The effect of tongue reduction for preventing adverse effects in patients undergoing class III orthognathic surgery: a three-dimensional comparative analysis.

OBJECTIVES: This study aims to evaluate the potential benefits of combining tongue reduction with mandibular setback surgery in patients undergoing class III orthognathic surgery. Specifically, we investigated whether this combined approach reduced the risk of surgical relapse, condylar resorption, and airway space reduction by mitigating tongue pressure on the mandible. MATERIAL AND METHODS: The study retrospectively enrolled patients who had undergone bilateral sagittal split ramus osteotomy (BSSRO) with at least 5 mm of setback and met the criteria of a body mass index > 20 kg/m2 and tongue volume > 100 mm3. The study included 20 patients with 10 in the tongue reduction group (TR, n = 10) and 10 in the BSSRO only group (SO, n = 10). RESULTS: The volumetric changes of the total airway space were significantly different between the TR and SO groups (p = 0.028). However, no significant differences were observed in the condylar resorption and postoperative relapse between the groups (p = 0.927 and 0.913, respectively). The difference between the resorption of the anterior and posterior segments of the condyle was also statistically insignificant (p = 0.826). Postoperative counterclockwise rotation of the proximal segment only demonstrated a significant correlation with postoperative relapse (p = 0.048). CONCLUSIONS: The reduction in tongue volume demonstrated a preventive effect on the reduction of the airway space after mandibular setback, although it did not yield statistical significance concerning surgical relapse and condylar volume. The counterclockwise rotation of the proximal segment might be responsible for the forward displacement of the distal segment and postoperative relapse. However, the clinical implications of this finding should be interpreted with caution owing to the limited sample size CLINICAL RELEVANCE: Tongue reduction could potentially serve as a preventive measure in preserving the airway space and might be beneficial in mitigating the risk of obstructive sleep apnea in patients with class III deformity.

Osteoinductive function of fucoidan on periodontal ligament stem cells: Role of PI3K/Akt and Wnt/ß-catenin signaling pathways.

BACKGROUND/OBJECTIVES: Fucoidan has been focused as a multifunctional therapeutic uses including bone health supplements. However, the critical molecular mechanisms of fucoidan for bone therapeutic agents have not been fully understood. We investigated the osteoinductive effect of fucoidan on periodontal ligament stem cells (PDLSCs) and how this polymer encouraged PDLSC osteogenesis. MATERIALS AND METHODS: Osteogenic induction of PDLSCs was processed by culturing cells with fucoidan treatment. Osteogenic differentiation of PDLSCs was verified by alkaline phosphatase (ALP) activity, matrix mineralization assay, intracellular calcium levels, and mRNA expression and protein levels of osteogenic markers. RESULTS: Fucoidan treatment showed higher osteogenic activity in the PDLSCs than the control groups. PDLSCs with fucoidan also presented increased levels of the phosphatidylinositol-3-kinase (PI3K) isoforms, p110α and p110γ compared to control cells. The phosphorylation of Akt, a PI3K downstream effector, was significantly increased at 90 min of fucoidan induction. Expression of ß-catenin, a coactivator of canonical Wnt pathways, was increased in PDLSCs with fucoidan. ß-catenin was found to link with PI3K activation during the fucoidan stimulation. When cells were blocked by PI3K inhibitor or ß-catenin-specific siRNA, fucoidan-induced osteogenic activity of PDLSCs was significantly attenuated. CONCLUSION: These findings suggest that the fucoidan stimulates osteogenic differentiation of PDLSCs via the PI3K/Akt and Wnt/ß-catenin pathways.

Is implant surgery a risk factor for osteonecrosis of the jaw in older adult patients with osteoporosis? A national cohort propensity score-matched study.

