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Purpose To assess the usefulness of the novel CARWL index in predicting radiation-induced tooth loss (RITL) rates in locally advanced nasopharyngeal cancer (LA-NPC) patients undergoing concurrent chemoradiotherapy (C-CRT). Methods The study retrospectively examined data from 323 LA-NPC patients. The patients were divided into two groups based on cutoff values for CAR and weight loss (WL). The ideal cutoff for RITL was 3.0 g/dL [AUC: 83.0%, sensitivity: 83.6%, specificity: 81.4%, J-index: 0.650]. CARWL index was created by combining pretreatment CAR and WL status (WL ≤ 5.0% vs > 5.0%, resulting in four groups: Group 1: CAR < 3.0 and WL ≤ 5.0%, Group 2: CAR < 3.0 and WL > 5.0%, Group 3: CAR ≥ 3.0 and WL ≤ 5.0%, and Group 4: CAR > 3.0 and WL > 5.0%. Results RITL was diagnosed in 67.2% of patients. Since the RITL rates of Groups 2 and 3 were statistically indistinguishable, we combined them and created the three-tiered CARWL score groups: CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. Comparative analysis revealed that the RITL rates gradually and significantly increased from CARWL-0 to CARWL-2 score groups (49.4% vs 64.7% vs 83.0%; P <0.001) despite similar baseline disease and patient characteristics. Results of the multivariate analysis showed that higher CARWL score groups were independent and significant predictors of increased RITL rates (p < 0.001). Conclusion Present results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.
Purpose To assess the usefulness of the novel CARWL index in predicting radiation-induced tooth loss (RITL) rates in locally advanced nasopharyngeal cancer (LA-NPC) patients undergoing concurrent chemoradiotherapy (C-CRT). Methods The study retrospectively examined data from 323 LA-NPC patients. The patients were divided into two groups based on cutoff values for CAR and weight loss (WL). The ideal cutoff for RITL was 3.0 g/dL [AUC: 83.0%, sensitivity: 83.6%, specificity: 81.4%, J-index: 0.650]. CARWL index was created by combining pretreatment CAR and WL status (WL ≤ 5.0% vs > 5.0%, resulting in four groups: Group 1: CAR < 3.0 and WL ≤ 5.0%, Group 2: CAR < 3.0 and WL > 5.0%, Group 3: CAR ≥ 3.0 and WL ≤ 5.0%, and Group 4: CAR > 3.0 and WL > 5.0%. Results RITL was diagnosed in 67.2% of patients. Since the RITL rates of Groups 2 and 3 were statistically indistinguishable, we combined them and created the three-tiered CARWL score groups: CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. Comparative analysis revealed that the RITL rates gradually and significantly increased from CARWL-0 to CARWL-2 score groups (49.4% vs 64.7% vs 83.0%; P <0.001) despite similar baseline disease and patient characteristics. Results of the multivariate analysis showed that higher CARWL score groups were independent and significant predictors of increased RITL rates (p < 0.001). Conclusion Present results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.
Periodontal infection is a long-lasting inflammatory condition caused by the growth and development of an abnormal and harmful community of microorganisms. This destructive illness leads to the loss of the tissues that support the teeth, degradation of the bone surrounding the teeth, and eventually tooth loss. To treat oral infections, it is necessary to use nonsurgical methods such as antibiotics. However, the indiscriminate and incorrect use of antibiotics results in drug resistance. Among these alternate therapeutic options, using nanoparticles to treat infectious dental disease was particularly significant. Consequently, researchers have worked to develop an effective and satisfactory drug delivery method for treating periodontal and dental illnesses. Albumin nanoparticles serve a considerable function as carriers in the drug delivery of chemical and biomolecular medications, such as anticancer treatments; they have several advantages, including biocompatibility and biodegradability, and they are well-tolerated with no adverse effects. Albumin nanoparticles have several benefits over other nanomaterials. Protein nanocarriers provide advantages such as biocompatibility, biodegradability, reduced immunogenicity, and lower cytotoxicity. Furthermore, this nanoparticle demonstrated significant intrinsic antibacterial properties without being loaded with antibiotic medicines. As a medication and antibacterial nanoparticle delivery method, albumin nanoparticles have substantial applications in periodontal and dental infectious disorders such as periodontal infection, apical periodontitis, and peri-implantitis. As a result, in this article, we studied the usage of albumin nanoparticles in dental disorders. Graphical Abstract
Periodontitis is the inflammation of the supporting structures around the dentition. Several microbial agents, mostly bacteria, have been identified as causative factors for periodontal disease. On the other hand, oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses. Traditionally, the focus of research about the oral flora has been on bacteria because the most widespread oral diseases, like periodontitis and dental caries, are outcomes of bacterial infection. However, recently and especially after the emergence of coronavirus disease 2019, there is a growing tendency toward including viruses also into the scope of oral microbiome investigations. The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two. Although the exact nature of the mechanism still is not clearly understood, this could be speculated through the manipulation of the immune system by viruses; hence facilitating the furthermore colonization of the oral tissues by bacteria. This review provides an extensive and detailed update on the role of the most common viruses including herpes family (herpes simplex, varicella-zoster, Epstein-Barr, cytomegalovirus), Human papillomaviruses, Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation, progression and prognosis of periodontitis.
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