Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Purpose: This study aimed to explore active ingredients in Scrophularia ningpoensis Hemsl (SNH) with potential effects on ameloblastoma (AM) using network pharmacological approach, bioinformatic gene analysis and in vitro cell experiments.

Methods: The active ingredients and their corresponding targets of SNH were identified from the Traditional Chinese Medicine Systems Pharmacology (TCMSP), as well as SwissTargetPrediction. Disease targets of AM were selected from GeneCards and DisGeNET databases. Differentially expressed genes (DEGs) of AM were identified, and Gene Ontology enrichment analysis were performed using the Gene Expression Omnibus (GEO) dataset GSE38494 through bioinformatic analysis. The STRING database platform was utilized to generate a protein-protein interaction network diagram, followed by hub gene analysis using Cytoscape software. AutoDock Vina software was used to perform molecular docking verification of the effects of the active ingredients on potential core targets. Additionally, in vitro experiments including quantitative reverse transcription polymerase chain reaction (RT-qPCR), EdU assay and CCK-8 cell proliferation assay were conducted using AM cell line AM-1 after SNH extract treatment.

Result: The study revealed that SNH contains eight active ingredients and a total of 388 drug targets, including 10 potential core targets in AM. Hub genes identified in the analysis were CCNA2, HRAS, PTGS2, PIK3CB, FGFR1, CASP3, MMP1, SLC2A1, MMP14, and MME. Molecular docking analysis demonstrated strong binding activity between key active ingredients (β-sitosterol, scropolioside A_qt, scropolioside D, scropolioside D_qt, and sugiol) and target genes (CASP3, FGFR1, HRAS, PTGS2, and SLC2A1). Gene Ontology enrichment analysis indicated that SNH exerts its effects on AM through pathways related to cellular response to abiotic stimulus, cellular response to hypoxia, and exopeptidase activity. Immunohistochemical analysis using tissue microarray showed higher expression of MMP14 and PTGS2 in AM compared to dentigerous cyst. Using AM-1 cell line, RT-qPCR results confirmed that SNH suppressed the expression of MMP14 and PTGS2 at mRNA level. Additionally, the EdUassay and CCK-8 assay indicated the inhibitory effect of SNH on the proliferation of AM-1 cells.

Conclusion: These findings showed that SNH could suppress expression of MMP14 and PTGS2 and restrain the proliferation of AM. Our study highlights the potential of SNH as a promising therapeutic candidate for AM, which may provide more options for clinical treatment.

Background: Attaining adequate osseointegration and mitigating infections are paramount issues in implantology, especially within dental and orthopaedic domains. Titanium implants have been utilised for their biocompatibility and mechanical strength; yet, problems such as peri‑implant infections and inadequate bone integration may undermine their efficacy. Coating titanium implants with iron nanoparticles (FeNp) has surfaced as a promising approach to improve osseointegration and antibacterial characteristics. FeNp's distinctive capacity to react to magnetic fields and produce reactive oxygen species (ROS) has the potential to enhance implant results.

Objective: To assess the influence of FeNp-coated titanium implants on osseointegration, mechanical stability, osteogenesis, and antibacterial effectiveness against prevalent implant-associated infections, Staphylococcus aureus and Escherichia coli.

Materials and methods: In vivo investigations were performed on animal models to evaluate implant stability by resonance frequency analysis (RFA) and removal torque measurements at 6 and 12 weeks post-implantation. Histopathological assessment was conducted to analyze the osseous formation and vascularization surrounding the implants. Furthermore, in vitro experiments were employed to assess the antibacterial efficacy of magnetized FeNp against S. aureus and E. coli.

Results: At 6 weeks, no substantial change was detected in (RFA) or removal torque between the control group (GROUP A) and the test group (GROUP B). However, by 12 weeks, GROUP B demonstrated significantly higher RFA scores (75.02 ± 5.11) compared to GROUP A (67.41 ± 9.85), indicating improved implant stability (p < 0.05). Removal torque values were also significantly higher in GROUP B at 12 weeks (76.30 ± 14.20) compared to GROUP A (46.10 ± 9.25), suggesting enhanced mechanical integration (p < 0.01). Histopathological analysis revealed greater new bone formation, increased osteoblast activity, and improved vascularization around FeNp-coated implants in GROUP B. Additionally, in vitro antibacterial testing demonstrated that FeNp coatings effectively inhibited the growth of Staphylococcus aureus and E. coli, providing further evidence of its antimicrobial effect CONCLUSION: FeNp-coated implants have dual advantages: improved osseointegration and antibacterial defence. The findings indicate that FeNp coatings might substantially enhance implant longevity and diminish the likelihood of infection, offering a potential approach for clinical applications, especially for patients at elevated risk of implant failure. Subsequent research should concentrate on enhancing the application of FeNp coatings in clinical environments and further examining their long-term biocompatibility and effectiveness.

Introduction: The prevalence of obesity is continually rising worldwide, posing a risk for the development of various serious diseases. The pathogenesis of obesity is complex and recent research suggests a link between obesity and the oral microbiome, though the specific mechanisms remain unclear.

