Measuring job stress of dental workers in China during the COVID-19 pandemic: reliability and validity of the hospital consultants' job stress questionnaire.

BACKGROUND: The Hospital Consultants' Job Stress Questionnaire (HCJSQ) has been widely used to assess sources and levels of job stress. However, its reliability and validity among Chinese dental workers have not been extensively studied. The objective of this study was to assess the reliability and validity of the HCJSQ specifically in Chinese dental workers. METHODS: The HCJSQ was used to explore the sources and the global ratings of job stress among Chinese dental workers. To assess the reliability and validity of the HCJSQ, various statistical measures were employed, including Cronbach's alpha coefficient, Spearman-Brown coefficient, Spearman correlation coefficient, exploratory factor analysis, confirmatory factor analysis, convergent validity, and discriminant validity. RESULTS: Of the participants, 526 (17.4%) reported high levels of stress, while 1,246 (41.3%) and 1,248 (41.3%) reported moderate and low levels of stress, respectively. The Cronbach's alpha coefficient for the modified HCJSQ was 0.903, and the Spearman-Brown coefficient was 0.904. Spearman correlation coefficient between individuals' items and the total score ranged from 0.438 to 0.785 (p < 0.05). Exploratory factor analysis revealed that three factors accounted for 60.243% of the total variance. Confirmatory factor analysis demonstrated factor loadings between 0.624 and 0.834 on the specified items. The fit indices of the confirmatory factor analysis indicated good model fit, with a Root Mean Square Error of Approximation of 0.064, Normative Fit Index of 0.937, Comparative Fit Index of 0.952, Incremental Fit Index of 0.952, Tucker-Lewis index of 0.941, and Goodness of Fit Index of 0.944. Additionally, the convergent validity and discriminant validity showed a good fit for the three-factor model. CONCLUSION: The results of this study confirm that Chinese dental workers experience high levels of stress, and the three-factor model of the HCJSQ proves to be a suitable instrument for evaluating the sources and levels of job stress among Chinese dental workers. Therefore, it is imperative that relevant entities such as hospitals, medical associations, and government take appropriate measures to address the existing situation.

Chronic restraint stress promotes oral squamous cell carcinoma development by inhibiting ALDH3A1 via stress response hormone.

BACKGROUND: Chronic restraint stress (CRS) has iteratively been reported to be possibly implicated in the development of numerous cancer types. However, its role in oral squamous cell carcinoma (OSCC) has not been well elucidated. Here we intended to evaluate the role and mechanism. METHODS: The effects of CRS were investigated in xenograft models of OSCC by using transcriptome sequencing, LC-MS, ELISA and RT-PCR. Moreover, the role of CRS and ALDH3A1 on OSCC cells was researched by using Trans-well, flow cytometry, western blotting, immunofluorescence, ATP activity and OCR assay. Furthermore, immunohistochemical staining was employed to observe the cell proliferation and invasion of OSCC in xenotransplantation models. RESULTS: CRS promoted the progression of OSCC in xenograft models, stimulated the secretion of norepinephrine and the expression of ADRB2, but decreased the expression of ALDH3A1. Moreover, CRS changed energy metabolism and increased mitochondrial metabolism markers. However, ALDH3A1 overexpression suppressed proliferation, EMT and mitochondrial metabolism of OSCC cells. CONCLUSION: Inhibition of ALDH3A1 expression plays a pivotal role in CRS promoting tumorigenic potential of OSCC cells, and the regulatory of ALDH3A1 on mitochondrial metabolism may be involved in this process.

Comprehensive analysis of m6A modifications in oral squamous cell carcinoma by MeRIP sequencing.

