The 3 rd Conference of Asian Society for Breath Odor Research

Transcription

1 The 3 rd Conference of Asian Society for Breath Odor Research ASBOR November 28, 2006 Okayama University 50th Anniversary Hall Okayama, Japan Asian Society for Breath Odor Research (Asian Division of International Society for Breath Odor Research)

2 The ASBOR is grateful to the following companies for their support of the 3 rd Conference of ASBOR. Main Sponsor Pfizer Cosponsor Ezaki Glico Special Gifts ABILIT Bee Brand G C Pine Medical

3 The 3 rd Conference of Asian Society for Breath Odor Research November 28, 2006 Okayama University 50th Anniversary Hall, Okayama, Japan Table of Contents Reception Campus Map Conference Schedule Abstract Keynote Speech Oral Presentation Organizing Committee

4 Reception November 28, 6:00 pm 8:00 pm ASBOR will hold a reception at Okayama Royal Hotel. The reception will start at 6:00 pm. Tickets for the event are 6,000 (JPN) per person. Tickets will be sold at the registration desk until 11:30 am. Okayama Royal Hotel 2-4 Ezu-cho Okayama Japan TEL: FAX: Call free:

5 Okayama University Campus Map

6 Conference Schedule 09:00 ~ Registration 09:45 ~ 10:00 Opening Oral Presentation 1 (Chairperson: Dr. Hideo Miyazaki, Niigata University) 10:00 ~ 10:10 O-01 M. Yoneda, N. Suzuki, T. Watanabe, T. Naito, T. Hirofuji (Fukuoka Dental College) Questionnaire Survey on the Knowledge and Consciousness of Breath Odor 10:10 ~ 10:20 O-02 H. Miyazaki, K. Nohno, T. Yamaga N. Kaneko (Niigata University) Effects of protease extracted from a plant on reduction of both tongue coating and VSCs 10:20 ~ 10:30 O-03 H. Murakami, D. Kato, I. Ikedo, K. Takeuchi, H. Hattori (Aichi-Gakuin University) Effects of Deodorization of Dentures using Ozone Cleaning Evaluation by Organoleptic Scores Oral Presentation 2 (Chairperson: Dr. Manabu Morita, Hokkaido University) 10:30 ~ 10:40 O-04 S. Awano, T. Ansai, I. Soh, A. Yoshida, T. Hamasaki, T. Takehara (Kyushu Dental College) Methyl mercaptan generating from tongue coating is a predictor of mortality from pneumonia in octogenarians 10:40 ~ 10:50 O-05 T. Imai, T. Kamoda, T. Murata K. Yaegaki (The Nippon Dental University) Hydorogen Sulfide Inhibited Cell Proliferation of Osteoblasts 10:50 ~ 11:00 O-06 T. Kamoda, T. Murata, K. Yaegaki (The Nippon Dental University) Development of Artificial Mouth System for Screening of Volatile Sulfur Compounds Keynote Speech 1 (Chairperson: Dr. Ken Yaegaki, Nippon Dental University) 11:00 ~ 12:00 K-1 H. Larjava (University of British Columbia) Periodontal considerations for anterior esthetic zone Lunch

7 Keynote Speech 2 (Chairperson: Dr. Akira Toyofuku, Fukuoka University) 13:00 ~ 13:30 K-2 K. Yaegaki (Nippon Dental University) EBM of Bad Breath Detectors and Treatment for Practical Clinics 13:30 ~ 14:00 K-3 S-C Shin (Dankook University) Garlic malodor from Korean foods and their controls Oral Presentation 3 (Chairperson: Dr. Thongchai Vachirarojpisan, Chulalongkorn University) 14:00 ~ 14:10 O-07 A. Talebian, R. Iranpoor, H. Talebian (Khoshboo Breath Odor Association) Addiction to cigarette smoking due to suffering from halitosis and the cessation following halitosis treatment. A case report 14:10 ~ 14:20 O-08 A. Toyofuku (Fukuoka University) Paroxetine and suicidal preoccupation in a patient of halitophobia 14:20 ~ 14:30 O-09 T. Yasukawa, M. Ohmori, S. Sato (The Nippon Dental University) Relationship between tongue plaque, subgingival plaque of periodontopathic bacteria and breath odor 14:30 ~ 14:40 O-10 N. Suzuki, M. Yoneda, T. Naito, T. Hirofuji (Fukuoka Dental College) Study of Clinical and Bacterial Parameters Related to Oral Malodor 14:40 ~ 14:50 O-11 T. Arai, S. Imai, N. Hanada, K. Yaegaki, K. Kamoi, Y. Numabe (The Nippon Dental University) Evaluation of Periodontopathic Microorganisms in Subgingival Plaque by Mouth Air Analyses Keynote Speech 3 (Chairperson: Dr. Seung-Chul Shin, Dankook University) 14:50 ~ 15:10 K-4 T. Vachirarojpisan (Chulalongkorn University) Antiseptic mouthrinse; a strategy for halitosis control 15:10 ~ 15:30 K-5 W. Qian (University of British Columbia) Effects of Oral Malodorous Compounds on Human Gingival Fibroblasts Closing 15:30~ Reception 18:00 ~ Okayama Loyal Hotel Ticket holder (see p3) and invitation only.

