SERPINA3: Stimulator or Inhibitor of Pathological Changes.

SERPINA3, also called α-1-antichymotrypsin (AACT, ACT), is one of the inhibitors of serine proteases, one of which is cathepsin G. As an acute-phase protein secreted into the plasma by liver cells, it plays an important role in the anti-inflammatory response and antiviral response. Elevated levels of SERPINA3 have been observed in heart failure and neurological diseases such as Alzheimer's disease or Creutzfeldt-Jakob disease. Many studies have shown increased expression levels of the SERPINA3 gene in various types of cancer, such as glioblastoma, colorectal cancer, endometrial cancer, breast cancer, or melanoma. In this case, the SERPINA3 protein is associated with an antiapoptotic function implemented by adjusting the PI3K/AKT or MAPK/ERK 1/2 signal pathways. However, the functions of the SERPINA3 protein are still only partially understood, mainly in the context of cancerogenesis, so it seems necessary to summarize the available information and describe its mechanism of action. In particular, we sought to amass the existing body of research focusing on the description of the underlying mechanisms of various diseases not related to cancer. Our goal was to present an overview of the correct function of SERPINA3 as part of the defense system, which unfortunately easily becomes the "Fifth Column" and begins to support processes of destruction.

Common therapeutic approaches in sleep and awake bruxism - an overview.

Bruxism, a common medical condition characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, can occur during sleep, when it is known as sleep bruxism (SB), or during wakefulness, when it is known as awake bruxism (AB). Although bruxism often causes headaches, temporomandibular joint pain, masticatory muscle pain, mechanical tooth wear, prosthodontic complications and cracked teeth, there is still not enough data to define and support a standardised approach to its treatment. The aim of this review was to present the pathophysiology, consequences, types and treatment methods of bruxism in order to increase readers' knowledge of this topic. Differences between awake and nocturnal bruxism are included, as well as risk factors and indicators visible during the clinical examination of affected patients. Among the causes we consider are genetics, stress, oral parafunctions and changes in the Central Nervous System (CNS). Potential and common methods of treatment are presented, along with suggested guidelines that should be followed when determining an appropriate treatment method. We draw attention to the notably dynamic development of bruxism in today's society and the importance of informational and preventive projects, especially those targeted at high-risk patients as well as those targeted at specialists, in order to better tackle the bruxism 'epidemic'.

Assessment of the Socioeconomic Status and Analysis of the Factors Motivating Patients to Apply for Prosthetic Treatment by Students of Dentistry at the Poznan University of Medical Sciences.

This study aimed to determine the motives for undertaking prosthetic treatment at the Prosthetics Clinic of the Poznan University of Medical Sciences (PUMS), pursued by fifth- and sixth-year medicine and dentistry students. The survey consisted of 18 questions, of which 1 to 11 concerned general patient data, while questions 12 to 18 concerned prosthetic treatment. The only open question in the questionnaire was one regarding the motives for the decision to receive treatment. The study group consisted of 153 patients (102 women-66.67% and 51 men-33.33%) of the Prosthetic Clinic. After collecting a total of 200 questionnaires, rejecting 47 (23.50%) due to the lack of answers to all questions (other than question 18), a total of 153 completed (76.50%) questionnaires were obtained. The main motivating factors for patients to undertake prosthetic treatment are functional and aesthetic considerations. In addition, it turned out, that the authority of the university unit is of greater importance than financial issues. Additionally, some patients undergo treatment by students because they can see positive aspects in it, both for them and for students. Hence, the evaluation of the treatment provided by students, as well as their communication skills and their attitude, are rated very highly, although, again, the evaluation was influenced by the education level.

Symptoms of the Eruption of Permanent Teeth.

