Cheiloscopy in sex estimation: a systematic review

This study aimed to conduct a systematic review to gather evidence to clarify if cheiloscopy can be used in sex estimation and identify the reasons behind the lack of consensus in the scientific community. The systematic review was performed following the PRISMA guidelines. A bibliographic survey was conducted in PubMed, Scopus, and Web of Science databases, restricted to articles published between 2010 and 2020. Studies were selected according to eligibility criteria, and then the study data were collected. The risk of bias in each study was assessed and applied as additional inclusion or exclusion criteria. The results of the articles eligible for analysis were synthesized using a descriptive approach. In the 41 included studies, several methodological flaws and variations between studies that contribute to the discrepancy in results were identified. The data gathered allowed us to conclude that there is no strong scientific evidence to support the use of cheiloscopy in sex estimation, as there is no specific pattern for each sex, which reduces the criminalistic interest of cheiloscopy in estimating this parameter.

Are lip prints hereditary? A systematic review

Hereditary lip prints have been studied by several researchers. However, the literature shows no consensus among the scientific community regarding this topic. Therefore, the aim of this study was to conduct a systematic review to gather evidence to clarify whether the surface structure of lip prints is hereditary and, consequently, if a familial relationship between individuals can be established through the analysis of lip prints. The systematic review was performed following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. A bibliographic survey was conducted in PubMed, Scopus, and Web of Science databases, restricted to articles published between 2010 and 2020. Studies were selected according to eligibility criteria, and then the study data were collected. The risk of bias of each study was assessed and applied as additional inclusion or exclusion criteria. The results of the articles eligible for analysis were synthesized by a descriptive approach. In the seven included studies, methodological variations, including the definition of similarity, that contribute to the heterogeneity of results were identified. The data gathered allowed to conclude that there is no strong scientific evidence to support the hypothesis of the existence of heredity in the surface structure of lip prints, since it was not proven that similarities between parents and children occur systematically in all families.

Characterization of Oral Enterobacteriaceae Prevalence and Resistance Profile in Chronic Kidney Disease Patients Undergoing Peritoneal Dialysis

Chronic Kidney Disease (CKD) is a growing public-health concern worldwide. Patients exhibit compromised immunity and are more prone to infection than other populations. Therefore, oral colonization by clinically relevant members of the Enterobacteriaceae family, major agents of both nosocomial and dialysis-associated infections with frequent prevalence of antibiotic resistances, may constitute a serious risk. Thus, this study aimed to assess the occurrence of clinically relevant enterobacteria and their antibiotic resistance profiles in the oral cavity of CKD patients undergoing peritoneal dialysis (CKD-PD) and compare it to healthy controls. Saliva samples from all the participants were cultured on MacConkey Agar and evaluated regarding the levels of urea, ammonia, and pH. Bacterial isolates were identified and characterized for antibiotic resistance phenotype and genotype. The results showed that CKD-PD patients exhibited significantly higher salivary pH, urea, and ammonia levels than controls, that was accompanied by higher prevalence and diversity of oral enterobacteria. Out of all the species isolated, only the prevalence of Raoultella ornithinolytica varied significantly between groups, colonizing the oral cavity of approximately 30% of CKD-PD patients while absent from controls. Antibiotic resistance phenotyping revealed mostly putative intrinsic resistance phenotypes (to amoxicillin, ticarcillin, and cephalothin), and resistance to sulfamethoxazole (~43% of isolates) and streptomycin (~17%). However, all isolates were resistant to at least one of the antibiotics tested and multidrug resistance isolates were only found in CKD-PD group (31,6%). Mobile genetic elements and resistance genes were detected in isolates of the species Raoultella ornithinolytica, Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, and Enterobacter asburiae, mostly originated from CKD-PD patients. PD-related infection history revealed that Enterobacteriaceae were responsible for ~8% of peritonitis and ~ 16% of exit-site infections episodes in CKD-PD patients, although no association was found to oral enterobacteria colonization at the time of sampling. The results suggest that the CKD-induced alterations of the oral milieu might promote a dysbiosis of the commensal oral microbiome, namely the proliferation of clinically relevant Enterobacteriaceae potentially harboring acquired antibiotic resistance genes. This study highlights the importance of the oral cavity as a reservoir for pathobionts and antibiotic resistances in CKD patients undergoing peritoneal dialysis.

