The relationship between sleep and salivary and serum inflammatory biomarkers in adolescents.

Objectives: Poor sleep behavior can trigger an inflammatory response and contribute to the development of inflammatory diseases. Cytokines can act as indicators of inflammation and may precede the onset of inflammatory diseases. This study aimed to determine the association between sleep timing parameters (bedtime, sleep duration, sleep debt, and social jetlag) and the levels of nine serum and salivary inflammatory and metabolic biomarkers. Methods: Data were collected from 352 adolescents aged 16-19 years enrolled in Kuwait's public high schools. The levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), adiponectin, leptin, and insulin were measured from saliva and serum samples. We conducted mixed-effect multiple linear regression modeling to account for the school variable as a random effect to assess the relationship between the sleep variables and salivary and serum biomarkers. Mediation analysis was conducted to check if BMI was a mediator between bedtime and the biomarkers. Results: There was a statistically significant elevation in serum IL-6 level associated with later bedtime (0.05 pg./mL, p = 0.01). Adolescents with severe sleep debt of ≥2 h had an increase in salivary IL-6 biomarker levels (0.38 pg./mL, p = 0.01) compared to those who had sleep debt of <1 h. Adolescents with sleep debt of ≥2 h had significantly higher levels of serum CRP (0.61 µg/mL, p = 0.02) than those without sleep debt. Additionally, we found that the inflammatory biomarkers (CRP, IL-6, IL-8, IL-10, VEGF, and MCP-1) and metabolic biomarkers (adiponectin, leptin, and insulin) had more statistically significant associations with the bedtime variables than with sleep duration variables. CRP, IL-6, and IL-8 were associated with sleep debt, and IL-6, VEGF, adiponectin, and leptin levels were associated with social jetlag. BMIz was a full mediator in the relationship between late bedtime and increased serum levels of CRP, IL-6, and insulin. Conclusion: Adolescents who go to bed at or later than midnight had dysregulated levels of salivary and serum inflammatory biomarkers, suggesting that disrupted circadian rhythm can trigger higher levels of systemic inflammation and potentially exacerbate chronic inflammation and the risk of metabolic diseases.

Analysis of Root Canal Characteristics in Permanent Canine Teeth Among 270 Saudi Subjects: A Cone-Beam Computed Tomography Study.

BACKGROUND An understanding of root canal morphology is vital for successful endodontic treatment. However, variations in the root canal system of permanent canines, especially in relation to population-based diversity, are not well-documented. This study thus aimed to analyze the root canal numbers, configurations, and bilateral symmetry in 1080 permanent canine teeth among 270 Saudi individuals using cone-beam computed tomography (CBCT), contributing to the existing body of knowledge and aiding clinicians in devising effective treatment strategies. MATERIAL AND METHODS The CBCT images of 270 participants, encompassing 1080 canines (540 pairs of upper and lower canines), were scrutinized for root and canal counts. Canal configurations were assessed based on Ahmed's and Vertucci's classifications. Bilateral symmetry in these parameters was recorded and the data were statistically analyzed. RESULTS The study revealed variable prevalence of multiple roots and canals in maxillary and mandibular canines. Ahmed's and Vertucci's type I canal configuration was predominantly observed. Notably, significant bilateral symmetry was noted in root and canal numbers, and canal configurations. CONCLUSIONS The most common configuration of permanent canines was a single root and canal, usually adhering to Ahmed's and Vertucci's type I classification. Mandibular canines showed a higher incidence of two canals than two roots. The extent of bilateral symmetry, especially in mandibular canines, could provide valuable insights for better contralateral tooth treatment planning.

Shear Bond Strength of Different Restorative Materials to Primary Tooth Dentin Treated with Silver Diamine Fluoride.

Purpose: To investigate shear bond strength (SBS) of three restorative materials on primary dentin after silver diamine fluoride (SDF) application.
Methods: Thirty primary teeth were randomized into three groups of 10 teeth. Each tooth was split mesiodistally and randomized into experimental (artificial caries plus SDF) and control (sound dentine without SDF) groups. Glass ionomer cement (GIC), resin-modified bioactive resin (ACTIVA), and composite resin (CR) restorations were tested for SBS and mode of failure (MF).
Results: All SDF groups exhibited significantly lower SBS compared to the control (CR: P =0.001; ACTIVA: P =0.001; GIC: P =0.004). For the SDF group, the compa- rison of materials was statistically significant (P =0.006); posthoc tests showed significance only between CR and ACTIVA (P =0.009) and between ACTIVA and GIC (P =0.020). The lowest mean value was obtained for ACTIVA (1.4 MPa) and the highest mean value was obtained for CR (3.3 MPa). For the control group, Welch's F test was statistically significant (P =0.044), but all posthoc tests were not. For MF, SDF exhibited a significantly greater percentage of adhesive failures with ACTIVA and CR than with GIC. In the control group, a mixed MF was more dominant with no significant differences.
Conclusion : The SDF group had significantly lower SBS.

