Clinical Oral Investigations最新文献

Objective: This study aimed to explore the effect of lavage with sterile saline (SS), sodium hypochlorite (NaOCl), and Ethylenediaminetetraacetic acid (EDTA) on success rate and postoperative pain in direct pulp capping of mature permanent teeth.

Methods: In this double-blind trial (NCT05878249), 140 patients with reversible pulpitis in permanent molars due to caries were enrolled. Following complete caries removal, hemostasis was achieved, and the cavities were randomly assigned to four groups for lavage: (European Society of Endodontology (ESE) developed by:, Duncan HF et al. Int Endod J 52(7):923-34, 2019); SS ( Asgary S et al. J Endod 44(4):529-35, 2018); 2.5% NaOCl ( Cushley S et al. Int Endod J 54(4):556-71, 2021); 12% EDTA, and ( Ricucci D et al. J Endod 49(1):45-54, 2023), 2.5% NaOCl followed by 12% EDTA (NaOCl/EDTA). Biodentine was applied to the exposed pulp, followed by a resin-modified glass-ionomer liner and composite restoration. Clinical and radiographic success was evaluated at 6 and 12 months. Visual Analog Scale was used to record pain for 7 days. Statistical analysis included Mann-Whitney U, Kruskal-Wallis, Chi-square tests, and Kaplan-Meier analysis. Multivariate Cox regression analysis was used to identify risk factors associated with tooth survival.

Results: The overall clinical and radiographic success rate at 12 months was 86.9%. Individual success rates among groups were 71.9% (SS), 90.6% (NaOCl), 87.9% (EDTA), and 97.0% (NaOCl/EDTA). NaOCl/EDTA group showed significantly higher success rates than SS group (p < 0.05). NaOCl and NaOCl/EDTA groups showed a significant reduction in pain compared to SS group on days 5-7 (p < 0.05). Pulp survival analysis revealed an overall success rate of 87.9%. Survival rates among the groups were: SS group - 74.3%, NaOCl group - 91.4%, EDTA group - 88.6%, and NaOCl/EDTA group - 97.1%. Log-rank test revealed a significant difference in the survival between the groups (p = 0.020). NaOCl, EDTA, and NaOCl/EDTA provided higher survival probability (meaning fewer failures) compared to the use of SS alone (P > 0.05). The failure risk was 14.3 times higher with SS than with NaOCl/EDTA (HR: 14.3, 95% CI: 1.7-118.6, p = 0.013).

Conclusions: The combined use of NaOCl/EDTA increased the success rates at 12 months. NaOCl and NaOCl/EDTA elicited significantly less postoperative pain than other groups.

Clinical relevance: Lavage with NaOCl/EDTA increased the success rates of direct pulp capping.

Objectives: This study aimed to evaluate whether fixed orthodontic treatment leads to measurable changes in taste perception. The primary objective was to assess alterations in the perception of sweet, salty, sour, and bitter tastes before and after treatment initiation.

Materials and methods: A total of 128 patients aged 10-19 from the Orthodontics Clinic of Biruni University were randomly assigned to either a fixed orthodontic treatment group (n = 64) or a control group (n = 64). Taste perception was evaluated using nine solutions (two concentrations each of sweet, salty, sour, and bitter, plus a neutral control) administered before treatment and again six weeks later. Perceived taste intensity was measured using a Visual Analog Scale (VAS). Statistical comparisons were performed using the Mann-Whitney U test, Wilcoxon Signed-Rank test, and Pearson Chi-Square test.

Results: Significant changes were observed within the experimental group: sweet taste scores (low concentration) decreased, and bitter taste scores (high concentration) increased from the first to the second session (p < 0.05). However, no significant differences were found between the experimental and control groups across all taste modalities and time points (p > 0.05).

Conclusions: Fixed orthodontic appliances may cause minor, short-term alterations in taste perception, specifically for sweet and bitter tastes. These changes are likely influenced by salivary flow and are not clinically significant when compared to untreated individuals.

