Clinical and Experimental Dental Research最新文献

Objectives: Antifungal drug resistance poses a major challenge in treating oral Candida infections. This study aimed to evaluate the antifungal activity of Honokiol, alone and combined with Fluconazole, against oral Candida isolates, and to investigate its mechanism of action via ergosterol biosynthesis inhibition and cell wall disruption.

Material and methods: Susceptibility testing was performed using CLSI (M27-A3) methodology on 16 oral Candida isolates, 8 endodontic isolates, and the reference strain ATCC 24433. Minimum inhibitory concentrations (MICs) of Honokiol and Fluconazole were determined alone and in combination. Ergosterol inhibitory assays and scanning electron microscopy (SEM) were used to assess cell wall integrity and morphological changes.

Results: Honokiol exhibited MICs of 16-64 µg/mL (oral isolates), 16 µg/mL (endodontic isolates), and 32 µg/mL (ATCC 24433). In combination with Fluconazole, Honokiol's MICs decreased 4-fold (4-16 µg/mL), while Fluconazole's MICs dropped 2- to 4-fold (1-32 µg/mL). Synergy was confirmed by a 95.61% reduction in fungal growth (OD600) compared to controls. SEM revealed severe cell wall distortion, rupture, and cytoplasmic leakage. Honokiol significantly inhibited ergosterol biosynthesis, disrupting cellular integrity.

Conclusion: Honokiol demonstrates potent antifungal activity against oral Candida isolates by targeting ergosterol biosynthesis and compromising cell wall integrity. Its synergistic enhancement of Fluconazole's effect suggests clinical potential as an adjunct therapy, potentially reducing resistance and lowering required drug doses in oral and endodontic candidiasis.

Objectives: Periodontitis is a common oral disease that affects populations globally, however, awareness of periodontal disease prevention remains limited. Since periodontal health knowledge may influence oral hygiene behaviors, which are essential for disease prevention and long-term maintenance, this study aimed to assess periodontal health-related knowledge and its association with oral hygiene practices among an adult cohort in Thailand using the validated Adult Periodontal Health Knowledge and Belief Questionnaire.

Material and methods: A cross-sectional survey of Thai adults (≥ 18 years) was conducted from December 2023 to January 2024. The questionnaire captured demographics, oral hygiene practices (brushing and interdental cleaning), and periodontal health knowledge (ALPHA-K). Descriptive statistics, non-parametric tests, exploratory factor analysis, and multiple linear regression were used.

Results: A total of 1770 participants completed the survey. The mean ALPHA-K score was 11.83 (2.88), which represents 59.2% of total score. While most recognized that plaque as the cause of gum disease, and smoking and diabetes as risk factors, misconceptions persisted (e.g., floss only removes food; tooth loss is inevitable with ageing; fluoride prevents gum disease). Higher periodontal health knowledge was associated with favorable flossing practices, brushing practices (longer brushing duration, extra-soft/soft bristles, manual toothbrush use) and higher education, higher income, and urban residence.

Conclusions: A significant knowledge deficit regarding periodontal health exists in this Thai cohort, particularly among rural residents, individuals with lower income, and those reporting inadequate brushing duration or preference for hard bristle brushes or electric toothbrushes in Thailand. Disseminating accurate information on periodontal health and disease is essential to enhance self-care practices and overall periodontal health outcomes.

Public health relevance: Thai adults, particularly those with lower education levels and living in rural areas, demonstrated considerable gaps in periodontal health knowledge. Addressing these gaps through tailored educational interventions is important for improving population-level periodontal health outcomes.

Objectives: Chronic kidney disease (CKD) is relatively common in patients with rheumatoid arthritis (RA). Periodontitis and periodontopathic Porphyromonas gingivalis are risk factors for CKD. However, the association of serum immunity to P. gingivalis and its peptidylarginine deiminase (PPAD), as well as periodontitis severity, with CKD in relation to RA has not been elucidated. The present study evaluated whether or not serum immunoglobulin G (IgG) titers against P. gingivalis and PPAD and periodontitis severity are associated with CKD in patients with RA and periodontitis.

Methods: Demographic, comorbidity, rheumatologic, and periodontal data were collected from 127 patients with RA and periodontitis in a retrospective cohort study. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or proteinuria of ≥ 3 months' duration. Serum IgG titers against P. gingivalis and PPAD were determined using an electrochemiluminescence immunoassay.

Results: Twenty patients showed an eGFR < 60 mL/min/1.73 m², while no patients had proteinuria. The 20 CKD patients were significantly older (p = 0.002), had higher percentages of former smokers (p = 0.01), had more sites with probing depth and clinical attachment level ≥ 4 mm (p = 0.03 and p = 0.02), and had higher levels of serum creatinine and eGFR (p < 0.001 for both) and anti-P. gingivalis IgG titers (p = 0.04) than the 107 non-CKD patients. A significant association was observed between anti-P. gingivalis IgG titers and eGFR (p < 0.001 for both) by bivariate and multivariate analyses and between anti-P. gingivalis IgG titers and CKD (p < 0.001) using a multiple logistic regression analysis after adjusting for age, gender, smoking status, comorbidity, RA condition, and RA-related drugs.

Conclusions: These results suggest that serum IgG titers against P. gingivalis, but not against PPAD, are associated with CKD in patients with RA and periodontitis.

Objectives: To compare the 6-month clinical success of atraumatic restorative treatment (ART) and silver-modified atraumatic restorative treatment (SMART) in primary molars of children with early childhood caries (ECC), and to assess the impact of these treatments on oral health-related quality of life (OHRQoL).

