Roberto Eleopra, Marcello Esposito, Anna Rita Bentivoglio
et al.
Cervical dystonia (CD) is the most common adult-onset focal dystonia, with heterogeneous clinical presentation and significant functional impairment. Currently, no structured Italian good clinical practice documents specifically addressing CD have been published. Optimizing CD management requires expert-based recommendations to guide diagnosis, treatment, and follow-up. A two-round Delphi process was conducted, involving a scientific board of six neurologists with expertise in CD management and an external panel of 56 Italian experts (neurologists and physiatrists managing CD patients). Fifty-two statements were developed, discussed, and voted using a 5-point Likert scale, with consensus defined as ≥75% agreement (‘strongly agree’ or ‘somewhat agree’). In Round 1, 48 of 52 statements (92.4%) reached consensus; the four remaining statements were revised, and two were re-voted in Round 2, both achieving consensus. Final recommendations emphasize comprehensive patient assessment in multiple postural conditions; individualized botulinum neurotoxin type A (BoNT-A) dosing taking into account tonic and phasic components, pain, and dysphagia; the use of instrumental guidance; standardized outcome measures; and integration of physiotherapy and psychological support. This article provides structured good clinical practice recommendations for CD management and offers clinicians, especially those with limited experience, a practical framework to standardize care, optimize treatment, and improve patient outcomes.
Saher Sultan, Muhammad Omar Niaz, Javidan Awais
et al.
Objective: To examine patterns of nicotine consumption, oral hygiene practices, and associated oral health
outcomes among undergraduate students in Pakistan, with a comparative focus on medical and non-medical
disciplines across two major cities in Pakistan.
Study Design: A comparative cross-sectional study.
Place and Duration of Study: The study was conducted from March 2024 to September 2024 among
undergraduate students enrolled in selected medical and non-medical universities across two major cities in
Pakistan —Islamabad and Peshawar.
Methods: A total of 500 undergraduate students were invited to participate; 364 completed the survey
(response rate: 73%). Participants were recruited using a structured convenience sampling approach through
classroom invitations and institutional online platforms. Data were collected via a validated, self-administered
questionnaire. Responses were analyzed using SPSS version 26, and associations were assessed using the chi- square test, with P < 0.05 considered statistically significant.
Results: The mean age was 21 ± 1.64 years. Nicotine use was reported by 58%, mainly via vapes/e-cigarettes
(48%) and cigarettes (35%). Use was higher among males than females (75.2% vs. 24.8%, P = 0.012), with no
difference between medical and non-medical students (49.5% vs. 50.5%, P = 0.285). Oral hygiene habits were
similar, though users reported greater use of adjunctive aids (90.5% vs. 75.3%, P < 0.001). Oral health problems
were significantly higher among users: oral lesions (38.1% vs. 13.6%), decay (40.5% vs. 11.7%), xerostomia
(52.9% vs. 16.2%), bleeding gums (41.4% vs. 29.2%), halitosis (20.0% vs. 9.1%), discoloration (51.0% vs. 29.9%),
and sensitivity (61.4% vs. 32.5%) (all P < 0.05).
Conclusion: Despite comparable hygiene behaviors across groups, nicotine consumption was strongly
associated with multiple oral health problems. These findings underscore the urgent need for targeted health
promotion, oral hygiene education, and campus-based nicotine cessation interventions to address this public
health concern among young adults.
How to cite this: Sultan S, Niaz MO, Awais J, Bashir S, Tahira K, Khosa ZA. Effect of Nicotine Consumption on Oral Health and Hygiene Practices among Medical and Non-Medical Undergraduate Students: A Comparative Cross-Sectional Study in Islamabad and Peshawar. Life and Science. 2025; 6(4): 528-535. doi: http://doi.org/10.37185/LnS.1.1.891
Background: Temporomandibular disorder (TMD) is the most common maxillofacial musculoskeletal disease involving various conditions such as chewing muscle disorders, disc displacement and osteoarthritis. However, its intricate pathogenesis remains unclear. Herein, by integrating evidence at the blood, tissue and cell levels, we aimed to investigate the association of cell death-related genes with TMD and predict potential target drugs. Methods: Summary-level data on methylation, expression and protein abundance levels of cell death-related genes were used to identify drug-targeted genes at the blood level. FUSION tool was employed to identify and validate associations at the tissue level. Single-cell analysis was utilised to determine whether TMD-associated cell death genes exhibited higher expression in specific cell types. Drug prediction and molecular docking was used to confirm drug-related effects of TMD-associated cell death genes. Results: Integrating the overlapping results of summary-data-based Mendelian randomisation of mQTL, eQTL and pQTL at the blood level with Bayesian co-localisation analysis, 3 cell death-related genes were identified as causally associated with TMD: TIE1 (Tier 1), IFI16 (Tier 1) and GATM (Tier 2). Based on tissue-level FUSION analysis, we validated the specific effects of TIE1 and GATM genes in muscle-skeletal histology. Meanwhile, single-cell data were utilised to further analyse the cell type-specific enrichment of the 3 target genes in TMD. Finally, drug prediction and molecular docking identified 5 pharmacokinetic associations of 3 TMD-associated cell death genes. Conclusion: Based on multilevel evidence of the blood, tissue and cell, we found that cell death-related genes TIE1, IFI16 and GATM were associated with TMD risk and predict potential target drugs such as fostamatinib. This study further elucidates the critical role of cell death-related molecules and drugs in TMD.
