Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

BACKGROUND: The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent. METHODS: Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias. RESULTS: Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

SPECT/CT and PET/CT, related radiopharmaceuticals, and areas of application and comparison.

The paper begins by identifying the key historical elements in the development of nuclear medicine imaging, focusing on the Anger camera and single photon emission computed tomography (SPECT) technologies. In this context, key reference is made to the physics of detection in Anger camera systems, especially key components such as the sodium iodide crystal, the function and performance of photomultiplier tubes, and the collimator design. It is discovered that within each component of technology, there are fundamental physical relationships that govern the performance of each component, and that overall image quality is the result of the complex interaction of all such elements. The increasing use of SPECT/CT imaging is described and illustrated with a range of typical clinical applications, which include brain, spinal, cardiac, and cancer studies. The use of CT imaging functionality allows for SPECT image correction based on compensation for absorption within tissue. Reference is also made to the basics of positron emission tomography (PET) imaging and, in particular, to the integration of PET/CT systems where the anatomy profile of the CT image is used to provide correction for photon absorption. A summary is provided of the radionuclides and radiopharmaceuticals commonly used in PET/CT imaging and a range of image studies referenced includes those of nasopharyngeal carcinoma, lung cancer investigation, brain investigation (cancer detection and dementia) and cardiac function. Reference is made to the development of "time of flight" (TOF) technology for improving of image resolution in PET/CT systems. Furthermore, SPECT/CT and PET/CT imaging systems are compared, where a key factor identified is the significantly higher number of photons detected with PET/CT technology and improved image resolution.

Effects of COVID-19 on Synaptic and Neuronal Degeneration.

Neurons are the basic building blocks of the human body's neurological system. Atrophy is defined by the disintegration of the connections between cells that enable them to communicate. Peripheral neuropathy and demyelinating disorders, as well as cerebrovascular illnesses and central nervous system (CNS) inflammatory diseases, have all been linked to brain damage, including Parkinson's disease (PD). It turns out that these diseases have a direct impact on brain atrophy. However, it may take some time after the onset of one of these diseases for this atrophy to be clearly diagnosed. With the emergence of the Coronavirus disease 2019 (COVID-19) pandemic, there were several clinical observations of COVID-19 patients. Among those observations is that the virus can cause any of the diseases that can lead to brain atrophy. Here we shed light on the research that tracked the relationship of these diseases to the COVID-19 virus. The importance of this review is that it is the first to link the relationship between the Coronavirus and diseases that cause brain atrophy. It also indicates the indirect role of the virus in dystrophy.

The Effect of ZnO, MgO, TiO2, and Na2O Modifiers on the Physical, Optical, and Radiation Shielding Properties of a TeTaNb Glass System.

Novel glass samples with the composition 75TeO2-5Ta2O5-15Nb2O5-5x (where x = ZnO, MgO, TiO2, or Na2O) in mole percent were prepared. The physical, optical, and gamma radiation shielding properties of the glass samples were studied over a wide energy spectrum ranging between 0.015 and 20 MeV. The glasses' UV-vis spectra were utilized to evaluate the optical energy gap and refractive index. Glass samples had a refractive index ranging from 2.2005 to 2.0967. The results showed that the sample doped with zinc oxide (ZnO) recorded the highest density (ρglass), molar polarizability (αm), molar refraction (Rm), refractive index (n), and third-order nonlinear optical susceptibility (χ3) and the lowest optical energy gap (Eopt) among the samples under investigation. When comparing the current glass system with various standard glass shielding materials, the prepared glass system showed superior shielding performance at energies ranging between 40 and 85 keV. These findings indicate that the prepared glass systems can be used in diagnostic X-rays, especially in dental applications.

Role of Probiotics for the Treatment of Peri-Implant Mucositis in Patients With and Without Type 2 Diabetes Mellitus.

