The Potential Therapeutic Effects of Platelet-Derived Biomaterials on Osteoporosis: A Comprehensive Review of Current Evidence.

Osteoporosis is a chronic multifactorial condition that affects the skeletal system, leading to the deterioration of bone microstructure and an increased risk of bone fracture. Platelet-derived biomaterials (PDBs), so-called platelet concentrates, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have shown potential for improving bone healing by addressing microstructural impairment. While the administration of platelet concentrates has yielded positive results in bone regeneration, the optimal method for its administration in the clinical setting is still debatable. This comprehensive review aims to explore the systemic and local use of PRP/PRF for treating various bone defects and acute fractures in patients with osteoporosis. Furthermore, combining PRP/PRF with stem cells or osteoinductive and osteoconductive biomaterials has shown promise in restoring bone microstructural properties, treating bony defects, and improving implant osseointegration in osteoporotic animal models. Here, reviewing the results of in vitro and in vivo studies, this comprehensive evaluation provides a detailed mechanism for how platelet concentrates may support the healing process of osteoporotic bone fractures.

A systematic review of the impact of Porphyromonas gingivalis on foam cell formation: Implications for the role of periodontitis in atherosclerosis.

BACKGROUND: The current literature suggests the significant role of foam cells in the initiation of atherosclerosis through the formation of a necrotic core in atherosclerotic plaques. Moreover, an important periodontal pathogen called Porphyromonas gingivalis (P. gingivalis) is indicated to play a significant role in this regard. Thus, the aim of this systematic review was to comprehensively study the pathways by which P. gingivalis as a prominent bacterial species in periodontal disease, can induce foam cells that would initiate the process of atherosclerosis formation. METHODS: An electronic search was undertaken in three databases (Pubmed, Scopus, and Web of Science) to identify the studies published from January 2000 until March 2023. The risk of bias in each study was also assessed using the QUIN risk of bias assessment tool. RESULTS: After the completion of the screening process, 11 in-vitro studies met the inclusion criteria and were included for further assessments. Nine of these studies represented a medium risk of bias, while the other two had a high risk of bias. All of the studies have reported that P. gingivalis can significantly induce foam cell formation by infecting the macrophages and induction of oxidized low-density lipoprotein (oxLDL) uptake. This process is activated through various mediators and pathways. The most important factors in this regard are the lipopolysaccharide of P. gingivalis and its outer membrane vesicles, as well as the changes in the expression rate of transmembrane lipid transportation channels, including transient receptor potential channel of the vanilloid subfamily 4 (TRPV4), lysosomal integral protein 2 (LIMP2), CD36, etc. The identified molecular pathways involved in this process include but are not limited to NF-κB, ERK1/2, p65. CONCLUSION: Based on the results of this study, it can be concluded that P. gingivalis can effectively promote foam cell formation through various pathogenic elements and this bacterial species can affect the expression rate of various genes and the function of specific receptors in the cellular and lysosomal membranes. However, due to the moderate to high level of risk of bias among the studies, further studies are required in this regard.

The Effect of Thymus Vulgaris Essential Oil and Chlorhexidine on Candida Albicans Accumulated on Removable Orthodontic Appliance: A Clinical Trial.

Statement of the Problem: Orthodontic removable appliances can facilitate the accumulation of certain microorganisms and microbial plaque on tooth surfaces and appliance components. Since long-term use of chemical agents is not recommended, an alternative option would be medicinal plants for disinfection of the oral cavity. Purpose: The aim of this study was to assess the efficacy of thymus vulgaris (T. vulgaris) essential oil to decrease the count of candida albicans (C. albicans) accumulated on removal orthodontic appliances. Materials and Method: In this 2-arm parallel controlled clinical trial, forty-four patients whose removable orthodontic appliances were contaminated with C. albicans were randomly divided into two groups by electronic random sampling. In the first group, T. vulgaris essential oil spray and in the second group, 0.2% chlorhexidine (CHX) spray was applied to the appliances. Thereafter, the C. albicans colony count was measured at baseline (T0) and at 2 (T1) and 5 (T2) days after the intervention. Microbial samples were collected by a sterile swab from 3 spots on the internal surface of orthodontic appliances. The Friedman test was used for within-group comparisons and the Mann Whitney test was employed to compare the efficacy of T. vulgaris essential oil with CHX. Results: The results of this study revealed that continuous use of 2%T. vulgaris essential oil or 0.2% CHX significantly decreased the colony count of C. albicans on removable orthodontic appliances; Howevere, no significant difference was noted in the efficacy of 2% T. vulgaris essential oil and 0.2% CHX in decreasing the C. albicans colony count. Conclusion: T. vulgaris essential oil and CHX have favorable antimicrobial activity against C. albicans. Moreover, 2% T. vulgaris essential oil can be considered as an alternative to 0.2% CHX to eliminate fungal contamination of orthodontic appliances.

