Dental and Medical Problems最新文献

Background: Pain is one of the most fundamental yet complex human biological experiences. A distinct category within this domain is orofacial pain. The orofacial region is anatomically complex, comprising a dense network of muscles, nerves and blood vessels. This complexity often makes the diagnosis and management of conditions affecting this area particularly challenging for clinicians.

Objectives: The primary aim of this study was to determine the global prevalence of oral and facial pain in the general population and to assess its distribution across different continents.

Material and methods: Literature searches were conducted in the MEDLINE and Scopus databases. This analysis synthesized data from 155 observational studies published between 2004 and 2024, encompassing 1,712,161 participants and 163,154 reported cases. Statistical analyses were performed using the R statistical language.

Results: The pooled global prevalence of concurrent oral and facial pain was 19.19%. By continent, the prevalence rates were as follows: Africa - 27.44%; Asia - 30.78%; Australia - 15.58%; Europe - 12.27%; North America - 14.53%; and South America - 25.61%.

Conclusions: Globally, the prevalence of concurrent oral and facial pain is 19%, compared with 12% for facial pain alone, and 21% for oral pain. Concurrent oral and facial pain was most common among individuals under 18 years of age (24%), decreasing to 16% among those aged 18-60 years and 10% in those aged >60 years. Females reported a higher prevalence (21%) of oral and facial pain than males (15%). Overall, the burden of concurrent oral and facial pain is greatest in Asia and South America, particularly among females, where prevalence exceeds 28%, while the lowest rates are found in Europe, especially among males (8%). The results of the present study should be interpreted with caution due to the high heterogeneity of the included studies. Further epidemiological research is recommended, employing rigorous methodology and adhering to current pain classification systems.

Background: The number of patients with bone defects is increasing. The treatment of damaged bones or bone defects is essential. Bone graft materials are frequently used in bone repair procedures. Researchers are attempting to replace damaged or defective bones with artificial ones, while also striving to improve the mechanical and biological compatibility of the scaffolds.

Objectives: The study aimed to establish and validate novel demineralized freeze-dried bovine bone xenograft nanoparticles (DFDBBX-NPs) for enhancing bone repair.

Material and methods: Demineralized freeze-dried bovine bone xenograft nanoparticles were extracted from bovine femoral bone. The physicochemical and biochemical properties of both native and demineralized freeze-dried materials were evaluated using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM), and the BrunauerEmmett-Teller (BET) analysis. Enzyme-linked immunosorbent assay (ELISA) kits were utilized to determine the content of type 1 collagen (Col-1) and bone morphogenetic protein-2 (BMP-2), water content percentage (WCP), and enzymatic degradation.

Results: The physicochemical analysis revealed non-porous DFDBBX-NPs with near spherical shapes of various sizes. The dried sample presented the nanoparticles agglomerated together, with an average size of 10-50 nm. The nanoparticles exhibit a type IV isotherm with an H3 hysteresis loop. They have a BET-specific surface area of 3 m2/g and a pore diameter of approx. 5.9 nm. The bioactive content of BMP-2 was higher than that of Col-1 in the DFDBBX-NPs. The DFDBBX-NP scaffold exhibited a slow rate of enzymatic degradation (0.098-0.240% over 14 days) and high water absorption (WCP ~202-215%).

Conclusions: Demineralized freeze-dried bovine bone xenograft nanoparticles demonstrated remarkable potential for the development of new bone grafts.

Background: The anaerobic commensal Fusobacterium nucleatum is scarce in healthy subgingival dental biofilms but is highly prevalent in periodontal pockets. Numerous genome-wide association studies and gene expression studies using microarrays or RNA sequencing (RNA-Seq) have been performed to better understand the genetic architecture of periodontal disease. However, these investigations have limited predictive capacity for identifying RNAs, particularly non-coding RNAs (ncRNAs). The mechanism of regulation of ncRNAs by F. nucleatum to alter disease progression in mice has not been thoroughly investigated.

Objectives: The aim of the study was to predict previously uncharacterized ncRNAs in F. nucleatum-infected mice using machine learning (ML).

