International dental journal最新文献

Background and aim: Recent studies have shown that electronic cigarettes (ECs) use disrupts the oral microbiome composition and diversity, impairing the metabolic pathways of the mucosal cells. However, to date, no reports have evaluated the role of EC exposure in the context of oral metabolome. Hence, the aim of this study was to investigate the role of EC aerosol exposure in the dysregulation of the oral microbiome and metabolome profile using in vitro 3D organotypic models of human oral mucosa.

Methods: 3D tissue-engineered human oral mucosa models were generated and infected with oral microbes obtained from saliva of a healthy donor. The epithelial surface of the oral mucosal models was exposed directly to the EC aerosol (flavoured; with and without nicotine) as it came out of a simulated activated device that mimicked the clinical situation. A comprehensive assessment of oral microbiome community composition by bacterial 16S rRNA gene sequencing was performed. A gas chromatography-based mass spectrometry analysis was also conducted to identify the effect of vaping on the oral metabolome profile.

Results: A higher alpha diversity in flavoured EC with nicotine groups was observed compared to controls, with notable differences in bacterial taxa abundance. Metabolomics analysis further demonstrated distinct clustering of control, EC with flavoured nicotine, and flavoured EC groups, confirming 13 metabolites that were statistically higher in levels in flavoured EC with nicotine group, indicating the adverse effects of nicotine on the oral mucosa model. Altered metabolites were mainly enriched in pathways associated with oral cancer progression.

Conclusion: This study underscores the significant impact of EC use on oral health, highlighting alterations in the oral microbiome, bacterial composition, and metabolite profiles via a clinically relevant in vitro 3D organotypic model of human oral mucosa.

Introduction and aims: Dental practices pose a high risk of microbial contamination due to frequent exposure to bodily fluids like saliva and blood. Bioengineering innovations have emerged as vital tools to enhance infection control in dental settings. This review aims to assess the global applications and effectiveness of these innovations, particularly focusing on antimicrobial biomaterials, sterilization techniques, and personal protective equipment (PPE).

Methods: A systematic review was conducted across major databases to identify studies from 2000 to 2024 that examined bioengineering technologies used in dental infection control. Inclusion criteria included studies focusing on antimicrobial materials, PPE, or novel sterilization technologies. Data extraction followed PRISMA guidelines, focusing on study design, dental settings, and clinical outcomes related to infection control.

Results: Nine studies met the inclusion criteria, covering diverse geographical regions, including Italy, Saudi Arabia, Brazil, and India. Antimicrobial agents like silver and zinc oxide nanoparticles, UV-C sterilization, and low-temperature plasma were found to significantly reduce microbial contamination. The pooled effect size across studies was 1.62 (95% CI: 1.41-1.82) with low heterogeneity (I² = 6.4%). However, barriers such as high costs and limited resource availability were highlighted, particularly in lower-income regions.

Conclusion: Bioengineering innovations show significant potential for enhancing infection control in dental settings worldwide. While the technologies offer improved safety and hygiene, challenges related to cost and accessibility persist. Further research is needed to explore cost-effective and scalable solutions, particularly in resource-limited settings.

Clinical relevance: The integration of bioengineering technologies in dental practices can significantly improve infection control measures, reducing microbial contamination and enhancing safety for both patients and healthcare workers. These innovations hold promise for global adaptation, particularly in response to emerging public health challenges.

Objective: The oral mucosa mirrors a range of latent systemic disorders, with potential clinical associations noted between autoimmune thyroid disease (AITD) and oral lichen planus (OLP). This study aims to explore the genetic relationship and underlying mechanisms mediating these conditions.

Methods: A 2-step Mendelian randomization (MR) analysis was conducted to elucidate the genetic relationship and mediating factors between AITD and OLP. Linkage disequilibrium score regression was employed to assess heritability and genetic correlations among phenotypes, followed by genetic colocalization analysis to discern shared genetic variants. A transcriptome-wide association study (TWAS) was also performed to pinpoint gene expression profiles.

Results: Genetically predicted AITD is associated with an increased risk of OLP (OR[95% CI]: 1.44[1.19,1.74], P=1.61 × 10^-4), potentially mediated by hypothyroidism. There is strong evidence of colocalization between AITD and OLP, with a shared PTPN22 gene variant driving this association. TWAS further identified RNASET2 and FGFR1OP within the HLA region as high-confidence shared genes for both conditions.

