The aim of this study was to assess TERT-CLPTM1L single-nucleotide polymorphisms (SNPs) (rs402710 C/T in the CLPTM1L gene; rs2736100 A/C and rs2736098 G/A in the TERT gene) as risk factors for development of oral squamous cell carcinoma (OSCC), and to investigate the relationship between the analyzed polymorphisms, relative telomere length (RTL), telomerase expression and clinicopathologic characteristics of OSCC in a Serbian population. Paraffin-embedded tumor samples and buccal swabs from cancer-free controls were genotyped using PCR-RFLP, while tumor RTL values and telomerase expression were estimated by real-time PCR and immunohistochemistry, respectively. CLPTM1L rs402710 and TERT rs2736100 polymorphisms were associated with a significantly increased risk of OSCC, and TERT rs2736098 with a significantly decreased risk. No significant association was found between TERT-CLPTM1L polymorphisms, tumor RTL values, telomerase expression, and clinicopathologic features, although a trend towards longer telomeres was evident in telomerase-positive samples and less advanced tumors. Kaplan-Meier survival analysis showed that patients with longer telomeres in their tumors had significantly better overall survival than patients with shorter telomeres. Our research seems to provide strong evidence for an association between CLPTM1L rs402710C/T and TERT rs2736100A/C SNPs and the risk of OSSC, and suggests that higher tumor RTL values and positive hTERT expression may be applicable as early prognostic markers.
Odontogenic tumors are a group of lesions arising from the odontogenic apparatus. Although the mechanism of oncogenesis and tumor progression in these lesions remains unknown, certain proteins, such as those involved in apoptosis, seem to be involved in the differentiation and proliferation of odontogenic epithelial cells. The aim of this study was to analyze the expression of p73 and TNF-related apoptosis-inducing ligand (TRAIL) in odontogenic tumors and cysts, and to clarify changes in the expression of these proteins. Immunohistochemical analysis was performed on 21 ameloblastomas, 15 keratocystic odontogenic tumors and 15 dentigerous cysts. We carried out quantitative assessment of p73 and TRAIL expression by determining the percentages of positive cells on a continuous scale. Five cases of orthokeratinized odontogenic cyst were also examined. The percentages of cells immunohistochemically positive for p73 were 52.6 ± 25.4% in ameloblastomas, 76.0 ± 13.1% in keratocystic odontogenic tumors, and 26.7 ± 30.7% in odontogenic cysts, whereas the corresponding figures for TRAIL were 57.6 ± 16.1%, 8.9 ± 10.0%, and 1.5 ± 0.5%, respectively. Imbalance of the apoptosis pathway, with dysregulation of p73 and TRAIL, seems to play a role in the oncogenesis of odontogenic tumors.
The aim of this clinical study was to determine levels of visceral adipose tissue-derived serpin (vaspin), omentin-1, and tumor necrosis factor-alpha (TNF-α) in the gingival crevicular fluid (GCF) of obese and non-obese periodontitis patients following nonsurgical periodontal therapy. Seventy-six subjects were separated into four groups according to periodontal and anthropometric measurements: a periodontal-healthy group, a chronic periodontitis (CP) group, a periodontal-healthy with obesity group, and a CP with obesity group. Nonsurgical periodontal treatment was administered to periodontitis patients. Before treatment and at 6 weeks after treatment, GCF samples were analyzed and clinical periodontal parameters were examined. Enzyme-linked immunosorbent assays were used to measure the levels of vaspin, omentin-1, and TNF-α. Obese and non-obese CP patients displayed higher levels of vaspin and TNF-α (P < 0.008), which declined following treatment (P < 0.025), and lower omentin levels (P < 0.008), which increased after treatment (P < 0.025). There was a negative correlation between the total amount of vaspin and omentin-1 in all groups. Obese and non-obese patients had opposing levels of vaspin and omentin-1 in the GCF; therefore, these may represent diagnostic and prognostic indicators of periodontal disease and therapeutic outcome.
