Clinical Oral Investigations最新文献

Objectives: Previous findings showed that nasal exposure to mastic resin volatiles stimulated salivary flow both in healthy volunteers and dry-mouth patients. This prompted the search for new volatile sialagogic compounds as well as other, more standardized delivery methods. Therefore, this study aimed to assess the sialagogic effects of α-pinene, basil, eugenol, and guaiacol volatiles using nasal inhalers.

Materials and methods: α-Pinene, basil, eugenol, and guaiacol volatiles were administered using nasal inhalers to act as an olfactory stimulus in healthy individuals (n = 12). Salivary flow, spinnbarkeit, and subjective mouthfeel were assessed before and after the use of the compounds. Furthermore, the possible effect of placebo nasal inhalers on salivary flow was also assessed.

Results: Stimulation with basil and guaiacol applied with nasal inhalers resulted in an increase in salivary flow (p ≤ 0.01). Furthermore, basil improved the feeling of moistness in the oral cavity (p < 0.05). The use of nasal inhalers did not reveal any placebo effect in healthy individuals.

Conclusions: These findings demonstrate that nasal inhalation of basil volatiles can effectively enhance salivary secretion and improve the sensation of oral moisture. This suggests basil in particular being a promising candidate for developing new topical treatment for dry mouth. Further studies with larger cohorts and clinical trials in dry-mouth patients are necessary to confirm and extend these results.

Objective: To combine quantitative measures of gingival thickness (GT), keratinized tissue width (KTW), and alveolar buccal bone thickness (ABT) for developing a novel classification of periodontal phenotype through a clustering analysis, using two digital images.

Materials and methods: This cross-sectional study comprised 180 subjects with a total of 1080 maxillary anterior teeth. GT and ABT were assessed utilizing superimposed Cone Beam Computed Tomography (CBCT) and intraoral scan data, while KTW was obtained from intraoral images employing a correction factor. Hierarchical cluster analysis (HCA) was conducted to discern phenotypic categories. Cutoff values for GT, KTW, and ABT were derived from cluster boundaries to provide a clinically applicable scoring system.

Results: Cluster analysis identified four statistically significant phenotypic groupings (p < 0.001). Only 48.9% of instances accounted for conventional "thin" or "thick" phenotypes, while 51.1% exhibited mixed characteristics. Cutoff values were established as GT = 0.85 mm, KTW = 3.0 mm, and ABT = 1.0 mm. Based on these cutoffs, a scoring system (0-3) was developed to classify individuals as fully thin, majority-thin (gingival thin/ bone thick)" and "majority-thick (gingival thick/ bone thin), or fully thick. This system demonstrated good internal consistency, with moderate to high coefficients of determination (R²) across parameters.

Conclusion: This study presents a comprehensive, data-driven classification of periodontal phenotype using quantitative evaluations of GT, KTW, and ABT, providing an innovative viewpoint on phenotype-based diagnostics. The proposed system offers a clinically relevant framework for phenotype-based diagnostics, risk evaluation, and individualized treatment planning.

Clinical relevance: By combining soft (GT, KTW) and hard (ABT) tissue parameters with 3D imaging and clustering analysis, this classification provides clinicians with a practical and quantitative tool for assessing periodontal phenotype, thereby supporting accurate diagnosis and evidence-based decision-making across multiple dental disciplines.

Objective: To compare postoperative pain intensity and incidence after root canal obturation using AH Plus or EndoSequence BC in asymptomatic molars.

Materials and methods: This randomized clinical trial included 152 patients and was conducted in accordance with CONSORT guidelines. Teeth were randomly allocated according to the sealer used. Postoperative pain was assessed using validated pain scales at 6, 12, and 24 h, and at 2 and 3 days after obturation. Quality of life was evaluated using the OHIP-14 questionnaire. Bite sensitivity and analgesic intake were also recorded.

Results: Postoperative pain intensity was very low in both groups at all time points. The AH Plus group showed slightly higher pain intensity within the first 24 h compared with the BC sealer group (p < 0.05). No differences were observed between groups regarding pain incidence, bite sensitivity, or impact on quality of life (p > 0.05). Analgesic intake was higher in the AH Plus group. A weak positive correlation was observed between pain intensity and functional limitation domains of the OHIP-14 (physical disability and social impairment).

Conclusions: Overall, both sealers resulted in very low postoperative pain. Although AH Plus showed slightly higher pain intensity compared with BC, both sealers demonstrated a similar risk of pain and comparable impact on quality of life.

Clinical relevance: Postoperative pain after root canal obturation was minimal with both AH Plus and EndoSequence BC sealers. Minor differences in pain intensity were observed during the early postoperative period, with a slightly faster reduction in pain reported for EndoSequence BC, and no differences in pain risk or impact on quality of life.

Objectives: Malocclusion, particularly anterior crossbite and open bite, contributes to abnormal occlusal stress distribution, potentially leading to tooth loss. We examined the association between anterior malocclusions and tooth loss-related outcomes in a large-scale, community-based sample of Japanese adults.

Materials and methods: This cross-sectional study targeted 17,349 participants aged ≥ 40 years from the Tohoku Medical Megabank Cohort Study (2013-2017). Based on overjet and overbite, participants were classified into normal occlusion (n = 16,790), anterior open bite (n = 177), anterior crossbite (n = 348), and combined malocclusion (n = 34). Outcomes included ≤ 19 remaining natural teeth and posterior tooth loss. Adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using modified Poisson regression models.

