Navigating therapeutic strategies: HPV classification in head and neck cancer.

The World Health Organisation recognised human papillomavirus (HPV) as the cause of multiple cancers, including head and neck cancers. HPV is a double-stranded DNA virus, and its viral gene expression can be controlled after infection by cellular and viral promoters. In cancer cells, the HPV genome is detected as either integrated into the host genome, episomal (extrachromosomal), or a mixture of integrated and episomal. Viral integration requires the breakage of both viral and host DNA, and the integration rate correlates with the level of DNA damage. Interestingly, patients with HPV-positive head and neck cancers generally have a good prognosis except for a group of patients with fully integrated HPV who show worst clinical outcomes. Those patients present with lowered expression of viral genes and limited infiltration of cytotoxic T cells. An impediment to effective therapy applications in the clinic is the sole testing for HPV positivity without considering the HPV integration status. This review will discuss HPV integration as a potential determinant of response to therapies in head and neck cancers and highlight to the field a novel therapeutic avenue that would reduce the cancer burden and improve patient survival.

A review of animal models for burning mouth syndrome: Mechanistic insights and knowledge gaps.

OBJECTIVES: The underlying mechanisms of burning mouth syndrome (BMS) remain unclear leading to challenges and unsatisfactory management. Current treatments focus primarily on symptom relief, with few consistently achieving a 50% reduction in pain. This review aims to explore animal models of BMS to gain a better understanding of the underlying mechanisms and to discuss potential and existing knowledge gaps. METHODS: A comprehensive review of PubMed®, Google Scholar, and Scopus was performed to assess advances and significant gaps of existing rodent models that mimic BMS-related symptoms. RESULTS: Rodent models of BMS involve reproduction of dry-tongue, chorda tympani transection, or overexpression of artemin protein. Existing preclinical models tend to highlight one specific etiopathogenesis and often overlook sex- and hormone-specific factors. CONCLUSION: Combining aspects from various BMS models could prove beneficial in developing comprehensive experimental designs and outcomes encompassing the multifaceted nature of BMS.

Reverse chewing patterns in patients with bilateral posterior crossbite are related to the occlusal features of the malocclusion.

BACKGROUND: Bilateral posterior crossbite (BPXB) is a severe malocclusion associated with maxillary hypoplasia. BPXB may involve the same or a different number of teeth between the sides. OBJECTIVES: To evaluate the masticatory function in BPXB and the association between the masticatory alterations and the occlusal features of BPXB. METHODS: This observational study included 170 participants: 130 patients with BPXB (65 occlusally symmetric BPXB, i.e. same number and type of posterior teeth in crossbite between the sides, F = 33, M = 32, median age 9.6 (8.2-13) [years.months]; 65 patients occlusally asymmetric BPXB, F = 30, M = 35, median age 9.9 (8.3-13.6)) and 40 controls (F = 25, M = 15, median age 10.2 (9.4-11.6)). The masticatory function was evaluated by the detection of the Reverse Chewing Cycles (RCCs) recorded with a kinesiograph using standardised soft and hard boluses. RESULTS: The frequency of RCCs was significantly increased in all BPXB patients compared to controls (p < .000). In symmetric BPXB patients, there were no significant differences in the frequency of RCCs during chewing on the left or the right side. In asymmetric BPXB patients, the frequency of RCCs was significantly increased during chewing on the side with relatively more teeth in crossbite (p < .000). CONCLUSIONS: The masticatory function was significantly altered in all BPXB patients and it was differently affected by symmetric or asymmetric occlusal features of the malocclusion.

Artificial intelligence chatbots and large language models in dental education: Worldwide survey of educators.

