Dental and Medical Problems最新文献

Background: Tooth loss significantly affects health and quality of life of older adults. Removable dentures are the most common solution for restoring oral function and aesthetics. In Poland, a significant portion of elderly population suffers from edentulism or partial tooth loss. However, not all of these individuals receive the prosthetic treatment they need. The measurement of unmet denture needs, defined as the proportion of individuals with tooth loss who lack appropriate dentures, offers critical insight into disparities in the access to oral healthcare.

Objectives: The aim of the study was to compare changes in unmet denture needs among Polish seniors over a decade and to assess patterns in denture use among those who received prosthetic treatment, taking into account sociodemographic factors such as sex, age, education, place of residence, and financial status.

Material and methods: The present study analyzed data from 2 nationally representative crosssectional surveys, PolSenior (2009) and PolSenior2 (2019), comprising 4,712 and 4,075 participants aged ≥65 years, respectively. The individuals were categorized based on their dental status, denture use and sociodemographic characteristics. Unmet denture need was defined as the absence of complete or partial dentures among individuals with edentulism or partial tooth loss. The χ2 test and age standardization were implemented for the purpose of the statistical analysis. The level of significance was set at p < 0.05.

Results: The proportion of edentulous and partially dentate individuals without dentures decreased from 19.4% in 2009 to 12.3% in 2019. The most pronounced improvements were noted among women, urban residents and individuals aged 85 years and older. Despite these gains, disparities by sex, place of residence, education level, and financial status persisted. Among individuals who owned dentures, denture use remained consistently high in both survey waves, exceeding 94%, with no significant differences between the study periods.

Conclusions: The unmet need for dentures among Polish seniors has decreased over time, indicating an improvement in the accessibility to prosthetic care. However, sociodemographic disparities remain, highlighting the necessity for targeted public health strategies aimed at mitigating barriers to dental rehabilitation. The high rates of denture use confirm the enduring functional and psychosocial value of prosthetic treatment in older populations.

Background: Awake bruxism (AB), characterized by repetitive jaw muscle activity during wakefulness, is often associated with stress, anxiety and depression.

Objectives: The aim of the study was to examine the long-term relationships between psychological distress, resilience and AB behaviors during stressful periods. To this end, a longitudinal, within-subject design of the study was used.

Material and methods: A repeated-measures design was employed to evaluate 136 individuals. The participants underwent 2 assessments: the baseline evaluation conducted at the onset of an armed conflict (phase 1); and the follow-up evaluation, performed 1 year later, when the conflict remained ongoing (phase 2). Each subject served as their own control. At each phase of the study, the participants completed a self-report questionnaire, the Oral Behavior Checklist (OBC), which addressed selfawareness of performance of teeth grinding, teeth clenching, tooth contact, and/or mandible bracing while awake. A score of 2 and above on any of the questions indicated positive awareness of the presence of AB behaviors. The additional questionnaires referred to subjects' ability to cope with stress adaptively, their ability to recover from stress, perceived stress, screening for depressive and anxiety symptoms, and screening for adjustment disorder and post-traumatic stress disorder (PTSD).

Results: A significant increase in teeth clenching was apparent during phase 2. The subjects' ability to cope with stress in an adaptive manner, as well as their perceived stress levels, increased the likelihood of AB behaviors during both phases (odds ratios ranging from 11% to 27%).

Conclusions: Awake bruxism behaviors in general, and teeth clenching in particular, should be considered as possible stress-relieving behaviors.

Background: Dentofacial infection resulting from untreated dental caries or periodontal disease is a serious disease that can spread to deeper tissues of the face and neck.

Objectives: The present study aimed to analyze the salivary cytokine profile and oxidative stress parameters as potential biomarkers of acute odontogenic infections in children.

Material and methods: The prospective study group (DI) consisted of 28 children aged 3-17 years with acute dentofacial infections, and the control group (CG) comprised 52 children aged 4-17 years with uncomplicated dental caries. The cytokine profile was analyzed using the Bio-Plex Pro™ Human Cytokine 27-plex kit. In addition, oxidative stress parameters, such as catalase (CAT), glutathione reductase (GR), superoxide dismutase (SOD), manganese SOD (Mn-SOD), copper-zinc SOD (CuZn-SOD), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA), in the saliva of children in both groups were compared.

Results: The levels of interleukin 6 (IL-6), macrophage inflammatory protein 1 alpha (MIP-1α) and tumor necrosis factor alpha (TNF-α) were significantly increased in children with dentofacial infections as compared to CG. In contrast, the levels of other pro-inflammatory cytokines, such as IL-1β, IL-1 receptor agonist (IL-Ra), IL-8, monocyte chemoattractant protein 1 (MCP-1), and MIP-1β, did not show statistically significant differences between the 2 groups. Among the measured oxidative stress and antioxidative parameters, only CAT and GR were elevated in children with dentofacial infections as compared to controls.

Conclusions: IL-6, MIP-1α, TNF-α, CAT, and GR can serve as selective biomarkers of oral cavity inflammation in children. These biomarkers can be useful in identifying and monitoring the progress and treatment of bacterial infections resulting in dentofacial inflammation.

