Pharmacological Doses of Thiamine Benefit Patients with the Charcot-Marie-Tooth Neuropathy by Changing Thiamine Diphosphate Levels and Affecting Regulation of Thiamine-Dependent Enzymes.

Charcot-Marie-Tooth (CMT) neuropathy is a polygenic disorder of peripheral nerves with no effective cure. Thiamine (vitamin B1) is a neurotropic compound that improves neuropathies. Our pilot study characterizes therapeutic potential of daily oral administration of thiamine (100 mg) in CMT neuropathy and its molecular mechanisms. The patient hand grip strength was determined before and after thiamine administration along with the blood levels of the thiamine coenzyme form (thiamine diphosphate, ThDP), activities of endogenous holo-transketolase (without ThDP in the assay medium) and total transketolase (with ThDP in the assay medium), and transketolase activation by ThDP [1 - (holo-transketolase/total transketolase),%], corresponding to the fraction of ThDP-free apo-transketolase. Single cases of administration of sulbutiamine (200 mg) or benfotiamine (150 mg) reveal their effects on the assayed parameters within those of thiamine. Administration of thiamine or its pharmacological forms increased the hand grip strength in the CMT patients. Comparison of the thiamin status in patients with different forms of CMT disease to that of control subjects without diagnosed pathologies revealed no significant differences in the average levels of ThDP, holo-transketolase, or relative content of holo and apo forms of transketolase. However, the regulation of transketolase by thiamine/ThDP differed in the control and CMT groups: in the assay, ThDP activated transketolase from the control individuals, but not from CMT patients. Thiamine administration paradoxically decreased endogenous holo-transketolase in CMT patients; this effect was not observed in the control group. Correlation analysis revealed sex-specific differences in the relationship between the parameters of thiamine status in both the control subjects and patients with the CMT disease. Thus, our findings link physiological benefits of thiamine administration in CMT patients to changes in their thiamine status, in particular, the blood levels of ThDP and transketolase regulation.

Nanocurcumin-containing Spongy Membrane for Improving the Quality of Hard and Soft Tissues in the Extracted Tooth Area: A Double-Blind Split- Mouth Clinical Trial Study.

BACKGROUND: The assessment of the hard and soft tissue conditions is part of the overall dental treatments. AIM: In this study, we investigated nano curcumin-containing membranes to improve the quality of the hard and soft tissues in the extracted tooth area as a clinical trial study. METHODS: After the patient was selected following the inclusion and exclusion criteria, the patients who had teeth extracted from both sides of the mouth (split mouth) on the side of the intervention received a membrane containing nanocurcumin, and on the control side, no material was placed in the socket. For data analysis, SPSS software version 24 was used. A significance threshold was deemed to be less than 0.05 in terms of probability. RESULTS: Two months after tooth extraction, during implant placement, the average gingival thickness on the "intervention side," was 3.1±0.34 mm, while the average gingival thickness on the "control side" was 2.6±0.42 mm. Then, the membrane could improve the quality of soft tissue (P< 0.0001). As another outcome, the application of this membrane did not significantly affect bone repair in these patients compared to the control group (P = 0.72). However, the histology data revealed that the newly generated bone of the intervention group was seen close to the membrane, demonstrating the osteoconductive ability of the membrane. CONCLUSION: Based on the obtained results, the newly developed membrane can be used to improve the quality of hard and soft tissues in the extracted tooth area. Nonetheless, more efforts in nanocurcumin dosage adjustment are needed for hard tissue regeneration in future studies.

Ubiquitin C-terminal hydrolase L1 activation in periodontal ligament cells mediates orthodontic tooth movement via the MAPK signaling pathway.

