Illustration of self-perceived knowledge, skills, and interests in undergraduate dental students using a visual metaphor- results of a monocentric cross-sectional study.

BACKGROUND: Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM). METHODS: Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman's Rho was used to reveal correlations between knowledge, skills, and interests in the cohort. RESULTS: Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students' interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05). CONCLUSION: PRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education.

The hypotheses of oral disease-associated perioprosthetic joint infections to understand the role of oral health for endoprostheses - a narrative review.

AIMS: Periprosthetic infections are a severe complication, causing enormous morbidity. The role of oral diseases in the development of such infections has been discussed controversially, showing a large discrepancy between prevalence of oral foci and infections of endoprostheses (EP). This narrative review aimed in explaining and discussing two hypotheses for the occurrence of oral disease-associated EP infections. METHODS AND RESULTS: The hypotheses include two mechanisms. (1) In case of an acute exacerbation during the early healingperiod after EP surgery (first 3 months). (2) Coincidental in the context of late EP infections (after successful initial healing), where an initial periprosthetic inflammation can be colonized secondarily by oral microorganisms. In both settings,oral foci are not primarily causative for EP infection, but represent an important reservoir for EP colonization, while the immunological conditions (locally and systemically) are crucial for the onset of an EP infection. As potential consequence, patients with risk factors should be orally rehabilitated prior to EP surgery. Usage of antibiotic prophylaxis during the first 3 months after EP implantation (initial healing period) might be considered, but has no reliable evidence. To avoid morbidity of patients, radical dental clearance is unfavorable for the respective patients. CONCLUSION: Altogether, patients with EP should receive increased attention from the dental perspective alongside with dental preventive measures, because they show a high dental and periodontal treatment need.

The antitumor effects of herbal medicine Triphala on oral cancer by inactivating PI3K/Akt signaling pathway: based on the network pharmacology, molecular docking, in vitro and in vivo experimental validation.

BACKGROUND: This research aimed to investigate the anti-tumor effects and underlying genetic mechanisms of herbal medicine Triphala (TRP) in oral squamous cell carcinoma (OSCC). METHODS: The target genes of Triphala (TRP) in oral squamous cell carcinoma (OSCC) were identified, and subsequent functional enrichment analysis was conducted to determine the enriched signaling pathways. Based on these genes, a protein-protein interaction network was constructed to identify the top 10 genes with the highest degree. Genes deregulated in OSCC tumor samples were identified to be hub genes among the top 10 genes. In vitro experiments were performed to investigate the influence of TRP extracts on the cell metabolic activity, migration, invasion, apoptosis, and proliferation of two OSCC cell lines (CAL-27 and SCC-9). The functional rescue assay was conducted to investigate the effect of applying the inhibitor and activator of an enriched pathway on the phenotypes of cancer cells. In addition, the zebrafish xenograft tumor model was established to investigate the influence of TRP extracts on tumor growth and metastasis in vivo. RESULTS: The target genes of TRP in OSCC were prominently enriched in the PI3K-Akt signaling pathway, with the identification of five hub genes (JUN, EGFR, ESR1, RELA, and AKT1). TRP extracts significantly inhibited cell metabolic activity, migration, invasion, and proliferation and promoted cell apoptosis in OSCC cells. Notably, the application of TRP extracts exhibited the capacity to downregulate mRNA and phosphorylated protein levels of AKT1 and ESR1, while concomitantly inducing upregulation of mRNA and phosphorylated protein levels in the remaining three hub genes (EGFR, JUN, and RELA). The functional rescue assay demonstrated that the co-administration of TRP and the PI3K activator 740Y-P effectively reversed the impact of TRP on the phenotypes of OSCC cells. Conversely, the combination of TRP and the PI3K inhibitor LY294002 further enhanced the effect of TRP on the phenotypes of OSCC cells. Remarkably, treatment with TRP in zebrafish xenograft models demonstrated a significant reduction in both tumor growth and metastatic spread. CONCLUSIONS: Triphala exerted significant inhibitory effects on cell metabolic activity, migration, invasion, and proliferation in OSCC cell lines, accompanied by the induction of apoptosis, which was mediated through the inactivation of the PI3K/Akt pathway.