Association Between USMLE Step 1 Scores and In-Training Examination Performance: A Meta-Analysis.

PURPOSE: On February 12, 2020, the sponsors of the United States Medical Licensing Examination announced that Step 1 will transition to pass/fail scoring in 2022. Step 1 performance has historically carried substantial weight in the evaluation of residency applicants and as a predictor of subsequent subject-specific medical knowledge. Using a systematic review and meta-analysis, the authors sought to determine the association between Step 1 scores and in-training examination (ITE) performance, which is often used to assess knowledge acquisition during residency. METHOD: The authors systematically searched Medline, EMBASE, and Web of Science for observational studies published from 1992 through May 10, 2020. Observational studies reporting associations between Step 1 and ITE scores, regardless of medical or surgical specialty, were eligible for inclusion. Pairs of researchers screened all studies, evaluated quality assessment using a modified Newcastle-Ottawa Scale, and extracted data in a standardized fashion. The primary endpoint was the correlation of Step 1 and ITE scores. RESULTS: Of 1,432 observational studies identified, 49 were systematically reviewed and 37 were included in the meta-analysis. Overall study quality was low to moderate. The pooled estimate of the correlation coefficient was 0.42 (95% confidence interval [CI]: 0.36, 0.48; P < .001), suggesting a weak-to-moderate positive correlation between Step 1 and ITE scores. The random-effects meta-regression found the association between Step 1 and ITE scores was weaker for surgical (versus medical) specialties (beta -0.25 [95% CI: -0.41, -0.09; P = .003]) and fellowship (versus residency) training programs (beta -0.25 [95% CI: -0.47, -0.03; P = .030]). CONCLUSIONS: The authors identified a weak-to-moderate positive correlation between Step 1 and ITE scores based on a meta-analysis of low-to-moderate quality observational data. With Step 1 scoring transitioning to pass/fail, the undergraduate and graduate medical education communities should continue to develop better tools for evaluating medical students.

Prevalence of oral conditions among methamphetamine users: NHANES 2009-2014.

OBJECTIVES: Methamphetamine (MA) is a widely used illicit drug and a nationwide public health concern. Although dental complications are consistently reported among MA users, yet limited nationally representative studies on the associations between MA use and oral health currently exist. METHODS: Using the National Health and Nutrition Examination Survey 2009-2014, we analyzed 8,762 respondents aged 30-64 years who had completed a periodontal examination. MA use was self-reported; periodontitis, untreated caries, and missing teeth were assessed by calibrated dentists. Descriptive statistics as well as multivariable regression analyses were performed. Data were weighted to yield representative estimates of the US adult population. RESULTS: Overall 7.8 percent of US adults aged ≥30 years had ever used MA. Ever-use prevalence was higher among males, whites, and individuals below the federal poverty level. Established MA users had a higher prevalence of untreated dental caries (36.6 percent), any periodontitis (54.8 percent), and severe periodontitis (12.2 percent) than those who had never used MA. The prevalence of any periodontitis was higher among current MA users (PR: 1.31; 95% CI: 1.05-1.62) than those who never used MA. Prevalence of untreated dental caries was higher among current MA users (PR: 1.53; 95% CI: 1.10-2.13) and established users (PR: 1.21; 95% CI: 1.02-1.48) than never users. Taking MA orally and/or through injection was associated with higher odds of severe periodontitis than orally only (AOR: 3.72; CI: 1.79-7.75). CONCLUSIONS: MA users had a higher prevalence of periodontitis and dental caries. Continued research assessing the relationship between MA use and oral health can inform clinical interventions and management of dental diseases in MA users.

Cocaine, polysubstance abuse, and oral health outcomes, NHANES 2009 to 2014.

