Higher frequencies of anemia, vitamin B12 deficiency, and gastric parietal cell antibody positivity in folic acid-deficient Taiwanese male oral submucous fibrosis patients.

Background/purpose: Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with folic acid (FA) deficiency (the serum FA level ≤6 ng/mL, so-called FA-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and vitamin B12 deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. Materials and methods: The blood Hb and serum iron, vitamin B12, FA, and GPCA concentrations in 59 Taiwanese male FA-deficient OSF patients were measured and compared with the corresponding data in 118 age-matched healthy male control subjects. Results: We found that 3 (5.1%), 35 (59.3%), and 7 (11.9%) of the 59 FA-deficient OSF patients had blood Hb (<13 g/dL) and serum vitamin B12 (≤450 pg/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 59 FA-deficient OSF patients had significantly higher frequencies of serum vitamin B12 deficiency and serum GPCA positivity than 118 healthy control subjects (all P-values <0.05). Of the 3 anemic FA-deficient OSF patients, one had macrocytic anemia and the other two had thalassemia trait-induced anemia. Conclusion: We conclude that Taiwanese male FA-deficient OSF patients have high frequencies of serum vitamin B12 deficiency and GPCA positivity than healthy control subjects. The vitamin B12 and FA deficiencies in FA-deficient OSF patients are more likely due to OSF symptoms and signs-caused insufficient intake, difficulty in chewing and swallowing, and malabsorption of food fragment-bound vitamin B12 and FA rather than the GPCA positivity in these OSF patients.

Higher frequencies of anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in vitamin B12-deficient Taiwanese male oral submucous fibrosis patients.

Abstract Background/purpose: Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with vitamin B12 deficiency (the serum vitamin B12 level ≤ 450 pg/mL, B12-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and folic acid deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. Materials and methods: The blood Hb and serum iron, vitamin B12, folic acid, and GPCA concentrations in 66 Taiwanese male B12-deficient OSF patients were measured and compared with the corresponding data in 132 age-matched healthy male control subjects. Results: We found that 6 (9.1%), 19 (28.8%), 35 (53.0%), and 9 (13.6%) of the 66 B12-deficient OSF patients had blood Hb (<13 g/dL) and serum iron (≤70 µg/dL), and folic acid (≤6 ng/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 66 OSF patients had significantly higher frequencies of blood Hb and serum iron and folic acid deficiencies, and serum GPCA positivity than 132 healthy control subjects (all P-values < 0.05). Of the 6 anemic B12-deficient OSF patients, one had macrocytic anemia, two normocytic anemia, and three thalassemia trait-induced anemia. Conclusion: Taiwanese male B12-deficient OSF patients have high frequencies of blood Hb, serum iron and folic acid deficiencies, and serum GPCA positivity. The anemia and hematinic deficiencies in B12-deficient OSF patients are likely due to OSF symptoms and signs-caused insufficient intake, poor chewing, and malabsorption of hematinic elements from ingested food stuffs rather than the GPCA positivity.

Overview of dental education system and gender distribution of undergraduate dental students in Taiwan.

Abstract Background/purpose: The gender distribution of dentists in Taiwan has been dominated by male dentists for a long time. This study analyzed preliminarily the appearance of the current dental education system and the gender distribution of undergraduate dental students. Materials and methods: This study used documentary analysis and secondary data analysis to survey mainly the current dental education system and the gender distribution of undergraduate dental students in Taiwan. Results: There were a total of 2474 dental students and 394 dental graduates in Taiwan in 2021. The numbers of male students (1435, 58.00%) and male graduates (207, 52.54%) were higher than those of female students (1039, 42.00%) and female graduates (187, 47.46%). The numbers of male dental students in the northern (629), central (428), and southern (378) regions were all higher than those of female dental students (423, 373, and 243, respectively). The chi-square test indicated the significantly higher proportion of male dental students in the northern and southern regions (P < 0.01). Besides, there were a total of 15,857 registered dentists. The number of male dentists (10,997, 69.35%) was higher than that of female dentists (4,860, 30.65%). Compared with population, the chi-square test showed the significantly higher proportion of male dental students and male registered dentists (all P-values < 0.001). Conclusion: In Taiwan, the dental education system must promote female students' interest in dentistry and elevate the proportion of female dental supervisors to increase the proportion of female dental students and female dentists in the future.

Radiographic characteristics of odontomas in patients in the National Taiwan University Children's Hospital.

Background/purpose: Odontoma is the most common odontogenic tumor. A literature review revealed limited data for odontomas in Taiwan. This study evaluated the radiographic characteristics of odontomas in 1280 patients in the National Taiwan University Children's Hospital (NTUCH). Materials and methods: This retrospective study analyzed the odontomas based on examination of mainly panoramic radiographs and related radiographs of 1280 patients in the NTUCH. Chi-square test was used for trend analysis. Results: Among 1280 patients (710 boys and 570 girls), a total of 16 patients with odontomas (10 boys and 6 girls) were identified. There were 14 compound and 2 complex odontomas. The mean age of the patients was 10.38 years with the majority of odontomas occurring in the first (37.5%) and second decade (62.5%) of life. Odontomas had a marked predilection for the mandible (56.25%) and for the anterior region of the jaws (75%), particularly for the anterior maxilla (43.75%). Ten odontomas (62.5%) were associated with the impacted corresponding permanent teeth. The sagittal position of odontomas and vertical relation of odontomas to the corresponding permanent teeth were significantly correlated with the eruption rate of corresponding permanent teeth (P < 0.05). Conclusion: The odontomas occur most commonly in male patients with a male to female ratio of 1.67:1. The incidence of odontomas in our 1280 patients is 1.25%. The age range of patients with odontomas is 6-17 years. The most frequent location of odontomas is the anterior maxillary region. Odontoma is frequently associated with an impacted corresponding permanent tooth.

