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Also the number of professional publications was very high in notable events in Outstanding contributions for the year are publications in high ranking biomedical journals i.

In addition to the output indicators given, the percentage of papers in high impact journals in the field gives valuable information.

ACTA published in total scientific papers in refereed journals, of which in journals with an impact factor SCI journals.

This means that a relatively large number of publications were published in the top journals in the field. On a personal level a considerable number of ACTA employees rank in the top of the dental and biomedical research community, as determined by the various indicators of esteem. In a total of 18 awards were received by ACTA scientists for their achievements.

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In the evaluation report of research at ACTA, these groups received ratings between 4 and 5 on a 5 point scale.

Societal impact impact on teaching and dental care The prime societal values of a strong research program in a dental discipline are the effect on teaching and on dental care. The research improves the quality of teaching given at ACTA, both for undergraduate students, graduate students, students participating in the post initial specialist courses, and for PhD students.

New findings and concepts are included in the curriculum at ACTA, but are also presented to dental practitioners at frequently held education activities, e. Research on different main areas of interest contributes to improved prevention, diagnosis and treatment of relevant patient groups. Furthermore, the societal impact is evident from the organisation of symposia and conferences in the Netherlands and abroad, presentations for dentists, medical specialists and patient groups, memberships of advisory councils, and frequent contacts with the industry.

In addition many scientists are also practising as dentists in specialized clinics at ACTA or in the Amsterdam region. Obviously the societal impact of their activities, individually as clinically active professionals and leading among their peers, should be acknowledged. This is also evident from the relatively large number of professional publications. Some ACTA researchers also wrote popularising publications aimed at a more general audience. Several research findings were highlightened in the general press.

A total of , lectures were given as invited speaker at international congresses and symposia. In addition a large number of presentations were given at international congresses after selection on submission of abstracts and during congresses and symposia for a Dutch or international audience.

Due to this large number, congress abstracts are not listed in this annual report. A total of 11 international meetings were organised by members of the different departments of ACTA. Management finances The overall budget of the research institute is divided into a part controlled directly by the directorate and another part that is allocated to the departments. The institute budget senso stricto of k is used for the management of the institute, the salaries of the PhD students and post doctoral employees, for travel allowances for these groups, for the organization of courses and for the annual two day IOT research meeting.

The research budgets for the departments in total being k are distributed based on a model containing several parameters, such as external peer review, bibliometric data over the last 5 years, education, PhD theses and external funding. In addition, standard bench fees are issued for the various categories of researchers staff, post docs, PhD students, technicians and other supporting OBP staff.

In addition to the university budget 1 st source ACTA scientists were involved in many research projects with external funding. The total amount of research grants 2 nd source was k , and the total amount of research contracts 3 rd source was k personnel The directorate of the institute comprises: prof. Everts, director of research dr. Meijer, secretary 0. A mean number of 9 new PhD students were appointed per year.

Despite budget restrictions 8 new PhD students could be appointed in The majority of PhD students have a dental background see Table 5. The research institute has started a procedure for allocation new PhD positions for the two main research themes. In five grants were awarded to the research themes; three of these in an open competition, and two personnel grants for talented PhD students. One talented post doc was appointed. Both the open competition and the grants for talented students or post docs will be continued in the coming years.

Figure 1. Furthermore, we planned a course in grant writing. Therefore, most PhD students follow external courses on specific research areas, given by experienced lecturers of research schools in other disciplines. PhD thesis duration and completion rate Attention has been paid to the problems related to the social security benefits of PhD students and the time that PhD students need to finish their thesis.

The mean time of 4. In addition, the mean duration of preparing a thesis shows a declining tendency over the years Figure 2. The external review committee noted in that they were impressed by the organisation and practice of PhD training and supervision at ACTA. They concluded that it is a well organised programme, with a remarkably high dissertation rate.

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Mean duration of completing the thesis of ACTA PhD students related to the year of entry 5,5 5 years 4,5 4 3,5 3 year of entry Figure 3. This was the result of the merging of the dental schools in the mid s. Now we are in a situation where heads of departments and senior scientists are retiring. Due to budget restrictions the number of persons involved in research had to be reduced slightly. Optimal research facilities at the new ACTA building are available to encourage collaboration between the research groups that require laboratory facilities.

