Dental and Medical Problems最新文献

Background: The persistence of dental plaque is attributable to the inaccessibility to all surfaces of the oral cavity. Thus, an integrated team designed an innovative toothbrush comprising a brush head assembly with an upper end and a lower end, and a handle rotatably configured with the lower end of the brush head assembly. The brush head is connected to the handle through a socket-ball joint, which allows the shank and the handle to rotate at any angle between 0° and 360° with respect to one another around an axis. Additionally, the brush head bends toward the handle, maintaining a bending angle of 15°.

Objectives: The aim of the present randomized controlled trial (RCT) was to analyze and assess the effectiveness of a toothbrush with a rotatable shank in comparison to toothbrushes with flexible and straight handles with respect to supragingival plaque and gingival health outcomes. The secondary objective of the study was to evaluate the feedback of individuals who used the rotatable shank toothbrush.

Material and methods: Three toothbrushes - one with a rotatable shank, one with a flexible handle and one with a straight handle - were compared in terms of efficacy in plaque and gingivitis control at 3 clinical centers (a multicenter trial). A total of 270 patients, aged 18-65 years, were included in the study. The collected data was analyzed and compared using the analysis of variance (ANOVA) with Tukey's post hoc test.

Results: All groups demonstrated improvement in gingival health and a reduction in the plaque index (PI) scores. Nonetheless, the improvement was more pronounced in the group that used the toothbrush with a rotatable shank.

Conclusions: The enhanced plaque removal and improved gingival health at all surfaces achieved with the rotatable shank toothbrush are ascribable to the incorporation of 2 features: the ability to rotate the toothbrush neck along its axis; and an inclination that facilitates access to all surfaces.

The important thing is not to stop questioning. Curiosity has its own reason for existence. One cannot help but be in awe when he contemplates the mysteries of eternity, of life, of the marvelous structure of reality. It is enough if one tries merely to comprehend a little of this mystery each day.Albert Einstein.

Background: Multiple myeloma (MM) is a hematological malignancy characterized by the presence of abnormal plasma cells. It is associated with anemia, bone lesions and renal dysfunction. Immunomodulatory drugs (IMiDs) are commonly used in MM treatment. Recent studies indicate that their therapeutic effect is caused by binding to cereblon (CRBN), which in turn causes the degradation of 2 important immune cell regulatory factors, IKZF1 and IKZF3. These are necessary for the anti-myeloma effect of IMiDs. Their expression level has been shown to affect MM survival and response to treatment. Potentially important single-nucleotide polymorphisms (SNPs) in the genes coding for IKZF1 and IKZF3 have been identified, but they have not been analyzed in MM patients before.

Objectives: The study was designed to establish the relationship between 4 SNPs in the genes coding for IKZF1 (rs61731359, rs4132601 and rs10272724) and IKZF3 (rs907091), and MM survival, response to treatment and other parameters.

Material and methods: The study involved 222 MM patients, as well as 100 control individuals. The IKZF1 and IKZF3 genotypes were determined by the LightSNiP assay. Genotyping was performed in the real-time polymerase chain reaction (PCR) LightCycler 480 device.

Results: No difference was observed between the patients and the controls for any of the SNPs, but the IKZF1 and IKZF3 variants were associated with various clinical parameters. Allele IKZF1 rs4132601 G was more common in the patients with worse response to first-line therapy (p = 0.040), particularly in the patients treated with thalidomide (p = 0.017). The patients tended to have worse overall survival. IKZF3 rs907091 CC was detected more commonly in the patients in stage I than in those in stages II and III, according to the International Staging System (ISS) criteria (p = 0.015). This genotype was also associated with a higher albumin level (p = 0.033), and was less common in the patients with the albumin level below 3.5 g/dL (p = 0.030).

Conclusions: Our results suggest that IKZF1 rs4132601 and IKZF3 rs907091 may affect response to treatment and progression in patients with MM.

Symmetry is present in various aspects of everyday life. A symmetrical face is considered attractive, whereas a lack of facial symmetry is regarded as a source of functional and aesthetic problems. Most of the people exhibit slight asymmetries, but some of them reveal severe asymmetries. Among patients presenting with severe facial asymmetries, there may be those with congenital defects. Congenital defects may manifest at the time of birth or be a result of birth trauma.One of the most prevalent asymmetrical birth defects is cleft lip and/or cleft palate. Other congenital defects include craniofacial syndromes, such as Treacher Collins syndrome (TCS) and Goldenhar syndrome. Among the rare syndromes with facial asymmetries, Klippel-Feil syndrome (KFS), PHACE (posterior fossa brain malformation, hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities) syndrome, plagiocephaly, and Parry-Romberg syndrome are worth noticing. The majority of craniofacial asymmetries require surgery to improve the patient's facial appearance. The treatment is multidisciplinary and long, and the most common procedures involve reparative and regenerative surgeries. The aim of this review was to present the most common congenital defects with facial asymmetry.

