Departmental Papers (Dental)

Penn Dental Medicine views scholarship as a central component of excellence in instruction and patient care and places a high priority on research. The School’s research enterprise spans scientific disciplines to translate new knowledge into clinical therapies that positively impact our understanding of oral disease and advance patient care.

 

 

 

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Now showing 1 - 10 of 723
  • Publication
    The Vaccine Efficacy Against the SARS-CoV-2 Omicron: A Systemic Review and Meta-Analysis
    (Zou, Huang, Jiang, Guo and Chen, 2022-07-12) Yuntao Zou, Doudou Huang, Qian Jiang,Yanglin Guo, Chider Chen
    Background: COVID-19 is a respiratory illness caused by SARS-CoV-2. The most recent variant is Omicron (line B.1.1.529), which was first identified in South Africa in November 2021. The concern with this variant is the ineffectiveness of vaccines currently available. We aim to systematically evaluate the effectiveness of the currently available COVID-19 vaccines and boosters for the Omicron variant. Methods: We searched the PubMed, Embase, the Cochrane Library and Web of Science databases from inception to June 5th, 2022. Studies that examined the effectiveness of SARS-CoV-2 vaccines against the Omicron variant infection were included. Random-effects model was used to estimate the pooled vaccine effectiveness against the Omicron variant. Results: A total of 13 studies were included to evaluate the effectiveness of the vaccine against the Omicron variant, and 11 studies were included to compare the effectiveness between the two-dose and three-dose (booster) vaccinations. Full vaccination (two-dose with or without booster) showed a protective effect against the Omicron variant compared to no vaccination (OR = 0.62, 95% CI: 0.56–0.69), while the effectiveness decreased significantly over 6 months after the last dose. The two-dose vaccination plus booster provided better protection against the Omicron variant compared to the two-dose vaccination without booster (OR = 0.60, 95% CI: 0.52–0.68). Additional analysis was performed for the most commonly used vaccines in the United Staes: BNT162b2(Pfizer) (OR = 0.65, 95% CI: 0.52–0.82) and mRNA-1273(Moderna) (OR = 0.67, 95% CI: 0.58–0.88) vaccines in the US, which showed similar effectiveness compared to no vaccination. Conclusions: The full dose of SARS-CoV-2 vaccination effectively reduces infection from the SARS-CoV-2 Omicron variant; however, the effectiveness wanes over time. The booster vaccine provides additional protection against the Omicron variant.
  • Publication
    The value of mentorship
    (The Author, 2022-08) Faizan Alawi DDS
    In a recent lecture focused on evidence-based disparities in health equity, the speaker stated that “race is not biological.” This statement resonated with me for a variety of reasons, but mostly because this was the first time I had heard this stated. I subsequently learned through various readings, including in prestigious scientific journals such as Science, about increasing concerns that race has been historically used, perhaps inappropriately, to explain biological differences in a variety of health care settings, including treatment outcomes. During this same lecture, several senior faculty members in the audience asked the speaker questions about how to accommodate for racial disparities in outcomes-related research. The speaker was a junior member of the same institution, and acknowledged the mentorship of many in the audience, including some of the faculty who asked questions. While the speaker's responses were insightful and thought-provoking, the entire question-and-answer period also resonated with me, but for a different reason. It reinforced my long-standing belief that mentorship should not be driven simply by the pairing of a senior individual with a junior individual, with a unidirectional flow of insight. In contrast, a mutually rewarding mentoring relationship can also evolve through the sharing of diverse experiences and context-specific advice without regard for professional rank or years of experience.
  • Publication
    The Mouth is the Mirror to the Body:
    (Delaware Academy of Medicine / Delaware Public Health Association (Academy/DPHA), 2023-04-22) Roopali Kulkarni
    Teeth do not just float about like objects in space. They are in fact attached to a person: a person with a unique background, experiences, and story. Although a clear division between dentistry and medicine has been created, the social determinants of health argue otherwise. Oral health and systemic health are intertwined, and all the various parts that make us who we are contribute to our health. Let’s discuss this, keeping in mind two of the most important dental instruments: the mirror and the explorer, with a reflection of our past and an excitement to venture into the future. The mouth is the mirror to the body and can reveal signs of underlying health issues. Thus, a team-based approach to care is needed to optimize patient health as we move into the next era.
  • Publication
    The complex genome and adaptive evolution of polyploid Chinese pepper (Zanthoxylum armatum and Zanthoxylum bungeanum
    (The authors, 2022-09) Lisong Hu, Zhongping Xu, Rui Fan, Guanying Wang, Fuqiu Wang, Xiaowei Qin, Lin Yan, Xunzhi Ji, Minghui Meng, Soonliang Sim, Wei Chen, Chaoyun Hao, Qinghuang Wang, Huaguo Zhu, Shu Zhu, Pan Xu, Hui Zhao, Keith Lindsey, Henry Daniell, Jonathan F. Wendel, Shuangxia Jin
