An Experimental Anatomic CBCT Study on the Correlations Between MB1 and MB2 of the Mesio-Vestibular Root of the Upper First Molars.

This experimental anatomic study aimed to investigate the correlations between the mesio-vestibular canal (MB1) and the second mesio-vestibular canal (MB2) of the mesio-vestibular root of the upper sexts using cone-beam computed tomography (CBCT) imaging. A total of 24 extracted maxillary first molars were collected and subjected to CBCT imaging. The presence, location, and morphology of MB1 and MB2 canals were evaluated using axial, coronal, and sagittal CBCT sections. The interrelation between MB1 and MB2 canals was assessed, including their separate canals, merging, and division points. Among the 24 maxillary first molars examined, 86.5% demonstrated the presence of an MB2 canal in addition to MB1. The MB2 and MB1 were confluent in 80% of the cases with a confluent height of 4,16 mm. The mean distance between MB1 and MB2 canals was 1.85 mm. This study provides detailed information on the anatomic correlations between MB1 and MB2 canals of the mesio-vestibular root in the upper sexts using CBCT imaging. The high prevalence of MB2 canals suggests their significance in endodontic procedures and emphasizes the importance of thorough exploration and identification during root canal treatment. The knowledge of the location and morphology of these canals can aid in successful endodontic therapy and enhance treatment outcomes.

A Brief Review on Engaging and Interactive Learning for Children: Exploring the Potential of Metaverse-Based Oral Health Promotion.

The importance of oral health for overall health makes it critical to establish proper oral hygiene practices in children early on. The traditional approaches to teaching children about dental health may not be successful since they may not be able to keep their interest. Metaverse technology offers a promising alternative, allowing for the design of engaging and immersive worlds that can effectively educate children about oral health. Despite the growing interest in the use of metaverse technology in healthcare, there is a lack of comprehensive reviews on its potential for oral health promotion in children. This review aims to fill this gap by providing an overview of the current state of metaverse-based oral health promotion for children, discussing its benefits and challenges, and highlighting its potential for improving children's oral health. By conducting this review, the authors hope to provide new information on the potential of metaverse-based oral health promotion for children and to contribute to the ongoing discussion on the use of metaverse technology in healthcare. This review may also provide valuable insights for dental organizations and practitioners interested in using metaverse technology to promote oral health and healthy living among children.

Dental problems in children with autism: a 5-year study.

Caries experience of children and complex clinical circumstances are an actual challenge for any healthcare professional. To investigate the early childhood caries (ECC) in autistic and non autistic children (≤4 years of age) evaluating the amount of dental damage and the treatments carried out in both groups. Data regarding the oral health status of 40 patients (≤4 years of age) were assembled. The sample group was constituted of 20 autistic children (12 males with a mean age of 2.5 years and 8 females with a mean age of 3.2 years) whereas 20 patients without the autistic spectrum represented the control group (11 males with a mean age of 3 and 9 females with a mean age of 3.3 years). There were no significant differences between the two groups as regards both the extent of dental damage and the treatments carried out. About the frequency, in the autistic group, the most frequent caries were the white spots and enamel proximal lesions (2.2%), followed by only white spots (1.2%) and brown-black cavities and root stumps (0.6%). In the control group, the brown-black cavities and root stumps represented the most frequent findings (2.2%), followed by white spots and enamel proximal lesions (1.4%) and white spots (0.4%). Regarding the treatments, the most repeated management of dental damage among autistic patients was composite restorations (2.2%) while in nonautistic patients were tooth extractions (2%).

Pharmacological therapy in the management of temporomandibular disorders and orofacial pain: a systematic review and meta-analysis.

BACKGROUND: Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs. METHODS: Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74). CONCLUSIONS: Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.

Chemical-Physical Characterization of PET-G-Based Material for Orthodontic Use: Preliminary Evaluation of micro-Raman Analysis.

