured
with M-Wire Blue and Conventional Superelastic Nickel Titanium
TOM BROWN, DEREK DUGGAN, ERIC RIVERA Department of Endodontics, University of North Carolina,
Chapel Hill, NC
Objectives: The purposes of this in vitro study are: 1) Compare the torsional and cyclic fatigue properties of three file
designs: EndoSequence (ES), Twisted File (TF), and Vortex (VT). 2) Manufacture these file designs with a new nickel
titanium alloy, M-Wire Blue (ESB, TFB, VTB) and compare using the same testing conditions. 3) Compare a given
file design in torsional and cyclic fatigue testing with and without M-Wire Blue (ES vs. ESB, e.g.). Nickel titanium
(NiTi) rotary instruments have allowed for better respect of the original canal anatomy and fewer procedural errors.
However, these files are still subject to distortion and instrument separation due to cyclic and torsional fatigue. M-Wire
Blue offers a potential increase in resistance to cyclic fatigue failure with no decrease in resistance to torsional failure.
Methods: fatigue testing will be performed in simulated steel canals with 90 degree curvature and 5 mm radius of
curvature. Files will be clamped at the apical 3 mm and rotated at 2 RPM until failure for torsional failure testing.
Reduced risk of cyclic fatigue failure will further improve the ability to safely instrument curved canals during
endodontic therapy. Results: Undetermined. Conclusions: Undetermined.
#66 Analysis of microRNA expression in periapical lesions of endodontic origin.
Linda Chan*, Sheng Zhong*, Afsar Naqvi#, Jezrom Self-Fordham#, Salvador Nares#, Eric Bair†, Asma Khan*†
*Department of Endodontics, #Department of Periodontics, † Center for Neurosensory Disorder, School of Dentistry,
University of North Carolina, Chapel Hill
It is well established that periapical lesions of endodontic origin result from an inflammatory and immune response to
microbial infections in the root canal system. However, the molecular mechanisms of this process are poorly
understood. Micro RNAs (miRNAs) are important regulators of gene expression that are implicated in a variety of
biological processes including inflammation and the immune response. Using microarray analyses we previously
identified 9 miRNAs which are differentially expressed in diseased periapical tissues as compared to healthy controls.
Objectives/Aims: The purpose of this study is to validate the differential expression of microRNAs in diseased
periapical tissues using quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and to explore their
association with the clinical presentation of odontogenic pain. Methods: Diseased periapical tissues will be collected
from patients (n=8) requiring apicoectomy surgery. Clinical signs and symptoms will be recorded. Healthy
periodontal ligament and pulpal tissue collected from extracted teeth will serve as controls. RNA extraction will be
performed and quantitative RT-PCR will then be used to confirm the results of the microarray experiments. miRNA
expression levels will be compared between case and control using non-parametric Wilcoxon test to determine any
significant differences. Potential mRNA target genes for differentially expressed miRNAs will be identified using
PUBMED and miRWalk, a comprehensive gene target database. Candidate mRNA will be selected if they are
identified as miRNA targets in at least 5 out of 8 databases and are linked to pain, immunity and inflammation by GO
Biological Process. Conclusions: This study has the potential to further our understanding of gene regulation and
pathogenesis of endodontic disease and could elucidate potential targets to help control inflammation and reduce pain.