In this descriptive study, we investigated the relationship between the clinical characteristics of idiopathic burning mouth syndrome (iBMS) and the quality of life. Eighteen iBMS patients were interviewed about their experience with pain, oral-associated complaints, cognitive status, and self-perceived quality of life using the French versions of the Hospital Anxiety and Depression Scale (HADS) and the Global Oral Health Assessment Index (GOHAI). The Spearman coefficient was used to analyze correlations. The level of significance was fixed at P < 0.05. The majority of patients described the association of oral burning sensations with other oral complaints, including dry mouth (77.8%), tactile abnormalities (66.7%), thermal abnormalities (44.5%), and taste disturbances (38.9%). HAD-anxiety scores were higher than 10 in 38.8% of iBMS patients and HAD-depression scores were higher than 10 in 33.3% of patients. A significant correlation was found between the number of associated complaints and HAD-depression scores. The mean GOHAI-add score was 37.9 ± 9.6 (mean ± SD), and 94.5% of iBMS patients had a score lower than 50. GOHAI-add scores strongly correlated with pain intensity, which was calculated using a visual analog scale and duration of pain. Our findings indicate a strong correlation between iBMS-related pain and self-perceived oral health-related quality of life. In addition, a correlation was observed between iBMS-associated oral complaints and cognitive status.
We evaluated the correlation between oral health-related quality of life (OHRQoL) and the Helkimo clinical dysfunction index (HDI) in patients with temporomandibular joint osteoarthritis (TMJ OA). Clinical data and scores for the Chinese version of the 14-item Oral Health Impact Profile (OHIP-C14) were recorded and analyzed for 541 patients with TMJ OA. Each patient was assigned an HDI score of 1 to 25, which was used to classify severity into three categories. OHRQoL was assessed by using OHIP-C14 score, which ranged from 0 to 56. Both HDI score and severity were significantly correlated with total OHIP-C14 score (P < 0.001 for both comparisons). The scores for all HDI domains except function impairment (P = 0.205) were significantly correlated with OHIP-C14 score. The scores for all seven OHIP-C14 domains were significantly correlated with HDI score and severity. Several correlations between OHIP-C14 domains and HDI domain scores were significant. HDI score and severity were correlated with OHIP-C14 score in TMJ OA patients. As compared with function-related domains, pain-related HDI domains were more strongly inversely related to OHRQoL.
The purpose of this study was to evaluate visfatin levels at different stages of periodontal disease and in healthy tissues. In addition, the effect of non-surgical periodontal therapy on visfatin levels in gingival crevicular fluid and serum was investigated. Forty-five patients were divided into three groups based on clinical and radiographical findings. Group 1 comprised periodontally healthy individuals (n = 15); group 2 comprised patients with gingivitis (n = 15); and group 3 was composed of patients with generalized chronic periodontitis (n = 15). Gingival crevicular fluid and serum samples were collected before treatment and at 1, 3, and 6 months after treatment. Visfatin levels were measured by enzyme-linked immunosorbent assays. Gingival crevicular fluid and serum visfatin levels were higher in patients with chronic periodontitis than those with gingivitis or healthy controls (P < 0.016). In addition, visfatin levels were higher in the gingivitis group than in healthy controls (P < 0.016). Non-surgical periodontal treatment resulted in a significant reduction in gingival crevicular fluid and serum visfatin levels. Furthermore, visfatin levels increased with inflammation and decreased following periodontal treatment. Our findings suggest that visfatin is an inflammatory biomarker of periodontal disease.
We evaluated 3-dimensional changes in the temporomandibular joints of children with skeletal Class III malocclusion and maxillary deficiency after facemask therapy for maxillary protraction. Eighteen children with anterior crossbite and a Class III molar relationship underwent facemask therapy for maxillary protraction, after which they exhibited positive overjet and a Class II molar relationship. Three-dimensional cone-beam computed tomography images of the patients were obtained before (T1) and after (T2) facemask protraction, and the 3-dimensional coordinates of the anatomical landmarks in T1 and T2 images were compared. After facemask therapy, the mandibular condyles of the patients were displaced outside, upward, and backward. Additionally, the anterior and posterior walls of the glenoid fossa had negative values for anteroposterior change. Three-dimensional analysis of the temporomandibular joint showed that facemask therapy resulted in bone apposition (to the anterior wall) and bone resorption (of the posterior wall) in the glenoid fossa. This bone remodeling resulted in upward and backward displacement of the condyle.
