This systematic review and meta-analysis evaluate the impact of edentulism and denture use on the oral microbiome, focusing on microbial diversity, colonization and biofilm formation in completely and partially edentulous patients. A comprehensive search was conducted across five databases (PubMed-Medline, Scopus, Embase, Lilacs, and Google Scholar) until June 1, 2024. Randomized and non-randomized clinical trials, observational studies, and cohort studies were included. Data extraction and risk of bias assessment followed PRISMA guidelines. Meta-analysis was performed using STATA and R software with a random effects maximum likelihood model. Microbial co-occurrence networks, heatmaps, and longitudinal trends were analyzed, with heterogeneity assessed using Higgin’s I² (substantial heterogeneity defined as I² > 50%). Thirty-two studies met the inclusion criteria. The oral microbiome in edentulous patients differed significantly from dentate individuals, influenced by denture materials, design, and time. Veillonella abundance in acrylic complete dentures was 13.63% (95% CI = -0.04, 27.29), I² = 90.98%, compared to 49.10% (95% CI = -29.62, 115.81), I² = 99.47% in dentate patients. Candida albicans increased over time in acrylic dentures, from 63.13% (95% CI = 48.93, 77.33), I² = 99.84% after insertion to 344.72 CFU/ml × 10² (95% CI = 139.19, 550.24), I² = 98.30% at nine months. Streptococcus mutans in CAD/CAM dentures increased from 45.54 CFU/ml × 10² (95% CI = 33.82, 57.25), I² = 87.26% at three months to 125.22 CFU/ml × 10² (95% CI = 38.25, 212.18), I² = 97.89% at nine months. Co-occurrence networks revealed strong Candida albicans–Streptococcus mutans synergy, while Fusobacterium nucleatum showed antagonistic interactions. Heatmaps demonstrated microbial dysbiosis in denture stomatitis cases, with increased Porphyromonas gingivalis and Candida albicans and reduced commensals. Longitudinal analyses highlighted the progressive dominance of opportunistic pathogens, emphasizing the need for early and consistent hygiene interventions. Denture wearers exhibit distinct microbial communities influenced by biofilm formation, denture materials, and hygiene practices. Findings highlight the importance of antimicrobial denture materials and effective cleaning protocols in managing microbial colonization. Given high heterogeneity, standardized methodologies are essential for future research. Frequent professional cleaning and individualized hygiene strategies are necessary to prevent denture-associated infections and maintain oral health.
目的：本系统综述和荟萃分析评估全牙颌和义齿使用对口腔微生物组的影响，重点关注全牙颌和部分全牙颌患者的微生物多样性、定植和生物膜形成。方法：到2024年6月1日，对PubMed-Medline、Scopus、Embase、Lilacs和谷歌Scholar等5个数据库进行全面检索。包括随机和非随机临床试验、观察性研究和队列研究。数据提取和偏倚风险评估遵循PRISMA指南。meta分析采用STATA和R软件，采用随机效应最大似然模型。分析了微生物共生网络、热图和纵向趋势，并使用Higgin's I²（实质异质性定义为I²> 50%）评估异质性。结果：32项研究符合纳入标准。受义齿材料、设计和使用时间的影响，无牙患者的口腔微生物组与有牙个体存在显著差异。丙烯酸全口义齿患者的细孔菌丰度为13.63% (95% CI = -0.04, 27.29), I²= 90.98%，而正牙患者的细孔菌丰度为49.10% (95% CI = -29.62, 115.81), I²= 99.47%。假牙中白色念珠菌随时间增加，从插入后的63.13% (95% CI = 48.93, 77.33), I²= 99.84%增加到9个月时的344.72 CFU/ml × 10²（95% CI = 139.19, 550.24）， I²= 98.30%。CAD/CAM义齿的变形链球菌从3个月时的45.54 CFU/ml × 10²（95% CI = 33.82, 57.25）， I²= 87.26%增加到9个月时的125.22 CFU/ml × 10²（95% CI = 38.25, 212.18）， I²= 97.89%。共生网络显示白色念珠菌-变形链球菌具有很强的协同作用，而核梭杆菌则表现出拮抗作用。热图显示，假牙口炎病例中微生物生态失调，牙龈卟啉单胞菌和白色念珠菌增加，共生菌减少。纵向分析强调了机会性病原体的逐渐优势，强调了早期和一致的卫生干预的必要性。结论：假牙佩戴者的微生物群落受生物膜形成、假牙材料和卫生习惯的影响。研究结果强调了抗菌义齿材料和有效清洁方案在管理微生物定植中的重要性。鉴于高度异质性，标准化方法对未来的研究至关重要。经常的专业清洁和个性化的卫生策略是预防假牙相关感染和维护口腔健康所必需的。
{"title":"Dentures and the oral microbiome: Unraveling the hidden impact on edentulous and partially edentulous patients - a systematic review and meta-analysis","authors":"Seenivasan Madhan Kumar, Shanmuganathan Natarajan, Sridharan KS, Senthil Kumar Sundarajan, Parthasarathy Natarajan, A. Selva Arockiam","doi":"10.1038/s41432-025-01149-0","DOIUrl":"10.1038/s41432-025-01149-0","url":null,"abstract":"This systematic review and meta-analysis evaluate the impact of edentulism and denture use on the oral microbiome, focusing on microbial diversity, colonization and biofilm formation in completely and partially edentulous patients. A comprehensive search was conducted across five databases (PubMed-Medline, Scopus, Embase, Lilacs, and Google Scholar) until June 1, 2024. Randomized and non-randomized clinical trials, observational studies, and cohort studies were included. Data extraction and risk of bias assessment followed PRISMA guidelines. Meta-analysis was performed using STATA and R software with a random effects maximum likelihood model. Microbial co-occurrence networks, heatmaps, and longitudinal trends were analyzed, with heterogeneity assessed using Higgin’s I² (substantial heterogeneity defined as I² > 50%). Thirty-two studies met the inclusion criteria. The oral microbiome in edentulous patients differed significantly from dentate individuals, influenced by denture materials, design, and time. Veillonella abundance in acrylic complete dentures was 13.63% (95% CI = -0.04, 27.29), I² = 90.98%, compared to 49.10% (95% CI = -29.62, 115.81), I² = 99.47% in dentate patients. Candida albicans increased over time in acrylic dentures, from 63.13% (95% CI = 48.93, 77.33), I² = 99.84% after insertion to 344.72 CFU/ml × 10² (95% CI = 139.19, 550.24), I² = 98.30% at nine months. Streptococcus mutans in CAD/CAM dentures increased from 