Clinical, Cosmetic and Investigational Dentistry最新文献

Background: Pregnancy can make women more vulnerable to oral health problems due to hormonal fluctuations. Periodontal disease, a chronic inflammatory condition that affects the gums and supporting tissues, has been linked to serious complications such as preterm birth and low birth weight. Despite the established connection between oral and general health, especially during pregnancy, many women, particularly in developing countries like Afghanistan, are not adequately informed about these risks.

Objective: The aim of this study was to explore the awareness, knowledge, and attitudes regarding periodontal disease among pregnant women in Kunduz, Afghanistan.

Methods: A descriptive cross-sectional study was carried out among 200 pregnant women attending antenatal clinics in Kunduz. Participants completed a structured questionnaire designed to assess their demographic characteristics and their understanding and perceptions of periodontal disease. The data were analyzed using descriptive statistics.

Results: Among the respondents, 63.0% were aged 22-34 years, and 39.0% were in their third trimester. Nearly half (49.5%) reported poor general health. Educational levels were low, with 64.0% being illiterate. Awareness of periodontal disease and its impact on pregnancy outcomes was generally poor, with only 40.5% agreeing that pregnancy increases gingival inflammation risk and 45.0% recognizing a link between dental health and pregnancy. Many participants held misconceptions, such as avoiding dental care during pregnancy due to safety concerns.

Conclusion: There is a critical need for targeted oral health education during pregnancy in Kunduz. Incorporating oral health education into antenatal care services may help bridge the current knowledge gap and reduce the risk of preventable complications.

Background: Periodontal diseases are prevalent and can be worsened by conditions such as obesity. Understanding obesity impact on periodontal health is essential for developing effective management strategies. Hence, the aim of the present study was to assess the prevalence of Selenomonas noxia and pro-inflammatory visfatin marker for periodontitis in overweight/obese and non-obese population and correlate them with periodontal status.

Materials and methods: Eighty-five participants aged from (30-50) years were divided into three groups: healthy controls (n=25), normal-weight periodontitis patients (n=30), and overweight/obese periodontitis patients (n=30). Unstimulated saliva was analyzed for visfatin level using ELISA, and subgingival plaque was examined for S. noxia prevalence using qPCR. Data were analyzed using Kruskal-Wallis, Spearman correlation, and ROC curves.

Results: Overweight/obese periodontitis patients had significantly higher salivary visfatin level (111.1 ± 277.4 ng/mL) compared with normal-weight periodontitis (28.2 ± 20.6 ng/mL) and controls (19.3 ± 4.6 ng/mL) (P<0.001). Similarly, S. noxia was more prevalent in overweight/obese individuals with periodontitis (155052.5±647,130.3) compared to persons with periodontitis and periodontal health (P<0.001). Strong positive correlation encountered between bacteria and visfatin level in both patient groups (P<0.001) and with BMI in the overweight/ obese group (P=0.001). ROC analysis showed excellent diagnostic accuracy for S. noxia in overweight/obese patients with periodontitis (AUC=0.86) and strong performance for visfatin (AUC=0.83).

Conclusion: Obesity might play a devastating role in the pathogenesis of periodontitis through the increased salivary visfatin level and S. noxia prevalence. This indicates that they may serve as potential markers for periodontal inflammation in the obese population.

Aim: To analyze the patterns and use of "X" as a social media platform for Saudi dental societies and to assess their engagement strategies in light of national digital transformation goals.

Methods: This cross-sectional, observational study analyzed publicly available data from the official X (formerly Twitter) accounts of Saudi dental societies (n=8) from July 2023 to June 2024. Data were collected using the Twitter API v2 via the Tweepy library in Python. Thematic analysis was performed, classifying posts into main themes like. Continuing education, research, and community outreach. Posts were also categorized by their originality (original, repost, or quote), language, and content nature (text, media, or both). To ensure reliability, two trained investigators coded the posts, and weighted Kappa statistics confirmed strong inter-rater and intra-rater agreement. Data analysis was performed using IBM SPSS Statistics, including descriptive statistics, ANOVA, and multiple linear regression to identify factors associated with engagement.

Results: A total of 2649 posts were analyzed. The Saudi Dental Society (SDS) was the most active, producing 1257 posts (47.45%). Posts primarily focused on continuing education (70.4%), with news and announcements being the most frequent content types. The vast majority of posts were original (94.1%) and media-enriched (86.1%). The mean total engagement per post was 9.67. Research-related posts achieved the highest total engagement (22 ± 24.04), despite their very low frequency (0.1%).

