Hasil untuk "Dentistry"

Khadijah Mukhtar, Kainat Javed, Mahwish Arooj et al.

Objective: During COVID-19 pandemic, the institutions in Pakistan have started online learning. This study explores the perception of teachers and students regarding its advantages, limitations and recommendations. Methods: This qualitative case study was conducted from March to April 2020. Using maximum variation sampling, 12 faculty members and 12 students from University College of Medicine and University College of Dentistry, Lahore were invited to participate. Four focus group interviews, two each with the faculty and students of medicine and dentistry were carried out. Data were transcribed verbatim and thematically analyzed using Atlas Ti. Results: The advantages included remote learning, comfort, accessibility, while the limitations involved inefficiency and difficulty in maintaining academic integrity. The recommendations were to train faculty on using online modalities and developing lesson plan with reduced cognitive load and increased interactivities. Conclusion: The current study supports the use of online learning in medical and dental institutes, considering its various advantages. Online learning modalities encourage student-centered learning and they are easily manageable during this lockdown situation.

Carol L. Schroeder, Kristopher M Schroeder

Cocaine is a naturally occurring compound indigenous to the Andes Mountains, West Indies, and Java. It was the first anesthetic to be discovered and is the only naturally occurring local anesthetic; all others are synthetically derived. Cocaine was introduced into Europe in the 1800s following its isolation from coca beans. Sigmund Freud, the noted Austrian psychoanalyst, used cocaine on his patients and became addicted through self-experimentation. In the latter half of the 1800s, interest in the drug became widespread, and many of cocaine's pharmacologic actions and adverse effects were elucidated during this time. In the 1880s, Koller introduced cocaine to the field of ophthalmology, and Hall introduced it to dentistry

A. Choi, B. Ben-Nissan, J. Matinlinna et al.

Abdillah Ahsan, Maulida Gadis Utami, Yuyu Buono Ayuning Pertiwi et al.

Objectives This study investigated the correlation between the type of health insurance membership as a proxy for the economic status of patients and the severity of their type two diabetes mellitus (T2DM) in Indonesia.Design The study conducted a secondary analysis of National Health Insurance (Jaminan Kesehatan Nasional) claim data provided by the Indonesian Social Security Agency, Badan Penyelenggara Jaminan Sosial (BPJS). We used ordered logistic regression with four severity levels for T2DM (0=outpatient, I=mild, II=moderate, III=severe) as dependent variables. The main independent variables (insurance membership categories) included subsidised insurance members (PBI), a combination of formally employed and nonsalaried informal workers (PBPU & PPU) and nonworkers (BP).Setting Secondary healthcare facilities in Indonesia.Participants The dataset included 2 989 618 claims for hospital visits of people with T2DM from 2018 to 2022.Primary outcome measures Severity level of T2DM patients.Result A higher percentage of T2DM patients who visited healthcare facilities with subsidised insurance (PBI), which represents a low-income group, have severe disease (6.9%) than patients in the PBPU & PPU (4.9%) and BP categories (5.5%). Moreover, regression analysis revealed that having PBI membership status was associated with a greater OR of having severe T2DM than nonsubsidised members. Among T2DM patients in the nonsubsidised insurance category, workers (PBPU & PPU) had an OR of 0.74 (95% CI: 0.735 to 0.745; p<0.0001) for having severe disease during hospital visits. Moreover, non-workers (BP) had a lower OR of 0.718 (95% CI: 0.711 to 0.725; p<0.0001) for severe disease than the PBI category.Conclusion These findings illustrate the lack of optimal access to health services for diabetes patients in low-income insurance membership categories and the challenges of better treatment in health facilities for low-income patients.

