Dentistry Journal最新文献

Background/Objectives: Accurate identification of dental malocclusions from routine clinical photographs can be time-consuming and subject to interobserver variability. A YOLOv11-based deep learning approach is presented and evaluated for automatic malocclusion detection on routine intraoral photographs, testing the hypothesis that training on a structured annotation protocol enables reliable detection of multiple clinically relevant malocclusions. Methods: An anonymized dataset of 5854 intraoral photographs (frontal occlusion; right/left buccal; maxillary/mandibular occlusal) was labeled according to standardized instructions derived from the Index of Orthodontic Treatment Need (IOTN) A total of 17 clinically relevant classes were annotated with bounding boxes. Due to an insufficient number of examples, two malocclusions (transposition and non-occlusion) were excluded from our quantitative analysis. A YOLOv11 model was trained with augmented data and evaluated on a held-out test set using mean average precision at IoU 0.5 (mAP50), macro precision (macro-P), and macro recall (macro-R). Results: Across 15 analyzed classes, the model achieved 87.8% mAP50, 76.9% macro-P, and 86.1% macro-R. The highest per-class AP₅₀ was observed for Deep bite (98.8%), Diastema (97.9%), Angle Class II canine (97.5%), Anterior open bite (92.8%), Midline shift (91.8%), Angle Class II molar (91.1%), Spacing (91%), and Crowding (90.1%). Moderate performance included Anterior crossbite (88.3%), Angle Class III molar (87.4%), Head bite (82.7%), and Posterior open bite (80.2%). Lower values were seen for Angle Class III canine (76%), Posterior crossbite (75.6%), and Big overjet (75.3%). Precision-recall trends indicate earlier precision drop-off for posterior/transverse classes and comparatively more missed detections in Posterior crossbite, whereas Big overjet exhibited more false positives at the chosen threshold. Conclusion: A YOLOv11-based deep learning system can accurately detect several clinically salient malocclusions on routine intraoral photographs, supporting efficient screening and standardized documentation. Performance gaps align with limited examples and visualization constraints in posterior regions. Larger, multi-center datasets, protocol standardization, quantitative metrics, and multimodal inputs may further improve robustness.

Background/Objectives: Cleft lip and/or palate are common craniofacial anomalies whose surgical repair is classified as clean-contaminated and may be complicated by surgical site infection or palatal fistula. Despite widespread perioperative antibiotic use, there are no standardized, evidence-based recommendations, and rising antimicrobial resistance underlines the need for rational prescribing. This systematic scoping review aimed to map current evidence on prophylactic antibiotic therapy and related perioperative measures in cleft surgery. Methods: A scoping review was conducted using the Arksey and O'Malley framework and reported in line with PRISMA 2020. PubMed, Mendeley and Google Scholar were searched (January 2015-10 February 2025) for English-language retrospective studies, clinical trials, survey studies and systematic reviews concerning prophylactic antibiotics, bone grafting procedures, mouthwash use or oral microbiota in patients undergoing cleft lip and/or palate surgery. Six reviewers independently screened records; two experienced clinicians extracted data on study characteristics, antimicrobial regimens and infectious or microbiological outcomes. Given heterogeneity and the scoping aim, no formal risk-of-bias assessment or meta-analysis was performed. Results: A total of 40 studies met the inclusion criteria, including 21 original research articles. Considerable variation in antibiotic choice, timing and duration was observed, with no clear superiority of any regimen. Single-dose perioperative prophylaxis appeared non-inferior to prolonged courses in several settings. Oral microbiota studies highlighted colonization by resistant and opportunistic pathogens in cleft patients. Conclusions: Current evidence supports individualized, often short-course perioperative antibiotic strategies rather than routine prolonged therapy. High-quality randomized and microbiological studies are required to develop standardized, resistance-conscious guidelines.

