Still Scholarworks (A.T. Still University)
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Bibliometric analysis of trends in dental management of the children with Autism Spectrum Disorder (ASD)
No full textThis study aimed to present a complete overview of the trends, difficulties, and improvements in dental treatment for children diagnosed with autism spectrum disorder through rigorous bibliometric analysis. The dimensional database field was chosen to enable the inclusion and recall of the greatest number of relevant entries. All peer-reviewed international journals published between 2004 and 2023 were included in this study. The sophisticated search keywords\u27 Autistic Disorder OR Autism Spectrum Disorder AND Dental management were used. Studies that examined patterns and difficulties in the dental care of children with ASD were included in the inclusion and exclusion criteria for this analysis. Among the listed countries, The United States had the highest number of documents and citations. Barbara Sheller is the most cited author, followed closely by Arthur H.Friedlander, Michael E.Mahler, and John A.Yagiela. This study also revealed that most articles involved multinational collaborations, highlighting the global scope of dental research. The United States leads in terms of research output and citations, followed by India and China. Research on autism spectrum disorder has grown substantially over the past few years, and the authors recommend that future research concentrate on creating effective behavioral techniques that will assist children with autism spectrum disorder in coping with dental treatment
Alterations of TGFBR2 and KRAS in cemento-osseous dysplasia of the jaw
No full textObjective: Cemento-osseous dysplasia (COD) is a common benign fibro-osseous lesion found in the periapical regions of the jaw. Despite its prevalence, the etiopathogenesis of COD remains largely unknown. We conducted targeted sequencing of 1,036 genes on two nondecalcified formalin-fixed, paraffin-embedded COD tissue samples. Study Design: The Promega Maxwell system was used for DNA isolation, while the sequencing method applied was Unmatched Normals and Mutant Allele Status Characterization, a tumor-only variant calling pipeline designed to enhance sensitivity, specificity, and precision in variant detection. Results: We identified canonical hotspot variants in TGFBR2 (specifically TGFBR2 p.Arg528His and TGFBR2 p.Arg553His) with an allelic frequency (AF) of 3%, and two noncanonical KRAS variants: one splice variant with a 10% AF and one single nucleotide variant (snV), KRAS p.Lys167Arg, with a 1.4% AF in a case. The second case had no gene alterations. Conclusion: We observed alterations in genes within the RAS-MAPK activation pathway, it is important to note that the allele frequencies were generally low. This suggests that most cells in the sample did not exhibit the variant, indicating that other, yet unidentified genes might be responsible for the pathogenesis. The genes we identified may play a role in the progression at a later stage
Three-dimensional printing technologies, techniques, and materials currently used dentistry: A comprehensive review
No full textThis review evaluated various 3D-printing technologies and materials utilized in dentistry. Digital manufacturing, rapid prototyping, additive manufacturing, and 3D printing have gained precedence over subtractive manufacturing or milling. This cutting-edge 3D printing technology offers precise and advanced manufacturing capabilities for various materials. Technologies have been used to fabricate 3D-printed models. Some problems were associated with 3D-printing technologies: (1) the layer-by-layer image superimposition causes distortion and reduces the mechanical properties of the material; (2) the thickness of the layer affects the final model\u27s smoothness; (3) the lack of trained technicians and clinicians hinders the implementation of 3D printers in regular clinics; (4) most 3D printing machines are not customized for dental use. Even though 3D printers can create a model in a shorter period, acquiring data takes time. To implement 3D printing in dentistry, manufacturers should aim to reduce costs and time, increase surface quality, and improve the reproducibility, reliability, and performance of this technology. Dental practitioners can customize the fabrication of temporary and permanent crowns, occlusal splints, implants, and dental aligners. However, 3D-printing machines are still less accepted than traditional treatment methods
Glutamate stress in the caudal nucleus tractus solitarii (nTS): Impact on respiratory function and synaptic signaling in an Alzheimer\u27s disease model