OBJECTIVES: Orthodontic treatment with clear thermoplastic aligners is in great demand by patients especially for aesthetics. Any alterations in the chemical composition of the thermoplastic material for aligners, subjected to the oral environment and exposure to various commonly used substances, could influence the desired orthodontic movement decreasing the predictability of the treatment. The objective of this study was to determine the chemical-physical characterization by micro-Raman spectroscopy of a thermoplastic material based on polyethylene terephthalate glycol (PET-G) used for the manufacture of Lineo aligners (Micerium Lab, Avegno, Italy) subjected to different staining beverages and cleaning agents. MATERIALS AND METHODS: Twenty-two thermoformed PET-G samples were immersed to various substances of daily use for 10 and 15 days (coffee, tea, Coca-Cola, red wine, colloidal silver disinfectant, nicotine, artificial saliva, cigarette smoke, and different combinations of saliva with some of the previous solutions). Subsequently, the chemical-physical characterization was investigated by micro-Raman spectroscopy. RESULTS: The analysis of the spectra acquired for all the specimens showed no difference in the exposure to the different solvents at 10 and 15 days. Furthermore, having ascertained the heterogeneous surface morphology of the PET-G material due to thermoforming, various deposits were present on all the samples whose consistency and concentration depended on the substance used. CONCLUSION: The spectroscopic investigations have provided a precise and detailed analysis of the qualitative and structural data of the PET-G material under examination. No significant structural modifications of the thermoplastic polymer were found after immersion in different solutions in the exposure times adopted.

The role of anxiety in patients with hereditary angioedema during oral treatment: a narrative review.

Objective: The present study investigated the clinical potential of managing anxiety during dental procedures to reduce acute attacks in patients with hereditary angioedema (HAE). HAE is a rare disease, little known to physicians and dentists, but with an increased hospitalization rate over the years. HAE is due to a deficiency/dysfunction of the C1 esterase inhibitor, leading to increased vascular permeability. Recommendations for HAE management include long-term and short-term prophylaxis and treatment of acute attacks, but the importance of anxiety control is underestimated. Materials and methods: The authors reviewed the literature to provide the scientific community with an overview of possible protocols for managing anxiety in dental practice and their effectiveness. Management can be used in prosthetics, periodontal and implant surgery, endodontics, and oral surgery. Discussions: Our analysis shows that although there are few articles in the indexed literature, protocols for managing anxiety in HAE patients in dentistry will become increasingly prevalent in the daily clinical practice of dentists due to its benefits. Conclusions: The benefits and better control of intraoperative complications and risks may lead clinicians to use sedation, assessment, or anxiety control techniques in daily clinical practice to reduce such attacks. Clinical relevance: This study suggests that controlling and managing anxiety can help prevent and reduce acute angioedema attacks.

Assessment of oral tissue alterations in patients diagnosed with SARS-CoV-2.

BACKGROUND: The aim of this study was to investigate oral mucosal changes in patients with confirmed moderate-scale severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We analyzed 85 COVID-19 patients (50 males, 35 females) with an average age of 53.6 years, treated at the prehospital infectious disease center and Aldent University Clinic in Tirana, Albania, from May 2021 to June 2022. RESULTS: Elevated C-reactive protein levels were observed in 82 patients (±44.20), with 20 patients showing significant fibrinogen increase (mean ± 5.85 g/L), and 22 patients having elevated D-Dimer (mean ± 336.6 mg/mL). Despite the absence of anticoagulant history, 13 patients exhibited bleeding. Xerodermia, xerostomia, and angular cheilitis were noted, with 41 patients displaying angular cheilitis. In 82 patients, oral mucosal and tongue examinations revealed color changes from white to bright yellow, with brown edema. Pigmentation in the fixed gingiva of upper and lower front teeth was observed in 35 patients. CONCLUSIONS: Oral mucosal changes during COVID-19 appear more influenced by drug treatment and disease progression than the infection itself, suggesting that secondary factors play a significant role. Despite the oral cavity's potential for viral entry, these changes seem connected to other underlying causes.