45.54 CFU/ml × 10² (95% CI = 33.82, 57.25), I² = 87.26% at three months to 125.22 CFU/ml × 10² (95% CI = 38.25, 212.18), I² = 97.89% at nine months. Co-occurrence networks revealed strong Candida albicans–Streptococcus mutans synergy, while Fusobacterium nucleatum showed antagonistic interactions. Heatmaps demonstrated microbial dysbiosis in denture stomatitis cases, with increased Porphyromonas gingivalis and Candida albicans and reduced commensals. Longitudinal analyses highlighted the progressive dominance of opportunistic pathogens, emphasizing the need for early and consistent hygiene interventions. Denture wearers exhibit distinct microbial communities influenced by biofilm formation, denture materials, and hygiene practices. Findings highlight the importance of antimicrobial denture materials and effective cleaning protocols in managing microbial colonization. Given high heterogeneity, standardized methodologies are essential for future research. Frequent professional cleaning and individualized hygiene strategies are necessary to prevent denture-associated infections and maintain oral health.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"150-150"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-27DOI: 10.1038/s41432-025-01166-z
Sukeshana Srivastav, Nitesh Tewari, Mohammad Atif, Gregory S. Antonarakis, Rabindra Man Shrestha, Partha Haldar
To assess the global status of the knowledge, attitudes, and practices of orthodontists regarding the orthodontic treatment of traumatized teeth. An a priori protocol was developed and registered (PROSPERO, CRD42022342038). The literature search based on the Population, Intervention, Comparator, and Outcome (PICO) elements of the research question was developed and conducted electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and the Cochrane Library, up to 31st August 2024. Gray literature and reference searches were also performed. Titles and abstracts were screened, and later, full-text articles were identified. Data extraction and analysis were performed, and the risk of bias was analyzed via the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional analytical studies. The data was synthesized in form of tables and interpretation was performed. From a total of 1272 articles initially identified, six studies qualified for the final synthesis. The awareness of orthodontic treatment of teeth with root fractures, crown fractures, crown‒root fractures, mild and severe injury to the periodontium, and teeth managed by revascularization and root canal treatment was found to be less than 40% in most of the studies. Awareness regarding the risk of resorption in teeth with external inflammatory root resorption and avoiding forces on teeth with ankylosis was greater than 90%. The risk of bias was found to be low in three studies. The knowledge of orthodontists regarding most aspects of orthodontic management of traumatized teeth was found to be low or inadequate. There are wide variations in the protocols preferred, which differ from contemporary recommendations and evidence.
目的：评估全球正畸医生对创伤牙正畸治疗的知识、态度和实践状况。方法：制定并注册先验方案（PROSPERO, CRD42022342038）。基于研究问题的人口、干预、比较器和结果（PICO）元素的文献检索在PubMed、LILACS、Web of Science、EMBASE、Scopus和Cochrane Library中进行，截止到2024年8月31日。还进行了灰色文献和参考文献检索。筛选标题和摘要，然后确定全文文章。进行数据提取和分析，并通过横截面分析研究的乔安娜布里格斯研究所关键评估清单分析偏倚风险。数据以表格的形式合成，并进行解释。结果：从最初鉴定的1272篇文章中，有6篇研究符合最终合成条件。在大多数研究中，对牙根骨折、牙冠骨折、牙冠-牙根骨折、牙周膜轻、重度损伤以及采用血管重建和根管治疗的牙齿的正畸治疗的知知率低于40%。对外炎症性牙根吸收的牙齿吸收风险的认识和避免对强直牙齿施加力的认识大于90%。三项研究发现偏倚风险较低。结论：正畸医师对创伤牙正畸治疗的大多数方面的知识水平较低或不足。不同于当前的建议和证据，首选的方案有很大的差异。
{"title":"Knowledge, attitudes and practices of orthodontists regarding orthodontic treatment of traumatized teeth: a systematic review","authors":"Sukeshana Srivastav, Nitesh Tewari, Mohammad Atif, Gregory S. Antonarakis, Rabindra Man Shrestha, Partha Haldar","doi":"10.1038/s41432-025-01166-z","DOIUrl":"10.1038/s41432-025-01166-z","url":null,"abstract":"To assess the global status of the knowledge, attitudes, and practices of orthodontists regarding the orthodontic treatment of traumatized teeth. An a priori protocol was developed and registered (PROSPERO, CRD42022342038). The literature search based on the Population, Intervention, Comparator, and Outcome (PICO) elements of the research question was developed and conducted electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and the Cochrane Library, up to 31st August 2024. Gray literature and reference searches were also performed. Titles and abstracts were screened, and later, full-text articles were identified. Data extraction and analysis were performed, and the risk of bias was analyzed via the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional analytical studies. The data was synthesized in form of tables and interpretation was performed. From a total of 1272 articles initially identified, six studies qualified for the final synthesis. The awareness of orthodontic treatment of teeth with root fractures, crown fractures, crown‒root fractures, mild and severe injury to the periodontium, and teeth managed by revascularization and root canal treatment was found to be less than 40% in most of the studies. Awareness regarding the risk of resorption in teeth with external inflammatory root resorption and avoiding forces on teeth with ankylosis was greater than 90%. The risk of bias was found to be low in three studies. The knowledge of orthodontists regarding most aspects of orthodontic management of traumatized teeth was found to be low or inadequate. There are wide variations in the protocols preferred, which differ from contemporary recommendations and evidence.