8 Keynote Speech Session 1 (11:00 ~ 12:00) Chairperson: Dr. Ken Yaegaki Session 2 (13:00 ~ 14:00) Chairperson: Dr. Akira Toyofuku Session 3 (14:50 ~ 15:50) Chairperson: Dr. Seung-Chul Shin

9 K-1 Periodontal Considerations for Anterior Esthetic Zone Hannu Larjava Division of Periodontics and Dental Hygiene, University of British Columbia, Vancouver, Canada Over the last decade the esthetic demands for improving the appearance of anterior teeth and smile have greatly increased. New materials and techniques such as veneers and all ceramic crowns, improved orthodontic and periodontal surgical techniques, and dental implants have provided dentists new tools to address these demands. Assessment of anterior esthetic zone includes collecting data for chief complaint, medical and dental history, facial symmetry, smile analysis and comprehensive intra-oral examination. Important factors for treatment planning are height of anatomical and clinical crowns, widths of incisors and canines, occlusal plane, tooth shape, width and thickness of gingiva, level of alveolar crest relative to CEJ and gingival margin, gingival display and proportion of teeth. Periodontist often works together with general dentists and other specialists to formulate a treatment plan for the patient. Patients often have unrealistic expectations and often orthognatic and plastic surgery are needed for optimal results. In general, maxillary anterior teeth (from canine to canine) should be assessed as one unit as tooth oriented approach may lead to severely compromised results. In ideal relationships, the central incisors are symmetric and the gingival margins locate about 1 mm apical to the lateral incisors. Margins of the canines also locate about 1 mm apical to the lateral incisors. Smile will display minimal gingiva except at the lateral incisors. The lengths of the teeth play a major role in decision-making. The average length for central incisors is 10-11mm, lateral incisors 9 mm and canines 10 mm. Gingival zenith (the most apical point of gingival tissue) is located distal to the longitudinal axis of the maxillary centrals and cuspids. The gingival zenith of the maxillary lateral incisors coincides with their longitudinal axis. Periodontal aspects of the treatment plan will address the need for esthetic crown lengthening, connective tissue graft, papilla restoration, ridge augmentation, and regenerative surgery or implant therapy. Tooth extractions in this zone should be done using atraumatic technique and often followed by socket preservation. After periodontal surgery or extraction, 6 month healing time is recommended before final restorations are made. Ovate pontics made out of patients own teeth can be used as temporary bridges reinforced with glass fiber polymers and composites. In the end, the esthetic dental treatment depends on accurate data collection and interpretation of all factors not forgetting patient s age, sex and personality. Many things in the dento-alveolar process can be changed but attractiveness to other people depends on multiple factors and cannot always be changed.

10 K-2 EBM of Bad Breath Detectors and Treatment for Practical Clinics Ken Yaegaki Department of Oral Health, Nippon Dental University. Tokyo, Japan Halitosis is classified into the categories of genuine halitosis, pseudo-halitosis and halitophobia. Genuine halitosis is subclassified into physiologic halitosis and pathologic halitosis, then pathologic halitosis is subdivided into oral and extraoral halitosis. The patients with pseudo-halitosis or halitophobia complain their oral malodor that does not never exist. Halitophobic patients are psychological. Thus, objective and correct measurements of oral malodor are required to diagnose these conditions. The organoleptic measurement is the most practical procedure, but a gas chromatography (GC) has been shown to be the gold standard for measuring oral malodor. GC is expensive, and must be modified specially for detecting volatile sulphur compounds (VSC) in mouth air. Therefore, several portable bad breath detectors were developed. EBM of these detectors were evaluated, a portable GC might be better than others. Further development of a new device will be necessary. Although oral pathologic or physiologic halitosis is easily reduced by a suitable treatment based on Treatment Needs (TN), which were defined by Miyazaki et al.. TN is the fundamental evidences for the treatment of halitosis, and patients can receive proper treatments for halitosis. Tongue cleaning of TN-1 is considered as the basic measure to reduce halitosis, although Cochrane report found the only short-term efficacy of tongue cleaning.

