Treatment of Gingival Recession Defects with Pouch and Tunnel Technique Using Connective Tissue Graft and Lyophilized Chorion Membrane in Smokers.

BACKGROUND The chorion membrane has been used for several decades as an allograft in tissue repair and various periodontal regenerative procedures. The present study, conducted at a single center in India, aimed to evaluate and compare the clinical outcomes of 26 gingival recession sites in chronic smokers treated using a pouch and tunnel technique with connective tissue graft (CTG) and lyophilized chorion membrane (LCM). MATERIAL AND METHODS The study included 22 smokers with 26 sites of recession defect, with Miller's class I and class II gingival recession, which were allotted into control and test groups. The control group (13 sites) was treated with CTG, and the test group (13 sites) was treated with LCM. Clinical parameters like recession depth, recession width, relative clinical attachment level (RCAL), relative gingival position, width of attached gingiva, and width of keratinized gingiva were recorded at baseline and 6 months postoperatively. Visual analogue scores for pain and wound-healing index scores were assessed in the first week after surgery. RESULTS All clinical parameters showed significant improvements from baseline to 6 months postoperatively in the control and test groups. Recession width, RCAL, width of attached gingiva, and width of keratinized gingiva demonstrated significant differences, whereas mean root coverage percentage and recession depth did not show any significant differences between the study groups at 6 months postoperatively. CONCLUSIONS This study supports the role of LCM allograft as a scaffold to promote soft tissue regeneration and has demonstrated a favorable role for its use in root coverage procedures in patients who smoke.

The effect of clear aligners on speech: a systematic review.

OBJECTIVE: To assess the effect of clear aligners on the speech of patients undergoing orthodontic therapy through a systematic review of the literature. Search methods and selection criteria: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694. An electronic search of the Scopus, Embase, Pubmed, and Web of Science databases was done for papers published between January 2000 till September 2021. Studies that evaluated speech difficulties in patients undergoing orthodontic treatment with clear aligners using objective and subjective analyses were included. The evaluated primary outcome was speech difficulties. Secondary outcomes were time to adaptation and recovery from speech difficulties. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions Handbook guidelines and ROBINS-I tool. RESULTS: Two hundred and eighty-three articles were screened to identify seven studies (n = 332 patients) that assessed speech difficulty with aligners, of which two were randomized trials. Meta-analysis was not performed due to the heterogeneity in the study designs. Five studies compared speech difficulty with aligners to fixed appliances. Two studies showed a moderate risk of bias and five studies had a serious risk of bias. Level of evidence was downgraded to low due to the methodological insufficiencies and risk of bias in the studies. All seven studies reported that aligners could influence the clarity and delivery of speech, similar to fixed appliances. Various phonemes were affected including /s/,/z/,/zh/,/sh/,/th/,/ch/ on wearing aligners. Errors in articulation of consonants and sibilants were noted with lisping and speech impairment. These speech difficulties were temporary and most patients recovered in 7-14 days while few patients took 30-60 days to recover. CONCLUSION: The likelihood of speech difficulties appears high with clear aligners. However, patients adapt quickly and speech returns to normal. The results of this review must be interpreted with caution and more well-designed randomized trials examining long-term effects of aligners on speech are indicated. CLINICAL SIGNIFICANCE: Orthodontists should counsel patients opting for clear aligner treatment of the potential transient speech difficulties. REGISTRATION: The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694.

A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report.

AIM: This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). BACKGROUND: Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. CASE DESCRIPTION: A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. CONCLUSION: This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. CLINICAL SIGNIFICANCE: Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.

Intake of Artificial Sweeteners by Children: Boon or Bane?

