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Dentistry is just the beginning

The mission of the Case Western Reserve University School of Dental Medicine is to provide outstanding programs in oral health education, patient care, research and scholarship, and service that are of value to our constituents. We accomplish this in an environment that fosters collegiality and professionalism that enables a diverse group of students to become competent practitioners of dentistry and contribute to the health and well-being of individuals and communities.


Study Finds Dental Implants Result in Better Quality of Life for Osteoporotic Women Than Other Treatment Options

Dr. Leena Palomo‌With age, postmenopausal women with osteoporosis are at greater risk of losing their teeth. But what treatment for tooth loss provides women with the highest degree of satisfaction in their work and social lives? A new study by CWRU School of Dental Medicine researchers suggests dental implants may be the best route to take, according to Leena Palomo, associate professor of periodontics and corresponding author. The research is part of a series of studies analyzing dental outcomes for women with osteoporosis.

In one of the first studies to examine quality of life after treatment to replace missing teeth in osteoporotic women, the researchers surveyed 237 women about their satisfaction with replacement teeth and how it improved their lives at work and in social situations. The 23-question survey rated satisfaction with their work, health, emotional and sexual aspects of their lives.

The women had restoration work done that included implants (64 women), fixed partial denture, which is a false tooth cemented to crowns of two teeth (60), a removal denture, better known as false teeth (47), or had no restoration work done (66). Women with dental implants reported a higher overall satisfaction with their lives, including emotional and sexual areas, while those without restorations scored the lowest in those two areas.

As health professions move to a patient-centered form of delivering dental service, understanding the patient’s outcomes for satisfaction of the treatment’s esthetics is as important as chewing function, said Christine DeBaz, third-year dental student and lead researcher on the project.

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Research Finds that Some Disease-Fighting Cells May Actually Prolong Inflammation

Dr. Pushpa Pandiyan‌‌Researchers have unraveled one of the mysteries of how a small group of immune cells work: That some inflammation-fighting immune cells may actually convert into cells that trigger disease. Their findings, recently reported in the journal Pathogens, could lead to advances in fighting diseases, said the project’s lead researcher Pushpa Pandiyan, an assistant professor at the dental school.

A type of white blood cell, called T-cells, is one of the body’s critical disease fighters. Regulatory immune cells, called “Tregs,” direct T-cells and control unwanted immune reactions that cause inflammation. They are known to produce only anti-inflammatory proteins to keep inflammation caused by disease in check. But using mouse models, the researchers studied how the body fights off a common oral fungus that causes thrush. They found that these harmful invaders activate a mechanism in Tregs that could transform the inflammation-fighting cells into cells that allow the disease to flourish.

During oral thrush, yeast sugars on the surface of the disease-causing fungus act as a binding agent and can activate a small population of Treg cells to make inflammatory proteins themselves. (The researchers are calling this novel subset of malfunctioning cells Treg-17 cells). “An excess of these malfunctioning cells can lead to the inflammatory disease process instead of stopping it,” Pandiyan said.

The findings will help researchers understand the origin of cells they suspect may keep the disease active or, at a minimum, don’t battle inflammation. Pandiyan believes the knowledge could lead to new ways to fight diseases. Future studies will investigate whether these cells are actually perpetrating inflammation.

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Research Finds that Treating Gum Disease Reduces Prostate Symptoms

Dr. Nabil Bissada‌‌Researchers from CWRU School of Dental Medicine and the Departments of Urology and Pathology at University Hospitals Case Medical Center report that treating gum disease reduced symptoms of prostate inflammation, called prostatitis. “This study shows that if we treat the gum disease, it can improve the symptoms of prostatitis and the quality of life for those who have the disease,” said Nabil Bissada, chair of the Department of Periodontics and the study’s corresponding author. Naif Alwithanani, a graduate student in the dental school, led the investigation as part of his residency in periodontics. Bissada explained that gum disease not only affects the mouth, but is a system-wide condition that can cause inflammation in various parts of the body. The dental school has previously found a link between gum disease and fetal deaths, rheumatoid arthritis and heart disease.

