International dental journal最新文献

Objective: This study aimed to compare the effectiveness of semi-annual application of 38% silver diamine fluoride (SDF) with and without light curing in arresting dentine caries in primary teeth.

Methods: Children aged 5-7 years with at least 1 active dentine carious lesion were randomly allocated into: Group 1 (38% SDF with light curing: applied SDF for 10 seconds and exposed to LED light for 20 seconds) and Group 2 (38% SDF without light curing: applied SDF for 10 seconds and isolated for 20 seconds). Both interventions were repeated every 6 months. At the baseline, demographic data, oral health-related behaviors and clinical parameters of the children were collected. The activity of carious lesion was assessed using the visual-tactile method and adverse effects, if any, were recorded at both 6-month and 12-month follow-up periods by the same examiner. Intention-to-treat analysis was employed to analyze the data.

Results: At baseline, 40 children (218 lesions) and 37 children (261 lesions) were recruited into Group 1 and Group 2. There were no significant differences between the 2 groups in terms of demographic data, oral health-related behaviors, and clinical parameters of the children at baseline (P > .05). After 12 months, 66 out of 77 children (85.74%) remained in the study. There was no significant difference in caries arrest rate between Group 1 (74.8%) and Group 2 (69.0%) with P = .161.

Conclusion: The semi-annual application of 38% SDF with or without light curing is equally effective in arresting dentine carious lesions in primary teeth. The addition of light curing to SDF-treated teeth has no significant effect in arresting dental caries in primary teeth.

Introduction and aims: Epidemiological observational studies have explored the link between bone joint-related diseases and temporomandibular disorders (TMD), but inconsistent conclusions have emerged due to various limitations. This study aims to investigate the causal relationship between bone joint-related diseases and TMD using Mendelian randomization (MR).

Methods: We utilized a two-sample MR design, applying pooled genome-wide association study (GWAS) data from six subtypes of bone and joint diseases and TMD. Primary analysis was conducted using the inverse-variance weighted (IVW) method, complemented by weighted median (WM), weighted mode, and MR-Egger regression to assess causal relationships. Additionally, we performed reverse causality analyses and applied sensitivity analyses, including MR-PRESSO, MR-Egger, Cochran's Q, and leave-one-out methods to evaluate result robustness, explore heterogeneity, and identify potential biases.

Results: MR genetic prediction analyses indicated that bone and joint-related diseases increase the risk of TMD, with specific odds ratios (OR) for ankylosing spondylitis (AS: OR 1.36, 95% CI: 1.04-1.77, P = .026), rheumatoid arthritis (RA: OR 1.08, 95% CI: 1.03-1.13, P = .001), and osteoporosis (OR 1.0751, 95% CI: 1.0047-1.1505, P = .036). Conversely, reverse MR analysis revealed a positive genetic link from TMD to RA (RA: OR 1.12, 95% CI: 1.02-1.23, P = .018). MR-Egger regression showed no influence of horizontal pleiotropy, and MR-PRESSO detected no outliers. The leave-one-out analysis confirmed the results' stability.

Conclusions: The findings demonstrate a positive, causal association between TMD risk and AS, RA, and osteoporosis. Moreover, TMD patients exhibit an increased risk of developing RA.

Clinical relevance: Understanding these relationships aids in better diagnosis and management of TMD and its association with bone joint diseases, potentially guiding clinical interventions.

Introduction and aims: Blood loss is a common side-effect in orthognathic surgery. Deliberated hypotensive anaesthesia can reduce blood loss. The purpose was to evaluate the effect of add-on dexmedetomidine compared with the usual hypotensive drug bolus on blood loss and patient outcomes in orthognathic surgery.

Methods: This double-blinded randomised controlled trial study was conducted on patients with American Society of Anaesthesiology class I or II, and 18 to 45 years-old, scheduled for bimaxillary orthognathic surgery. Patients were randomly divided into 2 groups: study (add-on dexmedetomidine; D group) and control (usual bolus of the hypotensive drug; C group) by block randomisation. The primary outcome variables were blood loss, postoperative haemoglobin, and incidence of intraoperative blood transfusion. The secondary outcome variables were the stability of the vital signs, overall pain score and opioid requirement, anaesthetic time, quality of the operative visual field, surgeons' satisfaction, hospital stay length and side effects. Statistical significance was defined as P-value <.05.

