Dental and Medical Problems最新文献

Background: The accuracy of cone-beam computer tomography (CBCT) in measuring the labial alveolar bone thickness requires further evaluation.

Objectives: The aim of the present study was to evaluate the impact of dental implants on the accuracy of CBCT in measuring the postoperative labial alveolar bone thickness in the maxillary anterior region.

Material and methods: The distance from the labial alveolar bone surface at the bone crest level to the implant neck was measured using 2 methods. One method involved using periodontal probes during an immediate implant surgery, while the other employed the CBCT scans obtained immediately postoperation.

Results: Twenty patients were recruited from the Department of General Dentistry at the Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China, from February 2023 to October 2023. In total, 20 implants with a diameter of 3.3 mm were placed surgically. The average distance from the labial alveolar bone surface at the bone crest level to the implant neck in the group of 20 patients, obtained through the intraoperative measurement, was 3.7 ±0.8 mm. The corresponding average value based on the CBCT data of the 20 patients was 3.1 ±0.6 mm. A significant difference was observed between the 2 methods (p < 0.001). The average diameter of the 20 implants measured using the CBCT scans was 4.1 ±0.4 mm, which was significantly greater than the actual implant diameter of 3.3 mm.

Conclusions: The distance from the labial alveolar bone surface at the bone crest level to the implant neck, which comprises the thickness of the labial alveolar bone and the jumping gap, was smaller according to the CBCT data than the actual values obtained from intraoperative measurements. However, the average diameter of the 20 implants measured using the CBCT scans exceeded the actual implant diameter of 3.3 mm. When assessing the thickness of the labial alveolar bone around implants in the maxillary anterior region using CBCT during follow-up, a moderate underestimation of the labial bone thickness may occur.

Background: Self-assessment is key to improving the quality of work performed by dental professionals. The ability to accurately self-assess has been found to correlate with better clinical performance, making it an important skill for students to master during their dental education. Furthermore, studies conducted in dental schools across the world have shown that lower-performing students tend to overestimate their abilities compared to their peers.

Objectives: This study aimed to evaluate the self-assessment skills of dental students in pre-clinical operative dentistry and to investigate the impact of gender on these skills.

Material and methods: Third-year undergraduate dental students (N = 335) took 2 pre-clinical practical exams: class II composite preparation and restoration. Students self-assessed each assignment using a standardized rubric, and 6 calibrated faculty members graded all procedures blindly and independently. The difference between students' self-assessment scores (S) and mean faculty grades (F) reflected the students' self-assessment skills and was referred to as the Student-Faculty (S-F) gap. A positive S-F gap indicates that students overestimate their work, while a negative S-F gap indicates that students underestimate their work. Data was stratified by gender and by faculty-determined student performance, and then statistically analyzed.

Results: The study demonstrated a statistically significant difference between faculty grades and students' self-assessment scores. Positive S-F gaps were observed across all procedures, indicating overestimation, with a mean S-F gap of 11.4 ±9.9%. A negative correlation was found between faculty grades and S-F gaps. Higher-performing students showed smaller S-F gaps (4.8 ±5.3%) compared to lower-performing students (21.2 ±9.68%). Furthermore, male students showed significantly higher S-F gaps (14.0 ±10.3%) compared to females (9.7 ±9.4%).

Conclusions: Overestimation was more prevalent among lower-performing and male students compared to higher-performing and female students. Future investigations should consider exploring effective interventions and educational strategies aimed at improving students' self-awareness and their ability to accurately assess their performance.

Background: According to the World Health Organization (WHO), malocclusion is the most common oral disease in children after dental caries. Disorders pertaining to smile aesthetics and appearance can cause psychosocial problems and feelings of marginalization in children.

Objectives: The aim of the study was to assess the prevalence of malocclusion and to compare the need for orthodontic treatment in children treated with removable appliances and those who are not treated orthodontically.

Material and methods: The study sample consisted of 653 children aged 9-12 years (349 boys and 304 girls) from a selected urban population in Poland. The clinical study was based on the evaluation of Angle's classification and analysis of other occlusal characteristics (overjet, overbite, crossbite, scissor bite, crowding, diastema, and midline shift). The assessment of orthodontic treatment needs was carried out according to the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC).