No full textRespiratory dysfunction is a prevalent comorbidity in Alzheimer\u27s disease (AD), yet its underlying mechanisms are poorly understood. Using the Streptozotocin (STZ) -induced rat model of AD, which replicates respiratory dysfunction and brain pathologies observed in human AD, we analyzed how these impairments relate to central neurological integration within the peripheral chemoreflex. Our focus was on glutamatergic signaling at the synapse between peripheral chemoafferents and second-order neurons in the nucleus tractus solitarii (nTS), a critical brainstem center for respiratory control. Activating the peripheral chemoreflex with potassium cyanide (KCN) increased respiratory frequency. Response magnitudes to repeated KCN injections typically decreased over time, which was exacerbated in the STZ-AD group. Similarly, repeated glutamate nanoinjections into the caudal/commissural nTS caused a pronounced reduction of respiratory frequency responses in STZ-AD. Electrophysiological analysis of nTS neurons within the peripheral chemoreflex revealed increased network activity, enhanced excitatory postsynaptic currents evoked by solitary tract stimulation (TS-EPSCs), and elevated asynchronous glutamate release following high-frequency stimulation (aEPSCs). These data were consistent with molecular evidence for astrogliosis (elevated GFAP expression), reduced astrocytic glutamate uptake (decreased EAAT2 expression), and presynaptic calcium dysregulation (increased TRPV1 expression). Additionally, presynaptic metabotropic glutamate receptors (mGluR3) were downregulated, while postsynaptic ionotropic receptor expression remained unchanged. With high-frequency solitary tract stimulation, STZ-AD rats had greater frequency-dependent TS-EPSC depression than controls, mirroring the diminished respiratory responses to KCN and glutamate nanoinjections. Our findings connect neurophysiological and molecular changes at the first nTS synapse of the peripheral chemoreflex with impaired respiratory responses to hypoxia in the STZ-AD model
Topological dynamics of rapid non-planar gaits in slithering snakes
No full textSnakes exhibit a wide variety of gaits, including gliding in air and sidewinding on land, which is particularly notable for its out-of-plane motion. Here we report the observation of another non-planar gait used as an escape strategy from threatening situations by juvenile anacondas (Eunectes notaeus), which we refer to as the S-start due to its shape. In this transient mode of locomotion, the snake writhes and bends out of the plane while rolling forward about its midsection without slippage. To quantify our observations, we develop a model for an active non-planar filament that interacts anisotropically with a frictional substrate. We demonstrate that locomotion is due to a propagating localized pulse of a topological quantity—the link density. A two-dimensional phase space characterized by scaled body weight and muscular torque shows that relatively light juveniles are capable of S-starts, whereas heavy adults are not, consistent with our experiments. We also show that a periodic sequence of S-starts naturally leads to a sidewinding gait
The influence of the gingival phenotype on implant survival rate and clinical parameters: a systematic review
No full textObjective: The goal of this systematic review was to verify whether the gingival phenotype (thick or thin) could impact the dental implant survival rate by affecting the marginal bone. Methods: The search was carried out on PubMed/MedLine, PubMed Central, and B-On databases. The research question was: “Does gingival phenotype positively or negatively influence marginal bone loss around dental implants?” The inclusion criteria were: any clinical trial/study, comparative study, prospective or retrospective articles, systematic review that addressed at least a 1-year follow-up with an assessment of the marginal bone loss (MBL) around dental implants, articles that reported the gingival phenotype (thin or thick) and were published in the last 13 years. The exclusion criteria were narrative or other reviews, letters to the editor, and commentaries. Data extraction included the author’s name, year of publication, type of study, sample size, number of implants, method used, and outcomes presented. The extracted data was summarized and presented in the results section. Critical Appraisal tool in JBI Systematic Reviews was used to determine the possibility of bias. Results: A total of 62 articles were found, but eight articles were relevant to compose this study. After deep evaluation, it was possible to observe the implant success rate for both gingival phenotypes, thin and thick, was greater than 91% within a follow-up of up to 5 years. Therefore, it is unclear whether the thickness of the gingival tissue surrounding the implant can directly influence the marginal bone level. The gingival phenotype may be indirectly involved in the survival rate of dental implants, as it can be a risk factor for peri-implantitis, leading to marginal bone loss beyond what is expected. Discussion: The thin gingival phenotype is one of the main risk factors for additional bone loss. It is crucial to know how to preserve the healthy condition. Conclusion: Within the results found, the gingival phenotype is indirectly related to implant survival rate and clinical parameters, which were respectively high and non-conclusive. Therefore, a higher risk of peri-implantitis is suggested when a thin phenotype is present