The increased number of scientists at one location will also facilitate to jointly take initiatives, such as in molecular aspects of dental research. The research at ACTA has always been characterized by a wide range of different topics that covered most dental disciplines.

The policy for the nearby future is to focus more on the two specific research areas with an excellent performance. Larger research groups with a good potential will focus on biofilms and oral infections including groups such as Cariology, Periodontology, Oral Biochemistry and Preventive Dentistry , and on bioengineering and reconstruction of bone and teeth including groups such as Oral Cell Biology, Oral Kinesiology, Oral Implantology, Periodontology, Dental Material Sciences and Functional Anatomy.

In coming years the research budget from the 1 st source University budget might be seriously diminished due to budget restrictions. It will be a big challenge to compete for 2 nd and 3 rd source grants and to maintain or improve the high output that ACTA has produced in the past. Conclusion The analysis of the various parameters of performance shows that the research at ACTA is, despite of budget restrictions, increasingly improving state.

Future performance will be dependent among others from the success in obtaining 2 nd and 3 rd source grants. Impact factor sum of ACTA publications, total scientific publications in refereed journals and total scientific personnel in fte IF sum ref publ total fte 12 Annual Research Report Table 2.

Also the personnel involved in full time equivalent fte and the impact factor sum IF sum are included in this table. The IF sum was calculated for each program by adding together the impact factor values of all publications.

Crielaard C. Wesselink Research objectives The research program of the Departments of Preventive Dentistry, Cariology, Endodontology and Pedodontology covers physico chemical, biochemical, microbiological and clinical aspects of enamel, dentin and root caries and infection of the root canal.

These aspects are studied by means of various intra oral and in vitro models which simulate the natural processes in the oral environment and which are designed to evaluate the effects of preventive measures and restorative materials and procedures, thereby covering the field of research from the molecular level up to in situ studies. The formation, structure and properties of biofilms on hard tissue surfaces are studied extensively.

Fluoride that, at present, is still the most effective caries preventive agent is subject for further study. A better understanding of its mode of action, also on the molecular level towards microbial metabolism, as well as its possible side effects fluorosis and the induction of a fluoride resistant oral microflora will help to improve formulations and the development of fluoride releasing devices and restorative materials.

In addition to fluoride, antimicrobials have come into focus as caries preventive agents. The efficacy alone or in combination with fluoride is still unknown and application protocols are not yet based on a critical evaluation of experimental and clinical results. The successes of antimicrobials in caries prevention are still limited.

The prevention of bacterial penetration in the root dentinal tubules and the root canal by a proper seal of the restoration is of major importance for the life expectance of teeth.

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Modified disinfection methods of the root canal are studied. New filling methods and contemporary adhesive systems are tested in in vitro leakage models and in clinical studies. Better treatment concepts preventive as well as conservative and in relation to behaviour management of dental caries in children are studied.

Treatment concepts like ART Atraumatic Restorative Treatment , the influence of total rehabilitation of the children s dentition on general and oral health, consequences of restorative treatment on the child s coping and anxiety are under investigation. Several research lines were followed to obtain such an insight. The antimicrobial resistance of microorganisms in biofilms and the polymicrobial interactions in these biofilms that modulate resistance require novel strategies to evaluate the efficacy of caries preventive compounds.

We developed a novel high throughput active attachment model to evaluate the effects of amine fluoride AmF on Streptococcus mutans and polymicrobial biofilms.

The effect of AmF on the viability of the polymicrobial biofilms was significantly less than that on the S. However, in dose response experiments AmF reduced lactate production in both types of biofilms to the same extent. Thus, when evaluating the efficacy of cariespreventive compounds it is essential to use appropriate polymicrobial biofilm models, and to judge on the reduction of acid formation i.

We investigated the effects of the probiotic bacterium Lactobacillus rhamnosus GG LGG on the cariogenic potential and microbial composition of saliva derived microcosms. LGG inhibited the growth of S. This suggests that other microorganisms besides S. There was a statistically significant increase in structurally bound fluoride in dentine, but not in enamel, when comparing the fluoride mouthrinse group with the placebo rinse group.

