Deep Learning Prediction of Inflammatory Inducing Protein Coding mRNA in P. gingivalis Released Outer Membrane Vesicles.

Aim: The Insilco study uses deep learning algorithms to predict the protein-coding pg m RNA sequences. Material and methods: The NCBI GEO DATA SET GSE218606's GEO R tool discovered P.G's outer membrane vesicles' most differentially expressed mRNA. Genemania analyzed differentially expressed gene networks. Transcriptomics data were collected and labeled on P. gingivalis protein-coding mRNA sequence and pseudogene, lincRNA, and bidirectional promoter lincRNA. Orange, a machine learning tool, analyzed and predicted data after preprocessing. Naïve Bayes, neural networks, and gradient descent partition data into training and testing sets, yielding accurate results. Cross-validation, model accuracy, and ROC curve were evaluated after model validation. Results: Three models, Neural Networks, Naive Bayes, and Gradient Boosting, were evaluated using metrics like Area Under the Curve (AUC), Classification Accuracy (CA), F1 Score, Precision, Recall, and Specificity. Gradient Boosting achieved a balanced performance (AUC: 0.72, CA: 0.41, F1: 0.32) compared to Neural Networks (AUC: 0.721, CA: 0.391, F1: 0.314) and Naive Bayes (AUC: 0.701, CA: 0.172, F1: 0.114). While statistical tests revealed no significant differences between the models, Gradient Boosting exhibited a more balanced precision-recall relationship. Conclusion: In silico analysis using machine learning techniques successfully predicted protein-coding mRNA sequences within Porphyromonas gingivalis OMVs. Gradient Boosting outperformed other models (Neural Networks, Naive Bayes) by achieving a balanced performance across metrics like AUC, classification accuracy, and precision-recall, suggests its potential as a reliable tool for protein-coding mRNA prediction in P. gingivalis OMVs.

Deep Learning Based Micro-RNA Analysis of Lipopolysaccharide Exposed Periodontal Ligament Stem Cells Exosomes Reveal Apoptotic and Inflammasome Derived Pathway Activation.

Background: The production of inflammatory factors in periodontium is increased by LPS, particularly from P. gingivalis, and the damage to periodontal tissues is exacerbated. Exosomes from periodontal ligament stem cells change regeneration and repair brought on by bacterial LPS. MiRNAs are carried by exosomes to recipient cells to affect epigenetic functions. Thus, this study aims to utilize deep learning algorithms to uncover novel micro-RNA biomarkers in bacterial LPS-exposed PDLSC stem cells to understand the activation pathway. Methods: Using NCBI GEO DATA SET GSE163489, the most differentially expressed micro RNAs were found to differ between healthy and LPS-induced PDLSC cells. Deep learning analysis, employing a Random Forest, Artificial Neural Network c, a Support Vector Machine (SVM), and a Linear Regression model implemented within the orange data mining toolkit, identified novel microRNA biomarkers. The orange data mining toolkit was utilized for deep learning analysis of microRNA expression data, providing a user-friendly environment for machine learning tasks like classification, regression, and clustering. Results: Random Forest emerged as the superior model, achieving the highest R 2 score (.985) and the lowest RMSE (0.189) compared to Neural Networks (R 2 = .952, RMSE = 0.332), Linear Regression (R 2 = .949, RMSE = 0.343), and SVM (R 2 = .931, RMSE = 0.398). This suggests its superior ability to capture the underlying patterns in the microRNA expression data. Given its robust performance, Random Forest holds promise for identifying novel biomarkers, developing more accurate diagnostic tools, and potentially guiding the stratification of patients for targeted therapeutic interventions in periodontal disease. Conclusion: The current study utilizes deep learning analysis of microRNA expression data to identify novel biomarkers associated with inflammasome activation and anti-apoptotic pathways. These findings hold promise for guiding the development of novel therapeutic strategies for periodontal disease. However, future studies are warranted to validate these biomarkers using independent datasets and experimental methods.

Interactions Between Oral Microbiota and Cancers in the Aging Community: A Narrative Review.

