What is the impact of nicotine pouches on oral health: a systematic review.

BACKGROUND: Increase in nicotine pouch (NP) users, particularly among the young, is a matter of concern requiring a comprehensive understanding of its short- and long-term oral health implications. The objective of this research was to systematically review potential oral side-effects associated with NP usage. METHODS: This systematic review was conducted following the PRISMA guidelines. Databases (Medline via PubMed, Scopus, Cochrane Trial, and Google Scholar) were searched for relevant studies up to February 2024. Modified Newcastle-Ottawa Scale (NOS) and the Risk Of Bias In Non-randomized Studies - of Exposure (ROBINS-E) tool were used to assess the quality and bias of the included studies. RESULTS: Three studies were included for this review, two from Europe and one from USA, and considered of a total of 190 participants. All studies were deemed to have a high risk of bias. Participants used NP for periods ranging from 1 month to 10 years. Among these studies, only one study provided information on the usage pattern between 1 and 5 units for an average of 11 ± 7 min per session. Oral mucosal changes at the site of placement were common among NP users. Oral lesions varied from slight wrinkling to various white lesions, seemingly related to the NP units consumed per day and their duration of usage. Other oral side effects included dry mouth, soreness, gingival blisters, and a strange jaw sensation. CONCLUSIONS: Research on the use of NP and its effect on oral health are currently limited. The use of NP should take into consideration the short-and-long-term effects, especially on oral health. Further studies are crucial to understand oral health implications associated with NP usage. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration number CRD 42,024,500,711.

Mechanical properties of dental tissue conditioner containing lemongrass essential oil.

STATEMENT OF PROBLEM: Overcoming compromised oral hygiene and susceptibility to opportunistic oropharyngeal candidal infections in patients with a maxillectomy are critical challenges. Tissue conditioners incorporated with lemongrass essential oil has been shown to have promising antifungal properties, but the effects of this incorporation on the mechanical properties of tissue conditioners remain unexplored. PURPOSE: The purpose of this in vitro study was to assess the effects of lemongrass essential oil incorporation at various concentrations on the tensile bond strength (TBS) and Shore A hardness (SAH) of tissue conditioners. The presence of lemongrass essential oil in the tissue conditioner was evaluated by using Raman spectroscopy. MATERIAL AND METHODS: Unmodified tissue conditioner served as the control, whereas tissue conditioner incorporated with lemongrass essential oil (final concentrations of 1.77%, 3.56%, and 7.17% [w/w]) and tissue conditioner incorporated with Nystatin served as the experimental groups. The SAH of Coe-Comfort specimens was measured at 2 hours, 24 hours, 7 days, and 30 days for each testing group (n=3/group). The TBS of tissue conditioner to denture base acrylic resin was determined by using a universal testing machine at a crosshead speed of 10 mm/minute (n=10/group). Furthermore, Raman spectra for the control and experimental tissue conditioner groups were obtained at 24 hours and 14 days. The data were analyzed with 2-way repeated measures ANOVA followed by the post hoc Bonferroni multiple comparison test for SAH testing and the 1-way ANOVA followed by the post hoc Tukey HSD multiple comparison test for TBS testing (α=.05). RESULTS: The unmodified tissue conditioner, 1.77% (w/w) lemongrass essential oil incorporated tissue conditioner, and Nystatin incorporated tissue conditioner showed no significant difference in SAH at ≤7 days (P>.05). However, at 30 days, the 1.77% (w/w) lemongrass essential oil and Nystatin groups showed no significant difference in SAH (P=.136), but both groups had significantly lower SAH compared with the control group (P=.016 and P<.001, respectively). The incorporation of 1.77% (w/w) lemongrass essential oil in tissue conditioners had no significant effect on TBS compared with the control group (P=.184), although both possessed significantly higher TBS than all remaining groups. In contrast, tissue conditioner incorporated with lemongrass essential oil concentrations ≥3.56% (w/w) and Nystatin showed a statistically significant decrease in TBS (P<.001). Raman spectrum analysis confirmed the presence of citral bands in the lemongrass essential oil incorporated specimens at 2 hours and 14 days, verifying its long-lasting presence. CONCLUSIONS: Incorporation of lemongrass essential oil in tissue conditioners at 1.77% (w/w) concentration produced both long-lasting antifungal properties and acceptable mechanical properties (SAH and TBS).

Novel vinegar solution for denture-cleansing agent.

