Quintessence international最新文献

Objectives: infraosseous periodontal defects are a challenge for restoring periodontal health. Regenerative techniques such as Entire Papilla Preservation (EPP) offer valid, minimally invasive alternatives. Platelet concentrates like leukocyte- and platelet-rich fibrin (L-PRF) may enhance the healing process. This pilot study aims to describe and assess the effectiveness of EPP for treating interproximal infra-bony defects, with and without L-PRF, focusing on clinical and radiographic parameters.

Materials and methods: The study included 11 cases from 7 patients treated at University of Los Andes Health Center. Periodontal defects with probing depth ≥6 mm were treated using EPP. L-PRF was added in 5 defects, placed intraosseously. Clinical and radiographic parameters were evaluated at baseline and 6 months post surgery.

Results: Probing depth decreased by a mean of 4.3 mm (p<0.05), with a clinical attachment level gain of 3.63 mm (p<0.05). No significant differences were observed between groups. Gingival margin position tended to recess in the EPP group (variation: -1 mm ± 0.7 mm), but remained stable in the EPP + L-PRF group (variation: 0.3 mm ± 0.5mm). Postoperative pain on the VAS scale was significantly lower at 24 and 72 hours with L-PRF (p<0.03). No complications were reported.

Conclusions: EPP has a positive effect on clinical and radiographic parameters, whether used alone or with L-PRF. L-PRF appears to improve postoperative pain and gingival margin stability in the medium term. This technique offers a low cost, minimally invasive option for periodontal regeneration with minimal complications.

Objective: Despite widespread antiretroviral therapy (ART) use, mild and asymptomatic cognitive impairment (CI) persists in people with HIV (PWH). Poor oral health is also commonly reported among PWH, yet the prevalence of specific oral diseases in the ART era remains uncertain. While CI has been linked to poor dental outcomes in people without HIV (PWoH), particularly older adults, its impact on oral health in PWH is less understood. This study aimed to compare oral health outcomes in PWH and PWoH; and PWH with and without CI.

Methods: A cross-sectional pilot study was conducted among 40 participants: 30 PWH and 10 PWoH. Cognitive function was assessed using the Penn Computerized Neurocognitive Battery (CNB), and oral health was evaluated through dental caries and periodontitis measures.

Results: PWH averagely had poorer battery test outcomes (p<0.0001), with social cognition being the most impaired domain. PWH had significantly worse oral health than PWoH, with higher scores for DMFT (p = 0.001), DFT (p = 0.027), and MT (p = 0.032). Among PWH, those with CI exhibited higher DFT scores (median 12.0 vs 7.0) and periodontal inflammation (with respect to bleeding on probing- 51.04% vs 31.67%) compared to those without CI.

Conclusion: Data suggests that PWH demonstrate poorer oral health compared to PWoH. CI in PWH is associated with worse periodontal and caries outcomes. These findings highlight the need for targeted oral health interventions and consideration of CI screening in dental care settings.

Objectives: The aim of this study was to investigate the factors influencing the success of biopsy quality in oral squamous cell carcinoma (OSCC) of the oral cavity.

Method and materials: This retrospective study included patient records of primary OSCC patients, diagnostic pathology reports of the primary biopsies, and corresponding resection tumor sections. The outcome variable was unsuccessful biopsy, defined as an inconclusive biopsy specimen for proper OSCC diagnosis. The primary predictor variable was the biopsy method used, grouped as punch or scalpel biopsy. Secondary predictor variables were sample area, depth, site, and number of samples. Patient- and tumor-related variables, background of the health care professional, and the health care unit were analyzed as additional predictor variables.

Results: Data from 312 OSCC patients were included in the study. Primary biopsy was inconclusive in 7.7% of the cases. Areas with punch biopsies yielded smaller (P .001) but diagnostically as accurate samples as scalpel biopsies. Biopsies from the floor of the mouth and gingiva had higher failure rates, while tongue and palate biopsies had higher success rates (P = .037). Punch and scalpel biopsies had similar diagnostic reliability. There were deficiencies in the documentation of prognostic features of the OSCC. Inflammation was the most consistently reported (33.3% in biopsies, 43.9% in resection samples), while tumor budding was documented in only one-third of biopsy samples (6.4%) compared to final resection samples (18.6%). Depth of invasion was reported in 55.1% of biopsies, with 6.1% indicating a minimum invasion depth.