BACKGROUND: Sugar is the main culprit in many health dysfunctions. Excessive sugar intake can negatively affect oral health, precipitate diabetes, and lead to weight gain and obesity. Sucrose is the primary form of sugar, and is strongly correlated with dental caries. Artificial sweeteners are chemically synthesized sugar substitutes that are generally regarded as being low-calorie. OBJECTIVE: This review examines the current evidence in the literature for the need for artificial sweeteners and outlines its implications for the health of children. We briefly outline its adverse effects, and concerns regarding their safety. REVIEW RESULTS: Artificial sweeteners are a widely used food additive. Six main artificial sweeteners are approved by the food and drug administration (FDA). The conflicting results and divergent regulatory norms of each sweetener are a constant cause of concern and debate. However, most studies have spotlighted the beneficial effects of artificial sweeteners. Dental caries diminish with the increase in sweetener intake. An increase in appetite and eventually weight gain is observed in individuals consuming artificial sweeteners. CONCLUSION: Artificial sweeteners are indeed a bane according to present studies, although more research on recently discovered non-nutritive artificial sweeteners is required. It also has a positive effect on overall health disorders. If one curbs the onset of dental caries, then the eventual rise is highly unlikely. CLINICAL SIGNIFICANCE: Artificial sweeteners' effect on lowering dental caries will help to reduce the caries index in general. Oral hygiene is maintained, and the growth of oral bacterium is depressed. Research on novel sweeteners will help to compare their efficacy in caries prevention compared to existing ones. It is necessary to educate people on artificial sweeteners and its implication as one can use them by being aware of their properties.

Evaluation of Orthodontic Mini-Implant Placement in the Maxillary Anterior Alveolar Region in 15 Patients by Cone Beam Computed Tomography at a Single Center in South India.

BACKGROUND In this study, we aimed to evaluate orthodontic mini-implant placement in the maxillary anterior alveolar region by cone beam computed tomography (CBCT) in 15 patients at a single center in South India. MATERIAL AND METHODS A total of 15 CBCT scans of orthodontic patients after completion of leveling and aligning stage were included. The thickness of labial alveolar bone, labio-palatal bone, and inter-radicular distance between the maxillary central incisors (U1-U1), maxillary central and lateral incisor (U1-U2), and maxillary lateral incisor and canine (U2-U3) at vertical levels 4 mm, 6 mm, and 8 mm above the interdental cementoenamel junction were measured. Descriptive statistics, ANOVA, and Tukey post hoc tests were done to assess the differences among the groups. An independent t test was done to analyze differences by sex. RESULTS The thickness of cortical bone in the labial region was higher in the U2-U3 site than in the U1-U1 site, at a height of 4 mm. Also, there was a significant difference between 4 mm and 8 mm heights in the U2-U3 region. No significant difference was noted in bone dimensions among men and women and in the labio-palatal bone thickness among the different sites. The inter-radicular distance was the highest between the U2-U3 site, while it was the lowest in the U1-U2 site. CONCLUSIONS The findings from this center showed that when CBCT was used to evaluate orthodontic mini-implant placement in the maxillary anterior alveolar region, the U2-U3 and U1-U1 locations at heights between 6 mm to 8 mm apical to the interdental cementoenamel junction were optimal for placement of the mini-implants.

Root Membrane Concept: Shield the Socket-A Case Report.

Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique. Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield.

Allicin May Promote Reversal of T-Cell Dysfunction in Periodontitis via the PD-1 Pathway.

We evaluated the role of allicin in periodontitis using an in silico and in vitro design. An in silico docking analysis was performed to assess the plausible interactions between allicin and PD-L1. The cytokine profile of gingival crevicular fluid (GCF) samples obtained from periodontitis patients was estimated by cytometric bead array. CD3+ lymphocytes isolated from the peripheral blood were sorted and characterized using immunomagnetic techniques. Cultured and expanded lymphocytes were treated with the GCF samples to induce T-cell exhaustion. Optimum concentrations of allicin were added to exhausted lymphocytes to compare the expression of TIM-3 and LAG-3 gene expression at baseline and post-treatment. Allicin was found to bind to the PD-L1 molecule as revealed by the in-silico experiment, which is possibly an inhibitory interaction although not proven. GCF from periodontitis patients had significantly higher concentrations of TNF-α, CCL2, IL-6, IFN-γ, and CXCL8 than controls. GCF treatment of CD3+ lymphocytes from the periodontitis patients significantly increased expression of T-cell exhaustion markers TIM-3 and LAG-3. Allicin administration with GCF treatment resulted in significant lowering of the expression of exhaustion markers. Allicin may exert an immunostimulatory role and reverse immune-destructive mechanisms such as T-cell exhaustion.