11 K-3 Garlic Malodor from Korean Foods and Their Controls Shin, Seung-Chul Department of Preventive Dentistry, School of Dentistry, Dankook University, Korea The Garlic has been known as one of the energetic or healthy foods in the world for a long times in spite of its unpleasant odor and irritant taste. The effects of the garlic is introduced such points as decreasing blood pressure through the control of blood cholesterol level by Allicin, main component of it, decreasing the incidences of the heart disease, or cardiovascular diseases. Moreover it has been proved as an excellent effect for anti-cancer by inhibiting the Nitro-Amine production as one of the carcinogen materials in the foods. Traditionally, Koreans favor to use the garlic in their diets everyday, through making such cooks as lots types of Kimchi, as one of the representative foods for Koreans, as well as preparing common soups or side-dishes at the dining table, and it let them get the tolerances on garlic odor for Korean lives. Otherwise, not so many investigations about garlic odor checks and the controls have been introduced in dentistry in Korea. In general, garlic odor is more strong and long lasted as 3 hours than other foods ingestion because Allyl Mercaptan and Allyl Methyl Sulfide, main components of garlic odor are known as from gut origin through the end-products of the metabolism as well as direct from oral cavity. I would like to introduce some studies on garlic odor checks and how to control them, not only at dental clinics but also in traditional ways, in Korea.

12 K-4 Antiseptic Mouthrinse; A Strategy for Halitosis Control Thongchai Vachirarojpisan Chulalongkorn University, Bangkok, Thailand Mouthrinse has become a common oral hygiene practice in patients suffering from halitosis. Two main action of mouthrinse for control halitosis are 1) reduction the number of micro-organisms and 2) conversion of volatile sulphur compounds (VSC) to non-volatiles. Chlorhexidine mouthrinse has been proved to the most effective agent that reduce VSC levels and in organoleptic rating. The action of chlorhexidine is strong antibacterial. However, chlorhexidine should not be use routinely due to many side effects have been report. The primary side effect of chlorhexidine is the tooth staining, burning sensation of mouth. In addition, a long-term use is its potential to disrupt the oral microbial balance. Therefore, the less side effect of the other antiseptic mouthrinse has been tested on halitosis. Antiseptic mouthrinse containing amine fluoride, stannous fluoride, essential oil, chloride dioxide, and triclosan have also been shown to be slight and moderate effective against halitosis. A zinc-containing mouthrinse have been found to reduce oral VSC concentrations remarkably due to its ability to react with volatile sulphur compounds to form nonvolatile and thus non-odoriferous compounds. Recently, several clinical studies evaluated the combination mouthrinse formulation and showed a good result on halitosis. Although a mouthrinse containing masking agents such as mints and deodorant can have a masking benefit, they act for only a short period, not provide antiseptic function and not deal with the real etiology of the halitosis. Conclusion: A non-chlorhexidine antimicrobial mouthrinse and zinc containing mouthrinse have been recommended to use for control halitosis.

13 K-5 Effects of Oral Malodorous Compounds on Human Gingival Fibroblasts Wei Qian 1) 1), 2), Ken Yaegaki 1) Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada 2) Department of Oral Health, Nippon Dental University, Tokyo, Japan Objectives: Hydrogen sulfide (H 2 S) is one of Volatile Sulfur Compounds (VSCs) responsible for oral malodor. Previous studies have shown that VSCs involved in periodontal pathogenesis. We reported H 2 S inhibited superoxide dismutase (SOD) activity. Therefore, we speculate that H 2 S will produce oxidative stress in human gingival fibroblasts (HGF), which may result in DNA damage and apoptosis. Methods: HGF is cultured and transferred to a special H 2 S incubation system with a constant flow of humidified 5%CO 2 air mixture with (test group)or without (control group) 100ng/ml H 2 S at 37 C. After 24, 48 and 72 hours, cells were collected and subjected to a series of assays, including trypan blue vitality test, LDH cytotoxicity test and single cell gel electrophoresis, cell SOD activity assay, apoptosis ELISA test for DNA fragment and Caspase 3. After staining with MitoSox (monitoring Reactive Oxigen Species in oxidative stress) and Annexin V and propodium iodide (specific marker for apoptosis), cells also went through flow cytometry anaysis for oxidative stress and apoptosis. Student T tests were carried out between test and control groups and different incubation time points. Results: Significant difference of the cell viability was not observed between test and control groups. The cytotoxicities of H2S were less than 10% at each incubation time. DNA fragmentation in cytoplasm was increased by H2S for 48 and 72 hours incubations. Tail Length was increased by H2S in 48hrs(p<0.0005) and 72hrs(p<0.0001). The %DNA in Tail and Tail Moment were increased in 72hrs(p<0.0005). Caspase 3 activity was increased in 48 and 72 hours incubations. The activity of Cu,Zn-SOD decreased by 80% (P<0.001) when exposed to H2S and that of HGF-SOD activity decreased by 42% (P<0.001). MitoSOX positive cells were significantly increased comparison with controls. More cells were labeled as apoptotic in test group after 48 and 72 hours incubation. Conclusion: 100ng/ml H 2 S induces oxidative stress, DNA damage and apoptosis in human gingival fibroblast, as detected by the above assay, but it is not a strong inducer. Key words: hydrogen sulfide, fibroblast, apoptosis, DNA damage, oxidative stress

14 Oral Presentation Session 1 (10:00 ~ 10:30) Chairperson: Dr. Hideo Miyazaki Session 2 (10:30 ~ 11:00) Chairperson: Dr. Manabu Morita Session 3 (14:00 ~ 14:50) Chairperson: Dr. Thongchai Vachirarojpisan

