Dentistry Journal最新文献

Objectives: This study aimed to determine whether surface wear, identified through the superimposition of intraoral scans (IOS), can predict subsurface damage progression detected by optical coherence tomography (OCT) during fatigue testing of computer-aided design/computer-aided manufacturing (CAD/CAM) composite crowns. Methods: Monolithic CAD/CAM composite crowns (Brilliant Crios; n=8) were adhesively luted to standardized prepared human teeth and artificially aged by cyclic loading in a mouth-motion simulator (50-500 N, 2 Hz, 37 °C). Under phantom-head condition, IOS (surface wear) and handheld swept-source (SS)-OCT (subsurface damage) were performed before loading and after every 250,000 cycles. OCT crack depth/width were normalized to local thickness and cusp-tip distance; correspondence between IOS- and OCT-derived metrics at each timepoint was assessed with Spearman's rank correlation coefficient (ρ) to test whether surface wear can predict subsurface damage under the given conditions. Results: All specimens survived without catastrophic failure, and both modalities revealed progressive damage from the earliest observation interval. OCT consistently showed higher defect percentages and larger dispersion (e.g., mean vertical defects (25.47 ± 4.97)% OCT vs. (4.36 ± 0.91)% IOS at T1 and (66.79 ± 19.53)% OCT vs. (7.78 ± 3.19)% IOS at T5). Across all timepoints, no statistically significant associations between IOS and OCT were observed (p = 0.146 to 0.955). Conclusions: Within the limitations of this exploratory, single-material in vitro study, restricted to a CAD/CAM composite (Brilliant Crios), surface-based monitoring alone did not reliably reflect subsurface damage progression. Clinically, this suggests that surface wear assessment may underestimate subsurface fatigue damage. Intraoral OCT may provide complementary, non-invasive information alongside routine IOS for individualized monitoring, but its added value needs to be confirmed in larger studies and other CAD/CAM composite materials and additional restorative material classes.

Background: Early childhood caries is closely associated with oral dysbiosis and the proliferation of Streptococcus mutans. Oral probiotics, particularly Lactobacillus reuteri and Lactobacillus rhamnosus, have been proposed as ecological modulators capable of reducing cariogenic microorganisms. Objective: To evaluate the efficacy of orally administered L. reuteri and L. rhamnosus in reducing salivary S. mutans levels in children aged 6 months to 12 years through a systematic review and meta-analysis. Methods: This review followed the PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420251086304). Searches were conducted in MEDLINE/PubMed, CENTRAL, Embase, Scopus and LILACS without language or date restrictions. Randomized controlled trials administering the target probiotic strains for ≥30 days were included. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. Random-effects meta-analyses were performed for continuous and dichotomous outcomes. Results: Six randomized controlled trials were included (N = 1362). Only two trials reported continuous outcomes in comparable log₁₀ CFU/mL format and could therefore be pooled for the continuous meta-analysis. This analysis showed a significant reduction in salivary S. mutans levels (MD = -0.65 log₁₀ CFU/mL; 95% CI: -0.97 to -0.34; p < 0.0001; I² = 19%), although the pooled estimate was largely driven by one study and should be interpreted cautiously. Four trials contributed to the dichotomous meta-analysis, which showed a non-significant trend toward risk reduction (OR = 0.73; 95% CI: 0.51-1.06; p = 0.10; I² = 35%). Short-term interventions using high oral-retention formulations demonstrated the most consistent microbiological effects. Conclusions: Oral probiotics may significantly reduce salivary S. mutans in the short-term, especially when delivered through slow-dissolving formulations. However, their effects vary according to strain, vehicle, and intervention duration. Larger, standardized, and longer-term clinical trials are needed to determine the sustainability and clinical relevance of these effects.

Background/Objectives: Artificial teeth in complete dentures are classified according to the materials used: porcelain (PO) or composite resin (CR). However, these materials' effects on function, patient satisfaction, and quality of life (QOL), as well as occlusal wear, remain unclear. We compared PO and CR complete dentures in edentulous patients by assessing masticatory function, patient satisfaction, and oral health-related QOL at 3, 6, and 12 months post-insertion, as well as occlusal surface morphology owing to material differences. Methods: In this open-label, randomized, single-center, parallel-group study, participants were edentulous patients who visited our hospital and underwent treatment with new complete dentures. The outcomes were oral health-related QOL; subjective satisfaction, assessed using a visual analog scale; and masticatory performance, evaluated with gummy jelly and were assessed at baseline and 3, 6, and 12 months post-denture insertion. Occlusal surface impressions were taken twice, digitized as STL models, superimposed, and analyzed for wear. The Wilcoxon rank-sum test was used to compare between groups. Results: All evaluated items showed improvement. However, no significant differences were observed between the PO and CR groups, including between the amount of wear observed in the two groups. However, the PO group showed a tendency toward less wear. Extended observation may be required to clarify the long-term effects of artificial tooth materials. Conclusions: In the short term, the artificial tooth material did not influence masticatory function, oral health-related QOL, or patient satisfaction.