Synergistic Effect of Biphasic Calcium Phosphate and Platelet-Rich Fibrin Attenuate Markers for Inflammation and Osteoclast Differentiation by Suppressing NF-κB/MAPK Signaling Pathway in Chronic Periodontitis.

BACKGROUND: Periodontitis is characterized by excessive osteoclastic activity, which is closely associated with inflammation. It is well established that MAPK/NF-kB axis is a key signaling pathway engaged in osteoclast differentiation. It is stated that that biphasic calcium phosphate (BCP) and platelet-rich fibrin (PRF) have significant antiostoeclastogenic effects in chronic periodontitis. OBJECTIVE: We aimed to elucidate the synergetic effect of PRF/BCP involvement of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) and the mitogen-activated protein kinase (MAPK) signaling pathway in osteoclast differentiation in chronic periodontitis. METHODS: We induced osteoclast differentiation in vitro using peripheral blood mononuclear cells (PBMCs) derived from patients with chronic periodontitis. We assessed osteoclast generation by tartrate-resistant acid phosphatase (TRAP) activity, proinflammatory cytokines were investigated by ELISA and NF-κB, and IKB by immunoblot, respectively. MAPK proteins and osteoclast transcription factors were studied by Western blot analysis and osteoclast transcriptional genes were assessed by RT-PCR. RESULTS: The results showed that the potent inhibitory effect of PRF/BCP on osteoclastogenesis was evidenced by decreased TRAP activity and the expression of transcription factors, NFATc1, c-Fos, and the osteoclast marker genes, TRAP, MMP-9, and cathepsin-K were found to be reduced. Further, the protective effect of PRF/BCP on inflammation-mediated osteoclastogenesis in chronic periodontitis was shown by decreased levels of proinflammatory cytokines, NF-kB, IKB, and MAPK proteins. CONCLUSIONS: PRF/BCP may promote a synergetic combination that could be used as a strong inhibitor of inflammation-induced osteoclastogenesis in chronic periodontitis.

Metformin pre-conditioning enhances the angiogenic ability of the secretome of dental pulp stem cells.

The aim of the present study was to assess the influence of metformin on the angiogenic ability of secretomes from dental pulp stem cells. The stem cells were obtained from the dental pulp (DPSCs) (n = 3) using the explant culture method. We treated the DPSCs with different concentrations of metformin and assessed the expression of the angiogenesis-related genes. We also tested the angiogenic effect of the secretomes on the yolk sac membrane of the chick embryos by counting the quaternary blood vessel formations on the yolk sac membrane. We found that metformin treatment enhanced the angiogenic potential of the stem cell secretome in a dose-dependent manner. This was evidenced by the increase in the quaternary blood vessel formations in the yolk sac membrane with lower to higher concentrations of metformin. Pre-treatment with metformin modulates the angiogenic potential of the stem cell-conditioned media in a dose-dependent manner. The augmentation of the angiogenic potential of the DPSCs can aid regeneration, especially in scenarios requiring the regeneration of vacuoles.

Comparative analysis of growth factors and chemokine secretions between conventional lingual and labial fixed orthodontic appliances.

BACKGROUND: Orthodontic appliances elicit the secretions of some cytokines, chemokines, and growth factors which further have some significances in the remodeling of periodontium tissues. The significant differential forces applied on the periodontium by different types of orthodontic appliances. The secretion of these factors is indirectly responsible for the proper resorption of bones of the periodontal region through molecular signaling, which further supports to facilitate organized movement of the teeth. Objective: In the present study, we carried out the assessment and comparative analysis of the growth factors and chemokines present in the saliva samples of the human subjects of orthodontic treatment with two different treatment modalities: conventional lingual and labial fixed orthodontic appliances. MATERIALS AND METHODS: Total 40 saliva samples were collected of which 20 subjects were treated with the conventional lingual appliances and 20 subjects with the labial fixed appliances. All the salivary samples were acquired from the subjects after 21 days treatment. Cytometric bead array was performed to assess the growth factors and chemokines in the saliva on the flow cytometer. RESULTS: No significant differences were seen in the growth factor secretion in the saliva of both types of subjects. The same trend was observed for the chemokine secretion in the saliva except CXCL8, CCL11, CCL2, CCL5, and CXCL9. CONCLUSION: The similarity in chemokine and growth factor profile between labial and lingual fixed orthodontic appliances indicates that their molecular mechanisms and overall effect on the periodontium are analogous.

