Performance comparison between three intraoral image receptors of different technology at a variety of tube potential, tube current and exposure time settings using a stepwedge phantom

Purpose: To comparatively evaluate the per-formance of three intraoral image receptors of different technology when exposed to different X-ray beam spectra, dose and dose rate levels using a stepwedge phantom. Materials and methods: The intraoral radiographic receptors evaluated were: the Kodak Insight F speed class film, the Kodak RVG 6000, and the Duerr Vis-tascan Combi PSP system. A dental quality control phantom made of Plexiglas, containing an aluminium stepwedge with 12 steps and 7 holes drilled in each step was radiographed using a dental X-ray unit offering a wide range of tube potential, tube current and exposure time settings. The visibility of the holes in the images produced with each one of the three receptors was assessed by three independent observers. For each image the total image quality score (TS) was derived from the summation of the number of visible holes in each step. The numbers of perceptible holes in each experimental condition (TSs) were statistically analyzed through use of analysis of variance. Intraobserver and interobserver agree-ment was also measured. Results: Vistascan ex-hibited the most extended useful exposure range, followed by RVG 6000 and Insight. RVG 6000 exhibited the largest TS values in all tube potential settings except 70 kV where the Vistascan performed better. Insight performed better than Vistascan only at 60 and 63 kV. Vistascan performed better at 66 and 70 kV, Insight at 60 and 66 kV, whereas RVG performed equally well at all tube potential settings, except than at 52 and 70 kV. For the Insight the largest TS values were obtained with the smallest ESAK values whereas with the Vistascan the largest TS were obtained with ESAK values that where the largest observed. Conclusions: The performance of all receptors tested was greatly dependent on the exposure parameters and mainly on the kV settings. Overall, the RVG 6000 offered the best image quality at doses somewhere in between those required by the Insight and the Vistascan.

Facial basal cell carcinoma:A retrospective study of 67 cases

BACKGROUND Basal cell carcinoma(BCC)is a slow-growing malignant tumor characterized by local invasiveness but an exceptionally rare metastatic potential.It ideally affects sun-exposed skin of older patients with more propensity for the facial region.AIM To evaluate the different clinicopathological characteristics of the facial BCC and the efficacy and safety of diode laser for the treatment of these lesions.METHODS We retrospectively reviewed facial BCC lesions of<1.5 cm in diameter and subjected them to diode laser ablation during the period from September 2016 to August 2021 at Al-Ramadi Teaching Hospital,Ramadi City,Iraq.Data matching the age,gender,duration,site,and clinical and histological types were registered for every subject.The functional and aesthetic outcomes and complications following diode laser ablation for each patient were also recorded.RESULTS Of 67 patients with facial BCC,there was 65.67%from the age group≥60 years and 58.21%males.The mean duration of the lesions was 5.15±1.836 mo.The most involved location was the nose(29.85%).About half of the cases belong to the noduloulcerative type.Solid histological type comprises 40.3%of the cases,while the least was keratotic(13.4%).Moreover,65.2%of the solid cases were from the age group≤60 years and 38.6%of the adenoid type from the age group>60 years(P value=0.007).Excellent aesthetic and functional outcomes were reported in all cases after 6 mo of follow-up.Few complications were reported after diode laser ablation.CONCLUSION Facial BCC was mostly seen in the elderly and men.The mean duration was 5.15 mo.The nose was the commonest involved site.Noduloulcerative lesions were seen in approximately half of the lesions.The age of the patients determined the histological type of the lesion(solid type was mostly seen in the age group≤60 years,while,adenoid in the age group>60 years).Diode laser ablation showed excellent functional and aesthetic outcomes following a 6-mo follow-up.

Typical Aspects of the Granular Cell Tumor of the Oral Cavity

Granular cell tumor (GCT) is a rare neoplasm that can occur in any part of the body, but mostly they are located intraorally. Its histogenetic origin remains controversial, but it probably arises from Schwann cells and is generally benign. The tumor is typically asymptomatic and appears as a nodule, with a relatively high predilection for the tongue. This article reports a case of a 72-year-old woman treated at the Center of Oral Diagnosis of the Funda&#231&#227o Hermínio Ometto Dental School. The patient presented with an asymptomatic nodule in the dorsal surface of the tongue for approximately 4 months. The patient was submitted to an excisional biopsy and histopatological examination revealed polyhedral cells with granular aspect. The immunohistochemical staining for S-100 presented strong reactivity, confirming the diagnosis of GCT. Finally, we made a concise discussion about the pathogenesis and fundamental clinico-pathological aspects of GCT making the differential diagnosis.