Preoperative dental screening can reduce periprosthetic infections of hip and knee endoprostheses in the first month after surgery: results of a cohort study.

PURPOSE: The oral cavity and, in particular, potential oral foci might pose a risk of periprosthetic joint infection (PJI). The aim of this cohort study was to determine whether practical preoperative dental screening would reduce the prevalence of early PJI in the first month after surgery. METHODS: Patients attending a specialized endoprosthesis implantation clinic between 2018 and 2022 were recruited. Two groups were examined. The test group consisted of patients attending the clinic between 2020 and 2022 and who were referred to their family dentist using a standardized form. The comparison group consisted of patients who were treated in the clinic between 2018 and 2020. They were not referred to their family dentist. The two groups were compared for the prevalence of PJI. Univariate analysis followed by multiple logistic regression was performed to confirm risk factors for PJI in this cohort. RESULTS: 2560 individuals (test group: 1227, comparison group: 1333) were included. The prevalence of PJI was significantly lower in the test group (0.8% vs. 1.8%, p = 0.04). Multiple logistic regression with PJI as the dependent variable showed that a dental referral was a strong predictor of a lower prevalence of PJI (OR: 0.43, CI95 0.205-0.917, p = 0.03). Male gender was also strongly associated with a higher frequency of PJI (OR: 2.68, CI95 1.32-5.42, p = 0.01). Age (OR: 1.06, CI95 1.01-1.10, p = 0.01) and BMI (OR: 1.11, CI95 1.05-1.17, p < 0.01) had little effect on the risk of PJI. CONCLUSION: Dental referral using a standardized form can reduce the prevalence of early PJI. Accordingly, orthopedists and dentists should collaborate in this practical way.

Oral Health-Related Quality of Life in Adult Patients with Depression or Attention Deficit Hyperactivity Disorder (ADHD).

The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered.

Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure-results of a German cohort.

OBJECTIVES: Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS: Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS: 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI95 1.158-8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS: In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF.

Dental Therapy of Patients Prior to Endoprostheses: A Retrospective, Telephone-Based Cohort Study.

The aim of this study was to assess, whether patients prior to endoprosthesis (EP) visit their dentist for need-oriented therapy and whether this would be associated with the occurrence of complications. Based on a cohort of patients, which was orally investigated prior to EP surgery between 04/2020 and 12/2021, a telephone interview was performed at least six months after EP implantation. Patients were classified into either low-risk (LR), moderate-risk (MR), or high-risk (HR) groups. Participants were interviewed based on a structured questionnaire regarding dental visits, dental therapy, and potential complications during the observational period. Out of the 311 patients from the baseline cohort, 96 patients after EP implantation could be included (participation rate of 31%). Nineteen patients were in LR (20%), 41 in MR (43%), and 36 in the HR group (37%). Overall, 79% (n = 76) of the patients followed the recommendation to visit their dentist; 94% of patients within the HR group visited the dentist (p = 0.02). Dental treatment procedures included tooth cleaning (57%), periodontal treatment (31%), restorative therapy/filling (28%), and tooth extraction (28%). In 64% of the HR patients (n = 23), the potential oral foci with a risk of EP infection were eliminated by their general dentist. Fourteen different complications occurred within the observation period, without any group effect (p > 0.05). In conclusion, most patients prior to EP visit their general dentist following referral, especially if they have a potential oral focus. The effect of dental clearance on infectious complications of EP remains unclear, whereby further clinical studies are needed.

Evaluation of a concept to classify anamnesis-related risk of complications and oral diseases in patients attending the clinical course in dental education.