BACKGROUND: Cocaine is the second most abused illicit drug in the United States. To date, no study has examined the association between cocaine use and oral health with a nationally representative sample. Our study examined the association between cocaine use-singly and with other substances-and oral health outcomes, including periodontitis and untreated caries, among US adults. METHODS: Data for 11,753 individuals, aged ≥30 years, who completed a periodontal examination, in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Descriptive analyses and multivariable binary logistic regression analyses were conducted on weighted data. RESULTS: Overall, 17% (20.5 million) of US adults aged ≥30 years had ever used cocaine, with higher likelihood seen among males, non-Hispanic whites, and those living in poverty. Current cocaine use prevalence was 2.6% (3.2 million). By number of co-used substances, the odds of having any periodontitis were higher among cocaine users who consumed ≥3 other substances (adjusted OR = 2.47; 95% CI = 1.15 to 5.30) when compared with solely cocaine users. By type of substance co-used, odds of having untreated caries were greater among those reporting cigarettes (adjusted OR = 1.94; 95% CI = 1.21 to 3.11) or methamphetamine (adjusted OR = 5.40; 95% CI = 1.92 to 15.14) usage. Odds of any periodontitis were higher among those reported ancillary cigarette use (adjusted OR = 2.84; 95% CI = 1.60 to 5.04) compared with cocaine-only users. CONCLUSIONS: In addition to a positive association between periodontal disease, dental caries, and cocaine use, select co-usage elevated the risk of oral disease. Patients should be screened for and counseled regarding substance abuse to facilitate a successful quit.

The pain-related behavior and pain perception associated with computerized anesthesia in pulpotomies of mandibular primary molars: A randomized controlled trial.

OBJECTIVE: The purpose of the study was to compare the pain-related behavior and the pain perception associated with three anesthetic techniques in pulpotomies of primary mandibular second molars: traditional inferior alveolar nerve block (IANB), IANB with computer-controlled local anesthetic delivery (CCLAD), and intraligamental anesthesia with CCLAD. METHOD AND MATERIALS: The sample comprised 91 randomly selected healthy children aged 5 to 9 years, who were scheduled for pulpotomy in the mandibular second molar. Patients were divided into three groups according to the type of anesthesia received. Group A received traditional IANB, group B received IANB with CCLAD, and group C received intraligamental anesthesia with CCLAD. Pain-related behavior and pain perception levels were assessed using the established behavior code and the Wong-Baker FACES Pain Rating Scale respectively. RESULTS: The mean of pain-related behavior was significantly lower (P < .001) in the intraligamental anesthesia with CCLAD group than in the other two groups. The pain perception scores were significantly higher in the traditional IANB group than in the IANB with CCLAD group, and the intraligamental anesthesia with CCLAD group (P = .044 and P < .001 respectively). The mean ± SD of the pain perception of IANB was 1.39 ± 0.200, IANB with CCLAD was 0.87 ± 0.133 and ILA with CCLAD was 0.13 ± 0.063. CONCLUSION: Intraligamental anaesthesia with CCLAD was clearly associated with less pain than the IANB with or without CCLAD.

Potent antagonistic activity of Egyptian Lactobacillus plantarum against multiresistant and virulent food-associated pathogens.

Recent years have shown a growing interest to replace the administration of antibiotics with the application of probiotics. The aim of our investigation was to screen for promising strains with broad antimicrobial activity and also more resistant to the challenges met in the gastrointestinal tract. In our study, only 32 out of 50 (64%) probiotic isolates showed antagonistic activity against certain major extensively and pandrug-resistant Gram-positive and -negative food-borne pathogens. Fifteen L. plantarum isolates had a broad antibacterial spectrum. Among these isolates, only five presented potent antibacterial activity relative to previous studies. The recorded inhibition zone diameter ranged from 25 to 44 mm. Pronounced cell-free supernatant activities (6400-25,600 AU/ml) were commonly detected at the end of the logarithmic phase at 37°C. A marked increase in the range of activity (12,800-51,200 AU/ml) was recorded after the addition of 0.9% Na Cl to the media. Moreover, subjecting these isolates to different stressors, including high temperature, low pH, and different concentrations of bile and Na Cl, revealed different responses, and only two out of the five L. plantarum isolates showed marked resistance to all of the stress factors. Accordingly, this study highlights the intense and broad antagonistic activity induced by L. plantarum against various food associated pathogens, and their ability to resist different stressors suggests that they can be used in the food and pharmaceutical industry.