Results: The sample was composed of 60 patients with a mean age of 25.93 (4.66) years and 26 (43.30%) were male. The blood loss for D and C groups was 401.67 (131.62) and 898.33 (548.58) mL, respectively (P < .001). The D group demonstrated a significantly lower overall pain score 2.43 (1.36) versus 4.10 (1.19) for C group. The quality of the surgical field using Fromme's scale was significantly higher in D group 0.93 (0.83) versus 2.53 (0.94). Nausea/vomiting was also significantly lower in D group.

Conclusions: Adding-on dexmedetomidine in orthognathic surgery decreases blood loss and improves patient outcomes, especially in overall pain score, quality of the surgical field, and incidence of nausea/vomiting.

Clinical relevance: Dexmedetomidine can be considered a safe and effective medication for performing DHA in orthognathic surgery. Adding-on dexmedetomidine significantly reduced estimated blood loss by over 50% and improves patient outcomes.

Introduction: This systematic review with network meta-analysis (NMA) analysed the current evidence on in vitro studies comparing trueness of fit, surface roughness, colour stability, surface wettability, water sorption, water solubility, and microbial adhesion between conventional and digital denture bases.

Methods: From inception until December 2023, a systematic search of published in-vitro studies from Scopus, PubMed, and the Cochrane Central Register of Controlled Studies was conducted. The protocol was registered in PROSPERO (CRD42024531416). NMA compared properties related to dimensional accuracy and surface properties between conventional and digital dentures. The ranking was performed using the surface area under the cumulative ranking guidelines.

Results: A total of 6004 articles were initially identified, of which 342 duplicates were removed, and 5566 were excluded by screening the titles and abstracts. A total of 96 articles were assessed by full-text reading, and 43 were included in the quantitative synthesis. As per the NMA results, MIL demonstrated significantly higher trueness of fit when compared with conventional compression moulding (standardized mean differences [SMD] = -2.25 [95% CI: -4.09, -0.40]), P = .017 (<.05) and TDP (SMD = -1.57 [95%CI: -3.14, -0.01]) P < .05. MIL demonstrated significantly lower surface roughness when compared with conventional compression moulding (SMD = -0.99 [95% CI: -1.72, -0.26]), P = .008 (<.05), and TDP (SMD = -1.08 [95%CI: -1.95, -0.22]) P < .05.

Conclusions: There is conclusive evidence that milled digital denture bases demonstrate higher trueness of fit and lower surface roughness than 3D-printed denture bases and conventional denture bases, as demonstrated by the concurrent network and pairwise results.

Clinical relevance: In vitro studies show that milled digital dentures exhibit higher accuracy and lower surface roughness. The clinical performance of milled dentures in relation to these properties needs to be evaluated by high-quality randomized controlled clinical trials.

Introduction and aim: The assessment of gingival inflammation surface features mainly depends on subjective judgment and lacks quantifiable and reproducible indicators. Therefore, it is a need to acquire objective identification information for accurate monitoring and diagnosis of gingival inflammation. This study aims to develop an automated method combining intraoral scanning (IOS) and deep learning algorithms to identify the surface features of gingival inflammation and evaluate its accuracy and correlation with clinical indicators.

Methods: The study included the periodontal probing data and intraoral scan images of 120 patients with periodontitis. The deep learning model GC-U-Net was used to automatically segment and identify the gingival inflammation regions. The performance of the model was evaluated by the Dice coefficient (Dice), intersection over union (IoU), and pixel accuracy (PA), and the correlation between the identification performance and the periodontal examination index was analysed.