BACKGROUND: Aim of the current study was the assessment of risk classes according to a previously established system to classify the anamnesis-related risk of complications and of oral diseases in a cohort of patients attending the dental student course for dental preventive measures. METHODS: Patients attending the student course between April 2020 and December 2021 were included. To assess the medical history, a specific anamnesis tool was used, which included the classification of different potential anamneis-related risks originating from general diseases, medications or lifestyle factors into a low, moderate or high risk of complications and/or risk of oral diseases. Thereby, the risk of complications was defined as the increaeed probability of harm during dental measures (professional tooth cleaning, invasive dental treatment or any kind of manipulation, which may cause a bacteremia), e.g. infectious endocarditis. On the other hand, the risk of oral diseases was an increaeed probability of development and/or progression of oral diseases like caries, periodontitis or mucosal diseases. Those risk classes were subsequently analyzed under consideration of age and gender. RESULTS: 858 patients, with a mean age of 50.48 ± 20.72 [median: 52.0] years, and a nearly balanced gender distribution (50.8% female and 49.2% male) were included. In the overall cohort, the risk of complications related with dental measures was low in 38.3%, moderate in 42.4% and high in 19.3% of participants. The risk of oral diseases was low in 33.1%, moderate in 37.2% and high in 29.7% of participants. Both, the risk of complications and the risk of oral diseases increased with patients' age (p < 0.01). Thereby, the risk of complications as well as the risk of oral diseases related to general diseases and medication significantly increased with age (p < 0.01). CONCLUSION: Nearly one fifth of patients in dental student couse show a high risk of complications related with dental measures. Morever, nearly one third of those individuals have a high anamnesis-related risk of oral diseases. With increasing age, the amount of patients in high risk classes becomes higher. Future dental education and research should address the high relevance of anamnesis-related risk factors.

Oral Health Screening for Risk Reduction for Early Periprosthetic Joint Infections of Hip and Knee Endoprostheses-Results of a Prospective Cohort Study.

This prospective observational study had two aims: (I) to assess whether a preoperative dental screening before endoprosthesis (EP) implantation with need-based dental intervention would decrease the prevalence of periprosthetic joint infection (PJI) and (II) to evaluate whether instructed orthopedic surgeons would achieve similar results in oral screening as dentists. The preoperative oral health statuses of the patients, prior to EP insertion, were either evaluated by the patients' general dentists (Ia) or, if the patient had not visited a general dentist, by an instructed orthopedic surgeon (Ib). Both the dentist and orthopedic surgeon used standardized risk estimation (low risk, moderate risk, and high risk) for an oral-health-related infectious complication after EP insertion, including a recommendation for further management of the patient. If required, a need-based dental rehabilitation was performed. In addition, retrospective data evaluation of a comparison group (II) was performed, which had not been screened orally preoperatively. A total of 777 patients (screening group (I): n = 402, of which 229 were screened by a dentist (Ia), 173 were screened by an orthopedic surgeon (Ib); comparison group (II): n = 375) were included. No general association between early infection rate and preoperative oral screening in general was found (1% PJI in screening group (I), 1.6% PJI in comparison group (II); p = 0.455). However, screening performance (dentist vs. orthopedic surgeon) had a significant impact on the prevalence of developed PJIs (p = 0.021). Thereby, 100% of observed infections in the screening group (I) occurred in the group with previous oral screening by an orthopedic surgeon (Ib). Furthermore, the C-reactive protein (CRP) value at discharge was significantly lower when general preoperative oral screening had been performed (group I vs. group II, p = 0.03). Only preoperative oral screening by a dentist had the potential to reduce oral-focus-associated EP infections; therefore, increased attention should be paid to the further promotion of interdisciplinary work between dentists and orthopedic surgeons. Dental screenings, using objectifiable criteria, as applied in this study, seem reasonable but require further validation in larger cohorts.

The rosetta stone of successful ageing: does oral health have a role?

Ageing is an inevitable aspect of life and thus successful ageing is an important focus of recent scientific efforts. The biological process of ageing is mediated through the interaction of genes with environmental factors, increasing the body's susceptibility to insults. Elucidating this process will increase our ability to prevent and treat age-related disease and consequently extend life expectancy. Notably, centenarians offer a unique perspective on the phenomenon of ageing. Current research highlights several age-associated alterations on the genetic, epigenetic and proteomic level. Consequently, nutrient sensing and mitochondrial function are altered, resulting in inflammation and exhaustion of regenerative ability.Oral health, an important contributor to overall health, remains underexplored in the context of extreme longevity. Good masticatory function ensures sufficient nutrient uptake, reducing morbidity and mortality in old age. The relationship between periodontal disease and systemic inflammatory pathologies is well established. Diabetes, rheumatoid arthritis and cardiovascular disease are among the most significant disease burdens influenced by inflammatory oral health conditions. Evidence suggests that the interaction is bi-directional, impacting progression, severity and mortality. Current models of ageing and longevity neglect an important factor in overall health and well-being, a gap that this review intends to illustrate and inspire avenues for future research.