INTRODUCTION: Interest is growing in the potential of artificial intelligence (AI) chatbots and large language models like OpenAI's ChatGPT and Google's Gemini, particularly in dental education. To explore dental educators' perceptions of AI chatbots and large language models, specifically their potential benefits and challenges for dental education. MATERIALS AND METHODS: A global cross-sectional survey was conducted in May-June 2023 using a 31-item online-questionnaire to assess dental educators' perceptions of AI chatbots like ChatGPT and their influence on dental education. Dental educators, representing diverse backgrounds, were asked about their use of AI, its perceived impact, barriers to using chatbots, and the future role of AI in this field. RESULTS: 428 dental educators (survey views = 1516; response rate = 28%) with a median [25/75th percentiles] age of 45 [37, 56] and 16 [8, 25] years of experience participated, with the majority from the Americas (54%), followed by Europe (26%) and Asia (10%). Thirty-one percent of respondents already use AI tools, with 64% recognising their potential in dental education. Perception of AI's potential impact on dental education varied by region, with Africa (4[4-5]), Asia (4[4-5]), and the Americas (4[3-5]) perceiving more potential than Europe (3[3-4]). Educators stated that AI chatbots could enhance knowledge acquisition (74.3%), research (68.5%), and clinical decision-making (63.6%) but expressed concern about AI's potential to reduce human interaction (53.9%). Dental educators' chief concerns centred around the absence of clear guidelines and training for using AI chatbots. CONCLUSION: A positive yet cautious view towards AI chatbot integration in dental curricula is prevalent, underscoring the need for clear implementation guidelines.

Artificial intelligence and smile design: An e-Delphi consensus statement of ethical challenges.

PURPOSE: Smile design software increasingly relies on artificial intelligence (AI). However, using AI for smile design raises numerous technical and ethical concerns. This study aimed to evaluate these ethical issues. METHODS: An international consortium of experts specialized in AI, dentistry, and smile design was engaged to emulate and assess the ethical challenges raised by the use of AI for smile design. An e-Delphi protocol was used to seek the agreement of the ITU-WHO group on well-established ethical principles regarding the use of AI (wellness, respect for autonomy, privacy protection, solidarity, governance, equity, diversity, expertise/prudence, accountability/responsibility, sustainability, and transparency). Each principle included examples of ethical challenges that users might encounter when using AI for smile design. RESULTS: On the first round of the e-Delphi exercise, participants agreed that seven items should be considered in smile design (diversity, transparency, wellness, privacy protection, prudence, law and governance, and sustainable development), but the remaining four items (equity, accountability and responsibility, solidarity, and respect of autonomy) were rejected and had to be reformulated. After a second round, participants agreed to all items that should be considered while using AI for smile design. CONCLUSIONS: AI development and deployment for smile design should abide by the ethical principles of wellness, respect for autonomy, privacy protection, solidarity, governance, equity, diversity, expertise/prudence, accountability/responsibility, sustainability, and transparency.

Deep learning for detection and 3D segmentation of maxillofacial bone lesions in cone beam CT.

OBJECTIVES: To develop an automated deep-learning algorithm for detection and 3D segmentation of incidental bone lesions in maxillofacial CBCT scans. METHODS: The dataset included 82 cone beam CT (CBCT) scans, 41 with histologically confirmed benign bone lesions (BL) and 41 control scans (without lesions), obtained using three CBCT devices with diverse imaging protocols. Lesions were marked in all axial slices by experienced maxillofacial radiologists. All cases were divided into sub-datasets: training (20,214 axial images), validation (4530 axial images), and testing (6795 axial images). A Mask-RCNN algorithm segmented the bone lesions in each axial slice. Analysis of sequential slices was used for improving the Mask-RCNN performance and classifying each CBCT scan as containing bone lesions or not. Finally, the algorithm generated 3D segmentations of the lesions and calculated their volumes. RESULTS: The algorithm correctly classified all CBCT cases as containing bone lesions or not, with an accuracy of 100%. The algorithm detected the bone lesion in axial images with high sensitivity (95.9%) and high precision (98.9%) with an average dice coefficient of 83.5%. CONCLUSIONS: The developed algorithm detected and segmented bone lesions in CBCT scans with high accuracy and may serve as a computerized tool for detecting incidental bone lesions in CBCT imaging. CLINICAL RELEVANCE: Our novel deep-learning algorithm detects incidental hypodense bone lesions in cone beam CT scans, using various imaging devices and protocols. This algorithm may reduce patients' morbidity and mortality, particularly since currently, cone beam CT interpretation is not always preformed. KEY POINTS: • A deep learning algorithm was developed for automatic detection and 3D segmentation of various maxillofacial bone lesions in CBCT scans, irrespective of the CBCT device or the scanning protocol. • The developed algorithm can detect incidental jaw lesions with high accuracy, generates a 3D segmentation of the lesion, and calculates the lesion volume.

