Systemic Manifestations of the Periodontal Disease: A Bibliometric Review

A Bibliometric Analysis of Literature on the Impact of Rheumatoid Arthritis on Oral Health (1987-2024)

This bibliometric analysis investigates the research landscape concerning the impact of rheumatoid arthritis (RA) on oral health through a comprehensive literature review. The study includes all English-language articles retrieved from the PubMed database, focusing on the relationship between RA and various aspects of oral health without any filter. The analysis of 261 publications revealed fluctuations in publication patterns from 1987 to 2024, with notable surges and declines in research activity. Collaborative networks among authors and institutions were identified, highlighting key contributors and prolific institutions such as Karolinska Institutet. The themes prevalent in the research included demographics, oral microbiota, biomarkers, treatment outcomes, and molecular mechanisms. Trend topic and thematic evolution analyses elucidated shifts in research focus from traditional concerns to emerging areas such as oral microbiology and immunological mechanisms. Key findings underscored the need for more clinical trials to comprehend the impact of RA on oral health, enhanced interdisciplinary collaboration, exploration of emerging areas, and longitudinal studies. This analysis provides valuable insights into the evolving research landscape, informing future investigations and interventions to improve oral health outcomes in individuals with RA.

Bibliometric analysis and visualization of top papers in dentistry from 2012 to 2022 based on essential science indicators

OBJECTIVES

This study aims to analyze and visualize the top dental papers from 2012 to 2022 using data from essential science indicators (ESIs).

MATERIALS AND METHODS

The present study was conducted using library and retrospective bibliometric analysis methods. Additionally, a science map has been created. Web of Science was searched on January 18, 2023. The results were limited to the top papers in ESIs. The bibliometric information of the top papers was evaluated. Next, the VOSviewer was used to perform a co-occurrence analysis and visualize data.

RESULTS

The findings showed that Mariano Belén Sanz and Maurizio S. Tonetti were the top two authors. The University of London and the University of Bern had the highest number of articles. These articles were published in 55 journals. According to the analysis of keyword co-occurrence, the most frequently used keywords in the field of dentistry include "periodontitis," "dental implants," "periodontal disease," "mechanical properties," "peri-implantitis," "oral health," "dental caries," "dental materials," "3D printing."

CONCLUSION

The findings of this study enable readers to pinpoint the authors, organizations, countries, and journals that have made the biggest contributions to the list of the most often cited dentistry papers. In medicine, bibliometric citation analysis is frequently used to assist researchers in learning the fundamentals of a subject and pinpoint subtopics of broad interest for additional study.

The 100 top-cited articles in uveitis from 1950 to 2022

OBJECTIVES

This bibliometric analysis aimed to clarify research characteristics and trends in research on uveitis by analyzing the top 100 most-cited articles.

METHODS

We used the Web of Science database to search articles published in English from January 1, 1950, to February 10, 2022, without other restrictions. The 100 most-cited articles related to uveitis were screened. The publication year, institution, author, journal, country, research topic, and research type of each article were analyzed.

RESULTS

The citations of the top 100 articles ranged from 144 to 2292 times. The years 2004 and 2005 included the largest number of articles published, with 17 in total. Most of the papers were published in Ophthalmology (n = 19), a specialized ophthalmology journal. The top 100 articles originated from 14 countries, with the most from the USA (n = 44). Twenty research institutions and 18 authors contributed two or more articles, with the National Eye Institute (USA) (n = 10) and Robert B. Nussenblatt (n = 10) contributing the most. The types of studies were mainly clinical studies (n = 64), focusing on the treatment of uveitis (n = 36).

CONCLUSION

This study summarizes and analyzes the research characteristics and trends of uveitis. The contribution of the USA is explained, the past and current treatments of uveitis are emphasized, and the directions of future research are clarified.