Abstract This study assessed the effects of photobiomodulation therapy (PBMT) with different laser wavelengths on the viability and differentiation of periodontal ligament mesenchymal stem cells (PDLMSCs) exposed to zoledronic acid (ZA). In this in vitro study, PDLMSCs were cultured with 5 µM ZA for 48 h and randomly assigned to 6 groups of positive and negative controls, and PBMT with 635 nm (2 and 4 J/cm2) and 980 nm (2 and 4 J/cm2) lasers. Cell viability was assessed by the methyl thiazolyl tetrazolium (MTT) assay after 24 and 72 h, and mineralized nodule formation was evaluated by Alizarin red staining. Mineralization was assessed by alkaline phosphatase (ALP) activity and expression analysis of osteocalcin (OCN), osteopontin (OPN), and RUNX2 by real-time polymerase chain reaction (PCR). Data were analyzed by one-way ANOVA and Tukey test (α = 0.05). ZA exposure in no-irradiation group decreased viability, ALP activity, mineralized nodule formation, and expression of osteogenic genes (P < 0.05). Cell viability in 980 nm (4 J/cm2) group at 24 h and in 635 nm (4 J/cm2) and 980 nm (2 and 4 J/cm2) groups at 72 h was significantly higher than that in ZA group (P < 0.05). Mineralized nodule formation in both 980 nm groups was significantly higher than that in ZA group (P < 0.001). PBMT with 635 nm laser caused significant downregulation of OCN and OPN with 4 J/cm2 and upregulation of OPN with 2 J/cm2 (P < 0.05) energy density. PBMT with 980 nm laser (2 and 4 J/cm2) caused significant upregulation of OCN, OPN, and RUNX2 (P < 0.05). PBMT with 980 nm laser (4 J/cm2) in presence of ZA increased PDLMSC viability, ALP activity, mineralized nodule formation, and expression of osteogenic genes.
Rizki Indah Alifiani, Sarah Taskia Prissynisa, Fahma Aldihyah Kunsputri
et al.
Introduction: The success of denture fabrication depends on retention and stabilization. The condition known as torus palatinus manifests as a nodular exophytic proliferation of compact bone along the central axis of the hard palate. The large size of the torus palatinus compromises retention and stabilization of dentures. This article describes the prosthodontic treatment for an edentulous patient with a big palatal torus palatinus, utilizing an aluminum foil spacer for the fabrication of a complete denture. Case report: A 69-year-old woman presented to RSGM UMY, reporting difficulty chewing and having all her teeth missing in the arch with a torus palatinus. A maxillary prosthesis was constructed utilizing a spacer that incorporated aluminum foil specifically within the region of the palatine torus. The presence of this bony growth in the palatine region can make the process of creating a complete denture for a patient with a torus palatinus more difficult. The modifications made to ensure patient comfort, functional stability, and optimal denture retention while accommodating the torus are what make the treatment process special. Furthermore, the aluminum foil spacer was designed to provide retention support for the complete denture. Conclusion: To ensure the stability and retention of the complete denture in a patient with a torus palatinus, the impression must generate a vacuum space. In cases of torus palatinus, in addition to employing a window design on the maxillary base plate, an aluminum foil spacer can be utilized over the relief of the torus, with the maxillary base plate covering the torus completely.