Results: The GC-U-Net model showed high recognition accuracy, with a Dice of 77.8%, an IoU of 65.4%, and a PA of 93.7%. This model demonstrated a strong positive correlation with the sulcus bleeding index (SBI; r = 0.836, P < .001), a moderately strong positive correlation with the bleeding index (BI; r = 0.618, P < .001), and a negative correlation with the probe depth (PD; r = - 0.425, P < .001).

Conclusion: The study has successfully developed an automatic identification method for surface characteristics of gingival inflammation based on deep learning and IOS technology, providing a standardised and automated auxiliary tool for clinical gingival inflammation examination with high accuracy and significant correlation with clinical indicators.

Clinical relevance: This method can reduce subjective judgment in the clinical assessment of gingival inflammation, improve the consistency and reliability of identification, and play an important auxiliary role in clinical diagnosis and treatment planning.

Objective: To analyse the clinical, radiographic, and pathological characteristics of aneurysmal bone cyst of the jaws (JABCs), and to provide reference for clinical diagnosis and treatment.

Materials and methods: A retrospective study was conducted on 19 patients with JABC diagnosed from 2018 to 2022.

Results: Of the 19 JABC patients (5 males, 14 females, aged 7-53 years, mean 23.7), 94.7% of the lesions were in the mandible, with only 5.3% in the maxilla. Painless swelling was the most common symptom. CT typically showed bone expansion with either a unilocular or multilocular appearance and visible intracystic septa. MRI revealed characteristic 'fluid-fluid' levels within the lesion. Microscopically, most cases were unilocular or multilocular; 10.5% were cystic-solid, and USP6 gene disruption was detected in 44.4% of tested cases (4/9). All the cases were treated surgically, ranging from curettage to extensive excision. The follow-up data of 16 patients were obtained, most of them had a good prognosis, with one patient relapsed 9 months after surgery.

Conclusion: JABC commonly occurs in the mandible, with a higher incidence in women. Swelling is the most common symptom. Radiographic findings were mostly unilocular or multilocular lesions with clear boundaries, and the characteristic multiple 'fluid-fluid' level could be used as an important basis for diagnosis. Smaller lesions can achieve good therapeutic effects through curettage, while larger ones often require radical excision followed by autologous bone graft reconstruction simultaneously. Prognosis is favourable in most cases.

Clinical relevance: JABC are rare but clinically significant, requiring accurate diagnosis and timely treatment. This study analyses 19 cases, highlighting their diverse clinical, imaging, and histological features. Early detection and personalized treatment, including surgery, are crucial to prevent recurrence and preserve function. Long-term follow-up is essential for monitoring outcomes. These findings enhance the understanding of JABC, guiding clinicians in management for better patient outcomes.

Objectives: The aim of this randomised controlled trial was to assess clinical, radiographic and patient reported outcomes of narrow versus standard diameter titanium zirconium (TiZr) implants supporting single crown restorations in posterior sites with limited bone width.

Materials and methods: Participants requiring replacement of single missing posterior teeth with implant-supported crowns were randomly allocated into 2 treatment groups: narrow (3.3 mm) or standard (4.1 mm) diameter implant. All implants were restored with screw-retained monolithic zirconia crowns. The changes in marginal bone level (MBL) were assessed at the time of delivery of definitive crown and after 1 year of function. Implant stability was measured at placement, 3 and 12 months. Implant success, pink esthetic score (PES), peri-implant parameters, and patient satisfaction were also evaluated.

Results: A total of 20 participants with 20 implant-supported single crowns completed the 1-year follow-up. All implants were successful. The narrow diameter implants had a higher bone remodeling of 0.39 ± 0.92 mm after 1 year of loading compared with only 0.10 ± 0.29 mm for the standard diameter implants but the difference was not statistically significant (P = .40). There were no statistically significant differences between the 2 implant groups in terms of PES and peri-implant outcomes.

Conclusions: Narrow and standard-diameter TiZr implants supporting screw-retained monolithic zirconia crowns in the posterior region were reliable treatment modalities with comparable clinical, radiographic and patient reported outcomes after 1 year of function. Patient satisfaction was high in both treatment groups.

