Dental trauma in endoscopy:A systematic review and experience of a tertiary endoscopy centre

BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.METHODS Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of procedures.Review of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected.Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay.Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.CONCLUSION Dental complications occur in approximately 1 in 300 of upper endoscopy cases.These are easily preventable by pre-endoscopy screening.Protocols to mitigate dental injury are also suggested.

Meeting report:a hard look at the state of enamel research

The Encouraging Novel Amelogenesis Models and Ex vivo cell Lines （ENAMEL） Development workshop was held on 23 June 2017 at the Bethesda headquarters of the National institute of Dental and Craniofacial Research （NIDCR）. Discussion topics included model organisms, stem cells/cell lines, and tissues/3D cell culture/organoids. Scientists from a number of disciplines, representing institutions from across the United States, gathered to discuss advances in our understanding of enamel, as well as future directions for the field.

Effect of zeta potentials on bovine serum albumin adsorption on crown composite resin surfaces <i>in vitro</i>

We previously studied the mechanism underlying the adsorption of oral bacteria on the surfaces of dental prosthetic materials such as ceramics and resins in vitro. The aim of the present study was to examine bovine serum albumin (BSA) adsorption on crown composite resin surfaces by means of zeta potential. We measured the zeta potentials of resins alone, BSA alone, and resins after BSA adsorption. Eight resins were pulverized into powders (300 - 1000 nm). All experiments were conducted in 10 mM sodium chloride solution (pH 6.5). BSA was dissolved in 10 mM NaCl with a concentration of 2.0 × 10-5 mol/l. An adsorption assay was performed for one hour at 37°C under continuous rotation (6 rpm). The zeta potentials of both resins and BSA were negative, with BSA itself less negative than the resins themselves as an absolute value (p < 0.0001). The zeta potentials of seven resin surfaces after BSA adsorption were significantly less negative than were those of the resins without BSA adsorption (p < 0.0001). Eight resins were divided into two classes based on the size of the surface potential difference between each resin and the BSA. The difference in surface potential between the resins and the BSA were small, leading to the theory that particles with identical charges repulse each other, and the amounts of adsorbed BSA on these resins might be less. On the other, when the differences between the other resins and BSA are large, so that the repulsive force between two nonidentical particles becomes zero and an attractive force might be generated, then more BSA might be adsorbed on those resins. Therefore, the zeta potentials were affected by BSA adsorption and became less negative. These results suggested that electrostatic interactions play an important role in the adsorption of BSA on resin surfaces.

Clinical performance of removable partial dentures: A retrospective clinical study

Removable partial dentures (RPDs) (conventional and implant-supported) treatment is considered a viable option to replace missing teeth as inexpensively as possible, but it has limitations. Objectives: This study reports the effect of gender and location (maxilla vs. mandible) on the clinical performance of removable partial dentures (RPDs). Materials and Methods: A total of 100 Patients who had RPDs delivered between 1990-1995 were evaluated. A 4-point scoring system was used to assess seventeen criteria. These criteria include acceptance, stability, support, retention, adaptation, occlusion, integrity, and design of the pros-theses, rest and rest seat preparation, occlusal wear, esthetics, phonetics, tissue condition, mobility of abutments, gingival and plaque indices. The data were analyzed using Kruskal-Wallis and Mann-Whitney U non-parametric statistical tests. Results: The results showed that acceptance of RPDs was rated the lowest. Other reasons for failure were poor retention, lack of integrity of the prostheses and inadequate adaptation. Retention and design of major connectors attributed to Mandibular RPD failure. Success rate of 75% was observed in male compared with 67.2% for female. Maxillary RPDs showed a higher success rate (78%) compared with the mandibular (70.1%). No significant statistical difference in Alpha scores between female and male patients and between maxillary and mandibular RPDs (p < 0.05). Conclusions: The clinical performance of RPDs showed a higher success rate in male patients compared to female patients and the maxillary RPDs showed a higher success rate compared to mandibular.

Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus

By removing a part of the structure,the tooth preparation provides restorative space,bonding surface,and finish line for various restorations on abutment.Preparation technique plays critical role in achieving the optimal result of tooth preparation.With successful application of microscope in endodontics for>30 years,there is a full expectation of microscopic dentistry.However,as relatively little progress has been made in the application of microscopic dentistry in prosthodontics,the following assumptions have been proposed:Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision?Is there a more accurate preparation technology intended for the microscope?To obtain long-term stable therapeutic effects,is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision?Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation.This article attempts to illustrate the concept,core elements,and indications of microscopic minimally invasive tooth preparation,physiological basis of dental pulp,periodontium and functions involved in tool preparation,position ergonomics and visual basis for dentists,comparison of tooth preparation by naked eyes and a microscope,and comparison of different designs of microscopic minimally invasive tooth preparation techniques.Furthermore,a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

Defective claudin-10 causes a novel variation of HELIX syndrome through compromised tight junction strand assembly

Formation of claudin-10 based tight junctions(TJs)is paramount to paracellular Na+transport in multiple epithelia.Sequence variants in CLDN10 have been linked to HELIX syndrome,a salt-losing tubulopathy with altered handling of divalent cations accompanied by dysfunctional salivary,sweat,and lacrimal glands.Here,we investigate molecular basis and phenotypic consequences of a newly identified homozygous CLDN10 variant that translates into a single amino acid substitution within the fourth transmembrane helix of claudin-10.In addition to hypohidrosis(H),electrolyte(E)imbalance with impaired urine concentrating ability,and hypolacrimia(L),phenotypic findings include altered salivary electrolyte composition and amelogenesis imperfecta but neither ichthyosis(I)nor xerostomia(X).Employing cellular TJ reconstitution assays,we demonstrate perturbation of cis-and trans-interactions between mutant claudin-10 proteins.Ultrastructures of reconstituted TJ strands show disturbed continuity and reduced abundance in the mutant case.Throughout,both major isoforms,claudin-10a and claudin-10b,are differentially affected with claudin-10b showing more severe molecular alterations.However,expression of the mutant in renal epithelial cells with endogenous TJs results in wild-type-like ion selectivity and conductivity,indicating that aberrant claudin-10 is generally capable of forming functional paracellular channels.Thus,mutant proteins prove pathogenic by compromising claudin-10 TJ strand assembly.Additional ex vivo investigations indicate their insertion into TJs to occur in a tissue-specific manner.