Bioinformatics and Data Mining Studies in Oral Genomics and Proteomics: New Trends and Challenges

Genomics and proteomics have promised to change the practice of dentistry and oral pathology, allowing the identification and the characterization of risk factors and therapeutic targets at a molecular level. However, mass-scale molecular genomics and proteomics suffer from some pitfalls: gene/protein expression are significant only if inserted in a detailed network of molecular pathways and gene/gene, gene/protein and protein/protein interactions

Immediate loading with fixed full-arch prostheses in the maxilla: review of the literature

Objectives: To critically review the evidence-based literature on immediate loading of implants with fixed full- arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure. Study Desing: Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extrac - tion implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications andmean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied. Results: Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic pro - cedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported. Conclusions: The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the con - clusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the conventional loading procedures

Minimally invasive prosthetic procedures in the rehabilitation of a bulimic patient affected by dental erosion

The population affected by dental erosion due to bulimia is generally very young. This population group has a high aesthetic requirement; the dentition in these patients is severely damaged, especially in the anterior maxillary quadrant. In terms of treatment, it is still controversial whether an adhesive rehabilitation is preferable to a longer-lasting but more aggressive conventional treatment, such as full-crown coverage of the majority of teeth. This case report describes the prosthetic rehabilitation of a young female patient previously affected by bulimia nervosa and presenting erosion of the maxillary teeth. The prosthetic rehabilitation was performed through indirect adhesive restorations of the anterior teeth and direct restorations of the posterior teeth. A clinical follow-up after 4 years showed that the occlusion remained satisfactorily restored. Posterior direct composite resin restorations and anterior indirect adhesive composite restorations proved to be an effective time and money-saving procedure to rehabilitate patients affected by dental erosion. Adhesive rehabilitation provides a functional and good aesthetic result while preserving tooth structure

Relationship between human oral lichen planus and oral squamous cell carcinoma at a genomic level: a datamining study

The leader gene approach is a data mining method based on the systematic search for genes involved in a specific process and their ranking according to the number of interconnections with the other genes identified. The genes with the strongest interconnections are termed leader genes, since they may be supposed to play an important role in the process. The potential of malignant progression of OLP to oral squamous cell carcinoma (OSCC) is still not completely clear. In this study, the leader gene approach is applied to investigate the association between OLP and OSCC at a molecular level. Results were integrated with those obtained in an experimental analysis (see paper 1 of this series). Genes involved in OLP and OSCC were identified by systematic queries to dedicated databases. Interconnections among identified genes were calculated and given a confidence value using STRING database. Leader genes were identified by clustering genes according to their interconnections. This theoretical analysis shows that OLP and OSCC share two leader genes: TP53 and CDKN1A, involved in the PI3K signalling events mediated by AKT pathway. This finding and those obtained in the experimental analysis suggest the possible involvement of some key genes/proteins LCK, PIK3CA, BIRC5, TP53 and CDKN1A in the malignant progression from OLP to OSCC. Moreover, these findings support the role of some molecular pathways, namely IL2 signalling events mediated by PI3K, PI3K signalling events mediated by AKT, and, possibly, Aurora A signalling in the association between OLP and OSCC

Immediate Versus Conventional Loading of Complete-Arch Implant-Supported Prostheses in Mandibles with Failing Dentition: A Patient-Centered Controlled Prospective Study

Purpose: The aim of this study was to compare, from the patients' perspective, immediate and conventional loading of fixed complete-arch prostheses to rehabilitate mandibles with failing dentition. Materials and Methods: This controlled, prospective, nonrandomized study included 36 consecutive patients: 18 treated with conventional loading (control) and 18 with immediate loading (test). Patient general satisfaction and specific satisfaction with esthetics, chewing, speaking, comfort, self-esteem, ease of cleaning, and treatment duration were evaluated using 10-cm visual analog scales before treatment and 3 and 12 months after treatment. Postoperative pain and swelling were monitored daily for 1 week. Statistical analysis was performed applying Mann-Whitney and Wilcoxon tests (alpha =.05). Results: Between baseline and 3 months, satisfaction in the test group increased significantly with the exception of speech; in the control group, satisfaction increased significantly for esthetics and decreased significantly for speech, chewing, and comfort, but did not vary for general satisfaction or self-esteem. After 3 months, satisfaction was significantly higher in the test group with the exception of ease of cleaning. Between 3 and 12 months, satisfaction improved in both groups but more so in the control group, so that after 12 months there were no differences. The test group showed lower mean pain, which began after the third day postsurgery. Mean swelling and maximum pain/swelling did not show significant differences at any point. Conclusions: Patient satisfaction was reported as significantly higher with immediate loading. However, at the end of the observation periods, reported functional differences had disappeared. Significant differences were only noted for postoperative pain after the third day

Extension implants in the atrophic posterior maxilla: 1-year results of a retrospective case-series

Background/purpose: Blade implants account for one of the most debated dental implants design in scientific literature. They have been reconsidered by clinicians since their re-classification by Food and Drug Administration in 2014. Materials and methods: The present study aimed to evaluate the outcome of newly manufactured extension implants in the treatment of moderate atrophic posterior maxillae. All the patients enrolled in the present retrospective case series study showed a moderate bone atrophy in the posterior maxilla with a maximum residual height ranging between 4 mm and 8 mm. Implants were inserted with the aid of an electro-magnetic device, and then they covered with screws and left healing. Three months after, implants were exposed and loaded. Results: Difference between the marginal bone level at the 3-month evaluation (5.57 ± 0.67 mm) and that at baseline (5.67 ± 0.55 mm) appeared to be not significant (p-value = 0.63). At the 12-month evaluation, the marginal bone level (4.95 ± 0.45 mm) underwent significant decrease respect to baseline value as proven by significant change at marginal bone level (−0.62 ± 0.51 mm with a p-value = 0.01). Conclusion: The results of the present study suggested a positive 12-month outcome for extension implants in the rehabilitation of the moderate atrophic maxilla, without the need of extensive reconstructive surgeries and grafting procedures

Bruxism and Cardio Vascular Diseases: A Cross-Sectional Study

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Mandibular Osteonecrosis Associated with Antacid Therapy (Esomeprazole)

Introduction: Osteonecrosis of the jaw has been consistently reported in the literature associated to the high-dose intravenous bisphosphonate therapy. However, osteonecrosis can also occur in patients who have other risk factors. Case description: An unusual case of ONJ in a patient being treated with esomeprazole is reported. Discussion: The probable association between proton pump inhibitor intake and osteonecrosis of the jaw should alert clinicians. Collaborations between medical and dental doctor and an early diagnosis might prevent or reduce the morbidity resulting from advanced destructive lesions of the jaw bone