15 O-1 Questionnaire Survey on the Knowledge and Consciousness of Breath Odor M. Yoneda 1), N. Suzuki 1), T. Watanabe 2), T. Naito 1), T. Hirofuji 1) 1) Section of General Dentistry, Department of General Dentistry, 2) Section of Social Dentistry, Department of Preventive & Public Health Dentistry, Fukuoka Dental College, Japan Objective: More people are worrying about their breath odor these days, and many people visit breath clinics and buy breath care products. The knowledge and consciousness of breath odor of people who are interested in their breath odor need to be clarified for the purposes of better treatment and market surveys. Materials and Methods: A public dental health promotion event (organized by Fukuoka City, The Fukuoka Dental Association etc) was held at Fukuoka in At the oral breath booth, we measured people s breath odor for 3 minutes using portable sulfide monitors. Prior to the event, we compiled questions regarding knowledge and consciousness of breath odor into a questionnaire. Results and Conclusion: A total of 93 people visited the oral breath booth, and 100% of them agreed to complete the questionnaire during their 3-minute measurement time. About 90% of the visitors had previously experienced other people s bad breath. When they noticed other people s bad breath, some people tried to keep their distance and others directly mentioned the bad breath, but half of them did nothing. Only 5% of them covered their nose with their fingers. More than 90% of the visitors always or sometimes worried about their own breath odor, and about 60% thought that stomach problems can cause breath odor. Most people brushed their teeth to reduce breath odor, but only about 20% also cleaned their tongue. Moreover, 70% of the visitors were unaware of the breath clinics at college hospitals. From these results, we infer that many people are thinking about their bad breath, but they may not have sufficient knowledge about breath odor. It is therefore necessary for us to provide more information regarding breath odor. Key words: breath odor, questionnaire survey, Halimeter, breath clinic, public dental health-promotion event Dr. Masahiro Yoneda: Section of General Dentistry, Department of General Dentistry, Tamura, Sawara-ku, Fukuoka, , Japan

16 O-02 Effects of protease extracted from a plant on reduction of both tongue coating and VSCs H. Miyazaki, K. Nohno, T. Yamaga N. Kaneko Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Japan Objectives: Tongue coating (TC) is one of the major sources of oral malodor. Therefore, it is clear that tongue cleaning is clinically highest priority to reduce oral malodor. The purpose of this study was to determine the reduction of TC and malodorous gases, and change of periodontopathic bacteria by cysteine protease. Methods: Five male adults aged years were employed for this study. TC status, levels of volatile sulfur compounds (VSCs) and prevalence of anaerobic bacteria on tongue surface were assessed before and after taking cysteine protease tablets (2 g). After mechanical cleaning of tongue dorsum using tongue brush, 1) tongue surface was swabbed, 2) VSC concentrations in mouth air were measured by gas chromatography (GC) equipped with a flame photometric detector and 3) picture of tongue dorsum was taken to measure area covered with TC by the computer image analysis, and all measurements were used as a baseline data. Subjects immediately started to expose protease tablets on their tongue dorsum and spent approximately 10 minutes to consume completely. After that, experimental samples were collected by same procedure for baseline. Bacterial samples were sent to laboratory and real-time PCR was used to measure levels of total bacteria and periodontopathic bacteria, including P. intermedia (Pi), P. gingivalis (Pg), B. forsythus (Bf), T. denticola (Td) and F. nucleatum (Fn). Results: Average percent of tongue dorsum area covered with TC was reduced from 71% to 48% after taking cysteine protease. VSC concentrations were also reduced from 11.3 ng/10 ml (H 2 S) and 3.3 ng/10 ml (CH 3 SH) to the values under detectable levels by GC. Mean total bacterial counts showed 9.8 (log CFU/ ml) before taking protease and 9.1 after taking protease. Mean count of each Pi, Pg, Bf, Td and Fn also decreased from 3.7, 2.0, 5.9, 2.2 and 6.6 to 2.9, 0.9, 5.4, 1.8 and 5.9, respectively. The ratio of Pi, Bf, and Td per total bacterial counts increased, while the ratio of Pg and Fn decreased by taking protease. Conclusions: The results may suggest that cysteine protease contributes to change qualitatively microbial flora of tongue surface in addition to reduction of both TC and VSCs. Key words: cysteine protease, tongue coating, real-time PCR, periodontopathic bacteria, VSCs Dr. Hideo Miyazaki: Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Gakkocho-Dori, Niigata, , Japan

