Journal of Applied Oral Science最新文献

Background: Considering that a single passive application of hydrochloric acid (HCl) as a resin infiltration pretreatment can remove between 20 and 45 µm of enamel and cause etching that extends up to 2 mm beyond the white spot lesions (WSLs), it is plausible that its repeated and active applications could result in a greater amount of dental tissue being removed.

Objective: To evaluate the enamel surface loss and micromorphology after etching with 15% HCl using two application methods (passive-P and active-A) and varying numbers of applications (C-placebo - 120 s; 1x HCl - 120 s; 2x HCl - 120 s + 120 s; 3x HCl - 120 s + 120 s + 120 s).

Methodology: Bovine incisors with ≤0.3 µm initial curvature were randomized into eight groups (n=12) based on microhardness, followed by WSL simulation. A central window was etched according to experimental conditions, and surface loss was assessed using optical profilometry and micromorphology via scanning electron microscopy (SEM). Two-way ANOVA and Tukey's test were used for surface loss, and the chi-square test evaluated the association of experimental conditions with etching patterns (α=0.05).

Results: 1xP generated intermediate mean surface loss, positioned between the values observed for passive control (PC) and active control (AC), and those for 2xP and 3xP. Losses from active applications were significantly higher than passive ones and were increased by the number of applications. SEM showed Types II and III etching patterns and Type II was more frequent. There was no association between treatment and etching pattern.

Conclusion: Multiple and active HCl applications may raise concerns about removal of the remaining tooth structure, challenging the principles of minimal intervention dentistry.

Background: The scanned abutment file for the digital design of restorations can be either obtained directly using the intraoral scanner (IOS) or scanning the impression or the working model with the extraoral scanner (EOS). The trueness of the scanned file pertains to its effect on the accuracy of the restoration.

Objective: This study aimed to compare the trueness of scan files from different intraoral scanners (IOSs) and the hybrid workflow using the E3 extraoral scanner (EOS) for ceramic restoration.

Methodology: The model of the mandibular right first molar was prepared for the ceramic crown, and it was scanned with the EOS in reference Standard Tessellation Language (STL) file format. The following seven experimental groups were investigated. The IOSs-iTero Element 5D (IT), Trios 4 (TF), Medit i700 (MI), Primescan (PM), Virtuo Vivo (VV)-were directly scanned on the prepared model. The silicone impression of the prepared model was scanned with EOS (IS). The working model poured from the impression was scanned with the EOS (WS). The test STL file was trimmed and superimposed on the reference STL file for the trueness assessment using Geomagic Control X. The point deviation at the surface and margin of each group were compared. The mean deviation was calculated and statistically analyzed with One-way ANOVA (α=0.05). The minimum and maximum deviation of each area were also recorded.

Results: Compared with the other groups, the impression scan group had a significantly greatest deviation (p<0.05) in surface (37.65±1.14 µm), margin (63.57±5.85 µm) and overall (50.61±3.28 µm). The WS group showed significantly greater deviation (p<0.05) in surface (23.93±1.20 µm), margin (46.18±2.00 µm) and overall (35.05±1.16 µm) than the IOS groups. In some IOS groups, the deviation was also significantly different (p<0.05).

Conclusion: The IOS is recommended for obtaining the scanned file due to its lesser deviation when compared to the hybrid workflow. While statistical differences exist among IOSs, the clinical relevance of these differences appears minimal. If the IOS does not exist, scanning the working model is preferred over scanning impressions directly. However, further clinical validation studies are necessary to confirm this finding.

Background: Dental pulp stem cells (DPSCs) are widely available sources of stem cells that have been extensively studied for its capacity to differentiate into osteoblasts and endothelial cells and to support bone repair and regeneration. Collagen type 1 (Col-1) is a well-known extracellular matrix component, which plays a vital role in regulating the signaling pathway for osteoinduction of bone progenitor cells. However, the exact mechanism of Col-1 activation during stem cell osteogenesis remains unclear.

