Retrospective study of the morphology of third maxillary molars among the population of Lower Silesia based on analysis of cone beam computed tomography.

INTRODUCTION: Understanding the anatomy of root canal systems and being aware of their variations is crucial for successful endodontic treatment. Specifically, the intricate and diverse nature of the root anatomy in maxillary third molars poses a significant challenge for dental clinicians. The study analyzed the morphology of the root canal system in maxillary third molars among residents of the Lower Silesia region in Poland using cone beam computed tomography (CBCT). MATERIAL AND METHODS: This retrospective cross-sectional imaging study was conducted at the X-Ray Diagnostics Laboratory of the Academic Dental Polyclinic of Wroclaw Medical University, Poland. The study evaluated 316 CBCT scans and included 196 maxillary third molars. They were obtained from 118 females and 78 males over the age of 18, in the period from January to April 2022 (three consecutive months). The number of roots, root canals, and root canal configurations according to Vertucci's classification were analyzed. RESULTS: Three-rooted maxillary molars were found most often (64.29%), followed by single-rooted (24.49%), two-rooted (7.65%), and four-rooted (3.57%) teeth. Among all the roots examined, Vertucci Type I root canals were the most prevalent. Our research found that single-rooted forms (40 teeth, 33.89% vs. 8 teeth, 10.26%, p = 0.0013) of maxillary third molars were significantly more common in females than in males. However, three-rooted forms (62 teeth, 79.49% vs. 64 teeth, 54.24%, p = 0.0013) of maxillary third molars were significantly more common in males than in females. DISCUSSION: In the Lower Silesia region, the typical maxillary third molar in the Polish population has a three-rooted structure with Vertucci Type I root canal configuration. We noted a sex-dependent correlation in maxillary third molar morphology, with single-rooted forms more prevalent in women and three-rooted forms in men.

Chitin scaffolds derived from the marine demosponge Aplysina fistularis stimulate the differentiation of dental pulp stem cells.

The use of stem cells for tissue regeneration is a prominent trend in regenerative medicine and tissue engineering. In particular, dental pulp stem cells (DPSCs) have garnered considerable attention. When exposed to specific conditions, DPSCs have the ability to differentiate into osteoblasts and odontoblasts. Scaffolds are critical for cell differentiation because they replicate the 3D microenvironment of the niche and enhance cell adhesion, migration, and differentiation. The purpose of this study is to present the biological responses of human DPSCs to a purified 3D chitin scaffold derived from the marine demosponge Aplysina fistularis and modified with hydroxyapatite (HAp). Responses examined included proliferation, adhesion, and differentiation. The control culture consisted of the human osteoblast cell line, hFOB 1.19. Electron microscopy was used to examine the ultrastructure of the cells (transmission electron microscopy) and the surface of the scaffold (scanning electron microscopy). Cell adhesion to the scaffolds was determined by neutral red and crystal violet staining methods. An alkaline phosphatase (ALP) assay was used for assessing osteoblast/odontoblast differentiation. We evaluated the expression of osteogenic marker genes by performing ddPCR for ALP, RUNX2, and SPP1 mRNA expression levels. The results show that the chitin biomaterial provides a favorable environment for DPSC and hFOB 1.19 cell adhesion and supports both cell proliferation and differentiation. The chitin scaffold, especially with HAp modification, isolated from A. fistularis can make a significant contribution to tissue engineering and regenerative medicine.

The impact of socioeconomic status, general health and oral health on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health among Polish older adults.

BACKGROUND: The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland. METHODS: The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P - Poisson model, NB-Negative Binomial model, ZIP - Zero Inflated Poisson model, ZINB - Zero Inflated Negative Binomial model. RESULTS: The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms. CONCLUSION: The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.

Therapeutic Potential of Dental Pulp Stem Cells According to Different Transplant Types.