CBD enhances the cognitive score of adolescent rats prenatally exposed to THC and fine-tunes relevant effectors of hippocampal plasticity.

Introduction: An altered neurodevelopmental trajectory associated with prenatal exposure to ∆-9-tetrahydrocannabinol (THC) leads to aberrant cognitive processing through a perturbation in the effectors of hippocampal plasticity in the juvenile offspring. As adolescence presents a unique window of opportunity for "brain reprogramming", we aimed at assessing the role of the non-psychoactive phytocannabinoid cannabidiol (CBD) as a rescue strategy to temper prenatal THC-induced harm. Methods: To this aim, Wistar rats prenatally exposed to THC (2 mg/kg s.c.) or vehicle (gestational days 5-20) were tested for specific indexes of spatial and configural memory in the reinforcement-motivated Can test and in the aversion-driven Barnes maze test during adolescence. Markers of hippocampal excitatory plasticity and endocannabinoid signaling-NMDAR subunits NR1 and 2A-, mGluR5-, and their respective scaffold proteins PSD95- and Homer 1-; CB1R- and the neuromodulatory protein HINT1 mRNA levels were evaluated. CBD (40 mg/kg i.p.) was administered to the adolescent offspring before the cognitive tasks. Results: The present results show that prenatal THC impairs hippocampal memory functions and the underlying synaptic plasticity; CBD is able to mitigate cognitive impairment in both reinforcement- and aversion-related tasks and the neuroadaptation of hippocampal excitatory synapses and CB1R-related signaling. Discussion: While this research shows CBD potential in dampening prenatal THC-induced consequences, we point out the urgency to curb cannabis use during pregnancy in order to avoid detrimental bio-behavioral outcomes in the offspring.

Insights about the ability of folate based supramolecular gels to act as targeted therapeutic agents.

With the aim to obtain targeted chemotherapeutic agents, imidazolium and ammonium-based folate salts were synthesized. Their photophysical behavior was investigated both in buffer and buffer/DMSO solution as well as in solid phase, performing UV-vis and fluorescence investigations. Properties of the aggregates were also analyzed by dynamic light scattering. Gelation ability of the salts was analyzed in biocompatible solvents, and gel phases obtained were characterized by determining critical gelation concentrations and gel-solution transition temperatures. Insights about gelator interactions in the tridimensional network were also gained performing ATR-FTIR investigation. Properties of soft materials were further analyzed performing rheology measurements, scanning electron microscopy, fluorescence and resonance light scattering investigations. Antiproliferative activity of organic salts was tested towards two breast cancer cell lines, expressing different levels of folate receptor, namely MDA-MB-231 and MCF-7, and a normal epithelial cell line, like h-TER T-RPE-1, by using MTT assay. Dichlodihydrofluorescein acetate test was performed to verify the role of oxidative stress in cell death. Finally, antiproliferative activity was also evaluated in gel phase, to verify if salts were able to retain biological activity also after the entrapment in the gelatinous network. Results collected evidence that folate based organic salts were able to behave as targeted chemotherapeutic agents both in solution and gel phase, showing uptake mechanism and selectivity indexes that depend on both cancer cell line nature and salt structure.

Dental trauma and prevention guidelines: a narrative review.

Dental injuries affect different patients every day in conditions that can range from domestic, work, or road accidents. As for traumas in the age of development, the field is restricted to domestic, sports, and school environments. The purpose of this study was to clarify the current protocols in the literature to limit and manage this type of pathology. This narrative review considers the literature of the last 20 years on this topic in different ways. The literature is in agreement with dividing the treatments into primary and secondary and also according to what is the place where the trauma occurred to evaluate the type of intervention. However, all protocols are aimed at implementing efficient preventive strategies rather than having to solve a problem subsequently, certainly, new protocols and protection systems can limit this problem which leads not only to more or less complex problems related to oral health and aesthetics but also possible subsequent psychological problems.