This systematic review aimed to identify, select and synthesize clinical studies reporting the prevalence of HPV infection among patients with OSCC, and to determine the odds ratio (OR) of HPV infection in a group of OSCC patients relative to non-OSCC controls through meta-analysis.The study incorporated primary clinical trials that assessed the impact of HPV infection on the development of OSCC. The search was conducted on August 31, 2023, using Bielefeld Academic Search Engine (BASE), as well as PubMed® and Scopus databases. The Newcastle-Ottawa Quality Assessment Scale was used to assess the risk of bias of the included studies. The collected data was then synthesized in the form of tables and a funnel plot. A total of 54 eligible studies were selected for the review, and 10 reports were included in the meta-analysis. Of the 10 papers, 7 reported extractable numerical data on HPV-16 and/or HPV-18 (1,035 patients).The limitations of the evidence included the following: inhomogeneity in terms of HPV type; small number of available controlled studies (not homogeneous in terms of virus type); small number of patients on whom controlled studies were conducted; and the risk of bias related to the selection of study and control groups (present in most studies qualified for the synthesis).In conclusion, HPV is detected by genetic testing in 0.0-74.5% of patients who develop OSCC. The weighted mean OR of detecting HPV-16 or HPV-18 in OSCC patients (OR = 17.1; standard deviation (SD) = 31.4) suggests a potential correlation between these infections and the incidence of OSCC.

Background: The biomimetic regeneration of the pulp-dentin complex is a modern approach involving the application of a bioactive substance. Bioactive substances (e.g., cement or stem cells) have been reported to be able to control the signaling and differentiation of the pulp cells, thus limiting the inflammatory reactions and enabling the repair and regeneration of tissues. One of such materials is MTA Repair HP (MTA HP) - a type of mineral trioxide aggregate (MTA) material characterized by high plasticity, composed of hydrophilic particles of mineral oxides.

Objectives: The aim of the present study was to analyze the reaction of the pulp-dentin complex of human teeth to MTA HP using 2 radiological techniques - cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT).

Material and methods: In the study, 6 caries-free, intact maxillary and mandibular third molars or premolars from 6 patients aged 30-37 years were analyzed. The teeth were scheduled to be extracted for orthodontic or surgical reasons.

Results: No statistically significant differences in the examined parameters of the tertiary dentin were observed in the CBCT and micro-CT images (p < 0.05).

Conclusions: The CBCT technique, similarly to micro-CT, proved to be effective in identifying and assessing the tertiary dentin. Furthermore, CBCT has the advantage of usability in clinical settings. Knowledge on the parameters of reparative dentin identified with radiological techniques is still insufficient, and further research is recommended.

Background: Oral lichen planus (OLP) is a chronic inflammatory T cell-mediated disease that is classified by the World Health Organization (WHO) as an oral potentially malignant disorder (OPMD). Despite the heightened interest in the influence of human papillomavirus (HPV) on oral cancer, the overall incidence of HPV affecting patients with OLP remains inconclusive.

Objectives: The study aimed to evaluate the presence of alpha-, betaand gamma-HPVs in saliva samples collected from 31 OLP patients and 19 control volunteers. This hospital-based study has the advantage of providing comprehensive clinical data and oral health history, along with saliva analysis for HPV in the specific OPMD.

Material and methods: The DNA extracted from saliva samples obtained from patients with a clinical presentation of OLP, classified as ICD-10:L43, was analyzed using HPV type-specific bead-based multiplex genotyping assays to detect 21 mucosal alpha-, 46 betaand 52 gamma-HPV types.

Results: The most common HPV type was HPV-49, with a statistically significant difference found between the OLP and control groups (p < 0.05). There was no statistical correlation between high-risk (HR) HPVs (HPV-16 and HPV-18) and OLP in the studied population. Positive results for the mucosal types of DNA in the saliva were associated with the positive beta and gamma types that were consistently identified in the analyzed biomaterial.

Conclusions: Beta-HPV-49 was significantly more prevalent in the saliva of patients with OLP. There was no relationship between HR HPVs and the OLP status, which represents the difference between OLP studied in this research and other OPMDs.

Background: The durability of indirect restorations is significantly influenced by marginal adaptation and internal fit. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) with digital impressions has reduced dental prosthesis fabrication errors, improving the long-term survivability of the restorations.

Objectives: The present study assessed the impact of intraoral and extraoral scanning methods on the marginal adaptation and internal fit of 2 different types of monolithic crowns manufactured using CAD/CAM.

Material and methods: A total of 40 three-dimensional (3D) resin-printed dies were randomly assigned to 2 groups based on the type of crown material (n = 20 per group). Each group was divided into 2 subgroups (n = 10 per group) according to the die-scanning technique: subgroup A, scanned using the intraoral scanner (IOS) Primescan; and subgroup B, scanned using the extraoral scanner (EOS) inEos X5. The digitized photos were converted into a 3D virtual crown design using CAD software. The internal discrepancy values, and the marginal gap between the 3D resin-printed die and the crown were assessed using a ×50 digital microscope. The data was checked for normality with the Kolmogorov-Smirnov test, and the Mann-Whitney U test was used to compare the tested groups. The collected data was analyzed at a significance level set at p < 0.05.

