Journal of Clinical Medicine

Editorial

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4 pages, 202 KiB

Open AccessEditorial

Stomatognathic Diseases: State of the Art and Future Perspectives

by Agostino Guida and Saman Warnakulasuriya

J. Clin. Med. 2022, 11(21), 6525; https://doi.org/10.3390/jcm11216525 - 3 Nov 2022

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Abstract

The World Health Organization (WHO) considers oral heath to be a key indicator of overall health, as it is linked to physical well-being and quality of life [...] Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

Research

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12 pages, 1266 KiB

Open AccessArticle

Extracellular DNA and Markers of Neutrophil Extracellular Traps in Saliva from Patients with Periodontitis—A Case–Control Study

by Alexandra Gaál Kovalčíková, Bohuslav Novák, Oksana Roshko, Eva Kovaľová, Michal Pastorek, Barbora Vlková and Peter Celec

J. Clin. Med. 2024, 13(2), 468; https://doi.org/10.3390/jcm13020468 - 15 Jan 2024

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Abstract

Periodontitis is a chronic inflammatory disease. We have previously shown that salivary DNA is higher in patients with periodontitis. Neutrophil extracellular traps (NETs) are involved in the pathogenesis of chronic inflammatory diseases. The objective of this case–control study was to compare patients with [...] Read more.

Periodontitis is a chronic inflammatory disease. We have previously shown that salivary DNA is higher in patients with periodontitis. Neutrophil extracellular traps (NETs) are involved in the pathogenesis of chronic inflammatory diseases. The objective of this case–control study was to compare patients with periodontitis and healthy controls regarding the salivary concentrations of extracellular DNA and NET components. Unstimulated saliva samples were collected from 49 patients with periodontitis and 71 controls before an oral examination. Salivary extracellular DNA was isolated and quantified fluorometrically and using PCR. NET-associated markers were assessed using ELISA. We have found significantly higher concentrations of salivary extracellular DNA in samples from periodontitis patients (five-times higher for supernatant and three times for pellet). Our results show that patients also have three-times-higher salivary nucleosomes and NET-associated enzymes—myeloperoxidase and neutrophil elastase (both two-times higher). Neutrophil elastase and salivary DNA in the pellet correlated positively with the pocket depth/clinical attachment level in periodontitis patients (r = 0.31—weak correlation; p = 0.03 and r = 0.41—moderate correlation, p = 0.004). Correlations between salivary extracellular DNA and NET enzymes were positive and significant. Based on our results, the higher salivary extracellular DNA in periodontitis seems to be related to components of NETs, albeit with weak to moderate correlations indicating that NETs are produced in periodontitis and can play a role in its pathogenesis similarly to other inflammatory diseases. Further studies should prove this assumption with potential diagnostic and therapeutic consequences. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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13 pages, 1299 KiB

Open AccessArticle

The Follow-Up Necessity in Human Papilloma Virus-Positive vs. Human Papilloma Virus-Negative Oral Mucosal Lesions: A Retrospective Study

by Armina Rushiti, Chiara Castellani, Alessia Cerrato, Marny Fedrigo, Luca Sbricoli, Eriberto Bressan, Annalisa Angelini and Christian Bacci

J. Clin. Med. 2024, 13(1), 58; https://doi.org/10.3390/jcm13010058 - 21 Dec 2023

Viewed by 699

Abstract

Human papilloma virus (HPV) is known as the main cause of cervical cancer. Data also indicate its role in head–neck cancer, especially oropharyngeal cancer. The correlation between high-risk HPV and oral cancer is still controversial. HPV-related lesions of the oral cavity are frequent [...] Read more.

