Clinical Oral Investigations最新文献

Background: Periodontitis (PD) is a chronic, multifactorial inflammatory disorder characterized by the progressive destruction of periodontal tissues. Increasing evidence indicates that the dysregulation of hypoxia-related genes (HRGs) plays a pivotal role in inflammatory diseases, including PD. Recent studies have also implicated cuproptosis-a novel copper-dependent form of programmed cell death-in PD pathogenesis, suggesting a potential link with cuproptosis-related genes (CRGs). Despite these findings, the interaction between hypoxia, cuproptosis, and PD progression remains poorly understood. This study aims to identify and characterize key biomarkers associated with hypoxia and cuproptosis in PD, offering novel insights into its molecular mechanisms.

Methods: PD datasets were downloaded from the Gene Expression Omnibus (GEO) database. PD biomarkers were obtained through differential analysis, gene set variation analysis (GSVA), machine learning, diagnostic evaluation, and expression level validation.A predictive nomogram incorporating these biomarkers was constructed to evaluate their clinical utility. Additionally, functional enrichment analysis, immune cell infiltration profiling, and drug prediction were conducted to explore the biological roles and therapeutic implications of the biomarkers. Single-cell RNA sequencing data from GSE152042 were also analyzed to assess cell-type composition and examine biomarker expression at the single-cell level.

Results: Differential analysis identified seven genes. The Boruta algorithm selected six feature genes (ALOX15B, FAM46C, IGHD, SAA1, SLC16A9, SPAG17), with SPAG17 showing the highest importance score. LASSO regression identified five genes (IGHD, FAM46C, SPAG17, SAA1, SLC16A9), while RFE pinpointed four genes (SPAG17, SLC16A9, SAA1, IGHD). In GSE16134 and GSE10334, SPAG17 and SLC16A9 exhibited significantly lower expression in PD compared to controls (Wilcoxon test, p < 0.05), whereas SAA1 and IGHD were significantly elevated. All four genes demonstrated AUC > 0.8. Unsupervised clustering identified eight cell types. SLC16A9 had the highest expression prevalence (82.1%) and mean expression (1.85 TPM) in epithelial cells; SPAG17 was predominantly expressed in perivascular cells (65.3%, 1.42 TPM), SAA1 in fibroblasts (73.6%, 2.01 TPM), and IGHD in B cells (89.2%, 2.37 TPM).

Conclusion: IGHD, SAA1, SLC16A9, and SPAG17 were identified as key biomarkers of PD. Pathway analysis and drug prediction provided insights into potential therapeutic targets, advancing the understanding of PD diagnosis and treatment.

Objectives: The aim of this study was to determine the location and severity of facial soft tissue deformities in patients with orofacial cleft prior to orthognathic surgery.

Materials and methods: Linear measurements were performed on 30 scans of male faces without cleft and 10 faces with cleft. Three-dimensional (3D) coordinates of anthropometric points were used to calculate an Asymmetry Index for each point. An average male face was generated from the 30 unaffected scans using GOM Inspect Suite 2000 software. By superimposing cleft faces onto the Assessment of facial asymmetry in patients with orofacial cleft based on biometric proposal of the average male face, the location and severity of deformities were visualised in the x, y, and z axes. Statistical analysis of linear measurements and Asymmetry Index values was performed using a Z-score, with significance determined by the p-value.

Results: Compared to controls, patients with orofacial clefts had a shorter and narrower face, a wider nose, and narrower lips. The Asymmetry Index identified the nose, upper lip, and chin as the regions with the most asymmetry. A significant deficiency of soft tissues in the oronasal area was observed, especially on the side affected by cleft.

Conclusions: 3D analysis enables precise localisation and quantification of soft tissue asymmetry in cleft patients. This method highlights the specific regions most affected by deformities and confirms the clinical applicability of 3D facial scanning. However, the relatively small sample size (10 males with clefts and 30 controls) and the exclusion of females limit the generalisability of these findings and should be addressed in future studies.

Clinical relevance: 3D scanning represents a valuable visual tool for assessing residual deformities related to clefts. Provides objective data that can improve surgical planning and individualised treatment strategies for patients undergoing orthognathic procedures.

Objectives: To evaluate effectiveness of cinnamaldehyde, vanillin and dialdehyde starch in stabilizing collagen in demineralized dentin against enzymatic degradation.

