Evidence for the Clinical Association between Demodex and Rosacea: A Review.

BACKGROUND: Rosacea is a chronic inflammatory dermatological condition in humans, and its pathogenesis remains unclear. However, the development of rosacea is suspected to be related to Demodex, a microscopic commensal organism that resides in or near hair follicles and sebaceous glands. Although Demodex is known to be a host-specific, obligate commensal organism, it is currently difficult to be cultured in vitro to parasitize and infect other animal hosts. Therefore, direct evidence for a pathogenic role of Demodex in rosacea is currently lacking. SUMMARY: As circumstantial evidence, non-invasive skin-detecting techniques have shown abnormally elevated numbers of Demodex in rosacea patients. Increased cytokine levels such as IL-10, IL-8, and IL-12p70 have been observed in human sebocytes following the Demodex challenge, and acaricides have been found to be effective in rosacea therapy, all point to a close relationship between Demodex and rosacea. Based on these findings, we conducted a comprehensive literature review to summarize the current state of knowledge, research insights, and clinical treatment recommendations for Demodex-associated rosacea, with the ultimate goal of improving patient outcomes.

A smartphone application with a gray card for clinical shade selection: A technique.

Shade selection is an inherently complex procedure, and its accurate reproduction in the definitive restoration involves an in-depth understanding of color science and its effective communication with the dental laboratory technician. A technique is presented that uses a smartphone application (Snapseed; Google LLC) and a gray card for clinical shade selection.

Rehabilitation of the severely resorbed maxilla by using quad zygomatic implant-supported prostheses: a systematic review and meta-analysis.

STATEMENT OF PROBLEM: Quad zygomatic implants have been used as a treatment option for patients with a severely resorbed maxilla. However, data on the average rate of success of the prosthesis, survival of the zygomatic implants, and associated complications are sparse. PURPOSE: The purpose of this systematic review and meta-analysis was to assess prosthetic and zygomatic implant success of treating severe maxillary resorption with prostheses supported by 4 zygomatic implants, with an additional review on potential complications. MATERIAL AND METHODS: A comprehensive search of studies published in English between January 2001 and December 2020 was performed in the PubMed, OVID, EBSCO, and EMBASE databases according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021219468). The population, intervention, comparison, and outcome (PICO) question was "What is the effectiveness of oral rehabilitations using only 4 zygomatic implants placed in severely resorbed maxillae?" The search results were subjected to a systematic review for articles reporting prosthetic success and zygomatic implant survival. Prosthetic success was analyzed by using a fixed-effects inverse-variance model. The random-effects model was adopted for meta-analysis as moderate heterogeneity was identified among studies that reported implant survival in quad zygoma treatments. The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. RESULTS: Of the 82 titles, 7 studies that met the inclusion criteria without an overlap of patient cohorts were quantitatively analyzed for the average rate of prosthetic success and implant survival. All prostheses in the aggregated studies were immediately loaded with acrylic resin interim prostheses replaced by a definitive prosthesis, which consisted of overdentures retained by bar splinting (n=2), metal bar-reinforced prostheses (n=2), fixed screw-retained acrylic resin prostheses (n=34), and screw-retained titanium prostheses with ceramic or acrylic resin teeth (n=75). Technical complications of zygomatic implants included mobility associated with a machined surface and fracture of the abutment screw. The most common prosthetic complications reported were fracture of the definitive prosthesis and loss of the interim prosthesis subsequent to the failure of at least 1 zygomatic implant. The results showed that prostheses supported by quad zygoma implants displayed an overall success of 100% (CI=95%, I2=0.00%, P=.850), whereas zygomatic implants showed a survival rate of 98% (CI=95%, I2=60.48%, P=.040) with minimal implant failures and few complications. CONCLUSIONS: Although the data analysis showed favorable results for rehabilitating severely resorbed maxillae by using quad zygoma with high prosthetic success and high implant survival rate, further long-term clinical studies are required to strengthen the evidence. However, potential implant and prosthetic complications should be considered while planning this treatment approach.

A 10-year (2010 to 2019) scientometric analysis of prosthodontic journals based on SCImago Journal and Country Rank indicators.

STATEMENT OF PROBLEM: Scientometrics is the study of measuring and analyzing scholarly literature. Scientometric analysis to determine the impact of prosthodontic journals on scientific contributions is lacking. PURPOSE: The purpose of this analysis was to compare the quality of prosthodontic journals based on performance indicators over 10 years (2010 to 2019). MATERIAL AND METHODS: The SCImago Journal and Country Rank portal was used to identify various prosthodontic journals under the subject of dentistry. Seven journals publishing in the English language with "Prosthetics" and "Prosthodontics" in the title were identified and analyzed. The statistical analyses of the scientometric indicators for the 7 highest-ranked journals were performed with 1-way analysis of variance (ANOVA) and the Tukey post hoc tests (α=.05). RESULTS: The absolute SCImago journal rank (SJR) was highest at various time periods for the Journal of Prosthetic Dentistry (JPD), International Journal of Prosthodontics (IJP), and Journal of Prosthodontic Research (JPR). The JPD and IJP scored higher SJR than other journals during this period (P<.05). The mean cites per document and the h-index were highest for JPD (P<.05). CONCLUSIONS: Scientometric tools enable the evaluation of journal performance to aid researchers when choosing a journal to which to submit their work. Analysis of the 7 prosthodontic journals revealed the performance of various journals and gives an insight into the journal characteristics for future researchers who wish to submit their scholarly work.

Three-dimensional finite element analysis of zygomatic implants for rehabilitation of patients with a severely atrophic maxilla.

STATEMENT OF PROBLEM: Stresses applied to zygomatic implants have been determined to be transferred mainly to the zygomatic bone; however, consensus regarding the stress distribution pattern in the bone surrounding zygomatic implants has not yet been reached. PURPOSE: The purpose of this 3-dimensional (3D) finite element analysis (FEA) study was to visually compare the stress distribution pattern in 2 different zygomatic implant treatment modalities and evaluate the effect of masseter musculature involvement. MATERIAL AND METHODS: A 3D FEA craniofacial model was constructed from the computed tomography (CT) data of a selected patient with a severely atrophic edentulous maxilla. Modeled zygomatic and conventional implants were inserted into the craniofacial model supporting a prosthesis superstructure. Two types of treatment were considered in the study: 2 zygomatic implants placed bilaterally or 2 zygomatic implants placed in conjunction with at least 2 conventional implants at the anterior maxilla. The models were loaded with a vertical force of 150 N, a lateral force of 50 N, and a distributed occlusal force of 300 N applied to the insertion area of the masseter muscle. The stresses on and deformations of the bones and implants were then observed and compared with and without the involvement of the musculature component. RESULTS: The stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull; however, a difference in distribution pattern was observed when the models were loaded without applying the muscle component. The maximum deformation of bones surrounding the implants occurred in the abutment connection of the conventional anterior implant in the model with an additional conventional anterior implant. CONCLUSIONS: The FEA revealed the stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull. However, the stresses in both models were concentrated in the zygomatic bone when incorporating the muscle component. Therefore, incorporating muscular force into FEA studies could affect the analysis result.

Surface trueness and precision of interim restorations fabricated by digital light processing and CAD-CAM milling systems.

STATEMENT OF PROBLEM: The development of digital dental technologies has enabled clinicians to use additive and subtractive manufacturing techniques to fabricate interim restorations. However, knowledge of the trueness and precision of such restorations fabricated using digital light processing (DLP) and computer-aided design and computer-aided manufacturing (CAD-CAM) methods is limited. PURPOSE: The purpose of this in vitro study was to assess and compare the accuracy of interim crowns fabricated using DLP and CAD-CAM methods. MATERIAL AND METHODS: A typodont mandibular first molar was prepared for a ceramic crown, and a digital scan (Medit T500) was obtained to design interim crowns by using the CAD software program. The CAD data were designated as the reference data. A total of 20 crowns were fabricated by DLP and CAD-CAM technology. The fabricated interim crowns were further scanned using a laboratory scanner and were superimposed with the CAD data by using a 3-dimensional (3D) point cloud assessing software program (CloudCompare) for the evaluation of trueness and precision. Root mean square values (RMS) were obtained for the evaluation of discrepancies. The Student t test was used to compare data as the Shapiro-Wilk test confirmed the normal distribution. RESULTS: RMS values for the trueness values of the external and intaglio surfaces of the 3D printed and milled interim crown displayed no statistically significant differences (P>.05). Precision for the external surface reported significance (P<.05), whereas that for the intaglio surface reported no significance (P>.05). CONCLUSIONS: The accuracy of interim crowns fabricated by using DLP was comparable with that of milled crowns. Both manufacturing systems produced a true reproduction of the CAD. As for precision, the external surface of the DLP interim crown was statistically different from that of the milled group as it relates to the CAD.

Digital superimposition of scans for recording and transferring vertical relation from provisional restorations when rehabilitating worn-out dentition: A dental technique.

Excessive wear of the natural dentition results in the loss of tooth anatomy and the vertical dimension of occlusion (VDO) which may necessitate full mouth rehabilitation. Successful full-mouth rehabilitation with increased VDO requires accurate recording and transfer of the newly raised VDO with provisional restorations. Conventional bite registration can incur errors during the recording and transfer of vertical dimensions. This article introduces a digital approach-the superimposition of scans using an intraoral scanner (IOS) to transfer VDO, occlusion, and aesthetic data from provisional restorations for designing and fabricating indirect restorations in the management of worn-out dentition.

Are YouTube videos on complete arch fixed implant-supported prostheses useful for patient education?

STATEMENT OF PROBLEM: Complete arch fixed implant-supported prostheses have gained substantial popularity as a treatment option for patients with edentulism or a failing dentition. While YouTube is a leading source of health-related information videos, the usefulness and quality of videos on YouTube about complete arch fixed implant-supported prostheses are unclear. PURPOSE: The purpose of this study was to evaluate the quality of videos on complete arch fixed implant-supported prostheses and assess their usefulness for the general population as an educational resource. MATERIAL AND METHODS: An electronic search for "complete arch fixed treatment using dental implants" was conducted on YouTube on October 10, 2021. The videos in English with a duration between 4 and 20 minutes were considered for the analysis. A total of 89 videos were subjected to quantitative analysis by using a usefulness score. Additionally, to evaluate video quality, 5-point global quality scale (GQS) criteria were applied. A 1-way analysis of variance (ANOVA) was used to compare mean scores among different subgroups. The Pearson correlation analysis investigated the relationship among the usefulness score, GQS score, and video demographics, which include video content, source, type (academic or nonacademic), total views, and upload days (the days since the video was uploaded to YouTube) (α=.05). RESULTS: The mean number of views for the 89 selected videos was 193 321 with a mean daily upload of 1241. The mean ±standard deviation usefulness score was 1.55 ±1.35, with 78.7% of the videos rated poor, 20.2% moderate, and 1.1% excellent. The majority of videos included procedures involved (44.9%) and advantages (41.9%), and the least discussed topics were contraindications (7.9%) and prognosis and survival (6.7%). The GQS scoring had a mean score of 1.98 ±0.78 out of a total score of 5. While statistically significant differences were not found among the video source, total views or upload days, and usefulness score (P>.05), significant differences were found between the type of videos and usefulness score (P<.001). CONCLUSIONS: The majority of videos on complete arch fixed implant-supported rehabilitation were rated as poor in usefulness for patient education. Quality videos on implant-supported fixed rehabilitation were lacking on YouTube (GQS score <1.50), with most videos consisting of marketing or promotional content rather than unbiased educational information.

Recent Insights Into the Protective Mechanisms of Paeoniflorin in Neurological, Cardiovascular, and Renal Diseases.

ABSTRACT: The monoterpene glycoside paeoniflorin (PF) is the principal active constituent of the traditional Chinese herbal medicines, Radix Paeoniae Alba and Radix Paeoniae Rubra, which have been used for millennia to treat cardiovascular diseases (eg, hypertension, bleeding, and atherosclerosis) and neurological ailments (eg, headaches, vertigo, dementia, and pain). Recent evidence has revealed that PF exerts inhibitory effects on inflammation, fibrosis, and apoptosis by targeting several intracellular signaling cascades. In this review, we address the current knowledge about the pharmacokinetic properties of PF and its molecular mechanisms of action. We also present results from recent preclinical studies supporting the utility of PF for the treatment of pain, cerebral ischemic injury, and neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Moreover, new evidence suggests a general protective role of PF in heart attack, diabetic kidney, and atherosclerosis. Mechanistically, PF exerts multiple anti-inflammatory actions by targeting toll-like receptor-mediated signaling in both parenchymal and immune cells (in particular, macrophages and dendritic cells). A better understanding of the molecular actions of PF may lead to the expansion of its therapeutic uses.

Conflicting Roles of 20-HETE in Hypertension and Stroke.

