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Nevin Manimala Statistics

Selected structures of middle ear relevant to cochlear implantation on the basis of computer tomography

Folia Morphol (Warsz). 2023 Dec 28. doi: 10.5603/fm.97820. Online ahead of print.

ABSTRACT

BACKGROUND: The primary objective of this study was to analyze middle ear structures critical for cochlear implantation using computed tomography.

MATERIALS AND METHODS: Patients who underwent cochlear implantation at the Department of Otolaryngology in Szczecin between 2015 and 2022 were eligible for the study. We analyzed computed tomography images of 57 ears in 52 patients. The following parameters were assessed: mastoid aeration, tegmen tympani height, sigmoid sinus position, posterior tympanotomy width, the distance between the facial nerve and chorda tympani, modified facial recess distance, and the prediction line described by other authors.

RESULTS: In 69% of patients, after the removal of the round window bony overhang, the round window membrane became fully visible. There were no statistically significant correlations found for parameters describing mastoid process anatomy or those rating the width of the posterior tympanotomy concerning round window access. The prediction lines, according to Kashio and Jwair, were found to be relevant. In cases where patients’ access to the niche and membrane of the window was rated as good or very good during clinical evaluation, they were more likely to describe the window as being located posteriorly or medially in the radiological evaluation. Using a binary Jwair scale provided a better correlation with the clinical assessment. In cases where the windows were graded as posterior, the clinical assessment indicated better surgical access, especially to the RWM (Round Window Membrane).

CONCLUSIONS: Evaluating middle ear anatomy on a computed tomography scan is useful for preparing for middle ear surgery but does not significantly affect the ability to access the round window. For such access, the position of the window in relation to the facial nerve is the most relevant factor, and measurements based on this relationship hold the highest clinical value.

PMID:38152919 | DOI:10.5603/fm.97820

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Salivary Amylase and Mucin in Chronic Periodontitis: Pre- /Posttherapy

J Contemp Dent Pract. 2023 Oct 1;24(10):813-817. doi: 10.5005/jp-journals-10024-3549.

ABSTRACT

AIM: The study aims to investigate the potential of salivary amylase as a reliable biochemical marker for assessing periodontal disease progression, establishing a potential correlation between salivary amylase levels and periodontal disease severity.

MATERIALS AND METHODS: The study included 40 participants, aged 25-65, equally divided into a control and study group of 20 individuals each. Clinical parameters, such as oral hygiene index, gingival index, probing depth, and clinical attachment level were recorded. Saliva samples were collected and analyzed for amylase and mucin levels using a semi-auto analyzer and spectrophotometer, respectively. These clinical parameters and salivary biomarkers were evaluated before and after 45 days of phase I periodontal therapy. Statistical analysis, including independent samples t-test, paired samples t-test, and correlation analysis were performed to assess the treatment effectiveness and explore associations between clinical parameters and salivary biomarkers.

RESULTS: The study group with chronic generalized periodontitis showed significantly higher salivary amylase (27022.5 ± 8598.9) and mucin levels (3258 ± 724.2) and worse clinical parameters than the control group at baseline. However, after phase I periodontal therapy, the study group exhibited reduced salivary biomarkers amylase (17924.0 ± 4703.6) and mucin (1828.45 ± 314.07) and improved clinical parameters, indicating the effectiveness of the treatment in enhancing periodontal health compared with the control group. Positive correlations were found between clinical parameters and salivary amylase/mucin levels both before and after therapy (p < 0.001).

CONCLUSION: Salivary amylase and mucin levels hold promise as valuable biomarkers for diagnosing active periodontal disease and evaluating treatment outcomes after phase I therapy.

CLINICAL SIGNIFICANCE: Salivary biomarker comparison offers a noninvasive diagnostic tool for periodontal disease, improving early detection and personalized treatment planning. Further research is required to validate its clinical value fully.

PMID:38152916 | DOI:10.5005/jp-journals-10024-3549

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An Observational Study on Cystic Alterations in Normal Dental Follicles Associated with Impacted Lower Third Molar for Early Intervention

J Contemp Dent Pract. 2023 Oct 1;24(10):809-812. doi: 10.5005/jp-journals-10024-3552.

ABSTRACT

AIM: To evaluate the cystic changes in the radiographically normal dental follicle associated with impacted mandibular third molar.

MATERIALS AND METHODS: This study was conducted on 80 patients. Samples were selected using a convenient sampling technique from the patients who had impacted mandibular third molars in Pell and Gregory’s positions B and C, with follicular space less than 2.5 mm in diameter. After surgical removal of an impacted tooth, the dental follicle was sent for histopathologic evaluation.

