Assessment of Skeletal Maturation in Nonsyndromic Cleft and Non-cleft Children-A Comparative Study.

The study aims to determine the difference in the skeletal maturation of unilateral cleft lip and palate (UCLP) and non-cleft children. This study also attempts to determine sexual dimorphism in attaining skeletal maturation between UCLP and non-cleft children. This was a retrospective, cross-sectional study. The total sample consisted of the lateral cephalogram of 131 UCLP (62 female and 71 male) children and 500 (274 female and 226 male) non-cleft children. The reviewer used the Baccetti method (2005) to review all the cephalograms for the cervical vertebrae maturation (CVM) stages. T -test was used to compare the mean chronological age and skeletal maturation of cleft and non-cleft children at each CVM stage. There was no significant difference in the mean chronological age and skeletal maturation status of UCLP and non-cleft children. There was no significant difference in skeletal maturation based on sex. The intraobserver assessment showed 80% and 85% kappa agreement, signifying absolute agreement. The correlation coefficient between chronological age and CVMIs was 0.86 ( P <0.001) in cleft children and 0.76 ( P <0.001) in non-cleft children, which was highly significant. The study indicates no significant difference in the skeletal maturation of UCLP and non-cleft children and no sex-related difference.

A Rare Case of Cleft Palate Associated With Tongue Hamartoma: A Case Report and Systematic Review.

INTRODUCTION: Palate development involves a genetic regulation through a complex molecular mechanism that may be disrupted by environmental factors, resulting in impaired fusion and cleft palate formation. An encounter with a case of cleft palate due to dorsal tongue hamartoma prompted us to perform this systematic review. OBJECTIVE: To review the clinical profile and management approach for a case with cleft palate and tongue hamartoma. DESIGN: A systematic literature search was conducted using keywords related to cleft palate and tongue hamartoma in PubMed, Scopus, MEDLINE, and Scielo databases through December 2021, with no time or language restrictions. PATIENTS, PARTICIPANTS: Studies reporting patients with cleft palate and tongue hamartoma were included. MAIN OUTCOME MEASURE(S): Information related to clinical profile, diagnostic tests, histopathology, management, and outcomes were extracted.Fourteen relevant publications were identified with 16 cases reported so far. Among them, thirteen patients were females (81.25%), and 3 were males (18.75%). The age of presentation varied from birth to 19 years. Oral-facial-digital syndrome (type II) was the most commonly associated syndrome.Congenital tongue hamartoma with cleft palate is a rare presentation, which can present as an isolated entity or part of a syndrome. Genetic evaluation is warranted, particularly for multiple hamartomatous lesions. The preferred treatment is immediate excision of hamartoma while following a standard timeline for palatoplasty.

A pattern of microbiological colonization of orthodontic miniscrew implants.

INTRODUCTION: Current orthodontic literature reveals a lack of studies on bacterial colonization of orthodontic miniscrew implants (MSI) and their role in the stability of MSI. This study aimed to determine the pattern of microbiological colonization of miniscrew implants in 2 major age groups, to compare it with the microbial flora of gingival sulci in the same group of patients and to compare microbial flora in successful and failed miniscrews. METHODS: The study involved 102 MSI placed in 32 orthodontic subjects in 2 age groups: (1) aged ≤14 years and (2) aged >14 years. Gingival and peri-mini implant crevicular fluid samples were collected using sterile paper points (International Organization for Standardization no. 35) >3 months and processed by conventional microbiologic culture and biochemical techniques. A microbiologist characterized and identified the bacteria, and the results were subjected to statistical analysis. RESULTS: Initial colonization was reported within 24 hours, with Streptococci being the dominant colonizer. The relative proportion of anaerobic bacteria over aerobic bacteria increased over time in peri-mini implant crevicular fluid. Group 1 had greater Citrobacter (P = 0.036) and Parvimonas micra (P = 0.016) colonizing MSI than group 2. Failed MSI showed a significantly higher presence of Parvimonas micra (P = 0.008) in group 1 and Staphylococci (P = 0.008), Enterococci (P = 0.011), and Parvimonas micra (P <0.001) in group 2. CONCLUSIONS: Microbial colonization around MSI is established within 24 hours. Compared to gingival crevicular fluid, peri-mini implant crevicular fluid is colonized by a higher proportion of Staphylococci, facultative enteric commensals and anaerobic cocci. The failed miniscrews showed a higher proportion of Staphylococci, Enterobacter, and Parvimonas micra, suggesting their possible role in the stability of MSI. The bacterial profile of MSI varies with age.

