Drug-induced gingival hyperplasia and scaffolds: they may be valuable for horizontal food impaction

Population Distribution and Patients' Awareness of Food Impaction: A Cross-Sectional Study

BACKGROUND

Food impaction can contribute to a variety of oral health problems. However, the prevalence of food impaction in the population and patient awareness of these issues are poorly reported on.

METHODS

A questionnaire about food impaction was designed and uploaded to an online platform (Sojump) which was then circulated among the study participants using various social media platforms. Participants were asked to anonymously respond to the questionnaire regarding the prevalence of food impaction, its influence on their quality of life, their consultation rates and their oral cleaning methods. The survey was conducted through an online survey portal. Statistical analyses were performed using SPSS and GraphPad. The Chi-Square test, Bonferroni test and the Kruskal-Wallis H test were used to measure categorical variables from the survey.

RESULTS

The results showed that the prevalence of food impaction in non-dental professional participants was 86.9%. Among these patients, 12,157 pairs/cases of proximal contacts were affected. The number of food impaction cases in posterior teeth was significantly higher than in anterior teeth. Approximately 81.9% of patients believed that food impaction could affect their lives. However, the consultation rate for these patients was only 17.7%.

CONCLUSIONS

This study revealed that food impaction continued to have a high rate of incidence and a low rate of consultation, potentially due to a lack of awareness regarding its influence on oral health. To effectively prevent and address problems resulting from food impaction, both dentists and society need to enhance oral health knowledge in the population.

Occlusal contact characteristics of molar teeth with food impaction: Insights from a new digital technique

OBJECTIVES

The objective of this study was to analyze the occlusal contact characteristics of the food-impacted teeth using a new digital technique.

METHODS

A 3D occlusal analysis method was developed for studying the occlusal contact characteristics of teeth affected by food impaction. In this self-controlled study, food-impacted molars from 20 participants constituted the experimental group. The corresponding healthy teeth on the opposite side served as the control group. Variables such as occlusal force (OF), occlusal contact area (OCA), and the number and distribution of occlusal contact points (OCN) in the mesio-distal directions were measured and compared between the two groups.

RESULTS

There was no statistical significant difference in the values of OF, OCA and OCN between the food-impacted molars and the healthy control molars (P > 0.05). However, paired T-tests indicated significant difference in the proportion of mesial OF, OCA, and OCN in the second molars of the experimental group (0.22, 0.28 and 0.28, respectively) and the control group (0.66, 0.63, and 0.63 respectively) (P < 0.001).

CONCLUSIONS

The abnormal distribution of occlusal contacts in the second molar, primarily characterized by excessive occlusal contact in the distal direction may contribute to the occurrence of food impaction.

CLINICAL SIGNIFICANCE

The present study identified variations in the distribution of occlusal contacts and occlusal component force in food-impacted teeth. These findings can assist dentists in making more targeted occlusal adjustments, or applying other treatment modalities, to effectively address food impaction.

Radiographic evaluation of a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis

Background

To evaluate a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis.

Methods

Total 55 patients receiving cross-shaped incision were assigned into thick-gingiva group (29 cases) and thin-gingiva group (26 cases). Follow-up was performed at 3 and 12-month after final restoration.

Results

Mesial and distal papilla height was significantly greater in thick-gingiva group than thin-gingiva group at 3 and 12 months, while periodontal depth and crestal marginal bone level around implant had no significant difference between the two groups during follow-up. No case of recession of buccal marginal gingiva was observed in thick-gingiva group. However, the recession of marginal gingiva of buccal aspect of the crown was found in 5 patients (19.2%) with thin-gingiva.

Conclusions

The cross-shaped incision may be applied to reconstruct gingival papillae and avoid the gingival recession in patients with thick-gingiva phenotype.

Trial registration This study was registered at ClinicalTrials.gov (registration number NCT04706078, date 12 January 2021, Retrospectively registered).