Validity and reliability of the Persian version of the short-form child perceptions questionnaire 11-14-year-old children (CPQ11-14).

BACKGROUND: The Child Perception questionnaire 11-14 (CPQ 11-14) is an efficient tool for assessment of oral health-related quality of life (OHRQoL). This questionnaire has been briefed to 16 items (CPQ11-14 ISF-16) to facilitate its employment. The purpose the present study was to translate CPQ11-14 ISF-16 to Persian language, culturally adapt, and initially evaluate its among adolescent population. MATERIAL AND METHOD: The questionnaire has been translated to Persian, then back-translated to English, and finally underwent cultural adaptation and pretesting assessment. It was then filled out by 318 participents (175 grils and 143 boys), with the age of 11 to 14 years resident in Shiraz, Iran. The Persian version of CPQ11-14 ISF-16 along with the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and two suggested global questions were administered among participants to assess its criterion validity. RESULTS: The factor analysis extracted two domains and the factor loading of domains ranged from 0.423 to 0.837. Persian version of CPQ11-14 ISF-16 presented high internal consistency (Cronbach's alpha = 0.854), and showed excellent criterion validity with PIDAQ (rho = 0.731, p < 0.001). There was a statistically significant positive moderate correlation between CPQ11-14 ISF-16 and its factors 1 and 2 and two global questions (first global question: rho = 0.439, p < 0.001; second global question: rho = 0.457, p = 0.035). CONCLUSION: The Persian version of CPQ11-14 ISF-16 has optimal validity and reliability in a general population of 11-14-year-old Persian children.

Influence of Multimedia Reminders on Oral Hygiene Status During Removable Orthodontic Treatment: A Randomized Controlled Trial.

Introduction: Orthodontic appliances complicate daily oral hygiene maintenance and enhance the formation of microbial biofilm on tooth surfaces and orthodontic appliances. Objective: This trial was conducted to assess the effect of reminders on oral hygiene of patients during removable orthodontic treatment. Methods: In this 2-arm parallel randomized controlled trial, 66 orthodontic patients with removable maxillary appliance were randomly allocated with 1:1 ratio to message reminders and the control group. The patients in the messaging group received one or two message reminders and educational videos weekly during the course of treatment. A single blinded examiner measured the plaque index (PI), gingival index (GI), and dental caries index of patients in both groups at baseline (T0) and one (T1), three (T2), and six (T3) months after the first day of treatment to assess their oral hygiene status during treatment. Results: A total of 30 patients in control group and 28 in reminder group completed the study. The PI and GI scores were increased neither in control group nor in message reminder group during T0 and T1, significantly. The PI and GI scores in message reminder group were significantly lower than those in the control group at T2 (PI: P = 0.001, GI: P = 0.003) and T3 (PI: P = 0.024, GI: P = 0.022). Slight significant increasing in the PI and GI score were found during T2 and T3 in message reminder group. Caries index showed no significant difference between two groups during study. Conclusion: It seems that reminders can efficiently promote oral hygiene of patients undergoing removable orthodontic treatment.

The feasibility of injectable PRF (I-PRF) for bone tissue engineering and its application in oral and maxillofacial reconstruction: From bench to chairside.

