Head & Face Medicine最新文献

Background: Tooth whitening is a popular cosmetic procedure; however, its perceived effectiveness and long-term psychosocial impact remain underexplored. This study investigated perceptions of tooth color change and the associated psychological and social effects over a one-year period, with particular attention to the role of individual personality traits.

Methods: Fifty participants aged 19 to 28 were randomly assigned to either an experimental group or a control group. The experimental group received a light-activated whitening gel, while the control group received an inactive gel. Evaluations were conducted at baseline, one week post-treatment, and one year post-treatment. Tooth color was measured using spectrophotometry. Standardized questionnaires were employed to assess psychosocial effects and personality traits. Data were analyzed using analysis of variance with Bonferroni post hoc tests and independent samples t-tests.

Results: The experimental group showed a significantly greater improvement in tooth color shortly after treatment compared to the control group. Although this improvement diminished over time, it remained above baseline levels at the one-year follow-up. In the short term, participants in the experimental group reported reduced psychological and social concerns, while the control group reported a decrease in psychological impact only. After one year, the experimental group experienced a return of psychosocial concerns, whereas the control group continued to report improvements. Personality traits influenced these outcomes: lower neuroticism and higher perfectionism were associated with enhanced short-term benefits, while higher conscientiousness was linked to more sustained long-term improvements.

Conclusions: Participants demonstrated limited ability to accurately perceive improvements in tooth color, often noticing relapse over time. The psychosocial impact of tooth whitening was influenced by personality traits, highlighting the importance of a personalized approach in cosmetic dental treatments. Practitioners should consider individual psychological profiles when managing patient expectations.

Trial registration: This clinical trial was prospectively registered with ClinicalTrials.gov (Identifier NCT03380702) on December 21, 2017.

Objectives: To evaluate the effectiveness of customized nasal conformers used after unilateral cleft lip repair on nasal symmetry and parental satisfaction.

Materials and methods: Fourteen medically free, non-syndromic children aged 10-24 weeks with unilateral cleft lip were divided into two groups. All patients underwent primary repair using the Fisher technique. Group I received customized nasal conformers fabricated using digital models, while Group II did not. Anthropometric measurements, including nostril height and width, columella deviation angle, and nasolabial angle were used to assess nasal symmetry between both groups. Parental satisfaction was evaluated using the Cleft Evaluation Profile (CEP).

Results: At six months postoperatively, Group I showed no significant difference between cleft and non-cleft sides across all parameters. In contrast, Group II exhibited significant asymmetry in nostril height and width, although no significant difference was observed in the nasolabial angle. CEP scores showed significantly higher satisfaction in fathers for lip, nose, and profile, and in mothers for nose and profile. No significant difference was noted in teeth appearance for either parent group. Intra-examiner reliability was reliable across all parameters.

Conclusions: The use of customized postsurgical nasal conformers in unilateral cleft lip repair was associated with improved symmetry between cleft and non-cleft sides and appeared to reduce relapse, which may have contributed to increased parental satisfaction with the treatment.

Trial registration: Was retrospectively registered at Clinicaltrials.gov on 23/10/2024 (NCT06637488).

Objectives: This study aimed to evaluate the effects of access cavity design and activation procedures on the penetration depth and bond strength of calcium silicate-based sealers to dentin, while also distinguishing the influence of the root level as an anatomical reference point.

Methods: Sixty-six mandibular molars were randomly divided into two groups based on the access cavity design (traditional (TEC) or conservative (CEC)). The distal root canals were prepared using Reciproc files (40.06). The fluorescent calcium tracer Fluo-3 was added to the calcium silicate- based sealer CeraSeal to evaluate sealer penetration into dentinal tubules in confocal laser scanning microscopy (CLSM).Each access cavity group was further divided into three subgroups according to the sealer activation technique (Non-activation (NA), EDDY, XP-Endo Finisher (XP-F)) (n = 11). Root slices of 2.0 mm thickness (± 0.1 mm) were obtained at 3-5 mm and 8-10 mm from the root apex for CLSM to evaluate the percentage of sealer penetration. The bond strength was assessed with an Instron machine. Statistical analysis was performed using three-way ANOVA with Bonferroni correction, with the significance level set at 0.05.

Results: There were no significant interaction effects among the independent variables (access cavity design, activation procedures and root level) (P > 0.05); however, each variable individually showed a significant main effect on both the percentage of sealer penetration and bond strength (P < 0.001). A significant main effect of access cavity design was observed, with TECs exhibiting significantly higher values than CECs in both outcomes (P < 0.001). Similarly, the root level significantly influenced results, with greater sealer penetration and bond strength at 9 mm compared to 4 mm (P < 0.001). The activation procedure also had a significant impact (P < 0.001). Post hoc comparisons using the Bonferroni correction revealed that both EDDY and XP-F significantly improved sealer penetration and bond strength compared to no activation (NA) (P < 0.001). However, no statistically significant difference was observed between EDDY and XP-F (P > 0.05).