17 O-03 Effects of Deodorization of Dentures Using Ozone Cleaning Evaluation by Organoleptic Scores H.Murakami, D.Kato, I Ikedo, K.Takeuchi, H.Hattori Department of Prosthodontics, School of Dentistry, Aichi-Gakuin University, Japan Objective: Problems can occur with the use of the various denture cleaners that are sold for the sterilization and deodorization of dentures. Some of these cleaners may be swallowed by mistake. Which can be said to be a form of misuse. Also, the smell of deodorant may linger in the dentures. Additionally, small amounts may remain in the dentures and be subsequently gradually absorbed into the body. Even when it is absorbed, the deodorant will have turned to harmless water by the time it reaches the stomach and there are consequently no side effects. A type of ozone with strong deodorization power was used for deodorization of the denture. Materials and Methods: A total of ten subjects ( five men and five women ), with fifteen dentures took part in this experiment. An organoleptic score was performed three times to test the odor of the denture. First, before it was washed with ozone, and then at five and ten minutes after washing. Results: Except for one person judged strongly smelling in the inspection before the ozone washing, the deodorization results of all the subjects were odorless after a five minute ozone wash, and one subject judged strongly smelling also became odorless in after a ten minute ozone wash. Conclusion: These results show that ozone is very effective for the deodorization of dentures when used for ten minutes. Key words: deodorization, denture odor, ozone, denture cleaner, organoleptic score Dr. Hiroshi Murakami: Department of Prosthodontics, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi Prif , Japan

18 O-04 Methyl Mercaptan Generating from Tongue Coating Is a Predictor of Mortality from Pneumonia in Octogenarians S. Awano, T. Ansai, I. Soh, A. Yoshida, T. Hamasaki and T. Takehara. Division of Community Oral Health Science, Kyushu Dental College, Japan Objective: The aim of this study is to evaluate the relationship between anaerobic bacteria generating methyl mercaptan (CH 3 SH) in tongue coating and mortality from pneumonia in elderly subjects. Methods: Participating in this study were 697 people (277 males, 420 females) residing in part of Fukuoka Prefecture, Japan. All participants were 80 years old. Data on oral and systemic health status were obtained in Four years later, follow-up investigations to all of the participants in our previous study were performed in As for subjects who died, we recorded the date and cause of death according to resident registration cards and official death certificates, which were available in the registers at the Public Health Centres of each district included in the study. Results: In the 4-year period from March 1998 to March 2002, 108 subjects (58 males, 50 females) died. 22 subjects died of pneumonia and 86 subjects died of other causes such as cancer and cardiovascular diseases. The survival analyses of mortality from pneumonia were evaluated using the Cox regression multivariate model. The subjects who generated CH 3 SH of more than 10 ng/ml from tongue coating were associated with a higher risk of mortality compared to those who did not generate it. Moreover, the increase of periodontal pockets more than 4 mm and Candida species more than 100 CFU on lingual surface also significantly predicted mortality from pneumonia. Conclusion: This study suggested that the high level production of CH 3 SH from tongue coating was a predictor of mortality from pneumonia, and that anaerobic bacteria generating CH 3 SH in the mouth might be associated with pathogenesis and progression of pneumonia. Key words: pneumonia, methyl mercaptan, anaerobic bacteria, mortality, the COX regression model Dr. Shuji Awano: Division of Community Oral Health Science, Kyushu Dental College, Manazuru, Kokurakita-ku, Kitakyushu, JAPAN.

19 O-05 Hydorogen Sulfide Inhibited Cell Proliferation of Osteoblasts T. Imai, T. Kamoda, T. Murata K. Yaegaki Department of Oral Health, School of Life Dentistry at Tokyo, Nippon Dental University, Japan Objectives: Oral malodorous compounds, hydrogen sulfide (H 2 S) or methyl mercaptan, were periodontal pathogenic. The aim of the study was to investigate the effect of H 2 S on cell proliferation of osteoblastic cells and on the mitogen-activated protein kinase in a signaling transduction pathway. Methods: The normal human osteoblasts (NHOst) (Cambrex) were cultured in Osteoblast growth medium supplemented with 10% fetal bovine serum in 5% CO 2 at 37. However the growth factors were removed from the medium during experiment, then the cells were cultured in the presence of H 2 S gas. Cell proliferation was measured by [ 3 H]thymidine incorporation in the 5% TCA insoluble fraction. The phosphorylation of Erk1/2 was determined with Western blot analysis. Results: After treatment of the NHOst cells with H 2 S for 24 hours, [ 3 H]thymidine incorporation into the DNA is decreased significantly and H 2 S dose-dependently. At a concentration of 100 ng/ml H 2 S, [ 3 H]thymidine incorporation decreased 79% compared to the controls. But no morphologic changes of the cells were observed after treatment with H 2 S. To investigate the effect of H 2 S on signal transduction pathways for controlling cell proliferation, we determined the Erk1/2 phosphorylation in the cells. The phosphorylation of Erk1/2 is increased by H 2 S, dose-dependently. The phosphorylation was started at not longer than 10 min after starting H 2 S incubation. Then, the phosphorylation slightly decreased. Conclusion: These results demonstrate that H 2 S inhibits cell proliferation of human osteoblastic cells by the activating Erk1/2. This work was supported by grants-in aid scientific research of JSPS ( ). Key words: hydorogen sulfide, osteoblasts, proliferation Dr. Toshio Imai: Department of Oral Health, School of Life Dentistry at Tokyo, Nippon Dental University, Fujimi, Chiyoda-ku, Tokyo, Japan