This study hypothesized that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for the treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type 2 diabetic and nondiabetic patients over a 12-month follow-up period. Patients with and without type 2 diabetes were included. PM patients were categorized into 2 groups based on the treatment procedure: (1) nonsurgical + PT and (2) nonsurgical MD alone. Demographics and education statuses were recorded. Gingival index (GI) and plaque index (PI), crestal bone loss (CBL), and probing depth (PD) were measured at baseline and after 6 and 12 months. Significant differences were detected with P < .01. The hemoglobin A1c level was significantly higher in patients with diabetes at all time durations than in patients without type 2 diabetes (P < .001). Baseline GI, PI, PD, and CBL were comparable in all groups. In patients with type 2 diabetes, there was no difference in PI, GI, PD, and CBL at 6- and 12-month follow-up. In patients without type 2 diabetes, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01) at 6-month and 1-year follow-up as compared with baseline. In patients without type 2 diabetes, MD with or without adjunct PT reduced soft-tissue inflammatory parameters in patients with PM.

Efficacy of Antibiotic Versus Probiotics As Adjuncts to Mechanical Debridement for the Treatment of Peri-Implant Mucositis.

The objective was to compare the efficiency of probiotic therapy (PT) vs antibiotic therapy (AT) as adjuvants to nonsurgical-mechanical debridement (NSMD) for the treatment of peri-implant mucositis (Pi-M). Volunteers with Pi-M were encompassed. Therapeutically, patients were randomly divided into 3 groups: (a) Group 1: NSMD + PT; (b) Group 2: NSMD + AT; and (c) Group 3: NSMD alone. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone loss (CBL) were recorded at baseline and at 3 and 6 months follow-up. P < .05 was selected as the indicator of statistical significance. Forty-two male individuals (14, 14, and 14 in Groups 1, 2, and 3, respectively) were included. At 3 and 6 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 2 than Group 1. At 3 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 3 than Group 2. At 6 months of follow-up, PI, BOP, and PD were comparable in Groups 2 and 3. In Group 3, PI, BOP, and PD were comparable with the respective baseline values at 6 months of follow-up. The CBL in all groups remained unchanged up to 6 months of follow-up. The NSMD with adjuvant PT is more effective than adjunct AT for the treatment of Pi-M for up to 3 months.

Enhancement of Mammographic Images Using Histogram-Based Techniques for Their Classification Using CNN.

In the world, one in eight women will develop breast cancer. Men can also develop it, but less frequently. This condition starts with uncontrolled cell division brought on by a change in the genes that regulate cell division and growth, which leads to the development of a nodule or tumour. These tumours can be either benign, which poses no health risk, or malignant, also known as cancerous, which puts patients' lives in jeopardy and has the potential to spread. The most common way to diagnose this problem is via mammograms. This kind of examination enables the detection of abnormalities in breast tissue, such as masses and microcalcifications, which are thought to be indicators of the presence of disease. This study aims to determine how histogram-based image enhancement methods affect the classification of mammograms into five groups: benign calcifications, benign masses, malignant calcifications, malignant masses, and healthy tissue, as determined by a CAD system of automatic mammography classification using convolutional neural networks. Both Contrast-limited Adaptive Histogram Equalization (CAHE) and Histogram Intensity Windowing (HIW) will be used (CLAHE). By improving the contrast between the image's background, fibrous tissue, dense tissue, and sick tissue, which includes microcalcifications and masses, the mammography histogram is modified using these procedures. In order to help neural networks, learn, the contrast has been increased to make it easier to distinguish between various types of tissue. The proportion of correctly classified images could rise with this technique. Using Deep Convolutional Neural Networks, a model was developed that allows classifying different types of lesions. The model achieved an accuracy of 62%, based on mini-MIAS data. The final goal of the project is the creation of an update algorithm that will be incorporated into the CAD system and will enhance the automatic identification and categorization of microcalcifications and masses. As a result, it would be possible to increase the possibility of early disease identification, which is important because early discovery increases the likelihood of a cure to almost 100%.