Clinical relevance: The clinical performance of narrow-diameter implants was comparable to standard-diameter implants in replacing a single missing posterior tooth in 12 months. Narrow- and standard-diameter implants can maintain marginal bone levels in 12 months.

Objectives: Periodontal disease is a significant public health concern among older adults due to its relationship with tooth loss and systemic health disease. However, there are numerous barriers that prevent older adults from receiving routine dental care, highlighting the need for innovative screening tools at the community level. This pilot study aimed first, to evaluate the accuracy of GumAI, a new mHealth tool that uses AI and smartphones to detect gingivitis, and the user acceptance of personalized oral hygiene instructions provided through the new tool, among older adults in day-care community centers.

Methods: Participants were invited from 3 day-care community centers. Intraoral photographs were captured and assessed by both GumAI (test) and a panel consisting of 2 calibrated periodontists and a dentist (benchmark). Mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and F1 score were calculated to determine GumAI's diagnostic performance in comparison to the benchmark. User acceptance with this tool was assessed using 2 Rasch Theory-based 5-point Likert-type questions.

Results: 44 participants were recruited out of 80 invited older adults. GumAI demonstrated a sensitivity of 0.93 and specificity of 0.50 compared to the panel's assessments, with a PPV of 0.90 and NPV of 0.56. The accuracy and F1 scores were 0.85 and 0.91, respectively. All participants expressed high acceptance of the process.

Conclusion: GumAI demonstrates high sensitivity, PPV, accuracy, and F1 score compared to the panel's assessments but falls relatively short in specificity and NPV. Despite this, the tool was highly accepted by older adults, indicating its potential to enhance gingivitis detection and oral hygiene management in community settings. Further refinements are necessary to improve specificity and validate usability measures.

Clinical relevance: This study may pave the way for broader applications of mHealth systems in community settings, enabling greater health coverage and addressing oral health disparities.

Objectives: The use of electronic cigarettes "e-cigarettes," or vaping is growing in popularity, especially among adolescents and young adults. While the effects of cigarette smoking on oral health are well-established, the exact impact that e-cigarettes may have on dental tissues is still uncertain. The aim of the current review was to summarize evidence related to the effect of vaping on the periodontal health status of e-cigarette users.

Methods: A comprehensive electronic search was performed using PubMed, Web of Science, and Scopus databases, until January 31^st, 2024. Two independent reviewers participated in the screening of studies, data extraction, and assessment of the included studies. Any disagreements were resolved by a third reviewer the quality assessment was done using the Newcastle-Ottawa Scale to assess the risk of bias. A frequentist meta-analysis was performed using R Statistical Software. The random effects model was adopted. Data were described as mean difference (MD) and 95% confidence interval (CI). A p-value of ≤ .05 was deemed statistically significant.

Results: Ten studies met the eligibility criteria. Overall, the findings were consistent, with most studies showing that e-cigarette users are at greater risk of periodontal disease than nonsmokers, but that they have a lower risk than cigarette smokers. Pooling results showed lower mean probing depth (PD) among nonsmokers than e-smokers (MD: -1.91; 95% CI: [-3.36: -0.47]; p-value = .01) while it was higher among cigarette smokers in participants with periodontitis (MD:0.43; 95%CI: [0.08:0.79]; p-value = .02). Compared to e-smoking, nonsmokers had lower PI (MD: -20.63; 95%CI: [-28.04: -13.21]; p-value < .001) while cigarette smokers had higher PI (MD: 4.88; 95% CI: [-1.52:11.29]; p-value = .135). Among participants with periodontitis, only cigarette smokers had significantly higher PI (MD: 4.53; 95%CI: [1.94:7.13]; p-value < .001).

Conclusion: Based on the current analysis, conventional cigarette smoking is the most detrimental to periodontal health among the groups compared in all included studies. This indicates that traditional cigarettes have a more severe impact on periodontal tissues than do e-cigarettes. The data suggest a gradient of risk where nonsmokers have the lowest risk, e-cigarette users have a moderate risk, and cigarette smokers have the highest risk for periodontal health issues.