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Health Science Reports Jun 2024Subclinical leaflet thrombosis (SLT) develops in 15% of patients undergoing trans-catheter aortic valve replacement (TAVR). TAVR is a procedure in which a faulty aortic...
OBJECTIVE
Subclinical leaflet thrombosis (SLT) develops in 15% of patients undergoing trans-catheter aortic valve replacement (TAVR). TAVR is a procedure in which a faulty aortic valve is replaced with a mechanical one. An aortic valve replacement can be done with open-heart surgery; this is called surgical aortic valve replacement (SAVR). A significant problem is defining the best course of treatment for asymptomatic individuals with SLT post-TAVR, including the use of oral anticoagulation (OAC) in it.
STUDY DESIGN
Systematic review.
METHOD
The most pertinent published research (original papers and reviews) in the scientific literature were searched for and critically assessed using the online, internationally indexed databases PubMed, Medline, and Cochrane Reviews. Keywords like "Transcatheter valve replacement" and "Subclinical leaflet thrombosis" were used to search the papers. Selected studies were critically assessed for inclusion based on predefined criteria.
RESULTS
The review examined the prevalence and characteristics of SLT after TAVR. To note, the incidence of SLT is seen to be higher in TAVR compared SAVR. Dual antiplatelet therapy, which is utilized in antithrombotic regimens post-TAVR, can possibly hasten SLT progression which could result in the impaired mobility of leaflets and the worsening of pressure gradients.
CONCLUSION
The use of dual antiplatelet drugs in routine antithrombotic therapy tends to accelerate initial subclinical leaflet thrombosis after TAVI, which results in a developing restriction of leaflet mobility and an increase in pressure differences.
PubMed: 38933424
DOI: 10.1002/hsr2.2200 -
Nutrients Jun 2024The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial,... (Review)
Review
The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial, and antioxidant properties. This systematic review synthesizes evidence from clinical trials to evaluate the efficacy of natural products in reducing inflammation and bacterial presence in orthodontic and orthognathic treatment settings. The database search was conducted across PubMed, Scopus, and Embase up to January 2024. The review focused on randomized controlled trials only. The selected studies centered on the anti-inflammatory, antibacterial, and antioxidant effects of natural products, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for data extraction. Nine studies, totaling 358 participants, were included. Significant findings demonstrated a reduction in gingival inflammation by over 40% with the use of Aloe vera compared to chlorhexidine. Another study noted a decrease in bleeding on probing by 13.6 points in the treatment group over placebo. Additionally, honey showed a rapid modulation of plaque pH and significantly reduced bacterial counts of . Furthermore, the use of resveratrol emulgel was linked to substantial improvements in gingival health, with a reduction in the gingival index and probing pocket depth. The results indicate that natural products can significantly enhance orthodontic treatment outcomes by reducing inflammation and bacterial levels. These products offer effective alternatives to traditional treatments and show potential for integration into routine orthodontic care protocols. Further research is encouraged to standardize application methods and dosages to maximize clinical benefits and patient satisfaction.
Topics: Humans; Aloe; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antioxidants; Biological Products; Chlorhexidine; Dentofacial Deformities; Gingivitis; Honey; Orthodontics; Plant Preparations; Randomized Controlled Trials as Topic; Resveratrol; Streptococcus mutans; Treatment Outcome
PubMed: 38931295
DOI: 10.3390/nu16121941 -
Journal of Clinical Medicine Jun 2024Floating-Harbor syndrome (FHS) is an extremely rare genetic disorder connected with a distinctive facial appearance, various skeletal malformations, delayed bone age,...