A Bibliometric Study on the Top 101 Most-Cited Articles of Dental Journals of the Middle East/North Africa Countries From 2011 to 2021

Introduction: This retrospective descriptive study evaluated the Scopus-indexed dental journals and their most-cited documents affiliated with the Middle East and North Africa (MENA) countries from 2011 to 2021. Methods: Dental journals affiliated with MENA countries, their bibliometric indicators (SJR, CiteScore, SNIP, and H-index), and the 101 most cited articles of the considered journals were extracted and studied through descriptive statistics. In addition, the "citation per year" of each top 101 articles was calculated. Spearman's rho test was used for pairwise comparisons of the correlation coefficient values between each two of the considered bibliometric indicators. Results: The number of citations of the 101 most-cited papers ranged from 35 to 203. The mean (SD) citations of studied articles were 61.33 (37.58) and the median was 46. Furthermore, CiteScore had the highest significant correlation with SJR (r=0.828, P˂0.001). Moreover, the citation per year of the top 101 documents had no significant relationship with any of the journals' bibliometric indicators. Conclusion: Because journal performance and citation rate are multi-dimensional concepts, a single metric cannot express them thoroughly despite correlations between indices. "European Journal of Dentistry" from Turkey, "Saudi Dental Journal" from Saudi Arabia, and "Iranian Endodontic Journal" and "Journal of Lasers in Medical Sciences" both from Iran had the highest ranks in the SCImago portal and the highest scores in bibliometric indices amongst the MENA dental journals.

Bibliometric analysis on research trends for contribution of photodynamic therapy in periodontitis

BACKGROUND

The objective of this bibliometric was to ascertain the research trend regarding the application of photodynamic therapy as a treatment modality for periodontal disease.

METHODS

An online search was administered using the Scopus database to retrieve all the relevant research literature published from 2003 till 26^th Dec 2022. After applying the inclusion criteria articles pertinent to the topic were manually selected. Data was saved as CSV. Data was read using VOSviewer software and further analysis was performed using Microsoft excel.

RESULTS

From a total of 545 articles, 117 scientific papers relevant to the field were evaluated. The keen interest of researchers was identified by an increase in the number of publications over the course of time, with the highest citations n=827 attained during the year 2009. Brazil, India, and USA made significant contribution by publishing highest number of papers. Organizations from the USA produced the highest publications which attained high citations. Author Sculean A. published the highest number of papers. Journal of periodontology was the leading journal, by publishing highest number of papers (n=15), followed by Journal of Clinical Periodontology.

CONCLUSION

This bibliometric analysis provided detailed information regarding the total number of publications from 2003 to 2022 and the number of citations attained. Brazil has been identified as the leading country, whilst all the leading organizations which contributed significantly, were from USA. The Journal of Periodontology published the highest number of papers which had been highly cited. Sculean A, affiliated with University of Bern, Switzerland published the highest number of papers.

Association of Serum Interleukin-10 Level with Glycemic Status to Predict Glycemic Alteration with Periodontitis: A Cross-Sectional, Observational Study

Background and Aim

Studies showed bidirectional relationship between chronic periodontitis (CPD) and diabetes. This study was conducted to estimate the levels of serum interleukin (IL)-10 in patients with CPD and type 2 diabetes mellitus (T2DM) to evaluate the association of serum IL-10 levels with glycemic status and to evaluate the influence of periodontal inflammation on glycemic control.

Setting and Design

A cross-sectional observational study.

Materials and Methods

Eighty patients were divided into four groups consisting of 20 patients in each group. Group 1: healthy control, Group 2: T2DM without chronic periodontitis, Group 3: chronic periodontitis only (CPD), and Group 4: T2DM with chronic periodontitis (CPD). Plaque index, gingival index, pocket probing depth, clinical attachment loss, random blood sugar, and glycated hemoglobin (HbA1c) level were recorded for categorizing patients into aforestated groups. Serum IL-10 level was measured by ELISA kit.

Statistical Analysis Used

ANOVA statistics and post hoc Tukey's test were performed for comparing individual groups.

Results

IL-10 was detected lowest in Group 3 followed by Group 4. Highest level of IL-10 was found in the healthy group then in Group 2.

