Dental and Medical Problems最新文献

Background: There is a well-established link between the use of smokeless tobacco (ST) and the development of oral cancer. This study was conducted to evaluate the impact of tobacco use, quid use, and other adverse habits related to smoking and alcohol consumption on ST-induced localized lesions.

Objectives: The aim of the study was to examine the demographic data, frequency and contact duration of ST on the lesion, as well as to conduct a clinical evaluation of these parameters.

Material and methods: A total of 13,442 patients who had been experiencing oral and dental symptoms for a period of at least 6 months were screened. Of these, 334 patients were diagnosed with STor quid-induced localized lesions and had a positive history of ST or quid use. A structured questionnaire was employed to conduct interviews with participants regarding their use of ST and other adverse habits, including smoking and alcohol consumption. Other information related to the use of ST or quid and clinical findings were also recorded, along with the patients' demographic details. A statistical analysis was carried out using the χ2 test and the regression analysis.

Results: The overall prevalence of ST-induced localized lesions was found to be 2.48%. In the study population, the majority of participants (58.7%) reported a habit of using khaini, while 26.8% reported using gutkha. The study found significant differences in the severity of ST-induced localized lesions and contact duration, frequency of the habit, and the presence of additional habits such as smoking and/or alcohol consumption. Based on this study, we proposed a modified Greer and Poulson's classification of ST-induced lesions, dividing them into 4 clinical types.

Conclusions: Smokeless tobacco-induced localized lesions frequently remain asymptomatic, with patients unaware of their presence. Other adverse habits, including smoking and alcohol consumption, as well as increased ST contact duration were associated with the development of more severe ST-induced localized lesions.

The complex interplay between the gut microbiota, cancer treatments and patient characteristics has emerged as a significant area of research. This study sought to examine these relationships in the context of colorectal cancer (CRC).A comprehensive search of relevant studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The studies included a variety of treatment modalities and microbiological parameters. A data extraction form, designed specifically for this review, was used to assess a range of variables across all studies.The analysis revealed a multifaceted interaction between the gut microbiota, genetic factors and treatment outcomes. Elderly patients with CRC frequently received single-agent chemotherapy, with outcomes that were comparable to those of younger patients. The presence of tumorigenic bacteria, including Escherichia coli and Bacteroides fragilis, was associated with early colon neoplasia. Additionally, an abundance of Fusobacterium spp. was observed in colonic adenomas, contributing to a pro-inflammatory environment. Although the FcγRIIIa-158 V/V genotype was associated with higher cetuximab-mediated antibodydependent cellular cytotoxicity (ADCC), no direct influence of FcγR polymorphisms on treatment response was noted. Furthermore, the combination of programmed cell death protein-1 (PD-1), BRAF and MEK inhibition showed favorable response rates. The gut microbiome, especially the presence of Fusobacterium spp., had a notable influence on the therapeutic response in CRC.These findings underscore the role of the gut microbiota and genetic factors in cancer treatment outcomes, emphasizing the potential of a holistic approach to cancer management. Future research should exploit these findings in order to develop microbiota-modulating strategies and personalized medicine approaches for the purpose of improving the efficacy of cancer treatment.

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: Coronavirus disease 2019 (COVID-19) quickly reached the pandemic status, with 765.22 million confirmed cases of COVID-19 and 6.92 million COVID-19 deaths reported worldwide by May 2023. Due to its sudden and global nature, the COVID-19 pandemic has had a significant impact on the emotional and mental health of many people. A group of COVID-19 patients who frequently require intensive care are geriatric patients. The cognitive performance of these patients and their independence in instrumental activities of daily living (IADL) may be crucial to their prognosis and risk of in-hospital death.

Objectives: The present study aimed to assess the level of independence in activities of daily living (ADL), mental fitness, the level of fear of COVID-19, and cognitive functions to determine their impact on in-hospital mortality in geriatric COVID-19 patients.

Material and methods: A total of 300 intensive care unit (ICU) patients with COVID-19 were included in the cross-sectional study, using the following questionnaires: the Lawton IADL scale, the Katz ADL index of independence, the fear of COVID-19 scale (FCV-19S), the abbreviated mental test score (AMTS), and the 15-item geriatric depression scale (GDS15).

Results: Patients aged 64 or below reported significantly greater independence on the IADL scale and the basic ADL scale, and showed a significantly higher level of mental fitness (Mann-Whitney U test; p = 0.001). Patient survival and in-hospital mortality were influenced by independence in basic and complex ADL.

Conclusions: The level of independence is an important prognostic indicator for in-hospital mortality in geriatric COVID-19 patients. The higher the level of mental fitness, the higher the level of independence in basic and instrumental activities of daily living. Patients aged ≥65 years are less independent in basic and instrumental activities of daily living. Moreover, they show a significantly lower level of cognitive functions.