Acknowledgements: This work was supported by the School of Dentistry, UNC and the American Association of
Endodontists Foundation
#67 Utilization of Blended Learning to Teach Preclinical Endodontics: Pilot Study
C. Maresca1, C. Barrero2, Eric Rivera1, Derek Duggan1, Enrique Platin3
1
Dept of Endodontics; 2Dept of Prosthodontics; 3 Dept of Radiology, School of Dentistry, UNC
Blended learning (BL) is the integration of classroom face-to-face learning experiences with online learning
experiences. It has been reported that BL can help dental educators overcome the challenge of growing needs and
expectations for higher education with reduced funds and faculty. The purpose of this pilot study was to determine if
there is a significant difference in acquiring manual dexterity and conceptual knowledge of a routine endodontic
procedure (Intra-orifice Barrier Placement) by second year dental students, after the use of a BL in a preclinical
Endodontics course as compared to those who did not. This study was also designed s to determine whether students
who used the BL approach had a preference for using it, and if they would recommend its use. Ten second-year dental
students were randomly selected and assigned to two groups: (1) students who were exposed to the BL approach and
(2) those who were not. After placing the Intra-orifice Barrier, students in both groups completed a questionnaire to
assess their preference for using the Endodontic Learning Module vs. Traditional Lecture. Two calibrated and masked
Endodontic faculty members determined the total number of error points based on performance criteria. The Sign Rank
Test was used to determine if there was a significant difference in student‘s preference to the BL approach. The
Wilcoxon Rank Sum Test was used to determine significant differences in total number of error points between the
two groups. Dental students who reviewed the Endodontic Learning Module preferred using it and would recommend
it to other Dental Students (p≤.05). No significant difference was found to exist between the two groups regarding the
total number of error points.
#68 Genome-wide gene expression profile of inflamed dental pulp in humans: implications in clinical diagnosis
and symptoms of pulpitis.
Johnah C. Galicia, Asma Khan. Department of Endodontics, University of North Carolina, Chapel Hill, NC
Objectives: The dental pulp is known to have multiple biologic roles and regenerative potential but it still remains to
be one of the least understood tissues in the human body, especially from a clinical perspective. To arrive at a
diagnosis, dentists rely mainly on history taking and pulp sensibility tests that have been around for decades; but
whether these clinical test results correlate well with pulpal histopathology or not remains unclear. The purpose of this
study is to explore a correlation between the biological and the clinical presentation of pulpal inflammation. Materials
and Methods: Dental pulp tissues (N=40) will be collected from teeth undergoing root canal therapy or extraction at
UNC-Chapel Hill Dental Clinics after a thorough clinical examination detailing the signs and symptoms associated
with the sample teeth is accomplished. RNA will then be extracted from each sample, reverse transcribed to c-DNA
and analyzed for gene expression using Microarray technology. The microarray data will be analyzed using Database
for Annotation, Visualization and Integrated Discovery (DAVID) link for gene functional annotations. Findings from
the DAVID will be confirmed by the Gene Set Enrichment analysis (GSEA) and its leading edge analysis software that
uses the permutation method. A correlation between subjective and objective symptoms of pulpitis and gene
expression will be explored. Conclusion: Data from this study will further our understanding of pulp biology and
provide critical information for the prevention and treatment of pulpal inflammation as well as for regenerative
endodontic therapy.
#69 Development of new biomimetic cement (Gemosil) as an alternative to Mineral Trioxide Aggregate
for use in endodontic therapy
Hsin Chen1, Asma Khan1, and Ching-Chang Ko2
1
Department of Endodontics; 2Department of Orthodontics, School of Dentistry, UNC
Mineral trioxide aggregate (MTA), (Proroot®, DENTSPLY Tulsa, Tulsa, Oklahoma) has proven to be an effective
material for vital pulp therapy, apexification, perforation repair and retrograde filling material in endodontics.
However, due to the high cost, long setting-time and permanent dentinal discoloration caused by MTA, its use is
limited. The aim of this study is to evaluate a potential alternative material, Gemosil (the UNC patent), which has
biological and mechanical properties comparable to those of MTA. Gemosil is a biomimetic cement with a short
setting time, consisting of a gelatinous hydroxyapatite nanocomposite, an aminosilane and calcium hydroxide powders.
