Assessing the Efficacy of AI Segmentation in Diagnostics of Nine Supernumerary Teeth in a Pediatric Patient.

We present a very rare case of a child with nine supernumerary teeth to analyze the potential, benefits, and limitations of artificial intelligence, as well as two commercial tools for tooth segmentation. Artificial intelligence (AI) is increasingly finding applications in dentistry today, particularly in radiography. Special attention is given to models based on convolutional neural networks (CNN) and their application in automatic segmentation of the oral cavity and tooth structures. The integration of AI is gaining increasing attention, and the automation of the detection and localization of supernumerary teeth can accelerate the treatment planning process. Despite advancements in 3D segmentation techniques, relying on trained professionals remains crucial. Therefore, human expertise should remain key, and AI should be seen as a support rather than a replacement. Generally, a comprehensive tool that can satisfy all clinical needs in terms of supernumerary teeth and their segmentation is not yet available, so it is necessary to incorporate multiple tools into practice.

Effectiveness of Plasma-Rich Fibrin and De-Epithelialized Free Gingival Graft in the Treatment of Gingival Recessions.

Introduction/Aim: Soft tissue dehiscences such as gingival recessions are a very common problem that we face in modern periodontics. This clinical study aimed to analyze the effectiveness of surgical procedures using a de-epithelialized gingival graft (DGG) combined with a coronally advanced flap and to evaluate the application of plasma-rich fibrin (PRF). Methods: The study included 40 teeth (20 patients) with Miller class I and II gingival recessions. Twenty recessions (20 patients) were treated utilizing the de-epithelialized gingival graft in combination with the coronally advanced flap, and on the opposite side of the jaw, the same number of recessions were treated utilizing plasma-rich fibrin combined with the coronally advanced flap. To evaluate tissue condition and the clinical parameters before and after the surgical procedure, the following parameters were used: the degree of epithelial attachment (DEA), the width of keratinized gingiva (WKG), and the vertical depth of recession (VDR). Results: based on the achieved results and the analysis of clinical parameters, a statistically significant reduction in the vertical depth of recession was proven in both groups, with very similar mean percentages of root coverage, with the difference being that the stability of the soft tissues of the treated region was more visible in the DGG. Conclusion: using modern surgical procedures allows the regeneration of not only the soft tissues but also deeper periodontal tissues.

Possible association of methotrexate use with osteonecrosis of the jaw: Systematic review.

The aim was to search systematically, evaluate, and then summarize scientific literature about possible methotrexate-associated osteonecrosis of the jaw (ONJ), its signs and symptoms, diagnosis, treatment, and prognosis in adults. After registration at PROSPERO this systematic review was conducted and reported according to the PRISMA checklist. The following databases were systematically searched: MEDLINE, EBSCO, The Cochrane Central Register of Controlled Trials (Central), SCIndex, Scopus, Google Scholar and Registry of clinical studies with human participants. In total 9 studies with 14 patients were included in the review. All cases of ONJ associated with methotrexate were described in patients suffering from Rheumatoid arthritis (RA), and only about 40% of them were taking other concomitant medication described to be associated with ONJ (bisphosphonates). Both sexes were equally affected, and the patients were rather old (over 60 years if age), already taking methotrexate for more than 12 years on average. Antibiotics were ineffective in the treatment of ONJ; after stopping methotrexate, all lesions healed after several months on average; however, half of the cases required covering of the exposed bone with mucosal flap. Recurrence of the methotrexate-associated ONJ was not observed for at least two years after the lesions were healed. Methotrexate-associated ONJ is serious clinical condition that may occur in patients with RA, but given the small number of cases we have found in the literature, direct involvement of methotrexate in the development of ONJ remains elusive.

Septic arthritis of the temporomandibular joint in adults: Systematic review.

