Advancements in alveolar bone reconstruction: A systematic review of bone block utilization in dental practice.

Alveolar reconstructive surgery employs a variety of surgical techniques and biomaterials, with a particular focus on bone blocks as a crucial methodology for restoring and augmenting deficient bone structures. Bone blocks are often employed to support periodontal health or as a foundation for future prosthetic rehabilitation with dental implants. This systematic review investigated recent advances in bone blocks for alveolar bone reconstruction, comparing autologous, allogeneic and xenogeneic types. A search of PubMed identified 56 records, of which 21 were included in the qualitative analysis. The studies involved 685 patients in total. Bone blocks are pivotal for three-dimensional bone regeneration, providing a stable scaffold for achieving the desired bone volume during healing. Autologous bone, harvested from the patient, boasts high biocompatibility, excellent osteogenic properties and minimal immunologic risks. However, its drawbacks include the need for an additional surgical site and extended procedural times. Allogeneic bone blocks involve transferring bone between individuals, offering increased graft availability and customization options without requiring a second surgical site. However, they exhibit moderate resorption rates and carry a heightened risk of immunologic reactions and disease transmission. Innovative techniques, such as tunneling, laser osteotomy, graft customization, and platelet-rich fibrin (PRF) application on wound during surgical treatment show promise in enhancing alveolar bone reconstruction efficacy. In conclusion, despite the traditional preference for autologous bone, the review suggests that alternative materials, particularly individualized allogeneic bone blocks, coupled with modern techniques, could emerge as a standard procedure for regenerating alveolar bone defects due to their satisfactory results and potential advantages.

Relationship in development of malocclusions to polymorphisms of selected vitamin D receptors.

BACKGROUND: The development of malocclusion is related to various factor, many of which are still not fully explained. The steroid hormone, 1,25-dihydroxyvitamin D3, has pleiotropic effects. It plays a key role in skeletal metabolism and the control of cell repair by attaching to the nuclear vitamin D steroid receptor (VDR). This vitamin affects bone turnover through the processes of bone tissue formation and resorption via its action on cells of the osteoblastic and osteoclastic lineage, exerts a modulating effect on the immune system, and is involved in the regulation of cell proliferation and differentiation. The role of vitamin D3 (VD3) and its receptor polymorphisms is a rarely studied topic in dentistry. Due to the proven influence on bone turnover processes and immune responses, the main research topic is its relation to periodontal diseases, but so far, its role in the formation and development of malocclusions has not been assessed. OBJECTIVES: This study aimed to assess the association of selected VDR polymorphisms: Cdx2 (rs11658820), TaqI (rs7975232), BsmI (rs1544410), ApaI (rs7975232), and FokI (rs2228570) with the development of malocclusions. MATERIAL AND METHODS: A prospective observational study was performed. The examination consisted of a medical interview, intraand extraoral orthodontic diagnosis, alginate impression, cone beam computed tomography (CBCT), and venous blood sample to obtain genomic DNA and assess VDR polymorphisms. RESULTS: The rs11658820 polymorphism causes an almost 4-fold increase in the probability of the presence of a malocclusion. GT and TT genotypes of rs7975232 are also associated with a similar risk - almost 6 and almost 5 times higher, respectively. In turn, the effect of the rs2228570-AG and GG genotype polymorphisms on the occurrence of transversal anomalies was demonstrated (odds ratio (OR) = 8.46 and OR = 6.92, respectively). CONCLUSIONS: The association of individual polymorphisms with specific malocclusions should be carefully assessed, especially since some trends have been indicated.

Oral cancer awareness among patients at 3 university hospitals in Poland and Germany: A survey research.

BACKGROUND: The epidemic of cancer (including oral cancer) is a growing public health and economic problem in the European societies. A high percentage of patients who come for the appropriate treatment are in the late stages of advancement, often with nodal and/or distant metastases. The literature on the public oral cancer awareness in Poland and Germany is limited. OBJECTIVES: To investigate the levels of public awareness about the early symptoms and risk factors of oral cancer, and to analyze the findings in the context of the socioeconomic profiles of the subjects. MATERIAL AND METHODS: The survey consisted of a 20-item questionnaire divided into 4 sections: socioeconomic and demographic factors, the awareness of oral cancer, symptoms of oral cancer, and its risk factors. It was distributed to 465 adult patients in Poland (Wroclaw and Lódz) and Germany (Dresden). RESULTS: The response rate was 97.6%. Most of the respondents (65.4%) had heard of oral cancer. The sources of information were mainly the traditional mass media and the Internet, with only 23.8% of the respondents indicating doctors as a source of information about oral cancer. What is worrying, only about 1/5 of the participants in each of the 3 centers had an oral cancer examination last year. The awareness of oral cancer correlated positively with the age of the respondents and negatively with the size of the place of residence. Education level had no significant impact on declared knowledge. CONCLUSIONS: The results of this survey do not only show unsatisfactory levels of patients' awareness of the risk factors and symptoms of oral cancer but also emphasize the need to improve the level of healthcare concerning this disease, including screening programs.