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"154-155"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alendronate (ALN) are pyrophosphates which prevent bone resorption and aid in periodontal regeneration. The present review aimed to evaluate the success of surgical periodontal therapy in the management of intrabony/ furcation defects with and without topical application of ALN. Using combinations of different search terms, the authors searched the standard electronic databases for randomised controlled trials. Version 2 of the Cochrane risk of bias tool for randomised trials was used for quality appraisal. The random-effects model was used for the statistical analysis of estimated effect sizes. The overall quality of evidence was assessed using GRADEpro GDT software. Nine studies satisfying all inclusion criteria were selected for qualitative analysis, and six studies with homogeneous data were selected for quantitative analysis. The overall risk of bias had “low” concerns in one study, “some” concerns in four studies, and “high” concerns in four studies. The pooled analysis showed that the experimental group showed a significant reduction in periodontal probing depth(PPD) and defect depth(DD) with a standard mean difference(SDM) of 1.06 mm (95% CI, 0.77–1.34; P < 0.00001; I2 = 0%) and 1.10 mm (95% CI, 0.65–1.54; P < 0.00001; I2 = 56%) respectively, significant improvement in the clinical attachment level (CAL) with SDM of 1.03 mm (95% CI, 0.42-1.64; P = 0.0009; I2 = 76%). The topical application of ALN has been shown to enhance the effectiveness of surgical periodontal therapy by reducing the PPD and DD and increasing the CAL; however, the certainty of evidence remains very low to low.
目的：阿仑膦酸钠（Alendronate， ALN）是一种防止骨吸收和促进牙周再生的焦磷酸盐。本综述的目的是评估手术牙周治疗在骨内/功能缺陷管理的成功与不局部应用ALN。方法：采用不同检索词组合检索标准电子数据库，检索随机对照试验。采用Cochrane随机试验偏倚风险工具第2版进行质量评价。随机效应模型用于估计效应量的统计分析。使用GRADEpro GDT软件评估证据的总体质量。结果：选取满足所有纳入标准的9项研究进行定性分析，选取资料均质的6项研究进行定量分析。总体偏倚风险在一项研究中有“低”关注，在四项研究中有“一些”关注，在四项研究中有“高”关注。合并分析显示，实验组牙周探诊深度（PPD）和缺损深度（DD）显著降低，标准平均差（SDM）为1.06 mm (95% CI, 0.77-1.34；P 2 = 0%)和1.10 mm (95% CI, 0.65-1.54；P 2 = 56%)，临床依恋水平（CAL）显著改善，SDM为1.03 mm (95% CI, 0.42-1.64；p = 0.0009；i2 = 76%)。结论：局部应用ALN可降低PPD和DD，增加CAL，从而提高牙周外科治疗的效果；然而，证据的确定性仍然非常低。
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Pub Date : 2025-05-24DOI: 10.1038/s41432-025-01163-2
Subhashree Mohapatra, Rahul Mohandas
Despite being the gold standard for chemical plaque treatment, chlorhexidine digluconate (CHX) mouthwash has adverse effects that make it necessary to use alternatives. Essential oil (EO) and cetylpyridinium chloride (CPC) mouthwashes effectively reduce plaque and gingivitis. Hence, the aim of this review is to assess and compare the available data on the efficacy of CPC and EO mouthwashes in reducing plaque and gingivitis. Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Science Direct, Web of Science, and Google Scholar were searched from the earliest available year (1990) till January 10, 2025. PICO Strategy: P: Individuals with plaque and gingivitis; I: CPC mouthwash; C: EO mouthwash; O: Reduction in plaque and gingivitis. The review only comprised randomised controlled trials. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool respectively. After meeting the eligibility requirements, seven full-text publications were assessed for qualitative synthesis and six articles for quantitative synthesis. Overall, there was no significant difference in the reduction of plaque and gingivitis between CPC and EO mouthwashes. At two weeks, however, EO demonstrated a greater reduction in gingivitis (SMD: 4.67 [4.08, 5.26]; p < 0.00001; I² = 0%). Both mouthwashes were equally effective at reducing plaque and gingivitis at one, three, and six months. While CPC mouthwash matched EO mouthwash’s long-term efficacy, EO mouthwash demonstrated superior short-term anti-gingivitis effects. Both were equally successful in reducing plaque. Depending on the needs of the patient, either can be utilized because of their distinct mechanism of action. Additional research should be done to reduce bias and enhance the methodology. CRD42025638243
背景：尽管二光酸氯己定（CHX）漱口水是化学治疗牙菌斑的金标准，但它有副作用，因此有必要使用替代品。精油（EO）和十六烷基吡啶氯化（CPC）漱口水有效地减少菌斑和牙龈炎。因此，本综述的目的是评估和比较CPC和EO漱口水在减少菌斑和牙龈炎方面的有效性。方法：检索Scopus、PubMed、Cochrane、Science Direct、EBSCOhost、Lilacs、Science Direct、Web of Science和谷歌Scholar，检索时间为最早可查年份（1990年）至2025年1月10日。PICO策略：P：有菌斑和牙龈炎的个体；一：CPC漱口水；C: EO漱口水；O：减少牙菌斑和牙龈炎。该综述仅包括随机对照试验。分别使用rob2工具和GRADE工具评估偏倚风险和证据质量。结果：满足资格要求后，7篇全文出版物进行定性综合评估，6篇进行定量综合评估。总体而言，CPC漱口水和EO漱口水在减少菌斑和牙龈炎方面没有显著差异。然而，在两周时，EO显示牙龈炎的减少更大(SMD: 4.67 [4.08, 5.26]；结论：CPC漱口水的长期疗效与EO漱口水相当，EO漱口水的短期抗牙龈炎效果更佳。两者在减少斑块方面同样成功。根据病人的需要，这两种药物都可以使用，因为它们的作用机制不同。应该做更多的研究来减少偏见和改进方法。普洛斯彼罗注册号：CRD42025638243。
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Pub Date : 2025-05-20DOI: 10.1038/s41432-025-01160-5
Niall Nagar, John Linden