Thus, for dentine a third fluoride moment may be beneficial in enhancing remineralisation. Because dentin is more caries susceptible than enamel, its demineralization may be more influenced by additional fluoride F. We hypothesized that a combination of professional F, applied as acidulated phosphate F APF , and use of ppm F dentifrice would provide additional protection for dentin compared with ppm F alone.

APF and FD increased F concentration in biofilm fluid and reduced root dentin demineralization, presenting an additive protective effect. Orthodontic treatment with fixed appliances is considered a risk factor for the development of white spot caries lesions WSL.

We tested the hypothesis that lingual brackets result in a lower caries incidence than buccal brackets. The number of WSL that developed or progressed on buccal surfaces was 4. When measured using quantitative light induced fluorescence QLF , the increase in integrated fluorescence loss was Fifty four orthodontic patients, with multiple white spot lesions observed upon the removal of fixed appliances, used CPP ACFP paste or control paste and were followed up for 3 months.

A retrospective study was performed in sixty six uncooperative children 4 18 years old with at least one tooth with clinically diagnosed deep caries who underwent by indirect pulp treatment. A 3 year survival analysis Kaplan Meier of treated teeth was performed.

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Dental decay and dental treatment are suggested to be related to body growth in children. We recorded caries prevalence and presence of dentogenic infections in three hundred eighty 6 year old Surinam children with untreated dental decay, assigned to four different treatment groups.

We observed negative correlations between anthropometric measures and the number of untreated carious surfaces and caries experience of the children. No significant differences in growth pattern between the treatment groups were observed. It is suggested that caries activity is a negative predictor for body growth in children and dental intervention does not show significant improvement within 3 years. Porphyromonas gingivalis is an oral pathogen strongly associated with destruction of the tooth supporting tissues in human periodontitis.

We aimed to investigate the effects of viable P. Viable P. Between individual donors there was large heterogeneity in responsiveness to P. Capsular polysaccharide CPS of P. Seven capsular serotypes have been described. We used micro array based comparative genomic hybridization analysis CGH to analyze a representative of each of the capsular serotypes and a non encapsulated strain against the highly virulent and sequenced W83 strain.

A conserved core P.

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Among aberrant genes between the test strains and control strain many CPS biosynthesis genes were found. To examine the role of the CPS in host pathogen interactions we constructed an insertional isogenic P. This mutant was non encapsulated. The epsc mutant induced significantly stronger inflammatory responses in gingival fibroblasts than the wildtype, whereas the complemented mutant was similar to the wild type.

This provides the first evidence that P. Through a literature review, we aimed to elucidate the feasibility of achieving protection against periodontitis though immunization against P. Also Tannerella forsythia is strongly associated with periodontal disease.

We investigated the prevalence of Porphyromonas gulae, P. Genotyping of T. The periodontal pathogen Aggregatibacter actinomycetemcomitans comprises six serotypes a f , and is often identified by its 16S rrna gene. Using 16S rrna gene sequence analysis we revealed an aberrant cluster of 19 strains within serotype e, denoted as serotype e', with gene sequence similarities between serotype e' strains from Overall, the data obtained in this study suggest that the serotype e' strains form an evolutionary relatively stable distinct subgroup within A.

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Host susceptibility is an important determinant in the development of periodontitis. We conducted a review of the literature for gene polymorphisms associated with chronic periodontitis CP susceptibility.

Candidate gene polymorphism studies with a case control design and reported genotype frequencies in CP patients were searched and reviewed, showing that growing evidence exists that polymorphisms in the IL1, IL6, IL10, vitamin D receptor, and CD14 genes may be associated with CP in certain populations.

Larger cohorts, well defined phenotypes, control for other risk factors, and analysis of multiple genes and polymorphisms are needed to get a more comprehensive insight into the contribution of gene polymorphisms in CP.

The presence of periodontal pathogens may influence failure of dental implants after osseointegration. We assessed the prevalence of seven periodontal marker pathogens, before implant placement and 1 yr after loading, and the effect of pre implant reduction of pathogens. In 93 individuals needing single tooth replacement the prevalence of periodontal pathogens was determined before implant treatment and 1 yr after loading, and threshold levels commonly used in Periodontology were applied.

