Indian Journal of Dental Research最新文献

Abstract: This systematic review was conducted to evaluate the diagnostic ability of artificial intelligence (AI) models for predicting an endodontic radiographically inferred condition. Review was performed in accordance to PRISMA-DTA checklist and registered under PROSPERO (CRD42025631782). Databases were searched from January 2000 to December 2024 for studies comparing the diagnostic ability of AI models compared to dental specialists. Risk of bias (ROB) assessment was done through QUADAS (Quality assessment of diagnostic accuracy studies)-2 tool and meta-analysis was performed in Meta-Disc 1.4 software and Review Manager 5.3 for pooled sensitivity, specificity, and summary receiver operating characteristics (SROCs). Five studies were included for analysis. Included studies revealed the presence of moderate to low ROB. Various AI models analysed and evaluated as an index test were artificial neural network, convolutional neural network, direct learning, and direct learning network. Meta-analysis revealed a pooled sensitivity of 0.83 (95% confidence interval (CI) 0.31-1.00) and a pooled specificity of 0.33 (95% CI 0.03-0.81); the summary receiver operating characteristics (SROC) through area under curve (AUC) was 0.54. The included AI models were trained and evaluated on radiographic data only; therefore, findings reflect diagnostic accuracy of image-based AI in detecting radiographic signs associated with endodontic disease rather than comprehensive clinical prognoses. While AI demonstrated moderate sensitivity for identifying these endodontic conditions, low specificity indicates a high false-positive rate when used as a standalone radiograph-based tool. These models may serve as adjunctive screening aids but require prospective validation that integrates clinical and treatment variables before they can be used to predict longitudinal treatment outcomes.

Background: Oral submucous fibrosis (OSF) is a chronic, progressive disorder characterised by reduced mouth opening (MO) and a risk of malignant transformation. Despite numerous non-surgical interventions, sustained functional improvement remains elusive. This study introduces a cost-effectiveness analysis framework to compare various OSF treatments, addressing a critical knowledge gap.

Materials and methods: Data from a previously published network meta-analysis (NMA) comprising 72 studies (N = 5268 patients) were analysed. Cost/millimeter of MO improvement (cost/mm) and cost/millimeter/week (cost/mm/week) were calculated. Incremental Cost-Effectiveness Ratio (ICER) was computed against placebo and multivitamins. P ≤0.05 considered significant.

Results: The median cost/mm was INR 1906.57, ranging from INR 403.35 (ultrasound + exercise) to INR 10,368.36 (steroids + exercise). Cost/mm/week ranged from INR 59.97 (topical steroids) to INR 2292.83 (steroids + exercise). Kruskal-Wallis tests showed significant differences in cost/mm (P = 0.002) and cost/mm/week (P = 0.004). ICER analysis identified steroid with or with spreading factor (SSF) + exercise as the most cost-effective (-4918.38 INR/placebo, -2365.78 INR/multivitamins), while SSF + placebo was least cost-effective (ICER: 8540.79 INR/placebo, 8382.25 INR/multivitamins).

Discussion and conclusion: This study presents the first cost-effectiveness analysis of non-surgical OSF treatments, revealing substantial economic variations across interventions. Ultrasound with exercise and SSF + exercise was the most cost-efficient, supporting the integration of multimodal non-pharmacological therapies into OSF management. Conversely, nutraceutical products (NPs) demonstrated inconsistent cost-effectiveness, with systemic NPs outperforming topical applications. Given the economic burden and limited efficacy of some treatments, these findings emphasise the need for evidence-based, cost-conscious decision-making. The cost/mm and cost/mm/week metrics provide a novel perspective, facilitating better resource allocation in OSF care.

Background: Oral lichen planus (OLP) is one of the most prevalent mucocutaneous immunological disorders affecting females. The aim of the study was to determine whether there is an association of serum estradiol levels with the occurrence of OLP in postmenopausal women and also to correlate the estradiol levels with the clinical types of OLP.

