Diagnostic Biomarkers for Gestational Diabetes Mellitus Using Spectroscopy Techniques: A Systematic Review.

Gestational diabetes mellitus (GDM) is associated with adverse maternal and foetal consequences, along with the subsequent risk of type 2 diabetes mellitus (T2DM) and several other diseases. Due to early risk stratification in the prevention of progression of GDM, improvements in biomarker determination for GDM diagnosis will enhance the optimization of both maternal and foetal health. Spectroscopy techniques are being used in an increasing number of applications in medicine for investigating biochemical pathways and the identification of key biomarkers associated with the pathogenesis of GDM. The significance of spectroscopy promises the molecular information without the need for special stains and dyes; therefore, it speeds up and simplifies the necessary ex vivo and in vivo analysis for interventions in healthcare. All the selected studies showed that spectroscopy techniques were effective in the identification of biomarkers through specific biofluids. Existing GDM prediction and diagnosis through spectroscopy techniques presented invariable findings. Further studies are required in larger, ethnically diverse populations. This systematic review provides the up-to-date state of research on biomarkers in GDM, which were identified via various spectroscopy techniques, and a discussion of the clinical significance of these biomarkers in the prediction, diagnosis, and management of GDM.

Success Rates of Zygomatic Implants for the Rehabilitation of Severely Atrophic Maxilla: A Systematic Review.

Zygomatic implants are a treatment solution for patients with severe maxillary atrophy. This treatment option allows delivering immediate fixed teeth within 24 h. Numerous peer-reviewed publications have reported different success rates, resulting in a disagreement on the topic. Therefore, the overall efficacy and predictability of this rehabilitation is still a matter of discussion. With this study, we aimed to identify the published literature on the use of zygomatic implants for the reconstruction of the severely atrophic maxilla and report the cumulative success rate (CSR) as a function of follow-up time. A systematic review of the literature on zygomatic implant for the treatment of severe maxillary atrophy was performed and 196 publications were included in the study. The cumulative success rate of zygomatic implants for the treatment of severe maxillary atrophy was 98.5% at less than 1 year, 97.5% between 1 and 3 years, 96.8% between 3 and 5 years and 96.1% after more than 5 years. The most commonly reported complications were soft tissue dehiscence, rhinosinusitis and prosthetic failures. The treatment of severe lack of bone in the upper maxilla with zygomatic implants is a safe procedure, reaching a cumulative success rate of 96.1% after more than 5 years.

Current Undergraduate Dental Implantology Teaching in UK.

Dental Implants are a popular treatment option for tooth replacement, with documented long-term success and survival rates of more than 95% over a period of 10 years. However, incorporating dental implantology into an undergraduate dental curriculum has issues associated. Therefore, the aim of this research was to examine and evaluate current undergraduate dental implantology education in the UK, investigate the amount of time allocated to this subject and analyse the barriers that are currently impeding the development of the programmes. An online questionnaire hosted by Online Surveys was designed, piloted, and sent to 16 dental schools providing undergraduate education in the UK. Ethical approval was gained from The University of Salford to conduct the study. Out of the 16 dental schools contacted, eight questionnaire responses were received, hence a response rate of 50% was achieved. The hours dedicated to the implant teaching programme varied from 3 h to 25 h, with a mean average of 11 h. It was identified from the results that no teaching of dental implantology was conducted in year 2; 12% of the schools responded that the subject was taught in year 1, 37% in year 3, 75% in year 4 and 50% in year 5. The methods used to deliver the programme were mainly lecture-based teaching, with only one dental school allowing students to place implants on patients. The main barriers to progression of the programme were financial (75%), followed by time limitations imposed by the curriculum (37%) and liability insurance (37%). However, there appears to be a consensus that further training beyond bachelor's degree level is required to teach implantology effectively.

3D Guided Dental Implant Placement: Impact on Surgical Accuracy and Collateral Damage to the Inferior Alveolar Nerve.

