Faculty Bibliography

A COMMENTARY ON/UNASSIGNED:Zhao Z, Attanasio C, Zong C, Pedano M S, Cadenas de Llano-Pérula M. How does orthodontic tooth movement influence the dental pulp? RNA-sequencing on human premolars. Int Endod J 2024; 57: 1783-1801. DESIGN-CROSS-SECTIONAL DESIGN/UNASSIGNED:Sample selection - The study sample consisted of healthy individuals requiring extraction of maxillary or mandibular premolars for fixed appliance orthodontic treatment. Exclusion criteria included systemic diseases, a history of smoking, antibiotic or analgesic use within the past three months, periodontal probing depths greater than 3 mm, alveolar bone resorption, and premolars with prior endodontic treatment. Participants were randomly divided into 3 groups: control, 7-day, and 28-day groups. Extractions were performed prior to orthodontic treatment, and 7 days and 28 days after application of orthodontic forces (OF) in the control, 7-day and 28-day group respectively. The applied orthodontic forces were in the range of 50-150 g. RNA extraction from pulp tissues was performed using the RNeasy mini kit. After total RNA extraction, a library was prepared, and RNA sequencing was conducted to examine and compare the genetic data among the groups within each jaw. DATA ANALYSIS/METHODS:Differentially expressed genes (DEGs) were identified in the 7-day and 28-day groups, followed by functional enrichment analysis to understand their biological significance. Furthermore, protein-protein interaction network analysis was conducted to investigate the complex network of protein interactions and locate key genes involved in orthodontic tooth movement. RESULTS:Immune response, hypoxia, DNA damage, and epigenetic regulation were the pulpal reactions reflected after 7 days of OF. Whereas, at 28 days, processes such as cell adhesion, migration, organization, and tissue repair became prominent. Pulp tissues in the maxilla and mandible responded differently to orthodontic force. The maxilla showed minimal changes, primarily involving immune response at 7 days and tissue repair at 28 days. In contrast, the mandible exhibited significant DNA damage and epigenetic regulation at 7 days, with a return to its baseline condition by 28 days. CONCLUSIONS:Dental pulp demonstrated different reactions at 7 and 28 days, with maxillary and mandibular pulp tissues presenting distinct responses. The study provided knowledge about gene regulatory mechanisms modulating pulp tissue response to OF.

The role of evidence-based health care (EBHC) in clinical decision-making, especially in medicine and dentistry, has been advocated as necessary for ensuring that the best available evidence is implemented and for providing quality patient care. In modern health care, integrating clinical expertise, patient values, and the most relevant research findings forms the cornerstone of evidence-based practice. Using this approach ensures that practitioners can offer treatments that are scientifically validated and tailored to individual patient needs and preferences. The following is an analysis of the role of EBHC in clinical decisions, its implications, and its applications in dentistry and prosthodontics.

Preclinical testing of tissue engineering modalities are commonly performed in a healthy wound bed. These conditions do not represent clinically relevant compromised oral wound environments due to radiation treatments seen clinically. This study aimed to characterize the bone regeneration outcomes in critical-sized mandibular defects using particulate grafting in an irradiated preclinical model of compromised wound healing. Sixteen New Zealand white rabbits were divided into two groups (n = 8/group), namely (i) irradiated (experimental) and (ii) non-irradiated (control). The rabbits in the experimental group received a total of 36 Gy radiation, followed by surgical intervention to create critical-sized (10 mm), full-thickness mandibular defects. The control group was subjected to the same surgical intervention. All defects were filled with bovine bone grafting material (Bio-Oss, Geistlich, Princeton, NJ, USA) and allowed to heal for 8 weeks. At the study endpoint, rabbits were euthanized, and their mandibles were harvested for micro-computed tomographic, histological, and histomorphometric processing and analysis. Qualitative histological analysis revealed increased levels of bone formation and bridging in the control group relative to the experimental group. This was accompanied by increased levels of soft tissue presence in the experimental group. Volumetric reconstruction showed a significantly higher degree of bone in the control group (27.59% ± 2.71), relative to the experimental group (22.02% ± 2.71) (p = 0.001). The irradiated rabbit model exhibited decreased bone regeneration capacity relative to the healthy subjects, highlighting its suitability as a robust compromised wound healing environment for further preclinical testing involving growth factors or customized, high-fidelity 3D printed tissue engineering scaffolds.

In dentistry, several types of 3D resin printers are commonly used, each with its advantages and applications. 3D printing traces back to the 1980s. Each type of 3D resin printer has its strengths and limitations, and the choice of printer depends on factors such as desired resolution, printing speed, material compatibility, and budget. In dental practice, a combination of different types of resin printers may be used to meet the diverse needs of patients and clinicians. In summary, 3D-printing is likely to become a mainstay of every dental office with significant applications in prosthodontics, enhancing patient care pathways.

Advancements in digital technologies over the past decade have revolutionized dentistry, particularly with the integration of digital workflows in removable partial dentures (RPDs). Key innovations include digital data capture and computer-aided design and manufacturing, which enhance patient comfort, streamline workflows, and reduce treatment time and costs. Initially embraced by fixed restorations, these technologies are now transforming RPDs, previously reliant on analog methods. The collaboration between dentists, laboratory technologists, and patients is essential for selecting optimal materials and achieving successful RPD treatments.