RESULTS: Pathologic alterations were found in 19% of cases out of 80 samples. Odontogenic keratocystic and dentigerous cystic changes were found in 7% of cases. A statistically significant cystic alteration was found in female patients and distoangular impacted teeth.

CONCLUSION: This study shows a significant cystic alteration in the radiologically normal dental follicles. Clinical and radiographic features alone may not be a reliable indicator of the absence of pathology. Early intervention of impacted teeth will help to reduce morbidity due to the development of pathology.

CLINICAL SIGNIFICANCE: This study will help educate patients on the risks of retaining impacted teeth, based on scientific facts, in order to minimize the risks and to assess the correlation of pathologic alterations with the depth of impaction and angular position of the impacted tooth.

PMID:38152915 | DOI:10.5005/jp-journals-10024-3552

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Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients

J Contemp Dent Pract. 2023 Oct 1;24(10):798-801. doi: 10.5005/jp-journals-10024-3573.

ABSTRACT

AIM: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients.

MATERIALS AND METHODS: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed.

RESULTS: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed.

CONCLUSION: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results.

CLINICAL RELEVANCE: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.

PMID:38152913 | DOI:10.5005/jp-journals-10024-3573

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Can an Alginate-based Wound Dressing Modified with Garden Cress Substitute for COE-PAK as a Wound Dressing? An In Vitro Study

J Contemp Dent Pract. 2023 Oct 1;24(10):787-797. doi: 10.5005/jp-journals-10024-3584.

ABSTRACT

AIM: The aim of the current study was to prepare a natural oral wound dressing from alginate modified with garden cress (GC), a rich source of antibacterial phytochemical compounds essential for wound healing.

MATERIALS AND METHODS: Sodium alginate (SA) dressing (negative control group), was prepared and modified with GC seeds extracts (25 µg/mL and 50 µg/mL) as the intervention groups, and COE-PAK was the positive control group. Cytotoxicity was measured using WST-1 assay (n = 15) after 24 and 48 hours. The in vitro wound healing assay (n = 15) was assessed in terms of wound width, and cell migration rate (0, 24, 48, and 72 hours). Agar diffusion test was performed to investigate the antibacterial action (n = 15) of the groups against Streptococcus mutans and Lactobacillus casei strains. Results were significant at p ≤ 0.05.

RESULTS: There was no statistically significant difference in cytotoxicity in all groups (p = 0.24 at 24 hours and 0.1 at 48 hours). Garden cress-containing groups revealed the lowest mean value of wound width (0.27 mm ± 0.01 and 0.23 mm ± 0.01 for 25 µg/mL and 50 µg/mL, respectively at 48 hours) and the highest mean value of cell migration rate (0.013 mm/hour ± 0.004 and 0.014 mm/hour ± 0.004 for 25 µg/mL and 50 µg/mL, respectively at 48 hours), in addition to the highest antibacterial action (1.49 mm ± 0.05 and 2.14 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against S. mutans, 1.43 mm ± 0.07 and 2.55 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against L. casei).

CONCLUSION: Alginate wound dressing modified with GC extract could be considered a promising wound dressing material in terms of wound healing and antibacterial action.

CLINICAL SIGNIFICANCE: Ready-to-use alginate-based wound dressing modified with GC extract may represent a promising natural alternative to the most commonly used oral wound dressing (COE-PAK).

PMID:38152912 | DOI:10.5005/jp-journals-10024-3584

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Soluble Receptor Activator of Nuclear Factor Ligand and Osteoprotegerin Levels in Gingival Crevicular Fluid among Cigarette Smokers and Non-smokers with and without Periodontitis

J Contemp Dent Pract. 2023 Oct 1;24(10):771-778. doi: 10.5005/jp-journals-10024-3580.

ABSTRACT

AIM: This study aimed to measure and compare the levels of soluble receptor activator of nuclear factor ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF), as well as their ratio, in smokers and nonsmokers with periodontitis.

MATERIALS AND METHODS: Gingival crevicular fluid samples were collected using PerioPaper strips, from 150 individuals, who were categorized into three groups: current smokers with periodontitis stage III grades C and B (n = 50), nonsmokers with periodontitis stages I and II grade A (n = 50), and control healthy individuals (n = 50). The concentrations (pg/mL) of sRANKL and OPG in the GCF were measured by enzyme-linked immunesorbent assays (ELISA).