Melatonin Mitigates iNOS-Related Effects of HEMA and Camphorquinone in Human Dental Pulp Cells: Relevance for Postoperative Sensitivity Mechanism in Type 2 Diabetes.

High elution and diffusion of 2-hydroxylethyl methacrylate (HEMA) and camphorquinone (CQ) through dentinal tubules may induce pulp injury and postoperative sensitivity. We aimed to investigate the melatonin protective effect in HEMA- and CQ-treated human dental pulp cells (hDPCs) as well as its relevance in a mechanism for postoperative sensitivity in diabetic patients. hDPCs were exposed to HEMA (5 mM) and/or CQ (1 mM) in the absence and presence of melatonin (MEL) (0.1 mM and 1 mM). Heme oxygenase-1 (HMOX1), NADPH oxidase-4 (NOX4), BCL-2-associated X-protein (BAX), B-cell lymphoma-2 (BCL-2) and caspase-3 (CASP3) gene expression levels, and superoxide dismutase (SOD) activity were measured in hDPCs while inducible nitric oxide synthase (iNOS) and melatonin protein expression were measured in human dental pulp as well, by RT-PCR, by ELISA, and spectrophotometrically. Bioinformatic analyses were performed by using the ShinyGO (v.0.75) application. Type 2 diabetic patients showed a higher incidence of postoperative sensitivity and lower melatonin and higher iNOS content in dental pulp tissue compared with non-diabetic patients. Melatonin, when co-added in hDPC culture, reverses HEMA and CQ cytotoxic effects via anti-apoptotic and anti-inflammatory/antioxidant iNOS-related effects. Enrichment analyses showed that genes/proteins, altered by HEMA and CQ and normalized by melatonin, are the most prominently overrepresented in type 2 diabetes mellitus pathways and that they share subcellular localization in different oligomeric protein complexes consisting of anti- and pro-apoptotic regulators. This is the first evidence of the ability of melatonin to counteract iNOS-mediated inflammatory and stress effects in HEMA- and CQ-treated hDPCs, which could be of significance for the modulation of presently observed immediate postoperative sensitivity after composite restoration in type 2 diabetic patients.

Accuracy of digital and conventional systems in locating occlusal contacts: A clinical study.

