Frontiers in oral health最新文献

Introduction: Upper aerodigestive tract cancers are prevalent, with a global incidence surpassing 500,000 new cases in 2018. Among these, oral squamous cell carcinomas (OSCC) constitute the majority. OSCC has a low 5-year survival rate due to late-stage diagnosis. Risk factors include alcohol and tobacco use. However, non-smokers and non-drinkers are also affected, especially young patients with tongue cancer. The impact of tumor microenvironment (TME) and tumor-infiltrating lymphocytes (TILs) on OSCC prognosis remains debated. Remarkably, Tertiary Lymphoid Structures (TLS) identified in solid tumors have shown associations with favorable outcomes, yet their prognostic significance in OSCC remains understudied.

Objective: Thus, this systematic review aims to explore the value of TLS in OSCC reported in the literature.

Method: A scoping review was conducted and six retrospective cohort studies involving 1,203 patients met the inclusion criteria.

Results: Predominantly male patients, with an average age of 49.3 years were included. Immunohistochemistry was the primary method to identify TLS, present in 21% up to 100% of cases. TLS were predominantly located in the peri-tumoral area (75.4%-84.8%) compared to the intra-tumoral area (33.8%-33.9%). Our review shows that the presence of TLS is associated with improved survival in OSCC.

Discussion: However, variations in TLS detection and classification methods across studies introduce potential biases, hindering direct comparisons between findings. For instance, reports that are based solely on examining HES-stained slides for TLS identification may raise reliability concerns. Standardization of methodologies is imperative to ensure consistency in criteria utilization, thereby facilitating meaningful data comparisons.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428010, PROSPERO (CRD42023428010).

Background: The styloid process (SP), a bony projection from the temporal bone which can become elongated, resulting in cervical pain, throat discomfort, and headaches. Associated with Eagle syndrome, this elongation can compress nearby nerves and blood vessels, leading to potentially severe complications. Traditional imaging-based methods for classifying various types of elongated styloid processes (ESP) are challenging due to variations in image quality, patient positioning, and anatomical differences, which limit diagnostic accuracy. Recent advancements in artificial intelligence, particularly deep learning, provide more efficient classification of elongated styloid processes.

Objective: This study aims to develop an automated classification system for elongated styloid processes using deep learning models and to evaluate the performance of two distinct architectures, EfficientNetB5 and InceptionV3, in classifying elongated styloid processes.

Methods: This retrospective analysis classified elongated styloid processes using Ortho Pantomograms (OPG) sourced from our oral radiology archives. Styloid process lengths were measured using ImageJ software. A dataset of 330 elongated and 120 normal styloid images was curated for deep learning model training and testing. Pre-processing included median filtering and resizing, with data augmentation applied to improve generalization. EfficientNetB5 and InceptionV3 models, utilized as feature extractors, captured unique styloid characteristics. Model performance was evaluated based on accuracy, precision, recall, and F1-score, with a comparative analysis conducted to identify the most effective model and support advancements in patient care.

Results: The EfficientNetB5 model achieved an accuracy of 97.49%, a precision of 98.00%, a recall of 97.00%, and an F1-score of 97.00%, demonstrating strong overall performance. Additionally, the model achieved an AUC of 0.9825. By comparison, the InceptionV3 model achieved an accuracy of 84.11%, a precision of 85.00%, a recall of 84.00%, and an F1-score of 84.00%, with an AUC of 0.8943. This comparison indicates that EfficientNetB5 outperformed InceptionV3 across all key metrics.

Conclusion: In conclusion, our study presents a deep learning-based approach utilizing EfficientNetB5 and InceptionV3 to accurately categorize elongated styloid processes into distinct types based on their morphological characteristics from digital panoramic radiographs. Our results indicate that these models, particularly EfficientNetB5, can enhance diagnostic accuracy and streamline clinical workflows, contributing to improved patient care.

Introduction: This study synthesizes evidence on the impact of subgingival periodontal treatment combined with antibiotics on reducing systemic inflammation markers-C-reactive protein (CRP), interleukins, and tumor necrosis factor-alpha (TNF-α)-in patients with metabolic syndrome (MS) and periodontal disease (PD), compared to supragingival periodontal treatment with placebo.

Methods: Randomized clinical trials (RCTs) published in English, Spanish, or Portuguese that addressed the research question were included. A search was conducted in eight databases (PubMed, EMBASE, CINAHL, LILACS, Scopus, WoS Core Collection, Dentistry & Oral Science Source, and Cochrane Central) on June 20, 2023. Risk of bias was assessed using the Cochrane RoB 2 tool, and evidence certainty was evaluated following GRADE guidelines. A qualitative synthesis of the evidence was performed.

Results: Two RCTs with 228 participants (ages 35-65) were included. Montero et al. reported significant reductions in CRP levels favoring the treatment group at 3 months (2.7 mg/L ± SE: 0.4 vs. 3.9 mg/L ± SE: 0.6; p = 0.001) and 6 months (2.9 mg/L ± SE: 0.4 vs. 4.0 mg/L ± SE: 0.8; p = 0.004). Lopez et al., however, found no significant differences throughout follow-up. Only Montero et al. reported on interleukin 1β and TNF-α, observing significant reductions at 3 months for interleukin 1β (0.9 pg/dl ± SE: 0.1 vs. 2.3 pg/dl ± SE: 0.5; p = 0.046) and TNF-α (6.4 pg/dl ± SE: 0.8 vs. 10.0 pg/dl ± SE: 2.3; p = 0.037).