Researchers studied 27 men, 21 years old and older. Each had confirmed inflammation of the prostate gland and a blood test that showed elevated prostate specific antigen (PSA) levels—possible signs of inflammation and cancer. The men were assessed for symptoms of prostate disease by answering questions on the International-Prostate Symptom Score (IPSS) test about their quality of life and possible urination issues.

All the men had moderate to severe gum disease, for which they received treatment. They were tested again for periodontal disease four to eight weeks later and showed significant improvement. During the periodontal care, the men received no treatment for their prostate conditions, but 21 of the 27 men showed decreased levels of PSA. Those with the highest levels of inflammation benefited the most from the periodontal treatment. Symptom scores on the IPSS test also showed improvement.

Bissada is now conducting follow-up research to support the first study’s findings. He hopes to make periodontal treatment a standard part of treating prostate disease, much like cardiac patients are often encouraged to visit their dentist before undergoing heart procedures and a dental checkup is advised for women who are pregnant or considering pregnancy.

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Education Level, Dental Habits of Low-Income Parents Linked to Children’s Oral Health

Dr. Masahiro Heima‌‌Studies have long associated low-income areas with poor oral health, but dental researchers at CWRU and University of Washington sensed that other factors related to income may be at work—in particular, education level. So, with data from 423 low-income African-American kindergarteners and their caregivers, researchers tested the hypothesis that a caregiver’s education level influences how often they and their children brush their teeth and visit the dentist for routine checkups, and how those habits result in decayed or filled teeth.

Caregivers who completed high school were 1.76 times more likely to visit the dentist, compared with those who did not graduate high school, and their children were nearly six times more likely to visit the dentist routinely. The education level of caregivers was directly associated with about a third fewer untreated decayed teeth, and 28 percent fewer decayed or filled teeth among the children they cared for.

The findings, reported in the Caries Research article “Caregiver’s Education Level and Children Dental Caries in African Americans: A Path Analytic Study,” confirm the role of caregiver education in child dental decay and indicate that the caregiver’s behavior influences a child’s oral health habits. Researchers hope to encourage parents to become better role models for their children, who pick up on both the positive and negative habits of their caregivers.

When dental problems where found during annual exams, letters were sent to parents to tell them their children needed follow-up dental care. But not all caregivers sought help for their children, Masahiro Heima, a pediatric dentist and faculty member at Case Western Reserve School of Dental Medicine, said. “Changing their ways with literature and instructions, didn’t always work,” said Heima. “So we need to focus on behavioral changes.”

Lee Wonik and Suchitra Nelson, from CWRU School of Dental Medicine, and Peter Milgrom, from University of Washington School of Dentistry, contributed to the study.

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CWRU and Cleveland Clinic Collaborate with Microsoft on Mixed-Reality Technology

Student Using HoloLens Technology (Microsoft)‌Microsoft HoloLens is the first fully untethered, see-through holographic computer, enabling high-definition holograms to come to life, seamlessly integrating with physical places, spaces, and things. Holograms mixed with the real world (mixed-reality) will unlock all-new ways to create, communicate, work, and play. CWRU Radiology Professor Mark Griswold spoke at Microsoft’s annual Build conference about how Microsoft’s HoloLens program can transform learning across countless subjects, from art to engineering, but began with a demonstration of a holographic heart. With HoloLens, students can, “see it truly in 3D. You can take parts in and out. You can turn it around. You can see the blood pumping—the entire system.” In other words, it can improve upon existing educational methods, and will do so for CWRU students at the new Health Education Campus.

After deciding to move forward with the new Health Education Campus, Cleveland Clinic CEO Toby Cosgrove approached Microsoft for a collaboration so that the state-of-the-art structure will also have pioneering technology and cutting-edge teaching techniques. Though the program has potential applications for engineering, astronomy, art history, and any number of other programs, the priority is on creating a full digital anatomy curriculum that students will experience at the new Health Education Campus.

Read more and watch the video here and visit hololens.com.

Fall 2014 Magazine

In this issue:

  • New Dean Kenneth Chance, DDS '79
  • Researchers Link Byproducts of Gum Disease with Oral Cancer Growth
  • Dr. Occhionero Celebrates 50 Years at the School of Dental Medicine
  • And much more!
Download the PDF here

Or peruse PDFs of past issues:

More magazines and departmental newsletters are available in the archive.