Evaluation of the soft tissue facial profile in different skeletal malocclusions in relation to age.

BACKGROUND: The aim of the study was to assess the thickness of the soft tissue facial profile (STFP) in relation to the skeletal malocclusion, age and gender. METHODS: All patients, aged 7-35 years, who were seeking orthodontic treatment at the Department of Orthodontics, Medical University of Warsaw between 2019 and 22 were included in the study. All patients had lateral head radiographs taken before the treatment. The cephalometric analysis was performed including the STFP analysis. The patients were allocated to one of six groups based on age and skeletal relations (ANB angle). The minimum number of patients in each group was 60 with equal gender distribution. The STFP analysis included ten linear measurements. RESULTS: A total of 300 patients were included in the study and allocated to five groups. Group 6 (growing patients with skeletal Class III malocclusion) was not included in the study as it failed to achieve the assumed group size. There were significant differences in the thickness of the STFP in relation to the skeletal malocclusions. Adults with skeletal Class III malocclusion had significantly thicker subnasal soft tissues compared to patients with skeletal Class I and Class II malocclusions. The thickness of the lower lip in patients with Class II skeletal malocclusion was significantly bigger compared to the other groups. Children and adolescents with Class II malocclusions had thicker lower lip in comparison to the group with Class I malocclusion. The majority of the STFP measurements were significantly smaller in children and adolescents compared to adults. The thickness of the STFP in males was significantly bigger in all age groups compared to females. CONCLUSIONS: The thickness of facial soft tissues depends on the patient's age and gender. The degree of compensation of the skeletal malocclusion in the STFP may be a decisive factor during orthodontic treatment planning regarding a surgical approach or a camouflage treatment of skeletal defects.

Hair Evaluation in Orthodontic Patients with Oligodontia.

Oligodontia can be isolated or syndromic, associated with other ectodermal abnormalities. The aim of the study was to perform hair examination in orthodontic patients diagnosed with oligodontia with a low clinical expression of symptoms of ectodermal origin. All available orthodontic patients diagnosed with oligodontia in the permanent dentition were enrolled. Hair examination included clinical evaluation of the patients' hair, trichoscopy, trichogram and evaluation of the hair shafts under a polarized light microscope. In total, 25 patients, 18 males and 7 females, aged 6 to 24 years were evaluated for the presence of dental and hair abnormalities. The number of congenitally absent teeth ranged from 6 to 24 teeth and diastemas, microdontia, taurodontism and altered tooth shape were found in 23 patients. Hair disorders were found in 68% of the subjects. Hypotrichosis, the heterogeneity of shaft color and loss of pigment, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa and pseudomoniletrix were observed. Trichoscopy and trichogram are valid non-invasive diagnostic tests which could be used to differentiate between isolated and syndromic oligodontia in patients with a low clinical expression of ectodermal symptoms.

Application of Artificial Intelligence (AI) in a Cephalometric Analysis: A Narrative Review.

In recent years, the application of artificial intelligence (AI) has become more and more widespread in medicine and dentistry. It may contribute to improved quality of health care as diagnostic methods are getting more accurate and diagnostic errors are rarer in daily medical practice. The aim of this paper was to present data from the literature on the effectiveness of AI in orthodontic diagnostics based on the analysis of lateral cephalometric radiographs. A review of the literature from 2009 to 2023 has been performed using PubMed, Medline, Scopus and Dentistry & Oral Sciences Source databases. The accuracy of determining cephalometric landmarks using widely available commercial AI-based software and advanced AI algorithms was presented and discussed. Most AI algorithms used for the automated positioning of landmarks on cephalometric radiographs had relatively high accuracy. At the same time, the effectiveness of using AI in cephalometry varies depending on the algorithm or the application type, which has to be accounted for during the interpretation of the results. In conclusion, artificial intelligence is a promising tool that facilitates the identification of cephalometric landmarks in everyday clinical practice, may support orthodontic treatment planning for less experienced clinicians and shorten radiological examination in orthodontics. In the future, AI algorithms used for the automated localisation of cephalometric landmarks may be more accurate than manual analysis.

Examination of oral biofilm microbiota in patients using fixed orthodontic appliances in order to prevent risk factors for health complications.

