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Maintaining a microbial-free environment in healthcare facilities is more widely recognized as an essential component of therapies to minimize transmission of viruses associated with healthcare sector. The global spread of COVID-19 and recent outbreaks have presented humanity with previously unheard-of challenges. The development of autonomous disinfection robots seems to be necessary given the urgent need for constant sterilization in the face of a labor shortage. Due to their automated and perceived cost advantages by eliminating cleaning staff, these robots are being advertised more and more as an easy solution to immediately disinfect rooms and operating areas. The use of these services lowers the danger of infection, and expense of traditional cleaning and, most significantly, builds trust and security in medical facilities. Currently, routine (manual) cleaning is not replaced by disinfection robots; rather, they may support it. Additional hospital and device design alterations are necessary to address the overshadowing (visibility) issue allowing Ultraviolet disinfectant (UV-D) robots move freely in the medical environment. More technical developments and clinical studies in a variety of hospitals are needed to overcome the current challenges and find ways to integrate this unique technology into hospitals now and in the future. Thus, we present a review that includes detailing all elements required for it to function, as well as both its advantages and disadvantages. To the best of our knowledge, very limited studies have collected an in- depth data on the sterilization effect using a disinfection robot in the field of dentistry. We believe that this data will work as a foundation in more advanced uses at diverse sites that require disinfection and will highlight unsolved challenges and potential research avenues for UV robot operational concerns in dental hospitals. The goal of this work is to offer a comprehensive manual for UV-D robots covering pertinent information on traditional Ultraviolet germicidal irradiation (UVGI) system along with advancements in UV-D robots and thereby focusing on in-depth application in medical and dental facilities.

Background: Temporomandibular disorders (TMDs) encompass a spectrum of orofacial conditions characterised by pain and dysfunction in the temporomandibular joint and surrounding structures. Tobacco smoking has been posited as a potential factor influencing the prevalence and intensity of TMD. However, the nature and extent of this relationship remain unclear due to variations in study outcomes. This systematic review aimed to consolidate existing research findings to elucidate the association between tobacco smoking and TMD pain intensity., Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published up to June 2023. Studies investigating the relationship between tobacco smoking and TMD pain were included. Data extraction was conducted by two reviewers. Quality assessment was performed using the New Castle-Ottawa scale. Review Manager 5.4 was used to quantitatively analyse the results., Results: The review included four studies employing similar TMD assessment techniques. All studies reported elevated TMD pain intensity among tobacco users, with non-smokers exhibiting lower pain intensity. The quality of the included studies was good. Meta-analytic results showed that TMD pain intensity was higher in the smokers group compared to the non-smokers group, with a weighted mean difference (WMD) of 0.65 (BPM) (95% CI: [0.10, 1.19], p = .02)., Conclusion: This systematic review provides a comprehensive synthesis of the existing literature on tobacco smoking and TMD symptoms. The findings underscore the multifaceted nature of the relationship between smoking and TMD pain, highlighting its clinical relevance and the need for tailored interventions. Further research is warranted to elucidate underlying mechanisms and potential moderating factors, contributing to a more nuanced understanding of this complex association., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: The study aimed to retrospectively assess the efficacy of hyaluronic acid (HA) in managing temporomandibular disorders (TMD) using the diagnostic criteria for temporomandibular disorders (DC/TMD). There has been an ongoing debate regarding the effectiveness of HA as a treatment option for TMD, which necessitated a thorough evaluation., Methods: The review adhered to PRISMA guidelines conducted across eight different databases, including PubMed, Embase, Web of Science, Cochrane Library, Scopus, ScienceDirect, PsycINFO and CINAHL. The selection criteria included studies that evaluated the efficacy of HA in TMD patients, utilised DC/TMD, and were published in English. Data extraction and quality assessment were performed independently by two reviewers. ROB-2 tool was employed to assess methodological quality of the assessed studies., Results: A total of 10 studies met the inclusion criteria. They demonstrated that HA was effective in improving various symptoms of TMD, such as pain, mouth opening and joint sounds over control group. But on the other end, platelet-rich plasma (PRP) was found to be better than HA intervention in alleviation of TMD symptoms. However, the degree of improvement varied across the studies. Some studies reported adverse effects, but these were typically minor and transient. Risk of bias assessment was low in all the included studies., Conclusion: The findings suggest that HA can be an effective treatment for TMD when evaluated with DC/TMD. However, the variation in effectiveness across studies indicates the need for individualised treatment planning and careful monitoring of adverse effects. Further research is needed to refine the treatment protocols and understand the long-term effectiveness and safety of HA in TMD management., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Dental anxiety, linked to avoiding dental treatment and heightened medical and surgical risks, prompted this systematic review. The objective is to synthesize existing evidence on conscious sedation techniques employed for managing dental anxiety in patients scheduled for third molar extraction surgery, aiming to identify optimal approaches and address knowledge gaps. This systematic review followed the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" checklist and the population, investigation, comparation, outcome framework. The protocol still needs to be registered. A thorough search was conducted, incorporating MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews until February 2024. Only randomized controlled trials were considered, following "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The risk of bias was evaluated following the Cochrane Handbook for Systematic Reviews of Interventions. Eighteen randomized controlled trials involving 2081 patients were included. Certain factors limited the feasibility of a meaningful meta-analysis, leading to a narrative synthesis. Conscious sedation with virtual reality showed an association with improved dental anxiety in 4 studies. One study reported reduced cortisol levels with midazolam compared with a placebo, whereas another noted significant variations in perioperative renin levels with remifentanil versus placebo. This review reveals inconclusive and conflicting findings regarding the role of conscious sedation in managing dental anxiety during third molar extraction surgery. Persistent uncertainties arise due to a need for consistent, standardized outcome measures. Addressing these limitations in study design is crucial for future research., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Oral cancer is a serious health issue in both the developing and developed worlds, and it is one of the most common forms of cancer of the head and neck. In accordance with the 2017 World Health Organization classification, oral cancer can affect any part of the mouth, including the buccal mucosa, the front two-thirds of the tongue, the lip, the palate, the vestibule, the alveolus, the floor of the mouth, and the gingivae. Hematology and electrolyte balance have been proposed as tumor indicators and paths into cancer's genesis. Examining the patient's blood count and electrolyte levels in order to better understand their oral cancer., Methods: Electrolyte abnormalities are common in cancer patients and may be caused by the disease itself or by treatment. Hyponatremia is the most frequent electrolyte problem in cancer patients, and it is typically caused by the syndrome of improper ADH secretion. Although electrolyte problems are associated with a worse prognosis for cancer patients, timely and effective therapy has the potential to enhance both short- and long-term results and quality of life. Hematological tests on patients with oral cancer, including differential cell count, white blood cell count, and hemoglobin level., Results: Compared to healthy controls, oral cancer patients show statistically significant differences in a number of biochemical parameters, including electrolytes (sodium, P<0.05; potassium, P=0.89; chloride, P<0.05); differential count (neutrophils, P<0.05; basophils, P<0.05). A significant risk factor for cancer patients is an electrolyte imbalance, which has been linked to inappropriate anti-diabetic hormone release., Conclusions: Clinicians will find these shifts in electrolytic level helpful in diagnosing and tracking oral cancer. Potentially malignant oral disorders and Oral squamous cell carcinoma may be better predicted using a combination of TLC, neutrophil, and lymphocyte counts, as shown in this study.

