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BACKGROUND: Surgery is an important treatment modality for patients with digestive system tumors, and perioperative management is crucial for the patients' recovery and quality of life. During the perioperative period, significant changes can occur in the oral environment of patients, such as dry mouth, mucosal ulceration, and oral infections. These issues not only cause discomfort to the patients but may also affect postoperative recovery and treatment outcomes. Therefore, it is essential to investigate and analyze the oral environment during the perioperative period in patients with digestive system tumors. AIM: This study aims to investigate the oral health status in patients with digestive system tumors during the perioperative period and analyze the influencing factors. METHODS: In this retrospective study, a total of 242 patients with digestive system tumors admitted to The Seventh Affiliated Hospital, Xinjiang Medical University from September 2021 to June 2023 were selected as the study population (patient group). During the same period, 245 healthy volunteers who received oral examinations were selected as the healthy group. The study compared the oral hygiene environment of the two groups, including the Dental Plaque Index (DI), Calculus Index (CI), and Periodontal Disease Index (PDI). Measurements were taken at admission (T0), 1 hour before surgery (T1), and 3 days after surgery (T2). Based on the PDI index, the patient group was divided into a periodontal disease group (PDI ≥ 3, n = 196) and a periodontal healthy group (PDI < 3, n = 46). The risk factors for the development of periodontal disease in digestive system tumor patients were analyzed, considering variables such as gender, age, BMI, smoking status, alcohol consumption frequency, monthly income, tumor type, oral self-care habits, low-grade inflammation, and nutritional status. RESULTS: The DI, CI and PDI indexes in patient group were higher than those in healthy group (3.23±0.64 vs 1.46±0.43, 1.92±0.46 vs 1.21±0.41, 3.83±0.79 vs 2.65±0.69, all P < 0.05). DI index, CI index and PDI index at T1 and T2 were significantly lower than those at T0 (P < 0.05), and these indices at T2 were slightly higher than T1, but the difference was not statistically significant (all P > 0.05). Multivariate analyses identified high levels of high-sensitivity C-Reactive Protein [OR: 15.070 (1.611-140.951)], low levels of hemoglobin [OR: 0.239 (0.058-0.981)], and presence of dental caries [OR: 246.737 (1.160-52464.597)] as risk factors associated with periodontal disease in patients with digestive system tumors. CONCLUSION: It is important to enhance the attention and management of the oral environment during the perioperative period for patients with digestive system tumors.

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Interest is growing in the relationship of the microbiota and intestinal environment with health in companion animals. Galacto-oligosaccharides (GOS), typical prebiotics, are expected to provide benefits in dogs. Previous studies of GOS in dogs have involved dogs with similar rearing conditions and diets, which may have biased the results. We conducted an open study of 26 healthy dogs kept in households with diverse rearing environments in order to evaluate how the intake of a GOS-containing syrup affects the intestinal microbiota and its metabolites. Each dog was fed 1.2-4.8 g of the GOS-containing syrup (GOS 0.5-2.0 g equivalent) for 8 weeks. Fecal microbiota, fecal concentrations of organic acids and putrefactive products, fecal odor, and serum uremic toxin concentrations were evaluated before intake (0 weeks), during the 8-week intake period (4 and 8 weeks), and 4 weeks after intake (12 weeks). The activity of N-benzoyl-DL-arginine peptidase in dental plaque, which may be associated with periodontal disease, was evaluated at 0 and 8 weeks. Continuous intake of GOS resulted in changes in fecal microbiota, with a particularly marked increase in the abundance of Megamonas, which produces propionic acid. Other findings included a significant increase in the fecal acetic, propionic, and n-butyric acid concentrations. Additionally, significant decreases in fecal odor, fecal phenol concentration, and serum indoxyl sulfate concentration. Intake of GOS was also associated with a significant decrease in N-benzoyl-DL-arginine peptidase activity in dental plaques. These results suggest that continuous intake of GOS may contribute to canine health.

