About

Daniel Fine is a faculty member at Rutgers School of Dental Medicine, serving as Chair of the Department of Oral Biology. His research over the last 30 years has focused on uncovering the causes of localized aggressive periodontitis through biological, molecular, and clinical studies with the aim of developing preventive strategies. His team has concentrated on the bacterium Aggregatibacter actinomycetemcomitans (Aa), investigating its virulence factors, including leukotoxin and adhesion mechanisms, through molecular systems, gene mutation studies, and in vitro and primate models. He has conducted longitudinal observational studies on adolescents of African descent to assess disease progression and has explored the microbiota associated with Aa to understand its role in periodontal inflammation and bone destruction. Recently, his research has expanded to include diagnostic and therapeutic studies related to SARS-CoV-2, focusing on detection methods and salivary IgA levels in infected patients.

Research topics

• Medicine
• Biology
• Dentistry
• Ecology
• Internal medicine
• Immunology
• Chemistry
• Virology
• Pathology
• Microbiology
• Geography
• Genetics
• Paleontology
• Evolutionary biology
• Psychology
• Endocrinology
• Mathematics
• Chromatography
• History
• Geometry
• Ancient history
• Anesthesia

Selected publications

• Nonopioid vs opioid analgesics after impacted third-molar extractions

  The Journal of the American Dental Association · 2025-01-04 · 9 citations

  articleOpen access

  BACKGROUND: Opioids are still being prescribed to manage acute postsurgical pain. Unnecessary opioid prescriptions can lead to addiction and death, as unused tablets are easily diverted. METHODS: To determine whether combination nonopioid analgesics are at least as good as opioid analgesics, a multisite, double-blind, randomized, stratified, noninferiority comparative effectiveness trial was conducted, which examined patient-centered outcomes after impacted mandibular third-molar extraction surgery. Participants were randomized to receive 5 mg of hydrocodone with 300 mg of acetaminophen (opioid) or 400 mg of ibuprofen and 500 mg of acetaminophen (nonopioid). After an initial dose, analgesic was taken every 4 through 6 hours as needed for pain. RESULTS: In this randomized multisite clinical trial (n = 1,815 adults), those not taking opioids experienced significantly less pain (numeric rating scale ranging from 0 [no pain] through 10 [worst pain imaginable]) for first day and night (mean difference, -0.70; 95% CI, -0.94 to -0.45; P < .001) and second day and night (mean difference, -0.28; 95% CI, -0.52 to -0.04; P = .015), and experienced no more pain than participants taking opioids over the entire postoperative period (mean difference, -0.20; 98.75% CI, -0.45 to 0.05; P = .172). Participants not taking opioids had higher overall satisfaction at the postoperative visit (85.3% extremely satisfied or satisfied vs 78.9%; 95% CI, 1.21 to 1.98; P = .006). CONCLUSIONS: The ibuprofen and acetaminophen combination managed pain better for the first 2 days and led to greater satisfaction over the entire postoperative period than hydrocodone with acetaminophen. At no time did hydrocodone outperform the nonopioid. PRACTICAL IMPLICATIONS: Routine opioid prescribing after dental surgery is not supported. The results of this study confirmed the American Dental Association's recommendations that ibuprofen and acetaminophen in combination should be the first-line therapy for acute pain management. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT04452344.

  PublisherDOI

• Reduced staining from a chlorhexidine mouthwash: A randomized clinical trial.

  PubMed · 2024-08-01

  articleSenior author

  PURPOSE: To investigate the stain preventing ability of a new chlorhexidine mouthwash while maintaining efficacy using a randomized clinical trial design. METHODS: 98 subjects were enrolled and completed a 4-week clinical study that evaluated the effectiveness of the new mouthwash on plaque, gingivitis, and staining as compared to a commercially available chlorhexidine mouthwash. A subset of 62 subjects was evaluated for the effectiveness of the mouthwashes against plaque bacteria. RESULTS: After 4 weeks of use, the new chlorhexidine mouthwash reduced staining by 42.6% (P< 0.05) as compared to the commercially available mouthwash. The two mouthwashes were equivalent with regards to their effect on gingivitis, plaque, and plaque bacteria. CLINICAL SIGNIFICANCE: A new mouthwash, containing 0.12% chlorhexidine gluconate, has been developed that delivers stain reduction while maintaining equivalent efficacy to a commercially available chlorhexidine mouthwash with regards to gingivitis, plaque, and plaque bacteria. These findings should be considered by dental practitioners when making recommendations to patients whose teeth stain easily and need an anti-gingivitis and anti-plaque mouthwash.