Dental Caries in Adult Patients with Rheumatoid Arthritis-A Systematic Review.

Patients suffering from rheumatoid arthritis (RA) are repeatedly affected by oral diseases or complaints, including xerostomia, periodontitis and dental caries. The aim of this systematic review was the evaluation of caries prevalence and/or incidence in patients with RA. Within this review, there is a systematic search of the literature based on PubMed, Web of Science and Scopus. Two independent researchers performed the search in February 2023. The search terms were "dental caries" AND "rheumatoid arthritis". Additionally, a manual search completed the review process. Studies on adult patients (age ≥ 18 years) only suffering from RA were included. Studies had to explicitly report on the prevalence or incidence of dental caries. The respective studies were checked regarding suitability and, if they were eligible, analyzed qualitatively. A quality appraisal was performed for all of the analyzed studies. A total of 336 studies were detected, of which 16 studies met the in- and exclusion criteria. The sample sizes of the clinical investigations ranged between 13 and 1337 participants. Twelve studies evaluated a healthy control group. In 8/12 studies, a significant difference in the prevalence/incidence of caries was found between RA patients and controls. The majority of the studies applied the decayed (DT), missing and filled teeth index (DMFT) for the diagnosis of caries. On average (mean value), 0.8 to 5.79 carious teeth per patient were reported across the studies. There was no information on the stadium, activity or location of caries (e.g., root caries) in any study. Quality appraisal revealed a moderate quality for most studies. In conclusion, caries prevalence was heterogeneous across studies, while a higher caries prevalence was repeatedly reported in RA patients against controls. Further research regarding dental caries in RA appears recommendable; multidisciplinary, patient-centered dental care for patients with RA should be fostered to improve patients' dental health status.

Systematic Review on Protocols of Coenzyme Q10 Supplementation in Non-Surgical Periodontitis Therapy.

This systematic review focuses on the different study protocols on CoQ10 as an adjunct in non-surgical periodontitis therapy. The study protocol was developed following PRISMA guidelines and was registered in PROSPERO (CRD42021156887). A sensitive search up to January 2022 considered MEDLINE via PubMed and Web of Science, Embase, Web of Science Core Collection via Web of Science, Google Scholar, Cochrane CENTRAL, WHO (ICTRP), ClinicalTrials.gov, and grey literature. Randomized controlled (SRP with/without placebo) clinical trials (RCTs) on all types of CoQ10 administration were included. The primary outcome was probing pocket depth (PPD). Secondary outcomes were bleeding on probing, clinical attachment loss, and gingival and plaque indices. Twelve RCTs with local and five with systemic CoQ10 administration were included. The study protocols were heterogeneous. Local CoQ10 administration was performed once or several times in a period up to 15 days. Systemic CoQ10 was applied twice or three times daily for six weeks up to four months. The reporting quality was low, including missing information about CoQ10 doses. Risk of bias was high or unclear. About half of the studies reported significant group differences for PPD. Until now, no statement on the effectiveness of CoQ10 in non-surgical periodontitis therapy is possible. Further high-quality RCTs are necessary and should consider the protocol recommendations of this review.

Lack of oral health awareness and interdisciplinary dental care: a survey in patients prior to endoprosthesis and orthopaedic centres in Germany.

OBJECTIVES: This cross-sectional survey aimed to evaluate the oral health behaviour of patients prior to endoprosthesis (EP), as well as the handling of oral health topics by German orthopaedic surgeons. MATERIALS AND METHODS: Consecutive patients prior to EP answered a questionnaire regarding oral health behaviour, oral hygiene, oral complaints and information on the relationship between EP and oral health. Another questionnaire was digitally mailed to orthopaedic centres throughout Germany. This questionnaire included the importance of oral health for EP and issues on dental referrals/consultations prior to EP. RESULTS: A total of 172 patients were included in the study, of whom 35.5% of patients reported that they were informed about oral health and EP. Half of the individuals reported regular professional tooth cleaning, and less than one-third (29.1%) reported of the performance of interdental cleaning. Information on oral health and EP was associated with regular professional tooth cleaning (yes: 59.8% vs. no: 35.6%, p = 0.01). A total of 221 orthopaedic clinics were included in the study, of which only a few had dental contact (14%), although the majority (92.8%) of the clinics were familiar with causal relationships between oral health and EP infections. Less than half of the centres reported of either verbal (48%) or written (43.9%) referrals for their patients to the dentist. University Medical Centres reported of more frequent dental contacts (p < 0.01). CONCLUSION: Prior to EP, patients exhibited deficits in oral health behaviour, and orthopaedic clinics exhibited a lack of dental collaboration. Improvements in interdisciplinary care, especially regarding practical concepts for patient referral and education on oral health, appear to be necessary.