The Potential Contribution of Biopolymeric Particles in Lung Tissue Regeneration of COVID-19 Patients.

The lung is a vital organ that houses the alveoli, which is where gas exchange takes place. The COVID-19 illness attacks lung cells directly, creating significant inflammation and resulting in their inability to function. To return to the nature of their job, it may be essential to rejuvenate the afflicted lung cells. This is difficult because lung cells need a long time to rebuild and resume their function. Biopolymeric particles are the most effective means to transfer developing treatments to airway epithelial cells and then regenerate infected lung cells, which is one of the most significant symptoms connected with COVID-19. Delivering biocompatible and degradable natural biological materials, chemotherapeutic drugs, vaccines, proteins, antibodies, nucleic acids, and diagnostic agents are all examples of these molecules' usage. Furthermore, they are created by using several structural components, which allows them to effectively connect with these cells. We highlight their most recent uses in lung tissue regeneration in this review. These particles are classified into three groups: biopolymeric nanoparticles, biopolymeric stem cell materials, and biopolymeric scaffolds. The techniques and processes for regenerating lung tissue will be thoroughly explored.

Evaluation of Fracture Load of Cement-, Screw-, and Multiscrew-Retained Abutments for Implant-Supported Fixed Partial Dentures.

PURPOSE: The purpose of this in vitro study was to evaluate the load-to-fracture values of cement-, screw-, and multiscrew-retained abutments for implant-supported fixed partial dentures (FPDs). MATERIALS AND METHODS: Thirty-six implants with a diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based upon the variations on abutment design, the FPDs were divided into three categories as follows: cement-retained, screw-retained, and multiunit screw-retained abutments. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with a load of 70 N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done, and fracture-load values were recorded as means and corresponding standard deviations; group comparisons were done using one-way analysis of variance and Tukey post hoc tests. A P value < .01 was considered as an indicator of statistical significance. RESULTS: The fracture-load values for cement-, screw-, and multiunit screw-retained abutments were 2,109.2 ± 139.6 N, 3,888.8 ± 70 N, and 3,319.4 ± 218.9 N, respectively. The load-to-fracture values were significantly higher in screw-retained abutments (3,888.8 ± 70 N; P < .001) than in cement-retained (2,109.2 ± 139.6 N) and multiunit screw-retained abutments (3,319.4 ± 218.9 N). CONCLUSION: Screw-retained implant-supported FPDs withstand higher occlusal forces compared with cement- and multiunit screw-based retention techniques. However, the results should be cautiously interpreted, as they were based on a relatively small sample size.

Relationship between buccal alveolar bone thickness and crown-to-root dimensions around mandibular first and second molars: A cone-beam-computed tomography-based study.

BACKGROUND: Assessment of buccal alveolar bone thickness (ABT) and crown-to-root dimensions are essential in implant density; therefore, three-dimensional evaluation of these parameters provides a superior visualization than conventional radiographs. OBJECTIVE: The present cross-sectional cohort study aims to investigate the relationship between buccal ABT and crown-to-root dimensions around the mandibular first and second molars using cone-beam-computed tomography (CBCT). METHODS: Initially, CBCT-based scans from 271 individuals were assessed. Based on the inclusion and exclusion criteria, 171 CBCT-based scans were excluded. In total, 100 CBCT-scans were included in the present investigation and processed for data extraction. On the mandibular first and second molars, the mesial and distal root lengths and mesiodistal diameter of the crowns were measured. The pulpal floor served as a reference point for assessment of root length. The buccal ABT was measured at the coronal, middle and apical one-third of the root. Statistical analysis was performed and the level of significance was set at P< 0.01. One-hundred CBCT-scans from 294 mandibular teeth (137 first molars and 157 second molars) were included. One hundred and eighty-nine and 105 teeth were from males and females, respectively. RESULTS: The normality plot showed a normal data distribution. The mesiodistal crown width showed a weak yet significant correlation with mesial root length (r= 0.137), bone thickness at mesial apical third (r= 0.180), distal apical (r= 0.157) and distal coronal third (r= 0.161). Bone thickness at mesial, middle and apical third correlated significantly with one other (r= 0.786). CONCLUSION: There is a direct correlation between the buccal ABT and tooth dimensions around the mandibular first and second molars.