Discussion: The evidence is limited by the small number of comparative RCTs. One RCT with low risk of bias demonstrated significant reductions in CRP, interleukins, and TNF-α levels at 3 months and CRP at 6 months. The other, with unclear risk of bias, showed no differences in CRP up to 12 months. Findings suggest that subgingival periodontal treatment with antibiotics reduces systemic inflammation for up to 6 months in patients with MS and PD. However, larger RCTs with standardized methods and longer follow-up are needed to confirm these results.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022366056, PROSPERO (CRD42022366056).

Palatogingival groove is a developmental anomaly that can lead to significant periodontal and periapical diseases, particularly in Type III, which extends to the apex and communicates with the periodontal membrane through the apical foramen. This case report details the management of a Type III palatogingival groove in a maxillary lateral incisor, combining root canal treatment and intentional replantation, followed by a 3-year follow-up to assess the mid-term efficacy of this approach. The patient presented with a narrow and deep periodontal pocket on the palatal side, destruction of the palatal root surface and labial bone plate, and a persistent sinus tract. Initial treatment involved controlling the intracanal infection using root canal treatment under a dental microscope. One week later, the tooth was extracted for ex vivo preparation, including apical retrofilling and segmented filling of the root surface groove, before replantation and stabilization with elastic fixation on the labial side. At the 2-month follow-up, the labial sinus tract had completely healed. The palatal area, which initially exhibited a probing depth of 10 mm, demonstrated an 8-mm gain in clinical attachment. Probing revealed no signs of bleeding or pus discharge. Radiographic examinations showed the disappearance of periapical radiolucency. Regular follow-ups at 12, 24, and 36 months indicated no discomfort, with radiographic evidence of new bone formation at the apex and gradual recovery of the periodontal membrane, achieving new periodontal attachment. This case demonstrates that root canal treatment combined with intentional replantation, with a focus on infection control, is an effective treatment method for managing Type III palatogingival groove in maxillary lateral incisors.

Introduction: Dental caries is the most prevalent chronic infectious disease globally, with Streptococcus mutans recognized as a primary causative agent due to its acidogenicity and robust biofilm-forming ability. In S. mutans biofilm formation, the role of autoinducers has been extensively studied, while the influence of other small molecules remains largely unexplored. Mutanofactins, a class of polyketide/non-ribosomal lipopeptide secondary metabolites, are emerging as potential modulators of S. mutans biofilm development.

Methods: Transcriptomic analysis was conducted to examine gene expression patterns in S. mutans NMT4863 across distinct growth phases and lifestyles, aiming to identify metabolic factors influencing biofilm formation. Transcriptomic profiles were compared between cells in early-, mid-, and late-exponential-, and stationary phase, as well as between planktonic and biofilm cells. Differentially expressed genes were identified, and pathway analyses revealed significant alterations in key metabolic and regulatory pathways. Specifically, the biosynthetic mutanofactin gene cluster was analyzed via quantitative real-time polymerase chain reaction.

Results: Several genes and operons were differentially expressed across the tested growth phases, with 1,095 genes showing differential expression between stationary-phase, planktonic and biofilm cells. Pathway analysis revealed significant changes in ascorbate metabolism, carbohydrate utilization and transport systems, lipoic acid metabolism, bacterial toxin pathways, two-component regulatory systems, and secondary metabolite biosynthesis. Notably, expression of the muf gene cluster, was elevated in early exponential-phase cells relative to stationary-phase cells. Additionally, the mufCDEFGHIJ genes were identified as components of a single transcriptional unit (muf operon). MufC, a transcriptional regulator of the TetR/AcrR-family, acts as a positive regulator of the muf operon in strain NMT4863. Bioinformatic analysis pinpointed a 20-bp regulatory sequence in the muf operon promoter region (5'-AAATGAGCTATAATTCATTT-3'). Interestingly, the muf operon was found to be significantly downregulated in biofilm cells.

Conclusion: This study provides key insights into gene expression dynamics that drive biofilm formation in S. mutans NMT4863, with a particular emphasis on the role of the muf operon. This operon is governed by the TetR/AcrR-family regulator MufC and plays a central role in biofilm development, offering a novel perspective on the molecular basis of S. mutans biofilm formation and resilience.