INTRODUCTION AND OBJECTIVE: In recent decades the use of orthodontic appliances in Poland has increased; however, data on their influence on changes of components of the microbiome connected with oral biofilm are scarce. The objective of this study was to evaluate oral microbiota in terms of their role as risk factors for health complications. MATERIAL AND METHODS: The study included 100 patients treated with removable or fixed appliances. Oral hygiene and gingival health were determined, and periodontal swabs taken from each patient for parasitological, bacteriological and mycological microscopic and in vitro examinations. RESULTS: Oral protists and various pathogenic and opportunistic bacterial and fungal strains were identified in the superficial layer of biofilm. A higher prevalence of bacteria, Enterococcus faecalis, E. faecium, Staphylococcus aureus and Escherichia coli, and various strains of yeast-like fungi from the Candida albicans group, occurred in patients treated with the fixed appliance than in those using a removable appliance or not treated orthodontically. In some periodontal samples from patients treated with fixed appliances, cysts of the Acanthamoeba spp. were found. CONCLUSIONS: The use of orthodontic appliances alters the status of the oral cavity; it has impact on the colonization of oral biofilm by opportunistic/pathogenic strains, and increases the risk of their dissemination to various human tissues and organs. Pretreatment examination of oral microbiome, its monitoring particularly during treatment with fixed appliances, and preventive elimination of the potentially pathogenic strains to avoid health complications, are highly recommended, especially in patients with impaired immunity.

Evaluation of in vitro effects of selected physical and chemical agents on detected in Poland Acanthamoeba strains ­ factors of increasing threats for public health

Acanthamoeba keratitis, the vision-threatening corneal disease reported with increasing frequency in Poland is difficult to treat due to extremely high resistance of the amoeba cysts to chemicals. The agents of possible anti-amoebic activity are still tested. Pathogenic Acanthamoeba samples/isolates acquired from severe cases of keratitis examined by molecular techniques to determine genotypes, compared to one another as well as to the environmental Acanthamoeba castellanii Neff strain were included in the studies. These strains were in vitro examined in terms of their sensitivity/resistance to selected chemicals and tolerance to temperature changes. Samples of the strains cultivated in vitro under bacteria-free conditions were monitored during different growth phases. Higher amoebic population dynamics was observed in both pathogenic Acanthamoeba strains during transfer to 37°C. Agents tested influenced population dynamics in different degree; they showed amoebostatic or amoebicidal effects, however a tendency toward induction of encystment also appeared. Because activation of the dormant cysts can lead to repeated development of amoebae, very important is cysticidal efficacy of chemicals. Further in vitro investigations on various Acanthamoeba strains with different chemicals are still necessary.

Studies on prevalence of infection with Trichomonas tenax identified by molecular techniques ­ in respect to oral health of patients with various systemic disease requiring immunosuppressive therapy

Trichomonas tenax, cosmopolitan flagellate inhabiting human oral cavity, is the etiological agent of oral trichomonosis associated with gingival and periodontium deterioration. Purpose of this studies was to investigate the prevalence of infection with Trichomonas tenax identified by molecular techniques amplifying the region of ITS1-5.8S rRNA-ITS2 specific for T. tenax. The study included 498 persons: diabetic, renal transplant, rheumatoid arthritis patients and the control group. Prevalence of T. tenax in oral cavity was 10.2% in control group, 14.1% in diabetics, 12.0% in renal transplant patients and 14.0% in rheumatoid arthritis patients. Comparative assessment of results showed symptoms of gingiva and periodontium deteriorations, at varying intensity in patients with various systemic diseases; higher prevalence of the trichomonad infection was revealed in adults in all groups. Simultaneously, renal transplantation, diabetes, rheumatoid arthritis and related therapy do not affect T. tenax incidences and no increased risk of the infection has been observed in the patients; the permanent medication used due to main disease should be taken into consideration as likely inhibitory factor.

Molecular identification of Trichomonas tenax in the oral environment of domesticated animals in Poland - potential effects of host diversity for human health.

