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   2019| January-June  | Volume 11 | Issue 1  
    Online since August 9, 2019

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The Use of Deep Convolutional Neural Networks in Biomedical Imaging: A Review
Yu-Cheng Chen, Derek Jin-Ki Hong, Chia-Wei Wu, Muralidhar Mupparapu
January-June 2019, 11(1):3-10
Introduction: This review sought to present fundamental principles of deep convolutional neural networks (DCNNs) and provides an overview of its applications in medicine and dentistry. Materials and Methods: Scientific databases including PubMed, Science Direct, Web of Science, JSTOR, and Google Scholar were used to search for relevant literature on DCNN and its applications in the medical and dental fields from 2010 to September 2018. Two independent reviewers rated the articles based on the exclusion and inclusion criteria, and the remaining articles were reviewed. Results: The comprehensive literature search yielded 110,750 citations. After applying the exclusion and inclusion criteria, 340 articles remained that pertained to the use of DCNN in medicine and dentistry. Further exclusion based on nonbiomedical applications yielded a total of 26 articles for review. Conclusion: Advances in the development of neural network systems have permeated into the medical and dental fields, particularly in imaging and diagnostic testing. Researchers are attempting to use deep learning as an aid to assess medical images in clinical applications and its optimization will provide powerful tools to the next generation. However, the authors caution that these tools serve as supplements to improve diagnosis and not replace the medical professional.
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Effect of Flap and Flapless Implant Surgical Techniques on Soft and Hard Tissue Profile in Single-Stage Dental Implants
Deepa Anumala, Modem Haritha, Sistla Sailaja, Egatela Prasuna, Gujjula Sravanthi, Nagireddy Ravindra Reddy
January-June 2019, 11(1):11-15
Introduction: Over the past 30 years, flap designs for implant surgery have been modified and atraumatic technique was introduced. It has several potential advantages, including reduction of complications at the patient level. The aim of the present study to compare the soft tissue profile and heights of crestal bone levels around the single-stage implants after single-piece implant placement with two different surgical techniques, that is, open flap procedure and flapless (FL) procedure. Materials and Methods: Thirty participants were randomly selected and categorized into two groups. Group 1 (flap technique) and Group 2 (flapless technique) consisted of 15 participants each. All of these participants underwent evaluation of soft tissue parameters of papillary index, probing pocket depth, sulcus bleeding index, and hard tissue evaluation such as crestal bone levels by radiovisiography at 0, 3, and 6 months. Results: All clinical parameters improved in FL technique when compared with the flap technique. Conclusion: The results concluded that the FL implant surgery results in lesser loss of interproximal bone and also results in better soft tissue changes when compared with the flap technique. However, controlled, further studies are needed to confirm this possibility.
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Intraoral Scanning and Digital Impression Techniques in Dentistry
Mel Mupparapu
January-June 2019, 11(1):1-2
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Common Knowledge About Temporomandibular Disorders and Associated Factors With Its Symptoms: Evidence From a Portuguese Population-Based Survey
Maria Paco, Daniela Simões, Paula Chaves, Vera Almeida, Jose Carlos Rocha, Lilliana Moreira, Jose Alberto Duarte, Teresa Pinho
January-June 2019, 11(1):16-26
Introduction: The purpose of this article was to develop and validate a scale to assess common knowledge about temporomandibular disorders (TMDs) in the general population, evaluate the status of TMDs knowledge in the Portuguese population, quantify the severity and prevalence of TMDs-related symptoms in the general population, and assess the association between TMDs-related symptoms’ severity and demographic, medical and oral associated factors. Materials and Methods: This study was an analytical cross-sectional survey design. The sample consisted of 2165 participants selected through a snowball sampling method. The participants completed an online questionnaire regarding social and demographic characteristics, medical history, oral habits, Fonseca’s Anamnestic Index, a scale about difficulties on impulsiveness control and also the TMDs knowledge scale developed. The psychometric properties of the scale developed was tested on a small number of participants (n = 210). The P value set was 0.05. Results: Concerning psychometric properties all items showed a moderate-to-strong positive association with the loading factor. The Cronbach’s alpha was 0.956, showing good reliability. TMDs knowledge was positive in 1295 participants (59.8%). Multivariate-adjusted odds showed that female gender, diagnosis of tension-type headache, migraine, anxiety, impulsiveness, facial trauma, and parafunctional habits increased the risk of developing TMDs (adjusted odds ratios from 1.84 to 49.38). Conclusion: The scale developed is psychometrically valid and reliable and the participants had an overall positive knowledge about TMDs. A high prevalence of TMDs-related symptoms among the Portuguese population was found and the associated factors were female gender, impulsiveness, tension-type headache, migraine, anxiety, facial trauma, and parafunctional habits.