Human papilloma virus (HPV) is known as the main cause of cervical cancer. Data also indicate its role in head–neck cancer, especially oropharyngeal cancer. The correlation between high-risk HPV and oral cancer is still controversial. HPV-related lesions of the oral cavity are frequent and, in most cases, benign. The primary aim of this study was to establish if there is a different follow-up necessity between HPV-positive compared to HPV-negative oral lesions. The secondary aim was to evaluate the recurrence of HPV-related lesions. All patients who underwent a surgical procedure of oral biopsy between 2018 and 2022, with ulterior histopathological examination and HPV typing, were examined. A total of 230 patients were included: 75 received traumatic fibroma as diagnosis, 131 HPV-related lesions, 9 proliferative verrucous leukoplakia, and 15 leukoplakia. The frequency and period of follow-up varied in relation to HPV positivity and diagnosis. This study confirms what has already been reported by other authors regarding the absence of recommendations of follow-up necessity in patients with oral mucosal lesions. However, the data demonstrate that there was a statistically significant difference in the sample analyzed regarding the follow-up of HPV-positive vs. HPV-negative patients. It also confirms the low recurrence frequency of HPV-related oral lesions. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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11 pages, 1352 KiB

Open AccessArticle

Detection of Periodontal Bone Loss on Periapical Radiographs—A Diagnostic Study Using Different Convolutional Neural Networks

by Patrick Hoss, Ole Meyer, Uta Christine Wölfle, Annika Wülk, Theresa Meusburger, Leon Meier, Reinhard Hickel, Volker Gruhn, Marc Hesenius, Jan Kühnisch and Helena Dujic

J. Clin. Med. 2023, 12(22), 7189; https://doi.org/10.3390/jcm12227189 - 20 Nov 2023

Viewed by 2390

Abstract

Interest in machine learning models and convolutional neural networks (CNNs) for diagnostic purposes is steadily increasing in dentistry. Here, CNNs can potentially help in the classification of periodontal bone loss (PBL). In this study, the diagnostic performance of five CNNs in detecting PBL [...] Read more.

Interest in machine learning models and convolutional neural networks (CNNs) for diagnostic purposes is steadily increasing in dentistry. Here, CNNs can potentially help in the classification of periodontal bone loss (PBL). In this study, the diagnostic performance of five CNNs in detecting PBL on periapical radiographs was analyzed. A set of anonymized periapical radiographs (N = 21,819) was evaluated by a group of trained and calibrated dentists and classified into radiographs without PBL or with mild, moderate, or severe PBL. Five CNNs were trained over five epochs. Statistically, diagnostic performance was analyzed using accuracy (ACC), sensitivity (SE), specificity (SP), and area under the receiver operating curve (AUC). Here, overall ACC ranged from 82.0% to 84.8%, SE 88.8–90.7%, SP 66.2–71.2%, and AUC 0.884–0.913, indicating similar diagnostic performance of the five CNNs. Furthermore, performance differences were evident in the individual sextant groups. Here, the highest values were found for the mandibular anterior teeth (ACC 94.9–96.0%) and the lowest values for the maxillary posterior teeth (78.0–80.7%). It can be concluded that automatic assessment of PBL seems to be possible, but that diagnostic accuracy varies depending on the location in the dentition. Future research is needed to improve performance for all tooth groups. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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9 pages, 927 KiB

Open AccessArticle

Expression of Interleukin 17A and 17B in Gingival Tissue in Patients with Periodontitis

by Małgorzata Mazurek-Mochol, Karol Serwin, Tobias Bonsmann, Małgorzata Kozak, Katarzyna Piotrowska, Michał Czerewaty, Krzysztof Safranow and Andrzej Pawlik

J. Clin. Med. 2023, 12(14), 4614; https://doi.org/10.3390/jcm12144614 - 11 Jul 2023

Cited by 1 | Viewed by 876

Abstract

Periodontitis (PD) is a chronic inflammatory disease that is initiated by oral microorganisms. The pathogens induce the production of cytokines, such as interleukin (IL)-17, which enhances the inflammatory response and progression of the disease. The aim of this study was to examine the [...] Read more.