Stem cells are unspecialised cells capable of perpetual self-renewal, proliferation and differentiation into more specialised daughter cells. They are present in many tissues and organs, including the stomatognathic system. Recently, the great interest of scientists in obtaining stem cells from human teeth is due to their easy availability and a non-invasive procedure of collecting the material. Three key components are required for tissue regeneration: stem cells, appropriate scaffold material and growth factors. Depending on the source of the new tissue or organ, there are several types of transplants. In this review, the following division into four transplant types is applied due to genetic differences between the donor and the recipient: xenotransplantation, allotransplantation, autotransplantation and isotransplantation (however, due to the lack of research, type was not included). In vivo studies have shown that Dental Pulp Stem Cells (DPSCs)can form a dentin-pulp complex, nerves, adipose, bone, cartilage, skin, blood vessels and myocardium, which gives hope for their use in various biomedical areas, such as immunotherapy and regenerative therapy. This review presents the current in vivo research and advances to provide new biological insights and therapeutic possibilities of using DPSCs.

Gender-wise comparison of oral health quality of life and its relationship with oral health parameters among elderly from Wroclaw, south-west Poland.

BACKGROUND: In recent years, there has been an increase of aging population with longer life expectancy in females. This study aims to compare some oral health parameters and quality of life in the elderly. METHODS: The survey involved 500 urban residents (Wroclaw, Poland) aged 65 and older, of both gender. Socio-demografic data were assessed by self-reported questionnaire. Clinical examination included oral health assessment by the World Health Organization criteria with extension and oral dryness (Chalacombe scale). Quality of Life (QoL) was evaluated using Euro-Quality of Life, Oral Health Impact Profile-14 and Patient Health Questionnaire-9, which were validated for the Polish population. The relationship strength between psychometric scale scores and sociodemographic and clinical factors was determined by calculating Spearman's linear correlation coefficient values and regression coefficient values. RESULTS: There was no gender-wise differences in oral health parameters, except for a higher number of decayed teeth in males (DT 1.9±3.2 vs 1.2±2.4; p = 0.34). Oral dryness was diagnosed significantly more frequently in females then males (36.9% vs. 25.5%; p = 0.076). The males were significantly more likely to have high treatment needs (36.1% vs. 26.9%; p = 0.032) and they required urgent dental treatment (7.2% vs. 2.8%; p = 0.022). There were no significant differences in terms of QoL evaluated by EQ-5D, EQ-5D VAS or OHIP-14 questionnaires between males and females (0.832±0.194 vs 0.855±0.197, 67.9±10.9 vs 66.1±18.6, 7.2±12.9 vs 8.5±14.0, respectively; p > 0.05). However, females presented the higher severity of depressive symptoms measured by the PHQ-9 questionnaire (4.0±4.1 vs. 2.8±3.8; p<0.001). CONCLUSION: It can be concluded that the independent predictors which significantly affect the high QoL scores on the EQ-5D scale were found to be female gender, age below 75, high or middle income, independence in daily life, a low number of comorbidities, lack of oral treatment needs.

Application of Texture and Fractal Dimension Analysis to Evaluate Subgingival Cement Surfaces in Terms of Biocompatibility.

Biocompatibility is defined as "the ability of a biomaterial, prosthesis, or medical device to perform with an appropriate host response in a specific application". Biocompatibility is especially important for restorative dentists as they use materials that remain in close contact with living tissues for a long time. The research material involves six types of cement used frequently in the subgingival region: Ketac Fil Plus (3M ESPE, Germany), Riva Self Cure (SDI, Australia) (Glass Ionomer Cements), Breeze (Pentron Clinical, USA) (Resin-based Cement), Adhesor Carbofine (Pentron, Czech Republic), Harvard Polycarboxylat Cement (Harvard Dental, Great Britain) (Zinc polycarboxylate types of cement) and Agatos S (Chema-Elektromet, Poland) (Zinc Phosphate Cement). Texture and fractal dimension analysis was applied. An evaluation of cytotoxicity and cell adhesion was carried out. The fractal dimension of Breeze (Pentron Clinical, USA) differed in each of the tested types of cement. Adhesor Carbofine (Pentron, Czech Republic) cytotoxicity was rated 4 on a 0-4 scale. The Ketac Fil Plus (3M ESPE, Germany) and Riva Self Cure (SDI, Australia) cements showed the most favorable conditions for the adhesion of fibroblasts, despite statistically significant differences in the fractal dimension of their surfaces.