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Evaluation of Eating Disorders Using “SCOFF Questionnaire” Among Young Female Cohorts and Its Dental Implications − An Exploratory Study
Nikita Rungta, Ramya Shenoy Kudpi
January-June 2019, 11(1):27-31
Introduction: Eating disorders can cause serious changes in eating habits that can lead to major, even life-threatening, health problems. This may cause devastating effects on teeth. Materials and Methods: The present study was conducted to assess eating disorders among 15 to 17-year-old female cohorts. The SCOFF [sick, control, one stone (1 stone is 6.3 kg), fat, and food] Questionnaire was distributed among the consented female cohorts. The study comprised five questions. The oral health examination was carried out using mouth mirror and WHO probe. The presence or absence of dental caries, dental erosion, gingivitis, as well as the body mass index was documented. The pamphlets regarding healthy dietary habits and ill effects of acidic foods were distributed to the participants after the oral health examination. Results: A total of 200 young female cohorts with mean age 15.85 ± 0.59 were screened. The prevalence of eating disorders according to the SCOFF Questionnaire was 10.5%. Those who had an eating disorder showed higher body mass index (19.21 ± 2.16) compared to those without it (17.51 ± 2.62). This showed statistical significance with P value equal to 0.005. However, there was no statistically significant difference in the dental caries experience among cohorts with disorders to without disorders. Conclusion: Although there was no difference in caries experience among cohorts with eating disorder to without disorder, it is the dentists’ duty to educate the person before they develop dental symptoms.
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Effect of Probiotics on Dental Caries and Periodontal Pathogens: An In Vitro Study
Subhajit Routh, Mithun Pai, Gururaghavendran Rajesh, Ramya Shenoy, Swapna Sarit
January-June 2019, 11(1):49-54
Introduction: Probiotics are microorganisms that are administered in live forms and can improve health and well being of human beings. Literature about their antimicrobial activity against oral pathogens is limited. The present study was conceptualized to ascertain the antimicrobial capabilities of common probiotics against microorganisms involved in dental caries and periodontal diseases. The aim of this article is to ascertain the action of probiotics on dental caries pathogen, Streptococcus mutans, and periodontal microbes that included Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Prevotella intermedia. Materials and Methods: The present study was an in vitro type of study. A. actinomycetemcomitans was cultivated in tryptic soy-serum-bacitracin-vancomycin-fluoride agar, Po. gingivalis in modified Wilkins–Chalgren medium, and Pr. intermedia in brain heart infusion agar. The samples were cultivated for 48 h in Brewer-like anaerobic jars. The first plate was impregnated with strains of the probiotic Lactobacillus acidophilus, the second plate with strain of the probiotic S. salivarius, and the third plate was kept as the control. Zones of inhibition were calculated by unaided eye employing a Vernier caliper to the nearest millimeter, including the diameter of the disk in the measurement. Results: Analysis of variance test exhibited significant findings at 24 and 48 h. Post hoc Tukey test revealed results that were statistically significant for all microorganisms but for A. actinomycetemcomitans and Pr. intermedia. Conclusion: The findings showed significant effect of probiotics on common microbes implicated in dental caries and periodontal diseases. The present study has crucial public health implications for the prevention and control of common oral diseases in populations.