INTRODUCTION: The protozoan Trichomonas tenax is considered to be a human specific flagellate of the oral cavity, found in humans with poor oral hygiene and advanced periodontal disease. Morphological variability and great similarity between species occurring in humans and animals, complicate the specific identification of trichomonads, using microscopic examination and other standard parasitological techniques. OBJECTIVE: The aim of the study was to search for and identify T. tenax in domesticated animals using molecular methods. The obtained data were assessed in terms of potential effects of a spread of the species deriving from the animals in the human environment. MATERIAL AND METHODS: 301 animals: 142 dogs, 57 cats and 102 horses, were examined in terms of their mouth status and occurrence of trichomonads. ITS1-5.8S rRNA-ITS2 region was amplified and sequenced. RESULTS: Finally, 7 dogs, 3 cats and 1 horse were diagnosed positive for T. tenax by PCR. In the oral cavity of 9 /11 animals, gingivitis and dental plaque accumulation were diagnosed. 9 /11 sequences of trichomonad isolates showed 100% identity with T. tenax sequence derived from the GenBank. The sequences of 2 isolates differed by substitutions. CONCLUSIONS: It was proved that T. tenax, considered so far as a human specific parasite, can also inhabit the oral cavity of dog, cat and horse. To summarize, T. tenax was detected in the mouths of different domesticated animals, indicating that in Poland it can colonize a wider range of hosts than previously known. The owners of 3 dogs showed oral tissue inflammation of different intensity and were also positive for T. tenax; therefore, oral trichomonosis spread from humans to domestic animals and conversely should be taken into consideration.

Examination of Oral Microbiota Diversity in Adults and Older Adults as an Approach to Prevent Spread of Risk Factors for Human Infections.

The oral cavity environment may be colonized by polymicrobial communities with complex, poorly known interrelations. The aim of this study was to determine oral microbiota diversity in order to prevent the spread of infectious microorganisms that are risk factors for human health complications in patients requiring treatment due to various disabilities. The study examined Polish adults aged between 40 and 70 years; parasitological, microbiological, and mycological data collected before treatment were analyzed. The diversity of oral microbiota, including relatively high prevalences of some opportunistic, potentially pathogenic strains of bacteria, protozoans, and fungi detected in the patients analyzed, may result in increasing risk of disseminated infections from the oral cavity to neighboring structures and other organs. Increasing ageing of human populations is noted in recent decades in many countries, including Poland. The growing number of older adults with different oral health disabilities, who are more prone to development of oral and systemic pathology, is an increasing medical problem. Results of this retrospective study showed the urgent need to pay more attention to the pretreatment examination of components of the oral microbiome, especially to the strains, which are etiological agents of human opportunistic infections and are particularly dangerous for older adults.

Comparative study on usefulness of gentamycin-containing collagen implants in the treatment of patients with osteitis and osteomyelitis of the craniofacial skeleton.

Introduction and objective. A reduction in incidences of peri-surgical complications due to infections is achieved by antibiotic prophylaxis The objective of the study was to assess the usefulness of gentamycin-containing collagen implants (GCCI) in the treatment of patients with osteitis and osteomyelitis of the craniofacial skeleton. Materials and method. The retrospective study included 103 patients with osteitis and osteomyelitis. 54 patients were treated intra-operatively with GCCI (Garamycin, EusaPharma, Europe). 49 patients were treated according to standard procedures. Light microscopy and in vitro culture techniques were applied for bacteria specific identification, and to investigate the resistance of detected microbiota to antibiotics. Patients received one dose of antibiotic pre-operatively. Post-operative antibiotic treatment was administered individually, according to clinical course and microbiological tests. The patients were followed-up on days 3, 7 and 14 after discharge for local complications; radiographic follow-up was performed 3, 6 and 12 months after surgery. Results. The course of post-operative antibiotic therapy was shorter in GCCI patients than in the control group (median 1 vs. 7 days); they also required shorter hospitalization (median 3 vs. 4 days). Implantation of GCCI significantly reduced the incidence of local complications (OR 0.30, 95%CI 0.11-0.83, p<0.0001), independently of the use of postoperative antibiotic therapy. On follow-up after 3-12 months, all patients presented with good soft tissue and bone healing. Conclusions. The results of this comparative study advocate the use of GCCI in osteomyelitis of various origin in oral and maxillofacial surgery, as they seemed to reduce the incidence of local complications, shorten antibiotic administration time and hospital stay.