Could Vitamin D3 Deficiency Influence Malocclusion Development?

The abnormal growth of the craniofacial bone leads to skeletal and dental defects, which result in the presence of malocclusions. Not all causes of malocclusion have been explained. In the development of skeletal abnormalities, attention is paid to general deficiencies, including of vitamin D3 (VD3), which causes rickets. Its chronic deficiency may contribute to skeletal malocclusion. The aim of the study was to assess the impact of VD3 deficiency on the development of malocclusions. The examination consisted of a medical interview, oral examination, an alginate impression and radiological imaging, orthodontic assessment, and taking a venous blood sample for VD3 level testing. In about 42.1% of patients, the presence of a skeletal defect was found, and in 46.5% of patients, dentoalveolar malocclusion. The most common defect was transverse constriction of the maxilla with a narrow upper arch (30.7%). The concentration of vitamin 25 (OH) D in the study group was on average 23.6 ± 10.5 (ng/mL). VD3 deficiency was found in 86 subjects (75.4%). Our research showed that VD3 deficiency could be one of an important factor influencing maxillary development. Patients had a greater risk of a narrowed upper arch (OR = 4.94), crowding (OR = 4.94) and crossbite (OR = 6.16). Thus, there was a link between the deficiency of this hormone and the underdevelopment of the maxilla.

Schemes for Drug-Induced Treatment of Osteonecrosis of Jaws with Particular Emphasis on the Influence of Vitamin D on Therapeutic Effects.

Drugs that inhibit bone resorption are prescribed most often by orthopedists, hematologists, or oncologists. Dental practice rarely draws attention to their importance and the effects they carry. The problem concerns mainly older people owing to oncological problems or postmenopausal consequences, but everyone can be at risk. Carefully conducted interviews and analysis of history and disease should always be performed before any action is taken by patients taking this type of medicine. Further action should consider possible complications and, above all, the risk of their occurrence. In this article, the most important issues related to the treatment of drug-induced osteonecrosis of the jaws (ONJ) are raised, including medication-related osteonecrosis of the jaw (MRONJ); conservative treatment, including the use of laser; and the impact of vitamin D supplementation on the overall treatment, prognosis, and prevention before complication, which is osteonecrosis of the jaw in the course of treatment with bisphosphonates and other drugs predisposing to MRONJ, such as denosumab and angiogenesis inhibitors. The degree of osteonecrosis is also critical, as it is possible to avoid surgical procedures for only conservative methods that sometimes bring good results. Surgical treatment of advanced stages is complicated and carries a high risk of error and complications. MRONJ is a disease that is easy to avoid, but it is difficult to treat and treatment sometimes leads only to a partial remission of the disease, not a complete cure.

Factors influencing an eruption of teeth associated with a dentigerous cyst: a systematic review and meta-analysis.

BACKGROUND: A dentigerous cyst (DC) is a pathology embracing the crown of an unerupted tooth at risk of malignant transformation. The causal tooth is usually removed together with the cyst. However, if there are orthodontic contraindications for extraction, two questions arise. (1) Which factors favor spontaneous eruption? (2) Which factors imply the necessity of applying orthodontic traction? This systematic review aimed to identify factors conducive/inconducive to the spontaneous eruption of teeth after dentigerous cyst marsupialization. METHODS: In accordance with the PRISMA guidelines, the main research question was defined in the PICO format (P: patients with dentigerous cysts; I: spontaneous tooth eruption after surgical DC treatment; C: lack of a spontaneous tooth eruption after surgical DC treatment; O: determining factors potentially influencing spontaneous tooth eruption). The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched for keywords combining dentigerous/odontogenic/follicular cysts with teeth and/or orthodontics, as well as human teeth and eruption patterns/intervals/periods/durations. The following data were extracted from the qualified articles (4 out of 3005 found initially): the rate of tooth eruption after surgical treatment of the cyst, the age and sex of the patients, the perpendicular projection distance between the top of the tooth cusp and the edge of the alveolar process, tooth angulation, the root formation stage, the cyst area, and the eruption space. The articles were subjected to risk of bias and quality analyses with the ROBINS-I protocol and the modified Newcastle-Ottawa QAS, respectively. Meta-analyses were performed with both fixed and random effects models. The GRADE approach was used to evaluate the quality of the evidence. The systematic review was registered in PROSPERO under ID CRD42020189044. RESULTS: Nearly 62% of DC-associated premolars erupted spontaneously after cyst marsupialization/decompression. Young age (mean = 10 years) and root formation not exceeding 1/2 of its fully developed length were the factors likely to favor spontaneous eruption. CONCLUSION: The small number of published studies, as well as their heterogeneity and the critical risk of bias, did not allow the creation of evidence-based protocols for managing teeth with DC after marsupialization. More high-quality research is needed to draw more reliable conclusions.