Lipei Liu, Megumi Watanabe, Tetsuo Ichikawa

Background: Robotics is progressing rapidly. The aim of this study was to provide a comprehensive overview of the basic and applied research status of robotics in dentistry and discusses its development and application prospects in several major professional fields of dentistry. Methods: A literature search was conducted on databases: MEDLINE, IEEE and Cochrane Library, using MeSH terms: [“robotics” and “dentistry”]. Result: Forty-nine articles were eventually selected according to certain inclusion criteria. There were 12 studies on prosthodontics, reaching 24%; 11 studies were on dental implantology, accounting for 23%. Scholars from China published the most articles, followed by Japan and the United States. The number of articles published between 2011 and 2015 was the largest. Conclusions: With the advancement of science and technology, the applications of robots in dental medicine has promoted the development of intelligent, precise, and minimally invasive dental treatments. Currently, robots are used in basic and applied research in various specialized fields of dentistry. Automatic tooth-crown-preparation robots, tooth-arrangement robots, drilling robots, and orthodontic archwire-bending robots that meet clinical requirements have been developed. We believe that in the near future, robots will change the existing dental treatment model and guide new directions for further development.

Ibrahim S. Younis, Mustafa M. Alsultan

Aims: The study aimed to assess the midfacial soft and hard tissue changes of males and females following maxillary skeletal expansion in young adults. Materials and methods: 24 patients, 11 males, and 13 females (mean age, 19.54 years; between 17 to 27) with maxillary transverse deficiency treated with MSE. CBCT scans taken before and after expansion were used to measure the changes in soft and hard tissue landmarks. Paired t-tests were used for statistical analyses. Results: Hard tissue lower interzygomatic distance increased by (3.41mm in males, and 2.97mm in females), intermolar distance increased by (5.84mm in males, and 5.51mm in females), the palatal separation anteriorly was (4.14mm in males, and 3.76mm in females), posteriorly was (3.24 mm in males, and 3.25 mm in females), however nasal width increased by (3.49mm in males, and 3.29mm in females). Soft tissue average lateral movement of the alar curvature points was (2.1mm in males, and 1.98mm in females). the nasolabial fold width was (3.54mm in males, and 2.55mm in females). and interzygomatic width was (2.27mm in males, and 1.85mm in females). Conclusions: Maxillary expansion using MSE resulted in an almost parallel expansion with significant lateral movements of the soft tissues of the cheek and alar curvature points on both sides in young adults and it was correlated with the hard tissue changes.

Kenji Tsuji, Hiroyuki Nakanoh, Kensaku Takahashi et al.

Rationale & Objective: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the corticomedullary region. However, the role of VMC and the clinical significance of VMC variants are poorly understood. In the present study, we investigated kidney prognostic values of VMC variants. Study Design: Retrospective cohort study. Setting & Participants: Among 808 patients who underwent a kidney biopsy from 2011 to 2019, 246 patients whose kidney biopsy specimens contained VMC were enrolled. Predictors: VMC variants; inflammatory-VMC (an infiltration of ≥80 inflammatory cells/mm2-VMC area) and VMC hypertrophy (hyper-VMC, a VMC average width ≥850 μm), and the interstitial fibrosis/tubular atrophy (IFTA) score. Outcomes: A decline in estimated glomerular filtration rate (eGFR) ≥40% from the baseline or commencement of kidney replacement therapy. Analytical Approach: Cox proportional hazards model. Results: Among 246 patients with data on VMC, mean baseline eGFR was 56.0±25.6 ml/min per 1.73 m2; 80 had high inflammatory-VMC, and 62 had VMC hypertrophy. There were 51 kidney events over median follow-up of 2.5 years. We analyzed 2 VMC variants. Multivariable logistic regression analysis revealed that eGFR negatively correlated with the presence of both inflammatory-VMC and hyper-VMC. A Cox proportional hazards analysis revealed that inflammatory-VMC (but not hyper-VMC) was independently associated with the primary outcome after adjustments for known risk factors of progression, including proteinuria, eGFR, and the interstitial fibrosis/tubular atrophy (IFTA) score (hazard ratio, 1.97; 95% confidence interval, 1.00-3.91). Limitations: Single-center study and small sample size. Conclusions: Assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. Plain-Language Summary: Assessment of kidney biopsies provides crucial information for diagnosis, disease activity, and prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system. Currently, the role of VMC in kidney health and diseases and the clinical significance of VMC variants are poorly understood. In the present study, we have shown that an infiltration of ≥80 inflammatory cells/mm2-VMC area (inflammatory-VMC) is independently associated with kidney disease progression after adjustments for known risk factors of progression. Therefore, assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy.