STATEMENT OF PROBLEM: The accuracy of methods used for locating occlusal contacts throughout the entire clinical procedure has been poorly studied. PURPOSE: The purpose of this clinical study was to determine the reproducibility and criterion validity for different methods of locating occlusal contacts. MATERIAL AND METHODS: Thirty-two adults with natural dentitions participated in this cross-sectional test-retest study. In total, occlusal contacts at maximum intercuspation were recorded by using 15 methods: silicone transillumination with Occlufast Rock (40, 50, 100, and 200 µm) and Occlufast CAD (40 and 50 µm); virtual occlusion (100, 200, 300, and 400 µm); articulating film (12-, 40-, 100-, and 200-µm-thick); and T-Scan III. Images of the occlusal records were scaled and calibrated spatially, and the occlusal contacts of the right posterior mandibular teeth were delimited by using the FIJI software program. Reproducibility was expressed as 95% confidence intervals (95% CI) of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against retest sessions using the same method. Criterion validity was expressed as 95% CI of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against images from Occlufast Rock (criterion standard). RESULTS: Occlufast Rock achieved 85% to 95% agreement in the location of the occlusal contacts between the 2 sessions, whereas Occlufast CAD, 200-µm articulating film, and T-Scan offered 79% to 86%, 68% to 75%, and 65% to 75% agreement, respectively. The most valid method was Occlufast CAD (74% to 80%) followed by the 200-µm articulating film (57% to 63%), 400-µm virtual occlusion (53% to 62%), 100-µm articulating film (52% to 60%), and T-Scan (48% to 56%). CONCLUSIONS: Conventional methods, such as 100- and 200-µm articulating film and digital methods, including 400 µm virtual occlusion and T-Scan, offer sufficient accuracy in locating the occlusal contacts. However, strategies are needed to improve accuracy.

Association of interleukin-1, interleukin-6, collagen type I alpha 1, and osteocalcin gene polymorphisms with early crestal bone loss around submerged dental implants: A nested case control study.

STATEMENT OF PROBLEM: The reason for variations in peri-implant early crestal bone loss is unclear but may be due to genetic differences among individuals. PURPOSE: The purpose of this nested case control study was to investigate the association of single-nucleotide polymorphisms of interleukin-1, interleukin-6, collagen type I alpha1, and osteocalcin genes to early crestal bone loss around submerged dental implants. MATERIAL AND METHODS: Dental implants were placed in the mandibular posterior region (single edentulous space) of 135 participants selected according to predetermined selection criteria. Bone mineral density measurement by using dual energy X-ray absorptiometry, cone beam computed tomography scans at the baseline and after 6 months, and interleukin-1A-889 A/G (rs1800587), interleukin-1B-511 G/A (rs16944), interleukin-1B+3954 (rs1143634), interleukin-6-572 C/G (rs1800796), collagen type I alpha1 A/C (rs1800012), and osteocalcin C/T (rs1800247) genotyping were performed in all participants. Early crestal bone loss measured around dental implants was used to group participants into clinically significant bone loss (BL)>0.5 mm and clinically nonsignificant bone loss (NBL)≤0.5 mm. Early crestal bone loss was calculated as the mean of the difference of bone levels at the baseline and bone levels after 6 months as measured with cone beam computed tomography scans. The obtained data for basic characteristics, early crestal bone loss, and genotyping were tabulated and compared by using a statistical software program (α=.05). RESULTS: AA genotype and the A allele frequency of interleukin-1B-511 and GG genotype and the G allele frequency of interleukin-6-572 were significantly higher in BL than in NBL (P<.05). Multiple logistic analysis suggested that interleukin-1B-511 AA/GG+AG and interleukin-6-572 GG/CC+CG genotype expression were significantly associated with early crestal bone loss (AA/GG+AG; P=.014, GG/CC+CG; P=.047) around dental implants. Other risk factors were not significantly different (P>.05). CONCLUSIONS: Of the genes studied, individuals with interleukin-1B-511 AA (rs16944) or interleukin-6-572 GG (rs1800796) genotype had higher susceptibility to early crestal bone loss around dental implants.

Growth differentiation factor-15 and circulating biomarkers as predictors of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial.