In-vitro efficacy of two spectrophotometer-based shade matching systems for color matching of ceramics after artificial accelerated aging / Eficácia in vitro de dois espectrofotômetros baseados em escalas de cor para avaliação de cor de cerâmicas após envelhecimento artificial acelerado

Objective: The objective of the present in-vitro study was to verify the efficacy of two spectrophotometer-based shade matching systems for color matching of ceramics after artificial accelerated aging (AAA). Material and Methods: The ceramics used were porcelain laminated veneers. Seventy standard-shaped discs (thickness x diameter: 0.5 mm x 10 mm) of B1 shades were used. Based upon the type of resin cement used, the specimens were divided into seven groups (10/group). The following light-cured cements were used: RelyX-Veneer (L-RV), Variolink-Veneer (L-VV), and Variolink-Esthetic (L-VE). The dual-cured cements were: RelyX Ultimate (D-RU), RelyX-Unicem (D-RC), and Variolink-Esthetics DC (D-VE). The control group consisted of ceramic only. All specimens were thermocycled in water for 3,500 cycles between 5 oC -55 oC, with dwell times of 30 s in each bath and a transfer time of 10 s between baths. All specimens were thermocycled in water for 3,500 cycles between 5 oC and 55 oC, and color measurement was done using the VITA Easyshade and ColorEye spectrophotometers. Baseline color reading was performed 24-hours after cementation. Differences in color (DE) of EasyShade and ColorEye before and after AAA were determined and compared statistically. Group comparisons were done using the paired t-tests. Level of significance was set at P< 0.05. Results: The mean differences in color (ΔE) values obtained from EasyShade spectrophotometer for light- and dual-cured cements, were 0.843±0.89 (L-RV ), 4.11±0.69 (L-VV) and 0.833±0.47 (L-VE); and 2.22±0.64 (D-RU), 3.37±0.83 (D-RC) and 0.38±0.92 (D-VE), respectively. The mean differences in color (ΔE) values obtained from ColorEye spectrophotometer for light- and dual-cured cements, were 0.68±0.86 (L-RV ), 4.55±0.83 (L-VV) and 2.68±0.26 (L-VE); and 2.06±0.84 (D-RU), 1.8±1.08 (D-RC) and 0.96±0.71 (D-VE), respectively. There was no significant difference in the mean DE values among the groups. Conclusion: The VITA Easyshade and ColorEye shade matching systems are comparable in terms of their efficacy for color matching of cerammics after AAA.(AU)