Background: S3-level clinical practice guidelines represent the highest standard of evidence-based healthcare, integrating systematic reviews, formal evidence grading, and structured expert consensus. In periodontology, current S3-level guidelines provide robust recommendations for the management of stage I-III periodontitis. However, increasing clinical complexity, emerging diagnostic technologies, and the need for patient-centred and implementation-oriented care highlight important gaps that warrant further methodological refinement. Objective: This review aims to critically appraise the conceptual foundations, strengths, and limitations of existing S3-level periodontal guidelines and to propose a structured roadmap for the development of next-generation S3 guidance. Methods: A narrative and methodological review was conducted focusing on key European S3-level guidelines in periodontology and endodontics, with emphasis on guideline methodology, evidence grading, outcome prioritization, and consensus processes. Results: Current S3-level periodontal guidelines demonstrate strong methodological rigor but show limited coverage of stage IV periodontitis, peri-implant diseases, and endo-perio lesions. In addition, emerging domains such as biomarker-based diagnostics, artificial intelligence-assisted decision support, and implementation science are not yet systematically integrated. Conclusions: Future S3-level periodontal guidelines should incorporate clinical complexity, patient-reported outcomes, precision diagnostics, digital technologies, and real-world implementation strategies to enhance personalization, transparency, and clinical impact.

Background: Intentional tooth replantation (ITR) is a promising treatment option for preserving teeth in cases where conventional endodontic therapy is challenging, or when previous endodontic treatment and apicoectomy have been unsuccessful. The procedure involves extracting the compromised tooth, preserving the alveolar socket and root surface, performing extraoral endodontic therapy, and replanting the tooth in the alveolar socket. Objective: An increase in evidence-based support for ITR has improved the viability of ITR as a treatment option for patients. This review aims to further establish and provide new areas of potential research for ITR with respect to root morphology, extraction, and surgical techniques, maintenance of the tooth socket, and methods for post-op stabilization. Materials and Methods: A literature review was performed across PubMed from 1 January 1980 to 1 July 2025, with a focus on oral surgery techniques, atraumatic extraction techniques, topographical discrepancies in root system anatomy, and ITR procedural outcomes. Conclusions: Although ITR is not a common procedure performed in contemporary clinical practice, gathering sufficient data on the variables influencing the procedure may help patient outcome and improve communication between the endodontist and oral surgeons.

Objectives: This study aims to evaluate the efficacy of hydroxyapatite-tricalcium phosphate (HAP-TCP) as a bone substitute in subantral augmentation for dental implants. Specifically, it investigates the effects of HAP-TCP on bone quality, density, and integration with implants over time. Methods: A prospective controlled longitudinal study was conducted on 22 patients (39-75 years of age) undergoing subantral augmentation and dental implantation. A total of 52 sites of augmented bone and 67 sites of native bone were analyzed using computed tomography (CT) to assess bone density in Hounsfield Units (HU), insertion torque measurements, and the Misch classification for bone quality. Augmented and native bone measurements were compared within each patient. Results: The augmented bone exhibited an average density of 1132.6 ± 334.9 HU, which is significantly higher (45.9%) than the average density of native bone at 519.3 ± 395.0 HU. Insertion torque values in the HAP-TCP augmented sites averaged 35 N·cm, showing a 71.4% increase compared to adjacent native bone sites (25 N·cm). The study found notable improvements in bone homogeneity and vascularization within the augmented zones. Conclusion: HAP-TCP demonstrates significant potential as a reliable and effective synthetic bone substitute for subantral augmentation in dental implants. It yields higher radiodensity and insertion torque than adjacent native bone, while mitigating complications associated with autogenous grafts. These observational findings support the potential clinical use of HAP-TCP for sinus augmentation.

Background/Objectives: Malocclusion is one of the most prevalent oral health concerns in paediatric dentistry, with anterior open bite (AOB) and posterior crossbite (PCB) being among the most common forms. Non-nutritive sucking habits (NNSHs), including digit-sucking habits (DSHs) and pacifier-sucking habits (PSHs), have been linked to malocclusion development. While both habits are known to impact dental and skeletal development, their comparative effects remain unclear. This systematic review and meta-analysis aims to determine the difference in the development and prevalence of anterior open bite and posterior crossbite between patients with digit-sucking and pacifier-sucking habits. Materials and Methods: An exhaustive review of the literature was conducted on the 25 November 2024 across three databases, namely EBSCOhost (including PubMed-Medline), Web of Science and Scopus. The following PICO question was constructed for the systematic review: "In children and teenagers, is there a difference in the development and prevalence of malocclusions (Anterior Open bite & Posterior Crossbite) between patients with a history of digit sucking habits and patients with a history of pacifier sucking habits?"A meta-analysis was also performed with the selected studies, and the software used to carry out the meta-analysis was R 4.3.1 (R Core Team (2023)). Results: From the initial search, 102 articles were found and a further 11 articles were obtained from manual findings. 12 articles were included in the final systematic review and meta-analysis. The meta-analysis indicated that the risk of AOB and PCB was increased by both DSH and PSH. Conclusions: Both DSH and PSH significantly increased the risk of AOB and PCB. PSH posed a significantly higher risk than DSH for PCB development (OR = 2.66, p < 0.001), while no significant difference in AOB prevalence was observed between DSH and PSH (OR = 1.77, p = 0.150).

