Combination of Diclofenac Potassium and Propolis in the Therapy of Oral Aphthosis: A Randomized, Clinical, Double-Blind, Placebo-Controlled Study

Background: Oral aphthosis has a negative impact on oral health. This study aimed to assess the effectiveness of gel formulation including diclofenac and propolis in the treatment of oral ulcers. Methods: Participants included 100 normal individuals with aphthous, excluding those having allergies to any ingredient in the diclofenac formulation. Patients were randomly assigned into two groups: one group received treatment with a combination of diclofenac potassium 3% (10 mg/g, 60 g) and propolis 5% gel (Group II), and the other group received a placebo (Group 1). The patient was evaluated using standard digital photographs and chronic oral mucosal questionnaires on days 1, 3, 5, and 7 after healing. Utilizing the Mann-Whitney U test, the two groups were compared. Each group’s changes were examined using Friedman’s test. Results: There was a statistically dramatic change over time in Group II. After one day, the median total score dropped statistically significantly, and from one to three days with effect size (d) 2.485, Group II demonstrated 48% complete healing and 52% partial healing, while Group I demonstrated 4% partial healing and 96% no change. Effect size (V): 0.995. Conclusions: The combination of diclofenac and propolis provided instant relief and an affordable new regimen for treating oral aphthosis.

A Case of Oral Squamous Cell Carcinoma with Scattered Metastases

We experienced a case of oral squamous cell carcinoma of the mandible with scattered distant metastases. After neoadjuvant chemoradiotherapy, the patient underwent segmental resection of the right mandible and right radical neck dissection. Surgical specimens confirmed remarkable nodal metastases. Unfortunately, the patient experienced a rapid fatal outcome, and numerous distant metastases were detected on autopsy. Moreover, postoperative 18F-fluorodeoxyglucose- positron emission tomography/computed tomography detected systemic distant metastases in this case. In our opinion, the use of preoperative FDG-PET/CT should be considered for patients with suspected poor prognoses.

Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification

Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies.These lesions can arise from various tissues,including bone,cartilage,and soft tissue,each presenting distinct challenges in diagnosis and treatment.While some pathologies exhibit characteristic imaging features that aid in diagnosis,many others are nonspecific.This overlap often necessitates a multimodal imaging approach,combining techniques such as radiographs,computed tomography,and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations.This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors,including updates on the 2022 World Health Organization classification of these tumors.The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.

MicroRNA-34a Regulates High Glucose-induced Apoptosis in H9c2 Cardiomyocytes

Hyperglycemia is an important initiator of cardiovascular disease, contributing to the de- velopment of cardiomyocyte death and diabetic complications. The purpose of the present study was to investigate whether high glucose state could induce apoptosis of rat cardiomyocyte cell line H9c2 through microRNA-mediated Bcl-2 signaling pathway. The expression of miR-34a and Bcl-2 mRNA was detected by using real-time PCR. Western blotting was used to examine the changes in apop- tosis-associated protein Bcl-2. Apoptosis of H9c2 cells was tested by using flow cytometry. The results showed that the expression of miR-34a was significantly elevated and that of Bcl-2 was strongly re- duced, and apoptosis of cardiomyocytes was apparently increased in the high-glucose-treated H9c2 cells as compared with normal-glucose-treated controls. In addition, we identified Bcl-2 gene was the target of miR-34a, miR-34a mimics reduced the expression of Bcl-2 and increased glucose-induced apoptosis, but miR-34a inhibitor acted as the opposite mediator. Our data demonstrate that miR-34a contributes to high glucose-induced decreases in Bcl-2 expression and subsequent cardiomyocyte apoptosis.

Priming strategies for controlling stem cell fate: Applications and challenges in dental tissue regeneration

Mesenchymal stromal cells(MSCs)have attracted intense interest in the field of dental tissue regeneration.Dental tissue is a popular source of MSCs because MSCs can be obtained with minimally invasive procedures.MSCs possess distinct inherent properties of self-renewal,immunomodulation,proangiogenic potential,and multilineage potency,as well as being readily available and easy to culture.However,major issues,including poor engraftment and low survival rates in vivo,remain to be resolved before large-scale application is feasible in clinical treatments.Thus,some recent investigations have sought ways to optimize MSC functions in vitro and in vivo.Currently,priming culture conditions,pretreatment with mechanical and physical stimuli,preconditioning with cytokines and growth factors,and genetic modification of MSCs are considered to be the main strategies;all of which could contribute to improving MSC efficacy in dental regenerative medicine.Research in this field has made tremendous progress and continues to gather interest and stimulate innovation.In this review,we summarize the priming approaches for enhancing the intrinsic biological properties of MSCs such as migration,antiapoptotic effect,proangiogenic potential,and regenerative properties.Challenges in current approaches associated with MSC modification and possible future solutions are also indicated.We aim to outline the present understanding of priming approaches to improve the therapeutic effects of MSCs on dental tissue regeneration.

