Oral Manifestations of COVID-19 Infection: An Analytical Cross-Sectional Study

ObjectivesThe current COVID-19 pandemic has created a huge impact across the globe. Recent literature has reported the occurrence of varied oral lesions in COVID-19 patients in the form of sporadic case reports. This analytical cross-sectional study was carried out to gauge and understand the pattern of oral lesions in qualitative RT-PCR-confirmed COVID-19 patients.MethodsA cross-sectional study involves a total of 500 qualitative RT-PCR confirmed, hospitalized COVID-19 patients who were meticulously scanned for any hard and soft tissue lesions developing concomitantly with the disease occurrence.ResultsThis study included a total of 367 (73.4%) males and 133 (26.6%) female patients with a mean age of 53.46 ± 17.50 years. Almost 51.2% of patients presented with gustatory disturbance, 28% with xerostomia and 15.4% of patients were found to have oral findings like erythema, ulcers, depapillation of tongue. There was a statistically significant correlation between oral manifestations and disease severity (p ≤ 0.001).ConclusionCOVID-19 is found to effect oral health with greater probability in patients with severe diseases (SARI) which may be due to disease itself, immune response and lack of motivation for personal hygiene measures.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12663-021-01679-x.     

Oral potentially malignant disorders in a large dental population

Objectives

Oral cancer (OC) may be preceded by clinically evident oral potentially malignant disorders (OPMDs). Oral carcinogenesis is a multistep process that begins as epithelial hyperplasia and progresses to oral epithelial dysplasia and finally to fully malignant phenotypes. The aim of our study was to estimate the prevalence of OPMDs in a large population of dental patients.

Methods

Patients were seen in the Oral Diagnosis and Oral Medicine clinics at Boston University Henry M. Goldman School of Dental Medicine between July 2013 and February 2014 and received a comprehensive oral examination to identify any possible mucosal lesions. Patients with a suspected OPMD (submucous fibrosis, oral lichen planus, leukoplakia and erythroplakia) that did not resolve in 2–3 weeks received a biopsy for definitive diagnosis. Logistic regression models were used to explore the relationship between OPMDs and associated risk factors.

Results

A total of 3,142 patients received a comprehensive oral examination [median age: 43 (range: 18–97); 54.3% females]. Among these, 4.5% had an oral mucosal lesion with 0.9% being an OPMD (one submucous fibrosis, three epithelial dysplasias, fourteen with hyperkeratosis/epithelial hyperplasia and nine with oral lichen planus). Males and current smokers were associated with higher odds of having OPMD (OR 1.7, 95% CI 0.8–3.8; OR 1.9, 95%CI 0.8–4.1). Increasing age was associated with having OPMDs (p<0.01).

Conclusion

Optimal oral visual screening for OC remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. Although OPMDs were rare, our results confirm the importance of a thorough chairside screening by dentists and dental students to detect any mucosal changes.     

Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage

Objective:To test the hypothesis that sagittal mandibular development has no effects on the dimensions of the awake pharyngeal airway passage.Materials and Methods:Ninety-one subjects (age 15–25 years) with a normal vertical growth pattern of the mandible, normally positioned maxilla, and various sagittal mandibular developments were divided into three groups based on the sagittal mandibular development. Group I included 37 subjects who had a normally positioned mandible (76° ≤ angle between ‘S,’ ‘N,’ and ‘B’; it represents the antero-posterior position of the maxilla in relation to the anterior cranial base [SNB] ≤ 82°), Group II included 31 subjects in whom the mandible was retrognathic (SNB < 76°), and Group III included 23 subjects in whom the mandible was prognathic (SNB > 82°) in relation to the anterior cranial base. Lateral cephalograms were traced manually to evaluate the pharyngeal airway passage.Results:The length of the soft palate was significantly smaller in mandibular prognathism subjects than in subjects with mandibular retrognathism (P < .01). The thickness of the soft palate was significantly greater among subjects with mandibular prognathism than in subjects with normal (P < .01) and retrognathic (P < .001) mandibular development. The sagittal mandibular development had no effect on the dimensions of the nasopharyngeal and hypopharyngeal airway passage. The depth of the oropharynx was comparable among the subjects with normal and retrognathic mandibles but was greater (P < .001) among subjects with mandibular prognathism.Conclusions:The hypothesis is rejected. Sagittal mandibular development had significant effects on the dimensions of the awake pharyngeal airway passage.     