Material and methods: Long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) were identified from the periodontitis gene expression dataset (GSE225589) obtained from the Gene Expression Omnibus (GEO) database and subsequently preprocessed. Long non-coding RNAs and circRNAs were labeled based on the gene expression. Transcriptomic features were analyzed using 3 ML algorithms: random forest (RF); adaptive boosting (AdaBoost); and naïve Bayes (NB). The dataset was labeled and divided into training (80%) and testing (20%) subsets with cross-validation. Additionally, receiver operating characteristic (ROC) curves, confusion matrices and area under the ROC curve (AUC) values were determined.

Results: The RF and AdaBoost models outperformed the NB model in classifying lncRNAs and circRNAs. Both RF and AdaBoost achieved an AUC of 100%, whereas the NB model achieved a slightly lower AUC of 92%.

Conclusions: This study is the first to apply ML to predict ncRNAs in F. nucleatum-infected mice using transcriptomic data. Random forest and AdaBoost showed superior classification performance in identifying lncRNAs and circRNAs associated with the infection. Further studies with larger cohorts and external validation are needed to confirm these findings.

Background: Sleep-related breathing disorders (SRBD), including obstructive sleep apnea (OSA) and habitual snoring, can substantially impair quality of life (QoL). However, evidence regarding their impact in patients with orofacial pain (OFP) remains limited. Although disentangling the specific consequences of SRBD from the overlapping conditions is challenging, validated psychometric instruments provide a valuable means of screening for associated biopsychosocial burdens, such as depression and anxiety.

Objectives: The aim of the present study was to investigate potential associations between respiratory distress caused by SRBD, using self-report data and psychometric variables as indicators of psychosocial stress, and the overall well-being in individuals with OFP.

Material and methods: Anonymized data from 415 patients was analyzed. The participants were screened and categorized according to the presence or absence of respiratory distress. Psychometric measures were examined descriptively. Based on the responses (positive or negative) to the screening question, group differences were evaluated within subgroups matched for sex, age decade, employment status, body mass index (BMI), and typical pain intensity. Associations between the variables were subsequently analyzed using multiple regression models.

Results: Most patients were female (n = 290; 69.9%), aged 20-59 years (n = 296; 71.3%), workers (n = 246; 59.3%), with a normal weight (n = 255; 61.4%) and without any respiratory distress (n = 324; 78.1%). Most patients who reported respiratory distress were female (n = 57; 62.6%), and more than a half were 40-59 years old (n = 49; 53.8%). For all domains of psychosocial stress, the percentage of patients reaching a clinically relevant score was higher for the group with respiratory distress, except for the Dysmorphic Concern Questionnaire (DCQ). Significant effects of typical pain intensity were observed across all questionnaires except DCQ, the Injustice Experience Questionnaire (IEQ), the Patient Health Questionnaire9 (PHQ-9), and the Patient Health Questionnaire for Stress (PHQ-Stress).

Conclusions: In this cross-sectional study, about 22% of the evaluated patients reported some form of SRBD. Moreover, SRBD were associated with higher psychometric scores, suggesting a close relationship between sleep-related respiratory difficulties and psychosocial impairment.

Background: Intraoral appliances are widely used in dentistry. Their surface roughness may influence patient comfort, biofilm formation and durability.

Objectives: The aim of the study was to evaluate and compare the effect of thermocycling on the surface roughness (Ra) of different materials used for the fabrication of intraoral appliances.

Material and methods: Seventy-two standardized specimens (40 mm × 10 mm × 2 mm) were fabricated from 3 materials: a self-curing poly(methyl methacrylate) (PMMA) resin (PMMA group); a light-cured urethane dimethacrylate (UDMA)-based resin (UDMA group); and a stereolithography (SLA) 3D-printed resin (SLA group). Surface roughness was measured before and after thermocycling (5,000 and 10,000 cycles between 5°C and 55°C) using a contact profilometer. Values were reported as mean (M) ±standard deviation (SD). The data was analyzed using repeated-measures or ordinary one-way analysis of variance (ANOVA), followed by Bonferroni-corrected post hoc tests (α = 0.0167).

Results: The UDMA group exhibited the lowest mean initial Ra values (0.078 ±0.020 μm). Thermocycling induced changes in surface roughness. In the PMMA group, a significant increase in mean Ra was observed after 5,000 cycles (0.103 ±0.028 μm before vs. 0.167 ±0.059 μm after; p = 0.0001) and after 10,000 cycles (0.107 ±0.024 μm before vs. 0.205 ±0.060 μm after; p < 0.0001). The increase in mean Ra following thermocycling was significantly greater in the PMMA group compared to the other groups (mean ΔRa after 5,000 cycles: 0.064 ±0.035 μm; after 10,000 cycles: 0.098 ±0.046 μm; all p < 0.0001).