Conclusion: The TEC design, the use of EDDY and XP-Endo Finisher activation techniques and the examination of coronal root levels resulted in a greater percentage in sealer penetration and higher values of bond strength.

Trial registrations: Clinical Trial Number: Not applicable.

Background: The apical terminus of root canal preparation plays a critical role in minimizing postoperative pain. Yet, significant debate remains regarding the optimal termination point. This prospective clinical study aimed to assess the effect of three different apical termini on postoperative pain in teeth with irreversible pulpitis.

Methods: Totally, 128 patients with asymptomatic or symptomatic irreversible pulpitis were consecutively enrolled. Participants underwent root canal preparation with the apical terminus positioned either at the apical foramen (AF) or 0.5 or 1 mm short of it. Pain intensity was rated using an 11-point numerical rating scale (NRS-11) at nine time points. Data were analyzed using repeated measures analysis of variance.

Results: In cases of irreversible pulpitis without preoperative pain (NRS = 0), the pain scores at 72 h after preparation were significantly lower in the AF-1 mm group than in the AF group (P < .05), with none of the patients in the AF-1 mm group reporting pain at this time point (P < .017). In cases of irreversible pulpitis with moderate preoperative pain (NRS = 4-7), the post-preparation pain scores at 4 h was significantly lower than the preoperative pain in all groups (P < .05). The pain scores in the AF-0.5 mm group remained lower than that in the other groups at 4 h, 24 h, 72 h, and 1 week. More patients reported decreased pain 4 h postoperatively in the AF-0.5 mm group than in other groups, with all patients in the AF-0.5 mm group reporting no pain at 1 week. In cases with mild preoperative pain (NRS = 1-3), the pain scores were significantly lower 72 h postoperatively than preoperatively (P < .05), with fewer patients reporting increased pain 24 h postoperatively in the AF-0.5 mm group than other groups.

Conclusions: Positioning the root canal apical terminus 0.5 and 1.0 mm short of the AF in symptomatic and asymptomatic cases of irreversible pulpitis, respectively, was most effective in reducing the severity and duration of postoperative pain. Tailoring apical preparation depth to the pulpal condition-symptomatic or asymptomatic-can optimize patient comfort and support more personalized endodontic care.

A migrant is a person who moves away from his or her place of habitual residence, whether within a country or across an international border, temporarily or permanently, and for a variety of reasons. Migrant population presents significant challenges in maintaining optimal oral health, because of the limitation in access to a balanced diet, excessive consumption of processed foods or those with a high percentage of sugars, as well as the cost of acquiring hygiene items such as toothbrushes or toothpaste, coupled with the lack of access to public services, they comprise a highly vulnerable population to developing oral disease.

Objective: This study aimed to identify and synthesize the oral health characteristics of migrant populations as reported in the literature. A search was conducted for articles that included studies that had some type of report on the oral health status of a migrant population. A bibliographic search was performed in the PubMed, ScienceDirect and Scopus databases from 2016 to 2025 using the keywords: "immigrants", "emigration", "oral health", "dental caries" and "periodontal disease". To perform the risk of bias analysis, the Joanna Briggs Institute tool for cross-sectional studies was used.

Results: Twenty-one studies were selected, nine studies were conducted on migrants of multiple nationalities, in 10 studies (45.4%), oral health characteristics were self-reported by participants, whereas in 11 studies (54.6%), assessments were conducted by a qualified examiner. Based on the reported caries indices, caries experience among the studied populations ranged from 5.5 to 30.9 affected teeth, Regarding the presence of periodontal disease, seven studies reported findings ranging from gingival bleeding to positive results indicating the loss of dental support, and oral lesions were only reviewed in two studies, the most common lesions reported were leukoplakia and fibrous lesions.

Conclusion: The evidence suggests that migrants try to maintain the custom of having a diet as natural as possible, but this may be diminished by the economic factor or by a process of resilience. The migrant individuals are characterized by limited access to health services, coupled with their limited economic resources, which makes them susceptible to developing oral diseases. This is corroborated by the high incidence of dental caries and bleeding gums. One of the main limitations of the study was the period (2016-2025) that was selected, which does not represent the totality of what has been published on the subject.

Background: This study aims to investigate whether indocyanine green lymphography (ICGL) facilitates the effectiveness and accuracy of current management of lingual microcystic lymphatic malformation (mLM).

