Exploring the ambiguity in the anatomical terminology among Dental professionals.

BACKGROUND: Anatomical terms in medical literature have been used with varying meanings, leading to confusion in clinical practice. This study aims to investigate the ambiguity of anatomical terms in clinical dentistry. METHODS: Dentists who have undergone specialised training with at least one year of clinical experience were recruited to participate in the study. They were requested to localize specific terms on a skull and provide explanations based on their experience or opinion. All data were recorded, and then descriptive statistics were used for analysis. RESULTS: Seventy-eight participating dentists gave their consent and were eligible to study. For each anatomical term presented to dentists at least two meanings were provided, with some terms having up to eight interpretations. While most meanings were consistent with medical or dental literature, some responses revealed new interpretations not documented in textbooks. CONCLUSIONS: Dentists expressed anatomical terms with diverse meanings, possibly influenced by their various subspecialties. It is crucial to acknowledge this variability to prevent confusion. Emphasizing the consistent use of anatomical terms among dental professionals in the future is essential.

Determining the position of the lingula and the mandibular foramen using the antilingula in orthognathic surgery.

BACKGROUND: The antilingula located on the lateral surface of the mandibular ramus has been served as a surgical landmark for the mandibular foramen on the medial surface for decades. However, whether the antilingula truly represents the lingula which is the bony prominence overlapping the mandibular foramen, or the foramen itself, is still unclear. This study thus aimed to examine the position of the antilingula in relation to three reference points: the lingula, the anterior and the posterior borders of the mandibular foramen, as well as to the reference plane used in the inferior alveolar nerve block, and to the posterior border of the mandible. METHODS: This observational study was performed in 113 Thai dry mandibles. The antilingula were identified followed by transferring the reference points to the lateral surface. The distances from the antilingula to the reference points, the reference plane and the posterior border of the ramus were then measured. Chi-square test was calculated for side-dependency of the antilingula. Paired t-test was calculated for difference in measurements in left and right sides. RESULTS: The antilingula could be identified in 92.48% of the mandibles with 86.67 - 90.00% accuracy and 86.67% reliability. There was no significant difference in the presence of the antilingula on left and right sides (p = 0.801). Only 2.5% and 0.83% of the antilingula correspond to the lingula and the anterior border of the mandibular foramen, respectively. However, 85% of the reference points were located within 11 mm radius. The antilingula was found located 2.80 mm inferior to the reference plane and 16.84 mm from the posterior border of the ramus. CONCLUSIONS: The antilingula does not concur with the reference points on the medial surface. Our study also suggests that the safe area for vertical osteotomy is 11 mm posterior to the antilingula or at 30% of the length from the posterior border parallel to the occlusal plane. The use of more accurate techniques in localizing the mandibular foramen combined with the antilingula is more recommended than using the antilingula as a sole surgical guide.

Pre-eruptive intramural resorption in unerupted teeth: a cone-beam computed tomography evaluation of prevalence and related factors.

OBJECTIVE: Pre-eruptive intramural resorption (PEIR) is defined as an abnormal, well-circumscribed radiolucency within the coronal dentin of the tooth, which is often overlooked in plain radiographs. This study aimed to investigate the prevalence of PEIR and its related factors using cone-beam computed tomography (CBCT). METHODS: CBCT images of 590 unerupted teeth were evaluated for the presence of PEIR, location of PEIR, number of lesions in the affected tooth, PEIR score, tooth angulation, tooth position, and pericoronal space. Binary logistic tests were used to analyze the association between the characteristics of PEIR and the patient's demographic data and related factors. RESULTS: The tooth prevalence of PEIR was 13.6% among unerupted teeth. However, it was noteworthy that 19.2% of the unerupted teeth with PEIR were planned to be kept. PEIR was significantly associated with transverse (p = 0.020), inverted-angulated (p = 0.035), and centrally-positioned teeth (p = 0.043). The severity of PEIR was more pronounced in teeth with distal (p = 0.019), lingual (p = 0.023), or inverted-angulated (p = 0.040) positions, and in the absence of pericoronal space (p = 0.036). CONCLUSION: PEIR should be suspected in transverse, inverted-angulated, centrally positioned unerupted teeth, particularly in molars, with no pericoronal space. Further monitoring through CBCT is recommended in such cases. CLINICAL RELEVANCE: The management of unerupted teeth does not always involve surgical removal. Instead, they could be utilized for artificial eruption or tooth transplantation. The present study emphasizes the significance of early detection of PEIR. Clinical recommendations for screening PEIR in unerupted teeth are also proposed, which can be applied to routine plain radiographs.

Establishing Clinically Acceptable PES/WES Threshold for Single- Tooth Implant Restoration.

