How ChatGPT performs in Oral Medicine: The case of oral potentially malignant disorders

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Genetic Susceptibility to Periodontal Disease in Down Syndrome: A Case-Control Study

Severe periodontitis is prevalent in Down syndrome (DS). This study aimed to identify genetic variations associated with periodontitis in individuals with DS. The study group was distributed into DS patients with periodontitis (n = 50) and DS patients with healthy periodontium (n = 36). All samples were genotyped with the “Axiom Spanish Biobank” array, which contains 757,836 markers. An association analysis at the individual marker level using logistic regression, as well as at the gene level applying the sequence kernel association test (SKAT) was performed. The most significant genes were included in a pathway analysis using the free DAVID software. C12orf74 (rs4315121, p = 9.85 × 10−5, OR = 8.84), LOC101930064 (rs4814890, p = 9.61 × 10−5, OR = 0.13), KBTBD12 (rs1549874, p = 8.27 × 10−5, OR = 0.08), PIWIL1 (rs11060842, p = 7.82 × 10−5, OR = 9.05) and C16orf82 (rs62030877, p = 8.92 × 10−5, OR = 0.14) showed a higher probability in the individual analysis. The analysis at the gene level highlighted PIWIL, MIR9-2, LHCGR, TPR and BCR. At the signaling pathway level, PI3K-Akt, long-term depression and FoxO achieved nominal significance (p = 1.3 × 10−2, p = 5.1 × 10−3, p = 1.2 × 10−2, respectively). In summary, various metabolic pathways are involved in the pathogenesis of periodontitis in DS, including PI3K-Akt, which regulates cell proliferation and inflammatory responseThe genotyping service was carried out at CeGen-PRB3-ISCIII; it is supported by grant PT13/0001, ISCIII-SGEFI/FEDERS

Mechanism of Action of <i>Streptococcus downii</i>, a New Bacterial Species with Probiotic Potential

Streptococcus downii is a recently reported bacterial species of oral origin, with inhibitory capacity against Streptococcus mutans, Actinomyces naeslundii, Veillonella parvula and Aggregatibacter actinomycetemcomitans, which confers upon it the potential of being an oral probiotic. The aim of the present study was to identify the potential mechanisms by which S. downii exerts its inhibitory effect on S. mutans. To this end, the study assessed the consumption of glucose and proteins available in the culture medium, the modification of the pH, the production of short-chain fatty acids, the changes in the protein panel of the inhibition halo, the production of hydrogen peroxide and the effect of proteinase K. There were no differences in the glucose values or in the protein content of the medium, but there was a reduction in pH (with no effect on the growth of S. mutans). Significant increases were detected in the levels of lactic and formic acid (with no effect on the growth of S. mutans), as well as changes in the peptide panel (with no effect on the growth of S. mutans). The inhibitory effect was maintained in the presence of peroxidase but disappeared after adding proteinase K. Based on these results, it is suggested that the main mechanism of inhibition of S. downii against S. mutans is the production of bacteriocins

Cranial-Vertebral-Maxillary Morphological Integration in Down Syndrome

Background: Morphological integration refers to the tendency of anatomical structures to show correlated variations because they develop in response to shared developmental processes or function in concert with other structures. The objective of this study was to determine the relationships between the dimensions of different cranial-cervical-facial structures in patients with Down syndrome (DS). Methodology: The study group consisted of 41 individuals with DS who had undergone cone-beam computed tomography (CBCT) at the Dental Radiology Unit of the University of Santiago de Compostela (Spain). In the historical archive of this same unit, 41 CBCTs belonging to individuals with no known systemic disorders or severe malformations of the maxillofacial region were selected, forming an age and sex-matched control group. Twenty-nine measurements were performed on each participant&rsquo;s CBCT images, which were grouped into three blocks: atlantoaxial dimensions, craniovertebral dimensions and cephalometric dimensions. To determine whether there were significant differences between the dimensions obtained in the DS and control groups, we applied multiple analysis of variance and linear discriminant analysis tests. The analysis of the association between blocks (in pairs) was performed with the canonical correlation analysis test. Results: The dimensions evaluated in the three blocks of variables of individuals with DS differ significantly from those of nonsyndromic controls (p &lt; 0.001). The highest discriminative capacity to identify controls and patients with DS was obtained with the cephalometric dimensions (87.5%). With regard to the association between blocks (two-by-two measurements), we found no significant relationship in the DS group. However, we confirmed a statistically significant correlation between all pairs of blocks of variables in the controls, especially between the atlantoaxial and cephalometric dimensions (p &lt; 0.001) and between the craniovertebral and cephalometric dimensions (p &lt; 0.001). Conclusions: Our results confirm a very poor morphological integration of the cranial-cervical-maxillary complex in individuals with DS. This finding reinforces the proposal that gene overload enhances the channeling process