Conclusion: Saudi dental societies primarily use the X platform for continuing education content, while posts focused on research, advocacy, and community outreach generate higher engagement. Analyzing these content and engagement patterns is important to guide strategic communication that enhances professional visibility, audience interaction, and public health outreach. These findings are also aligned with the Saudi Vision 2030 objectives promoting digital transformation and innovation in healthcare communication.

Background: Oral health is an essential component of overall well-being, yet it remains a neglected public health area in many low- and middle-income countries. Teachers play a vital role in shaping students' oral health behaviours, making their knowledge and practices crucial for school-based oral health promotion. This study assessed the knowledge, attitudes, and practices (KAP) regarding oral health among primary school teachers in Mchinji District, Malawi, to evaluate their readiness to support oral health education.

Methods: A cross-sectional survey was conducted among 316 primary school teachers using a structured questionnaire. Descriptive statistics summarized demographic and KAP variables, while chi-square tests and Cramér's V measured associations between demographic characteristics and oral health knowledge and practices.

Results: Among participants, 60.0% were male, 61.4% were aged 30-45 years, and 61.9% had more than 10 years of teaching experience. While 63.6% demonstrated average oral health knowledge and 29.4% showed good knowledge, awareness of preventive dental procedures such as dental scaling (26.7%) and flossing (14.2%) was low. Most teachers (82.2%) exhibited average oral hygiene practices, and only 10.2% had good practice scores. Although positive attitudes were widespread, with over 90% recognizing the importance of oral health and regular dental visits, only 26.4% had received oral health training, and 68.5% identified limited knowledge as a barrier to teaching oral health. Age was significantly associated with knowledge level (p = 0.007, Cramér's V = 0.152), while gender and teaching experience were not.

Conclusion: Primary school teachers in Mchinji District hold positive attitudes toward oral health but display knowledge and practice gaps. Strengthening teacher training through structured oral health capacity-building programs could enhance school-based health education and inform policies that integrate oral health into Malawi's primary school curriculum.

Purpose: Maxillary anterior tooth dimensions are critical in esthetic and restorative dentistry, yet data remain limited for some populations. Existing reference values may not apply universally, and sex-related differences are underreported. This study examined the clinical crown width (w), length (l), and width/length ratio (w/l) of maxillary central incisors, lateral incisors, and canines in a Kuwaiti adult population, and evaluated the sex-related differences.

Patients and methods: Maxillary 3D resin models were obtained from 126 healthy adults. Mesiodistal width (w) and clinical crown length (l) were measured with a digital caliper (0.01 mm). The w/l ratio was calculated, and reproducibility was tested on 24 models. Sex differences were assessed with independent sample t-tests.

Results: Of the participants, 84 (66.6%) were female and 42 (33.4%) were male, with a mean age of 29.8 years. Mean (± SD, range) crown widths were 8.83 ± 0.65 (7.5-9.8) mm, 6.83 ± 0.52 (6.0-7.8) mm, and 7.76 ± 0.58 (6.8-8.7) mm for central, lateral, and canine teeth, respectively. Corresponding lengths were 9.83 ± 0.72 (8.2-11.2) mm, 8.00 ± 0.60 (7.0-9.2) mm, and 9.14 ± 0.68 (8.0-10.4) mm. The corresponding w/l ratios were 91% (centrals), 86% (laterals), and 86% (canines). Statistically significant sex differences were observed in crown length (p < 0.001) and w/l ratio (p < 0.001) for all three tooth types, with males exhibiting longer crowns and females showing higher w/l ratios.

Conclusion: Width/length ratios were higher in females across all maxillary anterior teeth, whereas crown length of all anterior teeth and canine width were greater in males, showing the greatest sexual dimorphism. Ethnicity and sex significantly influence maxillary anterior tooth dimensions, highlighting the need for population- and sex-specific reference values to guide esthetic and restorative treatment.

Introduction: Dental restoration following endodontic treatment aims to restore tooth function, aesthetics, and strength compromised by caries or trauma. Loss of tooth structure post-treatment can reduce strength by up to 60%, increasing fracture risk. Restoration choice depends on remaining tooth structure, coronal sealing, retention, and occlusal factors. Direct restorations suit minimal damage, while indirect options like crowns or endocrowns address significant structural loss.