Role of matrix vesicles and crystal ghosts in bio-mineralization.

Matrix vesicles (MVs) are extracellular membrane-bound vesicles of about ~ 50-200 nm in diameter that play a role in the bio-mineralization process of hard tissue formation. The present review is based on the empirical phenomenon of primary mineralization process via matrix vesicle-mediated mechanism with special reference to crystal ghosts as well as the mechanism on the organic-inorganic relationship between matrix vesicles and crystal ghosts, and the transformation that these structures undergo during bio-mineralization.

Is toombak a risk factor for oral leukoplakia and oral squamous cell carcinoma ? A systematic review.

INTRODUCTION: Toombak is a form of smokeless tobacco that is not well known in Western Society but is widely used by the Sudanese population and many others in the sub-Sahara region. However, unlike other smokeless tobacco products, information on the carcinogenic potential of toombak is scarce. The present review explored any potential epidemiological association between the use of toombak and oral leukoplakia and oral squamous cell carcinoma (OSCC). METHODS: Databases including the Web of Science, SCOPUS, EMBASE and PubMed were searched for literature on the potential association between toombak and oral leukoplakia and OSCC. The search also included grey literature. The search period extended from 1990 to 2018. Following data mining, the study selection was conducted by two reviewers independently. RESULTS: Eight studies that satisfied the inclusion criteria were included. Based on these results, there was a threefoldto sevenfold increased risk of developing the oral leukoplakia and oral squamous cell carcinoma among toombak users compared with non-users. CONCLUSION: Based on the results of the systematic review, there is a strong epidemiological evidence to suggest toombak to be a major risk factor for both oral leukoplakia and OSCC. Further studies are necessary to evaluate the molecular pathway of toombak-induced oral carcinogenesis.

Are electronic nicotine delivery systems (ENDs) helping cigarette smokers quit?-Current evidence.

BACKGROUND: Electronic cigarettes (e-cigarettes) and other electronic vaping devices are commonly used as a method to help tobacco smoking cessation. However, the data on their safety and efficacy are currently scarce. The aim of this review was to explore the role of e-cigarettes in tobacco cessation among tobacco users. TYPES OF STUDIES REVIEWED: PubMed, EMBASE, Scopus, Web of Science, and grey literature from January 1990 were searched up to and including September 2018. Two independent reviewers performed the study selection according to eligibility criteria. RESULTS: A total of 13 studies that met the eligibility criteria were included. The majority of studies were done in the USA, and all studies were longitudinal cohort studies. The odds of increased smoking cessation in association with e-cigarette use ranged from onefold to sixfolds. No significant increase in smoking cessation was found among e-cigarette users compared with non-e-cigarette users. Pattern of e-cigarette had positive influence on smoking cessation among users. CONCLUSIONS AND PRACTICAL IMPLICATIONS: E-cigarette use was not significantly associated with increased smoking cessation among cigarette smokers. We also found that pattern of e-cigarette may have significant effect on smoking cessation capability of e-cigarettes. Well-designed randomized controlled clinical trials are needed to assess the clinical efficacy of e-cigarettes in comparison with approved smoking cessation therapies.

The Effect of Partial Corticotomy on the Rate of Maxillary Canine Retraction: Clinical and Radiographic Study.