Choonhawarakorn K, Kasemkhun P, Leelataweewud P. Effectiveness of a message service on child oral health practice via a social media application: a randomized controlled trial. Int J Paediatr Dent 2025; 35: 446-455. The early development of proper oral health behaviours is essential for mitigating the risk of early childhood caries. Interactive social media platforms offer a cost-effective means to support caregivers in this endeavour. To evaluate the efficacy of a LINE™ messaging service (MS) in promoting positive oral health behaviours among Thai children. A randomised controlled trial was conducted involving 190 caregiver–child dyads (children aged 6–36 months) recruited from a university dental hospital and two affiliated hospitals. Participants were randomly assigned to receive age-appropriate dental health education either via the MS or through conventional in-person visits. The MS group received weekly educational materials, including infographic posters, video clips, and supportive messages. Parental oral health knowledge, along with children’s oral health practices and status, were assessed at baseline and after six months. The MS group demonstrated significantly greater improvements in feeding habits (p = 0.034) and toothbrushing practices (p = 0.007) compared to the control group. While parental knowledge improved in both groups, the increase was significantly greater in the control group (p = 0.001). Both groups showed a reduction in debris scores; however, no significant difference was observed in caries progression. Caregivers reported high to very high satisfaction with both methods of education delivery. The LINE™ messaging service was found to be as effective as traditional dental visits in fostering positive oral health behaviours among young children.
{"title":"Brushing up on oral health: can messages through social media promote healthy oral health behaviours?","authors":"Niall Nagar, John Linden","doi":"10.1038/s41432-025-01160-5","DOIUrl":"10.1038/s41432-025-01160-5","url":null,"abstract":"Choonhawarakorn K, Kasemkhun P, Leelataweewud P. Effectiveness of a message service on child oral health practice via a social media application: a randomized controlled trial. Int J Paediatr Dent 2025; 35: 446-455. The early development of proper oral health behaviours is essential for mitigating the risk of early childhood caries. Interactive social media platforms offer a cost-effective means to support caregivers in this endeavour. To evaluate the efficacy of a LINE™ messaging service (MS) in promoting positive oral health behaviours among Thai children. A randomised controlled trial was conducted involving 190 caregiver–child dyads (children aged 6–36 months) recruited from a university dental hospital and two affiliated hospitals. Participants were randomly assigned to receive age-appropriate dental health education either via the MS or through conventional in-person visits. The MS group received weekly educational materials, including infographic posters, video clips, and supportive messages. Parental oral health knowledge, along with children’s oral health practices and status, were assessed at baseline and after six months. The MS group demonstrated significantly greater improvements in feeding habits (p = 0.034) and toothbrushing practices (p = 0.007) compared to the control group. While parental knowledge improved in both groups, the increase was significantly greater in the control group (p = 0.001). Both groups showed a reduction in debris scores; however, no significant difference was observed in caries progression. Caregivers reported high to very high satisfaction with both methods of education delivery. The LINE™ messaging service was found to be as effective as traditional dental visits in fostering positive oral health behaviours among young children.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"103-104"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-20DOI: 10.1038/s41432-025-01161-4
Chris Grumley
La Rosa G R M, Pedulla E, Chapple I et al. A systematic review of oral health outcomes following smoking cessation in type 2 diabetes: clinical and research implications. J Dent 2025; https://doi.org/10.1016/j.jdent.2025.105665 . This systematic review investigated the impact of smoking cessation in patients with type 2 diabetes. The review utilised multiple online academic publication search engines and highly cited journals to compile articles for review in accordance with PRISMA guidelines. A combination of human clinical studies, ranging from randomised control trials to cross-sectional studies involving type 2 diabetic patients with a current or past history of smoking, was employed. These studies were analysed to evaluate oral health outcomes related to periodontal disease and caries. Four of the 549 studies analysed met the inclusion criteria (n = 926 participants). Two were cross-sectional analyses of cohort studies, another was a cohort study, and the last was a report. Each assessed a person’s smoking status and its effects on the progression of periodontal disease and response to treatment in the type 2 diabetes subgroup. Overall, smoking cessation does not appear to improve the outcomes of periodontal disease or treatment for type 2 diabetics, but the area lacks robust research to draw any significant conclusions. Evidence that smoking cessation improves the outcomes of periodontal treatment in type 2 diabetics remains inconclusive. Smoking cessation is an important method of preventing health problems in the general population, but its effects related to diabetes are still unknown, and more research is necessary.