Background: Temporomandibular disorders (TMD) are a prevalent ailment with a global impact, affecting a substantial number of individuals. While some individuals are receiving treatment from orthodontists for TMD, a significant proportion of individuals obtain knowledge through websites., Objectives: Our purpose had been to evaluate, from a patient-oriented perspective, the readability of home pages of websites scored in the 10 most prominent devoted to TMD. We also determined what level of education would have been needed to get an overview of the information on the websites under scrutiny. This approach ensures that our findings are centred on the patient experience, providing insights into how accessible and understandable websites about TMD., Methods: We determined the top 10 patient-focused English language websites by searching for 'temporomandibular disorders' in the 'no country redirect' plugin of the Google Chrome browser (www.google.com/ncr). The readability of the texts was assessed using the Gunning fog index (GFI), Coleman Liau index (CLI), Automated readability index (ARI) Simple Measure of Gobbledygook (SMOG), Flesch Kincald grade level (FKGL), Flesh reasing ease (FRE) (https://readabilityformulas.com)., Results: The mean Flesch reading ease index score was determined to be 48.67, accompanied by a standard deviation of 15.04 and these websites require an average of 13.49 years of formal education (GFI), with a standard deviation of 2.62, for ease of understanding., Conclusion: Our research indicates that a significant proportion of websites related to TMD can be defined as a level of complexity that exceeds the ability to read comprehension of the general population., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: Temporomandibular disorders (TMDs) pose diagnostic challenges, and selecting appropriate imaging modalities is crucial for accurate assessment. This study aimed to compare the diagnostic accuracy and efficacy of ultrasonography (US) and magnetic resonance imaging (MRI) in identifying TMDs., Methods: A comprehensive meta-analysis was conducted, including studies that compared US and MRI for TMJ disorder assessments. Fixed-effects models were utilized to calculate pooled odds ratios (ORs) and relative risks (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the chi-squared test and I 2 statistic. Newcastle-Ottawa scale was used to assess the methodological quality of the studies included., Results: Six studies were included, involving a total of 281 participants. The meta-analysis demonstrated that MRI was statistically somewhat better than US in identifying TMJ disorders. The summary OR was 0.64 (95% CI: 0.46-0.90), and the summary RR was 0.80 (95% CI: 0.68-0.95). Heterogeneity among the studies was low (χ 2  = 2.73, df = 5, p = .74; I 2  = 0%). Demographic variables revealed variations in sample size, gender ratio and mean age across the studies., Conclusion: This meta-analysis provides evidence that MRI may be more effective than US in diagnosing TMDs. However, the study is limited by the small number of included studies and variations in demographic variables and study designs. Future research with larger samples and standardised protocols is essential to confirm and strengthen these findings. Understanding the diagnostic accuracy of MRI and US for TMJ disorders will aid clinicians in making informed decisions for effective TMJ disorder assessments and patient management., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Trial Design: This is a prospective, block-randomized, blinded, multiple arm and parallel-group superiority clinical trial., Methods: Seventy-eight patients satisfying the recruitment standards, were randomly allocated into three groups as follows: Group I (n = 26) - Inferior alveolar nerve block (IANB) devoid of aromatherapy (AT); Group II (n = 26) - IANB with lavender AT and Group III - IANB with rose AT (n = 26) with the help of the ultrasonic aroma diffuser (with respective oils)for 20 min/2 h in operatories 1,2 and 3 respectively. For AT, 3-4 drops of lavender and rose-conditioned oils were added from a 100 ml solution containing 100 mg of these medicinal plants. The pre-operative (PRO) and access opening (AO) pain as well as the anxiety of patients were recorded using the Visual Analog Scale (VAS) and Modified Dental Anxiety Scale (MDAS) respectively. Data thus obtained was entered into the Excel sheet and subjected to statistical tests (analysis of variance and paired t -test). The p-value less than 0.05 was considered statistically significant., Results: Group I showed non-significant disparity between PRO and AO for both VAS as well as MDAS (p = 0.62, p = 0.71). However, group II (p = 0.04, p = 0.02) and group III (p = 0.03, p = 0.01) revealed significant differences between PO - AO VAS and MDAS. MDAS and VAS intergroup comparison revealed a significant difference among groups I and II (p = 0.03, p = 0.04), and groups I and III (p = 0.02, p = 0.03). However non-significant disparity was observed among groups II and III (p = 0.85, 0.34). Moreover, there was a statistically significant reduction in anxiety levels in females compared to males after rose AT (p = 0.02). Nevertheless, groups I and II did not show any gender predilection for anxiety as well as pain., Conclusion: Alleviation of dental anxiety as well as reduction in pain during AO of teeth with SIP can be achieved using Lavender and rose AT. In female patients, rose AT can be preferred over lavender AT., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: High prevalence of tooth wear (TW) worldwide makes it important to assess its level in different populations. In developing countries, a shift towards geriatric population makes the evaluation of this condition even more relevant. Most indices for tooth wear are full mouth indices, which make mass population screening challenging. The objective of this study was to establish whether part-mouth recordings using selective teeth can provide similar sensitivity of the modified tooth wear index., Methods: This cross-sectional study was carried out over 40 working days on 400 dentate individuals aged 14-70 years, having at least 16 scorable teeth. Firstly, full mouth tooth wear of study population was recorded and categorized into four groups based on severity and extent of tooth wear. Following this, group wise data extraction was done using the full mouth scores and six different types of part-mouth analyses was done to arrive at the system which provides the best sensitivity. These part-mouth recordings should be specific such that it can differentiate to the same groups of tooth wear in the reduced data as well. Data were analyzed by means of SPSS version 21.0 (P<0.05)., Results: In 83%, at least one tooth had the exposed dentine. Part-mouth recording using "12 anterior teeth" as index teeth showed a high level of sensitivity (87.8%) than others for measuring tooth wear data., Conclusions: The prevalence of tooth wear is high and "the part-mouth recording applied to the 12 anterior teeth" is a faster and reliable method in large population surveys for measuring tooth wear.

Background: According to Centers for Medicare and Medicaid Services HHS 2017, when a medical disease suddenly manifests itself with acute symptoms of sufficient intensity (including extreme pain) endangering the patient's health, seriously impairing body functions or bringing an organ or its portion to be seriously dysfunctional, a medical emergency has occurred. Therefore, this study aimed to assess the knowledge, attitude, and perceived confidence in handling medical emergencies among dental students by the means of conducting this investigation., Methods: This is a cross-sectional study conducted among the different hierarchies of dentists of Riyadh using an online survey; 387 dentists from varying clinical levels (9 to 12) were included in this study. The questionnaire used for this study consisted of questions related to demographic data followed by questions including knowledge, attitude, and confidence towards handling medical emergencies in clinics., Results: In this study, male participants represented 64.4% and female subjects represented 35.6% of the total population. Most of the undergraduates were in their 5 th year of dentistry school and accounted for 36.9%, followed by 6 th year 36.2% and 4 th year 26.8%. 67.1% of the undergraduates never encountered any medical emergency during their study, while 32.9% encountered an emergency. Furthermore, 58.4% of the analyzed subjects recorded medical history thoroughly, while priority in an emergency was adrenaline, with a percentage of 45%. For the patient suffering syncope the Trendelenburg position was chosen. Also, the first action choice with unresponsive patients was CPR., Conclusions: In the present study, the findings revealed that the majority of the population never encountered an emergency in their career, but their knowledge about drug priority and patient's position was good. Most of them do not measure vital signs routinely; specifically, females do not usually measure, while males measure when needed. About Basic Life Support (BLS), participants took BLS or were interested in taking it in the future; furthermore, in group population, both have taken it and are interested in further carrying it.

Background: This in-vitro study aimes to compare the microleakage of different restorative materials namely EQUIA Forte (GC, Japan), Tetric Evoceram (Ivoclar Vivadent, Liechtenstein), and Activa BioACTIVE., Methods: A standardized class V cavity has been created on the buccal surface of 40 sound premolar teeth. The cavity had the following measurements: 3 mm buccolingual height, 2 mm axial depth, and 4 mm mesiodistal width. The gingival margin was 1mm below the cementoenamel junction, whereas the coronal margin was on the enamel with cavosurface margins were butt joints all around. Four groups of teeth were restored according to the restorative materials. Under a stereomicroscope, the dye penetration test was used to measure the microleakage after thermocycling of the teeth. Data were compared using Kruskal-Wallis H and Mann-Whitney U tests., Results: Occlusal and gingival margins did not show statistically significant differences among the four groups, but an intragroup analysis revealed a significant difference., Conclusions: The type of restorative material did not appear to have a substantial impact on microleakage, according to the findings of the current investigation.