  Publisher

• Molecular Analysis of Aggregatibacter actinomycetemcomitans ApiA, a Multi-Functional Protein

  Pathogens · 2024-11-18

  articleOpen accessSenior authorCorresponding

  Aggregatibacter actinomycetemcomitans ApiA is a trimeric autotransporter outer membrane protein (Omp) that participates in multiple functions, enabling A. actinomycetemcomitans to adapt to a variety of environments. The goal of this study is to identify regions in the apiA gene responsible for three of these functions: auto-aggregation, buccal epithelial cell binding, and complement resistance. Initially, apiA was expressed in Escherichia coli. Finally, wild-type A. actinomycetemcomitans and an apiA-deleted version were tested for their expression in the presence and absence of serum and genes related to stress adaptation, such as oxygen regulation, catalase activity, and Omp proteins. Sequential deletions in specific regions in the apiA gene as expressed in E. coli were examined for membrane proteins, which were confirmed by microscopy. The functional activity of epithelial cell binding, auto-aggregation, and complement resistance were then assessed, and regions in the apiA gene responsible for these functions were identified. A region spanning amino acids 186–217, when deleted, abrogated complement resistance and Factor H (FH) binding, while a region spanning amino acids 28–33 was related to epithelial cell binding. A 13-amino-acid peptide responsible for FH binding was shown to promote serum resistance. An apiA deletion in a clinical isolate (IDH781) was created and tested in the presence and/or absence of active and inactive serum and genes deemed responsible for prominent functional activity related to A. actinomycetemcomitans survival using qRT-PCR. These experiments suggested that apiA expression in IDH781 is involved in global regulatory mechanisms that are serum-dependent and show complement resistance. This is the first study to identify specific apiA regions in A. actinomycetemcomitans responsible for FH binding, complement resistance, and other stress-related functions. Moreover, the role of apiA in overall gene regulation was observed.

  PublisherDOI

• Delayed Tooth Development and the Impaired Differentiation of Stem/Progenitor Cells in Incisors from Type 2 Diabetes Mice

  International Journal of Molecular Sciences · 2024-12-19 · 2 citations

  articleOpen access

  Patients with diabetes mellitus (DM) have an increased risk of tooth decay caused by alterations in their tooth development and their oral environment, as well as a tendency to present with pulp infection due to compromised immune response. The present study analyzed the characteristic alterations in tooth development under DM conditions using incisors from db/db type 2 diabetic mouse model (T2DM mice). In micro-CT analyses, T2DM mice showed delayed dentin and enamel formation. Through transcriptomic analyses, pre-ameloblast- and pre-odontoblast-specific genes were found to be significantly decreased in the incisors of T2DM mice, whereas major ameloblast- and mature odontoblast-specific genes were not changed. Stem cell markers were decreased in T2DM mice compared to those from the control mice, suggesting that the stemness of dental pulp cells (DPCs) is attenuated in T2DM mice. In vitro analyses demonstrated that DPCs from T2DM mice have lower colony-forming units (CFU), slower propagation, and diminished differentiation characteristics compared to the control. These data suggest that T2DM conditions could impair the differentiation property of multiple progenitor/stem cells in the tooth, resulting in delayed tooth development in T2DM mice.

  PublisherOA PDFDOI

• Pragmatic Return to Effective Dental Infection Control through Triage and Testing (PREDICT): an observational, feasibility study to improve dental office safety