Immunoexpression of Metallothionein in Oral Squamous Cell Carcinoma

Background and Objectives

Metallothionein (MT) is a family of ubiquitous low molecular weight (7 kDa), intracellular (cytoplasmic/nuclear), cysteine rich proteins with high affinity for heavy metals, present in both normal cells and neoplastic cells. Increased expression of MT has been reported to be associated with poor prognosis in various tumours. The objectives of the present study were to compare the expression of MT in normal subjects and in patients with oral squamous cell carcinoma (OSCC), to correlate the expression of MT with respect to clinical staging of OSCC and to evaluate the expression of MT with respect to different histopathological grades of OSCC.

Methods

Thirty cases of OSCC were staged clinically and graded histopathologically. Immunohistochemical method was used to detect the expression of MT in OSCC. The scores obtained were documented and compared statistically.

Results

MT immunoreactivity was noticed in all cases of OSCC. A statistically significant difference was observed in immunoreactivity of MT between the normal and OSCC, and in different histopathological grades of OSCC (p = 0.00001*). However, no statistical significance was found in a number of immunopositive cells in different clinical stages of OSCC (p = 0.7573).

Conclusion

The MT immunoexpression increased from low grade to high grade OSCC. Hence, increased expression of MT may be related to poor prognosis in patients with OSCC.     

Dentists’ Perception of Oral Potentially Malignant Disorders

ObjectivesDentists play a major role in the diagnosis of oral potentially malignant disorders (OPMDs) that may lead to malignancy. Their knowledge on OPMDs and the risk factors associated with malignant disease needs to be sufficient. The aim of this study was to assess the level of knowledge, attitudes, and awareness of OPMDs amongst general dentists and dental specialists working in Saudi Arabia.Material and methodsQuestionnaires were distributed to dentists working in Saudi Arabia. A total of 303 dentists participated in the study. The questionnaire included 20 questions on knowledge, attitudes, and awareness of OPMDs.ResultsThe response rate was 55%. There was no significant difference between general dental practitioners and dental specialists regarding leukoplakia, which is the most common OPMD (P > .05) and in identifying tobacco and alcohol as the main risk factors for malignant transformation of OPMDs into cancer (P > .05). However, there was a significant difference (P < .05) between specialists (75.3%) and general practitioners (52.3%) in the diagnosis of OPMDs. There was a significant difference (P < .05) between specialists (63.5%) and general practitioners (28.0%) in recognising the likelihood of malignant transformation of proliferative verrucous leukoplakia. There was a significant difference between specialists (61.2%) and general practitioners (25.2%, P < .05) in recognising the erosive form or atrophic type of oral lichen planus, considering that it is more likely to undergo malignant transformation.ConclusionsDental specialists have better knowledge and awareness than general dentists regarding OPMDs. Improved continuous education programmes on the risk factors and diagnosis of OPMDs should be organised to train dentists.Key words: Oral potentially malignant disorder, Clinical feature, Risk factor, Age     

Stability of surgically assisted rapid maxillary expansion and orthopedic maxillary expansion after 3 years' follow-up

