International Journal of Dentistry最新文献

Background: Periodontitis is a chronic immune-mediated inflammatory disease characterized by the progressive degradation of periodontal tissues. Conventional therapies, including anti-inflammatory agents and antibiotics, are limited by systemic adverse effects and increased microbial resistance, highlighting the need for safer, multi-targeted treatments.

Objective: This review systematically evaluates the therapeutic potential of plant- and fungal-derived polysaccharides in periodontitis treatment. It focuses on their multifaceted biological activities, including anti-inflammatory, antioxidant, antimicrobial, and osteo-regenerative effects, and elucidates key molecular mechanisms, such as nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and BMP-2/Smad signaling pathways. Additionally, it identifies current research gaps and proposes strategies to facilitate the translational development of polysaccharide-based therapies.

Materials and methods: A systematic literature search was performed across PubMed, Scopus, Web of Science, and Google Scholar databases using a combination of Medical Subject Heading (MeSH) terms and keywords, including "periodontitis," "plant polysaccharides," "fungal polysaccharides," "inflammatory factors," and "bone regeneration." A total of 104 studies were included after screening for relevance to the therapeutic roles and molecular mechanisms of plant- and fungal-derived polysaccharides in periodontitis. The dataset encompassed both in vitro and in vivo investigations, and narrative synthesis was employed to integrate findings owing to the substantial heterogeneity in study designs, endpoints, and methodological approaches.

Conclusion: Plant- and fungal-derived polysaccharides have substantial potential as adjunct or alternative therapies for the treatment of periodontitis. Their multifunctional activities, including modulation of inflammation, inhibition of pathogenic biofilms, and promotion of periodontal tissue regeneration, are mediated through complex multi-pathway interactions. Clinical translation remains limited by structural heterogeneity, a lack of standardized preparation protocols, and insufficient in vivo validation. Future research should prioritize elucidating structure-activity relationships, optimizing extraction and formulation methods, and conducting well-designed clinical trials. Integrating evidence from 104 studies, this review underscores the anti-inflammatory, antimicrobial, and osteo-regenerative effects of these polysaccharides and emphasizes their importance in future clinical applications.

Background: The sealer's penetration into dentinal tubules creates a physical barrier that entombs any remaining bacteria and increases the surface contact with the root canal walls. This study aimed to evaluate the dentinal tubule penetration and push-out bond strength of four sealers and to assess the correlation between penetration depth and bond strength.

Methods: In this in vitro study, 40 human single-rooted anterior teeth were divided into four groups based on the sealer type and obturated using the single cone technique. Three slices of 1 ± 0.1 mm thickness were then prepared from each tooth at three regions-coronal, middle, and apical thirds-perpendicular to the longitudinal axis of the root. The depth and percentage of sealer penetration into the dentinal tubules were measured using confocal laser scanning microscopy (CLSM) on the prepared slices. To assess the bond strength of the sealers to dentin walls, a push-out bond strength test was performed using a universal testing machine. Data were analyzed using SPSS software through ANOVA, Tukey post hoc and Pearson's correlation tests. A p-value of <0.05 was considered statistically significant.

Results: Statistically significant differences were observed in the extent and percentage of penetration, and the push-out bond strength of the studied sealers (p  < 0.001 for all). Additionally, a significant correlation was found between bond strength and penetration percentage for AH Plus (p = 0.046 and r = 0.366), between bond strength and both penetration extent (p = 0.013 and r = 0.448) and penetration percentage (p = 0.001 and r = 0.572) for Endoseal MTA, and between bond strength and penetration extent for Endoseal TCS (p = 0.001 and r = 0.57).

Conclusion: Calcium silicate-based sealers (Endoseal MTA and Endoseal TCS) achieved the greatest penetration, whereas AH Plus demonstrated the highest bond strength. The positive correlations observed suggest that dentinal tubule penetration may contribute to stronger bonding for specific sealers.

Introduction: Majority of the traumatic dental injuries (TDIs) occur at schools. School teachers are the immediate person to come in contact after dental injuries, so it is necessary for them to have knowledge about the first aid management of the injured tooth.

Objective: To determine the knowledge of first aid management of TDIs among primary school teachers of Dharan, Nepal.