The working time of Gemosil is approximately five minutes, and the compressive strength reaches 50 MPa after two
hours setting in water and 100 MPa when fully dried. The chemical composition, mechanical strength, antibiotic
properties, degree of staining, biocompatibility and leakage between the two material groups (Gemosil and MTA) will
be compared. This in-vitro study will be performed using extracted human maxillary anterior teeth (n=10 per group)
and preosteoblast MC3T3-E1 for culture testing. Uniaxial compressive tests, Fourier transform infrared spectroscopy,
scanning electron microscopy and x-ray microanalysis will be used to assess physical properties. Date will be analyzed
and compared by the students T-test. The proposed research will investigate whether the Gemosil may be used as a
safe and viable substitute for MTA. Another downstream benefit includes future applications for endodotic tissue
regeneration using stem cell-based Gemosil technology.
#70 Development and Testing of a CBCT Educational Module for Dental Providers in the US Navy
Martin Evers, DDS, Enrique Platin, Ed.D., R.T., John Ludlow, DDS, MS, Professor Lauren Noble, Ed.D., R.T.. Oral
Radiology, University of North Carolina, Chapel Hill, NC
Objectives: This project included the development of an educational module addressing cone beam computed
tomography (CBCT) basics, anatomy, and interpretation of CBCT reconstructed multiplanar images containing
pathology. The subsequent objective was to test the efficacy of this educational tool. Methods: 32 Navy dental
providers completed a brief online demographic survey and multiple-choice pre-test evaluating their knowledge of
CBCT. The web based educational module was then made available to the cohort. After completing the module,
participants were given the link to the post-test and short feedback questionnaire. Results: Preliminary data
(additional data is still being collected) demonstrates an increase in the number of correct responses between the pre
and posttests. (Pretest=75.3% vs. Posttest=84.7%) Interestingly, the results limited to the interpretation section saw a
decrease in performance. (Pretest=69.7% vs. Posttest=58.1%) 100% of respondents to date agreed that the module
was helpful and accomplished its purpose. Conclusions (Preliminary): The module was successful in imparting
information to participants so that they could perform better on the posttest. The decrease in performance on the
interpretation section demonstrates that radiographic interpretation of CBCT multiplanar images is a skill set that is not
developed after a single educational intervention.
#71 A Comparison of 2D versus 3D Radiography in the Treatment Planning of Non Healing Root Canal
Treated Teeth
Heidi Kohltfarber1, Donald Tyndall1 John Ludlow1 and Eric Rivera2
1
Radiology, 2Department of Endodontics, School of Dentistry, UNC
Purpose: A pilot study was performed to compare volumes from a limited cone beam CT and periapical radiographs in
the diagnosis and treatment planning of lesions involving non-healing root canals. The clinician‘s confidence in that
treatment plan was also observed. Methods and Materials: A diagnostic comparison of two imaging modalities was
performed. The use of digital periapical radiographs alone were compared with the use of both periapical radiographs
and the Kodak 9000 3D limited volume CBCT scans from the same individuals. The control group consisted of
twenty scans and periapical radiographs that had already been performed and interpreted using the Kodak 9000 CBCT
and consisted of a records review. The scans and the radiographs were de-identified and randomized in order to
decrease the bias of the observers. IRB approval was obtained and patients were recruited from the UNC School of
Dentistry. The two dimensional images were loaded into Qualtrics and the volumes were viewed with Invivo 5.1
software by Anatomage. The periapical radiographs and the cone beam CTs were compared and evaluated in a
controlled environment by four observers. Each observer was asked to determine whether a lesion was present or not.
They were also asked what their treatment plan would be and how confident they felt that their treatment plan would
be the best option given the diagnosis with each modality. A five point Likert scale was used to answer each question.