Effectiveness of an oral health training program for nursing professionals in India: An interventional study.

OBJECTIVES: Nursing professionals form the first line of contact and are in a unique place to provide appropriate oral advice to patients. The study assessed the effectiveness of oral health training program for nurses. DESIGN: The effectiveness of the program was evaluated by a pre and post questionnaire assessment on 50 nurses. RESULTS: Nursing professionals had a significant increase (p < .003) in post-training knowledge scores compared to pre-training scores. CONCLUSION: Improvement in oral health knowledge of nursing professionals has the potential for translation into practice for oral health promotion of patients and the general population.

Palatal volume estimation in operated unilateral and bilateral cleft lip and palate subjects using digital study models.

OBJECTIVE: To quantify and compare palatal volume of operated unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) subjects. SETTING AND SAMPLE POPULATION: This cross-sectional study was conducted on 85 study models comprising of 40 operated UCLP subjects (UG; mean age 10.33 ± 1.76 years), 25 operated BCLP subjects (BG; mean age 10.44 ± 1.92 years) and 20 non-cleft controls (C; mean age 12.90 ± 1.68 years). MATERIALS AND METHOD: The study models were scanned using 3D scanner and palatal volume assessment done using 3-matic software. Kruskal-Wallis test for palatal volume and one-way ANOVA for intercanine (IC), interpremolar (IPM) and intermolar (IM) width comparison were used. Pearson correlation was done between IM, IPM, and IC width, and palatal volume for three groups. The control group sample was evaluated by two observers to evaluate the interobserver reliability. RESULTS: The median palatal volume of C, UG and BG groups was 5814.31 mm3 , 2452.34 mm3 and 1688.39 mm3 , respectively. Significantly smaller palatal volume was found in UG and BG compared to control. Significant difference was seen in IC width between three groups. The IM, IPM and IC width with palatal volume in UG and IM width with palatal volume in BG group showed significant correlation. The ICC showed excellent agreement (>0.9) between observers. CONCLUSION: Palatal volume of UG and BG groups was smaller by 57.82% and 71.1%, respectively, compared to controls. Improving IPM width in UG and IM width in BG seems to have more impact in correction of palatal volume.

Precision of manual landmark identification between as-received and oriented volume-rendered cone-beam computed tomography images.

INTRODUCTION: The objective of this study was to evaluate the effect of the orientation of cone-beam computed tomography (CBCT) images on the precision and reliability of 3-dimensional cephalometric landmark identification. METHODS: Ten CBCT scans were used for manual landmark identification. Volume-rendered images were oriented by aligning the Frankfort horizontal and transorbital planes horizontally, and the midsagittal plane vertically. A total of 20 CBCT images (10 as-received and 10 oriented) were anonymized, and 3 random sets were generated for manual landmark plotting by 3 expert orthodontists. Twenty-five landmarks were identified for plotting on each anonymized image independently. Hence, a total of 60 images were marked by the orthodontists. After landmark plotting, the randomized samples were decoded and regrouped into as-received and oriented data sets for analysis and comparison. Means and standard deviations of the x-, y-, and z-axis coordinates were calculated for each landmark to measure the central tendency. Intraclass correlation coefficients were calculated to analyze the interobserver reliability of landmark plotting in the 3 axes in both situations. Paired t tests were applied on the mean Euclidean distance computed separately for each landmark to evaluate the effect of 3-dimensional image orientation. RESULTS: Interobserver reliability (intraclass correlation coefficient, >0.9) was excellent for all 25 landmarks for the x-, y-, and z-axes on both before and after orientation of the images. Paired t test results showed insignificant differences for the orientation of volume-rendered images for all landmarks except 3: R1 left (P = 0.0138), sella (P = 0.0490), and frontozygomatic left (P = 0.0493). Also midline structures such as Bolton and nasion were plotted more consistently or precisely than bilateral structures. CONCLUSIONS: Orientation of the CBCT image does not enhance the precision of landmark plotting if each landmark is defined properly on multiplanar reconstruction slices and rendered images, and the clinician has sufficient training. The consistency of landmark identification is influenced by their anatomic locations on the midline, bilateral, and curved structures.

