Dentofacial mini- and microesthetics as perceived by dental students: A cross-sectional multi-site study.

BACKGROUND: How dental education influences students' dental and dentofacial esthetic perception has been studied for some time, given the importance of esthetics in dentistry. However, no study before has studied this question in a large sample of students from all grades of dental school. This study sought to fill that gap. The aim was to assess if students' dentofacial esthetic autoperception and heteroperception are associated with their actual stage of studies (grade) and if autoperception has any effect on heteroperception. METHODS: Between October 2018 and August 2019, a questionnaire was distributed to 919 dental students of all 5 grades of dental school at all four dental schools in Hungary. The questionnaire consisted of the following parts (see also the supplementary material): 1. Demographic data (3 items), Self-Esthetics I (11 multiple- choice items regarding the respondents' perception of their own dentofacial esthetics), Self-Esthetics II (6 Likert-type items regarding the respondents' perception of their own dentofacial esthetics), and Image rating (10 items, 5 images each, of which the respondents have to choose the one they find the most attractive). Both the self-esthetics and the photo rating items were aimed at the assessment of mini- and microesthetic features. RESULTS: The response rate was 93.7% (861 students). The self-perception of the respondents was highly favorable, regardless of grade or gender. Grade and heteroperception were significantly associated regarding maxillary midline shift (p < 0.01) and the relative visibility of the arches behind the lips (p < 0.01). Detailed analysis showed a characteristic pattern of preference changes across grades for both esthetic aspects. The third year of studies appeared to be a dividing line in both cases, after which a real preference order was established. Association between autoperception and heteroperception could not be verified for statistical reasons. CONCLUSION: Our findings corroborate the results of most previous studies regarding the effect of dental education on the dentofacial esthetic perception of students. We have shown that the effect can be demonstrated on the grade level, which we attribute to the specific curricular contents. We found no gender effect, which, in the light of the literature, suggests that the gender effect in dentofacial esthetic perception is highly culture dependent. The results allow no conclusion regarding the relation between autoperception and heteroperception.

Sour cherry extract inhibits human salivary α-amylase and growth of Streptococcus mutans (a pilot clinical study).

The purpose of this study was to determine whether cherry extract has any effect on salivary α-amylase activity (sAA) or on the level of Streptococcus mutans in human saliva. 70 patients (45 females and 25 males) in three age groups (22 children, 25 young adults, and 23 adults) were examined. All participants completed a questionnaire to obtain information on their oral health behaviour and life style. Clinical examination was performed to record the number of decayed, missing and filled teeth (DMF-T). Saliva samples were collected for the measurement of sAA and the salivary S. mutans level before and after chewing a gum with or without cherry extract. Statistical evaluation of data was performed. S. mutans and the sAA level of unstimulated saliva samples did not depend on either age or gender. The basal sAA value of adult patients was in linear correlation with the dental caries status. Habitual chewing-gum use decreased the resting sAA and the mean of DMF-T. The number of S. mutans cells was significantly lower in the resting saliva of allergic patients. The applied mechanical and gustatory stimuli by chewing gum resulted in higher sAA and S. mutans levels and a slow decrease of values was observed in the control group for the next 30 min. Thereafter, sAA and S. mutans levels decreased earlier in the presence of sour cherry extract than those of control cases. Chewing gum with sour cherry extract may be useful for the prevention of dental caries.

Salivary proteome profiling of oral squamous cell carcinoma in a Hungarian population.

Oral squamous cell carcinoma (OSCC) is the seventh most common malignancy and the ninth most frequent cause of cancer death in Europe. Within Europe, Hungary has one of the highest rates of OSCC incidence and mortality. Thus, there is an urgent need to improve early detection. Saliva, as a readily available body fluid, became an increasingly important substance for the detection of biomarkers for many diseases. Different research groups have identified salivary biomarkers specific for OSCC for different countries. In this study, saliva samples of Hungarian patients with OSCC were studied to discover disease-specific and perhaps region-specific biomarkers. LC-mass spectrometry (MS)/MS analysis on a linear ion trap-Orbitrap mass spectrometer was used for qualitative and quantitative salivary protein profiling. More than 500 proteins were identified from saliva by shotgun proteomics. The up- and downregulated proteins in the saliva of patients with OSCC highlighted the importance of protein-protein interaction networks involving the immune system and proteolysis in disease development. Two potential biomarkers from our shotgun analysis and a third candidate reported earlier by a Taiwanese group were further examined by ELISA on a larger reference set of samples. Resistin, a biomarker reported in Taiwan but not validated in our study, highlights the necessity of application of standardized analysis methods in different ethnic or geographical populations to identify biomarkers with sufficient specificity and sensitivity.