Clinical relevance: Clinicians should inform patients that mild and temporary changes in taste may occur during the initial phase of fixed orthodontic treatment. These effects are manageable and typically resolve with good oral hygiene and adaptation to the appliance.

Trial registration: This study was retrospectively registered at ClinicalTrials.gov (NCT06989736) on May 23, 2025.

Objectives: Mandibular reconstruction remains a clinical challenge due to a high rate of osseous non-unions. Mechanical factors are known to influence the bone regeneration process. Therefore, bite force levels, both immediately after surgery and during the bone healing process, are believed to play a critical role in the healing outcome. The aim of this study was to evaluate bite force and mandibular mobility measurements over time following mandibular reconstruction and to relate these measurements to the bone healing outcome.

Materials and methods: In this prospective study, 28 patients were included and underwent functional measurements pre-operatively and at two weeks, four weeks, eight weeks, three months, and six months post-reconstruction. Additionally, the healing outcome was assessed using post-operative imaging.

Results: After surgery, the functional parameters - including bite force, mouth opening, protrusion, and laterotrusion - significantly decreased. However, between the initial post-operative measurement and the final follow-up six months after surgery, all parameters showed a significant increase. Two weeks post-operatively, only 9 of the 28 patients were able to participate in the bite force measurement. However, 6 of these patients exhibited incomplete osseous union, which was associated with a mean bite force of 166 N at two weeks (mean over the whole cohort after six months of 154 N).

Conclusions: This study demonstrated the trends in functional measurements over time following mandibular reconstruction and identified a significant trend in association between excessive post-operative bite force and incomplete osseous union.

Clinical relevance: In consequence, clinical strategies to reduce mechanical over-stimulation could be evaluated in future studies, such as soft food intake for 3 months after mandibular reconstruction.

Objectives: A novel multi-slice real-time MRI (ms-rtMRI) approach was applied in order to bilaterally investigate temporomandibular joint (TMJ) kinematics during mastication and force-free jaw movements in healthy subjects and individuals with anterior disc displacement (with / without reduction).

Materials and methods: Nineteen subjects (mean age 31.2 ± 12.6 years) underwent clinical examination (DC/TMD) and bilateral sagittal-oblique ms-rtMRI on a 3T system with a customized 15-channel mandibular coil, achieving 55.6 ms temporal and 0.5 × 0.5 mm² in-plane resolution. A standardized mastication protocol involving food boluses with increasing elastic modulus (bread, cheese, carrot, caramel) was employed to capture ipsilateral and contralateral joint dynamics. Motion data were analyzed using Generalized Additive Modelling (GAM) after time-normalization in order to identify phase-specific differences in condylar translation and rotation.

Results: Force-free mandibular movements demonstrated coupled rotational and translatory excursions averaging 26.3°, 14.3 mm (anteroposterior), and 5.5 mm (craniocaudal). GAM analyses revealed that bolus type generally did not significantly alter TMJ kinematics, except caramel, which transiently affected contralateral rotation. Diagnostic subgroup comparisons showed marked deviations in subjects with anterior disc displacement without reduction (antDDwoR), especially contralaterally, manifesting as temporally extended disturbances in translatory and rotational trajectories.

Conclusion: The present approach combined ms-rtMRI with temporally resolved GAM, which effectively revealed diagnosis-specific alterations in TMJ biomechanics during mastication. TMJ kinematics remarkably remained robust even over various food consistencies. However, patients with antDDwoR exhibited temporally and spatially extended deviations in condylar translation and rotation, predominantly during contralateral chewing.

Clinical relevance: The present methodology overcomes limitations of established approaches in order to reveal TMJ biomechanics using multidimensional, time-normalized analyses. The results allow for the differentiation between normal and displaced discs during functional loading, which might expand dynamic evaluation of the TMJ in future diagnostic methods.

Objective: The aim of this umbrella review was to synthesize evidence on the effects of non-surgical periodontal therapy (NSPT) on cardiovascular biomarkers in adults with periodontitis.