PURPOSE: Periodontal ligament cells (PDLCs) play a significant role in orthodontic force induced bone remodeling. However, the molecular mechanisms by which PDLCs respond to mechanical stimuli and influence osteoclastic activities remain unclear. This study aims to investigate the role of UCHL1, a key deubiquitinating enzyme involved in protein degradation and cellular responses, in force-treated PDLCs during orthodontic tooth movement (OTM). MATERIALS AND METHODS: In this study, we conducted in vivo and in vitro experiments using human PDLCs and a rat model of OTM. Mechanical stress was applied to PDLCs, and UCHL1 expression was analyzed through quantitative real-time polymerase chain reaction (qPCR), Western blot, and immunofluorescence staining. UCHL1 knockdown was achieved using siRNA, and its effects on osteoclast differentiation were assessed. The role of the MAPK/ERK pathway was investigated using the MEK-specific inhibitor U0126. An animal model of OTM was established, and the impact of UCHL1 inhibitor-LDN57444 on OTM and osteoclastic activity was evaluated through micro-CT analysis, histological staining, and immunohistochemistry. RESULTS: Mechanical force induced UCHL1 expression in PDLCs during OTM. UCHL1 knockdown downregulated the RANKL/OPG ratio in PDLCs, affecting osteoclast differentiation. LDN57444 inhibited OTM and osteoclastic activity. UCHL1 activation correlated with ERK1/2 phosphorylation in force-treated PDLCs. CONCLUSIONS: Mechanical force mediated UCHL1 activation in PDLCs promotes osteoclast differentiation via the ERK1/2 signaling pathway during OTM.

Phytochemicals in vital tooth bleaching: Spectrophotometric evaluation of efficacy with papaya, pineapple, or kiwi extracts and 30% hydrogen peroxide.

Context: Dental bleaching, a common cosmetic treatment, typically uses hydrogen peroxide (H2O2). Yet, the search for natural options has prompted an investigation into fruit extract efficacies such as papain, bromelain, and actinidin for tooth whitening. Aim: The aim of this study was to evaluate the efficacy of 30% hydrogen peroxide and fruit extracts (papaya, pineapple, and kiwi) on human enamel using a spectrophotometer at different time intervals. Study Design: Eighty maxillary anterior teeth were stained with tea solution and evaluated for baseline color. They were then divided into four groups: hydrogen peroxide alone and hydrogen peroxide combined with papaya, pineapple, or kiwi extracts. Each group was further divided based on bleaching duration: 10 or 20 min. Materials and Methods: The color value of the bleached teeth was measured using a reflectance spectrophotometer. In order to analyze the data, one-way ANOVA, post hoc Tukey, and paired t-tests were used. The significance level was established at α =0.05. Results: Combining hydrogen peroxide with pineapple extract showed the highest efficacy, followed by papaya and kiwi extracts. Hydrogen peroxide alone also demonstrated significant bleaching efficacy, albeit lower than the combinations with fruit extracts. Conclusion: Combining hydrogen peroxide with pineapple and papaya extracts notably improves dental bleaching efficacy, as shown by reduced color difference (ΔE) values. This underscores the potential of natural enzymes in tooth whitening.

Effectiveness of KTP lasers in tooth bleaching, by comparing tooth color change after bleaching with KTP, Nd:YAG, Er:YAG, and diode laser system: A systematic review.

This systematic review evaluated the role of Potassium-titanyl-phosphate (KTP) lasers in dental bleaching by comparing tooth color change and rise in intrapulpal temperature after bleaching with KTP, Neodymium-doped yttrium aluminum garnet (Nd:YAG), Er:YAG, and diode laser system. Following were the inclusion criteria: in vitro studies in English available in full text. Articles published between 2000 and 2021 were selected. The search for was conducted on PubMed, Cochrane library/CENTRAL, Wiley online library, ProQuest, Science Direct, and Hand searching/specialized registers. Keywords were used: "Lasers" [Mesh] and "Tooth bleaching" [Mesh] using Boolean operators. A total of four articles fulfilled the inclusion criteria. The quality assessment of studies included was undertaken independently as part of data extraction process. KTP lasers demonstrated more effectiveness in attaining color change in stained teeth and showed the lowest rise in intrapulpal temperature. Based on the data obtained in the present review, the choice of bleaching treatment is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. Although all bleaching procedures were effective in color change, the KTP laser showed better results when compared to other laser activation. The bleaching treatment protocol is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. It has been demonstrated that a faster change in color can be obtained when bleaching is performed in combination with a light source, i.e., power bleaching aiming for a more in-depth change of color.

Coping with complexity: Navigating severe curve canals in endodontic root canal treatment: A clinical case series.