PURPOSE: To study the antimicrobial effects of a novel vinegar-based denture cleansing agent on oral Streptococci and Candida species and the inhibitory effects on pre-formed bacterial and Candida biofilms on denture base. METHODS: The microorganisms used in this study were Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Streptococcus sanguinis (S. sanguinis), Candida albicans (C. albicans), and Candida glabrata (C. glabrata). The antimicrobial activity of novel vinegar solution was evaluated by time kill assay and biofilm grown on denture base. RESULTS: Time kill assay showed that vinegar exhibited the highest antibacterial effect on S. sobrinus, S. sanguinis, and S. mutans after 15 min of treatment. A 99.9% reduction in C. glabrata and C. albicans required more than 4 and 6 h of treatment, respectively. Vinegar significantly inhibited streptococcal biofilm, with an approximately 6 log-reduction at 30 min of treatment. The results demonstrated that viable Candida cells in biofilm reduced in excess of 6-log CFU/mL after 3 h treatment with vinegar. Moreover, the vinegar-based denture cleanser inhibited bacterial and Candida biofilm formation compared to the control group without treatment with statistical significance. CONCLUSION: A novel vinegar-based denture cleansing agent showed moderate antibacterial properties, but required a slightly longer immersion time to attain anticandidal effects compared to Polident and 0.2% CHX.

Histopathological and risk factor analyses of oral potentially malignant disorders and oral cancer in a proactive screening in northeastern Thailand.

BACKGROUND: Lip and oral cavity cancer has been reported as the 10th most common cancer in Thailand. Recently, a screening program for oral potentially malignant disorders (OPMDs) and oral cancer was conducted in the northeastern Thailand which took into consideration a total of 371,911 people who resided in the provinces of Buriram, Chaiyaphum, Nakhon Ratchasima, and Surin. METHODS: A total of 330,914 subjects were consecutively screened for risk factors of oral cancer by village health volunteers (VHVs) using a questionnaire (S1). Then, 186,710 subjects with one or more risk factors for oral cancer were referred for oral screening by dental auxiliaries or dentists at sub-district level hospitals (S2) where 86,941 subjects were subsequently screened. Afterwards, 1576 subjects with suspicious oral lesions for OPMDs or oral cancer attended local hospitals for further investigation and treatment. Oral medicine specialists, oral surgeons, and local dentists at the district level hospitals performed biopsies and the samples were sent for histopathological analysis. The objectives of the study were to report the histopathology findings from the biopsies obtained from these subjects and the associated risk factors. RESULTS: Out of 427 subjects who received biopsies, complete diagnostic results were obtained from 409 patients (462 specimens). The 5 most common histopathological results from these specimens were mild epithelial dysplasia (27.3%), fibroepithelial hyperplasia (14.5%), oral lichen planus/oral lichenoid reactions (11.5%), moderate epithelial dysplasia (8%), and acanthosis with or without hyperkeratosis (5%). Oral squamous cell carcinoma was detected in 14 subjects and 11 other forms of oral cancer were revealed. Among the analyzed risk factors, habitual betel quid chewing was established as a statistically significant risk factor associated with OPMDs and oral cancer. CONCLUSION: The most frequently observed histopathological results of clinically suspected oral cancer and OPMDs included mild epithelial dysplasia, fibroepithelial hyperplasia, oral lichen planus/oral lichenoid reactions, moderate epithelial dysplasia, and acanthosis with or without hyperkeratosis. Betel quid chewing habit was found to be associated with OPMDs and oral cancer.

Psychosocial distress and psychological adjustment in patients with ocular loss: a framework analysis.

BACKGROUND: Patients with ocular loss tend to have physical and psychosocial difficulties. Maxillofacial prosthetic specialists involved in the treatment should be trained with competence to manage psychological complications. However, due to the multifactorial origin of the psychosocial distress, designing such training activities can be challenging. This research aimed to construct a conceptual framework illustrating the effects of ocular loss on patients' physical and psychosocial well-being and their coping strategies, to propose the learning content of training sessions. METHODS: A semi-structured interview and a topic guide were employed to explore the perceptions from patients who were receiving their first custom ocular prosthesis, fabricated by maxillofacial prosthodontists. The participants were selected using a purposeful sampling up until data saturation. The data were analyzed using framework analysis. RESULTS: Twelve patients participated in this research. Four main themes emerged from the data analysis: (1) Impact of ocular loss, (2) Factors influencing psychosocial distress, (3) Psychological adjustment, and (4) Expected treatment outcomes. Each theme appeared to have influence on the other, rather than presenting itself independently. Although patients with ocular loss experienced both physical and psychosocial difficulties, psychological distress was greatly influenced by self-perceived disfigurement, etiology, and social status. Therefore, they needed to develop their coping strategies including rehabilitation with ocular prosthesis. CONCLUSION: Various forms of psychological adjustments were necessary in these patients with ocular loss to resume their daily lives. The specialist involved in the treatment should also partake in patients' psychological adjustment and should be competent in psychological management skills, such as supporting patients to meet their expectations.