Odontometric parameters in human mandibular molars for sex estimation in a forensic context

When encountering human skeletal remains in forensic contexts, one important step in the identification process is the estimation of sex, because it reduces the number of individuals to approximately one half. The pelvis and skull are considered the most efficient elements for this estimation; however, when unavailable, teeth may be used alternatively. This study aims to evaluate the usefulness of specific odontometric parameters from the mandibular first molar – mesiolingual-distobuccal distance (MLDB) and mesiobuccal-distolingual distance (MBDL)  - on sex estimation, in a sample composed from 135 mandibles selected from the Coimbra Identified Skeletal Collection (University of Coimbra). Since canines seem to be the most accurate teeth for sexual diagnosis, comparison of molars parameters and canines was performed, through measurement of their mesiodistal dimensions (MD). Statistical analysis showed sexual dimorphism in human first molars and determination of cut-off points assigned individuals to the male or female group. In the first molar, 60.7% and 65.2% of individuals were correctly classified by using MLDB and MBDL, respectively. Highest sexual diagnosis accuracy was achieved with Canine MD, reaching 74.6%. Our results indicate that although mandibular molar dimensions are useful for sex estimation, the canine should be prioritized when using the dentition to perform this task.

Immediate one-piece zirconia implants with/without xenograft in the buccal gap: A 6-month pre-clinical study

OBJECTIVE

To histologically evaluate healing following grafting a xenogenous bone substitute in the buccal gap around the immediately placed one-piece zirconia implant.

MATERIALS AND METHODS

The third and fourth premolars (PM3 and PM4) in both quadrants of the mandible of nine Mongrel Hound dogs were used for this experiment. They have been removed, and the recipient sites were prepared. The implants were placed in a lingual position in the socket. In one side of the jaw, the gap between the implant and the socket walls was grafted (test) while no grafting was performed in the contralateral side (control), randomly selected. After 6 months of healing, biopsies were obtained and prepared for histological analysis. Vertical and horizontal measures were recorded in buccal and lingual surface.

RESULTS

The hard tissue was in a coronal position on the test side compared with the control side. The bone thickness around ZLA (zirconia large-grit sandblasted and acid-etched surface) level was larger on the test side. On the test side, the first bone-implant contact and bone crest, at the buccal aspect, were more coronal to ZLA in PM4 while in PM3 the same happened with the bone crest. The width of the buccal bone wall was larger in PM4 than in PM3 at the ZLA level and 1 mm apical to ZLA.

CONCLUSION

The placement of a xenograft in the gap between 1-piece zirconia implant and the buccal wall in dogs modified the process of hard tissue healing, providing additional amount of hard tissue.

Students' self-confidence and perceived quality of prosthodontics education: A study in the Faculty of Dental Medicine of the University of Porto

INTRODUCTION

Oral rehabilitation with removable dentures (RDs) is still a viable choice for the edentulous population. Fostering students' confidence in prosthodontic procedures should be a major concern in dental schools. This study has three purposes: (a) to measure the self-reported confidence levels of undergraduate dental students when performing removable prosthodontic treatments; (b) to evaluate the students' perceived quality of removable prosthodontics education; and (c) to assess the students' suggestions to improve removable prosthodontics education.

MATERIALS AND METHODS

An anonymous questionnaire was delivered to third-, fourth- and fifth-year students of the Faculty of Dental Medicine of the University of Porto (FMDUP) (n = 176). Data from quantitative questions were statistically analysed with IBM SPSS Statistics for Windows (V.24.0), whilst qualitative data were clustered into topics and analysed in Excel.

RESULTS

With a 100% response rate, most students felt "confident" and "very confident" in RD clinical procedures. Overall, the 5th-year students had higher confidence than 4th-year ones, except when surveying diagnostic casts. Our findings also revealed that students considered the removable prosthodontics education "Good" and "Very good," and their main suggestions were related to increasing the time allocated to clinical practice.

CONCLUSIONS

Students' confidence in carrying out removable prosthodontic procedures grew as they progressed through the course. Overall, the students' evaluation of the quality of prosthodontics education was positive, and their main suggestion to improve their confidence levels was increasing the clinical experience.

Pregnancy as a Period of Enhanced Risk for Non-Cavitated Caries Lesions

PURPOSE

To investigate if pregnancy represents a period of increased risk of non-cavitated dental caries related to changes in saliva and oral health behaviours.

MATERIALS AND METHODS

A non-randomised longitudinal study was performed with 27 pregnant women and 25 non-pregnant women, who were evaluated twice with the same time gap (24 weeks on average). At the first visit sociodemographic and oral health-related behaviours were assessed through a structured questionnaire. At the second visit changes related to eating sweet snacks and oral hygiene habits were also assessed. In both visits the surface-related caries status was evaluated according to ICDAS II criteria. Calculation of D0 (Sound), D1-2 (visual changes) and D3-4 (precavitated caries lesions) Index was based on data collected from clinical examination. Saliva pH and saliva flow rate were also assessed.