Methods: This retrospective included patients under 18 years old with mLM of the tongue staged I or IIA, who underwent ICGL-aided surgical resection and sclerotherapy (ICGL group) or only surgical resection and sclerotherapy (non-ICGL group) between January 2019 and June 2024. The peri- and postoperative parameters of safety and feasibility were compared between two groups.

Results: A total of 42 patients were included, 19 of whom received ICGL-guidance and the other 23 were in non-ICGL group. The comparison of baseline data between the two groups revealed no significant difference. Compared to the non-ICGL group, the ICGL group demonstrated superior efficacy (P = 0.017) and required fewer subsequent treatment sessions (P = 0.027), but had longer operative duration (P = 0.001). No significant differences were observed in terms of postoperative complications, length of hospital-stay, and follow-up period.

Conclusions: ICGL was associated with improved postoperative outcomes and less subsequent treatment. This technique may provide rational guidance with promising clinical prospects for management of mLM of the tongue.

Trail registration: This study was retrospectively registered on clinicaltrials.gov: NCT06755905, date of registration: January 20, 2025.

Objective: The study compares the contact pressure and pressure distribution of various pacifier shapes on the palatal surfaces of newborns and six-month-old infants using nonlinear finite element analysis (FEA). Additionally, it seeks to assess the extent and pattern of interaction between pacifier designs and the lateral and medial zones of the palates.

Materials and methods: 3D finite element models of four pacifiers (A = NUK^®, B = MAM^®, C = BIBS^®, D = CURAPROX^®) of newborn and six-month-old palate and tongue were developed. The palate geometries were based on dental stone impressions of a neonate and six-month-old infant. The pacifier designs were digitized using computed tomography and analyzed in ANSYS Mechanical 2024 R1 (Ansys, Inc., Canonsburg, USA). Hyperelastic silicone rubber properties were used, while the palate and tongue were modeled as rigid and the mucosa as flexible. The interaction between different pacifier designs and the palate of a newborn was assessed through deformation, contact area, and contact pressure relative to the vertical tongue displacement in the anterior, medial, and lateral zones of the palates.

Results: Pacifier D exhibited the highest lateral and medial pressures on both the newborn and six-month-old palates with its broad-winged design. Pacifiers A and B showed moderate but steady increases in lateral pressure. In contrast, pacifier C showed concentrated pressure in the anterior zone with its distinct, rounded shape, particularly on the newborn palate. Pressure distribution patterns differed significantly between pacifier designs, with pacifier D showing the most extensive and uniform pressure distribution across the palate.

Conclusions: Pacifier design significantly influences palatal interaction, with broader shapes resulting in higher pressure concentrations on the lateral sides that may affect the transversal palate dimension. Understanding the biomechanical impacts of pacifier use is the first step in giving valuable insights to both clinicians and parents in making informed decisions regarding pacifier selection to support optimal oral development. Further clinical studies are needed to validate these findings.

Background: Orthopantomograms (OPGs) are essential diagnostic tools in dental and maxillofacial care, providing a panoramic view of the jaws, teeth, and surrounding bone structures. Detecting bone loss, which indicates periodontal disease and systemic conditions like osteoporosis, is crucial for early diagnosis and treatment planning. Periodontists use OPGs to identify subtle radiographic features that signify different stages of bone loss. Automated systems integrating radiographic imaging with textual notes can enhance diagnostic accuracy and minimize interobserver variability. Radiographic notes, which summarize clinical observations and preliminary interpretations, can be utilized for classification through natural language processing techniques, including Transformer-based models. This study will classify bone loss severity (normal, mild, or severe) from OPG notes using a novel dual-embedding few-shot learning framework.

Methods: This study used a dataset of radiographic notes from OPGs gathered at Saveetha Dental College and Hospital in Chennai. Bone loss was classified according to Glickman's Classification system. The proposed DualFit model architecture consists of two main branches: a Text Processing Branch for converting textual data into dense vectors and a Feature Processing Branch for analyzing numerical and categorical data. Key techniques such as batch normalization and dropout layers were implemented to improve learning stability and reduce overfitting. A Fusion Layer was utilized to merge outputs from both branches, optimizing classification performance.

Results: The DualFit model outperformed leading models like BioBERT, ClinicalBERT, and PubMedBERT. It attained an accuracy of 98.98%, precision of 98.71%, recall of 99.14%, and an F1-score of 98.92%, marking a 5.53% accuracy increase over PubMedBERT. Additionally, the model excelled in multi-class classification tasks, ensuring class balance and achieving near-perfect values for precision, recall, and area under both the ROC and precision-recall curves.

Conclusions: The DualFit model significantly advances the automated classification of OPG radiographic notes related to periodontal bone loss. Outperforming existing Transformer-based models streamlines the diagnostic workflow, reduces the workload of radiologists, and enables timely interventions for improved patient outcomes. Future work should explore external validation and integration with multimodal diagnostic systems.