N6-methyladenosine (m6A) modifications are the most abundant internal modifications of mRNA and have a significant role in various cancers; however, the m6A methylome profile of oral squamous cell carcinoma (OSCC) in the mRNA-wide remains unknown. In this study, we examined the relationship between m6A and OSCC. Four pairs of OSCC and adjacent normal tissues were compared by Methylated RNA immunoprecipitation sequencing (MeRIP-seq). Gene Ontology, Kyoto Encyclopedia of Genes and Genomes (KEGG), and Ingenuity Pathway Analysis (IPA) analyses were used to further analyze the MeRIP-seq data. A total of 2,348 different m6A peaks were identified in the OSCC group, including 85 m6A upregulated peaks and 2,263 m6A downregulated peaks. Differentially methylated m6A binding sites were enriched in the coding sequence in proximity to the stop codon of both groups. KEGG analysis revealed genes with upregulated m6A-modified sites in the OSCC group, which were prominently associated with the forkhead box O (FOXO) signaling pathway. Genes containing downregulated m6A-modified sites were significantly correlated with the PI3K/Akt signaling pathway, spliceosome, protein processing in the endoplasmic reticulum, and endocytosis. IPA analysis indicated that several genes with differential methylation peaks form networks with m6A regulators. Overall, this study established the mRNA-wide m6A map for human OSCC and indicated the potential links between OSCC and N6-methyladenosine modification.

The prevalence of professional burnout among dentists: a systematic review and meta-analysis.

Professional burnout refers to mental weariness caused by occupational stress. However, there is a lack of systematic studies on the prevalence of professional burnout among dentists. The purpose of this study was to investigate the prevalence of professional burnout among dentists. Databases including PubMed, PsycINFO, Embase, Cochrane, and Web of Science were systematically searched from inception to 28 October 2021. The random-effects model and forest plots were used to assess the pooled prevalence of professional burnout among dentists. A total of 15 studies with a total of 6038 study subjects were included in the meta-analysis, and the overall professional burnout among dentists was 13% (95%CI: 6-23). Subgroup analysis suggested a high prevalence of burnout in Europe, and the least in the Americas. The pooled burnout prevalence in cross-sectional surveys was significantly lower than that in longitudinal studies. In addition, the overall burnout prevalence in the last decade was significantly lower than that of a decade ago. This meta-analysis demonstrated that the prevalence of burnout was relatively low among dentists, and there was a downward trend. Therefore, it is important to continue to pay close attention to the mental health of dentists and effectively prevent and treat professional burnout to better maintain the provision of health care services.

The overall prevalence of professional burnout among dentists was 13%.Subgroup analysis revealed that the prevalence of burnout differed in geographical regions, with the highest in Europe, followed by Asia, and the lowest in America.The pooled burnout prevalence in cross-sectional surveys was significantly lower than that in longitudinal studies. In addition, the overall burnout prevalence in the last decade was significantly lower than that of a decade ago.More attention should be paid to professional burnout among dentists to improve the provision of health care services.

Chronic restraint stress promotes the tumorigenic potential of oral squamous cell carcinoma cells by reprogramming fatty acid metabolism via CXCL3 mediated Wnt/ß-catenin pathway.

Chronic stress promotes tumor progression and may harm homeostasis of energy metabolism by disrupting key metabolic processes. Recently, emerging evidence that chemokines CXCL3 as a novel adipokine plays a new role in lipid metabolism and various human malignancies. However, the role and mechanism of the CXCL3 in oral squamous cell carcinoma (OSCC) progression and reprogramming lipid metabolism induced by chronic restraint stress is unclear. The analysis of transcriptome sequencing, LC-MS, GC-MS, CCK8, cell apoptosis assays, cell cycle analysis, qRT-PCR, ELISA, western blotting, immunofluorescence, immunohistochemistry, RNA interference and lentivirus transfection and a xenograft tumor growth and chronic restraint stress model were used to investigate the role of CXCL3 in the regulation of lipid metabolism and OSCC and explore the underlying molecular mechanisms. We showed that CXCL3 plays a critical role in in fatty acid de novo synthesis and tumor growth induced by chronic restraint stress. We demonstrated that chronic restraint stress promoted lipid accumulation, OSCC growth and metastasis in a mouse xenograft model. CXCL3 knockdown and FH535, an inhibitor of Wnt/ß-catenin pathway, could attenuate fatty acid de novo synthesis, cell proliferation and epithelial-mesenchymal transition induced by chronic restraint stress in OSCC cells. Our findings demonstrate that chronic restraint stress promotes the proliferation and metastasis of OSCC by reprogramming fatty acid metabolism via CXCL3 mediated Wnt/ß-catenin pathway. Our study provides novel insights to help understand the underlying mechanisms of CXCL3 in OSCC progression induced by chronic restraint stress.