Prevalence of Dental Caries in Patients on Renal Replacement Therapy-A Systematic Review.

Patients under renal replacement therapy (RRT) often show oral problems, including dry mouth, periodontal and dental diseases. This systematic review aimed to evaluate the caries burden in patients on RRT. Therefore, a systematic literature search based on the databases PubMed, Web of Science and Scopus was performed by two independent individuals in August 2022. Search terms were: "caries" AND "dialysis", "caries" AND "renal replacement therapy", "caries" AND "kidney". The systematic process was complemented by manual search. Studies on adult patients (age ≥ 18 years), treated by any form of RRT and explicitly reporting caries prevalence or incidence were checked for their eligibility and subsequently analyzed qualitatively. For all included studies, a quality appraisal was applied. From the systematic search, 653 studies were identified, of which 33 clinical investigations were included in the qualitative analysis. The majority (31 studies) of all included patients underwent hemodialysis (HD), with a sample size between 28 and 512 participants. Eleven studies investigated a healthy control group. Oral examinations were heterogeneous across studies; the caries burden was primarily assessed by decayed-(D-T), missing- and filled-teeth index (DMF-T). The number of decayed teeth ranged between 0.7 and 3.87 across studies. Only six out of these 11 studies found significant differences in caries prevalence/incidence between RRT and controls, whereby only four studies confirmed worse caries burden in RRT individuals. No information was provided on caries stadium (initial caries, advanced caries, invasive treatment need), caries activity or location (e.g., root caries) across studies. Most of the included studies were assessed to be of moderate quality. In conclusion, patients on RRT suffer from a high prevalence of dental caries. Alongside a need for further research in the field, improved, multidisciplinary, patient-centered dental care concepts are required to support dental and overall oral health in individuals on RRT.

Laser fluorescence is a predictor of lesion depth in non-cavitated root carious lesions - an in vitro study.

BACKGROUND: This in vitro study was designed to compare the assessment of carious root surfaces using laser fluorescence or visual assessment and µCT. METHODS: A total of 107 extracted human teeth were included in the study. For the subsequent assessment, a clinical evaluation according to Ekstrand and Nyvad criteria, laser fluorescence measurements (DIAGNOdent-Pen©), and µCT imaging (Bruker Skyscan 1172) of the included root surfaces were performed. For cavitated lesions, the surface was reconstructed on µCT. Target parameters were: clinical appearance, laser fluorescence reading (0-99), and lesion depth in µm (µCT). The statistical analysis included chi² and Spearman-Rho tests. RESULTS: Laser fluorescence values were significantly higher (p < 0.01) in leathery non-cavitated (median [IQR]: 73.50 [48.00]) and cavitated (88.50 [29.00]) surfaces than in hard intact surfaces (7.00 [35.00]). In addition, laser fluorescence values showed a significant correlation with lesion depth for non-cavitated surfaces (0.750; p < 0.01). Further statistically significant correlations were not detectable. Regression analysis showed that the laser fluorescence values increased with increasing demineralization depth (ß: 0.648, CI95: 0.631-1.053; p < 0.01). CONCLUSION: Laser fluorescence measured by DIAGNOdent© is a predictor for the depth of demineralization in carious root caries lesions with intact surfaces. Considering the limitations of this in vitro study, laser fluorescence is suitable for assessing the depth extent of (non-cavitated) root caries lesions and is a tool for clinical diagnosing and assessing the course of lesion development.

Influence of dental prophylaxis procedures on the tooth veneer interface in resin-based composite and polymer-infiltrated ceramic veneer restorations: an in vitro study.

