Dentistry Journal最新文献

Background: Oral health and cardiovascular disease share common inflammatory pathways, yet the relationship between tooth loss and post-myocardial infarction (MI) heart failure remains underexplored. Objective: To investigate the association between tooth loss and heart failure among patients with acute MI. Methods: In this cross-sectional study, 200 patients with documented MI were evaluated for tooth loss, cardiac function, and comorbidities. Heart failure was defined as an ejection fraction <40% or clinical diagnosis. Patients were categorized by tooth loss (0-8, 9-20, >20 missing teeth). Multivariate logistic regression was used to identify independent predictors of heart failure. Model performance was assessed using receiver operating characteristic (ROC) analysis. Results: The prevalence of heart failure was 38%. Mean ejection fraction declined progressively with greater tooth loss (50.1%, 44.8%, and 38.4% across the three categories; p for trend <0.001). After adjustment for age, sex, diabetes, and smoking, severe tooth loss (>20 missing teeth) remained independently associated with heart failure (adjusted OR 2.45; 95% CI, 1.15-5.23; p = 0.02). The final model demonstrated good discriminative ability (AUC = 0.78). Conclusions: Extensive tooth loss is strongly associated with heart failure among MI patients, suggesting a potential link between oral health deterioration and adverse cardiac remodeling. Integrating dental assessment into cardiovascular care may enhance risk stratification and promote holistic prevention strategies.

Background/Objectives: To analyze the behavior and release of bisphenol A (BPA) in the saliva of patients wearing clear aligners, and to evaluate differences in BPA levels between patients treated with aligners from the market-leading brand and those treated with in-office aligners. For the in-office group, 0.762 mm (0.30") thick thermoforming sheets from Ortolan^® were used to fabricate the aligners. Methods: Patients about to begin orthodontic treatment with clear aligners in the Master's degree program in Orthodontics at the University of Valencia were recruited for this prospective observational study. Patients were divided into two groups based on the type of aligners: The Invisalign^® group and the In-Office aligner group. Four saliva samples were taken from each patient at different times during treatment, with a one-week follow-up. The samples were stored at -80 °C and analyzed using mass spectrometry. Results: A total of 24 patients were included in the study, with 12 patients in each group. A statistically significant difference was found between baseline BPA levels and the increase observed half an hour after bonding the attachments. After a week, values returned to pre-treatment levels. Furthermore, BPA levels changed significantly during the follow-up period and were similar in both groups. Conclusions: An immediate increase was observed when the attachments were bonded with both treatments; however, differentiation from the 'peak' and recovery to baseline values was faster in patients treated with In-Office aligners. In those treated with Invisalign^®, after the placement of the aligners, values recorded were not significantly different from baseline, nor from the previous peak.

Background: All-on-six implants are a reliable and efficient full-arch restoration option in patients with atrophic maxilla. Aim: The present study aimed to evaluate and compare the distribution of stress surrounding implants and adjacent osseous structures by utilizing all-on-six tilted and zygomatic methodologies in the maxillary region by using finite element (FEA) analysis. Materials and Methods: Two finite element models were constructed with CT images of 50-year-old female. Model 1 was constructed with zygomatic implants, while model 2 was constructed with tilted implants. A vertical force of 150 N on the anterior component and 300 N on the posterior component were applied and maximum stress and deformation was assessed. Results: In the present study, the von Mises stress on the bone and implant overall was higher in the tilted implant model than the zygomatic implant model. Conclusions: The findings of the present study suggests that zygomatic implants help distribute occlusal loads more favourably, especially under horizontal and combined loading conditions in an all-on-six configuration.

Background/Objectives: Environmental contamination of dental surfaces is a major vector for cross-infection. Ultraviolet-C (UVC) irradiation provides rapid, chemical-free decontamination; however, depending on wavelength and ventilation conditions, ozone generation may occur. This study evaluated the germicidal efficacy of UVC on three high-touch surfaces: a wooden work table, a stainless-steel consumables table, and a dental unit table. Methods: Surfaces were sampled at baseline, after 5 min (27 mJ/cm²), and after 10 min (54 mJ/cm²) of UVC exposure at 90 µW/cm². Colony-forming units (CFU/cm²) were enumerated using Mueller-Hinton agar. Results: UVC achieved >99% reduction after 5 min and complete elimination after 10 min. Material properties (porosity, reflectivity, and grooves), along with quantified parameters like surface roughness (Ra) and contact angle, influenced minor differences in decontamination. Conclusions: Used with appropriate safety protocols, short-duration UVC irradiation effectively decontaminates dental surfaces and can complement chemical disinfection. Future studies must incorporate artificially soiled surfaces, biofilms, and emerging far-UVC/UV-LED technologies.