Results: In the sample group, 533 children (81.62%) were diagnosed with malocclusion. The most frequent diagnoses were class I malocclusions (43.80%) and class II malocclusions (35.99%), as well as crowding (37.98%). Among the children studied, 28.95% were receiving orthodontic treatment and using removable appliances. As many as half (50.26%) of the children treated with removable appliances exhibited no or minimal need for orthodontic treatment. The study revealed no significant association between the severity of patient's need for treatment and the probability of receiving orthodontic treatment with removable appliances.

Conclusions: The prevalence of malocclusion in the studied population is high. However, not all children with a diagnosed malocclusion require orthodontic treatment. For an effective plan of orthodontic care and rational budgeting, it is recommended that appropriate indicators be used to identify individuals with the most severe malocclusions who are eligible for treatment.

Background: Despite the fact that sleep bruxism (SB) is common in migraine, and that patients with migraine often report poor sleep quality, SB and sleep architecture in chronic migraine (CM) have not been fully explored.

Objectives: The aim of the study was to establish the association between SB and CM, with an assessment of sleep structure alterations in CM.

Material and methods: The diagnosis of migraine was made using the 3rd edition of the International Classification of Headache Disorders (ICHD-3). Sleep bruxism and sleep structure were assessed using polysomnography, according to the American Academy of Sleep Medicine (AASM) Guidelines. All results were adjusted for medication use in the treatment of migraine, which may interfere with sleep and SB.

Results: A total of 110 patients with migraine (mean age: 39.3 years; 88% female) were evaluated, including 65 individuals with CM and 45 episodic migraine (EM) patients. The patients with CM had lower REM sleep duration when compared to those with EM (median (Me): 21.4% of total sleep time (TST) vs. 24.4% of TST, p = 0.008), while REM sleep below 23.1% of TST was associated with increased odds of CM (odds ratio (OR): 3.61 (95% confidence interval (CI): 1.60; 8.15), p = 0.002). Seventy-six out of 110 (69%) participants were diagnosed with SB. The presence of mixed bruxism at a frequency of above 0.4 episodes per hour (n/h) was associated with increased odds of CM (OR: 2.40 (95% CI: 1.06; 5.46), p = 0.048). However, severe SB (bruxism episode index (BEI) >4) was associated with increased odds of migraine with aura (MwA) (OR: 2.68 (95% CI: 1.05; 6.83), p = 0.044). Migraine without aura showed a weak, negative correlation with BEI (r = -0.293, p = 0.002).

Conclusions: A decrease in the REM stage of sleep was associated with CM. Despite the high prevalence of SB in patients with migraine, SB was not associated with CM, while severe bruxism was associated with MwA. Therefore, if any association between SB and migraine exists, it is more likely related to aura phenomena than to migraine chronification.

Background: Oral infections that cause inflammation typically affect the gingival tissues. The immuneinflammatory reactions significantly influence the patient's vulnerability to periodontal diseases. Numerous studies have found a correlation between persistent inflammation and an increased risk of developing cancer in the afflicted oral epithelium. New research demonstrates a startling connection between periodontal conditions and various forms of cancer, including oral cancer.

Objectives: The aim of the study was to use bioinformatics techniques in order to predict interatomic hub genes in oral cancer and periodontitis.

Material and methods: The datasets were screened for differentially expressed genes (DEGs) in periodontitis and oral cancer using the Gene Expression Omnibus (GEO) database, a gene expression data analysis tool. GeneMANIA was used to identify hub genes between oral cancer and periodontitis. Orange machine learning was conducted for hub gene prediction using random forest, decision tree, AdaBoost, and neural network.