OBJECTIVES: The aim of this study was to investigate the influence of dental prophylaxis cleaning procedures and artificial aging on veneers in human teeth. The external marginal and internal tooth veneer as well as the restoration surfaces were examined. MATERIAL AND METHODS: Thirty-two extracted premolars were restored with resin-based composite (RBC) and polymer-infiltrated ceramic network (PICN) veneers. Artificial aging by alternating thermocycling and subsequent prophylaxis procedure (glycine-based powder air polishing or ultrasonic scaling) was conducted for five consecutive cycles. The external marginal interface was examined by height profile measurements and the internal interface was investigated using micro X-ray computed tomography. In addition, the surface texture of the veneer surface was analyzed using confocal laser scanning microscopy. RESULTS: The application of both prophylaxis procedures resulted in a deepening of the marginal interface (10 µm ± 8 µm) for materials. Furthermore, the internal interface of PICN restorations showed marginal gaps after both treatments and artificial aging (16 µm ± 3 µm). In contrast to the RBC specimens, a significant increase in surface roughness was identified for PICN veneers after ultrasonic scaling. CONCLUSIONS: The marginal and internal interface regions in veneers fabricated from PICN and RBC were affected by prophylaxis procedures. Furthermore, it may result in increased veneer surface roughness, especially in PICN and after ultrasonic scaling, which might affect bioadhesion and longevity. CLINICAL RELEVANCE: After dental prophylaxis procedures, examination of the marginal and the internal interface as well as the veneer surface provides a precise insight into damage mechanisms and offers an assessment of longevity.

Association between oral health and oral health-related quality of life in patients before hip and knee endoprosthesis surgery: a cross-sectional study.

OBJECTIVES: Aim of this cross-sectional study was the assessment of oral health-related quality of life (OHRQoL) health-related quality of life (HRQoL), oral health behaviour and oral health status in patients before hip and knee endoprosthesis (EP) surgery. Moreover, associations between OHRQoL, HRQoL and oral health should be examined. METHODS: Consecutive patients before hip and/or knee EP implantation were recruited and referred to the dental clinic for oral examination including: number of remaining teeth, dental findings (DMF-T-Index), periodontal condition (periodontal treatment need, Staging/Grading) and temporomandibular joint screening. OHRQoL was assessed by the German short form of oral health impact profile (OHIP G14), HRQoL by short-form 36 survey. RESULTS: Hundred and sixty two patients with a mean age of 66.80 ± 11.10 years were included, which had on average 18.22 ± 8.57 remaining teeth and a periodontal treatment need of 84.5%. The OHIP G14 sum score revealed a median of 1 (mean: 2.7 ± 4.4, 25-75th percentile: 0-4) and its dimension oral function of 0 (mean: 0.8 ± 1.8, 25-75th percentile: 0-1), what was also found for psychosocial impact (median: 0, mean: 1.4 ± 2.6, 25-75th percentile: 0-2). The OHIP G14 sum score and both dimensions were significantly associated with mental component summary (p < 0.01). A higher number of remaining teeth as well as remaining molars/premolars were associated with lower OHIP G14 sum score (p = 0.02). This was also found for the dimension oral function (p < 0.01). CONCLUSION: Patients prior to hip and knee EP had an unaffected OHRQoL, although they had an insufficient oral health. Individuals before EP implantation need increased attention in dental care, fostering information, sensibilization and motivation of the patients.

Salivary Diagnostic for Monitoring Strenuous Exercise-A Pilot Study in a Cohort of Male Ultramarathon Runners.