RESULT: The smokers’ group exhibited the highest sRANKL (pg/mL) concentration as a subsequent lead to a higher sRANKL/OPG ratio. The healthy control group exhibited higher OPG and lower sRANKL concentration, subsequently, the sRANKL/OPG ratio was reduced compared with the other study groups. However, there was no statistical significance of sRANKL and its relative ratio between periodontitis stage III grades C and B, periodontitis stages I and II grade A, and healthy control individuals. There was a statistically significant positive moderate correlation between smoking duration (years) and the sRANKL (pg/mL) concentration and a statistically significant negative moderate correlation between OPG (pg/mL) concentration and cigarettes smoked per day.

CONCLUSION: As a result, compared to the other research groups, smokers with periodontitis stage III grades C and B had greater GCF concentrations of sRANKL, lower OPG, and a higher sRANKL/OPG ratio. The difference in OPG (pg/mL) level was statistically significant. However, there was no statistically significant difference in sRANKL (pg/mL) or its relative ratio, sRANKL/OPG, across the groups.

CLINICAL SIGNIFICANCE: A characteristic that sets periodontitis apart is alveolar bone loss. Resorption is induced by RANKL and inhibited by OPG, resulting in a relative ratio. In light of this, the levels of RANKL and OPG may be helpful indicators for monitoring the activity of periodontal disease in both smokers and nonsmokers with and without periodontitis.

PMID:38152910 | DOI:10.5005/jp-journals-10024-3580

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Z-shaped Miniplates vs Conventional Miniplates for Fixation of Mandibular Parasymphyseal Fractures

J Contemp Dent Pract. 2023 Oct 1;24(10):761-770. doi: 10.5005/jp-journals-10024-3578.

ABSTRACT

AIM: The aim of this study was to evaluate a clinically and radiographically Z-shaped miniplate for the fixation of the parasymphyseal fractures.

PATIENTS AND METHODS: Twenty patients (10 patients in each group) who had parasymphseal mandibular fractures were randomly selected for this study. In this study, open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using two miniplates as group I, and open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using a newly designed Z-shaped miniplate as group II. Clinical and radiographic evaluations were made. Each patient was evaluated: (1) clinically evaluated preoperatively and postoperatively for operating time, ease of placement of the miniplate, and occlusion and (2) radiological: postoperative reduction of fracture was evaluated radiologically at 5-day, 1-month, 2-month, and 3-month intervals with orthopantomogram, and lingual splaying was evaluated by cone-beam computed tomography (CBCT) immediately postoperatively and at an interval of 3 months. The collected data were subjected to statistical analysis. Data analysis was performed by SPSS software, version 25 (SPSS Inc., PASW statistics for Windows version 25). Chicago: SPSS Inc.

RESULTS: There was a statistically significant difference (p < 0.001) between the mean intraoperative time. This indicates that group I had a longer time for fracture fixation than group II. Group I had a longer time elapsed for plate adaptation and definitive fixation than group II. Occlusion and reduction stability in both groups were similar. There was a statistically significant difference in postoperative lingual display control after 5 days and 3 months between the studied groups. This indicates that lingual display control in group II is better than in group I.

CONCLUSION: The Z-shaped miniplate is effective and provides three-dimensional stability for the fixation of parasymphyseal fractures, ease of use, easily adapted in cases of fractures near the mental nerve reduced operative time, and better control of lingual splaying than conventional miniplates.

CLINICAL SIGNIFICANCE: The newly designed Z-shaped miniplate is a valuable option for fixation parasymphysis fractures that need open reduction and internal fixation instead of using conventional miniplates, which are less successful in controlling lingual splaying.

PMID:38152909 | DOI:10.5005/jp-journals-10024-3578

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Nevin Manimala Statistics

Impact of Dental Institutions’ Values on Students’ Intent to Practice in Underserved Communities: A Cross-sectional Study

J Contemp Dent Pract. 2023 Oct 1;24(10):729-732. doi: 10.5005/jp-journals-10024-3585.

ABSTRACT

AIM: To evaluate how an institution’s values can impact students’ intent to practice in underserved areas.

MATERIALS AND METHODS: The values of 71 accredited dental schools in the United States were searched and tabulated. The American Dental Education Association (ADEA) survey results were used to tabulate the desire to serve the underserved population before entering dental school and upon graduation. Additionally, responses on the total amount of educational debt on graduation was compiled for LLUSD and all other dental schools. Fisher’s exact test was performed to compare the difference between the two cohorts and Wilcoxon test was used to assess difference within the groups. Tests were conducted at an alpha level of 0.05 with SAS v 9.1.3 (SAS Institute, Cary, NC, USA).