Knowledge of tooth anatomy and its variations are essential for the success of endodontic treatment. Dilacerations represent developmental anomalies marked by sudden deviations in a tooth's longitudinal axis. Common causes of treatment failures in such cases are primarily related to procedural errors such as ledging, fractured instruments, canal blockages, zipping, and elbow creations. The current case series presents three such interesting cases of endodontic management of curved root canals in mandibular molars.

Efficacy and inflammatory responses of root canal therapy plus periodontal non-surgical treatment for periodontal-endodontic combined dental lesions.

OBJECTIVE: To investigate the efficacy and inflammatory responses of treating periodontal-endodontic combined lesions (PECLs) with root canal therapy (RCT) alone versus RCT combined with periodontal non-surgical treatment (PNST). METHODS: A total of 103 patients with PECLs admitted between January 2019 and January 2020 to Shenzhen Baoan Women's and Children's Hospital were divided into control (RCT alone, 50 cases) and combined (RCT + PNST, 53 cases) groups. Comparative analyses included efficacy assessment, probing depth (PD), bleeding index (BI), plaque index (PLI), gingival index (GI), serum levels of interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP), pain severity during RCT, incidence of adverse reactions, post-treatment tooth conditions, and recurrence rates at 6 and 12 months. Univariate analysis identified factors associated with poor treatment outcome in PECL patients. RESULTS: The combined group demonstrated a higher total effective rate (90.57%) compared to the control group (74.00%) (P < 0.05). Patients receiving combined therapy showed significantly lower PD, BI, PLI, GI, IL-1ß, TNF-α, and hs-CRP levels, as well as reduced pain severity and lower recurrence rates at 6 and 12 months (all P < 0.05). The combined group also had a lower incidence of adverse (periodontal distending pain and local foreign body sensation) reactions (7.54%) compared to the control group (26.00%) (P < 0.05). After treatment, the incidence of periodontitis, percussion tenderness, and loosening of teeth in the combined group was lower than that of the control group, and the retention rate of affected teeth was significantly higher (all P < 0.05). Factors such as history of alcoholism, betel nut chewing, and treatment method (RCT) were significantly associated with poorer prognosis in PECL patients (P < 0.05). CONCLUSION: Combined RCT and PNST improves clinical efficacy, reduces pain severity and inflammation levels, decreases adverse reactions, and enhances tooth retention in PECL patients. This treatment approach should be considered the preferred option for managing PECLs.

A Comparative Ex Vivo Study on Apex Locator Precision in Mature Teeth and Immature Teeth With Divergent Canals.

AIM: This study investigates the accuracy of an apex locator in mature and immature teeth with divergent root canals ex vivo. MATERIALS AND METHODS: Fifty extracted premolar teeth were utilized for the study, with 25 mature teeth (Nolla stage 9 or 10) and 25 immature teeth (Nolla stages ≤ 8). The discrepancies between the actual length (AL) and the electronic length (EL), measured using a Bingo 1020 apex locator, were compared and analyzed. Statistical analysis included Pearson's correlation analysis, a T-test for independent samples, and multiple linear regression. Statistical significance was set at p < 0.05. RESULTS: The difference between AL and EL in immature teeth was significantly higher than in mature premolar teeth. Nonetheless, patient gender or jaw type (upper/lower) did not affect the accuracy of electronic apex locator (EAL) measurements. CONCLUSION: EAL readings are less accurate in immature teeth than in mature teeth. Supplementary measures, such as radiographic length determination and wet-dry paper point tests, are required to confirm the working length for improved treatment outcomes and patient compliance.

Exploring the complex relationships between health behaviors, health outcomes, social vulnerability, regional cultures, and oral health.

