Benefits of Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-analysis.

PURPOSE: The purpose of this study was to measure and compare coronectomy versus extraction in patients at increased risk for inferior alveolar nerve (IAN) injuries associated with third molar removal in terms of IAN injury and other complications. METHODS: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. We conducted a comprehensive literature search across six databases and the gray literature from July 15 to August 01, 2022. We employed Rayyan software to identify and remove duplicate articles to ensure data integrity. Our research followed the strategy patient (P), intervention (I), comparison (C), outcome (O), and study (S): (P) patients needing lower third molar surgery at higher risk of IAN injury; (I) surgery options, coronectomy or complete extraction; (C) comparisons included reduced risks of nerve injuries, postoperative complications (pain, infection, alveolitis), and increased risks of reoperation, root migration, and extraction; (O) desired outcomes were preventing nerve injuries and reducing other surgical complications; and (S) observational study designs (cohort, case-control). Excluded from consideration were studies involving teeth other than lower third molars, as well as reviews, letters, conference summaries, and personal opinions. To gauge the certainty of evidence, we employed the Grading of Recommendation, Assessment, Development, and Evaluation instrument, selecting the most current papers with the highest levels of evidence for inclusion. The primary outcome variable of our study centered on evaluating the incidence of IAN injury, and secondly, the lingual nerve (LN) injury, the postoperative pain, infection, localized alveolitis, the necessity for surgical reintervention, root migration, and extraction. These assessments were carried out with respect to their chosen operative technique for managing third molars, either coronectomy or extraction, as predictor variables. We also considered covariates such as age, gender, and the presence of systemic diseases in our analysis to account for potential confounding factors. The pooled data underwent rigorous analysis utilizing an inverse variance method with both random and fixed effect models by the "metabin" function in the R program's meta-package. Additionally, we assessed the risk of bias in the selected studies by utilizing the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data and the Critical Appraisal Checklist for Case Reports. RESULTS: Of the 1,017 articles found, after applying the inclusion and exclusion criteria, 42 were included in this study (29 cohort and 13 case-control studies), including 3,095 patients from 18 countries. The meta-analysis showed that coronectomy reduced the risk of IAN injury [OR (Odds Ratio): 0.14; 95% CI (confidence intervals): 0.06-0.30; I2 (inconsistency index) = 0%; P = .0001], postoperative pain (OR: 0.97; 95% CI: 0.33-2.86; I2 = 81%; P = .01), and alveolitis (OR: 0.38; 95% CI: 0.13-1.09; I2 = 32.2%; P = .01) when compared to complete tooth extraction. However, it also highlighted a greater risk of reintervention (OR: 5.38; 95% CI: 1.14-25.28; I2 = 0.0%; P = .01). CONCLUSIONS: This study has demonstrated that coronectomy is associated with a decreased risk for IAN injury and decreased pain and localized alveolitis when compared to complete tooth extraction. However, it is essential to acknowledge the higher likelihood of requiring reintervention with coronectomy. Therefore, clinicians should carefully consider the advantages and potential drawbacks of both techniques and tailor their choices to the unique clinical circumstances of each patient.

Assessing the Efficacy of Submental Liposuction Association in Orthognathic Surgery: A Systematic Review.

PURPOSE: Despite the vast literature on submental liposuction, there are few studies describing its simultaneous association in orthognathic surgery. This systematic review aimed to evaluate the available evidence on the effectiveness of the combination between the 2 techniques. METHODS: This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist and used a comprehensive literature search across 7 databases. All studies discussing submental liposuction in orthognathic surgery were eligible for inclusion, regardless of language. The Joanna Briggs Institute assessment tools were used to assess risk of bias. After a 2-step selection process, a total of 10 studies were included, including 2 cohort studies, 1 case-control study, 1 case series, and 6 case reports. RESULTS: Sixty-seven patients from 5 countries were evaluated. Ages ranged from 15.1 to 50 years. The prevalence according to the facial pattern was similar, with a higher incidence in women. The major indications for surgery were related to the presence of skeletal deformities and aesthetic changes in the cervical region. The forms of evaluation used to indicate surgery were photographs (n = 29; 43.28%), visual scale by 2 surgeons (n = 20; 29.85%), clinical examination (n = 23; 34.32%), and cephalometric analysis (n = 17; 25.37%). The postoperative follow-up time ranged from 6 months to 7.9 years. Despite the different forms of evaluation, all articles mentioned benefits with the association of submental liposuction in orthognathic surgery. The most cited complications were sensory changes in the lower lip (n = 4; 5.97), facial nerve injury (n = 2; 2.98%), infection (n = 2; 2.98%), maintenance of submental lipomatosis (n = 2; 2.98%), and skin irregularities (n = 2; 2.98%). CONCLUSION: This systematic review showed that submental liposuction associated with orthognathic surgery improves cervical aesthetics and that it is safe, with a low rate of complications. However, the number of studies on this topic is limited, and the studies are not standardized. There is lack of information especially regarding the evaluation methods used. Metric techniques such as ultrasound and tissue caliper adipometry could be possibilities for future studies.