An increase in the number of implants placed has led to a corresponding increase in the number of complications reported. The complications can vary from restorative complications due to poor placement to damage to collateral structures such as nerves and adjacent teeth. A large majority of these complications can be avoided if the implant has been placed accurately in the optimal position. Therefore, the aim of this in vitro pilot study was to investigate the effect of freehand (FH) and fully guided (FG) surgery on the accuracy of implants placed in close proximity to vital structures such as the inferior alveolar nerve (IAN). Cone-beam computed tomography (CBCT) and intraoral scans of six patients who have had previous dental implants in the posterior mandible were used in this study. The ideal implant position was planned. FG surgical guides were manufactured for each case. In this study, the three-dimensional 3D printed resin models of each of the cases were produced and the implants placed using FG and FH methods on the respective models. The outcome variables of the study, angular deviations were calculated and the distance to the IAN was measured. The mean deviations for the planned position observed were 1.10 mm coronally, 1.88 mm apically with up to 6.3 degrees' angular deviation for FH surgery. For FG surgical technique the mean deviation was found to be at 0.35 mm coronally, 0.43 mm apically with 0.78 degrees angularly respectively. The maximum deviation from the planned position for the apex of the implant to the IAN was 2.55 mm using FH and 0.63 mm FG. This bench study, within its limitations, demonstrated surgically acceptable accuracy for both FH and FG techniques that would allow safe placement of implants to vital structures such as the IAN when a safety zone of 3 mm is allowed. Nevertheless, a better margin of error was observed for FG surgery with respect to the angular deviation and controlling the distance of the implant to the IAN using R2 Gate® system.

Periostin: Immunomodulatory Effects on Oral Diseases.

Periostin is a microcellular adapter protein. It plays a wide range of essential roles during the development and in immunomodulation. Periostin is a prominent contributor during the process of angiogenesis, tumorigenesis, and cardiac repair. It is expressed in periodontal ligaments, tendons, skin, adipose tissues, muscle, and bone. This is a protein-based biomolecule that has the diagnostic and monitoring capability and can potentially be used as a biomarker to detect physiological and pathological conditions. The aim of the present review was to explore the periostin morphology and associated structural features. Additionally, periostin's immunomodulatory effects and associated biomarkers in context of oral diseases have been discussed.

Role of artificial intelligence and vibrational spectroscopy in cancer diagnostics.

INTRODUCTION: Raman and Infrared spectroscopic techniques are being used for the analysis of different types of cancers and other biological molecules. It is possible to identify cancers from normal tissues both in fresh and fixed tissues. These techniques can be used not only for the early diagnosis of cancer but also for monitoring the progression of the disease. Furthermore, chemical pathways to the progression of the disease process can be understood and followed. AREAS COVERED: More recently, Artificial Intelligence (AI), Neural Network (NN), and Machine Learning are being combined with spectroscopy, which is making it easier to understand the chemical structural details of cancers and biological molecules more precisely and accurately. In this report, these aspects are being outlined by using breast cancer as a specific example. EXPERT OPINION: A pathway showing to combine vibrational spectroscopy with AI and ML has immense potential in predicting various stages of different disease processes, in particular, in cancer diagnosis, staging, and designing treatment. This will result in improved patient care pathways.

Outbreak Of Chikungunya Virus In Karachi, Pakistan.

In this report, aim is to highlight the recent outbreak of Chikungunya virus in Karachi, the largest city of Pakistan. Chikungunya virus is transmitted by infected Aedes mosquitoes. Firstly, described as an outbreak in southern Tanzania in 1952 and later spread in Africa, Asia, Europe, and Pacific and Indian Oceans. In late 2016, the virus has been reported to cause severe morbidity and fatality among patients reporting to the local government hospital in Malir region of Karachi. Patients came to emergency ward with complaints of fever, skin rashes, fatigue and joint pain. To improve the existing knowledge and current epidemic in this area we reported the causes, sign & symptoms, precautions and treatment measures for the control from this virus spreading in mass gatherings. In addition, self-awareness, preventive measures implementation by public health officials in response to reports of Chikungunya virus will help to evaluate the outbreak settings.

Human Oral Defensins Antimicrobial Peptides: A Future Promising Antimicrobial Drug.