Background: Although the macroscopic assessment of dental caries and the assessment of bone elemental composition are quite different, efforts can be made to identify commonalities in the assessment of health and nutritional quality. Both indicators are correlated with dietary habits and are dependent on taphonomic processes occurring in the postmortem substrate. However, teeth exhibit structural resilience of their hard tissues to adverse environmental factors.

Objectives: The aim of the study was to establish a correlation between the elemental composition of bones and the presence of carious lesions.

Material and methods: The study material consisted of the following skeletal parts: 161 permanent teeth from 36 individuals and bridge fragments of 36 ribs. The presence of caries was assessed visually using a modified International Caries Detection & Assessment System (ICDAS II) scale. The rib samples were subjected to elemental analysis (zinc (Zn), iron (Fe), magnesium (Mg), calcium (Ca), phosphorus (P), strontium (Sr), barium (Ba)) using spectroscopic methods.

Results: The odontological and chemical analyses did not reveal any statistically significant relationships between the Ca/P diagenesis index and dental features. Postmortem tooth loss showed a weak correlation with the diagenesis index.

Conclusions: Discoloration, cracks and flaking of the dental crown surfaces may be associated with the intensity of Ca/P diagenesis. However, no significant correlation was found between these phenomena. Among other elements, only Zn levels exhibited a correlation with the caries index.

Background: Preand probiotics may help restore a dysbiotic oral ecosystem. The first years of life provide a window of opportunity to modulate the composition of the oral microbiota and prevent disease.

Objectives: The aim of the present study was to investigate the effect of a tablet containing inactivated Ligilactobacillus salivarius CECT 5317 and the cranberry extract on the development of caries in cariesactive preschool children.

Material and methods: The study employed a randomized, placebo-controlled, double-blind design. Preschool children (N = 73) with at least one active carious lesion were enrolled and randomly assigned to the test group or the placebo group. The intervention period was 3 months. Caries was assessed according to the International Caries Detection and Assessment System (ICDAS) II criteria at baseline and after 9 months, and oral hygiene was evaluated with the simplified oral hygiene index (OHI-S). The salivary counts of Streptococcus mutans and Lactobacillus spp. were determined at baseline, and then after 3 and 9 months through the conventional cultivation on TYCSB and MRS agar, respectively.

Results: Sixty children completed the trial (a dropout rate of 19%). The baseline caries prevalence was high in both groups (~71%) and there were no major differences between the groups with regard to background variables. The 9-month incidence of initial carious lesions (ICDAS 1+2) was significantly lower in the test group as compared to the placebo group (p < 0.05). The plaque levels, and the salivary counts of S. mutans and Lactobacillus spp. remained unchanged in both groups throughout the study.

Conclusions: A daily intake of a tablet containing a paraprobiotic and the cranberry extract reduced the 9-month incidence of initial non-cavitated carious lesions in caries-active preschool children. The present study is one of the first to show the impact of synbiotics on the development of caries in children.

The International Agency for Research on Cancer (IARC) "Handbook of Oral Cancer Prevention", vol. 19, provides a thorough and comprehensive evidence-based evaluation of primary and secondary prevention interventions for oral cancer.

The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.

Background: Pit and fissure sealants are the most commonly used preventive measure against caries in permanent molars. Advancements in dental materials have led to the development of hydrophilic sealants. However, their clinical efficacy must be evaluated and compared with that of conventional hydrophobic sealants.

Objectives: This study aimed to clinically evaluate and compare the retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants over a 12-month follow-up period.

Material and methods: The study was a split-mouth, double-blind, randomized controlled trial. A sample size calculation was performed, and 120 first permanent molars (60 in each group) were selected for inclusion in the study. According to the split-mouth design, the sample was randomly divided into 2 groups. Group A was treated with a hydrophilic sealant (UltraSeal® XT Hydro), while Group B was treated with a hydrophobic sealant (Conseal F). The sealants in both groups were applied in accordance with the manufacturer's instructions by a single operator. The sealants were evaluated clinically using visual and tactile methods by 2 independent examiners who were blinded to the procedure in accordance with the modified United States Public Health Service (USPHS) clinical rating system at placement and at 1, 3, 6, and 12 months.

Results: After 12 months of follow-up, the Conseal F sealant showed significantly better retention (p = 0.001), marginal adaptation (p = 0.023) and reduced marginal discoloration (p = 0.004) in comparison to the UltraSeal XT Hydro sealant.

Conclusions: The Conseal F (hydrophobic) sealant demonstrated superior retention, marginal adaptation and marginal discoloration compared to the UltraSeal XT Hydro (hydrophilic) sealant.

Background: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment.

Objectives: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery.

Material and methods: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure.

Results: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain.

Conclusions: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.