It has been documented that an increase of immune cells in periodontitis may stimulate the process of atherosclerosis and lead to ischemic stroke. The aim of this study was to investigate whether there is any significant difference in serum and gingival crevicular fluid (GCF) cytokine concentrations between patients with early ischemic stroke (IS) and a control group. Eighty-six patients were consecutively enrolled for this study, 50 with ischemic stroke and 36 as a control group with no previous stroke. Only dentulous patients were included. In each patient, GCF was collected from the deepest periodontal pocket. Blood serum samples were also taken from all subjects. The collected material was analyzed for cytokine concentrations using the cytometric bead array technique. Cerebral ischemia was found to be correlated with higher serum levels of IL-1β (13.01 ± 13.87 vs. 7.83 ± 2.11) and IL-6 (15.82 ± 16.64 vs. 6.64 ± 2.5) compared to the control group. The levels of IL-1, IL-6 and TNF-α in GCF were higher in patients with ischemic stroke but the difference was not significant. In conclusion, ischemic stroke was found to be associated with higher levels of IL-1β and IL-6 in serum. The cytokine concentrations in GCF did not appear to be directly correlated with those in serum in patients with ischemic stroke.
The orthodontic mini-implant (MI) is a widely used anchorage device in orthodontic treatment. This prospective study analyzed MI survival and factors associated with MI survival in 139 patients (114 females and 25 males; average age, 25.7 years; age range, 12-56 years) who had received orthodontic treatment with MIs. Survival analysis and Kaplan-Meier curves were used to identify clinical variables associated with MI survival. For the 254 MIs investigated, the overall success rate was 85.8%, and the 1-year cumulative survival rate was 81.6%. MI survival was significantly associated with patient age and MI size. Notably, MI survival was significantly longer in patients aged 20-30 years than in older patients. The Cox proportional-hazards model revealed a 5% increase in failure risk for every 1-year increase in age among participants older than 30 years. Additionally, MI failure risk was inversely associated with MI length. MIs are generally reliable anchorage devices for orthodontic treatment but should be used with caution in older patients, due to the higher rate of failure in that population. Another important factor in MI survival is implant size. Future studies should attempt to clarify associations between MI survival and clinical variables.
The purpose of the present study was to evaluate the response to periodontal management in obese individuals with poorly controlled diabetes mellitus (DM) and obese individuals without DM. Changes in clinical and biochemical parameters were also investigated. Seventeen obese patients with poorly controlled DM and 14 obese non-DM patients with generalized chronic periodontitis were enrolled. The anthropometric measurements, periodontal parameters, and serum levels of lipid (triglyceride, high-density lipoprotein cholesterol, total cholesterol, low-density lipoprotein cholesterol) and glucose (fasting plasma glucose [FPG], insulin, insulin resistance [IR], hemoglobin [Hb]A1c) metabolism, pro-inflammatory mediators (high-sensitivity C-reactive protein, tumor necrosis factor-α [TNF-α] and Pentraxim-3), and interleukin-6 were measured before and at 3 months, and 6 months after full-mouth scaling and root planing (FM-SRP) together with full-mouth disinfection (FMD). A significant reduction in TNF-α (P < 0.001) values was observed in both groups following periodontal healing. However, significant changes in FPG (P < 0.05), HbA1C (P < 0.05), and the homeostasis model assessment of IR (HOMA-IR; P < 0.05) were only observed after 3 months in the DM group. Our findings suggest that obesity with or without DM does not seem to be a modifying factor for the clinical outcome of FM-SRP and FMD.
The occurrence of ameloblastic fibro-odontoma (AFO) in the oral region is unusual and accounts for 1-3% of all odontogenic tumors. AFO presents mixed radiopaque patterns within the lesion with diverse findings; therefore, it is important to compare this tumor with other odontogenic tumors that radiographically present with calcified bodies. Herein, we observed the calcification patterns within the lesion in seven AFO cases (five males, two females; mean age, 8.3 years; age range, 4-13 years). Periapical and panoramic radiographs were obtained from all seven cases. Five cases underwent conventional computed tomography (CT) scanning, and one underwent cone beam CT. Classification of the calcifications primarily involved the following two characteristics on the X-rays: appearance and location of the lesions. All seven cases were located in the molar regions of the mandible in association with impacted teeth. The calcification patterns of these AFOs were mixed or inhomogeneous within the lesion with various findings, including complex odontoma-like calcifications. However, the patterns differed between panoramic radiography and CT in some cases. The radiolucent lesions in AFO demonstrated varying calcification patterns and were associated with impacted teeth on the CT images.