BACKGROUND: Septic arthritis of the temporomandibular joint (SATMJ) is acute or chronic bacterial or fungal infection involving temporomandibular joint (TMJ) space. It is a disease with high mortality in whole body joints, and about three-fourths of survivors have residual malfunctioning of the affected joint. OBJECTIVE: The aim of this review was to search systematically, evaluate and then summarize scientific literature about etiology, signs and symptoms, diagnosis, treatment and prognosis of the SATMJ in adults. METHODS: After registration at PROSPERO this systematic review was conducted and reported according to the PRISMA checklist. The following databases were systematically searched: MEDLINE, EBSCO, The Cochrane Central Register of Controlled Trials (Central), SCIndex, Scopus, Google Scholar and Registry of clinical studies with human participants. RESULTS: In total 37 studies with 91 patients were included in the review. Dominant signs and symptoms of SATMJ were pain and trismus, while fever was infrequent. The most frequent isolates from the TMJ were Staphylococcus aureus and Streptococci; however, less than 20% of patients had data about susceptibility of the isolates to antibiotics. Combination of third generation cephalosporin and metronidazole was the most frequently prescribed empirically, and antibiotics especially active against S. aureus (glycopeptides and anti-staphylococcal beta-lactams) were under-prescribed. Administration of antibiotics was prolonged (median over 30 days), although two weeks are sufficient treatment for SATMJ if right choice of antibiotics was made. There was high rate of repeated surgical interventions (53.5%), which were linked to higher risk of long-term functional defects. CONCLUSIONS: The SATMJ is serious infection that requires early empiric administration of antibiotics with good coverage of Gram-positive bacteria, and subsequent correction of antibiotic therapy according to susceptibility of isolates. Appropriate antibiotic therapy decreases risk of long-term functional disorders.

N-Acetylcysteine Protects against the Anxiogenic Response to Cisplatin in Rats.

Since cisplatin therapy is usually accompanied with numerous toxicities, including neurotoxicity, that involve tissue oxidative damage, the aim of this study was to evaluate the possible protective effect of N-acetylcysteine (NAC) on the anxiogenic response to cisplatin (CIS). Thirty-two male Wistar albino rats divided into four groups (control, cisplatin, NAC, and CIS + NAC). All treatments were delivered intraperitoneally. On day one, the control and cisplatin groups received saline while the NAC and CIS + NAC groups were administered with NAC (500 mg/kg). On the fifth day, the control group received saline while the CIS group was treated with cisplatin (7.5 mg/kg), the NAC group again received NAC (500 mg/kg), and the CIS + NAC group was simultaneously treated with cisplatin and NAC (7.5 and 500 mg/kg, respectively). Behavioral testing, performed on the tenth day in the open field (OF) and elevated plus maze (EPM) tests, revealed the anxiogenic effect of cisplatin that was significantly attenuated by NAC. The hippocampal sections evaluation showed increased oxidative stress (increased lipid peroxidation and decline in antioxidant enzymes activity) and proapoptotic action (predominantly by diminished antiapoptotic gene expression) following a single dose of cisplatin. NAC supplementation along with cisplatin administration reversed the prooxidative and proapoptotic effects of cisplatin. In conclusion, the results obtained in this study confirmed that antioxidant supplementation with NAC may attenuate the cisplatin-induced anxiety. The mechanism of anxiolytic effect achieved by NAC may include the decline in oxidative damage that down regulates increased apoptosis and reverses the anxiogenic action of cisplatin.

Stromal reaction and prognosis in acinic cell carcinoma of the salivary gland.

INTRODUCTION: Primary acinic cell carcinoma (ACC) is an uncommon malignant neoplasm of the salivary gland (SG), which usually presents as slow growing tumor. CASE REPORT: We reported a 69-year-old woman with tumor in the right parotid gland with a 5-year progress. Biopsy sections revealed a hybrid form of ACC with a low- and high-grade component and prominent lymphoid tissue in tumor stroma. Immunohistochemistry was performed to define the molecular profile of this unusual ACC, with special interest for stromal influence on to the proliferative activity of ACC with dedifferentiation. We detected that the level and the type of stromal lymphoid reaction (particularly CD8+/CD4+ ratio) had a significant influence on to Ki-67 index in the high-grade component of ACC, as well as the involvement of the CXCR4 signaling axis in the stromal reaction influence. CONCLUSION: We suggest that tumor stroma may be a source of potential new tumor biomarkers which can determine the aggressivity of this tumor.