Periodontal treatment reduced pathogen levels to below threshold values in Thus, Long term effectiveness of pre implant reduction of the selected marker pathogens appeared limited in our patient population. Child dental anxiety and dental behavioural management problems may be related to general emotional and behavioural problems. Children aged 4 and 5 years who had sleeping problems, attention problems and aggressive behaviour, displayed more disruptive behaviour during dental treatment.

Parental attitudes likely play a role in achieving and maintaining oral health in children. To be useful in individually delivered caries prevention programmes, parental attitudes should be identified at individual level. We used Q methodology to identify 39 parents of 6 year old children s prevailing attitudes towards the oral health of their children. Based on their beliefs, attitudes and cognitions, five categories of parents were found: i conscious and responsible, ii trivializing and fatalistic, iii appearance driven and openminded, iv knowledgeable but defensive and v conscious and concerned.

Q methodology appears to be a fruitful way to structure the complexity of parents' opinions and attitudes towards their children's dental health. The application of cone beam computed tomography CBCT continued to play an important role in our endodontic research this year. In a clinical study in cooperation with the Peking University in Beijing periapical radiography PR was compared with the CBCT in diagnosing apical periodontitis meanwhile correlating predicting co factors with a negative treatment outcome.

Density of root fillings and quality of coronal restoration appeared as predictors, which were identified with CBCT scans. The ability of CBCT to image root perforations in lower molars was investigated and found to be significantly better than conventional radiographs taken from 2 angles.

However CBCT has limitations in detecting strip perforations in curved mesial canals. In a clinical study the outcome of endodontic retreatment was evaluated and the CBCT showed more periapical lesions than conventional radiographs. Also clinically the sensitivity, specificity and accuracy of CBCT in detecting vertical root fractures was assessed. The overall accuracy of the CBCT was higher than that of periapical radiographs.

Continuing the use the dentinal defects model, it appeared that the more procedures performed, the more chance for dentinal damage: cleaning and shaping causes some damage, filling the root canals adds to the damage and retreatment procedures significantly increase the risk for vertical root fractures. In the irrigation studies, higher ultrasonic intensity is related to a higher oscillation amplitude of the file and resulted in a better cleaning efficacy of Passive Ultrasonic Irrigation PUI.

Using a tapered gutta percha cone to activate the irrigant in the root canal could enhance the efficiency of the Manual Dynamic Irrigation Technique that was more effective in removing dentin debris than the EndoVac system. Computational Fluid Dynamics is a good method to evaluate the irrigant flow in the root canal and the apical root canal needs a certain dimension for a good irrigant replacement correlated to the diameter of the needle used for syringe irrigation.

Diffusion is more successful than convection in irrigant replacement in the tubules. Activation of NaOCl is a strong modulator of its reaction rate; the consumption of available chlorine increased significantly during the rest phase after activation. Just as during the last year this year's results concentrate on the management of child dental patients, not only their treatment approach but also the method dental caries should be looked at, its treatment and the consequences for a child s quality of life.

Several articles have been produced on the subject giving way to the understanding that full treatment includes the awareness of the caries process. Dental treatment in children has a positive influence on the quality of life but treatment in general anaesthesia has no influence on development or reduction of dental anxiety.

This year a thesis on this subject has been finalized. The clinical trials of the section focused this year on the child related aspects of dental treatment. Published articles and clinical trials reported on the quality of care of paediatric dentists, and dental anxiety. Three PhD theses are in process focusing on dental materials, hypomineralisation defects as an alternative caries diagnosis for caries and child dental anxiety in relation to parent's behaviour.

All studies in paediatric dentistry focus on the child as a dental patient enabling a situation in which care can be tailor made for the child dental patient. Child dental fear and quality of life.

UvA Universiteit van Amsterdam pag. Hoogstraten, prof. Scientific publications refereed Adeyemi, A. The evaluation of a novel method comparing quantitative light induced fluorescence QLF with spectrophotometry to assess staining and bleaching of teeth. Clinical Oral Investigations, 14 1 , Beerens, M. Effects of casein phosphopeptide amorphous calcium fluoride phosphate paste on white spot lesions and dental plaque after orthodontic treatment: a 3 month follow up.