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A wide variety of microorganisms have been closely linked to metal corrosion in the form of adherent surface biofilms. Biofilms allow the development and maintenance of locally corrosive environments and/or permit direct corrosion including pitting corrosion. The presence of numerous genetically distinct microorganisms in the oral environment poses a threat to the integrity and durability of the surface of metallic prostheses and implants used in routine dentistry. However, the association between oral microorganisms and specific corrosion mechanisms is not clear. It is of practical importance to understand how microbial corrosion occurs and the associated risks to metallic materials in the oral environment. This knowledge is also important for researchers and clinicians who are increasingly concerned about the biological activity of the released corrosion products. Accordingly, the main goal was to comprehensively review the current literature regarding oral microbiologically influenced corrosion (MIC) including characteristics of biofilms and of the oral environment, MIC mechanisms, corrosion behavior in the presence of oral microorganisms and potentially mitigating technologies. Findings included that oral MIC has been ascribed mostly to aggressive metabolites secreted during microbial metabolism (metabolite-mediated MIC). However, from a thermodynamic point of view, extracellular electron transfer mechanisms (EET-MIC) through pili or electron transfer compounds cannot be ruled out. Various MIC mitigating methods have been demonstrated to be effective in short term, but long term evaluations are necessary before clinical applications can be considered. Currently most in-vitro studies fail to simulate the complexity of intraoral physiological conditions which may either reduce or exacerbate corrosion risk, which must be addressed in future studies. STATEMENT OF SIGNIFICANCE: A thorough analysis on literature regarding oral MIC (microbiologically influenced corrosion) of biomedical metallic materials has been carried out, including characteristics of oral environment, MIC mechanisms, corrosion behaviors in the presence of typical oral microorganisms and potential mitigating methods (materials design and surface design). There is currently a lack of mechanistic understanding of oral MIC which is very important not only to corrosion researchers but also to dentists and clinicians. This paper discusses the significance of biofilms from a biocorrosion perspective and summarizes several aspects of MIC mechanisms which could be caused by oral microorganisms. Oral MIC has been closely associated with not only the materials research but also the dental/clinical research fields in this work.

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Contemporary orthodontics entails using advanced materials and devices, simplifying the process of tooth movement. It is well documented that orthodontic materials are subjected to various fluctuations and stresses in the oral environment, such as salivary pH, dietary habits, temperature changes, and masticatory loads. These changes reduce bonding materials' longevity, plasticize resin polymers, and reduce elastic properties. In addition, the corrosion of orthodontic appliances in the oral environment has concerned clinicians for some time. This is focused on two principal issues: whether corrosion products are absorbed into the body and cause either localized or systemic effects, and the results of corrosion on the physical properties and the clinical performance of orthodontic appliances. Recently, another major concern is the potential release of bisphenol-A from materials containing polymers such as thermoplastic aligners and resins, which is known to induce xenoestrogenicity and cytotoxicity when the tissue level exceeds the daily recommended intake. However, most of these findings are based on in vitro studies that suffer from serious drawbacks such as failure to replicate the exact oral environment and process during orthodontic treatment. Therefore, developing clinically relevant methods should be the goal of future research related to the aging of orthodontic materials. The purpose of this review is to outline the impact of the oral environment on contemporary orthodontic materials.

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BACKGROUND: The number of patients with dementia is increasing worldwide. Modifying risk factors may significantly reduce the prevalence and cost of dementia. The number of remaining teeth, occlusal force, denture use, and periodontal disease status are associated with the risk of developing dementia. The oral environment may be a risk factor for dementia. This study aimed to investigate the association between the oral environment and cerebral blood flow in patients with mild cognitive impairment and dementia (either Alzheimer type dementia (ATD) or dementia with Lewy bodies (DLB)). We aimed to identify differences in the oral environment according to the underlying neurodegenerative disease. METHODS: The participants were 25 patients with ATD and 25 patients with DLB who visited the Department of Dementia and Geriatric Medicine, Kanagawa Dental University Hospital. Patients were diagnosed with ATD and DLB by well-trained specialists certified by the Japanese Dementia Society and categorised as Level 3 or 4 by the Functional Assessment Staging of Alzheimer Disease scale. The correlation between oral environment (number of teeth, periodontal tissue, and oral function) and cerebral blood flow in each brain area calculated by single photon emission computed tomography was examined. RESULTS: The DLB group showed a significant correlation between masticatory performance and cerebral blood flow in some areas, while no such correlation was observed in the ATD group. Significant correlations were found between periodontal pocket depth and bleeding on probing and cerebral blood flow in some areas in both groups, although the correlation was considerable in the ATD group. CONCLUSIONS: The results of this study suggest that the association between changes in the oral environment and cerebral blood flow may differ among patients with ATD and DLB, depending on the underlying causative disease.