[Oral mucositis as the most common complication of childhood cancer therapy. Review of the literature]. / A gyermekkori malignus kórképek kemoterápiájának leggyakoribb mellékhatása, az oralis mucositis. Irodalmi áttekintés.

Mucositis is the most common oral complication of cancer therapy. Oral mucositis in childhood is more frequent and severe compared to adults, especially in children with leukemia. Lesions develop as the chemotherapeutic agents attack the rapidly dividing cells of the oral mucous membrane. Patients may experience trouble in eating, drinking, swallowing or even speaking due to the significant pain caused by the ulceration of the oral mucosa. Oral mucositis has a direct impact on the quality of life and may affect survival. The regular assessment of the oral mucosa is crucial during chemotherapy to evaluate the effectiveness of the oral mucositis prevention and treatment. Several oral mucositis scoring tools have been developed for adults to qualify the symptoms, but there is no universally accepted assessment scale for children. The prevention and treatment of therapy-related mucositis is difficult, though several methods and pharmacologic agents have been tested. Here we discuss the pathogenesis of chemotherapy-induced oral mucositis, the available assessment tools and their applicability to pediatric patients and the available therapeutic and preventive strategies. Orv Hetil. 2018; 159(13): 495-502.

Oral cancer report from Northeastern Hungary.

In Hungary oral and pharyngeal cancers have been reported the fourth most common malignancy in males and the sixth for both sexes. The aim of the present study was to characterize oral squamous cell carcinoma (OSCC) patients in Northeastern Hungary. 119 randomly selected patients with OSCC were included in the study. Epidemiological data, clinicopathological parameters and the risk factors were registered. The most common sites of OSCC were the floor of the mouth (27.7%), the lip (26.9%) and the tongue (22.7%). The majority of the patients was diagnosed with early stage (I-II) lesions and moderately differentiated tumors. The 5-year overall survival rate was 38.7%. There was a significant correlation between survival and tumor size, lymph node involvement and clinical stage. At the time of diagnosis 65.5% of the patients were smokers. Smoking significantly correlated with younger age, male gender, advanced clinical stages and alcohol consumption. 75.5% of the patients consumed alcohol, 41.1% of them exceeding the conventional amount regularly. Drinking habit significantly correlated with younger age, male gender and tumor site i.e. gingiva, retromolar region, tongue. The dental status was acceptable only in 12.6% of the cases. There was a significant correlation between dental status and age, smoking and drinking habits. Clinical stage has the most significant impact on survival and the most important high-risk habits in Northeastern Hungary are smoking and alcohol consumption. Therefore, early detection and treatment, cessation of tobacco and alcohol abuse, and a regular dental care may improve patients' survival in the region.

[Oral squamous cell carcinoma in north-eastern Hungary. II. Etiological factors]. / Szájüregi laphámrákok az eszakkelet-magyarországi régióban. II. Etiológiai faktorok.

The purpose of this study is to determine the possible etiological factors of oral squamous cell carcinoma (OSCC) in North-Eastern Hungary. The medical records of 119 randomly selected patients with OSCC admitted to the Department of Maxillofacial Surgery of the Faculty of Dentistry, University of Debrecen were reviewed. The following risk factors were investigated: tobacco and alcohol consumption, dental status, rural vs. urban residence, and high risk HPV infection. The presence of HPV DNA has been evaluated by polymerase chain reaction from the tissue samples. Results were correlated with clinical data. At the time of diagnosis 65.5 percent of the patients were smokers. Under the age of 45 the rate was 86.4%. Smoking significantly correlated with younger age, male gender, advanced clinical stages and alcohol consumption. The majority of the patients (75.5%) consumed alcohol, 41.1% regularly over the acceptable range. Drinking habit significantly correlated with younger age, male gender and tumor site (gingiva, retromolar region, tongue). HR-HPV types were detected in 42.8% of samples tested. HPV DNA presence was not related to gender, clinical stage, histological grade or other risk factors. Authors found weak correlation between HR-HPV positivity, younger patient age and better 5-year survival rate. The dental status was acceptable only in 12.6 percent of the cases. There was a correlation between dental status and age, smoking and drinking habits. No significant urban-rural differences were found. In the study population the most important risk factor for developing oral cancer is tobacco smoking followed by alcohol consumption. Avoidance of tobacco smoking and a reduced amount of alcohol, together with healthy nutrition and regular dental care should be emphasized.