Conclusion

IL-10 levels have an inverse relationship with HbA1c. Lowest level of IL-10 in CPD dictates periodontal inflammation itself influences in regulating serum IL-10 level and poor glycemic control. Serum IL-10 level may be one of the predictors of glycemia.

Global research trends on maternal exposure to methylmercury and offspring health outcomes

This study aimed to analyze the landscape of maternal methylmercury exposure and its offspring consequences based on knowledge mapping of the 100 most-cited papers about this theme. A search was performed using the Web of Science, without any restriction of language or publication year. Data bibliometrics, such as the number of citations, citation density, corresponding author’s country, year of publication, study design, and keywords, were extracted from each paper and analyzed. VOSviewer software was used to create graphical bibliometric maps. Of a total of 1,776 studies on this theme, the 100 most-cited papers rendered the number of citations ranged from 110 to 1,356 citations. The non-systematic reviews and cohort studies from Anglo-Saxon countries published in the first decade of the 2000s were the most frequent. Clarkson, Grandjean, and Myers were the authors with higher citation density. A total of 520 keywords represented the evolution of the theme, from classic episodes of MeHg intoxication, as well as main the health changes until the different forms of exposure and, in recent years, biomonitoring studies were highlighted. Our findings provide the global research trends highlighting the network of most influential authors and a better understanding of the evolution and future scenarios of this theme.

Current State and Challenges of the Global Outcomes of Dental Caries Research in the Meta-Omics Era

Despite significant healthcare advances in the 21st century, the exact etiology of dental caries remains unsolved. The past two decades have witnessed a tremendous growth in our understanding of dental caries amid the advent of revolutionary omics technologies. Accordingly, a consensus has been reached that dental caries is a community-scale metabolic disorder, and its etiology is beyond a single causative organism. This conclusion was based on a variety of microbiome studies following the flow of information along the central dogma of biology from genomic data to the end products of metabolism. These studies were facilitated by the unprecedented growth of the next- generation sequencing tools and omics techniques, such as metagenomics and metatranscriptomics, to estimate the community composition of oral microbiome and its functional potential. Furthermore, the rapidly evolving proteomics and metabolomics platforms, including nuclear magnetic resonance spectroscopy and/or mass spectrometry coupled with chromatography, have enabled precise quantification of the translational outcomes. Although the majority supports ‘conserved functional changes’ as indicators of dysbiosis, it remains unclear how caries dynamics impact the microbiota functions and vice versa, over the course of disease onset and progression. What compounds the situation is the host-microbiota crosstalk. Genome-wide association studies have been undertaken to elucidate the interaction of host genetic variation with the microbiome. However, these studies are challenged by the complex interaction of host genetics and environmental factors. All these complementary approaches need to be orchestrated to capture the key players in this multifactorial disease. Herein, we critically review the milestones in caries research focusing on the state-of-art singular and integrative omics studies, supplemented with a bibliographic network analysis to address the oral microbiome, the host factors, and their interactions. Additionally, we highlight gaps in the dental literature and shed light on critical future research questions and study designs that could unravel the complexities of dental caries, the most globally widespread disease.

Gingival crevicular fluid CSF-1 and IL-34 levels in patients with stage III grade C periodontitis and uncontrolled type 2 diabetes mellitus

PURPOSE

Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD).

METHODS

In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay.

RESULTS

All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05).

CONCLUSIONS

These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04891627.

'CARE compliance' of case reports published in Dental Traumatology in the past two decades: A bibliometric analysis

BACKGROUND/AIMS

The journal Dental Traumatology (DT) is one of the best resources in the field of dental traumatology. It has always encouraged publication of case reports of good quality. The CARE statement (2011) was developed for uniform and transparent reporting of cases in medical sciences. Since case reports are inseparable from the DT literature, the aim of this bibliometric-analysis was to evaluate the case reports published in the DT in the last two decades (2001-2021) and assess their compliance regarding CARE guidelines for elucidating the trends in DT and the reporting quality of these papers.

