The potential use of nanozymes as an antibacterial agents in oral infection, periodontitis, and peri-implantitis

Several studies suggest that oral pathogenic biofilms cause persistent oral infections. Among these is periodontitis, a prevalent condition brought on by plaque biofilm. It can even result in tooth loss. Furthermore, the accumulation of germs around a dental implant may lead to peri-implantitis, which damages the surrounding bone and gum tissue. Furthermore, bacterial biofilm contamination on the implant causes soft tissue irritation and adjacent bone resorption, severely compromising dental health. On decontaminated implant surfaces, however, re-osseointegration cannot be induced by standard biofilm removal techniques such as mechanical cleaning and antiseptic treatment. A family of nanoparticles known as nanozymes (NZs) comprise highly catalytically active multivalent metal components. The most often employed NZs with antibacterial activity are those that have peroxidase (POD) activity, among other types of NZs. Since NZs are less expensive, more easily produced, and more stable than natural enzymes, they hold great promise for use in various applications, including treating microbial infections. NZs have significantly contributed to studying implant success rates and periodontal health maintenance in periodontics and implantology. An extensive analysis of the research on various NZs and their applications in managing oral health conditions, including dental caries, dental pulp disorders, oral ulcers, peri-implantitis, and bacterial infections of the mouth. To combat bacteria, this review concentrates on NZs that imitate the activity of enzymes in implantology and periodontology. With a view to the future, there are several ways that NZs might be used to treat dental disorders antibacterially.

Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal?

BACKGROUND

Several measures have been implemented to minimize the side effects of impacted third molar (M3) removal including the use of platelet-rich fibrin (PRF).

PURPOSE

This study compared the effects of three modifications of PRF (leukocyte-PRF [L-PRF], advanced-PRF [A-PRF], and advanced-PRF plus [A-PRF +]) on the side effects of impacted M3 removal.

STUDY DESIGN, SETTING, AND SAMPLE

This double-blinded randomized controlled trial was conducted at the Oral Surgery Department of Kashan University between September 2022 and May 2023 on patients undergoing mandibular impacted M3 removal. Exclusion criteria were age over 30, local inflammation and infection, medication usage, and systemic disease.

INDEPENDENT VARIABLE

The independent variable was the PRF product grouped into four categories (control, L-PRF, A-PRF, and A-PRF+). Study subjects were randomly distributed among the four groups.

MAIN OUTCOME VARIABLE(S)

The main outcome variables were postoperative sequelae including measures of soft tissue healing, pain, analgesic use, alveolar osteitis, trismus, and swelling. Subjects were assessed at baseline and on days 1, 2, 3, and 7 postsurgery.

COVARIATES

Age, sex, duration of surgery, and side of surgery were the covariates.

ANALYSES

Changes at different time points were analyzed using repeated measures analysis of variance. Pairwise comparisons were performed if significant. P values ≤.05 were considered statistically significant.

RESULTS

The sample consisted of 64 subjects (16 per group). All three modifications of PRF yielded significantly better soft tissue healing index than the control group on days 2, 3, 7, and 14 postoperatively (P > .05). A-PRF and A-PRF + had significantly better healing index than L-PRF on the third day (P = .02, P = .01). All the study groups significantly reduced visual analog scale pain score than the control group on days 1, 2, and 3. A-PRF and A-PRF + had significantly lower visual analog scale scores than L-PRF on the second day (P = .003, P = .02). No significant difference was found in maximum mouth opening during follow-up sessions (P = .2). Study groups had less facial swelling on days 2 and 3 than the control group (P < .05).

CONCLUSION AND RELEVANCE

L-PRF, A-PRF, and A-PRF + can improve postoperative outcomes after M3 removal but may not impact trismus. A-PRF and A-PRF + may be more effective than L-PRF in promoting soft tissue healing and reducing pain. A-PRF and A-PRF + have comparable results.

The effect of photobiomodulation therapy in common maxillofacial injuries: Current status

The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.