Effects of Disinfection Methods on the Color Stability of Precolored and Hand-Colored Maxillofacial Silicone: An In Vitro Study.

Maxillofacial prostheses are used in rehabilitation of patients with facial defects. Typically, these prostheses are fabricated with medical grade silicone and are tinted corresponding to the patients' natural skin color. However, exposure to environment and disinfectants can result in color changes. This study aimed to evaluate the effects of four different disinfection methods on the color stability of precolored and hand-colored maxillofacial silicones. Forty specimens each of precolored and hand-colored silicone were prepared. The specimens were randomly divided into eight groups (n = 10) and cleansed with four different disinfection methods. Disinfection was carried out six times/day for 60 days, simulating once-a-day disinfection for a year. Color evaluation was carried out at day 0 and day 60 using a UV-vis spectrophotometer. Color alterations were calculated by the CIE L ∗ a ∗ b ∗ system. Data were analyzed by two-way ANOVA with post hoc Tukey HSD and t-tests (α = 0.05). Disinfectants can affect the color stability of maxillofacial silicone. In our study, chlorhexidine solution and liquid soap resulted in the highest color change. Precolored silicone showed higher color stability than its hand-colored counterpart.

Antimicrobial Properties of Ocimum Species: An In Vitro Study.

Objective: This study aimed to determine the antimicrobial activity of ethanol-extracts obtained from Ocimum gratissimum L. (clove or African basil, Lamiaceae) and O. santum L. (holy basil) against some microorganisms present in oral cavity related to either medical or dental disease. Materials and Methods: Antimicrobial properties of both ethanol-extracts of Ocimum species against Streptococcus mutans KPSK2, S. pyogenes ATCC 19615, Staphylococcus aureus ATCC 16794, and Candida albicans ATCC 10231 were primarily determined by agar disk diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal or fungicidal concentration (MBC or MFC) of these herbal extracts were further determined by broth micro-dilution method. Results: Ethanol-extracts of O. sanctum L. and O. gratissimum L. inhibited the growth of all tested microorganisms in various degrees ranging from the strongest antimicrobial activity of O. sanctum against S. pyogenes [MIC at 0.19% (w/v); MBC at 0.78% (w/v)] to the least inhibitory activity of O. gratissimum against C. albicans [MIC at 12.5% (w/v); undetectable MFC]. The ethanol-extract of O. sanctum showed stronger antimicrobial property against the tested bacteria and fungus than O. gratissimum. The ethanol-extracts of both Ocimum species showed stronger antibacterial than antifungal activity. However, the ethanol-extract of O. gratissimum even at a high concentration of 50% (w/v) was unable to eliminate the tested fungus. Conclusion: Ethanol-extracts of Ocimum species contain effective antibacterial and antifungal properties that may be beneficial for further development of antimicrobial agents in medical and dental fields.

Pilot Model for Community Based Oral Cancer Screening Program: Outcome from 4 Northeastern Provinces in Thailand.

Management of advanced-stage oral cancer adds a great burden to individuals and health care systems. Community-based oral cancer screening can be beneficial in early detection and treatment. In this study, a novel oral cancer screening program was conducted utilizing an existing network of health care personnel, facilities, and digital database management for efficient coverage of a large population. The screening program considered 392,396 individuals aged ≥40 from four northeastern provinces in Thailand. Three levels of screening were performed: S1 by village healthcare volunteers to identify risk groups, S2 by dental auxiliaries to visually identify abnormal oral lesions, and S3 by dentists for final diagnosis and management. A total of 349,318 individuals were interviewed for S1, and 192,688 were identified as a risk group. For S2, 88,201 individuals appeared, and 2969 were further referred. Out of 1779 individuals who appeared for S3, oral potentially malignant disorders (OPMDs) were identified in 544, non-OPMDs in 1047, doubtful lesions in 52, and no results in 136 individuals. Final treatment was carried out in 704 individuals that included biopsies of 504 lesions, exhibiting 25 cancerous lesions and 298 OPMDs. This study is so far one of the largest oral cancer screening programs conducted in Thailand and showed effective implementation of community-based oral cancer screening.

