Clinical Oral Investigations最新文献

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.

Objective: Bacteria and viruses are components of the oral microbiome and are linked to various oral diseases. Clinical observations indicate a higher prevalence of apical periodontitis (AP) during viral epidemics. However, research on this association is limited. This meta-analysis aimed to explore the relationship between viral infections and AP.

Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were identified through systematic database searches, and data were extracted for eligible studies. Three validated quality assessment tools were used to ensure rigor. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the strength of the association.

Results: Out of 427 screened records, 31 studies comprising 1,341,636 participants met the inclusion criteria. The meta-analysis revealed that the prevalence of AP was 2.78 times higher in patients with viral infections compared to controls (95% CI = 1.88-4.12, p < 0.001). Infected individuals demonstrated more severe clinical symptoms (OR = 3.49, 95% CI = 2.07-5.90, p < 0.001) and significantly larger periapical lesions (OR = 3.84, 95% CI = 1.08-13.67, p < 0.05).

Conclusions: The evidence suggests a significant association between viral infections and AP, particularly in cases of viral co-infections.

Clinical relevance: These findings suggest that evaluating viral infections, particularly herpesviruses, could inform the clinical management of AP. However, further research is required to establish causality.

Objectives: To characterize restorative materials, including low-viscosity resin composites containing or not S-PRG fillers, under erosive challenge.

Methods: Specimens of glass-ionomer (GC Gold Label 2-GL), resin composites without (Filtek Supreme Flowable Restorative-FSF; Filtek Bulk Fill Flowable Restorative-FBF) and with S-PRG fillers (Beautifil Flow Plus F00-F00 and Beautifil Bulk Flowable-BBF) were prepared. Materials were assessed for color stability (CIELab/CIEDE 2000), Knoop microhardness (KHN), flexural strength (FS), elastic modulus (E) and Energy Dispersive Spectroscopy (EDS) before and after cycling in orange juice (3 cycles/5min/5 days). Shrinkage stress (SS) was assessed to complement their characterization.

Results: Material, storage condition and their interaction were significant for most tests (p < 0.05). Under acidic conditions, GL was more vulnerable, with color change, reduced KHN, and elemental loss. Resin composites maintained both color stability and microhardness after erosive challenge. Among them, BBF and F00 exhibited higher KHN values than FBF. GL and BBF showed stable FS, while the elastic modulus increased for all materials except BBF. BBF also showed the lowest SS compared to FBF and GL.

Conclusions: Low-viscosity resin composites, in particular containing S-PRG fillers were able to resist under erosive challenge. BBF presented the best balance of color stability, resistance and low SS among the tested materials.

Clinical significance: The bulk-fill resin composite containing S-PRG fillers represents a promising restorative strategy for cervical erosive lesions, combining resistance to surface degradation with reduced shrinkage stress that may help preserve the adhesive interface.

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.