Dental Implant Placement in Medically Compromised Patients: A Literature Review.

As a discipline of dentistry, oral implantology deals with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures for the purpose of regaining contour, function, aesthetics, and speech in a partially or completely edentulous patient. The present review aims to provide the currently available knowledge about the impact of certain systemic disorders and the usage of some medications on the survival rate of dental implant therapy and to highlight the importance of patient management under these conditions. Diabetes, osteoporosis, cardiovascular diseases, and the intake of some medications can increase the risk of the failure of a dental implant. Even though there are relatively few medical contraindications to dental implant treatment, certain conditions may increase the risk of failure or complications.

Molecular modelling of fullerene C60 functionalized by nitric oxide for use in biological environment.

The unique potential of fullerene C60 for various biological applications has ignited significant interest. However, its inherent non-polarity poses a critical challenge for its effective integration within biological systems. This study delves into the intricate physicochemical characteristics of the innovative [C60 + NO] complex using density functional theory and time-dependent density functional theory. The computational analyses encompass molecular charge, surface electrostatic potential, and dipole moment evaluations. Impressively, the dipole moment of the [C60 + NO] complex significantly increases to 12.92 D. Meticulous surface analysis reveals a subtle interplay between molecular structures, indicating weak interactions. The analysis of the absorption spectrum unveils a noteworthy red-shift of 200 nm subsequent to complex formation. To elucidate the electron transfer mechanisms, we explore photo-induced electron transfer through CAM-B3LYP. This exploration elucidates intricate pathways governing electron transfer, with complementary insights gleaned from Marcus theory's outputs, especially the Gibbs free energy of electron transfer. Changes in the physicochemical properties of approaching C60 and NO molecules reveal interesting results compared to separate molecules. These findings resonate profoundly in the context of potential biological and pharmaceutical utilization. With implications for the biomedical area, the outcomes linked to the [C60 + NO] complex kindle optimism for pioneering biomedical applications.

Optimizing PCL/PLGA Scaffold Biocompatibility Using Gelatin from Bovine, Porcine, and Fish Origin.

This research introduces a novel approach by incorporating various types of gelatins, including bovine, porcine, and fish skin, into polycaprolactone and poly (lactic-co-glycolic acid) using a solvent casting method. The films are evaluated for morphology, mechanical properties, thermal stability, biodegradability, hemocompatibility, cell adhesion, proliferation, and cytotoxicity. The results show that the incorporation of gelatins into the films alters their mechanical properties, with a decrease in tensile strength but an increase in elongation at break. This indicates that the films become more flexible with the addition of gelatin. Gelatin incorporation has a limited effect on the thermal stability of the films. The composites with the gelatin show higher biodegradability with the highest weight loss in the case of fish gelatin. The films exhibit high hemocompatibility with minimal hemolysis observed. The gelatin has a dynamic effect on cell behavior and promotes long-term cell proliferation. In addition, all composite films reveal exceptionally low levels of cytotoxicity. The combination of the evaluated parameters shows the appropriate level of biocompatibility for gelatin-based samples. These findings provide valuable insights for future studies involving gelatin incorporation in tissue engineering applications.

Carotid Artery Stenosis on Panoramic Radiographs and CT Scans in Patients With Malignancies After Radiotherapy.

BACKGROUND/AIM: This study aimed to identify the progression of carotid artery stenosis (CAS) in patients with head and neck cancer following radiation therapy (RT) by characterizing associated risk factors. PATIENTS AND METHODS: Panoramic radiographs (OPG), computed tomography (CT) scans, cone-beam CT (CBCT) scans, and ultrasonography (US) of 69 patients with head and neck tumors were selected and analyzed to identify the presence of CAS. Data on tumor location, smoking status, hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), and treatment were collected from the patients' medical records. Patients who received chemotherapy or no treatment were excluded from the study. The differential diagnosis of other radiopacities and anatomical landmarks were excluded. Patients were divided into two groups: those with CAS (group1) and those without CAS (group 2) and their clinical information was compared. RESULTS: The overall prevalence of CAS on the panoramic radiographs was 16%. Of the 69 patients, 44 underwent radiography before and after radiotherapy, only seven had mild CAS on radiographs after radiotherapy, and no significant difference in CAS was identified before and after radiotherapy. There were also no differences between the groups regarding age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, tumor location, and RT dose before and after radiation (p>0.05). CONCLUSION: Radiotherapy does not seem to affect the prevalence of CAS, although it has been identified in some patients after radiotherapy completion.

Predicting Chronic Hyperplastic Candidiasis Retro-Angular Mucosa Using Machine Learning.

