Cosmetic dentistry is increasingly becoming an issue of concern to patients who hope to improve their smile. A systematic and comprehensive dentofacial analysis must be performed before commencing esthetic treatment. Several computer software programs have been developed for digital smile design (DSD) to assist clinicians in this process. This article compares DSD programs commonly used in cosmetic dentistry and their ability to assess esthetic parameters. A literature review was performed of current dentofacial aesthetic parameters and clinical applications of computer technology to assess facial, dentogingival and dental esthetics. Eight DSD programs (Photoshop CS6, Keynote, Planmeca Romexis Smile Design, Cerec SW 4.2, Aesthetic Digital Smile Design, Smile Designer Pro, DSD App and VisagiSMile) were compared. Photoshop, Keynote and Aesthetic Digital Smile Design included the largest number of esthetic analysis parameters. Other studied DSD programs presented deficiencies in their ability to analyze facial esthetic parameters but included comprehensive dentogingival and dental esthetic functions. The DSD App, Planmeca Romexis Smile Design, and Cerec SW 4.2 were able to perform 3D analysis; furthermore, Cerec SW 4.2 and PRSD could be used jointly with CAD/CAM. The DSD App and Smile Designer Pro are available as mobile phone applications. It can be concluded that despite the fact that they were not specifically designed for dental diagnosis, Photoshop CS6 and Keynote provide a more comprehensive smile analysis than most specialized DSD programs. However, other program functions should also be considered when deciding which DSD program is applicable to individual clinical setups.
The SARS-CoV-2 virus causes elevated production of senescence-associated secretory phenotype (SASP) markers by macrophages. SARS-CoV-2 enters macrophages through its Spike-protein aided by cathepsin (Cat) B and L, which also mediate SASP production. Since M-CSF and IL-34 control macrophage differentiation, we investigated the age-dependent effects of the Spike-protein on SASP-related pro-inflammatory-cytokines and nuclear-senescence-regulatory-factors, and CatB, L and K, in mouse M–CSF– and IL-34-differentiated macrophages. The Spike-protein upregulated SASPs expression in young and aged male M–CSF–macrophages. In contrast, only young and aged male IL-34-macrophages demonstrated significantly reduced pro-inflammatory cytokine expression in response to Spike-protein
in vitro
. Furthermore, the S-protein elevated
CatB
expression in young male M–CSF–macrophages and young female IL-34-macrophages, whereas
CatL
was overexpressed in young male IL-34- and old male M–CSF–macrophages. Surprisingly, the S-protein increased CatK activity in young and aged male M–CSF–macrophages, indicating that CatK may be also engaged in the COVID-19 pathology. Altogether, we demonstrated the age- and sex-dependent effects of the Spike-protein on M-CSF and IL-34-macrophages using a novel
in vitro
mouse model of SARS-CoV-2/COVID-19.
Systemic inflammation and the host immune responses associated with certain viral infections may accelerate the rate of neurodegeneration in patients with Creutzfeldt–Jakob disease (CJD), a rare, transmissible neurodegenerative disease. However, the effects of the newly emerged SARS-CoV-2 infection on the pathogenesis of CJD are unknown. In this study, we describe the case of an elderly female patient with sporadic CJD that exhibited clinical deterioration with the emergence of seizures and radiological neurodegenerative progression following an infection with SARS-CoV-2 and severe COVID-19. Despite efforts to control the progression of the disease, a dismal outcome ensued. This report further evidences the age-dependent neurological effects of SARS-CoV-2 infection and proposes a vulnerability to CJD and increased CJD progression following COVID-19.
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