Objetivos: O objetivo do presente estudo in vitro foi verificar a eficácia de dois espectrofotômetros baseados em escalas de cor para avaliação de cor de cerâmicas após envelhecimento artificial acelerado (EAA). Material e Métodos: As cerâmicas utilizadas foram laminados cerâmicos. Foram usados setenta discos de formato padrão (0,5mm de espessura x 10 mm de diâmetro) de tonalidades B1. Com base no tipo de cimento resinoso utilizado, os corpos-de-prova foram divididos em sete grupos (10 / grupo). Foram utilizados os seguintes cimentos fotopolimerizáveis: RelyX-Veneer (L-RV), Variolink-Veneer (L-VV) e Variolink-Esthetic (L-VE). Os cimentos de cura dual foram: RelyX Ultimate (D-RU), RelyX-Unicem (D-RC) e Variolink-Esthetics DC (D-VE). O grupo controle consistia apenas de cerâmica. Todos os corpos-de-prova foram termociclados em água por 3.500 ciclos entre 5oC-55oC, com tempos de permanência de 30s em cada banho e um tempo de transferência de 10s entre os banhos. A medição da cor foi feita usando os espectrofotômetros VITA Easyshade e ColorEye. A leitura da cor inicial foi realizada 24 horas após a cimentação. As diferenças na cor (ΔE) do EasyShade e ColorEye antes e depois do EAA foram determinadas e comparadas estatisticamente. As comparações dos grupos foram feitas usando o teste t pareados. O nível de significância foi estabelecido em p <0,05. Resultados: os valores médios de diferenças na cor (ΔE) obtidos no espectrofotômetro EasyShade para cimentos fotopolimerizáveis e duais foram de 0,843 ± 0,89 (L-RV), 4,11 ± 0,69 (L-VV) e 0,833 ± 0,47 (L-VE ); e 2,22 ± 0,64 (D-RU), 3,37 ± 0,83 (D-RC) e 0,38 ± 0,92 (D-VE), respectivamente. os valores médios de diferenças na cor (ΔE) obtidos no espectrofotômetro ColorEye para cimentos fotopolimerizáveis e duais foram de 0,68 ± 0,86 (L-RV), 4,55 ± 0,83 (L-VV) e 2,68 ± 0,26 (L-VE); e 2,06 ± 0,84 (D-RU), 1,8 ± 1,08 (D-RC) e 0,96 ± 0,71 (D-VE), respectivamente. Não houve diferença significativa nos valores médios de ΔE entre os grupos. Conclusão: Os sistemas de combinação de cores VITA Easyshade e ColorEye são comparáveis em termos de eficácia para avaliação de cores de cerâmicas após EAA. (AU)

Implant Treatment for a Patient With Large Condensing Osteitis: Case Report.

Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial.

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

In Vitro Comparison of Modes of Failures among Titanium and One- and Two-piece Zirconia Abutment under Static Load.

OBJECTIVES: The objective was to assess modes of failures under static load (SL) among titanium (Ti) and one- and two-piece zirconia abutment (ZA) in vitro. MATERIALS AND METHODS: The Ti abutments were digitally scanned for the fabrication of the one- and two-piece zirconia abutment specimens. This was done to standardize the design of the one-piece abutment and make it the blueprint of the Ti abutment. Twenty-one implant abutments and 21 implant replicas were categorized into three groups as follows: group 1 (Titanium group), group 2 (one-piece ZA group), and group 3 (two-piece ZA group). A 250K-cycle, linear fatigue-load, reaching 10 to 210 Newton (N), was put on all specimens using an all-electric dynamic test instrument and the specimens were loaded until fracture. STATISTICAL ANALYSIS: Assessment of mode of fracture among the groups was done visually. Significance was based below 0.05. RESULTS: Screw fracture (n = 7) and abutment bending at the apical part (n = 7) occurred in the Ti group. In the one-piece zirconia group, screw and abutment fractures occurred in seven and seven cases, respectively. In the two-piece zirconia group, screw fracture (n = 7) above the Ti zirconia junction (transgingival segment) and abutment fracture (n = 7) were determined as the failure modes. CONCLUSION: In conclusion, all abutments underwent failures under SL in vitro; and the mode of failure modes varied among the different abutment designs used.

Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up.

BACKGROUND: It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. METHODS: Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. RESULTS: In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). CONCLUSIONS: Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.

Diagnostic performance of morphometric vertebral fracture analysis (MXA) in children using a 33-point software program.