Long-term stability of retreated defective restorations in patients with vertical food impaction

Background:

Vertical food impaction (VFI) is a common complaint among patients receiving interproximal restorations. However, there is a gap in the literature regarding outcomes of treating defective restorations with VFI. This study sought to determine 10-year stability of retreated defective restorations in patients diagnosed with VFI.

Materials and Methods:

A total of 150 teeth (75 pair), in 38 patients comprised our study population. All the participants had been diagnosed with VFI due to faulty restorations and treated by means of redoing the restoration to build a stable contact in at least one restored tooth. The criteria for building an optimum dental contact were defined. Demographic characteristics, date and frequency of redoing the restoration, type and material of restoration, number of restored surfaces, occlusal intercuspal relationship, missing adjacent and/or opposing teeth, cemento enamel junction to alveolar crest distance, recurrence of VFI symptoms, recurrent caries, and periapical pathology as well as periodontal variables were recorded.

Results:

Kaplan–Meier estimator revealed that the mean ± standard deviation of 1, 3, 5, and 10-year stability of reconstructed contacts was 89/2% ± 3/6%, 79/2% ± 5%, 70/7% ± 0/06%, and 66/3% ± 7/1%, respectively. The overall cumulative stability rate was 74/4%. Further analysis predicted that over a 12-year period, restored contacts were stable for 8.86 ± 0.6 years. Cox regression model indicated that having cusp to marginal ridge occlusal relationship (95% confidence interval [CI] for hazard risk (HR) = 1/1–13/9, HR = 3/93), and being over 40 years of age (95% CI for HR = 0/88–17/66, HR = 3/95) were major determinants of contact stability.

Conclusions:

Long-term stability of retreated and restructured tooth contacts with a history of VFI was 66%–89% in this specific sample.

Anti-vascular endothelial growth factor antibody monotherapy causes destructive advanced periodontitis in rice rats (Oryzomys palustris)

OBJECTIVE

Angiogenesis inhibitors (AgI) are commonly used in combination chemotherapy protocols to treat cancer, and have been linked to osteonecrosis of the jaw (ONJ). However, it is unknown if AgI therapy alone is sufficient to induce ONJ. We have previously established an ONJ model in rice rats with localized periodontitis that receive zoledronic acid (ZOL). The purpose of this study was to use this model to determine the role of anti-vascular endothelial growth factor A (anti-VEGF) antibody treatment of rice rats with localized maxillary periodontitis. We hypothesized that rice rats with localized maxillary periodontitis given anti-VEGF monotherapy will develop oral lesions that resemble ONJ, defined by exposed, necrotic alveolar bone.

METHODS

At age 4 weeks, 45 male rice rats were randomized into three groups (n = 15): 1) VEH (saline), 2) ZOL (80 μg/kg body weight, intravenously once monthly), and 3) anti-VEGF (5 mg B20-4.1.1/kg body weight, subcutaneously twice weekly). After 24 weeks, rats were euthanized, jaws were excised and a high-resolution photograph of each quadrant was taken to assign a severity grade based on gross appearance. Jaws were then fixed, scanned by MicroCT, decalcified and sectioned for histopathologic and immunohistochemical analyses.

RESULTS

40-80% of the rats in the three groups developed gross oral lesions. 50% of ZOL rats developed ONJ. In contrast, 80% of the anti-VEGF rats developed destructive advanced periodontitis that was characterized by extreme alveolar bone loss and fibrosis. Anti-VEGF rats never developed exposed, necrotic bone. Furthermore, only anti-VEGF rats developed mild to severe mandibular periodontitis. Compared to VEH rats, more T-cells were found in periodontal lesions of anti-VEGF rats and more cells of the monocyte lineage were found in ONJ lesions of ZOL rats.

CONCLUSIONS

Anti-VEGF monotherapy administered to a validated rodent model of ONJ caused a destructive advanced form of periodontitis that differed significantly from ONJ.