评：La Rosa G R M， Pedulla E， Chapple I等。2型糖尿病患者戒烟后口腔健康结果的系统综述：临床和研究意义[J] Dent 2025；https://doi.org/10.1016/j.jdent.2025.105665目的：本系统综述探讨戒烟对2型糖尿病患者的影响。方法：该综述利用多个在线学术出版物搜索引擎和高被引期刊，根据PRISMA指南汇编文章进行综述。采用了人体临床研究的组合，从随机对照试验到涉及目前或过去吸烟史的2型糖尿病患者的横断面研究。对这些研究进行分析，以评估与牙周病和龋齿相关的口腔健康结果。结果：549项研究中有4项符合纳入标准（n = 926名受试者）。两个是对队列研究的横断面分析，另一个是队列研究，最后一个是报告。每项研究都评估了一个人的吸烟状况及其对2型糖尿病亚组牙周病进展和治疗反应的影响。总的来说，戒烟似乎并没有改善牙周病或2型糖尿病治疗的结果，但该领域缺乏强有力的研究来得出任何有意义的结论。结论：戒烟改善2型糖尿病患者牙周治疗结果的证据尚不明确。戒烟是预防普通人群健康问题的重要方法，但其与糖尿病的关系尚不清楚，需要更多的研究。
{"title":"Is smoking cessation the key to better oral health outcomes for type 2 diabetic patients with periodontal disease?","authors":"Chris Grumley","doi":"10.1038/s41432-025-01161-4","DOIUrl":"10.1038/s41432-025-01161-4","url":null,"abstract":"La Rosa G R M, Pedulla E, Chapple I et al. A systematic review of oral health outcomes following smoking cessation in type 2 diabetes: clinical and research implications. J Dent 2025; https://doi.org/10.1016/j.jdent.2025.105665 . This systematic review investigated the impact of smoking cessation in patients with type 2 diabetes. The review utilised multiple online academic publication search engines and highly cited journals to compile articles for review in accordance with PRISMA guidelines. A combination of human clinical studies, ranging from randomised control trials to cross-sectional studies involving type 2 diabetic patients with a current or past history of smoking, was employed. These studies were analysed to evaluate oral health outcomes related to periodontal disease and caries. Four of the 549 studies analysed met the inclusion criteria (n = 926 participants). Two were cross-sectional analyses of cohort studies, another was a cohort study, and the last was a report. Each assessed a person’s smoking status and its effects on the progression of periodontal disease and response to treatment in the type 2 diabetes subgroup. Overall, smoking cessation does not appear to improve the outcomes of periodontal disease or treatment for type 2 diabetics, but the area lacks robust research to draw any significant conclusions. Evidence that smoking cessation improves the outcomes of periodontal treatment in type 2 diabetics remains inconclusive. Smoking cessation is an important method of preventing health problems in the general population, but its effects related to diabetes are still unknown, and more research is necessary.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"93-94"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-20DOI: 10.1038/s41432-025-01162-3
Beth Cunningham, John Linden
Karim R, Splieth C H, Schmoeckel J. Effect of choice of flavour of fluoride varnish on behaviour in dental visits in schoolchildren. Clin Exp Dent Res. 2025; https://doi.org/10.1002/cre2.70069 . To assess the efficacy of giving children choice within the dental surgery to improve behaviour outcomes, investigated by letting them choose the flavour of fluoride varnish (FV). This single-blinded, randomised control trial recruited children attending the specialised paediatric dental service within the Greifswald University Hospital for a dental check-up and preventative FV application. Upon attendance, children were randomly assigned to one of two groups: the control group, where the flavour of FV was predetermined, or the test group, where the children selected their preferred flavour. A blinded observer used Frankl behaviour rating scale (FBRS) to assess behaviour during the appointment, and taste acceptance was assessed using the Facial image scale (FIS). 70 participants were recruited at the time of their appointment. These were healthy (ASA I or ASA II) German children aged 5 to 10. Exclusion criteria included their first dental experience, experiencing dental pain or an allergy to FV. 35 children were randomly allocated to both groups. Most children, regardless of their allocation, were assessed as positive, or definitely positive according to FBRS (n = 58, 82.8%), though results on behaviour outcomes were statistically insignificant (p = 0.376). There were no significant differences between the control group or the test group on flavour ratings of the FV, with most children (n = 53, 75.7%) scoring happy, or very happy according to FIS. History of negative dental behaviour was also taken into consideration (n = 27), and whilst it appeared children with history of negative experience displayed more positive behaviour in the test group vs the control group (75% vs 54.5%), results were not statistically significant (p = 0.244). This study shows that allowing children a sense of control by permitting them to choose their flavour of FV may be a useful behaviour management tool, though the results are not statistically significant.