Effect of periodontal treatment on adipokines in type 2 diabetes

The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

Role of Topical Application of Growth Factors on Periodontal Repair

Reconstruction of lost or injured periodontal tissues in such a way that both the original structures and their function are completely restored. Restoring of lost periodontal tissues involves a creation of new attachment, including the formation of a new periodontal ligament with its fibers inserted in newly formed cementum and alveolar bone. The purpose of this research is to illustrate the biological actions of topical application of growth factors TGF-β1, VEGF on periodontal cells and tissues, which are involved in periodontal regeneration. Fifty-four male Albino rats were subjected for non surgical operation of distal sides of both lower anterior teeth, right side was considered as experimental site treated with 1 μm of VEGF, TGF-β1, while left side treated with 1 μm of normal saline as a control one. All the samples were studied histologically and histometry at three interval periods 3, 7, 14 days postoperatively. The results demonstrated that the mean value of amount of new bone and the mean of the length of junctional epithelia is showed to be higher in VEGF group, while the mean of periodontal ligament width and mean of rate of bone maturation are reported to be higher in combination group. High mean value for the width of cellular cementum is recorded in TGF group. Conclusion: The present study suggested that growth factors application in injured periodontium have a role in periodontal healing and VEGF illustrates to be the most powerful one.

Evaluation of xerostomia closely associated with systemic diseases using a dental approach

Based on the findings of epidemiological surveys in western countries, the number of person with suspected xerostomia in Japan is estimated to be 30,000,000. Xerostomia is caused by: 1) Systemic diseases;2) Medications;3) Tumors or trauma;4) Radiotherapy;and 5) Neurological factors. Its symptoms can be alleviated, and its progression can be stopped by close cooperation between the dental and medical departments. However, at present, symptomatic treatment methods such as water drinking, oral rinsing with water, and administration of Kampo medicines or parasymptomimetic drugs are mainly used, and a standard treatment has not been established. On the other hand, previous studies on xerostomia have reported improvement in dry mouth symptoms using dental approaches or a relationship between the development of candidiasis and the salivary flow rate. Therefore, in this study, to establish a dental method useful for improving xerostomia associated with systemic diseases and medications for them, we restored occlusal function, and as a result, increased the salivary flow rate, and evaluated changes in oral findings.

Pemphigus vulgaris macroscopically and cytologically resembling oral squamous cell carcinoma

We describe the clinical, macroscopic, cytological, histopathological, immunohistochemical, serodiagnostic and aspects of pemphigus vulgaris (PV) in the oral gingiva that clinically mimicked oral squamous cell carcinoma (OSCC) in a 57-year-old Japanese man. He developed slight haphalgesia of the buccal gingiva around teeth numbers 18 and 19 2 years ago. A dentist diagnosed intractable ulcer, but the patient ignored the condition for about 2 years until a sharp pain in the gingiva worsened. He consulted an otolaryngologist, who referred the patient to our hospital under a cytological diagnosis of OSCC. An oral examination revealed several extensive painful erosions/ ulcers from the buccal and lingual gingiva around teeth numbers 18 to 21 to the distal alveolar mucosa of no. 18 and the buccal and lingual gingiva around tooth number 31. A presumptive diagnosis of PV with dysplastic changes was determined from cytological smears. The cytological Nikolsky test was positive. The diagnosis of PV was confirmed from clinical and histopathological findings of a biopsy specimen obtained from the perilesional site. Although the definitive diagnosis of PV required only 2 weeks after this patient presented at our hospital, 2 years had elapsed since the onset of oral lesions.

Assessment of Maxillary and Mandibular Bone Mineral Density in Controlled Type II Diabetes in Completely Edentulous Patients Using Cone-Beam Computed Tomography—A Cross Sectional Study with Comparison Group

This study was undertaken to assess and compare bone mineral density in nondiabetic and controlled diabetic subjects using cone beam computed tomography. A group of 60 completely edentulous patients, comprising of 30 nondiabetic and 30 controlled type 2 diabetics between the age group of 45 - 75 years, were enrolled in the study. Glycemic control of the diabetics was assessed using glycosylated hemoglobin test and level between 6.1% - 8% was considered controlled. A radiographic stent was fabricated for each patient by using chemically cured transparent acrylic resin. Bone densities at trabecular, buccal and lingual cortical regions of maxillary and mandibular ridges were measured by a cone beam tomography machine in Hounsfield units. The data thus obtained at 10 prospective oral implant sites of maxillary and mandibular ridges were tabulated and analyzed using STATA, version 14.0 statistical software. This study results showed no significant changes in the bone mineral density between the nondiabetic and controlled diabetic subjects. Within the limitations of this study, it can be concluded that bone mineral density does not seem to be affected in controlled type 2 diabetic patients.

Cleidocranial dysplasia with a rare mutation:Study of a family with review of literature

Introduction: The present study was aimed at advancing the understanding of the pathogenesis of cleidocranial dysplasia (CCD) by presenting a case study based on history, physical examination, typical radiological features, and molecular analysis and a review of the literature. Methods: This study began with a 23-year-old boy (proband) who was referred to the department of oral and maxillofacial radiology with chief complaint of the upper-left first molar tooth and routine dental examination. While evaluating the panoramic radiograph, the patient had approximately 57 teeth in his both of the jaws. Clinical, radiographical and molecular features of the proband, two siblings and their parents were examined and then, DNA analysis was performed. Results: Overall, we present 3 CCD patients with a mutation in the VWRPY motif. The deletion of c. 1754_1757 delTTTG (NM_001024630.2) is determined and it leads to a frame shift mutation and stop codon, p. V585Gfs56X. Conclusions: The present study emphasized the importance of further clinical and molecular investigation when even a single case of CCD is identified within a family. This is the first study performed in Turkey about a family with a mutation in the VWRPY motif. Genotype-phenotype association studies in individuals with CCD are necessary to provide important insights into molecular mechanisms associated with this disease.