This prospective study examined a population of 520 urban and rural children aged 5 to 9 years. Every 2−4 weeks, the clinical symptoms accompanying primary tooth replacement such as a cough, a runny nose, pain, and body temperature were assessed in each child's medical records. The authors were able to show in a statistically significant manner that the frequency, time, and type of cough were strongly related to the type of erupting teeth (p < 0.001 for each relationship). A cough dependent on the type of erupting teeth was observed in 86% to 92% of the examined children, with a morning bronchial cough being connected with an eruption of the lower teeth, and an eruption of the upper teeth producing an all-day pharyngeal cough caused by mucus secretions dripping down the back of the throat. A statistically significant relationship was also confirmed between the type of erupting teeth and the incidence of a runny nose (p < 0.001), the frequency of a runny nose (p < 0.001), and the time when runny nose symptoms occurred (p < 0.001). This study shows that the period when primary dentition is replaced with permanent teeth in children is characterized by a physiological cough and a runny nose.

Polymorphic variants in genes related to stress coping are associated with the awake bruxism.

BACKGROUND: Chronic stress is one of the leading predisposing factors in bruxism aetiology, but the influence of genetic factors is also suggested. We aimed to study whether sequence variants in genes involved in stress regulation pathways: NTRK2 and BDNF, may be associated with awake bruxism susceptibility, clinical presentation, and patients' perceived stress level. METHODS: The study group included 104 patients with probable awake bruxism and 191 population controls. Patients underwent dental examination concerning the symptoms of bruxism and psychological testing. Genotyping was performed using HRMA and sequencing. Statistical analyses were conducted, and P values below 0.05 were considered statistically significant. RESULTS: We observed a positive correlation of measured stress level and pathological teeth attrition in the anterior segment (r = 0.45, P < 0.001), enamel attritions (r = 0.44, P < 0.001), tongue impressions (r = 0.50, P < 0.001) and posterior teeth attrition (r = 0.27, P = 0.005). Moreover, the c.196A variant (p.66Met) of the BDNF gene and c.1397-31392G allele of the NTRK2 gene were present with elevated frequency, comparing to controls. CONCLUSIONS: This study hence the thesis that perceived stress level is a substantial contributing factor to awake bruxism occurrence and its clinical manifestations. Moreover, sequence variants in genes related to stress coping may be correlated with awake bruxism's susceptibility via elevated perceived stress level.

Standardization of the ultrasound examination of the masseter muscle with size-independent calculation of records.

BACKGROUND: As ultrasonography provides objective parameters and values, it is a reliable method of examining the structure and dimensions of the masseter muscle. Although the method is well known, there is no standardization in clinical examination and data analysis yet. OBJECTIVES: The study aimed to measure masseter muscle thickness in designated areas to establish the most repeatable and clinically applicable method of ultrasound examination, and to assess differences in measurements in designated areas for clinical purposes by devising the size-independent parameter. The size-independent parameter may potentially be more clinically applicable than distance records, which are affected by the size of the subject. MATERIAL AND METHODS: An ultrasound examination of 124 masseter muscles was performed. Axial examination in 3 horizontal regions (lower, middle and upper) and coronal examination in 2 vertical regions (proximal and distal) was carried out. Masseter muscle thickness was measured in every designated area when relaxed (muscle at rest (RMT)) and with clenched teeth (contracted muscle (CMT)). A morphological independent functional index of thickness difference (FITD) was calculated. RESULTS: The study revealed very high statistical differences between RMT and CMT (p < 0.0001) in all designated areas but with location variations. Masseter muscle thickness significantly differed depending on the examined area and transducer projection. CONCLUSIONS: The ultrasound study showed that masseter muscle thickness significantly differs depending on the examined area. The authors emphasize the necessity to examine the masseter muscle in specified areas with both coronal and axial projections to achieve objective and repeatable examination. Notable clinical value is assigned to FITD, which is independent from the morphological dimensions of the muscle.

Sexual dimorphism of maxillary sinuses in children and adolescents - A retrospective CT study.