Floating-Harbor syndrome (FHS) is an extremely rare genetic disorder connected with a distinctive facial appearance, various skeletal malformations, delayed bone age, and expressive language delays. It is caused by heterozygous mutations in the Snf2-related CREBBP activator protein (SRCAP) gene. The aim of this paper is to describe the case of a 14-year-old male with FHS, referring to a review of the literature, and to collect all reported symptoms. In addition, the orthodontic treatment of the patient is described. For this, the electronic databases PubMed and Scopus were searched using the keyword "Floating-Harbor syndrome". Similar to previous cases in the literature, the patient presented with short stature; a triangular face with a large bulbous nose; deep-set eyes and narrow eyelid gaps; a wide mouth with a thin vermilion border of the upper lip; and dorsally rotated, small ears. They also presented some less-described symptoms, such as macrodontia and micrognathia. Moreover, mild mental retardation, microcephaly, and delayed psychomotor development were found. On the basis of an extraoral, intraoral examination, X-rays, and CBCT, he was diagnosed with overbite, canine class I and angle class III, on both sides. To the best of our knowledge, orthodontic treatment of this disease has not been assessed in detail so far, so this is the first case.
PubMed: 38929963
DOI: 10.3390/jcm13123435 -
Journal of Clinical Medicine Jun 2024: The improvement of oral-health-related quality of life (OHRQoL) with different types of prosthesis for completely edentulous jaws in the elderly population is a... (Review)
Review
: The improvement of oral-health-related quality of life (OHRQoL) with different types of prosthesis for completely edentulous jaws in the elderly population is a critical factor in clinical decision making for these vulnerable patients. This review aims to evaluate the changes in OHRQoL after treatment with different types of full-arch prostheses in the elderly edentulous population to determine the prostheses that result in the greatest improvement in OHRQoL. : Clinical studies of different types of full-arch prostheses that measured the OHRQoL in edentulous patients 60 years or older were searched for in the PubMed, Embase and Scopus electronic databases, with additional hand searching to summarize the outcomes of the selected studies. : Among the 302 identified studies, 10 studies were selected. A total of 504 patients wearing 133 complete dentures, 372 implant overdentures and 39 fixed prostheses were assessed among the selected studies. The overall OHIP and GOHAI scores were evaluated at baseline and in the 3rd, 6th, 12th and 18th months of treatment with the respective prostheses. The improved OHRQoL with overall OHIP scores associated with conventional dentures were 9.21-12.5% from the 3rd month to 1 year after treatment, whereas those associated with implant overdentures and full-arch fixed prosthesis were 9-25.26% at 1 year and 18.53-26.79 at the 18th-month follow-up, respectively. The increased overall GOHAI scores were 21.3-25.43% for conventional dentures, 36.82-41.32% for implant overdentures and 39.48-42.83% for full-arch fixed prosthesis from the 3rd month to the 6th-month follow-up. : In general, the improvement in OHRQoL after rehabilitation with implant overdentures declined at one year, and that with full-arch fixed prosthesis declined at the 18th-month follow-up; meanwhile, the OHRQoL associated with conventional dentures improved stably up to one year, but the implant-supported prostheses resulted in an obviously greater improvement in the OHRQoL than that obtained with conventional dentures. However, studies with longer follow-up periods are still required to evaluate the long-term clinical effectiveness.
PubMed: 38929921
DOI: 10.3390/jcm13123391 -
Journal of Personalized Medicine Jun 2024AI is included in a lot of different systems. In facial surgery, there are some AI-based software programs oriented to diagnosis in facial surgery. This study aims to... (Review)
Review
AI is included in a lot of different systems. In facial surgery, there are some AI-based software programs oriented to diagnosis in facial surgery. This study aims to evaluate the capacity and training of models for diagnosis of dentofacial deformities in class II and class III patients using artificial intelligence and the potential use for indicating orthognathic surgery. The search strategy is from 1943 to April 2024 in PubMed, Embase, Scopus, Lilacs, and Web of Science. Studies that used imaging to assess anatomical structures, airway volume, and craniofacial positions using the AI algorithm in the human population were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project instrument. The systematic search identified 697 articles. Eight studies were obtained for descriptive analysis after exclusion according to our inclusion and exclusion criteria. All studies were retrospective in design. A total of 5552 subjects with an age range between 14.7 and 56 years were obtained; 2474 (44.56%) subjects were male, and 3078 (55.43%) were female. Six studies were analyzed using 2D imaging and obtained highly accurate results in diagnosing skeletal features and determining the need for orthognathic surgery, and two studies used 3D imaging for measurement and diagnosis. Limitations of the studies such as age, diagnosis in facial deformity, and the included variables were observed. Concerning the overall analysis bias, six studies were at moderate risk due to weak study designs, while two were at high risk of bias. We can conclude that, with the few articles included, using AI-based software allows for some craniometric recognition and measurements to determine the diagnosis of facial deformities using mainly 2D analysis. However, it is necessary to perform studies based on three-dimensional images, increase the sample size, and train models in different populations to ensure accuracy of AI applications in this field. After that, the models can be trained for dentofacial diagnosis.