Spotlight on therapeutic efficiency of green synthesis metals and their oxide nanoparticles in periodontitis

Periodontitis, one of the most prevalent dental diseases, causes the loss of bone and gum tissue that hold teeth in place. Several bacteria, commonly present in clinically healthy oral cavities, may induce and perpetuate periodontitis when their concentration rises in the gingival sulcus. Antibacterial effect against various Gram-negative and Gram-positive bacteria, including pathogenic and drug-resistant ones, has been shown for several distinct transient metal and metal oxide NPs. Therefore, NPs may be used in biomedicine to treat periodontal problems and in nanotechnology to inhibit the development of microorganisms. Instead of using harmful chemicals or energy-intensive machinery, biosynthesis of metal and metal oxide nanoparticles (NPs) has been suggested. To produce metal and metal oxide NPs, the ideal technique is "Green" synthesis because of its low toxicity and safety for human health and the environment. Gold NPs (AuNPs) appear to be less toxic to mammalian cells than other nanometals because their antibacterial activity is not dependent on reactive oxygen species (ROS). AgNPs also possess chemical stability, catalytic activity, and superior electrical and thermal conductivity, to name a few of their other advantageous characteristics. It was observed that zinc oxide (ZnO) NPs and copper (Cu) NPs exhibited discernible inhibitory effects against gram-positive and gram-negative bacterial strains, respectively. ZnO NPs demonstrated bactericidal activity against the microorganisms responsible for periodontitis. Medications containing magnetic NPs are highly effective against multidrug-resistant bacterial and fungal infections. The titanium dioxide (TiO2) NPs are implicated in elevating salivary peroxidase activity in individuals diagnosed with chronic periodontitis. Furthermore, specific metallic NPs have the potential to enhance the antimicrobial efficacy of periodontitis treatments when combined. Therefore, these NPs, as well as their oxide NPs, are only some of the metals and metal oxides that have been synthesized in environmentally friendly ways and shown to have therapeutic benefits against periodontitis.

Cross Talk Between Cells and the Current Bioceramics in Bone Regeneration: A Comprehensive Review

The conventional approach for addressing bone defects and stubborn non-unions typically involves the use of autogenous bone grafts. Nevertheless, obtaining these grafts can be challenging, and the procedure can lead to significant morbidity. Three primary treatment strategies for managing bone defects and non-unions prove resistant to conventional treatments: synthetic bone graft substitutes (BGS), a combination of BGS with bioactive molecules, and the use of BGS in conjunction with stem cells. In the realm of synthetic BGS, a multitude of biomaterials have emerged for creating scaffolds in bone tissue engineering (TE). These materials encompass biometals like titanium, iron, magnesium, and zinc, as well as bioceramics such as hydroxyapatite (HA) and tricalcium phosphate (TCP). Bone TE scaffolds serve as temporary implants, fostering tissue ingrowth and the regeneration of new bone. They are meticulously designed to enhance bone healing by optimizing geometric, mechanical, and biological properties. These scaffolds undergo continual remodeling facilitated by bone cells like osteoblasts and osteoclasts. Through various signaling pathways, stem cells and bone cells work together to regulate bone regeneration when a portion of bone is damaged or deformed. By targeting signaling pathways, bone TE can improve bone defects through effective therapies. This review provided insights into the interplay between cells and the current state of bioceramics in the context of bone regeneration.

Investigating the effect of insertion torque on marginal bone loss around dental implants

BACKGROUND/PURPOSE

The use of dental implants in restoring function, esthetics, speech, and health of oral tissues has been growing in recent years. Evaluating marginal bone resorption and the survival rate of implants placed with different torques values is crucial. The primary aim of the present study was to evaluate the effect of different insertion torque values on marginal bone loss around dental implants placed in the posterior region of the mandible.

MATERIALS AND METHODS

37 patients were involved in this study. Patient data (age, gender), implant characteristics (length, diameter), insertion torque values, gingival biotype, and bone quality were recorded, and parallel periapical radiographs measured marginal bone loss. The relationship between variables was obtained using independent t-tests, Pearson correlations, and regressions.

RESULTS

The present study found a positive and significant correlation between implant insertion torque and marginal bone loss (MBL)around the dental implants during the first year after placement. Furthermore, patients with D2 bone density at the implant placement site and thin gingival biotype also had significantly higher MBLs from baseline until crown delivery and first-year follow-up than those with D3 bone density and thick gingival biotypes, respectively.

CONCLUSION

A lower torque is necessary for high-risk patients to increase implantation success due to identifying patients with an increased risk for MBL.