Materials and methods: Cross-sectional study on patients diagnosed clinically and histopathologically as OLP ( n = 50) and the controls consisted of 50 postmenopausal women randomly selected with clinically normal oral mucosa. The serum estradiol was estimated for both groups. Student's t -test was used to compare the quantitative variables.

Results: Serum estradiol of OLP patients was 13.45 ± 7.96, remarkably less than the controls, 19.49 ± 6.59 ( P ≤ 0.01). Also, estradiol was seen to decline with the severity of OLP with reticular type (15.5 pg/mL) than erosive (11.1 pg/mL) and bullous (12 pg/mL). Both the patients and controls showed a decline in levels of estradiol with the increase in the period of last menstruation. Increased prevalence of OLP in patients who underwent hysterectomy and oophorectomy than in the controls ( P < 0.01).

Conclusion: Serum estradiol in postmenopausal patients with OLP declined with increased severity of OLP type.

Introduction: The remineralization potential of three recent remineralizing agents on white spot lesions ( WSLs ) was compared and evaluated using the Vicker's microhardness testing machine. This short study aims to evaluate and compare the remineralization potential of recently introduced remineralizing agents like Curodont Protect gel, GC Tooth Mousse Plus, and Dente 91 on the surface hardness of WSLs in human teeth.

Methods and materials: Thirty single-rooted human premolars (BBDCODS/IEC/09 / 2022), extracted due to periodontal or orthodontic reasons, were chosen for this study. The teeth were decoronated at the cemento-enamel junction level. Samples were then mounted in auto-polymerization acrylic resin. All the groups were subjected to a demineralization process to induce WSLs. A post-demineralization Vicker hardness test was performed, followed by random allocation to the three groups. The three groups were namely self-assembling peptide (P11-4), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and nanohydroxyapatite. A post-remineralization Vickers hardness test was conducted to evaluate the remineralization potential of the tested agents.

Result: An analysis of variance was performed to determine the significant difference in Vickers microhardness. Self-assembling peptide (P11-4) showed the highest microhardness value.

Conclusion: Self-assembling peptide (Curodont Protect gel) was more efficient than nanohydroxyapatite (Dente-91) and CPP-ACP (GC Tooth Mousse Plus) for the prevention of WSLs.

Aim: Mineral trioxide aggregate (MTA) is a dental biomaterial that is used for various endodontic treatments. However, the major limitation of MTA is its hardness and retrievability. The aim of this study is to evaluate the influence of various chemicals on micro-hardness of MTA.

Materials and methods: 200 hollow cylindrical stainless-steel molds of specified dimensions (5 mm height and 5 mm internal diameter) were made. MTA was mixed homogeneously and condensed into the molds. After the setting, MTA was exposed to three experimental groups, Group 1: back-set, Group 2: carbonic acid, and Group 3: citric acid at 1, 3, and 5 minute exposure at the end of Day 1 and 21. Then the samples were evaluated exposed to Vickers micro-hardness testing. The data were evaluated statistically using analysis of variance (ANOVA) and post-hoc with P = 0.05 were used to perform multiple comparison tests.

Results: On day 1, the reduction in micro-hardness was greater in back-set when compared with carbonic acid and citric acid. At the end of Day 21, the highest mean surface micro-hardness reduction was seen with back-set at 5 min, 3 min, and 1 min intervals, respectively. However, there was no significant difference noted between the citric and carbonic acids at 1 and 3 minutes.

Conclusion: It can be concluded that back-set was found to be the most effective in reducing the micro-hardness of MTA when compared to citric and carbonic acid.

Aims: The aim was to comparatively evaluate the ability of Ledemix and non-setting calcium hydroxide intracanal medicaments to reduce postoperative pain in teeth undergoing root canal treatment (RCT).