    Zanthoxylum armatum and Zanthoxylum bungeanum, known as ‘Chinese pepper’, are distinguished by their extraordinary complex genomes, phenotypic innovation of adaptive evolution and species-special metabolites. Here, we report reference-grade genomes of Z. armatum and Z. bungeanum. Using high coverage sequence data and comprehensive assembly strategies, we derived 66 pseudochromosomes comprising 33 homologous phased groups of two subgenomes, including autotetraploid Z. armatum. The genomic rearrangements and two whole-genome duplications created large (~4.5 Gb) complex genomes with a high ratio of repetitive sequences (>82%) and high chromosome number (2n = 4x = 132). Further analysis of the high-quality genomes shed lights on the genomic basis of involutional reproduction, allomones biosynthesis and adaptive evolution in Chinese pepper, revealing a high consistent relationship between genomic evolution, environmental factors and phenotypic innovation. Our study provides genomic resources and new insights for investigating diversification and phenotypic innovation in Chinese pepper, with broader implications for the protection of plants under severe environmental changes.
  • Publication
    Tooth Failure Post-Radiotherapy in Head and Neck Cancer: Primary Report of the Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad) Study
    (Elsevier BV, 2022) Brennan, Michael T; Treister, Nathaniel S; Sollecito, Thomas P; Schmidt, Brian L; Patton, Lauren L; Lin, Alexander; Elting, Linda S; Hodges, James S; Lalla, Rajesh V
    Purpose: To elucidate long-term sequelae of radiation therapy (RT) in head and neck cancer (HNC) patients, a multicenter, prospective study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), was established with tooth failure as its primary outcome. We report tooth failure and associated risk factors. Methods and materials: Demographics and cancer and dental disease characteristics were documented in 572 HNC patients at baseline and 6, 12, 18, and 24 months after RT. Eligible patients were aged 18 or older, diagnosed with HNC, and receiving RT to treat HNC. Tooth failure during follow-up was defined as losing a tooth or having a tooth deemed hopeless. Analyses of time to first tooth-failure event and number of teeth that failed used Kaplan-Meier estimators, Cox regression, and generalized linear models. Results: At 2 years, the estimated fraction of tooth failure was 17.8% (95% confidence interval, 14.3%-21.3%). The number of teeth that failed was higher for those with fewer teeth at baseline (P < .0001), greater reduction in salivary flow rate (P = .013), and noncompliance with daily oral hygiene (P = .03). Patients with dental caries at baseline had a higher risk of tooth failure with decreased salivary flow. Patients who were oral-hygiene noncompliant at baseline but compliant at all follow-up visits had the fewest teeth that failed; greatest tooth failure occurred in participants who were noncompliant at baseline and follow-up. Conclusions: Despite pre-RT dental management, substantial tooth failure occurs within 2 years after RT for HNC. Identified factors may help to predict or reduce risk of post-RT tooth failure.
  • Publication
    Nanozyme-Based Robotics Approach for Targeting Fungal Infection
    (The Authors, 2023-07-08) Min Jun Oh; Seokyoung Yoon; Alaa Babeer; Yuan Liu; Zhi Ren; Zhenting Xiang; Yilan Miao; David P Cormode; Chider Chen; Edward Steager; Hyun Koo
    Fungal pathogens have been designated by the World Health Organization as microbial threats of the highest priority for global health. It remains a major challenge to improve antifungal efficacy at the site of infection while avoiding off-target effects, fungal spreading, and drug tolerance. Here, a nanozyme-based microrobotic platform is developed that directs localized catalysis to the infection site with microscale precision to achieve targeted and rapid fungal killing. Using electromagnetic field frequency modulation and fine-scale spatiotemporal control, structured iron oxide nanozyme assemblies are formed that display tunable dynamic shape transformation and catalysis activation. The catalytic activity varies depending on the motion, velocity, and shape providing controllable reactive oxygen species (ROS) generation. Unexpectedly, nanozyme assemblies bind avidly to fungal (Candida albicans) surfaces to enable concentrated accumulation and targeted ROS-mediated killing in situ. By exploiting these tunable properties and selective binding to fungi, localized antifungal activity is achieved using in vivo-like cell spheroid and animal tissue infection models. Structured nanozyme assemblies are directed to Candida-infected sites using programmable algorithms to perform precisely guided spatial targeting and on-site catalysis resulting in fungal eradication within 10 min. This nanozyme-based microrobotics approach provides a uniquely effective and targeted therapeutic modality for pathogen elimination at the infection site.
  • Publication
    The Influence of Mental Health Diagnoses on Patient Experiences and Outcomes in Patients Undergoing WALANT Hand Surgery
    (The Authors, 2024-02-02) Brian Ford MD; Dillon Neumann BS; Matthew Pina MD; Rafael Olivieri-Ortiz BS; Joel Ferreira MD; Anthony Parrino MD
