Salivary oxidative stress biomarkers in periodontitis-free smokers: a cross sectional study.

BACKGROUND: Salivary oxidative stress has been extensively studied with attempts to correlate changes in the oxidative stress markers with local and systemic factors, including smoking. The objective of this study was to evaluate the influence of two forms of smoking, cigarettes and waterpipe smoking (WPS), on selected oxidative stress biomarkers in saliva. METHODS: Three groups of participants were enrolled into the study, controls (never smokers), cigarette smokers and WPS. Participants were clinically free from periodontitis and systemic conditions known to affect the saliva constituents. Unstimulated whole saliva samples were collected according to a standard protocol and concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG), myeloperoxidase (MPO), malondialdehyde (MDA), total antioxidant capacity (TAC), and cortisol. The one-way ANOVA test was used to compare the levels of each oxidative stress biomarker between the three study groups and the hierarchical linear regression analysis was used to test the levels of salivary cortisol for prediction of other oxidative stress biomarkers. Significance levels were set at 95% confidence intervals and probability values ≤0.05. RESULTS: 8-OHdG was highest in WPS group (mean±SE 11,030.35±1829.16 pg/mL) while MDA and cortisol levels were highest in the cigarette smokers group (mean±SE 3.33±0.52 µM and 3.99±0.48 ng/mL, respectively) and MPO was highest in the control group (mean±SE 7.760±1.55 ng/mL). WPS group showed the highest TAC (mean±SE 0.3±0.03 mM). However, none of the tested makers reached a statistically significant difference. CONCLUSIONS: Despite subtle changes in some biomarkers, the salivary oxidative stress does not appear to be significantly influenced by smoking habits in periodontitis-free smokers.

The expression of salivary EGF, VEGF, endothelin, and transferrin in waterpipe and cigarette smokers.

The aim of this study was to evaluate the effects of two forms of tobacco smoking, cigarettes and water pipe smoking (WPS), on the expression of a panel of salivary proteins in healthy adults. Three groups of age and gender-matched participants were enrolled in the study: never-smokers, cigarette smokers and WPS (N = 55 per group). Expression of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), endothelin and transferrin in unstimulated whole saliva was estimated using enzyme-linked immunosorbent assays. Statistical analysis consisted of one-way ANOVA and Tukey's post hoc tests, in addition to bioinformatics analysis. VEGF expression was the least in WPS (51.1 ± 14.5 pg/ml) compared to both controls (150.1 ± 13.8 pg/ml) and cigarette smokers (93 ± 9.9 pg/ml), with a significant difference in WPS (p < 0.001) and cigarette smokers (p < 0.01) compared to controls. Furthermore, transferrin showed the weakest expression in the WPS group (1238 ± 261.4 pg/ml) compared to controls (2205.6 ± 298.6 pg/ml) (p = 0.05) and cigarette smokers (1805.4 ± 244 pg/ml). Neither EGF nor endothelin expression showed any statistical difference between the groups (p > 0.05). Gene-gene interaction network demonstrated that FLT1, TFRC, KDR, VEGFB and PGF genes had the highest potential for interaction with the studied proteins. Further functional annotations on the identified markers in the interaction network were performed to identify HIF-1 pathways among the most relevant pathways. In conclusion, smoking habits alter the expression of salivary VEGF and transferrin, which may correspond to early sub-clinical changes in the oral mucosa. The clinical relevance of these salivary changes requires further research.

The Effect of Various Preparation and Cementation Techniques of Dental Veneers on Periodontal Status: A Systematic Review and Meta-Analysis.

Dental veneers are widely used to restore or/and enhance dental aesthetics. However, it is not well understood how various veneer preparation and cementation methods affect periodontal health. To provide a quantitative estimate of the overall effect size of the intervention, this study was conducted to synthesize the available evidence on the impact of various dental veneer preparation and cementation methods on periodontal status. A thorough search strategy was implemented using Medical Subject Headings keywords and Boolean operators across various major databases, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Nine papers were ultimately selected for inclusion in the review. Seven studies demonstrated a positive impact of dental veneers on overall periodontal health, while two studies reported a slight worsening. The forest plot analyses showed a somewhat protective effect of dental veneers on periodontal health, with odds ratio of 0.18 and relative risk of 0.34, suggesting that dental veneers may have a positive impact on overall periodontal health. The current study, with considerable heterogeneity among the studies, indicates that dental veneers are associated with an overall positive effect on the periodontal health. However, given the variations in study designs, sample sizes, and follow-up times, additional research may be required to confirm and generalize these results.