Effect of clopidogrel in bone healing-experimental study in rabbits

BACKGROUND Clopidogrel is a widely prescribed drug for prevention of myocardial infarction and stroke in patients at risk.It inhibits thrombus formation via inhibition of the P2Y12 purinergic receptor on platelets,which is important in their activation by ADP.However,the P2Y12 receptor has also been found to be expressed in both osteoblasts and osteoclasts.Accumulated evidence suggests that purinergic receptors regulate important functions of bone turnover.Previous studies on the effect of clopidogrel on bone metabolism indicated potential harmful effects,but their results remain conflicting.Thus,clopidogrel treatment may affect bone healing,but it has not yet been studied.AIM To evaluate if continuous perioperative clopidogrel treatment has any negative effect on bone healing in the rabbit calvarial defect model.METHODS Sixteen male white New Zealand rabbits were randomly assigned in two groups:One group received daily 3 mg/kg of clopidogrel per os and the other group received the vehicle alone for a week prior to the surgical procedures;the treatments were continued for another 6 wk postoperatively.The surgical procedures included generation of two circular calvarial defects 11 mm in diameter in every animal.After the 6-wk period of healing,postmortem radiographic and histomorphometric evaluation of the defects was performed.RESULTS Both the surgical procedures and the postoperative period were uneventful and well tolerated by all the animals,without any surgical wound dehiscence,signs of infection or other complication.New bone was formed either inwards from the defect margins or in the central portion of the defect as separated bony islets.While defect healing was still incomplete in both groups,the clopidogrel group had significantly improved radiographic healing scores.Moreover,the histomorphometric analysis showed that bone regeneration(%)was 28.07±7.7 for the clopidogrel group and 19.47±4.9 for the control group,showing a statistically significant difference between them(P=0.018).Statistically significant difference was also found in the defect bridging(%),i.e.72.17±21.2 for the clopidogrel group and 41.17±8.5 for the control group,respectively(P=0.004),whereas there was no statistical difference in bone tissue density between the groups.CONCLUSION Our results indicate that maintenance of perioperative clopidogrel treatment does not negatively affect bone healing but rather promotes it.Further research is needed in order to find useful applications of this finding.

Comparison of computed tomography and magnetic resonance imaging for the detection of mandibular condylar osteochondroma

Objective The purpose of this study was to compare computed tomography(CT) and magnetic resonance imaging(MRI) for the detection of mandibular condylar osteochondroma.Methods Preoperative CT and MRI of 33 patients with unilateral condylar osteochondroma were reviewed. The morphology, location, continuity with the parent bone, cartilage cap, perichondrium of tumors, and changes in soft and hard tissues adjacent to the lesions were investigated by two reviewers. Data were analyzed using Mc Nemar test. A P value < 0.05 was considered significant.Results Among the 33 condylar osteochondromas, 11 were of the diffuse type, 10 were of the sessile type, and 12 were of the pedunculated type. Continuity with the cortex and marrow of the host condyle was observed on both CT and MRI. Both modalities had identical detection rates of surface reconstruction of the temporal bone joint, condylar dislocation, and pseudarthrosis formation. However, MRI showed significantly higher detection rates of the cartilage cap and perichondrium than CT(P < 0.05). Furthermore, MRI showed ipsilateral and contralateral temporo-mandibular joint(TMJ) disc displacement in 4 cases and 6 cases, respectively, and ipsilateral and contralateral TMJ effusion in 20 cases and 14 cases, respectively.Conclusion CT can intuitively display the morphology and spatial location of condylar osteochondromas through three-dimensional reconstruction. MRI may be superior to CT in the detection of cartilage cap, perichondrium of the condylar osteochondroma, and changes in the TMJ and adjacent soft tissues.

The effectiveness of local anesthetic and sodium hyaluronate injection for the posterior disc displacement: A case report

Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.