The oral microbiome potentially wields significant influence in the development of cancer. Within the human oral cavity, an impressive diversity of more than 700 bacterial species resides, making it the second most varied microbiome in the body. This finely balanced oral microbiome ecosystem is vital for sustaining oral health. However, disruptions in this equilibrium, often brought about by dietary habits and inadequate oral hygiene, can result in various oral ailments like periodontitis, cavities, gingivitis, and even oral cancer. There is compelling evidence that the oral microbiome is linked to several types of cancer, including oral, pancreatic, colorectal, lung, gastric, and head and neck cancers. This review discussed the critical connections between cancer and members of the human oral microbiota. Extensive searches were conducted across the Web of Science, Scopus, and PubMed databases to provide an up-to-date overview of our understanding of the oral microbiota's role in various human cancers. By understanding the possible microbial origins of carcinogenesis, healthcare professionals can diagnose neoplastic diseases earlier and design treatments accordingly.

Interactions between oral microbiota shifts and cancer: The oral microbiome potentially wields significant influence in the development of cancer. Within the human oral cavity, an impressive diversity of more than 700 bacterial species resides, making it the second most varied microbiome in the body. This finely balanced oral microbiome ecosystem is vital for sustaining oral health. However, disruptions in this equilibrium, often brought about by dietary habits and inadequate oral hygiene, can result in various oral ailments like periodontitis, cavities, gingivitis, and even oral cancer. There is compelling evidence that the oral microbiome is linked to several types of cancer, including oral, pancreatic, colorectal, lung, gastric, and head and neck cancers. This review discussed the critical connections between cancer and members of the human oral microbiota. Extensive searches were conducted across the Web of Science, Scopus, and PubMed databases to provide an up-to-date overview of our understanding of the oral microbiota's role in various human cancers. By understanding the possible microbial origins of carcinogenesis, healthcare professionals can diagnose neoplastic diseases earlier and design treatments accordingly.

Podoplanin immunoexpression in odontogenic lesions: a systematic review, meta-analysis, and integrated bioinformatic analysis.

BACKGROUND: Podoplanin (PDPN) is a transmembrane glycoprotein implicated in the pathogenesis of odontogenic lesions (OL). It is localized at the membrane and cytoplasmic level, and its interaction with other proteins could trigger cell proliferation, invasion and migration. The main objective of this systematic review is to explore the immunoexpression pattern of podoplanin in OL. In addition, as secondary objectives, we aimed to compare the immunostaining intensity of PDPN in OL, to analyze its interaction networks by bioinformatic analysis and to highlight its importance as a potential diagnostic marker useful in the pathogenesis of OL. METHODS: The protocol was developed following PRISMA and Cochrane guidelines. The digital search was performed in the databases: PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science and Google Schoolar from August 15, 2010 to June 15, 2023. We included cross-sectional and cohort studies that will analyze the pattern of PDPN immunoexpression in OL. Two investigators independently searched for eligible articles, selected titles and abstracts, analyzed full text, conducted data collection, and performed assessment of study quality and risk of bias. In addition, part of the results were summarized through a random-effects meta-analysis. STRING database was used for protein-protein interaction analysis. RESULTS: Twenty-nine relevant studies were included. The ages of the subjects ranged from 2 to 89 years, with a mean age of 33.41 years. Twenty-two point two percent were female, 21.4% were male, and in 56.4% the gender of the participants was not specified. A total of 1,337 OL samples were analyzed for PDPN immunoexpression pattern. Ninety-four (7.03%) were dental follicles and germs, 715 (53.47%) were odontogenic cysts, and 528 (39.49%) were odontogenic tumors. Meta-analysis indicated that the immunostaining intensity was significantly stronger in odontogenic keratocysts compared to dentigerous cysts (SMD=3.3(CI=1.85-4.82, p=0.000*). Furthermore, bioinformatic analysis revealed that PECAM-1, TNFRF10B, MSN, EZR and RDX interact directly with PDPN and their expression in OL was demonstrated. CONCLUSIONS: The results of the present systematic review support the unique immunoexpression of PDPN as a potential useful diagnostic marker in the pathogenesis of OL.

Exceptional bone remodeling over composite restoration in the management of external root resorption: A case report.