BACKGROUND: There is significant inter and intraobserver variability in diagnosing vertebral fractures in children. PURPOSE: We aimed to evaluate the diagnostic accuracy of morphometric vertebral fracture analysis (MXA) using a 33-point software program designed for adults, on dual-energy x-ray absorptiometry (DXA) images of children. MATERIALS AND METHODS: Lateral spine DXA images of 420 children aged between 5 and 18 years were retrospectively reviewed. Vertebral fracture assessment (VFA) by an expert pediatric radiologist using Genant's semiquantitative scoring system served as the gold standard. All 420 DXA scans were analyzed by a trained radiographer, using semi-automated software (33-point morphometry). VFA of a random sample of 100 DXA was performed by an experienced pediatric clinical scientist. MXA of a random sample of 30 DXA images were analyzed by three pediatric radiologists and the pediatric clinical scientist. Diagnostic accuracy and inter and intraobserver agreement (kappa statistics) were calculated. RESULTS: Overall sensitivity, specificity, false positive (FP) and false negative (FN) rates for the radiographer using the MXA software were 80%, 90%, 10%, and 20% respectively and for mild fractures alone were 46%, 92%, 8%, and 54% respectively. Overall sensitivity, specificity, FP, and FN rates for the four additional observers using MXA were 89%, 79%, 21%, and 11% respectively and for mild fractures alone were 36%, 86%, 14%, and 64% respectively. Agreement between two expert observers was fair to good for VFA and MXA [kappa = 0·29 to 0·76 (95% CI: 0·17-0·88) and 0·29 to 0·69 (95% CI: 0·17-0·83)] respectively. CONCLUSION: MXA using a 33-point technique developed for adults is not a reliable method for the identification of mild vertebral fractures in children. A pediatric standard is required which not only incorporates specific vertebral body height ratios but also the age-related physiological changes in vertebral shape that occur throughout childhood.

Role of oral yeasts in the etiopathogenesis of peri-implantitis: An evidence-based literature review of clinical studies.

OBJECTIVE: The aim of the present study was to review original clinical studies published in indexed databases, which assessed the role of oral yeasts in the etiopathogenesis of peri-implantitis. DESIGN: The focused question was "Do oral yeasts play a role in the etiopathogenesis of peri-implantitis?". Indexed databases were searched up to and including November 2019 using different combinations of the following key indexing terms: alveolar bone loss; candida, dental implant, oral; probing depth, peri-implant mucositis; peri-implantitis; and yeast. Original clinical studies were included. Studies performed on animal models, letters to the Editor, in-vivo/in-vitro/ex-vivo studies, commentaries, case-reports/series and historic reviews were excluded. The pattern of the present review article was customized to summarize the pertinent information. RESULTS: The initial search yielded 69 studies. Sixty-two studies, which did not fit the eligibility criteria were excluded. Seven studies were included and processed for data extraction. In all studies, oral yeasts were identified in conjunction with pathogenic bacteria in the oral biofilm samples collected from patients with peri-implantitis. In 1 study on type-2 diabetic and non-diabetic patients with peri-implantitis, the counts of oral yeasts were significantly higher in type-2 diabetic and systemically healthy patients with peri-implantitis than individuals without peri-implantitis. A prior sample-size estimation was performed in 3 of the 7 included studies. CONCLUSION: There is no direct evidence to confirm that oral yeasts contribute towards the etiopathogenesis of peri-implantitis.

Effect of Different Implant-Abutment Connection Materials on the Fracture Resistance of Zirconia Abutments.

The aim of the present in vitro study was to assess the modes of failures under static load among titanium (Ti) and 1- and 2-piece zirconia abutments. The 1- and 2-piece zirconia abutment specimens were fabricated from prescanned Ti abutments. Twenty-one implant abutments and 21 implant replicas were equally divided into 3 groups as follows: (a) Group 1 (Titanium group); (b) Group 2 (1-piece zirconia abutment group); and (c) Group 3: 2-piece zirconia abutment group). A 250 000-cycle linear fatigue load ranging between 10 N and 210 N was applied to all specimens using an all-electric dynamic test instrument. The specimens were loaded until they fractured. In all groups, assessment of mode of fracture was done on visual assessment by a trained and calibrated investigator. Prior sample-size estimation was performed; and sample distribution was assessed using the Kolmogorov and Shapiro tests. Screw fracture (n = 7) and abutment bending at the apical part (n = 7) occurred in the Ti group. In the 1-piece zirconia group, screw and abutment fractures occurred in 7 and 7 cases, respectively. In the 2-piece zirconia screw fracture (n = 7) above the Ti zirconia junction (transgingival segment) and abutment fracture (n = 7) were determined as the failure modes. In vitro, the 1-piece zirconia abutments are more fracture resistant than titanium and 2-piece zirconia abutments. From a clinical perspective, further studies are needed to determine the minimum static load value required to induce fracture of the 1- and 2-piece zirconia abutments.

