Future of Decellularized Dental Pulp Matrix in Regenerative Endodontics

With the advancements in tissue engineering, the repair and regeneration of oral/dental tissue are becoming possible and productive. Due to periodontal diseases, the tooth loses bone support resulting in tooth loss, but bone grafting stabilizes with new bone. It is seen that due to the progression of dental caries, pulp damage happens, and the vitality of the tooth is compromised. The current theme of dental pulp regeneration through biological and synthetic scaffolds, is becoming a potential therapy for pulp revitalization.

Salivary Exosomes: From Waste to Promising Periodontitis Treatment

Periodontitis is a chronic inflammatory condition that causes tooth loss by destroying the supporting components of the teeth. In most cases, it is difficult to diagnose early and results in severe phases of the disease. Given their endogenous origins, exosomes, which are rich in peptides, lipids, and nucleic acids, have emerged as a cell-free therapeutic approach with low immunogenicity and increased safety. Because the constituents of exosomes can be reprogrammed depending on disease states, exosomes are increasingly being evaluated to act as potential diagnostic biomarkers for dental disease, including periodontitis. Exosomes also have been demonstrated to be involved in inflammatory signal transmission and periodontitis progression in vitro, indicating that they could be used as therapeutic targets for periodontal regeneration. Nevertheless, a review on the involvement of salivary exosomes in periodontitis in impacting the successful diagnosis and treatment of periodontitis is still lacking in the literature. Thus, this review is intended to scrutinize recent advancements of salivary exosomes in periodontitis treatment. We summarize recent research reports on the emerging roles and characteristics of salivary exosomes, emphasizing the different expressions and changed biological roles of exosomes in periodontitis.

Tooth loss and associated self-rated health and psychological and subjective wellbeing among community-dwelling older adults: A cross-sectional study in India

Background Losing teeth has been considered as part of normal aging. However, in developing countries, tooth loss among older adults is shown to be more negatively associated with self-image and quality of life compared to their western counterparts. This study examines the association of tooth loss with self-rated health and psychological and subjective wellbeing among older adults in India. Methods Data were derived from the "Building Knowledge Base on Population Ageing in India" (BKPAI) survey which was carried out in 2011. The final sample size for the analysis was 9231 older adults. Descriptive statistics and bivariate analysis along with binary logistic regression analysis were conducted to fulfil the objective of the study. Results A proportion of 12.3% of older adults reported complete tooth loss. It was found that older adults who reported tooth loss were 2.38 times significantly more likely to have poor self-rated health (SRH) [2.38; CI: 1.99,2.83] than older adults who did not report tooth loss. The odds of low psychological health were high among older adults who suffered from tooth loss than their counterparts [OR: 1.59; CI: 1.33,1.91]. Older adults who reported tooth loss had 65% significantly higher odds of low subjective well-being than older adults who did not report tooth loss [OR: 1.65; CI: 1.38,1.97]. Conclusion Complete loss of teeth is associated with older individuals’ poor SRH as well as low psychological and subjective well-being, but such a consequence is avoidable by practising the efforts to maintain good oral health.

Cognitive deterioration in association with teeth loss in elderly population: A study from Eastern India

Background: With the global increase in cognitive impairment and dementia, the need to investigate into the possible ways that can be used to prevent or delay such occurrence has been growing. Maintenance of dental care and oral hygiene has been promoted as one such aspect. Aims and Objectives: To study the association between cognitive impairment in patients without registered diagnosis of dementia with tooth loss and chewing ability. Materials and Methods: It was a cross-sectional hospital-based study where consenting elderly persons attending Dental outpatient department over 1½ years were included. Data obtained on socio-demographic details, number of tooth loss, number of remaining teeth, subjective chewing ability, cognitive assessment as per mini-mental state examination (MMSE), and Clock Drawing Test were analyzed statistically to check correlational association. Results: In this study 96 eligible elderly persons of mean age of 68.30±6.28 years showed increased cognitive impairment among females (P=0.003), increased age (P=0.009), rural background (P=0.033) and low income groups (P=0.001). Positive correlation was found between chewing capacity (P=0.348), number of remaining teeth (r=0.418) with MMSE scores. Conclusion: Our study population showed positive correlation between impaired cognition and the number of extracted tooth and chewing capacity. With further study on wider and representative population, we hope to project the role of maintaining good oral hygiene and dental care as a possible preventive strategy among many others to combat the increased burden of cognitive impairment.

Prevalence of partial edentulism among the patients visiting a Tertiary Health Care Center in the Western Region, Nepal

Introduction: Tooth loss causes impairment, functional limitation, physical, psychological, and social disability. Hence, the study of pattern of tooth loss can provide a rough information about the frequency, cause and magnitude of oral problems, its sequelae that eventually can act as mirror image of prosthodontic treatment needs. Objectives: To assess the prevalence of partial edentulism and its etiology, to determine its association with sociodemographic parameters, and to find out the motivational factor/s for replacement in willing patients. Methods: Total 417 patients with partial edentulism were examined intraorally on the basis of Kennedy’s classification with Applegate’s modification. The descriptive analysis was done using frequency distribution. Pearson Chi-square analysis test was used to determine the association between demographic variables and type of tooth loss where p-value ≤0.05 was considered statistically significant. Results: Partial edentulism was more prevalent in mandibular arch (41.7%) followed by both arches (30.9%). Kennedy’s Class III was the commonest and Kennedy’s class III modification 1 was second most common type of partial edentulism. Age and educational status had statistically significant association while gender had no association with various classes of partial edentulism. Dental caries (62.8%) followed by periodontitis (25.9%) were the major causes of tooth loss. Functional demand (46.8%) was the key motivational factor for the replacement among those who were willing (78.4%). Conclusions: This study can help in assessing the epidemiological features of partial edentulism of one community in a more classified form and can help gather information necessary to assess the treatment needs.