Background: Patients undergoing oral mucosa harvesting for urethroplasty may experience several challenges during recovery like scarring or changes in oral sensitivity, which can lead to long-term discomfort. In this retrospective study long-term donor site complications after harvesting of oral mucosa for urethroplasty were evaluated and a new measurement method for oral volume differences between the non-operated and operated sides was applied.

Methods: Thirty adult male patients who underwent urethroplasty with buccal mucosa grafting were included. At a median of 43 months after surgery, a standardized questionnaire was used, and clinical examinations were conducted to measure the postoperative elasticity of the buccal mucosa. This measurement compared the non-operated side with the operated side. Additionally, we examined descriptive statistics and the influence of smoking status, diabetes mellitus, immunosuppression, alcohol consumption, and graft size.

Results: In total, 36% of the patients reported persistent subjective postoperative impairments, such as tightness in the oral cavity or numbness. In all patients, a difference in buccal volume was observed between the operated side and the non-operated side. This volume difference ranged from 3 to 15 ml (mean 8.10 ml, SD ± 3.4; p < 0.001). As the size of the harvested transplant increased, the postoperative buccal volume difference also increased significantly (p < 0.001). In one patient, follow-up surgery was required due to the severity of scarring. The presence of diabetes mellitus, immunosuppressive medication, smoking status, and alcohol consumption had no statistically significant effect on postoperative buccal elasticity or mouth opening.

Conclusions: The use of buccal mucosa grafts for urethroplasty is an established procedure in urology, but the oral harvesting procedure can lead to scarring within the buccal area, which is associated with a statistically significant decrease in buccal volume compared with the non-operated site. The volume analysis was performed by applying a new measurement method, which enables, for the first time, the quantification of oral donor site morbidity.

Objective: This study aimed to evaluate the effects of various teething oral gels, containing lidocaine, hyaluronic acid, and herbal-based ingredients, on cell viability and to compare the antifungal properties.

Materials and methods: The effect of the six different teething oral gels (Gengigel Teething, Orajel Baby, Calgel, Hyland's Baby Organic Soothing Gel, Buccotherm Teething Gel and Aftamed Teething) on cell viability was evaluated through the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay on L-929 mouse fibroblast cells. The antifungal activity of teething oral gels against Candida albicans ATCC 90,028, C. tropicalis ATCC 750, C. glabrata ATCC 2001, C. parapsilosis ATCC 22,019, and C. krusei ATCC 6258 was assessed using the broth dilution method.

Results: The cell viability analysis revealed that Aftamed Teething exhibited the highest level of cytotoxicity among the tested teething oral gel products, whereas Buccotherm Teething Gel demonstrated the lowest cytotoxicity. The teething oral gels can be ordered based on their respective cytotoxicity profiles: Aftamed Teething (IC₅₀ 4.62 mg/ml) > Calgel (IC₅₀ 33.40 mg/ml) > Gengigel Teething (IC₅₀ 122.85 mg/ml) > Orajel Baby (IC₅₀ 137.13 mg/ml) > Hyland's Baby Organic Soothing Gel (IC₅₀ 229.20 mg/ml) > Buccotherm Teething Gel (IC₅₀ 284.38 mg/ml) (p < 0.05). The results indicate that Buccotherm Teething Gel, Hyland's Baby Organic Soothing Gel and Orajel Baby did not exhibit any antifungal activity against C. albicans, while Gengigel Teething and Aftamed Teething demonstrated marginal effects at the 100 mg/ml concentration threshold. The Calgel exhibited the highest efficacy against C. albicans, with a minimum inhibitory concentration of 12.5 mg/ml (p < 0.05). From non-albicans Candida species, it was ascertained that Gengigel exhibited a modest antifungal effect on C. tropicalis and C. parapsilosis, while Calgel demonstrated a modest antifungal effect on C. glabrata. Additionally, Calgel demonstrates antifungal activity against C.tropicalis and C.parapsilosis, with a minimum inhibitory concentration of 25 mg/ml (p < 0.05).

Conclusion: Teething oral gels containing lidocaine, hyaluronic acid, and herbal formulations demonstrated varying degrees of cytotoxicity and antifungal efficacy. Herbal-based teething oral gels may be a more suitable option for young children compared to products containing lidocaine or hyaluronic acids, as they exhibit reduced cytotoxicity and enhanced biocompatibility. Lidocaine-containing gel may be preferred for opportunistic fungal infections, considering their high cytotoxic properties, solely to leverage their antifungal capabilities on different species.

Clinical relevance: Lidocaine-containing teething oral gel has demonstrated potent antifungal properties on both C.