Exploring the anticancer activity and the mechanism of action of pyrrolomycins F obtained by microwave-assisted total synthesis.

Pyrrolomycins (PMs) are a family of naturally occurring antibiotic agents, isolated from the fermentation broth of Actinosporangium and Streptomyces species. Pursuing our studies on pyrrolomycins, we performed the total synthesis of the F-series pyrrolomycins (1-4) by microwave-assisted synthesis (MAOS), thus obtaining the title compounds in excellent yields (63-69%). Considering that there is no evidence so far of the anticancer effect of this class of compounds, we investigated PMs for their antiproliferative activity against HCT116 and MCF-7 cancer cell lines. PMs showed anticancer activity at submicromolar level with a minimal effect on normal epithelial cell line (hTERT RPE-1), and they were able to induce several morphological changes including elongated cells, cytoplasm vacuolization, long and thin filopodia as well as the appearance of tunneling nanotubes (TNTs). These data suggest that PMs could act by impairing the cell membranes and the cytoskeleton organization, with subsequent increase of ROS generation and the activation of different forms of non-apoptotic cell death.

Teledentistry: Evaluation of Instagram posts related to bruxism.

BACKGROUND: Instagram statistic has attracted roughly one billion, monthly active users. In 2021, Instagram belonged to the most popular social networks worldwide. It has been considered an effective tool that contributes to the contemporary sharing of information for raising public awareness while providing educational information. The growing presence of Instagram and frequent user engagement has made it a potentially effective platform for patient communication, seeking educational information, product information for consumers, and advertisements in the form of images and videos. OBJECTIVE: To assess and compare the contents of Instagram posts by healthcare professionals (HP) and non-professional healthcare workers (NPHW) on bruxism and to assess public engagement with this content. METHODS: Twelve "hashtag" terms linked to bruxism were searched. HP and NPHW analyzed the content of relevant posts for the presence of domains. Discourse analysis assessed the post quality for themes. We conducted the descriptive and univariate statistical analysis, whereas inter-rater reliability was tested using Cohen's kappa. RESULTS: A total of 1184 posts were retrieved, with the majority uploaded by NPHW (622 posts). The posts by HPs were in text and image(s) format (53%) with the range of 25-1100 Instagram post "Likes." "Mouthguard" (90) % was the most frequently included domain posted by HP, followed by "treatment plan/pain management", and complaints of clicking or locking of TMJ" (84%). Greater number of domains (p= 0.03) were seen in the posts by NPHWs, compared to HP's having more bruxism-related content. The inter-rater reliability method (0.89) was used for the presence of domains. CONCLUSION: NPHW uses Instagram more frequently to post bruxism-related information than HP. HPs must ascertain that the content posted by NPHW is relevant and the concerns addressed in posts are to the purpose.

Prenatal Exposure to Δ9-Tetrahydrocannabinol Affects Hippocampus-Related Cognitive Functions in the Adolescent Rat Offspring: Focus on Specific Markers of Neuroplasticity.

Previous evidence suggests that prenatal exposure to THC (pTHC) derails the neurodevelopmental trajectories towards a vulnerable phenotype for impaired emotional regulation and limbic memory. Here we aimed to investigate pTHC effect on hippocampus-related cognitive functions and markers of neuroplasticity in adolescent male offspring. Wistar rats were exposed to THC (2 mg/kg) from gestational day 5 to 20 and tested for spatial memory, object recognition memory and reversal learning in the reinforce-motivated Can test and in the aversion-driven Barnes maze test; locomotor activity and exploration, anxiety-like behaviour, and response to natural reward were assessed in the open field, elevated plus maze, and sucrose preference tests, respectively. The gene expression levels of NMDA NR1-2A subunits, mGluR5, and their respective scaffold proteins PSD95 and Homer1, as well as CB1R and the neuromodulatory protein HINT1, were measured in the hippocampus. pTHC offspring exhibited deficits in spatial and object recognition memory and reversal learning, increased locomotor activity, increased NR1-, decreased NR2A- and PSD95-, increased mGluR5- and Homer1-, and augmented CB1R- and HINT1-hippocampal mRNA levels. Our data shows that pTHC is associated with specific impairment in spatial cognitive processing and effectors of hippocampal neuroplasticity and suggests novel targets for future pharmacological challenges.

