Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study.

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.

Vitamin D deficiency and risk of recurrent aphthous stomatitis: updated meta-analysis with trial sequential analysis.

Background: Growing evidence suggests a significant association between vitamin D deficiency and RAS. Hence, the present meta-analysis and trial sequential analysis sought to investigate the potential association between low serum vitamin D levels and RAS. Methods: PubMed, Scopus, Embase, and Web of Science were comprehensively searched on December 1st, 2022 to retrieve all relevant studies. The grey literature was also searched via ProQuest. All case-control studies on the association between vitamin D and RAS were considered. The quality appraisal of the included studies was done using Newcastle-Ottawa scale. RevMan 5.0 and trial sequential analysis (TSA) programs were used for analyses. Results: A total of 14 case-control studies with 1468 subjects (721 RAS patients and 747 controls) were included. The pooled data revealed a significant association between low serum levels of vitamin D and the risk of RAS (mean difference = - 8.73, 95% CI: - 12.02 to - 5.44, I2 = 94%, P < 0.00001). Additionally, TSA findings indicated that the current studies surpassed the required information size, confirming that the differences were reliable. Conclusion: The available evidence suggests that Vitamin D deficiency may have a role in the pathogenesis of RAS. Therefore, evaluation of vitamin D should be considered in RAS patients. Additionally, the results support the possibility of using vitamin D supplements in the management of RAS patients with inadequate serum levels of vitamin D. Future interventional studies are required to evaluate the benefits of vitamin D replacement in prevention and treatment of RAS.

Efficacy of lycopene for management of oral potentially malignant disorders: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to investigate the available evidence on the efficacy of lycopene in the management of oral potentially malignant disorders (OPMDs). STUDY DESIGN: PubMed, Scopus, Web of Science, Google Scholar, China National Knowledge Infrastructure, and ProQuest databases were searched up to April 20, 2022. All clinical trials that assessed the efficacy of lycopene (I) on the signs/symptoms (O) of patients with OPMDs (P) in comparison to either active control or placebo (C) were included. Meta-analysis was conducted using the RevMan software (Cochrane Collaboration, London, UK). RESULTS: A total of 27 clinical trials (20 on oral submucosa fibrosis [OSF], 5 on oral lichen planus [OLP], and 2 on leukoplakia) were included. Overall, lycopene was efficacious in reducing signs and symptoms of OSF, OLP, and leukoplakia. The pooled data revealed comparable efficacy of lycopene and prednisolone in reducing pain and promoting clinical resolution of OLP. Additionally, the pooled data reported comparable efficacy of lycopene and conventional controls in improving the mouth opening and tongue protrusion in patients with OSF. CONCLUSIONS: The results reveal promising effects of lycopene in alleviating signs and symptoms of OSF, OLP, and leukoplakia. However, owing to the observed heterogeneity and short follow-up periods, further well-designed studies with long-term therapy and follow-up are highly recommended.

Mycophenolate Mofetil-Induced Aphthous Stomatitis After Kidney Transplant: A Clinical Case Report.

Aphthous stomatitis, with frequent and painful aphthous ulcers (also called canker sores or simply oral ulcers) on the non-keratinized oral mucous membranes, is often a cutaneous complication in kidney transplant recipients. Mycophenolate mofetil is a drug that is part of an immunosuppressive regimen in kidney transplant recipients, along with corticosteroids and calcineurin inhibitors. Mycophenolate mofetil, the triggering agent for mouth ulcers in kidney transplant recipients, has been communicated in scientific literature. Herein, we report a case of multiple painful oral ulcerations secondary to mycophenolate mofetil in a 23-year-old female kidney transplant recipient. The oral ulcers resolved immediately after discontinuation of the mycophenolate mofetil. Withdrawal of mycophenolate mofetil or switching to other medicine must be considered when a patient with a kidney transplant history complains of oral ulcers and a negative workup for other etiologies.

Knowledge and Attitude Among the Saudi Dentists Towards Coronectomy of Impacted Mandibular Third Molars.

Purpose: Compared to the complete extraction of impacted third molars that are in close proximity to the mandibular canal, the coronectomy procedure is used as an alternative, owing to its minimal risk of damaging the Inferior alveolar nerve. Despite clear coronectomy concepts mentioned in the literature, the procedure is debatable. This study aimed to assess the knowledge and attitude towards the coronectomy procedure among dentists in Saudi Arabia. Patients and Methods: The 16 close-ended questionnaire was distributed electronically to 377 dentists over the country. It included the demographic data and the options given to their patients with complicated impacted third molars, and the number of coronectomy they have performed. The retrieved data were exported and transferred to the SPSS software program for analysis. The Chi-squared and Fisher's exact tests were used as appropriate for comparisons. A P-value <0.05 was considered significant. Results: Only 54 (15%) participants performed coronectomy procedure, and only 28.3% of the participants advised their patients to do coronectomy. Nearly two-thirds of the participants (71.9%) were aware of coronectomy procedures, with no significant differences (P> 0.05) between the groups. About 68.9% of the participants agreed that coronectomy aims to protect inferior alveolar nerve damage. More than 60% of participants believed that coronectomy is a reliable technique, while 40.6% of participants claimed that they were capable of deciding whether to do coronectomy or extraction. No significant differences were found between the groups concerning most of the study variables (P> 0.05). Conclusion: Knowledge of Saudi dentists towards coronectomy is good, while their attitude is still low. More learning strategies about coronectomy should be implemented.