Materials and methods: Seven databases were searched up to March 2025 (PROSPERO: CRD420250656185). Included studies evaluated the impact of NSPT on cardiovascular biomarkers, including C-reactive protein (CRP), Interleukin-6, Tumor Necrosis Factor-α, lipid profiles (LDL, HDL, total cholesterol, and triglycerides), and vascular function measures (systolic and diastolic blood pressure, and flow-mediated dilation). The GROOVE tool was used to quantify review overlap, AMSTAR2 for methodological quality and GRADE for evidence certainty. Meta-analyses were recalculated using a random-effects model.

Results: Of 1,525 records screened, 17 systematic reviews met the inclusion criteria. Pooled findings showed NSPT yielded reductions in CRP (-0.58 mg/L; 95% CI: - 0.91 to - 0.25), LDL (-0.10 mmol/L; 95% CI: - 0.17 to - 0.04), and increased HDL (0.03 mmol/L; 95% CI: 0.03 to 0.05), while other markers and vascular measures showed inconsistent and low-certainty results. Most evidence was classified as weak (Class IV) or non-significant due to heterogeneity, high risk of bias, and study overlap.

Conclusions: NSPT is modestly beneficial for CRP, IL-6, HDL, and LDL levels; however, the overall evidence is limited by methodological weaknesses.

Clinical relevance: NSPT may offer small yet clinically meaningful improvements in systemic cardiovascular risk markers in patients with periodontitis. Coordinated medical-dental care, targeted patient education, and timely delivery of NSPT can be pragmatically integrated to support cardiovascular risk reduction.

Objectives: This study aimed to investigate the correlation between the dental cervical morphology (DCM) of maxillary anterior teeth and facial parameters, with the goal of validating the predictive efficacy of these facial parameters for DCM of the maxillary anterior teeth in a Chinese population.

Materials and methods: This cross-sectional study was conducted at Stomatology Hospital of Fujian Medical University. Facial parameters of participants were obtained using a 3D facial scanner and subsequently imported into reverse engineering software for measurement. Cone beam computed tomography (CBCT) data were imported into imaging software, where specific landmarks were annotated. The distance between these landmarks at the cemento-enamel junction (CEJ) level was then quantified and defined as dental cervical morphology (DCM). Pearson correlation analysis was employed to identify relationships between facial and DCM measurements. Linear regression was performed on significantly correlated variables, while t-tests evaluated the difference of real value and predicted value (α = 0.05).

Results: A total of 147 volunteers participated in this study. Significant correlations for DCM were observed with interlateral canthus width (LCW) in males (P < 0.05) and with intermedial canthus width (MCW) in females (P < 0.05). Regression equations based on facial parameters showed no significant differences between predicted and actual values for DCM (P > 0.05), with LCW used for males and MCW for females (P > 0.05).

Conclusions: DCM of the maxillary anterior teeth was found to be associated with facial width, with LCW serving as a potential predictor for males and MCW for females. These findings suggested that facial morphology could be a valuable predictor for DCM.

Clinical relevance: Facial parameters offer a reliable basis for the precise design of customized abutments, enhancing the accuracy and efficiency of clinical prosthodontic treatments, particularly in implantology and aesthetic restoration.

Trial registration: This study was approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University (approval no. 2023-24).

Objectives: Helicobacter pylori (H. pylori) is a prevalent gastric bacterium increasingly detected in the oral cavity and may contribute to the progression of oral diseases. This study aimed to assess the association between oral diseases and oral H. pylori infection.

Materials and methods: A systematic review and meta-analysis of observational studies was conducted to compare oral H. pylori prevalence between patients with oral diseases and healthy controls. Data were pooled to estimate overall associations, and subgroup analyses were performed by oral disease type, detection site, detection methods, and region to assess their potential impact on the observed relationships.