Objectives: This in vitro study assessed the accuracy (trueness and precision) of different 3D-printed resin denture bases with 0°, 45°, and 90° printing orientations. Methods: Denture base was designed and fabricated using three 3D-printed denture base resins (DentaBASE, Denture 3D+, and FormLabs). Each resin was printed with its own printer and fabricated with different printing orientations, resulting in a total of 72 specimens (n = 8). Trueness and precision were evaluated before and after thermal aging using the superimposition method with best-fit alignment. The data were collected and analyzed using two-way ANOVA followed by post hoc Tukey's test (α = 0.05). Results: The printing orientation significantly affected the trueness of 3D-printed resins (p < 0.001). The highest trueness was observed for NextDent at 0° printing orientation, while the lowest value was observed for ASIGA at 0° and 45° printing orientations. The precision of the denture base was significantly affected by different printing orientations for ASIGA (p = 0.006) and NextDent (p < 0.001) before thermal cycling, while the precision of FormLabs was significantly affected (p = 0.017) after thermal cycling. The highest precision was recorded for FormLabs at 45° printing orientation, while the lowest precision was observed for NextDent at 45° and 90° printing orientations. Moreover, the effect of thermal cycling on trueness was only significant for ASIGA at 0° printing orientation; however, the effect of thermal cycling on precision was significant for NextDent at 0° and 90° printing orientations. A 45° printing orientation provided the most accurate clinical fit. Conclusions: ASIGA showed the lowest trueness, while FormLabs exhibited the lowest precision, revealing performance differences between printers.

Background: Periodontitis and oral dysbiosis have been linked to systemic inflammation and carcinogenesis. Among oral pathogens, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) are biologically plausible contributors to colorectal cancer (CRC) via inflammatory and immunomodulatory pathways. However, the magnitude and consistency of these associations remain uncertain. Objective: To evaluate whether periodontitis and key oral pathogens are associated with CRC risk and prognosis through a systematic review, meta-analysis, and trial sequential analysis (TSA). Methods: We searched PubMed, Scopus, and Web of Science from inception to December 2024 following PRISMA 2020. Eligible observational studies assessed periodontitis exposure or detection of oral bacteria in relation to CRC incidence or survival. Effect estimates (RRs/HRs) were log-transformed and pooled using random-effects models; heterogeneity was quantified with I². TSA was conducted to appraise information size and the stability of the primary association. Risk of bias was evaluated with ROBINS-I/QUIPS as appropriate. PROSPERO: CRD420251168522. Results: Five studies evaluating periodontitis/oral-pathogen exposure and CRC incidence yielded a 70% higher risk (HR = 1.70; 95% CI: 1.33-2.19; I² = 0%). Detection of Fn was associated with approximately threefold higher risk of CRC (RR = 3.20; 95% CI: 1.76-5.82; p < 0.001). Pg presence was linked to worse overall survival (HR ≈ 2.4; p < 0.01). TSA suggested that the accrued evidence for the primary incidence association is likely sufficient to reduce random errors; nevertheless, interpretability is constrained by the small number of observational studies and between-study differences in exposure and outcome ascertainment. Conclusions: Current evidence indicates that periodontitis and oral pathogens-particularly Fn and Pg-are significantly associated with CRC development and progression. These findings support the clinical relevance of the oral-gut axis and underscore oral health as a potentially modifiable factor in cancer prevention. Further large, well-designed prospective cohorts and mechanistic studies are warranted to strengthen causal inference.

Background/Objectives: Scaling is central to non-surgical periodontal therapy; however, it is often perceived as uncomfortable, particularly in periodontitis. Psychological distress may amplify pain and reduce adherence. This comparative pilot study assessed whether ultrasonic technology influences patient-reported pain and psychoemotional status while quantifying the contribution of the periodontal condition and baseline psychological factors. Methods: A monocentric split-mouth design enrolled 42 adults (21 with stage I-III, grade B periodontitis; 21 periodontally healthy). Maxillary scaling was performed with Device nr.1 and mandibular scaling was performed with Device nr.2, and no anesthesia was used. Pain was measured immediately post-procedure using the Short-Form McGill Pain Questionnaire (SF-MPQ; sensory and affective subscales). Psychological status was assessed pre- and post-session with the Kessler Psychological Distress Scale (K10) and the Rosenberg Self-Esteem Scale (RSES). Construct validity was examined via exploratory factor analysis. The Mann-Whitney U, Wilcoxon signed-rank, Spearman's ρ, and Cliff's δ were applied (α = 0.05). Results: The overall pain was low. Between devices, sensory pain did not differ, whereas affective pain was modestly lower with the "No Pain" device (p = 0.017). Periodontitis was the dominant determinant of pain: higher sensory (U = 509.00, p = 0.0004; δ = 0.42) and affective scores (U = 290.00, p < 0.0001; δ = 0.67) occurred irrespective of device, while device-related effects were negligible (sensory δ = -0.03) to small (affective δ = 0.27). Somatic distress correlated with affective pain (ρ = 0.25, p = 0.023) and was borderline for sensory pain (ρ = 0.21, p = 0.060); emotional distress showed no significant associations. During the session, K10 scores decreased and RSES values increased, indicating immediate psychoemotional benefits. Conclusions: Pain perception during scaling is shaped primarily by periodontal status and psychological distress rather than by ultrasonic technology per se. Although the electronic module to dynamically adjust the power of the instrument technology may attenuate the affective component, standardized atraumatic techniques and routine psychosocial screening are likely to yield greater gains. The observed short-term improvements in distress and self-esteem support integrating patient-reported outcomes into individualized, patient-centered periodontal care.