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Candidate Genes for Suicide Risk in Head and Neck Squamous Cell Carcinoma Patients
Anusa Arunachalam Mohandoss, Rooban Thavarajah, Elizabeth Joshua, Umadevi Krishnamohan Rao, Kannan Ranganathan
January-June 2019, 11(1):37-48
Intoduction: Suicide is relatively more common among cancer patients as compared to general population. There are several identified candidate genes for suicide (CGS). There is a dearth of research examining the association of differential expression (DE) of CGS among the treatment-naïve head and neck squamous cell carcinoma (HNSCC) patients. The present study was undertaken to identify the DE of messenger Ribo Nucleic Acid (mRNA) of CGS in HNSCC tumor and correlate with clinical and other known genetic factors that promote oncogenesis as well as suicide. Material and Methods: Using previously described method, CGS lists were identified. The DE of the mRNA of the CGS were obtained from The Cancer Genome Atlas–HNSCC patients along with clinical details. The DE of mRNA pertaining to known factors such as inflammation, serotonergic, and dopaminergic functions as well as clinical parameters were studied for association with the risk of DE of CGS. Appropriate statistics were performed and P ≤ 0.05 was taken as significant. Results: A total of 520 HNSCC patients formed the study group. There were 46 (8.85%) patients who had DE of CGS. Expression of genes associated with inflammatory signaling pathway, ribosomal protein pathway, mechanistic Target of Rapamycin (mTOR), and metastasis, and invasion set of genes as well as the noradrenergic group of genes were associated significantly with DE of CGS. The association of DE of CGS and the major HNSCC clinical predictors of smoking, human papilloma virus status, clinical and cancer staging, histology grading, as well as patient status were not statistically significant. With a male predilection, gender exhibited statistically significant difference (P = 0.012). Discussion: In cancer patients, transcriptomes have been postulated to mediate suicide by targeted action on human brain. DE of putative genes associated with suicide have been demonstrated in HNSCC tumor. These DEs could predispose the patients to suicidal ideation/behavior in confluence with immediate psychosocial constructs. Addressing depression and suicidal thoughts in cancer patients would help to mitigate the risk of suicide.
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Oral Candidal Carriage Among Patients with Oral Squamous Cell Carcinoma: A Case-Control Study
Sankar Leena Sankari, Krishnan Mahalakshmi
January-June 2019, 11(1):55-58
Introduction: Etiology of oral squamous cell carcinoma is multifaceted. The established risk factors include tobacco, alcohol, and immunodeficiency states with infections gaining an importance. Candida species has been implicated in oral squamous cell carcinoma (OSCC). The present study aims at determining the prevalence of Candida species in the saliva of patients with OSCC and healthy cohorts. Materials and Methods: Unstimulated saliva was collected from patients with OSCC (n = 90) and age and sex matched healthy subjects (n = 170). The samples were inoculated onto sabouraud dextrose agar and incubated for a week. The isolates were enumerated using a colony counter. The isolates were identified using standard phenotypic methods. The significance of oral candidal carriage was calculated using chi-square test. Odds and risk ratio was calculated using pearson’s chi-square test. Result: Oral candidal carriage were present in 70% of patients with oscc, while healthy cohorts had a prevalence of 20%. The oral candidal carriage among OSCC patients in comparison to healthy cohorts was highly significant. (p = 0.0001). C. albicans and non-albicans Candida were equally distributed in the OSCC group. Colony-forming units were high among patients with oscc. Significant odds and risk ratio was observed for the prevalence of Candida species among OSCC (p <0.001). Conclusion: The present study shows significant association of oral candidal carriage with OSCC in comparison to healthy cohorts.
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Cone Beam Computed Tomography Detection of Extracranial Vertebral Artery (EVA) Calcification and Ectasia
Steven Richard Singer, Mel Mupparapu
January-June 2019, 11(1):65-70
Carotid artery calcification is frequently noted in panoramic dental radiographs but more evident on cone beam computed tomography (CBCT) examinations. Vertebral artery calcification and ectasia, although rare, can place the patient for equal risk for a cerebrovascular accident (stroke). The aim of this article is to radiographically identify calcified atheromatous plaque, as well as, atresia related to vertebral artery in large field of view CBCT examinations. This article presents two patients with radiographic diagnosis of vertebral artery disease. In case 1, the large field of view CBCT volume was obtained for evaluation of the temporomandibular joints. A curvilinear high-density structure was seen within the left transverse foramen of C3. Based on the density, location, and shape, a radiographic diagnosis of calcified atheromatous plaque was made. The patient was referred to her physician for management. In case 2, irregularly shaped, small, high-density structures were noted on the CBCT examination close to the left carotid bifurcation at the level of C3–C4. It was also noted that the left transverse foramen of C4 was enlarged. A diagnosis of calcified atheroma of left carotid was made in patient 1, and calcified atheromatous plaque in the left carotid bifurcation area and concomitant vertebral artery ectasia was made in patient 2. Both the patients were referred to their physicians for management. Although prevalence of carotid artery stenosis and calcification is noted more frequently in CBCT examinations, vertebral artery calcification or ectasia is rare but because of its potential risk for causation of stroke, identification is paramount.