Radiographical Measurements of Overeruption in Unopposed Posterior Teeth Among Selected Population of Saudi Arabia

The suspended replacement of extracted teeth may disrupt the structural integrity of the whole dental arch, particularly in posterior maxillary or mandibular tooth/teeth. This phenomenon often has consequences of masticatory deficiency and temporomandibular joint disorders. This work aims to assess and measure the overeruption of posterior teeth from panoramic radiographs (OPGs) and its relation to gender, age, tooth type, arch, sides, and cause of tooth loss. A total of 100 OPGs were included in this in vitro study. The level of posterior overeruption was measured in mm using the panoramic digital radiograph machine and its software systems. Other variables such as gender, tooth/teeth involved, arches, and side were considered. All parameter values were inputted to a software program and assessed. P value < 0.05 was considered as statistically significant. Males accounted for 63% of the OPGs. Age groups 18–30 and 31–45 years had the highest frequency and percentage (34%). Approximately 74% of the patients got their tooth/teeth extracted 4–6 years ago. The 0.7–1.2 mm overeruption subgroup had the highest proportion of 41%. The rate of overeruption in mandibular molars was 36%, which was the highest among the subgroups. Males had higher percentage than females in ≥60 and 31–45 age groups (84.65% and 76.5%, respectively), 4–6 years post-extraction time (85.7%), with significant differences, also, mandibular molars (85.0%) and mandibular arches (74.3%) were the higher among males. The highest level of overeruption was 0.7–1.2 mm, and mandibular molars were the most affected type. Significant differences between genders were detected in age groups, years after tooth loss, and arch side but not in cause of tooth loss, supra-erupted tooth type, and arch type parameters.

Effects of the Co-occurrence of Diabetes Mellitus and Tooth Loss on Cognitive Function

Objective: Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer’s disease and related dementia among older adults. This study assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their interactions. Methods: Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with 18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used to test the associations, overall and stratified by sex. Results: Compared with older adults without neither DM nor complete TL, those with both conditions (b = -1.35, 95% confidence interval [CI]: -1.68, -1.02), with complete TL alone (b = -0.67, 95% CI: -0.88, -0.45), or with DM alone (b = -0.40, 95% CI: -0.59, -0.22), had lower cognitive scores. The impact of having both conditions was significantly greater than that of having DM alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were similar in males and females, except having DM alone was not significant in males. Conclusion: The co-occurrence of DM and complete TL poses an additive risk for cognition. Healthcare and family-care providers should pay attention to the cognitive health of patients with both DM and complete TL. Continued efforts are needed to improve older adults’ access to dental care, especially for individuals with DM.

The Link between Periodontal Disease and Oral Cancer—A Certainty or a Never-Ending Dilemma?

Periodontal disease can have a substantial systemic influence on the body that extends beyond the oral cavity and can lead to local inflammation, bone damage, and tooth loss. A great number of studies suggest that periodontitis and oral cancer are linked, however it is unclear if specific periodontal bacteria promote the development of systemic illness. The mediators of the relationship between those two pathologies are still being discovered, but the research findings indicate the existence of a correlation. Additional research, including confounding factors, is needed to strengthen this link.

Relationship of tooth loss to mild cognitive impairment among middle-aged Mongolians: Mon-Timeline study

Cognitive impairment is common in elderly people, so it is considered an ageing disorder. However, cognitive decline, including dementia, can also occur in middle-aged people. Cognitive impairment is associated with multiple risk factors. We hypothesised that tooth loss might also be a potential risk factor among Mongolians, as oral health problems are one of the significant health issues in Mongolia, especially in middle-aged people. In this cross-sectional study, we used the baseline data from the Mon-Timeline cohort study, including people older than 40 years of age (n=279). The amount of tooth loss was assessed by a trained researcher. Mild cognitive impairment (MCI) was defined as those participants scoring a total of £ 24 points based on the Mini-Mental State Examination (MMSE). Unadjusted analysis showed that having more tooth loss (>10) increased the risk of MCI by an odds ratio of 3.03 (1.49-6.17), as compared with having less tooth loss (£10). Even after adjusting for covariates, the association remained significant, suggesting that tooth loss is associated with MCI risk, independent of age, education, and other socioeconomic factors. There was no significant interaction effect of age in the association between tooth loss and MMSE scores. In conclusion, tooth loss may play a role in developing cognitive decline, especially in the early onset of dementia. Further studies are needed to investigate whether early tooth loss at younger ages is associated with dementia, especially among middle-aged people.