This study aimed to investigate the effect of frequency on shear fatigue strength (SFS). The SFS of a resin composite bonded to dentin was determined using three self-etch adhesive systems: G-ænial Bond, Scotchbond Universal, and Optibond XTR. The staircase method of fatigue testing was used to determine the SFS at frequencies of 5, 10, and 20 Hz for 50,000 cycles. The failed bonding sites observed were classified based on the type of bond failure as follows: adhesive failure, cohesive failure in composite, cohesive failure in dentin, or mixed failure (partially adhesive, partially cohesive). A modified t-test with Bonferroni correction was used to analyze the SFS data, and a complex chi-square test was used to analyze the fracture modes. The SFS of OX was significantly greater than that of GB at both 5 and 10 Hz. However, no significant differences in SFS were found among the three frequencies (5, 10, and 20 Hz) in the three self-etch adhesive systems. Furthermore, no significant differences in bond failure mode were observed among the three frequency rates in all the three adhesives used.
The present study aimed to evaluate the levels of soluble receptor for advanced glycation end products (sRAGE) and tumor necrosis factor-α (TNF-α) in serum and gingival crevicular fluid (GCF) in chronic periodontitis (CP) patients with and without type 2 diabetes mellitus (T2DM). A total of 70 subjects were divided into four groups: group 1 (n = 15; subjects with healthy periodontium); group 2 (n = 20; CP patients); group 3 (n = 20; CP patients with T2DM); and group 4 (n = 15; CP patients without T2DM). The serum and GCF levels of human sRAGE and TNF-α were assessed using enzyme-linked immunosorbent assay and correlated with clinical parameters, including probing depth, gingival index and clinical attachment level. Both sRAGE and TNF-α levels varied with the inflammatory state of the patient; the highest levels of sRAGE were seen in group 1, whereas the lowest levels in group 3 (P < 0.05). Conversely, TNF-α levels were found to be the highest in group 3 and lowest in group 1 (P < 0.05). Thus, human sRAGE and TNF-α can be considered as possible GCF and serum markers of inflammatory activity in CP and T2DM.
The aim of the present study was to evaluate the association of single nucleotide polymorphisms (SNPs) in toll-like receptor 4 (TLR4) with chronic obstructive pulmonary disease (COPD) in Han Chinese patients with chronic periodontitis (CP). Six candidate SNPs of TLR4—rs10759930, rs10983755, rs11536879, rs1927907, rs11536889 and rs7873784—and 18 haplotype-tagging SNPs (tagSNPs) were genotyped in 339 patients with chronic periodontitis only (CP group), and 373 CP patients with COPD (CP with COPD group). The genotype distribution and allele frequencies of TLR4 rs1927907 among the CP (AA: 26, 8.5%, AG: 109, 35.5%, GG: 172, 56.0%) and CP with COPD (AA: 41, 12.0%, AG: 143, 41.7%, GG: 159, 46.4%) groups were significantly different (P = 0.039). After adjusting for age, sex, smoking status, and oral hygiene habits, CP patients carrying the AG polymorphism in TLR4 rs1927907 were found to be more susceptible to concomitant COPD than those carrying the GG genotype (P = 0.005, OR = 1.94, 95% CI for OR: 1.22-3.03). In conclusion, TLR4 gene polymorphism plays a role in the common pathophysiology of CP and COPD, indicating that CP patients with TLR4 gene rs1927907 polymorphism may be more susceptible to COPD.
This study evaluated the effects of different auxiliary irrigation devices on smear layer removal with a chelating solution (QMix). Fifty single-rooted permanent human teeth were shaped with a sequence of nickel-titanium instruments. A 2% chlorhexidine gel was used as a chemical auxiliary substance during preparation. Samples were assigned to five groups (n = 10 each) according to final irrigation protocol, namely, distilled water (control group), QMix 1 min, QMix + passive ultrasonic irrigation (PUI), QMix + plastic endodontic finishing file (EC), and QMix 3 min. Teeth were prepared and evaluated by scanning electron microscopy, and three photomicrographs (magnification, 1,000×) were obtained for each root third. Two blinded and precalibrated evaluators analyzed and scored the images, and the data were statistically analyzed by the Kruskal-Wallis and Dunn tests (P < 0.05). Groups were ranked according to the extent of smear layer removal. The total area of the root canal walls and apical root thirds was calculated, and the groups ranked PUI > EC = QMix 3 min > QMix 1 min > control. QMix 1 min was effective for smear layer removal only when used with auxiliary devices, and QMix + passive ultrasonic irrigation yielded the best results, particularly for the apical third.