Isolated nonsyndromic cleft palate: multicenter epidemiological study in the Brazil.

BACKGROUND: Nonsyndromic orofacial clefts (NSOC) are the craniofacial most common congenital malformations. There are evidences that the nonsyndromic cleft palate (NSCP) development differs from other NSOC. However, most of the publications treat NSCP without considering that information. Furthermore, few studies focus on NSCP. The aim of this study was to describe epidemiological findings of patients with isolated NSCP in Brazil. METHODS: In this cross-sectional multicenter study, four reference Centers for treatment in three different Brazilian states was investigated. Data were obtained from clinical records of patients, between November 2021 and June 2022. Researched variables were sociodemographic, clinical characteristics and pregnancy and family history. Pearson's chi-square and ANOVA One-way tests were used for associations. RESULTS: Majority were female (58.1%), white (60.7%) with incomplete NSCP (61.2%). There was an association between complete NSCP and a positive history of medical problems during pregnancy (p = 0.016; 27.9%; OR: 1.94; 1.12-3.35). Systemic alterations were perceived in 40.6% of the sample with odds ratio for development of the complete type (OR: 1.21; 0.74-1.97). Higher OR was visualized in medication use during pregnancy (OR: 1.35; 0.76-2.37) and positive family history of oral cleft (OR: 1.44; 0.80-2.55). Dental and surgical care was associated with higher age groups (p < 0.050). CONCLUSIONS: NSCP was most prevalent in white skin color female. Complete NSCP is associated with medical problems during pregnancy. Medication use during pregnancy and positive family history of oral cleft increase the chance of developing complete NSCP.

Comparison between sex and polymorphisms on FKBP5: perception of quality of life in non-syndromic patients. A cross-sectional study.

This study aimed to compare factors that influence perception of quality of life (QoL) in patients scheduled for orthognathic surgery. This was a cross-sectional study with 91 participants from two universities in Curitiba. The orthognathic quality of life questionnaire (OQLQ) was used to assess patients' perceptions of their QoL. Sociodemographic data were collected and facial profiles classified into classes I, II, and III. DNA was extracted from oral mucosal cells and markers rs3800373 and rs1360780 for FKBP prolyl isomerase 5 were genotyped. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney, and chi-squared tests, with a significance level of 5%. There was a negative impact on general perception of QoL in females (p = 0.019) and in the domains of "oral function" (p=0.032) and "awareness of the deformity" (p=0.009). In the dominant model (CC/CT), the presence of at least one C allele for the rs1360780 marker had a negative impact on QoL in the "facial aesthetics" domain (p = 0.037). The negative impact on QoL was greater in females than in males. The perception of QoL was more negative in individuals with rs1360780 polymorphism on the FKBP5 gene and a CC/CT genotype than it was in those with a TT genotype.

A rare LMNA missense mutation causing a severe phenotype of mandibuloacral dysplasia type A: a case report.