Objective:To evaluate the stability of surgically assisted rapid palatal expansion (SARME) and orthopedic maxillary expansion (OME) after 3 years of follow-up, and compare these changes with a control group.Materials and Methods:The subjects of the study were divided into three groups. Group 1 was composed of 10 patients (6 males, 4 females) with a mean age of 15.51 years (range: 13.33–17.58 years) and treated with OME, Group 2 comprised 10 patients (7 males, 3 females) with a mean age of 19.01 years (range: 16.25–25.58 years) and treated with SARME. Group 3 was the control group, consisting of 10 untreated, skeletal Class 1 subjects (6 males, 4 females) with a mean age of 15.27 years (range: 13.42–17.00 years) and matched to the OME group for sex and age. Lateral cephalometric and posteroantererior films were taken before expansion (T1), postexpansion (T2), and 3 years after the retention period (T3).Results:After OME and SARME, significant increases were observed for both dental and skeletal transverse widths (P < .01). After 3 years of follow-up, maxillary basal width decreased 1.35 ± 0.44 mm in the SARME group and 1.19 ± 0.41 mm in the OME group, while upper molar width decreased 2.23 ± 1.24 mm in the SARME group and 2.79 ± 1.01 mm in the OME group.Conclusions:Both the OME and SARME procedures remained stable after 3 years of follow-up with some amount of postretention relapse, compared with the control group.     

Marginal Bone Resorption Around Dental Implants Placed in Alveolar Socket Preserved Sites: A 5 Years Follow-up Study

AimThe present study evaluated the clinical and radiological stability of hard and soft tissues following alveolar socket preservation (ASP) procedure with a follow-up of 5 year from implant insertion.Materials and methodsThe initial sample consisted of seven patients who underwent single tooth extraction and ASP procedure by means of demineralized bovine bone mineral particles covered with a porcine-derived non-cross-linked collagen matrix (CM). Each patient received a submerged single implant in the healed site. Mesial and distal peri-implant marginal bone resorption (MBR) rates were assessed radiographically at 1 year (T₁) and 5 years (T₂) after implant placement (baseline value).Results and StatisticsNo dropouts occurred up to 5 years. At T₁, the MBR was 0.08 ± 0.16 mm at the mesial aspect and 0.1 ± 0.12 mm at the distal aspect. This difference was not statistically significant (P = 0.867). At T₂, the mesial MBR was 0.15 ± 0.17 mm and the distal MBR was 0.11 ± 0.14 mm, with a non-statistically significant difference (P = 0.532). Therefore, no statistically significant differences were detected comparing mesial and distal MBR at any time point. With respect to the intra-group comparisons, no differences were observed comparing the different study periods within each variable. Indeed, the comparison between T₀, T₁ and T₂ was non-statistically significant at both mesial (P = 0.06) and distal (P = 0.06) aspects. After 5 years, the volume of the soft tissues appeared clinically well maintained with a natural aspect around dental implants and adjacent teeth.ConclusionASP using demineralized bovine bone mineral in combination with CM proved to be an effective technique to maintain stable dimensional volumes of both hard and soft tissues.     

Hypovitaminosis D,oral potentially malignant disorders,and oral squamous cell carcinoma: a systematic review

Background Oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (OPMDs) could be associated with low levels of vitamin D. This systematic review aimed to determine the relationship between serum levels of vitamin D with OPMDs and OSCC.Material and Methods This review was conducted according to Cochrane guidelines (PROSPERO CRD42020207382) on literature retrieved from the PubMed, Cochrane, and Web of Science databases. The antecedents extracted were study design, methodology, sample (country, number of patients, age, and sex), oral manifestations (type of lesion, location, prevalence, and follow-up), serum vitamin D levels or use of vitamin D supplements, results, and conclusions.Results Twelve articles were selected. Some of the most relevant findings were alterations in vitamin D could favor the progress of OPMDs to OSCC. Higher levels of vitamin D can increase levels of anti-inflammatory mediators, CD4+ T lymphocytes and CD8+ T lymphocytes and CD3+ T lymphocytes in intratumoral tissue. The normalization of vitamin D levels in patients with OSCC can increased cytotoxic activity of natural killer cells, favoring antitumor immune response. Vitamin D supplemented can lower adverse effects associated with chemotherapy like mucositis and pain. Tobacco can increase risk of developing OSCC altering vitamin D levels.Conclusions Hypovitaminosis D could increase risk of developing OSCC from OPMDs, thus altering the immune response and it is associated with a lower survival rate in patients with OSCC, a greater recurrence of tumors in patients who underwent surgical treatment, and an increase in adverse reactions to chemotherapy. The use of vitamin D supplements can be a complement to primary therapy to prevent the recurrence of lesions and reduce adverse events associated with treatment. Key words:Oral squamous cell carcinoma (OSCC), Oral potentially malignant disorders (OPMDs), Vitamin D, Oral cancer.     