A 65-year-old Caucasian male was referred to an endodontic specialist practice in a private clinic in December 2019 for the management of an asymptomatic, radiolucent lesion located at the cervical level of the distal root of his right lower first molar, noticed during a routine periapical radiograph. After an accurate evaluation with cone-beam computed tomography (CBCT), the subgingival lesion was diagnosed as a supracrestal external cervical resorption (ECR), with a circumferential spread ⩽90°, confined to dentine without pulp involvement. The lesion was treated with the following sequence: (1) a full flap accessed the ECR, (2) the granulomatous tissue was removed from the root area, (3) the cavity was refreshed and filled with a well-refined and polished resin composite, (4) the flap was sutured at the cemento-enamel junction. A mandibular CBCT scan was performed before treatment, right after treatment, and 3 years postoperatively. Compared to the 3-year posttreatment CBCT scan, the immediate posttreatment one, revealed the absence of bone loss and an unexpected coronal bone remodeling with new bone formation over the treated lesion.

Salivary 8-hydroxy-2'-deoxyguanosine levels in patients with oral cancer: a systematic review and meta-analysis.

BACKGROUND: DNA is an important target for oxidative attack and its modification may increase the risk of mutagenesis. The aim of this study was to evaluate and compare salivary levels of the oxidative stress biomarker 8-hydroxy-2'-deoxyguanosine (8-OHdG) in patients with oral cancer (OC) compared to the control group by a comprehensive search of the available literature. METHODS: The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered in Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/X3YMR. Four electronic databases were used to identify studies for this systematic review: PubMed, Scopus, ScienceDirect, and Web of Science from January 15, 2005, to April 15, 2021. The Joanna Briggs Institute (JBI) tool was used to assess article quality. RESULTS: Of the 166 articles identified, 130 articles were excluded on the basis of title and abstract screening (duplicates, reviews, etc.). Thirty-six articles were evaluated at full text and 7 articles met the inclusion criteria. Of these, only 5 studies had compatible data for quantitative analysis. An increase in salivary 8-OHdG levels was found in patients with OC compared to healthy subjects, but without statistical significance. 8-OHdG: SMD = 2,72 (95%CI= -0.25-5.70); *p = 0.07. CONCLUSIONS: This systematic review and meta-analysis suggests a clear trend of increased 8-OHdG levels in saliva of OC patients compared to the control group. However, further studies are required to clarify and understand the altered levels of this oxidative stress marker.

In Silico Docking of Medicinal Herbs Against P. gingivalis for Chronic Periodontitis Intervention.

OBJECTIVE: This study aimed to explore the therapeutic potential of medicinal herbs for chronic periodontitis by examining the molecular interactions between specific herbal compounds and the heme-binding protein of Porphyromonas gingivalis, a key pathogen involved in the disease. METHODS: The crystal structure of heme-binding protein was obtained from the Protein Data Bank. Herbal compounds were identified through an extensive literature review. Molecular docking simulations were performed to predict binding affinities, followed by Absorption, Distribution, Metabolism, and Excretion (ADME) parameter prediction. Drug-likeness was assessed based on Lipinski's Rule of Five, and pharmacophore modeling was conducted to identify key molecular interactions. RESULTS: The molecular docking simulations revealed that chelidonine, rotenone, and myricetin exhibited significant binding affinities to the heme-binding protein, with docking scores of -6.5 kcal/mol, -6.4 kcal/mol, and -6.1 kcal/mol, respectively. These compounds formed stable interactions with key amino acid residues within the binding pocket. ADME analysis indicated that all 3 compounds had favourable pharmacokinetic properties, with no violations of Lipinski's rules and minimal predicted toxicity. Pharmacophore modeling further elucidated the interaction profiles, highlighting specific hydrogen bonds and hydrophobic interactions critical for binding efficacy. CONCLUSIONS: Chelidonine, rotenone, and myricetin emerged as promising therapeutic candidates for chronic periodontitis due to their strong binding affinities, favorable ADME profiles, and lack of significant toxicity. The detailed pharmacophore modeling provided insights into the molecular mechanisms underpinning their inhibitory effects on the heme-binding protein of P. gingivalis. These findings suggest that these compounds have the potential for further development as effective treatments for chronic periodontitis. Future research should focus on in vitro and in vivo validation of these findings to confirm the efficacy and safety of these compounds in biological systems.

Advanced machine learning for estimating vascular occlusion percentage in patients with ischemic heart disease and periodontitis.