Relationship between Job Burnout, Depressive Symptoms, and Career Choice Regret among Chinese Postgraduates of Stomatology.

A qualified Chinese dental postgraduate requires at least eight years of training. The huge academic burden, strict clinical requirements, and high workload increases the risk of job burnout, depression symptoms, and career choice regret of dental postgraduates, which may cause one to waver in their choice of a career as a doctor. Therefore, we aimed at assessing the relationship between job burnout, depressive symptoms, and career choice regret among Chinese dental postgraduates. The Chongqing Stomatological Association conducted an online cross-sectional study among 558 dental postgraduates in China, with an average age of 22.54 ± 2.44. Demographic information, the Maslach Burnout Inventory, the 2-item Primary Care Evaluation of Mental Disorders scale, and career choice regret scale were included in the questionnaire. About 41.0% of dental postgraduates experienced job burnout, 44.1% had depressive symptoms, and 41.6% reported career choice regret. Logistic regression analysis indicated the risk factors for job burnout were time worked/studied per week, depressive symptoms, and career choice regret. Job burnout and career choice regret was significantly related to depressive symptoms (p < 0.001). Risk factors for career choice regret were gender, postgraduate entrance examination score, daily hours of sleep, job burnout, and depressive symptoms. Such results suggest that job burnout, depressive symptoms, and career choice regrets are prevalent among dental postgraduates. Accurate measures should be taken to change this situation.

Multi-omics analysis reveals the effects of microbiota on oral homeostasis.

The oral epithelium's normal morphological structure and function play an important role in maintaining oral homeostasis, among which microbiota and chronic stress are key contributing factors. However, the effects of microbiota and chronic stress on the morphological structures and molecular function of oral homeostasis remain unclear. In this study, morphological staining was used to compare the tongue structure of specific pathogen-free and germ-free mice, and an integrated multi-omics analysis based on transcriptomics, proteomics, and metabolomics was performed to investigate the regulatory mechanisms of microbiota and chronic stress on oral homeostasis. We found that the morphological structure of the tongue in germ-free mice was disordered compared with in specific pathogen-free mice, especially in the epithelium. Multi-omics analysis indicated that differentially expressed molecules of the tongue between germ-free and specific pathogen-free mice were significantly enriched in the mitochondrial metabolic process and immune response. Interestingly, microbiota also significantly influenced the permeability of the oral epithelial barrier, represented by the differential expression of keratinization, and cell adhesion molecules. It was worth noting that the above changes in the tongue between specific pathogen-free and germ-free mice were more significant after chronic stress. Collectively, this is the first study to reveal that the microbiota might maintain oral homeostasis by reshaping the structure of the oral epithelial barrier and changing the function of molecular biology, a process that may be driven by the immune response and mitochondrial metabolic process of oral tissue. Furthermore, chronic stress can enhance the regulatory effects of microbiota on oral homeostasis.

Occupational Differences in Psychological Distress Between Chinese Dentists and Dental Nurses.