METHODOLOGY

Two authors independently observed the tables of contents in all issues of DT from 2002-2021 and identified case reports. Selected articles were scrutinized to determine their eligibility. Data extraction was performed, case reports were segregated into domains, and their CARE compliance was evaluated by using a self-designed-validated method. Differences between the case reports published in two decades (2002-2011 and 2012-2021) were analysed with the Chi-square test.

RESULTS

A total of 1612 articles published between February 2002 and October 2021 were scrutinized to identify 357 case reports with 277 from the period of 2002-2011 and 80 between 2012 and 2021. The highest number of case reports originated from Asia (2002-2011:135, 2012-2021:28). The CARE compliances of the majority of reports in the decade of 2002-2011 were between 75 and 85% (good) while the CARE compliances of the majority of reports from 2012-2021 were between 85 and 95% (very good) or >95% (excellent). These differences were statistically significant (p < .005).

CONCLUSIONS

The number of case reports published in the decade of 2002-2011 were more than three times the number of case reports published in the decade of 2012-2021. The highest number of reports in both decades were from Asia and belonged to the therapeutic and prognostic domains. The CARE compliances of the reports in the decade of 2012-2021 were better than those from 2002-2011.

Knowledge about oral manifestations of systemic diseases among medical and dental students from Jordan: An interdisciplinary educational gap

OBJECTIVE

To assess the ability of medical students to recognize oral manifestation of selected systemic diseases and compare their performance with dental students.

MATERIALS AND METHODS

A total of 400 senior medical and dental students were approached to participate. The study protocol involved two parts; a self-administered survey and a direct interview involving clinical photographs for oral signs of systemic diseases.

RESULTS

A total of 283 (70.8%) agreed to participate and completed the two- part study. The study population was made of 110 (38.9%) [82 females and 28 males] dental students, and 173(61.1%) [98 females and 75 males] medical students. The knowledge score regarding questions about the normal mouth and oral structures was 15.7 ± 6 out of 22. Dental students had a significantly higher knowledge score about normal mouth and oral structures (20.9 ± 4; range from 17 to 22) compared to medical students (10.6 ± 7; range from 4 to 21) (p = .029). The knowledge score regarding questions about oral manifestations of systemic diseases was 26.8 ± 6 out of 40. Dental students had a significantly higher knowledge score about oral manifestations of systemic diseases (30.8 ± 7; range from 15 to 37) compared to medical students (22.9 ± 4; range from 10 to 36) (p = .031). Only 24.3% (n = 42) medical students reported having adequate training to be able to distinguish between normal mouth and diseases. Nearly all medical students (91.3%; n = 158) felt that it is important to have more formal training in oral examination and disease diagnosis.

CONCLUSION

Medical students lack adequate knowledge, diagnostic ability, and confidence with regard to diagnosis of oral signs of systemic diseases. To ensure that medical students have necessary skills in assessing oral diseases, curricula revisions and modifications are required, and specific oral health-related learning outcomes should be introduced and reinforced through clinical training.

Grafting Resveratrol onto Mesoporous Silica Nanoparticles towards Efficient Sustainable Immunoregulation and Insulin Resistance Alleviation for Diabetic Periodontitis Therapy

The treatment of diabetic periodontitis (DP) has become a tough challenge in dental clinic mainly due to the intrinsic drawbacks of conventional therapy strategy and currently unclear mechanisms to elucidate...

A bibliometric analysis of the top 100 most-cited case reports and case series in Endodontic journals

AIM

To identify the top 100 most-cited case reports and case series published in Endodontic journals and to analyse their bibliometric characteristics.

METHODOLOGY

The Clarivate Analytics' Web of Science (WoS), Scopus and PubMed databases were used to identify the top 100 most-cited case reports and case series in Endodontic journals. Complete bibliographic records of the selected case reports and case series were exported in plain text or BibTeX format and imported into the R environment for statistical computing and graphics. The following parameters were then analysed: names and affiliations of the authors, title, year of publication, journal of publication, first author, corresponding author, literature cited within reports, language, citation counts, impact factor of the journal, keywords, Keywords Plus and research topic.

