International Journal of Dentistry最新文献

Introduction: To provide the optimum level of oral healthcare, the supply of dentists should mirror the population's oral health care needs. However, the ongoing inter-country movement of oral health professionals is reducing Ireland's capacity to maintain an adequate oral health workforce. This study aimed to identify the determinants of future dentists' intentions to engage in inter-country movement.

Methods: A cross-sectional survey was conducted among final-year dental students at University College Cork (UCC), Ireland. To collect the data, a Microsoft Forms based questionnaire was distributed among all students. Descriptive statistics were calculated to characterise students' motives for pursuing a future career abroad.

Results: A total of 50 out of 50 invited final-year dental students participated in the study. The sample consisted of equal proportions of Irish nationals and international students (n = 25 each). Canadian students represented the predominant international cohort, accounting for 42% of all participants. Regarding immediate career plans, 8% of Irish students intended to move abroad compared with 68% of international students. The sample consisted of equal proportions of Irish nationals and international students (n = 25 each), with Canadian students comprising the largest subgroup at 42% of the total sample. A marked difference was observed between the two cohorts in terms of immediate career intention. Only 8% of Irish students indicated plans to work abroad, compared with 68% of international students, the majority of whom expressed a desire to return to their home country. Regarding long-term career plans, 20% of Irish students anticipated relocating abroad, whereas only 12% of international students reported intentions to leave their country of origin. The most frequently cited push factors influencing decisions to emigrate from Ireland included more favourable economic conditions, improved lifestyle opportunities, increased access to training programmes and family-related considerations.

Conclusion: The majority of international dental students in Ireland are aiming to pursue their dental career in their home countries due to better economic conditions and living standards. These findings suggest that Irish policymakers and educational institutions might need to consider new approaches for the retention of newly graduating dentists.

Background: Oral health disparities among adults with disabilities remain a significant challenge.

Objective: To systematically evaluate the effectiveness of educational, behavioral, and pharmacological strategies intended to enhance oral health self-care among independent adults with disabilities.

Methods: This systematic review adhered to PRISMA 2020 recommendations and was registered with PROSPERO (CRD420251015528). We identified randomized controlled trials (RCTs) published in English from 2000 to 2024 through extensive searches of PubMed, Scopus, EBSCOhost, the Cochrane Library, ProQuest, and relevant gray literature sources. Studies were eligible if they involved adults aged 18-70 years with psychiatric, neurological, intellectual, or physical disabilities who were able to perform their own oral hygiene. Interventions included educational, behavioral, or pharmacological strategies compared to any control. Two reviewers independently completed the screening and data-extraction processes and appraised study quality using the Cochrane RoB 2.0 tool. Narrative synthesis was conducted due to heterogeneity.

Results: Ten RCTs involving 681 participants from diverse countries met the inclusion criteria. Educational and behavioral interventions, including oral hygiene instruction (OHI), visual aids, hands-on demonstration, and motivational interviewing (MI), significantly improved oral health knowledge, attitudes, and self-care practices in adults with disabilities. These interventions were particularly effective when tailored to the specific needs of participants and delivered with ongoing reinforcement. Pharmacological strategies, primarily chlorhexidine-based adjuncts, further reduced plaque, gingival bleeding, and oral microbial load, especially when combined with education or behavioral support. While most interventions produced significant short-term improvements in clinical and behavioral outcomes, overall certainty of evidence was limited by heterogeneity in study designs, intervention protocols, and risk of bias.

Conclusions: Multifaceted interventions that combine tailored education, behavioral reinforcement, and pharmacological support improve oral health outcomes for independent adults with disabilities. Future research should prioritize standardized methodologies, rigorous risk-of-bias assessment, and long-term follow-up to strengthen the evidence base and guide clinical practice and policy.

Purpose: This study aimed to evaluate the potential use of machine learning to automatically classify electromyography (EMG) data into bruxism simulated movement with tooth contact (BMwTC), bruxism simulated movement without tooth contact (BMwoTC), and non-bruxism movement (non-BM).