Farzaneh Agha‐Hosseini, Kimia Hafezi Motlagh

Abstract Introduction Oral lichen planus (OLP) is a chronic inflammatory disorder with cell‐induced immunopathological responses and is considered a potential malignancy disorder in the oral cavity. Due to the high prevalence of OLP as well as the potential for malignancy, human papillomaviruses (HPVs) may play an important role in it. Although previous studies have explored the possible relationship between HPV and OLP, the findings have been conflicting and nonconclusive. This study aims to review the studies that investigated HPV‐16 and HPV‐18 in OLP. Methods and Materials The research protocol followed the Preferred Reporting Items for Systematic Reviews (PRISMA2020) checklist. The online databases Pubmed, Scopus, Embase, Google Scholar, and Cochrane were searched using the following individual keywords: “OLP” OR “Oral Lichen Planus” OR “HPV” OR “Human Papillomavirus.” The search strategy resulted in the selection of 80 articles. The articles were evaluated, and after duplication removal, 53 abstracts were reviewed, resulting in the selection of 25 studies according to inclusion and exclusion criteria. The risk of bias assessment was done by using the Modified Newcastle–Ottawa quality assessment scale. The overall prevalence of HPV in OLP lesions varied from 2.7% to 70%, depending on the type of diagnostic method used. Conclusion Despite the studies conducted on the relationship between OLP and HPV infection, there is still no conclusive evidence that HPV can play a role in the etiopathogenesis of OLP, either in clinical manifestations or in the malignant transformation of lesions.

Nada Binmadi, Maha Alsharif, Soulafa Almazrooa et al.

(1) Objectives: This systematic review and meta-analysis aimed to summarize current evidence regarding the prognostic role of perineural invasion (PNI) in patients with oral squamous cell carcinoma (OSCC). (2) Methods: We searched Cochrane Central, ProQuest, PubMed, Scopus, Science Direct, and Web of Science, using relevant keywords to identify eligible articles. Two independent reviewers conducted two-stage screening, data extraction, and quality assessment. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) criteria. All analyses were performed using comprehensive meta-analysis (CMA; version 3.3.070) software. (3) Results: The study included 101 published articles encompassing 26,062 patients. The pooled analyses showed that PNI was associated with significantly worse overall survival (OS; HR = 1.45, 95% CI: 1.32–1.58; <i>p</i> < 0.001), worse disease-specific survival (DSS; HR = 1.87, 95% CI: 1.65–2.12; <i>p</i> < 0.001), and worse disease-free survival (DFS; HR = 1.87, 95% CI: 1.65–2.12; <i>p</i> < 0.001). Similarly, both local recurrence-free survival (LRFS) and regional recurrence-free survival (RRFS) were worse in patients with PNI (HR = 2.31, 95% CI: 1.72–3.10, <i>p</i> < 0.001; and HR = 2.04, 95% CI: 1.51–2.74, <i>p</i> < 0.001), respectively. The random-effect estimate of three studies demonstrated that the presence of PNI was associated with worse failure-free survival (FFS; HR = 2.59, 95% CI: 1.12–5.98, <i>p</i> < 0.001). (4) Conclusions: The current evidence suggests that PNI can be used as an independent predictor of the prognosis for patients with OSCC. The presence of PNI was associated with worse OS, DFS, DSS, FFS, and with recurrence. Asian patients and patients with extra-tumoral or peripheral PNI invasion were associated with worse prognosis.