Molecular Detection of Streptococcus downii sp. nov. from Dental Plaque Samples from Patients with Down Syndrome and Non-Syndromic Individuals

A new bacterial species has recently been identified in the dental plaque of an adolescent with Down syndrome. The species is known as Streptococcus downii sp. nov. (abbreviated to S. downii), and it inhibits the growth of S. mutans and certain periodontal pathogens. The aim of this study was to determine the distribution of S. downii in the oral cavity of individuals with Down syndrome. Methods: A specific polymerase chain reaction for the operon of bacteriocin (class IIb lactobin A/cerein 7B family) was designed to detect S. downii in individuals with Down syndrome (n = 200) and in the general population (n = 100). We also compared the whole genome of S. downii and the regions related to its bacteriocins against 127 metagenomes of supragingival plaque of the &ldquo;Human Microbiome Project&rdquo;. Results: We detected the specific gene of the S. downii bacteriocin in an individual with Down syndrome (Cq, 34.52; GE/&mu;L, 13.0) and in an individual of the non-syndromic control group (Cq, 34.78 Cq; GE/&mu;L, 4.93). The prevalence of S. downii was &le;1% both in Down syndrome and in the general population, which did not allow for clinical-microbiological correlations to be established. This result was confirmed by detecting only one metagenome with an ANIm with approximately 95% homology and with 100% homology with ORFs that code class IIb lactobiocin A/cerein 7B bacteriocins among the 127 metagenomes of the &ldquo;Human Microbiome Project&rdquo; tested. Conclusions: The detection rate of S. downii in the supragingival dental plaque was very low, both in the Down syndrome individuals and in the non-syndromic controls. A clinical-microbiological correlation could therefore not be established

Is It Useful to Determine the Temperature of Children for COVID-19 Screening in the Dental Setting?

Background: To date, the efficacy of temperature readings of children in the dental setting for COVID-19 screening has not been evaluated. The aim of this pilot study was to assess the usefulness of forehead temperature measurements in a dental clinic for COVID-19 screening in healthy children (without systemic disease) and in children with neurodevelopmental disorders. Methods: Using an infrared thermometer, we recorded the forehead temperature of 200 pediatric patients (100 healthy children and 100 children with neurodevelopmental disorders). We performed temperature measurements &ldquo;before&rdquo;, &ldquo;during&rdquo;, and &ldquo;after&rdquo; the dental procedure. Oropharyngeal swabs were taken of all participants to detect SARS-CoV-2. Results: Sex, age, administration of local anesthesia, and use of rotary instrumentation did not affect the temperature values. In the children with neurodevelopmental disorders with a value of 1 on the Frankl behavior scale, the temperatures were significantly higher than in those with values of 2, 3, and 4 (p = 0.032, p = 0.029, and p = 0.03, respectively). The PCR for SARS-CoV-2 was positive for two patients (one healthy and the other with a neurodevelopmental disorder), whose &ldquo;before&rdquo; temperatures were 36.4 &deg;C and 36.5 &deg;C, respectively. Conclusions: Forehead temperatures increase during dental procedures and are conditioned by the patient&rsquo;s behavior. An isolated temperature reading does not identify children infected by SARS-CoV-2

Plaque removal efficacy of a new toothbrush with a double-sided head and rotating handle-a pilot randomized control trial in acquired brain injury patients

Objectives: To assess the efficacy of a new toothbrush (Balene) for the mechanical removal of dental plaque in patients with acquired brain injury. Material and methods: The study group consisted of 25 adults with acquired brain injury. The participants underwent 2 sessions of toothbrushing lasting 1 min, one with a conventional toothbrush and the other with the Balene toothbrush. This new double-headed toothbrush has 6 active sides, which allows for the simultaneous toothbrushing of both alveolar arches, with elastomer bristles angled at 45°, as well a handle that rotates up to 180°. Therefore, the user does not need to remove the toothbrush from the oral cavity during the toothbrushing process. Dental plaque accumulation was assessed using the simplified oral hygiene index of Greene and Vermillion. Results: The plaque index was significantly reduced both with the Balene toothbrush (p < 0.001) and with the conventional toothbrush (p < 0.001). The dental plaque removal efficacy was similar with the two toothbrushes. There were also no statistically significant differences in the removal of plaque with the Balene toothbrush between the autonomous and assisted toothbrushing modalities (p = 0.345). Conclusions: For patients with acquired brain injury, the Balene toothbrush was as effective as a conventional toothbrush, regardless of whether the toothbrushing modality was autonomous or assisted. Clinical relevance: The Balene® toothbrush's efficacy in removing dental plaque is similar to that of conventional toothbrushes, both with the autonomous and assisted toothbrushing modality. Given its particular ergonomics, this toothbrush could be indicated for certain select patients with acquired brain injury (i.e., those whose degree of cooperation allows for toothbrushing, with a sufficient mouth opening, with no substantial abnormalities in the intermaxillary relationship, and with no significant edentulous sections)Open Access funding provided thanks to the CRUE-CSIC agreement with Springer NatureS