Background: The present study was performed to rehabilitate maxillary single denture cases with implantretained telescopic or ball-and-socket attachments, and to evaluate the validity of two-implantretained maxillary overdentures as a treatment approach in the maxillary arch.

Objectives: The aim of the present study was to evaluate patient satisfaction in maxillary single denture wearers with 2 different attachment systems (telescopic attachment vs. ball-and-socket attachment).

Material and methods: A total of 18 completely edentulous maxillary ridge patients (45-60 years old; mean age: 53 years) were selected for this study. Maxillary single dentures were constructed for all the patients. Group 1 patients received 2 implants with a telescopic attachment and group 2 patients received 2 implants with a ball-and-socket attachment. Patient satisfaction with the implant-retained maxillary single denture was evaluated after insertion, and 3 months after the delivery of each implant-retained maxillary single overdenture.

Results: All 18 patients completed the study. After 3 months, the telescopic group showed significant improvement in terms of comfort, chewing, handling, and overall satisfaction, and in the ball-and-socket group, significant improvement was recorded for appearance only. When comparing the 2 groups, after insertion, group 1 showed significantly better results for the 'handling' and 'hygiene' parameters, whereas group 2 showed a significantly better mean score for the 'appearance' parameter. After 3 months, group 1 showed significantly better results for the 'comfort', 'handling', 'hygiene', and 'overall satisfaction' parameters, and group 1 proved significantly better in terms of 'appearance' and 'speech' parameters.

Conclusions: Maxillary single dentures with a telescopic attachment showed an advantage over those with a ball-and-socket attachment regarding patient satisfaction. Concerning the implant number, twoimplantretained maxillary overdentures can be considered a promising approach for patients from developing countries.

Background: The body is in a continuous state of inflammatory burden due to local and systemic inflammation, which is triggered in periodontal tissues in response to microorganisms. A number of studies have linked periodontitis to systemic diseases such as diabetes mellitus, cardiovascular disease and respiratory disease. Periodontal inflammation acts as a focus of infection, which can cause detrimental effects on distant target organs. In some cases, it may lead to tumor progression in various cancers.

Objectives: The aim of the study was to evaluate the correlation between periodontal disease (PD) and its potential role as a risk factor for the development of systemic cancer and its metastasis.

Material and methods: A single-center, cross-sectional study was conducted, including 66 patients with different systemic malignancies (group 1, the test group) and 66 healthy individuals (group 2, the control group). Group 1 was further subdivided into 2 categories: M0, comprising patients without metastases (n = 34); and M1, comprising patients with distant metastases (n = 32). The number of missing teeth, Greene and Vermilion's simplified oral hygiene index (OHI-S), probing pocket depth (PPD), Löe and Silness' bleeding on probing (BoP), clinical attachment loss (CAL), and Ramfjord's periodontal disease index (PDI) were recorded. Appropriate statistical tests were performed to analyze the data. A p-value <0.05 was considered statistically significant.

Results: The differences between the PDI, CAL and PPD values in both group 1 and group 2 were found to be statistically significant (p = 0.000). In M0 and M1, no statistically significant differences were observed between any of the parameters. The odds ratios (ORs) between group 1 and group 2 for CAL and PDI were 3.986 and 4.286, respectively. The ORs for M0 and M1 with regard to CAL and the mean number of teeth lost were 0.373 and 0.188, respectively.

Conclusions: The findings of the study indicate a significant association between the overall risk of cancer and PD. In cases of known systemic malignancies, no significant correlation has been identified between PD and the risk of metastasis.

Background: Temporomandibular disorders (TMD) are musculoskeletal and/or neuromuscular conditions that affect the muscles, joints and associated structures of the stomatognathic system.

Objectives: This study aimed to evaluate the quality and reliability of publicly available English-language videos on YouTube about TMD exercises, and to examine the video sources and professional groups responsible for the creation of the videos.

Material and methods: The quality and reliability of the YouTube videos related to TMD exercises were evaluated using the DISCERN score, the global quality scale (GQS) and the JAMA (Journal of the American Medical Association) score.

Results: Of the 121 videos evaluated, 30 (24.8%) were uploaded by professional organizations, 49 (40.5%) by health information websites, and 42 (34.7%) were uploaded by independent users. Professional organizations had a significantly higher number of subscribers, likes, comments, and views than healthcare webpages and independent users (p < 0.001). The duration of videos uploaded by independent users was significantly longer than that of videos uploaded by healthcare webpages (p = 0.018). With regard to the profession of the video narrators, the unspecified group exhibited significantly lower JAMA (p < 0.001), GQS (p = 0.011) and DISCERN scores (p = 0.002) compared to chiropractors, physiotherapists, physicians, and other healthcare professionals. The JAMA scores for physicians, personal trainers and chiropractors were significantly lower than those for other healthcare professionals (p < 001). The JAMA score was positively correlated with the GQS (r = 0.469, p < 0.001) and DISCERN (r = 0.505, p < 0.001) scores. Similarly, the DISCERN score was positively correlated with the GQS score (r = 0.924, p < 0.001).