Quantitative and qualitative assessment of anchorage loss during en-masse retraction with indirectly loaded miniscrews in patients with bimaxillary protrusion.

INTRODUCTION: This study provides vital insight in assessing anchorage loss when miniscrews are indirectly loaded. METHODS: The study sample comprised 18 patients with bimaxillary protrusion (14 girls, 4 boys; mean age, 17.3 ± 4.6 years) selected from a database of 89 patients treated with miniscrews. All subjects who were selected required extraction of all first premolars and maximum anchorage. After initial leveling and aligning, miniscrews were placed between the first molar and the second premolar in all 4 quadrants and loaded by the indirect method at 3 weeks after placement with 200-g nickel-titanium alloy closed-coil springs for en-masse retraction. Mean treatment duration was 29.7 ± 6.8 months. Pretreatment and posttreatment lateral cephalograms were analyzed to measure the amount of anchorage loss, incisor retraction, and the incisors' angular change in reference to the pterygoid vertical reference line and were evaluated by the structural superimposition method. RESULTS: The ratio of incisor retraction to molar protraction was 4.2 in the maxilla and 4.7 in the mandible. The first molars showed mean extrusion of 0.20 mm in the maxilla and 0.57 mm in the mandible; these were statistically insignificant. The mean angular change of the first molars was -2.43° in the maxilla and -0.03° in the mandible. The mean anchorage loss in reference to the pterygoid vertical was 1.3 mm in the maxilla and 1.1 mm in the mandible; these were statistically significant. Structural superimpositions showed mean change in molar position of 0.83 mm in the maxilla and 0.87 mm in the mandible, and 5.77 mm in the maxillary incisor and 5.43 mm in the mandibular incisor. These results were compared with the direct anchorage method reported in the literature. CONCLUSIONS: Indirect miniscrew anchorage can be a viable alternative to direct anchorage.

Surface deterioration and elemental composition of retrieved orthodontic miniscrews.

INTRODUCTION: This study provides insight into surface and elemental analyses of orthodontic retrieved miniscrew implants (MSIs). The sole purpose was to investigate the behavior of MSIs while they are in contact with bone and soft tissues, fluids, and food in the oral cavity. The information thus gathered may help to understand the underlying process of success or failure of MSIs and can be helpful in improving their material composition and design. METHODS: The study was carried out on 28 titanium-alloy MSIs (all from the same manufacturer) split into 3 groups: 18 MSIs were retrieved after successful orthodontic treatment, 5 were failed MSIs, and 5 were as-received MSIs serving as the controls. All MSIs were subjected to energy dispersive x-ray microanalysis to investigate the changes in surface elemental composition and to scanning electron microscopy to analyze their surface topography. Data thus obtained were subjected to suitable statistical analyses. RESULTS: Scanning electron microscope analysis showed surface manufacturing imperfections of the as-received MSIs in the form of stripes. Their elemental composition was confirmed to the specifications of the American Society for Testing of Materials for surgical implants. Retrieved MSIs exhibited generalized surface dullness; variable corrosion; craters in the head, neck, body, and tip regions; and blunting on tips and threads. Energy dispersive x-ray analyses showed deposition of additional elements: calcium had greater significance in its proportion in the body region by 0.056 weight percent; iron was seen in greater proportion in the failed retrieved MSIs compared with the successful miniscrews; cerium was seen in greater proportions in the head region by 0.128 weight percent and in the neck region by 0.147 weight percent than in the body and tip regions of retrieved MSIs. CONCLUSIONS: Retrieved MSIs showed considerable surface and structural alterations such as dullness, corrosion, and blunting of threads and tips. Their surfaces showed interactions and adsorption of several elements, such as calcium, at the body region. A high content of iron was found on the failed MSIs, and cerium was seen in the head and neck regions of retrieved MSIs.

