Clinical Oral Investigations最新文献

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.

Objectives: The aim of this study was to compare volumetric and linear hard tissue changes, as well as the efficacy of augmentation using periosteal secured suture (PSS) and fixation devices (FD) for resorbable membrane stabilization in horizontal guided bone regeneration (GBR).

Materials and methods: A retrospective matched cohort study was conducted on 14 patients undergoing horizontal GBR, with 7 in each of the PSS and FD (screws/tacks) groups. Inclusion criteria included the availability of high-quality pre- and post-GBR cone beam computed tomography (CBCT) scans and complete documentation of patient- and GBR-related characteristics. Patient-related variables (medical history and demographics) and GBR-related variables (location, type of bone substitute and membrane, and complications) were extracted from dental records. Postoperative CBCT scans were obtained at least 5 months after GBR procedure. CBCT subtraction analysis was performed using spatial registration and semi-automatic segmentation. Outcome variables included volumetric hard tissue gain (primary outcome), volumetric hard tissue loss, efficacy of augmentation (i.e. volumetric gain relative to defect extent), and changes in linear vertical and horizontal hard tissue dimensions between pre- and post-operative scans, measured at the mesial, middle, and distal planes.

Results: Both PSS and FD groups demonstrated significant increases in the linear horizontal dimension from preoperative to postoperative (p < 0.05). The mean horizontal hard tissue gains at 3 mm from the crestal bone in the middle plane were 2.8 ± 1.6 mm for the PSS group and 3.8 ± 1.2 mm for the FD group. The mean volumetric gain and efficacy of augmentation were 0.8 ± 0.9 cm³ and 0.025 ± 0.018 cm³/mm for the PSS group, and 0.6 ± 0.3 cm³ and 0.024 ± 0.010 cm³/mm for the FD group, respectively. No significant differences were observed between groups in linear dimensions, volumetric changes, or efficacy (p > 0.05).

Conclusions: Stabilizing resorbable membranes using periosteal secured sutures or fixation devices in horizontal guided bone regeneration procedures results in comparable linear and volumetric hard tissue gains, demonstrating similar efficacy in hard tissue augmentation.

Clinical relevance: Periosteal secured sutures and fixation devices are both reliable methods for stabilizing resorbable membranes in horizontal guided bone regeneration, yielding comparable efficacy in hard tissue augmentation.

Objectives: To quantitatively evaluate the progression of non-carious cervical lesions (NCCLs), gingival recession (GR), and occlusal tooth wear (OTW) over 25 years.

Methods: This observational, retrospective study involved 33 dental students who completed a questionnaire regarding their oral habits, diet, and health information. Impressions from the baseline and the 25-year follow-up were used to create digital casts, which were analyzed with 3D software (Geomagic Control; 3D Systems) to measure the progression of NCCLs, GR, and OTW. Occlusal analysis from Phase I, using the T-Scan system (Tekscan), was also included to evaluate occlusal interferences.

Results: NCCL dimensions (area, height, and width) showed moderate associations with GR and only weak correlations with OTW. Multivariate regression analyses identified significant factors associated with NCCL progression. For NCCLs, visible plaque, vigorous toothbrushing, occlusal interferences, dentin hypersensitivity, alcohol consumption, smoking, and frequent exposure to acidic or cariogenic diets were associated with increased NCCL progression. For GR, was significantly associated with occlusal contact, dentin hypersensitivity, alcohol consumption, and smoking. For OTW, unilateral mastication, long-term orthodontic treatment, and smoking were positively correlated with wear progression.

Conclusions: Mechanical and behavioral factors-particularly vigorous toothbrushing, occlusal interferences, and lifestyle habits such as smoking and alcohol consumption-significantly influenced the long-term progression of NCCLs, GR, and OTW. Mandibular molars and premolars were the most frequently affected teeth.

Clinical significance: The use of digital three-dimensional analysis allows accurate monitoring of NCCLs, GR, and OTW. Preventive measures should prioritize controllable risk factors, including brushing habits, smoking, alcohol consumption, and occlusal imbalances.

Objectives: To evaluate angular and linear tooth movements following orthodontic treatment for correction of moderate to severe crowding using clear aligner therapy (CAT).

Materials and methods: This retrospective study included 46 patients treated with clear aligners in permanent dentition for correction of moderate to severe crowding. Twenty-three patients (6 males, 17 females; mean age 20.0 years) were treated with premolar extractions and 23 patients (8 males, 15 females; mean age 17.3 years) were treated without premolar extractions. Three-dimensional tooth linear and angular displacements were quantified in the pre- and post-treatment digital dental models superimposed using the Slicer Automated Dental Tools module of 3D Slicer software ( www.slicer.org ). Generalized estimation equations were used for group comparisons (p < 0.05).

Results: CAT correction of moderate to severe crowding with premolar extraction led to significant retroclination of upper and lower incisors (upper: -6.71° ±7.79, P < 0.001 and lower: -5.11° ±8.49, P < 0.001). Anchorage control in extraction cases was limited, with approximately equal molar mesialization and incisor lingualization. In non-extraction cases, crowding was corrected through arch expansion with flaring of incisors. Vertical changes were similar between groups.

Conclusions: CAT of moderate to severe crowding without extraction led to arch expansion and proclination of incisors. In contrast, premolar extraction cases often presented incisor retroclination and molar mesial tipping, requiring careful biomechanical management.

Clinical relevance: These findings help clinicians plan treatments, manage patient expectations, and anticipate side effects, enabling the use of proper strategies and resources to optimize outcomes in both extraction and non-extraction cases.