[Oral squamous sell carcinoma in North-Eastern Hungary I. Epidemiology]. / Száüregi laphámrákok az északkelet-magyarországi régióban I.

The purpose of this study was to characterize the epidemiological data of oral squamous cell carcinoma (OSCC) patients in North-Eastern Hungary. The medical records of 119 randomly selected patients with OSCC admitted to the Department of Maxillofacial Surgery of the Faculty of Dentistry, University of Debrecen were reviewed. Cases were identified according to the epidemiological data, as to site, tumor size, lymph node involvement, clinical stage, histological differentiation, treatment obtained, recurrence of disease and survival rate. There was an obvious male predominance (male:female = 5.2:1). The median age at diagnosis was 57.4 years. The most common sites of OSCC were the floor of the mouth (27.7%), the lip (26.9%) and the tongue (22.7%). The majority of the patients (58,8%) presented with early-stage (I-II) disease at the time of diagnosis, and 48.6% had moderately differentiated tumors. The most frequent therapeutic modality used was surgery with or with out of radiotherapy. Roughly one fifth of the cases (20.7%) experienced a recurrence of disease during the follow-up period. The overall 5-year survival rate was 38.7% (stage I: 68.3%, stage II: 31.0%, stage III: 22.6%, stage IV: 11.1%). There was a correlation between survival and tumor size, lymph node metastasis, clinical stage and surgical treatment (p < or = 0.05, respectively). We found no significant correlation between histological differentiation and survival. Clinical stage exerts the most strongly significant impact on survival. Therefore, early detection and proper surgical intervention enhance patients' survival most effectively.

The Ekman-Westborg and Julin trait: report of a case.

Macrodontia associated with multituberculism, central cusps, and pulpal invaginations is reported in a 7-year-old Hungarian girl. Over 5 years' follow-up the problems of the diagnosis, the similarity with and relationship to the Ekman-Westborg and Julin trait, and the difficulties of the treatment are discussed.

[Prevalence of hypodontia in 4-18-year-old children in Department of Paediatric Dentistry, Faculty of Dentistry, University of Debrecen from 1999 to 2003]. / A csírahiányok elofordulási gyakoriságának vizsgalata a DEOEC FOK Gyermekfogászatán 1999 és 2003 között.

Hypodontia is one of the most common human dental anomalies. Its management is often complicated. This survey was carried out to study the prevalence, localisation and combination of congenital aplasia in Department of Paediatric Dentistry, Faculty of Dentistry, University of Debrecen. The study group consisted of 669 children, 283 boys and 386 girls, aged 4-18 years. Orthopantomograms and clinical examinations were used for the retrospective study. The prevalence of hypodontia was found to be 7.76 percent, excluding the third molars. Most of the congenitally absent teeth were the upper lateral incisors and the lower second premolars. The most frequent combinations were the 12-22 and the 35-45 ones. We found that our data were very similar to the different international results.

Expression of p16(INK4A), p53, and Rb proteins are independent from the presence of human papillomavirus genes in oral squamous cell carcinoma.