Zoledronate treatment duration is linked to bisphosphonate-related osteonecrosis of the jaw prevalence in rice rats with generalized periodontitis

OBJECTIVES

To determine the extent that zoledronate (ZOL) dose and duration is associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ) prevalence in rice rats with generalized periodontitis (PD), characterize structural and tissue-level features of BRONJ-like lesions in this model, and examine the specific anti-resorptive role of ZOL in BRONJ.

MATERIALS AND METHODS

Rice rats (n = 228) consumed high sucrose-casein diet to enhance generalized PD. Groups of rats received 0, 8, 20, 50 or 125 µg/kg IV ZOL/4 weeks encompassing osteoporosis and oncology ZOL doses. Rats from each dose group (n = 9-16) were necropsied after 12, 18, 24 and 30 weeks of treatment. BRONJ-like lesion prevalence and tissue-level features were assessed grossly, histopathologically and by MicroCT. ZOL bone turnover effects were assessed by femoral peripheral quantitative computed tomography, serum bone turnover marker ELISAs and osteoclast immunolabelling.

RESULTS

Prevalence of BRONJ-like lesions was significantly associated with (a) ZOL treatment duration, but plateaued at the lowest oncologic dose, and (b) there was a similar dose-related plateau in the systemic anti-resorptive effect of ZOL. ZOL and BRONJ-like lesions also altered the structural and tissue-level features of the jaw.

CONCLUSION

The relationship between BRONJ-like lesion prevalence and ZOL dose and duration varies depending on the co- or pre-existing oral risk factor. At clinically relevant doses of ZOL, BRONJ-like lesions are associated with anti-resorptive activity.

Zoledronic acid increases the prevalence of medication-related osteonecrosis of the jaw in a dose dependent manner in rice rats (Oryzomys palustris) with localized periodontitis

OBJECTIVE

Investigate role of dose/duration of zoledronic acid (ZOL), a powerful anti-resorptive (pAR), on prevalence of medication-related osteonecrosis of the jaw (MRONJ) in rice rats (Oryzomys palustris), a species with natural susceptibility to food impaction-induced localized periodontitis (FILP). We hypothesize that ZOL induces MRONJ lesions in rice rats with FILP, and that the prevalence of MRONJ rises with increasing dose and duration of ZOL treatment.

METHODS

We performed a toxicology experiment with clinically-relevant doses of ZOL in female rats (N=230) fed standard (STD) rodent chow. At age 4weeks (baseline), 12 rats were necropsied. The rest were randomized into five groups that began to receive 0, 8, 20, 50 or 125μg/kg ZOL IV/q 4weeks. After 12, 18, 24 and 30weeks, subgroups (N=9-16) from each of the dose groups were necropsied. High-resolution macroscopic photos of all jaw quadrants were given a gross quadrant grade (GQG) (0-4 or MRONJ) that classified FILP lesion severity and determined presence of gross MRONJ. Quadrants with GQG≥1 were examined histopathologically. Logistic regression analysis (ZOL dose/duration) of MRONJ prevalence was completed.

RESULTS

We found: 1) 75% of 0μg/kg ZOL rats developed FILP lesions; 2) baseline rats and rats treated with 0μg/kg ZOL had no MRONJ; 3) 29 gross MRONJ cases were identified; 4) all gross MRONJ cases were confirmed histopathologically by the observation of exposed necrotic bone, and 53 new cases were discovered (total=82); 5) ZOL dose (P<0.001), but not duration (P=0.326), was a significant predictor of MRONJ prevalence; 6) 13% prevalence of gross MRONJ among all rats, with 22% prevalence among rats exposed to ZOL oncologic doses (20-125μg/kg); 7) 38% prevalence of histopathologic MRONJ among all rats, with 73% prevalence among rats exposed to ZOL oncologic doses.

CONCLUSIONS

This is the first experiment to show a dose response relationship between clinically relevant doses of ZOL and MRONJ prevalence.