Analysis of alveolar ridge width in an area of central lower incisor using cone-beam computed tomography in vivo.

BACKGROUND: Planning a comprehensive dental treatment should include assessment and classification of the condition of the alveolar ridge. Existing classifications are insufficient. This study aimed to investigate the frequency of bone deficiencies in the anterior mandible and to develop an extension of one of the alveolar bone dehiscence classification. METHODS: Cone-beam computed tomography scans of 100 adults with the mean age of 36.75 ±â€¯11.77 years were analyzed. Measurements were taken from the 31. tooth. RESULTS: The presence of any bone defect was found in 91 (91%) of cases. Fenestrations were detected in 9% of study images, and dehiscence were detected in 90% of study images. A thin alveolar plate of below 0.2 mm independent from the side was found in 37 (37%) of cases. The mean height of buccal fenestration was 3.10 ±â€¯1.09 mm, and the mean height of lingual fenestration was 2.73 ±â€¯0.91 mm. The mean height of buccal dehiscence was 4.39 ±â€¯1.82 mm, and the mean height of lingual dehiscence was 4.27 ±â€¯2.49 mm. CONCLUSIONS: An attempt to restore the correct morphology of the alveolar process after improper treatment constitutes a therapeutic challenge. The frequent occurrence of bone deficiency prompts establishing safe treatment planning strategies, including careful assessment of the alveolar process supported by the comprehensive classification of bone defects.

Expression of syndecan-1 in oral cavity squamous cell carcinoma.

Syndecan-1 (SDC1) belongs to heparan sulfate proteoglycans which may interact with different growth factors, cytokines, morphogens and promote tumor growth and invasion. The aim of the present study was to assess the immunohistochemical expression of syndecan-1 in oral squamous cell carcinoma (OSCC) and oral cysts. Evaluation of the staining pattern with the clinico-histological characteristics of patients was performed. A total of 42 OSCC and 23 oral cysts tissue samples were examined. Statistical tests were used for the significance analysis. The positive expression of syndecan-1 was significantly higher in OSCC compared to cyst located in the oral cavity. Moreover, the results indicate that the intensity of the expression correlated with grading score (p = 0.046). The data indicate that syndecan-1 is altered in OSCC and its excessive amount relates in a predictive manner to neoplastic transformation. As such, SDC1 expression may be used as an adjunctive biomarker in molecular diagnostics of oral squamous cell carcinoma.

Potential of Using Shear Wave Elastography in the Clinical Evaluation and Monitoring of Changes in Masseter Muscle Stiffness.

The study aimed to evaluate masseter muscle stiffness in adult healthy volunteers referred to a massage treatment and also to investigate whether shear-wave elastography can be used to monitor the effect of massage on the masseter muscle. The study included 21 healthy volunteers, who were subjected to a 30-minute massage of the masseter muscle. Muscle stiffness was measured by shear-wave elastography before and directly after the massage. Pain during the massage was assessed using the visual analogue scale (VAS). The data of 20 patients (one excluded due to severe pain) with a median age of 34.5 years were analysed. The stiffness values were 11.46 ± 1.55 kPa before and 8.97 ± 0.96 kPa after the massage (p < 0.0001). The mean drop was 2.49 ± 1.09 kPa. The greatest decrease was observed in people with higher elasticity values before the massage (r = 0.79; p < 0.0001). The median intensity of pain was 7.2 (range: 6-9.5). We concluded that shear-wave elastography is a sensitive tool to monitor changes in the stiffness of the masseter muscle.

Oral cancer: The first symptoms and reasons for delaying correct diagnosis and appropriate treatment.

