-
Journal of Clinical Medicine May 2024: This study aimed to identify the salivary levels of six hormones (progesterone, estradiol, testosterone, cortisol, thyroxine T3, and triiodothyronine T4) in pregnant...
: This study aimed to identify the salivary levels of six hormones (progesterone, estradiol, testosterone, cortisol, thyroxine T3, and triiodothyronine T4) in pregnant women, and to assess the association between salivary hormones, dental caries, and cariogenic microorganisms. : This cross-sectional study included 181 low-income US pregnant women who were in their third trimester. Demographic details, oral hygiene practices, and medical backgrounds were obtained via questionnaires and medical records. Calibrated dentists obtained data on plaque index and caries status through comprehensive oral examinations. Unstimulated saliva was collected 2 h before eating and brushing. Salivary hormones were measured with a multiplex assay. Oral () and () were quantified via colony-forming unit (CFU) counts. A latent model was used to generate clusters of pregnant women based on salivary hormone levels, followed by post-clustering analysis. Factors associated with salivary cariogenic microorganisms were further evaluated via multiple regression analyses. : Estradiol, progesterone, testosterone, cortisol, T3, and T4 in saliva were detectable at rates of 92%, 97%, 77%, 99%, 71%, and 50%, respectively. Three distinct participant clusters (high, intermediate, and low) were identified based on salivary hormone levels. Intermediate-level and high-level clusters had increased numbers of decayed teeth, decayed surfaces, ICDAS scores, and salivary and , compared to the low-level cluster ( < 0.05). Covariate analysis demonstrated that the high-level cluster was positively associated with salivary carriage of (CFU/mL) ( < 0.05). Participants with higher levels of progesterone, estradiol, testosterone, and cortisol were associated with a high carriage status of in saliva (>10 CFU/mL) ( < 0.05). : This study demonstrated the feasibility of detecting salivary hormones during pregnancy and revealed the positive association between salivary steroid hormones and cariogenic pathogens.
PubMed: 38892893
DOI: 10.3390/jcm13113183 -
Journal of Clinical Medicine May 2024Temporomandibular disease (TMD) is commonly seen, and divers also experience pain in the temporomandibular joint (TMJ) or masticatory muscles. This article aims to...
Temporomandibular disease (TMD) is commonly seen, and divers also experience pain in the temporomandibular joint (TMJ) or masticatory muscles. This article aims to provide a tool for diving physicians or medical professionals involved in diving medicine since jaw pain among divers is a pertinent subject and can be challenging to evaluate without some background in dentistry or maxillofacial surgery. A basic algorithm was developed to provide a tool to differentiate jaw pains experienced by divers. Three brief case studies were developed, and five diving physicians were tasked with diagnosing the cases using the algorithm. Additionally, simple exercises and massage techniques that can benefit patients with TMD, particularly immediately after diving, are outlined. All five diving physicians successfully diagnosed the cases using the algorithm. However, three of them were unable to diagnose the first case (disc luxation) without consulting the algorithm. Nevertheless, all physicians acknowledged the utility of the algorithm. Jaw pain in divers can stem from diverse causes, but effective treatment options exist. Our study findings provide valuable insights to assist diving physicians in making accurate diagnoses and guiding appropriate patient management, which may include referrals to specialists such as dentists, maxillofacial surgeons, or orthodontists.
PubMed: 38892877
DOI: 10.3390/jcm13113167 -
International Journal of Molecular... Jun 2024Periodontitis is a common oral condition that can have a significant impact on the overall health of the body. In recent years, attention has been paid to potential... (Review)
Review
Periodontitis is a common oral condition that can have a significant impact on the overall health of the body. In recent years, attention has been paid to potential relationships between periodontitis and various hematological disorders. This publication aims to present information available in the literature on this relationship, focusing on examples of red blood cell disorders (such as aplastic anemia and sickle cell anemia) and white blood cell disorders (such as cyclic neutropenia, maladaptive trained immunity, clonal hematopoiesis, leukemia, and multiple myeloma). Understanding these associations can help physicians and dentists better diagnose, monitor, and treat patients associated with both groups of conditions, highlighting the need for interdisciplinary care for patients with oral disorders and hematologic diseases.