Combined evaluation of both WEE1 and phosphorylated cyclin dependent kinase 1 expressions in oral squamous cell carcinomas predicts cancer recurrence and progression.

Background/purpose: WEE1 is a mitotic inhibitor at G2 checkpoint of the cell cycle that negatively regulates cyclin-dependent kinase 1 (CDK1) through inhibitory phosphorylation. This study assessed whether the expressions of both WEE1 and phosphorylated CDK1 in specimens of oral squamous cell carcinoma (OSCC) might predict the OSCC recurrence and progression. Materials and methods: This study used immunohistochemistry to examine the expressions of WEE1 and phosphorylated CDK1 proteins in 75 specimens of OSCC and 30 specimens of normal oral mucosa (NOM). Results: The mean WEE1 labeling index (LI) was significantly lower in 75 OSCC samples than in 30 NOM samples (P < 0.001), whereas the mean phosphorylated CDK1 LI was significantly higher in 75 OSCC samples than in 30 NOM samples (P < 0.001). We found a significant association of low WEE1 LI (<21%) with OSCC recurrence (P = 0.047) and a significant association of low phosphorylated CDK1 LI (<10%) with larger tumor size (P = 0.011) and more advanced clinical stages (P = 0.021) of OSCC. Conclusion: Combined evaluation of WEE1 and phosphorylated CDK1 LI in specimens of OSCC may predict the OSCC recurrence and progression.

Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients.

Background/purpose: : Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients. Materials and methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively. Results: We found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients. Conclusion: The younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients.

Dental technology of Taiwan during the Japanese colonial period.

Background/purpose: During the Japanese colonial period, the Taipei Hospital had already provided complete dental services with a fixed price per treatment. This study tried to compare the differences in the prices of various dental treatments between the Japanese colonial period and today. Materials and methods: This study used the "Dental Treatment Fees in the 27th Annual Report of Taipei Hospital (Taisho 12)" as the study materials to compare the differences in the prices of various dental treatments between the Japanese colonial period and today using the monthly salary of a novice elementary school teacher as an income benchmark. Results: A hundred years ago, the Taipei Hospital had already provided the dental treatments such as scaling and endodontic, operative dentistry, prosthodontic, and orthodontic treatments. Of these treatment items, the prices for prosthodontic and orthodontic treatments were more expensive. After a century of development, the costs of scaling and operative dentistry treatments dropped, while the costs of endodontic, prosthodontic, and orthodontic treatments increased. Conclusion: During the Japanese colonial period, Taiwan's dental treatment technology had already had the forms of modern dentistry with several dental specialties. At that time, the costs of dental treatments are quite expensive. Today's dental treatment items are more detailed and diverse. The health insurance system provides Taiwanese people with convenient and cheap general dental treatments such as scaling and treatments related to operative dentistry, endodontics, periodontics, and oral surgery. However, the costs of prosthodontic and orthodontic treatments increase and have to be paid by the patients themselves.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in male and female burning mouth syndrome patients.

Background/purpose: Our previous study found that 19.8%, 16.2%, 4.8%, 2.3%, 19.2%, and 12.3% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 212 male and 672 female BMS patients. Materials and methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 212 male and 672 female BMS patients were measured and compared with the corresponding levels in 106 male and 336 female healthy control subjects, respectively. Results: We found that 212 male BMS patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels and significantly higher mean serum homocysteine levels than 106 male healthy control subjects. Moreover, 672 female BMS patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 336 female healthy control subjects. In addition, 212 male BMS patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than 672 female BMS patients. Conclusion: The male BMS patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than the female BMS patients.

Development of dental education for medical students in Taiwan during the Japanese colonial period.

Background/purpose: During the Japanese colonial period, Taiwan had a medical school education system for cultivating physicians, but did not have a dental school education system for cultivating "real" dentists. In this investigation, we collected and analyzed the historical documents related to dental education to study the development of dental education for medical students in Taiwan during the Japanese colonial period. Materials and methods: This study mainly analyzed the changes in the development of dental education for medical students in Taiwan during the Japanese colonial period through the collection and sorting of relevant historical materials. Results: During each stage of Taiwan's medical education system in the Japanese colonial period, the medical school offered compulsory dental courses for medical students, including theory and clinical practice of dentistry. Although there was no specific dental subject included in the graduation examination, evidence showed that the content of dentistry was covered by the subject of Surgery in the examination. Moreover, Taipei Imperial University established the Medical Faculty in 1936. Its curriculum increased the weight of dentistry and added the "Dentistry & Oral Surgery" as a graduation examination subject, indicating the importance of dental education for medical students in that period. Conclusion: In the Japanese colonial period, although there was no dental school for cultivating dentists in Taiwan, there was still dental education for medical students to let them understand the Dentistry and to enable them to become dental practitioners. This can be regarded as a workaround in the medical and healthcare policy.