Intense physical stress, such as that in ultramarathon running, affects the immune system. For monitoring in sports medicine, non-invasive methods, e.g., salivary analysis, are of interest. This pilot cohort study aimed to assess changes in salivary parameters in response to an ultramarathon. The results were compared to blood parameters. Male, healthy finishers (n = 9, mean age: 48 ± 8.8 years, mean height: 1.8 ± 0.1 m, mean weight: 72.5 ± 7.2 kg, mean BMI: 23.5 ± 1.9 kg/cm²) of a 160 km ultramarathon were included. Saliva and blood samples were collected at three time points: T1 (baseline), T2 (shortly after the ultramarathon) and T3 (after recovery). In saliva, cortisol, testosterone, IL-1ß, IL-6, IL-8, IL-10, TNF-α, albumin, IgA, α-amylase, aMMP-8, and neopterin were assessed via ELISA. In blood, cortisol, testosterone, IL-1ß, IL-6, IL-8, IL-10, TNF-α, blood cell counts, procalcitonin, CRP, osmolality, albumin, and α-amylase were analyzed. The statistical evaluation comprised longitudinal testing and cross-sectional testing between saliva and blood using ratios of T2 and T3 to baseline values. Various parameters in saliva and blood changed in response to the ultramarathon. Comparing blood and saliva, the longitudinal changes of testosterone (p = 0.02) and α-amylase (p = 0.03) differed significantly. Despite the limitations of the study, it underlines that saliva is an interesting option for comprehensive monitoring in sports medicine and necessitates further studies.

Identifying crosstalk genetic biomarkers linking a neurodegenerative disease, Parkinson's disease, and periodontitis using integrated bioinformatics analyses.

Objective: To identify the genetic linkage mechanisms underlying Parkinson's disease (PD) and periodontitis, and explore the role of immunology in the crosstalk between both these diseases. Methods: The gene expression omnibus (GEO) datasets associated with whole blood tissue of PD patients and gingival tissue of periodontitis patients were obtained. Then, differential expression analysis was performed to identify the differentially expressed genes (DEGs) deregulated in both diseases, which were defined as crosstalk genes. Inflammatory response-related genes (IRRGs) were downloaded from the MSigDB database and used for dividing case samples of both diseases into different clusters using k-means cluster analysis. Feature selection was performed using the LASSO model. Thus, the hub crosstalk genes were identified. Next, the crosstalk IRRGs were selected and Pearson correlation coefficient analysis was applied to investigate the correlation between hub crosstalk genes and hub IRRGs. Additionally, immune infiltration analysis was performed to examine the enrichment of immune cells in both diseases. The correlation between hub crosstalk genes and highly enriched immune cells was also investigated. Results: Overall, 37 crosstalk genes were found to be overlapping between the PD-associated DEGs and periodontitis-associated DEGs. Using clustering analysis, the most optimal clustering effects were obtained for periodontitis and PD when k = 2 and k = 3, respectively. Using the LASSO feature selection, five hub crosstalk genes, namely, FMNL1, MANSC1, PLAUR, RNASE6, and TCIRG1, were identified. In periodontitis, MANSC1 was negatively correlated and the other four hub crosstalk genes (FMNL1, PLAUR, RNASE6, and TCIRG1) were positively correlated with five hub IRRGs, namely, AQP9, C5AR1, CD14, CSF3R, and PLAUR. In PD, all five hub crosstalk genes were positively correlated with all five hub IRRGs. Additionally, RNASE6 was highly correlated with myeloid-derived suppressor cells (MDSCs) in periodontitis, and MANSC1 was highly correlated with plasmacytoid dendritic cells in PD. Conclusion: Five genes (i.e., FMNL1, MANSC1, PLAUR, RNASE6, and TCIRG1) were identified as crosstalk biomarkers linking PD and periodontitis. The significant correlation between these crosstalk genes and immune cells strongly suggests the involvement of immunology in linking both diseases.

Comparison of PRISM and numeric scale for self-assessment of learning progress during a clinical course in undergraduate dental students.

OBJECTIVES: To compare Pictorial Representation of Illness and Self-Measure (PRISM) and a numeric scale for self-reflection in dental students. METHODS: Fourth year dental students were randomly assigned to each receive one interview based on PRISM or a numeric scale to self-assess their competencies at the beginning (t1), the middle (t2) and the end (t3) of integrated clinical course. Questionnaires were used to assess self-perceived benefit of the interviews at each time points. RESULTS: Students in PRISM group perceived a higher benefit regarding the self-assessment of their practical skills at all time points (P < 0.05), for theoretical knowledge at t2 and t3 (P < 0.05) and reaching the course objectives at t3 (P = 0.04). At all time points, PRISM group rated their interview (P = 0.04), the applied instrument (PRISM, P = 0.01) and the benefit of the combination of both higher than numeric scale group (P < 0.05). CONCLUSION: In this preliminary study, PRISM was superior against a numeric scale and can be recommended for dental education to facilitate self-assessment.