A unique case of a calcifying cystic odontogenic tumor

The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontogenic tumor by the WHO calcification in 2005 due to its histological complexity, morphological diversity and aggressive proliferation [2]. Here, we describe a case of a calcifying cystic odontogenic tumor in a 4- year-old boy. The lesion was surgically removed, and the histopathological examination revealed it to be a cystic tumor with ghost cells, a stellate reticulum and small amount of dentinoid tissue in the cystic wall.

Accessory Mental Foramen Misdiagnosed as Radiolucent Tumour by Conventional Dental Radiography

The mental foramen is an important landmark for identifying the mental nerve, and the accessory mental foramen is a rare anatomical variation. This article describes the use of computed tomo- graphy (CT) to detect an accessory mental foramen that was initially misdiagnosed as a radiolu- cent tumour in the right premolar region of a 39-year-old woman by panoramic radiography. The case suggests that preoperative CT should be performed to detect any anatomical variations. This knowledge would help in diagnosis, preoperative planning and prevention of intraoperative nerve or vascular injury.

Malignant Lymphoma with Initial Symptoms in the Mandibular Region

Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extranodal non-Hodgkin’s lymphoma (NHL) with initial mandibular symptoms in our department. At initial treatment of dental clinics, dentists had diagnosed as dental or gingival diseases and had performed dental treatment. Neurological disorder to involvement of the inferior alveolar nerve was present in 80.0% of our cases. On dental or panoramic radiography a specific radiolucent lesion in the mandible was not detected, except for dental lesions. On CT, NHL of the mandible region has no widening and no clear destruction but a slit-like the cortex bone destruction pattern with keeping in shape of the mandibular body (62.5% of CT-examined cases), and extraosseous soft tissue mass are clearer on MRI (100.0% of MRI-examined cases). Histopathologically, 80.0% of our cases were diagnosed as diffuse large B cell lymphoma (DLBCL). One case as B-cell lymphoblastic lymphoma and one case as B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma were Stage IV (Ann Arbor staging system) and had poor prognosis. The disease-specific survival rate was 77.8% at 5 years. If unexplained non-specific symptoms such as swelling of the jaw, pain, neurological disorder of the inferior alveolar nerve, tooth mobility are observed, oral surgeons and dentists should not perform dental treatments. CT and MRI show disease specific appearance to be able to give a definitive diasnosis as NHL. PET/CT is useful for scaninng of whole body. A deep bone biopsy is preferred for suspected malignant lymphoma.

Registration of Two Dental Panoramic Radiographs

In dental panoramic images, the information on physical changes of alveolar bone or jaw bone is very important to diagnose several diseases. To detect such change, it is useful to compare two panoramic x-ray images acquired at different times. These two images are usually acquired with different conditions in terms of the positioning of the dental arch, and thus these images can be impaired from some geometrical changes related to the scale of the panoramic images and deformation of the teeth and jaw bones. As a result of this, it is very hard to make an accurate registration. To cope with this issue, we developed a dedicated image registration method to match these two images by a newly introduced non-rigid transformation method and registration method using the cross-correlation of localized regions. We evaluated our proposed method with several sets of two images acquired with different geometrical conditions. The material evaluated in this study was a skull phantom. The results of these experiments showed the validity and intrinsic ability of our proposed method in clinical examinations.

Removal of the Shadow of Cervical Vertebrae from Panoramic X-Ray Images with a Tomosynthesis Method

The purpose of this study is to remove the shadow of cervical vertebrae from dental panoramic x-ray images with a tomosynthesis method and improve the contrast of details in both the teeth and jaw bones. To measure the shift-amount at each angular position that was required for reconstruction of panoramic x-ray images of the dental arch, strip images of a calibration phantom were acquired. Then, a shift-amount table was prepared from these images, and the other shift-amount table, which was used to reconstruct a panoramic image of the cervical vertebrae, was prepared by inverting the curve of the shift-amount table upside down. Using these two tables, images focused on the dental arch and cervical vertebrae of a patient were made with the original strip data of the patient. The shadow of the cervical vertebrae appearing on the image focused on the dental arch was removed using the two above-mentioned images and blurring functions defined at two focusing geometries. The validity of the proposed method was evaluated with clinically acquired data of two patients. The shadow of the cervical vertebrae was successfully eliminated, and the contrast of the front teeth and detailed structures of the jaw bones was improved. The results of the experiments showed that our proposed method was significantly effective in removing the shadow of the cervical vertebrae from conventional panoramic x-ray images.