Social impairment of individuals suffering from different types of chronic orofacial pain

Background

The daily life of patients suffering from orofacial pain is considerably impaired as compared to healthy subjects. The aim of this study was to investigate the influence of different categories of orofacial pain on the habitual life of adult individuals.

Methods

Seven hundred eighty-one individuals with orofacial pain were recruited from an initial sample of 1,058 patients. All the individuals were allocated to groups according to their diagnosis: myofascial pain (group A, 676 subjects, 525 females and 151 males; mean age ± SD = 35.2 ± 12.6), migraine (group B, 39 subjects, 29 females and 10 males; mean age ± SD 36.0 ± 10.7), and both myofascial pain and migraine (group C, 66 subjects, 56 females and 10 males, mean age ± SD = 35.6 ± 10.8). Characteristic pain intensity (CPI), disability days (DD), disability score (DS), and graded chronic pain intensity (GCPS) were calculated according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis II. Depression and somatization (nonspecific physical symptoms) scores were also calculated.

Results

A significant association between groups and GCPS categories was found (p < 0.0001). Post hoc tests showed a significant difference between groups A and B and between A and C, but not between B and C. In group A, the most frequent GCPS score was grade II. The most frequent GCPS score in groups B and C was grade III, indicating a moderate limiting impairment. This score was more frequent in group B (41%) than in the other groups (group A = 20.6%, group C = 34.8%). GCPS grade IV was more frequent in group C (19.7%) than in the other groups. Group C had significantly higher scores for nonspecific physical symptoms than group A (p < 0.05).

Conclusions

Myofascial pain and migraine sensibly affect the common daily life of adult individuals. The comorbidity of both conditions determines a major impairment.     

Treatment of Oral Submucous Fibrosis Using Split Skin Graft and a Polyethylene Stent: A Prospective Study

Aim

Aim of this study was to evaluate the split skin graft held in place with a polyethylene stent for the treatment of oral submucous fibrosis.

Methods

Fifteen prospective patients diagnosed clinically with oral submucous fibrosis, from June 2011 to 12 December 2012, were recruited for this study. All patients were treated surgically using the same surgical technique of fibrotomy followed by split skin graft along with a polyethylene stent. Preoperative and postoperative mouth opening measurements at 1 week and after a minimum of 6 months were evaluated by measuring the inter incisal distance.

Results

Mean follow up was 9.8 months with a minimum of 6 months. Mean preoperative mouth opening was 12.9 mm (6–20 mm). Intraoperatively mean mouth opening was 37.9 mm (36–41 mm). After 1 week mean mouth opening was 35.8 mm (31–40 mm). At 6 months follow up, mean mouth opening was 33 mm (20–40 mm).

Conclusion

Fibrotomy followed by split skin graft along with a polyethylene sheet stent and sufficient postoperative physiotherapy is a simple, cost effective and viable treatment modality for oral submucous fibrosis.     

