Assess the Association Between Periodontitis and Maxillary Sinusitis: A Cross-Sectional Cone-Beam Computerized Tomography (CBCT) Study.

Background/purpose Periodontal pathologies which are considered odontogenic in origin can be a major cause of maxillary sinusitis, along with other dental and non-dental causes. The aim of this study is to define and assess the relationship between periodontitis and maxillary sinusitis. Material and methods A total of 415 CBCT datasets of periodontitis patients were cross-sectionally evaluated. Alveolar bone loss and maxillary sinus mucosal thickening were measured in coronal and sagittal sections, these two variables represent the severity of periodontitis and maxillary sinusitis, respectively. Results This study found that mucosal thickening was significantly higher in patients with increased alveolar bone loss severity (P=0.03). Mucosal thickening was significantly higher among males (83.5%) than among females (69.8%) (P=0.001). moderate or severe alveolar bone loss had a significantly higher risk of mucosal thickening with an odds ratio of 1.8 when compared to those with mild alveolar bone loss (95% CI: 1.04-3.2). Males had an increased risk of mucosal thickening compared to females with an odds ratio of 2.2 (95% C.I.: 1.4-3.6). Conclusion In conclusion, periodontal structure can affect maxillary sinus and its health. Therefore, after confirming a diagnosis of maxillary sinusitis, a detailed examination of periodontal health is needed. These results can be used to increase the awareness of dental students and practitioners in clinical and diagnostical judgement.

Influence of gingival display on smile attractiveness assessed by Saudi Arabian laypersons and dental professionals.

This study was undertaken to evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. A smiling photograph of a male and a female dental students were selected and digitally manipulated to create changes the amount of gingival display from 4 mm of gingival display to 4mm of gingival covered by the upper lip in 1 mm increments. Each photo was accompanied by a visual analog scale (VAS) for rating. Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score ± SE, 7.3 ± 3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7 ± 3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3 ± 3.18). The same rating was given by 48.3% of laypeople (6.1 ± 3.6) (p ≤ 0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient.

The Combination of Radiation with PARP Inhibition Enhances Senescence and Sensitivity to the Senolytic, Navitoclax, in Triple Negative Breast Tumor Cells.

Despite significant advances in the treatment of triple-negative breast cancer, this disease continues to pose a clinical challenge, with many patients ultimately suffering from relapse. Tumor cells that recover after entering into a state of senescence after chemotherapy or radiation have been shown to develop a more aggressive phenotype, and to contribute to disease recurrence. By combining the PARP inhibitor (PARPi), talazoparib, with radiation, senescence was enhanced in 4T1 and MDA-MB-231 triple-negative breast cancer cell lines (based on SA-ß-gal upregulation, increased expression of CDKN1A and the senescence-associated secretory phenotype (SASP) marker, IL6). Subsequent treatment of the radiation- and talazoparib-induced senescent 4T1 and MDA-MB231 cells with navitoclax (ABT-263) resulted in significant apoptotic cell death. In immunocompetent tumor-bearing mice, navitoclax exerted a modest growth inhibitory effect when used alone, but dramatically interfered with the recovery of 4T1-derived tumors induced into senescence with ionizing radiation and talazoparib. These findings support the potential utility of a senolytic strategy in combination with the radiotherapy/PARPi combination to mitigate the risk of disease recurrence in triple-negative breast cancer.

The relationship between matrix metalloproteinases-8 and peri-implantitis: A systematic review and meta-analysis.