{"title":"Using flavour in your favour: does giving children an element of control help them engage more positively with the dental experience?","authors":"Beth Cunningham, John Linden","doi":"10.1038/s41432-025-01162-3","DOIUrl":"10.1038/s41432-025-01162-3","url":null,"abstract":"Karim R, Splieth C H, Schmoeckel J. Effect of choice of flavour of fluoride varnish on behaviour in dental visits in schoolchildren. Clin Exp Dent Res. 2025; https://doi.org/10.1002/cre2.70069 . To assess the efficacy of giving children choice within the dental surgery to improve behaviour outcomes, investigated by letting them choose the flavour of fluoride varnish (FV). This single-blinded, randomised control trial recruited children attending the specialised paediatric dental service within the Greifswald University Hospital for a dental check-up and preventative FV application. Upon attendance, children were randomly assigned to one of two groups: the control group, where the flavour of FV was predetermined, or the test group, where the children selected their preferred flavour. A blinded observer used Frankl behaviour rating scale (FBRS) to assess behaviour during the appointment, and taste acceptance was assessed using the Facial image scale (FIS). 70 participants were recruited at the time of their appointment. These were healthy (ASA I or ASA II) German children aged 5 to 10. Exclusion criteria included their first dental experience, experiencing dental pain or an allergy to FV. 35 children were randomly allocated to both groups. Most children, regardless of their allocation, were assessed as positive, or definitely positive according to FBRS (n = 58, 82.8%), though results on behaviour outcomes were statistically insignificant (p = 0.376). There were no significant differences between the control group or the test group on flavour ratings of the FV, with most children (n = 53, 75.7%) scoring happy, or very happy according to FIS. History of negative dental behaviour was also taken into consideration (n = 27), and whilst it appeared children with history of negative experience displayed more positive behaviour in the test group vs the control group (75% vs 54.5%), results were not statistically significant (p = 0.244). This study shows that allowing children a sense of control by permitting them to choose their flavour of FV may be a useful behaviour management tool, though the results are not statistically significant.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"97-98"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-17DOI: 10.1038/s41432-025-01145-4
Sasidharan Sivakumar, Sankar Narayanan R, Aswath N, Priyadharshini S, Rajesh E, Bhuminathan S, Seethalakshmi C, Gowardhan Sivakumar
This systematic review and meta-analysis aimed to compare the efficacy of intralesional platelet-rich plasma and intralesional steroids in managing oral lichen planus, focusing on pain and lesion size reduction. A systematic search of MEDLINE (via PubMed), Web of Science, Scopus, and Embase was conducted up to May 30, 2024, to identify randomized controlled trials (RCTs) comparing the efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroids in managing oral lichen planus (OLP). The study adhered to a predefined PICOS framework: (P) adults diagnosed with OLP, (I) PRP application, (C) steroid application, (O) outcomes related to pain reduction and lesion size, and (S) RCTs. The analysis utilized both random-effects and Weighted Least Squares (WLS) models to account for heterogeneity and assess publication bias. Seven articles met the eligibility criteria, of which six were included in the meta-analysis, encompassing 141 participants. While the analysis was limited by a small sample size, significant heterogeneity, and a lack of long-term follow-up, analysis with random-effects and WLS model provided a robust comparative evaluation of PRP and steroids for OLP treatment. Pain Reduction: The pooled effect size was −0.34 (95% CI: −0.94 to 0.27; p = 0.274), indicating a moderate, non-significant preference for steroids over PRP. Moderate to high heterogeneity (I² = 68.516%) suggested substantial variability in effect sizes. Lesion Size Reduction: The pooled effect size was −0.10 (95% CI: −0.58 to 0.39; p = 0.697), favoring PRP slightly but without statistical significance. Low to moderate heterogeneity (I² = 31.42%) was observed. PRP demonstrated comparable efficacy to steroids in reducing pain and lesion size in OLP patients, with the added advantage of fewer side effects. However, significant heterogeneity and publication bias necessitate further high-quality research to substantiate these findings.
{"title":"Efficacy of intralesional platelet-rich plasma versus intralesional corticosteroids in the management oral lichen planus: A systematic review and meta-analysis of randomized controlled trials using random effects and weighted least square methods","authors":"Sasidharan Sivakumar, Sankar Narayanan R, Aswath N, Priyadharshini S, Rajesh E, Bhuminathan S, Seethalakshmi C, Gowardhan Sivakumar","doi":"10.1038/s41432-025-01145-4","DOIUrl":"10.1038/s41432-025-01145-4","url":null,"abstract":"This systematic review and meta-analysis aimed to compare the efficacy of intralesional platelet-rich plasma and intralesional steroids in managing oral lichen planus, focusing on pain and lesion size reduction. A systematic search of MEDLINE (via PubMed), Web of Science, Scopus, and Embase was conducted up to May 30, 2024, to identify randomized controlled trials (RCTs) comparing the efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroids in managing oral lichen planus (OLP). The study adhered to a predefined PICOS framework: (P) adults diagnosed with OLP, (I) PRP application, (C) steroid application, (O) outcomes related to