Background: Dental implants are increasingly favored as a therapeutic replacement option for edentulism. Titanium (Ti), due to its excellent biocompatibility and unique osseointegration properties, is commonly used in dental implants. Various surface modifications have been explored to improve osseointegration outcomes. Graphene oxide (GO) is a promising material with various applications. Chitosan, found in the exoskeleton of crustaceans and in marine algae, has several biomedical applications. Silver (Ag) is another promising antibacterial agent that increases permeability and damages the bacterial cell membrane upon binding., Objectives: The present study applied a novel implant surface coating of Ag-decorated GO and chitosan on Ti implants to promote bone formation. We further analyzed the physiochemical and antibacterial properties of this surface coating., Material and Methods: A solution was prepared by mixing 3 mL of 1% chitosan solution with 10 mg of Ag-GO nanoparticles (NPs). Titanium metal was heated to 70-80°C on a hotplate and the solution was applied onto Ti to obtain an adhesive surface coating. The coated implant was further analyzed for surface properties, using scanning electron microscopy (SEM), the energy dispersive X-ray (EDX) analysis, the attenuated total reflectance-Fourier transform infrared (ATR-FTIR) technique, and the biocompatibility and corrosion analyses., Results: The SEM analysis revealed a homogenously spread, rough, fibrillar and porous layer of coating on the metal surface. The EDX and ATR-FTIR analyses confirmed the successful coating of the implant surface with Ag-decorated GO and chitosan layers. The cell culture assay demonstrated excellent biocompatibility of the surface coating. The corrosion analysis showed improved corrosion resistance of the developed implant surface coating., Conclusions: The various analyses of the coating showed ideal properties for improved cell attachment, differentiation and proliferation while maintaining an antimicrobial environment on the implant surface.

Aim: The primary goal of the present comprehensive systematic review is to assess the treatment results attained through PSIO in individuals with NSCLP, as well as to explore its effectiveness. This will be accomplished by examining a range of existing published studies that focus on patient groups who have undergone PPIO., Materials: A comprehensive search strategy was devised by a single author for each database without language restrictions. The databases searched were PubMed, Cochrane library Google Scholar, Web of Science and Scopus. The search period was limited to the years 2001 to 2023. Duration and study design filter was used. Furthermore, conference proceedings, abstracts, and reference lists of relevant studies were sought to obtain additional records., Conclusion: The examined protocols for passive presurgical infant orthopaedics (PPIO) in individuals with CLP typically did not reveal notable treatment outcomes when compared to a lack of treatment across a range of domains. These domains encompass feeding patterns, facial aesthetics, maxillary dentoalveolar factors, cephalometric measurements, speech and language-related aspects, dental arch alignments, economic assessments, as well as occurrences of adverse effects or complications associated with applied appliances or procedures.

Mandibular asymmetry refers to dimensional differences between the left and right sides of the mandible in terms of size, form and volume. This condition may result in problems with functionality as well as appearance. Early intervention is often deemed optimal for addressing mandibular asymmetry; however, there is a lack of consensus regarding the diagnostic approach and strategy for identifying asymmetries in developing individuals. The purpose of this narrative review (NR) is to provide a clinician-focused update on the radiographic techniques for identifying mandibular asymmetries in orthodontic patients. Selective database searches were conducted until November 2023 to assess the available literature on mandibular asymmetry diagnosis. A health-sciences librarian developed a search strategy utilizing appropriate terms associated with mandibular asymmetry diagnosis. The databases used were Web of Science, Embase, Scopus, Liliacs and PubMed. Fifty-two studies were included in this review and data regarding the evaluation of mandibular asymmetries were presented with a narrative approach delineating clinical indications based on retrieved findings. There is no unanimous consensus on the method for diagnosing mandibular asymmetries. Cone beam computed tomography emerges as the preferred examination method for diagnosing mandibular asymmetry, thanks to the assessment of a 3D structure with a 3D image. However, the use of only orthopantomography could be advisable as a first-line diagnostic tool in children due to less radiation exposure., Competing Interests: The authors declare no conflict of interest. Antonino Lo Giudice is serving as one of the Editorial Board members of this journal. We declare that Antonino Lo Giudice had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to NM., (©2024 The Author(s). Published by MRE Press.)

Background: Obstructive sleep apnoea syndrome (OSAS) has garnered increasing attention in recent years due to its potential association with cancer. This systematic review and meta-analysis aimed to assess the prevalence of OSAS in cancer patients through a comprehensive analysis of existing literature., Methods: This systematic review and meta-analysis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, aimed to evaluate the prevalence of OSAS in cancer patients. A comprehensive search of electronic databases was performed to identify relevant studies published up to September 2021. Eligible studies reporting on the prevalence of OSAS in cancer patients, encompassing various study designs, were included in the analysis. Pooled estimates of the odds ratios (OR) with 95% confidence intervals (CIs) were calculated using a random effects model. Heterogeneity among the studies was assessed using the I 2 statistic., Results: Seventeen studies fulfilled the inclusion criteria and were subsequently included in the review. The prevalence of OSAS in cancer patients was estimated to have an overall OR of 0.80 (95% CI: 0.75-0.85). In comparison with non-cancer patients, cancer patients had a statistically significant greater risk of OSAS, as indicated by the total estimated RR for the prevalence of OSAS in cancer patients, which was 0.89 (95% CI: 0.86-0.92). Nonetheless, there was a significant amount of heterogeneity (I 2  = 96%) among the studies., Conclusion: The overall data analysed in this review indicates that patients with cancer had far reduced likelihood of developing OSAS than individuals without cancer. However, the significant variation across the included studies highlights the need for additional investigation to fully clarify the complex association between OSAS and cancer incidence. These results emphasise how critical it is to identify OSAS as a possible comorbidity in cancer patients, one that should be taken into account for clinical management and ongoing research., (© 2024 John Wiley & Sons Ltd.)

Background: Artificial intelligence (AI) has emerged as a revolutionary technology with several applications across different dental fields, including pedodontics. This systematic review has the objective to catalog and explore the various uses of artificial intelligence in pediatric dentistry., Methods: A thorough exploration of scientific databases was carried out to identify studies addressing the usage of AI in pediatric dentistry until December 2023 in the Embase, Scopus, PubMed, and Web of Science databases by two researchers, S.L.R. and A.L.G., Results: From a pool of 1301 articles, only 64 met the predefined criteria and were considered for inclusion in this review. From the data retrieved, it was possible to provide a narrative discussion of the potential implications of AI in the specialized area of pediatric dentistry. The use of AI algorithms and machine learning techniques has shown promising results in several applications of daily dental pediatric practice, including the following: (1) assisting the diagnostic and recognizing processes of early signs of dental pathologies, (2) enhancing orthodontic diagnosis by automating cephalometric tracing and estimating growth and development, (3) assisting and educating children to develop appropriate behavior for dental hygiene., Conclusion: AI holds significant potential in transforming clinical practice, improving patient outcomes, and elevating the standards of care in pediatric patients. Future directions may involve developing cloud-based platforms for data integration and sharing, leveraging large datasets for improved predictive results, and expanding AI applications for the pediatric population.

Background: Zirconia crowns, resembling crystals and with enamel-like aesthetics, are recent entrants in pediatric restorative dentistry. Despite growing use, their empirical efficacy remains under-explored. The aim of this study is to compare resin composite strip crowns and premanufactured zirconia crowns on primary maxillary incisors., Methods: In the Pediatric Dental Clinics, 240 primary maxillary incisors (69 patients) were treated with either zirconia (120 teeth) or composite strip crowns (120 teeth). Evaluations of gingival health, plaque, secondary caries, restoration failure, and opposing teeth wear occurred at 3, 6, and 12-month intervals., Results: At 3 months, zirconia crowns showed less gum bleeding (P=0.006) and plaque. Through 6 and 12 months, zirconia crowns exhibited fewer failures but higher opposing teeth wear. Strip crowns indicated greater tooth material loss., Conclusions: Zirconia crowns demonstrated superior gingival health and durability over composite resin strip crowns but caused increased wear on opposing teeth.

