Minerva dental and oral science最新文献

The aim of this study was to analyze clinical strategies supported by validated references during two of the most frequent dental emergencies (i.e. restorative and endodontic treatment) in the COVID-19 pandemic. Coronavirus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of an emergency in the health system worldwide and a potentially fatal disease. Person-to-person transmission of SARS-CoV-2 through aerosol and droplets led to extensive preventive measures to contain COVID-19 outbreak. Dental care providers have been exposed to a high risk of SARS-CoV-2 infection, due to the face-to-face communication and the exposure to saliva, blood, and other body fluids during routine interventions; this can also contribute to a high risk for cross-infection, even though dentist usually cope with those situations in everyday practice. Restorative and endodontic emergencies represented a high proportion of dental emergencies, with prolonged exposure time for dentists/endodontists in contact with suspected or confirmed infected patients. Lack of knowledge and undefined progression controlled the decision-making in clinical dentistry. The dynamicity of the situation determined change of views and recommendations in dental setting. The implementation of strict restorative and endodontics protocols are aimed at preventing circumstances similar to those observed with COVID-19.

Background: The retromolar canal (RMC) is an anatomical structure of the mandibular bone located distal to the last molar. The frequency of anatomical variation in human anatomy is approximately 30-35%. This study aimed to evaluate the prevalence of the retromolar canal in a population subjected to cone beam computed tomography (CBCT).

Methods: The radiographic images belonged to 200 patients (100 males and 100 females; older than 13 years old) were examined following a strict protocol. Four hundred hemi-mandibles of 100 male and 100 female patients were examined between 2019 and 2022.

Results: The collected data showed 136 patients presented the RMC, bilateral in 72 cases (68%) and unilateral in the other 64 cases (32%). Gender variation did not yield statistically significant differences, with 76 male (56%) and 60 female (44%) patients affected (P>0.05). A statistically significant difference was observed for side predilection, with unilateral RMC more prevalent on the right side in 24 cases (37.5%) and on the left side in 40 cases (62.5%) (P<0.05).

Conclusions: Based on the results obtained and other anatomical considerations, this study proposes a new classification for RMC.

Background: In recent decades, implant dentistry has evolved to become a highly predictable treatment modality in the rehabilitation of different types of edentulism. The present retrospective analysis aimed to report the middle-term outcome of severely atrophic jaws rehabilitated with extra-maxillary zygomatic implants placed in conjunction with standard implants.

Methods: Thirty-one patients were included in the present study with 62 zygomatic implants and 90 standard implants positioned. Outcome measures were prosthetic success/survival, implant success/survival, complications, modified Plaque Index (mPLI), modified Bleeding Index (mBI), mucosal seal efficacy evaluation (MSEE) >4 mm, and zygomatic implants classification level (ZICL).

Results: No implant and no prosthesis were lost; one patient had mucositis at one zygomatic implant; implant and prosthetic cumulative success rates at more than 3 years were respectively 98.4% and 87% using implant and patient as units of analysis. Mechanical and biological complications occurred in seven patients; all resolved. Eighty percent of the patients practiced proper hygiene and 77% of patients suffered absent or minor mucosal bleeding. Distribution of the variable "mucosal seal efficacy evaluation" led to 81% of sites with values less than 4, and 19% of sites with values higher than 4. In more than 80% of cases, so then, the zygomatic implants clinical level showed a level 1 at the end of the survey.

Conclusions: With 100% survival rates, zygomatic bilateral prosthetic configurations were an effective therapeutic option for individuals with highly reabsorbed maxillae undergoing initial full-arch fixed rehabilitation.

Background: All dental implants must be placed following radiological, clinical and aesthetic indications in compliance with prosthetic principles avoiding iatrogenic damage to patients. In implantology, among the key choices, to obtain predictable results, it is essential to establish (by cone beam computed tomography [CBCT]) the sites where to insert the implants; these sites must be identified, during the surgical phase, in the oral cavity. Surgical guides represent a valid aid especially in complex cases that require multiple implants. For some clinical conditions, expert operators choose the free hand technique during which identifying the chosen implant sites on CBCT in the oral cavity is more difficult.