Materials and methods: A single-blinded, randomised controlled clinical trial was conducted at Ajman University College of Dentistry, involving 59 patients requiring RCT on maxillary and mandibular first molars. Patients were randomly allocated into two groups: Group 1 received Ledermix paste, while Group 2 received non-setting calcium hydroxide paste. Treatments were performed by supervised fifth-year dental students using standardised aseptic techniques. Local anesthesia was administered, and rubber dam isolation was ensured. After access cavity preparation, root canals were instrumented using WaveOne Gold Files with sodium hypochlorite irrigation. The assigned intracanal medicament was placed, and the cavity was sealed with a temporary restoration. Pain levels were assessed preoperatively and at 4 h and 4 days postoperatively using a visual analogue scale by a blinded investigator. Clinical and demographic data, including age, gender, smoking status, medical history, and pulpal/periapical diagnoses, were recorded.

Results: Data were analysed using SPSS 28.0. T-tests were used to compare pain levels between groups, with significance set at P < 0.05. The average pain score decreased significantly from 3.95 ± 0.52 preoperatively to 1.47 ± 0.30 at 4 h and 0.42 ± 0.18 at 4 days postoperatively ( P = 0.001). Ledermix was associated with greater pain reduction at 4 h ( P = 0.004), no significant differences between groups were observed at 4 days ( P = 0.665).

Conclusion: Both medicaments effectively reduced pain, with Ledermix offering superior early relief.

Introduction: Menopause affects the oral cavity along with various hormonal changes; for example, the level of follicle stimulating hormone (FSH) increases, whereas the level of estrogen and progesterone decreases. High bone turnover in post-menopausal women is primarily caused due to the increased alkaline phosphatase (ALP) levels. Thus, finding an association between FSH, ALP, and chronic periodontitis is essential, which will aid in early diagnosis and treatment planning.

Materials and methods: Sixty post-menopausal females in the age group of 45-57 years visiting the Department of Periodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, were selected. The subjects were assigned in each group based on the periodontal parameters; that is, group I consisted of 30 post-menopausal females without chronic periodontitis and group II consisted of 30 post-menopausal females with chronic periodontitis. Serum FSH and ALP levels were evaluated, and the data obtained were statistically analyzed.

Results: The result showed that age did not differ significantly between groups I and II. Although serum FSH levels were high for both groups I and II, it was however not statistically significant. Serum ALP levels were significantly raised in both the groups and were statistically significant (P = 0.001). The periodontal parameters like gingival index, probing depth, and clinical attachment loss were recorded.

Conclusion: A causal relationship between FSH and periodontitis could not be established. However, ALP is shown to be increased in post-menopausal women with chronic periodontitis. ALP is an intracellular enzyme produced by many cells such as polymorphonuclear leukocytes, macrophages, fibroblasts, osteoblasts, and white blood cells. When periodontal tissue is destroyed, secretion of this enzyme actively increases and hence can be related with disease severity. Thus, it could be used as a reliable diagnostic marker for periodontal disease in post-menopausal women.

Introduction: Tobacco leaf (Nicotiana Tabacum L.), rich in antibacterial and antifungal compounds, is a potential denture cleanser but may cause colour changes in thermoplastic nylon denture bases. The study was conducted to determine the effect of immersion in 75% tobacco leaf extract (TLE) effervescent tablets for 16 and 32 days on the colour change of thermoplastic nylon denture bases.

Materials and methods: A pre-post test group design was employed using simple random sampling. Thirty-square thermoplastic nylon plates (20 × 20 × 2 mm) were divided into three sample groups. Each group was soaked for 16 and 32 days in distilled water, 75%-TLE effervescent tablets, and a commercially available tooth cleanser. The colour stability of thermoplastic nylon was measured using a colour reader. Data were analysed using one-way ANOVA followed by post-hoc least significance different (LSD).

Results: The ANOVA test showed a significant difference in thermoplastic nylon-soaked colour change for 16 and 32 days ( P < 0.005). The LSD test revealed significant differences among all groups.

Conclusion: Immersion in 75%-TLE effervescent tablets (Nicotiana tabacum L.) for 16 days and 32 days caused colour change in thermoplastic nylon dentures. Nevertheless, the colour change in thermoplastic nylon dentures soaked for 16 days remained safe to wear.