Effect of Probiotics Lactobacillus rhamnosus and Lactobacillus plantarum on Caries and Periodontal Diseases: A Systematic Review.

Caries and periodontitis are the most prevalent oral diseases worldwide. Major factors contributing to the development of these oral conditions include poor oral hygiene, dental biofilm formation, high carbohydrates diet, smoking, other systemic diseases, and genetic factors. Various preventive measures have been established to mitigate the risk of caries and periodontal disease development. The present review aims to discuss the role of the probiotics Lactobacillus rhamnosus and Lactobacillus plantarum in the prevention and treatment of caries and periodontal diseases. The study was conducted in accordance with PRISMA guidelines and was registered on PROSPERO. The search involved PubMed, Web of Science, and Scopus and considered the PICO format. Studies were screened by two reviewers independently, and disagreements were solved by consensus with a third reviewer. Data extraction included details about the type of probiotics, strains, and purpose of administration. A total of 15 RCTs were included, of which just 1 was about tooth cavities. Overall, 87% of the included studies were good-quality papers regarding the Jadad Scale. Several studies agreed on the potential of probiotics L. rhamnosus and L. plantarum, both alone and combined, to prevent and improve clinical outcomes in caries and periodontal treatments, weaker evidence is provided for the microbiological benefit.

Ultrasound-guided diagnosis on a parapharyngeal mass.

Masses in the parapharyngeal area are rare and often due to infectious phenomena arising from the oral cavity or pharynx which lead to abscess formation. Less frequently, the lesion can be neoplastic. Tumours of the parapharyngeal space are rare, accounting for less than 1% of all head and neck neoplasms. We report the case of a patient who came to our observation for mandibular pain. Multiparametric diagnostic imaging was done thus showing a parapharyngeal mass. An ultrasound guided biopsy was performed by a transcutaneous route with a high median approach at neck level, to characterize the mass in the right tonsillar region. The histological examination reported the final histological diagnosis of sarcomatoid carcinoma.

Exploring Interleukin Levels in Type 1 Diabetes and Periodontitis: A Review with a Focus on Childhood.

Diabetes can trigger an increase in cytokine levels leading to the production of C-reactive protein and fibrinogen. These molecules promote subclinical inflammation, causing the expression of adhesive molecules and endothelial dysfunction. Despite the lack of a comprehensive panel for single-nucleotide polymorphisms (SNPs) for interleukins associated with type 1 diabetes mellitus (T1DM), understanding the inflammatory role of SNPs is crucial because periodontitis, the sixth complication of diabetes, is influenced via these genetic variations. This review focuses on the interleukin levels in T1DM patients with and without periodontitis, with a particular focus on childhood and on SNPs when reported. A search of PubMed and Scopus identified 21 relevant studies from the past five years. Several ILs were analyzed, emphasizing that T1DM still needs to be thoroughly explored regarding an IL polymorphisms panel; however, the last five years have led to the increased independence of this condition, causing autonomous inflammatory effects, which require further investigation. The periodontitis and T1DM association in children and adolescents represents a severe gap in the literature that should be filled; this scarce presence of studies serves as motivation for further clinical research.

Potential Relationship between Poor Oral Hygiene and MRONJ: An Observational Retrospective Study.