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The study focuses on the problem of lowering the pH around a composite filling concerning the polymerization modes and methacrylic acid release, which may affect not only the oral health but also the whole organism. A total of 90 specimens (30 of each: Filtek Bulk Fill, Evetric and Riva LC) were placed in 90 sterile hermetic polyethene containers with saline and incubated at 37 °C. Ten samples of each material were light-cured for 40 s with one of the three curing modes: full power mode (FPM), ramping mode (RM) and pulse mode (PM). The pH and methacrylic acid release evaluation were performed at the following time points: after 2 h and after 3, 7, 21 and 42 days from the specimen preparation. Regardless of light-curing mode, all used materials were characterized by a gradual elevation in methacrylic acid concentration. Only for Filtek Bulk Fill, increased methacrylic acid release was closely associated with lower pH. The choice of the polymerization mode has no significant influence on the methacrylic acid release. However, further research about composite light-curing is necessary to create the procedure algorithm, reducing the local and systemic complications associated with composite fillings.

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BACKGROUND/AIM: Amitriptyline is a major tricyclic antidepressant that is also used to relieve chronic orofacial pain. Recently, alterations in gut flora due to various antidepressants have been demonstrated. However, it remains unknown how antidepressants affect the oral environment, including microbiota and innate immunity. The aim of this study was to investigate the effects of amitriptyline on oral microflora and antimicrobial peptides. MATERIALS AND METHODS: Sprague-Dawley rats were intraperitoneally injected with amitriptyline for 2 weeks. The DNA extracted from the oral swabs were used to perform 16SrRNA sequencing to evaluate the oral microbiome. Quantitative RT-PCR was performed to evaluate the mRNA levels of antimicrobial peptides in the buccal tissues. RESULTS: No significant differences in salivary flow rates were observed between the amitriptyline and control groups. Taxonomic analysis showed significant alterations in bacteria such as Corynebacterium, Rothia, and Porphyromonas due to amitriptyline administration. The beta diversity showed significant differences between the amitriptyline and control groups. Additionally, the predicted metagenome functions were significantly different between the two groups. The mRNA expression levels of antimicrobial peptides in the amitriptyline group were significantly higher as compared to controls. CONCLUSION: Systemic administration of amitriptyline may affect the oral environment, including oral microbes and innate immunity in the oral mucosa.

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BACKGROUND: Several reports suggest that the microbiome of the digestive system affects vaccine efficacy and that the severity of coronavirus disease (COVID-19) is associated with decreased diversity of the oral and/or intestinal microbiome. The present study examined the effects of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine on the oral microbiome. METHODS: Forty healthy Japanese oral healthcare personnel were recruited, and unstimulated saliva was collected before vaccination, after the 1st vaccination, and after the 2nd vaccination. Genomic DNA was extracted from saliva samples, and PCR amplicons of the 16S rRNA gene were analyzed using next-generation sequencing. Microbial diversity and composition were analyzed using Quantitative Insights into Microbial Ecology 2. In addition, alterations in microbial function were assessed using PICRUSt2. RESULTS: SARS-CoV-2 mRNA vaccination significantly increased oral bacterial diversity and significantly decreased the proportion of the genus Bacteroides. CONCLUSIONS: The SARS-CoV-2 mRNA vaccine alters the oral microbiome; accordingly, vaccination might have beneficial effects on oral health.