Conclusion: General dental practitioners must be both alert and properly trained to perform biopsies. However, considering the internationally varying role of general dental practitioners in biopsy procedures, this requirement must be understood within the context of each country's health care system. OSCC biopsies generally yield high diagnostic success; however, small biopsy size especially impairs diagnostic accuracy. Ensuring larger or several biopsy samples in general and ensuring representative biopsies from particularly challenging areas, such as the gingiva and floor of the mouth, improves the likelihood of conclusive diagnosis in primary OSCC diagnostics. Additionally, clinicians should pay more attention not only to the area but also to biopsy depth. Taken together, there may be a need for more precise biopsy guidelines and protocols for lesions suspicious for OSCC to optimize patient treatment planning.

Objectives: The objectives of this article were to provide a review of published cases of frostbite injuries of the head and neck associated with abuse of nitrous oxide (NO) and to summarize other pathophysiologic consequences.

Method and materials: A literature search was undertaken for articles on the development of frostbite injuries to the head and neck from recreational use of NO, including review papers, clinical investigations, case reports, case series, cohort studies, and letters to the editor. Relevant articles were attained from the electronic databases of PubMed and Google Scholar from 1 January 1985 through 5 July 2025 and from references cited within culled sources.

Results: The search identified 13 articles, involving 16 patients, with NO-related frostbite injuries to the head and neck. Commonly affected sites included the face, palate, lips, and oropharynx. Six patients required hospital admission, including three who were referred to the intensive care unit.

Conclusions: Oral health care practitioners should be aware of contemporary modalities of substance abuse, particularly from the recreational use of NO and the consequent risk of frostbite to the mucocutaneous structures of the head and neck. Attending clinicians are advised to educate their patients about the potential for these injuries from recreational NO abuse.

Objectives: This study addresses the gap in retrospective analyses concerning submandibular triangle masses, utilizing a large Chinese cohort, to provide experience for preoperative diagnosis and a basis for individualized treatment.

Method and materials: Details were collected including basic demographic information, medical histories, physical examination findings, imaging results, and histopathologic diagnoses for 608 patients who underwent surgical procedures in the submandibular triangle at Xiangya Hospital, Central South University, from January 2009 to June 2019. Statistical analyses were conducted to identify differences between malignant and benign masses, employing both univariate and multivariate analyses.

Results: The cohort comprised 405 males and 203 females, with an average age of 43.2 ± 17.5 years (range 1 to 80 years). The prevalence of congenital masses, inflammatory masses, and tumors were 2.6%, 63.5%, and 33.9%, respectively. Among the identified tumors, benign, borderline, and malignant tumors represented 48.4%, 1.6%, and 50.0%, respectively. Pleomorphic adenoma and lymphoma emerged as the most frequent benign and malignant pathologies, respectively, with metastatic tumors primarily originating from head and neck cancers. Univariate analysis revealed significant differences based on sex, age, smoking status, alcohol consumption, betel nut chewing habits, mass characteristics (mobility and texture), and the presence of cervical lymph nodes. Multivariate analysis identified age, alcohol consumption, and betel nut chewing as significant risk factors for malignancy.

Conclusion: A comprehensive analysis of clinical parameters aids in the preoperative diagnosis of submandibular triangle masses.

Juvenile idiopathic arthritis is the most prevalent chronic rheumatic disease in children. Temporomandibular joint involvement is common but often asymptomatic, with overlapping temporomandibular disorders making diagnosis challenging. This report describes ten pediatric patients diagnosed with both temporomandibular disorders and juvenile idiopathic arthritis. Evaluation included clinical, psychological, hematologic, and radiologic assessments. Temporomandibular disorders symptoms were assessed after 6 months of dental and rheumatologic management. Temporomandibular joint involvement in juvenile idiopathic arthritis frequently precedes systemic symptoms and may occur even when blood markers appear negative, highlighting the importance of imaging for early diagnosis and timely intervention. Conventional temporomandibular disorders treatment combined with rheumatologic interventions generally yield favorable results even when juvenile idiopathic arthritis underlies temporomandibular disorders symptoms.

Objective: This study aimed to investigate the causal relationship between metabolites and periodontitis using Mendelian randomization (MR), and validate findings through gingival crevicular fluid metabolomic profiling.