These answers were compared with those from a consensus panel of experts and ROC analysis was obtained. Results:
Pending Conclusions: Pending
#72 Effective Dose and Image Quality of CBCT Diagnostic Imaging Scans
Cameron G Walker -Department of Orthodontics, John B. Ludlow - Maxillofacial Radiology, School of Dentistry,
UNC
Objectives: To address the important issues surrounding the CBCT imaging modality we have initiated an
investigation of CBCT dosimetry in pediatric and adult patients, and its relation to image quality. This ongoing
research is the first step on which to build future imaging standards, taking into consideration both diagnostic yield and
dose. Methods: Dose information was obtained from Newtom 3G, Sirona Galileos, and iCat Nextgen CBCT machines
using pediatric and adult anthropomorphic phantoms. The phantoms contained 24 optical stimulated luminescent
(OSL) dosimeters. Dosimeter readings were used to calculate effective dose using 2007 ICRP guidelines. Image
quality was objectively assessed by the calculation of contrast to noise ratio and modulation transfer function utilizing
an acrylic phantom. Because effective dose from a CBCT examination can vary with different exposure parameters,
additional dosimeter runs using variations in available exposure options such as current (mA), exposure time(s),
kilovoltage (kV), and field of view (FOV) were conducted. Results: Our data outlines the relationship between patient
age/size, scan parameters, effective dose, and image quality in the three tested CBCT machines. Conclusions: The data
from this investigation will enable users and manufactures to optimize machine settings to obtain acceptable diagnostic
quality while minimizing the risk to adult and pediatric patients. Additionally, this study will provide important
reference data for the development of future dose and image quality standards. Supported by NIH DE022160
#73 4-year radiographic and esthetic evaluation of peri-implant tissue in immediate implants replacing single
teeth in the esthetic zone
Theresa Wang and Lyndon Cooper. Department of Prosthodontics, School of Dentistry, UNC
Objectives: Interproximal bone levels are major determinants of implant esthetics. It is suggested that encroachment
of the implant-abutment interface(IAI) to the existing tooth (< 1.5mm), negatively affects bone levels. The objective
of this study is to compare the crestal bone & esthetic outcome of dental implants replacing single teeth in the esthetic
zone at time of placement versus 4 years. Methods: 51 previously placed implants replacing single teeth in the
esthetic zone were evaluated by two calibrated examiners independently. Data was obtained from patients (n=37)
enrolled in an ongoing prospective clinical trial at UNC School of Dentistry. Bone levels were measured from the
implant-abutment(IA) interface on periapical radiographs to assess a relationship between IAI– tooth distances and
bone changes at baseline and 4 years using digital methods. To assess the esthetic outcome, Pink Esthetic Scores(PES)
were assigned by two calibrated examiners independently using calibrated dental photographs. Results: The
mesiodistal position of dental implant in relation to adjacent tooth and interproximal bone levels were compared to
PES. Current data assessed fails to indicate a relationship between IAI – tooth distances and bone changes at 4 years.
Conclusions: Preliminary data suggest that there is no correlation between proximity of dental implant to adjacent
tooth and interproximal soft tissue fill. Data also suggest that crestal bony changes following immediate dental
implant placement do not have any relationship with soft tissue esthetics. Further investigations are necessary to
examine soft and hard tissue architecture and their influence on esthetics.
#74 Prosthetic Complications With a Monolithic Zirconia Implant Supported Fixed Prosthesis – The UNC
Protocol
Bryan Limmer1, Lyndon Cooper1, Glenn Reside2, and Anne Sanders 3
Department of Prosthodontics, 2Department of Oral and Maxillofacial Surgery and 3Dental Ecology, School of
Dentistry, UNC
Objectives: The purpose of this study is to investigate the number and type of prosthetic complications that occur with
a full arch 4-implant supported fixed prosthesis (ISFP), as well as to examine the change in patient quality of life over
the course of 1 year. Methods: A consecutive sample of 20 edentulous patients was enrolled. Each patient was
provided with conventional dentures. A cone beam CT and radiographic guide were used in surgical planning, and 4
implants were placed in the parasymphyseal mandible with immediate provisionalization. After 2 months, a screw
retained monolithic zirconia ISFP was delivered. Survival and complication data was recorded for both implants and
prosthetic components. The 49 question Oral Health Impact Profile was administered at enrollment, implant surgery, 6
month recall, and 1 year recall to measure change in quality of life. Results/ Conclusions: Fifty percent of the study
patients have completed the 6 month recall and none have reached the 1 year mark. Preliminary results indicate
biologic or prosthetic complications are rare, and that OHIP-49 scores decrease over the course of treatment.