The effect of photodynamic therapy in controlling the oral biofilm: A comprehensive overview

Several resistance mechanisms are involved in dental caries, including oral biofilms. An accumulation of bacteria on the surface of teeth is called plaque. Periodontitis and gingivitis are caused by dental plaque. In this review article, we aimed to review the studies associated with the application of photodynamic therapy (PDT) to prevent and treat various microbial biofilm-caused oral diseases in recent decades. There are several studies published in PubMed that have described antimicrobial photodynamic therapy (APDT) effects on microorganisms. Several in vitro and in vivo studies have demonstrated the potential of APDT for treating endodontic, periodontal, and mucosal infections caused by bacteria as biofilms. Reactive oxygen species (ROS) are activated in the presence of oxygen by integrating a nontoxic photosensitizer (PS) with appropriate wavelength visible light. By causing irreversible damage to microorganisms, ROS induces some biological and photochemical events. Testing several wavelengths has been conducted to identify potential PS for APDT. A standard protocol is not yet available, and the current review summarizes findings from dental studies on APDT.

Jael's syndrome: Hemostatic management of an impacted knife in the facial site-A case report

Key Clinical Message

It is essential to take a specific multidisciplinary approach in penetrating maxillofacial traumas; securing the airway, completing the hemodynamic stabilization, and systemic evaluation and consideration regarding the beneficial therapeutic regime.

Abstract

Jael's syndrome is defined as a deliberate injury caused by a knife to the skull and facial area. This article describes the case of a young male patient with a penetrating knife on the left side of the face following an assault. Due to the high probability of injury to the descending palatine artery, it was decided to make a femoral pathway for catheter angiography in the operation room and have a standby vascular surgeon for selective embolization of the external carotid artery in case of severe bleeding. The treatment plan included removing the foreign body, exploring the wound, suturing, tetanus immunization, and prescribing antibiotics. There was no significant complication in the postoperative period. However, In the 6-month follow-up, the patient complained of weakness in the left upper lip and hypoesthesia in the pathway of the left infraorbital nerve. Jael's syndrome can be life-threatening, so there is a need for accurate initial management performed by a multidisciplinary team to raise the survival rate of these patients.

Periodontitis and progression of gastrointestinal cancer: current knowledge and future perspective

Periodontitis is a polymicrobial disorder caused by dysbiosis. Porphyromonas gingivalis (P.gingivalis) and Fusobacterium nucleatum (F.nucleatum) are pathobiont related to periodontitis pathogenesis and were found to be abundant in the intestinal mucosa of inflammatory bowel disease (IBD) and colorectal cancer (CRC) patients. Besides, periodontal infections have been found in a variety of tissues and organs, indicating that periodontitis is not just an inflammation limited to the oral cavity. Considering the possible translocation of pathobiont from the oral cavity to the gastrointestinal (GI) tract, this study aimed to review the published articles in this field to provide a comprehensive view of the existing knowledge about the relationship between periodontitis and GI malignancies by focusing on the oral/gut axis.

Facilitating the removal of a foreign body in the tongue by intraoperative ultrasound guidance: A case report

The presence of soft tissue foreign bodies (FBs) presents a substantial concern due to their potential to induce both acute and chronic pain as well as tissue irritation. This case report documents the admission of a 25-year-old female with a history of bur fractures during endodontic treatment, accompanied by signs of infection. The clinical examination and radiographic assessment revealed an embedded foreign body within her tongue. The surgical procedure was informed by repeated ultrasound scans through the incision, facilitating precise targeting. Intraoperative ultrasound enables the accurate detection of submucosal foreign bodies in dynamic tissues like the tongue and facilitates focused and image-guided dissection, thereby decreasing surgical trauma to the delicate soft tissues.

Assessment of the Expression of GLUT1 in Renal Cell Carcinoma and its Various Subtypes