BACKGROUND: In the postnatal period, some sexual dimorphism is observed from the moment of birth, but it is most pronounced from puberty. The aim of the study based on CT images was to assess possible sexual dimorphism of the maxillary sinus in children aged 0-18. METHODS: The retrospective analysis of CT images of the head (assessed as normal by radiologists) of 170 patients aged 0-18 (85 females and 85 males) was performed. The maxillary sinuses of every patient were bilaterally measured in three planes. Three diameters were obtained: maximum transverse (horizontal) diameter (the maxillary sinus width, MSW); maximum vertical diameter (the maxillary sinus height, MSH) and maximum antero-posterior diameter (maxillary sinus length, MSL). The automatic CT image segmentation algorithm was used (Syngo Via for Oncology, Siemens) to establish maxilla retrospective analysis of CT images of the head (assessed as normal by radiologists) of 170 patients aged 0-18 (85 females and 85 males) was performed. The maxillary sinuses of every patient were bilaterally measured in three planes. Three diameters were obtained: maximum transverse (horizontal) diameter (the maxillary sinus width, MSW); maximum vertical diameter (the maxillary sinus height, MSH) and maximum antero-posterior diameter (maxillary sinus length, MSL). The automatic CT image segmentation algorithm was used (Syngo Via for Oncology, Siemens) to establish maxillary sinus volume (MSV). The coefficient of variation used in the study allowed the biological variation between sexes to be observed. RESULTS AND CONCLUSIONS: The sexual dimorphism of maxillary sinus parameters is variable and depends on the phase of ontogenesis. All investigated parameters of maxillary sinuses are larger in males at 2-3 years (except for the length, which is larger in females by the end of three years, between six and nine years and after 15 years). The sexual dimorphism is less evident during the first year of age, and the most evident between 15 and 16 years. During the first two years, females are dominant with all parameters being larger than in males. The maxillary sinus length is developmentally the most stable parameter of maxillary sinuses, because throughout the investigated ontogenesis, the sexual differences are very similar. The most evident sexual dimorphism is observed in the volume of the maxillary sinus.

Application of auxological methods, including dental age estimation, in the assessment of delayed puberty in girls in gynecological practice.

Developmental gynecology uses methods practiced in auxology - the science of human ontogenetic development.An important and jointly used concept in gynecology and auxology is the concept of developmental age, which, unlikecalendar age, is a measure of the biological maturity of the organism, indicating the stage of advancement in the developmentof certain features or body systems. Developmental age assessment methods include: a) morphological (somatic)age - body height and weight, b) secondary sex characteristics - breast in girls, genitalia (penis and testes) in boys, andpubic hair in both sexes, c) bone age - hand and wrist x-ray, and d) dental age. An important marker of developmentalage is also age at menarche, treated as a late indicator of puberty in girls. All of these methods are useful in the context ofassessing regularity and disorders of puberty, such as delayed puberty. The paper discusses developmental age assessmentmethods that can be used to diagnose delayed puberty as well as the causes of delayed puberty in girls. It should be emphasizedthat in assessing the process of physical development of a given individual, the cooperation of specialists in the fieldof developmental gynecology, pediatrics, auxology, dentistry, endocrinology, and dietetics would be the most desirable.

Psychosocial Predictors of Bruxism.

OBJECTIVES: The study aimed to investigate the psychosocial predictors of bruxism. The association of various psychosocial factors such as alexithymia, emotional processing, state and trait anxiety, and stress with awake bruxism was analysed. METHODS: The study involved 52 volunteers diagnosed with awake bruxism. The toolkit that was used included the Toronto Alexithymia Scale (TAS-20), the Emotional Processing Scale (EPS), the Cohen Perceived Stress Scale (PSS-10), and the State- and Trait-Anxiety Inventory (STAI), with independent individual psychological diagnoses being made for every patient. The results were statistically analysed using IBM SPSS Statistics 24. RESULTS: The obtained data clearly show that psychological traits-both permanent dispositions (e.g., state anxiety and alexithymia) and temporary states (e.g., trait anxiety, emotional processing deficits, and psychological stress)-are significant determinants of awake bruxism. The percentage of explained variance indicates the presence of other factors as well. CONCLUSIONS: Psychosocial factors such as state anxiety and trait anxiety, alexithymia, and perceived stress are as important as somatic causes in the occurrence and maintenance of awake bruxism. The profile of the obtained data suggests the possibility of preventing or minimizing the symptoms of awake bruxism through properly constructed psychoprophylactic interactions.

Computed Tomography versus Optical Scanning: A Comparison of Different Methods of 3D Data Acquisition for Tooth Replication.