Conclusions: Materials used for the fabrication of intraoral appliances exhibit material-specific responses to thermal aging. The light-cured UDMA-based resin demonstrated superior surface integrity after aging, whereas conventional PMMA and the 3D-printed resin were more susceptible to surface alterations.

Background: Obstructive sleep apnea (OSA) is a prevalent chronic condition characterized by recurrent episodes of upper airway narrowing or collapse during sleep. Obstructive sleep apnea is associated with various health issues, including cardiovascular disease and metabolic disorders. The cervico-craniomandibular complex (CCMC) plays a critical role in musculoskeletal functions such as mouth opening and head stabilization; however, its relationship with OSA remains insufficiently explored.

Objectives: The aim of the study was to evaluate the association between cervico-cranio-mandibular musculoskeletal function and OSA severity, based on the hypothesis that dysfunctions within the CCMC are associated with greater OSA severity.

Material and methods: A pilot cross-sectional study was conducted involving 32 patients with symptoms of OSA. The participants underwent assessment of cervico-cranio-mandibular musculoskeletal function and an ambulatory sleep study to determine OSA severity. Spearman's tests were used to analyze the relationships between cervico-cranio-mandibular musculoskeletal parameters and OSA severity.

Results: Significant negative correlations were observed between cervical range of motion (ROM) (flexion, left rotation, right/left lateral flexion) and OSA severity. The strongest correlation was identified for cervical movement in the frontal plane (r = -0.607, p < 0.001), especially among females (r = -0.772, p < 0.01). A positive relationship was found between mouth-opening muscle endurance and OSA severity in male participants (r = 0.445, p < 0.05).

Conclusions: This preliminary study highlights potential associations between specific musculoskeletal characteristics of the CCMC and OSA severity, with notable sex-specific patterns. These findings may contribute to the development of targeted screening approaches and support individualized physiotherapeutic interventions.

Background: Poor oral health can affect the overall health of the body, which may result in suboptimal performance in sports.

Objectives: The aim of the present study was to evaluate the occurrence of tooth decay, the prevalence of hygiene and dietary habits, and the influence of the workout session on the selected salivary parameters in youth swimmers.

Material and methods: The study involved 40 adolescents, aged 12-15 years (mean age: 13 ±0.5 years), including 30 competitive swimmers and 10 controls. The decayed, missing and filled teeth index (DMFT) was assessed. Data on oral hygiene and dietary habits was collected through a questionnaire created by the authors. Salivary samples were collected from all subjects in the morning and in the afternoon, and from swimmers before and after training. The salivary flow rate (V), pH, buffering capacity, and calcium (Ca) level were measured.

Results: The DMFT in the group of swimmers was 4.5 ±3.54, which was significantly higher than in the control group (1.6 ±2.59) (p = 0.0007). There were no statistically significant differences in oral hygiene habits between the 2 groups. However, swimmers significantly more often consumed chocolate bars (p = 0.004), energy drinks (p = 0.017) and water (p = 0.002) as compared to the control group. Among the consumed beverages, significantly more sweet carbonated drinks were consumed by swimmers than controls (p = 0.026). After the workout session, both in the morning and in the afternoon, there was a significant decrease in V (p = 0.006 and p = 0.009, respectively) and a significant increase in the Ca level (p = 0.001 and p = 0.001, respectively) in swimmers. While comparing swimmers before training with the control group in the morning, significantly higher V (p = 0.012) and lower pH (p = 0.003) were observed in swimmers. In the afternoon, significantly lower pH was found in swimmers (p = 0.006).

Conclusions: Oral health prevention and promotion should be an important aspect of sports participation, through greater awareness of the impact of oral hygiene and diet on overall health, which can influence sports performance.

Background: Anxiety resulting from dental treatment often leads to avoidance of dental appointments and consequently has a negative impact on oral health. Non-pharmacological approaches have been identified as suitable alternatives for the management of dental anxiety. In this context, lavender oil has traditionally been used in aromatherapy (AT) due to its sedative, carminative, antidepressive, antiinflammatory, and antimicrobial properties.