Material and methods: We collected saliva samples from 9 non-obese and 13 obese participants and conducted 16S rRNA sequencing to analyze the differences in oral microbiota between obese and non-obese individuals in terms of microbial abundance, functionality, and interaction networks.

Results: Obese participants exhibited a distinct composition of salivary microbiota compared to non-obese participants, with a greater number of ASVs detected and higher α diversity indices. Specifically, Haemophilus, Aggregatibacter, and Actinobacillus were significantly enriched, while Actinomyces showed significant depletion. Functional prediction analysis indicated that biofilm formation pathways were significantly more abundant in the obese group. Random forest regression model analysis identified Bergeyella as the most contributive genus, and interaction network analysis suggested that Bergeyella may function as a bridge node, linking the obese group-enriched genera to the broader microbial community and facilitating the exchange of information and resources.

Discussion: Our study suggests that obesity may be closely associated with salivary microbiota dysbiosis and functional changes. Further research is needed to elucidate the causal relationship and underlying molecular mechanisms between obesity and oral microbiota dysbiosis, or to determine if they mutually influence each other.

Background: Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignancies worldwide, arising from the mucosal epithelium of the oral cavity, oropharynx, hypopharynx, nasopharynx, larynx, and sinuses. In addition to the conventional morphologic pattern characterized by the degree of cellular atypia and squamous differentiation, HNSCC is classified into eight histopathologic subtypes: basaloid, spindle cell, adenosquamous, cuniculatum, verrucous, lymphoepithelial, papillary, and acantholytic.

Methods: This review provides a comprehensive review of the literature on the prognostic implications of the histological subtypes of HNSCC.

Results: Although there is extensive literature on HNSCC, few studies specifically focus on the treatment and prognosis of its histopathologic subtypes. Among these subtypes, verrucous squamous cell carcinoma and carcinoma cuniculatum generally have a favorable prognosis, while others, such as basaloid and spindle cell squamous cell carcinoma, tend to follow a more aggressive clinical course.

Conclusion: In this review, we delve into the histopathological subtypes of HNSCC and explore their clinicopathological, molecular, and prognostic findings. Further molecular investigations aimed at identifying targeted therapies for these subtypes are necessary. Moreover, it is crucial to recognize the emerging histopathological variants documented in the literature, considering the ongoing limitations in prognostic assessment.

Objectives: The aim of this study is to verify the positioning of the condyles in computed tomography (CT) scans of skeletal Class II and Class III patients in virtual surgical planning before orthognathic surgery. The secondary aim is to determine whether occlusal devices are mandatory for performing a CT examination.

Materials and methods: In this retrospective randomized double-blind study, 42 CT scans were evaluated from patients who had undergone to orthognathic surgery at the University Hospital of the University of São Paulo. Male and female patients between the ages of 25 and 40 were included. The sample consisted of skeletal Class II and III patients. The CTs were randomly selected into centric relation (CR) and maximal intercuspal position (MI). Statistical analysis was performed with R Statistical Package and was considered significant in the case of p <0.0001.

Results: A total of 504 measurements were carried out in 42 patients. Three joint spaces on each side were used. No statistically significant difference between the inter- and intraobservers was found for CR and MI. Some scores were performed to avoid the risk of gender bias.

Conclusions: No statistically significant value was found between patients in CR and MI after mandibular manipulation. The use of a positioning guide to perform a CT scan prior to virtual planning is not absolutely necessary.

Background: Diffuse sclerosing osteomyelitis (DSO) in mandible is a disease with unusual and undefined clinicoradiographic manifestations. Several medicines have been administrated for therapy, but the efficacy in bone remolding remains to be systematically evaluated.

Observation: A 37-year-old male and a 28-year-old female were diagnosed DSO after revealing diffuse sclerosis and osteolytic changes in the mandible, and treated by Janus-activated kinase signal and IL-6 inhibitor, respectively. Their symptoms were well controlled and the inflammatory indicators were decreased. During the mandible remolding, the osteolytic destruction in one patient migrated from the left mandible to the right, while DSO lesion migrated from the left mandibular body to the ramus and condyle in the other.

Conclusion: DSO presented as migratory lesions in mandible after biological inhibitors therapy, while the periosteal reaction wasn't conformed to the osteolytic focus. These findings suggest that periostitis may be the direct cause of DSO rather than the infectious triggers.

Background: Zygomatic implants, either alone or in combination with dental implant placement, have emerged as a viable surgical option for elderly patients with severe bone atrophy for occlusal restoration. This study aims to examine the biomechanical impact of the three-dimensional contact area between zygomatic implants and bone on biomechanics under different surgical methods.