PURPOSE: Determining the esthetic success of single-tooth implant restorations (STIR) requires an objective tool such as one devised by Belser et al., 2009 - pink esthetic scores and white esthetic scores (PES/WES). This study aimed to utilized PES/WES to establish threshold scores based on (1) detectability and (2) acceptability of a STIR by lay person perception, (3) to study the difference in the ability of laypeople and dentists in detecting the presence of STIR, and (4) to study the pink and white deficiencies in relation to the detectability of the presence of STIR. MATERIALS AND METHODS: A total of 38 calibrated photographs of STIR in the anterior region were scored with PES/WES by 3 prosthodontists. Next, 100 laypeople and 60 dentists were instructed to identify the STIR among the anterior teeth and provide reasoning behind the identification (based on pink and white esthetic criteria). The acceptance of the STIR was recorded. Receiver Operating Characteristics (ROC) analysis was utilized to determine the threshold scores. RESULTS: At the PES/WES score of 17, 71% of laypeople could not correctly identify the STIR, and at the PES/WES score of 12, 80% of laypeople accepted the implant. Out of 3,800 occasions, laypeople correctly identified the STIR 1,770 (46.58%) of those occasions. Among the correctly identified STIR, 751 (42.43%) of those occasions were identified with pink deficiencies and 1019 (57.57%) of those occasions were with white deficiencies. Out of 2,280 occasions, dentists correctly identified STIR 1869 (81.98%) of those occasions. CONCLUSIONS: The PES/WES score of 12 indicates the clinically acceptable threshold, while the score of 17 indicates the detectable threshold for an exceptional esthetic outcome. Laypeople tend to accept the implant despite its detectability. For both laypeople and dentists, root convexity/soft tissue color and texture are the most focused criteria of PES/WES, followed by overall white deficiencies that remain influential. Compared to laypeople, dentists tend to have a higher ability to detect STIR.

Standardized Centella asiatica extract ECa 233 alleviates pain hypersensitivity by modulating P2X3 in trigeminal neuropathic pain.

OBJECTIVE: During oral surgery and temporomandibular joint repositioning, pain hypersensitivity often occurs due to irritation or inflammation of the nerve endings in the orofacial region. This study aimed to investigate the effects of ECa 233, a Centella asiatica-standardized extract, on the development of mechanical hyperalgesia and allodynia induced by chronic constriction injury of the infraorbital nerve in mice. METHODOLOGY: The right infraorbital nerves of the mice were ligated. Oral carbamazepine (20 mg/kg) or ECa 233 (30, 100, or 300 mg/kg) was administered daily for 21 days. Von Frey and air-puff tests were performed on both sides of the whisker pad on days 0, 7, 14, and 21. Thereafter, the expression of purinergic receptor subtype 3 (P2X3) and voltage-gated sodium channel 1.7 (NaV1.7), a transmembrane protein, in the trigeminal ganglion and c-fos immunoreactivity-positive neurons in the trigeminal nucleus caudalis was assessed. RESULTS: After 21 days of infraorbital nerve ligation, the mice showed allodynia- and hyperalgesia-like behavior, P2X3 and NaV1.7 were upregulated in the trigeminal ganglion, and nociceptive activity increased in the trigeminal nucleus caudalis. However, the oral administration of carbamazepine (20 mg/kg), ECa 233 (100 mg/kg), or ECa 233 (300 mg/kg) mitigated these effects. Nevertheless, ECa 233 failed to affect NaV1.7 protein expression. CONCLUSION: Carbamazepine and ECa 233 can prevent pain hypersensitivity in mice. Considering the side effects of the long-term use of carbamazepine, ECa 233 monotherapy or combined ECa 233 and carbamazepine therapy can be used as an alternative for regulating the development of hypersensitivity in trigeminal pain. However, further detailed clinical studies should be conducted to provide comprehensive information on the use of ECa 233.

Standardized Centella asiatica extract ECa 233 alleviates pain hypersensitivity by modulating P2X3 in trigeminal neuropathic pain

Abstract During oral surgery and temporomandibular joint repositioning, pain hypersensitivity often occurs due to irritation or inflammation of the nerve endings in the orofacial region. Objective: This study aimed to investigate the effects of ECa 233, a Centella asiatica-standardized extract, on the development of mechanical hyperalgesia and allodynia induced by chronic constriction injury of the infraorbital nerve in mice. Methodology: The right infraorbital nerves of the mice were ligated. Oral carbamazepine (20 mg/kg) or ECa 233 (30, 100, or 300 mg/kg) was administered daily for 21 days. Von Frey and air-puff tests were performed on both sides of the whisker pad on days 0, 7, 14, and 21. Thereafter, the expression of purinergic receptor subtype 3 (P2X3) and voltage-gated sodium channel 1.7 (NaV1.7), a transmembrane protein, in the trigeminal ganglion and c-fos immunoreactivity-positive neurons in the trigeminal nucleus caudalis was assessed. Results: After 21 days of infraorbital nerve ligation, the mice showed allodynia- and hyperalgesia-like behavior, P2X3 and NaV1.7 were upregulated in the trigeminal ganglion, and nociceptive activity increased in the trigeminal nucleus caudalis. However, the oral administration of carbamazepine (20 mg/kg), ECa 233 (100 mg/kg), or ECa 233 (300 mg/kg) mitigated these effects. Nevertheless, ECa 233 failed to affect NaV1.7 protein expression. Conclusion: Carbamazepine and ECa 233 can prevent pain hypersensitivity in mice. Considering the side effects of the long-term use of carbamazepine, ECa 233 monotherapy or combined ECa 233 and carbamazepine therapy can be used as an alternative for regulating the development of hypersensitivity in trigeminal pain. However, further detailed clinical studies should be conducted to provide comprehensive information on the use of ECa 233.