* Global Health Organization Leadership, * Regional Leaders in Health

Dear COP 28 President-Designate Sultan Ahmed Al-Jaber, This year, world leaders gathering in the UAE to take stock of their climate commitments will for the first time engage in official programming focused on health. We, the signatories of this letter, support your leadership in bringing health front and center at COP28. As global health leaders, we are committed to achieving health and well-being for all; this is not possible without a safe and stable climate. The Paris Agreement enshrined the “right to health” as a core obligation for climate action. Yet, communities, health workers, and health systems around the world already face the alarming impacts of a changing climate. Climate change-induced extreme weather events are becoming more frequent and severe; many countries are grappling with the health consequences of extreme heat, unprecedented storms, floods, food and water insecurity, wildfires, and displacement. For COP28 to truly be a “health COP,” it must address the root cause of the climate crisis: the continued extraction and use of fossil fuels, including coal, oil, and gas. We call on the COP28 Presidency and the leaders of all countries to commit to an accelerated, just, and equitable phase-out of fossil fuels as the decisive path to health for all. Ending our dangerous dependency on fossil fuels will improve the health prospects of future generations and will save lives. Keeping the global temperature increase within the 1.5°C target of the Paris Agreement is essential to ensure good health and economic prosperity for all. This will only be possible if we rapidly phase out fossil fuels. Fossil fuel phase-out will limit global warming, thereby protecting health from the devastating impacts of extreme weather, and preventing further ecological degradation and biodiversity loss. Failing to do so will lead to overwhelming health consequences, as well as the loss of key natural resources and ecosystem services that are critical to both human and non-human species health, 1 there by undermining One Health and planetary health. In addition to climate-related health impacts, air pollution caused in part by burning fossil fuels causes 7 million premature deaths annually. 2 The economic costs 3 of air pollution-related health impacts amounted to over US$8.1 trillion, or 6.1% of global GDP, in 2019. By improving air quality, governments can reduce the burden of disease from multiple cancers, heart disease, neurological conditions including stroke, and chronic and acute respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Investments in clean energy sources will save hundreds of billions of dollars in health care costs associated with air pollution every year, while reducing economic losses from extreme weather events with damages worth US$253 billion (in 2021). 4 A full and rapid phase-out of fossil fuels is the most significant way to provide the clean air, water, and environment that are foundational to good health. We cannot rely on unreliable and inadequate solutions, like Carbon Capture and Storage (CCS), which extend the use of fossil fuels but do not generate the real and immediate health improvements which a renewable energy transition provides. False solutions like CCS risk making harmful emissions worse, straining the health of overburdened communities, and delaying our progress toward meaningful climate progress. The energy transition must be just and equitable for all. In transitioning to a clean energy future, there is an opportunity to undo the injustices of the fossil fuel-dependent system, taking a systemic approach and emphasizing health, care and community well-being, leaving no one behind. Global leaders must ensure everyone, including fragile states and the most remote and excluded communities, has access to non-polluting, affordable, reliable, accessible, and resilient clean energy, as well as to emerging technologies that make the best use of this energy. A just transition offers the opportunity to reduce health inequities faced by minority and marginalized communities, especially with respect to the health effects of ongoing fossil fuel use and dependence.  