Objective: The study aimed to assess the efficacy of advanced machine learning algorithms in estimating the percentage of vascular occlusion in ischemic heart disease (IHD) cases with periodontitis. Methods: This study involved 300 IHD patients aged 45 to 65 with stage III periodontitis undergoing coronary angiograms. Dental and periodontal examinations assessed various factors. Coronary angiograms categorized patients into three groups based on artery stenosis. Clinical data were processed, outliers were identified, and machine learning algorithms were applied for analysis using the orange tool, including confusion matrices and receiver operating characteristic (ROC) curves for assessment. Results: The results showed that Random Forest, Naïve Bayes, and Neural Networks were 97 %, 84 %, and 92 % accurate, respectively. Random Forest did exceptionally well in identifying the severity of conditions, with 95.70 % accuracy for mild cases, 84.80 % for moderate cases, and a perfect 100.00 % for severe cases. Conclusions: The current study, using Periodontal Inflammatory Surface Area (PISA) scores, revealed that the Random Forest model accurately predicted the percentage of vascular occlusion.

Prevalence of rapid calculus formers and its associated factors amongst patients visiting a dental hospital: a preliminary investigation.

BACKGROUND: This study focuses on the determination and classification of patients as rapid or slowcalculusformersbasedontherateofcalculusformationafteroralprophylaxis. It also aims to determine the factors that positively impact the formation and deposition of calculus in patients and identify the factors that accelerate or decelerate the deposition of calculus. METHODS: The study was conducted in the Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University Chandigarh, India. We examined 51 patients after a month of the oral prophylaxis, recorded the amount of calculus present in the oral cavity, and then recorded a detailed history which was briefly divided into Age, Sex, Residence, Oral habits, and maintenance of oral hygiene. RESULTS: An evident and meaningful link was found between age and the rate at which dental calculus forms. The average age of individuals differed significantly between the rapid and slow calculus formers, which could be ascribed to the decline in manual dexterity as age increases, resulting in less effective oral hygiene habits, including toothbrushing. None of the other factors dietary and oral hygiene related could be identified distinctly, probably owing to the small sample of the study. The oral health status exhibited a significant difference between slow and rapid calculus formers. CONCLUSIONS: Within the limitations of the study, the data analyzed, identified age as a significant determinant that impact the rate of formation of calculus in patients and reported a significant difference in the oral health status of rapid and slow calculus formers.

Faculty application and perceived effectiveness of cognitive psychology principles in medical education. A mixed method study.

OBJECTIVE: The objective of the study was to explore the extent to which faculty members in undergraduate medical education apply cognitive psychology principles in their teaching practices, and to evaluate the perceived effectiveness of these principles in enhancing student learning. METHODS: This mixed method study was conducted on faculty members of public and private sector universities. Focused group discussions were conducted, and the responses of the participants were measured on a 5-point- Likert Scale. The instrument was tested for validity and reliability by measuring Cronbach's alpha and performing exploratory factor analysis. Mann-Whitney U test was applied on the attributes scores to compare 13 attributes by institutions, designations and domains. RESULTS: One theme, 7 sub-themes and 19 categories were identified from the focused group discussion. as Kaiser- Meyer-Olkin index was 0.88 and Bartlett's test of sphericity was significant. Reliability was established at 0.95. The faculty self-perceived practicing psychology principles mostly scored in the middle level, where they think they apply less strategies. While highly significant results were noted for using Meyer's multimedia principles. CONCLUSION: Faculty members followed the principles of cognitive psychology to some extent. However, they all felt that using these principles can transform the teaching and learning of medical education.

Increased of IL-18 levels are associated with periodontitis: a systematic review and meta-analysis.