Higher gastric parietal cell antibody titer significantly increases the frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia in patients with burning mouth syndrome.

BACKGROUND/PURPOSE: Our previous study found 109 gastric parietal cell antibody (GPCA)-positive burning mouth syndrome (BMS) patients (so-called GPCA+BMS patients in this study) in a group of 884 BMS patients. This study evaluated whether high-titer (GPCA titer ≥ 160) GPCA+BMS patients had greater frequencies of macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than low-titer (GPCA titer < 160) GPCA+BMS patients or 442 healthy control subjects. MATERIALS AND METHODS: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 42 high-titer GPCA+BMS patients, 67 low-titer GPCA+BMS patients, and 442 healthy control subjects were measured and compared. RESULTS: We found that 33.3%, 38.1%, 19.0%, 33.3%, 2.4%, and 57.1% of 42 high-titer GPCA+BMS patients and 10.4%, 25.4%, 14.9%, 6.0%, 1.5%, and 11.9% of 67 low-titer GPCA+BMS patients were diagnosed as having macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 42 high-titer and 67 low-titer GPCA+BMS patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.001). In addition, 42 high-titer GPCA+BMS patients also had greater frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia than 67 low-titer GPCA+BMS patients (all P-values < 0.01). CONCLUSION: The high-titer GPCA+BMS patients have significantly greater frequencies of macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than healthy control subjects and significantly greater frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia than low-titer GPCA+BMS patients.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in serum gastric parietal cell antibody-positive burning mouth syndrome patients without serum thyroid autoantibodies.

BACKGROUND/PURPOSE: Our previous study found that 70 of 884 burning mouth syndrome (BMS) patients have serum gastric parietal cell antibody (GPCA) positivity but without thyroglobulin antibody (TGA) and thyroid microsomal antibody (TMA) (so-called GPCA+TGA-TMA-BMS patients). This study assessed whether these 70 GPCA+TGA-TMA-BMS patients had significantly higher frequencies of macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia than 553 GPCA-negative, TGA-negative, and TMA-negative BMS (GPCA-TGA-TMA-BMS) patients or 442 healthy control subjects. MATERIALS AND METHODS: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, GPCA, TGA, and TMA levels in 70 GPCA+TGA-TMA-BMS patients, 553 GPCA-TGA-TMA-BMS patients, and 442 healthy control subjects were measured and compared. RESULTS: We found that 15.7%, 28.6%, 20.0%, 11.4%, 2.9%, and 25.7% of 70 GPCA+TGA-TMA-BMS patients and 3.8%, 17.7%, 15.9%, 3.8%, 2.7%, and 20.1% of 553 GPCA-TGA-TMA-BMS patients had macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 70 GPCA+TGA-TMA-BMS patients and 553 GPCA-TGA-TMA-BMS patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.05). In addition, 70 GPCA+TGA-TMA-BMS patients also had greater frequencies of macrocytosis, anemia, serum vitamin B12 deficiency, and hyperhomocysteinemia than 553 GPCA-TGA-TMA-BMS patients (all P-values < 0.05). CONCLUSION: The GPCA + TGA-TMA-BMS patients have significantly greater frequencies of macrocytosis, anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than healthy control subjects and significantly greater frequencies of macrocytosis, anemia, serum vitamin B12 deficiency, and hyperhomocysteinemia than GPCA-TGA-TMA-BMS patients.

Comparison of learning effectiveness between physical classroom and online learning for dental education during the COVID-19 pandemic.

BACKGROUND/PURPOSE: Online learning has been used to continue dental education activities during the coronavirus disease 2019 (COVID-19). This study aimed to compare the learning effectiveness between physical classroom and online class learning for dental education during the COVID-19 pandemic by the questionnaire survey. MATERIALS AND METHODS: A questionnaire-based online survey was used to evaluate the learning effectiveness on the dental students who took the compulsory course entitled "oral pathology and diagnosis" in School of Dentistry, National Taiwan University in 2021. Student's t-test and Mann-Whitney U test were used to analyze the difference in learning effectiveness between physical classroom and online class learning for dental education during the COVID-19 pandemic. RESULTS: In this study, dental students tended to have a viewpoint that the learning effectiveness of online class learning was better than that of physical classroom learning. On the contrary, they tended to have a viewpoint that the convenience and fairness of physical classroom examination was better than that of online examination (all P-values < 0.001). CONCLUSION: We conclude that our dental students are ready to take online courses. In terms of blended learning courses, the combination of physical classroom and online courses is the future trend of dental education. At this moment, dental schools must prepare their abilities for the implementation of online courses to respond to the COVID-19 pandemic and the next crisis, as well as for the needs of future dental education.