Chronic periodontitis and its possible association with oral squamous cell carcinoma – a retrospective case control study

Introduction: Different inflammatory processes may trigger the development of malignancies. Therefore, the aim of the present study was to evaluate a potential association between radiological determined chronic periodontitis (CPA) and oral squamous cell carcinoma (OSCC). Methods: In a retrospective study, OSCC-patients and a control group without malignant tumors were radiographically examined for bone loss. Via telephone survey and questionnaire, general clinical data on the individual oral hygiene and concomitant diseases together with tobacco and alcohol use were assessed and data were compared between the groups. Results: 178 OSCC-patients and 123 controls were included. In univariate analysis, a statistically relevant higher mean bone loss was seen in the OSCC group (4.3 mm (SD: 1.8; 95% confidence interval (CI): 4-4.6) vs. 2.9 mm (SD: 0.7; 95% CI: 2.8-3); p < 0.001)). This was confirmed in a multivariate regression model (OR: 2.4, 95% CI: 1.5-3.8; p < 0.001). A history of periodontal treatment was associated with significantly reduced OSCC risk (p < 0.001; OR: 0.2, CI: 0.1-0.5). Conclusions: CPA is a common disease and the monitoring as well as the treatment of such a chronic oral inflammation may be beneficial in reducing one potential cause of OSCC. Therefore, further clinical studies on oral neoplasms should consider clinical periodontal parameters as well

Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions

Objectives This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview. Materials and methods A literature search across PubMed, Embase, and Cochrane Library informed the analysis. Results Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain. Conclusions Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial. Clinical relevance Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals

Data for: Establishment of a Numerical Model to Design an Electro-Stimulating System for a Porcine Mandibular Critical Size Defect: [research data]

This data set provides the necessary computer-aided design project files (Materialise 3-matic) and 3D geometries to create the finite element model of an electrically stimulated minipig mandible that are described in the paper "Establishment of a Numerical Model to Design an Electro-Stimulating System for a Porcine Mandibular Critical Size Defect" published in the special Issue "Biomaterials for Bone Tissue Engineering" of the MDPI journal Applied Sciences (ISSN 2076-3417). Further, the finite element simulation models (COMSOL Multiphysics) are provided. The simulations allow to determine the electric field distribution and optimised stimulation parameters in the 3D model of the electrically stimulated minipig mandible

Consequences of the COVID-19 Pandemic and Governmental Containment Policies on the Detection and Therapy of Oral Malignant Lesions-A Retrospective, Multicenter Cohort Study from Germany

(1) Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. (2) Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity and time to intervention. The periods lockdown (LD) (13 March-16 June 2020), post-lockdown (PLD) (17 June-1 November 2020), and the corresponding equivalents in 2018/19 were differentiated and compared. (3) Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. (4) Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD to possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures

Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Terms of Staging and Treatment Strategies by Dental Students at Different Educational Levels

Background: The role of medication-related osteonecrosis of the jaw (MRONJ) as a dentomaxillo- facial pathology is becoming increasingly important due to its growing prevalence. The success of preventive and therapeutic measures relies mainly on the dentist’s ability to correctly diagnose the disease. Methods: The aim of this study was to evaluate the skills of dental students of different educational levels in choosing the correct stage, diagnostics, and treatment option for MRONJ based on clinical and radiographic imaging (panoramic radiograph, CBCT). The study was designed as a cross-sectional cohort study. Twenty dental students were asked to complete a questionnaire in their third and fifth year of studies in which they had to correctly stage the disease, choose the radiological diagnostics and recommend the treatment. The control group contained experienced oral and maxillofacial surgeons. Results: With an overall performance of 59% (third year: 145.2/248 points; fifth year: 145.3/248 points), no statistically significant difference between the educational levels could be observed. The classification based on CBCT imaging was significantly more often correct compared to panoramic radiographs (p < 0.001). Conclusions: This study highlights students’ lack of knowledge in staging, diagnostics, and treatment of MRONJ, even though the CBCT positively affected decision-making. No significant increase in knowledge could be confirmed through clinical education. This study highlights the need for students to catch up on MRONJ diagnostics and treatment planning. Further expansion of teaching in this disease’s context and X-ray diagnostics is needed

The Effect of Optical Conditioning of Preparations with Scan Spray on Preparation Form