BACKGROUND: During the last decades, in patients with periodontitis, periodontal treatment has been shown to reduce the potential release of local and systemic biomarkers linked to an early risk of systemic inflammatory disorders. This study evaluated the efficacy of non-surgical-periodontal treatment (NSPT) on growth differentiation factor 15 (GDF-15) and related circulating biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) in periodontal patients and explored whether subjects who had high GDF-15 levels at baseline showed increased clinical benefits following NSPT at 6-months follow-up. METHODS: For this two-arm, parallel randomized clinical trial, patients with periodontitis were randomly allocated to receive quadrant scaling and root-planing (Q-SRP, n = 23, median age 51 years old) or full-mouth disinfection (FMD, n = 23, median age 50 years old) treatment. Clinical and periodontal parameters were recorded in all enrolled patients. The primary outcome was to analyse serum concentrations changes of GDF-15 and of GPx-1, hs-CRP, and SP-D at baseline and at 30, 90, and 180-days follow-up after NSPT through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques. RESULTS: In comparison with FMD, patients of the Q-SRP group showed a significant improvement in clinical periodontal parameters (p < 0.05) and a reduction in the mean levels of GDF-15 (p = 0.005), hs-CRP (p < 0.001), and SP-D (p = 0.042) and an increase of GPx-1 (p = 0.025) concentrations after 6 months of treatment. At 6 months of treatment, there was a significant association between several periodontal parameters and the mean concentrations of GDF-15, GPx-1, hs-CRP, and SP-D (p < 0.05 for all parameters). Finally, the ANOVA analysis revealed that, at 6 months after treatment, the Q-SRP treatment significantly impacted the reduction of GDF-15 (p = 0.015), SP-D (p = 0.026) and the upregulation of GPx-1 (p = 0.045). CONCLUSION: The results evidenced that, after 6 months of treatment, both NSPT protocols improved the periodontal parameters and analyzed biomarkers, but Q-SRP was more efficacious than the FMD approach. Moreover, patients who presented high baseline GDF-15 and SP-D levels benefited more from NSPT at 6-month follow-up. TRIAL REGISTRATION: NCT05720481.

Roles of exosomes in regenerative periodontology: a narrative review.

Periodontitis is the primary cause of irreversible destruction of the periodontium surrounding teeth. Proinflammatory cytokines are secreted by pathogens in the biofilm and destroy the periodontium. Exosomes released into all biological fluids from saliva have enabled many innovations in the early diagnosis and treatment of periodontal diseases. This narrative review describes the role of exosomes in various diseases, and their involvement in periodontal diseases and periodontal regeneration primarily. Since guided tissue regeneration offers unpredictable results that vary according to the case, new developments in periodontal treatment are needed. Exosomes are suitable drug carriers for periodontal regeneration due to their isolation from every biological fluid, biocompatibility, low toxicity and high concentration of drugs reaching the target tissue. Exosomes obtained from mesenchymal stem cells can be used for periodontal regeneration in periodontal flaps, scaffolds, or periodontal defect areas through biomaterials such as drugs and hydrogels. Exosomes are significant in the early diagnosis and development of treatment of many diseases such as cardiovascular, neurodegenerative, diabetes and prognostic markers in cancer. Future studies are needed to elucidate the effects and possible mechanisms of exosomes in periodontitis and periodontal diseases and other systemic diseases, as they have many promises in diagnosis, treatment, and prognosis.

Clinical outcomes of flap versus flapless immediately loaded single dental implants in the mandibular posterior region: One-year follow-up results from a randomized controlled trial.