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Comparative Evaluation of Laminin 1 Expression in Odontogenic Keratocyst, Dentigerous Cyst, and Ameloblastoma: An Immunohistochemical Study
Maya Ramesh, Vinod Thomas, Balakrishnan Sekar, Jissy George
January-June 2019, 11(1):59-64
Introduction: Odontogenic keratocysts, dentigerous cysts, and ameloblastoma are the most common forms of cystic pathology that affect the jaw bones. The purpose of this study was to assess the immunohistochemical expression of laminin 1 in these lesions and to study the probable role of laminin 1 in their biologic behavior. Materials and Methods: Serial sections of 4 µm were obtained from the archival blocks using standard microtome. One set of sections was used for immunohistochemical study. Presence of brown colored end product at the site of target antigen was considered as positive immunoreactivity. Results: Of the 10 ameloblastomas, 9 were positive. Among the 10 odontogenic keratocysts, 9 showed a positive immunoreactivity for laminin 1 and 1 case was negative. Among the 10 dentigerous cysts, all of them showed a positive immunoreactivity for laminin 1. A statistical analysis was carried out using chi-square test and the statistical significance was evaluated. Discussion: All the lesions that showed positive immunoreactions for laminin 1 had basement membrane immunolocalization. The laminin 1 in odontogenic keratocysts showed that it is not involved in the formation of daughter cysts and the separation of epithelium and surrounding connective tissue. Conclusion: Expression of laminin 1 in the stellate reticulum can be a sign of the aggressiveness of ameloblastoma. Laminin 1 expression in the lining epithelium of dentigerous cyst can be used to explain its potential to transform to ameloblastoma. It can be concluded that the nature and aggressiveness of odontogenic cysts and tumors can be explained using laminin 1.
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In Vitro Analysis of the Proliferation of HaCaT Cells Stimulated by Pigments Used for Maxillofacial Prostheses
Marcelo Coelho Goiato, Adhara Smith Nobrega, Estefania Marrega Malavazi, Aline Satie Takamiya, Sandra Helena Penha de Oliveira
January-June 2019, 11(1):32-36
Introduction: Although physical and mechanical properties are extremely important for the effectiveness of prosthetic treatment, materials used for facial rehabilitation should be biocompatible, as the maxillofacial prosthesis is in close contact with the patient’s skin. The objective of this study was to evaluate the influence of different eluates formation periods obtained from the methyl tetrazolium salt (MTT) and Alamar Blue assays, analyzed in different silicones and pigments used in the manufacture of maxillofacial prostheses in the proliferation of human keratinocytes (HaCaT cells). Materials and Methods: For the preparation of samples, A2 A-2186 and Silastic MDX4-4210 silicones and three types of pigments (bronze, black, and medium pink) were selected. Two of the pigments were specific for the characterization of the prosthesis and already available in dental market in bronze and black colors, and a new pigment was tested in the medium pink color. Five samples were prepared for each group and distributed according to the type of silicone and pigment added, aiming to prepare the eluates after 24 and 72 h of sample’s immersion in culture medium. In vitro assays of MTT and Alamar Blue were performed for cytotoxic analysis. Data obtained were submitted to analysis of variance and the Tukey test, with a 5% significance level. Results: All groups had cell proliferation percentages higher than 75%, indicating absence of cytotoxicity. Conclusions: It can be concluded that all the materials used are not cytotoxic, including the proposed new pigment, for the preparation of maxillofacial prostheses.
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