Investigating oral health among individuals with depression: NHANES 2015–2016

ObjectivesDepression is highly prevalent across populations, yet studies on its contribution to oral health are lacking. Therefore, our goal is to examine the association of depression and oral health problems (preventative care, access to dental care, and oral condition in relation to quality of life) controlling for sociodemographic and chronic disease indicators (CDI).Methods5,992 respondents’ data 18+ years old were analyzed from the 2015–2016 National Health and Nutrition Examination Survey (NHANES). The independent variable of interest was depression symptoms status. Oral health outcomes were the dependent variables. We used the Patient Health Questionnaire-9 (PHQ-9) for depression and the Oral Health Questionnaire (OHQ) to measure oral health outcomes. Covariates included sociodemographics (age, education, sex, race/ethnicity, and income) and CDI included current smoking, diabetes, and body mass index. All data were weighted using 2 years sample weight.ResultsThe mean age of respondents was 47.22 years (45.97–48.46) and 46% were males. Participants with depression present 6.93%, and females 63.85% were higher than males 36.15%.Participants with depression have significantly low income 43.10% than others p value < 0.0001. After adjusting for sociodemographics and CDI, participants who have depression were more prone to report fair/poor oral condition [aOR = 1.91 (1.29–2.84)], oral pain [aOR = 2.66 (1.91–3.71)], and difficulty accessing needed dental care [aOR = 2.52 (1.96–3.24)] than others. Having depression was associated with poor oral health perceptions [aOR = 2.10 (1.41–3.13)], and having difficulty at job/school because of their oral health [aOR = 2.85 (1.90–4.26)].ConclusionBased on the empirical evidence provided by our study, there is an association between depression and oral health outcomes and oral health-related quality of life.     

Long-Term Effects of Rapid Maxillary Expansion Followed by Fixed Appliances

Objective:To evaluate the long-term changes in maxillary arch widths, overjet, and overbite in patients who were treated with rapid maxillary expansion (RME) followed by edgewise appliances.Materials and Methods:The material for the study consisted of study casts taken from 41 patients (19 males, 22 females) on four different occasions (before treatment, T1; after RME, T2; after treatment, T3; and during follow-up period, T4). The upper intercanine, interpremolar, and intermolar widths and overjet and overbite were measured on each set of study casts. Mean age of the subjects was 13.2 ± 1.3 years (range, 11.2–16.9 years) at T1, 13.3 ± 1.3 years (range, 11.3–17 years) at T2, 15.5 ± 1.4 years (range, 13.1–18.8 years) at T3, and 20.4 ± 1.6 years (range, 17.9–24.8 years) at T4.Results:The net increase in intercanine width, interpremolar width, intermolar width, overjet, and overbite was 1.4 ± 2.4 mm, 4.6 ± 2.6 mm, 4.3 ± 2.5 mm, 0.1 ± 0.6 mm, and 0.2 ± 0.6 mm, respectively, and the relapse rates were 37% for intercanine width, 19% for interpremolar width, and 17% for intermolar width at the end of the follow-up period.Conclusions:A significant amount of relapse occurred in maxillary arch widths at the postretention assessment, the greatest being in intercanine width. RME significantly decreased overbite and increased overjet, and a statistically significant decrease was observed in both overbite and overjet at the postretention assessment.     

Dentists’ Perception of Oral Potentially Malignant Disorders

ObjectivesDentists play a major role in the diagnosis of oral potentially malignant disorders (OPMDs) that may lead to malignancy. Their knowledge on OPMDs and the risk factors associated with malignant disease needs to be sufficient. The aim of this study was to assess the level of knowledge, attitudes, and awareness of OPMDs amongst general dentists and dental specialists working in Saudi Arabia.Material and methodsQuestionnaires were distributed to dentists working in Saudi Arabia. A total of 303 dentists participated in the study. The questionnaire included 20 questions on knowledge, attitudes, and awareness of OPMDs.ResultsThe response rate was 55%. There was no significant difference between general dental practitioners and dental specialists regarding leukoplakia, which is the most common OPMD (P > .05) and in identifying tobacco and alcohol as the main risk factors for malignant transformation of OPMDs into cancer (P > .05). However, there was a significant difference (P < .05) between specialists (75.3%) and general practitioners (52.3%) in the diagnosis of OPMDs. There was a significant difference (P < .05) between specialists (63.5%) and general practitioners (28.0%) in recognising the likelihood of malignant transformation of proliferative verrucous leukoplakia. There was a significant difference between specialists (61.2%) and general practitioners (25.2%, P < .05) in recognising the erosive form or atrophic type of oral lichen planus, considering that it is more likely to undergo malignant transformation.ConclusionsDental specialists have better knowledge and awareness than general dentists regarding OPMDs. Improved continuous education programmes on the risk factors and diagnosis of OPMDs should be organised to train dentists.     