    Purpose: The purpose of this study was to gauge whether patients with preexisting mental health conditions have desirable outcomes when undergoing wide-awake local anesthesia with no tourniquet (WALANT) hand surgery. Methods: A retrospective review of 133 patients who underwent WALANT surgery by 2 senior authors from August 2019 to October 2020 was performed. Patients were administered a 10-question post operative survey detailing perioperative pain, experience, and satisfaction concerning their procedure. Analysis was performed for patient responses to the questionnaire, demographics, comorbidities, and patient-reported outcomes using the Single Assessment Numeric Evaluation (SANE). Results: There were 61 patients identified as having a preexisting psychiatric diagnosis compared to 70 patients without who underwent WALANT surgery. Comparing psychiatric diagnosis and nonpsychiatric diagnosis cohorts, there was no significant difference in preoperative anxiety (3.75 vs 3.30), pain during procedure (0.67 vs 0.56), or pain after surgery (4.89 vs 4.26). There was a significantly higher pain score with preoperative injection in the psychiatric diagnosis cohort (4.07 vs 2.93). When asked if they would have a WALANT procedure again, 95.1% of patients in the psychiatric diagnosis cohort and 98.6% of patients in the nonpsychiatric diagnosis group said they would. There was no significant difference in average preoperative SANE scores (59.67 [no psych diagnosis] vs 61.70 [psych diagnosis]) or post operative SANE scores (82.82 [no psych diagnosis] vs 81.06 [psych diagnosis]) between the two cohorts. Conclusions: WALANT surgery was nearly as well tolerated in patients with a preexisting mental health diagnosis when compared to those without a preexisting diagnosis. Clinical Relevance: Surgeons who are currently or potentially performing WALANT surgery should not rule out patients as eligible candidates because of a prior diagnosis of a mental health condition.
  • Publication
    Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement A randomized clinical trial on patient-reported outcome measures
    (The Authors, 2023-11-28) João Gaspar; João Botelho; Luís Proença; Vanessa Machado; Leandro Chambrone; Rodrigo Neiva; José João Mendes
    Objectives To compare patient-reported outcome measures and additional surgical outcomes after sinus floor elevation (SFE) with osseodensification (OD) versus lateral window (LW), both with simultaneous implant placement. Materials and Methods Twenty participants requiring single-implant rehabilitation with residual bone height (RBH) ≤4 mm were enrolled. Pain experience, quality of life (QoL) via the Oral Health Impact Profile-14 (OHIP-14), analgesics intake, and other symptoms were self-reported for a week on a daily basis. Surgery duration, complications, and implant stability quotient at baseline (ISQ T0) and after 6 months (ISQ T6) were registered. Participants were followed up for 1 year. Results From Day 0 (day of surgery) to Day 3, pain experience was significantly lower (p < 0.05) in the OD group. OHIP-14 score was significantly lower (p < 0.05) in the OD group on all postoperative days, except on Day 5. Average analgesics intake was significantly lower (p < 0.001) in the OD group. Surgery mean duration was significantly higher (p < 0.001) in LW compared to OD (71.1 ± 10.4 vs. 32.9 ± 5.3 min). After osseointegration period, all implants were successfully restored with screw-retained crowns. Conclusions Within the limitations of this study, it can be concluded that OD and LW techniques were similarly effective in SFE with simultaneous implant placement when RBH ≤ 4 mm. However, OD significantly outperformed LW in pain experience, impact on self-perceived QoL, surgery duration, postoperative edema, and analgesics intake.
  • Publication
    “Regulation of Metabolism and Inflammation: Links with Oral and Systemic Health”: Part I Host-Microbial Interactions
    (John Wiley and Sons Inc, 2024-04) Zhang, Ping; Sahingur, Sinem Esra; Culshaw, Shauna
    The oral cavity has one of the most complex microbial communities in the human body, harboring over 1000 species of microorganisms (Lamont et al., 2018). This microbial ecosystem interacts dynamically and bidirectionally with the host, influencing various physiological processes. Under normal conditions, the oral microbiome and host are in a state of equilibrium. However, disruptions in this equilibrium can lead to dysbiosis, triggering inflammatory responses. Dysregulated and unresolved inflammatory responses can progress to chronic inflammation, as seen in periodontitis. Emerging research suggests that there is a strong association between periodontitis and systemic diseases (Hajishengallis, 2022; Hajishengallis & Chavakis, 2021). It is believed that in periodontitis, systemic dissemination of inflammatory mediators and oral bacteria into the bloodstream can potentially contribute to the initiation and aggravation of systemic conditions such as cancer, cardiovascular diseases, diabetes, rheumatoid arthritis, and Alzheimer's disease, via trained immunity.
  • Publication
    Effect of Immediate Dentin Sealing on the Bonding Performance of Indirect Restorations A Systematic Review
    (MDPI AG, 2024-03) Fusun Ozer; Zeynep Batu Eken; Jessica Hao; Nuray Tuloglu; Markus B. Blatz
    The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.