Methods: Twelve eligible healthy participants (female/male: 2/10, mean age: 35.3 ± 8.4 years) were asked to perform the simulated movements (all the tasks were performed five times for 5 s each with a 30-s rest interval). The electrodes were placed on the masseter, infrahyoid, inframandibular, and chin muscles. A sound sensor was placed adjacent to the masseter. The EMG and sound data were sampled at 1 and 44.1 kHz, respectively. Single- and multi-stream hidden Markov models (HMMs) were used to automatically discriminate the tested behavior from the others using a hamming window with 100 ms and shift length of 50 ms. The leave-one-out method was used for training and testing the model, with data from 11 participants used for training and one for testing. Each participant was evaluated, and the final performance was measured by averaging the results of 12 classification trials. The validity of the discrimination was assessed by calculating the harmony mean values using six EMG signals and the sound data.

Results: The masseter EMG demonstrated significantly higher discrimination accuracy in the single-stream model (p  < 0.05, One-way ANOVA, Tukey HDS). The multi-stream model also demonstrated higher accuracy; however, no significant difference was observed. Notably, the accuracy of BMwoTC was less than 0.5.

Conclusion: The machine-learning-based discriminative system accurately discriminates BMwTC from non-BM using masseter EMG.

Background: Chios mastic gum, a natural resin derived from the mastic tree, has a history of traditional use for its beneficial effects on the gastrointestinal system, its anti-inflammatory properties, and its antimicrobial activity.

Objective: This study aimed to integrate network pharmacology and standardized in vitro analyses to elucidate the antimicrobial mechanisms and therapeutic potential of P. lentiscus phytochemicals.

Material and methods: This study employed a systematic methodology integrating data mining, network construction, and network analysis to explore the intricate relationships between the constituents of mastic gum and their diverse biological targets. The primary active compounds of P. lentiscus were identified through multiple databases, including the Indian Medicinal Plants, Phytochemistry, and Therapeutics database. ADME/T profiling, Lipinski's rule of five, and target prediction were performed to assess drug likeness and pharmacokinetics. Protein-protein interaction networks and gene ontology (GO) enrichment were analyzed using STRING and Cytoscape to identify biological pathways associated with antimicrobial activity. Moreover, the antibacterial efficacy of these compounds was evaluated following the Polish-European standard 1040, and antifungal activity was assessed according to the European standard 1650 by enumerating colony-forming units after a 24-h incubation period.

Results: Four major phytochemicals - alpha-terpineol, linalool, myrcene, and verbenone - were identified as key bioactive compounds. These exhibited favorable pharmacokinetic properties and predicted interactions with targets related to inflammation, oxidative stress, and microbial virulence. In vitro, the ethanolic extract of P. lentiscus achieved ≥ 5 log reductions in both bacterial and fungal strains, demonstrating potent antimicrobial activity comparable to chlorhexidine. The hydroalcoholic extract showed moderate yet significant reductions.

Conclusion: The integrative in silico and in vitro analyses indicate that P. lentiscus exerts antimicrobial effects through multiple complementary mechanisms, including membrane disruption, inhibition of virulence and biofilm formation, and modulation of host inflammatory pathways. These findings provide a mechanistic framework supporting the use of P. lentiscus as a natural adjunct for managing periodontal infections and warrant further preclinical and clinical evaluation.

Objectives: This systematic review is meant to evaluate the effectiveness of ascorbic acid (vitamin C) in gingival depigmentation and assess its potential as a minimally invasive alternative for managing gingival hyperpigmentation.

Materials and methods: Electronic searches were conducted across major databases, yielding eight relevant studies, including five randomized clinical trials and three case series. These studies reported different application techniques, with intramucosal injection (mesotherapy) being the most frequently used approach.

Results: All studies demonstrated improvement in gingival pigmentation following vitamin C therapy, as assessed by indices such as the Dummett-Gupta oral pigmentation index (DOPI). Mesotherapy generally produced faster and more pronounced results than topical gel application. High patient satisfaction and minimal adverse effects were consistently reported. Nevertheless, marked heterogeneity in study design, dosing, and outcome evaluation limited direct comparison among studies.

Conclusions: Vitamin C shows promise as an effective, safe, and minimally invasive treatment for gingival depigmentation. However, standardized clinical protocols and long-term randomized trials are required to establish its comparative efficacy and ensure consistent outcomes.

Objective: This study investigated the prevalence of dental anomalies within the athlete population in Qatar using panoramic radiographs.