Supported by Astratech AB, Zirkonzahn Gmbh, and American College of Prosthodontists Education Fund
#75 Dynamic Finite Element Analysis of Maxillary Incisor Trauma
Jordan Olsen1, DDS Lorne Koroluk, DMD, MSD, MS1,2 Ching-Chang Ko, DDS, MS, PhD2 Jessica Lee, DDS, MPH,
PhD1 1Pediatric Dentistry, 2 Orthodontics School of Dentistry, UNC
The epidemiology, etiology, and treatment of traumatized maxillary central incisors have been well documented in the
literature. Minimal research has investigated mechanical energy production and dissipation during dental injuries; the
biomechanics of traumatic dental injures (TDI) is not well understood. Animal and human-based TDI research is
difficult due to ethical constraints. Computer-based trauma simulation, finite element analysis (FEA) or method
(FEM), is a potential option for understanding the biomechanics of TDI. OBJECTIVE: Specific Aim 1) Construct a 3D FEM model of a complete maxilla including: alveolar process (cortical/trabecular bone), enamel, dentin, pulp, and
periodontal ligament (PDL). Specific Aim 2) Introduce dynamic/sinusoidal forces with a planar object to simulate a
fall onto the maxillary central incisor and adjacent teeth. Evaluate the relationship between the following independent
variables—acceleration and orientation of impact, and time against the outcome variables—stress distribution
(Principal and Von Mises) and displacement field. SIGNIFICANCE: To date there have only been four studies
reported which have addressed dynamic FEM for TDI, three of these are 2-D, one is 3-D. This 3-D FEM does not
incorporate anatomic detail, physical properties of the teeth, or a PDL. Creation of a more complete 3-D dynamic FEM
incorporating a full maxilla with exceptional anatomic accuracy, physical properties integrity, and realistic multi-tooth
impact loading is essential for understanding TDI biomechanics. This will allow clinicians to more accurately
diagnose, treat, and prevent dentoalveolar injuries. METHODS: The FEM will be constructed from a multi-slice micro
CT image of an 18 year-old female. Various software packages will be used to segment, smooth, and integrate physical
properties of the various elements. A solid block will introduce the impact into the system. Principal stress, Von Mises
stress/strain distribution, and displacement field will be measured over time against changes in orientation and
acceleration of the dynamic, sinusoidal, impact force.
#76 Dietary Recommendations for Infants and Toddlers among Pediatric Dentists in North Carolina
Chien Sim, Hiroko Iida, William F. Vann, Jr, Rocio B. Quinonez, Michael J. Steiner. Department of Pediatric
Dentistry, School of Dentistry, UNC
Objectives: Several infant and toddler dietary issues should be addressed during the infant and toddler oral health visit,
including breastfeeding, bottle-feeding practices, the use of fluoridated water to reconstitute infant formula, and juice
consumption. At present, little is known about pediatric dentists‘ practice variations in delivering specific dietary
recommendations for infants and toddlers. The objective of the study is to determine the knowledge, attitudes, and
practice patterns of pediatric dentists in North Carolina (NC) in delivering dietary recommendations for infants and
toddlers and to identify barriers that limit them from embracing the professional recommendations. Methods: This is a
cross-sectional survey design, relying upon a self-administrated questionnaire to be returned by mail. The
questionnaire was developed based on Cabana‘s conceptual framework that relates to barriers to guideline compliance.
The survey has been mailed to 150 pediatric dentists in NC who are licensed and in clinical practice for at least 10
hours weekly. Data will be analyzed using SAS software version 9.2. Preliminary results: The survey instrument was
pretested with randomly selected UNC pediatric dental alumni practicing outside of NC and revised. The initial
mailing of the surveys has been mailed, with two follow-up mailings to be sent in accordance with the recruitment
approach described by Dillman and colleagues. Conclusion: This study is underway. It is anticipated that the findings
will illuminate strategies to improve curricular content, residency education, and continuing educational offerings to
enhance pediatric dentists‘ involvement in early childhood dietary recommendations.