Evaluating the effectiveness of low-level laser therapy in patients undergoing lower third molar extraction: A double-blinded randomized controlled trial
No full textBackground: The use of low-level laser is a therapeutic resource that has been widely used in medicine in general, which has properties capable of modulating inflammatory effects such as pain, edema, and trismus resulting from oral surgeries for the extraction of impacted third molars. This study aimed to evaluate the effect of laser therapy at two different wave frequencies (660nm and 808nm) in patients undergoing impacted 3rd third lower molar extraction. For this, 30 patients were selected and randomly distributed into three groups with 10 individuals each (Control Group, 660nm Group, and 808nm Group). Material and Methods: Each participant, according to their experimental group, received irradiation before the start of each surgery and immediately after the surgical procedure. The data regarding edema, pain intensity, and trismus collected before the surgeries, immediately after, and after seven days were spreadsheeted and analyzed to determine the mean and standard deviation. After the Shapiro-Wilk normality test, differences between the experimental groups were determined using Multiple Analyses of Variance, considering a significance level of 5% (p\u3c0.05). Results: The results showed no statistically significant difference between the experimental groups in the analyzed items. Despite this, both groups irradiated with 660nm and 808nm frequencies experienced a reduction in the perception of postoperative pain, thus suggesting the benefit of using low-power laser therapy as an adjunct in the surgical treatment of impacted lower third molars. Conclusions: Despite the results showing no differences between the groups, using LLLT resulted in lower pain perception in the irradiated participants compared to those in the control group. This fact supports the use of LLLT as an adjuvant therapy in patients undergoing oral surgery procedures to remove impacted third molars
Use of a dual-purpose implant scan body to obtain both digital and analog records for complete arch fixed implant restorations
No full textA technique is described for capturing relative dental implant positions for an implant-supported fixed prosthesis in a completely edentulous arch with a novel implant indexing apparatus that also functions as a scannable verification device. A series of intraoral scans are made to record the contours and occlusal records of the existing prosthetics and soft tissue. The individual scans are aligned by using a dental software program to design either an interim or definitive prosthesis. The technique reduces the time needed to gather the records dental laboratory technicians require to fabricate a complete arch implant-supported prosthesis
Assessing BMI and Risk for Hypertension in Pediatric Dental Patients
No full textObjective: Hypertension (HTN) is an important modifiable risk factor for premature cardiovascular disease, yet blood pressure (BP) is infrequently recorded in the dental office. Rates of obesity, sedentary lifestyle and HTN are increasing in children and adolescents. The purpose of this study was to assess risk for HTN in a population of pediatric dental patients.
Experimental Methods: Pediatric patients of record, ages 3 to 12 years, were recruited for the study. Consented subjects had their height, weight, BMI, and pre-/post-treatment BP recorded. Other variables collected included demographics, pertinent medical history, # of days of participation in and level of physical activity, and caffeine intake. American Heart Association (AHA) BP classification was determined and verified by a pediatrician. ATSU Mesa IRB #2023-163.
Results: 101 subjects (62 male, 39 female), with a mean age of 8.73 years (range 3 to 12) participated. BP changed before/after dental treatment. Subjects with pre-/post-treatment HTN were classified as elevated (n=7 [6.9%], n=9 [8.9%]), Stage 1 (n=13 [12.9%], n=22 [21.8%]), and Stage 2 (n=2 [2%], n=4 [4%]) respectively. BMI calculations revealed that 12 subjects were overweight (11.9%), 15 were obese (14.9%), and 8 (7.9%) were severely obese. Pre- and post-treatment AHA BP classifications were significantly correlated: x2(5, N=101) = 7.2, p \u3c 0.001. A Spearman’s correlation analysis revealed a moderate and positive relationship between BMI and pre-treatment BP (rs = .230, n = 101, p = 0.021). There was no statistical relationship between race/ethnicity, diabetes, caffeine intake, or exercise level and pre-/post-treatment BP. However, subjects with Stage 1 and Stage 2 HTN drank more caffeine and exercised less than those with healthy or elevated BP.
Conclusions: Children present with risk factors for HTN. Assessing BP pre-/post-treatment may be beneficial. Dental professionals are well-positioned to assess risk for and the presence of HTN in pediatric patients