RESULTS

Throughout pregnancy, a statistically significant increase of eating sweet snacks between main meals was reported, with no effective adaptation of oral hygiene habits. In comparison to the non-pregnant group, pregnant women presented a lower saliva pH at both the first and second visit, p < 0.0005. During the follow-up period, a decrease in the frequency of caries-free surfaces was observed in the pregnant women (p = 0.004) and an increase in precavitated caries lesions (p = 0.011).

CONCLUSION

The main results support the hypothesis that during pregnancy women are prone to enamel demineralisation, namely, to exhibiting additional lesions characterised by precavitated caries lesions.

Orofacial manifestations in outpatients with anorexia nervosa and bulimia nervosa focusing on the vomiting behavior

OBJECTIVE

This case-control study aims to evaluate the oral health status and orofacial problems in a group of outpatients with eating disorders (ED)-either anorexia nervosa (AN) or bulimia nervosa (BN)-further focusing on the influence of vomit.

MATERIALS AND METHODS

Fifty-five women outpatients with AN or BN diagnosis were invited to participate, of which 33 agreed. ED outpatients and matched controls were submitted to a questionnaire and clinical oral examination.

RESULTS

Multivariate analysis identified a significantly higher incidence of teeth-related complications (i.e., tooth decay, dental erosion, and self-reported dentin hypersensitivity), periodontal disease, salivary alterations (i.e., hyposalivation and xerostomia), and oral mucosa-related complications in ED outpatients. Dental erosion, self-reported dentin hypersensitivity, hyposalivation, xerostomia, and angular cheilitis were found to be highly correlated with the vomiting behavior.

CONCLUSIONS

ED outpatients were found to present a higher incidence of oral-related complications and an inferior oral health status, compared to gender- and age-matched controls. Alterations verified within outpatients were acknowledged to be quite similar to those previously reported within inpatients, in both of nature and severity, thus sustaining that the cranio-maxillofacial region is significantly affected by ED, even in the early/milder forms of the condition, as expectedly verified within outpatients.

Oral yeast colonization throughout pregnancy

Background

Recent studies suggest that placenta may harbour a unique microbiome that may have origin in maternal oral microbiome. Although the major physiological and hormonal adjustments observed in pregnant women lead to biochemical and microbiological modifications of the oral environment, very few studies evaluated the changes suffered by the oral microbiota throughout pregnancy. So, the aim of our study was to evaluate oral yeast colonization throughout pregnancy and to compare it with non-pregnant women.

Material and Methods

The oral yeast colonization was assessed in saliva of 30 pregnant and non-pregnant women longitudinally over a 6-months period. Demographic information was collected, a non-invasive intra-oral examination was performed and saliva flow and pH were determined.

Results

Pregnant and non-pregnant groups were similar regarding age and level of education. Saliva flow rate did not differ, but saliva pH was lower in pregnant than in non-pregnant women. Oral yeast prevalence was higher in pregnant than in non-pregnant women, either in the first or in the third trimester, but did not attain statistical significance. In individuals colonized with yeast, the total yeast quantification (Log10CFU/mL) increase from the 1st to the 3rd trimester in pregnant women, but not in non-pregnant women.

Conclusions

Pregnancy may favour oral yeast growth that may be associated with an acidic oral environment.

Key words:Oral yeast, fungi, pregnancy, saliva pH.

A new approach to sex estimation using the mandibular canine index

Rao et al.'s mandibular canine index (MCI) is a simple odontometric method which uses the mandibular canine as the key to sex estimation. This index is defined as the ratio between the right canine mesiodistal dimension and the mandibular canine arch width. The aim of this study was to contribute to sex estimation using dental techniques by analysing the MCI efficiency, and to propose a new approach for its use. Measurements were taken from 120 plaster casts (70 females) in the 16-30 year age group. Although statistically significant sexual dimorphism was observed in both the mesiodistal dimension and the mandibular canine arch width, the MCI showed a low accuracy in sex classification (54.2% correct identifications). This accuracy was improved to 64.2% using receiver operating characteristics curve analysis. Yet, despite the better accuracy, these results reinforce the idea that the MCI may not be particularly useful in sex prediction, since it may not reflect the same degree of sexual dimorphism as its absolute measures.