Levels of advanced glycation end products in gingival crevicular fluid of chronic periodontitis patients with and without type-2 diabetes mellitus.

BACKGROUND: It is hypothesized that levels of advanced glycation end products (AGEs) are higher in the gingival crevicular fluid (GCF) of chronic periodontitis (CP) patients with type-2 diabetes mellitus (type-2 DM) than controls (systemically healthy individuals without CP. The aim was to assess the levels of AGEs in the GCF of CP patients with and without type-2 DM. METHODS: Participants were divided into three groups as follows. Group-1: Patients with type-2 DM and CP; group-2: Non-diabetic individuals with CP; group-3: Non-diabetic individuals without periodontal diseases. Demographic data were collected using a questionnaire. Full-mouth plaque-index (PI), bleeding-on-probing (BOP), probing depth (PD), clinical attachment loss (AL), and marginal-bone-loss (MBL) were assessed. Hemoglobin A1c (HbA1c) levels were recorded. The GCF was collected and levels of AGEs were assessed using standard techniques. Group comparisons were performed and P <0.05 was considered statistically significant. RESULTS: Ninety-four individuals (32, 31, and 31 individuals in groups 1, 2, and 3, respectively) were included. Mean HbA1c levels were significantly higher in group-1 than groups 2 (P <0.05) and 3 (P <0.05). The mean age of individuals in groups 1, 2, and 3 were 55.2, 51.5, and 50.7 years, respectively. The mean duration of type-2 DM among individuals in group-1 was 8.2 years (7 to 10 years). Levels of AGEs were detected in all the patients. The mean GCF levels of AGEs were significantly higher among patients in group-1 (521.9 pg/mL [428.5 to 569.3 pg/mL]) (P <0.01) than groups 2 (234.84 pg/mL [216.8 to 318.9 pg/mL]) and 3 (87.2 pg/mL [75.2 to 97.8 pg/mL]). The mean GCF levels of AGEs were significantly higher among patients in group-2 (P <0.01) than group-3 (P <0.01). CONCLUSION: The GCF levels of AGEs are higher in CP patients with type-2 DM compared to systemically healthy individuals with and without periodontal diseases.

"Religious Belief": An Undervalued Ethical Inclusion Criterion for Clinical Trials on Bone Grafting Procedures.

The aim of the present review was to assess randomized controlled trials (RCTs) on bone grafting procedures that included religious belief as an eligibility criterion. Indexed databases were searched up to and including February 2019 using different search strategies. In strategy 1, the following terms were used: (a) belief; (b) bone graft; (c) faith; (d) inclusion; (e) exclusion; (f) eligibility; (g) criteria; (h) randomized clinical trial; (i) religion; and (j) xenograft. In strategy 2, the following terms were used in addition to those used in strategy 1: Xenografts AND oral surgery OR xenografts AND maxillofacial OR xenografts AND dental implants. These searches were filtered using the terms "Randomized clinical trial" and "human studies". The initial search yielded 3932 studies. Filtration of results using the terms "Randomized clinical trial" and "human studies" showed 0 studies. Evaluation of patients' religious beliefs seems to be undervalued in RCTs related to the placement of xenografts. This is an essential and ethical criterion that should be taken into consideration prior to inclusion of participants and signing the informed consent form for RCTs related to the placement of bone grafts.