Association of serum immunoglobulin G IgG levels against two periodontal pathogens and prothrombotic state: a clinical pilot study. Comparison of periodontal pathogens between cats and their owners. Veterinary Microbiology, 1 2 , Borden, W. Percentages of gutta percha filled canal area observed after increased apical enlargement.

Journal of Endodontics, 36 9 , Boutsioukis, C. Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. Journal of Endodontics, 36, Boutsioukis, C. Irrigant flow in the root canal: experimental validation of an unsteady computational fluid dynamics model using high speed imaging. International Endodontic Journal, 43 5 , Boutsioukis, C. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computational Fluid Dynamics model.

International Endodontic Journal, 43, Boutsioukis, C. The effect of needle insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. The effect of root canal taper on the irrigant flow: evaluation using an unsteady Computational Fluid Dynamics model.

International Endodontic Journal, 43, Brunner, J. The capsule of Porphyromonas gingivalis reduces the immune response of human gingival fibroblasts.

BMC Microbiology, 10 5. Brunner, J. The core genome of the anaerobic oral pathogenic bacterium Porphyromonas gingivalis. BMC Microbiology, 10, Cheng, L. Effect of Galla chinensis on the in vitro remineralization of advanced enamel lesions. Factors increasing the caries risk of second primary molars in 5 year old Dutch children. Different response to amine fluoride by Streptococcus mutans and polymicrobial biofilms in a novel high throughput active attachment model.

Caries Research, 44 4 , Gruythuysen, R. Long term survival of indirect pulp treatment performed in primary and permanent teeth with clinically diagnosed deep carious lesions. Journal of Endodontics, 36 9 , Hassan, B. Comparison of five cone beam computed tomography systems for the detection of vertical root fractures. Journal of Endodontics, 36, Jiang, L. An evaluation of the effect of pulsed ultrasound on the cleaning efficacy of passive ultrasonic irrigation.

Evaluation of a sonic device designed to activate irrigant in the root canal. Influence of the oscillation direction of an ultrasonic file on the cleaning efficacy of passive ultrasonic irrigation.

Journal of Endodontics, 36, Jong, R. Feasibility and therapeutic strategies of vaccines against Porphyromonas gingivalis. Expert Review of Vaccines, 9 2 , Kranendonk, A.

Child dental fear and general emotional problems: a pilot study. In situ remineralisation of enamel and dentin after the use of an amine fluoride mouthrinse in addition to twice daily brushings with amine fluoride toothpaste. Caries Research, 44 3 , Laine, M. Gene polymorphisms in chronic periodontitis. International Journal of Dentistry, Macedo, R. Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and ph.

Microbiota around teeth and dental implants in periodontally healthy, partially edentulous patients: is pre implant microbiological testing relevant? The role of salivary histatin and the human cathelicidin LL 37 in wound healing and innate immunity.

Biological chemistry, 5 , Pham, L. Effects of Lactobacillus rhamnosus GG on saliva derived microcosms. Archives of Oral Biology, 56 2 , Raggio, D. Effect of insertion method on knoop hardness of high viscous glass ionomer cements. Brazilian Dental Journal, 21 5 , Reijden, W. Phylogenetic variation of Aggregatibacter actinomycetemcomitans serotype e reveals an aberrant distinct evolutionary stable lineage. Infection, Genetics and Evolution, 10 7 , Schaefer, A. Genes and Immunity, 11, Schaefer, A.

COX 2 is associated with periodontitis in Europeans. Journal of Dental Research, 89 4 , Scheres, N. Gingival and periodontal ligament fibroblasts differ in their inflammatory response to viable Porphyromonas gingivalis. A comparison of paediatric dentists' and general dental practitioners' care patterns in paediatric dental care.

Incidence of dentinal defects after root canal filling procedures. International Endodontic Journal, 43, Sluis, L. Journal of Endodontics, 36 4 , Splieth, C. Caries outcomes after orthodontic treatment with fixed appliances: do lingual brackets make a difference? Attitudes towards oral health among parents of 6 year old children at risk of developing caries. Transfer of manual dexterity skills acquired in the Simodont, a dental haptic trainer with a virtual environment, to reality.

A pilot study. Simodont, a haptic dental training simulator combined with courseware. Population molecular genetics of periodontitis.