Methods: This experimental study is based on the use of thermo-molded mask as an alternative to surgical guides when the freehand technique is adopted in totally edentulous patients. These innovative masks, containing radiopaque references, are initially worn by patients during the execution of the CBCT, and later during surgery to identify the implant sites in the oral cavity.

Results: The procedure described proved to be very useful and able to increase the precision of the freehand technique even if it does not provide information on the inclination of the implants. The metal references help clinical identification of the implant site.

Conclusions: Our thermo-molded masks, in particular clinical conditions, could represent a valid and economical alternative to the classic surgical guide. The described procedure does not increase costs for the patient and significantly increases the precision in inserting the implants during free-hand techniques.

Background: Cadaverine and hydrocinnamic acid are frequent metabolites in inflamed periodontal areas. Their role as a metabolite for plant growth inhibition has been established, but their relevance in humans has yet to be determined. Moreover, Vascular endothelial growth factor (VGEF) is a consistent growth factor in neo-angiogenesis in periodontal regeneration. The aim of the study was to utilize an in-silico approach to investigate the potential interaction between Cadaverine and hydrocinnamic acid, metabolites found in inflamed periodontal areas, and vascular endothelial growth factor (VEGF), with a focus on understanding their role in periodontal regeneration.

Methods: Desmond MD simulation is an efficient technique for analyzing the dynamics of protein-ligand complexes. The system is minimized and equilibrated after the protein-ligand combination has been solvated in a water box. The system is simulated for a desired time, typically 10-100 nanoseconds. The simulation data is examined to reveal the interactions between proteins and ligands, such as binding affinities, contact maps, and hydrogen bonding patterns. VEGF interactome of metabolites was assessed.

Results: Docking interactions between hydrocinnamic acid and VEGF with binding energy -5.0 kcal/mol and docking interactions between Cadaverine and VEGF with -3.6 kcal/mol. Fluctuations in RMSD values remain within 2.0 for the simulation duration, which is perfectly fine. Ligand RMSD values fluctuated within 1.0 Angstrom up to 25 ns, flipped in ligand mode, regained equilibrium at 80 ns, and remained steady for the simulation duration.

Conclusions: The current in-silico study suggests that metabolites like Cadaverine and hydrocinnamic acid, which are produced during periodontal inflammation, may have the ability to block pro-angiogenic vascular endothelial growth factors. This interference can have notable effects on the healing and regeneration of tissues by preventing the formation of blood vessels and the expression of VEGF.

Background: Boswellic acid (BA) is a bioactive compound derived from Boswellia trees. This study aims to investigate the anti-cancer properties of BA against KB oral squamous cancer cells and elucidate the underlying mechanisms.

Methods: Escalating doses of BA were administered to KB cells, and various analyses were conducted using bioinformatic tools such as GEO, GEO2R, and STITCH database. MTT and trypan blue assays has been validated to measure the cytotoxicity by treating BA in KB Cells. Flow cytometry assessed cell cycle progression, apoptosis induction, and metabolic alterations. Network analysis identified relevant signaling pathways, while RT-PCR validated mRNA expression changes. Docking studies by Autodock evaluated beta-BA's binding affinity with mTOR-mediated pathways.

Results: BA effectively hindered KB cell progression, inducing G0/G1 phase cell cycle arrest and apoptosis. It also inhibited aerobic glycolysis, a hallmark of oral cancer cells. Network analysis revealed involvement in apoptosis and mTOR targets. RT-PCR confirmed downregulation of genes associated with aerobic glycolysis and apoptosis. Docking studies indicated strong binding between BA and mTOR pathways.

Conclusions: BA shows promise in inhibiting KB oral squamous cancer cell growth. These findings underscore its potential as a treatment for oral cancer. Further research and clinical studies are needed to unlock its full therapeutic potential.

Background: Oral cancer is a predominant and aggressive form of head and neck cancer with limited treatment options. Stevioside, a naturally occurring biocompatible compound, has gained attention for its potential therapeutic properties, although its molecular mechanistic role in OSCC merely understood. This study aims to elucidate the impact of stevioside on OSCC cells, focusing on its inhibitory effects on cell proliferation and epithelial-mesenchymal transitions (EMT).

Methods: KB cells, representative of OSCC, were subjected to stevioside treatment in a time-dependent manner. The findings obtained from the MTT assay revealed a notable suppression of KB cell growth following 48 hours of treatment with stevioside.