OBJECTIVES: Health and social factors show large heterogeneity across regional cultural geographies and influence oral health as well. The purpose of this study is to confirm associations between county-level general health, behaviors, social factors, and oral health indicators and to further analyze the patterns of distribution of oral health indicators across dominant regional cultures in the United States (US) as defined by the American Nations model. METHODS: We calculated a Lifestyle Health Index (LHI) from the 2023 PLACES database using county-level, age-adjusted health data and merged it with (a) 2020 Social Vulnerability Index (SVI) database, (b) dominant regional cultures from Nationhood Lab's American Nations model, (c) dentist visits and teeth lost data from the 2023 PLACES database, and (d) access to dentistry data from the County Health Rankings database. RESULTS: Correlation coefficients between the LHI (and sub scores), SVI (and sub scores), and dental variables showed strong associations. ANOVA post-hoc test results revealed significant differences for dental visits and teeth lost for LHI, SVI and access to dentists. Prevalence of dental visits and teeth lost showed clear heterogeneity across regional cultures. CONCLUSIONS: Oral health is strongly linked to lifestyle health factors, social vulnerability, access to dentistry, and cultural norms and belief systems. Within the US, significant heterogeneity exists in the distribution of oral health indicators across dominant regional cultural geographies. Oral health communications and policy solutions focused on health-related behaviors (e.g., tobacco, diet), disease-specific considerations (e.g., diabetes), and the social environment (e.g., poverty, housing) should be tailored to regional cultures rather than a single US-based culture to improve dental care and oral health outcomes.

Effect of compressive force combined with vibration on CCL2 and CCL5 in human periodontal ligament cells.

Purpose: To investigate the effect of compressive force combined with vibration on expression of CC-chemokine ligand 2 (CCL2) and 5 (CCL5) in human periodontal ligament (hPDL) cells. Methods: Human PDL cells were cultured and assigned into four groups: control (Con), compressive force 2.0 g/cm2 for 24 h and 48 h (C), vibration 0.3 g 30 Hz for 20 min every 24 h (V), and compressive force combined with vibration (VC). At 24 h and 48 h, mRNA and protein levels of CCL2 and CCL5 were examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Results: At 24 h and 48 h, CCL2 mRNA and protein levels in C and VC were significantly higher than Con. At 24 h, VC showed significantly higher CCL2 mRNA expression than C. However, there was no significant difference between CCL2 protein in C and VC at both time points. At 24 h and 48 h, CCL5 mRNA expression was significantly down-regulated in V and VC, whereas CCL5 protein was undetectable in all groups. Conclusions: Application of compressive force combined with vibration resulted in the upregulation of CCL2 mRNA and protein levels, whereas CCL5 mRNA expression was down-regulated.

Systemic Factors Affecting Orthodontic Treatment Outcomes and Prognosis - Part 1.

This article explores the intersection of various systemic conditions with orthodontic treatment. Renal diseases, including chronic kidney disease and renal transplant, present challenges such as delayed tooth eruption and gingival overgrowth, necessitating careful orthodontic planning and collaboration with physicians. Liver diseases, particularly hepatitis, heighten the risk of periodontal disease and mandate strict infection control measures during orthodontic procedures. Ehlers-Danlos syndrome poses challenges related to collagen fragility, rapid tooth movement, and orthodontic relapse. Autoimmune diseases like diabetes mellitus and juvenile idiopathic arthritis require tailored orthodontic approaches considering oral complications and joint involvement.

Acceleration of Orthodontic Tooth Movement: A Bibliometric and Visual Analysis.

BACKGROUND: Prolonged orthodontic treatment duration has long been a concern for orthodontists and patients, leading to a surge in publications on accelerated orthodontic tooth movement (OTM). This study aims to investigate the knowledge landscape, hotspots, and research trends in acceleration of OTM using bibliometric and visual analyses. METHODS: A comprehensive search was conducted in the Web of Science (WOS) Core Collection to identify relevant publications related to acceleration of OTM. R Biblioshiny, VOS viewer, and a bibliometric online analysis platform were used to conduct the bibliometric and visualization analysis. Curve fitting and correlation analysis were performed to examine the correlation global and country economics and publication trends, and to predict publication numbers. RESULTS: A total of 647 articles on accelerated OTM were included in the analysis, with clinical and non-clinical publications accounting for 43.59% and 31.22%, respectively. The annual publication numbers exhibited an upward trend, correlating positively with both global gross domestic product (GDP) (r = 0.915, P < .001) and the GDP of individual countries/regions (r = 0.976, P < .001). China produced the most documents (94), while the USA led in citation count (2758) and international collaborations. Wilcko WM was the top-cited author, with eight of the top 10 authors from the USA and the remainder from Asia. Keywords such as 'tooth movement', 'corticotomy', 'piezocision' and 'low-level laser therapy' were the most prominent themes, while topics like 'micro-osteoperforation', 'plasma', 'gingival crevicular fluid' and 'pain' have become recent research hotspots and frontiers. CONCLUSIONS: This study provides a comprehensive overview of the research on accelerated OTM, highlighting hotspots and frontiers, fostering collaboration among authors and countries/regions, and contributing to future research endeavours.