Role of Salivary Biomarkers in Cystic Fibrosis: A Systematic Review.

BACKGROUND: Saliva biomarkers could be easily used as a noninvasive alternative tool for diagnosing cystic fibrosis (CF) disease. In this study, the significance of changes in salivary compositions in patients with CF was systematically reviewed. METHODS: An electronic search was utilized to include studies published in English, with case-control, cohort, or cross-sectional design. The evaluated salivary components were extracted and summarized. The included studies were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. RESULTS: Out of 498 identified studies, nine met the eligibility criteria. Salivary electrolytes showed a substantial alteration in the CF group, especially with chloride and sodium. Total protein concentration was higher in patients with CF. However, SCN- concentration was lower in patients with CF. In addition, a reduction in the salivary flow rate and amylase levels was found in patients with CF. CONCLUSION: Alterations in salivary biomarkers among patients with CF could be used as a promising diagnostic tool for cystic fibrosis.

CD44-positive cancer stem cells from oral squamous cell carcinoma exhibit reduced proliferation and stemness gene expression upon adipogenic induction.

We proposed to assess adipogenic differentiation and its effect on the proliferation and stemness markers in CD44 + OSCC CSCs. D44 + CSCs were sorted by magnetic sorting from the single-cell suspension of the OSCC tumor. Adipogenic differentiation was induced by an adipogenic induction medium. Lipid droplet formation was confirmed by oil red O staining. The expression of the cell surface marker was analyzed by flow cytometry. Real-time qPCR was performed to examine the gene expression activity. CD44 + OSCC CSCs can differentiate into adipocytes and adipogenesis in these cells decrease their proliferation and stemness gene expression. Adipogenic induction can make the cancer stem cells from OSCC tumors lose their stemness potential. Oral cancer, especially OSCC, is a huge burden worldwide. Similar to other stem cells, cancer stem cells can differentiate into other lineage cells. Our study shows that the proliferation and stemness gene expression in the CSCs from OSCC tumors can be thwarted by inducing them to differentiate into adipocytes, which could be advantageous to find out new clinical approaches in the treatment of cancers, like OSCC.

Knowledge, Attitude, and Practice of Infection Control among Dental Healthcare Personnel: The Updated Guidelines for COVID-19 in Dental Settings.

AIM: The study sought to evaluate the knowledge, attitude, and practice of infection control among dental healthcare personnel (DHCP) in dental settings, with updated guidelines and recommendations regarding the coronavirus disease (COVID-19) pandemic. MATERIALS AND METHODS: This was an observational cross-sectional study. A self-administrative online survey consisting of 45 close-ended statements was prepared, validated, and revised by an expert panel, and pilot tested with a convenience sample. The survey comprised four parts covering the following aspects: demographic data, infection control facilities in the dental office, knowledge of infection control measures, and attitude toward infection control. Data were collected, analyzed, and presented as frequencies and percentages or means and standard deviations, when applicable. The independent t-test or analysis of variance (ANOVA), as appropriate, were used for differences in knowledge and attitude scores between the groups, with the significance level of p-value < 0.05. RESULTS: Out of 176 participants, 54 (30.7%) were men, and 122 (69.3%) were women. A total of 143 participants were dental practitioners (81.3%), and more than half [94 (53.4%)] were from governmental universities, followed by those from government dental clinics [44 (25%)]. In general, most participants acknowledged the infection control facilities in their dental offices. Dental assistants, respondents working in private universities, and respondents working in the eastern region showed better knowledge than their counterparts (p < 0.05). However, no significant differences were noticed between the different groups concerning attitude toward infection control (p > 0.05). CONCLUSION: The participants exhibited acceptable knowledge and attitude, with respondents from private universities and dental assistance attaining better knowledge scores. More infection control programs and training courses should be implemented in dental settings.

Detection of Nail Oncometabolite SAICAR in Oral Cancer Patients and Its Molecular Interactions with PKM2 Enzyme.