BACKGROUND: The presence of a polymicrobial dysbiotic film in direct and constant contact with periodontal tissues initiates the host immune response. Interleukin 18 (IL-18) triggers up-regulates the production of other proinflammatory cytokines (TNF-α, IL-1ß, IL-6), creating a vicious cycle that expands the inflammatory and destructive process in the periodontal tissue. A systematic review and meta-analysis was carried out with the main propose to investigate IL-18 expression in different biological samples from subjects with chronic periodontitis. METHODS: The protocol followed PRISMA guidelines and was registered in Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/BS9GM . A digital search was conducted in the databases PubMed, ScienceDirect, Google Scholar, Web of Science and Dentistry & Oral Sciences Source databases were consulted from March 15th, 2005 to February 10th, 2023. Study quality was assessed using the JBI tool for cross-sectional studies and clinical trials. A meta-analysis was performed using a random/fixed effects model to evaluate the concentration of IL-18 in serum, plasma, saliva, gingival tissue and GCF of exposure group compared to control group. RESULTS: The search strategy provided a total of 3,156 articles, of which 18 investigations met the inclusion criteria and 15 articles were quantitatively analyzed. The total number of patients studied was 1,275 (682 cases and 593 controls). The meta-analysis revealed significantly elevated IL-18 levels of serum, saliva and GCF of subjects with chronic periodontitis compared to healthy subjects (Serum: SMD = 62.73, 95%CI: 25.43-100.03, Z = 3.29, p = 0.001*; Saliva: SMD = 243.63, 95%CI: 8.68-478.59, Z = 2.03, p = 0.042*; GCF: SMD = 150.26, 95%CI: 56.86-243.66, Z = 3.15, p = 0.02*). CONCLUSION: IL-18 levels in serum, saliva and GCF could have the potential to be used as complementary diagnostic tools to the clinical and radiographic parameters in subjects with periodontitis.

Immediate functional loading of implant-supported mandibular prostheses with customized UCLA'S attachments with distal extension: A case report.

Implant-supported complete dentures are a common procedure for patients with mandibular edentulism problems. This article documents the protocol for immediate functional loading of fixed transient mandibular prostheses with fully moldable attachments and distal extensions to prevent fractures. A 56-year-old female patient was referred to the Oral Rehabilitation and Implantology Service due to periodontal problems, difficulty in chewing capacity and aesthetic compromise. The patient was treated in a single surgical procedure with dental extractions, guided regularization of the alveolar process and guided placement of five interforaminal implants and placement of functional fixed mandibular prostheses with immediate loading with personalized UCLA'S, distal extensions and short arc occlusal scheme. At 3 months postoperatively, the definitive placement of fixed mandibular metal acrylic prostheses and conventional upper prostheses was performed. The functional and aesthetic integrity of the fixed mandibular prosthesis implant preserved with UCLA'S documents that implant placement in the interforaminal zone with an immediate loading protocol is a viable treatment option for prosthetic rehabilitation of the fully edentulous mandibular arch and that design with distal extensions in the posterior sector of the mandibular arch is an effective option to avoid fracture of the prostheses, presenting a survival of the five mandibular implants of 100% at 1 year postoperatively.

Expression of IL-33 in subjects with periodontitis: a systematic review and meta-analysis.

BACKGROUND: Activation of the IL-33/ST2 axis leads to the production of proinflammatory cytokines and thus to the triggering of osteoclastogenesis, which is why it plays an important role in the immunopathogenesis of periodontitis. The aim of this study was to compare IL-33 levels in serum, plasma, saliva and gingival crevicular fluid (GCF) of subjects with chronic periodontitis (CP) in comparison with the control group (CG). METHODS: This systematic review and meta-analysis followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/YHUWA . Six electronic databases were used for study identification; PubMed, Google Scholar, ScienceDirect, Web of Science, Scopus and Dentistry & Oral Sciences Source from March 10, 2012 to April 30, 2024. The Joanna Briggs Institute (JBI) tool was used to assess the quality of the included cross-sectional articles and clinical trials. RESULTS: Of the 949 articles identified, 14 were included according to the inclusion and exclusion criteria. The total number of individuals studied in the included investigations was 814 of whom 445 had CP and 369 were healthy. The reported age range was from 20 to 50 years, with a mean age ± standard deviation of 40.29 ± 7.83 years. Four hundred and twenty-six (52%) patients were men and 388 (48%) were women. Meta-analysis revealed that there is an increase in IL-33 levels in plasma, saliva and GCF of subjects with CP compared to CG (p = * < 0.05). CONCLUSIONS: This study found a significant increase in IL-33 levels in different biological samples (plasma, saliva and GCF) of individuals with CP compared to CG, thus IL-33 has potential to be a biomarker in the diagnosis of periodontitis.

DFT-based investigation of polyetherketoneketone materials for surface modification for dental implants.