BACKGROUND: The first symptoms of oral cancer are nonspecific. They raise suspicions of other, less serious conditions. Treatment of oral cancer is challenging, and the time of its detection and the implementation of appropriate therapy affect the prognosis. OBJECTIVES: To identify predisposing factors, symptoms, time of, and reasons for delays in the diagnosis and appropriate treatment of oral cancer. MATERIAL AND METHODS: This retrospective analysis includes patients who were hospitalized with a diagnosis of carcinoma at the Clinical Department of Maxillofacial Surgery at the 4th Military Clinical Hospital and Polyclinic in Wroclaw, Poland, between 2008 and 2018, and at the Department of Maxillofacial Surgery at Wroclaw Medical University Hospital between 2010 and 2018. The analysis took into account the data obtained from the patients' medical records. RESULTS: This study comprised 305 patients (112 female; 36.7% and 193 male; 63.3%). The most frequent diagnosis was squamous cell carcinoma (N = 294; 96.4%). The floor of the mouth was the most frequent primary site (N = 103; 33.8%), followed by the anterior 2/3 of the tongue (N = 94; 30.8%) and lower gingiva (N = 43; 14.1%). A significant percentage were reported at an advanced stage (73.5% in stages III and IV combined). The reasons for the late-stage diagnoses depended on the patients (40.6%), the doctors (24.9%) or both (10.8%). Only 47.5% of patients reported because of the initial symptom noticed. Nearly half of the patients reported after 3-6 months of observing symptoms, usually to a general practitioner (GP; 35.7%) or a dentist (31.8%). CONCLUSIONS: The oncological awareness of patients and healthcare professionals is an essential issue. Doctors often recommend inappropriate treatment, sometimes without monitoring its effectiveness. Dentists should consider cancer in the differentiation of clinical manifestations of other oral disorders.

A comparative study of osteopontin expression, Ki67 index and prognosis in squamous cell carcinoma and cysts of the oral cavity.

BACKGROUND: Recent studies have shown a strong relationship between the expression of osteopontin and oral carcinogenesis. Osteopontin (OPN) has been shown to play a major role in regulating the aggressiveness of cancer cells and promote tumor growth. Odontogenic cysts are an essential aspect of oral and maxillofacial pathology. They are relatively frequent lesions with different clinical behavior. Some of them may have a proliferative pattern of growth and neoplastic nature. Evaluation of osteopontin expression with Ki-67 index may help examine clinical behavior and recurrence of oral squamous cell cancer and radicular cyst patients. METHODS: A total of 44 oral cavity cancer cases and 21 cysts samples were analyzed by immunohistochemical staining. Data used for analysis were derived from medical records. The following information was obtained from all patients' medical records: survival, age, sex, lymph node status, tumor size, and location, as well as grade and histologic type of tumor. Expression status of OPN and Ki-67 was statistically assessed. RESULTS: Our data demonstrated that for summary immunoreactive scores of OPN and Ki-67 expressions in OSCC vs. RC patients statistical significance was found for both markers' between OSCC and RC groups. Moreover, osteopontin is significantly higher expressed in larger OSCC tumors. CONCLUSIONS: In conclusion, the role of OPN expression both in oral squamous cancer cells and radicular cyst and possible correlation with demographic and clinicopathological features remain undetermined in some aspects, further high-powered studies to develop a more standardized assessment of Ki-67 and osteopontin expression in OSCC and are needed.

Prevalence and Overlaps of Headaches and Pain-Related Temporomandibular Disorders Among the Polish Urban Population.

AIMS: To investigate the prevalence and overlaps of headaches and pain-related temporomandibular disorders (TMD) among the Polish urban population. METHODS: The study was conducted in four Polish cities (Wroclaw, Lublin, Katowice, and Lodz) between February and November 2017. Participation in the study was voluntary. The examination consisted of two parts: a clinical examination of TMD using the Diagnostic Criteria for TMD Examination Form and the Head-HUNT Study questionnaire filled in by the participants to determine the occurrence and type of headaches. An experienced and qualified clinician trained all the examiners in the clinical examination protocol. Statistical analyses were based on descriptive and nonparametric statistics. In addition, univariate logistic regression was used. The significance level was set at α = .05. RESULTS: Overall, 213 individuals were examined (149 women and 64 men). The mean age of the participants was 37 ± 15.82 years. The diagnosis for 55.9% of the participants was pain-related TMD, including myalgia (47.4%), myofascial pain (14.1%), arthralgia (21.1%), or headache attributed to TMD (10.3%). In the study population, 48.8% were diagnosed with temporomandibular joint disorders, most frequently disc displacement with reduction (47.9%). A total of 73% of the individuals had experienced headaches in the previous 12 months. The majority of the participants described the headache episodes as occurring less than 7 days/month and lasting less than 4 hours. Among people with painful TMD, the frequency of headaches was almost twice as high as that in nondisordered individuals (48.35% and 25.35%, respectively; P < .0001). The logistic regression model confirmed a significant overlap between headache and painful TMD (OR = 4.77, 95% CI 2.44-9.32, P = .0000). For the entire studied population, no statistically significant connections were established between the occurrence of identified TMJ disorders and headache reports or diagnoses (P > .05). CONCLUSION: Headaches and pain-related TMD are major problems among the Polish urban population. Headache was a much more frequent problem for participants with painful TMD. This issue requires further research and identification of cause-and-effect relationships. Considering the entire studied population, the relationship between identified TMJ disorders and headache is negligible.