Objective Facial asymmetries are common, especially deviated nose and chin. The clinician must consider these variables when establishing the smile, placement and angulation of the occlusal plane. The purpose of this article is to determine if nose and chin deviations affect the perception of laypeople towards different angulations of the occlusal plane cant. Materials and Method An asymmetric facial model was created from a symmetric facial model used in a previous study. Nose and chin were deviated 3 mm to the left and eight different pictures were created, each with different degrees of occlusal plane cant in both direction. Using a visual Likert scale delivered via Websurvey within the private practice setting, 120 randomly selected laypersons evaluated each image according to their own beauty preferences. Results In an asymmetric face, nose and chin deviated 3 mm to the left, a minor occlusal plane angulation of 2° can be perceptible regardless of the direction of the cant. Conclusions The occlusal plane should be as parallel to the interpupillary line as possible. If occlusal cant is present, less than 2° of angulation it is preferable, regardless of the direction of the nose and chin. Clinical Significance In the presence of an asymmetric face, the occlusal plane should be as parallel as possible to the interpupillary line. The direction of the deviation of the nose and the chin are irrelevant factors to determine the occlusal plane. An inclination of the occlusal plane can cause vertical discrepancy, which could subsequently create malocclusion. A complete dentofacial analysis can aim at assessing the angulation of the occlusal plane not only for esthetic outcomes, but for also allowing correct occlusal function.
Colorectal cancer (CRC) is the third most common cancer and the third leading cause of cancer death in the United States. Among all the racial/ethnic groups, African American (AA) patients have the highest incidence of CRC and mortality rate. Periodontitis is an oral chronic inflammatory disease that damages the soft tissue and bone that supports the tooth and is among the 10 most prevalent chronic diseases. AAs are more often diagnosed with periodontal disease than other racial or ethnic groups. A dysbiotic oral microbiome might induce local and systemic immune dysregulation that produces a pro-inflammatory environment that could lead to colon cancer. The human bacteria Fusobacterium nucleatum (Fn), which primarily inhabits the oral cavity, causes periodontal disease and also has been implicated in the development of colorectal cancer. This pro-inflammatory bacteria has been shown to be significantly higher in the colon tumors from AAs compared to Caucasian American patients. No studies have been published describing differences in levels of inflammatory proteins and bacterial communities between the right/left location of colon cancer in AA patients. This pilot study aimed to determine the feasibility of measuring serum cytokines and evaluating oral bacterium associated with periodontitis (Fn) in the setting of colon cancer. Methods: We assessed quantitative measurement of 20 human periodontal disease associated inflammatory cytokines (IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IFNg, TNFa, and CRP); matrix metalloproteinases (MMP-9, and MMP-13) and their inhibitors (MIP-1a); bone metabolism related cytokines (OPG, OPN, RANK), osteoactivin, and TGFb1. Readings were taken using the Quantibody Human Periodontal Disease Array, which is a multiplexed sandwich using an enzyme-linked immunosorbent assay (ELISA)-based quantitative array platform on a glass slide. Quantitative polymerase chain reaction (qPCR) assays was used to detect Fn DNA in colon tumor tissues and measured the levels as compared to non-tumor tissues. Results: Right-sided colon cancer patients have increased levels of cytokines associated with periodontitis. Stage III patients have significantly elevated levels of OPG (p= 0.0157) and OPN (p= 0.0033) compared with early stages I-II. Fn is present in both tumor and non-tumor tissues. Conclusion: Circulating cytokines, like OPG and OPN, and oral pathogens associated with periodontitis (Fn), could be a potential indicator for location and stage of cancer when combined with other serological markers. Next step will be to evaluate the microbiome composition in tumor and non-tumor tissues from AA colon cancer patients using 16S rRNA amplicon sequencing. Citation Format: Sofia C. Tortora, Marzia Spagnardi, Jenny Paredes, Olalekan Lanipekun, Laura Martello-Rooney. Markers of periodontitis in the setting of colon cancer in African American patients [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C011.
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