Periodontitis (PD) is a chronic inflammatory disease that is initiated by oral microorganisms. The pathogens induce the production of cytokines, such as interleukin (IL)-17, which enhances the inflammatory response and progression of the disease. The aim of this study was to examine the expression and localization in gingival tissue of IL-17A and IL-17B in patients with periodontitis. This study included 14 patients with periodontal disease and 14 healthy subjects without periodontal disease as a control group. There were no statistically significant differences in the expression of IL-17A mRNA between patients with periodontitis and control subjects. The expression of IL-17B mRNA was statistically significantly lower in patients with periodontitis in comparison with healthy subjects (p < 0.048). The expression of IL-17A correlated significantly with the approximal plaque index. The IL-17B expression in gingival tissue correlated with the clinical attachment level. This correlation reached borderline statistical significance (p = 0.06). In immunohistochemical analysis, we have shown the highest expression of IL-17 protein in inflamed connective tissue, epithelium, and granulation tissue from gingival biopsy specimens from patients with periodontitis. In biopsy specimens from healthy individuals, no IL-17 was found in the epithelium, while an expression of IL-17 was found in the connective tissue. The results of our study confirm the involvement of IL-17 in the pathogenesis of periodontitis. Our results suggest that an increase in IL-17 protein expression in the gingival tissue of patients with periodontitis occurs at the post-translational stage. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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17 pages, 6623 KiB

Open AccessArticle

METTL3-Mediated lncSNHG7 m⁶A Modification in the Osteogenic/Odontogenic Differentiation of Human Dental Stem Cells

by Yeqing Yang, Junkai Zeng, Chong Jiang, Jiawen Chen, Ci Song, Ming Chen and Buling Wu

J. Clin. Med. 2023, 12(1), 113; https://doi.org/10.3390/jcm12010113 - 23 Dec 2022

Cited by 2 | Viewed by 1410

Abstract

Background: Human dental pulp stem cells (hDPSCs) play an important role in endodontic regeneration. N6-methyladenosine (m⁶A) is the most common RNA modification, and noncoding RNAs have also been demonstrated to have regulatory roles in the expression of m⁶A [...] Read more.

Background: Human dental pulp stem cells (hDPSCs) play an important role in endodontic regeneration. N6-methyladenosine (m⁶A) is the most common RNA modification, and noncoding RNAs have also been demonstrated to have regulatory roles in the expression of m⁶A regulatory proteins. However, the study on m⁶A modification in hDPSCs has not yet been conducted. Methods: Single base site PCR (MazF) was used to detect the m⁶A modification site of lncSNHG7 before and after mineralization of hDPSCs to screen the target m⁶A modification protein, and bioinformatics analysis was used to analyze the related pathways rich in lncSNHG7. After knockdown and overexpression of lncSNHG7 and METTL3, the osteogenic/odontogenic ability was detected. After METTL3 knockdown, the m⁶A modification level and its expression of lncSNHG7 were detected by MazF, and their binding was confirmed. Finally, the effects of lncSNHG7 and METTL3 on the Wnt/β-catenin pathway were detected. Results: MazF experiments revealed that lncSNHG7 had a m⁶A modification before and after mineralization of hDPSCs, and the occurrence site was 2081. METTL3 was most significantly upregulated after mineralization of hDPSCs. Knockdown/ overexpression of lncSNHG7 and METTL3 inhibited/promoted the osteogenic/odontogenic differentiation of hDPSCs. The m⁶A modification and expression of lncSNHG7 were both regulated by METTL3. Subsequently, lncSNHG7 and METTL3 were found to regulate the Wnt/β-catenin signaling pathway. Conclusion: These results revealed that METTL3 can activate the Wnt/β-catenin signaling pathway by regulating the m⁶A modification and expression of lncSNHG7 in hDPSCs to enhance the osteogenic/odontogenic differentiation of hDPSCs. Our study provides new insight into stem cell-based tissue engineering. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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12 pages, 463 KiB

Open AccessArticle

Salivary Biomarkers in Periodontitis Post Scaling and Root Planing

by K. Lakshmi Priya, Jaideep Mahendra, Little Mahendra, Anilkumar Kanakamedala, Khalaf F. Alsharif, Maryam H. Mugri, Saranya Varadarajan, Ahmed Alamoudi, Ali Abdel-Halim Abdel-Azim Hassan, Mrim M. Alnfiai, Khalid J. Alzahrani, Maha A. Bahammam, Hosam Ali Baeshen, Thodur Madapusi Balaji and Shilpa Bhandi

J. Clin. Med. 2022, 11(23), 7142; https://doi.org/10.3390/jcm11237142 - 1 Dec 2022

Cited by 2 | Viewed by 1668

Abstract

Objectives: This study was conducted to evaluate the levels of salivary uric acid and arginase in patients with periodontitis, generalized gingivitis, and in healthy individuals. Then, the effects of non-surgical periodontal therapy on levels of salivary arginase and uric acid were also investigated. [...] Read more.

