Dental implant considerations in patients with systemic diseases: An updated comprehensive review.

BACKGROUND: Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM: The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS: The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS: In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION: In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.

Hard tissue formation in pulpotomized primary teeth in dogs with nanomaterials MCM-48 and MCM-48/hydroxyapatite: an in vivo animal study.

BACKGROUND: This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA). METHODS: This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent. RESULTS: The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320). CONCLUSION: MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.

The effect of photobiomodulation therapy in common maxillofacial injuries: Current status.

The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.

Oral Complications Associated with the Piercing of Oral and Perioral Tissues and the Corresponding Degree of Awareness among Public and Professionals: A Systematic Review.

This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the corresponding society. The second objective was determining public/professional sectors' awareness of the subject. This research followed PRISMA and Cochrane guidelines for conducting systematic reviews and searching scientific databases, including PubMed, Scopus, Cochrane, and Google Scholar, until April 2023. Cross-sectional, cohort, and case-control studies in English were deemed eligible. The methodological quality of the included studies was assessed using proper quality assessment guidelines. Of the 965 initial articles retrieved, 34 were considered suitable for qualitative synthesis after screening procedures and removing duplicates and irrelevant records. There appears to be an imbalance between the general public's low and dentists' high awareness. This draws attention to the shortage of professional and societal knowledge-sharing and education initiatives. Women were more than twice as likely as men to have oral piercings. Piercing usage had a low incidence among a cohort of students with a mean age of 16. Merely circumstantial evidence has indicated a plausible correlation between oral and perioral piercings and the emergence of secondary bacterial and fungal colonization, particularly periodontopathogenic bacteria and Candida albicans. Furthermore, several adverse consequences have been observed linked to various piercings-such as lip and tongue piercings. These include caries, gingivitis/periodontitis, dental fractures, enamel chipping/cracks, plaque buildup, bone loss, bleeding, inflammation, and swelling. Given the risks involved and the complications that might impair oral health, the prevalence of oral piercings is alarming. As a result, public health authorities need to firmly support initiatives to raise awareness of the risks associated with oral/perioral piercings. For piercers to enhance their expertise in this field, professional training is necessary because there is a shortage of knowledge on the possible adverse effects of piercings.

The effect of photodynamic therapy in controlling the oral biofilm: A comprehensive overview.

Several resistance mechanisms are involved in dental caries, including oral biofilms. An accumulation of bacteria on the surface of teeth is called plaque. Periodontitis and gingivitis are caused by dental plaque. In this review article, we aimed to review the studies associated with the application of photodynamic therapy (PDT) to prevent and treat various microbial biofilm-caused oral diseases in recent decades. There are several studies published in PubMed that have described antimicrobial photodynamic therapy (APDT) effects on microorganisms. Several in vitro and in vivo studies have demonstrated the potential of APDT for treating endodontic, periodontal, and mucosal infections caused by bacteria as biofilms. Reactive oxygen species (ROS) are activated in the presence of oxygen by integrating a nontoxic photosensitizer (PS) with appropriate wavelength visible light. By causing irreversible damage to microorganisms, ROS induces some biological and photochemical events. Testing several wavelengths has been conducted to identify potential PS for APDT. A standard protocol is not yet available, and the current review summarizes findings from dental studies on APDT.

Protective effect of quercetin on alteration of antioxidant genes expression and histological changes in the dental pulp of the streptozotocin-diabetic rats.

OBJECTIVE: We aimed to assess the effect of quercetin as one of the most common polyphenols with anti-inflammatory and antioxidant properties on expression levels of catalase (CAT), superoxide dismutase 1 (SOD1), and glutathione peroxidase 1 (GPX1), involved in the detoxification of reactive oxygen species (ROS), and histology of dental pulp in streptozotocin-diabetic rats. DESIGN: Type 1 diabetes mellitus (T1DM) was induced by intraperitoneal injection of streptozotocin in adult male Wistar rats. Animals (n = 24) were equally distributed into control, diabetes, and diabetes treated with quercetin groups. Rats were gavaged daily with quercetin (25 mg/kg) for forty days. To measure the mRNA levels of antioxidant genes, quantitate real-time PCR was applied. The oxidative stress parameters such as total antioxidant capacity (TAC) and histopathological assessments were performed. RESULTS: A significant increase in the relative quantification mRNA levels of SOD1, CAT, GPX1 was detected in diabetic rat dental pulp. Besides, persistent hyperglycemia led to the enhancement of TAC level and degeneration of connective tissue of the dental pulp. Interestingly, quercetin normalized the expression mRNA levels of CAT, SOD1, GPX1 to near the normal level. Moreover, quercetin treatment normalized TAC levels. CONCLUSIONS: Because of the crucial role of antioxidants in diabetic complications, the findings of the current study presented a molecular basis for the protective effect of quercetin on dental pulp in diabetic conditions.