Unlocking finance is essential to deliver a healthy and just transition. Achieving climate and health goals will only be feasible if we stop investing in fossil fuels and invest instead in proven climate and health solutions. Each year, countries spend hundreds of billions of dollars subsidizing the fossil fuel industry, money that could be spent investing in a healthy future. High-income countries, development finance institutions, and the private sector must dramatically increase and fulfill their commitments to drive investments in clean energy, clean air, and economic development for the communities most harmed by climate change and fossil fuel pollution. Fossil fuel interests have no place at climate negotiations. The fossil fuel industry cannot be allowed to continue its decades-long campaign of obstructing climate action at the UNFCCC negotiations and beyond. Just as the tobacco industry is not allowed to participate in the WHO Framework Convention on Tobacco Control, it is imperative to safeguard global collaboration on climate progress from the lobbying, disinformation, and delays in favor of industry interests. Without ambitious climate action, the burden on health care systems and health care workers will be insurmountable. Health gains made in recent decades will be in vain and we will see the harmful impacts of climate change ruin our chances for a safe, equitable and just future.  In this extraordinary year, with health for the first time on the COP agenda, we urge you to deliver real climate progress: commit to an accelerated, just, and equitable phase-out of fossil fuels and invest in a renewable energy transition as the decisive path to health for all.  Sincerely, Global Health Organization Leadership (Alphabetical by organization) • Githinji Gitahi, CEO, Amref Health Africa • Pam Cipriano, President, International Council of Nurses • Salman Khan, Liaison Officer for Public Health Issues, International Federation of Medical Students' Associations • Naveen Thacker, President, International Pediatric Association • Dr Christos Christou, International President, Médecins Sans Frontières • María del Carmen Calle Dávila, Executive Secretary, Organismo Andino du Salud (Andean Health Organization) • Luis Eugenio de Souza, President, World Federation for Public Health Associations • Lujain Alqodmani, President, World Medical Association Regional Leaders in Health (Alphabetical by surname) • Mary T. Bassett, Director, FXB Center for Health and Human Rights, Harvard University • Fiona Godlee, Former Editor-in-chief of the British Medical Journal • (Dr.) Arvind Kumar, Chairman, Institute of Chest Surgery, Chest Onco Surgery and Lung Transplantation, Medanta Hospital, India • Dame Parveen Kumar, Emeritus Professor of Medicine and Education, Barts and The London School of Medicine and Dentistry • Lwando Maki, Secretary, Public Health Association of South Africa • Jemilah Mahmood, Executive Director, Sunway Center for Planetary Health - Malaysia • Kari C. Nadeau, MD, PhD, Chair of the Department of Environmental Health at Harvard School of Public Health • (Dr.) K Srinath Reddy, Past President of Public Health Foundation of India This letter is supported and endorsed by: National Health Organization Leadership (Alphabetical by organization) • Rosana Teresa Onocko Campos, President, Associação Brasileira de Saúde Coletiva (Brazil) • Katie Huffling, DNP, Executive Director, Alliance of Nurses for Healthy Environments (US) • Dr Latifa Patel, Representative Body Chair, British Medical Association • Kamran Abassi, Editor-in-Chief, British Medical Journal (UK) • Frances Peart, President & Board Chair, Climate and Health Alliance (Australia) • Kate Wylie, Executive Director, Doctors for the Environment Australia • Agonafer Tekalenge, President, Ethiopian Public Health Association • Diederik Aarendonk, Forum Coordinator Global Health Organization Leadership, European Forum for Primary Care • Kevin Fenton, President, Faculty of Public Health (UK) • Ansgar Gerhardus, Board Chair, German Public Health Association • Vital Ribeiro, Chair, Associação Civil Projeto Hospitais Saudáveis (Healthy Hospitals Project) • Sheila Sobrany, President, Royal College of Nursing • The Board of the Public Health Association of South Africa • Diana Zeballos, Executive Secretary, Sustainable Health Equity Movement (SHEM) • Adeline Kimambo, Executive Secretary, Tanzania Public Health Association • Richard Smith, Chair, UK Health Alliance on Climate Change