Background: Doctors and allied health professionals are facing serious mental health issues, which have received widespread attention. This study aimed to explore the occupational differences in psychological distress between Chinese dentists and dental nurses. Materials and Methods: The data was collected from a cross-sectional study conducted by the Chongqing Stomatological Association. Medical personnel involved in this survey were invited to complete a battery of self-administrated questionnaires, specifically the General Health Questionnaire-12, Maslach Burnout Inventory, and career choice regret scale. Data on demographic characteristics and working conditions were also collected. The results of these questionnaires were analyzed with SPSS (version 23.0). Univariate and multivariable analyzes were conducted to explore the influencing factors. Results: A total of 3,020 valid questionnaires, including 1,855 dentists and 1,165 dental nurses, were collected from 11 provinces of China. In general, 23.8% of responders exhibited psychological distress. The rate of dentists was 25.7%, and that of dental nurses was 20.8%. The prevalence was 4.9% higher in dentists than in dental nurses (P < 0.05). The multivariable analysis showed that factors associated with psychological distress for dentists were lower income, burnout, high job stress, career-choice regret, and lack of sufficient personal time, and that for dental nurses were age, lower income, longer working hours per week, burnout, high job stress, low job satisfaction, lack of sufficient personal time, and poor medical environment. Conclusion: The prevalence of psychological distress was relatively high among dental medical staff, and dentists showed a higher prevalence than dental nurses. Nurses have more risk factors for psychological distress than dentists. These results indicate that it is necessary to monitor the mental health status of dental medical staff and implement accurate strategies for dentists and dental nurses to promote their physical and mental health.

Gender Differences in Job Burnout, Career Choice Regret, and Depressive Symptoms Among Chinese Dental Postgraduates: A Cross-Sectional Study.

Background: Job burnout, career choice regret, and depressive symptoms among medical students have received widespread attention. However, little is known about the role of gender in these areas for dental postgraduates. This study aimed to explore gender differences in job burnout, career choice regret, and depressive symptoms among Chinese dental postgraduates. Methods: The data were collected from an epidemiological survey conducted by our group from February 2021 to March 2021. We used a self-administered questionnaire covering demographic characteristics, the Maslach Burnout Inventory, the Primary Care Evaluation of Mental Disorders scale, and the Career Choice Regret scale. Univariate and multivariable analyses were performed to explore influencing factors. Results: A total of 558 valid dental postgraduate questionnaires were included in this study. The prevalence of job burnout, career choice regret, and depressive symptoms exceeded 30% in males and females. The prevalence of job burnout was 4.7% higher in females than in males; career choice regret was 12.2% higher in females than in males (P < 0.05), and depressive symptoms were 4.9% higher in females than in males. The multivariable analysis showed that factors associated with job burnout for males were sleep time and career choice regret for females. The influencing factors on career choice regret for females were postgraduate entrance examination score, sleep time, and job burnout. Depressive symptoms were a common influencing factor for job burnout and career choice regret in male and female dental postgraduates. Also, job burnout and depressive symptoms had the highest odds ratio for influencing factors on each other. Conclusion: Over 30% of dental postgraduates suffered from job burnout, career choice regret, and depressive symptoms, and incidences were higher in females. A discrepancy of influencing factors existed between male and female dental postgraduates. Targeted measures should be taken to change this situation.

Reliability and Validity of General Health Questionnaire-12 in Chinese Dental Healthcare Workers During the COVID-19 Pandemic.

BACKGROUND: The General Health Questionnaire-12 (GHQ-12) is a widely used instrument to assess mental health status. However, little is known about its applicability in Chinese healthcare workers. This study aimed to evaluate the reliability and validity of the GHQ-12 in Chinese dental healthcare workers. METHODS: Dental healthcare workers participated in the first occupational survey in China conducted by the Chongqing Stomatological Association from February 2021 to March 2021 by filling out GHQ-12. The reliability and validity of GHQ-12 were then tested. RESULTS: A total of 3,020 valid electronic questionnaires were acquired. The positive detection rate of self-reported mental health status was 23.80% (719/3,020). The Cronbach's α coefficient of the GHQ-12 was 0.892, and the Cronbach's α coefficient was 0.877-0.888 after the deletion of individual items, and the split-half reliability was 0.843. The correlation coefficient between the item-total score ranged from 0.465 to 0.762 (P<0.05). The exploratory factor analysis found 2 common factors with a factor load of 0.564-0.818. The confirmatory factor analysis showed that the factor load on the specified items was 0.480-0.790. CONCLUSIONS: The two-factor model of GHQ-12 featured good reliability and validity, which could be used to assess the mental health status of Chinese dental healthcare workers.