OBJECTIVE: To report the case of a girl presenting a severe phenotype of mandibuloacral dysplasia type A (MADA) characterized by prominent osteolytic changes and ectodermal defects, associated with a rare homozygous LMNA missense mutation (c.1579C>T). CASE DESCRIPTION: A 6-year-old girl was evaluated during hospitalization exhibiting the following dysmorphic signs: subtotal alopecia, dysmorphic facies with prominent eyes, marked micrognathia and retrognathia, small beaked nose, teeth crowding and thin lips, generalized lipodystrophy, narrow and sloping shoulders, generalized joint stiffness and bone reabsorption in the terminal phalanges. In dermatological examination, atrophic skin, loss of cutaneous elasticity, hyperkeratosis, dermal calcinosis, and hyperpigmented and hypochromic patches were observed. Radiology exams performed showed bilateral absence of the mandibular condyles, clavicle resorption with local amorphous bone mass confluence with the scapulae, shoulder joints with subluxation and severe bone dysplasia, hip dysplasia, osteopenia and subcutaneous calcifications. COMMENTS: MADA is a rare autosomal recessive disease caused by mutations in LMNA gene. It is characterized by craniofacial deformities, skeletal anomalies, skin alterations, lipodystrophy in certain regions of the body and premature ageing. Typical MADA is caused by the p.R527H mutation in the LMNA gene. However, molecular analysis performed from oral epithelial cells obtained from the patient showed the rare mutation c.1579C>T, p. R527C in the exon 9 of LMNA. This is the sixth family identified with this mutation described in the literature.

Novel mutations in GJA1 in two Brazilian families with oculodentodigital dysplasia.

Oculodentodigital dysplasia (ODDD; MIM #164200), a rare genetic disorder characterized by abnormal craniofacial, dental, ocular, and digital features, is caused by mutations in GJA1 (gap junction alpha-1) gene and inherited in an autosomal dominant pattern. However, an autosomal recessive pattern is also reported. Here we described 2 families with members affected by ODDD. In the first family, the c.752G>C (p.S251T) and c.848C>T (p.P283L) heterozygous missense mutations and the c.825C>T (p.T275T) silent mutation were identified in the proband, which showed mild ODDD phenotypes, and in his mother, which displayed hemolytic anemia and thrombocytopenia. In the second family, the patients displayed typical features of ODDD, and Sanger sequencing identified a novel homozygous c.604C>T (p.R202C) missense mutation, whereas the parents carried the mutation. Together, these findings suggest that homozygous mutation in GJA1 induces a more severe ODDD phenotype, though interfamilial phenotype variability was observed, whereas compound heterozygous mutations in GJA1 cause a mild phenotype.

New evidence of genetic heterogeneity causing hereditary gingival fibromatosis and ALK and CD36 as new candidate genes.

BACKGROUND: Hereditary gingival fibromatosis (HGF) is an uncommon genetic condition characterized by slow but progressive fibrous, non-hemorrhagic, and painless growth of the gingival tissues due to the increased deposition of collagen and other macromolecules of the extracellular matrix. HGF occurs in approximately 1:750,000 individuals and can exhibit dominant or recessive inheritance. To date, five loci (2p21-p22, 2p22.3-p23.3, 4q12, 5q13-q22, and 11p15) and three genes [REST (RE1-silencing transcription factor), SOS1 (Son-of-Sevenless-1), and ZNF862 (zinc finger protein 862 gene)] have been associated with HGF. Here, our study aimed to identify genetic variants associated with HGF by applying whole-exome sequencing (WES) and bioinformatics analyses. METHODS: Thirteen Brazilian individuals with HGF and nine relatives without HGF from four unrelated families were chosen for our investigation. Blood collected from the patients and their relatives were used for WES. Five Web-available tools, namely, CADD, PolyPhen, SIFT, Mutation Taster, and Franklin's algorithms, were used to predict protein damage. RESULTS: WES revealed pathogenic variants affecting the known HGF genes REST (c.1491_1492delAG) and SOS1 (c.3265_3266insTAAC) in two families. Additionally, potentially pathogenic variants segregating in the other two families were mapped to ALK receptor tyrosine kinase gene (ALK) (c.361C > T) and to collagen type I receptor and thrombospondin receptor gene (CD36) (c.1133G > T). CONCLUSION: Our findings reinforce the high genetic heterogeneity of HGF, identifying new variants in HGF known genes (REST and SOS1) and ALK and CD36 as new genes that cause HGF.

Dental anomalies in syndromes displaying hypertrichosis in the clinical spectrum.