Aim: To comparatively analyse the skeletal and dento-alveolar changes after treatment with Class III Bi-Maxillary Plates (BMPs) and FM appliances in growing patients with Class III skeletal malocclusion., Conclusion: BMPs with class III elastics provided a similar pattern of skeletal and dento-alveolar changes compared to FMs, however supported by slightly greater dentoalveolar effects that contribute to the correction of the class III malocclusion in growing subjects.

Background: Acute myocardial infarction (AMI) risk correlates with C-reactive protein (CRP) levels, suggesting systemic inflammation is present well before AMI. Studying different types of periodontal disease (PD), extremely common in individuals at risk for AMI, has been one important research topic. According to recent research, AMI and PD interact via the systemic production of certain proinflammatory and anti-inflammatory cytokines, small signal molecules, and enzymes that control the onset and development of both disorders' chronic inflammatory reactions. This study uses machine learning to identify the interactome hub biomarker genes in acute myocardial infarction and periodontitis., Methods: GSE208194 and GSE222883 were chosen for our research after a thorough search using keywords related to the study's goal from the gene expression omnibus (GEO) datasets. DEGs were identified from the GEOR tool, and the hub gene was identified using Cytoscape-cytohubba. Using expression values, Random Forest, Adaptive Boosting, and Naive Bayes, widgets-generated transcriptomics data, were labelled, and divided into 80/20 training and testing data with cross-validation. ROC curve, confusion matrix, and AUC were determined. In addition, Functional Enrichment Analysis of Differentially Expressed Gene analysis was performed., Results: Random Forest, AdaBoost, and Naive Bayes models with 99%, 100%, and 75% AUC, respectively. Compared to RF, AdaBoost, and NB classification models, AdaBoost had the highest AUC. Categorization algorithms may be better predictors than important biomarkers., Conclusions: Machine learning model predicts hub and non-hub genes from genomic datasets with periodontitis and acute myocardial infarction., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Objective: This study aimed to evaluate the effects of sterile saline solution irrigation (lavage) performed after mandibular third molar extraction on postoperative complications, utilizing a split-mouth randomized clinical trial design., Methods: Seventeen healthy participants requiring bilateral mandibular third molar extraction were enrolled in this single-center study. In each participant, one impacted third molar was designated as the experimental group and subjected to saline lavage at 4 °C. In contrast, the control group was the other impacted third molar, undergoing saline lavage at 25 °C. Various parameters, including postoperative pain, mouth opening, and facial swelling, were assessed using standardized measures and three-dimensional facial scanning at multiple time points., Results: The average age of participants was 26.66 ± 4.1 years, with no postoperative complications observed in either group. The duration of surgery did not significantly differ between groups. Postoperative pain was significantly reduced in the experimental group during the immediate postoperative period compared with the control group, but this difference diminished over time. No significant differences were observed in mouth opening or facial swelling between groups at any time., Conclusion: In site 4 °C, sterile saline solution irrigation after mandibular third molar extraction may effectively reduce early postoperative complications, particularly pain, without prolonging surgical duration., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Digital complete dentures fabricated using a mucostatic impression, like intraoral scans, are desirable for their beneficial effect on long-term residual ridge stability but may have less retention than those fabricated with a mucocompressive impression. Border molding procedure may improve initial retention, thus favoring adaptation to new dentures, especially in cases where neuromuscular dysfunctions may diminish the patient's ability to cope with adapting to existing motor patterns or learn new ones. However, a mucocompressive impression may cause higher residual ridge resorption, thus resulting in a retention decrease over time. A desirable combination would be a digital denture with a mucostatic intaglio surface obtained from intraoral scans and functional borders. A cast-free digital workflow for that is demonstrated in this technical report., (© 2024 by the American College of Prosthodontists.)

Objectives: The medium-term effects of rapid maxillary expansion (RME) on nasal cavity (NC) and upper airway (UA) dimensions based on chronological age are still unclear. This retrospective study evaluated the medium-term changes occurring in the NC and pharyngeal airways (PA) after RME in two distinct age-based cohorts of patients., Methods: This retrospective study included 48 subjects who underwent RME grouped in two cohorts: a 6-9-year-old group (EEG group: early expansion group - 25 subjects) and an 11-14-year-old group (LEG group: late expansion group - 23 subjects). NC and PA volumes were analyzed from CBCT imaging segmentation before RME (T0) and twelve months after RME (T1). The amount of maxillary expansion (PW) and minimal cross-sectional area (CSmin) were also considered., Results: All PAs' volumetric sub-regions, CSmin and PW showed a significant volumetric increment (p < 0.05). Inter-group comparisons showed significant differences (p < 0.05) for nasopharynx and CSmin parameters (p < 0.05), while no significant changes were recorded for the other UA's sub-regions and PW (p > 0.05). According to a deviation analysis, part of the UA increase (more marked for the nasopharynx area) may have occurred due to reduced adenotonsillar tissues, which were larger in the EEG group., Conclusions: Twelve months after treatment, clinicians should not expect changes in the UAs dimensions to be solely related to treatment effects of RME; instead, normal craniofacial growth changes and spontaneous regression of the adenotonsillar tissue could represent the most significant factors influencing UAs changes., Clinical Significance: From the clinical perspective, the results of the present study encourage caution when considering the therapeutic effects of RME on airways dimensions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Obstructive sleep apnea (OSA) syndrome is characterized by repeated airway collapse during sleep. It determines cardiovascular, pulmonary, and neurocognitive consequences and is associated with several daytime and nighttime symptoms that influence the patient's quality of life. The contribution of the dental specialist in the clinical management of OSA patients entails participating in the screening process as diagnostic sentinels and providing adequate treatment using mandibular advancement devices (MADs). Since the treatment of OSA requires a multidisciplinary approach, including different medical specialists, dentists should have a comprehensive understanding of medical and dental factors that influence the strategy and effectiveness of OSA treatment with MAD. Such expertise is crucial in determining the appropriate treatment indications and helps clinicians establish a consolidated position within the multidisciplinary OSA team. In this regard, this review summarizes the evidence of the clinical indications for MAD treatment and provides the dental specialist with helpful information about medical, functional, and other relevant factors that should be considered during diagnosis, treatment plan, and follow-up stages. Information retrieved was organized and discussed, generating specific domains/queries oriented to the clinical management of OSA patients from the clinical perspective of dental specialists., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2024 Antonino Lo Giudice et al.)

Background and Objective: In recent years, the complex interplay between systemic health and oral well-being has emerged as a focal point for researchers and healthcare practitioners. Among the several important connections, the convergence of Type 2 Diabetes Mellitus (T2DM), dyslipidemia, chronic periodontitis, and peripheral blood mononuclear cells (PBMCs) is a remarkable example. These components collectively contribute to a network of interactions that extends beyond their domains, underscoring the intricate nature of human health. In the current study, bioinformatics analysis was utilized to predict the interactomic hub genes involved in type 2 diabetes mellitus (T2DM), dyslipidemia, and periodontitis and their relationships to peripheral blood mononuclear cells (PBMC) by machine learning algorithms., Materials and Methods: Gene Expression Omnibus datasets were utilized to identify the genes linked to type 2 diabetes mellitus(T2DM), dyslipidemia, and Periodontitis (GSE156993).Gene Ontology (G.O.) Enrichr, Genemania, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were used for analysis for identification and functionalities of hub genes. The expression of hub D.E.G.s was confirmed, and an orange machine learning tool was used to predict the hub genes., Result: The decision tree, AdaBoost, and Random Forest had an A.U.C. of 0.982, 1.000, and 0.991 in the R.O.C. curve. The AdaBoost model showed an accuracy of (1.000). The findings imply that the AdaBoost model showed a good predictive value and may support the clinical evaluation and assist in accurately detecting periodontitis associated with T2DM and dyslipidemia. Moreover, the genes with p-value < 0.05 and A.U.C.>0.90, which showed excellent predictive value, were thus considered hub genes., Conclusion: The hub genes and the D.E.G.s identified in the present study contribute immensely to the fundamentals of the molecular mechanisms occurring in the PBMC associated with the progression of periodontitis in the presence of T2DM and dyslipidemia. They may be considered potential biomarkers and offer novel therapeutic strategies for chronic inflammatory diseases., (© 2024. The Author(s).)