Results: The crossbite group demonstrated a higher prevalence of ≤ 19 remaining teeth (PR, 1.48; 95% CI, 1.04-2.10) and posterior tooth loss (PR, 1.14; 95% CI, 1.07-1.20) than the normal group; the open bite group exhibited a lower prevalence of posterior tooth loss (PR, 0.79; 95% CI, 0.69-0.90). Heatmap analysis revealed lower molar tooth retention in the crossbite group and higher retention in the open bite group.

Conclusions: Anterior crossbite is associated with increased posterior tooth loss, whereas open bite shows a weaker association. These findings suggest that specific anterior malocclusions may be linked to reduced tooth retention.

Clinical relevance: Identification of anterior malocclusion types, particularly anterior crossbite, may help identify individuals at higher risk for tooth loss. Orthodontic management of anterior crossbite might support posterior dentition preservation and long-term oral function.

Objective: This study aimed to develop, validate, and implement a novel wearable monitor to detect mouth breathing rates and analyze their correlation with malocclusion severity using craniofacial measurements obtained from CBCT and 3D photographs.

Materials and methods: The monitor was equipped with two sensors mounted in a 3D-printed holder for oral and nasal breathing detection respectively, which senses humidity changes by silk fibroin and interprets into capacitive values. After qualitatively and quantitatively validated by polysomnography and the infrared thermography, the monitor was employed to calculate mouth breathing rates. Malocclusion parameters were derived from CBCT and 3D photographs, and correlated to mouth breathing rates.

Results: The accuracy, precision and recall of this novel monitor were 101.07 ± 5.21%, 98.80 ± 3.70% and 99.85 ± 2.08% respectively. The temperature changes and normalised capacitance values showed strong negative correlation during both inhalation and exhalation, with the mean correlation coefficients K at -0.8985 and -0.9332 respectively in the same breathing process. Strong correlations were identified between mouth breathing rates and maxillary canine width, palatal operculum height, left and right mandibular angle, lower face height, lower lip protrusion, nasolabial angle, chin-lip angle and the volumes of adenoid, nose, total airway and nasopharynx airway.

Conclusion: This novel wearable monitor can qualitatively and quantitatively monitor mouth and nasal breathing accurately and precisely, potentially establishing itself as gold standard for mouth breathing diagnose and severity assessment. The strong correlations observed between mouth breath rates and malocclusion emphasize the importance of early orthodontic intervention in addressing mouth breathing habits.

Objectives: This study aimed to map the complex relationships among physiological, psychological, and social factors of oral frailty using network analysis. The primary goal was to identify the most central and influential elements within this network to guide future intervention strategies.

Materials and methods: A cross-sectional study included 991 community-dwelling older adults in Jiangsu Province, China. Data were collected on oral frailty (OFI-8), oral health self-efficacy (GSEOH), depressive symptoms (GDS-5), family support (APGAR), personal mastery (PMS), and nutritional appetite (SNAQ). A Gaussian Graphical Model network was constructed, and centrality indices were calculated to identify key nodes.

Results: The analysis revealed a stable network where personal mastery (PMS), nutritional appetite (SNAQ), and oral health self-efficacy (GSEOH) emerged as the most central nodes. The strongest connection was found between GSEOH and SNAQ, highlighting a key psycho-physiological link. Notably, oral frailty (OFI) exhibited lower centrality and was negatively associated with these core psychosocial resources.

Conclusions: Oral frailty should be conceptualized as an outcome of dysregulation within a broader biopsychosocial system, rather than a central driver. Personal mastery, nutritional appetite, and oral health self-efficacy form a critical, interconnected core. A holistic approach strengthening these hubs may be more effective in managing oral frailty than focusing on oral symptoms alone.

Clinical relevance: This study advocates for a clinical shift from reactive symptom management to proactively enhancing older adults' psychological resources, such as personal mastery. Interventions targeting the feedback loop between nutritional appetite and self-efficacy represent a promising strategy to prevent oral frailty and promote healthy aging.

Objectives: Conventional plaque assessment methods, such as clinical indices and planimetry, rely on plaque-disclosing agents and may overemphasize thin biofilm areas due to plaque thickness variations. This study introduces a digital 3D method to quantify and visualize dental plaque volume from consecutive intraoral scans (IOS) and compares it with the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPlI) and planimetry.

Methods: After professional supragingival debridement at baseline (T0), fifteen participants refrained from oral hygiene for four days (T4). De novo plaque formation was assessed at T4 using TMQHPlI after application of a two-tone (pink/purple) plaque-disclosing agent. IOSs (3Shape TRIOS 4) were obtained at T0 and T4. Plaque accumulation was quantified using color-coded IOS comparisons with the Volumetric Plaque Index (VPI) and Adjusted VPI (AVPI). Machine learning (Trainable Weka Segmentation) was used to calculate the Planimetric Plaque Index (PPI).

Results: A correlation between plaque surface area and volume was observed only for purple/mature plaque (p = 0.043). Early plaque growth was dominated by expansion of pink-stained, newly formed plaque. Once more than one-third of the surface was covered, further increases resulted mainly from vertical thickening rather than lateral spread.

Conclusions: 3D volumetric analysis offers a comprehensive, objective, and clinician-friendly method for assessing dental biofilms.

Clinical relevance: The proposed 3D approach enables accurate monitoring of plaque accumulation and maturation, improving personalized oral hygiene assessment, patient education, and clinical decision-making.