Temporomandibular Joint Disk Displacement: Etiology, Diagnosis, Imaging, and Therapeutic Approaches.

An estimated 8 to 15% of women, and 3 to 10% of men currently suffer from Temporomandibular disorders, and it has been reported that sounds are a common finding and have been observed in 28% to 50% of the adult population; sounds are almost always connected to "internal derangements" a condition in which the articular disk displaced from its position on the mandibular condyle. Due to the multifactorial etiology of temporomandibular joint dysfunction, any accurate diagnosis based on clinical examination alone often proves to be difficult, so a clinical examination should be utilized together with other imaging methods to determine the relationship between the disk and condyle before and after treatment. In general, management of temporomandibular joint-related conditions is necessary when pain or dysfunction is present, so many surgical or nonsurgical methods of treatment have been reported. The Occlusal splint is 1 of the most widespread treatment it induces a slight vertical condylar distraction and eliminates the occlusal factor, which can be responsible for Temporomandibular joint disturbances, removing the influence of the teeth on the joint position by the slight distraction of the joint which, in turn, enables damaged connective tissue to heal.

Benefits in Oral Health during Orthodontic Treatment of Patients Aged 17 to 21 Years.

OBJECTIVES: The aim of the present study was to evaluate the effects of orthodontic treatment on patients' oral health-related quality of life (OHRQoL) in a population aged 17 to 21 years. The influence of gender and malocclusion severity was also investigated. MATERIALS AND METHODS: In the present study, 108 patients were enrolled. Each patient completed a questionnaire about oral health impact profile (OHIP)-14 before treatment and after 12 months of treatment. The severity of the initial malocclusion was evaluated through the index for orthodontic treatment need (IOTN). STATISTICAL ANALYSIS: Statistical analysis was performed to assess the presence of difference in OHRQoL score before and after the treatment, and the influence of gender and IOTN score on the observed outcomes. RESULTS: We found no significant differences related to gender regarding their perception of how malocclusion affects the quality of life before orthodontic treatment. Moreover, no significant differences were found between males and females regarding their perception of how orthodontic treatment affects the quality of life 12 months after orthodontic treatment. Also, the analysis showed no statistically significant difference between males and females in the correlation IOTN-OHIP for Grades 2 and 3. A statistically significant difference between males and females was found only in Grade 4, both before (p = 0.046) and after treatment (p = 0.051). CONCLUSION: Finally, OHIP-14 can be a valuable instrument to assess the perceptions and the expectations of patients toward orthodontic treatment.

Social stress under binge-like alcohol withdrawal in adolescence: evidence of cannabidiol effect on maladaptive plasticity in rats.

BACKGROUND: Alcohol binge drinking may compromise the functioning of the nucleus accumbens (NAc), i.e. the neural hub for processing reward and aversive responses. METHODS: As socially stressful events pose particular challenges at developmental stages, this research applied the resident-intruder paradigm as a model of social stress, to highlight behavioural neuroendocrine and molecular maladaptive plasticity in rats at withdrawal from binge-like alcohol exposure in adolescence. In search of a rescue agent, cannabidiol (CBD) was selected due to its favourable effects on alcohol- and stress-related harms. RESULTS: Binge-like alcohol exposed intruder rats displayed a compromised defensive behaviour against the resident and a blunted response of the stress system, in addition to indexes of abnormal dopamine (DA)/glutamate plasticity and dysfunctional spine dynamics in the NAc. CBD administration (60 mg/kg) was able to: (1) increase social exploration in the binge-like alcohol exposed intruder rats, at the expenses of freezing time, and in control rats, which received less aggressive attacks from the resident; (2) reduce corticosterone levels independently on alcohol previous exposure; (3) restore DA transmission and (4) facilitate excitatory postsynaptic strength and remodelling. CONCLUSIONS: Overall, the maladaptive behavioural and synaptic plasticity promoted by the intersection between binge-like alcohol withdrawal and exposure to adverse social stress can be rescued by a CBD détente effect that results in a successful defensive strategy, supported by a functional endocrine and synaptic plasticity. The current data highlight CBD's relevant therapeutic potential in alcohol- and stress-related harms, and prompt further investigation on its molecular targets.