OBJECTIVES: This study aimed to investigate the association between dental implant therapy and osteonecrosis of the jaw (ONJ) in osteoporotic patients and the relationship between tooth extraction, dental implantation, and ONJ. MATERIAL AND METHODS: This retrospective cohort study used the Customized Health Information Data from the National Health Insurance Corporation in South Korea. The study population included patients older than 70 years with a history of osteoporosis; the cases included patients who had undergone dental implant surgery between July 2014 and July 2016 with specific procedure codes. The case and control cohorts were stratified by tooth extraction because it was the strongest risk factor to consider in this study. Each group of patients was matched using the propensity score. To investigate the relationship between dental implants and ONJ, a Cox proportional hazard model was applied to socio-economic factors, comorbidities, and bisphosphonates (BPs). All analyses were conducted using SAS statistical software. RESULTS: Based on the fully adjusted model, the propensity score-matched osteoporosis patients with dental implants had a 0.51 times hazard ratio of osteonecrosis. On the contrary, tooth extraction was associated with a higher risk of ONJ (HR = 5.89). The patients with rheumatoid arthritis (RA) and those using BPs had a higher HR, respectively, 6.80 and 4.09 HR (p < .001). CONCLUSIONS: Dental implantation was not a risk factor and patients with implants show rather lower ratios. However, older osteoporotic Korean patients who had undergone tooth extraction had higher risks of ONJ. A significantly higher risk of ONJ was associated with RA and BPs as well.

Antibacterial effects of sodium tripolyphosphate against Porphyromonas species associated with periodontitis of companion animals.

Porphyromonas species are closely associated with companion animal periodontitis which is one of the most common diseases in dogs and cats and leads to serious systemic diseases if left untreated. In this study, we evaluated the antimicrobial effects and mode of action of sodium tripolyphosphate (polyP3, Na5P3O10), a food additive with proven safety, using three pathogenic Porphyromonas species. The minimum inhibitory concentrations (MICs) of polyP3 against Porphyromonas gulae, Porphyromonas cansulci, and Porphyromonas cangingivalis were between 500 and 750 mg/L. PolyP3 significantly decreased viable planktonic cells as well as bacterial biofilm formation, even at sub-MIC concentrations. PolyP3 caused bacterial membrane disruption and this effect was most prominent in P. cangingivalis, which was demonstrated by measuring the amount of nucleotide leakage from the cells. To further investigate the mode of action of polyP3, high-throughput whole-transcriptome sequencing was performed using P. gulae. Approximately 30% of the total genes of P. gulae were differentially expressed by polyP3 (> 4-fold, adjusted p value < 0.01). PolyP3 influenced the expression of the P. gulae genes related to the biosynthesis of thiamine, ubiquinone, and peptidoglycan. Collectively, polyP3 has excellent antibacterial effects against pathogenic Porphyromonas species and can be a promising agent to control oral pathogenic bacteria in companion animals.

Effects of Sodium Tripolyphosphate on Oral Commensal and Pathogenic Bacteria.

Polyphosphate (polyP) is a food additive with antimicrobial activity. Here we evaluated the effects of sodium tripolyphosphate (polyP3, Na5P3O10) on four major oral bacterial species, in both single- and mixed-culture. PolyP3 inhibited three opportunistic pathogenic species: Fusobacterium nucleatum, Prevotella intermedia, and Porphyromonas gingivalis. On the contrary, a commensal bacterium Streptococcus gordonii was relatively less susceptible to polyP3 than the pathogens. When all bacterial species were co-cultured, polyP3 (≥ 0.09%) significantly reduced their total growth and biofilm formation, among which the three pathogenic bacteria were selectively inhibited. Collectively, polyP3 may be an alternative antibacterial agent to control oral pathogenic bacteria.Polyphosphate (polyP) is a food additive with antimicrobial activity. Here we evaluated the effects of sodium tripolyphosphate (polyP3, Na5P3O10) on four major oral bacterial species, in both single- and mixed-culture. PolyP3 inhibited three opportunistic pathogenic species: Fusobacterium nucleatum, Prevotella intermedia, and Porphyromonas gingivalis. On the contrary, a commensal bacterium Streptococcus gordonii was relatively less susceptible to polyP3 than the pathogens. When all bacterial species were co-cultured, polyP3 (≥ 0.09%) significantly reduced their total growth and biofilm formation, among which the three pathogenic bacteria were selectively inhibited. Collectively, polyP3 may be an alternative antibacterial agent to control oral pathogenic bacteria.

Inequalities in oral health among adolescents in Gangneung, South Korea.