Impact of household vinegar on calculus removal and mechanical properties of orthodontic resin.

PURPOSE: This study evaluated calculus removal efficacy of household vinegar and its effect on autopolymerizing orthodontic resin following repeated immersion. METHODS: A total of 72 sectioned specimens of orthodontic retainers with calculus deposits following cleaning with the help of immersion in vinegar of different dilutions between 12.5% and 100%, tap water, effervescent tablets, and mechanical debridement were digitally analyzed. Changes in Ca and Fe ions in vinegar were assessed by atomic emission spectroscopy (AES). For mechanical testing, autopolymerizing polymethyl methacrylate (PMMA) samples were similarly grouped and immersed for 78 cycles and their flexural strength and hardness measured. Fourier-transform infrared spectroscopy (FTIR) was performed to evaluate changes in their chemical composition. One-way analysis of variance (ANOVA) and Tukey's test were used to analyze the differences in the mean flexural strength and hardness between the groups (p ≤ 0.05). RESULTS: A minimum immersion of 2 h in 25% vinegar solution combined with brushing attained efficiency of 74.13 ± 22% calculus removal. Whereas, tap water and effervescent tablets had 15% and 49% efficiency, respectively. AES results showed diffusion of Ca ions from calculus into the vinegar solution as a plausible mechanism for its structural weakening and removal. Results of mechanical testing showed that undiluted vinegar solution affected the flexural strength of PMMA and this effect was significantly different from that of the effervescent tablets and the remaining vinegar concentrations. There was no significant difference in hardness between the groups. The FTIR showed no changes in the chemical composition of PMMA samples following repeated immersions. CONCLUSION: Vinegar can be useful in the removal of calculus from dental appliances but should be used in diluted forms to minimize side effects.

A two-step functional impression technique for the fabrication of an implant-retained silicone auricular prosthesis.

Excessive movement of the underlying tissue bed can lead to poor retention of an implant-retained silicone auricular prosthesis. This article describes a 2-step impression technique with a secondary functional pickup impression of the wax pattern. A wide range of tissue movements can be recorded while maintaining a stable relationship between the abutment analog assembly and retentive elements. The definitive cast is modified accordingly to provide an accurate reproduction of the patient's tissues during function, thus, increasing the overall retention and stability of the definitive prosthesis.

Pain and quality of life related to suture removal after 3 or 7 days at the extraction sites of impacted lower third molars.

BACKGROUND: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. METHODS: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. RESULTS: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. CONCLUSIONS: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

Rapid fabrication of a digital prosthesis.

Finger prosthesis often needs refabrication due to its discoloration following use. This article presents a novel, economical, and cost-effective technique to duplicate the patient׳s existing prosthesis to obtain a new wax replica, which is then clinically tried and processed to obtain new silicone finger prosthesis. This technique requires comparatively less clinical and laboratory steps as to fabricate an entirely new prosthesis. The newly fabricated silicone finger prosthesis has the fit and marginal adaptation of the patient׳s existing prosthesis but the esthetics is improved.

Prosthodontic rehabilitation of congenital auricular defect: a clinical report.

This clinical report presents the prosthetic rehabilitation of a congenital auricular defect. The rehabilitation was initially performed with an adhesive retained silicone prosthesis. After careful evaluation of the patient's retentive needs, two endo-osseous craniofacial implants were placed in the mastoid region. After integration, an implant-retained silicone prosthesis was fabricated using a Hader bar with two ERA attachments, which restored the defect with good aesthetic and functional outcome. Prosthetic rehabilitation is a viable treatment option for restoring auricular defects and can be indicated in situations where surgical reconstruction may not be feasible.

Rapid fabrication of silicone orbital prosthesis using conventional methods.

Restoration of orbital defects with silicone prosthesis has been a well-documented and accepted treatment option. Adhesive retained prosthesis offer the patients with adequate retention and treatment satisfaction. However, marginal breakdown and discoloration are common problems associated with these prostheses, necessitating their refabrication. Fabrication of a silicone orbital prosthesis is time consuming and requires multiple clinical and laboratory procedures. This technical article describes simple and cost effective steps for rapid fabrication of a silicone prosthesis using conventional methods.

Fabrication of a new silicone auricular prosthesis without removing the existing metallic framework.