In vivo confocal microscopy and in vitro culture techniques as tools for evaluation of severe Acanthamoeba keratitis incidents

Amphizoic amoebae belonging to the genus Acanthamoeba are known as etiological agents of sight-threatening Acanthamoeba keratitis. The leading risk factor for the development of this serious human disease is contact lens wearing which popularity increases worldwide, also in Poland. The disease with active epithelial inflammations, corneal ulcers, including loss of the visual acuity is a serious medical problem as an emerging threat for the public health related to improper contact lens hygiene. The treatment of the amoebic keratitis is difficult, often unsuccessful due to delayed proper diagnosis. The clinical picture of the disease, often with severe course is nonspecific, similar to that occurring in viral, fungal or bacterial keratitis, thus clinical symptoms alone are not sufficient to identify the causative agent of the amoebic infection. Early diagnosis is decisive for the suitable therapeutic management and the treatment efficacy. In our studies, several complicated, difficult to treat Acanthamoeba keratitis incidences pertaining Polish patients using contact lenses have been retrospectively analyzed in terms of the usefulness of non-invasive methods of in vivo confocal microscopy and in vitro culture techniques applied for diagnosis. Hyper-reflective double-walled spherical Acanthamoeba cysts, with a more reflective outer wall were detected in the epithelium and anterior layers of the corneal stroma. In vivo confocal microscopy, if available, may be a valuable, sensitive tool for diagnosis in late identified severe infections mainly with strong viability strains, however confoscan may offer limited value at lowintensity amoebic infections. The microscopic visualization of amoebae in slides prepared directly from corneal scraping and laboratory examinations of specimens from in vitro cultivated corneal isolates allow to confirm or verify results of in vivo examinations, furthermore to identify directly the pathogens and to clarify previous misdiagnoses.

Identification of infectious microbiota from oral cavity environment of various population group patients as a preventive approach to human health risk factors.

INTRODUCTION AND OBJECTIVE: This study presents the results of comparative investigations aimed to determine microbiota that can occur in the oral environment in different human populations. The objective of the research was to identify pathogenic oral microbiota, the potential cause of health complications in patients of different population groups. MATERIALS AND METHOD: The study included 95 patients requiring dental or surgical treatment; their oral cavity environment microbiota as risk factors of local and general infections were assessed. RESULTS: In clinical assessment, differences occurred in oral cavity conditions between patients with malformations of the masticatory system, kidney allograft recipients and individuals without indications for surgical procedures. The presence of various pathogenic and opportunistic bacterial strains in oral cavities were revealed by direct microscopic and in vitro culture techniques. CONCLUSIONS: Colonization of oral cavities of patients requiring surgical treatment by the potentially pathogenic bacteria constitutes the threat of their spread, and development of general infections. Assessment of oral cavity infectious microbiota should be performed as a preventive measure against peri-surgical complications.

Comparative assessment of selected intraoral microorganisms ­ potential factors for peri-surgical management complications

In this research, a comparative analysis of results of investigations involving different human populations, in terms of a relation between the oral cavity health and the species composition of mouth microbiota is reported. The purpose of this analysis was to identify and assess microorganisms that could cause health complications in patients with neoplasm requiring dental problem-related surgical management. The patients with the oral cancer surgically treated and those without neoplasm were assessed for their oral health: status of teeth, gingiva, periodontium, and occurrence of inflammatory processes. From each patient, microorganisms isolated of periodontium, dental plaque, and dental pocket swabs were identified in wet and stained microscopic preparations; standard microbiology in vitro techniques were also applied to determine the fungal and bacterial strains. The comparative analysis of results of direct microscopic examinations and in vitro cultures assessment indicated significant differences in prevalences of fungi, parasitic oral protozoans and bacteriae in particular patient's groups. Yeast-like fungi belonging to Candida genus, mostly of C. albicans group, were identified in 93.75% patients with the oral cancer, while in 25% of individuals assessed without neoplasm. E. gingivalis amoebae were only found in 12.5% patients with the serious disease; no trichomonads were detected in all patients analyzed. Among bacteria species, potentially pathogenic Enterobacteriaceae were found in the patients with oral cancer. The pronounced shift in the microbiota species composition in the patients who needed prolonged treatment due to oral cavity cancer, compared to other generally healthy persons has been showed in this analysis.