Objectives: The aim of the study was to perform a triple-blind randomized clinical trial to address the effectiveness of AT with lavender essential oil (ATL) on the dental anxiety of patients undergoing mandibular third molar surgery.

Material and methods: Participants scheduled to undergo mandibular third molar surgery were enrolled in the study and randomly assigned to either the ATL group or the control group. Dental anxiety was assessed using the preoperative Modified Dental Anxiety Scale (MDAS). Vital signs were evaluated before and after the intervention. Cortisol levels were measured by enzyme-linked immunosorbent assay (ELISA). Additionally, a visual analog scale (VAS) was used, and the requirements for anesthesia were determined.

Results: A comparison of the pre-operative MDAS scores between the ATL and control groups revealed no statistically significant differences (p = 0.268). The levels of respiratory rate (RR) (p = 0.011) and heart rate (HR) (p = 0.021) significantly decreased in the ATL group after the intervention. Also, the number of local anesthetic cartridges needed (p = 0.030) and cortisol levels (p < 0.0001) were significantly lower in the ATL group.

Conclusions: The evidence suggests that ATL could be helpful in the management of dental anxiety.

Background: The conventional method of removing caries lesions is an anxiety-inducing process that often necessitates the administration of local anesthesia and the extensive removal of tooth structure. Therefore, minimally invasive procedures are required to preserve tooth structure and minimize discomfort.

Objectives: The aim of the study was to compare 3 minimally invasive treatments for the management of dental caries, evaluating factors such as treatment time, the need for anesthesia, reported adverse events, and restorative material follow-up.

Material and methods: A clinical trial was conducted on 45 children aged 7-8 years with active caries in primary molars. The samples were divided into 3 groups based on the applied treatment: 38% silver diamine fluoride (e-SDF®) group; BRIX3000® group; and CeraBur® group. The duration of treatment was recorded using a stopwatch. Adverse events, including tooth pain irritations, lesions, spots, and discolorations, were reported by parents within 2 weeks. The durability of the restorative material, namely glass ionomer cement (GIC), was assessed after 3 months. The χ2 and Kruskal-Wallis tests were conducted to analyze the data. The values were considered statistically significant at p ≤ 0.05.

Results: A significant difference in the duration of caries removal procedure was noted between the 3 treatment methods based on the median values (e-SDF®: 471 s, CeraBur®: 171 s, BRIX3000®: 1,173 s) (p < 0.001). Post hoc pairwise comparisons indicated significant differences in duration of the procedure between the CeraBur® and BRIX3000® groups, as well as between the e-SDF® and BRIX3000® groups (p < 0.001). The need for local anesthesia varied significantly between the 3 methods (p = 0.021). A significant difference was observed in the incidence of postoperative complications among the 3 methods, with the rate of adverse events equaling 9 (60.0%) in the e-SDF® group and 2 (13.3%) in the remaining groups (p = 0.013). A 3-month follow-up revealed a borderline significant difference in GIC integrity among the 3 methods (p = 0.052).

Conclusions: Caries excavation using BRIX3000® required a longer duration compared with e-SDF® and CeraBur®. Silver diamine fluoride was found to be a simple, minimally invasive approach for caries management and was effective in reducing the need for local anesthesia during treatment. Further research is required to evaluate patient satisfaction and restoration outcomes over longer follow-up periods.

Background: Oral lichen planus (OLP) is an inflammatory condition of mucous membranes with an immunological basis. To date, no standardized treatment protocol has been established. Another complicating factor in clinical research is the assessment of disease activity and treatment efficacy. Fractal dimension analysis offers an objective method for evaluating mucosal irregularities, making it well suited for assessing OLP lesion morphology and treatment outcomes.

Objectives: The aim of the present study was to assess the effectiveness of photodynamic therapy (PDT) using methylene blue as a photosensitizer and topical clobetasol therapy in the treatment of OLP.

Material and methods: Fractal dimension analysis of oral mucosa images under white light and 405 + 450 nm light was used as an objective method of treatment evaluation.

Results: The use of autofluorescence at 405 + 450 nm enabled the detection of subtle differences in the pattern of the healed mucosa as compared to the reference mucosa, which were not visible during conventional white-light examination. Both treatment methods (topical clobetasol and PDT using methylene blue) demonstrated comparable efficacy in treating OLP.

Conclusions: The use of autofluorescence at 405 + 450 nm is an objective method of assessing healing, more accurate than observations under white light.