Hypertrichosis and dental anomalies may occur alone or in combination in the spectrum of many syndromes. To identify genetic entities characterized by hypertrichosis and dental anomalies, a search was performed in the Mendelian Inheritance in Man database with the terms "hypertrichosis" or "hirsutism" and "tooth" or "dental abnormalities." Nondependent androgen metabolism disturbances were classified as hypertrichosis. Genetic entities with hypertrichosis and dental anomalies were included in the study. Additional searches were performed in the PubMed and Orphanet databases, when necessary, in order to include data from scientific articles. An integrative analysis of the genes associated with the identified syndromes was conducted using STRING to characterize biological processes, pathways, and interactive networks. The p-values were subjected to the false discovery rate for the correction of multiple tests. Thirty-nine syndromes were identified, and dental agenesis was the most frequent dental anomaly present in 41.02% (n = 16) of the syndromes. Causative genes were identified in 33 out of 39 genetic syndromes. Among them, 39 genes were identified, and 38 were analyzed by STRING, which showed 148 biological processes and three pathways that were statistically significant. The most significant biological processes were the disassembly of the nucleosome (GO:0006337, p = 1.09e-06), chromosomal organization (GO:0051276, p = 1.09e-06) and remodeling of the chromatin (GO: 0006338, p = 7.86e-06), and the pathways were hepatocellular carcinoma (hsa05225, p = 5.77e-05), thermogenesis (hsa04714, p = 0.00019), and cell cycle (hsa04110, p = 0.0433). Our results showed that the identification of hypertrichosis and dental anomalies may raise the suspicion of one of the thirty-nine syndromes with both phenotypes.

Associated oral manifestations with HIV southeastern Brazilian patients on antiretroviral therapy.

OBJECTIVES: This study aimed to assess the prevalence of oral lesions in patients living with HIV infection and their association with CD4 count, viral load, and antiretroviral therapy in patients with HIV. METHODS: A cross-sectional study was conducted on a sample of 161 patients attending the… All the patients were examined for their oral lesions, current CD4 counts, type, and duration of the therapy. Data analyses were carried out using Chi-Square, Student T/Mann-Whitney, and logistic regression tests. RESULTS: Oral lesions were observed in 58.39% of patients with HIV. Periodontal disease with 78 (48.45%) or without mobility 79 (49.07%) was observed more frequently, followed by hyperpigmentation of oral mucosa 23 (14.29%), Linear Gingival Erythema (LGE) 15 (9.32%), candidiasis pseudomembranous 14 (8.70%). Oral Hairy Leukoplakia (OHL) was observed only in 3 (1.86%). A relationship between periodontal disease with dental mobility and smoking was found (p=0.04), as well duration of treatment (p=1.53e-3) and age (p=0.02). Hyperpigmentation was related to race (p=0.01) and smoking (p=1.30e-6). CD4 count, CD4:CD8 ratio, viral load, or type of treatment were not associated with oral lesions. Logistic regression showed that the duration of treatment has a protective effect on the periodontal disease with dental mobility (OR = 0.28 [-2.27 to -0.25]; p-value=0.03), independent of age or smoking. To hyperpigmentation, the best model included smoking (OR=8.47 [1.18-3.10], p= 1.31e-5), without race or type and duration of treatment. CONCLUSION: Among HIV patients undergoing antiretroviral treatment, oral lesions can be observed, predominantly periodontal disease. Pseudomembranous candidiasis and oral hairy leukoplakia were also observed. No relationship was found between associated oral manifestations in HIV patients and the start of the treatment, TCD4+ and TCD8+ cell count, TCD4:TCD8 ratio, or viral load. The data indicate that there is a protective effect of duration of treatment with relation to periodontal disease with mobility and that hyperpigmentation seems to be more related to smoking than type and duration of treatment. LEVEL OF EVIDENCE: Level 3 (OCEBM Levels of Evidence Working Group*. "The Oxford 2011 Levels of Evidence").

Self-assembly peptide P11-4 induces mineralization and cell-migration of odontoblast-like cells.