pain reduction and lesion size, and (S) RCTs. The analysis utilized both random-effects and Weighted Least Squares (WLS) models to account for heterogeneity and assess publication bias. Seven articles met the eligibility criteria, of which six were included in the meta-analysis, encompassing 141 participants. While the analysis was limited by a small sample size, significant heterogeneity, and a lack of long-term follow-up, analysis with random-effects and WLS model provided a robust comparative evaluation of PRP and steroids for OLP treatment. Pain Reduction: The pooled effect size was −0.34 (95% CI: −0.94 to 0.27; p = 0.274), indicating a moderate, non-significant preference for steroids over PRP. Moderate to high heterogeneity (I² = 68.516%) suggested substantial variability in effect sizes. Lesion Size Reduction: The pooled effect size was −0.10 (95% CI: −0.58 to 0.39; p = 0.697), favoring PRP slightly but without statistical significance. Low to moderate heterogeneity (I² = 31.42%) was observed. PRP demonstrated comparable efficacy to steroids in reducing pain and lesion size in OLP patients, with the added advantage of fewer side effects. However, significant heterogeneity and publication bias necessitate further high-quality research to substantiate these findings.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 3","pages":"152-152"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-16DOI: 10.1038/s41432-025-01159-y
Neeraj Gugnani, Shalini Gugnani
Van Doornik SP, van Kammen L, Ren Y, Manton D J, Kuijpers-Jagtman A M. Effect of a plaque-identifying toothpaste on plaque amount in 12–16-year-olds with fixed orthodontic appliances: a randomised, double-blind, controlled clinical trial. Orthod Craniofac Res 2025; https://doi.org/10.1111/ocr.12904 . The study aimed to evaluate the effectiveness of a plaque-identifying toothpaste in improving plaque removal among adolescents undergoing fixed orthodontic treatment. This was a double-blind, parallel-group RCT with active-control, having two groups with equal allocation ratio. Participants were healthy adolescents aged 12–16 years with fixed orthodontic appliances in both arches for a minimum of three months. Another inclusion criterion was presence of permanent teeth (canine to canine), while exclusion criteria included toothpaste allergies, syndromic conditions, craniofacial abnormalities, and participants from the same household. A total of 77 participants were included, and were randomized into the intervention (plaque-identifying toothpaste) and control groups (conventional toothpaste). The intervention group was provided with a toothpaste containing disclosing dyes (Mara Expert) intended for plaque-identification, while the control group was provided with a standard toothpaste (Colgate Fresh Gel). The patients were instructed to use the toothpastes for a period of 4–7 weeks, following which assessments were done. The primary outcome included evaluation of changes in the plaque accumulation from baseline to follow-up, as assessed by determining change in fluorescence, which was evaluated using Quantitative Light-Induced Fluorescence (QLF). Secondary outcomes were assessed through a structured questionnaire focusing on user experience and self-perceived oral hygiene behaviours. Patients in both groups showed plaque reduction over time. But the difference observed in plaque reduction between the two groups was not found to be statistically significant (F = 0.211; p = 0.647). However, in the questionnaire, users of the plaque-disclosing toothpaste felt ‘they are removing more plaque with their new toothpaste’ (p = 0.018), and some participants found its colour to be unappealing (p = 0.028). Overall compliance was good, and no adverse effects were reported. Plaque-identifying toothpaste did not demonstrate a superior clinical reduction in plaque levels compared to the control, though increased awareness of plaque removal was observed in the intervention group.
Van Doornik SP, Van Kammen L, Ren Y, Manton D J, Kuijpers-Jagtman A M.牙菌斑识别牙膏对12-16岁固定正畸矫治器牙菌斑数量的影响：一项随机、双盲、对照临床试验。颅面矫形器2025；https://doi.org/10.1111/ocr.12904 .设计：本研究旨在评估牙菌斑识别牙膏在接受固定正畸治疗的青少年中促进牙菌斑清除的有效性。这是一项双盲、平行组、主动对照的随机对照试验，两组分配比例相等。病例选择：参与者是12-16岁的健康青少年，在双牙弓固定正畸矫治器至少三个月。另一个纳入标准是存在恒牙（犬对犬），而排除标准包括牙膏过敏，综合征条件，颅面异常和来自同一家庭的参与者。共纳入77名参与者，并随机分为干预组（牙菌斑识别牙膏）和对照组（传统牙膏）。数据分析：干预组使用含有揭露染料的牙膏（玛拉专家）用于牙菌斑识别，对照组使用标准牙膏（高露洁新鲜凝胶）。指导患者使用牙膏4-7周，随后进行评估。主要结果包括评估从基线到随访期间斑块积累的变化，通过测定荧光变化来评估，荧光变化使用定量光诱导荧光（QLF）进行评估。次要结果通过关注用户体验和自我感知口腔卫生行为的结构化问卷进行评估。结果：两组患者的斑块均随时间减少。但两组在斑块减少方面的差异无统计学意义(F = 0.211；p = 0.647)。然而，在调查问卷中，使用暴露牙菌斑牙膏的人认为“他们用新牙膏可以清除更多的牙菌斑”（p = 0.018），一些参与者认为新牙膏的颜色不吸引人（p = 0.028）。总体依从性良好，无不良反应报告。结论：与对照组相比，牙菌斑识别牙膏在减少牙菌斑水平方面并没有表现出卓越的临床效果，尽管在干预组中观察到牙菌斑清除意识的增强。
{"title":"Can plaque-identifying toothpastes inspire better oral hygiene among orthodontic patients?","authors":"Neeraj Gugnani, Shalini Gugnani","doi":"10.1038/s41432-025-01159-y","DOIUrl":"10.1038/s41432-025-01159-y","url":null,"abstract":"Van Doornik SP, van Kammen L, Ren Y, Manton D J, Kuijpers-Jagtman A M. Effect of a plaque-identifying toothpaste on plaque amount in 12–16-year-olds with fixed orthodontic appliances: a randomised, double-blind, controlled clinical trial. Orthod Craniofac Res 2025; https://doi.org/10.1111/ocr.12904 . The study aimed to evaluate the effectiveness of a plaque-identifying toothpaste in improving plaque removal among adolescents undergoing fixed orthodontic treatment. This was a double-blind, parallel-group RCT with active-control, having two groups with equal allocation ratio. Participants were healthy adolescents aged 12–16 years with fixed orthodontic appliances in both arches for a minimum of three months. Another inclusion criterion was presence of permanent teeth (canine to canine), while exclusion criteria