Does oral dryness influence quality of life? Current perspectives in elderly dental care.

BACKGROUND: The oral condition can functionally, socially and psychologically influence the quality of life. Oral dryness often occurs in the elderly due to the presence of systemic diseases and medications, which favors the development of many lesions and complaints, including dental caries, candidiasis, retention of full removable denture, taste disturbance and it enforces a change in nutrition. OBJECTIVES: The aim of this study was to assess the impact of oral dryness on oral health-related quality of life in older subjects. MATERIAL AND METHODS: Five hundred subjects of both genders, aged 65 and over (mean 74.4 ±7.4) were involved in the study. Oral dryness was evaluated clinically with use of the Challacombe scale (CODS, Clinical Oral Dryness Score). The oral health-related quality of life was assessed by the Oral Health Impact Profile scale (OHIP-14). RESULTS: Oral dryness occurred in 32.8% of subjects, most often on a mild level (29.6%). The average value of the OHIP-14 scale was 8.01 ±13.59. The regression analysis demonstrated a significant association between oral dryness and two domains of the OHIP-14 scale, i.e. functional limitation (p < 0.01) and psychological disability (p < 0.05). CONCLUSIONS: Oral dryness is substantially related to the oral health-related quality of life, which indicates the necessity of monitoring oral dryness as part of routine dental care.

Oral health condition and occurrence of depression in the elderly.

Depression is a common disorder among the elderly; however, it is not a standard element of the ageing process. Depression can affect oral health as a result of neglecting oral hygiene procedures, cariogenic nutrition, avoidance of necessary dental care which leads to an increased risk of dental caries and periodontal disease.Assessment of the relationship of oral health parameters with depression.500 subjects aged ≥65 (mean 74.4 ±â€Š7.4) were involved in the study. Dental condition (decay-missing-filled index [DMFT], number of missing teeth [MT], removable denture wearing, teeth mobility), periodontal condition (bleeding on probing [BoP], pocket depth [PD], loss of attachment), oral dryness (the Challacombe Scale) and depression according to the Patient Health Questionnaire-9 (PHQ-9) scale were assessed.Depression on a minimal level was detected in 60.2% of the subjects, mild-in 22.2%, moderate-in 6.0% and moderately-in 2.6%. The mean of the PHQ-9 scale was 3.56 ±â€Š4.07. Regression analysis showed a positive relationship of the PHQ-9 value with DMFT, the number of MT, oral dryness and with age. No correlation was observed between other examined oral health indicators, such as periodontal condition (BoP, PD, clinical attachment level), periodontitis, removable denture wearing a PHQ-9.The results of our study have shown that among people aged 65 and over, the severity of depression increases with a higher number of MT, the number of decayed teeth, as well as prevalence of oral dryness.

Application of Chitosan and Propolis in Endodontic Treatment: A Review.

Chitosan and propolis are natural substances that can be commonly found in the environment. Chitosan is one of the several cationic polysaccharides found in nature. It is a natural biopolymer transformed from chitin which is a product of crustacean shells. Propolis is produced by honeybees through mixing the secretions of their hypopharyngeal glands with the digested product of resins collected from plants. Due to their excellent chemical and biological properties, chitosan and propolis arouse keen interest in dental science, including endodontics. There are various possibilities for applying propolis and chitosan based medicaments in endodontic treatment of root canals, and what is particularly emphasized is their potential effectiveness against resistant microorganisms such as E. faecalis and C. albicans, as well as biocompatible to the periapical tissues in comparison with the most commonly used agents. They aim at microflora which is difficult to eliminate, and their medicinal properties, including anti-inflammatory, antifungal and antiseptic properties, make them suitable for use in endodontic treatment. Due to the potential side effects of commonly used synthetic drugs and other safety related reasons, natural alternatives for endodontic usage are continuously explored and tested. The paper presents the possibilities of applying propolis and chitosan in endodontic treatment on the basis of chosen articles published in recent years.

Oral Health and Quality of Life in Old Age: A Cross-Sectional Pilot Project in Germany and Poland.