The study aimed to evaluate, clinically and radiographically, the effect of partial corticotomy of the buccal plate distal to the canine on the rate of maxillary canine retraction. A clinical trial with the split-mouth design was conducted among twenty orthodontic patients, recommended for first premolar extraction with an age range from 13 to 21 years, selected from patients seeking orthodontic treatment in private dental clinics in Jeddah, Kingdom of Saudi Arabia. After extraction of the maxillary right and left first premolar, partial corticotomy was performed distal to the canine on the right side. The canine retraction was carried out with a power chain on both sides extended between the canine and the maxillary first molar. The data collected from the current study were tabulated and statistically analyzed using an independent sample t-test with p < 0.05 considered statistically significant. The rate of canine retraction was significantly higher on the corticotomy side than the control side (p < 0.05). Under the limitations of the present study, it can be concluded that the technique of partial corticotomy of the buccal plate distal to the canine is a straightforward surgical procedure enhancing the rate of canine retraction significantly.

Comparison of Effectiveness of Corticotomy-assisted Accelerated Orthodontic Treatment and Conventional Orthodontic Treatment: A Systematic Review.

AIM: To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment. DATA SOURCES: The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method. STUDY SELECTION: Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors. RESULTS: Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment. CONCLUSION: There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2-3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions. CLINICAL SIGNIFICANCE: Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.

Effectiveness of Various Dental Varnishes in Prevention of Enamel Demineralization around Orthodontic Brackets: An In Vitro Study.

AIM: The present study aimed to assess the efficacy of different dental varnishes in prevention of demineralization of enamel along the orthodontic brackets. MATERIALS AND METHODS: A total of 60 premolars that do not have caries and were extracted for orthodontic purposes were used in this study. Transbond™ Plus was used to bond premolar brackets onto the treated surface of enamel. The teeth were then divided into three groups. Group I: Profluorid varnish, group II: CPP-ACP varnish, and group III: Duraflor™ varnish. A Vickers diamond indenter was used to assess the microhardness of the surface of enamel at baseline, fourth day, and seventh day. RESULTS: A slightly meaner surface microhardness (SMH; 334.20 ± 2.10) was seen in group III when compared with group I (332.16 ± 3.02) and group II (330.40 ± 2.02). The mean SMH was 342.02 ± 0.82 in group I on the fourth day which was slightly higher than that of the baseline values, followed by group III (339.48 ± 0.34) and group II (336.64 ± 1.14). No statistically significant differences were noted between the groups. A higher mean microhardness of 349.84 ± 0.66 was seen in group I on the seventh day, followed by group III (342.26 ± 1.08) and group II (338.18 ± 1.08). A statistically highly significant difference was seen between the groups. CONCLUSION: The present study concluded Profluorid varnish to have maximum potential to reduce demineralization of enamel followed by Duraflor and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group. CLINICAL SIGNIFICANCE: A most common clinical challenge encountered in orthodontic clinical practice is enamel demineralization or white spot lesion (WSL) development throughout the fixed appliance treatment. Thus, the information about several available varnishes is important to prevent demineralization in regular dental practice.

Antibiotics for Periodontal Infections: Biological and Clinical Perspectives.

AIM: The review is to highlight the use of antibiotics in periodontal infections and prevent indiscriminate use of antibiotics. BACKGROUND: Periodontitis is the most common disease of the periodontal attachment apparatus, and its etiological factor can be related to the existence of virulent microorganisms in the dental plaque biofilm which harbors millions of microorganisms. In addition, the pathogenesis of this disease is greatly influenced by the host immune response that leads to the cyclic destruction and healing pattern. REVIEW RESULTS: Periodontitis is mostly treated through mechanical debridement using surgical and nonsurgical therapy. However, many times, this treatment does not render desired results due to poor patient compliance, altered immune response, or other host-related factors. This leads to the administration of antibiotics as an adjunct to mechanical debridement. Antibiotics are useful in eliminating periodontopathic microbes, but these agents should be cautiously used and prescribed only if indicated. CONCLUSION: Indiscriminate use of antibiotics can lead to unforeseen adverse effects as well as the development of resistant strains of microorganisms. CLINICAL SIGNIFICANCE: Hence, it is crucial for the dentists to know the indications, contraindications, undesirable effects, correct choice, and dosage of the antimicrobial agent before prescribing it to their patients thereby ensuring the success of periodontal therapy. Thus, the clinician should keep in mind that the antibiotics are merely adjuncts to mechanical therapy and not its replacement.