OBJECTIVES: Self-assembling peptide P11-4 is amphiphilic and pH-triggered, effective on repairing early enamel carious lesions and dentin remineralization. However, P11-4 effects on dentin biomineralization and repair ability remain unexplored. Thus, cytocompatibility and effectiveness of P11-4 on inducing mineralization and migration of odontoblast-like cells (MDPC-23) were investigated. METHODS: MDPC-23 were seeded in contact with P11-4 (0.5 and 1 µg/ml), Dentin Matrix Protein 1 (DMP1 0.5 and 1 µg/ml) or Calcium hydroxide (Ca(OH)2 100 µg/ml) solutions. Cell viability was verified using MTT (n = 6/group). Mineral deposition was tested using Alizarin Red (n = 4/group). Cell migration was assessed by light microscopy (n = 2/group). MTT and Alizarin Red data were compared using Kruskal-Wallis and Mann-Whitney (α=0.01). RESULTS: P11-4 (0.5 and 1 µg/ml) and DMP1 (0.5 and 1 µg/ml) resulted the highest cell viability; Ca(OH)2 presented the lowest. 1 µg/ml DMP1 and 1 µg/ml P11-4 promoted the highest mineral deposition. Ca(OH)2 presented lower values of mineral deposits than DMP1 1 µg/ml (p < 0.01), but similar to P11-4 1 µg/ml. P11-4 and DMP1 at 0.5 µg/ml induced lesser mineral precipitation than P11-4 and DMP1 at 1 µg/ml (p < 0.01), with no difference to Ca(OH)2. All materials stimulated cell migration, however, lower concentrations of DMP1 and P11-4 demonstrated a higher migration potential. CONCLUSION: P11-4 did not affect cell viability, induces mineral deposition and MDPC-23 migration like DMP1. CLINICAL SIGNIFICANCE: Self-assembling peptide P11-4 does not affect the cell viability and induces mineral deposition comparable to native protein involved in biomineralization. Combined with its ability to bind type I collagen, P11-4 is a promising bioinspired molecule that provides native-tissue conditions and foster further studies on its ability to form dentin bridges in pulp-capping strategies.

Evaluation of the economic impact of COVID-19 on Brazilian private dental clinics: A cross-sectional study.

BACKGROUND: The changes in dental care in the face of the COVID-19 pandemic resulted in the need for greater financial investment by dentists in biosafety measures and increase in the costs of dental consultations. OBJECTIVE: To evaluate the economic impact of the COVID-19 pandemic on dental practices in private clinics in Brazil. METHODS: A cross-sectional study was carried out, using an online questionnaire indexed in Google Forms, and distributed among dentists. The data obtained were analyzed using the IBM SPSS 25.0 software, evaluating the factors associated with strong or very strong impact on the participants' income and the factors that motivated the dentists to look for a credit line. Multiple logistic regression models were constructed to identify the associated factors. Variables with p < 0.05 were considered statistically significant. RESULTS: Most participants were female, with a median age of 35 years. Dentists who are most concerned about their professional future (OR = 3.134; 95% CI: 1.804-5.445), who have longer office hours (OR = 2.056; 95% CI: 1.198-3.529), who had the greatest impact on the flow of patients (OR = 16.358; 95% CI: 9.408-28.443) and in need of investing in infrastructure (OR = 1.756; 95% CI: 1.014-3.041), had the greatest impact on monthly earnings. CONCLUSIONS: The pandemic and the new biosafety recommendations for care during this period had a negative impact on the income of Brazilian dental offices and increased the chance of seeking credit to alleviate the financial deficit.

Impact of COVID-19 on dental practice and anxiety among increased risk group dentists: A cross-sectional study.

BACKGROUND: The likelihood of infection with SARS-COV-2 (COVID-19) in the dental office is considered high. OBJECTIVES: Assessing the impact of the COVID-19 on dental practices and anxiety levels in risk group Brazilian dentists. METHODS: A cross-sectional study was performed using an online questionnaire. The data obtained were analyzed using the IBM SPSS 25.0 software (Pearson's Chi-square association test, multivariate logistic regression, and Poisson multiple regression), with subsequent calculation of the odds ratio at a 95% confidence interval, with a significance level of 5%. RESULTS: Responses of 578 dentists distributed in all regions of Brazil were collected. Most of the dentists were female, with an average age of 35. Of the participants, 23.4% were part of the increased risk group for COVID-19. The professionals who belonged to the increased risk group had a greater chance of not feeling prepared to perform consultations (OR = 1.67) and were not performing any procedures during the pandemic (OR = 2.03). Belonging to the increased risk group did not influence anxiety levels among the dentists. The factors associated with increased anxiety were being female, being younger, working in the southeastern region of the country, being afraid of contracting COVID-19 while working, and being concerned for one's professional future. CONCLUSIONS: The pandemic has had a negative impact on the professional practice of individuals at risk, but the level of anxiety was like professionals who were not part of the increased risk group for COVID-19.