Tomasz Stołtny, Michał Dobrakowski, Aleksander Augustyn et al.

Abstract Purpose Current epidemiological data forecast an almost 40% increase in the number of hip arthroplasty performed in the population of patients with osteoarthritis in 2060, compared to year 2018. On the basis of 10 years of observation, the failure rate after a metal-on-metal hip replacement is between 56.7 and 88.9%, depending on the used implant. Methods Seventy-six men operated using metaphyseal hip prostheses, with modular metal heads: the J&J DePuy ASR and Biomet Recap-Magnum systems, after a period of about 5–7 years after the procedure, were assessed twice (an interval of 6 months) in terms of the parameters of oxidative stress and the concentration of chromium, cobalt and ions nickel, as well as their impact on the current clinical status and quality of life. Results The mean values of the Co and Cr ion concentrations increased in a statistically significant manner at the individual stages of the study (13.20 Co and 18.16 Cr) for J&J DePuy ASR. Using the WOMAC-hip, HHS and SF-12 rating scales, the functional status of operated patients in both study groups did not change in a statistically significant manner during subsequent visits. There was a statistically significant increase in perceived pain in patients operated bilaterally with the J&J DePuy ASR system. The severity of pain could be related to the increase in the concentration of Co and Cr ions; however, it concerned a small group of bilaterally operated patients (n = 3 + n = 4). Conclusions Metal-on-metal configuration in hip arthroplasty significantly influences with the increase in the concentration of chromium and cobalt ions in a double assessment. A statistically significant increase in the concentration of the tested Co and Cr ions in the blood correlates with an increase in the intensity of pain, especially in patients undergoing bilateral surgery. The limitation of this study is the relatively small number of bilaterally operated patients. Elevated levels of Co and Cr ions in the blood of patients operated on with the J&J DePuy ASR system increased steadily during both follow-up visits.

Simona Claudia Cambrea, Elena Dumea, Lucian Cristian Petcu et al.

<i>Background and Objectives:</i> The present study assessed the fetal growth restriction and clinical parameters of both human immunodeficiency virus (HIV)-negative and HIV-positive newborns from HIV-infected mothers in two HIV-acquired immunodeficiency syndrome regional centers (RCs) in Constanta and Craiova, Romania, in order to evaluate the adverse birth-related outcomes. <i>Materials and Methods:</i> These represent a retrospective study conducted between 2008 and 2019, in which 408 pregnant HIV-positive women, 244 from Constanta RC and 164 from Craiova RC, were eligible to participate in the study. Consecutive singleton pregnancies delivered beyond 24 weeks of pregnancy were included. Growth restriction in newborns was defined as the birth weight (BW) being less than the third percentile, or three out of the following: BW < 10th percentile; head circumference (HC) < 10th percentile; birth length (BL) < 10th percentile; prenatal diagnosis of fetal growth restriction; and maternal pregnancy information. Of the 244 newborns delivered in Constanta, RC, 17 were HIV-positive, while in Craiova, RC, of the 164 newborns, 9 were HIV-positive. All HIV-positive women were on combined antiretroviral therapy (cART) during pregnancy, similar to all HIV-positive newborns who received ARTs for the first six weeks. We search for the influence of anthropometrical parameters (i.e., HC, BL, and BW), as well as clinical parameters (i.e., newborn sex and Apgar score) for both HIV-negative and HIV-positive newborns, along with the survival rate of HIV-positive newborns. <i>Results:</i> There were no differences in the sex of the newborns within either group, with more than 50% being boys. Similarly, the Apgar score did not show any statistically significant values between the two groups (i.e., <i>p</i> = 0.544 for HIV-positive newborns vs. <i>p</i> = 0.108 for HIV-negative newborns). Interestingly, our results showed that in Craiova, RC, there was a chance of 2.16 to find an HIV-negative newborn with an HC < 10th percentile and a 2.54 chance to find an HIV-negative newborn with a BL < 10th percentile compared to Constanta, RC, without any significant differences. On the contrary, Constanta, RC, represented a higher risk of death (i.e., 3.049 times, <i>p</i> = 0.0470) for HIV-positive newborns compared to Craiova, RC. <i>Conclusions:</i> Our results support the idea that follow-up of fetal growth restriction should be part of postnatal care in this high-risk population to improve adverse birth-related outcomes.