BACKGROUND: This study aims to evaluate inequality in oral health among adolescents and to explain the mechanisms of such inequalities in Gangneung, South Korea. METHODS: One thousand two hundred sixty-seven students in their first year from four vocational and three general schools participated in the baseline survey of 2011, and 84.7% of them were surveyed again in 2013. Oral examinations by the same dentist and a self-administered questionnaire were repeated during both waves. Outcome measure for oral health was the existence of untreated dental caries (DT). As socioeconomic position (SEP) indicators, school type (general vs. vocational), father's and mother's education, perceived economic status, and Family Affluence Scale (FAS) were measured. Variables measuring oral health related behaviours included tooth brushing frequency, frequency of eating snacks and drinking sodas, smoking, and annual visits to dental clinics. Chi-square tests and panel logistic regression were adopted to examine the associations between dental caries and SEP indicators by STATA version 15.1. RESULTS: Having a less educated father and attending a vocational school were significant predictors for untreated caries after controlling for SEP indicators. However, students from general schools, higher SEP by father's education, perceived economic status, or FAS, or having non-smoking experience or annual visits to dental clinics were more likely to stay caries-free. CONCLUSIONS: There were socioeconomic inequalities in oral health on an adolescent panel. Given that oral health status during adolescents can persist throughout the course of a person's life, intervention to tackle such inequalities and school environments are required.

Postoperative B-type natriuretic Peptide levels associated with prolonged hospitalization in hypertensive patients after non-cardiac surgery.

BACKGROUND AND OBJECTIVES: B-type natriuretic peptide (BNP) is an important marker for the diagnosis of heart failure and is useful towards predicting morbidity and mortality after non-cardiac surgery. Nevertheless, information on the relationship between postoperative BNP levels and perioperative prognosis after non-cardiac surgery is scarce. The purpose of the study was to assess whether postoperative BNP levels could be used as a predictor of prolonged hospitalization in elderly hypertensive patients after non-cardiac surgery. SUBJECTS AND METHODS: Ninety-seven (97) patients, aged 55 years or older (mean age: 73.12±10.05 years, M : F=24 : 73) were enrolled in a prospective study from May 2005 through August 2010. All patients underwent total knee or hip replacement. Postoperative BNP and other diagnostic data were recorded within 24 hours of surgery. Patients that required a prolonged hospital stay due to operative causes, such as wound infection and re-operation, were excluded. RESULTS: The length of hospital stay was significantly correlated with postoperative BNP levels (p=0.031). Receiver operating characteristic curves demonstrated postoperative BNP levels as predictors of hospital stay ≥30 days with areas under the curve of 0.774 (95% confidence interval: 0.679-0.87, p<0.0001). A BNP cut-off value above 217.5 pg/mL had a sensitivity of 80.6% and a specificity of 66.7% for predicting postoperative hospital stays of 30 days or more. CONCLUSION: Postoperative BNP levels may predict the length of hospital stays after non-cardiac surgery in hypertensive patients. Elevated BNP levels were associated with prolonged hospitalization after elective orthopedic surgery.

Socio-economic status and oral health-related behaviours in Korean adolescents.

The principle objective of this study was to assess the association between socio-economic status (SES) and oral health-related behaviours in Korean adolescents aged 13-18, using the Family Affluence Scale (FAS). The secondary objective was to assess the influences of other factors (pocket money, school type, family structure and psychological factors) on this association. Cross-sectional data were from the national 2007 Korean Youth Risk Behavior Web-based Survey. Oral health-related behaviours included health-enhancing behaviours (frequency of toothbrushing and dental visits) and health-compromising behaviours (smoking and frequency of intake of soft drinks and confections). Logistic regression models were used to analyse the data. To assess the influence of other factors, additional models adjusting for sex, school grade and each of the other factors were compared to the initial model, which adjusted for sex and school grade only. We found that family affluence had a linear association with health-enhancing behaviours and a roughly U-shaped association with health-compromising behaviours. After adjusting for a number of variables, the linear association with health-enhancing behaviours persisted. The U-shaped association with health-compromising behaviours remained but was partly attenuated and flattened. In addition, we found a marked influence of school type and family structure and pocket money on the association between FAS and oral health-compromising behaviours. The findings indicate that the health-enhancing behaviours of adolescents were strongly associated with family affluence, but the health-compromising behaviours were more strongly linked to factors other than family affluence. However, it is difficult to determine which factors contribute most in relation to family affluence because of other confounding factors, such as the education system, peer group, youth culture, part-time work and advertising. Therefore, further studies are needed to assess factors that interact with family SES to better understand the association between the SES and the oral health-compromising behaviours of adolescents.