Clinical study on the posterior occlusal plane and morphology of temporomandibular joint / Estudio clínico sobre el plano oclusal posterior y la morfología de la articulación temporomandibular

The objective of the study was to investigate the morphological features of the temporomandibular joint in adult patients with posterior occlusal plane and different inclinations. Fifty five skeletal I occlusion patients with average were included, shooting CBCT in the intercuspal position, divided into 3 groups according to OPP-FH angle, and measurement of the temporomandibular joint morphology was calculated with cone beam computed tomography (CBCT) special software Invivo 5.0, Statistical analysis of three groups of data using SPSS23.0. The condyle usually locates in the middle of the fossa, the maximum axial area of the condyle (A) was statistically significant between the group 1 and the group 3. The internal and external diameter (MD) of the condyle was statistically significant between group 1 and group 3, and group 2 and group 3. The bilateral TMJ morphological features of the three groups were basically symmetrical. The position of the condyle in the fossa is mostly centered, and some of the posterior, the maximum axial area and the internal and external diameter of the condyle are different in three groups.

El objetivo de este estudio fue investigar las características morfológicas de la articulación temporomandibular (ATM) en pacientes adultos con plano oclusal posterior y diferentes inclinaciones. Se incluyeron 55 pacientes con oclusión esquelética tipo I, visualizados por tomografía computarizada de haz cónico (CBCT) en posición intercuspiana, y se dividieron en 3 grupos según el ángulo OPP-FH. La medición morfológica de la articulación temporomandibular se calculó con CBCT y mediante el software especial Invivo 5.0. El análisis estadístico de datos se realizó con el software SPSS 23.0. El cóndilo de la mandíbula generalmente se ubica en el centro de la fosa; el área axial máxima del cóndilo de la mandíbula (A) fue estadísticamente significativa entre los grupos 1 y 3. Los datos de los diámetros medial y lateral (DM) del cóndilo de la mandíbula fueron estadísticamente significativos entre los grupos 1 y 3 y los grupos 2 y 3. Las características morfológicas de la ATM de los tres grupos fueron básicamente simétricas. La posición del cóndilo de la mandíbula en la fosa fue principalmente centrada, y parte del área axial máxima, posterior y los diámetros medial y lateral del cóndilo de la mandíbula fueron diferentes en los tres grupos.

Expression of Ihh signaling pathway in condylar cartilage after bite-raising in adult rats.

Temporomandibular joint osteoarthritis (TMJOA) is a complex inflammatory condition with multiple factors and degenerative processes co-occurring. However, its pathogenesis remains uncertain. The purpose of the study was to observe the expression of Indian hedgehog (Ihh) signal related molecules in TMJOA induced by bite-raising and to study the effect and mechanism of Ihh signaling. Our research indicated that Ihh signaling pathway can be activated in condylar cartilage induced by bite-raising. The histological analysis showed TMJOA-like structural changes of condylar cartilage in experiment groups. Ihh, Smoothened (Smo), and Gli zinc finger transcription factors-1 (Gli-1) were activated in the experimental groups, and the expression levels increased significantly over time, whereas the sham control groups showed no fluctuation. Additionally, the expression levels of matrix metalloproteinase-13 (MMP-13) and cysteinyl aspartate specific proteinase-3 (Caspase-3) in the experiment groups increased in a time-dependent manner compared with the matched sham control groups. In conclusion, our results indicated that the Ihh signaling pathway may activate the occurrence of TMJOA by mediating the hypertrophy of chondrocytes, which may be an important regulatory mechanism and potential therapeutic target in the repair of condylar cartilage.