Marieta Bujak, Ivan Brakus, Ratka Borić

Objectives: The primary aim was to compare the amount of bone height change that occurs around the tooth and the implant when having tooth-implant-supported prosthetic restorations versus bone height change that appears around implants in only implant-supported prosthetic restorations. The secondary aim was to examine the influence of various factors such as the number of teeth involved in the construction, their endodontic treatment, number of implants, the type of implantology construction, the jaw in which the construction is located, the condition of the opposite jaw, gender, age, and working time, as well as to examine whether the initial bone level influenced the amount of change in bone height itself. Materials and methods: With a total of 50 respondents, 25 X-ray panoramic images were representing tooth-implant-supported prosthetic restorations, while the other 25 were representing implant-supported prosthetic restorations. Bone measures were taken (from enamel-cement junction/implant neck to the most apical bone point) from 2 panoramic radiographs. The first one is immediately after the implant placement and the second and the last one again in half a year up to seven years after, depending on the time when the photo was taken for each patient. The obtained difference represented the bone resorption, the bone formation, or a state without change. Influence of different factors, such as sex, age of the patient, working time, the number of teeth involved in the construction, endodontic treatment, number of implants, the type of implant construction, the jaw where the construction is located, the condition of the opposite jaw, as well as the initial bone condition, was examined. During the statistical analysis, frequency tables, basic statistical parameters, the Mann-Whitney U test, the Kruskal-Wallis Anova, Wilcoxon test, and regression analysis were used, and the results were presented in tabular form and the form of the Pareto diagram of t-values. Results: No statistically significant difference in bone change (whether we are talking about the place of the implant (-0.359±1.009 and median value 0.000), the place of a tooth (-0.428±0.746 and median value -0,150) in tooth-implant supported restorations, or the place of the implant in case of implant-supported structures (-0,059±0,200 and median value -0,120)) was proven. When talking about the influence of other factors, by regression analysis, the number of implants was shown to be the only factor with a statistically significant influence (β=0.54; P=0.019) in a change of bone level, but only when talking about implant-supported restorations. Conclusion: No significant difference was proven between bone height change, neither around the tooth nor the implant in tooth-implant-supported prosthetic restorations compared to the bone height changes around the implant in only implant-supported prosthetic restorations. Among all the examined factors, the number of implants has shown to have statistically significant contribution to the amount of bone height change in implant-supported prosthetic restorations.

Maryam Tofangchiha, Anita Ebrahimi, Mamak Adel et al.

Background and aims: Considering the advantages of rotary files in instrumenting the root canals of permanent teeth and a lack of adequate data on the use of these systems in primary teeth, the present study aimed to evaluate two rotary files and compare them with hand files in the cleaning efficacy of the root canals of primary molar teeth. Materials and methods: In the present study, three groups of teeth were prepared with Kedo-S paediatric rotary file system, RaCe (reamer with alternating cutting edges), and hand files (n = 40). The groups were evaluated under a stereomicroscope concerning the cleaning efficacy of the files after cleaning the teeth in the apical, middle, and coronal thirds. The data were analyzed with SPSS 24 (IBM Corporation, USA, 2016) using Fisher’s exact test and chi-squared test; statistical significance was set at p < 0.05. Results: There were no significant differences in the apical and middle thirds between the different study groups. However, there were significant differences in the coronal third between the hand file and Kedo-S (p = 0.016) and RaCe and Kedo-S (p = 0.001) groups. Conclusions: The present study showed that Kedo-S files were more effective than RaCe and hand files in the coronal area than the hand and RaCe files.

Yu. A. Vasyuk, E. Yu. Shupenina, G. A. Namazova et al.

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome associated with frequent hospitalizations, high mortality rates, and an absence of proven effective therapy. This type of heart failure is often accompanied by comorbidity that complicate the diagnosis of the underlying disease. The algorithm developed in 2016 does not take into account the heterogeneity of patients and course of HFpEF. Recently, new diagnostic algorithms (H2FPEF, HFA-PEFF) and biomarkers have appeared that allow detecting HFpEF at an early stage, taking into account the pathogenesis, which may contribute to development of new effective treatment methods.

Iris Lin, Madhurima Datta, Denise M. Laronde et al.