BACKGROUND: Polyetherketoneketone (PEKK) is a high-performance thermoplastic polymer with unique structural and mechanical properties that make it a promising candidate for surface modification of dental implants. This study was conducted to investigate the feasibility of PEKK for this purpose using the Cambridge Serial Total Energy Package (CASTEP) code based on density functional theory (DFT). METHODS: This study examined the ground state energy, structural properties, thermodynamic behavior, cohesive energy, refractive index, stress analysis, mechanical properties, and anisotropic behavior of PEKK. RESULTS: This study found that PEKK has a complex crystal structure with an orthorhombic unit cell shape, triclinic lattice type, and a centered structure. It also has a 2D layered structure owing to the presence of carbonyl groups, which provides a large surface area for interaction with biological tissues. Thermodynamic analysis showed that PEKK exhibited bond elongation and structural changes at 380 °C, indicating thermal degradation. The cohesive energy of PEKK was calculated to be - 440 eV, indicating its stability and structural integrity. PEKK has a complex refractive index, with real and imaginary components that affect its optical properties. Stress analysis showed that PEKK is resistant to shear deformation and has high hydrostatic stress, which contributes to its stability and biocompatibility. CONCLUSION: The mechanical properties of PEKK, including its high stiffness, resistance to volume change under pressure, and ability to accommodate natural movements, make it suitable for surface modification of dental implants.

Cytokines profile in gingival crevicular fluid of subjects wearing fixed dental prostheses: a systematic review and meta-analysis.

BACKGROUND: Fixed dental prostheses (FDP) can affect the production of inflammatory cytokines causing damage to periodontal tissues. A systematic review and meta-analysis was carried out with the following two objectives: (1) to determine the prevalence and function of the different inflammatory cytokines present in gingival crevicular fluid (GCF) of teeth with metal-ceramic (M/C) and all-ceramic (A-Cs) prostheses, and (2) to analyze and compare the levels of inflammatory cytokines in GCF of teeth with M/C and A-Cs prostheses. METHODS: The protocol followed PRISMA and Cochrane guidelines and was registered in the OSF:10.17605/OSF.IO/RBHJU. A digital search was conducted in the databases PubMed/MEDLINE, Cochrane Library, Dentistry & Oral Sciences Source, Scopus, Web of Science, ScienceDirect, and Google Scholar, from July 15th, 2000 to March 1st, 2024. Study quality was assessed using the JBI tool for cross-sectional and longitudinal studies. A meta-analysis was performed using a random-effects model to evaluate the concentration of IL-1ß in GCF of teeth with FDP of M/C and A-Cs. RESULTS: The search strategy provided a total of 8,172 articles, of which 14 investigations met the inclusion criteria. The total number of patients studied was 468 of whom 53% were women and the rest (47%) were men. The ages of the patients ranged from 19 to 73 years, with a mean age ± standard deviation (SD) of 38,5 ± 12,8 years. A total of 843 fixed dental prostheses were studied, of which 407 (48,27%) were M/C prostheses and 410 (48,63%) were A-Cs prostheses. We found that the levels of IL-1ß, IL-1α, PGE2, NKA, CGRP, and CX3CL1 were increased in teeth with M/C prostheses compared to teeth with A-Cs prostheses. Meta-analysis revealed that there are no significant differences between IL-1ß levels in GCF in teeth with M/C prostheses compared to teeth with A-Cs prostheses (SMD = 13.89 pg/ml (CI = -14.29-42.08), p = > 0.05). CONCLUSIONS: A trend toward increased levels of inflammatory cytokines was found in GCF of teeth with M/C prostheses compared to teeth with A-Cs prostheses.

Exploring Technological Progress in Three-Dimensional Imaging for Root Canal Treatments: A Systematic Review.