Biomechanical analysis of micro-implants lingual straight wire appliance during retracting maxillary anterior teeth / Análisis biomecánico de microimplantes con dispositivo de alambre recto lingual durante la retracción de dientes maxilares anteriores

This study aimed to establish three-dimensional finite element models of micro-implants-lingual straight wire appliance and to investigate the effects of different wire patterns on the initial displacement of the maxillary anterior teeth and the stress of the periodontal ligament and tooth root during retracting maxillary anterior teeth in lingual orthodontics. A three-dimensional geometric models of maxilla with maxillary dentition was established using Cone-beam CT scan .Three types of maxilla models including microimplants and Duet-Slot Lingual Bracket appliance with three different arch wires ( model A: 0.016 inch × 0.022 inch stainless steel square wire; modelB: 0.016 inch stainless steel round wire; model C: double wire of 0.016 inch × 0.022 inch stainless steel square wire + anterior teeth 0.016 inch stainless steel round wire) were assembled by Unigraphics NX 8.5 software. The labial intrusion force and lingual retraction force were simulatively loaded to obtain initial displacement of the anterior teeth and the stresses of each tooth root and periodontal ligament, using three-dimensional finite element calculation software Ansys Workbench 15. The initial displacement of the lateral incisors was close to the bodily movement; and central incisors and lateral incisors slightly extruded. Compared with group A and group C, canine teeth appeared obviously horizontal "arched effect" by crown labial tipping in group B. The stress distribution of the tooth root and periodontal ligament was minimal and uniform in the group C. The 0.016 × 0.022- in stainless steel rectangular wire combined with 0.016- in stainless steel round wire used in the anterior teeth can better control the torque of the maxillary anterior teeth for space close in lingual orthodontics. Moreover, the stress distribution of tooth root and periodontal ligament is even, which is difficult to damage the periodontal ligament or result in external resorption of tooth root.

Este estudio tuvo como objetivo establecer modelos tridimensionales de elementos finitos de microimplantes linguales de alambre recto e investigar los efectos de diferentes patrones de alambre en el desplazamiento inicial de los dientes maxilares anteriores y el estrés del ligamento periodontal y la raíz del diente durante la retracción lingual sobre los dientes anteriores del hueso maxilar en ortodoncia. Se establecieron modelos geométricos tridimensionales del hueso maxilar con dentición utilizando una exploración por tomografía computarizada de haz cónico. Tres tipos de modelos maxilares, incluidos los microimplantes y el dispositivo Duet-Slot Lingual Bracket con tres arcos diferentes (modelo A: 0.016 pulgada × 0.022 pulgada alambre cuadrado de acero inoxidable; modelo B: alambre redondo de acero inoxidable de 0.016 pulgadas; alambre cuadrado de acero inoxidable de 0.016 pulgada × 0.022 pulgada y alambre redondo de acero inoxidable de 0.016 pulgada) ensamblados por el software Unigraphics NX 8.5. La fuerza de intrusión labial y la fuerza de retracción lingual se cargó simultáneamente, para obtener el desplazamiento inicial de los dientes anteriores y las tensiones de cada raíz dental y ligamento periodontal, usando el software tridimensional de cálculo de elementos finitos Ansys Workbench 15. El desplazamiento inicial de los incisivos laterales se relacionaba al movimiento corporal; mientra que los incisivos centrales e incisivos laterales se mostraron ligeramente extruidos. Comparado con el grupo A y el grupo C, los dientes caninos presentaron un "efecto arqueado" horizontal por la inclinación labial de la corona en el grupo B. La distribución del estrés de la raíz del diente y el ligamento periodontal fue mínima y uniforme en el grupo C. El alambre rectangular de acero inoxidable combinado con el alambre redondo de acero inoxidable de 0.016 usado en los dientes anteriores puede controlar mejor el torque de los dientes maxilares anteriores para cerrar el espacio en ortodoncia lingual. Además, la distribución del estrés de la raíz del diente y del ligamento periodontal es pareja, lo que dificulta dañar el ligamento periodontal o provocar una resorción externa de la raíz del diente.