Surgical outcomes of the surgical techniques following management of iatrogenic trigeminal nerve injuries: A systematic review.

Objective: To investigate the effectiveness of the microsurgical treatment in restoring full sensory recovery following trigeminal nerve injuries caused by iatrogenic oral and maxillofacial surgical interventions. Methods: A detailed search was conducted on the Cochrane central register of controlled trials, Medline and Embase. Clinical studies with at least twelve months of follow up were included and assessment of risks of bias was made using the Robbin I assessment tool. Results: Six studies were identified in the searches which include 227 patients. The lingual nerve was the most common injured nerve, followed by the inferior alveolar nerve. Third molar removal was the most frequent cause of nerve injury, followed by root canal treatment, pathology excision, coronectomy, orthognathic surgery, dental implants and then local anaesthetic injections. Overall, surgical interventions for nerve injuries showed neurosensory improvement postoperatively in the majority of patients. Conclusion: Direct neurorrhaphy is still the gold-standard technique when the tension at the surgical site is minimal. Promising results have been noted on conduit applications following traditional repair or grafting. Further research is needed on the efficacy of allografting and conduit applications in nerve repair.

Impact of COVID-19 on the self-esteem, psychological and dental esthetics of dental students.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has badly affected the mental health, quality of life, and self-esteem of students worldwide. OBJECTIVE: The current study aimed to evaluate the psychological impact and self-esteem of dental students using Rosenberg self-esteem scale and PIDAQ during the COVID-19 pandemic. METHOD: This cross-sectional research was conducted amongst the dental students studying at various dental colleges in Karachi, Pakistan from January to May 2022. Evaluation of psychological aspect and self-esteem of students was carried out using "Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)", and "Rosenberg self-esteem scale" as perceived by students during the pandemic. For data analysis SPSS v24 was used. Data analysis comprised of descriptive analysis, Spearman correlation, One-way Anova and Linear regression. The level of significance of p value was less than 0.05. RESULTS: Overall 332 students participated, among which there were 181 females (54.5%), 151 males (45.5%). Dental self-confidence showed a negative relationship with social influence, psychological effect, and aesthetic concern, while it was positively linked with self-esteem during the pandemic. Social impact demonstrated association with psychological impact, aesthetic concern, and self-esteem, while it was negatively correlated with dental confidence. Rosenberg score showed positive correlation with all the variables. Statistically significant association was identified for variables when compared with gender. Regression analysis indicated association of age with dental confidence and RSS, while gender with social influence. CONCLUSION: The pandemic, aside from affecting the health of individuals worldwide, also badly affected the well-being, mental health, and self-esteem of the dental students. Dental aesthetics plays a crucial role in the mental wellbeing and self-esteem of the students.

Influence of Smoking on Periodontal and Implant Therapy: A Narrative Review.

BACKGROUND: smoking is considered the most modifiable risk factor for periodontal disease. OBJECTIVE: the aim of this narrative review is to emphasize the effect of smoking on periodontal and implant therapy. METHODS: The authors reviewed the literature reporting the clinical outcomes of smoking on periodontal surgical and nonsurgical treatment. The impact of smoking on implant therapy and sinus lifting procedures were also reviewed. RESULTS: Periodontal and implant therapy outcomes are adversely affected by smoking. Smokers respond less favorably to periodontal therapy and periodontal flap procedures as compared to nonsmokers. Clinical outcomes for smokers are 50-75% worse than for nonsmokers. Studies reveal that smokers experience a significantly lower reduction in pocket depth compared to nonsmokers as well as less bone growth after treating infra-bony defects with guided tissue regeneration. The relative risk of implant failure is significantly higher in patients who smoke 20 cigarettes or more per day compared to nonsmokers. Additionally, smoking has also been shown to increase postoperative wound dehiscence and infection rates following sinus floor elevation. Longitudinal studies on smoke cessation have shown a reduction in bone loss and probing depths for periodontitis patients after cessation compared to those who smoke. CONCLUSION: Smoking cessation can reduce probing depths and improve clinical attachment after nonsurgical periodontal therapy. There is insufficient evidence regarding the effect of smoking on peri-implantitis, as well as the loss of implants in the long-term.

Impact of Metformin on Periodontal and Peri-Implant Soft and Hard Tissue.

Periodontal and peri-implant soft and hard tissue in diabetic patients have always been a topic of interest for researchers and clinicians alike. Among which, a subtopic that has attracted more attention is the beneficial effect of metformin (MF) on periodontal and peri-implant soft and hard tissue. This review aimed to assess the impact of MF on the periodontal and peri-implant soft- and hard-tissue healing among diabetic patients. Research was conducted using the keywords 'metformin', 'diabetes', 'periodontitis', 'implant', and 'peri-implantitis' via the Medline (PubMed) and Google Scholar databases. Selected articles were reviewed. A total of 21 articles, discussing the impact on periodontal health (six animal studies, seven clinical studies, and three systematic reviews) and five studies on peri-implant health (four animal studies and one clinical study) were included. All have reported a positive impact of MF on decreasing the inflammatory response, oxidative stress, and ultimate bone loss. Similarly, human studies reported a positive effect of MF on clinical and radiographic parameters compared with controls. Despite systematic reviews reporting heterogeneity among the included studies, MF has shown a positive impact on periodontal health. In animal, clinical studies, and systematic reviews, MF showed a protective impact on periodontal and peri-implant health.