Effect of Discontinuation of Supportive Periodontal Therapy on Periodontal Status-A Retrospective Study.

AIM: To assess the impact of active (APT) and supportive periodontal therapy (SPT) on the change in probing depth (PD) and annual tooth loss in partially and fully compliant and drop-out patients. MATERIAL AND METHODS: Data of 280 periodontally treated partially and fully compliant (regular supportive visits, SPT duration 5.5 ± 4.5 years) and 55 drop-out patients (SPT and drop-out duration 8.3 ± 3.8 years, only drop-out duration 5.3 ± 3.7 years) were recorded. PD data and the number of teeth present at the start of APT (T1) and at the start of SPT (T2) were taken from the patient files and evaluated at the time of the final examination (T3). RESULTS: Annual tooth loss during SPT was significantly higher (p < 0.001) in drop-out patients than in partially and fully compliant patients (0.31 ± 0.50 vs. 0.19 ± 0.55, respectively). In partially and fully compliant and drop-out patients, the mean PD (all available site data) decreased significantly between T1 (3.61 ± 0.82 vs. 3.70 ± 0.73 mm) and T2 (2.68 ± 0.40 vs. 2.76 ± 0.42 mm), while the values increased again slightly up to T3 (2.74 ± 0.41 vs. 2.99 ± 0.75 mm). CONCLUSIONS: In partially and fully compliant patients, SPT had a positive impact on PD stability and medium-term tooth preservation. In contrary to expectations, drop-out patients, PD did not return to baseline values, although PD stability was not achieved.

Analysis and comparison of tooth wear in late antiquity and early middle age in populations that lived in continental and coastal Croatia using digitized VistaMetrix method.

BACKGROUND: Tooth wear is a non-pathological loss of hard tissues on the incisal and occlusal tooth surface. In archaeology, the loss of dental tissue through attrition is associated with living opportunities and habits, availability, characteristics and methods of food preparation. In forensics, tooth wear is used to estimate the dental age on cadavers. MATERIAL AND METHODS: For this study, we used an archaeological sample from two sample collections. In this study, tooth wear was compared in archaeological samples of well-preserved maxilla and mandible specimens (n=392) from Croatian coastal and continental populations from Late Antiquity (LA) and the Early Middle Ages (EMA). The computer system VistaMetrix 1.38 was used to analyse the abrasion and attrition of hard dental tissues. The Shapiro-Wilk and chi-square tests were performed for categorical data to test the difference between two historical periods and two geographical locations, while the Kruskal-Wallis test was performed for continuous data. RESULTS: There was a statistically significant difference in the proportion of tooth wear in total teeth area (P < 0.001) when comparing continental and coastal Croatia in LA and coastal Croatia between LA and EMA (P = 0.006 and P < 0.001, respectively). Samples from coastal Croatia from the LA period had the lowest percentage of tooth wear with a median of 8.35%, while samples from coastal Croatia from the EMA had the highest percentage of tooth wear with a median of 18.26%. Our results generally show greater tooth wear in the EMA period in male subjects. CONCLUSION: The results of the tooth wear research obtained with the Vista Metrix software can contribute to the study of life circumstances and changes that the analysed population has experienced in its historical development.

Evaluating the efficiency of mandibular molar protraction using Herbst appliances versus temporary anchorage devices: a retrospective case-controlled study.