PubMed: 38929868
DOI: 10.3390/jpm14060647 -
Journal of Personalized Medicine May 2024Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the... (Review)
Review
Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the findings from the earlier studies and determine the potential advantages and limitations of each method. The present systematic review aimed to compare the accuracy of digital and manual tracing in cephalometric analysis for the identification of skeletal and dental landmarks. A systematic search was performed using the keywords "Digital" AND "Manual" AND "Cephalometry" to identify relevant studies published in the English language in the past decade. The electronic data resources consulted for the elaborate search included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PsycINFO, Scopus, ERIC, and ScienceDirect with controlled vocabulary and free text terms. A total of = 20 studies were identified that fulfilled the inclusion and exclusion criteria within the timeframe of 2013 to 2023. The data extracted from the included articles and corresponding meta-analyses are presented in the text. The findings of the present systematic review and meta-analysis revealed trends suggesting that digital tracing may offer reliable measurements for specific cephalometric parameters efficiently and accurately. Orthodontists must consider the potential benefits of digital cephalometry, including time-saving and user-friendliness.
PubMed: 38929786
DOI: 10.3390/jpm14060566 -
Medicina (Kaunas, Lithuania) May 2024: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets... (Meta-Analysis)
Meta-Analysis Comparative Study Review
: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets with and without periapical pathology. : After the search and review of the literature in the electronic databases, 109 publications were achieved. The titles and abstracts of 66 publications were screened. After the evaluation of the full text of 22 publications, based on the inclusion criteria, six controlled clinical studies were included in this systematic review and meta-analysis. The statistical calculation showed no heterogeneity among the studies included. The implant survival was 99.6% in the test (socket with periapical pathology) and control (socket without periapical pathology) groups of all the clinical trials. The results of the meta-analysis showed no statistically significant difference between test and control groups regarding the marginal bone level and the width of keratinized mucosa in all the studies. Other parameters indicating plaque level, bleeding on probing, and gingival recession also did not differ between test and control groups at the final follow-up in nearly all studies. : Within the limitation of this systemic review and meta-analysis, the obtained data suggest that implants immediately placed into the extraction sockets of teeth exhibiting periapical pathology can be successfully osseointegrated for an extended period.
Topics: Humans; Tooth Socket; Dental Implantation, Endosseous; Dental Implants; Immediate Dental Implant Loading
PubMed: 38929509
DOI: 10.3390/medicina60060893 -
Medicina (Kaunas, Lithuania) May 2024: Multiple sclerosis (MS) is a chronic neurodegenerative disease often linked with systemic conditions such as periodontal diseases (PDs). This systematic review aims to... (Review)
Review
: Multiple sclerosis (MS) is a chronic neurodegenerative disease often linked with systemic conditions such as periodontal diseases (PDs). This systematic review aims to explore the association between inflammatory markers in saliva and PDs in MS patients, assessing the use of saliva as a non-invasive tool to monitor disease progression. : 82 publications were examined after a thorough search of scholarly databases to determine whether inflammatory markers were present in MS patients and whether they were associated with periodontal disease (PD). Quality and bias were assessed using the Newcastle-Ottawa Scale, resulting in eight articles that were thoroughly analyzed. : The results point to a strong correlation between MS and periodontal disorders, which may point to the same pathophysiological mechanism. It does, however, underscore the necessity of additional study to determine a definitive causal association. : The findings indicate a strong association between MS and PDs, likely mediated by systemic inflammatory responses detectable in saliva. The review highlights the importance of oral health in managing MS and supports the utility of saliva as a practical, non-invasive medium for monitoring systemic inflammation. Further research is necessary to confirm the causal relationships and to consider integrating salivary diagnostics into routine clinical management for MS patients.