Stem cell-derived exosomes from human exfoliated deciduous teeth promote angiogenesis in hyperglycemic-induced human umbilical vein endothelial cells

Abstract Objective To investigate the angiogenesis in human umbilical vein endothelial cells (HUVEC) under high glucose concentration, treated with exosomes derived from stem cells from human exfoliated deciduous teeth (SHED). Methodology SHED-derived exosomes were isolated by differential centrifugation and were characterized by nanoparticle tracking analysis, transmission electron microscopy, and flow cytometric assays. We conducted in vitro experiments to examine the angiogenesis in HUVEC under high glucose concentration. Cell Counting Kit-8, migration assay, tube formation assay, quantitative real-time PCR, and immunostaining were performed to study the role of SHED-derived exosomes in cell proliferation, migration, and angiogenic activities. Results The characterization confirmed SHED-derived exosomes: size ranged from 60-150 nm with a mode of 134 nm, cup-shaped morphology, and stained positively for CD9, CD63, and CD81. SHED-exosome significantly enhanced the proliferation and migration of high glucose-treated HUVEC. A significant reduction was observed in tube formation and a weak CD31 staining compared to the untreated-hyperglycemic-induced group. Interestingly, exosome treatment improved tube formation qualitatively and demonstrated a significant increase in tube formation in the covered area, total branching points, total tube length, and total loop parameters. Moreover, SHED-exosome upregulates angiogenesis-related factors, including the GATA2 gene and CD31 protein. Conclusions Our data suggest that the use of SHED-derived exosomes potentially increases angiogenesis in HUVEC under hyperglycemic conditions, which includes increased cell proliferation, migration, tubular structures formation, GATA2 gene, and CD31 protein expression. SHED-exosome usage may provide a new treatment strategy for periodontal patients with diabetes mellitus.

Optimal culture conditions for neurosphere formation and neuronal differentiation from human dental pulp stem cells

Abstract Objectives Human dental pulp stem cells (DPSCs) have been used to regenerate damaged nervous tissues. However, the methods of committing DPSCs into neural stem/progenitor cells (NSPCs) or neurospheres are highly diverse, resulting in many neuronal differentiation outcomes. This study aims to validate an optimal protocol for inducing DPSCs into neurospheres and neurons. Methodology After isolation and characterization of mesenchymal stem cell identity, DPSCs were cultured in a NSPC induction medium and culture vessels. The durations of the culture, dissociation methods, and passage numbers of DPSCs were varied. Results Neurosphere formation requires a special surface that inhibits cell attachment. Five-days was the most appropriate duration for generating proliferative neurospheres and they strongly expressed Nestin, an NSPC marker. Neurosphere reformation after being dissociated by the Accutase enzyme was significantly higher than other methods. Passage number of DPSCs did not affect neurosphere formation, but did influence neuronal differentiation. We found that the cells expressing a neuronal marker, β-tubulin III, and exhibiting neuronal morphology were significantly higher in the early passage of the DPSCs. Conclusion These results suggest a guideline to obtain a high efficiency of neurospheres and neuronal differentiation from DPSCs for further study and neurodegeneration therapeutics.

A standardized extract of Centella asiatica (ECa 233) prevents temporomandibular joint osteoarthritis by modulating the expression of local inflammatory mediators in mice

Abstract Objectives To investigate the effect of a standardized extract of Centella asiatica (ECa 233), which has anti-inflammatory properties, on the local expression of the transient receptor potential vanilloid 1 (TRPV1), the acid-sensing ion channel subunit 3 (ASIC3), and the calcitonin gene-related peptide (CGRP) in the temporomandibular joint (TMJ) structure 21 days after injecting the TMJ with complete Freund's adjuvant (CFA). Methodology A mouse model was induced by analyzing the CFA-injected TMJ on days 7, 14, and 21. We assessed TMJ histology by the osteoarthritis cartilage grade score. Then, we observed the effect of different ECa 233 concentrations (30, 100, and 300 mg/kg) and of 140 mg/kg ibuprofen doses on TRPV1, ASIC3, and CGRP local expression on day 21. Results Osteoarthritis cartilage scores were 1.17±0.37 and 3.83±0.68 on days 14 and 21, respectively, in the CFA group (n=5). On day 21, TRPV1, ASIC3, and CGRP expression significantly increased in the CFA group. In the ibuprofen-treated group, TRPV1 expression significantly decreased, but ASIC3 and CGRP showed no significant difference. All ECa 233 doses reduced TRPV1 expression, but the 100 mg/kg ECa 233 dose significantly decreased ASIC3 expression. Conclusions TRPV1, ASIC3, and CGRP expression increased in mice with TMJ-OA on day 21. All ECa 233 and ibuprofen doses inhibited pathogenesis by modulating the local expression of TRPV1 and ASIC3. Therefore, ECa 233 was more effective than ibuprofen.