Results: The IC50 values, which represent the concentration at which the inhibitory effect of stevioside is at 50% at 110.54 µM, as determined by this assay, were subsequently utilized further for the analysis of gene expression through RT-PCR. Furthermore, our investigation involved the examination of EMT-related genes (ECADH, SNAIL1, SLUG, and VIM) using molecular docking analysis.

Conclusions: In conclusion, this study sheds light on the significant role of stevioside in oral cancer. The observed inhibition of KB cell proliferation and its pronounced impact on EMT-related gene expression indicate the potential of stevioside as a promising therapeutic agent in the context of OSCC. The multifaceted effects of stevioside on OSCC cells present an exciting avenue for advancing our understanding of this devastating disease and the development of innovative therapeutic strategies.

Background: In recent years, there has been a gradual increase in cases of dentin hypersensitivity, often related to gingival recession, enamel abrasion from brushing, and wear of root cementum. This condition can affect patients of all ages but is more common between 20 and 40 years of age, especially in females and individuals with periodontal disease. The study aimed to evaluate and compare the efficacy over time of a product for at-home treatment of dentin hypersensitivity.

Methods: One hundred five patients aged between 28 and 65 years were recruited, each with at least two hypersensitive teeth due to erosions, abrasions, gingival recessions, and/or periodontal diseases. Participants were selected through the Schiff Test and anamnestic evaluations, with compilation of periodontal records. Patients are instructed to use the product three times a day, to be applied with a soft-bristled toothbrush and/or topically as a gel on teeth with strong sensitivity and deep cervical lesions and gingival recessions.

Results: There were no statistically significant differences between measurements at baseline and after scaling. However, significant differences were observed in follow-ups from the 1^st to the 8^th week, with a progressive decrease in values. The average trend of product efficacy increases over time according to the Schiff Test, with a significant improvement observed at follow-ups conducted after four and eight weeks.

Conclusions: The results indicate that the product enriched with biomimetic hydroxyapatite and lactoferrin is effective in reducing the painful symptoms of dentin hypersensitivity and in counteracting the inflammatory state of the supporting tissues.

The field of immediate loading implantology has grown rapidly, offering quicker solutions for prosthetic rehabilitation. However, the complexity of this technique raises significant medico-legal concerns regarding patient safety, treatment planning, and professional liability. These issues are particularly relevant in elective procedures where failure could lead to litigation. A comprehensive review of current literature, including clinical studies, legal rulings, and malpractice claims, was conducted to assess the legal implications of immediate loading implantology. The analysis focused on professional liability, patient consent, and complications during treatment. The evidence indicates that a high standard of care, including detailed preoperative planning, risk assessment, and clear patient communication, is essential in minimizing legal risks. Malpractice claims often arise from inadequate patient information or failure to follow established protocols. Proper documentation of informed consent and adherence to evidence-based dentistry (EBD) guidelines are crucial to protect both patients and practitioners. Immediate loading implantology offers numerous benefits, but it requires meticulous planning and patient management to avoid medico-legal issues. Ensuring comprehensive patient consent and following evidence-based practices are key to reducing professional liability and improving outcomes. Further studies should explore standardized protocols for reducing complications and legal disputes in implantology.

Background: In daily surgical practice, the dentist deals with various types of oral surgery. At the first visit, the patient fills out a questionnaire about their state of health. If the questionnaire does not reveal any particular hematological problems, no special tests are usually required to determine the platelet count. The aim of this prospective study was to evaluate the healing process of patients and its correlation with platelet levels before surgery.

Methods: A total of 50 patients were included in whom blood chemistry tests were performed with special attention to the platelet count and before their mandibular eights were extracted .The type of healing (EHI) and pain on the second day (VAS) were assessed using methods validated in the literature.

Results: After the EHI and VAS scores were noted in the medical records, envelopes containing the platelet scores of the previously requested blood samples, which were not read at the time of observation, were opened. An increase in EHI scores and a decrease in VAS scores was observed that were statistically significantly correlated with increasing platelet scores.

Conclusions: These results suggest that the dentist should request chemistry tests on preoperative blood, especially if the patient is to undergo a particularly demanding oral surgical procedure, such as implants, guided bone regeneration or complex extractions.