Design: This retrospective, cross-sectional study was conducted at Aspetar Hospital in Qatar.

Materials and methods: Digital panoramic radiographs of 5000 records of athletes attending dental department were investigated for dental anomalies affecting tooth position, such as impaction and transposition; anomalies affecting tooth number, such as hypodontia and supernumerary teeth; and anomalies affecting tooth shape such as taurodontism. Panoramic radiographs were obtained over a 15 year period (March 2007 to September 2022). Radiographs were evaluated by two experienced dentists: a prosthodontist and an endodontist with a minimum of 12 years of experience. To assess interexaminer agreement, a random sample of 20 radiographs were evaluated independently by each examiner. The agreement was calculated using Cohen's kappa statistics, with a strong level of agreement achieved (K > 0.95). Discrepancies were resolved by consensus discussion.

Results: An initial total of 5000 athlete records from individuals attending the dental department were reviewed. After applying the study's inclusion and exclusion criteria, 1483 records were excluded as they did not meet the specified requirements. Consequently, a final sample of 3517 athletes (mean age: 21.3 ± 7.07 years) was included in the analysis, with a predominance of males (3142; 89.3%) compared to females (375; 10.6%). Among those athletes, 1003 (28.5%) had at least one dental anomaly, and 73 athletes (2.1%) had two anomalies. The prevalence of anomalies affected teeth position, shape, and number were 20.0%, 7.7%, and 2.9%, respectively. The most observed dental anomalies were tooth impaction (19.8%), followed by taurodontism (7.7%). The prevalence of hypodontia was 1.8% and that of supernumerary teeth was 1.1%. Tooth transposition was the least found with a prevalence rate of 0.2%.

Conclusion: Our findings demonstrate a notable presence of dental anomalies among athletes in Qatar, with tooth impaction being the most prevalent, followed by taurodontism and hypodontia. This highlights the importance of early detection and management of such anomalies.

Objective: This systematic review assessed the diagnostic capability of ultrasound (US) to evaluate temporomandibular joint (TMJ) arthritis in children with Juvenile Idiopathic Arthritis (JIA), with MRI, CT, or CBCT as reference standards.

Material and methods: A search was conducted on electronic databases (Medline, Embase, Cochrane, Web of Science, and Scopus) and partial gray literature without restrictions of language and time. Eligibility criteria included diagnostic studies (randomized clinical trials, cohort studies, observational studies) evaluating the diagnostic potential of 2D or 3D US in assessing the TMJ (i.e., disc displacement, joint effusion, condylar changes) of children with JIA compared to CBCT/CT and/or MRI as the reference standard. The Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate risk of bias.

Results: After eligibility criteria were applied, eight studies were included. All studies were methodologically acceptable, presenting low applicability concerns, although none fulfilled all QUADAS-2 criteria. Results from individual studies ranged from poor to excellent, with a sensitivity (SN) of B-mode US ranging between 21% and 85% and a specificity (SP) between 36.4% and 89%, depending on the TMJ alterations assessed (condylar changes - CC, joint effusions - JE, synovial thickness, and lateral periarticular space - LPAS). The certainty of the evidence for the diagnostic performance of US to detect TMJ involvement in JIA was graded low for SN and moderate for SP.

Conclusion: This systematic review demonstrated that although MRI remains the reference standard imaging modality, US shows promising diagnostic capability in assessing the TMJ of children with JIA. It can provide valuable supplementary information to assist in diagnosis alongside clinical examination and guide the need for advanced diagnostic assessment.

Background: Mandibular third molar is the most frequent impacted tooth in the oral cavity. Its presence can be associated with complications including the temporomandibular joint (TMJ) symptoms. Therefore, the present study aimed to assess the prevalence of impacted mandibular third molar (IMTM), associated pathologies, and its correlation with TMJ morphology in a hospital-based Spanish cohort.

Methods: We retrospectively reviewed existing orthopantomographs (OPGs) records, panoramic images of patients aged ≥18 with at least one IMTM who attended the Dental Hospital of the University of Barcelona (HOUB) between September 2021 and May 2023. The OPGs were assessed and interpreted by an experienced oral and maxillofacial radiologist for the type of impaction according to Winter's classification system, associated pathologies, and shape of mandibular condyle.

