Head & Face Medicine最新文献

Objectives: This study aimed to evaluate the antibacterial and antifungal efficacy, as well as postoperative pain levels, following non-surgical retreatment of single-rooted teeth using tricalcium silicate- or calcium hydroxide-based intracanal dressings.

Materials and methods: Forty-nine patients diagnosed with apical periodontitis were randomly assigned to two groups: tricalcium silicate (n = 25) and calcium hydroxide (n = 24). Microbiological samples were obtained before instrumentation (S1), after chemo-mechanical preparation (S2), and 10 days post-medication (S3). Total bacterial load and Candida albicans levels were quantified using qPCR. Postoperative pain was assessed on days 1, 3, 5, 7, and 10.

Results: No significant differences were found between the groups in demographic variables. The calcium hydroxide group showed a significantly greater reduction in total bacterial load in S3 samples. No significant differences were observed between groups regarding C. albicans levels or postoperative pain at any time point. However, a significant reduction in pain was noted on day 1 compared to baseline in the calcium hydroxide group.

Conclusions: Both materials were effective in reducing microbial load; however, calcium hydroxide demonstrated superior antibacterial efficacy. Antifungal activity and postoperative pain outcomes were comparable between the groups.

Trial registration: This trial was registered at Clinicaltrials.gov on 15/01/2025 (NCT06779370).

Objectives: We aimed to compare the intra- and interobserver agreements of postgraduate students in selecting tooth color using various conventional or digital tools.

Methods: Color selection was performed by four postgraduate students. Prior to the study, the students attended a lecture for calibration. Tooth color was assessed on the maxillary central incisors of 32 healthy patients. Visual color selection was performed using VITA Classical (VC) and VITA 3D (V3D) color scales. Digital color selection was performed using VITA Easyshade V and Canon D80 digital camera. The enamel (incisal) and dentin (cervical) from an anterior composite resin set were temporarily adhered to the facial surface of the incisor using the button technique. Digital photographs were captured and color selection was performed. Enamel (E1) and dentin (D1) colors were created based on the original photographs. The enamel color (E2) was selected by converting the photographs to black and white. The dentin colors (D2) were chosen by increasing the contrast of the images. Data were statistically analyzed using the intraclass correlation coefficient (ICC) test.

Results: Poor or moderate agreement was observed between the VC-V3D, VC-VE, and V3D-VE in terms of intraobserver agreements. Conversely, the intraobserver agreements between E1 and E2 were good for all four observers. The ICC results for the interobserver agreement were good for evaluations of photographs alone, whereas the agreement was poor for the other methods.

Conclusions: Color selection in the aesthetic region can be safely performed using the button technique based on original digital photographs.

Clinical relevance: Digital dental photography is important in improving the accuracy of clinical tooth color selection.

Study objectives: Functional orthopedics induces mandibular advancement caused by neuromuscular adaptations. These adaptations can affect the position of the hyoid bone and may contribute to the amount of skeletal outcomes. The skeletal response is triggered by the quality and quantity of growth as well as muscular reactions. The aim of this clinical trial was to evaluate the hyoid bone position before and after functional orthodontic treatment.

Methods: This prospective cohort study included 31 patients (mean age: 12.3 ± 0.9 years) with skeletal class II meeting the following inclusion criteria: ANB > 4°, > ½ Class II molar relationship, overjet > 6 mm, neutral/horizontal growth pattern, and CVMS II-III. All patients were treated with the Sander Bite Jumping Appliance (BJA) with wear time monitored through microsensors. Lateral cephalograms were taken at baseline (t0) and after 1 year (t1). Linear and angular hyoid measurements were analyzed. Statistical analysis was performed using IBM SPSS (v29.0.2.0), employing paired t-tests and an exploratory post hoc grouping based on total mandibular length changes (Δco-pg), with significance set at p < 0.05.

Results: BJA therapy resulted in a significant more superior and anterior position of the hyoid in all patients. A greater increase in Δco-pg at t1 was associated with a more pronounced hyoid shift, while patients with a less Δco-pg showed a more inferior hyoid position at t0 and a greater tendency towards a vertical growth pattern.

Conclusion: A more inferior initial hyoid position was associated with limited mandibular advancement, suggesting a potential anatomical link to airway physiology, warranting further investigation into its implications for OSA risk.

Clinical trial registration: German Clinical Trials Register (DRKS); URL: http://www.germanctr.de; Identifier: DRKS00021090; registration date: 12.03.2020.

Objective: To analyse the characteristics of electrically evoked middle latency responses (EMLR) in patients with profound sensorineural hearing loss (SNHL) and tinnitus.