RESULTS: The top five values of US dental institutions based on frequency were excellence, diversity/inclusion, integrity, innovation, and respect. There was no statistically significant difference between LLUSD and all other dental schools in their desire to serve the underserved community upon graduation (p > 0.05, in all instances). Overall, there was a trend that upon graduation, the desire to serve the underserved had less impact on students’ decision-making on their career choices. This drop in the desire to serve the underserved was statistically significant within both cohorts in the year 2021 (p < 0.001).

CONCLUSIONS: Dental institutions should focus on better understanding of how their values impact their students’ career choices so that they can develop strategies to better align their values with the mission of addressing the dentist shortage in underserved areas.

CLINICAL SIGNIFICANCE: Dental institutions’ values play a major role in impacting students’ career choices upon graduation and should be assessed using metrics that are measurable.

PMID:38152903 | DOI:10.5005/jp-journals-10024-3585

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Mitochondrial DNA copy number and cancer risks: A comprehensive Mendelian randomization analysis

Int J Cancer. 2023 Dec 27. doi: 10.1002/ijc.34833. Online ahead of print.

ABSTRACT

Mitochondrial DNA plays a critical role in the pathophysiology of cancer. However, the associations between mitochondrial DNA copy number (mtDNA-CN) and cancer risk are controversial. Mendelian randomization (MR) analyses were performed using three independent instrumental variables (IVs) to explore potential associations between mtDNA-CN and 20 types of cancer. The three sets of IVs were primarily obtained from participants in the UK Biobank and the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium using different methods. The outcome data of cancers were investigated using summary statistics from the FinnGen cohort. The potential causal associations were evaluated using the MR-Egger regression, weighted median, inverse-variance weighted (IVW), and weighted mode methods. The robustness of IVW estimates was validated using leave-one-out sensitivity analysis. Additionally, a meta-analysis was conducted to pool results from three sets of IVs. The results revealed that genetically predicted mtDNA-CN was not associated with cancer risk (odds ratio = 1.02; 95% confidence interval: 0.95-1.10). Subgroup analyses indicated no causal association between mtDNA-CN and breast, lung, prostate, skin, colorectal, gastric, liver, cervical uteri, esophageal, thyroid, bladder, pancreas, kidney, corpus uteri, ovary, brain, larynx, and anus cancers. It was observed that mtDNA-CN was associated with lip, oral cavity, and testis cancers. However, these results should be interpreted with caution because a small number of patients with lip and oral cavity or testis cancers were included. The comprehensive MR analysis demonstrated that mtDNA-CN is not a suitable biomarker for tumor risk assessment.

PMID:38151753 | DOI:10.1002/ijc.34833

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Health disparities in hymenoptera venom allergy management

Allergy Asthma Proc. 2024 Jan 1;45(1):50-52. doi: 10.2500/aap.2024.45.230071.

ABSTRACT

Background: Hymenoptera venom anaphylaxis (HVA) is reported in up to 3% of stings and accounts for approximately 40 US deaths annually. HVA patients require immediate availability of epinephrine and Allergist referrals for consideration of venom immunotherapy. Data regarding epinephrine autoinjector prescriptions, Allergist referral rates, and potential racial disparities are limited. Objective: The primary objective was to determine if there were statistically significant differences in epinephrine autoinjector prescriptions and Allergist referrals between white and African American patients. The secondary objectives were to determine if there were statistically significant differences between adult and pediatric patients and to determine if there were significant differences between epinephrine prescriptions between patients with and without Allergist referrals. Method: This study is a retrospective, descriptive chart review analyzing patients seen between January 01, 2019 and December 31, 2021. Data were obtained utilizing the Epic Systems (Verona, WI) application Slicer Dicer. Individual chart review was performed for age, race, epinephrine autoinjector prescription, and Allergist referral. Results: 342 patients were identified as having HVA. White patients (60 out of 219; 27.4%) were more likely to get epinephrine autoinjector prescriptions than African American patients (17 out of 109; 15.6%) (p = 0.018). Adult patients (25 out of 314; 8.0%) were less likely than pediatric patients (8 out of 28; 28.6%) to have Allergist referrals (p = 0.004). Patients with Allergist referrals (25 out of 32; 78.1%) were more likely to be prescribed an epinephrine autoinjector than patient without Allergist referrals (54 out of 310; 17.4%) (p < 0.00001). Conclusion: Epinephrine autoinjector prescriptions and Allergist referrals are low overall in HVA. Racial disparities were identified with African American patients being significantly less likely to receive epinephrine autoinjector prescriptions. Additionally, adult patients, who may be at increased risk, were less likely to receive Allergist referrals.

PMID:38151734 | DOI:10.2500/aap.2024.45.230071