The extraction of maxillary lateral incisors for the treatment of a Class II crowded malocclusion: a case report.

BACKGROUND: The extraction of an upper lateral incisor for orthodontic purposes is rare and must be adequately justified. AIM: The present case report describes the management of a skeletal Class II crowded malocclusion that was facilitated by the extraction of upper lateral incisors and lower first premolars. METHODS: A 14-year-old male patient presented with a skeletal Class II crowded malocclusion with associated speech and chewing difficulties. Phase I of treatment involved the extraction of the upper lateral incisors and functional appliance therapy. Phase II included the extraction of lower first premolars and mechanotherapy using full fixed appliances. RESULTS: An improvement in aesthetics and sagittal relations was achieved during phase I therapy as the mandible was advanced over a period of eight months. Mandibular skeletal change was 6.5 mm observed at pogonion. During phase II therapy, the maxillary canines were substituted for lateral incisors and a functional occlusion was achieved. The skeletal correction and occlusion were stable one year after debonding. CONCLUSION: The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review.

MRI-based cephalometrics: a scoping review of current insights and future perspectives.

OBJECTIVE: This review aims to explore the current status of magnetic resonance imaging (MRI) as a cephalometric tool, summarize the equipment design and methods, and propose recommendations for future research. METHODS: A systematic search was conducted in electronic databases, including PubMed, Ovid MEDLINE, Scopus, Embase, Web of Science, EBSCOhost, LILACS, and Cochrane Library, using broad search terms. The articles published in any language till June 2022 were considered. Cephalometric studies conducted using the MRI dataset on human participants, phantom or cadaver were included. Two independent reviewers assessed the final eligible articles using the quality assessment score (QAS). RESULTS: Nine studies were included in the final assessment. Studies used various methods, including 1.5 T or 3 T MRI systems and 3D or 2D MRI datasets. Among the imaging sequences, T1-weighted, T2-weighted and black bone MR images were used for cephalometric analysis. In addition, the reference standards varied among studies, such as traditional 2D cephalogram, cone-beam CT and phantom measurements. The mean QAS of all the included studies was 79% (± 14.4%). The main limitation of most studies was the small sample size and the heterogeneity of the methods, statistical tools used, and metric outcomes assessed. CONCLUSIONS: Despite the heterogeneity and lack of metrological evidence on the effectiveness of MRI-based cephalometric analysis, the preliminary results demonstrated by in vivo and in vitro studies are encouraging. However, future studies exploring MRI sequences specific to cephalometric diagnosis are required for wider adoption of this technique in routine orthodontic practice.

Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis.