Periodontal disease is a widespread chronic inflammatory state influencing the supporting anatomy of the teeth, distinguished by oxidative stress, progressive bone loss, and tissue damage. Recent articles have highlighted the significance of mitochondrial dynamics, mainly Mitofusin-1 (MFN1) along with Mitofusin-2 (MFN2), inflammation regulation, tissue homeostasis, and in cellular function. The aim of the current study is to comprehensively review including evaluate the roles of MFN2 and MFN1 in the pathogenesis as well as the progression of periodontal disease, foregrounding their effect on mitochondrial integrity, inflammatory pathways, and oxidative stress. Studies were selected depending on inclusion criteria based on the roles of MFN2 and MFN1 in periodontal disease and health. Data from chosen in vivo, clinical studies, and in vitro were synthesized. Outcomes indicate that MFN2 and MFN1 are important for preserving cellular function, mitigating oxidative damage, and mitochondrial fusion. Decreased levels of these proteins were related to elevated oxidative stress, inflammation, and increased mitochondrial dysfunction in periodontal tissues. The current comprehensive review shows the important roles of MFN1 along with MFN2 in inflammation regulation, cell survival, and mitochondrial dynamics within periodontal disease. The prospective for targeting MFN1 along with MFN2 in therapeutic policy is promising, presenting avenues for upgraded periodontal management and regeneration.

The morbidity of oral disorders, including gingivitis, caries, endodontic-periodontal diseases, and oral cancer, is relatively high globally. Pathogenic cells are the root cause of many oral disorders, and oral therapies depend on eradicating them. Photodynamic therapy (PDT) has been established as a potential and non-invasive local adjuvant treatment for oral disorders. PDT consists of three essential components: photosensitizer (PS), a light source with a certain wavelength, and oxygen dissolved in the cells. These three components can interact to cause damage to proteins, lipids, nucleic acids, and other biological components within diseased tissues. Herein, we aimed to provide a detailed understanding of PDT and how it can treat oral diseases. Concerns about PDT and potential remedies are also a factor. PDT has been shown in numerous clinical studies to be an efficient supplementary therapy that can reduce pathogenic cells. The PDT has great potential for dental applications, including treating bacterial and fungal infections during root canal therapy and preventing oral cancer, potentially malignant disorders, periodontitis, dental caries, and peri-implant disorders. Although PDT has been promoted as having significant potential and utility in dentistry, more clinical research must be conducted before being used broadly.

Objectives: This study aims to examine kindergarten teachers' satisfaction and their perceived impact of an oral health education (OHE) training program.

Methods: This study followed the steps outlined in the Program Evaluation Standards in Public Health recommended by the Centers for Disease Control and Prevention. All kindergarten teachers in Hong Kong were invited to attend the OHE training. The training comprised a lecture and a group discussion among six to eight teachers facilitated by trained dentists. The participating teachers were invited to complete an online questionnaire after the training. The questionnaire consisted of seven questions: six close-ended questions to evaluate teachers' satisfaction with the training, their perceived oral-health-related knowledge, and their perceived competence in delivering OHE, and one open-ended question to collect their comments and suggestions for enhancing the OHE training.

Results: A total of 6,210 teachers joined the OHE training and 4,882 teachers completed the questionnaires (response rate: 79%). The survey found that 4,691 (96%) teachers were satisfied with the training, and the same number agreed that the OHE training was essential for delivering OHE. In addition, 4,680 (96%) teachers found the lecture informative and 4,393 (90%) teachers rated the group discussion as useful. After the OHE training, 4,716 (96%) teachers reported that they were more knowledgeable in recognizing childhood oral diseases and 4,665 (96%) teachers believed they were more skillful in delivering OHE. Regarding comments and suggestions, teachers opined that the OHE was informative and comprehensive. They suggested developing videos and hands-on workshops for the OHE training and expressed a desire to learn more about the dental treatment of common dental diseases. They also recommended providing teaching aids, such as booklets and tooth models, for use in kindergartens.

Conclusion: The kindergarten teachers generally had a better understanding of childhood oral conditions after the OHE training. They were generally satisfied with the training and became more confident in delivering OHE to kindergarten children.

Introduction: Previous studies have shown Streptococcus mutans (S. mutans) esterase is a key mediator of dental composite biodegradation, which can contribute to recurrent caries. This study is to investigate the inhibitory effects of a novel Chemically-Modified-Curcumin (CMC 2.24) on esterase activities and related dental material biodegradation.

Methods: Dental adhesive materials and composite resins were incubated in S. mutans suspension with CMC 2.24 and other compounds, including doxycycline, Chemically-Modified-Tetracycline (CMT-3), and curcumin for 4 weeks. The pre- and post-incubation surface roughness were evaluated by either laser diffraction pattern and/or a 3D laser scanning microscope. Esterase enzyme inhibition assays were performed with the same test groups and activities were determined spectrophotometrically.

Results: Among all experimental groups, CMC 2.24 significantly reduced surface roughness of dental composite (p < 0.01) and adhesive (p < 0.01) materials compared to bacteria-only group. Additionally, CMC 2.24 reduced porcine esterase activity by 46.5%, while other compounds showed minimal inhibition. In the S. mutans esterase assay, CMC 2.24 showed inhibition of 70.0%, while other compounds showed inhibition ranging from 19% to 36%.

Conclusion: Our study demonstrated that CMC 2.24 inhibited biodegradation of dental composite material more effectively than its mother compound, curcumin. Moreover, the mechanism of this biodegradation was likely mediated through bacterial esterase activity. Doxycycline achieved similar inhibition by completely eradicating S. mutans with its antibiotic action; hence, it is not recommended for long-term use.