BACKGROUND: Mandibular second premolar agenesis is a common problem in orthodontics and is often treated in conjunction with maxillary counterbalancing extractions. However, in cases without maxillary crowding or dental protrusion, space closure may pose challenges leading to compromised occlusal results or patient profile. Multiple techniques have been described to treat these patients; nevertheless, there is a paucity of data comparing effectiveness of space closure utilizing various anchorage techniques. The goal of this study is to assess the effectiveness of the Herbst device during mandibular molar protraction and compare it to the use of temporary anchorage device (TADs) in patients with mandibular second premolar agenesis. MATERIALS AND METHODS: This retrospective study included 33 patients with mandibular premolar agenesis treated without maxillary extractions. Of these patients, 21 were treated with protraction Herbst devices and 12 with TADs. Changes in molar and incisor positions, skeletal base positions and occlusal plane angulations were assessed on pretreatment (T0) and post-treatment (T1) lateral cephalograms. Scans/photographs at T0 and T1 were used to evaluate canine relationship changes representing anchorage control. Space closure and breakage/failure rates were also compared. Data was analyzed with paired and unpaired t-tests at the significance level of 0.05. RESULTS: Within the Herbst group, changes in mandibular central incisor uprighting and mandibular molar crown angulations were statistically significant. However, no significant differences were noted between the Herbst and TAD groups. Protraction rates as well as overall treatment times were comparable (0.77 mm/month vs. 0.55 mm/month and 3.02 years vs. 2.67 years, respectively). Canine relationships were maintained or improved toward a class I in 82.85% of the Herbst sample, compared to in 66.7% of the TAD sample. Emergency visits occurred in 80.1% of the Herbst group, with cementation failures or appliance breakages as the most common reasons. CONCLUSION: The Herbst device could be a viable modality in cases with missing mandibular premolars where maximum anterior anchorage is desired, or if patients/parents are resistant to TADs. Furthermore, they could be beneficial in skeletal class II patients with mandibular deficiency who also need molar protraction. However, the increased incidence of emergency visits must be considered when treatment is planned.

Color Comparison Between Intraoral Scanner and Spectrophotometer Shade Matching: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review and meta-analysis compared the accuracy of intraoral scanners and spectrophotometers in determining tooth shade. MATERIALS AND METHODS: An electronic search of five databases (PubMed, Scopus, Embase, Web of Science, CENTRAL) was conducted on October 19, 2023. A total of 163 studies were identified from the databases, of which 23 articles were eligible for inclusion. In vivo and in vitro quasi-experimental studies were included. After data extraction, a quantitative analysis was performed to determine the accuracy of the intraoral scanner in subgroups using four outcomes: trueness and precision with different measurement locations. A random-effects model was used to pool effect sizes. The pooled proportion with a 95% confidence interval (CI) was used for the effect size measure. RESULTS: Eleven articles were included in the meta-analysis. Trueness with the intraoral scanner was between 0.28 (CI: 0.09-0.60) and 0.38 (CI: 0.24-0.53). Repeatability was between 0.81 (CI: 0.64-0.91) and 0.85 (CI: 0.74-0.92). Trueness showed low, and precision had moderate certainty of evidence. CONCLUSION: The trueness of shade matching with intraoral scanners is low compared to spectrophotometers, although the precision is considered high and is similar to spectrophotometers. CLINICAL SIGNIFICANCE: Shade determination with intraoral scanners is not recommended.

Hereditary spastic paraplegia and extensive leukoencephalopathy: a case report of a unique phenotype associated with a GJB1/Cx32 p.Pro174Ser variant.

BACKGROUND: Pathogenic variants in Gap junction protein beta 1 (GJB1), which encodes Connexin 32, are known to cause X-linked Charcot-Marie-Tooth disease (CMTX), the second most common form of CMT. CMTX presents with the following five central nervous systems (CNS) phenotypes: subclinical electrophysiological abnormalities, mild fixed abnormalities on neurological examination and/or imaging, transient CNS dysfunction, cognitive impairment, and persistent CNS manifestations. CASE PRESENTATION: A 40-year-old Japanese male showed CNS symptoms, including nystagmus, prominent spastic paraplegia, and mild cerebellar ataxia, accompanied by subclinical peripheral neuropathy. Brain magnetic resonance imaging revealed hyperintensities in diffusion-weighted images of the white matter, particularly along the pyramidal tract, which had persisted since childhood. Nerve conduction assessment showed a mild decrease in motor conduction velocity, and auditory brainstem responses beyond wave II were absent. Peripheral and central conduction times in somatosensory evoked potentials elicited by stimulation of the median nerve were prolonged. Genetic analysis identified a hemizygous GJB1 variant, NM_000166.6:c.520C > T p.Pro174Ser. CONCLUSIONS: The patient in the case described here, with a GJB1 p.Pro174Ser variant, presented with a unique CNS-dominant phenotype, characterized by spastic paraplegia and persistent extensive leukoencephalopathy, rather than CMTX. Similar phenotypes have also been observed in patients with GJC2 and CLCN2 variants, likely because of the common function of these genes in regulating ion and water balance, which is essential for maintaining white matter function. CMTX should be considered within the spectrum of GJB1-related disorders, which can include patients with predominant CNS symptoms, some of which can potentially be classified as a new type of spastic paraplegia.