Objective: To evaluate the durability and success of post-endodontic restorations through a scoping review focused on remaining tooth structure, restoration techniques, materials, and post use.

Methods: A scoping review was conducted using PubMed, ScienceDirect, and Scopus, following PRISMA-ScR guidelines. Included studies were randomized controlled trials, cross-sectional studies, and case-control studies published in English within the last five years. In vitro studies, non-randomized clinical trials, and literature reviews were excluded.

Results: From 353 articles, 14 met inclusion criteria. The studies found that indirect restorations exhibited higher success rates (63% to 91.61%) than direct restorations (43.2% to 86.7%). This finding attributed to the inherent advantages of indirect approach. Indirect restorations demonstrated higher 3-year survival rates (82.7 to 99.1%) than direct restorations (75 to 97.6%). Among these, full-coverage crowns were superior, due to their enhanced fracture resistance, ferrule effect, and stress distribution while direct resin composites suffice when adequate tooth structure remains. Direct restorations are recommended for endodontically treated teeth that still have two or more intact coronal walls, as their prognosis and success rates are quite good for both anterior and posterior teeth. Glass-fiber posts reduce root fracture risk compared to metal posts; however, outcomes depend on post design and occlusal load.

Conclusion: The long-term success of post-endodontic restorations depends on multiple factors, with remaining tooth structure being paramount. Evidence shows a clear hierarchy: indirect restorations, particularly full-coverage crowns (FCCs), demonstrate superior success and survival rates due to their fracture resistance and effective stress distribution. Direct composites are only viable with substantial remaining tooth structure (≥2 intact walls). Glass-fiber posts are preferred over metal posts to reduce fracture risk. Ultimately, a ferrule-effect-based, tailored approach that matches biomechanical demands to clinical conditions is essential for optimal outcomes.

Background: People with disabilities experience disproportionate oral health burdens worldwide. In Thailand, despite universal health coverage (UHC), persistent barriers-including transportation, caregiver availability, distance, and costs-limit access to care. Since 2011, government and partners have pursued multilevel actions to improve equity for this population, yet no comprehensive synthesis of their evolution has been reported.

Objective: To describe the context and content of Thailand's 2011 to 2025 initiative for people with disabilities, summarize what was implemented across policy, workforce, curriculum, services, and governance, and identify observed results, limitations, and next steps for sustainability.

Methods: A national secondary synthesis aligned with SQUIRE 2.0 analyzed policy documents, program reports, and training materials (2011 to 2025) using document and thematic analyses with contribution analysis and triangulation. Eligibility required relevance to disability-inclusive oral health in Thailand; units were policies, curricula, service models, and financing/monitoring, and engagement mechanisms were extracted as reported; no human data were used, and ethics approval was not required.

Results: The initiative advanced through four overlapping phases: Phase 1 (2011 to 2014) comprised Thai Health Promotion Foundation (ThaiHealth) funded pilot projects to increase access, followed by increasingly explicit government policy in Phase 2 (curriculum integration and professional development, 2015 to 2017), Phase 3 (network expansion and digital knowledge sharing, 2017 to 2020), and Phase 4 (institutionalization and policy integration, 2021 to 2025). Actions were associated with expansion of dental service sites from 11 to 30 across 12 provinces, integration of special care dentistry into multiple dental curricula, establishment of specialty boards, and adoption of national strategic frameworks. Persistent barriers included workforce shortages, transportation difficulties, and gaps in national oral health data.

Conclusion: Thailand's phased, system-level strategy demonstrates how policy integration, curriculum reform, and network development can accelerate equity in oral health care for people with disabilities. Priorities for sustainability include a nationwide disability-focused oral health survey, rural workforce pipelines, integration of special care dentistry into UHC benefits, and expanded use of digital platforms. Lessons may inform similar reforms in other middle-income settings.

Background: Oral fluids are considered a promising diagnostic method to demonstrate the biomarkers for many oral inflammatory and physiological conditions. Orthodontic treatment is associated with changes in bone remodeling and tissue inflammatory biomarkers.

Objective: The research assessed the effectiveness of salivary biomarkers, which include cytokines, MMPs, and bone turnover markers, in describing the unwanted oral and dental pathological outcomes and to provide clinical precision in following orthodontic treatment in patients who were treated with the fixed orthodontic appliance.