Role of salivary transcriptomics as potential biomarkers in oral cancer: A systematic review.

INTRODUCTION: Transcriptomes in saliva can be used as potential biomarkers for both diagnostic and response to treatment in oral squamous cell carcinoma (OSCC). In this review, we explored their application in this increasingly common disease. MATERIALS AND METHODS: PubMed, EMBASE, Scopus, Web of Science and grey literature from January 1990 to May 2017 were searched. Two independent reviewers performed the study selection according to eligibility criteria. RESULTS: A total of nine studies were included. Three studies showed increased expression of DUSP1, IL8, IL1B, OAZ1, SAT1, S100P and two showed increased expression of miRNA-31 among study groups compared to normal healthy controls. The sensitivity ranged from 14% to 100%, while the specificity ranged from 38% to 100%. miRNA-27b had the highest AUC (write in full) of 0.9643 and DUSP1 had the minimum AUC of 0.41. CONCLUSION: Salivary transcriptomics may play an effective role as a robust and non-invasive biomarker sighting tool for the diagnosis and management of OSCC.

Cytokine levels in gingival crevicular fluid during orthodontic treatment with aligners compared to conventional labial fixed appliances: a 3-week clinical study.

Objective: To test the hypothesis that the levels of IL-1ß and TNF-α increased more and IL-1α, IL-2, IL-6, IL-8 increased less, after 3 weeks of treatment with conventional labial fixed appliance and with aligners. Material and methods: Forty patients who were treated either with labial brackets (n = 20) or aligners (n = 20). Gingival crevicular fluid (GCF) samples were collected at baseline and after 21 days. Cytokine levels were evaluated by enzyme-linked immune sorbent assay (ELISA). Plaque index (PI), gingival index (GI), and bleeding on probing (POB) were also examined. Results: The levels of IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α in the GCF were significantly increased in both groups. The levels of IL-2, IL-6, IL-8 increased more in patients treated with aligners compared to those treated by labial fixed appliances. There was a statistically significant difference in change of the mean cytokine levels of IL-1α, IL-2, IL-6, IL-8 and TNF-α compared to labial fixed appliances and aligners. Conclusions: The levels of the six studied cytokines in GCF (IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α) increased after 3 weeks both after treatment with conventional labial fixed appliance and with aligners. IL-1ß and TNF-α showed a prominent increase compared to the other cytokines in the GCF of teeth by both the labial fixed appliance and aligners. However, there were only minor differences in the changes of the cytokine levels from baseline to 3 weeks between the two groups. There were no differences between the groups regarding PI, GI or POB.

Significance of Cephalometric Radiograph in Orthodontic Treatment Plan Decision.

AIM: The lateral cephalometric radiograph is a standard component of clinical records taken for orthodontic diagnosis and treatment planning. The present study was conducted to assess the utility of cephalometric radiography and analysis in modern orthodontic diagnosis and treatment planning. MATERIALS AND METHODS: A research survey was conducted at Jacksonville University School of Orthodontics. Thirty-one residents and faculty were the participants. The survey sample was collected from the university patients' pool. A survey was given to participants at two time points. At the first time point (T1), the participants were given full records without lateral cephalogram. At the second time point (T2), they were given full records with lateral cephalogram. Two measures were analyzed: (1) a change in orthodontic treatment decision and (2) a change in the orthodontic treatment plan. A traditional McNemar's test was used on paired binary data. We used the conditional logistic regression model with robust variance at a participant level to adjust for a participant-level clustering effect to test the difference in treatment decision before and after. A statistical significance was determined at p = 0.05. RESULTS: It was found that 93.6% of the treatment decisions and 70% of the extraction decisions were consistent after the introduction of lateral cephalograms. There was no statistically significant association observed between two outcome measures and the use of cephalograms (p = 0.80). CONCLUSION: Sufficient evidence does not exist to warrant lateral cephalometric radiographs be taken as a part of standard diagnostic records on every individual seeking orthodontic treatment. CLINICAL SIGNIFICANCE: Evidenced-based selection criteria for prescribing lateral cephalometric radiographs should be developed to reduce the amount of radiation exposure to the general public.