Svrha rada: Za primjenu sustava CAD/CAM u ordinacijama dentalne medicine potrebno je odabrati sprej za skeniranje. Njegovom primjenom mijenja se prekrivena preparacija, što može nepovoljno utjecati na rubno zatvaranje i interno prianjanje restauracije. Zadaća ovog istraživanja bila je odrediti utjecaj spreja na preparacijsku formu procjenom morfologije i debljine triju različitih sprejeva za skeniranje. Materijali i metode: Određivala se površinska morfologija prekrivanja triju (A, B, C) različitih sprejeva za skeniranje uz pomoć konfokalnoga laserskog mikroskopa. Debljina sprejem nanesenog premaza mjerila se na staklenoj pločici i u simuliranim kliničkim uvjetima profilometrom i uređajem za digitalizaciju površine. Podaci su analizirani jednosmjernim testom ANOVA (α = .05). Rezultati: Konfokalni laserski mikroskop prikazao je grubu i nepravilnu sprejem pokrivenu površinu nakon uporabe svih sprejeva, te se od spreja A preko spreja B do spreja C broj malih zrnaca povećavao. Srednja debljina prekrivanja na staklenoj pločici iznosila je za sprej A 25,3 Μm, za B 18,9 Μm i za C 19,2 Μm. Statistički značajne razlike bile su između sprejeva A i B (p=0,017). U simuliranim kliničkim uvjetima srednja debljina prekrivanja iznosila je za sprej A 15,5 Μm, za B 15,0 Μm i za C 13,3 Μm. Razlika je bila statistički značajna samo između sprejeva A i C (p=0,033). Zaključak: Premazi nakon korištenja različitih sprejeva imali su drugačije površinske morfologije i različite debljine. Posljedično tome primjena spreja za skeniranje utječe i na konačnu CAD/CAM restauraciju, premda se kliničkim korištenjem postigla prihvatljiva debljina prekrivanja.Objective: CAD/CAM systems require scan spray for chairside sampling of tooth surfaces. However, this leads to alterations of the sprayed preparation and may affect marginal and internal adaption of the restoration. The aim of this study was to define the effect of scan spray on preparation form by evaluating the morphologies and the thicknesses of three different scan sprays. Materials and Methods: The surface morphology of the coatings of different scan sprays (A, B, C) was evaluated by use of a confocal laser scanning microscope. The thicknesses of spray coatings were measured on a glass plate as well as under simulated clinical conditions using a profilometer and a surface digitalisation device. The data were analysed by a 1-way ANOVA (α = .05). Results: The confocal laser scanning microscopy showed rough and irregular formed coating surfaces of all sprays, whereas an increasing numbers of small spray particles were seen from spray A over spray B to spray C. Mean coating thicknesses on the glass plate were: spray A 25.3 Μm, spray B 18.9 Μm and spray C 19.2 Μm. Significant differences were detected between spray A and B (P = .017). Under simulated clinical conditions median coating thicknesses were: spray A 15.5 Μm, spray B 15.0 Μm and spray C 13.3 Μm. A statistically significant difference could be detected only between spray A and C (P = .033). Conclusions: The coatings of the used scan spray systems showed different surface morphologies and exhibited different thicknesses. Consequently, the application of scan sprays affects the precision of the final CAD/CAM restorations. However, the scan sprays under investigation showed acceptable coating thicknesses for clinical use

Bisphosphonates: restrictions for vasculogenesis and angiogenesis: inhibition of cell function of endothelial progenitor cells and mature endothelial cells in vitro

Abstract Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is one of the main side effects in patients treated with bisphosphonates for metastasis to the bone or osteoporosis. BP-ONJ usually occurs in patients treated with highly potent nitrogen-containing bisphosphonates. The exact mechanism of action and etiopathology is still unknown. In addition to inhibition of bone remodelling, an anti-angiogenetic effect has become the focus of research. The aim of these study was to investigate the effect of different bisphosphonates on human umbilicord vein endothelial cells (HUVEC) and endothelial progenitor cells (EPC), which play an important role in angiogenesis. Using varying concentrations, the impact of one non-nitrogencontaining bisphosphonate (clodronate) and three nitrogencontaining bisphosphonates (ibandronate, pamidronate and zoledronate) on HUVEC and EPC was analysed. The biologic behaviour of HUVEC after incubation with different bisphosphonates was measured in a Boyden migration assay as well as in a 3D angiogenesis assay. The number of apoptotic cells was measured by Tunnel assay. To underline the importance of neoangiogenesis in the context of BP-ONJ, we measured the EPC number after incubation with different bisphosphonates in vitro. HUVEC and EPC were significantly influenced by bisphosphonates at different concentrations compared with the non-treated control groups. The nitrogen-containing bisphosphonates pamidronate and zoledronate had the greatest impact on the cells, whereas clodronate followed by ibandronate was less distinct on cell function. These results underline the hypothesis that inhibited angiogenesis induced by bisphosphonates might be of relevance in the development and maintenance of BP-ONJ. The increased impact by highly potent bisphosphonates on HUVEC and EPC may explain the high prevalence of BP-ONJ in patients undergoing this treatment