Among all the biomaterials introduced in the field of bone tissue engineering, injectable platelet-rich fibrin (I-PRF) has recently gained considerable attention. I-PRF, as a rich source of biologically active molecules, is a potential candidate which can be easily obtained in bedside and constitutes several biological factors which can result in higher anti-bacterial, anti-inflammatory and regenerative capabilities. According to the studies evaluating the osteogenic efficacy of I-PRF, this biomaterial has exhibited favorable outcomes in terms of adhesion, differentiation, migration, proliferation and mineralization potential of stem cells. In addition, the injectability and ease-of-applicability of this biomaterial has led to its various clinical applications in the oral and maxillofacial bone regeneration such as ridge augmentation, sinus floor elevation, cleft palate reconstruction and so on. Furthermore, to enhance the clinical performance of I-PRF, albumin gel-PRF as a long-lasting material for long-term utilization has been recently introduced with a gradual increase in growth factor release pattern. This review provides a comprehensive approach to better evaluate the applicability of I-PRF by separately appraising its performance in in-vitro, in-vivo and clinical situations. The critical approach of this review toward the different production protocols and different physical and biological aspects of I-PRF can pave the way for future studies to better assess the efficacy of I-PRF in bone regeneration.

The application of injectable platelet-rich fibrin in regenerative dentistry: A systematic scoping review of In vitro and In vivo studies.

Background: Ongoing research in the dental field has begun to focus on the use of injectable platelet-rich fibrin (I-PRF) as a regenerative tool with the potential to prompt tissue regeneration. In this regard, this systematic scoping review aimed to collect, map, and appraise the in vitro and in vivo studies regarding the role of I-PRF in or soft and hard tissue regeneration in relation to oral and maxillofacial structures. Methods: A systematic electronic search of Medline, Scopus, Web of Science, and Embase databases was performed from 2000 to December 2021 using a combination of keywords. All in vitro and in vivo studies, written in English and concerning the potential role of I-PRF in regenerative dentistry were considered. Results: In total, 18 in vitro studies, 5 animal studies, 6 case reports, and 31 clinical studies have evaluated the effect of I-PRF on oral and maxillofacial soft and hard tissue regeneration. The investigated studies verified the anti-inflammatory, anti-microbial efficacy and the positive effects of I-PRF application for wound, periodontal, bone, cartilage, and pulp regeneration, as well as acceleration in tooth movement during orthodontic treatment. Conclusions: Current literature approves the feasibility of I-PRF application as a promising regenerative adjunct to dental procedures.

Skeletal maturation and the location of the mandibular foramen within the ramus mandibulae.

PURPOSE: It is well documented that the mandible does not grow at a constant rate. There are significant correlations between the increase of mandibular size and cervical vertebral maturation. The peak growth velocity of the mandible occurs after the third stage of cervical vertebral maturation. The location of the mandibular foramen (MF) and its changes subsequent to growth are of great interest to clinicians as they relate to the anesthesia of the inferior alveolar nerve and to mandibular surgical procedures. Therefore, the aim of the present study was to assess the influence of the mandibular growth spurt on the location of the MF in various skeletal growth patterns. METHODS: Panoramic and lateral cephalometric radiographs of 98 (32 orthognathic, 50 retrognathic, 16 prognathic) patients before and after the growth peak were collected. For each subject, the maturational stage of the cervical vertebrae was defined on successive lateral cephalograms and the vertical and horizontal position of the MF was evaluated on two panoramic radiographs, one before and one after the growth peak. RESULTS: The MF-Post/MF-Ant ratio (MF distance to the posterior border of the ramus/MF distance to the anterior border of the ramus) significantly increased after the growth peak in orthognathic and retrognathic subjects (P = 0.015 and 0.02, respectively). This ratio did not significantly increase in prognathic subjects (P = 0.882). No statistically significant changes in the vertical position of the MF were found in the three groups after the growth spurt. CONCLUSION: The horizontal position of the MF moves in an anterior direction in orthognathic and retrognathic subjects during the mandibular growth spurt. The vertical position of the mandibular foramen remains unchanged during this period.

Use of nano-hydroxyapatite serum and different finishing/polishing techniques to reduce enamel staining of debonding after orthodontic treatment : A randomized clinical trial.