Abstract Background Previous studies have suggested a potential link between the crown-to-root ratio (CRR) and root morphology in patients with mild chronic periodontitis, which may be associated with tooth mobility. However, these findings have not been thoroughly investigated. Our previous study found that 76% of patients with aggressive periodontitis, particularly those with premolar involvement, exhibited abnormal root morphology, severe alveolar bone loss, and increased tooth mobility, leading to poor clinical outcomes. This study aims to investigate the specific correlations among alveolar bone resorption, root morphology, CRR, and periodontal clinical indicators with premolar mobility in stage III/IV grade C periodontitis patients aged ≤ 35 years. Materials and methods A total of 1,064 premolars from 151 stage III/IV grade C periodontitis patients aged ≤ 35 years were included in the study. Clinical periodontal parameters and radiographic measurements were recorded. Logistic regression analysis was used to explore the relationships between these indicators and tooth mobility. Results Significant variations in premolar root lengths were observed, ranging from 6.80 mm to 20.96 mm. Teeth with shorter roots (mean length: 10.22 mm) exhibited grade I mobility with only 28% alveolar bone resorption, whereas those with medium-length (mean length: 12.67 mm) and longer roots (mean length: 14.91 mm) exhibited mobility at 34% and 37% bone resorption, respectively. Regression models incorporating the bone-level CRR, average probing depth, and root length demonstrated strong predictive accuracy for tooth mobility (P < 0.001, AIC = 1700.574). Conclusion Premolar mobility is influenced by variations in root length, alveolar bone resorption, and probing depth. The bone-level CRR is an effective predictor for assessing tooth mobility, especially when there are differences in root length and alveolar bone resorption.
Massimiliano Ciribè, Erika Cirillo, Martina Mammone
et al.
Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12–20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (<i>p</i> < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.
Introduction: The introduction of artificial intelligence-driven applications is revolutionizing dentomaxillofacial imaging.
Objectives: To describe the current status of artificial intelligence applications in dentomaxillofacial diagnostics; to assess their impact; and to identify future directions for research and implementation.
Methods: A narrative review was performed, using systematic searches in databases such as PubMed, Google Scholar, IEEE Xplore, among others; the study focused on articles published from 2010 to the present. Researches applying artificial intelligence technologies in dentomaxillofacial diagnosis were included; their quality and relevance were evaluated using the established tools.
Results: Artificial intelligence, especially deep learning, has shown significant improvements in image segmentation, disease detection and treatment planning in dentomaxillofacial imaging. Artificial intelligence techniques have enabled automation of image analysis tasks, improved efficiency and diagnostic accuracy.
Conclusions: Artificial intelligence has significant potential to revolutionize dentomaxillofacial imaging, as it offers improvements in diagnostic accuracy, efficiency in image interpretation, and treatment planning. Further research is needed to overcome technical, ethical and privacy challenges and to validate the clinical applicability of these technologies.
ABSTRACT Artificial intelligence (AI) is a commonly used term in daily life, and there are now two subconcepts that divide the entire range of meanings currently encompassed by the term. The coexistence of the concepts of strong and weak AI can be seen as a result of the recognition of the limits of mathematical and engineering concepts that have dominated the definition. This presentation reviewed the concept, history, and the current application of AI in daily life. Applications of AI are becoming a reality that is commonplace in all areas of modern human life. Efforts to develop robots controlled by AI have been continuously carried out to maximize human convenience. AI has also been applied in the medical decision-making process, and these AI systems can help nonspecialists to obtain expert-level information. Artificial neural networks are highly interconnected networks of computer processors inspired by biological nervous systems. These systems may help connect dental professionals all over the world. Currently, the use of AI is rapidly advancing beyond text-based, image-based dental practice. This presentation reviewed the history of artificial neural networks in the medical and dental fields, as well as current application in dentistry. As the use of AI in the entire medical field increases, the role of AI in dentistry will be greatly expanded. Currently, the use of AI is rapidly advancing beyond text-based, image-based dental practice. In addition to diagnosis of visually confirmed dental caries and impacted teeth, studies applying machine learning based on artificial neural networks to dental treatment through analysis of dental magnetic resonance imaging, computed tomography, and cephalometric radiography are actively underway, and some visible results are emerging at a rapid pace for commercialization.