RESULTS

In total, 88 case reports and 12 case series published in English between 1977 and 2016 were identified as the most-cited reports in the field of Endodontics. The terms "case report(s)" or "case series" were not included in the title of 57 articles. The number of authors per report ranged from one to seven, with the average number of co-authors per report being 3.14. The most-cited author was M Trope (University of Pennsylvania, USA). The University of Washington and Private Practice, Cetraro, Italy, were the most productive institutions. The country whose case reports received the largest total number of citations was the United States. The largest number of the most-cited reports appeared in 2002, 2004 and 2007 (n = 7, respectively). According to the WoS database, the total number of citations ranged from 42 to 453, with the average number of citations per report being 79.97. The majority of the top 100 most-cited articles were published in the Journal of Endodontics and the International Endodontic Journal. The most frequently used author keywords were revascularization and mineral trioxide aggregate. The majority of the case reports and case series dealt with topics related to pulp regeneration.

CONCLUSION

This bibliometric study provides a comprehensive overview on the progress, trends and current directions in clinical practice within the field of Endodontics.

Endodontic Microbiology: A Bibliometric Analysis of the Top 50 Classics

Background

Citation analysis has emerged to play a significant role in recognition of the most useful areas of research. Endodontic microbiology has been a topic of interest for endodontists as well as periodontists and oral surgeons. This bibliometric analysis is aimed at identifying and reporting the characteristics of the top 50 cited articles on endodontic microbiology.

Methods

The articles were identified through a search on Web of Science (WoS), property of Clarivate Analytics database published on endodontic microbiology. The citation information of the selected articles was recorded. The Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, Dental Traumatology, and Australian Endodontic Journal were searched in the search title. Descriptive and bivariate analyses were performed using a statistical software package SPSS. Statistical analysis was performed using Shapiro-Wilk, Kruskal-Wallis, Post hoc, Mann-Kendall trend, and Spearman-rank tests.

Results

The 50 most cited articles were published from 1965 to 2012 with citation count varying from 1065 to 103 times. The total citation counts of articles recorded were 11,525 (WoS), 12,602 (Elseviers' Scopus), and 28,871 (Google Scholar). The most prolific years in terms of publications were 2001, 2002, and 2003, with five publications each, followed by 2005 with four. The year with most citations was 1998, with 1,330 citations, followed by 1965 and 2001, with 1,065 and 1,015 citations, respectively. A total of 136 authors contributed to the top 50 most cited articles with 27 corresponding institutions from 12 different countries. The most common methodological design was in vitro study, followed by clinic-laboratory study, literature review, systematic review and meta-analysis, and animal study.

Conclusions

The present study provided a detailed list of the top 50 most cited and classic articles on microbiology in endodontics. This will help researchers, students, and clinicians in the field of endodontics as an impressive source of information.

COVID-19 and oral diseases: Assessing manifestations of a new pathogen in oral infections

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a recently identified virus responsible for life-threatening coronavirus disease 19 (COVID-19). The SARS-CoV-2 infected subjects can be asymptomatic or symptomatic; the later may present a wide spectrum of clinical manifestations. However, the impact of SARS-CoV-2 on oral diseases remain poorly studied. Detection of SARS-CoV-2 in saliva indicates existence of virus in the oral cavity. Recent studies demonstrating the expression of ACE-2, a SARS-CoV-2 entry receptor, in oral tissues further strengthens this observation. Cytokine storm in severe COVID-19 patients and copious secretion of pro-inflammatory cytokines (IL-6, IL-1β and TNF-α) in multiple symptomatic oral pathologies including periodontitis and periapical periodontitis suggests that inflammatory microenvironment is a hallmark of both COVID-19 and oral diseases. Hyperinflammation may provide conducive microenvironment for the growth of local oral pathogens or opportunistic microbes and exert detrimental impact on the oral tissue integrity. Multiple case reports have indicated uncharacterized oral lesions, symptomatic irreversible pulpitis, higher plaque index, necrotizing/desquamative gingivitis in COVID-19 patients suggesting that SARS-CoV-2 may worsen the manifestations of oral infections. However, the underlying factors and pathways remain elusive. Here we summarize current literature and suggest mechanisms for viral pathogenesis of oral dental pathology derived from oral microbiome and oral mucosa-dental tissue interactions. Longitudinal studies will reveal how the virus impairs disease progression and resolution post-therapy. Some relationships we suggest provide the basis for novel monitoring and treatment of oral viral disease in the era of SARS-CoV-2 pandemic, promoting evidence-based dentistry guidelines to diagnose virus-infected patients to improve oral health.