Longitudinal association between dentition status and gait speed among older Brazilian adults: SABE cohort study.

BACKGROUND: Oral health has been associated with general health conditions, but few longitudinal studies evaluated the effect of dentition status on gait speed. OBJECTIVE: This study aimed to investigate the longitudinal association between different time-varying measures of dentition status (i.e., number of teeth, the presence of periodontal pockets and the functional impact of oral health) and gait speed (outcome) in older Brazilian adults. MATERIALS AND METHODS: This was a prospective study using data from the Health, Well-being and Aging cohort study (SABE) from 2006, 2010 and 2015. The gait speed was the dependent variable and the independent variables of interest were dentition status evaluated using the number of teeth, use of dental prostheses, presence of periodontal pocket, clinical attachment loss and self-perceived poor functional oral health. Dentition status measures were obtained through clinical oral examinations, performed by trained dentists using standardized criteria proposed by the World Health Organization. Self-perceived poor functional oral health was evaluated using the functional domain of the Geriatric Oral Health Assessment Index. The longitudinal effect of dentition status on gait speed was evaluated using mixed-effects linear models. The effect of the number of teeth/periodontal pocket/attachment loss on gait speed change over time was evaluated by including an interaction term between these variables. The effect of periodontal pocket was tested only among dentate individuals. RESULTS: Data for the complete sample included 3,306 observations from 1,964 individuals. The analyses for dentate individuals included 1,883 observations from 1,149 individuals. There was a positive association between the number of teeth and mean gait speed. Individuals using dental prostheses also had higher means of gait speed than those without dental prostheses. Gait speed was lower among individuals with periodontal pockets and with attachment loss. No interaction was found between any of the indicators of dentition status and time. CONCLUSION: Gait speed was associated with dentition status and this association was constant over time.

Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management.

BACKGROUND: Palatal groove represents a relatively uncommon developmental root anomaly, usually found on the palatal aspect of maxillary incisors. While its origin is controversial, its presence predisposes to severe periodontal defects. AIM: This study aimed to provide a systematic review of the literature focusing on the varied diagnostic techniques and treatment modalities for periodontal lesions arising from the presence of palatal groove. Based on the existing evidence and knowledge, the study also provides a comprehensive decisional tree, guiding clinicians in the challenging decision-making process face to a palatal groove. METHODS: The literature search was conducted on Medline and Cochrane databases by two independent reviewers, who also performed the screening and selection process, looking for English written articles reporting on diagnosis and management (all treatment approaches) of periodontal lesion(s) associated with a palatal groove. Based on this literature, a comprehensive decisional tree, including a standardized palatal groove evaluation and tailored treatment approaches, is proposed. Moreover, a clinical case is described to demonstrate the practical application of the developed decisional tree. RESULTS: Over a total of 451 articles initially identified, 34 were selected, describing 40 patients with 40 periodontal lesions associated with palatal grooves. The case report illustrates a deep, large, circumferential intra-bony defect on the palatal side of the tooth #22 associated with a shallow, moderately long palatal groove in an 18-year-old male patient. Following reevaluation, a single flap surgery was deemed necessary, combined with a regenerative procedure. At 2 years post-treatment, the tooth #22 is healthy, in a functional and esthetic position. The decision-making process, based on local and systemic patient's conditions, should allow an early and precise diagnosis to prevent further complications and undertake an adequate treatment. CONCLUSION: Palatal grooves are relatively rare; however, they are frequently associated with severe periodontal defects. The identification, diagnosis, prompt, and tailored management of the associated lesion is essential to mitigate potential periodontal and endodontic complications related to the presence of palatal groove. SYSTEMATIC REVIEW REGISTRATION: [ https://www.crd.york.ac.uk/prospero/ ], identifier [C CRD42022363194].