Materials and methods: A randomized controlled split-mouth trial included 32 children (aged 3-7 years) with 68 primary molars exhibiting active dentin carious lesions (ICDAS II scores 4 or 5). Each child received one ART restoration using high-viscosity glass ionomer cement and one SMART restoration with silver diamine fluoride, followed by HVGIC in the same session. Clinical success was assessed after 6 months, using modified ART criteria. Parents completed the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) at baseline and after 6 months to assess changes in OHRQoL. Data analysis included chi-square, Fisher's exact test, Student's t-test with effect sizes reported, and a significance level set at 95%.

Results: Of the 68 restorations (34 ART, 34 SMART), 6-month success rates were 67.6% for ART and 70.5% for SMART, with no statistically significant difference (p = 0.66). SMART showed slightly better caries arrest. Class I restorations had higher success rates than Class II for both techniques. Failures were mainly due to wear and marginal integrity loss. Mean ECOHIS scores improved from 16.9 at baseline to 10.13 at 6 months, though the change was not statistically significant (p = 0.125).

Conclusion: SMART and ART techniques showed similar short-term clinical outcomes, with SMART showing a minor, nonsignificant advantage in caries management. Failures in ART were more often linked to active caries and pulp involvement, suggesting that SMART may enhance caries arrest. Placement of both restorations did not significantly affect OHRQoL.

Clinical significance: Incorporating SDF may improve caries arrest and the effectiveness of GIC restorations in primary molars.

Trial registration: ClinicalTrials.gov identifier: NCT07023939.

Objectives: This RCT study aimed to investigate the clinical performance of IPS e.max endocrowns as an alternative option compared to conventional crowns to restore damaged molar teeth after an 18-month follow-up.

Materials and methods: A sample of 30 patients with 40 molars, who needed a single-tooth restoration, was enrolled to receive either a conventional crown (n = 20) or an endocrown (n = 20). After molar preparation, all crowns were manufactured with the IPS e.max press system, then cemented using dual-cure resin. All crowns were assessed using the modified United States Public Health Service criteria (USPHS) at baseline, 6, 12, and 18 months following placement. Patient satisfaction was evaluated using a questionnaire. Statistical analyses were performed using Mann-Whitney U and Friedman tests (95% confidence interval).

Results: All teeth in the conventional crown group and endocrown group showed 100% clinical success with no failure at 6, 12, and 18 months after placement in terms of marginal adaptation, contact points, and surface texture. No significant difference was found between endocrowns and conventional crowns in adhesive failure at 6 months (p = 0.075), 12 months (p = 0.317), and 18 months (p = 1.000). 100% of patients were very satisfied with the esthetics and comfort of the prosthesis. The function percentage was 93.3%.

Conclusions: Both restorative options are durable and maintain their integrity. Adhesive failure occurred in a notable number of cases in the endocrown group compared to the conventional crown group. Patient satisfaction was high with both restoration types.

Objectives: The aim of this study was to evaluate the effect of sodium dicholoroisocyanurate (NaDCC) as intracanal medicament on the dentin microhardness and fracture resistance of teeth compared to calcium hydroxide (CH).

Material and methods: Root canals of mandibular premolars (n = 153) were instrumented and randomized into two treatment groups and an untreated control group (n = 51). Treatment groups received either NaDCC or CH. After 1 week, 1 month, or 3 months, 17 teeth were randomly selected from each group, and two root cylinders were obtained: one for fracture resistance and the other for microhardness test. Two-way ANOVA, one-way ANOVA, and Tukey post hoc tests were used for statistical analysis.

Results: The microhardness and fracture resistance in the control and CH groups were not affected by time (p > 0.05). However, NaDCC caused significant decreases in dentin microhardness after 1 month and 3 months (p < 0.001) as well as in fracture resistance (p < 0.05) after 1 month. The groups comparison at each time point showed no significant differences in microhardness and fracture resistance after 1 week (p > 0.05). However, after 1 month, a significant reduction in microhardness and fracture resistance was detected for NaDCC and in the fracture resistance for CH (p < 0.05). After 3 months, compared to the control group, lower microhardness in NaDCC and CH groups and lower fracture resistance in CH group were detected (p < 0.05).

Conclusion: Short-term application of NaDCC and CH did not adversely affect dentin microhardness. However, prolonged use reduced dentin microhardness, and both medicaments significantly decreased fracture resistance compared with the control group. Limiting the duration of intracanal medicament application is therefore recommended.

Objectives: Rising demands for aesthetic outcomes make precise preoperative assessment essential. Despite advances in digital workflows, their accuracy versus conventional techniques remains uncertain. The current study comparatively assessed the trueness of digitally- and conventionally-fabricated mockups.

Materials and methods: Fourteen patients needing ceramic veneers in the anterior maxilla participated. Each received three mockups: one fabricated conventionally and two digitally (additive and subtractive). The mockups were placed intraorally and scanned. The scans were superimposed on a reference model to evaluate the accuracy of the entire workflow and on the reference wax-up to assess production accuracy. Data were analyzed by paired samples test, repeated measures ANOVA, Bonferroni test, and generalized estimating equation (GEE) (α = 0.05).

Results: For the whole production process, the root mean square (RMS) was 0.13 (0.04) for the conventional method, which was significantly lower than that for the additive as 0.60 (0.07) and subtractive of 0.51 (0.07) digital techniques (p < 0.001). Also, for the production phase, the mean RMS of different methods was significantly different (p < 0.001). The conventional method showed the lowest mean by 0.22 (0.07), and the additive technique showed the highest mean by 0.76 (0.02) RMS. The mean RMS was 0.73 (0.02) for the subtractive method.

Conclusions: The trueness of the conventional method was higher than that of the digital method for both the whole production process and the production phase. The conventional method significantly decreases the chairside time especially when tooth surface treatment is not required. The trueness of the subtractive method was higher than that of the additive method.