Oncometabolites are known to drive metabolic adaptations in oral cancer. Several oncometabolites are known to be shared between cancer cells and non-cancer cells including microbiotas to modulate the tumor microenvironment. Among potential oncometabolites, succinylaminoimidazolecarboxamide ribose5'-phosphate (SAICAR) supports the growth and invasiveness of cancer cells by pyruvate kinase M2 (PKM2) enzyme in a glucose starved tumor microenvironment. There is a significant gap that shows the detection of SAICAR in biological samples including nails of oral cancer patients. Metabolite identification of SAICAR was investigated in the nails of oral cancer patients using novel vertical tube gel electrophoresis (VTGE) and LC-HRMS. Further molecular docking and molecular dynamics simulations (MDS) were employed to determine the nature of molecular interactions of SAICAR (CHEBI ID:18319) with PKM2 (PDB ID: 4G1N). Molecular docking of SAICAR (CHEBI ID:18319) was performed against pyruvate kinase M2 (PDB ID: 4G1N). Data suggest the presence of oncometabolite SAICAR in nails of oral cancer. Molecular docking of SAICAR with PKM2 showed appreciable binding affinity (-8.0 kcal/mol) with residues including ASP407, THR405, GLU410, ARG443, GLY321, ARG436, HIS439, LYS266, and TYR466. Furthermore, MDS confirmed the specific binding of SAICAR within the activator site of PKM2 and the stability of SAICAR and PKM2 molecular interactions. In conclusion, SAICAR is a promising oncometabolite biomarker present in the nails of oral cancer patients. A significant activation potential of SAICAR exists with the PKM2 enzyme.

Effect of Ascorbic Acid on Differentiation, Secretome and Stemness of Stem Cells from Human Exfoliated Deciduous Tooth (SHEDs).

Stem cells from human exfoliated deciduous teeth (SHEDs) are considered a type of mesenchymal stem cells (MSCs) because of their unique origin from the neural crest. SHEDs can self-renewal and multi-lineage differentiation with the ability to differentiate into odontoblasts, osteoblast, chondrocytes, neuronal cells, hepatocytes, adipocytes, etc. They are emerging as an ideal source of MSCs because of their easy availability and extraordinary cell number. Ascorbic acid, or vitamin C, has many cell-based applications, such as bone regeneration, osteoblastic differentiation, or extracellular matrix production. It also impacts stem cell plasticity and the ability to sustain pluripotent activity. In this study, we evaluate the effects of ascorbic acid on stemness, paracrine secretion, and differentiation into osteoblast, chondrocytes, and adipocytes. SHEDs displayed enhanced multifaceted activity, which may have applications in regenerative therapy.

Early Diagnosis of Stevens-Johnson Syndrome in the Dental Clinic Setting.

Stevens-Johnson syndrome (SJS) is a life-threatening acute and fatal dermatological disease. It can present with many variations and rapidly worsens in a short period of time. Early diagnosis and management play an important role in stopping SJS from progression. Various drugs such as antibiotics, anticonvulsants and non-steroidal anti-inflammatory drugs can trigger the disease as an adverse effect. Oral and dental manifestation of SJS is uncommon. However, dentists should be clinically oriented towards signs and symptoms of the disease, both oral and systemic. We present a case of a 37-year-old male with no past medical history who presented to the dental emergency clinic complaining of dysphagia and burning sensation in the mouth. On oral examination, oral rash and blisters were observed. In addition, a bilateral forearm erythematous, non-blanching painful rash with some blisters was found after antibiotic administration three days earlier. The antibiotic was stopped and the patient was started on topical betamethasone for 14 days, topical chlorhexidine for 10 days, and oral nystatin suspension 100,000 units. A complete resolution of the oral and systemic manifestation was seen without the need for hospital admission.

Pleomorphic Adenoma: A Systematic Review.

BACKGROUND: Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. OBJECTIVE: The aim was to carry out a systematic literature of reports on pleomorphic adenoma from 2000 to 2018 to determine patient's age spread, gender, anatomical location, capsular invasion, histopathology, treatment and patient outcome. MATERIALS AND METHODS: A PubMed search was conducted with the following key words: adenoma, pleomorphic adenoma, and mixed salivary tumor. RESULTS: Twenty-two articles in English were read in full after fulfilling the eligibility criteria. The mean age of PA occurrence was 44.14 years with a definite female predilection (M:F ratio = 13:8). It most commonly occurred in the facial region (42.85%), and surgical approach is the preferred intervention. CONCLUSION: Pleomorphic adenomas are benign salivary gland neoplasms that can grow into extensive sizes if left untreated and hence need to be diagnosed early. Complete excision of the tumor is the definitive treatment, as enucleation can result in recurrence. Facial nerve has to be preserved if PA occurs in the parotid gland. HOW TO CITE THIS ARTICLE: Almeslet AS. Pleomorphic Adenoma: A Systematic Review. Int J Clin Pediatr Dent 2020;13(3):284-287.