Background: Non-syndromic cleft lip/palate (NCL/P) is a prevalent congenital anomaly. Despite an unclear epidemiological link between orofacial clefts and dental caries, genetic studies suggest that polymorphisms in taste receptor genes may influence caries risk. Objectives: This study had two primary objectives: (1) to compare SNPs in NCL/P-associated genes (IRF6, FOXE1) between Kuwaiti NCL/P cases and controls, and (2) to explore whether variants in caries-associated (KLK4, DSPP) and taste receptor (TAS1R2, TAS2R38) genes are associated with dental caries susceptibility in individuals with NCL/P, independent of overall caries prevalence. Methods: A case-control design was employed, with 25 NCL/P cases and 25 unaffected controls recruited from a Dental Craniofacial Clinic in Kuwait. Genomic DNA was extracted from buccal swabs, and SNP genotyping was performed using real-time PCR for genes related to NCL/P, dental caries, and taste perception. Caries status was assessed using the dmft/DMFT scoring system. The genotyped genes included NCL/P-related (IRF6, FOXE1), caries-related (KLK4, DSPP), and taste receptor genes (TAS1R2, TAS2R38). Results: At nominal significance, KLK4, DSPP, and TAS1R2 showed associations with NCL/P status, while IRF6 and FOXE1 did not. After applying Benjamini-Hochberg FDR correction across 10 SNPs, no allele- or genotype-level association remained significant (q < 0.05). The strongest signal was KLK4 rs2235091 (allele-level p = 0.016; q = 0.159). An exploratory age- and sex-adjusted logistic model for KLK4 suggested a possible effect (aOR 0.40; 95% CI 0.18-0.87; p = 0.021). Within-group analyses of caries burden revealed no associations that survived FDR control (lowest q = 0.056 for FOXE1 in controls). Conclusions: After controlling for multiple testing, no SNP showed a statistically significant association with NCL/P or caries burden. Nominal signals for KLK4, DSPP, and TAS1R2 did not survive FDR correction; an exploratory adjusted model suggested a possible KLK4 effect, but this requires cautious interpretation. The small sample size is a key limitation, and the findings highlight the need for larger, well-powered studies to clarify genetic contributions to NCL/P and caries risk.

Background & Objectives: Periodontal disease (PD) is a common oral disease that affects the supporting structures of the teeth and is a leading cause of tooth loss worldwide. This study aimed to estimate the prevalence of PD among 9th-grade teachers in the northern West Bank and examine its association with key behavioral and socioeconomic factors. Methods: A cross-sectional study was conducted among 920 teachers selected through proportional stratified random sampling from governmental and private schools. Periodontal health was assessed using the WHO Community Periodontal Index for Treatment Needs (CPITN), and oral hygiene status was measured with the Simplified Oral Hygiene Index (S-OHI). A structured questionnaire was administered to collect data on socioeconomic status, oral hygiene practices, dietary habits, and smoking behaviours. Data was analysed using descriptive statistics, bivariate and multivariate logistic regression. Results: Only 11.8% of participants exhibited completely healthy gingiva, with the mean condition ranging between calculus and shallow pockets. Oral hygiene practices were the strongest predictors of periodontal outcomes: frequent tooth brushing (Adjusted Odds Ratio: AOR = 0.015), morning brushing (AOR = 0.015), and regular toothbrush replacement (AOR = 2.514) were protective. Higher red meat intake was negatively associated with periodontal health (AOR = 0.032), while frequent nut consumption was protective (AOR = 0.227). The number of cigarettes smoked per week was positively associated with PD (AOR = 1.085). Conclusions: PD is highly prevalent among Palestinian adults, with significant behavioural and lifestyle-related determinants. Targeted oral health interventions are urgently needed to improve adults' oral health.