Index of Meeting Presentations
Name
Xi
Cynthia
Viviana
Qun
Nuha
Tom
Paul
Linda
Hsin
Brittney
Johnah
Bashir
Cristina
Steven
Shad
Sheng
Kristi
Roopwant
Hiroko
Hideaki
Silvia
Ayesha
Christopher
Shijia
Christine
Lin
Thatsanee
Sodsi
Ning
Martin
Chen
Lambert
Ruiz
Tang
Ahmad
Brown
Carruth
Chan
Chen
Ciszek
Galicia
Hosseini
Maresca
Richardson
Smith
Zhong
Erickson
Kaur
Nagaoka
Nagaoka
Amaya-Pajares
Swarn
Dibble
Hu
Kim
Lin
Saladyanant
Wirojchanasak
Yu
Evers
Level
Faculty
Masters
Masters
Masters
Masters
Masters
DDS
Masters
Masters
Staff
Masters
Masters
Masters
Masters
Faculty
Masters
Masters
Masters
Masters
PostDoc
Masters
Masters
PhD
PostDoc
PhD
PhD
PhD
PhD
PhD
Masters
Heidi
Kohltfarber
Masters
B. Jake
Philips
Masters
Eric
Draper
DDS
George
Soung
DDS
Raquel
Burger-Calderon
PhD
Department
Dental Ecology
Dental Hygiene
Dental Hygiene
Dental Hygiene
Dental Hygeine
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Endodontics
Operative Dentistry
Operative Dentistry
Operative Dentistry
Operative Dentistry
Operative Dentistry
Operative Dentistry
Oral Biology
Oral Biology
Oral Biology
Oral Biology
Oral Biology
Oral Biology
Oral Biology
Oral Maxillofacial
Radiology
Oral Maxillofacial
Radiology
Oral Maxillofacial
Radiology
Oral & Maxillofacial
Surgery
Oral & Maxillofacial
Surgery
Oral Pathology
Meeting Presentation
Special Care Dentistry Association
ADHA
ADHA
ADEA/AADR/IADR
ADEA/AADR/IADR
DRR Day
DRR Day
DRR Day
AAE
DRR Day
AAE
DRR Day
AAE
AAE
IASP
AAE
DRR Day
ADEA/AADR/IADR
ADEA/AADR/IADR
ADEA/AADR/IADR
DRR
ADEA/AADR/IADR
Angioma Alliance
DRR Day
DRR Day
DRR Day
DRR Day
DRR Day
DRR Day
DRR Day
AAOMR
ADEA/AADR/IADR
DRR Day
AAOMS
DRR Day
Index of Meeting Presentations (continued)
Name
William
Jocelyn
Crystal
Matthew
Nayoung
Taneisha
Gibson
Maura
Carroll Ann
Cameron
Heather
Carolina
Folabomi
Thomas
Cortney
Heather
Allison
Travis
Lauren
C. Marshall
Clark
Jordan
Kerry
Chance
Chien
Abdel-ghany
Afsar
Andre
Li
Jonathan
Michael
Alice
Shaoping
Bryan
Russell
Theresa
Daniella
Gustavo
Edward
Uvoh
Seaman
Beville
Cox
Larson
Lee
Livingston
McCall
Slack
Trotman
Walker
Hendricks
Meloto
Oladosu
Pardue
Winkle
Zimmerman
Cavenaugh
Hicks
Katz
Long
Morris
Olsen
Dove
Powell
Sim
Alsaidi
Naqvi
Paes
Qian
Reside
Stella
Wu
Zhang
Limmer
Mack
Wang
Mendonca
Mendonca
Givens
Onoriobe
Level
PostDoc
Masters
Masters
Masters
PostDoc
Staff
Masters
Masters
Faculty
Masters
DDS
PhD
PhD
Res Assistant
PhD
DDS
Masters
Masters
DDS
Masters
DDS
Masters
Masters
DDS
Masters
Masters
PostDoc
Masters
DDS
Masters
Masters
Masters
Masters
Masters
Res Asst
Masters
PostDoc
Faculty
Masters
Resident
Department
Oral Pathology
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Orthodontics
Other
Other
Other
Other
Other
Other
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Pediatric Dentistry
Periodontology
Periodontology
Periodontology
Periodontology
Periodontology
Periodontology
Periodontology
Periodontology
Prosthodontics
Prosthodontics
Prosthodontics
Prosthodontics
Prosthodontics
Prosthodontics
Public Health
Meeting Presentation
International Papillomavirus Conf.