Chronic hyperplastic candidiasis (CHC) presents a distinctive and relatively rare form of oral candidal infection characterized by the presence of white or white-red patches on the oral mucosa. Often mistaken for leukoplakia or erythroleukoplakia due to their appearance, these lesions display nonhomogeneous textures featuring combinations of white and red hyperplastic or nodular surfaces. Predominant locations for such lesions include the tongue, retro-angular mucosa, and buccal mucosa. This paper aims to investigate the potential influence of specific anatomical locations, retro-angular mucosa, on the development and occurrence of CHC. By examining the relationship between risk factors, we present an approach based on machine learning (ML) to predict the location of CHC occurrence. In this way, we employ Gradient Boosting Regression (GBR) to classify CHC lesion locations based on important risk factors. This estimator can serve both research and diagnostic purposes effectively. The findings underscore that the proposed ML technique can be used to predict the occurrence of CHC in retro-angular mucosa compared to other locations. The results also show a high rate of accuracy in predicting lesion locations. Performance assessment relies on Mean Squared Error (MSE), Root Mean Squared Error (RMSE), R-squared (R2), and Mean Absolute Error (MAE), consistently revealing favorable results that underscore the robustness and dependability of our classification method. Our research contributes valuable insights to the field, enhancing diagnostic accuracy and informing treatment strategies.

Clinical Experience with Autofluorescence Guided Oral Squamous Cell Carcinoma Surgery.

In our study, the effect of the use of autofluorescence (Visually Enhanced Lesion Scope-VELscope) on increasing the success rate of surgical treatment in oral squamous carcinoma (OSCC) was investigated. Our hypothesis was tested on a group of 122 patients suffering from OSCC, randomized into a study and a control group enrolled in our study after meeting the inclusion criteria. The preoperative checkup via VELscope, accompanied by the marking of the range of a loss of fluorescence in the study group, was performed before the surgery. We developed a unique mucosal tattoo marking technique for this purpose. The histopathological results after surgical treatment, i.e., the margin status, were then compared. In the study group, we achieved pathological free margin (pFM) in 55 patients, pathological close margin (pCM) in 6 cases, and we encountered no cases of pathological positive margin (pPM) in the mucosal layer. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases, and pFM in 40 of all cases in the mucosal layer. This study demonstrated that preoperative autofluorescence assessment of the mucosal surroundings of OSCC increased the ability to achieve pFM resection 4.8 times in terms of lateral margins.

Metaverse and Medical Diagnosis: A Blockchain-Based Digital Twinning Approach Based on MobileNetV2 Algorithm for Cervical Vertebral Maturation.

Advanced mathematical and deep learning (DL) algorithms have recently played a crucial role in diagnosing medical parameters and diseases. One of these areas that need to be more focused on is dentistry. This is why creating digital twins of dental issues in the metaverse is a practical and effective technique to benefit from the immersive characteristics of this technology and adapt the real world of dentistry to the virtual world. These technologies can create virtual facilities and environments for patients, physicians, and researchers to access a variety of medical services. Experiencing an immersive interaction between doctors and patients can be another considerable advantage of these technologies, which can dramatically improve the efficiency of the healthcare system. In addition, offering these amenities through a blockchain system enhances reliability, safety, openness, and the ability to trace data exchange. It also brings about cost savings through improved efficiencies. In this paper, a digital twin of cervical vertebral maturation (CVM), which is a critical factor in a wide range of dental surgery, within a blockchain-based metaverse platform is designed and implemented. A DL method has been used to create an automated diagnosis process for the upcoming CVM images in the proposed platform. This method includes MobileNetV2, a mobile architecture that improves the performance of mobile models in multiple tasks and benchmarks. The proposed technique of digital twinning is simple, fast, and suitable for physicians and medical specialists, as well as for adapting to the Internet of Medical Things (IoMT) due to its low latency and computing costs. One of the important contributions of the current study is to use of DL-based computer vision as a real-time measurement method so that the proposed digital twin does not require additional sensors. Furthermore, a comprehensive conceptual framework for creating digital twins of CVM based on MobileNetV2 within a blockchain ecosystem has been designed and implemented, showing the applicability and suitability of the introduced approach. The high performance of the proposed model on a collected small dataset demonstrates that low-cost deep learning can be used for diagnosis, anomaly detection, better design, and many more applications of the upcoming digital representations. In addition, this study shows how digital twins can be performed and developed for dental issues with the lowest hardware infrastructures, reducing the costs of diagnosis and treatment for patients.