In Vivo Modulation of Angiogenesis and Immune Response on a Collagen Matrix via Extracorporeal Shockwaves

The effective management of tissue integration and immunological responses to transplants decisively co-determines the success of soft and hard tissue reconstruction. The aim of this in vivo study was to evaluate the eligibility of extracorporeal shock wave therapy (ESWT) with respect to its ability to modulate angiogenesis and immune response to a collagen matrix (CM) for tissue engineering in the chorioallantoic membrane (CAM) assay, which is performed with fertilized chicken eggs. CM were placed on the CAM on embryonic development day (EDD) 7; at EDD-10, ESWT was conducted at 0.12 mJ/mm2 with 500 impulses each. One and four days later, angiogenesis represented by vascularized area, vessel density, and vessel junctions as well as HIF-1α and VEGF gene expression were evaluated. Furthermore, immune response (iNOS2, MMP-9, and MMP-13 via qPCR) was assessed and compared between ESWT- and non-ESWT-groups. At EDD-14, the vascularized area (+115% vs. +26%) and the increase in vessel junctions (+751% vs. +363%) were significantly higher in the ESWT-group. ESWT significantly increased MMP-9 gene expression at EDD-11 and significantly decreased MMP-13 gene expression at EDD-14 as compared to the controls. Using the CAM assay, an enhanced angiogenesis and neovascularization in CM after ESWT were observed. Furthermore, ESWT could reduce the inflammatory activity after a latency of four days

Zoledronate Causes a Systemic Shift of Macrophage Polarization towards M1 In Vivo

Background: Immunomodulatory properties of bisphosphonates (BP) are suggested to contribute to the development of medication-associated osteonecrosis of the jaw (MRONJ). Furthermore, bisphosphonate-derived immune modulation might contribute to the anti-metastatic effect observed in breast cancer patients. Macrophages are potential candidates for the mediation of immunomodulatory effects of bisphosphonates. The study aimed to investigate the influence of bisphosphonates alone and in combination with surgical trauma on systemic macrophage polarization (M1 vs. M2) using an in vivo rat model. Methods: A total of 120 animals were divided into four groups. Groups 2 and 4 were treated with 8 × 40 μg/kg body weight of the BP Zoledronate i.p. (week 0–7). Groups 3 and 4 were exposed to surgical trauma (week 8, tooth extraction + tibia fracture), whereas in Group 1 neither medication nor surgical trauma was applied. After 8, 10, 12 and 16 weeks, skin, lung and spleen were immunohistochemically examined for macrophage polarization via expression analysis of CD68, CD163 and iNOS using a tissue microarray (TMA). Results: A significant shift of macrophage polarization towards M1 was observed in skin, spleen and lung tissue of animals, with and without surgical trauma, treated with BP when compared to those without BP application. Surgical trauma did not cause a significant increase towards M1 polarization. Conclusions: BP application leads to a systemic pro-inflammatory situation in vivo, independent of surgical trauma, as evidenced by the shift in macrophage polarization towards M1 in various somatic tissues. This provides a possible explanation for the clinically observed anti-tumor effect of bisphosphonates and might also contribute to pathogenesis of MRONJ

Accuracy Analysis of a Next-Generation Tissue Microarray on Various Soft Tissue Samples of Wistar Rats

This study aimed to investigate accuracy in different sectional planes of the TMA Grand Master (3DHISTECH) Workstation in various soft tissue samples collected from Wistar rats. A total of 108 animals were sacrificed and 963 tissue specimens collected from 12 soft-tissue types. A total of 3307 tissue cores were punched and transferred into 40 recipient TMA blocks. Digital image analysis was performed. Core loss showed a significant correlation with tissue type and was highest in skin tissue (p < 0.001), renal medulla and femoral artery, nerve, and vein bundle (p < 0.01). Overall, 231 of 3307 tissue cores (7.0%) were lost. Hit rate analysis was performed in 1852 punches. The target was hit completely, partially and missed totally by 89.4%, 7.2% and 2.2%. A total of 54.5% of punches had good accuracy with less than 200 µm deviation from the centre of the targeted region and 92.6% less than 500 µm. Accuracy decreases with greater sectional depth. In the deepest sectional plane of roughly 0.5 mm median depth, almost 90% of cores had a deviation below 500 µm. Recommendations for automated TMA creation are given in this article. The ngTMA®-method has proven accurate and reliable in different soft tissues, even in deeper sectional layers