Topics: Humans; Saliva; Multiple Sclerosis; Periodontal Diseases; Biomarkers; Inflammation
PubMed: 38929476
DOI: 10.3390/medicina60060859 -
Antioxidants (Basel, Switzerland) May 2024Curcumin (Curcumin) belongs to the polyphenol family. It is extracted by drying the root of a plant of Asian origin, belonging to the family. The best-known species is... (Review)
Review
Curcumin (Curcumin) belongs to the polyphenol family. It is extracted by drying the root of a plant of Asian origin, belonging to the family. The best-known species is . Curcumin has been recognized as having great therapeutic powers since ancient times. Studies on curcumin have since confirmed its powerful antioxidant properties, preventing both the formation of free radicals and their neutralization, having anti-inflammatory, antibacterial, immunological, and neuroprotective properties, as well as being a regulator of the intestinal microbiota with beneficial effects on the clinical manifestations of metabolic syndrome. Our study aimed to highlight how all these therapeutic aspects could benefit oral health, both preventing and improving the course of pathological processes. The effect of mouthwashes, and curcumin-based gels on the regulation of bacterial plaque and in the control of gingivitis, was largely comparable to that of using 0.20% chlorhexidine, with fewer side effects. Being a highly hydrophobic substance, it has a high permeability to cross the cell membrane. Bioavailability increases when combined with liposoluble substances (e.g., olive oil) and piperine, which improves absorption. Curcumin also has a negligible degree of toxicity, making it an excellent alternative to the use of gold standard products for oral disinfection.
PubMed: 38929099
DOI: 10.3390/antiox13060660 -
Diagnostics (Basel, Switzerland) Jun 2024This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic... (Review)
Review
OBJECTIVE
This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars.
MATERIALS AND METHODS
A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and Web of Science, from the inception of the databases to March 2024. Keywords and Medical Subject Heading (MeSH) terms such as "dentigerous cysts", "odontogenic keratocysts", "immunohistochemistry", "Ki-67", and "p53" were used. The PRISMA 2020 guidelines were followed to ensure methodological rigor. Inclusion criteria encompassed studies on humans and animals providing definitive diagnoses or specific signs and symptoms related to DCs and OKCs, with results on protein expression derived from immunohistochemistry, immune antibody, proteomics, or protein expression methods.
RESULTS
Of the 159 studies initially identified, 138 met the inclusion criteria. Our analysis highlighted significantly higher expressions of Ki-67 (22.1% ± 4.7 vs. 10.5% ± 3.2, < 0.001), p53 (15.3% ± 3.6 vs. 5.2% ± 1.9, < 0.001), and Bcl-2 (18.4% ± 3.2 vs. 8.7% ± 2.4, < 0.001) in OKCs compared to DCs, indicating a higher proliferative index, increased cellular stress, and enhanced anti-apoptotic mechanisms in OKCs. Additionally, PCNA levels were higher in OKCs (25.6% ± 4.5 vs. 12.3% ± 3.1, < 0.001). Genetic mutations, particularly in the PTCH1 gene, were frequently observed in OKCs, underscoring their aggressive behavior and potential malignancy.
CONCLUSIONS
The findings emphasize the significant role of immunohistochemical markers in distinguishing between DCs and OKCs, with elevated levels of Ki-67, p53, Bcl-2, and PCNA in OKCs suggesting a higher potential for growth and recurrence. Genetic insights, including PTCH1 mutations, further support the need for personalized treatment approaches. These markers enhance diagnostic accuracy and inform targeted therapeutic strategies, potentially transforming patient management in oral and maxillofacial surgery.
PubMed: 38928661
DOI: 10.3390/diagnostics14121246