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The oral microbiome is ecologically diverse, complex, dynamic, and little understood. We describe the microbiota of four oral habitats in a birth cohort at age 32 and examine differences by sex, oral hygiene, and current smoking status, dental caries, and periodontal health. Oral biofilm samples collected from anterior labial supragingival, posterior lingual supragingival, subgingival, and tongue sites of 841 Dunedin Multidisciplinary Health and Development Study members were analysed using checkerboard DNA-DNA hybridization; focusing on 30 ecologically important bacterial species. The four habitats exhibited distinct microbial profiles that differed by sex. Streptococcus gordonii was more dominant in supragingival and tongue biofilms of males; Porphyromonas gingivalis exhibited higher relative abundance in subgingival biofilm of females. Males had higher scores than females for periodontal pathogens at supragingival sites. The relative abundance of several putative caries and periodontal pathogens differed in smokers and non-smokers. With poor oral hygiene significantly higher proportions of Gram-negative facultative anaerobes were present in subgingival biofilm and there were higher scores for the principal components characterised by putative cariogenic and periodontal pathogens at each site. Distinctive microenvironments shape oral biofilms and systematic differences exist by sex, oral hygiene, and smoking status.

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OBJECTIVES: A narrative review on the NO properties and their relationship with the oral environment describing NO's molecular origin, role, and perspectives regarding oral pathological, physiological, and regenerative processes for future applications and possible use as prevention or treatment in dentistry. MATERIALS AND METHODS: Pubmed was searched using the word "nitric oxide." Reviews, clinical studies, and experimental studies were eligible for the screening process. Similar search procedures were then performed with the additional search words "conservative dentistry," "orthodontics," "endodontics," "implants," "periodontics," "oral cancer," "pulp revascularization," and "oral surgery." Furthermore, references of included articles were examined to identify further relevant articles. RESULTS: There is a relationship between NO production and oral diseases such as caries, periodontal diseases, pulp inflammation, apical periodontitis, oral cancer, with implants, and orthodontics. Studies on this relationship and uses of NO, in diagnosis, prevention, and treatment, are being developed. Also, some NO and oral cavity patents have already registered. CONCLUSIONS: The understanding of how NO can interfere in oral health maintenance or disease processes can contribute to elucidate the disease development and optimize treatment approaches. CLINICAL RELEVANCE: NO has considerable biotechnological potential and can contribute to improving diagnostics and treating the oral environment. As a biomarker, NO has an important role in the early diagnosis of diseases. Regarding treatments, NO can possibly be used as a regulator of inflammation, anti-biofilm action, replacing antibiotics, inducing apoptosis of cancerous cells, and contributing to the angiogenesis. All these studies are initial considerations regarding the relationship between NO and dentistry.

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The use of metal-free thermoplastic materials plays a key role in the orthodontic digital workflow due to the increasing demand for clear aligner treatments. Three thermoplastic polymers commonly used to fabricate clear aligners, namely Duran®, Biolon® and Zendura®, were investigated to evaluate the effect of thermoforming (T.), storage in artificial saliva (S.A.S.) and their combination on their mechanical properties. Elastic modulus and yield stress of the specimens were characterized. Each material was characterized for each condition through tensile tests (ISO527-1). The results showed that thermoforming does not lead to a significant decrease in yield stress, except for Zendura® that showed about a 30% decrease. An increase of the elastic modulus of Duran® and Zendura®, instead, was observed after thermoforming. The same increase was noticed for the yield stress of Duran®. For S.A.S. specimens, the elastic modulus generally decreases compared to supplier condition (A.S.) and simply thermoformed material. A decrease of yield stress, instead, is significant for Zendura®. The results demonstrated that the impact of the operating conditions on the mechanical properties can vary according to the specific polymer. To design reliable and effective orthodontic treatments, the materials should be selected after their mechanical properties are characterized in the simulated intraoral environment.