Conclusion: Our study provides novel evidence of a possible genetic association between AITD and OLP. These findings highlight the critical role of endocrine alterations in maintaining oral immune homeostasis, though further research is warranted to validate our findings.

Background: Previous studies have indicated a potential relationship between iron status and oral health outcomes, specifically periodontitis and dental caries. This study employed Mendelian randomization (MR) to investigate the causal effects of iron status on these oral health conditions. The focus of this study was on key iron biomarkers, namely serum iron, ferritin, transferrin saturation (TSAT), and total iron-binding capacity (TIBC).

Methods: This two-sample MR analysis employed genome-wide association study (GWAS) data. The instrumental variables (IVs) were selected based on their genome-wide significance and independence from confounders. The statistical analyses employed the inverse variance weighted (IVW) method, MR-Egger regression, weighted median, and weighted mode. Additionally, sensitivity analyses were conducted to verify the reliability of the causal association results.

Results: The MR analysis indicated a suggestive negative causal relationship between TIBC and periodontitis, with an odds ratios of 0.875 and a 95% CI of 0.766-0.998, with a P-value of .047. No significant other associations were found. The results of sensitivity analyses demonstrated the robustness of these findings.

Conclusion: This MR study suggested a potential negative association between TIBC and periodontitis, highlighting the importance of considering iron status in the clinical management of chronic periodontitis. However, more standardized, multi-population studies are needed to confirm this causality.

Objectives: Periodontal ligament stem cells (PDLSCs) are promising for regenerative therapies due to their self-renewal and multilineage differentiation, essential for periodontal tissue repair. Although magnesium plays a vital role in bone metabolism, its specific effects on PDLSCs and potential applications in regeneration are unclear. This study aimed to investigate the effects of magnesium chloride (MgCl₂) on the proliferation and osteogenic differentiation of human PDLSCs (hPDLSCs).

Methods: hPDLSCs were isolated, characterised, and treated with 0.1-40 mM MgCl₂. Cell viability and proliferation were assessed using an MTT assay. Cell migration was measured by a scratch assay. Colony-forming unit formation and cell cycle analysis were examined using crystal violet and propidium iodide staining. Osteogenic differentiation was assessed through alkaline phosphatase activity, Alizarin Red S staining, and RT-qPCR for osteogenic-related gene expression. RNA sequencing was performed to evaluate differential gene expression patterns in hPDLSCs treated with 10 mM MgCl₂. All statistical analyses were evaluated at P < .05.

Results: hPDLSCs exhibited mesenchymal stem cell characteristics. MgCl₂ concentrations higher than 10 mM were cytotoxic. Significant increases in cell proliferation, colony-forming unit percentages, and active cell cycle activity were observed when treated with 0.1, 0.5, and 1 mM MgCl₂. However, MgCl₂ had no effect on cell migration. Mineralised nodule formation was observed in hPDLSCs treated with 0.1 and 0.5 mM MgCl₂ in osteogenic induction media, mediated by TRPM7 cation channel, along with upregulated expression of osteogenic marker genes. Bioinformatic analysis indicated alterations in chemokine signalling and cellular calcium homeostasis pathways when treated with 10 mM MgCl₂.

Conclusions: MgCl₂ at a dose of 0.1 mM is the most effective concentration to promote cell proliferation and stimulate osteogenic differentiation of hPDLSCs in vitro. These findings indicate that MgCl₂ enhances both the proliferation and osteogenic differentiation of hPDLSCs, supporting its potential application in periodontal tissues and alveolar bone regeneration.

Introduction and aims: Neutrophil percentage-to-albumin ratio (NPAR) is a novel biomarker of systemic inflammation. The aim of this study was to explore the relationship between NPAR and periodontitis.