Results: The top 5 hub genes (RSPO4, CDHR2, DDAH2, HLA-J, and IRF3) were prioritized to explore their relationship with oral cancer and periodontal disease. The receiver operating characteristic (ROC) curve was constructed, with the area under the curve (AUC) for random forest at 0.999, for the decision tree at 0.998, for AdaBoost at 1.000, and for the neural network model at 0.865. The AdaBoost model, followed by random forest and decision tree, exhibited the highest level of accuracy (1.000). These results suggest that the 3 models demonstrate good predictability and may facilitate the early detection of periodontitis and oral cancer.

Conclusions: The insights derived from this study may contribute to the development of novel diagnostic and therapeutic techniques for chronic inflammatory periodontitis and oral cancer by utilizing computational approaches and integrating multi-omics data. The identification of interactome hub genes in these diseases has important clinical ramifications. The obtained outcomes may help decipher disease pathways, promote early detection, and create targeted treatments for better patient outcomes. The accurate prediction of hub genes may promote their utilization as biomarkers in the development of individualized treatment plans for both illnesses.

Background: The basic mechanisms underlying early atherosclerosis remain controversial. Several theories centered on lipid accumulation have been proposed, but increasing evidence highlights the central roles of inflammation and endothelial dysfunction in the initiation of the disease. Two major processes - chronic lipid-driven injury and maladaptive inflammatory and cellular responses - are closely involved in early atherogenesis and offer potential targets for new management strategies in atherosclerotic cardiovascular disease (ASCVD).

Objectives: The aim of the present study was to evaluate the effects of colchicine compared with atorvastatin on the expression of interleukin-1β (IL-1β), a key pro-inflammatory cytokine, and nitric oxide (NO), a protective mediator, both of which play important roles at the early stages of atherosclerosis.

Material and methods: This was an in vivo experimental study. A total of 20 male Wistar rats (Rattus novergicus) were divided into 4 groups: the control (normal) group (N); the dyslipidemia group fed an atherogenic diet (DL); the dyslipidemia group receiving both an atherogenic diet and colchicine (DLK); and the dyslipidemia group receiving both an atherogenic diet and atorvastatin (DLA). All kinds of treatment were administered for 14 days.

Results: The results showed that colchicine and atorvastatin were equally effective in terms of IL-1β reduction (p > 0.05). Yet, the data also showed that the NO levels were significantly higher in the DLK group as compared to the DLA group (p < 0.05).

Conclusions: In the early development of atherosclerosis, colchicine was significantly more effective than atorvastatin in increasing the NO levels and demonstrated a comparable ability to reduce the IL-1β levels. These findings suggest that colchicine may offer superior benefits as a primary preventive therapy in populations at risk for ASCVD.

Background: Oral cancer (OC) is a major public health problem in the Indian subcontinent. As many as 90% of all OC cases are oral squamous cell carcinomas (OSCCs), often developing from oral potentially malignant disorders (OPMDs). Although the oral cavity is freely accessible, visual identification is often challenging. Biopsy and a microscopic examination is the only confirmatory diagnostic test. Recently, the analysis of volatile organic compounds (VOCs) has emerged as a new, non-invasive, rapid, and inexpensive strategy with promising potential in clinical diagnostics. The human VOCs produced in metabolic pathways, present in body fluids and the exhaled air, can be used for monitoring several oral diseases, including OC.

Objectives: The aim of the present study was to determine the potential diagnostic capabilities of salivary VOCs in OC through identifying and comparing the salivary volatilomic profiles among OSCC and OPMD subjects, as well as healthy controls, using the gas chromatography-mass spectrometry (GC-MS) analysis.

Material and methods: Unstimulated saliva samples were collected from 35 OSCC subjects, 35 OPMD subjects and 40 healthy controls. The VOCs extracted from the ZSM-5/PDMS film were condensed with 100 μL of methanol, of which 1.0 μL was subjected to the GC-MS analysis.

Results: A total of 128 salivary VOCs were detected and identified among the OSCC and OPMD subjects and the healthy controls. Twenty-five metabolites were determined to be statistically significant in differentiating among the 3 groups. Organic acids, alcohols, ketones, alkanes, and acid amides were the major classes of VOCs in the OSCC subjects, while organic acids, alcohols, ketones, acid amides, heterocyclic compounds, and phenols constituted the VOC profile in the OPMD subjects. 1-chloro-dodecane and 1-tridecanol were significant VOCs observed among the controls.