OBJECTIVES: This review aimed to critically appraise the evidence for biomarkers in blood serum, gingival crevicular fluid (GCF), saliva, and urine in comparison with standard radiographic indices for skeletal maturation assessment. MATERIALS AND METHODS: A thorough literature search in multiple databases was conducted for biomarkers in body fluids for skeletal maturation assessed with cervical vertebrae in lateral cephalograms or on hand-wrist radiographs. Different combinations including free text, MeSH terms, and Boolean operators were used. Two researchers used strict inclusion and exclusion criteria to screen title, abstract, and full text, and used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 instrument for risk of bias assessment of individual studies. Meta-analysis was performed on eligible studies using RevMan 5 software. RESULTS: A total of 344 articles were screened, of which 33 met the inclusion criteria and quality assessment. The skeletal maturity indicators included insulin-like growth factors (IGF-1), alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), dehydroepiandrosterone sulfate (DHEAS), vitamin D binding protein (DBP), parathormone-related protein (PTHrP), osteocalcin, metalloproteins, and serotransferrin (TF) along with different metabolites. At puberty, a significant rise was seen in IGF-1, DBP, ALP, osteocalcin, TF, and BALP. However, the serum DHEAS and PTHrP increased from pre-pubertal to post-pubertal stages. Due to the data heterogeneity, a meta-analysis could be performed on seven studies in total on IGF-1 in serum and blood. Of these, five were included for data in males and six in females, and four studies on IGF-1 in serum and blood. A significant difference in IGF-1 levels was seen between stages of peak pubertal growth spurt (CS3 and CS4) and decelerating pubertal growth (CS5) compared with growth initiation stage (CS2). CONCLUSIONS: Pubertal growth spurts were correlated with peak serum IGF-1 and BALP in both sexes individually. Peak ALP levels in GCF were correlated with the pubertal spurt in a combined sample of males and females. Standard biofluid collection protocols and homogeneity in sampling and methodology are strongly recommended for future research.

Bone density and miniscrew stability in orthodontic patients.

OBJECTIVES: The purpose of this study was to evaluate bone density in buccal inter-radicular bone between second premolars and first permanent molars and its association with the clinical stability of miniscrews used for en masse retraction of anterior teeth in extraction cases. MATERIALS AND METHODS: Thirty-eight miniscrews were placed in ten patients (8 females, 2 males: mean age, 18.9 +/- 4.12 years) to provide indirect orthodontic anchorage. Twenty miniscrews were placed in the maxilla and eighteen were inserted in the mandible. All of the miniscrews were placed in the buccal inter-radicular bone between the second premolar and the first permanent molar. Bone density at each miniscrew site was recorded by computed tomography and recorded in Hounsfield units (HU) before miniscrew placement. Nickel-titanium closed-coil springs were used to apply an orthodonticforce of 2N within one week following placement. RESULTS: Cortical bone density values ranged from 506.7- 1705.6 HU (Mean, 929.27 +/- 322.12 HU) in the maxilla and 503.8 - 1544.8 HU (Mean, 1116.2 +/- 298.33 HU) in the mandible. Cancellous bone density values ranged from 185.9 - 930.8 HU (Mean, 450.09 +/- 205.66 HU) in the maxilla and 197.3 - 803.6 HU (Mean, 561.87 +/- 170.83 HU) in the mandible. There was no statistically significant difference between right and left sides. A bone density comparison between the maxilla and mandible revealed statistically significant higher values in mandibular cortical bone (p = 0.008), while no significant difference was found in cancellous bone values (p = 0.097). Clinically, the success rate of miniscrews in the maxilla was 100% but only 77.8% in the mandible. Miniscrew failures were associated with peri-implant inflammation and miniscrew proximity to dental roots. No relation was found between bone density and miniscrew stability. CONCLUSION: The present study determined that no definitive association could be established between miniscrew success and bone density.

A quantitative analysis of macrophage-colony-stimulating factor in peri-miniscrew implant crevicular fluid before and after orthodontic loading.