Panoramic radiography is an extraoral radiography modality that provides two-dimensional information about the teeth and the maxillofacial skeleton. It is a valuable adjunct for diagnosis and treatment planning as it facilitates one-time imaging of all teeth, the mandible, parts of maxilla including a large part of the maxillary sinus, hard palate and temporomandibular joints (TMJs). As a tomographic image is prone to errors and artefacts, a good quality radiograph in most patients can be achieved by following the standard rules and through proper patient positioning. In this article, we will discuss indications for panoramic radiography imaging, steps in taking the radiograph, as well as limitations, pitfalls and complications of the procedure. Tomographic imaging of temporomandibular joint is also discussed.
With the advancements in technology, dental pedagogy has also evolved, and new learning technologies have emerged. Virtual reality (VR) as an education tool in dentistry is underutilised. VR as an adjunct in local anaesthesia (LA) teaching in paediatric dentistry has not been investigated. The study aimed to investigate dental student’s perception of dental LA VR simulation on a paediatric patient and to determine whether this can improve students learning experience. Seventy-one students participated in a self-administered questionnaire before and after the use of dental LA VR simulator. Descriptive analysis was performed to determine the perceptions of experience gained through VR. The data were tabulated, graphed, and analysed using SPSS and GraphPad Prism software. The study noted that 89.9% of participants perceived that it would improve their LA skills. After using dental LA VR, 83.1% of participants experienced more engaged in the learning activity, and 55.0% of participants agreed/strongly agreed that it improved their understanding of anatomical landmarks. Around 56.4% of participants agreed/strongly agreed that it added value compared with traditional LA teaching methods. It can be concluded that the use of VR simulation can enhance students engagement and learning experience in paediatric dentistry settings and can be used as an additional means of LA training.
Denise Bitencourt de SOUZA, Adriana Ismerim OLIVEIRA, Giovana Renata GOUVÊA
et al.
ABSTRACT Objective: To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons. Methods: The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher’s exact test, considering the level of significance of 5%. Results: The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes. Conclusion: The influence of orthodontists’ and laypersons’ aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.
Adeel Aslam, Che Suraya Zin, Shazia Jamshed
et al.
Self-medication with antibiotics (SMA) has become considerably common in developing countries, which is a critical factor for driving antibiotic resistance. Individuals involved in SMA generally do not have adequate knowledge regarding the appropriate use, indications and dosage of these drugs. The objective of the present study was to investigate population SMA practices, knowledge and sociodemographic factors associated with SMA in Islamabad, Pakistan. The study adopted a cross-sectional methodology and data collection was performed through an anonymous, structured and pilot-tested questionnaire, which was interview-administered. Inferential statistics and multivariate logistic regression were performed. Out of 480 participants, 55.6% (<i>n</i> = 267) were male with a mean age of 37.1 ± 10.1 years; the total prevalence of SMA was 32.5%. Ciprofloxacin (42.9%) was the most commonly used antibiotic to treat coughs or colds, a runny nose, flu or sore throat, diarrhea or fevers, which were relevant reasons for SMA. Findings from multivariate logistic regression showed that predictors of SMA were: male gender (95% CI: 0.383–1.005), age (95% CI: 0.317–0.953) and highest level of education (95% CI: 0.961–0.649). Despite reasonable access to healthcare facilities, people are still obtaining antibiotics without prescription, bypassing diagnostic and consultative healthcare services. Thus, the government must implement strict healthcare policies to restrict the sale of antibiotics without prescriptions, while at the same time, targeted public awareness campaigns about the proper use of antibiotics are also required.
IntroductionCleft palate (CP) is one of the most common congenital birth defects in the craniofacial region, retinoic acid (RA) gavage is the most common method for inducing cleft palate model. Although several mechanisms have been proposed to illuminate RA-induced cleft palate during embryonic development, these findings are far from enough. Many efforts remain to be devoted to studying the etiology and pathogenesis of cleft palate. Recent research is gradually shifting the focus to the effect of retinoic acid on gut microbiota. However, few reports focus on the relationship between the occurrence of CP in embryos and gut microbiota.MethodsIn our research, we used RA to induce cleft palate model for E10.5 the feces of 5 RA-treated pregnant mice and 5 control pregnant mice were respectively metagenomics analysis.ResultsCompared with the control group, Lactobacillus in the gut microbiome the RA group was significantly increased. GO, KEGG and CAZy analysis of differentially unigenes demonstrated the most abundant metabolic pathway in different groups, lipopolysaccharide biosynthesis, and histidine metabolism.DiscussionOur findings indicated that changes in the maternal gut microbiome palatal development, which might be related to changes in Lactobacillus and These results provide a new direction in the pathogenesis of CP induced by RA.