STATEMENT OF PROBLEM: Flapless implant placement with immediate functional loading has been reported in anterior locations. However, data on posterior locations are lacking. PURPOSE: The purpose of this randomized controlled trial was to determine and compare clinical outcomes of flap versus flapless surgically placed single posterior mandibular dental implants subjected to immediate functional loading. MATERIAL AND METHODS: Participants with missing mandibular first molar teeth were recruited and randomized into 2 groups (n=51): flapped and flapless. Dental implants were surgically placed and loaded immediately with interim restorations following implant protective occlusion. Outcome measures were implant failure, crestal bone loss, and periodontal parameters: modified plaque index, modified sulcus bleeding index, and pocket depths. Outcome data were recorded at baseline, 6-month, and 12-month follow-up visits. Cone beam computed tomography scans were used to calculate crestal bone loss, and periodontal outcomes were recorded by using a resin covered periodontal probe (α=.05). RESULTS: After 12 months, similar implant failure rates (P>.05) were found between the groups. Crestal bone loss in the flapped group was statistically higher than in the flapless group at 6 months (0.83 ±0.21 mm versus 0.75 ±0.23 mm) and at 12 months (1.04 ±0.27 mm versus 0.90 ±0.24 mm) from the baseline. The modified plaque index, modified sulcus bleeding index, and peri-implant probing depths (PDs) in both groups increased from the baseline to 6-month follow-ups (Baseline modified plaque index: 0.82 ±0.54 versus 0.79 ±0.21; Baseline modified sulcus bleeding index: 0.74 ±0.21 versus 0.70 ±0.43; Baseline PD: 1.25 ±0.37 mm versus 1.20 ±0.22 mm; 6 months modified plaque index: 1.54 ±0.70 versus 1.21 ±0.45; 6 months modified sulcus bleeding index: 1.93 ±0.54 versus 1.51 ±0.61; 6 months PD: 3.20 ±0.73 mm versus 2.80 ±0.43 mm). At 12-month follow-ups after repeated oral hygiene reinforcements, periodontal parameters had improved (decreased) significantly. CONCLUSIONS: Flapless implant insertion with immediate functional loading could be considered as an appropriate treatment option for providing functional restorations on the day of implant placement with minimal surgical intervention, reducing crestal bone loss, and periodontal complications.

Deep learning for cephalometric landmark detection: systematic review and meta-analysis.

OBJECTIVES: Deep learning (DL) has been increasingly employed for automated landmark detection, e.g., for cephalometric purposes. We performed a systematic review and meta-analysis to assess the accuracy and underlying evidence for DL for cephalometric landmark detection on 2-D and 3-D radiographs. METHODS: Diagnostic accuracy studies published in 2015-2020 in Medline/Embase/IEEE/arXiv and employing DL for cephalometric landmark detection were identified and extracted by two independent reviewers. Random-effects meta-analysis, subgroup, and meta-regression were performed, and study quality was assessed using QUADAS-2. The review was registered (PROSPERO no. 227498). DATA: From 321 identified records, 19 studies (published 2017-2020), all employing convolutional neural networks, mainly on 2-D lateral radiographs (n=15), using data from publicly available datasets (n=12) and testing the detection of a mean of 30 (SD: 25; range.: 7-93) landmarks, were included. The reference test was established by two experts (n=11), 1 expert (n=4), 3 experts (n=3), and a set of annotators (n=1). Risk of bias was high, and applicability concerns were detected for most studies, mainly regarding the data selection and reference test conduct. Landmark prediction error centered around a 2-mm error threshold (mean; 95% confidence interval: (-0.581; 95 CI: -1.264 to 0.102 mm)). The proportion of landmarks detected within this 2-mm threshold was 0.799 (0.770 to 0.824). CONCLUSIONS: DL shows relatively high accuracy for detecting landmarks on cephalometric imagery. The overall body of evidence is consistent but suffers from high risk of bias. Demonstrating robustness and generalizability of DL for landmark detection is needed. CLINICAL SIGNIFICANCE: Existing DL models show consistent and largely high accuracy for automated detection of cephalometric landmarks. The majority of studies so far focused on 2-D imagery; data on 3-D imagery are sparse, but promising. Future studies should focus on demonstrating generalizability, robustness, and clinical usefulness of DL for this objective.

Atypical presentation of polymicrobial cervicofacial necrotizing fasciitis: An extraordinary odontogenic infection in a healthy female patient.

Cervicofacial necrotizing fasciitis (CNF) can occur as a dental complication in young, healthy individuals. Early diagnosis, treatment, and awareness of severe acute cervicofacial pain, rapid swelling, and radiological gas formation are crucial. Broad molecular profiling is recommended for understanding the organisms involved in such infections in future research.

Deep-learning performance in identifying and classifying dental implant systems from dental imaging: a systematic review and meta-analysis.