Potential link between SARS-CoV-2 and Kawasaki disease: importance of dentists for the diagnosis.

Kawasaki disease (KD) is a vasculitis with predilection for coronary arteries. Due to a lack of reliable confirmatory laboratory tests, the diagnosis of KD is based on a characteristic pattern of clinical findings that appear in a typical temporal sequence. The diagnostic criteria have been periodically modified and the American Heart Association has proposed the most recent guidelines for its diagnosis. However, patients may have incomplete or atypical forms of KD and diagnosis can often be difficult. Because oropharyngeal manifestations are a common and important feature for diagnosing KD and recent studies have hypothesized a possible association between KD and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in this review we highlight the importance of dentists in the diagnosis of KD and its potential association with SARS-CoV-2.

Self-regulated learning perception of undergraduate dental students during the COVID-19 pandemic: A nationwide survey in Brazil.

BACKGROUND: This study aimed to evaluate the perception of self-regulated learning of Brazilian undergraduate dental students during the COVID-19 pandemic. MATERIAL AND METHODS: A nationwide cross-sectional survey was conducted. Data were collected in 2020, through an anonymous self-administered virtual questionnaire, which comprised an initial section related to the students' sociodemographic data, category of educational institution where they enrolled, and the possible impacts of COVID-19 pandemic on family income, teaching activities (maintained remotely or totally suspended), and self-perception of academic performance during e-learning. The second part comprising 31 questions related to the adapted Self-Regulated Learning Perception Scale (SRLPS). For statistical analysis, Student's t-test of independent samples, Kruskal-Wallis, and Mann-Whitney U test were used, considering a significance of 5%. RESULTS: From 779 students, 425 (54.6%) reported distance learning activities during the pandemic, and 354 (45.4%) experienced complete interruption of teaching activities. Students with good performance during e-learning were more skilled in self-regulated learning when compared to those who reported regular (p = 0.026), bad (p = 0.000), and very bad (p = 0.000) performance. In addition, students who stated a good performance during e-learning were more skilled in self-regulated learning than those with fully suspended teaching activities (p = 0.000). CONCLUSIONS: E-learning performance of undergraduate dental students during COVID-19 pandemic influenced the self-regulated learning perception. In addition, the pandemic negatively impacted the self-regulated learning of students who experimented full suspension of teaching activities. Changes in family's income did not affect their self-regulated learning. Key words:Dental education, community health, e-learning, learning, pandemics.

The impact of the COVID-19 pandemic on undergraduate and graduate dental courses in Brazil.

BACKGROUND: The COVID-19 pandemic has raised challenges in adapting to teaching and learning methods in dental education. OBJECTIVE: This study aimed to evaluate the impact of the COVID-19 pandemic on the academic activities of undergraduate (UDG) and graduate (GD) dental students in Brazil. Additionally, students' perceptions and attitudes toward teaching activities during this period were analyzed. METHODS: A nationwide cross-sectional survey was conducted with a sample of Brazilian UDG and GD dentistry students. Data were collected in 2020 through an online, self-administered, and anonymous questionnaire, which comprised 26 questions related to demographic data, activities of the college, family and individual student income, and attitudes and perceptions about e-learning during the pandemic. The data were tabulated and analyzed using descriptive statistics. RESULTS: The sample included 1,166 students (779 UDG and 387 GD). Among these, 425 (54.6%) UDG and 270 (69.8%) GD students remotely participated in teaching activities, of which 42.6% of the UDG considered their performance in e-learning to be bad or very bad and 49.8% of the GD regarded it as good or excellent. The survey also showed that 354 (45.4%) UDG and 102 (26.4%) GD expressed a desire to discontinue the course following the outbreak of the pandemic. Among the GD, 225 (58.4%) said that their experiments were completely interrupted. CONCLUSIONS: This study reveals the poor perception and performance of dental students regarding e-learning. Additionally, the findings suggest a negative impact of the pandemic on dental education in Brazil. Effective measures should be taken to mitigate these significant consequences.

The 100 most-cited papers in oral medicine and pathology.