Cerebral activation during unilateral clenching in patients with temporomandibular joint synovitis and biting pain： an functional magnetic resonance imaging study

Background Functional magnetic resonance is a non-invasive method that can examine brain activity and has been widely used in various fields including jaw movement and pain processing. Temporomandibular disorder （TMD） is one of the most frequent facial pain problems. The objective of this study was to investigate the brain activities using functional magnetic resonance imaging （fMRI） during unilateral maximal voluntary clenching tasks in the TMD synovitis patients with biting pain.Methods Fourteen TMD synovitis patients with unilateral biting pain and 14 controls were included in the study.Contralateral biting pain was defined as right molar clenching causing left temporomandibular joint （TMJ） pain. Ipsilateral biting pain was defined as right molar clenching causing right TMJ pain. Symptom Check List-90 （SCL-90） was administered to the patients and controls. Independent sample t-test was used to compare the SCL-90 subscales between the two groups. Unilateral clenching tasks were performed by the patients and controls. Imaging data were analyzed using SPM99.Results Patients were divided into contralateral TMD biting pain group （n=8） and ipsilateral TMD biting pain group （n=6）. The SCL-90 subscales were significantly different between the two groups for somatization, depression, anxiety,phobic anxiety, and paranoid ideation. Group analysis of the controls demonstrated brain activations in the inferior frontal gyrus, precentral gyrus, middle frontal gyrus, superior temporal gyrus, and insular. The areas of activation were different between right and left clenching task. In TMJ synovitis patients with contralateral or ipsilateral biting pain, the group analysis showed activations in the inferior frontal gyrus, superior temporal gyrus, medium frontal gyrus, precentral gyrus,and anterior cingulate cortex.Conclusions The inferior frontal gyrus and precentral gyrus play essential roles during the unilateral clenching task.Activation of anterior cingulate cortex in the synovitis patients with biting pain was associated with higher levels of psychological distress.

SIALOGRAPHIC FOLLOW-UP STUDY OF PATIENTS WITH SJOGREN'S SYNDROME

Sialographic follow-up studies of 36 cases of Sjogren's syndrome (SS) were performed with the duration of 5-72 months (mean 25 months). Three groups were divided according to the international criteria: secondary group, 14 cases (xerophthalmia, or / and xerostomia, and connective tissue diseases), primary group, 14 cases (xerostomia and xerophthalmia), and possible group, 8 cases (xerophthalmia or xerosptomia only). Sialographic findings at follow-up examination included (1) delayed evacuation, which may occur as early as 5 months later; (2) increased punctate sialectasis; (3) decreased punctate sialectasis with globular increase; (4) punctate, globular, and cavity sialectasis with radiolucent sialolith; and (5) centripetal atrophy. The cases with secondary and possible SS without xerostomia demonstrated little involvement of the parotid gland, without sialectasis. But sialodochitis was shown when radiolucent sialolith formed. The stimulated whole salivary flow rate (SWSFR) was closely related to Sialographic appearance, i.e., the cases with lower value of SWSFR showed more siatectasis sialographically, but with higher SWSFR value, and less sialectasis. The relationship between the SS and pyogenic or candidal infection was discussed.

Dimethylamino group modified polydopamine nanoparticles with positive charges to scavenge cell-free DNA for rheumatoid arthritis therapy

Excessive cell-free DNA(cfDNA)released by damaged or apoptotic cells can cause inflammation,impacting the progression of rheumatoid arthritis(RA).cfDNA scavengers,such as cationic nanoparticles(NPs),have been demonstrated as an efficient strategy for treating RA.However,most scavengers are limited by unfavorable biocompatibility and poor scavenging efficacy.Herein,by exploiting the favorable biocompatibility,biodegradability and bioadhesion of polydopamine(P),we modified P with dimethylamino groups to form altered charged DPs to bind negatively charged cfDNA for RA therapy.Results showed that DPs endowed with superior binding affinity of cfDNA and little cytotoxicity,which effectively inhibited lipopolysaccharide(LPS)stimulated inflammation in vitro,resulting in the relief of joint swelling,synovial hyperplasia and cartilage destruction in RA rats.Significantly,DPs with higher DS of bis dimethylamino group exhibited higher positive charge density and stronger cfDNA binding affinity,leading to excellent RA therapeutic effect among all of the treated groups,which was even close to normal rats.These finding provides a novel strategy for the treatment of cfDNA-associated diseases.