Silicone prostheses require constant repair and refabrication. Auricular prostheses retained with implants have better retention than adhesive-retained prostheses. However, refabrication is complicated if the patient is unwilling to surrender the metallic framework attached to the implants and revert to the use of adhesives. This article describes a technique by which the metal framework of the existing prosthesis need not be removed, thereby improving the patient's quality of life until the new prosthesis is delivered.

Prosthetic rehabilitation of an ocular defect with post-enucleation socket syndrome: A case report.

Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results.

Late effects of orbital enucleation and radiation on maxillofacial prosthetic rehabilitation: A clinical report.

The retinoblastoma is one of the most common tumors of the eye diagnosed in childhood. The treatment for patients with retinoblastoma includes surgical removal of the lesion along with adjunctive chemotherapy and radiotherapy. If the tumor is controlled, these treatments can have secondary adverse effects pertaining to the growth and development of orofacial structures in young patients. This clinical report describes the prosthetic rehabilitation of a patient who underwent enucleation followed by radiation therapy and adjunctive chemotherapy to treat the primary diagnosis of retinoblastoma. This therapy resulted in a combination of dental and facial growth and developmental abnormalities.

In vitro effects of Salvia officinalis L. essential oil on Candida albicans.

OBJECTIVE: To determine the anticandidal activities of Salvia officinalis L. (S. officinalis) essential oil against Candida albicans (C. albicans) and the inhibitory effects on the adhesion of C. albicans to polymethyl methacrylate (PMMA) resin surface. METHODS: Disc diffusion method was first used to test the anticandidal activities of the S. officinalis L. essential oil against the reference strain (ATCC 90028) and 2 clinical strains of C. albicans. Then the minimal inhibitory concentration (MIC) and minimal lethal concentration (MLC) were determined by modified membrane method. The adhesion of C. albicans to PMMA resin surface was assessed after immersion with S. officinalis L. essential oil at various concentrations of 1×MIC, 0.5×MIC and 0.25×MIC at room temperature for 30 min. One-way ANOVA was used to compare the Candida cell adhesion with the pretreatment agents and Tukey's test was used for multiple comparisons. RESULTS: S. officinalis L. essential oil exhibited anticandidal activity against all strains of C. albicans with inhibition zone ranging from 40.5 mm to 19.5 mm. The MIC and MLC of the oil were determined as 2.780 g/L against all test strains. According to the effects on C. albicans adhesion to PMMA resin surface, it was found that immersion in the essential oil at concentrations of 1×MIC (2.780 g/L), 0.5×MIC (1.390 g/L) and 0.25×MIC (0.695 g/L) for 30 min significantly reduced the adhesion of all 3 test strains to PMMA resin surface in a dose dependent manner (P<0.05). CONCLUSIONS: S. officinalis L. essential oil exhibited anticandidal activities against C. albicans and had inhibitory effects on the adhesion of the cells to PMMA resin surface. With further testing and development, S. officinalis essential oil may be used as an antifungal denture cleanser to prevent candidal adhesion and thus reduce the risk of candida-associated denture stomatitis.

Silicone nasal prosthesis retained by an intranasal stent: a clinical report.

Nasal defects after tumor excision can leave a patient functionally and esthetically impaired. Loss of nasal septal cartilage support causes the soft tissue to collapse or undergo stenosis, further compounding the problem. Intranasal stents can be used to maintain the patency of such nasal defects. This clinical report describes the use of an acrylic resin nasal stent bonded to a silicone nasal prosthesis to rehabilitate a patient with a nasal defect.

In vitro antimicrobial effects of grape seed extract on peri-implantitis microflora in craniofacial implants.

OBJECTIVE: To determine the antimicrobial effects of grape seed on peri-implantitis microflora. METHODS: The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Candida albicans (C. albicans) and clinical strains of S. aureus, Klebsiella pneumonia (K. pneumonia) and Candida parapsilosis (C. parapsilosis) by disk diffusion test. Minimum inhibitory concentrations (MIC) and minimum cidal concentrations (MCC) were determined using modified agar dilution millpore method. The extract was further combined with polyethylene glycol and propylene glycol, and was tested for antimicrobial effects. RESULTS: Grape seed extract showed positive inhibitory effects with S. aureus at MIC of 0.625 mg/mL and MCC of 1.25 mg/mL respectively. However the extracts showed minimal or no reactivity against strains of E. coli, K. pneumonia, C. parapsilosis and C. albicans. The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S. aureus. CONCLUSIONS: The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skin-abutment interface of craniofacial implants.