The nature and structural composition of antimicrobial peptides are derived from their innate immune response and they are active against various bacteria, fungi and other microorganisms. The aim of this paper was to pool up the literature on the features of human oral defensins antimicrobial peptides. The defensins showed antimicrobial activity against Gram-positive and Gram-negative bacteria and various fungi and viruses. As with their other properties like antiviral, antifungal and antibacterial, human defensins peptides are thought to have a unique amino acid-based structure with Disulphide Bridge which makes them synthesize chemically or naturally with the help of these bacteria. The data contributing in this study was gathered from the research papers published in English language in the last twenty-five years. This literature mainly elaborates the general and analytical characteristics of antimicrobial peptides in the human oral cavity; focusing on the types, biochemistry, and mechanism of action of defensins with its clinical importance.

Human salivary protein extraction from RNAPro·SAL™, Pure·SAL™, and passive drooling method.

OBJECTIVE: The aim of the current study was to carry out a preliminary validation of devices for standardized collection of whole mouth fluid (WMF) in comparison to the passive drooling method for protein analysis in healthy subjects. MATERIALS AND METHODS: A carefully designed sample collection/pretreatment protocol is crucial to the success of any saliva proteomics project. In this study, WMF was collected from healthy volunteers (n = 10, ages: 18-26 years). Individuals with any oral disease were excluded from the study group. In our study, we evaluated the following collection methods; the classical passive drooling method (unstimulated whole saliva) and standardized tools for saliva collection (Pure·SAL™, and RNAPro·SAL™) from Oasis Diagnostics® Corporation (Vancouver WA, USA). For estimation of protein levels, we used the bicinchoninic acid assay and protein assay kit (Thermo Fisher). The two-dimensional gel electrophoresis sample analysis was carried out for the estimation of proteins in one of the samples. RESULTS: When gels were compared, the difference was seen in the resolution of spots. Protein spots were fading from high- to low-molecular weight masses. Hence, advanced devices in comparison to spitting method resulted in much clearer protein spots which in turn prove the validation of devices. CONCLUSIONS: In this study, we concluded that protein extraction could be possible by both methods such as passive drooling method and through advanced saliva collection devices (Pure·SAL™ and RNAPro·SAL™).

Advancing Point-of-Care (PoC) Testing Using Human Saliva as Liquid Biopsy.

Salivary diagnostics is an emerging field for the encroachment of point of care technology (PoCT). The necessity of the development of point-of-care (PoC) technology, the potential of saliva, identification and validation of biomarkers through salivary diagnostic toolboxes, and a broad overview of emerging technologies is discussed in this review. Furthermore, novel advanced techniques incorporated in devices for the early detection and diagnosis of several oral and systemic diseases in a non-invasive, easily-monitored, less time consuming, and in a personalised way is explicated. The latest technology detection systems and clinical utilities of saliva as a liquid biopsy, electric field-induced release and measurement (EFIRM), biosensors, smartphone technology, microfluidics, paper-based technology, and how their futuristic perspectives can improve salivary diagnostics and reduce hospital stays by replacing it with chairside screening is also highlighted.

Salivary IL-8, IL-6 and TNF-α as Potential Diagnostic Biomarkers for Oral Cancer.

Saliva has been useful as a liquid biopsy for the diagnosis of various oral or systemic diseases, and oral squamous cell carcinoma (OSCC) is no exception. While its early detection and prevention is important, salivary cytokines expression, specifically of Interleukin-8 (IL-8), Interleukin-6 (IL-6) and Tumor necrosis factor (TNF-α), does contribute to the pathogenesis of cancer and these cytokines serve as potential biomarkers. Their excessive production plays a role in cancer progression and establishment of angiogenesis. However, other inflammatory or immunological conditions may affect the levels of cytokines in saliva. This article reviews the expression of levels of specific cytokines i.e., IL-8, IL-6 and TNF-α, their signaling pathways in the development of oral cancer, and how they are essential for the diagnosis of OSCC and updates related to it. Apart from serum, the saliva-based test can be a cost-effective tool in the follow-up and diagnosis of OSCC. Moreover, large-scale investigations are still needed for the validation of salivary cytokines.