Medication-related osteonecrosis of the jaw (MRONJ) is a drug-related side effect linked but not limited to antiresorptive and antiangiogenic molecules. It recognizes several triggers in dental procedures, such as surgery, endodontic treatments, and root planing, but also prosthesis decubitus or with a spontaneous onset. Although there are many reports about the onset of this pathology, oral hygiene status is mainly described as a consequence of MRONJ. Not so much is known about the oral hygiene situation as a concurrent factor in the pathogenesis of severe stages and about non-surgical periodontal therapy in patients affected by MRONJ. Actually, clear instructions for non-surgical periodontal therapy are poor in the literature. The primary outcome of the present study is to evaluate the oral hygiene status in MRONJ patients. In addition, a secondary outcome is to review the factor of poor oral hygiene as a cause or worsening aspect for MRONJ. A total of 45 subjects (19 males and 26 females) with a mean age of 59 ± 12 were enrolled. The Pearson correlation coefficient showed no significant results for the variable of the Simplified Oral Hygiene Index (OHI-S) and the American Association of Oral and Maxillofacial Surgeons (AAOMS) stage, although the majority of patients showed poor oral hygiene with an OHI-S average of 3.39 ± 1.83. As stated by the last AAOMS position paper, poor plaque control is related to a worsened MRONJ stage. The relation between the lack of oral hygiene and MRONJ onset is still unclear.

Exploring Oral Microbiome in Healthy Infants and Children: A Systematic Review.

Recent advances in the development of next-generation sequencing (NGS) technologies, such as the 16S rRNA gene sequencing, have enabled significant progress in characterizing the architecture of the oral microbiome. Understanding the taxonomic and functional components of the oral microbiome, especially during early childhood development, is becoming critical for identifying the interactions and adaptations of bacterial communities to dynamic conditions that may lead to the dysfunction of the host environment, thereby contributing to the onset and/or progression of a wide range of pathological conditions. We aimed to provide a comprehensive overview of the most recent evidence from studies of the oral microbiome of infants and young children, focusing on the development of oral microbiome in the window of birth to 18 years, focusing on infants. A systematic literature search was conducted in PubMed, Scopus, WOS, and the WHO clinical trial website for relevant articles published between 2006 to 2022 to identify studies that examined genome-wide transcriptome of the oral microbiome in birth, early childhood, and adolescence performed via 16s rRNA sequence analysis. In addition, the references of selected articles were screened for other relevant studies. This systematic review was performed in accordance PRISMA guidelines. Data extraction and quality assessment were independently conducted by two authors, and a third author resolved discrepancies. Overall, 34 studies were included in this systematic review. Due to a considerable heterogeneity in study population, design, and outcome measures, a formal meta-analysis was not carried out. The current evidence indicates that a core microbiome is present in newborns, and it is stable in species number. Disparity about delivery mode influence are found. Further investigations are needed.

KCNQ2-Related Neonatal Epilepsy Treated With Vitamin B6: A Report of Two Cases and Literature Review.

Potassium Voltage-Gated Channel Subfamily Q Member 2 (KCNQ2) gene has been initially associated with "Benign familial neonatal epilepsy" (BFNE). Amounting evidence arising by next-generation sequencing techniques have led to the definition of new phenotypes, such as neonatal epileptic encephalopathy (NEE), expanding the spectrum of KCNQ2-related epilepsies. Pyridoxine (PN) dependent epilepsies (PDE) are a heterogeneous group of autosomal recessive disorders associated with neonatal-onset seizures responsive to treatment with vitamin B6 (VitB6). Few cases of neonatal seizures due to KCNQ2 pathogenic variants have been reported as successfully responding to VitB6. We reported two cases of KCNQ2-related neonatal epilepsies involving a 5-year-old male with a paternally inherited heterozygous mutation (c.1639C>T; p.Arg547Trp), and a 10-year-old female with a de novo heterozygous mutation (c.740C>T; p.Ser247Leu). Both children benefited from VitB6 treatment. Although the mechanisms explaining the efficacy of VitB6 in such patients remain unclear, this treatment option in neonatal-onset seizures is easily taken into account in Neonatal Intensive Care Units (NICUs). Further studies should be conducted to better define clinical guidelines and treatment protocols.

Synaptopathies in Developmental and Epileptic Encephalopathies: A Focus on Pre-synaptic Dysfunction.