Topics: Humans; Periodontitis; Hematologic Diseases
PubMed: 38892299
DOI: 10.3390/ijms25116115 -
International Journal of... 2024Exceedingly high levels of the chemokine CCL5/RANTES have been found in fatty degenerated osteonecrotic alveolar bone cavities (FDOJ) and aseptic ischemic osteolysis of... (Comparative Study)
Comparative Study
Exceedingly high levels of the chemokine CCL5/RANTES have been found in fatty degenerated osteonecrotic alveolar bone cavities (FDOJ) and aseptic ischemic osteolysis of the jaw (AIOJ) from toothless regions. Because CCL5/RANTES seems to have a prominent role in creating the COVID-19 "cytokine storm", some researchers have used the monoclonal antibody Leronlimab to block the CCR5 on inflammatory cells. Is preexisting FDOJ/AIOJ jaw marrow pathology a "hidden" co-morbidity affecting some COVID-19 infections? To what extent does the chronic CCL5/RANTES expression from preexisting FDOJ/AIOJ areas contribute to the progression of the acute cytokine storm in COVID-19 patients? Authors report on reducing the COVID-19 "cytokine storm" by treating infected patients through targeting the chemokine receptor 5 (CCR5) with Leronlimab and interrupting the activation of CCR5 by high CCL5/RANTES signaling, thus dysregulating the inflammatory phase of the viremia. Surgical removal of FDOJ/AIOJ lesions with high CCL5/RANTES from patients with inflammatory diseases may be classified as a co-morbid disease. Both multiplex analysis of 249 FDOJ/AIOJ bone tissue samples as well as serum levels of CCL5/RANTES displayed exceedingly high levels in both specimens. By the results the authors hypothesize that chronic CCL5/RANTES induction from FDOJ/AIOJ areas may sensitize CCR5 throughout the immune system, thus, enabling it to amplify its response when confronted with the virus. As conventional intraoral radiography does little to assess the quality of the alveolar bone, ultrasonography units are available to help dentists locate the FDOJ/AIOJ lesions in an office setting. The authors propose a new approach to containment of the COVID-19 cytokine storm by a prophylactic focus for future viral-related pandemics, which may be early surgical clean-up of CCL5/RANTES expression sources in the FDOJ/AIOJ areas, thus diminishing a possible pre-sensitization of CCR5. A more complete dental examination includes trans-alveolar ultrasono-graphy (TAU) for hidden FDOJ/AIOJ lesions.
Topics: Humans; COVID-19; Chemokine CCL5; Comorbidity; Male; Female; Middle Aged; Receptors, CCR5; Aged; Jaw Diseases; SARS-CoV-2; Cytokine Release Syndrome; Antibodies, Monoclonal, Humanized; Adult
PubMed: 38889772
DOI: 10.1177/03946320241265265 -
Clinical Oral Investigations Jun 2024Tooth extraction is one of the most frequently performed medical procedures. The indication is based on the combination of clinical and radiological examination and...
OBJECTIVES
Tooth extraction is one of the most frequently performed medical procedures. The indication is based on the combination of clinical and radiological examination and individual patient parameters and should be made with great care. However, determining whether a tooth should be extracted is not always a straightforward decision. Moreover, visual and cognitive pitfalls in the analysis of radiographs may lead to incorrect decisions. Artificial intelligence (AI) could be used as a decision support tool to provide a score of tooth extractability.
MATERIAL AND METHODS
Using 26,956 single teeth images from 1,184 panoramic radiographs (PANs), we trained a ResNet50 network to classify teeth as either extraction-worthy or preservable. For this purpose, teeth were cropped with different margins from PANs and annotated. The usefulness of the AI-based classification as well that of dentists was evaluated on a test dataset. In addition, the explainability of the best AI model was visualized via a class activation mapping using CAMERAS.
RESULTS
The ROC-AUC for the best AI model to discriminate teeth worthy of preservation was 0.901 with 2% margin on dental images. In contrast, the average ROC-AUC for dentists was only 0.797. With a 19.1% tooth extractions prevalence, the AI model's PR-AUC was 0.749, while the dentist evaluation only reached 0.589.
CONCLUSION
AI models outperform dentists/specialists in predicting tooth extraction based solely on X-ray images, while the AI performance improves with increasing contextual information.
CLINICAL RELEVANCE
AI could help monitor at-risk teeth and reduce errors in indications for extractions.
Topics: Humans; Radiography, Panoramic; Tooth Extraction; Artificial Intelligence; Dentists; Female; Male; Adult
PubMed: 38886242
DOI: 10.1007/s00784-024-05781-5 -
The Saudi Dental Journal Jun 2024This randomized clinical trial aimed to evaluate the impact of DryShield isolation (DSI) and rubber dam isolation (RDI) system usage on vital signs, behavior, pain and...
OBJECTIVES
This randomized clinical trial aimed to evaluate the impact of DryShield isolation (DSI) and rubber dam isolation (RDI) system usage on vital signs, behavior, pain and discomfort, and chairside time required among children with different airway patencies based on the Modified Mallampati Classification (MMC).