This pilot study evaluated the clinical efficacy of a mouthwash containing 1% Matricaria chamomilla L. (MTC) extract in reducing gingival inflammation and plaque formation in patients undergoing orthodontic treatment with fixed appliances. This randomized, double-blind, placebo-controlled study enrolled a total of 30 males and females (age, 10-40 years) with fixed orthodontic appliances and a minimum of 20 natural teeth. The participants were allocated to three groups (n = 10 each) and asked to rinse with 15 mL of a placebo, 0.12% chlorhexidine (CHX), or 1% MTC mouthwash, immediately after brushing for 1 min, in the morning and evening, for 15 days. Data (mean ± SD) on visible plaque index (VPI) and gingival bleeding index (GBI) were recorded on days 1 and 15. The placebo group exhibited increases in VPI and GBI (10.2% and 23.1%, respectively) from day 1 to day 15. As compared with placebo, VPI and GBI significantly decreased in the MTC group (−25.6% and −29.9%, respectively) and the CHX group (−39.9% and −32.0%, respectively). In summary, MTC reduced biofilm accumulation and gingival bleeding in patients with gingivitis, probably because of its antimicrobial and anti-inflammatory activities.
We investigated the direct and indirect (residual) antibacterial effects of various concentrations of triple antibiotic paste (TAP) loaded into a methylcellulose system. Enterococcus faecalis (E. faecalis) was grown on sterilized dentin blocks (n = 60) and treated with clinically used TAP (1,000 mg/mL), low concentrations of methylcellulose-based TAP (100, 10, and 1 mg/mL), placebo paste, or 1.5% NaOCl (n = 10). The pastes were then removed, and biofilm disruption assays were performed. Additional dentin blocks (n = 120) were pretreated with the same experimental groups (n = 20). The pastes were rinsed off, and the samples were immersed independently in phosphate-buffered saline for 2 and 4 weeks (n = 10). E.faecalis was then grown on the dentin blocks, and biofilm disruption assays were performed. Fisher’s Exact and Wilcoxon rank sum tests were used for statistical analyses. With regard to direct antibacterial effects, all treatment groups demonstrated complete eradication of biofilms in comparison to placebo paste, while 10 mg/mL of TAP or higher provided substantial residual antibacterial effects. However, dentin treated with 1 mg/mL of TAP or 1.5% NaOCl did not provide substantial residual antibacterial effects. Dentin pretreated with 10 mg/mL of TAP or higher exhibited extended residual antibacterial effects and can thus be used during endodontic regeneration.
A number of concepts and devices have been proposed for caries removal. Among these, the Er:YAG laser is a potential alternative to conventional mechanical treatment. This study compared the effectiveness of the Er:YAG laser with that of low-speed rotary instruments for removal of carious tissue in 26 extracted human molars and premolars with severe decay (i.e., large occlusal or proximal decay but no pulpal contact). The teeth were divided into three groups of eight teeth, and two teeth were used as controls. After sectioning all the teeth through the center of the carious lesion before excavation, each group was randomly assigned to three groups—Er:YAG laser versus tungsten bur, Er:YAG laser versus polymer bur, and polymer bur versus tungsten bur—to evaluate the efficacy of the three techniques. The time required for carious treatment of each half was recorded, and samples were then histologically examined. Mean duration of caries removal did not significantly differ in relation to the technique used. Histological analysis of tooth halves treated with the Er:YAG laser revealed a regular 5-µm-thick stained layer that appeared to be denatured collagen. A smear layer was often detectable in halves treated with carbide burs. A superficial disorganized layer, which was found to be affected dentin, was observed in halves treated with polymer burs. The present findings indicate that the three techniques were clinically and histologically effective in removing the infected dentin layer.