Three-dimensional cone-beam computed tomography comparison of shorty and standard Class II Carriere Motion appliance

ObjectivesTo compare treatment effects of the standard and shorty Class II Carriere Motion appliances (CMAs) on adolescent patients.Materials and MethodsFifty adolescents with Class II malocclusion formed group 1, who were treated with shorty CMA (n = 25, 12.66 ± 1.05 years), and age- and sex–matched group 2, who were treated with standard CMA (n = 25, 12.73 ± 1.07 years). Treatment effects were analyzed by tracing with Invivo software to compare pretreatment (T1) cone-beam computed tomography (CBCT) images with post-CMA (T2) CBCT images. A total of 23 measurements were compared within and between groups.ResultsIn groups 1 and 2, maxillary first molars showed significant distal movement from T1 to T2 (1.83 ± 2.11 mm and 2.14 ± 1.34 mm, respectively), with distal tipping and rotation in group 1 (6.52° ± 3.99° and 3.15° ± 7.52°, respectively) but only distal tipping (7.03° ± 3.45°) in group 2. Similarly, in both groups, the maxillary first premolars experienced significant distal movement with distal tipping but no significant rotation. In group 1, maxillary canines did not undergo significant distal movement. In both groups 1 and 2, mandibular first molars experienced significant mesial movement (1.85 ± 1.88 mm and 2.44 ± 2.02 mm, respectively). Group 1 showed statistically significantly less reduction in overjet and less canine distal movement with less distal tipping than group 2 (α < .05).ConclusionsThe shorty CMA achieved Class II correction similarly to the standard CMA, with less change in overjet and distal tipping movement of the maxillary canines.     

Change in dental pulp parameters in response to different modes of orthodontic force application

Objectives:(1) To evaluate dental pulp sensitivity by electrical pulp testing and measure aspartate aminotransferase activity in the pulp after 14 days of orthodontic intrusion, and (2) to compare those measurements with measurements obtained in teeth after 7 days of intrusion and 7 days of rest.Materials and Methods:The study sample included 13 subjects (mean age  =  16.5 ± 2.7 years). For every subject, before extraction, two contralateral premolars were included in a spring and loaded by a force. Two study groups were formed: Group A, teeth with 14 days of mechanical load, and Group B, teeth with 7 days of mechanical load plus 7 days of rest. Electrical pulp testing and aspartate aminotransferase activity measurements were performed after 14 days in all tested teeth. After extraction, aspartate aminotransferase activity in the pulp was determined spectrophotometrically at 20°C.Results:Mean aspartate aminotransferase activity values were 0.21 U/mg (SD  =  0.15) in Group A and 0.27 U/mg (SD  =  0.17) in Group B. Mean electrical pulp testing readings were 38.92 µA (SD  =  24.61) in Group A and 36.77 µA (SD  =  26.84) in Group B. Mean values of the intrusive force magnitude did not differ in both groups.Conclusions:Different durations of orthodontic intrusion, defined as 14 days of load and 7 days of load followed by 7 resting days, were not reflected by electrical pulp testing or by aspartate aminotransferase activity levels in the pulp of the affected teeth. However, the response threshold to electrical pulp stimulation was elevated in all tested teeth.     