Methods: Thirty adults with profound SNHL and tinnitus who underwent cochlear implantation were selected as the tinnitus group, and 15 patients with profound SNHL but without tinnitus served as the control group. Preoperative data were retrospectively analysed. Electrically evoked middle latency responses were recorded intraoperatively, and the electrophysiological characteristics were compared between groups. Changes in tinnitus were assessed using the Tinnitus Handicap Inventory (THI), and correlations between EMLR parameters and THI scores were analysed.

Results: No postoperative complications occurred in any of the patients. Electroauditory responses were successfully elicited in all 45 patients. Intraoperative EMLR showed increased Na-Pa amplitude and delayed Pa latency, with significant differences observed between the tinnitus and control groups (P < 0.05). One year after cochlear implantation, the average comfort level (C value) and the EMLR threshold showed a significant linear correlation (r = 0.915, P < 0.01). Postoperative THI scores showed a significant decrease (P < 0.05) compared with preoperative scores. A significant correlation was found between the intraoperative EMLR Na-Pa wave amplitude and THI change at 1 year (r = 0.815, P < 0.05), with an area under the ROC curve of 0.673 (P = 0.002).

Conclusion: The intraoperative EMLR waveform of patients with profound SNHL and tinnitus is significantly different from that of patients without tinnitus. Cochlear stimulation effectively inhibits tinnitus, and EMLR provides an objective tool for evaluating tinnitus and optimising its management. However, further studies with larger sample sizes are needed to validate these preliminary findings.

Background: This cohort study aimed to evaluate the relationship between sella turcica (ST) morphology and dentofacial anomalies three-dimensionally (3D).

Methods: Cone beam computed tomograms (CBCTs) and computed tomography scans (CTs) of 90 adults (46 women; age 28.1 ± 11.3 years) were analyzed. Dentofacial anomalies were evaluated (1) sagittally regarding skeletal classes (Wits appraisal), (2) vertically regarding the inclination of the jaws (maxillomandibular plane angle), and (3) transversally regarding skeletal symmetry (menton deviation from midsagittal plane). Sella morphology was assessed (a) linearly by ST-length, -width, -height, -diameter, and position to nasofrontal suture (CB); and (b) volumetrically by total, anterior, and posterior volume (Vol_T, Vol-A, Vol_P). Five porcine skulls were scanned by CBCT, CT, and micro-CT for method validation.

Results: CBCT and CT both underestimated the ST volume compared to the volume measured with micro-CT. ST morphology differed significantly between the skeletal classes. Individuals with skeletal class I showed higher ST length than participants with skeletal class II (p = .024). Vol_T and Vol_A were higher in class II than in class III (p = .047; p = .019). Vol_A correlated with the Wits appraisal (r = .337, p < .001). Vertical and transversal jaw relation showed no correlation with ST variables. ST-width and CB were significantly higher in men than women (p = .004; p < .001).

Conclusion: 3D-diagnostics of ST morphology enabled conclusions about underlying dentofacial anomalies. Vol_A seemed to be a relevant marker based on its correlation and class-specific volumes. Future research could help to identify this as prognostic factor of developing anomalies.

Background: Squamous cell carcinoma of the lip (LSCC) is a relatively rare malignancy. The criteria for performing a neck dissection remain unclear, as reliable predictors for lymph node metastasis (LNM) have not been fully established. This study aimed to identify risk factors for LNM to guide the indication for elective neck dissection.

Methods: A total of 57 patients with LSCC were evaluated based on 81 clinical and pathological parameters, including three previously published pathological grading systems. Statistical analyses focused on identifying the most relevant and independent predictors of LNM using univariate and multivariate logistic regression, supplemented by the LASSO algorithm for feature selection.

Results: Tumor size (OR 1.008, p = 0.85) and peritumoral tumor budding (OR 1.43, p = 0.059) emerged as the most relevant independent predictors of LNM. Notably, the number of peritumoral tumor buds was significantly higher in lymph node-positive (pN +) patients compared to lymph node-negative (pN -) patients (p < 0.01). Receiver operating characteristic (ROC) curve analysis demonstrated that peritumoral tumor budding outperformed other classification systems, with the highest area under the curve (AUC = 0.86).

Conclusion: Peritumoral tumor budding shows strong predictive potential for lymph node metastasis in LSCC, offering valuable insights for the preoperative evaluation and indication for elective neck dissection.

Background: Surgical correction of unilateral cleft lip and palate (UCLP) aims to restore normal facial development and function. Achieving symmetry is essential for dental arch development and facial symmetry. The surgical treatment can result in midfacial retrusion, maxillary constriction, and alveolar segment collapse. The aim of this study was to develop a novel 3D analysis method for assessing possible effects on maxillary arch development following different surgical techniques for lip repair in UCLP patients.