Dental desensitization by dentists and occupational therapists for autistic adults: A pilot study

Castaño Novoa, P., Limeres Posse, J., García Mato, E., Varela Aneiros, I., Abeleira Pazos, M. T., Diz Dios, P., & Rivas Mundiña, B. (2024). Dental desensitization by dentists and occupational therapists for autistic adults: A pilot study. Autism, 28(2), 515-519. Copyright © SAGE Publications 2024. https://doi.org/10.1177/13623613231173757The aim of this pilot study was to assess the efficacy of a desensitization program developed by dentists and occupational therapists, targeted at autistic adults, to encourage their cooperation in the dental setting. The study group consisted of 18 individuals with autism (10 men and 8 women, aged 18–45 years). The patients underwent a baseline examination, after which they were progressively exposed to oral examination maneuvers and ultimately dental procedures. To this end, the participants engaged in a weekly desensitization session performed by an occupational therapist and a monthly assessment session by a dentist applying the Frankl scale, for a maximum period of 30 weeks. During the first session, 44% of the participants completed all oral examination procedures, reaching 94% by the fourth visit and 100% by the seventh visit. None of the participants completed a simple dental treatment up to the third session, subsequently increasing the percentage progressively until reaching a maximum of 61% in the seventh visit. In conclusion, a dental desensitization program implemented by dentists and occupational therapists could help in performing oral examinations and simple therapeutic procedures for a considerable percentage of adults with autism, without having to resort to pharmacological behavioral control techniquesS

Development of a new tool for predicting the behavior of individuals with intellectual disability in the dental office: A pilot study

Background: The dental treatment of individuals with intellectual disability can represent a considerable professional challenge. Objective: To develop a model for predicting the behavior of patients with intellectual disability in the dental office. Methods: The study group comprised 250 patients with Down syndrome (DS), autism spectrum disorder (ASD), cerebral palsy (CP), idiopathic cognitive impairment or rare disorders. We collected their demographic, medical, social and behavioral information and identified potential predictors (chi-squared test). We developed stratified models (Akaike information criterion) to anticipate the patients'behavior during intraoral examinations and to discern whether the dental treatment should be performed under general anesthesia. These models were validated in a new study group consisting of 80 patients. Goodness of fit was quantified with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic curve (AUC). We developed a mathematical algorithm for executing the models and developed software for its practical implementation (PREdictors of BEhavior in Dentistry, “PREBED”). Results: For patients with DS, ASD and CP, the model predicting the need for physical restraint during examination achieved a PPV of 0.90, 0.85 and 1.00, respectively, and an NPV of 0.66, 0.76 and 1.00, respectively. The model predicting the need for performing treatment under general anesthesia achieved a PPV of 0.63, 1.00 and 1.00, respectively, and an NPV of 1.00, 1.00 and 0.73, respectively. However, when validating the stratified models, the percentage of poorly classified individuals (false negatives + false positives) ranged from 24% to 46.6%. Conclusions: The results of the PREBED tool open the door to establishing new models implementing other potentially predictive variables.S

Evaluation of Intraligamentous and Intraosseous Computer-Controlled Anesthetic Delivery Systems in Pediatric Dentistry: A Randomized Controlled Trial

Computer-controlled local anesthetic delivery systems (CDS) represent one of the resources that have progressed the most in recent years, but their efficacy and applicability in pediatric dentistry is still the subject of certain controversies. This randomized, controlled, split-mouth clinical trial assessed two CDS in children (n = 100) with deep caries in the temporary dentition that required invasive therapeutic procedures, using inferior alveolar nerve block as the gold standard. Half of the patients (n = 50) underwent the intraligamentary technique (Wand STA®) on one side of the mouth and conventional inferior alveolar nerve block on the contralateral side, while the other half (n = 50) underwent the intraosseous technique (QuickSleeper®) on one side of the mouth and conventional inferior alveolar nerve block on the contralateral side. The following were considered covariates: age, sex, type of dental procedure and the applied local anesthesia system. The outcome variables were the pain caused by the anesthesia injection, the physical reaction during the anesthesia injection, the need for anesthetic reinforcement, pain during the therapeutic procedure, the overall behavior during the visit, the postoperative morbidity and, lastly, the patient’s preference. In conclusion, we confirmed the efficacy of intraligamentary and intraosseous techniques administered using a CDS for conducting invasive dental treatments in children, their advantages compared with inferior alveolar nerve block in terms of less pain generated by the anesthesia injection and less postoperative morbidity, as well as the pediatric patients’ preference for CDS versus conventional techniques