20 O-06 Development of Artificial Mouth System for Screening of Volatile Sulfur Compounds T. Kamoda, T Murata, K, Yaegaki Department of Oral Health, School of Life Dentistry at Tokyo, Nippon Dental University, Japan Objective: The aim of this study is to evaluate the reliability or feasibility of an artificial mouth system (AMS) for screening the products treating halitosis in vitro. Methods: The AMS consisted of artificial mouth, anaerobic chamber and peristaltic pump. The artificial mouth was made from transparent vinyl chloride tube (7.6 cm diameter tube), and was placed in an anaerobic chamber (Ruskinn Technology) to maintain the anaerobic condition and the temperature at 37. The artificial mouth was air tightly sealed. Four cover glasses were seated on a holder made with Teflon. The holder was positioned at the center of the artificial mouth. Cover glasses were coated by Human collagen type1. When we simulate the tongue dorsum surface, a epoxy resin replica of human tongue is utilized instead of cover glasses. Four stainless steel tubes (1.0 mm OD) were inserted into the artificial moth through the upper chamber, then sealed with epoxy resin. Via these tubes, brain heart infusion broth (BHI: Difco Laboratories) supplemented with hemin and menadione, and bacterial cell suspension were supplied with a peristaltic pump. If we evaluate the liquid products, the test solution was also supplied through one of these tubes,. Porphyromonas gingivalis ATCC (P. gingivalis) was used for the initial study. P. gingivalis was cultured in anaerobic condition. Bacterial cells were collected by centrifugation, and washed once with phosphate-buffered saline (PBS). The cell suspensions of bacteria in PBS solutions were adjusted to an optical density 1.0 at 550 nm. After biofilm was produced, the evaluation of the products was started. Gas chromatography (Shimadzu GC8A, Japan) was used to determine the concentrations of Volatile Sulfur Compounds (VSC) in artificial mouths. Results: VSC in artificial mouths were detected at five minutes after starting supply P. gingivalis cell suspension and others. Significant concentrations of VSC in artificial mouths increased with time. This result showed that enough amount of VSC was produced in artificial mouth to evaluate the efficacy of the products for reducing VSC. Conclusion: This study suggested that AMS introduced in this paper may be very efficient for in vitro screening of the products to reduce volatile sulfur compounds in mouth air. Key words: artificial mouth system, volatile sulfur compounds, Porphyromonas gingivalis Dr. Takeshi Kamoda Department of Oral Health, School of Life Dentistry at Tokyo, Nippon Dental University, Fujimi, Chiyoda-ku, Tokyo, Japan

21 O-07 Addiction to Cigarette Smoking Due to Suffering from Halitosis and the Cessation Following Halitosis Treatment. A Case Report A. Talebian, R. Iranpoor, H. Talebian Khoshboo Breath Odor Association, Iran Aim: In this paper a case of addiction to cigarette smoking due to suffering from halitosis is presented accompanied with its diagnostic and treatment approach. Method: The patient history was taken through a comprehensive questionnaire. In order to determine the origin of the halitosis, it was measured by a portable GC (OralChroma) and organoleptic method. The concentrations of H 2 S, CH 3 SH, and (CH 3 ) 2 S were measured by the instrument and the odor of 7 sites in the oral cavity was measured organolepticly. To confirm the diagnosis "mouthwash test" was performed. The patient was asked to rinse with 5 ml of a zinc-containing commercial mouthwash for 1 minute. Organoleptic and chromatographic analyses were performed after 60 minutes. Results: As all measurements after 60 minuets showed a reduction, it was confirmed that the patient suffered from physiologic plus extraoral pathologic halitosis with a psychological condition. it was confirmed that the patient suffered from physiologic plus extraoral pathologic halitosis with a psychological condition. To get rid of extraoral halitosis he was asked to cease smoking; and to reduce physiologic halitosis, he was instructed to clean the posterior and anterior surface of the tongue with a commercial tongue scraper followed by brushing with an extra soft toothbrush twice a day and to rinse with a zinc-containing commercial mouthwash two times a day. One month later in the follow-up visit the treatment was proved successful. Conclusion: There are a lot of drives toward becoming addicted to cigarette smoking and suffering from halitosis must be considered as a potential one. As there is not a documented statistics about the effect of halitosis on rising cigarette smokers number, particular studies are needed to investigate the subject precisely. Key words: halitosis, cigarette smoking, portable GC, organoleptic method, mouthwash Dr. Alireza Talebian: Khoshboo Breath Odor Association, 19 Baharestan Lane, Serahe Simin, Esfahan, Iran, post box No