  Pilot and Feasibility Studies · 2024-02-28

  articleOpen access

  BACKGROUND: During the COVID-19 pandemic, there was a substantial interruption of care, with patients and workers fearful to return to the dental office. As dental practice creates a highly aerosolized environment, the potential for spread of airborne illness is magnified. As a means to increase safety and mitigate risk, pre-visit testing for SARS-CoV-2 has the potential to minimize disease transmission in dental offices. The Pragmatic Return to Effective Dental Infection Control through Testing (PREDICT) Feasibility Study examined the logistics and impact of two different testing mechanisms (laboratory-based PCR viral testing and point-of-care antigen testing) in dental offices. METHODS: Dental healthcare workers (DHCWs) and patients in four dental offices within the National Dental Practice-based Research Network participated in this prospective study. In addition to electronic surveys, participants in two offices completed POC testing, while participants in two offices used lab-based PCR methods to detect SARS-CoV-2 infection. Analysis was limited to descriptive measures, with median and interquartile ranges reported for Likert scale responses and mean and standard deviation for continuous variables. RESULTS: Of the total 72 enrolled, 28 DHCWs and 41 patients completed the protocol. Two patients (4.9%) tested positive prior to their visit, while 2 DHCWs (12.5%) tested positive for SARS-CoV-2 infection at the start of the study. DHCWs and patients shared similar degree of concern (69% and 63%, respectively) for contracting COVID-19 from patients, while patients feared contracting COVID-19 from DHCWs less (49%). Descriptive statistics calculations revealed that saliva, tongue epithelial cells, and nasal swabs were the most desirable specimen collection method; both testing (LAB and POC) protocols took similar amounts of total time to complete; and DHCWs and patients reported feeling more comfortable when both groups were tested. CONCLUSIONS: While a larger-scale, network study is necessary for generalizability of results, this feasibility study suggests that SARS-CoV-2 testing can be effectively implemented into dental practice workflows and positively impact perception of safety for DHCWs and patients. As new virulent infectious diseases emerge, preparing dental personnel to employ an entire toolbox of risk mitigation strategies, including testing, may have the potential to decrease dental practice closure time, maintaining continuity of dental care services for patients. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05123742.

  PublisherOA PDFDOI

• New Classification of Periodontal Diseases, the Obstacles Created and Opportunities for Growth

  Pathogens · 2024-12-12 · 1 citations

  editorialOpen access1st authorCorresponding

  The purpose of this Editorial is to expose the gaps in the knowledge created by a decision by the World Workshop Consensus Conference (WWCC), held in 2017, which was focused on the re-classification of periodontal diseases [...].

  PublisherOA PDFDOI

• A Rose by Any Other Name: The Long Intricate History of Localized Aggressive Periodontitis

  Pathogens · 2024-09-29 · 3 citations

  reviewOpen access1st authorCorresponding

  This review addresses the recent World Workshop Consensus Conference (WWCC) decision to eliminate Localized Aggressive Periodontitis (LAgP) in young adults as a distinct form of periodontitis. A “Consensus” implies widespread, if not unanimous, agreement among participants. However, a significant number of attendees were opposed to the elimination of the LAgP classification. The substantial evidence supporting a unique diagnosis for LAgP includes the (1) incisor/molar pattern of disease, (2) young age of onset, (3) rapid progression of attachment and bone loss, (4) familial aggregation across multiple generations, and (5) defined consortium of microbiological risk factors including Aggregatibacter actinomycetemcomitans. Distinctive clinical signs and symptoms of LAgP are presented, and the microbial subgingival consortia that precede the onset of signs and symptoms are described. Using Bradford–Hill guidelines to assess causation, well-defined longitudinal studies support the unique microbial consortia, including A. actinomycetemcomitans as causative for LAgP. To determine the effects of the WWCC elimination of LAgP on research, we searched three publication databases and discovered a clear decrease in the number of new publications addressing LAgP since the new WWCC classification. The negative effects of the WWCC guidelines on both diagnosis and treatment success are presented. For example, due to the localized nature of LAgP, the practice of averaging mean pocket depth reduction or attachment gain across all teeth masks major changes in disease recovery at high-risk tooth sites. Reinstating LAgP as a distinct disease entity is proposed, and an alternative or additional way of measuring treatment success is recommended based on an assessment of the extension of the time to relapse of subgingival re-infection. The consequences of the translocation of oral microbes to distant anatomical sites due to ignoring relapse frequency are also discussed. Additional questions and future directions are also presented.

  PublisherOA PDFDOI

• From Global to Nano: A Geographical Perspective of Aggregatibacter actinomycetemcomitans

  Pathogens · 2024-09-27 · 3 citations

  reviewOpen access

  The periodontal disease pathobiont Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) may exert a range of detrimental effects on periodontal diseases in general and, more specifically, with the initiation and progression of Localized Stage III Grade C periodontitis (molar–incisor pattern). In this review of the biogeography of this pathobiont, the full range of geographical scales for A. actinomycetemcomitans, from global origins and transmission to local geographical regions, to more locally exposed probands and families, to the individual host, down to the oral cavity, and finally, to spatial interactions with other commensals and pathobionts within the plaque biofilms at the micron/nanoscale, are reviewed. Using the newest technologies in genetics, imaging, in vitro cultures, and other research disciplines, investigators may be able to gain new insights to the role of this pathobiont in the unique initial destructive patterns of Localized Stage III Grade C periodontitis. These findings may incorporate the unique features of the microbiome that are influenced by variations in the geographic environment within the entire mouth. Additional insights into the geographic distribution of molar–incisor periodontal breakdown for Localized Stage III Grade C periodontitis may derive from the spatial interactions between A. actinomycetemcomitans and other pathobionts such as Porphyromonas gingivalis, Filifactor aclocis, and commensals such as Streptococcus gordonii. In addition, while the association of A. actinomycetemcomitans in systemic diseases is limited at the present time, future studies into possible periodontal disease–systemic disease links may also find A. actinomycetemcomitans and its geographical interactions with other microbiome members to provide important clues as to implications of pathobiological communications.