Objectives: This study was conducted to evaluate the levels of salivary uric acid and arginase in patients with periodontitis, generalized gingivitis, and in healthy individuals. Then, the effects of non-surgical periodontal therapy on levels of salivary arginase and uric acid were also investigated. Methods: A total of 60 subjects were divided into three groups based on periodontal health: group I comprised 20 healthy individuals; group II comprised 20 subjects who had generalized gingivitis; group III comprised 20 subjects who had generalized periodontitis. On day 0, the clinical examination of periodontal status was recorded, following which saliva samples were collected. Group II and group III subjects underwent non-surgical periodontal therapy. These patients were recalled on day 30 to collect saliva samples. The periodontal parameters were reassessed on day 90, and saliva samples were collected for analysis of salivary arginase and uric acid levels. Results: Group II and group III showed improvement in clinical parameters following non-surgical periodontal therapy on the 90th day. The MGI score, PPD, and CAL showed improvement. On day 0, at baseline, salivary arginase levels in group III and group II were higher than those in healthy subjects, whereas on day 0, salivary uric acid levels in group III and group II were lower than those in healthy subjects. Both on day 0 and day 90, the salivary arginase level showed a positive correlation with the periodontal parameters, whereas the salivary uric acid level was positively correlated with the periodontal parameters on day 90. Conclusion: the level of salivary arginase was a pro-inflammatory marker and a raised level of salivary uric acid was an anti-inflammatory marker following periodontal therapy, suggesting their pivotal role in assessing periodontal status and evaluation of treatment outcome. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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Review

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18 pages, 2188 KiB

Open AccessReview

It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders

by Angela Militi, Mirjam Bonanno and Rocco Salvatore Calabrò

J. Clin. Med. 2023, 12(10), 3528; https://doi.org/10.3390/jcm12103528 - 17 May 2023

Cited by 1 | Viewed by 1651

Abstract

Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients’ swallowing, masticatory and phonation functions and, therefore, their quality of life. The [...] Read more.

Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients’ swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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Other

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23 pages, 378 KiB

Open AccessSystematic Review

Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review

by Dorin Nicolae Gheorghe, Francesco Bennardo, Margarita Silaghi, Dora-Maria Popescu, George-Alexandru Maftei, Marilena Bătăiosu and Petra Surlin

J. Clin. Med. 2023, 12(21), 6936; https://doi.org/10.3390/jcm12216936 - 5 Nov 2023

Cited by 2 | Viewed by 2290

Abstract

Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm [...] Read more.

Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm removal. The objective of this systematic review was to assess existing literature regarding the subgingival use of various types of air-polishing powders, as an effective method of subgingival biofilm control. For this, 55 articles on this subjected were sourced from searched databases and subjected to an evaluation process of their contained information, which was subsequently structured and compiled into this manuscript. The existing literature acknowledges that good subgingival biofilm control is essential for the success of periodontal therapy, including through subgingival air-polishing, as an adjunctive procedure. This approach has the potential to enhance patient comfort during and after subgingival mechanical plaque removal, thereby mitigating damage to periodontal structures. Consequently, it may lead to improved healing capabilities within the periodontal tissues and the formation of a more stable reparative gingival junctional epithelium. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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7 pages, 229 KiB

Open AccessOpinion

COVID-19 and Oral Lichen Planus: Between an “Intriguing Plot” and the “Fata Morgana Effect”

by Gaetano Scotto, Vincenzina Fazio, Salvatore Massa, Lorenzo Lo Muzio and Francesca Spirito