Evaluation of selected oral cavity microbiota--risk factors of management complications in patients with masticatory system disorders.

The retrospective analysis of data on oral cavity clinical status in relation to microbiota species composition is presented. The research regards patients of different age, with and without congenital malformation, pretreatment assessed for occurrence of pathological changes in the masticatory system. Samples of the swabs collected from each patient (from dental plaque, periodontium and dental pockets) were used for identification of oral protozoans in wet slides and stained preparations; additionally, transmission electron microscope examination was performed. The material was used for in vitro cultures to identify bacteria strains. Clinically, intensity of tissue deteriorations was higher in patients with a congenital disease. Alive Trichomonas tenax and Entamoeba gingivalis, species with confirmed pathogenic impact on oral cavity and neighboring structures, were detected with higher prevalence in older patients. Enterococci, Staphylococcus aureus, various Enterobacteriaceae were more frequently detected in patients with somatic and mental retardations; in mouths of those patients, Klebsiella pneumonia and Pseudomonas aeruginosa opportunistic strains occurred. Masticatory system abnormalities favor colonization of oral cavity by exogenous species and dissemination of infections, especially dangerous for patients with congenital diseases. Oral microbiota assessment and preventive measures may be helpful to avoid subsequent peri-surgery complications.

In vitro effects of selected contact lens care solutions on Acanthamoeba castellanii strains in Poland.

Free-living, cosmopolitan amoebae of the Acanthamoeba genus may be the causative agents of Acanthamoeba keratitis (AK) - a progressive, vision-threatening infection of the human cornea described particularly among contact lens wearers. Use of contact lens care solutions, effective against these organisms, is important in preventing AK infections. 3 different strains of Acanthamoeba castellanii of the T4 genotype (Neff strain and two others, isolated from patients with AK) were exposed to 4 selected multipurpose contact lens care solutions available in Poland: Ciba Vision AoSept Plus, Bausch & Lomb ReNu MultiPlus, Alcon Opti-Free, Ciba Vision Solo Care Aqua. No amoebicidal effect was observed. The strongest amoebostatic effect was visible after 24h of exposition to Opti-Free and ReNu solution and associated with percentage increase of rounded, motionless forms. This is significantly longer than minimum disinfection time recommended by manufacturers of all tested multipurpose solutions. Surprisingly, no clear induction of the encystation process was observed.

[Studies on the susceptibility of Trichomonas hominis to some abiotic factors. I. Preliminary assessment of antitrichomonal activity of selected compounds in vitro]. / Badania nad wrazliwscia Trichomonas hominis na czynniki abiotyczne. I. Wstepna ocena przezywalnosci wiciowców w wybranych mediach w warunkach in vitro.

The flagellate Trichomonas hominis is often identified in human diarrheic stools. Because of the fecal-oral transmission rout, infection with T. hominis is more frequently reported in children than in adults. Although infections with the trichomonads in some world regions are as often as with Giardia, no prevention and optimal treatment are defined. The purpose of our in vitro studies was to examine susceptibility of T. hominis to a newly synthesized imidazole derivative--1-metylo-2-(2,4-dinitrobenzylotio)-1H-imidazol--P27; in order to make a comparison between this new and previously known compounds, chlorhexidine and metronidazole were used. The protozoans derived from the diarrheic stool of adult patient were grown on the liquid Pahm medium and subcultured twice a week. Assays of trichomonad cultures were incubated with one of the following substances: chlorhexidine, metronidazole or P27. For each compound, two different concentrations were applied. After 24h exposition, an antitrichomonal effect of the above substances was assessed, namely a quantity of the surviving trichomonads was microscopically determined and compared with that observed in control cultures. The protozoans showed different susceptibility, depending on kind and concentration of tested compound. In comparison to the control cultures, the reduction in number of surviving protozoans appeared in the assays with metronidazole, chlorhexidine and P27 (to 63%, 52% and 8.7%, respectively). The highest in vitro susceptibility of T. hominis was revealed to a new imidazole derivative P27. The obtained results allow us to suppose that the further studies in this field will be very helpful for explaining the mechanisms of the antitrichomonal activity of the tested compounds as well as for assessment of the influence of various abiotic factors.