Methods: Data from the National Health and Nutritional Examination Survey (NHANES) between 2009 and 2014 (N = 10,128) were utilized in this cross-sectional study. Periodontitis categories were defined according to the Centres for Disease Control and Prevention and American Academy of Periodontology (CDC/AAP) classification. The NPAR was calculated by dividing the neutrophil percentage by serum albumin. Covariates included age, sex, race, education level, annual household income, marital status, smoking status, BMI, recreational activity, work activity, diabetes mellitus, hypertension, and cardiovascular disease. Weighted logistic regression analysis was conducted to investigate the linkage between NPAR and moderate/severe periodontitis, and weighted linear regression analysis was performed to explore the relationship of NPAR with mean attachment loss (AL) and mean probing pocket depth (PPD).

Results: Our analysis revealed a positive linear relationship between NPAR and periodontitis. Specifically, we found that the risk of moderate/severe periodontitis increased by 12% for each standard deviation increase in NPAR. Individuals in the highest tertile of NPAR were 28% more likely to have periodontitis compared to those in the lowest tertile (OR_tertile3vs1 = 1.28, 95% CI: 1.10-1.49). These findings were consistent across different subgroups analysed. Furthermore, our study demonstrated that NPAR was also positively correlated with mean AL and PPD, which are key indicators of periodontal health.

Conclusions: Our results suggest that NPAR is significantly linked to poor periodontal health. However, owing to the cross-section design of this study, additional longitudinal studies are necessary to further enhance our comprehension of the impact of NPAR on periodontal status.

Clinical relevance: Elevated neutrophil counts and low albumin levels correlate with moderate/severe periodontitis. Monitoring these markers may aid in assessing periodontitis risk.

Introduction and aims: We aimed to investigate the efficacy of air-polishing in restoring the original tooth colour of standardised tobacco-stained tooth specimens.

Methods: Seventy-two specimens consisting of half dentine and half enamel were daily exposed to the smoke of five cigarettes in an automated smoking chamber. Four repetitions of a 14-day smoking cycle were performed. Specimens were cleaned after each cycle, either by air-polishing with erythritol or sodium bicarbonate powder, or with a rubber cup and pumice stone as control. Spectral photometric colour changes (ΔE) and profilometric surface roughness were measured before and after each cycle. All samples were stored for the entirety of the study period in artificial saliva to mimic oral conditions and to establish a pellicle layer on the samples.

Results: The tested cleaning procedures effectively removed tobacco staining from dentine and enamel samples, however, none of the treatments could restore the original colour. Mean [SD] tooth colour of enamel specimens after four cycles was not statistically significantly different between erythritol (E = 77.6 [6.6]) and sodium bicarbonate air-polishing (E = 79.8 [7.0]) (P > .05). ΔE showed no significant differences between the air-polishing groups after four cycles (P > .05) but with the control group (P < .001). On dentine there was no statistically significant difference of ΔE between all three groups (P > .05). No significant differences in enamel and dentine roughness compared to baseline were observed after repeated air-polishing with erythritol (P > .05).

Conclusions: Erythritol air-polishing removed smoker's discolourations just as effectively as air-polishing with sodium bicarbonate and polishing with pumice, without altering the roughness of the tooth structures. Tobacco stains do not reoccur faster or stronger after the use of air-polishing devices than after polishing with rubber cup and paste.

Clinical relevance: Air-polishing with erythritol emerged as a safe and efficient option for removing extrinsic tooth discolourations with the least abrasive character. These findings support the clinical relevance of incorporating air-polishing devices, particularly with erythritol powder, in dental practice for managing tobacco-induced tooth discolourations.

Background: This study was conducted to assess the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on dental healthcare workers (DHCWs) during the pandemic. Due to frequent exposure to aerosol-generating procedures, DHCWs are at an increased risk of a SARS-CoV-2 infection, increasing their mortality risk. Therefore, this retrospective study aimed to ascertain the mortality of DHCWs attributable to SARS-CoV-2 infection from databases in the public domain during the pandemic.

Methods: The data were obtained from three public-domain online databases: Medscape, FNOMCeO, and X. All collected data from March 2020 to May 2024 were merged into a tabulated format. An analysis was conducted on the data collectively and through a subgroup analysis based on the country, detailed profession, age, gender, and date of death.