22 O-08 Paroxetine and Suicidal Preoccupation in a Patient of Halitophobia A. Toyofuku Department of Dentistry and Oral Surgery, School of Medicine, Fukuoka University, Japan Objectives: We had reported the efficacy of Selective Serotonin Reuptake Inhibitors (SSRIs) for halitophobia. But some cases had experienced SSRI induced side effects like suicidal attempts. To ring an alarm for less attention for halitophobia and easy administration of SSRIs for these patients, we report a case of halitophobia with paroxetine associated suicidal attempts. Materials and methods: A 25 year-old female with halitophobia is shown as a case of a possible link between paroxetine and suicidal preoccupation. She had once recovered from halitophobia with fluvoxamine and supported herself for several years. But a recurrence needed her for a help of psychiatrist two years ago. After administration of paroxetine, feeling abnormal and suicidal preoccupation attacked her several times, and she got worse every time of dose-up of it. She had repeated suicidal attempts for 4 times in a year. Results: She had taken to our clinic by her mother. After washing out psychotropic agents, we had administrated fluvoxamine and loflazepate ethyl for her, and got good clinical course. After 2 months, she has become able to support herself again. Conclusion: A possible link between paroxetine and suicidal preoccupation is suggested in this case. Not all psychiatrists have enough knowledge for halitophobia, and they often misdiagnosed halitophobic patients as depression or obsessive compulsive disorders. We supposed the difference of effects for CYP450 (especially for CYP2D6) of each SSRIs played important role for these adverse effects. Use of SSRIs, especially paroxetine, for halitophobia needs some attentions for these phenomenons. Key words; halitophobia, suicidal preoccupation, SSRI, paroxetine, fluvoxamine Dr. Akira Toyofuku: Department of Dentistry and Oral Surgery, School of Medicine, Fukuoka University, Nanakuma, Johnan-ku, Fukuoka, , Japan

23 O-09 Relationship Between Tongue Plaque, Subgingival Plaque of Periodontopathic Bacteria and Breath Odor T. Yasukawa, M. Ohmori, S. Sato Department of Periodontology, The Nippon Dental University School of Life Dentistry at Niigata, Japan Objectives: The objective of this study considers the influence oral status affects of breath odor, and it is considering the relation in periodontally healthy subjects between breath odor and periodontopathic bacteria of tongue plaque, subgingival plaque. Materials and Methods: The subjects were 62 adults of periodontally healthy subjects. Clinical tests item were examined organoleptic scores, tests of cleaning status in oral [PCR, PlI], periodontal tissue tests [4mmPD, BOP, GI], tongue coat status, and gas chromatography [total VSC, H 2 S, CH 3 SH, and, (CH 3 ) 2 S ] Halimeter, and Breathtron. The bacterial tests detected five periodontopathic bacterias [P. gingivalis(p.g), T. forsythensis(t.f), T. denticola(t.d), A. actinomycetemcomitans(a.a), P. intermedia(p.i)] from the tongue plaque sample and the plaque sample using the PCR method. Results and Conclusion: The Spearman s rank correlation was used for correlation between an organoleptic scores and other clinical tests item. Significant correlation was observed in PCR, PlI, tongue coat status, gas chromatography, Halimeter, and Breathtron. Therefore, it seems that the factor of breath odor in periodontally healthy subjects originates deposit of tongue plaque in many cases. Moreover, the Mann-Whitney s U test was used between organoleptic scores and existence of five periodontopathic bacteria in tongue plaque, plaque. With the bacteria in tongue plaque, the significant difference was observed between existence of T.f and Halimeter. Furthermore, the significant difference was observed between existence of T.d and organoleptic scores, tongue coat status, total VSC, H 2 S, CH 3 SH, Halimeter, and Breathtron. With the bacteria in plaque, the significant difference was solely observed between existence of P.i and tongue coat status. Accordingly, a possibility that existence of T.d in tongue plaque would reinforce breath odor was suggested. However, the significant difference was not shown between existence of the periodontopathic bacteria in plaque, and breath odor. Therefore, it is that a possibility that existence of periodontopathic bacteria will reinforce breath odor is low. Key words: breath odor, tongue plaque, periodontopathic bacteria, organoleptic scores, gas chromatography Dr. Toshiyuki Yasukawa: Department of Periodontology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura, Niigata Japan