Objectives: This study aims to identify the key signalling pathway and proteins interaction associated with Col-1-induced osteogenesis of DPSCs.

Methodology: The localization of OCN protein was assessed by immunocytochemistry analysis, followed by Western blot analysis on OCN, AKT, p- AKT, Smad2/3, p-Smad2/3, ERK1/2, and p-ERK1/2 pathways. Protein profiling was performed using gel-free digestion and LC-MS/MS, followed by protein-protein interaction analysis using STRING online tools to assist in determination of link between various pathways.

Results: The data indicated that the PI3K/AKT pathway is the key signaling pathway involved in Col-1-induced DPSC, showing a significant impact and potential crosstalk with TGF-b/Smad and MAPK/ERK mainly via focal adhesion protein complexes.

Conclusion: The evidence suggests that PI3K/AKT signaling pathway is more dominant than the TGF-β/Smad and MAPK/ERK pathways, acting via stimulation of the focal adhesion protein complex. Together, these findings may provide deeper insight into cellular biology of differentiated cells for potential manipulation in bone tissue repair and regeneration.

Objective: To investigate the effects of dealcoholized red wine supplementation on blood cells and the redox state in male rats with established apical periodontitis (AP).

Methodology: Thirty-two male Wistar rats were assigned to one of four groups: control (C), dealcoholized red wine (DRW), red wine (RW), and alcohol (AL). AP was induced, and supplementation was administered for 30 days, starting 30 days after AP induction. At the end of the 60th day, the maxillae were removed for AP radiographic analysis and blood was collected for blood cell and redox state analysis. Statistical tests were applied (p<0.05).

Results: The C and DRW groups showed higher weight gain percentages (p<0.05). The DRW and AL groups exhibited the smallest and the largest periapical lesion areas, respectively (p<0.05). The RW and DRW groups showed similar red blood cell parameters to the C group but different from the AL group (p<0.05). Lymphocyte counts were smaller in the DRW and RW groups compared to the AL and C groups (p<0.05), and the neutrophil count was lower in the AL group (p<0.05). No significant differences were found in monocytes and in lipid and protein oxidative damage. Superoxide dismutase activity was lower in the AL group (p<0.05). The DRW group presented a higher glutathione concentration compared to the RW and AL groups (p<0.05).

Conclusion: DRW reduced periapical lesion size and altered the blood profile by reducing the lymphocyte count and increasing the concentration of endogenous antioxidants such as GSH in male rats with established AP.

The success of orthodontic treatment depends on several factors that may influence the desired outcome, such as patient motivation and cooperation.

Objective: This study compared patient compliance during the first year of orthodontic treatment using aligners and conventional fixed appliances.

Methodology: The sample included 39 participants (22.1±4.62 years, 25 males, 14 females) randomized into two groups: orthodontic aligners (OA, 20 patients, 23.7±5.6 years, 12 males, 8 females) and fixed appliances (FA, 19 patients, 20.5±4.5 years, 12 males, 7 females). Patient compliance was measured using the Orthodontic Patient Cooperation Scale (OPCS) composed of 10 questions related to attitudes and attendance of patients in relation to treatment. The questionnaire was applied at three different points: at 3 months (T1), at 6 months (T2), and at 12 months (T3) of treatment. The psychosocial profile of the patients was assessed using the anxiety (IDATE) and stress (PSS-14) questionnaires. Both groups were comparable in age, gender and psychosocial profile. Compliance comparisons between groups at T1, T2 and T3, as well as between genders, were performed using the Mann-Whitney test. Comparison between T1, T2 and T3 were performed using the Friedman test. The correlation between age and compliance scores was assessed using the Spearman's correlation coefficient. The psychosocial profile was analyzed using the Independent t-test. All tests considered p<0.05.

Results: The type of appliance (OA or FA) and the time of assessment did not significantly influence patient compliance. The age and gender of patients were not correlated with their degree of compliance. Patient compliance was similar in the first 12 months of treatment, regardless of the protocol used, the patient's gender and age.