Decisional capacity determination and serious mental illness in oncology: Implications for equitable and beneficent care

BACKGROUND

Patients with Serious Mental Illness (SMI) have worse survival compared to cancer patients without SMI after controlling for delayed diagnosis. Decision-making capacity (DMC) may be impaired in both populations (cancer or SMI). DMC may be further impaired based on coupled vulnerability factors that challenge Shared Decision Making (SDM) for patients with cancer and SMI.

METHODS

Psychiatric consultations for DMC in hospitalized patients with cancer (n = 97) were consecutively evaluated across a single institution cancer center. SMI data, demographic, and cancer-related variables were obtained from the medical record. Descriptive data were contrasted in patients with and without DMC and used for logistic regression modeling.

RESULTS

Overall, 42% had DMC with no significant differences based on SMI (χ²  = 2.60, p = 0.11). Patients with SMI were younger, receiving anticancer treatment, and were less likely facing end of life issues. Age (OR 1.03, p = 0.05) and no recent anticancer treatments (OR 0.34, p = 0.02) were associated with decisional incapacity. At 3 months post discharge, almost two-thirds were dead with no difference based on SMI (χ²  = 0.01, p = 0.91). But End of Life (EOL) concerns were documented in 63% of non-SMI patients and only 36% of SMI patients (χ²  = 5.63, p = 0.02). Healthcare proxy (16%), four determinates of DMC (22%), and repeated psychiatric DCM assessments (35%) were documented with no differences based on SMI.

CONCLUSION

SDM is not equitable for cancer patients with SMI. Advanced directives and a robust effort to provide value-congruent care for patient with SMI who develop cancer may lessen this health inequity for cancer patients with SMI.

Emerging Role of Epigenetics in Explaining Relationship of Periodontitis and Cardiovascular Diseases

Cardiovascular diseases such as ischemic heart diseases or stroke are among the leading cause of deaths globally, and evidence suggests that these diseases are modulated by a multifactorial and complex interplay of genetic, environmental, and lifestyle factors. Genetic predisposition and chronic exposure to modifiable risk factors have been explored to be involved in the pathophysiology of CVD. Environmental factors contribute to an individual's propensity to develop major cardiovascular risk factors through epigenetic modifications of DNA and histones via miRNA regulation of protein translation that are types of epigenetic mechanisms and participate in disease development. Periodontal disease (PD) is one of the most common oral diseases in humans that is characterized by low-grade inflammation and has been shown to increase the risk of CVDs. Risk factors involved in PD and CVD are determined both genetically and behaviorally. Periodontal diseases such as chronic inflammation promote DNA methylation. Epigenetic modifications involved in the initiation and progression of atherosclerosis play an essential role in plaque development and vulnerability. Epigenetics has opened a new world to understand and manage human diseases, including CVDs and periodontal diseases. Genetic medicine has started a new era of epigenetics to overcome human diseases with various new methodology. Epigenetic profiling may aid in better diagnosis and stratification of patients showing potential predisposed states for disease. A better understanding of the exact regulatory mechanisms of epigenetic pathways driving inflammation is slowly emerging and will aid in developing novel tools for the treatment of disease.