included toothpaste allergies, syndromic conditions, craniofacial abnormalities, and participants from the same household. A total of 77 participants were included, and were randomized into the intervention (plaque-identifying toothpaste) and control groups (conventional toothpaste). The intervention group was provided with a toothpaste containing disclosing dyes (Mara Expert) intended for plaque-identification, while the control group was provided with a standard toothpaste (Colgate Fresh Gel). The patients were instructed to use the toothpastes for a period of 4–7 weeks, following which assessments were done. The primary outcome included evaluation of changes in the plaque accumulation from baseline to follow-up, as assessed by determining change in fluorescence, which was evaluated using Quantitative Light-Induced Fluorescence (QLF). Secondary outcomes were assessed through a structured questionnaire focusing on user experience and self-perceived oral hygiene behaviours. Patients in both groups showed plaque reduction over time. But the difference observed in plaque reduction between the two groups was not found to be statistically significant (F = 0.211; p = 0.647). However, in the questionnaire, users of the plaque-disclosing toothpaste felt ‘they are removing more plaque with their new toothpaste’ (p = 0.018), and some participants found its colour to be unappealing (p = 0.028). Overall compliance was good, and no adverse effects were reported. Plaque-identifying toothpaste did not demonstrate a superior clinical reduction in plaque levels compared to the control, though increased awareness of plaque removal was observed in the intervention group.","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":"26 2","pages":"101-102"},"PeriodicalIF":2.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-13DOI: 10.1038/s41432-025-01152-5
Mohammad Zakaria Nassani
Meijer H J A, Slagter K W, Gareb B, Hentenaar D F M, Vissink A, Raghoebar G M. Immediate single-tooth implant placement in bony defect sites: a 10-year randomized controlled trial. J Periodontol 2025; 96: 151–163. This single-center, 10-year randomized controlled trial (RCT) was conducted at the University Medical Center Groningen (UMCG), the Netherlands, to compare immediate and delayed implant placement in patients with a failing tooth in the aesthetic region and a buccal bony defect of ≥5 mm. Forty patients were randomly assigned to either the Immediate Group (immediate implant placement with bone grafting and delayed provisionalization) or the Delayed Group (ridge preservation followed by delayed implant placement and provisionalization). Cone beam computed tomography (CBCT) was used preoperatively to assess palatal bone availability. Surgical procedures were standardized and performed by a single experienced oral and maxillofacial surgeon, while prosthetic procedures were completed by a single prosthodontist. Patients were followed up for 10 years to assess marginal bone levels (MBL), buccal bone thickness (BBT), soft tissue changes, aesthetic outcomes, patient satisfaction, and biological and technical complications. Patients with a compromised tooth in the maxillary aesthetic zone and a buccal bone defect of ≥5 mm following extraction were included. Patients were excluded if they met any of the following criteria: poor oral hygiene, inadequate mesio-distal space for implant placement, presence of periodontal disease, smoking, an American Society of Anesthesiologists (ASA) score of ≥II, or a vertical bony defect of less than 5 mm in the labial socket wall after tooth extraction. The primary outcome, change in marginal bone level, was analyzed using a per-protocol strategy. Normally distributed data were summarized using means and confidence intervals and compared with the independent samples t-test, while non-normally distributed data were described using medians and interquartile ranges and compared using the Mann-Whitney U test. To check the robustness of the findings, sensitivity analyses were conducted, including an intention-to-treat analysis. For outcomes with repeated measurements, multivariable linear mixed-effect models were utilized to examine differences between the treatment groups over time. All statistical analyses were performed using the R software (version 4.0.5), and a p-value less than 0.05 was the criterion for statistical significance. After 10 years, the mean marginal bone level change was −0.71 ± 0.59 mm in the Immediate Group and −0.36 ± 0.39 mm in the Delayed Group, with no statistically significant difference between them (p = 0.063). Secondary outcomes showed no significant variations between the two groups. Immediate implant placement with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm yielded similar long-term outcomes to delayed implant placement after ridge preservation in the aesth
mejer H J A, Slagter K W, Gareb B, Hentenaar D F M, Vissink A, Raghoebar G .骨缺损即刻单牙种植的10年随机对照试验。牙周病杂志；96: 151 - 163。设计：这项单中心、10年随机对照试验（RCT）在荷兰格罗宁根大学医学中心（UMCG）进行，比较美学区缺牙和颊骨缺损≥5mm患者的即刻和延迟种植体置放。40例患者被随机分配到立即组（立即种植体植入植骨并延迟固定）或延迟组（保留脊骨后延迟种植体放置和固定）。术前使用锥形束计算机断层扫描（CBCT）评估腭骨可用性。手术程序标准化，由一名经验丰富的口腔颌面外科医生执行，而修复程序由一名修复牙医完成。患者随访10年，评估边缘骨水平（MBL）、颊骨厚度（BBT）、软组织变化、美学结果、患者满意度以及生物和技术并发症。病例选择：包括上颌美观区受损牙齿和拔牙后颊骨缺损≥5mm的患者。符合以下任何条件的患者均被排除：口腔卫生差，种植体中-远端间隙不足，存在牙周病，吸烟，美国麻醉医师协会（ASA）评分≥II，或拔牙后唇槽壁垂直骨缺损小于5mm。数据分析：主要结果，边缘骨水平的变化，使用每协议策略进行分析。正态分布的数据使用均值和置信区间进行汇总，并与独立样本t检验进行比较，而非正态分布的数据使用中位数和四分位数范围进行描述，并使用Mann-Whitney U检验进行比较。为了检查结果的稳健性，进行了敏感性分析，包括意向治疗分析。对于重复测量的结果，使用多变量线性混合效应模型来检查治疗组之间随时间的差异。所有统计分析均使用R软件（4.0.5版）进行，p值小于0.05为统计学显著性标准。结果：术后10年，即刻组平均骨缘变化为-0.71±0.59 mm，延迟组为-0.36±0.39 mm，差异无统计学意义（p = 0.063）。次要结果显示两组间无显著差异。结论：在拔牙后颊骨缺损≥5mm的牙槽即刻植入骨增强体与在美观区保留牙脊后延迟植入相似，在10年内在骨稳定性、临床表现、美观性或患者满意度方面没有显著差异。
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