INTRODUCTION AND AIMS: Root canal therapy is a crucial aspect of endodontic treatment aimed at preserving natural dentition. Over the years, advancements in three-dimensional (3D) technology have revolutionized diagnosis and treatment planning. Different 3D technologies are used in dental care, such as cone-beam computed tomography (CBCT), which ensures 3D slice visualization, root canal microanatomy, and dynamic navigation throughout the pulp cavity. By exploring the latest technological progress in this field, we seek to understand how these innovations are enhancing precision, efficiency, and patient outcomes, shedding light on the benefits and potential impact of 3D imaging in improving root canal procedures. METHODS: Literature was searched from different databases, including PubMed, ScienceDirect, The Cochrane Library, Scopus, and Google Scholar. Inclusion criteria involved studies on 3D technology in root canal therapy with comparison groups, including RCTs and non-RCTs. Excluded studies lacked 3D imaging advancements, a control group, or were review articles or case studies. Quality assessment utilized QUIN for in vitro studies and ROBINS-I for non-RCTs to evaluate the studies' validity. RESULTS: According to the PRISMA guidelines, among 5015 initial articles, 16 were included. CBCT was the most used 3D imaging technique for root imaging followed by micro-computed tomography (MCT) and limited CBCT (LCBCT) imaging methods. 2D radiographs and 2D histological methods and clearing techniques were the most common comparative modalities. Overall, 3D imaging streamlined dental treatment as clinicians could visualize much clearer and higher-quality images. Different resolutions and voxel sizes were applied to improve imaging quality. CONCLUSION: Three-dimensional imaging, especially CBCT, improves root canal treatments by providing superior image quality. CBCT outperforms other techniques like MCT and LCBCT, enhancing clarity. Varying resolutions and voxel sizes optimize the effectiveness of 3D imaging in root canal therapy. CLINICAL RELEVANCE: The advancements in 3D imaging technology, particularly CBCT, have significantly enhanced the diagnosis and treatment planning for root canal therapy. CBCT provides detailed insights into intricate root canal anatomy, improving diagnostic accuracy.

Activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults with dental caries: a systematic review and meta-analysis.

BACKGROUND: Cytokines play an important role in the immunopathogenesis of dental caries. A systematic review and meta-analysis was carried out with the following three objectives: 1)To deepen and discuss through a comprehensive analysis of the literature the effects of dental caries on the activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults, 2)To compare the levels of this cytokines in saliva of the exposure group (moderate-severe dental caries) with the control group (caries-free or mild dental caries), and 3)To determine whether the levels of these cytokines could be used as a complementary clinical diagnostic tool to assess the severity of dental caries. METHODS: The protocol followed PRISMA and Cochrane guidelines and was registered in the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/MF74V . A digital search was performed in PubMed/MEDLINE, Cochrane, Scopus, and Google Schoolar databases from February 15th, 2012, to January 13th, 2024. The methodological validity of the selected studies was assessed using Joanna Briggs Institute (JBI) tool. A meta-analysis was performed using a random-effects model to evaluate the association between dental caries/health, and the concentration of TNF-α, IL-6 and IL-8. RESULTS: The search strategy provided a total of 126 articles, of which 15 investigations met the inclusion criteria. The total number of patients studied was 1,148, of which 743 represented the case/exposure group, and 405 represented the control group. The age of the patients ranged from 3 to 25 years. IL-6 was the most prevalent cytokine in the saliva of children and young adults with active dental caries. The meta-analysis revealed that there are significant differences between the levels of IL-6 and TNF-α in saliva of children with active dental caries compared to their control groups. CONCLUSIONS: The findings suggest that IL-6 and TNF-α levels may have potential as complementary biomarkers for assessing dental caries severity. However, further research is needed to validate these findings in larger and more diverse populations before clinical application.

Prescription writing pattern among the dental practitioners of a tertiary care hospital in Karachi.