BACKGROUND: The process of ageing influences all dimensions of social life and personal well-being, but the influence of health on different dimensions of quality of life (QoL) among the elderly is rarely examined. OBJECTIVES: The aim of the pilot study is to test the feasibility of a comprehensive study design to evaluate general and dental health as well as QoL in a bi-national sample. In addition, this pilot study should allow for the exploration of potential interactions between QoL, socioeconomic, health and oral health variables. MATERIAL AND METHODS: Individuals aged 64 years and older (n = 100) from university dental clinics of the Wroclaw Medical University, Poland (n = 50) and of the University Hospital in Dresden, Germany (n = 50) were examined. The oral health status of participants was assessed by clinical examination. Socio-demographic, environmental and general health status were evaluated during the medical interview. General quality of life (GQoL) was assessed by an overall question with a visual analogue scale (VAS) from -5 (worst) to +5 (best). Health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) were measured with the EQ-5D and OHIP-14 questionnaires. Statistical analyses comprised Pearson's c2 test, Wilcoxon test, linear regression model for statistical analysis and different multivariate linear regression analyses. RESULTS: For the GQoL-VAS-Score the results for QoL measurements were 1.22 ± 2.62 (x± SD), for EQ-5D-Score 7.45 ± 2.25 (x± SD), and for OHIP-14-ADD-Score 11.04 ± 13.56 (x± SD). Differences between Polish and German populations were observed. CONCLUSIONS: The study design proved to be feasible for a senior population. The overall GQoL question, EQ-5D and OHIP-14 were regarded as appropriate instruments. Subjective and objective (oral) health measures showed differences between Germany and Poland. For methodological reasons, these differences are not generalizable, but of value for study hypotheses in larger samples.

Salivary lactate dehydrogenase and aminotransferases in diabetic patients.

Diabetes mellitus (DM) is a group of metabolic diseases resulting from impaired insulin secretion and/or action. DM is characterized by hyperglycemia that can lead to the dysfunction or damage of organs, including the salivary glands.The aim of this study was to compare the levels of salivary lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in diabetic patients.The study was approved by the Bioethics Committee of Wroclaw Medical University (Poland). The study comprised 90 adults of both sexes, aged 21 to 57 years. The patients were divided into 3 groups: type 1 diabetics (D1), type 2 diabetics (D2), and a healthy control group (C). Each group consisted of 30 age- and sex-matched subjects. Total protein (P, by Lowry method), LDH, AST, ALT (with Alpha Diagnostics kits), and salivary flow rate were measured in unstimulated mixed saliva. The level of glycosylated hemoglobin (HbA1c) was measured with DCA 2000 Reagent Kit. The obtained data were analyzed using the Mann-Whitney U test and the Spearman rank at a significance level of P < 0.05 with the use of STATISTICA 9.0 software.In comparison with C, D1 presented a significantly higher activity of LDH (P < 0.001), AST (P < 0.001), and ALT (P < 0.01), whereas D2 indicated higher levels of LDH (P < 0.001) and ALT (P < 0.05) compared with C. Comparing D1 to D2, approximately 3-fold higher activity of AST (P < 0.01) and approximately 4.5-fold higher activity of ALT (P < 0.01) was observed.Higher levels of salivary LDH, AST, and ALT in D1 compared with D2 and C confirm that salivary glands of D1 might be attributed to autoimmunological damage associated with the pathomechanism of DM.

Validation of the Polish version of the oral health impact profile-14.