OBJECTIVES: To analyze macrophage-colony-stimulating factor (M-CSF), a bone remodeling biomarker in the peri-miniscrew implant crevicular fluid (PMICF) after insertion and orthodontic loading. MATERIALS AND METHODS: This prospective study included 40 miniscrew implant (MSI) sites in 10 subjects undergoing fixed orthodontic mechanotherapy utilizing miniscrew anchorage. After dental alignment, miniscrews were inserted between the second premolar and first molar roots. After 21 days of insertion, MSIs were direct loaded with closed-coil springs (200 g force) for en masse retraction of anterior teeth. PMICF was collected with Periopaper™ strips from the gingival crevice around MSIs at six time points (T1-T6: 1 hour, 1 day, 21 days postinsertion, and 7, 21, and 42 days postloading). PMICF was quantified for M-CSF by enzyme-linked immunosorbent assay. Paired comparison of mean M-CSF concentrations before and after loading stages (T1-T6) was made using the Wilcoxon signed-rank test. RESULTS: The mean M-CSF concentration showed a significant peak at T3 (21 days postinsertion; 12.646 pg/mL; T1 vs T3: P < .0001). After orthodontic loading of miniscrews, M-CSF levels increased to 13.570 pg/mL at T4 (7 days after loading; T1 vs T4: P < .001) and maintained at a plateau to T5 (21 days postloading; 11.994 pg/mL). However, the difference between preloading and postloading was not statistically significant (T3 vs T4). CONCLUSIONS: The maximum M-CSF activity around MSIs was observed at around 3 weeks of miniscrew insertion, suggesting underlying bone remodeling after surgical injury. However, orthodontic force on MSIs did not cause any significant surge in M-CSF levels postloading.

Fabrication and evaluation of antimicrobial biomimetic nanofiber coating for improved dental implant bioseal: An in vitro study.

BACKGROUND: A weak implant-soft tissue interface may lead to bacterial ingression, breakdown of underlying tissues, and eventually implant failure. This study proposes a surface modification technique of titanium alloy (Ti), using a nano-biopolymer scaffold to enhance soft tissue attachment in dental implants. METHODS: Gelatin (20% w/v) embedded with 10 ± 2 nm silver nanoparticles (AgNPs) was electrospun to form a gelatin electrospun mat (GEM) scaffold, bonded to Ti alloy surface using chemical surface functionalization. Antimicrobial activity of AgNPs was tested against representative Gram-positive (Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli) at 4, 24, and 48 hours and after embedding in scaffold at 48 hours. Cytotoxicity analysis (MTT assay) was performed using the 3T3 mouse fibroblast cell line at 24 and 72 hours for two groups: control (unmodified Ti disc) and experimental (GEM embedded with AgNPs); and further validated by scanning electron microscopy. RESULTS: The AgNPs-embedded GEM showed good antimicrobial activity at 48 hours, with the AgNPs showing complete (99.99%) inhibition of bacterial colony counts at 24 and 48 hours. Cell viability and proliferation over the GEM modified Ti discs were seen to be significantly increased (P < 0.05) at 72 hours as compared with control. SEM images revealed intimate spreading of fibroblasts, with differentiated cell morphology and pseudopodial processes, indicative of enhanced fibroblastic adhesion, growth, and differentiation over the scaffold. CONCLUSION: Results show good antifouling properties and biocompatibility of the fabricated coating, making it a promising strategy to reduce postoperative infections and peri-implant diseases in Ti dental implants.

Effects of submucosally administered platelet-rich plasma on the rate of tooth movement.

OBJECTIVES: To evaluate the effects of submucosally administered platelet-rich plasma (PRP) on the rate of maxillary canine retraction. Levels of soluble receptor activator of nuclear factor-κb ligand (sRANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF) were also measured over 2 months. MATERIALS AND METHODS: This split-mouth trial involved 20 sites in 10 subjects randomly assigned to PRP (experimental) side and control side. After alignment, the freshly prepared PRP was injected submucosally distal to the experimental side maxillary canine, and retraction was performed using NiTi closed-coil springs (150 g) on 0.019 × 0.025-inch stainless steel wire. The rate of canine movement was assessed using digital model superimposition at 0, 30, and 60 days. The OPG and sRANKL were assayed using enzyme-linked immunosorbent assay from GCF collected at 0, 1, 7, 21, 30, and 60 days. RESULTS: Twenty sites were analyzed using paired t test. The rate of tooth movement increased significantly by 35% on the PRP side compared with the control side in the first month (P = .0001) and by 14% at the end of the second month (P = .015). Using the Mann-Whitney U test, OPG levels were found to be significantly decreased on the 7th (P = .003) and 30th day on the PRP side (P = .01), while sRANKL became detectable by the third week postinjection on the PRP side (P = .069). CONCLUSIONS: Submucosal injection of platelet-rich plasma significantly increased tooth movement during the 60-day observation period. Local injection of PRP significantly altered the levels of OPG and sRANKL in GCF.