Inhibition of SARS-CoV2 viral infection with natural antiviral plants constituents: An in-silico approach.

Background and Objective: In 2019, a novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) was declared pandemic. Advancement in computational technology has provided rapid and cost-effective techniques to test the efficacy of newer therapeutic agents. This study evaluated some of the potent phytochemicals obtained from AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy)-listed medicinal plants against SARS-CoV-2 proteins using computational techniques. Materials and methods: The potential SARS-CoV-2 protein targets were utilized to study the ligand-protein binding characteristics. The bioactive agents were obtained from ashwagandha, liquorice, amla, neem, tinospora, pepper, and stevia. Ivermectin was utilized as a reference agent to compare its efficacy with phytochemicals. Results: The computational analysis suggested that all the bioactive components from the selected plants possessed negative docking scores (ranging from -6.24 to -10.53). The phytoconstituents were well absorbed, distributed in the body except for the CNS, metabolized by liver enzymes, well cleared from the body, and well tolerated. The data suggest that AYUSH-recommended plants demonstrated therapeutic efficacy against SARS CoV-2 virus infection with significantly reduced toxicity. Conclusion: The phytoconstituents were found to hinder the early stages of infection, such as absorption and penetration, while ivermectin prevented the passage of genetic material from the cytoplasm to the nucleus. Additional research involving living tissues and clinical trials are suggested to corroborate the computational findings.

Lymph Node Involvement and the Clinical Stage as Predictors of the Survival of Patients With Adenoid Cystic Carcinoma of the Head and Neck: A Systematic Review and Meta-Analysis.

In the treatment of various patients, the presence of lymphovascular invasion is a prognostic determinant, often taken into account by surgeons and oncologists. The exact frequency and prognostic impacts of this microscopic event in adenoid cystic carcinoma (ACC) patients are, however, not clear. This systematic review and meta-analysis aimed to investigate the lymph node involvement and the clinical stage of cancer as predictors of ACC prognosis. A systematic search was conducted covering a number of databases, including PubMed, Science Direct, Google Scholar, Web of Science, and EBSCO. A total of three studies were included in this analysis, with 591 participants, 247 of whom were males. Lymph node involvement and clinical stage were demonstrated as significant bad prognosis factors among ACC patients (HR = 1.48, 95% CI, 1.00, 1.96; P<0.0001). We found that lymph node involvement and clinical stage of the cancer are both significant predictors of bad prognosis of ACC.

Comparative Evaluation of Surface Roughness and Hardness of 3D Printed Resins.

The effect of printing parameters on the surface characteristics of three-dimensional (3D)-printed denture base resins (DBRs) is neglected. Therefore, this study investigated the effect of printing orientation and post-curing time on the surface roughness and hardness. One conventional heat-polymerized (HP) resin and two 3D-printing resins (NextDent (ND) and ASIGA (AS)) were used to fabricate a total of 250-disc (10 × 2.5 mm) specimens. ND and AS specimens were printed with different orientations (0-, 45-, and 90-degree) and each orientation group was subjected to four post-curing times (30, 60, 90, 120 min). Printed specimens were thermo-cycled (10,000 cycles) followed by the measuring of surface roughness (Profilometer (Ra)) and hardness (a Vickers hardness (VH)). ANOVA and post hoc tests were used for data analysis (α = 0.05) at significant levels. AS and ND showed no significant changes in Ra when compared with HP (p ˃ 0.05), except the 45-degree orientation (AS/90 min and AS/120 min) significantly increased surface roughness (p ˂ 0.001). There was no significant difference in Ra with different orientations and post-curing time for both materials AS and ND (p ˃ 0.05). Compared with HP, 3D-printed DBRs showed low VH values (p ˂ 0.001). For AS, 90-degree orientation showed a significant decrease in VH at 60, 90, and 120 min when compared with 0- and 45-degree orientation (p ˂ 0.001), while ND showed no significant difference in VH with different printing orientations (p ˃ 0.05). The VH of AS and ND improved when increasing post-curing time to 120 min (p ˂ 0.001), and the printing orientations and post-curing time did not affect the Ra of 3D-printed DBRs.

Balloon Laryngoplasty in Pediatric Population with Subglottic Stenosis: 5 Years Experience in King Abdulaziz University Hospital a Tertiary Center.

We reviewed our experience with balloon laryngoplasty (BLP) as a primary management of SGS in a tertiary care center in Saudi Arabia. In this review, a total of 147 patients who underwent Laryngobronchoscopy were reviewed. Only 10 pediatric patients diagnosed with SGS who underwent BLP as primary treatment in the period from January 2012 to December 2017 were included. After obtaining ethical approval, included patients' charts were reviewed. Adult patients and those with airway anomalies other than SGS were excluded. This study describes the outcome of 25 episodes of BLP for the selected participants. Sixty percent of the participants were males. Participants' age ranged from 1 to 14 years (mean 6.4 years). Four participants had comorbidities other than SGS. Most patients required more than one episode of BLP (average 3 episodes). Mean hospital stay was 11.7 days. There was no difference in recurrence of symptoms between using laser or knife in subglottic tissue release (p = 0.182). Although recurrence of symptoms was seen in 56% of the patients, almost all patients (100%) became free of symptoms eventually. Patients with co-morbid diseases were more likely to be transferred to PICU post-operatively (p = 0.003). In the treatment of acquired SGS, BLP is an effective and relatively safe alternative to open airway surgery.