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The aim of this study was to investigate the cumulative effects of fruit juices and/or alcoholic beverages on wear track area of the restorative materials by simulating the oral environment in vitro. A microhybrid, a sub-microhybrid, a nanofill resin composite, and a giomer material were used. A daily exposure habits model was created to simulate consumption frequency of acidic and/or alcoholic beverages. Two-body wear tests were carried out using a reciprocating wear tester. ANOVA and Tukey's HSD tests were used for statistical analyses (p < 0.05). When considering experimental groups related to daily exposure habits, statistical difference was found between restorative materials in terms of wear track area (p < 0.01). Joint effect of rmaterial and exposure on wear track area was statistically significant (p < 0.01). Giomer was found to be more affected by acidic and alcoholic beverages. Microhybrid resin composites showed less wear than the other restorative materials. Cumulative effects of alcoholic beverages and fruit juice on wear track area of materials could be related to material's composition and frequency of consumption of acid or ethanol-containing beverages. Daily cumulative effect of acidic and alcoholic beverages was found to be stronger than only acidic fruit juice consumption in terms of wear track area. The plasticizing effect and the concentration of ethanol in the alcoholic beverages provided the basis for the increased wear track area on the restorative materials.

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The aim of the study was to evaluate the oral environment and the taste function of Japanese HIV-infected patients treated with antiretroviral therapy. Their median age of 73 patients taking anti-HIV drugs was 46 years. The median period of taking anti-HIV drugs was 30 months. The oral condition was evaluated by measurement of oral moisture, amount of saliva secretion, the number of oral bacteria, presence of oral candida, a taste test, and the number of missing teeth. The levels of oral moisture and secreted saliva were significantly lower in the HIV-infected group than in the healthy volunteer (control) group. The HIV-infected group showed a more robust decrease in taste sensation than the control group. The number of missing teeth was significantly higher in the HIV-infected group than in the control group. Furthermore, all of the evaluated oral conditions were worse in the HIV-infected patients whose CD4+ T lymphocyte counts were less than 500/mm3 than in the control group. It became clear that the patients taking anti-HIV drugs, especially the CD4+ count < 500/mm3 group, had a deteriorated oral environment and dysgeusia, suggesting that the management of oral hygiene is necessary to maintain oral health, which leads to systemic health.

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Objectives @#The purposes of this study were to evaluate the long-term mechanical property, bacteria-killing ability, protein resistance and cytotoxicity of a novel antibacterial methyl methacrylate (MMA) resin. @*Methods @#The 2-methacryloyloxyethyl phosphorylcholine (MPC) has been added into the MMA used for making Hawley orthodontic retener according to the mass percentage 0% (control group), 1.5%, 2.25%, 3%, 4.5% and 6%. Specimens from the control group and MPC group were water-aged for 1 d, 90 d and 180 d, and then the universal material testing machine was used to investigate the long-term mechanical properties of the modified MMA specimens in the oral environment. The biofilm metabolic activity, colony-forming unit (CFU) and live/dead staining assay of the biofilms in the control group and MPC group in the oral environment were tested using the dental plaque biofilm model. The micro-bicinchoninic acid (BCA) method was used to determine the amount of protein adsorbed on the specimens. The MTT method was used to evaluate the cytotoxicity of the control group and MPC group.@*Results @#In the simulated oral environment, the addition of 0% to 3% MPC had no significant effect on the mechanical properties of the MMA specimen (P > 0.05). The control group and the modified MMA specimens with 3%MPC were statistically significant in time and the interaction effects between the two groups (P < 0.05). With increasing intervention time, the mechanical strength of both groups decreased, and the effect of time varied with grouping. The protein adsorption on the surface of the modified MMA material after adding 3% MPC decreased by approximately 80%, the metabolic activity of the biofilm decreased by approximately 50%, and biofilm CFU counts decreased by approximately 70% (P < 0.05) compared with the control. There was no statistically significant difference in time or interaction effects between the two groups. The amount of live green bacteria in the 3% MPC group decreased significantly after 1, 90, and 180 d of water aging. There was no significant difference in cytotoxicity between the control group and the MPC group (P > 0.05). @*Conclusions @#The addition of MPC into the MMA resin did not compromise the mechanical properties of the resin and exhibited long-lasting antibacterial and protein-repellent effects.