Oral cancer is a global health issue with substantial morbidity and a high mortality rate mainly because of late-stage diagnosis. Cancerous lesions are often preceded by potentially malignant lesions that may be detected during routine dental examinations. Not only is the oral cavity easily accessible for screening, but the clinical risk factors of the disease are also known. However, patients may not always be able to access screening services or receive follow-up for diagnosed lesions. In these circumstances, intraoral photos are crucial for timely triage, risk assessment, and monitoring of oral lesions. Further, photos form an integral part of a patient's records, facilitate patient education and communication between health care providers, and provide important information during the referral process. To ensure that intraoral photos are of good quality and standardised there is a need to establish recommendations regarding intraoral photography in oral mucosal screening. This article recommends methods to help health professionals and patients obtain interpretable intraoral photographs. Suggestions to achieve ideal lighting, mirror placement, camera angle, and retraction have been discussed. These recommendations are adaptable to easily available smartphone or point-and-shoot cameras and may be further used to develop future teledentistry platforms.

Scott R. Echternacht, BA, Miranda A. Chacon, BS, Michael F. Catanzaro, MD et al.

Harneet Singh, Adarsh Kumar, Ambika Gupta et al.

Background: COVID-19 and associated lockdown have had some detrimental effects on the health care professionals. With the maximum fear of getting infected and further transmitting the infection, dentists are suffering from the psychological meltdown along with the physical changes due to altered lifestyle. Aim and Objectives: To evaluate the psychological and physical effects of COVID-19 and consequential lockdown on dentists and to understand the possible reasons for the problems they were facing amidst lockdown due to the changes in their lifestyle. Settings and Design: A questionnaire-based survey to evaluate disaster mental health and analysis of musculoskeletal symptoms was designed and sent to the various groups of dentists. A total of 453 respondents completed the survey. Materials and Method: Cluster sampling method was used and the dentists were segregated into four groups. The responses were evaluated for Post-traumatic stress disorder, Depression, Anxiety and Pain or discomfort. Statistical Analysis: Chi Square test was applied to statistically assess the association of responses. Results: Out of 453 respondents 65.1% were females and 34.9% were males. Based on profession, 23% were academicians, 18.8% private practitioners, 16.8% post-graduate students and 41.5% undergraduates. Females were significantly affected and showed a tendency towards Post traumatic stress disease (PTSD) and potential depression along with pain and discomfort. All the three groups except undergraduate students showed potential symptoms. Conclusion: COVID-19 and the lockdown exhibited significant psychological and physical effects on the dentists. Counselling centers or helplines/portals need to be set up to avoid any grave consequences and untoward losses.

Raíza Dias Freitas, Raíza Dias Freitas, Rosane Borges Dias et al.

Oral Squamous Cell Carcinoma (OSCC) presents an important challenge for the health systems worldwide. Thus, unraveling the biological mechanisms involved in OSCC pathogenesis is essential to the discovery of new drugs with anticancer potential. The Hedgehog (HH) pathway has shown promising results as a therapeutic target both in vitro and in vivo. This study aimed to investigate the effects of vismodegib and itraconazole on the expression of Hedgehog (HH) genes (PTCH1, SMO, and GLI1), cell cycle and cell death in OSCC cells. Alamar Blue assay was used to assess the cytotoxicity of vismodegib and itraconazole in a panel of oral cancer cell lines, including CAL27. The expression of HH signaling components after treatment with vismodegib and itraconazole, at concentrations of 25 or 50 μg/ml was evaluated by qPCR. Cell cycle and apoptosis were evaluated by flow cytometry after 72 h treatment with 50 μg/ml of vismodegib or itraconazole. HH signaling was activated in OSCC cell lines CAL27, SCC4, SCC9, and HSC3. Vismodegib and itraconazole significantly reduced CAL27 cell viability after 48 h of treatment. Gene expression of PTCH1, SMO, and GLI1 decreased in response to 24 h of treatment with vismodegib or itraconazole. Furthermore, CAL27 cells exhibited alterations in morphology, cell size, and cellular granularity. An increase in the DNA fragmentation was observed after treatment and both inhibitors induced apoptosis after 72 h. In conclusion, SMO inhibitors vismodegib and itraconazole demonstrably reduced the expression of HH genes in CAL27 OSCC cell line. In addition, treatment with vismodegib and itraconazole reduced cellular viability and altered the morphology of CAL27 cells, and also induced apoptosis.

Bart Vandenberghe