24 O-10 Study of Clinical and Bacterial Parameters Related to Oral Malodor N. Suzuki, M. Yoneda, T. Naito, T. Hirofuji Section of General Dentistry, Department of General Dentistry, Fukuoka Dental College, Japan Objectives: The aim of this study is to evaluate the diagnostic methods for oral malodor and to assess the relationship between halitosis and clinical and bacterial factors. Materials and Methods: The study population consisted of 139 subjects (52 males and 87 females) aged years with mean age 47.3 ± 14.6 years presenting to the Oral Malodor Clinic of Fukuoka Dental College Medical and Dental Hospital. The severity of oral malodor in each individual was assessed using organoleptic test (OLT), MS-Halimeter E (Morita) and gas chromatography (GC14B; Shimadzu Works). Assessment of oral health included tongue coating, plaque index, periodontal pocket depth, decayed, missing and filled teeth, stimulated salivary flow rate, tooth mobility, and occult blood test in saliva. The prevalence of periodontal bacteria including Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium spp. and Prevotella spp. in saliva was determined by using PCR. Quantitative analysis for these bacteria using Invader assay was performed by the manufacturer s services (BML Inc.). Results and Conclusions: OLT score showed relatively better correlation with the levels of log-transformed volatile sulfur compounds (VSCs) by halimeter (r=0.675, p=0.000), H 2 S (r=0.721, p=0.000) and CH 3 SH (r=0.698, p=0.000). Step-wise linear regression analysis revealed that OLT was well explained with H 2 S and CH 3 SH, showing contribution factor of Other sixty percent of gas compound was still unknown. Tongue coating and periodontal parameters were consistently showed linear correlation with any oral malodor test. Caries and ill-fitted margin showed little influence on the presence of oral malodor. H 2 S gas was significantly correlated with log-transformed numbers of T. forsythia and Prevotella spp. CH 3 SH gas showed significant correlation with the numbers of Prevotella spp., but did no show any relation with T. forsythia. This indicates that some types of sulfide gas are predominantly produced by specific bacterial species. Key words: oral malodor, diagnosis, volatile sulfur compound (VSC), clinical parameter, bacterial parameter Dr. Nao Suzuki: Section of General Dentistry, Department of General Dentistry, Fukuoka Dental College, Tamura, Sawara-ku, Fukuoka, , Japan

25 O-11 Evaluation of Periodontopathic Microorganisms in Subgingival Plaque by Mouth Air Analyses T. Arai 1), 2), S. Imai 2), N. Hanada 2), K. Yaegaki 3), K. Kamoi 2), 4), Y. Numabe 5) 1) Division of General Dentistry, Nippon Dental University Hospital at Tokyo, Japan, 2) National Institute of Public Health, Japan, 3) Department of Oral Health, 5) Department of Periodontology, 3), 5) School of Life Dentistry at Tokyo, 3), 4), 5) Nippon Dental University, Japan, Objectives: Volatile sulfur compounds (VSCs) are produced by various periodontal pathogenic microorganisms. P gingivalis is one of very active microorganism for producing VSCs. The purpose of this study is to clarify the relationships among mouth air, clinical score, and number of periodontal pathogenic microorganisms in subgingival plaque. Methods: Thirty subjects (mean age, 30.4 ± 8.6years; 16 females) who visited the General Dentistry, Nippon Dental University Hospital at Tokyo were recruited. Clinical examinations including probing pocket depth, gingival index, bleeding on probing, organoleptic score, clinical attachment level and tongue coating score were examined. A gas chromatography equipped with a flame photometric detector (GC-17A, SHIMADZU, Japan) and E-nose (FF-1, SHIMADZU) were used to measure malodorous compounds in mouth air. The numbers of P. gingivalis, A. actinomycetemcomitans, P. intermedia, T. forsythensis, and T. denticola in subgingival plaque were determined by real-time PCR. Exclusion criteria included: smokers; subjects suffering from systemic disease; taking antibiotics within the last 3 months; denture wearers. Results: Methyl mercaptan/hydrogen sulfide (M/H) ratio and the total mode by E-nose correlate significantly with total number of 5 periodontal pathogenic microorganisms in subgingival plaque (R 2 =0.339;p<0.001 and R 2 =0.435:p<0.004, respectively). Multiple linear regression analyses also showed that the total numbers of the microorganisms in subgingival plaque were affected by M/H ratio and by the total mode of E-nose (R 2 =0.779 p<0.001). The regression formula was also obtained among the total number of the microorganisms, M/H ratio and E-nose readings. Conclusions: Our data suggest that analysis of mouth air will predict total number of main periodontal pathogenic microorganisms in subgingival plaque. Key words: mouth air, clinical assessment, periodontal pathogenic microorganisms, electronic nose, malodor Dr. Takako Arai: Division of General Dentistry, Nippon Dental University Hospital at Tokyo, Fujimi, Chiyoda-ku, Tokyo, Japan

26 Organizing Committee Ken Yaegaki, Chair Nippon Dental University, Japan Hideo Miyazakai Niigata University, Japan Tsutomu Sato Nippon Dental University, Japan Toshio Imai Nippon Dental University, Japan Takatoshi Murata Nippon Dental University, Japan Conference Staff (Nippon Dental University, Dept of Oral Health) Dr. Atsuko Gotoh Dr. Mayumi Herai Dr. Takeshi Kamoda Dr. Hatsuko Kamoi Ms. Kayoko Kitada Dr. Haruko Suzuki Dr. Tomoko Tanaka

27 ASBOR Nippon Dental University, Department of Oral Health Fujimi, Chiyoda-ku, Tokyo, Japan TEL: FAX: