Radiological findings associated with postoperative wound infection after extraction of impacted mandibular third molar: A retrospective study.

INTRODUCTION: Studies directly relating radiological findings to the risk of postoperative wound infection (PWI) in impacted mandibular third molars (M3) are limited and poorly understood. This study aimed to clarify the radiological risk of PWI. MATERIALS AND METHODS: Twenty-six patients who developed PWI after M3 extraction were retrospectively analyzed using orthopantomography (OPG) and computed tomography (CT) before M3 extraction to determine the association between M3 impaction status and PWI. These were compared with an equal number of non-infected groups. Moreover, the possibility of assessing the same risk in OPG as in CT imaging was examined. RESULTS: Multivariate analysis identified class III and position B of the Pell and Gregory classification system as independent risk factors for PWI. On CT, an axial overlap distance (AOD) >3.5 mm was significantly associated with PWI. Furthermore, the sagittal overlap distance (SOD) and AOD of the OPG were significantly greater in group III-B. A strong positive correlation was observed between SOD and AOD. CONCLUSION: These results indicate that class III, position B, and an AOD >3.5 mm may be novel risk factors for M3 PWI. The strong correlation between SOD and AOD suggests that the risk assessment for PWI can be performed by evaluating OPG alone.

Association between salivary proteases and protease inhibitors linked with viral infections and oral inflammatory diseases.

INTRODUCTION: Despite the role of transmembrane protease, serine 2 (TMPRSS2) in facilitating the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the primary cause of the global COVID-19 pandemic, the interaction of extracellular and intracellular proteases in this process remains poorly elucidated. Thus, we monitored the salivary expression concentration (SEC) of TMPRSS2 and its inhibitor, alpha-1 antitrypsin (A1AT), and investigated whether oral inflammatory diseases affected the SEC of both proteins. MATERIALS AND METHODS: We collected saliva samples before and after surgical treatment of inflammatory cystic diseases (radicular and inflammatory dentigerous cysts) in 25 patients. The SEC of TMPRSS2 and A1AT was measured using enzyme-linked immunosorbent assay. SEC in multiple patient status groups and subgroups of each status were investigated. Finally, the correlation between TMPRSS2 and A1AT SEC was analyzed. RESULTS: The TMPRSS2 and A1AT SEC did not significantly change pre- or post-treatment. The TMPRSS2 SEC was significantly higher before and after treatment in patients aged >50 years, patients with radicular cysts, and patients with the basic disease. A1AT SEC was significantly decreased after treatment in the acute inflammation, large-sized, and patients without basic disease groups. No significant correlation was observed between the SEC of either protein before and after treatment. DISCUSSION: Individual-specific SEC for TMPRSS2 may be influenced by age, lesion type, and basic disease; however, oral inflammatory diseases may not have a direct effect. Moreover, the extent of oral inflammatory diseases and the presence of basic diseases may be associated with A1AT SEC. Furthermore, the SEC between the two proteins may be independent.

Analysis of false-negatives in exfoliative cytology in oral potentially malignant disorders: A retrospective cohort study.

INTRODUCTION: Keratinized lesions have been a conceivable false-negative (FN) factor in oral exfoliative cytology (OEC); however, other factors are poorly analyzed. In this study, we aimed to identify the factors influencing the accuracy of OEC and FNs focusing on the lesion characteristics, patient background, and surgeon factors in oral potentially malignant disorders (OPMD). MATERIAL AND METHODS: We retrospectively studied 44 patients who underwent both OEC and histopathological diagnosis. Sensitivity, specificity, FN rate, false-positive (FP) rate, and prevalence of both methods were compared. Similarly, accuracy indices were compared among clinical diagnosis groups (leukoplakia vs. other diagnosis). The association between patient and surgeon-related factors influencing FN OEC results were investigated using Fisher's exact test and a multiple logistic regression analysis. RESULTS: Overall, the sensitivity; specificity; and FN, FP, and prevalence rates of OEC were 31.8%, 82.1%, and 68.8%, 17.9%, and 36.4%, respectively. Leukoplakia was significantly more common in clinical diagnosis (P = 0.007) with sensitivity, specificity, and FN rates of 20.0%, 95.2%, and 80.0%, respectively. Contrarily, non-keratinized lesions had sensitivity, specificity, and FN of 83.3%, 85.7%, and 16.7%, respectively. In the prevalent group, leukoplakia and anucleate squamous cells were significantly associated with FN cases (P = 0.013, P = 0.050). On multivariate analysis in OEC negative patients, age ≤64 (P = 0.050) and location on the tongue (P = 0.047) was independently associated with FNs. CONCLUSION: FN of OEC was conceivable to be due to poor deep-seated cell sampling, which was associated with leukoplakia, age, and location. Therefore, these factors may be considered in the evaluation of OEC results.

Somatosensory evoked magnetic fields of periodontal mechanoreceptors.

To evaluate the localization of responses to stimulation of the periodontal mechanoreceptors in the primary somatosensory cortex, somatosensory evoked fields (SEFs) were measured for stimulation of the left mandibular canine and first molar using magnetoencephalography in 25 healthy subjects. Tactile stimulation used a handmade stimulus device which recorded the trigger at the moment of touching the teeth.SEFs for the canine and first molar were detected in 20 and 19 subjects, respectively. Both responses were detected in the bilateral hemispheres. The latency for the canine was 62.1 ± 12.9 ms in the ipsilateral hemisphere and 65.9 ± 14.8 ms in the contralateral hemisphere. The latency for the first molar was 47.4 ± 6.6 ms in the ipsilateral hemisphere and 47.8 ± 9.1 ms in the contralateral hemisphere. The latency for the first molar was significantly shorter than that for the canine. The equivalent current dipoles were estimated in the central sulcus and localized anteroinferiorly compared to the locations for the SEFs for the median nerve. No significant differences in three-dimensional coordinates were found between the canine and first molar. These findings demonstrate the precise location of the teeth within the orofacial representation area in the primary somatosensory cortex.

Evaluating age-related change in lip somatosensation using somatosensory evoked magnetic fields.

Somatosensory evoked fields (SEFs) to electrical stimulation on the right and left sides of the lower lip were measured using magnetoencephalography and compared in the bilateral hemispheres of 31 healthy normal young and 29 healthy normal elderly subjects to evaluate age-related change in lip somatosensation. The initial peak of the response around 13 ms, designated as N13m, and the second peak of the response, designated as P21m, were investigated. The N13m response, which was detected in 22 of 62 hemispheres in young adults and 37 of 58 hemispheres in elderly adults, showed significantly prolonged latency and increased equivalent current dipole (ECD) moment in the elderly adults. The P21m response, which was detected in 56 of 62 hemispheres in young adults and in 52 of 58 hemispheres in elderly adults, showed longer peak latency in the elderly adults. No significant difference was found in the ECD moment for P21m, which suggests that aging affected the SEFs of the lip somatosensation, but the effects of aging on N13m and P21m differed. Prolonged latency and increased ECD moment of N13m might result from decreased peripheral conduction and increased cortical excitation system associated with aging. Therefore, the initial response component might be an objective parameter for investigating change in lip function with age.

Role of the spinal trigeminal nucleus in the rat autonomic reflex.

The goal of the present study was to investigate the regional differences between the three subnuclei (oralis, interpolaris, and caudalis) of the spinal trigeminal nucleus (Vsp) in eliciting parasympathetic and sympathetic reflex autonomic responses. We evoked changes in lower lip blood flow (LBF) and systemic arterial blood pressure (SABP) by electrically stimulating these subnuclei in artificially ventilated, urethane-anaesthetised, cervically vago-sympathectomized rats. The LBF increases evoked by electrical stimulation of the Vsp at interpolaris were much larger than those at the sites of the oralis and caudalis. No significant difference in SABP increase was observed by Vsp stimulation between the interpolaris and caudalis, although the SABP increase evoked by electrical stimulation of the oralis was much smaller than in the interpolaris and caudalis. The present findings show that the Vsp at the interpolaris subnucleus of the Vsp participates as a relay in lingual nerve- and Vsp-evoked somato-autonomic reflex.