Results: During the SARS-CoV-2 pandemic, 100 DHCWs were deceased. The DHCWs in the study were employed in 14 countries, with the United States (40%) and Italy (34%) listing the highest percentages of deaths of these workers. Dentists constituted 79% of the total DHCWs. The gender distribution among the deceased was 85 (85%) men and 15 (15%) women. The age of 57 deceased DHCWs was known, resulting in a mean age of 58 years (ranging from 28 to 88). The DHCWs at ages 60 to 70 years (49%) exhibited the highest mortality rate from SARS-CoV-2. The date of death was known for 73 DHCWs, who were deceased between March 2020 and February 2023.

Conclusion and clinical relevance: During the global pandemic, DHCWs worked in the context of general practice. The DHCWs adhered to infection prevention protocols according to standard guidelines and incorporated new adjunctive measures, especially for the pandemic, including adopting coronavirus disease 2019 guidelines for oral healthcare. These measures provided satisfactory protection, with less than 0.006% mortality of the estimated DHCWs worldwide.

Background: While observational studies have demonstrated a potential link between inflammatory cytokines and oral diseases, the question of causality is warranting further investigation. This study aimed to comprehensively assess the potential causal role of 41 inflammatory cytokines in common oral diseases.

Methods: A two-sample Mendelian randomization (MR) study was conducted using the summary statistics from the largest publicly available genome-wide association study (GWAS) for 41 inflammatory cytokines and common oral diseases (indicated by the index of decayed and filled tooth surfaces divided by number of tooth surfaces (DFSS), index of decayed, missing and filled tooth surfaces (DMFS), number of natural teeth, and periodontitis). Inverse variance weighted regression (IVW) was used as the primary method to estimate odds ratios (OR) and 95% confidence interval (CI) for assessing the causal effect. Sensitivity analyses with other four analytical approaches were performed to test the validity of our findings.

Results: Increased levels of hepatocyte growth factor (HGF) and stem cell growth factor beta (SCGF-β) were significantly associated with the risk of DFSS, with the ORs of 1.058 (95% CI: 1.004-1.115, P = .033) and 1.035 (95% CI:1.002-1.069, P = .038), respectively. Interleukin-1 receptor antagonist (IL-1RA) exhibited a negative association with DMFS (OR = 0.934, 95% CI: 0.886-0.985, P = .012). Furthermore, interleukin-9 (IL-9) was associated with in increased risk of periodontitis (OR = 1.148, 95% CI:1.031-1.277, P = .011). Additionally, no significant association was found between inflammatory cytokines and the number of natural teeth. Sensitivity analyses yielded generally consistent results.

Conclusions: This MR study provides evidence supporting potential causal associations of four inflammatory cytokines (HGF, SCGF-β, IL-1RA, IL-9) with the risk of common oral diseases, which may contribute to the development of more targeted prevention strategies for these diseases.

The number of elderly people worldwide and their need for dental care increases in a yearly basis. A dental practice website can be a valuable source of information to these patients that may need comprehensive or adjusted care. Therefore, this study aimed to evaluate the information on Dutch general dental practice websites on topics relevant to the treatment of (frail) elderly patients. Websites were selected from (1) a random sample of 217 Dutch general dental practices (sample-group) and (2) dental practices of 130 members of the Dutch Association for Gerodontology (gero-group), and screened for items in 4 categories: website functionality, contact details and accessibility, composition of the dental team, and specific information for elderly patients. Of the selected websites, 196 in the sample-group and 54 in the gero-group were eligible for data collection. Most websites mentioned opening hours, a phone number, and the composition of the dental team. Other information was overall scarce, especially regarding (frail) elderly patients. The gero-group significantly more often mentioned elderly as a specific target patient group (11,1% vs 2,6%), but numbers were overall low. Websites in the gero-group were hardly more informative or adjusted to elderly than in the sample-group; wheelchair accessibility was the only feature mentioned significantly more often (37.0% vs 17.3%). Only one website in the sample-group and 2 websites in the gero-group mentioned the possibility of home visits. In conclusion, dental practice websites lack information in general, and information relevant to elderly patients in particular, and there is room for improvement in website functionality. Additionally, general dental practices seem insufficiently equipped for the treatment of (frail) elderly patients, highlighting the need for improvement of oral healthcare for this specific patient group. This study addresses the insufficiencies in the provision of information on dental practice websites, allowing for targeted future studies towards improvement.