Effect of tumor necrosis factor alpha (TNF-α) -308 and -1031 gene polymorphisms on periodontitis among Saudi subjects

ObjectivesPeriodontitis is an infectious disorder that leads to irreversible loss of the surrounding attachment and bone destruction. Genetic polymorphism of cytokines has been suggested to play a role in periodontitis. This case-control study aimed to investigate the relationship between periodontitis and two single nucleotide polymorphisms (SNPs): rs1800629 (-308 G/A) and rs1799964 (-1031 T/C), in the TNF-α gene promoter area.Materials and methodsPeripheral blood was used to prepare genomic DNA from 60 subjects with stage II to stage III periodontitis, as along with 65 control subjects. Polymerase chain reaction and restriction endonuclease digestion were used to genotype TNF-α SNPs.ResultsThe distribution of both genotypes and alleles of TNF-α (-308 G/A) polymorphism did not vary between periodontitis subjects and the controls (P > 0.05). However, the CT genotype and C allele of the TNF-α (-1031 T/C) polymorphism were observed more frequently in the periodontitis subjects than in the controls, while the TT genotype and the T allele were more predominant in the control subjects than in the periodontitis patients (OR: 3.149; 95% CI: 1.494–6.639; P = 0.002 and OR: 2.933; 95% CI: 1.413–6.090; P = 0.003, sequentially).ConclusionThe TNF-α (-308 G/A) polymorphism potentially has no correlation with periodontitis susceptibility, whereas the TNF-α (-1031) CT genotype and C allele might be related to periodontitis among Saudi subjects.     

The relationship between personality traits,pain perception and attitude toward orthodontic treatment

Objective:To investigate the relationship between personality traits and a person''s attitude toward orthodontic treatment and perception of pain during orthodontic treatment.Materials and Methods:The sample consisted of two groups: group 1 consisted of 200 untreated subjects (100 males, 100 females; average age, 21.50 ± 3.35 years), and group 2 consisted of 200 treated subjects (100 males, 100 females; average age, 20.92 ± 2.48 years). The instrument for data collection was a questionnaire that included assessment of patients'' personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitudes toward orthodontic treatment.Results:Gender, treatment status, and personality traits did not affect subjects'' average attitude toward orthodontic treatment, whereas gender was the only variable that affected subjects'' average pain perception (P < .01). The average attitude score in subjects who experienced pain during orthodontic treatment was 5.06 ± 1.43, compared to 4.32 ± 1.35 for subjects who did not experience pain (P < .001). The average pain perception scores in treated subjects with previous knowledge of orthodontic treatment was 5.29 ± 1.94, compared to 6.07 ± 1.95 in subjects who did not have previous knowledge of orthodontic treatment (P < .01).Conclusions:Personality traits did not affect attitude toward orthodontic treatment and pain perception/experience during orthodontic treatment. A more positive attitude was found in patients who experienced less pain during orthodontic treatment.     

Connexin 43, Bcl-2, Bax,Ki67, and E-cadherin patterns in oral squamous cell carcinoma and its relationship with GJA1 rs12197797 C/G