This study aimed to analyze the 100 most-cited papers in the field of oral medicine and pathology over time, identifying the areas of more intense research. Papers in journals of oral medicine and pathology were identified using the Web of Science database. The specified research period was between 1900 and 2019. Descriptive statistics was used to analyze the data. Pearson's correlation analysis was used to explore the relationships among Web of Science citations, Dimensions citations, and Altmetric Attention Score. The number of citations of an article in the top 100 most-cited papers published in 1953 or later ranged from 541 to 3623. The papers were published in 47 different journals. The New England Journal of Medicine, American Cancer Society, and Nature Genetics published the most papers. Authors from 18 different countries published papers on head and neck cancer, craniofacial congenital anomalies, and osteonecrosis. Most of the papers were laboratory and descriptive studies. A correlation analysis showed a strong correlation only between Web of Science and Dimensions citations. In sum, although non-specific journals for pathology and oral medicine published the majority of the 100 most-cited papers, this biometric citation study show that head and neck cancer was the issue with the most citations. Together, these results make an important scientific contribution by providing a historical perspective on the research carried out.

COVID-19 pandemic and the impact on dental education: discussing current and future perspectives.

Due to the COVID-19 pandemic crisis, many dental schools and instructors are rethinking the way they teach and interact with students. New perspectives regarding a change in face-to-face activities, social isolation and the reformulation of clinical activities result in a transition toward e-learning and e-teaching processes. In this review, we discuss some favorable aspects and difficulties associated with virtual teaching and learning, searching for available tools and techniques as well as new perspectives.

Association between MSX1 rs12532 polymorphism with nonsyndromic unilateral complete cleft lip and palate and tooth agenesis.

OBJECTIVES: To investigate the association of MSX1 rs12532 polymorphism with the risk of nonsyndromic unilateral complete cleft lip and palate (NSCLP) and tooth agenesis. MATERIALS AND METHODS: The study is comprised of 384 individuals divided into 4 groups: group 1, patients with unilateral complete NSCLP and premolar agenesis (n = 57); group 2, patients with unilateral NSCLP without tooth agenesis (n = 117); group 3, patients with premolar agenesis without oral cleft (n = 53) and group 4 (n = 157), a control group with individuals without tooth agenesis and oral cleft. Genotyping of rs12532 was carried out with Taqman chemistry, and associations were investigated using logistic regression analyses. RESULTS: Overall rs12532 allele and genotype distributions revealed no significant differences between the groups of NSCLP or tooth agenesis. CONCLUSION: Although our results are consistent with a lack of association of MSX1 rs12532 and the risk of unilateral NSCLP and tooth agenesis, further studies with additional SNPs and a more diverse ethnic cohort are warranted.

A novel combination of biallelic ALPL mutations associated with adult hypophosphatasia: A phenotype-genotype association and computational analysis study.

Hypophosphatasia (HPP) is an inherited metabolic disorder that causes defective skeletal and dental mineralization. HPP exhibits a markedly heterogeneous range of clinical manifestations caused by dysfunction of the tissue-nonspecific isozyme of alkaline phosphatase (TNSALP), resulting from loss-of-function mutations in the ALPL gene. HPP has been associated with predominantly missense mutations in ALPL, and a number of compound heterozygous genotypes have been identified. Here, we describe a case of a subject with adult-onset HPP caused by a novel combination of missense mutations p.Gly473Ser and p.Ala487Val, resulting in chronic musculoskeletal pain, myopathy, persistent fatigue, vomiting, and an uncommon dental phenotype of short-rooted permanent teeth. Pedigree and biochemical analysis indicated that severity of symptoms was correlated with levels of residual ALP activity, and co-segregated with the p.Gly473Ser missense mutation. Bioinformatic analysis to predict the structural and functional impact of each of the point mutations in the TNSALP molecule, and its potential contribution to the clinical symptoms, revealed that the affected Gly473 residue is localized in the homodimer interface and predicted to have a dominant negative effect. The affected Ala487 residue was predicted to bind to Tyr479, which is closely located the N-terminal α-helix of TNSALP monomer 2, suggesting that both changes may impair dimer stability and catalytic functions. In conclusion, these findings assist in defining genotype-phenotype associations for HPP, and further define specific sites within the TNSALP molecule potentially related to neuromuscular manifestations in adult HPP, allowing for a better understanding of HPP pathophysiology.