Results: The different scanning techniques used had a statistically significant effect on the vertical marginal gap and the internal fit [μm] (p < 0.05). As far as the crown materials are concerned, BRILLIANT Crios showed a significantly higher marginal gap as compared to Tetric CAD when scanned with inEos X5 (p = 0.004), whereas the differences were insignificant with regard to the internal fit (p > 0.05).The crown parameters tested with both scanning systems were within the clinically acceptable ranges.

Conclusions: Scanning methods and crown materials had an impact on the internal fit and vertical marginal gap of monolithic crowns.

Background: The success of endodontic retreatment relies on the effective elimination of pathogenic microflora from the root canal.

Objectives: The study aimed to investigate the effects of an erbium-doped yttrium-aluminum-garnet (Er:YAG) laser and a 635-nm laser on the healing of asymptomatic chronic periapical lesions (PLs) in endodontically treated teeth and the reduction of postoperative pain.

Material and methods: Forty patients with PLs in mandibular molars were referred for root canal retreatment (RCR). Conventional chemo-mechanical endodontic treatment was conducted in the control group (G1; n = 20). In the test group (G2; n = 20), in addition to conventional chemo-mechanical treatment, Er:YAG laser-activated irrigation (LAI) with 2% NaOCl and 17% EDTA was performed. The laser parameters were as follows: 50 mJ; 25 Hz; 1 W; 300 μs; a tip diameter of 300 μm; fluence of 71.4 J/cm2; and power density of 1,428.6 W/cm2. Subsequently, the canals were filled with thermo-condensed guttapercha, using the AH Plus sealer. In group G2, additional photobiomodulation (PBM) with a wavelength of 635 nm (400 mW, 5 s per point, a dose per point: 2 J, a dose per square centimeter: 4 J, an applicator diameter of 8 mm) was applied, with 2 application points at the apex level, administered over 4 sessions - on the treatment day, and after 24 h, 48 h and 96 h. Endodontic lesion remission was assessed by measuring the PL size with the use of cone-beam computed tomography (CBCT) at 6 and 12 months postoperatively. Postoperative pain was evaluated using the visual analog scale (VAS) after 1, 2 and 4 days.

Results: The study results demonstrated a statistically significant decrease in the mean PL size at 6 months postoperatively in the test group (mean PL size: 1.55 ±0.51 mm) as compared to the control group (mean PL size: 1.95 ±0.71 mm) (p < 0.05). In the test group, postoperative pain on VAS was significantly lower after the procedure (p < 0.05).

Conclusions: The application of Er:YAG and 635-nm diode lasers improved PL healing and decreased postoperative pain.

The purpose of this systematic review was to provide a comprehensive assessment of the literature on the relationship between the presence of effusion, as determined by magnetic resonance imaging (MRI), and clinical pain in patients with temporomandibular disorders (TMD). The study was performed in order to answer the following clinical question: "Can MRI-detected temporomandibular joint (TMJ) effusion be considered a marker of clinical pain?"On June 15, 2024, a systematic literature review was performed in the PubMed® and Scopus databases. The Medical Subject Headings (MeSH) terms used to initiate the search were "temporomandibular joint" AND "MRI". A PICO (Population, Intervention, Comparison, and Outcome) structured reading model was employed to identify and assess articles that evaluated the correlation between TMJ effusion visible on MRI scans and clinical pain reported by patients. The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A total of 539 articles were initially retrieved, of which 14 answered the research question. The review revealed a consistent pattern of results, with 12 out of the 14 articles reporting an association between effusion and pain.The findings indicate that there is a link between the occurrence of effusion and the experience of pain in individuals diagnosed with TMD.

This review aims to comprehensively examine the historical development, molecular mechanisms and clinical applications of checkpoint inhibitors in squamous cell carcinoma of the head and neck (SCCHN). Squamous cell carcinoma of the head and neck represents a significant global health challenge as the 7th most common malignancy worldwide. Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 and CTLA-4 pathways have emerged as promising therapeutic approaches. Current evidence supports the use of ICIs in the recurrent/metastatic (R/M) setting, while data for neoadjuvant and adjuvant applications is evolving. Pembrolizumab monotherapy or in combination with chemotherapy has demonstrated survival benefits in PD-L1-positive R/M SCCHN, while nivolumab has shown efficacy in the second-line setting. Results from trials combining ICIs with radiotherapy have been mixed, with several phase III studies failing to meet primary endpoints.The integration of ICIs has transformed the treatment landscape for R/M SCCHN, while the ongoing research continues to define their optimal use in earlier disease settings and in novel therapeutic combinations. Future directions include exploring combination strategies with targeted therapies, identifying predictive biomarkers beyond PD-L1 expression, and developing immunotherapy approaches tailored to HPV-positive vs. HPV-negative disease.