Conclusions: The level of patient compliance with orthodontic treatment was not influenced by the type of appliance (conventional fixed appliances or aligners), nor by the patient's age or gender.

Objective: Tongue squamous cell carcinoma (TSCC) is an aggressive oral cancer with notable treatment resistance. This in vitro study investigated anti-cancer effects of honey bee venom (BV)-a mixture of bioactive compounds-on the human TSCC cell line.

Methodology: The cytotoxicity of serial BV concentrations (0.01-100 µg/mL) was tested on the cultured human TSCC cell line (HNO-97) to determine the half-maximal inhibitory concentration (IC50) value. Group I (BV) included cells treated with IC50 of BV, and Group II (control) received no treatment; both were incubated for 48 hours. The apoptotic effect of BV was evaluated using the Annexin V assay and the BAX and BCL-2 gene expression. The BV effect on cell viability, proliferation, and division was evaluated by cell cycle assay. Additionally, Transwell migration assays were performed to demonstrate the potential impact of BV on cell migration.

Results: BV showed dose-dependent cytotoxicity and anti-proliferative activity on HNO-97 cells (IC50: 12.96 μg/mL). The treated group exhibited cell cycle arrest, reduced cell migration, significantly decreased BCL-2 gene expression (p=0.001), and increased BAX gene expression (p=0.03) compared to the untreated group.

Conclusion: BV demonstrated anti-cancer activity on human TSCC by inducing apoptosis and inhibiting cell migration. These findings warrant further preclinical investigations to evaluate BV as an alternative for current tongue carcinoma therapies.

Objectives: Finding certain biomarkers and threshold values of periodontitis and incorporating them into classifications can further highlight its impact on systemic health. This cross-sectional observational study aims to evaluate the efficacy of some biomarkers in grading periodontitis using artificial intelligence (AI) models.

Methodology: AI models were developed to automatically classify periodontal status (N=240) and grades in periodontitis patients (n=120) using Python based on sociodemographic, anthropometric, clinical, radiological, and biochemical attributes. A total of 35 serum levels of whole blood attributes (white blood cell (WBC), platelet, erythrocyte, neutrophil, lymphocyte counts, and mean platelet volume), lipid profile [triglycerides; high-, low-, and very low-density lipoproteins (HDL, LDL, VLDL), and total cholesterol levels], salivary and serum interleukin (IL)-1β and matrix metalloproteinase (MMP)-8 levels), and 11 other attributes were used in the current classification.

Results: In total, 23 out of 46 attributes achieved a 0.967 classification accuracy, whereas nine, a 0.858 classification accuracy. Attributes such as WBC, serum IL- 1β, triglyceride/HDL ratio, neutrophil/lymphocyte ratio, and HDL were instrumental in periodontal status classification. HDL, LDL, neutrophil/lymphocyte ratio, total cholesterol, salivary IL-1β, and MMP-8 were key attributes in grading.

Conclusions: AI models showed significant classification accuracy, particularly with serum and salivary IL-1β levels and other blood parameters, underscoring the potential of these biomarkers, which could be integrated into the current classification.

Objective: To evaluate factors influencing the response to periodontal therapy in patients with periodontitis and type 2 diabetes mellitus (DM) using machine learning (ML) techniques, considering periodontal parameters, metabolic status, and demographic characteristics.

Methodology: We applied machine learning techniques to perform a post hoc analysis of data collected at baseline and a 6-month follow-up from a randomized clinical trial (RCT). A leave-one-out cross-validation strategy was used for model training and evaluation. We tested seven different algorithms: K-Nearest Neighbors, Decision Tree, Support Vector Machine, Random Forest, Extreme Gradient Boosting, and Logistic Regression. Model performance was assessed using accuracy, specificity, recall, and the area under the Receiver Operating Characteristic (ROC) curve (AUC).