J. Clin. Med. 2023, 12(14), 4829; https://doi.org/10.3390/jcm12144829 - 21 Jul 2023

Cited by 2 | Viewed by 1435

Abstract

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its declaration as a global pandemic in March 2020. Alongside the typical respiratory symptoms, unusual clinical manifestations such as oral lichen planus (OLP) have been observed. [...] Read more.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its declaration as a global pandemic in March 2020. Alongside the typical respiratory symptoms, unusual clinical manifestations such as oral lichen planus (OLP) have been observed. OLP is a chronic inflammatory mucocutaneous dermatosis that results from a cell-mediated reaction, and its pathogenesis involves the loss of immunological tolerance. OLP has been associated with several triggering factors, such as certain drugs, stress, smoking, and even some viruses. Exposure to the spike protein antigen of SARS-CoV-2 during an infection can trigger autoimmune reactions and lead to the onset or flare of OLP. The E3 protein ligase TRIM21, which is identified in the lamina propria of OLP lesions, is overexpressed in COVID-19 patients and plays a critical role in autoimmune pathologies. Furthermore, the psychological stress of the lockdown and quarantine can be a trigger for the onset or exacerbation of OLP. However, the diagnosis of OLP is complex and requires a biopsy in order to confirm a clinical diagnosis, rule out other pathologies, and establish the most appropriate therapeutic procedure. Further research is needed to understand the potential link between Co-19 and OLP. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

21 pages, 8436 KiB

Open AccessSystematic Review

Comparative Efficacy and Safety of Interventions for the Treatment of Oral Lichen Planus: A Systematic Review and Network Meta-Analysis

by Xin Yi Leong, Divya Gopinath, Sakil M. Syeed, Sajesh K. Veettil, Naresh Yedthare Shetty and Rohit Kunnath Menon

J. Clin. Med. 2023, 12(8), 2763; https://doi.org/10.3390/jcm12082763 - 7 Apr 2023

Cited by 3 | Viewed by 1766

Abstract

Background: This systematic review and network meta-analysis aimed to assess comparative efficacy and safety of interventions to treat symptomatic, biopsy-proven oral lichen planus (OLP). Methods: Search was conducted for trials published in Medline, Embase and Cochrane Central Register of Controlled Trials. Network meta-analysis [...] Read more.

Background: This systematic review and network meta-analysis aimed to assess comparative efficacy and safety of interventions to treat symptomatic, biopsy-proven oral lichen planus (OLP). Methods: Search was conducted for trials published in Medline, Embase and Cochrane Central Register of Controlled Trials. Network meta-analysis was performed on data from randomized controlled trials that assessed efficacy and safety of interventions used in the treatment of OLP. Agents were ranked according to their effectiveness in treatment of OLP based on outcomes using surface under the cumulative ranking [SUCRA]. Results: In total, 37 articles were included in the quantitative analysis. Purslane was clinically significant and ranked first in improving clinical symptoms [RR = 4.53; 95% CI: 1.45, 14.11], followed by aloe vera [RR = 1.53; 95% CI: 1.05, 2.24], topical calcineurin [RR = 1.38; 95% CI: 1.06, 1.81] and topical corticosteroid [RR = 1.35 95% CI: 1.05, 1.73]. Topical calcineurin demonstrated the highest incidence of adverse effects [RR, 3.25 [95% CI: 1.19, 8.86. Topical corticosteroids were significant in achieving clinical improvement of OLP with RR1.37 [95% CI: 1.03, 1.81]. PDT [MD = −5.91 [95% CI: −8.15, –3.68] and showed statistically significant improvement in the clinical score for OLP. Conclusions: Purslane, aloe vera and photodynamic therapy appear promising in treatment of OLP. More high-quality trials are recommended for strengthening the evidence. Although topical calcineurin is significantly efficacious in the treatment of OLP, significant adverse effects are a concern for clinical use. Based on the current evidence, topical corticosteroids are recommended for treatment of OLP owing to their predictable safety and efficacy. Full article

(This article belongs to the Special Issue Stomatognathic Diseases: State of the Art and Future Perspectives)

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