Materials and methods: Demineralized dentin collagen films were prepared from human teeth and treated for 3 min with 4% cinnamaldehyde, 4% vanillin or 4% dialdehyde starch. Deionized water and 4% glutaraldehyde served as negative and positive control. Crosslinker-collagen interaction was analysed using Fourier transform infrared spectroscopy (FTIR) (3 samples per group). After enzymatic degradation with collagenase type II, degradation was assessed via hydroxyproline assay (16 samples per group). Collagen network ultrastructure was examined using transmission electron microscopy (TEM) (2 samples per group). Data were analysed using the Kruskal-Wallis test and Dunn's multiple comparison (p = 0.05).

Results: FTIR confirmed that cinnamaldehyde, vanillin and dialdehyde starch did not disrupt the collagen triple-helix. Hydroxyproline release (µg) from dentin treated with water, vanillin, cinnamaldehyde, dialdehyde starch and glutaraldehyde were 15.5 ± 6.4, 13.6 ± 8.0, 11.1 ± 6.7, 6.1 ± 4.3 and 0.9 ± 0.8 (water, vanillin, cinnamaldehyde > dialdehyde starch, glutaraldehyde; p < 0.05). TEM revealed intact collagen fibrils in dentin treated with glutaraldehyde and dialdehyde starch, but not the dentin treated with water, vanillin and cinnamaldehyde.

Conclusions: Among the three naturally derived aldehydes, this laboratory study showed that dialdehyde starch could be a promising cross-linking agent to stabilize demineralized dentin collagen.

Clinical relevance: Incorporating natural crosslinkers such as dialdehyde starch into preventive strategies may improve the preservation of demineralized dentin by stabilizing the collagen matrix.

Objectives: This study aimed to evaluate the effect of print orientation on the dimensional accuracy of attachments in directly 3D-printed orthodontic aligners.

Materials and methods: For n = 10 patients, 34 single-tooth aligner segments were digitally designed (17 for tooth 1.1 and 17 for tooth 1.6) incorporating a planned 3 mm horizontal rectangular buccal attachment. These aligners were printed in TC-85 DAC resin (Graphy Inc, Seoul, Korea) at different inclinations (8 in anterotation and 8 in postrotation, at 10° intervals from the horizontal) and used as templates to transfer attachments onto corresponding 3D-printed dental models. This models with transferred attachments were scanned with a laboratory scanner and superimposed onto the attachment surface of the master digital file. Percentage volume deviations of the transferred versus planned attachment were quantified using Geomagic Control software (v.2020.1.1, ©2020 3D Systems, Inc., Rock Hill, SC) and analysed with an unpaired two-tailed t-test (P < 0.05).

Results: For tooth 1.1, the mean volumetric deviation of transferred attachments was significantly lower in postrotation orientations (88.87% ± 4.13) than in anterotation (69.01% ± 4.33), indicating that positioning the template with the vestibular surface facing the build platform improves accuracy (p < 0.0001). For tooth 1.6, no statistically significant difference was found (p = 0.0992; 78.16% ± 2.26 vs. 79.99% ± 1.87).

Conclusions: Composite attachments transferred with 3D-printed templates exhibited a volumetric alteration respect the master digital file and print orientation particularly affects anterior teeth's attachments.

Clinical relevance: Aligners orientation during 3D-printing is crucial to ensure accurate attachments transfer, especially anterior regions.

Objectives: Management of Stage III/IV Grade C periodontitis (SIII/IVGrC) remains challenging, and the optimal non-surgical approach has not been clearly established. This randomized controlled clinical trial aimed to compare the clinical, biochemical, and microbiological outcomes of single-session versus three-session non-surgical periodontal therapy in patients with SIII/IVGrC.

Materials and methods: Thirty-three patients with SIII/IVGrC were randomly allocated to single-session (SSTG, n = 16) or three-session (TSTG, n = 17) therapy. Fifteen periodontally healthy individuals served as controls. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and at 1, 3, and 6 months. The primary outcome was the change in probing depth, while secondary outcomes included changes in CAL, BOP, and selected microbiological and biochemical parameters. Gingival crevicular fluid (GCF) levels of IL-1β, IL-6, clusterin, cystatin C, and osteocalcin were quantified, and subgingival microbiota -including Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans- were analyzed using checkerboard DNA-DNA hybridization.