Material and methods: Using Cone Beam Computed Tomography (CBCT) images from 10 patients with severe bone atrophy, we reconstructed 3D maxillary bone models and created corresponding 3D zygomatic implant models. Two distinct surgical methods (extramaxillary or intrasinus approaches) were employed based on the position and angle of the zygomatic implant for each patient. The 3D bone-to-implant contact percentage (BIC%) was calculated, and finite element analysis with nonlinear contact was conducted to assess the relationship between 3D BIC% and surrounding bone stress for both surgical methods.

Results: The 3D BIC% of extramaxillary approach (57.63 %) and intrasinus approach (56.49 %) for total bone (including cortical and cancellous bone) was similar (P = 0.425) in zygomatic implant surgery. In contrast, the intrasinus method exhibited higher 3D BIC% in cortical bone contact (28.08 %) compared to the extramaxillary approach (21.92 %) (P = 0.011). The correlation between 3D BIC% and high bone stress was stronger in the intrasinus approach, likely due to increased contact area in cortical bone.

Conclusion: The intrasinus approach led to lower bone stress and a more robust correlation between bone stress and 3D BIC%, particularly in cortical bone contact. Importantly, the coverage area of cortical bone surrounding the zygomatic implant significantly influenced biomechanical performance of the zygomatic implants.

Purposes: One notable anomaly, presence of distomolars, arises beyond the typical sequence of the human dental system. In this study, convolutional neural networks (CNNs) based machine learning methods were employed to classify distomolar tooth existence using panoramic radiography (PR).

Methods: PRs dataset, composed of 117 subjects with distomolar teeth and 146 subjects without distomolar teeth, was constructed. These images were assessed using AlexNet, DarkNet, DenseNet, EfficientNet, GoogLeNet, ResNet, MobileNet, NasNet-Mobile, VGG, and XceptionNet frameworks for distomolar teeth existence. Considering the moderate number dataset samples, transfer learning was also utilized to improve the performance of these CNN based networks along with 5-fold cross-validation. The final classification was obtained through the fusion of the classifiers results.

Results: Performance of the experimental studies was assessed utilizing accuracy (Acc), sensitivity (sen), specificity (spe) and precision (pre) metrics. Best accuracy value of 96.2 % was obtained for the fusion of DarkNet, DenseNet, and ResNet, three best individual performing architectures, in distomolar teeth classification problem.

Conclusion and practical implications: In summary, this study has demonstrated the significant potential of CNNs in accurately detecting distomolar teeth in dental radiographs, a critical task for clinical diagnosis and treatment planning. The fusion of CNN architectures, particularly ResNet, Darknet, and DenseNet, has shown exceptional performance, pointing towards the future of artificial intelligence (AI) driven dental diagnostics. Our findings showed that these systems can help clinicians during radiologic examinations.

Background: Necrotizing fasciitis (NF) is a rare, rapidly progressing soft tissue infection characterized by the widespread necrosis of fascial planes and surrounding tissues.

Material and methods: We discuss four consecutive necrotizing fasciitis cases of the head and neck region, that accrued in a time window of 6 months. Patient demographics, clinical features, laboratory analyses, imaging findings, surgical interventions, and outcome were collected, assessed and discussed. These findings were checked against recent epidemiological data of invasive Group A Streptococcus (iGAS) in Europe.

Results: Four patients (two males and two females) aged between 31 and 65 years were included. The most common presenting symptom was severe pain and facial swelling (100 %), followed by fever (50 %) and erythema (50 %). All patients underwent emergency surgical debridement, and broad-spectrum antimicrobial therapy was initiated promptly. Streptococcus pyogenes was isolated in every patient. Three patients required multiple debridement procedures, and one case necessitated extensive neck resection due to the involvement of deeper structures. Overall, two patients recovered with no to minor residual deficits, one patient experienced persistent trismus and one patient passed away due to septic shock and multiorgan failure.

Conclusion: Prevalence of iGAS infections have increased in European countries, therefore increased vigilance is recommended so that a quick diagnosis can be established and appropriate treatment can be administered to avoid serious morbidity and mortality.

Ocular complications associated with anesthesia of the lower dental nerve may arise during or after administration of the local anesthetic, whether temporary or permanent. This situation generates concern for both the clinician and the patient. The purpose of this article is to identify ocular complications related to lower dental nerve block, analyzing signs, symptoms, gender, age, type of procedure, and duration of complications.

Methods: In September 2023, we conducted a systematic review using various databases, such as PubMed, ScienceDirect, and Google Scholar, using relevant search terms. There were no restrictions on the date or language of the articles.

Results: We identified 39 articles that met the selection criteria, covering an analysis of 45 cases. Complications showed a higher incidence in women, with 65.11 %, compared to 34.8 % in men. The most frequent ocular complications reported were diplopia (44 %), amaurosis (28 %) and eyelid ptosis (17.77 %).

Conclusions: Ocular complications related to lower tooth nerve block are rare, but they can occur. A higher incidence is observed in women than in men, and there is no specific age that predominates in its appearance. Diplopia is the most common ocular complication, followed by amaurosis, eyelid ptosis, and blurred vision. These complications may manifest during the infiltration of the anesthetic, immediately after the procedure, or a few hours later.