Results: a total of 75 patients were included. Using the first exploratory data analysis, we observed three clusters of patients who achieved the clinical endpoint related to HbA1c values. HbA1c ≤ 9.4% was correlated with lower PD (r=0.2), CAL (r=0.1), and the number of sites with PD ≥5 mm (r=0.1) at baseline. This study induced AI classification models with different biases. The model with the best fit was Random Forest with a 0.83 AUC. The Random Forest AI model has an accuracy of 80%, a sensitivity of 64%, and a specificity of 87%. Our findings demonstrate that PD and CAL were the most important variables contributing to the predictive performance of the Random Forest model.

Conclusion: The combination of nine baseline periodontal, metabolic, and demographic factors from patients with periodontitis and type 2 DM may indicate the response to periodontal therapy. Lower levels of full mouth PD, CAL, plaque index, and HbA1c at baseline increased the chances of achieving the endpoint for treatment at 6-month follow-up. However, all nine features included in the model should be considered for treatment outcome predictability. Clinicians may consider the characterization of periodontal therapy response to implement personalized care and treatment decision-making. Clinical trial registration ID: NCT02800252.

Background: Certain genes present variants associated with molar-incisor hypomineralization (MIH) pathogenesis, especially genes encoding enamel development proteins related to morphogenesis, immune response, and hormone transcription and reception, demonstrating that MIH is likely a gene-environment issue with multiple genes having small individual effects.

Objective: To evaluate the association between single nucleotide polymorphisms (SNPs) and MIH.

Methodology: A sample of 90 children with MIH and 262 children without MIH were included in this study. Calibrated examiners diagnosed MIH (Kappa≥0.75) using the European Academy of Paediatric Dentistry (EAPD) criteria and modified DDE index in clinical exams. SNPs in the IL-6 (rs2069840 and rs2069833), ESR (rs9340799, rs1256049, rs4986938, and rs2234693), VDR (rs739837 and rs2228570), and 5-HTT genes (rs1042173 and rs38133034) were genotyped by real-time polymerase chain reaction from oral mucosa cells collected. Associations between MIH and SNPs genotypes (recessive and dominant models) and allele frequencies were tested using the chi-square test. Odds ratio (OR) and confidence intervals (CI) were calculated. A significance level of 5% was adopted. Genotypes were tested by the Hardy-Weinberg Equilibrium using chi-square.

Results: In rs4986938 (ESR2 gene), children with CT/TT presented significantly lower odds of MIH than CC (OR=0.57, CI 95% [0.35-0.92]). There was no significant association between MIH and other evaluated genes.

Conclusion: The genetic polymorphism in the ESR gene is associated with MIH, suggesting that MIH etiology presents a polygenetic involvement.

Objective: The infectious and inflammatory process of the periodontal tissues can contribute to hyperglycemia in patients with diabetes. The objective of this study was to evaluate the effect of non-surgical periodontal therapy on glycemic control in individuals with type 2 diabetes mellitus.

Methodology: In this clinical trial with two months of follow-up, 31 participants were included, with 15 having adequate glycemic control and 16 inadequate glycemic control. The participants underwent non-surgical periodontal therapy. Biological, social, and behavioral variables were collected. Periodontal clinical examination was performed at baseline and two months after the intervention. Laboratory tests to assess serum levels of glycated hemoglobin, fasting glucose, and C-reactive protein were requested for all participants at baseline and two months after periodontal treatment.

Results: The difference in glycated hemoglobin levels between baseline and two months after non-surgical periodontal therapy was statistically significant in the total sample (p=0.045) and in the group of individuals with adequate glycemic control (p=0.016). No significant difference was observed in glycated hemoglobin levels in the group of individuals with inadequate glycemic control. No significant variation was observed in fasting glucose and C-reactive protein levels after treatment in the studied sample. A reduction in probing depth, gingival inflammation, and gain in clinical attachment was observed in the total sample and in both groups according to glycemic control.

Conclusion: Periodontal intervention may contribute to improved glycemic control in individuals with type 2 diabetes mellitus and periodontitis (Brazilian Clinical Trials Registry RBR-9fvwk4m).