Background: Peri-implantitis diagnosis typically involves evaluating inflammation, pocket depth, bleeding, and bone loss around dental implants. Although these methods are reliable and convenient, they mainly determine the history of the disease instead of the current activity or disease susceptibility. This meta-analysis evaluates whether the matrix metalloproteinase (MMP)-8 level in the peri-implant crevicular fluids (PICF) can be associated with peri-implantitis. Methods: The research was conducted in February 2022, where three electronic databases were searched and complemented with a manual search. The search criteria included original cross-sectional and longitudinal studies that compared MMP-8 biomarkers in crevicular fluids around healthy implants with unhealthy implants (peri-implantitis). To assess the risk of bias, the Newcastle-Ottawa Quality Scale was used. The data was analyzed using the RevMan program, and the standardized mean difference (SMD) with a 95% confidence interval was applied to evaluate the MMP-8 levels, with a significance level of p less than 0.05. Results: Out of 1978 studies, six were eligible. This meta-analysis included 276 patients divided into two groups; 121 patients (124 implants) in the peri-implantitis group and 155 patients (156 implants) in the health implants group. The quality of the included studies was evaluated as high to moderate. The meta-analysis showed a significant increase in MMP-8 levels in individuals with peri-implantitis compared to those with healthy implants (SMD = 1.43, 95% CI [0.19, 2.68], p = 0.02). Conclusion: The current meta-analysis found that the levels of MMP-8 in PICF were significantly elevated in peri-implantitis cases compared to healthy controls, indicating a potential link between MMP-8 and peri-implantitis. However, the meta-analysis does not provide evidence for MMP-8 as a diagnostic test for peri-implantitis. Further research, specifically diagnostic accuracy studies, is needed to establish the value of MMP-8 as a diagnostic tool for peri-implantitis.

High molecular weight hyaluronic acid reduces the growth and biofilm formation of the oral pathogen Porphyromonas gingivalis.

Background: Porphyromonas gingivalis (P. gingivalis) is viewed as a keystone microorganism in the pathogenesis of periodontal and peri-implant diseases. Hyaluronic acid (HA) is believed to exert antimicrobial activity. The aim of this study is to assess the in-vitro growth and biofilm formation of P. gingivalis under HA and compare the effect of HA to that of azithromycin (AZM) and chlorhexidine (CHX). Materials and methods: In each material, the minimum inhibitory concentration (MIC), 50% MIC, 25% MIC, and 12.5% MIC were tested. The growth of P. gingivalis was evaluated by absorbance spectrophotometry after 48 h. A biofilm inhibition assay was performed on a 72-hour culture by washing planktonic bacterial cells, fixing and staining adherent cells, and measuring the variation in stain concentrations relative to the untreated control using absorbance spectrophotometry. Results: The results show that the overall growth of P. gingivalis after 48 h was 0.048 ± 0.030, 0.008 ± 0.013, and 0.073 ± 0.071 under HA, AZM, and CHX, respectively, while the untreated control reached 0.236 ± 0.039. HA was also able to significantly reduce the biofilm formation of P. gingivalis by 64.30 % ± 22.39, while AZM and CHX reduced biofilm formation by 91.16 %±12.58 and 88.35 %±17.11, respectively. Conclusions: High molecular-weight HA significantly inhibited the growth of P. gingivalis. The overall effect of HA on the growth of P. gingivalis was similar to that of CHX but less than that of AZM. HA was also able to significantly reduce the biofilm formation of P. gingivalis. However, the ability of HA to prevent the biofilm formation of P. gingivalis was generally less than that of both AZM and CHX.

Alleviation of cisplatin-induced neuropathic pain, neuronal apoptosis, and systemic inflammation in mice by rapamycin.

Platinum-based chemotherapeutic treatment of cancer patients is associated with debilitating adverse effects. Several adverse effects have been well investigated, and can be managed satisfactorily, but chemotherapy-induced peripheral neuropathy (CIPN) remains poorly treated. Our primary aim in this study was to investigate the neuroprotective effect of the immunomodulatory drug rapamycin in the mitigation of cisplatin-induced neurotoxicity. Pain assays were performed in vivo to determine whether rapamycin would prevent or significantly decrease cisplatin-induced neurotoxicity in adult male Balb/c mice. Neuropathic pain induced by both chronic and acute exposure to cisplatin was measured by hot plate assay, cold plate assay, tail-flick test, and plantar test. Rapamycin co-treatment resulted in significant reduction in cisplatin-induced nociceptive-like symptoms. To understand the underlying mechanisms behind rapamycin-mediated neuroprotection, we investigated its effect on certain inflammatory mediators implicated in the propagation of chemotherapy-induced neurotoxicity. Interestingly, cisplatin was found to significantly increase peripheral IL-17A expression and CD8- T cells, which were remarkably reversed by the pre-treatment of mice with rapamycin. In addition, rapamycin reduced the cisplatin-induced neuronal apoptosis marked by decreased neuronal caspase-3 activity. The rapamycin neuroprotective effect was also associated with reversal of the changes in protein expression of p21Cip1, p53, and PUMA. Collectively, rapamycin alleviated some features of cisplatin-induced neurotoxicity in mice and can be further investigated for the treatment of cisplatin-induced peripheral neuropathy.

Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review of Pathophysiology, Risk Factors, Preventive Measures and Treatment Strategies.

Medication-related osteonecrosis of the jaw (MRONJ) is a major problem that can occur in people taking certain medications such bisphosphonates and denosumab. It can be used to treat osteoporosis or cancer. Bisphosphonate exposure, dental diseases and procedures, age, sex, anatomical factors, medical issues, and hereditary factors are all variables that enhance the risk of MRONJ. Even though MRONJ and antiresorptive medications have a close association, the pathophysiology of MRONJ is unknown. Careful dental preparation and oral hygiene instructions significantly minimize the risk of osteonecrosis of the jaw (ONJ). It is ideal to start antiresorptive treatment after the completion of required dental treatment; it is not contraindicated and carries low risk in patients who are on oral antiresorptive medications for less than three years. Drug holidays are one proposed solution to address MRONJ. However, there is still inadequate evidence to support their effectiveness. The objectives of this literature review are to recognize the main diagnostic principles and risk factors and to review the pathophysiology, protective procedures and treatment modalities related to MRONJ. The following topics are covered in the review: epidemiology, diagnostic criteria, risk factors, pathogenesis and mechanism, MRONJ staging and symptoms, clinical and radiographic findings, treatment strategies, prevention and drug holiday.

Oral fluid-based biomarkers in periodontal disease - part 2. Gingival crevicular fluid.

Periodontal diagnosis and treatment plan are based on the assessment of probing depth, clinical attachment level, plaque index, gingival index, bleeding on probing, suppuration, furcation involvement, mobility, and radiographic findings. However, these clinical parameters are not sufficiently sensitive and specific to identify disease activity in individual sites or to predict future attachment loss. Hence, attention is focused on the development of diagnostic tools that could screen and differentiate the active inflamed sites and predict future tissue destruction. Gingival crevicular fluid (GCF), has gained great interest on possible diagnostic value in periodontal disease. It contains a large number of proteins and peptides derived from inflamed host tissues. The analysis of the GCF components can reflect the disease status of individual sites and thus, identify potential biomarkers of periodontitis. A literature search was carried out to find out all the available tests that indicate periodontal disease markers in GCF. All major databases were searched to compile the information on published reports between 1999 and 2014. The list of GCF-biomarkers available to date is compiled and presented in a table format. Based on the available literature on GCF biomarkers, it can be concluded that several sensitive and reliable markers are present to detect the presence, severity, and response to treatment. Further studies are warranted to analyze the sensitivity and reliability of these indicators which might help in developing noninvasive tests that could help in the diagnosis of periodontal disease.

Oral fluid based biomarkers in periodontal disease: part 1. Saliva.

Traditional clinical measurements such as probing pocket depth, bleeding on probing, clinical attachment loss; plaque index and radiographs used for periodontal diagnosis are often of limited usefulness as they are indicators of previous periodontal disease rather than present disease activity. A literature search was carried out to find out all the available tests that indicate periodontal disease markers in saliva. All major databases were searched to compile the information on published reports between 1999 and 2014. The list of biomarkers available to date is compiled and presented in a table format. Each biomarker is discussed separately based on the available evidence. Based on the evidence, it can be concluded that several sensitive salivary indicators of periodontitis are available to detect the presence, severity and response to treatment. Further studies are warranted to analyze the sensitivity and reliability of these indicators that might help in developing non-invasive tests that could help in the diagnosis of periodontal disease.