Clinical Oral Investigations最新文献

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.

Objectives: This split‑mouth randomized pilot trial compared two innovative piezocision techniques-reticulated static computer‑guided surgery and dynamic computer‑guided surgery-to assess their effectiveness in preventing tissue overheating.

Methods: Ten adult patients undergoing accelerated orthodontic treatment received both interventions in different quadrants. Preoperative planning combined cone‑beam computed tomography (CBCT) and optical scanning to align DICOM and STL data. The static technique employed a digitally designed reticulated surgical guide with a plurality of openings, forming a net-like structure, whereas the dynamic technique used a real‑time navigation system. Tissue temperatures were recorded preoperatively, intraoperatively, and immediately postoperatively via an infrared smartphone camera. The Wilcoxon signed-rank test was used to evaluated thermographic differences. A post-hoc power calculation yielded 82.6%.

Results: Pre-operative temperatures were similar in both groups (p > 0.05). The lowest intraoperative temperature (23 °C) occurred in the upper premolar region with dynamic guidance, while the highest (50 °C) was observed in the lower molar region using the static guide. Descriptive analysis revealed a maximal postoperative temperature disparity of approximately 10 °C between techniques.

Conclusions: Dynamic computer‑guided piezocision significantly reduces surface tissue overheating compared to the reticulated static guide by enabling unobstructed irrigation and real‑time feedback, suggesting an alternative associated with lower surface temperature under our protocol forpiezocision procedures.

Clinical relevance: Dynamic navigation provides an alternative to static guides in corticotomy procedures, in terms of the prevention of tissue burns, by mitigating tissue overheating. This advancement has the potential to enhance patient safety, optimize protocols in accelerated orthodontics, and promote the integration of smartphone‑based thermography in dental procedures.

Objectives: To investigate the impact of three commonly used cleaning methods-mechanical cleaning, chemical cleaning, and ultrasonic cleaning-on the optical transmittance and surface roughness of thermoplastic orthodontic retainers following coffee-induced staining.

Materials and methods: Standardized thermoplastic specimens were assigned to five groups (n = 10): an unstained control group, a coffee-stained group without cleaning, and three post-staining cleaning groups treated with either mechanical cleaning, chemical cleaning using Polident tablets, or ultrasonic cleaning. Optical transmittance was measured using ultraviolet-visible (UV-Vis) spectrophotometry. Surface roughness parameters (Ra, Rz, RSm) were analyzed via surface profilometer, and surface morphology was examined using scanning electron microscopy (SEM).

Results: Coffee staining significantly reduced transmittance and increased surface roughness, indicating adverse effects on both optical transmittance and microstructural integrity. Ultrasonic cleaning effectively restored transmittance and surface integrity to near-control levels, with minimal surface damage. Mechanical cleaning successfully removed surface stains but introduced linear abrasions and led to a significant decrease in RSm values. Chemical cleaning achieved moderate stain removal but left visible surface residues.

Conclusions: Among the cleaning protocols evaluated, ultrasonic cleaning demonstrated superior performance in stain removal and preservation of surface integrity. Mechanical cleaning was effective but caused surface wear, while chemical cleaning offered limited cleaning efficacy and left undesirable deposits.

Clinical relevance: Cleaning strategies for orthodontic retainers should balance stain removal efficiency with material preservation. Ultrasonic cleaning provides a clinically favorable option, offering effective cleaning with minimal adverse effects on surface characteristics.

Objectives: The aim of this study was to analyze the content of YouTube™ videos related to dental visits for children with autism spectrum disorder (ASD), as well as to evaluate their quality, usefulness, reliability, and accuracy in supporting preparation for the first visit to the dentist.

Material and method: A total of 93 videos were analyzed between April 24^th to 4^th May 2025. Two evaluators assessed each video using the Global Quality Scale (GQS), modicied DISCERN (mDISCERN) and a Veracity Classification. Discrepancies were resolved by a third reviewer. Recorded variables included: video type, language, country, duration, views, likes, comments, source, category, and the interaction index. As well as quality, usefulness, reliability, and accuracy classifications. Benjamini-Hochberg False Discovery Rate (FDR) method to adjust multiple comparisons.

Results: Videos created by health professionals showed significantly higher mean GQS scores (3.9 ± 0.6) compared with those based on personal experiences (2.8 ± 0.7), with a mean difference of 1.1 points (95% CI: 0.8-1.4; p < 0.001). Webinars were rated as the most useful by dental professionals, while families valued personal experiences more highly. Tips-oriented videos were consistently considered useful by both groups.

Conclusions: YouTube™ serves as a valuable, freely accessible repository of information to help families prepare children with ASD for dental visits.

Clinical relevance: Promoting high-quality, accurate, and reliable online content can support better preparation for first dental visits of children with ASD. Dental professionals should recommend trustworthy videos and participate in the creation of evidence-based educational materials.