PURPOSE: The aim of this study was to assess the effect of nano-hydroxyapatite serum and different finishing, polishing techniques on color alterations of enamel caused by debonding procedures after comprehensive orthodontic treatment by use of a spectrophotometer. METHODS: This randomized clinical trial recruited 20 participants with previous non-extraction orthodontic treatment and acceptable hygiene to evaluate enamel staining after orthodontic debonding. The usage of a carbide bur alone, as the conventional method, and the combination use of carbide burs and Sof-Lex discs (3M™ ESPE, St. Paul, MN, USA) were compared to each other followed by 10 days application of nano-hydroxyapatite after debonding. Then the enamel staining was evaluated by a reflectance spectrophotometer in three periods: immediately, and 2 and 4 months after debonding. RESULTS: The comparison of the groups showed a significant interaction between Sof-Lex groups and the control side after the first interval of the study (p = 0.042). Application of nano-hydroxyapatite demonstrated no significant difference in color parameters between upper and lower arches of the participants at all intervals of this study (p > 0.05). The mean total color change (ΔE) in all groups and between all intervals had been clinically perceptible (ΔE > 3.3). CONCLUSIONS: The applied concentrations of nano-hydroxyapatite had no significant effect in reducing tooth color changes after debonding in orthodontic treatment. Sof-Lex discs can significantly reduce tooth color changes in a short time.

The adjunctive effect of autologous platelet concentrates on orthodontic tooth movement: A systematic review and meta-analysis of current randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness of autologous platelet concentrates (APCs) as adjuncts on accelerating orthodontic tooth movement (OTM) of the human subjects undergoing orthodontic treatment and to critically appraise the available literature. METHODS AND MATERIALS: Five electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Central Register of Controlled Trials) were searched from 2000 up to May 2021 to retrieve eligible randomized controlled trials (RCTs) investigating patients who underwent orthodontic treatment that involved OTM of maxillary and mandibular incisors and canines. All the enrolled cases were treated with APCs and had no local or systemic interfering factors. The quality of the included studies was assessed using the modified JADAD scale. The effect sizes were assessed using mean difference (MD). The heterogeneity analysis was conducted using (I2) statistic at α=0.10. RESULTS: Finally, seven RCTs were included in the qualitative, and two RCTs were included in the quantitative analysis. The meta-analysis was performed regarding the effect of injectable platelet-rich fibrin (I-PRF) on the rate of canine tooth movement in millimeters at different intervals of the 1st, 2nd, and 3rd months. In the 1st month, I-PRF (WMD:0.12mm, CI95% -5.01 to 5.24, I2=90%) did not significantly affect OTM. In the 2nd month, I-PRF (WMD:0.66mm, CI95% 0.60 to 0.73, I2=10%) significantly increased the OTM. However, in the 3rd month, I-PRF did not significantly increase the OTM (WMD:0.54mm, CI95% -1.38 to 2.47, I2=67%). CONCLUSIONS: According to the low certainty of evidence about this topic, providing a definite conclusion is not possible. However, applying I-PRF seems to be efficient in accelerating the OTM of the canines. Further high-quality studies with larger sample sizes will be indispensable to validate this conclusion.

The effect of learning style and general self-efficacy on satisfaction of e-Learning in dental students.

INTRODUCTION: The COVID-19 pandemic has had a significant impact on education. e-Learning has been becoming most popular. Satisfaction of the student is one of important goal of e-Learning, therefore factors affecting this satisfaction should be considered extensively. This study aims to evaluate the effect of learning style and General Self-Efficacy (GSE) on satisfaction of e-Learning in dental student. METHOD: Electronic questionnaires were sent to 85 fifth and sixth-year students who had passed the face-to-face orthodontics course in the previous semester and were studying online orthodontics at the time of this study. Three questionnaires were used including Soloman and Felder learning styles index, General self-efficacy questionnaire and Satisfaction questionnaire for online education. RESULTS: The results of the reliability test showed that Cronbach's alpha index for the self-efficacy and satisfaction questionnaire was 0.836 and 0.96, respectively. The correlation between satisfaction and the dimensions of learning style showed that the active dimension of processing information had a significant relationship with the level of satisfaction. In the understanding dimension, a relatively strong correlation was observed in the Global dimension. Moderate significant relationship between the total score of self-efficacy and the level of satisfaction has been found. CONCLUSION: The results of the present study highlight the necessity of more studies regarding defining effective on student satisfaction during e-Learning. GSES and active learning style in the processing dimension and global learning style in the understanding dimension affect students' satisfaction.