BACKGROUND: The overexpression of p16(INK4A) and suppression of p53 and Rb proteins are key features of oncogenic transformation by human papillomaviruses (HPV) in anogenital cancers. HPV genomes are often detected in cancers of the oral cavity, but it is unclear whether HPV has a specific oncogenic role there. OBJECTIVES: The objectives of the study were to investigate the expression of p53, Rb, and p16(INK4A) proteins and identify HPV infection and viral integration into the host genome. METHODS: Seventy-nine cases of oral squamous cell carcinoma (OSCC) were studied by immunohistochemistry. Polymerase chain reaction (PCR) was performed to identify HPV DNA from the samples. The results were correlated with clinical data. RESULTS: Thirty-three cases were HPV positive for high-risk HPV (HR-HPV) types, of which 27 harbored HPV16. In 25 of 27 HPV16-positive tumors, the HPV16 genome was fully integrated into the host genome, as evidenced by the lack of PCR-amplifiable E2 gene sequences. Forty-five patients were p53 overexpressing, 20 with HR-HPV-positive and 25 with HR-HPV-negative tumors. p16(INK4A) protein was overexpressed in 4 of 31 HR-HPV-positive and 9of 45 HR-HPV-negative cases. Twenty-six of 32 HR-HPV-positive and 37 of 44 HR-HPV-negative samples exhibited pRb nuclear staining. These differences between HR-HPV-positive and -negative tumors were not statistically significant. No correlation was found between these biological factors and tumor location, stage, differentiation grade, or alcohol or tobacco abuse. CONCLUSIONS: A tumor immunophenotype, similar to HPV-related anogenital cancers, is not present in OSCC and highly oncogenic HPV types are therefore unlikely to be specific or independent risk factors for oral cancer.

p21WAF1/CIP1 expression is a marker of poor prognosis in oral squamous cell carcinoma.

BACKGROUND: Previous research on the prognostic relevance of p21(WAF1/CIP1) in oral squamous cell carcinomas (OSCC) yielded inconclusive and contradictory data. OBJECTIVES: To investigate the prognostic significance of p21(WAF1/CIP1) expression, its relationship to p53 accumulation, proliferation-associated proteins Ki-67 and cyclin D1 in relation to survival and clinicopathological features in OSCC. METHODS: Surgical specimens taken from 106 randomly selected patients were studied by immunohistochemistry. Expression of the protein of interest was correlated with clinical data. RESULTS: p21(WAF1/CIP1) expression was found in 61.3% of OSCCs. Expression of p21(WAF1/CIP1) significantly correlated with tumor size (P = 0.005), lymph node involvement (P = 0.002), clinical stage (P < 0.001), and tumor site (P = 0.002). Patients with tumors showing p21(WAF1/CIP1) immunopositivity had decreased 2-year survival (P = 0.018). Expression of p21(WAF1/CIP1) was not related to age, gender, risk factors (tobacco, alcohol), dental status, or tumor differentiation grade. The p21(WAF1/CIP1) expression positively correlated with proliferation-related variables Ki-67 (P = 0.010) and cyclin D1 (P < 0.001), but not with p53 expression. CONCLUSIONS: The expression of p21(WAF1/CIP1) was found to be associated with poorer prognosis and tumor aggressivity in OSCC.

[Treatment of young permanent teeth following luxation based on two clinical cases]. / Luxálódott fiatal maradófogak ellátása két eset kapcsán.

Treatment of young permanent teeth following luxation based on two clinical cases The most problematic field of pediatric dentistry is the treatment of dental trauma. There has been a remarkable increase in the number of dental injuries resulting in damaged periodontal tissues at the pediatric dentistry department of the University of Debrecen. The aim of the authors' present study was to call attention to the most common problems emerging during the treatment of dental trauma of young permanent teeth following luxation based on two clinical cases. Furthermore, the article offers guidance for the more effective therapy of traumatized teeth according the IADT protocols in Hungarian.

[Structural disorder of dental enamel caused by antineoplastic agents--case report]. / Antineoplastikus terápia okozta zománcszerkezeti rendellenesség--Esetismertetés.

Cancer is the second most common cause of mortality in childhood. Complex therapy decreases the rate of mortality, but chemotherapy and irradiation may, however, create acute and long-term side effects. Although immuno- and myelo-suppressive side effects of anti-neoplastic therapy are unavoidable, their detrimental impact on oral health can and should be avoided contributing to a better quality of life of these children.

[The effect of dental fear and anxiety on the dental status of children aged 12-14]. / 12-14 éves gyermekek "fogászati félelmének és szorongásának" hatása a fogazat állapotának alakulására.

There are many different causes thus many different forms of fear and anxiety. The so called 'dental fear' and 'dental anxiety' are especially significant for the dentists since they determine the attitude of the patients during therapy. Negligence caused by fear and anxiety influence the dental status. The authors investigated the effect of the dental fear and anxiety on the dental status of children aged between 12-14. A significant correlation was found between the level of the fear and anxiety and the number of the untreated or extracted tooth. Children studying well at school had lower level of fear and better dental status. The mother's educational level also influenced the child's fear significantly.