Methods: The dimensions of the maxillary arch were analyzed and compared in children with UCLP who had undergone Delaire or Tennison-Randall/Pfeifer surgery before lip and palate closure using digitized dental plaster casts. Two different evaluation methods were used in the study: the 2D analysis was based on linear measurements using reference points in the OnyxCeph3™ software. The semi-automatic 3D analysis was based on the curve-fitting method and our self-developed customized software application (SMP).

Results: No significant differences were observed using the 2D method. However, the 3D analysis detected statistically significant differences in the Q coefficient (p = 0.001393) between the two surgical techniques, demonstrating the superior ability of the 3D method to assess morphological changes.

Conclusions: The 3D analysis did not depend on classical reference points. It provided new information for assessing the collapse of maxillary segments. This analysis is a valuable tool for evaluating the impact of surgical techniques on maxillary arch development in children with UCLP. These findings advocate the integration of advanced 3D imaging tools in cleft surgery planning and postoperative assessment.

Background and objectives: Oral squamous cell carcinoma (OSCC) is a highly aggressive malignancy with poor prognosis and limited treatment options. N6-methyladenosine (m⁶A) modification represents a pivotal layer of epitranscriptomic regulation in cancer. Fat mass and obesity-associated protein (FTO), an m⁶A demethylase, has been implicated in several malignancies. While FTO's involvement in OSCC is emerging, its regulation of glycolytic metabolism remains uncharacterized. This study aimed to investigate the biological function of FTO in OSCC and determine whether it modulates PKM2 expression through an m⁶A-dependent mechanism involving YTHDF2.

Materials and methods: FTO expression was analyzed in OSCC tissues by immunohistochemistry and Western blotting. Functional assays were performed in SCC25 and CAL27 cells with stable FTO knockdown or overexpression to assess proliferation, migration, invasion, and glycolytic activity. Global m⁶A levels, RNA-protein associations, and mRNA stability were examined using dot blot, RIP-qPCR, and actinomycin D treatment. NF-κB pathway activation was evaluated by Western blotting. In vivo tumorigenicity was assessed using xenograft models.

Results: FTO was markedly upregulated in OSCC tissues and correlated with aggressive clinical features. Silencing FTO attenuated malignant phenotypes and glycolytic flux. Mechanistically, FTO stabilized PKM2 mRNA by reducing YTHDF2-mediated degradation via m⁶A demethylation. FTO expression also coincided with enhanced NF-κB signaling activity.

Conclusion: These findings define an FTO/m⁶A/YTHDF2/PKM2 axis that promotes OSCC progression through glycolytic reprogramming and tumor growth, highlighting a potential metabolic vulnerability for therapeutic intervention.

Objectives: The objective of this prospective, randomized, parallel-group clinical study was to compare the 6- and 12-month clinical performances of direct composite restorations with or without fiber-reinforced composite applied to endodontically treated posterior teeth (ETpT) in bruxists.

Materials and methods: Thirty-two ETpT were randomly restored with only posterior composite (gneal posterior, GC; CR group) or fiber-reinforced composite (EverX flow, GC) + posterior composite (FRCR group) in bruxists aged 18-65 years (n = 16). The inclusion criteria were as follows: bruxists with ETpT; class 1/2 cavities; the remaining functional wall at least 3 mm thick; teeth with a natural tooth in the opposite arch; and adjacent teeth on both approximal sides. The presence of periapical symptoms, posterior teeth with tubercule loss, and teeth with root canal fillings at least 2 mm short of the radiographic apex were excluded.

Results: All restorations were evaluated at 6 and 12 months on the basis of the World Dental Federation (FDI) criteria. No failure was reported, and clinical success was recorded for all aesthetic, functional, and biological criteria at 6 and 12 months of follow-up in both groups.

Conclusions: Small/medium-sized direct composite restorations with or without fiber-reinforced composites demonstrated excellent and similar clinical performances at 12 months in bruxists.

Clinical relevance: Since parafunctional forces can be significantly higher than normal chewing forces, the study focused exclusively on patients with bruxism. The 12-month clinically successful outcomes of direct composite restorations both with and without SFRC in this study will guide future long-terms studies in evaluating restorations of ETpT in bruxists.

Date of registration: 2025-03-11 (retrospectively registered).

Clinical trial registration: This prospective, randomized, parallel-group clinical study was registered in a publicly accessible database with clinicalTriald.gov.ID No. NCT06870188.