BACKGROUND: The Oral Health Impact Profile-14 (OHIP-14) is an example of a specific questionnaire used for assessing the quality of life in relation to oral health. OBJECTIVES: The aim of this study was to validate the Polish version of the original English Short-Form OHIP-14 questionnaire. MATERIAL AND METHODS: The Polish version of the OHIP-14 instrument had been prepared in accordance with generally accepted standards. The main study was conducted among a group of 150 subjects of both genders, aged from 35 to 91 who were randomly selected. Statistical analysis was made by STATISTICA software using the Cronbach alpha reliability test, Mann-Whitney U test, multiple comparison post-hoc test - LSD and Spearman`s correlation coefficient. RESULTS: The total OHIP-14 score was 8.72 ± 13.39, out of which the highest value was for item 4 (uncomfortable to eat 0.89 ± 1.19). The value of the alpha Cronbach coefficient was above 0.9 for all 14 items of the OHIP-14 instrument indicating excellent internal consistency. Positive relationships between all items of the matrix of the inter-items correlation coefficients were found. The value of coefficients ranged from 0.56 to 0.90 at a significance level of p < 0.01. Construct validity was supported by the fact that oral health condition was correlated with total OHIP score. It was observed that there is a correlation between the quality of life evaluated with the OHIP-14 test and dental condition, dental needs, wearing removable dentures and self-assessment of general health and oral health condition. CONCLUSIONS: The obtained data indicated the reliability and validity of OHIP-14 instrument for the assessment of oral health-related quality of life for in Polish adult population.

Selected antibacterial factors in the saliva of diabetic patients.

OBJECTIVE: Diabetes mellitus leads to many systemic complications, including changes in the morphology, function of the salivary glands, and the composition of saliva. DESIGN: The study comprised a randomly selected 156 adults, of both genders, aged from 21 to 79, out of which patients with diabetes type 1 and 2, and healthy subjects forming two control age- and gender matched to the ill subjects. In unstimulated mixed saliva, total protein, peroxidase, myeloperoxidase and immunoglobulin A were measured as well as salivary flow rate. The periodontal condition was assessed with the use of GI, mSBI and PSR index. The obtained data were analysed with the use of U Mann-Whitney's test, Spearman's rang correlation and Chi-square test at a significant level of p < 0.05 with use of Statistica 9.0 software. RESULTS: Type 1 diabetics in comparison to healthy age and gender matched control group had a lower salivary flow rate (p < 0.01), a higher content of total protein (p < 0.01), myeloperoxidase (p < 0.001) and immunoglobulin A (p < 0.001). Similarly, type 2 diabetics in comparison to control subjects had a higher level of total protein concentration (p < 0.01), myeloperoxidase (p < 0.05) and immunoglobulin A (p < 0.001). We also found worse periodontal condition. CONCLUSION: Within the limitation of the study it may be stated that diabetes type 1 and 2 can cause abnormalities in salivary glands function resulting in the diminishing of salivary flow rate and the increase in total protein content. Higher levels of myeloperoxidase and IgA in the saliva can be linked to worse periodontal condition in the diabetic patients.

Prevalence of xerostomia and the salivary flow rate in diabetic patients.

BACKGROUND: Diabetes is a metabolic disease characterized by hyperglycemia, which results from relative or absolute insulin deficiency. One of the first oral symptoms of diabetes is xerostomia. OBJECTIVES: The aim of the study was to determine the prevalence of the xerostomia symptoms and salivary flow rate in diabetic patients according to the type of diabetes, the level of metabolic control and the duration of the disease. MATERIAL AND METHODS: The study involved 156 adult patients of both sexes including 34 patients with diabetes type 1 (group C1), 59 with diabetes type 2 (group C2), and 63 generally healthy individuals as two control groups, sex- and age-matched to the diabetic group. The patients suffering from both types of diabetes were additionally subdivided according to the level of metabolic control and the duration of the disease. Xerostomia was diagnosed with the use of a specially prepared questionnaire and Fox's test. Moreover, the salivary flow rate of resting mixed saliva was measured. RESULTS: In type 1 diabetics, a significantly lower salivary flow rate in comparison to the age-matched control group (0.38 ± 0.19 mL/min vs. 0.53 ± 0.20 mL/min, p < 0.01) was found. However in type 2 diabetics, a slight lower salivary flow rate was noticed (on average, 20% lower). Dry mouth was far more frequently diagnosed in type 1 diabetics than in the control group. CONCLUSIONS: In type 1 diabetics, in comparison to healthy subjects, a significantly lower resting flow rate of saliva and significantly higher prevalence of xerosomia were observed, but in type 2 diabetics, only a trend of such variability was observed.