OBJECTIVES: The study aimed to compare the accuracy of different methods of data acquisition and data reconstruction and to assess their usefulness for 3D printing of tooth replicas. METHODS: 3-dimensional models of molar and canine teeth obtain utilizing CBCT examination with different protocols, and optical scanning was compared with models derived from micro-computed (micro-CT) examination using Geomagic Studio Qualify software. A pairwise comparison of 3D models with analysis of standard deviation and the value of the mean distance of given surfaces was performed. RESULTS: Standard deviation and the value of the mean distance were lowest for optical scanning followed by CBC in high and standard resolution in all tested protocols. Models, obtained with high-resolution CBCT protocols, of teeth in and outside of alveolar bone showed similar average distance parameters, but standard deviation parameter was significantly lower for models of teeth scanned outside of the socket. Good surface representation on all models was seen at relatively smooth areas while in areas of high changes in the geometry CBCT based models performed inferiorly to those obtained from an optical scanner. CONCLUSIONS: In case of teeth of noncomplicated texture, independently from a position (within or outside the alveolar socket), the high-resolution CBCT seems to be a sufficient method to obtain data for 3D printed tooth replica. Optical scanning performs better when a detailed replica is necessary.

A Comparison between the Implant Stability Quotient and the Fractal Dimension of Alveolar Bone at the Implant Site.

OBJECTIVES: Fractal analysis of the radiographic pattern of bone has been used to evaluate its quantitative properties. However, the relation between initial implant stability and quality of bone remains unclear. The objective of this study was to evaluate RFA values in relation to the fractal dimension of bone where the implant was inserted. MATERIAL AND METHODS: A total of 50 two-stage dental implants were placed in the maxilla and mandible of 32 patients. After implant placement, an implant stability quotient (ISQ) was measured in two perpendicular planes. On intraoral digital periapical radiographs, three 35x35 pixels' regions of interest (ROIs) were chosen covering the bone adjacent to the neck (ROI 1), middle (ROI 2), and apical (ROI 3) part of the implant, respectively. For every ROI, a fractal dimension (FD) was calculated. A linear correlation, as well as a logistic regression analysis, was used to identify a possible relation between the ISQ and FD values for every ROI in the maxilla and mandible. RESULTS: The ISQ and FD values were found to be correlated at ROI 1 for the maxilla. There was no linear correlation between ISQ and FD values in any of the three ROIs in the mandible. However, logistic regression analysis showed that in ROI 1 and ROI 3 the values of FD and ISQ are statistically important and may be used to express the difference between maxilla and mandible. CONCLUSION: The fractal dimension of alveolar bone measured from intraoral digital radiographs alone may be an insufficient parameter to determine initial implant stability.

The Association between Maxillary Sinus Dimensions and Midface Parameters during Human Postnatal Growth.

OBJECTIVE: The aim of the study based on CT images was to assess the age-related changes in maxillary sinus diameters in relation to diameters of the facial skeleton. MATERIALS AND METHODS: The retrospective analysis of CT images of the head of 170 patients aged 0-18 years (85 females and 85 males) was performed. Specific orientation points (zy, zm, pr, ns, n, and P) were identified in every patient and the following distances were measured: zy-zy, maximum facial width; zm-zm, midfacial width; n-pr, upper facial height; ns-pr, alveolar facial height; and ns-P, distance not indicated in craniometry. RESULTS: The maxillary sinuses of every patient were bilaterally measured in three planes. Three diameters were obtained: maximum transverse (horizontal) diameter called MSW, maximum vertical diameter called MSH, and maximum anteroposterior diameter (length) called MSL. In females, the correlation of MSW, MSH, and MSL and zy-zy, as well as n-pr distances, is very strong. Moreover, the significant correlation was found between all measurements of maxillary sinus and ns-pr as well as ns-P distances in females. The correlation between MSL and all measurements of midface as well as MSH and MSW and all measurements except ns-P is stronger in females than in males. In males, all measurements of maxillary sinus correlate with ns-P distance very strongly. CONCLUSIONS: The statistical analysis (correlation and determination coefficient) showed that all measurements of maxillary sinuses correlate with midface dimensions.

Introducing a simple method of maxillary sinus volume assessment based on linear dimensions.

