ABSTRACT
@#As the world’s population ages, age-related cognitive decline and dementia are becoming important challenges for geriatric care. Despite the ongoing search for solutions to address cognitive decline, effective interventions have not yet been established. There is increasing evidence from clinical, epidemiological, and animal studies that masticatory dysfunction due to occlusal disharmony is a risk factor for cognitive decline and an increased incidence of dementia. The mechanisms may involve altered nutritional intake, decreased cerebral blood flow, chronic stress, and hippocampal morphological function. These findings suggest that maintaining and adequately restoring the entire masticatory system has a positive impact for the prevention of cognitive decline.
ABSTRACT
@#Occlusal disorder is an abnormal condition in which the static and dynamic relations between the upper and lower teeth are not well aligned . The most common occlusal disorder in clinical practice is the inability to reach the intercuspal position due to early contact of individual points or occlusal interference due to occlusal high points, which can lead to periodontal tissue damage, decreased masticatory function, temporomandibular joint and muscle discomfort; these results can occur through the overactivation of the locus coeruleus-sympathetic-adrenal medullary system and hypothalamic-pituitary-adrenal axis induce elevated serum corticosteroid levels, which leads to chronic stress in the body. This article reviews the effects of chronic stress caused by occlusal disorder on bone tissue, stomatognathic system, emotional health and cognitive function. It has been found that occlusal disorders not only result in the loss of bone in the oral cavity, the reduction of bone mass in the whole body and damage to the local function of the stomatognathic system but also negatively affect the body’s anxiety, sleep, cognitive function and spatial memory ability as a result of the neuroendocrine changes . In recent years, concern about occlusal disorders has been on the rise. Early detection and timely adjustment of uncoordinated occlusion has become an issue that cannot be ignored in the clinic.
ABSTRACT
The development of inhibitors of immune checkpoints has revolutionized the treatment for a subset of patients with advanced nonsmall cell lung cancer (NSCLC), resulting in promising clinical outcomes and durable responses. Pembrolizumab, a humanized anti-programmed cell death-1 (PD-1) antibody, has been approved as a first-line treatment for patients with advanced NSCLC with PD-L1 expression of ≥50% and as a second-line treatment for PD-L1 expression of ≥1%. Pembrolizumab in combination with standard chemotherapy has shown better clinical outcomes than chemotherapy as a first-line therapy in patients with advanced NSCLC without targetable mutations, regardless of PD-L1 expression. In this review, we summarized the current indications of pembrolizumab for NSCLC, briefly described immune-relevant pneumonitis and discussed potential biomarkers to predict clinical efficacy.