Objective: This study aimed to assess the impact of different adhesive systems on the color stability of composite veneers following their exposure to various common beverages.

Materials and methods: A single layer of commercially available adhesives (4th and 7th generations) and two experimental adhesives based on hydroxyapatite and bioactive glass were applied, followed by composite restoration on incisor typodonts. The typodonts were prepared with depths of 0.3, 0.5, and 0.7 mm at the cervical, middle, and incisal regions, respectively. Samples from each group were immersed in coffee, Cola, and deionized water, and color stability was analyzed on days 1 and 60. One-way and two-way analyses of variance were performed.

Results: The interaction between groups and solutions was statistically significant (p = 0.001) across all tooth regions. Coffee and Cola caused significant color changes (p = 0.001). The 4th generation demonstrated better color stability than the 7th generation in the middle and cervical regions (p-values = 0.083 and 0.003, respectively). The findings showed that the bioactive glass-based bonding agent exhibited greater discoloration than the hydroxyapatite-based adhesive (p = 0.001).

Conclusions: The composite thicknesses are influenced differently by adhesives with respect to shade matching. Bioactive materials-based adhesives showed more resistance towards color change than commercial adhesives.

Background: The majority of cleft palate patients have been reported to suffer from otitis media with effusion (OME). The improvement of velopharyngeal function (VPF) after palatoplasty might be evidence for the improvement of the function of the Eustachian tube. The improvement of the function of Eustachian tube by palatoplasty has been reported to be effective for the treatment of OME simultaneously with the insertion of a ventilation tube into the tympanic membrane. There are only a few reports that clearly show the association between improvement of VPF and improvement of OME after palatoplasty. In this study, we discussed whether the improvement of VPF after palatoplasty in cleft palate patients with OME improved OME. Methods: Twenty-six patients with cleft palate were included in the study. We retrospectively extracted the information of cleft type, gender, surgical technique, and presence of OME risk factors from electronic medical records. We also investigated the recurrence of OME and the improvement level of VPF at 36 months postoperatively. OME was assessed based on the otolaryngologist's findings in electronic medical records, with a good prognosis group with no symptom of OME, or a recurrence group with prolonged or recurrent OME. Results: At 36 months after palatoplasty, 19 of 23 patients (82.6%) were in the OME good prognosis group and four (17.4%) were in the OME recurrence group. The rate of patients with recurrent OME did not differ significantly by the degree of improvement of VPF. This study indicated that clear association between other risk factors for OME and OME recurrence could not be shown. Conclusion: We observed that most patients with cleft palate who underwent palatoplasty showed a good prognosis for OME at 36 months after surgery. However, further studies are needed to investigate the impact of different surgical techniques on the improvement of OME and the degree to which VPF improves, as well as the effect of each OME risk factor.

Objective: To evaluate the prevalence of systemic chronic diseases among patients undergoing endodontic therapy in a University Department of Endodontology and to assess their potential implications for treatment planning and prognosis. Methods: A retrospective cross-sectional study analysis was performed on clinical records of patients aged > 18 years treated at the Department of Endodontics, University of Bologna. Data collected included demographic information, presence of chronic systemic diseases, endodontic disease and medication history. Descriptive statistics were used to estimate prevalence rates. Results: More than one third of patients (35%) presented with at least one systemic chronic disease or multiple comorbidities. Cardiovascular diseases (19.8%) were the most prevalent. Polypharmacy was observed in 32% of patients. Patients aged 40 years and older showed a significantly higher prevalence of systemic conditions compared to younger individuals. Conclusions: The study supports the finding that a high percentage of patients undergoing endodontic therapies present systemic chronic diseases, multiple comorbid conditions and polypharmacy. It is important to assess these factors and to customize endodontic treatment and decision-making. These realities are likely to become even more pronounced in the coming years, as global population aging continues apace.