Deep learning (DL) offers promising performance in computer vision tasks and is highly suitable for dental image recognition and analysis. We evaluated the accuracy of DL algorithms in identifying and classifying dental implant systems (DISs) using dental imaging. In this systematic review and meta-analysis, we explored the MEDLINE/PubMed, Scopus, Embase, and Google Scholar databases and identified studies published between January 2011 and March 2022. Studies conducted on DL approaches for DIS identification or classification were included, and the accuracy of the DL models was evaluated using panoramic and periapical radiographic images. The quality of the selected studies was assessed using QUADAS-2. This review was registered with PROSPERO (CRDCRD42022309624). From 1,293 identified records, 9 studies were included in this systematic review and meta-analysis. The DL-based implant classification accuracy was no less than 70.75% (95% confidence interval [CI], 65.6%-75.9%) and no higher than 98.19 (95% CI, 97.8%-98.5%). The weighted accuracy was calculated, and the pooled sample size was 46,645, with an overall accuracy of 92.16% (95% CI, 90.8%-93.5%). The risk of bias and applicability concerns were judged as high for most studies, mainly regarding data selection and reference standards. DL models showed high accuracy in identifying and classifying DISs using panoramic and periapical radiographic images. Therefore, DL models are promising prospects for use as decision aids and decision-making tools; however, there are limitations with respect to their application in actual clinical practice.

Oral and periodontal manifestation related during human papilloma virus infections: Update on early prognostic factors.

Human Papilloma Virus (HPV) is considered one of the most common sexually transmitted infections and has been shown to play an important role in the pathogenesis of squamous cell carcinomas (SCC) of the cervix and head and neck. Manifestations of HPV infections can be manifold, ranging from asymptomatic infections to benign or potentially malignant lesions to intraepithelial neoplasms and invasive carcinomas. The heterogeneity of clinical manifestations from HPV infection depends on the interactions between the viral agent and the host, a direct consequence of the ability on the part of HPV is to remain silent and to evade and convey the action of the host immune system. The oral mucosa represents one of the tissues for which HPV has a distinct tropism and is frequently affected by infection. While much information is available on the role that HPV infection plays in the development of SCC in the oral cavity, there is less information on asymptomatic infections and benign HPV-induced oral lesions. Therefore, the purpose of this review is to analyze, in light of current knowledge, the early clinical and bio-humoral prognostic features related to the risk of HPV malignant transformation, focusing on subclinical conditions, benign lesions, and the correlation between oral infection and infection in other districts. The data show that the main risk associated with HPV infection is related to malignant transformation of lesions. Although HPV-driven OPSCC is associated with a better prognosis than non-HPV-driven OPSCC, primary prevention and early detection of the infection and affected genotype are essential to reduce the risk of malignant neoplastic complications and improve the prognosis.

Volumetric analysis of mastoid air cells in orthodontic malocclusions in 3D cone beam computed tomography (CBCT).

Objectives: To determine age- and sex-related changes in mastoid air cells volume in orthodontic malocclusions (class 1, class 2, class 3) in cone beam computed tomography (CBCT), morphometric analysis, and age prediction on the basis of mastoid air cells. Methods: In total, 150 3D CBCT scans of study subjects having class 1, class 2, and class 3 malocclusions have been analyzed retrospectively for the estimation of volume of mastoid air cells by Dolphin imaging software V11.9, and measurement data of volumes have been recorded and analyzed using SPSS software 24.v. Results: The volume of mastoid air cells was highest in age group of 14-28 years which was statistically not significant (P value >.05). The volume of mastoid air cells in the right side of cranium is greater than mastoid air cells in the left side. The mastoid air cell volume was higher in males than females. The volume of mastoid air cells (right side) was highest in class II malocclusion (2404.53 ± 1737.50 mm3) followed by class III and was least in class I malocclusion (1842.09 ± 1263.78 mm3). However, the volume of mastoid air cells in the left side was highest in class III malocclusion (2368.03 ± 1853.00 mm3) followed by class II and was least in class I (1920.52 ± 1285.34 mm3). Conclusions: The volume of mastoid air cells varies in different class of orthodontic malocclusions. The mastoid air cells volume is higher in males than females. On the basis of mastoid air cells volume, we are able to predict the age, sex, and class of orthodontic malocclusion.