Conclusions: Despite the abundance of video content on YouTube about TMD exercises, the quality of these videos is low, and their reliability is questionable.

Alveolar reconstructive surgery employs a variety of surgical techniques and biomaterials, with a particular focus on bone blocks as a crucial methodology for restoring and augmenting deficient bone structures. Bone blocks are often employed to support periodontal health or as a foundation for future prosthetic rehabilitation with dental implants. This systematic review investigated recent advances in bone blocks for alveolar bone reconstruction, comparing autologous, allogeneic and xenogeneic types. A search of PubMed identified 56 records, of which 21 were included in the qualitative analysis. The studies involved 685 patients in total. Bone blocks are pivotal for three-dimensional bone regeneration, providing a stable scaffold for achieving the desired bone volume during healing. Autologous bone, harvested from the patient, boasts high biocompatibility, excellent osteogenic properties and minimal immunologic risks. However, its drawbacks include the need for an additional surgical site and extended procedural times. Allogeneic bone blocks involve transferring bone between individuals, offering increased graft availability and customization options without requiring a second surgical site. However, they exhibit moderate resorption rates and carry a heightened risk of immunologic reactions and disease transmission. Innovative techniques, such as tunneling, laser osteotomy, graft customization, and platelet-rich fibrin (PRF) application on wound during surgical treatment show promise in enhancing alveolar bone reconstruction efficacy. In conclusion, despite the traditional preference for autologous bone, the review suggests that alternative materials, particularly individualized allogeneic bone blocks, coupled with modern techniques, could emerge as a standard procedure for regenerating alveolar bone defects due to their satisfactory results and potential advantages.

The presence of toxic metals in the human environment can have detrimental effects on people's wellbeing. This literature review examines the ways in which various environmental and non-environmental factors can contribute to the accumulation of heavy metals in hard dental tissues. It is of the utmost importance to ensure the safety of the environment by restricting the presence of toxic metals originating from both industrial and non-industrial sources. The aim of this study is to analyze current research and identify the primary sources of heavy metal exposure and the mechanisms by which these metals are deposited in dental tissues. Moreover, the objective of this review is to synthesize data from various studies to determine the main environmental and non-environmental sources of toxic metal exposure that contribute to their presence in dental tissues, as well as the biological and chemical processes that are responsible for the deposition of heavy metals in hard dental tissues. Additionally, the review aims to assess the impact of heavy metal accumulation on dental health and its potential systemic effects on overall well-being. The accumulation of heavy metals in the teeth is influenced by a number of factors, such as age, systemic conditions, the nutritional status, and dental caries. The presence of supernumerary teeth results in altered levels of microelements, including an increase in cadmium (Cd) and copper (Cu). Additionally, smoking exacerbates toxic metal accumulation, especially Cd and lead (Pb), and disrupts the balance of essential minerals within the teeth. These findings underscore the impact of environmental pollution on dental health and highlight the potential of teeth as biomarkers of environmental exposure, emphasizing the need for continued research to address the health risks associated with environmental toxins.

Background: Periodontitis is a chronic inflammatory disease of the supporting tissue surrounding the teeth. The disease is caused by specific bacteria, such as Porphyromonas gingivalis, which lead to the destruction of periodontal ligaments and alveolar bone.

Objectives: The study aimed to evaluate the relationship between the prevalence of P. gingivalis in subgingival plaque and coronary artery disease (CAD).

Material and methods: Fifty patients with CAD and 50 healthy controls (non-CAD) participated in this case-control study. The periodontal health in the groups was evaluated through the assessment of the pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BoP). The presence of P. gingivalis in subgingival plaque samples was determined through real-time polymerase chain reaction (RT-PCR). The data was analyzed using the χ2 test and the Mann-Whitney U test.

Results: The mean PD was 3.30 ±1.55 mm and 3.56 ±0.97 mm in CAD patients and non-CAD subjects, respectively (p = 0.028). No significant differences were observed in the CAL (p = 0.858) and BoP (p = 1.000) between the groups. The RT-PCR results revealed the presence of P. gingivalis 16S rDNA in 32% and 22% of the subgingival plaque of patients with CAD and non-CAD, respectively, with a mean concentration of 7.7 × 106. No statistically significant association was observed between the prevalence of P. gingivalis and CAD (p = 0.260). The results of the multiple logistic regression analysis showed an association between CAD and male sex (p = 0.004, odds ratio (OR): 4.163), as well as age (p = 0.011, OR: 1.067).

Conclusions: The findings of this study indicated that there is no statistically significant correlation between the prevalence of P. gingivalis in subgingival plaque and CAD.