AAO
DRR Day
AAO
DRR Day
ADEA/AADR/IADR
DRR Day
DRR Day
DRR Day
Moyers Symposium
ADEA/AADR/IADR
ADEA/AADR/IADR
DRR Day
DRR Day
DRR Day
ADEA/AADR/IADR
DRR Day
AAPD
ADEA/AADR/IADR
AAPD
ADEA/AADR/IADR
AAPD
AAPD
ADEA/AADR/IADR
DRR Day
AAP
ADEA/AADR/IADR
DRR Day
ADEA/AADR/IADR
DRR Day
DRR Day
DRR Day
DRR Day
ACP
ADEA/AADR/IADR
DRRD
Academy of Osseointegration
Academy of Osseointegration
DRR Day
NC Oral Health Section
2012 Dental Research in Review Acknowledgements
Posters graphic design and printing- Ms. Sheri Moyer
Cover photo montage- Ms. Ramona Hutton-Howe
DRRD Breakfast- Ms. Menessah Jones
Oral sessions and teleconference set up- Mr. Tarrl Morley
NC-AADR Webmasters
Mr. David Arnold
Dr Eric Everett
Mr. Younus Syed
Mr. Tim Murphy
Dental Research in Review Day Planning Committee
Dr. Ingeborg De Kok
Dr. Eric Everett
Dr. Sylvia Frazier-Bowers
Mr.. Ross Fahey
Ms.. Kelly Higgins
Dr. Hiroko Iida
Dr. Asma Khan
Mr. Tarrl Morley
Ms. Sheri Moyer
Mr. Timothy Murphy
Dr. Salvador Nares
Ms. Yonesha Phair
Mr. Chance Powell
Dr. Jennifer Webster-Cyriaque
Dental Research in Review Day Judges
Ingeborg DeKok (Prosthodontics)
Kimon Divaris (Pediatric Dentistry)
Janet Guthmiller (Periodontology)
Gustavo Mendonca (Prosthodontics)
Valerie Murrah (Oral Pathology)
Paul Emile Rossouw (Orthodontics)
John Stamm (Dental Ecology)
David Zajac (Dental Ecology)
Roger Arce (Periodontology)
Timothy Turvey (OMFS)
Office of the Dean- Dr Jane Weintraub
Office of Dental Research – Dr James Beck
Dental Foundation of North Carolina- Mr. Paul Gardner
UNC Dental Alumni Association
UNC Upsilon Upsilon Chapter of the Omicron Kappa Upsilon
Special thanks to the North Carolina Section of the American Association for Dental Research (NC-AADR) for
its continuing support and leadership in coordinating Dental Research in Review Day.
The mission of the School of Dentistry is to promote the health of the people of North Carolina, the nation and
the world through excellence in teaching, patient care, research and service.
www.dent.unc.edu
We Extend Grateful Acknowledgment to the Following Sponsors
UNC-Chapel Hill School of Dentistry Sponsors:
Student Research Group, NCAADR, Office of the Dean, Office of Dental Research, Dental Foundation of
North Carolina and the UNC Dental Alumni Association
Corporate Sponsors:
Tar Heel
Endodontic Association