Proposal for Tier-Based Resumption of Dental Practice Determined by COVID-19 Rate, Testing and COVID-19 Vaccination: A Narrative Perspective.

Since the emergence of the new coronavirus disease (COVID-19), profound alterations in general and specialist dental practice have been imposed to provide safe dental care. The guidelines introduced in response to the COVID-19 pandemic to mitigate healthcare disruption are inconsistent regarding the dental practice re-installation, particularly during a transitional time. Despite the successful mass vaccination campaigns rolled out in 2021, the presence of more than 80 genotypes of COVID-19, rapid neutralisation of antibodies within a short period of seropositivity, and the likelihood of recurrent infection raise some doubts on whether vaccination alone will provide long-term immunity against COVID-19 and its variants. Here, from this perspective, we aim to provide an initial proposal for dental services reinstallation, easily applicable in various care settings. We discuss the potential options for the transition of dental services, as well as challenges and opportunities to adapt to new circumstances after mass COVID-19 vaccination. The proposal of the universal three-tier system of dental services resumption, determined by regional COVID-19 rates, testing accessibility, and vaccination rollout has been presented. Following herd COVID-19 immunity enhancement, it would be prudent to confer various preventative measures until virus spread naturally diminishes or becomes less virulent. Based on modelling data, dental practices may not return to normal, routine operation even after global vaccination as there would still be a significant risk of outbreaks of infection. Variable, multi-level measures will still be required, depending on the local COVID-19 cases rate, to secure safe dental care provision, despite predicted success of vaccination agendas. This approach can be implemented by achievable, practical means as a part of risk assessment, altered work pattern, and re-arrange of dental surgery facilities. The adequate standard operating procedure, with the support of rapid point-of-care testing at workplace, would vastly intensify the uninterrupted recovery of the dental care sector.

The impact of general self-efficacy and the severity of malocclusion on acceptance of removable orthodontic appliances in 10- to 12-year-old patients.

BACKGROUND: The patients' acceptance of a treatment plan and their subsequent cooperation play a crucial role in achieving the best results in orthodontic treatments. Evidences show some personality traits such as general self-efficacy (GSE) and some dental traits such as severity of malocclusion are correlated with motivation of orthodontic treatment. These factors may predict the patients' compliance and acceptance in using removable orthodontic appliances. This cross sectional study was conducted to assess the correlation of GSE and the severity of malocclusion with patients' acceptance in using removable orthodontic appliances. METHODS: This study recruited 50 patients aged 10-12 years who required removable orthodontic appliances. The severity of malocclusion was determined using the index of orthodontic treatment need (IOTN) before the onset of treatment and GSE of participants were assessed using GSE scale self-report. The acceptance questionnaire was proposed to the patients on first (T1), third (T2), and sixth (T3) month after the delivery of the appliance. RESULTS: The GSE score had a statistically significant correlation with the total score of the acceptance questionnaire, subscale score of satisfaction with the appliance during eating and oral hygiene practice, duration of usage of the appliance, and interest in using it (P < 0.05). The IOTN had no significant correlation with the acceptance questionnaire. CONCLUSIONS: Our findings substantiate the role of the GSES, concurrently declining the role of the IOTN in prediction of 10-12-year-old children's acceptance and cooperation in treatment of malocclusion with removable appliances.

The practice of oral and maxillofacial radiology during COVID-19 outbreak.

The current coronavirus disease 2019 (COVID-19) outbreak has brought substantial challenges to the world health system, including the practice of dental and maxillofacial radiology (DMFR). DMFR will carry on an imperative role in healthcare during this crisis. This rapid communication has collected and evaluated all the best current evidence and published guidelines as well as professional recommendations to help maxillofacial radiologists and dental practitioners for safer radiological and imaging examinations on healthy, suspected, or confirmed COVID-19 patients during outbreak. Some strategies have been depicted including procedural indications, infection control, and correct employment of personal protection equipment along with evoking the proper practice environment during and after the COVID-19 outbreak.