Measuring sinus volume in a general practice clinic is a complex and time-consuming procedure, requiring experience in the use of radiological methods In the presented research, the automatically estimated maxillary sinus volume was compared with maxillary sinus volume assessed with mathematical formulas used to calculate the volume of spheres and pyramids. The starting point for the statistical analysis were specific measurements of the sinuses. We wanted to discover which geometric shape has the volume that is nearest to the automatically estimated volume. The study was performed using samples of CT scans of pediatric patients age 1-17. The dimensions (maximal width, maximal height, maximal length) were used for manual calculations. For the automatic volume calculation, the CT Image Segmentation algorithm (Syngo Via for Oncology, Siemens) was used. Pearson's correlation coefficient was applied to analyse the interrelationship between automatically and manually calculated volume of maxillary sinus. It was statistically established that the "sphere", "pyramid" and "mean" manually calculated maxillary sinus volume were accurate and strongly correlated with the automatically estimated maxillary sinus volume. The volume of the sphere corresponds better with the automatic measurements than the volume of the pyramid. The variations are significant and they were made reliable with the application of a statistical test. It is quick and easy to calculate the maxillary sinus volume based on its linear dimensions instead of applying advanced software. The manual method for maxillary sinus volume calculation requires three linear measurements of the sinus (length, width, and height) and can be recommended if the automatically estimated volume cannot be obtained.

Maxillary sinuses and midface in patients with cleidocranial dysostosis.

The cleidocranial dysplasia is general skeletal disorder with an autosomal dominant inheritance. It is manifested by many craniofacial abnormalities, of which the maxillary hypoplasia is the most evident. The aim of the study was to use CBCT to evaluate the volume of the maxillary sinuses and the dimensions of maxillae in patients with CCD and compare them with healthy individuals. Files of four children with cleidocranial dysplasia were investigated. Volume of every maxillary sinus as well as two dimensional measurements of distances between particular points of interest located on surface of maxilla were calculated from reconstructed CBCT examination. Data were compared with a control group. Statistical analysis was performed. Linear and volumetric data obtained using CBCT was collected and compared with a control group. All affected children had both maxillary sinus volume and maxillary dimensions smaller than control values. The maxillary sinuses were underdeveloped up to half of normal values. The largest differences were recorded in vertical linear dimensions of the maxillae. Horizontal dimensions were also lower. There are morphological modifications of bone tissue which accompany CCD. It seems that these changes occur on the midfacial region and to a greater extent concern the maxillary sinus volume.

Analysis of human dentition from Early Bronze Age: 4000-year-old puzzle.

This paper presents the first ever paleodontological investigation of human remains from an archeological site in Central Europe dating from the Early Bronze Age and attributed to the Strzyzow Culture. It corroborates the knowledge gained from archeological, anthropological and genetical investigations. Our study aimed to assess dental status, dental morphology and dental pathologies as well as tooth wear and enamel hypoplasia based on visual inspection and stereomicroscopic investigation. The research was supported by CBCT imaging to obtain digital images and 3D reconstructions as well as 2D radiographs essential for dental age estimation. All of the 191 teeth discovered showed morphological similarity, with adult teeth showing similar color, shape and size. A maxillary molar presenting with a unique root morphology and a mandibular molar with a rare occlusal surface were found. Both permanent and deciduous dentition presented significant tooth wear. A few specimens displayed signs of dental caries, periapical pathology and antemortem tooth loss. Three individuals exhibited linear enamel hypoplasia. CBCT provided high-quality 2D images useful for dental age estimation by non-destructive methods. Estimated dental age correlated with the age estimated by other anthropological methods. In one case, this was crucial because of insufficient material for anthropological analysis. The presented studies have proved that besides the skeleton, teeth can be used as a fundamental tool in assessing the overall health and living conditions of paleopopulations. It would seem that there is potential for considerable development to be made in the research and investigation of paleodontological material using CBCT.

Accuracy of the anthropometric measurements of skeletonized skulls with corresponding measurements of their 3D reconstructions obtained by CT scanning.