Introduction: Over the years, implant therapy has been a commonly used treatment option for individuals who are partially or totally edentulous, with a long-term success rate of over 90%. With significant advancements in biomaterials and technology, implant dentistry can now conduct prosthetic rehabilitations in the majority of patients catering to all types of needs. However, in order to meet the demands of a patient base that is always growing, new trends in implantology are emerging in recent years that are focused on minimally invasive surgery and financial sustainability. In certain clinical scenarios, connecting teeth and implants to support fixed partial prosthesis (FPPs) may be a predictable and workable course of treatment., Materials and Methods: 22 patients were selected for this study who had tooth and implant supported prosthesis placed as a final restoration. Out of these 22 patients; 12 were male and 10 were female patients. Implants were placed following proper protocol and if grafting procedures were required they were carried out. A second stage surgical procedure was carried out and delayed loading protocols were followed. The statistical analysis was done using the IBM SPSS 24.0, Chicago, USA. The survival of the implants and teeth were measured by the Kaplan Meier survival scale. Bone loss was assessed at baseline(upon loading), 12 months and 24 months., Results: The implant survival rate was measured at 6 months, 12 months, 18 months and 24 months. At 24 months, one implant showed failure, so the survival rate of the implants were 95.4%. Bone loss of 1 mm was seen around one implant at 12 months. Bone loss of 1 and 2 mm was present around two implants and one implant respectively at 24 months., Conclusion: From the results of this study, we can conclude that tooth implant supported prosthesis show very good survival when used in rehabilitation cases., (© 2024. The Author(s).)

Background: The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient's psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations., Methods: A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II)., Results: Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80- 1.71; Z:0.82; P = .41), suggesting that there is no difference between Axis I and Axis II., Conclusion: In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms., (© 2024. The Author(s).)

Background: The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms., Methods: This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests., Results: The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05)., Conclusions: Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: Juvenile idiopathic arthritis (JIA) is a very common systemic inflammatory rheumatic disorder affecting the musculoskeletal system in children below 16 years of age. Joint inflammation and tissue destruction is the prime characteristic of the disease. Along with the systemic involvement in the long joints, several studies are mentioning the increased association of temporomandibular disorders (TMDs) in JIA. This current systematic review intends to find the prevalence rate of TMD in JIA-affected individuals as compared to healthy controls., Methods: We have searched in PubMed, Scopus and Ovid SP for articles published between the timeframe 1 January 1990 and 1 June 2023. All the searched articles were subjected to the Population, Exposure, Comparison, and Outcome model (PECO) based on which inclusion or exclusion is carried out. Participants (P) are children below 18 years of age, Exposure (E) is children or adolescents with a diagnosis of JIA, Comparator is age and gender-matched healthy controls who has no JIA or any systemic disorder, Outcome (O) is the prevalence of TMD. Only the studies that evaluated TMD using diagnostic criteria for evaluation of TMD (DC/TMD) were included in the analysis. We have set the exclusion to the following reasons- diagnostic sensitivity studies, case reports, and systematic reviews. The software Review Manager Version 5.4 (Cochrane Collaboration) was used to perform the pooled analysis. We measured the risk ratio (RR) between the two groups (JIA and no JIA) for the outcome TMD., Results: The pooled total included subjects were 366 in this review with an established diagnosis of JIA as evaluated by DC/TMD. The overall effect of the pooled data suggests that there is a significant difference in the TMD prevalence in the JIA group when compared to the control, results suggest that TMD is more prevalent in the JIA group RR 3.86; 95% CI [2.59, 5.76]., Conclusion: Overall, based on the data we can suggest a positive relationship between JIA and TMD, hence presence of JIA can be a risk factor for the development of TMD. The sensitivity of DC/TMD is low when compared to magnetic resonance imaging., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Introduction: The prevalence of adults with partially dental arches is expected to be more than imagined and patients requiring replacement of missing teeth are slowly increasing in number too. Removable partial dentures are known to provide for substantial replacement for the missing teeth with also added advantages when compared to fixed or implant prosthesis, mainly in elderly patients. Denture base material performance and durability are greatly influenced by wettability and water contact angle. In the case of dentures; adequate moisture distribution is necessary to ensure excellent wettability which has an influence on comfort and oral health. The purpose of conducting this study was to find out whether the advancements made using PEEK (Polyether ether ketone) would prove to be more beneficial than the current upgrades in the current material spectrum., Materials and Methods: This study was performed under in vitro conditions. All the fabrication and processing was done only by one operator. The materials used were divided into three groups each comprising 20 samples. Group A was modified polymethylmethacrylate (Bredent Polyan), Group B was polyoxymethylene acetal resin (Biodentaplast) and Group C was PEEK. An Ossila Goniometer was used to measure the contact angle. The three types of liquids used for the testing included distilled water, natural saliva and mouth wetting solution (Wet Mouth Liquid, ICPA India). Human saliva was collected from an individual with no medical conditions and normal salivary secretion., Results: The data was analyzed using One-way ANOVA test and a pairwise comparison using the Post Hoc Tukey's Honest Significant Difference. Table 1 consists of the mean water contact angles of the denture base materials and mean contact angles of various denture base materials. In saliva, mouth wetting solution and distilled water, the highest mean and least mean contact angle was seen in Polyan and Biodentaplast respectively. A signicant difference was seen between PEEK and Polyan and Biodentaplast and Polyan on further comparison., Conclusion: From the resources and the materials at our disposal, it could be concluded that Polyan, Biodentaplast and PEEK and could be used as viable options in cast partial denture framework., (© 2024. The Author(s).)

Introduction: Temporomandibular disorder (TMD) is a multifaceted condition impacting the chewing system, with its frequency varying across different age groups and showing a higher incidence in women. The involvement of estrogen in TMD has been examined due to the presence of estrogen receptors in the TMJ area. However, the exact effect of estrogen on TMD is complex. During pregnancy, marked by significant hormonal fluctuations, the impact on TMD has been hypothesized but remains unclear due to inconsistent results from various studies., Methods: In this cross-sectional study, we enrolled 32 pregnant women consecutively. We gathered information on demographics, TMD evaluations (using the Graded Chronic Pain Scale, Jaw Functional Limitation Scale-20, and Oral Behaviors Checklist), and mental health assessments (including Patient Health Questionnaire-9, Patient Health Questionnaire-15, and Generalized Anxiety Disorder-7). We employed descriptive statistics to summarize continuous and categorical data and used t-tests and chi-square tests for comparisons. We also conducted multivariate linear regression, adjusted for demographic factors, to investigate correlations., Results: The study group mainly consisted of women aged 30-35 (40.6%) and 25-30 (18.8%). Most participants had completed high school (50%) and were married (71.9%). A notable association was found between younger women (under 30) and higher levels of somatic symptoms (p = 0.008) and generalized anxiety (p = 0.015). Women in their second trimester showed lower severity of somatic symptoms (p = 0.04). A significant link was also observed between depression severity and somatic symptom severity (p = 0.01). However, we found no significant correlations with other TMD-related health aspects., Discussion: Our study identified significant associations between psychosomatic and psychological symptoms with variables like age and pregnancy trimester in pregnant women. However, it notably failed to establish a clear relationship between pregnancy-related factors and the severity of temporomandibular disorders (TMD). More comprehensive studies with larger participant pools are necessary to further validate and expand these findings., (© 2024. The Author(s).)