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

ABSTRACT Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Countryand sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies (AU).

Long-term adverse events of three COVID-19 vaccines as reported by vaccinated physicians and dentists, a study from Jordan and Saudi Arabia.

Assessment of safety of COVID-19 vaccines is an ongoing process. This study aims to explore long-term adverse events reported by physicians and dentists who received at least two COVID-19 vaccine doses. A group of physicians and dentists were invited to complete a validated questionnaire that was composed of items on: socio-demographics, medical history, administered vaccines, and long-term adverse events (LTAE). Data of a total of 498 practitioners were included. Age ranged from 22 to 71 years (mean age= 35.75 ± 11.74) with a female majority (N = 348, 69.9%). The most frequently administered vaccines were Pfizer-BioNtech, Sinopharm and AstraZeneca vaccines. A total of 80 (16.0%) participants reported LTAEs which were mainly fatigue, menstrual disturbances, myalgia, arthralgia, dizziness, and headache (N = 32, 15, 8, 6, 4, and 4, respectively). There was no statistically significant association between LTAEs and: age, gender, or medical history (P > .05). The collective symptoms of fatigue, myalgia, arthralgia, dizziness, and headache were significantly associated with Sinopharm vaccine (P = .04). This was further confirmed by general linear multivariate model analysis. Less than 20% of COVID-19 vaccine recipients may complain of LTAEs that are mostly fatigue-related. It seems that factors such as age, gender, and medical status play a negligible role in development of these AEs. On the other hand, Sinopharm vaccine showed the highest significant association with these AEs followed by AstraZeneca vaccine.

Effect of statin therapy on oral Candida carriage in hyperlipidemia patients: A pioneer study.

BACKGROUND: Hyperlipidemia affects about 25% of the adult population globally. Statins are the most commonly used drugs in the management of hyperlipidemia. Laboratory and retrospective clinical studies have observed the inhibitory effects of statins on the growth of different Candida species. The effect of statin therapy on oral Candida carriage has not yet been investigated. OBJECTIVES: This pioneer controlled study aimed to assess and compare asymptomatic oral Candida carriage in a group of 50 hyperlipidemic patients who were on regular statin therapy (HLS group) and in a control group of 50 subjects, matched in terms of gender, age and dental status, who were hyperlipidemic, but not on statin therapy (HLNS group). MATERIAL AND METHODS: The patients were recruited from the outpatient clinics of 2 university hospitals. The concentrated oral rinse technique was used to isolate oral Candida species in both groups. Candida species were identified using the germ tube test and the VITEK® 2 system. RESULTS: The Candida prevalence and colony count were significantly lower in the HLS group as compared to the HLNS group (n = 20, 40% vs. n = 30, 60%, respectively; p = 0.040). There was no significant difference in the oral Candida prevalence or colony count between different age groups in either the statin or control subjects. CONCLUSIONS: Statin therapy is associated with a reduction in oral Candida carriage in both prevalence and the colony count in hyperlipidemic patients.

Three-dimensional assessment of the effect of micro-osteoperforations on the rate of tooth movement during canine retraction in adults with Class II malocclusion: A randomized controlled clinical trial.

INTRODUCTION: The purpose of this split-mouth trial was to investigate the effect of micro-osteoperforations (MOPs) on the rate of tooth movement. METHODS: Thirty-two patients (24 female, 8 male; mean age, 19.26 ± 2.48 years) who required fixed orthodontic treatment and maxillary first premolar extractions participated in this trial with MOPs randomly allocated to either the right or left sides distal to the maxillary canines. Eligibility criteria included Class II Division 1 malocclusion, healthy periodontal condition, no smoking, and no systemic disease. Miniscrews were used to support anchorage and retract the canines with the aid of closed-coil nickel-titanium springs with 150 g of force. Randomization was accomplished with block randomization with a permuted block size of 2 with a 1:1 allocation ratio to either right or left with allocations concealed in opaque, sealed envelopes. Blinding was used at the data collection and analysis stages. Three MOPs were performed using miniscrews (5 mm depth, 1.5 mm width) on the buccal bone distal to the canines on the randomly selected side. The primary outcome was the rate of canine retraction measured from 3-dimensional digital models superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients' daily life, patients' satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated. RESULTS: There was no statistically significant difference in the rates of tooth movement between the MOP and the control sides at all time points (first month: P = 0.77; mean difference, 0.2 mm; 95% CI, -0.13, 0.18 mm; second month: P = 0.50; mean difference, -0.08 mm; 95% CI, -0.33, 0.16 mm; third month: P = 0.76; mean difference, -0.05 mm; 95% CI, -0.40, 0.29 mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point (P >0.05). MOPs had no effect on the patients' daily life except for a feeling of swelling on the first day (P = 0.05). Level of satisfaction and degree of easiness of the procedure were high. A significant percentage of patients were willing to repeat the procedure and recommend it to others. No serious harm was observed. CONCLUSIONS: Three MOPs were not effective in accelerating tooth movement at any time point. Other secondary parameters evaluated were not different between the MOP and control sides except for the feeling of swelling on day 1 on the MOP side. Patients were highly satisfied with the MOP procedure, and many considered MOPs an easy procedure and were willing to repeat and recommend it to friends. REGISTRATION: This trial was registered at Clinicaltrials.gov with identifier number NCT02473471. PROTOCOL: The protocol was not published before trial commencement. FUNDING: This work was supported by Jordanian University of Science and Technology (grant number 20150263). No conflict of interest is declared.