Hypertension is the most common modifiable risk factor for stroke, and understanding the underlying mechanisms of hypertension and hypertension-related stroke is crucial. 20-hydroxy-5, 8, 11, 14-eicosatetraenoic acid (20-HETE), which plays an important role in vasoconstriction, autoregulation, endothelial dysfunction, angiogenesis, inflammation, and blood-brain barrier integrity, has been linked to hypertension and stroke. 20-HETE can promote hypertension by potentiating the vascular response to vasoconstrictors; it also can reduce blood pressure by inhibition of sodium transport in the kidney. The production of 20-HETE is elevated after the onset of both ischemic and hemorrhagic strokes; on the other hand, subjects with genetic variants in CYP4F2 and CYP4A11 that reduce 20-HETE production are more susceptible to stroke. This review summarizes recent genetic variants in CYP4F2, and CYP4A11 influencing 20-HETE production and discusses the role of 20-HETE in hypertension and the susceptibility to the onset, progression, and prognosis of ischemic and hemorrhagic strokes.

Attenuation of Blood-Brain Barrier Breakdown and Hyperpermeability by Calpain Inhibition.

Blood-brain barrier (BBB) breakdown and the associated microvascular hyperpermeability followed by brain edema are hallmark features of several brain pathologies, including traumatic brain injuries (TBI). Recent studies indicate that pro-inflammatory cytokine interleukin-1ß (IL-1ß) that is up-regulated following traumatic injuries also promotes BBB dysfunction and hyperpermeability, but the underlying mechanisms are not clearly known. The objective of this study was to determine the role of calpains in mediating BBB dysfunction and hyperpermeability and to test the effect of calpain inhibition on the BBB following traumatic insults to the brain. In these studies, rat brain microvascular endothelial cell monolayers exposed to calpain inhibitors (calpain inhibitor III and calpastatin) or transfected with calpain-1 siRNA demonstrated attenuation of IL-1ß-induced monolayer hyperpermeability. Calpain inhibition led to protection against IL-1ß-induced loss of zonula occludens-1 (ZO-1) at the tight junctions and alterations in F-actin cytoskeletal assembly. IL-1ß treatment had no effect on ZO-1 gene (tjp1) or protein expression. Calpain inhibition via calpain inhibitor III and calpastatin decreased IL-1ß-induced calpain activity significantly (p < 0.05). IL-1ß had no detectable effect on intracellular calcium mobilization or endothelial cell viability. Furthermore, calpain inhibition preserved BBB integrity/permeability in a mouse controlled cortical impact model of TBI when studied using Evans blue assay and intravital microscopy. These studies demonstrate that calpain-1 acts as a mediator of IL-1ß-induced loss of BBB integrity and permeability by altering tight junction integrity, promoting the displacement of ZO-1, and disorganization of cytoskeletal assembly. IL-1ß-mediated alterations in permeability are neither due to the changes in ZO-1 expression nor cell viability. Calpain inhibition has beneficial effects against TBI-induced BBB hyperpermeability.

Low-Dose Naltrexone for Excoriation Disorder.

Excoriation (skin-picking) disorder (ED) is a condition characterized by the repeated compulsion to pick at the skin, causing physical trauma and psychiatric distress. Patients often desire to cease skin-picking behavior but are unable to do so. Multiple treatment modalities are effective for ED, including naltrexone. Previous reports of naltrexone for ED were at a high dose of 50 mg. The efficacy of low-dose naltrexone (LDN) at 4.5 mg in managing ED has not been reported. We present a case of a 51-year-old female with ED who was evaluated in the pain clinic for fibromyalgia management. Her medications included gabapentin 600 mg PO TID and a history of opioid prescription for diffuse pain. She was started on naltrexone 4.5 mg PO QD for the management of fibromyalgia. Three months later, the patient reported improvement in her skin-picking disorder, with a lessened compulsion to itch at her skin and improved healing of existing lesions. When the naltrexone was temporarily interrupted for an elective procedure, her lesions worsened. Her lesions improved after she resumed the medication. Thereby, this patient experienced a therapeutic benefit from naltrexone for her skin-picking disorder, as demonstrated by the temporal changes in her symptoms. To our knowledge, this is the first reported case of ED improving with LDN, as other cases utilized 50 mg. Though few clinical trials or systematic reviews recommend the use of naltrexone for EDs, our case supports trialing LDN in the appropriate context.