Materials and methods: Blended longitudinal and Cross-sectional study: one hundred patients were followed up throughout one year after enrollment, aged between twelve and eighteen years old. Salivary and Gingival Crevicular Fluid biomarker concentrations were assayed at the beginning of the study and at multiple time points regarding the treatment. Interleukin IL-1β, Tumor Necrosis Factor TNF-α, Matrix Metalloproteinases MMP8 and MMP9, and bone turnover markers (RANKL/OPG) were the biomarkers included.

Results: The mean concentrations of both cytokines were 1.55-fold higher in the first month. MMP-8 and MMP-9 concentrations increased between the third and sixth months from baseline in 50% and 45% respectively. Patients with high cytokine MMP levels resulted in tooth movement, with 15% enhanced compared to the control group, and finished treatment quicker. There were disparities in cytokine levels whereby, generally, males had slightly elevated levels of cytokines compared to the female patients, although this did not influence treatment efficacy. The RANKL/OPG ratio is elevated during the first three months in the active phase of bone remodeling.

Conclusion: The reliability of salivary and GCF biomarkers as predictors. Thus, cytokines and MMPs, and the RANKL/OPG ratio, being biomarkers, identify response to a specific treatment and also in orthodontic management, including avoiding root resorption, unwanted bone remodeling, and oral pathologies.

Background: This study aimed to evaluate the effect of three oral mouthwashes on the surface roughness of stainless steel orthodontic brackets from two commercial brands, ORMCO and 3M Unitek.

Methods: A total of sixty upper bicuspid stainless steel brackets were used, divided equally between the two brands: 30 ORMCO brackets and 30 3M Unitek brackets. Each brand group was further subdivided into three subgroups of ten brackets, with each subgroup immersed in one of three oral rinses: water and salt solution, LISTERINE™ sodium fluoride mouthwash and OREX™ sodium fluoride mouthwash. Surface roughness was measured using an optical profilometer after 90 minutes of immersion and again after seven days, to assess the potential influence of exposure duration on surface roughness.

Results: One-way ANOVA revealed no statistically significant differences in surface roughness among most groups (p ≥ 0.05). The highest surface roughness was observed in the ORMCO brackets immersed in OREX fluoridated mouthwash for seven days (mean = 0.9169 µm). The lowest was in the 3M Unitek group immersed in the water and salt solution for 90 minutes (mean = 0.9130 µm). Although the roughness values showed a statistically significant difference, the magnitude of the difference was minimal (0.0039 µm) and considered clinically insignificant.

Conclusion: This study found that sodium fluoride mouthwashes resulted in slightly higher surface roughness of stainless steel orthodontic brackets compared to water and salt rinse. However, the differences are not clinically relevant and will not impact plaque accumulation or bracket function.

Purpose: Clinical consensus on prophylactic extraction of impacted mandibular third molars is still debated. This study aims to explore the impaction patterns of mandibular third molars and their associated effects on the adjacent second molars within a Saudi population, thereby providing some clinical insights for prophylactic extraction.

Methods: This retrospective cross-sectional study evaluated 1700 orthopantomograms of Saudi patients, obtained from the dental hospital database at King Abdulaziz University, Jeddah, Saudi Arabia, from August 2024 to June 2025, with convenience sampling. Mandibular third molar impaction patterns were assessed according to Winter's classification, along with their association with pathological conditions, including carious lesions and periodontal defects affecting the adjacent mandibular second molars.

Results: 681 impacted mandibular third molars were identified and analyzed. The prevalence of these impactions was higher in females (54.2%) than in males (45.8%) (p < 0.05). Mesioangular impaction pattern was the most frequently detected, followed by horizontal. A significant association was observed between gender and the impaction patterns (p < 0.001), with the inverted and buccolingual impaction patterns predominantly observed in males, accounting for 100% and 90.0% of the impactions, respectively. The prevalence of carious lesions and periodontal defects was 23.9% and 66.9%, respectively. The two most frequent impaction patterns, horizontal and mesioangular, were significantly associated with these pathological conditions (p < 0.001).

Conclusion: Prophylactic extraction of impacted mandibular third molars, particularly those exhibiting mesioangular and horizontal impaction patterns, should be considered to prevent the deleterious consequences of their retention. However, this recommendation is specific to the population inspected. Further studies focusing on diverse populations are encouraged to acquire evidence-based, population-specific recommendations to support broader clinical applicability.