Conclusions: The study demonstrates that salivary VOC profiling can reveal distinct metabolomic alterations in OSCC and OPMDs, with several VOCs emerging as potential tumor-specific biomarkers. While these findings highlight the promise of VOC-based screening, larger studies are needed to validate these markers and establish their clinical applicability.

Oral mucositis (OM) is a common and debilitating side effect of cancer therapy that impairs nutrition, increases infection risk, and often disrupts oncologic treatment. Photobiomodulation therapy (PBMT) has emerged as an effective, non-invasive method for OM prevention and management.This umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Joanna Briggs Institute (JBI) methodology. A comprehensive search of PubMed®/MEDLINE, Embase, Scopus, and Cochrane Library identified systematic reviews and meta-analyses on laser therapy for OM published through July 2025. The data extraction process centered on clinical outcomes, laser parameters and safety.Twenty-two reviews met the inclusion criteria. Photobiomodulation therapy significantly reduced the incidence of OM, disease severity, pain, and healing time across adult and pediatric populations. Preventive PBMT decreased the risk of severe OM (grade 3-4) by 40-80%, while therapeutic PBMT shortened ulcer duration by 4-7 days. The combination of PBMT and photodynamic therapy (PDT) enhanced mucosal healing and alleviated pain. Optimal outcomes were achieved when wavelengths of 630-670 nm (intraoral) and 780-850 nm (extraoral) were used, with fluences of 2-6 J/cm2. No serious adverse events were reported.Photobiomodulation therapy demonstrates strong efficacy and safety in the management of OM, improving quality of life and treatment continuity in oncology patients. The Polish Society for Laser Dentistry (PTSL) endorses PBMT as a standard supportive care modality, particularly in the context of hematopoietic stem cell transplantation (HSCT) and head and neck chemoradiation. Protocol adherence and parameter standardization are essential to ensure the reproducibility and clinical effectiveness of research findings.

Artificial intelligence (AI) shows significant potential in supporting development and management in everyday dental practice; however, significant challenges, limitations and uncertainties remain.

Background: This article presents the global consensus report of the World Federation for Laser Dentistry (WFLD) on laser-assisted caries prevention and management. Laser-assisted caries removal is a minimally invasive approach based on selective ablation, targeting demineralized tissues while preserving the adjacent healthy enamel and dentin. This approach aligns with the principles of modern conservative dentistry. Erbium-doped yttrium aluminum garnet (Er:YAG) and erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) lasers are highly absorbed by water and hydroxyapatite (HAP), enabling precise ablation with minimal thermal diffusion and collateral damage. Laser wavelengths can also exhibit bactericidal effects through thermal and photomechanical mechanisms, reducing the microbial load in carious lesions.

Objectives: The aim was to review, evaluate and consolidate the current evidence on the use of laser technologies in caries prevention and treatment, in light of the emerging scientific knowledge and clinical advancements.

Material and methods: This summary is based on the current evidence from in vitro, ex vivo and clinical studies evaluating the interaction of erbium-based lasers (Er:YAG, Er,Cr:YSGG) with enamel and dentin, their effect on the microbial load, fluoride uptake and resin adhesion, and their use in photobiomodulation (PBM) therapy.

Results: Laser irradiation induces physicochemical changes in enamel, such as superficial melting and recrystallization, reducing porosity and increasing resistance to acid attacks. Fluoride uptake is enhanced through microstructural modifications, especially when combined with topical fluoride. Subablative laser settings synergize with fluoride to enhance retention without damaging enamel. Laser conditioning before fissure sealing improves surface energy and resin adhesion, reducing microleakage. Photobiomodulation promotes remineralization in early lesions via cellular stimulation.

Conclusions: Laser-assisted caries treatment offers precise, minimally invasive management of dental caries with added benefits, such as microbial reduction, structural enhancement and improved adhesion. Careful control of parameters is essential to balance efficacy and safety. Further studies are needed to standardize protocols and confirm long-term outcomes in clinical practice.