Periodontal Disease and Pregnancy: Correlation with Underweight Birth.

Periodontal disease is a risk factor for many systemic diseases including preterm birth and underweight birth. The purpose of this systematic review is to analyze the literature and to highlight any clinical correlation. Information sources such as PubMed, MEDLINE, and Web of Science were consulted to obtain our results with these keywords "periodontal disease," "pregnancy," "weight loss" using the connector "AND." After the first screening by authors, only 27 articles were included in this review. From the analysis of the literature, it was noted that the presence of periodontal disease could have a correlation with underweight birth. Surely, control oral hygiene and oral health is essential during pregnancy to reduce risks, and these results should be essential in establishing a protocol to be maintained during pregnancy.

Monkeypox: An Unfamiliar Virus-Clinical and Epidemiological Characteristics, Diagnosis, and Treatment with Special Emphasis on Oral Health.

With the recent increased prevalence of human outbreaks, monkeypox has been recognized for decades as an infectious disease with substantial pandemic potential. The majority of cases of this virus have been observed in the European region (11,865), with few cases in the Western Pacific (54). Various governing health agencies are striving to restrain the fatal monkeypox virus (MPXV). Health practitioners around the world are learning about the many clinical manifestations of this infection, and its potential therapies. Despite the plethora of new evidence and rising cases, the essential questions remain unsolved. Thus, in this review, we have modernized the outlook for monkeypox, which will be helpful for various medical practitioners. In the light of continuing outbreaks around the world, we have also presented our assessment of the readiness of India against this outbreak, with a special focus on its effects on oral health.

Stem Cells in Temporomandibular Joint Engineering: State of Art and Future Persectives.

Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease, characterized by gradual cartilage degradation, bone remodeling, synovitis, and chronic pain. Due to the limited self-healing capacity in condylar cartilage, traditional clinical therapy have limited symptom-modifying and structure-modifying effects to restore impaired cartilage as well as other TMJ tissues. In last years, stem cell-based therapy has collected much attention as a possible approach toward tissue repair and regeneration. Mesenchymal stem cells (MSCs), derived from the bone marrow, synovium, and even umbilical cord, play a role as seed cells for the cartilage regeneration of TMJ. MSCs possess multilineage differentiation potential, including chondrogenic differentiation as well as osteogenic differentiation. In addition, the modulations of MSCs exert anti-inflammatory and immunomodulatory effects under aberrant conditions. Furthermore, MSCs combined with appropriate scaffolds can form cartilaginous or even osseous compartments to repair damaged tissue and impaired function of TMJ. In this review, we will describe the potential sources of MSCs and novel approaches for the cartilage regeneration of TMJ, particularly focusing on the MSC-based therapy and tissue engineering.

Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report.

Implantology represents the gold standard in oral rehabilitation. Unfortunately, a new pathology begins to show itself to clinicians that no longer affects only and solely the supporting tissues of the tooth but also dental implants and peri-implantitis. In this study, we present a case report regarding a tissue regeneration maneuver involving dental implants. The clinical and radiographic results are encouraging, regarding the use of these techniques on implant surfaces. Surely, the advent of new biomaterials and surgical techniques will make this practice safe and predictable.