Metaverse and Healthcare: Machine Learning-Enabled Digital Twins of Cancer.

Medical digital twins, which represent medical assets, play a crucial role in connecting the physical world to the metaverse, enabling patients to access virtual medical services and experience immersive interactions with the real world. One serious disease that can be diagnosed and treated using this technology is cancer. However, the digitalization of such diseases for use in the metaverse is a highly complex process. To address this, this study aims to use machine learning (ML) techniques to create real-time and reliable digital twins of cancer for diagnostic and therapeutic purposes. The study focuses on four classical ML techniques that are simple and fast for medical specialists without extensive Artificial Intelligence (AI) knowledge, and meet the requirements of the Internet of Medical Things (IoMT) in terms of latency and cost. The case study focuses on breast cancer (BC), the second most prevalent form of cancer worldwide. The study also presents a comprehensive conceptual framework to illustrate the process of creating digital twins of cancer, and demonstrates the feasibility and reliability of these digital twins in monitoring, diagnosing, and predicting medical parameters.

Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery.

The reconstruction of oral tongue and floor of mouth defects after resections of squamous cell carcinoma is a challenging task in reconstructive surgery aiming for appropriate restoration of oral function and quality of life improvement. In this study, the authors introduce the innovative reconstruction technique of medium-sized defects consisting of tunnelized facial artery myomucosal island flap and submandibular gland flap as the local chimeric flap pedicled on facial vessels. A retrospective case series evaluation of 4 patients suffering from oral cavity cancer (stages III and IVa), who underwent transoral tumor excision with neck dissection and immediate reconstruction in the time period September 2020 to July 2021, was conducted. No flap losses or flap-related complications were identified. No recurrences occurred during the follow-up at 11.0±4.5 months (range: 6-16 mo, median=11 mo). Tunnelized facial artery myomucosal island flap and submandibular gland flap local chimeric flap expands the reconstruction options of medium-sized defects after ablative oral cancer surgery in carefully selected patients primarily not suitable for free flap reconstructions.

Retromandibular Transparotid Approach for the Treatment of Benign Nontraumatic Conditions of the Mandible. A Retrospective Consecutive Case-Series Study.

ABSTRACT: The retromandibular transparotid approach enables the most direct access to the central and posterior part of the mandibular ramus including the condylar region. So far it has not been widely used for the management of benign pathology of the mandible. The purpose of this study was to evaluate the utilization rate of this approach in the nontrauma setting including the determination of suitable indications for this access. In total, 105 patients with 107 retromandibular transparotid approaches performed in the 6.5 years (from May 2014 to November 2020) were evaluated. Patients suffering from nontrauma pathology accounted for 4.7% of all cases. The recurrences of different types of odontogenic cysts and secondary chronic osteomyelitis were surgically managed via this approach with aesthetically acceptable resultant scar achievement and no identified postoperative complications. All lesions resolved and no recurrences occurred during the follow-up 32.0 ±â€Š20.7 months (range 6 to 59 months, median = 26 months). The retromandibular transparotid approach may be considered for the enucleation of benign bone lesions in selected patients. Another type of surgery for the management of benign nontraumatic conditions in an accessible area without requirements for continuity resection and jaw reconstruction may be also suitable for using this approach.

Evaluating the osseointegration of nanostructured titanium implants in animal models: Current experimental methods and perspectives (Review).

The aim of this paper is to review the experimental methods currently being used to evaluate the osseointegration of nanostructured titanium implants using animal models. The material modifications are linked to the biocompatibility of various types of oral implants, such as laser-treated, acid-etched, plasma-coated, and sand-blasted surface modifications. The types of implants are reviewed according to their implantation site (endoosseous, subperiosteal, and transosseous implants). The animal species and target bones used in experimental implantology are carefully compared in terms of the ratio of compact to spongy bone. The surgical technique in animal experiments is briefly described, and all phases of the histological evaluation of osseointegration are described in detail, including harvesting tissue samples, processing undemineralized ground sections, and qualitative and quantitative histological assessment of the bone-implant interface. The results of histological staining methods used in implantology are illustrated and compared. A standardized and reproducible technique for stereological quantification of bone-implant contact is proposed and demonstrated. In conclusion, histological evaluation of the experimental osseointegration of dental implants requires careful selection of the experimental animals, bones, and implantation sites. It is also advisable to use larger animal models and older animals with a slower growth rate rather than small or growing experimental animals. Bones with a similar ratio of compact to spongy bone, such as the human maxilla and mandible, are preferred. A number of practical recommendations for the experimental procedures, harvesting of samples, tissue processing, and quantitative histological evaluations are provided.