  PublisherOA PDFDOI

• A Rose by Any Other Name: The Long Intricate History of Localized Aggressive Periodontitis

  2024 · 1 citations

  1st authorCorresponding
  • History
  • Ancient history
  • Medicine

  This narrative review challenges the recent World Workshop Consensus (WWC) conferences failure to classify aggressive periodontitis (AP) in young adults as distinct from adult periodontitis. Deficiencies in the consensus process, results of these deficiencies, and their impact on disease classification are presented. Support for retaining localized aggressive periodontitis (LAgP) in adolescents as a unique disease, focuses on the; 1) age of onset, 2) rate of bone loss in those affected, and 3) unique microbiological etiological associations. Examples of, 1) unique clinical signs and symptoms of LAgP are presented, and 2) the microbial subgingival consortia that precedes these clinical signs and symptoms are described. Tables show, 1) decreased publications for AP since publication of WWC guidelines and 2) Bradford-Hill guidelines that support the unique etiological consortia replicated in clinically well-defined longitudinal studies. The review describes major deficiencies in the WWC as compared to other medically-related well-run consensus conferences that, 1) set pre-conference standards for 70 &amp;ndash; 80% agreement of expert participants, and 2) published the dissenting point of view. In contrast, the WWC conference was decided by a mere majority, and never presented the dissenting view. The review concludes that averaging of mean pocket depth reduction, or attachment gain can misrepresent disease and/or success of treatment in aggressive diseases. In contrast, clinical assessment of time to recurrence of subgingival re-infection with possible translocation of oral microbes to distant sites is presented as an alternative measurement of success. Other questions and future directions are presented.

  PublisherOA PDFDOI

• Computational approaches to investigate the relationship between periodontitis and cardiovascular diseases for precision medicine

  Human Genomics · 2024-10-19 · 3 citations

  reviewOpen access

  Periodontitis is a highly prevalent inflammatory illness that leads to the destruction of tooth supporting tissue structures and has been associated with an increased risk of cardiovascular disease (CVD). Precision medicine, an emerging branch of medical treatment, aims can further improve current traditional treatment by personalizing care based on one's environment, genetic makeup, and lifestyle. Genomic databases have paved the way for precision medicine by elucidating the pathophysiology of complex, heritable diseases. Therefore, the investigation of novel periodontitis-linked genes associated with CVD will enhance our understanding of their linkage and related biochemical pathways for targeted therapies. In this article, we highlight possible mechanisms of actions connecting PD and CVD. Furthermore, we delve deeper into certain heritable inflammatory-associated pathways linking the two. The goal is to gather, compare, and assess high-quality scientific literature alongside genomic datasets that seek to establish a link between periodontitis and CVD. The scope is focused on the most up to date and authentic literature published within the last 10 years, indexed and available from PubMed Central, that analyzes periodontitis-associated genes linked to CVD. Based on the comparative analysis criteria, fifty-one genes associated with both periodontitis and CVD were identified and reported. The prevalence of genes associated with both CVD and periodontitis warrants investigation to assess the validity of a potential linkage between the pathophysiology of both diseases.

  PublisherOA PDFDOI

Recent grants

• NIH Grant R01DE017968

  NIH · $5.5M · 2020

• NIH Grant R21DE016474

  NIH · $428k · 2007

• NIH Grant P50DE010592

  NIH · $6.8M · 2001

• NIH Grant R21DE021172

  NIH · $373k · 2015

• NIH Grant R01DE016306

  NIH · $1.2M · 2010

Frequent coauthors

• David Furgang

  Rutgers, The State University of New Jersey

  45 shared

• Mauro Ferrari

  40 shared

• Mauro Ferrari

  University of Pisa

  35 shared

• Alessandro Grattoni

  Methodist Hospital

  35 shared

• Ananth Dodabalapur

  The University of Texas at Austin

  26 shared

• Helen Schreiner

  22 shared

• Artūras Žiemys

  Houston Methodist

  20 shared

• Kenneth Markowitz

  Rutgers, The State University of New Jersey

  20 shared

Education

• Perio certificate, Periodontology

  New York University