Results: Ten studies with 1166 participants met the inclusion criteria. Oral H. pylori infection was significantly associated with oral diseases (OR = 3.24, 95%CI:1.78-5.92, p = 0.0001), particularly periodontitis (OR = 4.28, 95%CI:2.46-7.44). The strongest associations were observed when H. pylori was detected in dental plaque (OR = 4.65, 95% CI: 2.60-8.33), using polymerase chain reaction (PCR)-based methods (OR = 4.09, 95% CI: 2.31-7.24), and in Asian populations. Sensitivity analyses confirmed the robustness of these results, and no publication bias was detected.

Conclusions: Oral H. pylori, particularly when detected in dental plaque by PCR, is strongly associated with periodontitis, suggesting that it may contribute to the progression of oral diseases. However, these findings are limited by potential confounding and the observational nature of the included studies, warranting cautious interpretation and further prospective research.

Clinical relevance: Oral H. pylori is associated with periodontitis, highlighting the need for standardized detection methods and further prospective studies to clarify causal mechanisms and guide integrated management of oral diseases and the risk of gastric reinfection.

Objectives: Oral toxicities affect a high proportion of head and neck cancer (HNC) patients receiving radiotherapy, lacking reliable predictive biomarkers for incidence and severity. We investigated salivary metabolites and metabolic pathways as non-invasive predictors of radiotherapy-induced oral mucositis (OM) and candidiasis.

Material and methods: HNC patients undergoing radiotherapy were prospectively studied. Saliva samples of 45 HNC patients and 30 controls were analysed using NMR spectroscopy, and patients were assessed for oral complications during treatment.

Results: Significant metabolite differences were identified between patients with and without complications. An increased concentration of lactate (p < 0.000), and a reduced concentration of formate (p = 0.018) and pyruvate (p = 0.045), was found in HNC patients at risk for OM during RT. Comparison of salivary metabolites between patients at risk or not risk for candidiasis presented increases in acetate (p = 0.005), alanine (p = 0.009), proline (p = 0.002), tyrosine (p < 0.000), trimethylamine (p = 0.007) and fucose (p < 0.000), whereas the level of citrate (p = 0.008) was decreased. Of the metabolic pathways, glucose-alanine cycle and thyroid hormone synthesis, were significantly different in patients at risk for candidiasis.

Conclusions: Salivary metabolomics is a promising predictive tool for radiotherapy-induced oral complications, potentially enabling early intervention and personalized supportive care.

Clinical relevance: Elevated level of salivary lactate seems to predict the development of OM, while fucosis was a sign of candidiasis. Multicentre validation studies are needed for its clinical implementation.

Objective: An increase in the incidence of oral cancer in women has been reported in some countries. This study investigated demographic, clinicopathological, risk factors, treatment outcomes and predictors for survival in female patients with oral cancer treated in a reference head and neck cancer center for the past 32 years.

Methods: This retrospective cohort study reviewed the clinical records of women patients with oral squamous cell carcinoma (OSCC). The proportion of OSCC cases in women relative to men over the last three decades was investigated. Clinicopathological data were correlated with treatment outcomes using logistic regression analysis. The 2 and 5-year overall survival (OS) and disease-specific survival (DSS) were assessed through the Kaplan-Meier and Cox regression analyses.

Results: In total, 133 women patients with OSCC were investigated. The ratio of oral cancer cases in women to men has almost doubled in the last decade. Most female patients were non-smokers (51.9%) and non-alcoholics (69.2%) and had early-stage disease at the time of diagnosis (51.9%). The most frequent tumor sites were tongue (46.6%) and alveolar ridge (18%). Advanced clinical stage was the independent predictor for worse 5-year OS (p < 0.001) and DSS (p < 0.001), while non-surgical treatment was associated with poor OS only at the 2-year cutoff (p = 0.003).

Conclusion: This study demonstrates an increase in the proportion of oral cancer cases in women in the last decade. Advanced-stage tumors remain the main predictor for women with oral cancer, denoting the need to strengthen policies to increase the rate of early diagnosis for this population.

Clinical relevance: The number of female patients with oral cancer without the classic risk factors for the disease has been increasing over the years. Clinicians should be alerted to ulcerated lesions in the oral mucosa of non-smoking and non-alcoholic women, favoring early diagnosis.