Background To our knowledge, there is no useful and accurate prognostic biomarker or biomarkers for patients with oral squamous cell carcinoma (OSCC), a tumor with uncertain biological behavior, and unpredicTable clinical progress. The purposes of this study were: a) to determine the expresión profile of Connexin 43, Bcl-2, Bax, E-cadherin, and Ki67 in patients with OSCC; b) identify the GJCA1 rs12197797 genotypic composition.Material and Methods A cross-sectional study using genomic DNA and biopsy samples extracted from the oral mucosa with/without OSCC, older than 18 years, both genders, attended at Facultad de Odontología, Universidad Nacional Córdoba. Immunostaining for Cx43, Bcl-2, Bax, E-cadherin, and Ki67 and genotyping GJA1 rs12197797 by RFLP were performed. Odds Ratio (95% CI), Spearman Coefficient were estimated. Mann-Whitney test was applied to analyze immunostaining between controls/cases (p <0.05 was set for statistical significance).Results GG (mutant) was the most frequent genotype in patients with OSCC diagnosis (53.2%) in relation to CC “healthy” genotype (p=0.00487; OR=7.33; CI95% [1.1-54.7]). And, the allele G (mutant) had a presence in 75.5% of OSCC patients. However, no significant association was observed between alleles C/G and diagnosis (p=0.0565). The heterozygous genotype was the most frequent in the patients of both groups Cx43 and E-cadherin markers were lower in OSCCs in relation to controls. Ki67 and Bcl-2 immunolabeling were high on OSCC, and Bax immunomarker was diminished in OSCC.Conclusions We hypothesized that the oral epithelium losses Connexin 43 and E-cadherin in the membrane, which modifies cell differentiation. The Ki67 and Bcl2 overexpression would increase the cell density in the tissue, by promoting proliferation and decreasing apoptosis. And, this study shows evidence that patients who carry on allele G of GJA1rs12197797 could be at risk of developing OSCC. Key words:Cx43, E-cadherin, Ki67, Bax, Bcl-2, immunostaining expression profile, GJA1 rs12197797 genotyping.     

The inclination of mandibular incisors revisited

Objective: To reassess the inclination of lower incisors and evaluate possible associations with gender, age, symphyseal parameters, and skeletal pattern.Materials and Methods:Twelve hundred and seventy-two (605 females, 667 males) cephalograms of untreated subjects of a craniofacial growth study (age: 8–16 years) were evaluated. Correlations between the angulation of the lower incisors and age, symphyseal distances (height, width, and depth), symphyseal ratios (height-width, height-depth), and skeletal angles (divergence of the jaws and gonial angle) were investigated for all ages separately and for both sexes independently.Results:The inclination of lower incisors increased over age (8 years: girls  =  93.9° [95% CI, 92.3°–95.7°], boys  =  93.3° [95% CI, 91.8°–94.9°]; 16 years: girls  =  96.1° [95% CI, 94.1°–98.2°], boys  =  97.1° [95% CI, 95.6°–98.6°]). Inclination of lower incisors correlated with the divergence of the jaws for all ages significantly or highly significantly, except for boys and girls 9 years of age and girls 11 and 12 years of age, for which only a tendency was observed. Similarly, a strong correlation to gonial angle could be observed. No correlation could be found between the inclination of lower incisors and any symphyseal parameters (absolute measurements and ratios), except for symphyseal depth.Conclusion:Lower incisor inclination is linked to the subject''s sex, age, and skeletal pattern. It is not associated with symphyseal dimensions, except symphyseal depth. Factors related to natural inclination of lower incisors should be respected when establishing a treatment plan.     

Evaluation of the xerostomia,taste and smell impairments after Covid-19

Background The purpose of this study was to explore the effects of coronavirus disease 19 (Covid-19) on the oral cavity by evaluating the oral findings in the patients who recovered after treatment.Material and Methods This study involved confirmed Covid-19 patients whose treatment completed at least two weeks ago. A questionnaire consist of eight parts was applied to explore the oral findings after Covid-19. Also stimulated salivary flow rate was evaluated with a salivary flow test.Results 177 patients reached and 107 of them participate in the study. Regarding gender significant differences were found in terms of the presence of taste impairment after treatment (p=0.007), the degree of taste (p=0.021) and smell (p=0.010) impairment. 18 % (5/27) of the patients evaluated were showed hyposalivation. No significant differences were observed regarding salivary flow between males (mean±SD: 1.14±0.65) and females (mean±SD: 1.12±0.43), (p=0.928); among the patients having treatment at home (mean±SD: 1.03±0.48) or hospital (mean±SD: 1.33±0.65), (p=0.187). In some of the patients’ taste [15], smell [23] impairment, and xerostomia [43] still observed at least two weeks after the treatment is completed.Conclusions The most frequent finding in patients after the treatment was xerostomia. Taste and smell impairments were more frequently observed in females. Key words:Saliva, oral findings, hyposalivation, Covid-19.