The Top 100 Most Cited Articles Published in Dentistry: 2020 Update

This bibliometric review is aimed to analyze the top 100 most-cited publications in dentistry and to compare its outcomes. A literature search was performed using Elsevier's Scopus, without any restriction of language, publication year, or study design. Of 336,381 articles, the top 100 were included based on their citation count, which ranged from 638 to 4728 citations (Feijoo et al., 326 to 2050). The most productive decade was the 2000s, with 40 articles on the list (Feijoo et al., 1980s: 26). Marx RE (7%) was the major contributor in this study (Feijoo et al., Socransky SS: 9%), and almost half (48%) of articles were from the USA. Of the top 100 articles, 26% focused on periodontology (Feijoo et al., periodontology: 43%), while 17% of the total were published in the Journal of Dental Research (Feijoo et al., Journal of Clinical Periodontology: 20%). Most of the publications were narrative reviews/expert opinion (36%), (Feijoo et al., case series: 22%), and were within the evidence level V (64%) (Feijoo et al., 54%). The citation count that a paper secures is not necessarily a reflection of research's quality, however, the current analysis provides the latest citation trends in dentistry.

Gingival Crevicular Fluid (GCF): A Diagnostic Tool for the Detection of Periodontal Health and Diseases

The methodologies applicable for the evaluation of periodontal associated diseases are constantly evolving to provide quick, realistic, and scientifically proven results. Trends in the past followed a clinical evaluation of periodontal tissues and radiographic-based reports that formed the foundation for detection of diseases involving the structures supporting the teeth. As the confines and limitations of conventional strategies became obvious over the passage of time, hand in hand variety of techniques have evolved and experimentally justified. These improvisations are based on an improved understanding of the periodontal-pathogenic cascade. Periodontal pathogenesis and a paradigm shift from disease understanding to disease prevention and treatment entail few prerequisites that demand the objectivity of diagnostics procedure that includes sensitivity and specificity along with an explanation of the intensity of the disease, Gingival crevicular fluid an oral bio-fluid resides in the close proximity with gingival tissues have been widely used to understand and differentiate the periodontal health and diseased status. The biomarkers present in the GCF can be a reliable tool to detect the minute changes seen in the disease processes. The GCF consists of various host and bacterial-derived products as well as biomarkers which in turn can be evaluated for the diagnosis, prognosis as well as management of the periodontal disease. Thus, the review aims at describing GCF as a potential oral biofluid helpful in differentiating periodontal health and disease status.

Effect of gingival mesenchymal stem cell-derived exosomes on inflammatory macrophages in a high-lipid microenvironment

OBJECTIVE

The aim of this study was to examine the effect of gingival mesenchymal stem cells derived exosomes (GMSC-Exos) on lipopolysaccharide/interferon-gamma (LPS/INF-γ)-induced inflammatory macrophages in a high-lipid microenvironment.

MATERIALS AND METHODS

Exosomes were obtained by culturing gingival mesenchymal stem cells (GMSCs) in alpha-MEM with exosome-free fetal bovine serum for 48 h. The control group was produced in vitro by inducing human acute monocytic leukemia cells (THP-1 cells) into naïve macrophages (M0). Inflammatory macrophages (M1) were made by activating M0 macrophages with LPS/IFN-γ. These M1 macrophages were treated with oxidized low-density lipoprotein (ox-LDL) to create the high-lipid group, of which some macrophages were further treated with GMSC-Exos for 24 h to form the GMSC-Exos group. Supernatants were collected, and total RNA were extracted for downstream analysis. The expression of surface markers in macrophages were analyzed by flow cytometry. The lipid accumulation level was assessed by oil red O staining.

RESULTS

Exosomes were successfully isolated from GMSC medium. The GMSC-Exos group showed lower Tumor Necrosis Factor-α (TNF-α), Interleukin-6 (IL-6), Interleukin-1β (IL-1β), and cluster of differentiation 86 (CD86) expression levels than the high-lipid group, and the highest levels of Interleukin-10 (IL-10) among all groups. The GMSC-Exos group showed significant reductions in TNF-α levels than the high-lipid group, and significant escalations in IL-10 levels than the other two groups. Oil red o Staining showed that lipid accumulation in macrophages was inhibited in the GMSC-Exos group.

CONCLUSIONS

GMSC-Exos reduce the release level and expression of inflammatory factors, inhibit lipid accumulation, and promote the polarization of pro-inflammatory macrophages into anti-inflammatory phenotype in a high-lipid microenvironment.