Results: Out of 80 OPGs, 60% (95% confidence interval [CI]: 48.4%-70.7%) were females, and the majority 53.8% (95% CI: 42.3-64.9) were between 18 and 28 years of age. The prevalence rate of IMTM was 86.88%, with the left side commonly involved. On both sides, oval-shaped condyle and vertical IMTM were the most common, with dental caries and bone loss being the frequently observed pathologies. Sclerotic changes were depicted in 15% (95% CI: 8.2%-24.7%) of the cases on both sides of TMJ. On the other hand, no statistically significant associations were noticed between the pathologies and condyle shape (p > 0.05, Cramér's V < 0.25). Vertical and mesioangular, followed by horizontally IMTMs, were the most prevalent types of impactions, indicating nonsignificant association with condylar shape (p > 0.05, Cramér's V = 0.21-0.23).

Conclusion: In this hospital-based cohort, vertical IMTM and oval condylar morphology were predominant; however, condylar shape did not correlate with impaction type on panoramic radiographs. The findings are preliminary and require validation in sufficiently powered cone beam computed tomography (CBCT)-based studies with clinical TMJ assessment.

Objective: This bibliometric analysis aimed to systematically evaluate publication performance and identify evolving trends in dental anxiety research over the past three decades, providing a structured overview of key research topics and thematic progression.

Methods: The study analyzed 1556 articles indexed in the Science Citation Index Expanded database from 1991 to 2024. Data extraction included titles, abstracts, author keywords, and Keywords Plus. The analytical approach incorporated bibliometric indicators such as total citations, citations per publication, and annual publication trends. A word analysis technique identified five major research topics and their evolution across three distinct periods: 1991-2011, 2012-2019, and 2020-2024.

Results: Analysis highlighted significant growth in dental anxiety research publications, particularly in recent years, reflecting increased global interest. The study identified five main thematic areas: etiology and risk factors, clinical presentation and consequences, prevalence and assessment tools, treatment and preventive interventions, and pediatric dentistry. The trends indicated a growing emphasis on multidisciplinary approaches, like cognitive-behavioral therapy (CBT) and adjunctive therapies such as virtual reality and aromatherapy. Pediatric dentistry consistently emerged as a critical field, underscoring the importance of early interventions.

Conclusion: This bibliometric review demonstrated substantial advancements in understanding dental anxiety, emphasizing multidisciplinary treatments and tailored pediatric interventions. Future research should focus on integrating novel therapeutic strategies and refining preventive measures to mitigate dental anxiety effectively.

Introduction: Ultrasonography (USG) offers a safe, affordable and effective diagnostic tool for various dental applications, yet its use in routine dental practice remains limited, particularly in South Africa. This study, guided by the Knowledge-Attitude-Behaviour (KAB) model, assessed dental practitioners' knowledge and attitudes towards USG at a South African university. The null hypothesis tested whether attitudes and knowledge differed significantly by the year of graduation or academic department.

Methods: A quantitative cross-sectional study surveyed 108 dental practitioners at the University of the Western Cape (UWC), Faculty of Dentistry using a custom-developed, expert-reviewed online questionnaire. Approval was obtained from the Biomedical Research Ethics Committee (BMREC) and UWC faculty officials for the study. Data were collected via Research Electronic Data capture (REDCap) and analysed with Microsoft Excel and STATA. Participation was voluntary, anonymous and conducted with informed consent.

Results: The questionnaire showed acceptable internal consistency for attitudes (α = 0.705) and lower consistency for knowledge (α = 0.537), as expected due to varied content. Results indicated a 58.3% response rate with generally positive attitudes towards USG, varying across departments. The Craniofacial Biology, Pathology and Radiology department had the highest attitude score, and Maxillofacial and Oral Surgery showed the highest familiarity with USG, with specific questions yielding statistically significant results. Regarding knowledge, the overall score was 71%. Knowledge levels were high in head and neck swellings and salivary gland disorders, while caries had the lowest score. However, no significant differences were observed across graduation years or departments.

Conclusion: Dental practitioners are not only receptive to learning about USG but also enthusiastic about its potential in patient care. By integrating an USG course into the dentistry curriculum, dental practitioners would be empowered with the skills and knowledge needed to effectively harness the benefits of USG, addressing critical healthcare challenges within South Africa and third-world countries alike.