Role of S100 A7 as a diagnostic biomarker in oral potentially malignant disorders and oral cancer.

Background: S100 proteins have been implicated in the tumorigenesis of different human cancers and in oral dysplasia, as they are keratinocytes. Materials and Methods: In the present study, we have attempted to compare the expression of S100-A7 within young-onset (age ≤45 years, Group 1) oral squamous cell carcinoma (OSCC), OSCC in older age groups (age >45 years Group 2), oral potentially malignant disorders (OPMDs, Group 3) and inflammatory lesions (Group 4). The tissue sections were scored based on the percentage of immunostained cells and staining intensity. Nuclear, cytoplasmic and membrane immunoreactivity were also scored. Results: The present study comprised 153 histopathologically diagnosed case subjects of OSCC >45 years (n = 41), OSCC <45 years (n = 36), OPMD (n = 40) and inflammatory lesions (n = 36). The present study revealed a statistically significant difference of distribution with regard to S100A7 staining (cytoplasmic and nuclear) between OPMDs and OSCC (P < 0.05). The nuclear, cytoplasmic and membrane staining as well as the staining intensity had significantly different scoring patterns among the OSCC group, OPMD group and the inflammatory lesions with the OSCC group having the highest scoring of the S100A7 staining (irrespective of the age). Conclusions: The present study concludes that S100A7 can be used as a diagnostic biomarker to differentiate between OPMDs and OSCC lesions. However, the marker is unable to distinguish between OSCCs in younger and older patients as the molecular pathogenesis of tumors in either of these age groups is probably similar.

Expression of circulating cell-free nucleic acids around miniscrew implant during orthodontic tooth movement-a prospective study.

OBJECTIVES: Literature shows that the expression of various biomarkers in peri-miniscrew crevicular fluid (PMICF) is related to the stability of miniscrew implants (MSIs). The present study investigated the role and alterations in levels of circulating cell-free nucleic acids (cfNAs) in PMICF before and after orthodontic loading. MATERIAL AND METHODS: This prospective study consisted of forty-six MSIs placed between the second premolar and first molar in the maxillary and mandibular arches. Direct loading was done after 3 weeks of MSI insertion with nickel-titanium closed coil spring exerting a force of 200 g. The PMICF sample was collected at various time intervals, and the level of cfNA was determined. Clinical parameters, including implant mobility and gingival health, were also assessed. Pre-loading and post-loading parameters were assessed using Wilcoxon's rank-sum test. RESULTS: Among 46 MSIs, 36 were stable during the study and 10 MSIs showed peri-implant inflammation and increased mobility. There was a significant rise in the cfNA concentration 24 h after implant insertion (0.4 ± 0.86 ng/µl). The level of cfNAs significantly decreased over 3 weeks and reached the baseline level (0.2 ± 0.31 ng/µl). There was also a significant rise in the levels of cfNA (0.8 ± 0.70 ng/µl) at 24 h after loading MSIs, which gradually decreased to 0.2 ± 0.24 ng/µl after 63 days. The expression of cfNAs was on the average 0.32 units more in the cases with failed implants (P = 0.05). CONCLUSIONS: cfNA levels in PMICF showed an upward trend 24 h after MSI insertion and 24 h after orthodontic loading. The expression of cfNA was more in cases with failed MSIs. Hence, the cfNAs can be considered as a prognostic biomarker of MSI stability.