MATERIAL AND METHODS
Healthy, cooperative children who required fissure sealant in at least two contralateral, fully erupted, permanent first molars were included. Airway patency was determined by two trained and calibrated dentists using the MMC. The participants were categorized based on their MMC scores into patent airways (classes I and II) and non-patent airways (classes III and IV). The dental procedure was videotaped during treatment, and vital signs, including arterial oxygen saturation, heart rate, and blood pressure, were recorded every 3 min. The participants' subjective pain and discomfort were evaluated using a previously validated Arabic interview questionnaire and a validated Arabic version of the Wong-Baker Faces Pain Rating Scale. The participants' behavior and behavioral pain were evaluated utilizing the Frankl Behavior Scale and the face, legs, activity, cry, and consolability scales, respectively.
RESULTS
There were no significant differences in any of the vital signs between DSI and RDI. DSI use yielded a significant reduction in chairside time ( < 0.001) and was more bothersome ( < 0.001) than RDI use among all participants, regardless of airway patency. DSI was associated with significantly better behavior during the dental procedure ( = 0.002) and less behavioral pain ( < 0.001) among all participants, regardless of airway patency.
CONCLUSION
Irrespective of airway patency, DSI outperformed RDI in terms of behavior, pain, and procedure duration; however, DSI was characterized by noise, pressure on soft tissues, and an increased tendency to induce gag reflexes.
PubMed: 38883897
DOI: 10.1016/j.sdentj.2024.03.013 -
Cureus May 2024Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction appliance to maintain the space for the...
Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction appliance to maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised procedures that pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of, gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years, but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP) and the Gingival Index (GI) using the Loe and Silness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analysed in IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilk test was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines. Results At the beginning of the study, 46 children (22 girls and 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steel crown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.
PubMed: 38883065
DOI: 10.7759/cureus.60473 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).
AIM AND OBJECTIVE
To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT).
MATERIALS AND METHOD
A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study's inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years.
RESULTS
The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome.
CONCLUSIONS
Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.
PubMed: 38882901
DOI: 10.4103/jpbs.jpbs_1095_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Children's conduct is significantly impacted by pain during dental procedures. Children's pain and discomfort can be reduced using computer-controlled local anesthetic...
Children's conduct is significantly impacted by pain during dental procedures. Children's pain and discomfort can be reduced using computer-controlled local anesthetic delivery, which applies a steady, gradual flow of the anesthetic solution into the tissues. Using a self-report anxiety scale, the study aimed to assess and compare children's perceptions of discomfort following a new auto-controlled injection method to a traditional local anesthetic procedure. A total of 25 children, ages 6-12 requiring the use of local anesthesia for treatment on both sides of the arch were selected. It was a split-mouth design, in which each participating child received both types of infiltrations in two separate, consecutive visits, using a metallic syringe in one session, and using the I-Ject device in the other. Before administering anesthesia, all the children's anxiety scales were recorded using the Modified Child Dental Anxiety Faces Scale simplified to assess the anxiety level of a child. In the first appointment, Conventional anesthetic technique was and in the second appointment anesthesia was delivered using a computer-controlled device. Faces pain scaleRevised, a selfreport measure of pain was recorded immediately after completion of both types of local anesthesia (LA) administration. Patients reported greater comfort with the I-Ject computer-controlled device than with conventional anesthesia. Together with the practitioner, the computer system produced a pleasant and cozy environment for the youngster.
PubMed: 38882898
DOI: 10.4103/jpbs.jpbs_1214_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The most significant accomplishment of dentists is the early detection of oral dysplasia or the rapid diagnosis of potentially malignant lesions. An additional test that...
The most significant accomplishment of dentists is the early detection of oral dysplasia or the rapid diagnosis of potentially malignant lesions. An additional test that assists in the diagnosis of numerous oral illnesses is exfoliative cytology. This study was conducted among dental professionals in the city of Bhubaneswar to assess their exfoliative cytology knowledge, attitudes, and practices. Fifty-eight dental interns participated in a cross-sectional, descriptive, Web-based questionnaire study. The findings reveal that while some interns were knowledgeable about some components of exfoliative cytology in oral cancer (OC) screening, they lacked a thorough understanding of other crucial elements. To enhance early diagnosis and lessen the prevalence of OC, it is critical that dental practitioners increase their understanding of and use of exfoliative cytology. To address the misconcepts found in the study, it draws attention to the necessity of patient education and public awareness campaigns. The study recommends more awareness and education among dental practitioners and emphasizes the need of tackling OC through preventive measures and appropriate diagnostic techniques such as exfoliative cytology.
PubMed: 38882891
DOI: 10.4103/jpbs.jpbs_619_23