BACKGROUND: The anthropometric measurements of the skeletonized skull are crucial in the investigation of human remains, mostly for personal identification. The images of the skull are used if the superimposition or approximation of the facial appearance is to be performed. The aim of the study was to compare the accuracy of the anthropometric measurements of skeletonized skulls with corresponding measurements of their 3D reconstructions obtained by CT scanning. METHODS: Ten skeletonized skulls and their 3D digital reconstructions were measured according to standard anthropometric procedures. The results were compared and statistical analysis was performed. RESULTS: The statistical analysis revealed that the 3D reconstruction is absolutely reliable for any measurements within the skull. The results of the measurements obtained from the CT image were accurate and comparable to the results of the anthropometric analysis of the skeletonized skull. The correlation between the anthropometry of the skeletonized skulls and the CT reconstructions was strong. CONCLUSIONS: It is relevant that 3D reconstructions of the skull can be used in forensic anthropology for personal identification.

Development of the maxillary sinus from birth to age 18. Postnatal growth pattern.

OBJECTIVES: Anatomical and developmental descriptions of the maxillary sinus may be of great clinical importance. An understanding of age-related changes in the dimensions and volume of the normal maxillary sinus may help in the evaluation of radiographs and identification of sinus abnormalities. The aim of the present study was to define growth patterns of maxillary sinuses in children up to the age of 18 years and evaluate the correlation between normal age-related changes in dimensions and volume. METHODS: The research sample consisted of CT scans of 170 patients subdivided into 17 groups based on age. Normal developmental changes were investigated and linear dimensions measured. RESULTS: The maxillary sinus, present at birth, increases in size until the end of the 18th year. The growth pattern includes changes in vertical, horizontal and antero-posterior directions. No bilateral dimorphism was observed, but gender-related differences were found in children over the age of 8 years. The most extensive period of growth occurs during the first 8 years and by the end of the 16th year the maximal values of all diameters and volume are reached. CONCLUSIONS: A CT study of developing maxillary sinuses allowed a precise evaluation of age-related changes in all diameters and volume to be made.

Difficulties in personal identification caused by unreliable dental records.

This paper demonstrates a case of personal identification that initially seemed straightforward, mainly because complete and comprehensive antemortem dental records of a missing person were made available for analysis. Skeletal remains were found and the skull (most crucial for human identification) was delivered for analysis. Comparative analysis of antemortem and postmortem dental records excluded identification, while the results of superimposition (simultaneously performed by another team member) revealed sufficient concordant points to establish identity. The results caused confusion and additional information was required. The need for more evidence resulted in delivery of elements of the postcranial skeleton. Identification was finally achieved when concordant points were established in a comparison of antemortem X-rays and the humerus. Team members concluded that the dental records were in fact not adequate and that mistakes in numbering the teeth (superior canine instead inferior canine and right and left premolars) were considered to be the initial reason a positive identification had not been made. The authors conclude that a multidisciplinary approach is crucial to making a positive identification and that caution should be exercised when carrying out personal identification from dental records alone. The need to adequately train police officers to collect and preserve dental evidence is also emphasized.

Body mass estimation in modern population using anthropometric measurements from computed tomography.

Forensic anthropologists are able to estimate the stature of a skeleton, its sex and biological age at death, with a relatively high degree of accuracy. Body mass estimation from the stature and bi-iliac (maximum pelvic) breadth and femoral head breadth can be useful in forensic investigations involving unidentified skeletal remains. Predicting the body mass of skeletal remains always involves significant inaccuracy, however when body mass extremes are disregarded average figures provide the best estimation. The aim of the study was to investigate whether the methods usually used in body mass estimation are accurate in different BMI ranges. The usefulness of these methods in forensic anthropology was discussed. The study was performed using CT images of widely differing body types of modern central European populations. Maximum pelvic breadth and anteroposterior femoral head breadth were measured directly from the appropriate CT scan slices for each individual. Body mass index was established for each individual. Four different methods of body mass estimation were applied. The statistical analysis showed that body mass prediction methods based on the bi-iliac breadth with known stature and the femoral head breadth show strong correspondence. The results of body mass estimation using different methods were in high correlation with normal BMI. The accuracy of body mass prediction of underweight and obesity cases (BMI extremes) showed significant inaccuracy. Body mass estimation methods can provide important information for forensic anthropological investigation and personal identification. However, one should be aware of the discrepancies and should apply the equations carefully as they can carry significant errors.