Objective: The aim of the study was to analyze factors influencing the radiographic outcome of first-time endodontic treatment of teeth with periapical lesions. Methods: From March 2008 to October 2022, 804 cases of primary apical periodontitis with radiographically detectable lesions were treated conservatively by postgraduate students at the Department of Endodontics. A total of 437 patients had recall 11-48 months after completion. Post-operative and control radiographs of the teeth were scored by the periapical index (PAI) adjusted to define strict and lenient criteria for success. Patients' sex and age, the tooth treated, the number of visits, and several tooth- and treatment-related factors were registered and related to radiographic outcomes in bivariate and regression, with actual p levels recorded. Results: Overall success rate was 68% by strict and 83% by lenient criteria. In binary analyses, a high preoperative PAI score, older age, poorer periodontal status, tooth type (anterior teeth and premolars), and higher number of visits were negatively related to the outcome. Logistic regression analysis of the whole material confirmed an adverse effect on outcome by these factors. In particular, the number of visits (OR = 1.3, p = 0.003) and the initial PAI (OR = 1.9, p < 0.001) were the strongest predictors of reduced success. Conclusions: Outcome of treatment of primary apical periodontitis by postgraduate students was negatively affected by higher preoperative PAI score, higher patients' age, poorer periodontal status, and higher number of visits for completion. Clinical Relevance: This study provides clinically relevant insight into multiple prognostic factors that influence the outcome of primary root canal treatment in teeth with periapical lesions, including patient-related, tooth-related, and procedural variables. The results reflect real-world outcomes in a postgraduate clinical setting and confirm the favorable outcome of single-visit treatments found in randomized studies.

Background/Objectives: Climate change is a major global issue affecting all facets of society, including dentistry. In response, the idea of green dentistry has developed, prioritising the reduction in environmental damage and the protection of patient health. This scoping review seeks to assess the level of awareness, understanding and practices of oral health professionals concerning the proper management of biomed. Methods: Searches were carried out in the Medline/PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, analysing studies published between 2020 and 2025. Out of a total of 822 articles, 27 met the eligibility criteria. Results: In most of these studies, the respondents' level of knowledge was found to be unsatisfactory or average, and only 17% of the studies reported respondents having a positive attitude towards adherence to sustainability principles. Although many professionals stated they were aware that dental waste could negatively impact the environment and human health if not properly managed, some still failed to provide correct answers to all the questions. Conclusions: The synthesis results indicated that oral health professionals have significant gaps in certain aspects of biomedical waste management, highlighting the need for proper training and to supplement the undergraduate and postgraduate curricula with courses on this topic.

Background/Objectives: To determine the optimal site preparation and placement protocols for immediate implant positioning in robot-assisted surgeries. Methods: In vitro models of immediate and healed extraction sockets were created using 3D printing. A robotic system was used for implant site preparation and implant placement. The implant surgeries were allocated into eight experimental groups using 12 printed models in total. Each model incorporated two implant sites, an immediate site (tooth 21) and a healed site (tooth 26), resulting in 24 implants overall. With 3 implants assigned to each group, the 24 implant placements were evenly distributed across the 8 groups. For each group, the lateral force experienced during surgery was recorded by the haptic sensor on the robotic arm, and implant positional deviations were assessed by superimposing post-surgical CBCT images with the virtual implant planning. Results: Healed sites showed significantly higher accuracy than immediate sites, with reduced platform and apical deviations (p < 0.001) and markedly lower lateral force experienced by drills. In fully guided procedures, thread tapping greatly improved accuracy in immediate sites but had limited benefit in healed sites. Compared with partially guided workflows, fully guided rCAIS markedly enhanced accuracy in immediate sites (≈0.8 mm reduction in platform/apical deviation, p < 0.001), while no meaningful differences were observed in healed sites. Fully guided protocols also reduced insertion force in healed sites. Conclusions: Immediate sites showed lower implant positional accuracy and experienced higher lateral forces during surgery than healed sites. In immediate sites, thread tapping and fully guided rCAIS improved placement accuracy.