Objective: One of the most imprortant factors in achieving ideal teeth positions is the precision of the slot dimensions of orthodontic brackets into the archwires are inserted.This study aimed to assess the accuracy of the dimensions of orthodontic bracket slots and molar buccal tube apertures and to compare them with the specifications provided by the manufacturers., Method: A total of sixty brackets and ten molar buccal tubes with varying slot heights were examined using a scanning electron microscope from the mesial side. The dimensions and morphology of these bracket slots and buccal tubes apertures were assessed using the AutoCAD Software. A one-sample t-test was conducted to compare the measurements with the values provided by the manufacturer., Results: The findings of the present study indicated that the height of the measured bracket slots and buccal tube apertures dimensions were significantly larger than the actual dimensions and exhibiting divergent walls. On the other hand, the depth of the brackets slots showed significantly smaller values than the actual one., Conclusion: A need for careful consideration when selecting a commercially accessible brand for everyday use is essential as certain materials may not meet acceptable standards., (© 2024. The Author(s).)

Background: The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive., Methods: A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI)., Results: The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations., Conclusion: The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development., (© 2024. The Author(s).)

Background: The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment., Methods: A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst)., Results: The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68)., Conclusion: Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs., (© 2024. The Author(s).)

Background: Bruxism, a common oral parafunctional behavior characterized by the grinding or clenching of teeth, is a multifactorial condition with potentially detrimental effects on oral health and overall well-being. In recent years, there has been growing interest in understanding the relationship between bruxism and alcohol abuse, as both are prevalent issues that may share underlying factors and exacerbate each other. This systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, aims to evaluate the frequency of bruxism among individuals with alcohol abuse., Methods: A comprehensive search of electronic databases, including PubMed, Lilacs, Scopus and Web of Science, will be conducted to identify relevant studies published up to the knowledge cutoff date in January 2023. The search strategy will include keywords related to bruxism, alcohol abuse, and their synonyms. Inclusion criteria will encompass original research studies, such as observational, cross-sectional, cohort, and case-control studies, as well as clinical trials, that examine the relationship between bruxism and alcohol abuse. Two independent reviewers will perform the study selection, data extraction, and quality assessment, with discrepancies resolved by consensus., Results: The systematic review will present a summary of the identified studies, including the study design, characteristics of the study populations, and key findings related to the association between bruxism and alcohol abuse. The potential mechanisms underlying this relationship will also be explored. Subgroup analyses and the quality of evidence will be assessed. Finally, the implications of this association for clinical practice and further research will be discussed., Conclusions: This systematic review will contribute to a better understanding of the interplay between bruxism and alcohol abuse, shedding light on potential risk factors, mechanisms, and clinical implications. The findings may have significant implications for the prevention, management, and treatment of bruxism, particularly in individuals with a history of alcohol abuse., (© 2024. The Author(s).)

Background: Estrogen replacement therapy (ERT) is a common hormonal treatment for postmenopausal women, aimed at alleviating menopausal symptoms and reducing the health risks associated with estrogen deficiency. However, the impact of ERT on temporomandibular disorders (TMDs) remains unclear. This systematic review aims to evaluate the relationship between ERT and TMDs, including TMD occurence, pain, and associated symptoms., Methods: A comprehensive search of seven electronic databases was conducted using predefined search terms and Boolean operators. Inclusion criteria encompassed studies examining the association between ERT and TMDs. Two independent reviewers screened the identified articles, extracted data, and assessed the risk of bias using the RoB -2 tool., Results: Search strategy identified a total of 3 articles which met the inclusion criteria. The included studies investigated the impact of ERT on TMD occurrence and its related symptoms. The analysis revealed no significant association between ERT and TMD occurrence. A significant dose relationship was noted in one of the studies while another mentioned the possible relationship of TMD with educational status. Risk of bias among the studies was low, and the overall quality of evidence was deemed to be high., Conclusion: This systematic review suggests that there is no conclusive evidence supporting an increased risk of TMDs among women receiving ERT. The findings indicate that ERT is unlikely to have a noticeable impact on TMDs. However, due to the limited number of studies available, further research is warranted to strengthen these conclusions and explore potential factors that may influence the relationship between ERT and TMDs., (© 2023. The Author(s).)

Background: In the past, dentistry heavily relied on manual image analysis and diagnostic procedures, which could be time-consuming and prone to human error. The advent of artificial intelligence (AI) has brought transformative potential to the field, promising enhanced accuracy and efficiency in various dental imaging tasks. This systematic review and meta-analysis aimed to comprehensively evaluate the applications of AI in dental imaging modalities, focusing on in-vitro studies., Methods: A systematic literature search was conducted, in accordance with the PRISMA guidelines. The following databases were systematically searched: PubMed/MEDLINE, Embase, Web of Science, Scopus, IEEE Xplore, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar. The meta-analysis employed fixed-effects models to assess AI accuracy, calculating odds ratios (OR) for true positive rate (TPR), true negative rate (TNR), positive predictive value (PPV), and negative predictive value (NPV) with 95 % confidence intervals (CI). Heterogeneity and overall effect tests were applied to ensure the reliability of the findings., Results: 9 studies were selected that encompassed various objectives, such as tooth segmentation and classification, caries detection, maxillofacial bone segmentation, and 3D surface model creation. AI techniques included convolutional neural networks (CNNs), deep learning algorithms, and AI-driven tools. Imaging parameters assessed in these studies were specific to the respective dental tasks. The analysis of combined ORs indicated higher odds of accurate dental image assessments, highlighting the potential for AI to improve TPR, TNR, PPV, and NPV. The studies collectively revealed a statistically significant overall effect in favor of AI in dental imaging applications., Conclusion: In summary, this systematic review and meta-analysis underscore the transformative impact of AI on dental imaging. AI has the potential to revolutionize the field by enhancing accuracy, efficiency, and time savings in various dental tasks. While further research in clinical settings is needed to validate these findings and address study limitations, the future implications of integrating AI into dental practice hold great promise for advancing patient care and the field of dentistry., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs., Methods: Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74)., Conclusions: Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically., (© 2024. The Author(s).)

Hemorrhage control is a crucial aspect of dental procedures, and achieving efficient hemostasis remains a key challenge. The advent of hemostatic dressings has revolutionized the field of dentistry by providing effective and convenient solutions for managing bleeding in vari-ous dental scenarios. This article aims to provide an overview of hemostatic dressings, their mechanisms of action, and their diverse applications in dentistry. We applied the following Pop-ulation, Exposure, Comparator, and Outcomes (PICO) model to assess the document eligibility. A literature search was performed on major search engines, using keywords. At the end of the search, 3 articles were selected that matched the PICO. Three items were selected after the screen-ing process, and bleeding times were analyzed between the control group and the study group. The overall effect showed a substantial and statistically significant difference with bleeding time in favour of HDD-treated patients, showing that this garrison is very useful in controlling bleed-ing for patients taking anticoagulants and antiplatelets (Mean difference - 5.61; C.I. -5.70, - 5.52); Overall, hemostatic dressings have revolutionized the management of bleeding in dentistry, offering a promising solution to achieve optimal hemostasis, improve treatment outcomes, and enhance patient care, particularly Hemcon., (© 2023. The Author(s).)