INTRODUCTION/UNASSIGNED:Periodontitis affects a significant portion of the global population and is associated with systemic health issues. Salivary biomarkers such as salivary matrix metalloproteinase-8 (MMP-8) and its activated form (aMMP-8) have been studied for their roles in tissue degradation and inflammation in periodontitis. This meta-analysis investigates the association between salivary MMP-8 and aMMP-8 levels and periodontitis. METHODS/UNASSIGNED:A systematic literature search was conducted utilizing PubMed, Embase, Web of Science, and Cochrane Library databases up to October 2023, yielding 35 studies that quantified MMP-8 or aMMP-8 in saliva from patients with periodontitis and healthy controls. Data were extracted, and standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed, and subgroup analyses were performed based on saliva collection techniques. Meta-regression analysis evaluated the impact of publication year on heterogeneity. RESULTS/UNASSIGNED: = 0.445). Subgroup analyses by saliva collection technique did not reduce heterogeneity significantly. Meta-regression showed that publication year did not impact heterogeneity. Small-study effects and publication bias were present, suggesting caution in interpreting the results. DISCUSSION/UNASSIGNED:The findings support the potential of MMP-8 and aMMP-8 as biomarkers for periodontitis, although substantial heterogeneity and methodological differences among studies pose challenges. Standardized protocols and larger sample sizes are necessary to enhance the reliability of these biomarkers in clinical practice. Despite limitations, salivary diagnostics hold promise for non-invasive, early detection and monitoring of periodontitis. CONCLUSION/UNASSIGNED:Salivary MMP-8 and aMMP-8 levels are significantly associated with periodontitis, highlighting their potential as diagnostic biomarkers. However, methodological improvements and standardization are essential for their clinical application. Collaborative efforts and advancements in salivary diagnostics are crucial for improving periodontitis management and patient outcomes.

Laboratory communication in dentistry involves the exchange of detailed information between clinicians and technicians for fabricating restorations, ensuring optimal patient outcomes. Effective communication includes written narratives, photographs, digital scans, and physical materials. Clinicians must understand laboratory processes, while technicians need to interpret and execute requests accurately. Certification and adherence to legal standards are essential. Effective communication impacts patient care by ensuring proper case planning, patient education, and setting realistic expectations. Clear, precise exchanges between clinicians and technicians are crucial for quality and compliance, fostering a collaborative and respectful relationship that ultimately benefits patient care outcomes.

Radiology is essential in prosthodontics for diagnosis and treatment planning, utilizing intraoral radiographs, panoramic imaging, and cone beam computed tomography (CBCT) while adhering to the as low as reasonably achievable principle. CBCT provides 3 dimensional (3D) evaluations of bone quality, dimensions, and proximity to vital structures, aiding implant placement and reducing surgical risks. Artificial intelligence (AI) and computer-assisted surgery have transformed prosthodontics, improving treatment planning and implant precision and reducing complications. The future of prosthodontic radiology will increasingly integrate AI-driven imaging and robotic assistance to enhance precision and treatment success.

Introduction Tooth loss, often perceived as a localized dental issue, has profound implications for systemic health. It is frequently associated with underlying factors such as periodontal disease, smoking, poor dietary habits, and psychological stress. These factors contribute to tooth loss locally and are linked to various systemic conditions, including diabetes and cardiovascular disease. This study explores the predictive value of tooth loss as a biomarker for systemic health conditions, emphasizing its potential to serve as an early warning indicator for broader health risks and highlighting the interconnected nature of oral and systemic health. Background The interconnection between oral and systemic health has received significant attention in recent years. Chronic oral conditions, particularly periodontal disease, contribute to systemic inflammation, a key factor in the development of diseases such as atherosclerosis and diabetes. Tooth loss, often resulting from severe oral pathology, reflects a history of chronic inflammation, poor oral hygiene, and adverse lifestyle choices. Despite its clinical relevance, tooth loss remains underutilized as a marker for systemic health status. This study seeks to address this gap by evaluating the systemic health trajectories of patients with significant tooth loss over a 15-year period. Materials and methods This study retrospectively analyzed the chart records of 35 patients who experienced significant tooth loss (321 teeth in total) due to factors such as age, smoking, dietary deficiencies, psychological stress, bruxism, fractures, and periodontal infections. Medical and dental records spanning a 15-year period were reviewed to monitor the progression of systemic health conditions. Statistical analyses, including correlation and logistic regression, were performed to evaluate the relationships between tooth loss and systemic health outcomes. Kaplan-Meier survival analysis assessed the time to disease onset in relation to oral health deterioration. A health score prediction equation was developed. Results The findings revealed that tooth loss was strongly associated with systemic conditions such as cardiovascular disease, diabetes, and respiratory disorders. A significant positive correlation was observed between tooth loss and diabetes (r = 0.72, p < 0.01) and cardiovascular disease (r = 0.68, p < 0.01). Logistic regression demonstrated that patients with severe periodontal disease had significantly higher odds of developing cardiovascular disease (OR = 3.5) and diabetes (OR = 2.8). Kaplan-Meier survival curves indicated that patients with extensive tooth loss experienced earlier onset of systemic conditions than those with minimal tooth loss (median time: 7 vs. 12 years, p = 0.03). Smoking, poor diet, and psychological stress emerged as exacerbating factors. Conclusions Tooth loss is a significant biomarker for systemic health conditions, reflecting the cumulative effects of chronic oral and systemic inflammation, adverse lifestyle factors, and psychological health. This study highlights the importance of integrating dental and medical care to address the root causes of both oral and systemic diseases. Proactive oral health interventions, with systemic disease prevention strategies, can improve overall health outcomes. Further research involving larger cohorts is recommended to validate the findings and enhance predictive models for clinical application.