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AIM: The importance of oral care has been recognized for the prevention of airway infections in older individuals who require long-term care. The present prospective cohort study was carried out a decade ago to identify risk factors with numerous intraoral conditions as possible predictors involved in the onset of pneumonia and acute viral respiratory infection (AVRI) in older people requiring long-term care during a 6-month follow-up period (including winter). METHODS: This study included 1785 older individuals residing in 31 long-term care facilities in which dental hygienists were involved in instruction on daily oral care. Primary end-points were development of pneumonia and AVRI during the 6-month follow-up period. Several factors related to each participant's general condition, oral environment, swallowing function and vaccinations (or lack thereof) were evaluated by calibrated dentists and dental hygienists before the study onset. RESULTS: During the 6-month follow-up period, 74 participants (4.1%) developed pneumonia, and 28 participants (1.6%) developed AVRI. Cox proportional hazard analysis showed that poor nutritional status and the presence of dysphagia were significant risk factors for pneumonia onset. The presence of dry mouth and halitosis were significant risk factors for AVRI. CONCLUSIONS: This prospective multicenter cohort study identified poor nutritional status and dysphagia as independent risk factors for the development of pneumonia, and dry mouth and halitosis as independent risk factors for the development of AVRI in older people who require long-term care and who routinely receive professional oral care. Geriatr Gerontol Int 2019; 19: 1136-1140.

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OBJECTIVE: The aim of this study was to investigate the effect of intraoral conditions and fluoride mouthwashes on mechanical properties and surface characteristics of different types of titanium molybdenum alloy (TMA) wires. MATERIALS AND METHODS: Three types of TMA wires of dimension 0.017" × 0.025" [1. Standard TMA (TMA), 2. ion-implanted, low-friction TMA (LF) and 3. Colored, Honey Dew TMA (HD)] were tested in three conditions as three groups; A) Control (as received), B) No fluoride (following intraoral use without fluoride) and C) Fluoride (following intraoral use with fluoride rinses). Surface roughness was evaluated using 3D Optical Profilometer. Three point bending tests were done to evaluate load deflection characteristics (LDR), ultimate tensile strength (UTS), and Young's modulus (E). Statistical evaluation was done using one-way analysis of variance (ANOVA), Bonferroni multiple comparison, and paired t-tests. RESULTS: Control group TMA exhibited significantly higher surface roughness, peak height, and LDR as well as lower UTS and E when compared to LF and HD (P < 0.001). In nonfluoride group, the surface roughness and LDR increased significantly for all three types of wires (P < 0.001). The UTS and E showed a significant decrease (P < 0.001). Additional use of fluoride mouthwashes (fluoride group) further increased surface roughness and LDR and decreased the UTS and E (P < 0.001). CONCLUSION: The ion-implanted LF/HD varieties had better surface smoothness, lower LDR, higher UTS, and higher E than standard TMA in the control group, pointing towards a better efficiency of these wires. Intraoral conditions significantly increased surface roughness and deteriorated mechanical properties of all types of TMA wires. With the use of daily fluoride mouthwashes, the deterioration was much worse.