Influence of Sub-Lethal and Lethal Concentrations of Chlorhexidine on Morphology and Glucosyltransferase Genes Expression in Streptococcus mutans UA159

Chlorhexidine (CHX) is regarded as one of the most successful antiplaque agents in controlling the formation of dental biofilm. Nevertheless, molecular mechanisms of their effects in Streptococcus mutans are largely unknown. In this work, the effects of sub-lethal and lethal concentrations of chlorhexidine (CHX) on planktonic or biofilm-organized Streptococcus mutans cells were investigated in dose- and time-dependent manner. The Minimum Inhibitory Concentration (MIC) and the Minimum Bactericidal Concentration (MBC) for planktonic cells and biofilm conditions were determined by standard methods. Quantitative PCR (qPCR) was used to quantify the relative levels of glucosyltransferase B (gtfB), gtfC and gtfD transcription of S. mutans in the presence of CHX. The CHX activity in the initial biofilm structure and morphological alterations in planktonic cells were examined by Scanning Electron Microscopy (SEM). The results indicate that CHX increased expression of gtfC and gtfD in planktonic S. mutans cells and CHX reduced the expression of gtfB, gtfC, and gtfD in biofilms. High concentrations of CHX resulted in several wilted S. mutans planktonic cells with spilled intracellular material, while decreased cells’ chain length and matrix was found when the initial biofilm was exposed to increasing concentrations of CHX. CHX’s effects against bacteria depend on the type of growth organization and the concentration and time of exposure to the drug. At sub-lethal concentrations, CHX affects the expression of glucosyltransferases, which may have anticariogenic effect.

Clinical and radiographic features of Hutchinson-Gilford progeria syndrome: A case report

Hutchinson-Gilford progeria syndrome(HGPS) is a rare dysmorphic syndrome characterized by several features of premature aging with clinical involvement of the skin, bones, and cardiovascular system. HGPS has an estimated incidence of one in four million to one in eight million births. The main clinical features of HGPS include short stature, craniofacial dimorphism, alopecia, bone fragility, and cardiovascular disorders. The most frequent cause of death is myocardial infarction at a mean age of 13 years old. Dental manifestations include delayed development and eruption of teeth, discoloration, crowding and rotation of teeth, and displaced teeth. Cone beam computed tomography images revealed the absence of the sphenoid, frontal, and maxillary sinus, flattening of the condyles and glenoid fossa, and bilateral hypoplasia of the mandibular condyles. The disease is caused by mutations in lamin A/C(LMNA). Here, we present a case report of an 11-year-old boy with classical features of HGPS, which was caused by a de novo germ-line mutation(C1824T, G608G) in exon 11 of the LMNA gene. Some uncommon HGPS-associated features in our patient, such as alterations in the facial sinuses and hypoplasia of the condyles, contributed to the expansion of the phenotypic spectrum of this syndrome from a dentomaxillofacial perspective.

MicroRNA-activated hydrogel scaffold generated by 3D printing accelerates bone regeneration

Bone defects remain a major threat to human health and bone tissue regeneration has become a prominent clinical demand worldwide.The combination of microRNA(miRNA)therapy with 3D printed scaffolds has always posed a challenge.It can mimic physiological bone healing processes,in which a biodegradable scaffold is gradually replaced by neo-tissue,and the sustained release of miRNA plays a vital role in creating an optimal osteogenic microenvironment,thus achieving promising bone repair outcomes.However,the balance between two key factors-scaffold degradation behavior and miRNA release profile-on osteogenesis and bone formation is still poorly understood.Herein,we construct a series of miRNA-activated hydrogel scaffolds(MAHSs)generated by 3D printing with different crosslinking degree to screened the interplay between scaffold degradation and miRNA release in the osteoinduction activity both in vitro and in vivo.Although MAHSs with a lower crosslinking degree(MAHS-0 and MAHS-0.25)released a higher amount of miR-29b in a sustained release profile,they degraded too fast to provide prolonged support for cell and tissue ingrowth.On the contrary,although the slow degradation of MAHSs with a higher crosslinking degree(MAHS-1 and MAHS-2.5)led to insufficient release of miR-29b,their adaptable degradation rate endowed them with more efficient osteoinductive behavior over the long term.MAHS-1 gave the most well-matched degradation rate and miR-29b release characteristics and was identified as the preferred MAHSs for accelerated bone regeneration.This study suggests that the bio-adaptable balance between scaffold degradation behavior and bioactive factors release profile plays a critical role in bone regeneration.These findings will provide a valuable reference about designing miRNAs as well as other bioactive molecules activated scaffold for tissue regeneration.