Lactic Acid and Salt Separation Using Membrane Technology.

Acid whey is a by-product of cheese and yoghurt manufacture. The protein and lactose within acid whey can be recovered using nanofiltration and electrodialysis, but this leaves a waste stream that is a mixture of salts and lactic acid. To further add value to the acid whey treatment process, the possibility of recovering this lactic acid was investigated using either low energy reverse osmosis membranes or an electrodialysis process. Partial separation between lactic acid and potassium chloride was achieved at low applied pressures and feed pH in the reverse osmosis process, as a greater permeation of potassium chloride was observed under these conditions. Furthermore, lactic acid retention was enhanced by operating at lower temperature. Partial separation between lactic acid and potassium chloride was also achieved in the electrodialysis process. However, the observed losses in lactic acid increased with the addition of sodium chloride to the feed solution. This indicates that the separation becomes more challenging as the complexity of the feed solution increases. Neither process was able to achieve sufficient separation to avoid the use of further purification processes.

The Role of Ion Exchange Membranes in Membrane Capacitive Deionisation.

Ion-exchange membranes (IEMs) are unique in combining the electrochemical properties of ion exchange resins and the permeability of a membrane. They are being used widely to treat industrial effluents, and in seawater and brackish water desalination. Membrane Capacitive Deionisation (MCDI) is an emerging, energy efficient technology for brackish water desalination in which these ion-exchange membranes act as selective gates allowing the transport of counter-ions toward carbon electrodes. This article provides a summary of recent developments in the preparation, characterization, and performance of ion exchange membranes in the MCDI field. In some parts of this review, the most relevant literature in the area of electrodialysis (ED) is also discussed to better elucidate the role of the ion exchange membranes. We conclude that more work is required to better define the desalination performance of the proposed novel materials and cell designs for MCDI in treating a wide range of feed waters. The extent of fouling, the development of cleaning strategies, and further techno-economic studies, will add value to this emerging technique.

Comparison between cone beam computed tomography and multislice computed tomography in diagnostic accuracy of maxillofacial fractures in dried human skull: an in vitro study.

BACKGROUND: The aim of this study was to compare the accuracy of cone beam computed tomography (CBCT) and multislice computed tomography (MSCT) in diagnosing factitious fractures in maxillofacial region as well as to investigate the influence of field of view (FOV) size on the interpretation of maxillofacial fractures in CBCT. METHODS: Simulated fractures were created in the right and left sides of five dried human skulls using a micro-saw 20 mm blade without displacement. The skulls were scanned with a spiral 16-slice MSCT scanner and a CBCT device with two FOVs (6 × 6, 15 × 15). Three observers assessed and interpreted the images judging whether fracture was present or absent. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic (ROC) curve were calculated. RESULTS: The sensitivity of CBCT 6 × 6, CBCT 15 × 15, and MSCT was 87.5%, 70.7%, and 49.7% and the specificity of three modalities was 91.7%, 88.0%, and 98.3%, respectively. The area under ROC curve was 0.90 (95% CI: 0.85, 0.94) for CBCT with FOV 6 × 6, 0.79 (95% CI: 0.75, 0.85) for CBCT with FOV 15 × 15, and 0.74 (95% CI: 0.69, 0.79) for MSCT. The Kappa value for interobserver agreement was highest for CBCT 6 × 6 among imaging modalities. CONCLUSIONS: CBCT with small FOV had higher diagnostic accuracy in detecting simulated maxillofacial fractures than MSCT. However, additional evidence based on in vivo studies is needed to confirm the superiority of CBCT on MSCT in diagnosis of maxillofacial traumatic fractures.