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BACKGROUND: The oral microflora primarily involved in early childhood caries (ECC) is Streptococcus mutans while Streptococcus sanguinis is related to healthy caries-free mouth. The antagonism between the two at biological level is well recognized. AIM: This study aims to compare the pre- and posttreatment salivary levels of S. mutans and S. sanguinis in ECC. METHODS: This cross-sectional study was performed on 40 eligible participants. Clinical examination was done, and decayed teeth were recorded. Pre- and Posttreatment saliva sample was taken, processed and bacterial counts were compared. RESULTS: A statistically significant posttreatment reduction was found in S. mutans counts; however, a significant posttreatment elevation was seen in S. sanguinis counts (P < 0.001) using Wilcoxon signed-rank test. A significant weak positive correlation was found between S. mutans and decayed teeth in the mouth (r = 0.366 and P = 0.028) using Spearman's correlation. No significant gender association was found between pre- and posttreatment S. mutans and S. sanguinis counts (P = 0.908) and also between decayed teeth (P = 0.321) using Mann-Whitney U-test. CONCLUSION: Complete dental treatment procedure showed significant reduction and elevation in S. mutans and S. sanguinis counts, respectively. A positive association was observed between S. mutans and ECC while S. sanguinis were positively associated with posttreatment oral environment.

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OBJECTIVE: Mouth breathing syndrome (MBS) is defined as a set of signs and symptoms that may be completely or incompletely present in subjects who, for various reasons, replace the correct pattern of nasal breathing with an oral or mixed pattern. It is important to identify the relevant factors affecting MBS in order to diagnose its cause since breathing obstructions can result from multiple factors. The purpose of this study is to clarify the relevant factors and the interrelationships between factors affecting MBS among children. DESIGN: We surveyed 380 elementary school children from 6 to 12 years in age. The questionnaire consisted of 44 questions regarding their daily health conditions and lifestyle habits and was completed by the children's guardians. A factor analysis was performed to classify closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors. RESULTS: Twenty-six out of the 44 questions were selected, and they were classified into seven factors. Factors 1-7 were defined as "Incompetent lip seal", "Diseases of the nose and throat", "Eating and drinking habits", "Bad breath", "Problems with swallowing and chewing", "Condition of teeth and gums", and "Dry lips", respectively. There were also correlations between these factors themselves. CONCLUSION: MBS was categorized according to 7 major factors. Because Factor 1 was defined as "Incompetent lip seal", which was representative of the physical appearance of mouth breathers and correlated with other factors, we suggested that MBS should consist of 7 factors in total.

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Silane is a dominant coupler that is widely used in dentistry to promote adhesion among the components of dental composites. Silica-based fillers can be easily silanized because of their similarly ordered structure. However, silane is hydrolytically degraded in the aqueous oral environment and inefficiently bonds to non-silica fillers. Thus, the development of hydrolytically stable dental composites is an important objective in the research on dental materials. Titanate coupling agents (TCAs) exhibit satisfactory interfacial bonding, enhanced homogeneous filler dispersion, and improved mechanical properties of the composites. Titanates also provide superior hydrolytic stability in wet environments, which should be considered in fabricating dental composites. The addition of a small amount of titanates can improve the resistance of the composites to moisture. This paper reviews the effects of the instability of silanes in moisture on the performance of dental composites and presents TCAs as alternative couplers to silanes for fabricating dental composites.

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Cancer is now the leading cause of death in Japan. A rapid increase in cancer mortality is expected as Japan is facing a super-aged society. Many causes of cancer are known to be closely linked to life style factors, such as smoking, drinking, and diet. The oral environment is known to be involved in the pathogenesis and development of various diseases such as bronchitis, pneumonia, diabetes, heart disease, and dementia. Because the oral cavity acts as the bodily entrance for air and food, it is constantly exposed to foreign substances, including bacteria and viruses. A large number of bacteria are endemic to the oral cavity, and indigenous oral flora act to prevent the settlement of foreign bacteria. The oral environment is influenced by local factors, including dental plaque, tartar, teeth alignment, occlusion, an incompatible prosthesis, and bad lifestyle habits, and systemic factors, including smoking, consumption of alcohol, irregular lifestyle and eating habits, obesity, stress, hormones, and heredity. It has recently been revealed that the oral environment is associated with cancer. In particular, commensal bacteria in the oral cavity are involved in the development of cancer. Moreover, Candida, human papilloma virus and Epstein-Barr virus as well as commensal bacteria have been reported to be associated with the pathogenesis of cancer. In this review, we introduce recent findings of the correlation between the oral environment and cancer.