Correlating dental caries with oral bacteria and the buffering capacity of saliva in children in Madinah, Saudi Arabia.

INTRODUCTION: Caries is associated with high counts of mutans streptococci (MS), lactobacillus (LB), and a low saliva buffering capacity (BC). No study using odds ratios (OR) has correlated caries and these factors and no similar study has been done in Saudi Arabia before. OBJECTIVES: To determine: The prevalence of caries, the number of colony forming units (CFUs) of MS and LB, the saliva buffering capacity (BC) and the relationship between these factors. MATERIALS AND METHODS: This was an analytical cross sectional study on children from Madinah. Caries was recorded using dmft/DMFT (decayed, missing, filled teeth). The scores for MS and LB and the BC of saliva was calculated using the Caries Risk Test (CRT)(®). RESULTS: A total of 316 students were examined; two-thirds (62%) were female and 25% were caries free. Saliva was collected from 235 participants and the majority had high MS and LB scores (66 and 71%, respectively) while 25% had a low saliva BC. The odds for those who had high LB and MS CFUs, were 9 and 4 times more at risk to developing dental caries and those with a low BC had significantly more caries (P = 0.03). The likelihood for those having severe caries and high counts of LB and MS was 25 (P < 0.01) and 6 (P = 0.042) times greater, respectively, compared to those with no or mild caries. Those with multiple risk factors were more likely to have caries compared to those with single or no risk factors present. CONCLUSIONS: The prevalence of caries was relatively high and many respondents had greater than 10(5) CFUs/ml of MS and LB. Almost all with a low BC had severe caries. There was a strong correlation between high MS, high LB, and low BC and the high prevalence of caries; hence the combination of these factors could be confidently used to predict caries in this population.

Clinical measurement of the height of the interproximal contact area in maxillary anterior teeth.

OBJECTIVES: To clinically quantify the apicoincisal height of interproximal areas directly in patients' mouths. METHODOLOGY: Thirty participants (11 females and 9 males, mean age=26±1.5 years) were recruited into this study. Measurement of interproximal contact areas was carried out directly in patients' mouths using digital caliper (TERENSA, USA) with measuring accuracy of 0.01 mm. The interproximal contact areas that were measured are: central incisor to central incisor, central incisor to lateral incisor, lateral incisor to canine, and canine to first premolar on both sides of the jaw. Statistical significance was based on probability values less than 0.05 (p<0.05). RESULTS: The largest contact point was the one present between central incisors and it ranged from 2.9 to 6.5 mm. On the other hand, the contact point between canine and first premolar was the smallest on both sides of the arch and ranged from 0.6 to 2.5 mm. The dimensions of the contact points declined as we move from anterior area backwards. Statistical analysis using t-test showed that there were significant differences between the measurements of interproximal points of each tooth (P<0.05). CONCLUSIONS: the apicogingival dimension of the contact point decreased as we moved from anterior to posterior teeth. The contact area between the central incisors was largest and the one between canine and premolar was the smallest. This study is the first to report direct intra-oral clinical measurement of contact points. Clinical evaluation of contact point dimensions using digital caliber is a viable, quick and accurate method to use.

Management of dental unit water lines.

Dental unit water lines harbour considerable amounts of bacteria, derived from the biofilm on their inner surfaces, and the continuous reservoir of bacteria carries the potential to infect patients and dental workers alike. This article reviews the different methods of control and provides recent recommendations for ensuring that water of satisfactory quality is delivered to the patient.