Background/Objectives: Oral mucosal wounds are frequently encountered in daily dental practice and are often difficult to manage because of continuous exposure to saliva, mastication, and mechanical irritation. This technical note describes the clinical practicality of an oral liquid bandage (ORAPLA) as a film-forming protective barrier for traumatic and surgical oral mucosal wounds. Methods: ORAPLA was applied in four clinical scenarios: a traumatic lip bite injury, a postoperative mucosal defect following leukoplakia excision, a biopsy wound for suspected oral squamous cell carcinoma (OSCC), and aphthous stomatitis. Clinical observations included patient-reported symptom relief, film retention, and the clinical appearance of epithelialization at follow-up (1-2 weeks). Results: In all cases, ORAPLA formed a thin protective film immediately after application and was typically observed to remain on the wound surface for approximately 5-6 h under routine daily activities. Patients reported prompt subjective pain relief, and no adverse events were observed. Epithelialization proceeded without clinically evident secondary infection during the follow-up period. Conclusions: In this small descriptive case series, ORAPLA was feasible to apply, well tolerated, and provided temporary mechanical protection with immediate subjective comfort. Controlled studies using standardized outcome measures are warranted.

Background: Periodontitis is a chronic inflammatory condition characterized by progressive destruction of tooth-supporting tissues and sustained microbial dysbiosis. Increasing evidence suggests that chronic oral inflammation may be associated with oral and oropharyngeal carcinogenesis, although findings across epidemiological and prognostic studies remain heterogeneous. Objective: To systematically evaluate the epidemiological association between clinically defined periodontitis and the risk of oral and/or oropharyngeal cancer, and to explore, in a distinct analytical component, the prognostic association between tumor-associated periodontal pathogens, particularly Porphyromonas gingivalis, and survival outcomes in affected patients. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD420251273975). Observational studies evaluating periodontitis and oral/oropharyngeal cancer risk (Arm 1) and prognostic studies assessing tumor-associated periodontal pathogens and survival outcomes (Arm 2) were identified through comprehensive database searches. Random-effects meta-analyses were performed to pool adjusted effect estimates. Risk of bias was assessed using the Newcastle-Ottawa Scale and the QUIPS tool. Results: Six observational studies were included in the epidemiological meta-analysis. Periodontitis was significantly associated with an increased risk of oral and/or oropharyngeal cancer (pooled HR = 2.14; 95% CI: 1.53-2.98), with substantial heterogeneity; trial sequential analysis supported the statistical robustness of this association. In the separate prognostic analysis, three studies evaluating intratumoral Porphyromonas gingivalis were included. A higher presence or expression of P. gingivalis was associated with poorer overall survival (HR = 2.89; 95% CI: 1.93-4.32), with no observed heterogeneity. Sensitivity and influence analyses confirmed the stability of these findings. Conclusions: This systematic review and meta-analysis demonstrate a consistent epidemiological association between periodontitis and an increased risk of oral and/or oropharyngeal cancer. In addition, exploratory prognostic evidence suggests that the presence of Porphyromonas gingivalis within tumor tissue may be associated with adverse survival outcomes. These findings should be interpreted as addressing distinct clinical and microbiological constructs, underscoring the need for further well-designed prospective and mechanistic studies.

Background/Objectives: Orthodontically induced root resorption (OIRR) is a well-documented but undesired consequence of orthodontic treatment. This systematic review and meta-analysis aimed to assess the diagnostic performance of artificial intelligence (AI) models applied to cone-beam computed tomography (CBCT) for detecting and quantifying OIRR while evaluating their agreement with manual reference standards and the impact of model architecture, validation design, and quantification strategy. Methods: Comprehensive searches were conducted across PubMed/MEDLINE, Scopus, Web of Science, and EMBASE up to November 2025. Studies were included if they employed AI for OIRR diagnosis using CBCT and reported relevant performance metrics. Following PRISMA guidelines, data were extracted and a random-effect meta-analysis was performed. Subgroup analyses explored the influence of model design and validation. Results: Seven studies were included. Pooled sensitivity from three eligible studies was 0.903 (95% CI: 0.818-0.989), suggesting excellent true positive rates. Specificity ranged from 82% to 98%, and area under the receiver operating characteristic curve values reached up to 0.96 across studies using EfficientNet, U-Net, and other convolutional neural network (CNN)-based architectures. The pooled intraclass correlation coefficient for agreement with manual quantification was 1.000, reflecting near-perfect concordance. Subgroup analyzes showed slightly superior performance in CNN-only models compared to hybrid approaches, and better diagnostic metrics with internal validation. Linear assessments appeared more sensitive to early apical shortening than volumetric methods. Conclusions: AI models applied to CBCT demonstrate excellent diagnostic accuracy and high concordance with expert assessments for OIRR detection. These findings support their potential integration into clinical orthodontic workflows.