Background: In dentistry, there is a growing preference for computer-aided design and computer-aided manufacturing (CAD/CAM) systems over traditional laboratory procedures. However, there is not much literature comparing various CAD/CAM materials. Thus, this study aimed to assess and compare the color stability and hardness of gingival and tooth colored milled and 3D-printed acrylic resins., Materials and Methods: Four types of CAD/CAM materials were prepared: 3D-printed pink shade (PP), milled polymenthymethacrylate (PMMA) pink shade (MP), 3D-printed tooth shade (PT) and milled PMMA tooth shade (MT) (n = 6). For hardness, disc shaped samples of 15 mm × 2 mm and for color stability, bar shaped samples of 65mmx10mmx2.5 mm were prepared and polished. Vickers hardness test was performed in a microhardness tester. Color stability test was done by immersing in coffee solution and coca cola for 7 days. Day 0 and day 7 measurements were recorded using a digital spectrophotometer and the change in color was calculated. For statistical analysis, one-way ANOVA and Tukey's post hoc tests were done., Results: For color stability, milled PMMA was superior to 3D-printed resin samples. Milled pink and tooth shade samples had similar color stability, whereas 3D-printed tooth shade samples were more color stable as compared to pink shade 3D-printed samples. For hardness, milled tooth shade PMMA was the most superior one, followed by 3D-printed tooth shade, whereas pink shade milled PMMA and 3D-printed resin samples had similar hardness values and were inferior to the tooth shade CAD/CAM materials., Conclusion: Color stability of milled PMMA is superior to that of 3D-printed resins. Hardness of tooth shade milled and 3D-printed resins is more than that of pink shade milled and 3D-printed resins., (© 2024. The Author(s).)

Background: Epidermolysis bullosa (EB) is a genetic syndrome afflicting skin and mucous membranes. The manifestation depends on the form: in mild conditions, occasionally, vesicular-bullous lesions of the oral cavity may be present, which heal spontaneously without leaving scars. Patients following joint rupture have scars that limit food intake and restrict quality of life. This study aims to evaluate the possibility of carrying out an implant therapy and the success rate of this therapy., Methods: Until January 3, 2000, PubMed, Web of Science, and Lilacs were searched. Clinical studies were selected that considered implant therapy in patients with epidermolysis bullosa. Articles were therefore selected that addressed oral health and implant survival in patients with epidermolysis, with no differentiation between the various subtypes. A risk of bias assessment was performed through Cochrane., Results: Twenty-one studies were found after the investigation. Only five were chosen to create the current systematic study; 16 articles were skipped over. 10 papers were disregarded because they had been reviewed; 4 were ignored because they contained case studies; and two were omitted because they were not written in English. The results show that implant survival is at around 97%., Conclusions: Patients with epidermolysis bullosa can be treated with implant therapy without the risk of an increased implant failure rate. Indicate the main conclusions or interpretations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Literature evidence describes various treatment protocols that have been employed for the effectiveness in improving survival and addressing associated symptoms of cracked teeth., Objective: This systematic review investigates the survivability of endodontically treated cracked teeth and associated assessments, focusing on various treatment protocols., Methods: The PRISMA guidelines were utilised for guiding the article selection framework of this review. A comprehensive search of relevant literature was conducted in May 2023 across various databases, and studies meeting the inclusion criteria were selected. Data extraction, guided by a standardized form, captured crucial details, including study characteristics, treatment protocols, and treatment outcomes, enhancing the consistency and accuracy of information collection. Data extraction and synthesis was done by two reviewers independently. The Newcastle Ottawa tool was used to measure the methodological quality of the study. Six observational studies were eventually included., Results: Mandibular molars are particularly prone to developing cracks, with research indicating a heightened susceptibility to this dental issue. Studies reveal that endodontically treated cracked teeth boast robust overall survival rates ranging from 75.8% to 100%. The risk of bias assessment, utilizing the Newcastle Ottawa scale, indicated a moderate risk across studies, highlighting the necessity for careful interpretation of findings., Conclusion: Endodontically treated cracked teeth show marked success in survival, with the incorporation of crowns post-endodontic treatment significantly enhancing longevity and resilience.

Background: Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12-18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments., Results: At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05)., Limitations: The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials., Conclusions: Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion., (© 2023. The Author(s).)

Background: Haemophilia A, B and von Willebrand disease are the most common bleeding disorders. There is an increased tendency of spontaneous bleeding into joints resulting in intra-articular infection. It is believed that Temporomandibular Joint (TMJ) can be affected in a similar manner which can further lead to limited mouth opening and ankylosis. The association between bleeding disorders (BD) and development of temporomandibular disorders (TMD) is poorly understood. This systematic review intends to evaluate the association of TMD in individuals with inherited bleeding disorders as compared to healthy controls., Methods: PubMed, Ovid SP and Google Scholar were searched for articles published between the times of inception to 1 May 2023. All the articles were subjected to Population, Exposure, Comparison and Outcome model (PECO) based on which inclusion and exclusion criteria were applied. Participants (P) is children, adults or adolescents; Exposure (E) is children, adults or adolescents with a diagnosis of Haemophilia or bleeding disorder (BD); Comparator (C) is age and gender-matched healthy controls who do not have Haemophilia or bleeding disorder; Outcome (O) is prevalence of any signs or symptoms (clinical, radiographic) that is suggestive of temporomandibular disorder (TMD). Studies showing the prevalence of TMD are included for qualitative analysis. Only the studies which provided data of the prevalence of TMD in both the groups (BD and healthy controls) were included in the quantitative analysis. TMD diagnosis can be by clinical signs and symptoms, radiographic criteria, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or any other imaging criteria (MRI). We have set the exclusion criteria as articles without a control group, diagnostic sensitivity studies, case reports and systematic reviews and narrative reviews. The software Review Manager version 5.4 (Cochrane Collaboration) was used to perform the pooled analysis. We measured the risk ratio (RR) between the two groups (BD and healthy controls) for the outcome TMD., Results: A total of seven studies are included for qualitative analysis of data. The age of the population (BD and control) in the included studies ranged between 2 and 57 years. The prevalence of TMD in individual studies varied from 2% to 77%, and controls in the individual studies varied from 2% to 14%. Among the included studies, only clinical signs, symptoms and history were taken into consideration in four studies. Four studies were included for meta-analysis, the pooled result of the four studies suggests there is no significant difference in the prevalence of TMD in BD and control group (p value = .11, RR 2.19; 95% CI [0.84, 5.73])., Conclusion: This systematic review and meta-analysis elicits no association between bleeding disorders and increased prevalence of TMD., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Objective: Obesity is a growing epidemic in the world. It increases the risk for severe health conditions, including diabetes, heart disease and stroke. Recent research has found that obesity is associated with an increased risk for temporomandibular disorders (TMDs). The purpose of this literature review with meta-analysis is to analyse the possible association between obesity and temporomandibular disorders., Materials and Methods: Pubmed, Web of Science and Lilacs were systematically searched until 01/03/2000. Articles dealing with TMD and obesity were selected, and numbers that might be useful in the meta-analysis were extracted., Results: Fifty articles were chosen after using all three search engines. Thirty-five articles were considered during the initial screening step. Four papers were chosen for title and abstract screening based on the PECO model. A manual search of bibliographies and the Cochrane database was also carried out, but no publications that matched the inclusion criteria were located. The articles and meta-analysis did not show a clear association between obesity and temporomandibular disorders., Conclusion: There is no evidence regarding the reliability of either method. Both have superimposable results., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to provide an overview of the clinical indications for the use of EAs according to the available evidence and to identify potential research areas for unexplored applications., Materials and Methods: To assess the available literature on the subject, selective database searches were performed between July 2023 and September 2023. With the assistance of a health sciences librarian, a search strategy that utilized terms related to elastodontic therapy was developed. Embase, Scopus, PubMed, and Web of Science were the databases used., Results: The current literature addressing the usability of EAs is scarce and mostly limited to case reports and case series. After 2168 citations were found through the searches, 13 studies were ultimately included. In this regard, information about the clinical use and effectiveness of EAs are reported in a narrative form, defining specific domains of the application that are clinically oriented, including sagittal and transversal discrepancies, atypical swallowing, teeth malposition, two-phase orthodontics and a lack of teeth retention., Conclusions: Within the intrinsic quality limitation of the available literature, it seems that EAs may represent a promising treatment alternative for managing mild-to-moderate malocclusion in children as an adjuvant therapy to the interruption of spoiled habits.