Isotopological remeshing and statistical shape analysis: Enhancing premolar tooth wear classification and simulation with machine learning.

OBJECTIVE: The aim of this study was to evaluate the accuracy of a combined approach based on an isotopological remeshing and statistical shape analysis (SSA) to capture key anatomical features of altered and intact premolars. Additionally, the study compares the capabilities of four Machine Learning (ML) algorithms in identifying or simulating tooth alterations. METHODS: 113 premolar surfaces from a multicenter database were analyzed. These surfaces were processed using an isotopological remeshing method, followed by a SSA. Mean Euclidean distances between the initial and remeshed STL files were calculated to assess deviation in anatomical landmark positioning. Seven anatomical features were extracted from each tooth, and their correlations with shape modes and morphological characteristics were explored. Four ML algorithms, validated through three-fold cross-validation, were assessed for their ability to classify tooth types and alterations. Additionally, twenty intact teeth were altered and then reconstructed to verify the method's accuracy. RESULTS: The first five modes encapsulated 76.1% of the total shape variability, with a mean landmark positioning deviation of 10.4 µm (±6.4). Significant correlations were found between shape modes and specific morphological features. The optimal ML algorithms demonstrated high accuracy (>83%) and precision (>86%). Simulations on intact teeth showed discrepancies in anatomical features below 3%. CONCLUSION: The combination of an isotopological remeshing with SSA showed good reliability in capturing key anatomical features of the tooth. CLINICAL SIGNIFICANCE: The encouraging performance of ML algorithms suggests a promising direction for supporting practitioners in diagnosing and planning treatments for patients with altered teeth, ultimately improving preventive care.

Salivary and serum estrogen level assessment in oral lichen planus patients and its correlative analysis with OLP and stress.

Background: Lichen planus is a chronic inflammatory disease of the skin and mucous membrane with higher predilection seen in the female population. Oral lichen planus (OLP) has been associated with various etiological factors, such as stress, hormonal imbalance, and immunological variation. The purpose of this study was to assess serum and salivary estrogen (E2) levels in OLP patients and correlate them with stress levels. Objectives: This study aimed to evaluate serum and salivary estrogen levels in female patients with OLP, along with the assessment of stress and its correlation with estrogen levels. Methods: A total of 78 females, 39 clinically diagnosed with OLP and 39 healthy females, were included in the study as the case and control groups, respectively. 2 ml each of salivary and serum samples was obtained from each participant to measure the estrogen levels. Stress levels in the study group patients were assessed using the Depression Anxiety Stress Scale (DASS-21) and the Perceived Stress Scale (PSS). The nonparametric Mann-Whitney test was used for intergroup comparisons. Results: Significantly higher serum estrogen levels with higher DASS-21 and PSS scores were noted in patients with OLP. Overall, significant positive correlations were observed between salivary E2 and serum E2 (r = 0.361, P = 0.001). There was a positive correlation between salivary and serum E2 and DASS score (r = 0.410, P < 0.001, and r = 0.768, P < 0.001, respectively), serum/salivary E2 and PSS score (r = 0.745, P < 0.001, and r = 0.410, P < 0.001, respectively), and DASS score and PSS score (r = 0.878, P < 0.001). Conclusion: Estrogen can be used as a useful biomarker for OLP in the future. Salivary samples can prove to be an accurate and feasible alternative to serum estrogen level determination. We also suggest that OLP patients must be given supportive psychological treatment for improved life quality and disease management.