Method and materials: A two-sample MR analysis used genetic data from 486 metabolite Genome-Wide Association Study (GWAS) and periodontitis statistics, with inverse-variance weighting as the primary method, supported by MR-Egger, weighted median, and weighted mode. Sensitivity analyses included Cochran Q, MR-Egger, and MR-PRESSO tests. Gingival crevicular fluid metabolomics compared five periodontitis patients and five controls, identifying differential metabolites via t tests and partial least squares-discriminant analysis (PLS-DA), with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment.

Results: Mendelian randomization analysis identified 17 metabolites causally linked to periodontitis, spanning amino acids, lipids, energy metabolism, and cofactors/vitamins. Protective metabolites included betaine (OR 0.478, 95% CI 0.235-0.975), laurate (0.51, 0.267-0.974), and glycerol 3-phosphate (0.312, 0.105-0.926), while phenylalanine (39.651, 2.173-723.565), pelargonate (2.527, 1.059-6.030), and 3-methylhistidine (1.481, 1.074-2.042) increased risk. Sensitivity analyses confirmed minimal heterogeneity, no pleiotropy (except 4-acetamidobutanoate), and no reverse causation. Gingival crevicular fluid metabolomics revealed 75 upregulated and 245 downregulated metabolites, with pathway enrichment in lipid, amino acid, and vitamin metabolism. Notably, betaine-protective in Mendelian randomization analysis-was significantly reduced in periodontitis, aligning with its anti-inflammatory role.

Conclusion: This study indicates that some circulating metabolites (eg, betaine) may protect against periodontitis. Integrating Mendelian randomization and gingival crevicular fluid analyses, key metabolic risk factors were identified. Clinically, metabolites like betaine and glycerol 3-phosphate could serve as noninvasive early biomarkers, providing new avenues for personalized periodontitis prevention and treatment.

Objective: Definitions play a pivotal role in scientific disciplines, including dentistry, by providing clarity and precision to the terminology employed. However, over time, definitions are sometimes subject to modification, which can result in communication misunderstandings among clinicians, patients, and third parties. This narrative review aims to present and discuss different patterns of definitional changes.

Method and materials: Observations regarding changes to established definitions in the dental literature and clinical practice were supplemented by searches of the bibliographic database PubMed.

Results: Three patterns of terminological change of a given term were distinguished: redefinition (eg, 'centric relation'), narrowing (eg, 'centric occlusion'), or broadening (eg, 'bruxism') of established terms.

Conclusion: The alteration of established definitions can result in the introduction of inconsistencies in the meanings and connotations of clinically significant terms. This can potentially lead to confusion among individuals who have been familiar with the original definition for an extended period. These changes have the potential to expose patients to various risks and may ultimately call into question the scientific basis of dentistry as a discipline.

Objectives: To comprehensively characterize dental unit waterline biofilms through integrated analysis combining scanning electron microscopy and high-throughput sequencing, examining structural features and microbial community composition across different tubing sections.

Method and materials: For each of the eight dental units with high-speed handpiece waterlines in continuous clinical service for ≥ 6 months at a university dental hospital, three 2-cm segments were collected from proximal, middle, and distal sections (total n = 24). Scanning electron microscopy evaluated biofilm coverage percentage and morphology across 10 fields per specimen using a nine-grid quantification method. Microbial communities were analyzed using 16S rRNA gene V3-V4 region sequencing with subsequent bioinformatic processing through QIIME 2. Statistical analyses included ANOVA, Kruskal-Wallis tests, and PERMANOVA to assess sectional differences.

Results: Scanning electron microscopy revealed a gradient of biofilm coverage increasing from proximal (31%) to middle (87%) and distal sections (nearly 100%). Structural features included partially detached biofilm fragments and distinctive bulging bacterial aggregates. Molecular analysis identified Proteobacteria as the predominant phylum, followed by Bacteroidetes and Firmicutes, with significant variations in community composition between sections. The distal section showed the highest microbial diversity, with significant differences observed in Chao1 richness (P = .025), observed species (P = .025), and Good's coverage (P = .024) between study groups. Principal coordinate analysis confirmed distinct clustering patterns among biofilm communities from different tubing sections.

Conclusion: This multidimensional analysis achieved its aim of comprehensively characterizing dental unit waterline biofilms, establishing that heterogenous distribution patterns warrant section-specific monitoring approaches for effective contamination control.