Objectives: The present study aims to assess the serum circulating cell-free (cfDNA) concentrations in patients with periodontitis and cardiovascular disease (CVD) and to evaluate the impact of periodontitis on circulating cfDNA levels and the confounding factors that might mediated the possible relationship., Materials and Methods: Healthy controls (n=30) and patients with CVD (n=31), periodontitis (n=31), and periodontitis + CVD (n=30) were enrolled in the present study. All subjects underwent regular periodontal examination and blood sampling and cfDNA evaluation. The analysis of the plasma cfDNA concentrations was performed using a dsDNA Assay Kit., Results: In comparison with healthy controls and CVD patients, periodontitis and periodontitis+CVD exhibited significantly higher expression of circulating cfDNA (p<0.05). There was a positive correlation among plasma cfDNA and clinical attachment loss (CAL) (p=0.019), high sensitivity C-reactive protein (hs-CRP) (p=0.027), and periodontal inflamed surface area (PISA) (p=0.003). Furthermore, the multivariate regression analysis evidenced that PISA (p<0.001), hs-CRP (p=0.014), and full-mouth bleeding score (FMBS) (p=0.004) were significant predictors of circulating cfDNA concentrations., Conclusions: The results of the study highlighted that the periodontitis and periodontitis + CVD group showed higher circulating cfDNA expression in comparison with healthy controls and CVD patients. Moreover, the extent of periodontitis was correlated with the increased cfDNA levels and represented a significant predictor of the increased circulating cfDNA concentrations., Clinical Relevance: Unbalanced circulating cfDNA concentrations have been indicated to represent a possible risk of CVD and endothelial dysfunction. Periodontitis and periodontitis + CVD patients showed higher circulating cfDNA expression; moreover, the extent of periodontitis significantly predicted higher circulating cfDNA concentrations, suggesting the potential increased risk of developing CVD in periodontitis patients., (© 2023. The Author(s).)

Introduction: Oral diseases are common and affect millions of people worldwide. They can range from mild and easily treatable conditions to more severe and serious diseases. Proper oral hygiene and regular dental monitoring are essential for maintaining good oral health. When it comes to children's health and well-being, parents' education level plays a critical role. Research has shown that parents' higher educational attainment is associated with better health outcomes for their children. Our aim is to evaluate whether parents' education level and employment influence children oral health and its impact on the family., Methods: We enrolled consecutively healthy subjects aged between 0-16 and their parents at the Dental Clinic of the University of Campania "L. Vanvitelli". The Italian version of the ECOHIS (I-ECOHIS) was administered to parents of the enrolled subjects referred to the Dental Clinic of the University of Campania "L. Vanvitelli". Linear regression models, adjusted for age and sex, were used to explore the association between parents' employment or education level and the ECOHIS scores. Statistical significance was accepted when p value < 0.05., Results: We found a significative association of a higher I-ECOHIS total score (coeff. 4.04244; CI 95%: 1.530855-6.554026; p = 0,002) and higher I-ECOHIS children section score (coeff. 3.2794; CI 95%: 1.29002-5.268; P = 0,002) and the father unemployed status. We also found that a higher education level of the father was associated with a lower ECOHIS total score (coeff. -1.388; IC 95%: -2.562115--0.214 p = 0.021) and a higher education level of the mother was associated with a lower ECOHIS in children section (coeff. -0.972; IC95%: -1.909356-0.034; p = 0.042)., Conclusions: Father unemployed status and a lower educational level for both parents may negatively affect oral health status., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Acquisition of psychomotor skills is of utmost importance for competent preclinical restorative dentistry. Recent advancements in haptic feedback technology have been incorporated into preclinical dental education to augment the conventional phantom head-based training., Objective: This systematic review aims to assess the effectiveness of haptic feedback device, Simodont, in improving the skill development and learning outcomes of dental students during their preclinical training., Materials and Methods: Electronic databases Web of Science, Scopus, PubMed were searched for relevant studies since inception up until March, 2023. Only English language studies that assessed the effectiveness of haptic feedback devices in preclinical dental education were included. We excluded studies that did not use Simodont as the haptic feedback device or did not involve preclinical restorative work. Study quality was assessed using the revised Cochrane risk of bias tool and ROBINS-I. The primary goal of the study is to evaluate the efficacy of Simodont as a complementary training modality for dentistry students., Results: Results from 9 high-quality studies were analyzed and synthesized to evaluate the overall impact of haptic feedback devices on various aspects of preclinical training. The studies were conducted on 826 undergraduate dental students enrolled in various years of their training across dental colleges and universities in different parts of the world. A majority of studies showed some concerns regarding risk of bias. Haptic feedback devices added a new layer to Virtual Reality (VR) through the perception of touch and force feedback. It assisted junior dental students improve their psychomotor skills and movement skills. Instantaneous feedback on the students' performance helped enhance their self-assessment and correction, and also eliminated the subjectivity of evaluation. Data derived from virtual simulators helped stratify dental students and predict their clinical performance, providing an opportunity to tailor the learning process to meet individual diversity in students' expertise., Conclusion: Based on the limited evidence available, Simodont was effective in preclinical training of dental students, offering advantages such as unlimited reproducibility, objective evaluation of preparation by computer assessment, and cost reduction. And further studies are warranted to explore the incorporation of patient's oral environment simulation for better skill training., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: While Temporomandibular disorders (TMDs) are not typically considered a primary symptom of Parkinson disease (PD), recent studies have documented a correlation between ageing and TMDs, a cluster of conditions affecting the temporomandibular joint and surrounding musculature, thereby underscoring the potential for an increased frequency of TMDs in the ageing PD population., Objective: The purpose of this review is to systematically evaluate the existing literature on the topic and provide a comprehensive overview of the prevalence of TMDs in patients with PD., Methods: To determine eligibility, we utilised the Population (human subjects), Exposure (PD), Comparator (PD vs non-PD subjects), and Outcomes (TMD) (PECO) model. To conduct this systematic review, we searched for articles published in PubMed, Web of Science and Lilacs from the beginning until April 15, 2023., Results: Three studies were selected. All together they comprised a total of 55 828 subjects, out of which 12 629 were affected by PD or Parkinsonism, and the remaining 43 199 were non-PD subjects matched for age and sex. The study aimed to evaluate the prevalence of TMDs in subjects affected by PD. The results showed that 193/12629 (1.53%) of PD individuals presented with TMD symptoms or were diagnosed with TMD, while 260/43199 (0.6%) of non-PD subjects were diagnosed with the same. The meta-analysis showed that there was a higher TMD prevalence in PD subjects compared to non-PD subjects (RR 1.57; 95% CI: 1.30-1.89)., Conclusion: The studies reviewed suggest a possible association between TMD and PD. Further research is needed to clarify the relationship between TMD and PD and to identify possible mechanisms and treatment strategies., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Introduction: The COVID-19 pandemic has had a significant impact on substance abuse patterns in recent times. Many people have experienced increased stress, anxiety, and social isolation, which has led to higher rates of substance abuse and addiction. It impacts on the orofacial region, particularly temporomandibular joint (TMJ). This review was undertaken to assess the association between substance abuse and temporomandibular disorders. (TMDs)., Materials and Methods: The databases of PubMed, Google Scholar, Web of Science and Cochrane were searched for articles based of set PECO criteria. A comprehensive search using keywords of "Psychoactive substances", "Illegal substances", "substance abuse", "narcotics", "temporomandibular joint" and "temporomandibular joint disorders" yielded a total of 1405 articles. Modified Newcastle-Ottawa Scale for observational studies assessed the risk of bias of included studies., Results: Two studies were reviewed. Samples recruited were either from rehabilitation centres or prisoners and fell in the second to fourth decade. A definite association was noted between psychoactive substance and TMDs. Moderate to low risk of bias was noted in all the studies evaluated., Conclusion: Further research is needed to better understand the nature of this relationship and the underlying mechanisms involved. It is important for healthcare providers to be aware of this potential association and to screen for substance abuse in patients with TMD symptoms., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)