Results: Both treatment groups showed significant clinical improvements over 6 months (p < 0.05), with no intergroup differences in PD, CAL, BOP, or PI. At baseline, GCF IL-1β and cystatin C were elevated in SIII/IVGrC compared to controls (p < 0.05). TSTG achieved greater reductions in IL-1β (3 and 6 months) and cystatin C (3 months) and demonstrated more pronounced decreases in red and orange complex species than SSTG (p < 0.05).

Conclusions: Three-session therapy provided superior biochemical and microbiological improvements compared with single-session therapy, indicating a more stabilizing effect on host-microbe interactions.

Clinical relevance: For patients with SIII/IVGrC periodontitis, three-session therapy may offer enhanced modulation of inflammatory and microbial parameters while achieving comparable clinical outcomes to single-session therapy.

Aim: This study aims to comparatively evaluate the performance of four different artificial intelligence-based chatbots (ChatGPT-4o (Free), ChatGPT-5 (Plus), DeepSeek, and Google Gemini) in the diagnosis and treatment processes of dental trauma cases.

Material and methods: Based on the International Association of Dental Traumatology (IADT) guidelines, eleven fictional cases were developed, each representing different diagnostic possibilities of dental trauma. The cases cenarios were based on a standardized dataset including clinical examination, radiographic findings, and pulp sensitivity tests. All AI models were tested for three days for each case. Two researchers analyzed the responses using ablinding method according to five evaluation criteria (diagnostic accuracy, treatment plan appropriateness, splinting duration accuracy, antibiotic indication, and reference accuracy).

Results: According to the results, while no significant difference was found in terms of diagnostic accuracy (p > 0.05), Google Gemini showed the highest performance with 100% accuracy. ChatGPT-4o (Free) stood out with a 97% accuracy rate in antibiotic indication, while in splinting duration prediction, ChatGPT-5 (Plus) was the most successful model with 75.8%. DeepSeek exhibited the highest variability (p < 0.05).

Conclusions: The findings show that AI chatbots have promising potential as complementary tools in dental trauma diagnosis, but evidence-based validation, expert supervision, and methodological standards are needed for safe use in clinical practice.

Aim: To compare pulpal anaesthesia and injection pain between maxillary buccal infiltration with intraseptal (MBI + ISI) or palatal (MBI + PI) infiltration in the vital maxillary first permanent molars of 6- to 18-year-old patients.

Materials and methods: The primary outcome of this non-inferiority randomised controlled trial was pulpal anaesthesia, which was assessed pre-operatively using a cold test and intra-operatively based on patients' reported pain on the Wong-Baker FACES Pain Scale (WBFPS) and requests for supplementary injections. This trial hypothesised that the pulpal anaesthesia success of the MBI + ISI was non-inferior to that of the MBI + PI by a margin of - 15%. The secondary outcome was injection pain, reported by patients on the WBFPS, with success defined as a WBFPS score ≤ 4.

Results: The final sample comprised 22 boys and 35 girls aged 6.8 to 16.2 years (mean: 10.5 ± 1.9 years) and included 57 teeth (28 in the MBI + ISI group and 29 in the MBI + PI group). Baseline characteristics were similar between groups. The pulpal anaesthesia success was 78.6% in the MBI + ISI group and 82.8% in the MBI + PI group (risk difference [RD]: -4.2%, 95% confidence interval [CI]: -24.7%-16.3%, p = 0.689). For injection pain, success was 84.9% in the MBI + ISI group and 29.0% in the MBI + PI group (RD: 55.8%, 95% CI: 35.7%-75.9%, p < 0.001).

Conclusion: Compared to MBI + PI, non-inferiority of pulpal anaesthesia in MBI + ISI was not demonstrated; however, MBI + ISI reduced injection pain and achieved similar success rates of pulpal anaesthesia, suggesting it may be considered in selected paediatric cases.

Clinical relevance: MBI + ISI offers comparable pulpal anaesthesia success to MBI + PI while significantly reducing injection pain. This makes it a valuable alternative for anaesthetising vital maxillary first permanent molars in children and adolescents, particularly in cases where minimising discomfort is a priority.