Background: Digital intraoral scanning has become an essential component of modern restorative dentistry, offering enhanced accuracy, workflow efficiency, and patient comfort compared to conventional impression techniques. Despite these advantages, the accuracy of intraoral scanners (IOS) can be affected by multiple parameters, among which scanning strategy and device design are particularly influential. Purpose: This study aimed to investigate the effect of different scanning strategies on scan accuracy and precision, focusing on two widely used intraoral scanners (Medit i700 and Trios 5) in a controlled in vitro environment. Materials and Methods: A standardized digital test object was created according to ISO 20896-1 specifications to ensure uniformity and comparability. The object was printed using a high-precision 3D printer and scanned multiple times with both IOS systems, employing distinct scanning strategies under identical environmental conditions. Data analysis was performed using descriptive and comparative statistics, including Mean, Median, Mean Absolute Deviation (MAD), Root Mean Square Error (RMSE), Standard Deviation (SD), and Variance, to evaluate trueness and precision. Results: The Medit i700 consistently exhibited lower deviation values and greater precision compared with the Trios 5, reflecting higher trueness and precision. Scanning strategy influenced scan outcomes; structured, systematic scanning paths produced more stable and accurate datasets. The Trios 5 demonstrated higher variability, suggesting increased sensitivity to operator motion and scanning trajectory. Conclusions: Both the scanner type and scanning strategy substantially affect intraoral scan accuracy. The superior performance of the Medit i700 indicates greater robustness and operator-independent stability. Clinically, these results underscore the importance of standardized scanning protocols, as operator consistency may be a key determinant of digital impression accuracy and, consequently, of clinical outcomes.

Background: Peri-implantitis, a condition characterized by inflammation and progressive bone loss around dental implants, presents a significant challenge in contemporary dentistry. Conventional non-surgical treatments often fail to fully eliminate bacterial biofilms, particularly on complex implant surfaces. Laser therapies have emerged as potential adjuncts due to their antimicrobial and bio-modulatory properties. However, their microbiological effectiveness and suitability for individualized patient treatment planning remain unclear. Objective: Τhis study aims to systematically assess and synthesize the microbiological effects of various laser-assisted non-surgical treatments for peri-implantitis compared to conventional mechanical debridement. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251035354). Randomized controlled trials (RCTs) evaluating microbiological changes following laser-assisted non-surgical treatment of peri-implantitis, with a minimum follow-up of one month, were identified through searches in multiple databases and registries up to February 2025. The ncluded studies used lasers such as diode, Er: YAG, and photodynamic therapy (PDT) either alone or as adjuncts to mechanical debridement. Outcomes of interest included bacterial counts. Risk of bias was assessed using the RoB2 tool, and certainty of evidence was evaluated via GRADE. Quantitative synthesis used random-effects meta-analysis, with standardized mean differences (SMDs) calculated. Results: Eight RCTs involving 266 patients and 335 implants were included in the systematic review. Quantitative synthesis of three pathogens (counts of Fusobacterium nucleatum, P. gingivalis, T. denticola) across three studies displayed no statistically significant differences between laser and control groups at 3 and 6 months (p > 0.05 for all comparisons). When examining individual study findings, PDT, particularly in patients with diabetes or acute abscess, showed short-term reductions in red complex bacteria (e.g., Porphyromonas gingivalis and Treponema denticola). In contrast, diode and Er: YAG lasers demonstrated inconsistent or transient effects. The quality of evidence was rated as very low according to GRADE. Conclusions: Laser-assisted therapies, especially PDT, may provide targeted microbiological benefit in selected patient groups, supporting their adjunctive use within personalized treatment planning rather than as replacements for mechanical debridement, which remains the gold standard. Further high-quality RCTs incorporating well-defined patient risk profiles, such as systemic conditions and behavioral factors, and precision treatment algorithms are needed.