The proper connection between the pre- and post-synaptic nervous cells depends on any element constituting the synapse: the pre- and post-synaptic membranes, the synaptic cleft, and the surrounding glial cells and extracellular matrix. An alteration of the mechanisms regulating the physiological synergy among these synaptic components is defined as "synaptopathy." Mutations in the genes encoding for proteins involved in neuronal transmission are associated with several neuropsychiatric disorders, but only some of them are associated with Developmental and Epileptic Encephalopathies (DEEs). These conditions include a heterogeneous group of epilepsy syndromes associated with cognitive disturbances/intellectual disability, autistic features, and movement disorders. This review aims to elucidate the pathogenesis of these conditions, focusing on mechanisms affecting the neuronal pre-synaptic terminal and its role in the onset of DEEs, including potential therapeutic approaches.

Epileptic Phenotype and Cannabidiol Efficacy in a Williams-Beuren Syndrome Patient With Atypical Deletion: A Case Report.

Epilepsy is a rare clinical manifestation in Williams-Beuren syndrome patients. However, some studies report the presence of infantile spasms and epilepsy in patients carrying larger deletions. Herein, we describe a 13-year-old female affected by Williams-Beuren syndrome and pharmacoresistant epilepsy reporting a de novo large heterozygous 7q11.21q21 deletion (19.4 Mb) also including the YWHAG gene. Studies indicate that cannabidiol is effective as adjunctive therapy for seizures associated with tuberous sclerosis complex, and it is under investigation also in focal cortical dysplasia. When treated with cannabidiol, our patient showed a significant reduction in seizure frequency and intensity, and improved motor and social skills. We hypothesized that CBD could exert a gene/disease-specific effect.

Altered tetrahydrobiopterin metabolism in patients with phenylalanine hydroxylase deficiency.

The tetrahydrobiopterin (BH4) cofactor is essential for the activity of various enzymes, including phenylalanine (Phe) hydroxylase. In phenylketonuria (PKU) patients, who are chronically exposed to high Phe levels, high urinary excretion of BH4 metabolites neopterin and biopterin is observed. The aim of this longitudinal study was to investigate consistence and variability of the urinary excretion of pterins (neopterin and biopterin) in PKU patients in relation to age and concomitant blood Phe and tyrosine levels. The study was based on the result of 274 pterin examinations (3-13 exams per subject) performed in 47 PKU patients (aged 6 days to 37 years). Multivariate analysis showed that urinary biopterin and neopterin excretion was affected by age and concomitant blood Phe concentration. The influence of blood Phe on both biopterin and neopterin levels was greater in patients younger than 4 months. Later on, interindividual variability was higher than intraindividual variability for both biopterin and neopterin. CONCLUSION: Common metabolic (blood Phe levels) and individual (age) factors implicated in the assessment of PKU outcome account only marginally and transiently for the variability of neopterin and biopterin excretion in PKU patients. Other unknown homeostatic factors may probably affect the individual response to chronically elevated Phe levels. What is Known: • In PKU patients, a high urinary excretion of biopterin and neopterin is found. • Biopterin and neopterin excretion is influenced by age and phenylalanine levels. W hat is New: • Blood phenylalanine concentration is the major determinant on pterin excretion in PKU patients in the first months of life. • In older PKU patients, the influence of phenylalanine on pterin excretion is less prominent.

Novel (glycerol)borate-based ionic liquids: an experimental and theoretical study.

A series of newly designed (glycerol)borate based ionic liquids were synthesized and characterized. The synthesis of these ionic liquids involves, first, the preparation of the bis(glycerol)boric acid(s) followed by neutralization with the appropriate base, [cat]OH. Ionic liquids bearing inorganic (Li(+), Na(+), K(+)) or organic cations have been prepared and characterized. The ability of the bis(glycerol)borate anions to undergo dissociation reaction in the presence of water, depending on cation nature, was investigated by NMR. Theoretical calculations were also performed to evaluate the relative stability of the possible bis(glycerol)borate isomers as nude ions or as ion pairs with Li(+), Na(+), and H(+). Important information about the structural features of H[Gly(2)B] useful to rationalize the chemical behavior have been obtained.