Photobiomodulation Therapy in Oral Mucositis and Potentially Malignant Oral Lesions: A Therapy Towards the Future

Photobiomodulation therapy (PBMT) is an effective treatment modality, which has the significant advantage of enhancing a patient’s quality of life (QoL) by minimising the side effects of oral cancer treatments, as well as assisting in the management of potentially cancerous lesions. It is important to note that the major evidence-based documentation neither considers, nor tackles, the issues related to the impact of PBMT on tumour progression and on the downregulation of cellular proliferation improvement, by identifying the dose- and time-dependency. Moreover, little is known about the risk of this therapy and its safety when it is applied to the tumour, or the impact on the factor of QoL. The review aimed to address the benefits and limitations of PBMT in premalignant oral lesions, as well as the conflicting evidence concerning the relationship between tumour cell proliferation and the applied dose of photonic energy (fluence) in treating oral mucositis induced by head and neck cancer (H&N) treatments. The objective was to appraise the current concept of PBMT safety in the long-term, along with its latent impact on tumour reaction. This review highlighted the gap in the literature and broaden the knowledge of the current clinical evidence-based practice, and effectiveness, of PBMT in H&N oncology patients. As a result, the authors concluded that PBMT is a promising treatment modality. However, due to the heterogeneity of our data, it needs to undergo further testing in well-designed, long-term and randomised controlled trial studies, to evaluate it with diligent and impartial outcomes, and ensure laser irradiation’s safety at the tumour site.

Nano-hydroxyapatite use in dentistry: a systematic review

Nano-hydroxyapatite (nano-HA) is a material with multiple uses due to its biocompatibility and its resemblance to the nonorganic bone structure. It is used in various dental domains such as implantology, surgery, periodontology, esthetics and prevention. The aim of this study is to provide a wide understanding of nano-HA and to promote treatments based on nanomaterials in dentistry. A search in two data bases, Scopus, and PubMED, was conducted over a 5 years period. We chose a 5 years period because this revealed the most recent published studies with the key words 'nano-HA' and 'dentistry'. A number of 32 studies were included in this systematic review. In implantology the main use of nano-HA was as a coating material for titanium implants and its effect was assessed in the matter of osteointegration and inflammatory response as well as antibacterial activity. In tissue engineering the use of nano-HA was directed to surgery and periodontology and this material was assessed mainly as a grafting material. In esthetics and prevention its use was mainly focused on dentinal hypersensitivity treatment, remineralizing potential and as bleaching co-agent. Nano-HA is a relatively novel material with outstanding physical, chemical, mechanical and biological properties that makes it suitable for multiple interventions. It outperformed most of the classic materials used in implantology and surgery but it should be further investigated for bone engineering and caries prevention therapy.

Evaluation of the outcome of various laser therapy applications in root canal disinfection: A systematic review

BACKGROUND

Any successful endodontic therapy requires elimination of the endodontic biofilms through meticulous root canal disinfection methods. Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are the most common effective irrigants, in removing smear-layer from the coronal and middle thirds of the dental canals but reduced considerably towards the apical one third. In recent years, newly alternative treatment modalities have been proposed, including high-power lasers and antimicrobial photodynamic therapy (aPDT). Our work was conducted to evalaute the outcome of root canal disinfection in relation to the efficacy of various treatment modalities. Furthermore, every effort was made to present an overview of the aPDT outcomes, as a model for this application, and to propose laser parameters protocol with positive results.

METHODS

The electronic databases PubMed was searched from January 2013- January 2019. Our inclusive criteria based on laser therapy applications, as a model for root canal disinfection. The search terms utilised various combinations as follows: photodynamic therapy or antimicrobial photodynamic therapy or photoactivated disinfection or light activated disinfection or laser activated disinfection or laser therapy, and endodontic.

RESULTS

The results of this systematic review concluded that the effectiveness of aPDT and various laser wavelengths protocols, in removing endodontic biofilms from infected root canals, remains unattainable.

CONCLUSIONS

Study concluded that the combination of aPDT with antimicrobial irrigants could provide a synergetic effect. However, due to the heterogeneity of the selected studies and their limitations, in terms of lack of standardised protocol or discrepancy in the methodology, authors suggest further validated approaches to achieve optimal outcomes.

Metabolic Profile and the Risk of Early Atherosclerosis in Patients with Obesity and Overweight

Obesity and Overweight have the highest rate of incidence and prevalence in the past 3 decades, as global pathologies. The purpose of this study was to evaluate cardiovascular, classic and modern risk factors in overweight and obese patients by studying lipid metabolism (total cholesterol, HDL-cholesterol, non-HDL-cholesterol, LDL-cholesterol, serum triglycerides), glucose metabolism, insulin resistance and insulin sensitivity, the prevalence of hypertension (HBP) and the prevalence of metabolic syndrome (MS). This analytical study was performed on 111 subjects divided as follows: Group I consisting of 27 normal weight subjects - NW; Group II consisting of 84 overweight and obese subjects - OW + O: 36 overweight patients - OW; 33 patients with grade I obesity - O-I; 13 patients with grade II obesity - O-II; 2 patients with grade III obesity - O-III. The overweight and obese, although unknown with heart disease, have significant metabolic changes, such as atherogenic dyslipidemia, dysglycemia, high insulin resistance and low insulin sensitivity, metabolic syndrome, these being the first steps towards endothelial dysfunction and early atherosclerosis.

Nicotine Addiction : Objective in Educational Programs for Smoking Prevention in Young People

In those countries where education and smoking prevention campaigns are carried out at school level, there has been a decline in the prevalence of smoking among pupils. Nicotine addiction represents a sum of pharmacological, electrophysiological and molecular genetic mechanisms and behavior patterns. The study was conducted from December 2016, to July 2017 and it consisted in an online survey posted on a website. The participants accessed the survey through an e mail link. The study population consisted of 1144 teachers (from primary school, gymnasium and college). The declared percentage of daily smokers was 14%, below the European average, while 20.5% were declared ex-smokers, 11.2% were occasional smokers and 54.4% never smoked. The theme of smoking was approached by 79.2% of teachers during conducting classes and 81.6% of them advised smokers to stop smoking. Teachers can influence the pupils� behavior by personal example and by teaching, inside and outside the school, thus preventing nicotine addiction. Decreasing the prevalence of smoking among teachers will inevitably lead in the future to a decrease of adolescent smokers� incidence. Our study was a pilot project that can draw important directions in educational and preventive campaigns in schools.

The Influence of Smoking on Nicotine Exposure Biomarkers and Inflammatory Profile Among Foster Care Teenagers, Romania

Foster care young people have an increased overall risk for the development of chronic health conditions.Smoking is a major risk factor for many conditions with inflammatory component. We performed a cross-sectional pilot study to assess the correlation between tobacco consumption status and inflammatory profile among adolescents living with foster parents in the central region of Romania. A number of 35 teenagers aged 10-18 were enrolled. Blood samples were collected by venipuncture for complete blood count (CBC), fibrinogen, Interleukin-6 (IL 6), C reactive protein (CRP). Exhaled CO was measured and urine samples were collected in the same session for cotinine assessment. Of the 123 teenagers initially enrolled, 35 completed the entire study protocol. Urinary cotinine accurately reflected smoker status. Smoking did not affect hemoglobin levels or other hematological parameters in foster care teenagers. The value of C-reactive protein was higher in smokers. Plasma fibrinogen correlated with the daily number of cigarettes. Interleukin-6 did not correlate with the smoker status or the daily number of cigarettes consumed. Our study highlights the existence of an inflammatory response to smoking in foster care adolescents, a social category otherwise predisposed to various addictive behaviors.