BACKGROUND: Renal cell carcinoma is one of the most common tumors of the kidney. Glucose transporters, transport glucose, and increased expression of these transporters have been reported in various tumor types. Glucose transporter 1 (GLUT1), the best-known glucose transporter, has an important role at several stages in cancer progression. The overexpression of GLUT1 in the tumor cells indicates an increased proliferation and invasive behavior of the tumor. AIM: This study aims to investigate the expression of GLUT1 in renal cell carcinoma and its subtypes. METHODS: This study is a descriptive cross-sectional study that was performed on patients with renal cell carcinoma. Seventy reports of formalin fixed; paraffin-embedded blocks of renal cell carcinoma were selected from pathology archives. The samples included: clear cell type renal cell carcinoma, RCC clear cell type with sarcomatoid feature, papillary renal cell carcinoma, and chromophobe renal cell carcinoma. RESULTS: In this study, 50 male and 20 female samples (71.4% and 28.6%) with the mean age of 57.9 ± 13.1 years were studied. Forty-three samples (61.4%) were positive for GLUT1 and 27 (38.9%) were negative for it. For the GLUT1 expression being positive or negative between the two groups, was not significantly affected by the age, sex, and the grade of the tumor, </AQ17>while the difference between the two groups was statistically significant in terms of stage and type of tumor (p < 0/001, p = 0.039). CONCLUSION: Renal cell carcinoma of ccRCC type is associated with increased GLUT1 expression. Therefore, the GLUT1 immunohistochemistry marker can be a useful marker for diagnosis of RCC, specifically ccRCC type.

Dental Student’s Satisfaction with the Video-assisted Educational Approach in Teaching Oral and Maxillofacial Surgery Principles

BACKGROUND: Educating dental students in practical skills are a difficult task that has become increasingly demanding since the outbreak of COVID-19. Today, the use of digital media plays an essential role in teaching practical skills. AIM: This study investigated the effect of educational videos on oral and maxillofacial surgery basics on dental student’s satisfaction. METHODS: Six subjects were chosen from the principles of oral and maxillofacial surgery, and according to the necessary standards, educational videos were made based on the needs assessment of students. Fellow attending evaluated and approved each video. Students were shown videos in six 2-h sessions. Students were given a researcher-created questionnaire with proven validity and reliability. Students filled out questionnaires to evaluate the impact of educational videos as well as the structure of educational videos. RESULTS: Two hundred and three students participated in this study in their 4th−6th years. In this study, 203 students in their 4th to the 6th year participated. Most students were satisfied with the structure of educational videos (73.9%); in general, 84.7% of students expressed their satisfaction with this method. Half of the students preferred video training over face-to-face training in oral and maxillofacial surgery (50.4%). Many students suggested that these videos be included in the curriculum (80.7%). CONCLUSION: Students’ overall satisfaction with the structure and impact of educational videos indicates that educational videos made and evaluated by dental professors can help teach practical topics as a part of the curriculum.

The role of current herbal extracts in bone regeneration through dental implants: in vitro/in vivo/clinical studies

The quality and quantity of bone at the interface of an implant system are determining factors in the implant's stability. Alternative agents have been studied to augment implants and bone defects, including bone-conductive and bone-inducing agents. By modifying implant surface coatings on the nanoscale, one can enhance osseointegration by stimulating bone cell adhesion, bone matrix formation, and mineralization. Because alternative agents stimulate osteoblasts to mineralize and can control pectin structure, plant-derived silicone has been suggested as a potential candidate for surface nanocoatings on orthopedic and dental titanium implants. Inducing the differentiation of cells or accelerating bone regeneration is possible with the plant extract. Coating these extracts on implant devices can improve cell attachment, differentiation, and proliferation. This review article discusses the role of herbal materials in bone regeneration through dental implants.

Anthropomorphic assessment of the retromolar foramen and retromolar nerve: anomaly or variation of normal anatomy?

The retromolar foramen, retromolar canal, and retromolar nerve constitute a variation of the inferior alveolar nerve (IAN) with a prevalence of 12-75%; this represents type 1 bifidity of the IAN. The aim of this study was to assess the prevalence of the retromolar nerve in our population and to obtain related data. One hundred and thirty-six mandibles of fresh cadavers aged 20-75 years were dissected. The buccolingual location, diameter, and distance from the third molar, and their associations with sex, were measured. The area of innervation and demographic data were also documented and analysed statistically. The retromolar foramen and retromolar nerve were observed in 55 cases (40.4%). The mean diameter of the retromolar foramen was 1.7 mm (range 1.1-2.1 mm); the mean diameter was 1.8 mm in males and 1.5mm in females. Histological findings showed that the retromolar nerve extended from the anterior border of the ramus, innervating the retromolar pad and continuing to the buccal gingiva of up to two teeth anteriorly (first molar region). This high percentage of IAN type 1 bifidity (40.4%) suggests it to be a normal anatomical variation of the IAN rather than an anomaly.