OBJECTIVE: To identify the frequency and types of prescription errors, assess adherence to WHO prescribing indicators, and highlight the gaps in current prescribing practices of Junior dental practitioners in a tertiary care hospital in Karachi, Pakistan. METHODS: This cross-sectional study was conducted from January 2021 to March 2021. The study included the prescriptions by house surgeons and junior postgraduate medical trainees for walk-in patients visiting the dental outpatient department. A total of 466 prescriptions were evaluated for WHO core drug prescribing indicators. The prescription error parameters were prepared by studying the WHO practical manual on guide to good prescribing and previous studies. Prescription errors, including errors of omission related to the physician and the patients, along with errors of omission related to the drug, were also noted. The statistical analysis was performed with SPSS version 25. Descriptive analysis was performed for qualitative variables in the study. RESULTS: The average number of drugs per encounter was found to be 3.378 drugs per prescription. The percentage of encounters with antibiotics was 96.99%. Strikingly, only 16.95% of the drugs were prescribed by generic names and 23.55% of drugs belonged to the essential drug list. The majority lacked valuable information related to the prescriber, patient, and drugs. Such as contact details 419 (89.9%), date 261 (56%), medical license number 466 (100%), diagnosis 409 (87.8%), age and address of patient 453 (97.2%), form and route of drug 14 (3%), missing drug strength 69 (14.8%), missing frequency 126 (27%) and duration of treatment 72 (15.4%). Moreover, the wrong drug dosage was prescribed by 89 (19%) prescribers followed by the wrong drug in 52 (11.1%), wrong strength in 43 (9.2%) and wrong form in 9 (1.9%). Out of 1575 medicines prescribed in 466 prescriptions, 426 (27.04%) drug interactions were found and 299 (64%) had illegible handwriting. CONCLUSION: The study revealed that the prescription writing practices among junior dental practitioners are below optimum standards. The average number of drugs per encounter was high, with a significant percentage of encounters involving antibiotics. However, a low percentage of drugs were prescribed by generic name and from the essential drug list. Numerous prescription errors, both omissions and commissions, were identified, highlighting the need for improved training and adherence to WHO guidelines on good prescribing practices. Implementing targeted educational programs and stricter regulatory measures could enhance the quality of prescriptions and overall patient safety.

Analysis of satisfaction levels and perceptions of clinical competency: a mixed method study on objective structured clinical examinations in undergraduate dental students.

OBJECTIVE: To analyze the satisfaction levels, perceptions of developing clinical competencies through objective structured clinical examination and to explore the experiences, challenges, and suggestions of undergraduate dental students. METHODS: The study adopted a mixed-method convergent design. Quantitative data were collected from 303 participants through surveys, evaluating satisfaction levels with objective structured clinical examination (OSCE). Additionally, qualitative insights were gathered through student focus group interviews, fundamental themes were developed from diverse expressions on various aspects of OSCE assessments. The Chi-Square tests, was performed to assess associations between variables. Data integration involved comparing and contrasting quantitative and qualitative findings to derive comprehensive conclusions. RESULTS: The satisfaction rates include 69.4% for the organization of OSCE stations and 57.4% for overall effectiveness. However, a crucial challenge was identified, with only 36.7% of students receiving adequate post-OSCE feedback. Furthermore, a majority of students (50%) expressed concerns about the clinical relevance of OSCEs. The study showed a significant associations (p < 0.05) between satisfaction levels and years of study as well as previous OSCE experience. Student focus group interviews revealed diverse perspectives on OSCE assessments. While students appreciate the helpfulness of OSCEs, concerns were raised regarding time constraints, stress, examiner training, and the perceived lack of clinical relevance. CONCLUSION: The students anticipated concerns about the clinical relevance of OSCEs, highlighting the need for a more aligned assessment approach. Diverse perspectives on OSCE assessments reveal perceived helpfulness alongside challenges such as lack of feedback, examiner training, time constraints, and mental stress.

Are implant-based treatments considered viable for patients with focal or florid cemento-osseous dysplasia? A systematic review.

BACKGROUND: Focal and florid cemento-osseous dysplasia are benign fibro-osseous lesions affecting the quality and quantity of the jawbones. This study aimed to determine the viability of implant-based approaches in the affected patients. MAIN TEXT: Different scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar, were searched until October 8, 2023, using a pre-determined search strategy. Two reviewers screened the retrieved reports and extracted the required information from the included studies. The eligibility criteria included English-language case reports/series or clinical trials. The JBI critical appraisal checklist for case reports was used to assess the methodological quality of the included studies. Three studies were deemed eligible to be included in this study out of the initial 202 records found. Five implants were placed in three patients, positioned in the proximity of the lesion area, without any additional treatment to remove the pathology. The mandibular posterior area was the affected site in all patients. Only one implant failed in one patient after 16 years, which was attributed to peri-implantitis and not the lesion. Other implants demonstrated successful maintenance over follow-up periods. CONCLUSIONS: Although the number of the included records was relatively low to draw firm conclusions, it seems that implant-based treatments in patients with focal/florid cemento-osseous dysplasia could be viable, considering a conservative and well-planned approach.