Methods: A cross-sectional questionnaire based study was conducted among primary school teachers of Dharan city. A self-administered questionnaire was distributed among 110 school teachers equally from both public (n = 55) and private (n = 55) schools. Descriptive statistics, chi-square test, and logistic regression analysis were used to report the data. The level of significance was set at p  < 0.05.

Results: The mean age of the school teachers participating in the study was 36.38 ± 10.98 years. Majority of them (73.6%) were females. Only few school teachers (23.6%) were informed or trained about dental trauma. The primary source of information was through the internet (57.7%). More than two-third of the school teachers had poor knowledge (85.5%) on first-aid management of TDIs. A statistically significant difference was observed in the primary management of avulsed tooth between teachers of public and private schools (p = 0.007).

Conclusion: The findings of this study concluded that primary school teachers of Dharan city had poor knowledge on first-aid management of TDIs which reflects a need to improve their knowledge on the same.

Introduction: Orofacial clefts require multidisciplinary management and if not properly intervened can impair various functions and reduce the quality of life of the patient. Good knowledge about orofacial clefts is very important for health students to prepare for comprehensive case management. The purpose of this study was to determine the level of knowledge and awareness of Padjadjaran University health students regarding orofacial clefts.

Methods: This study used a cross-sectional method with a survey study, where the measuring instrument used was a questionnaire given online to undergraduate students of dentistry, medicine, midwifery, and nursing at Padjadjaran University with a total population of 2611 students. The sample was taken by stratified random sampling using the binomial proportion sample size formula with a minimum of 315 respondents from all study programs. The questionnaire was self-developed with 16 questions in the knowledge section and eight questions in the awareness section. This questionnaire underwent validity and reliability testing, with results exceeding the correlation coefficient value (0.361) and Cronbach's α (0.891). Data were analyzed by frequency distribution with categorization of knowledge and awareness levels, and the chi-square test with CI 95% and α = 0.05.

Results: Respondents were predominantly female (89.2%), aged 20-22 years (65.4%), and from urban areas (62.2%). The majority (52.7%) of students had good knowledge of orofacial clefts, with dental students showing the best knowledge. A total of 77.5% of respondents had good awareness, with dentistry's the highest (97.6%). Knowledge and awareness increased with age and level of study. Students who had attended orofacial clefts lectures showed better knowledge and awareness than those who had not.

Conclusion: The majority of health students had good knowledge and awareness of the orofacial clefts, increasing with semester and related course experience, with variation between courses showing differences in curriculum emphasis.

Objective: This randomized clinical trial (RCT) compares the effectiveness of ozone gel (GeliO3) and hyaluronic acid (HA) gel (Gengigel) in enhancing wound healing and reducing postoperative discomfort following free gingival graft (FGG) harvesting.

Methods: Fifty-six patients requiring FGG for mucogingival defects were randomly assigned into two groups: the ozone gel group and the HA gel group. The primary outcome was postoperative pain, assessed using the visual analog scale (VAS) and analgesic consumption. Secondary outcomes included wound healing, evaluated using the Landry healing index, and color match assessment. Data were analyzed using appropriate statistical tests with a significance level of p < 0.05.

Results: Both treatment groups exhibited significant pain reduction over time (p < 0.001). Although there was no statistically significant difference between the groups, a faster decline in pain was observed in the ozone group by Day 3. Analgesic consumption was significantly lower in the ozone group on Days 2 and 3 (p = 0.042). The healing index and color match scores showed a steady improvement in both groups, with the ozone group demonstrating slightly higher values at various time points, though not statistically significant.

Conclusion: Both ozone gel and HA gel effectively enhanced post-FGG healing, reduced pain, and improved tissue esthetics. Ozone therapy showed potential advantages in early pain relief and lower analgesic dependence. These findings suggest that ozone therapy may serve as an alternative or adjunctive treatment for palatal wound management in periodontal surgery. Further research is needed to confirm its clinical superiority over HA gel.

Background and objectives: Knowledge about the effects of medications and supplements on orthodontic tooth movement (OTM) is imperative for orthodontists. This study aimed to assess the effects of acute and chronic stress and cannabinoid extract (CE; marijuana) injection on OTM in rats.

Materials and methods: In this animal experimental study, 220 male Wistar rats were randomly assigned to 22 subgroups (n = 10) in two main groups of acute and chronic stress. The rats in the acute group were evaluated over a 21-day period in the following 11 subgroups (1) no orthodontic treatment/no medication (2), orthodontic treatment/no medication (3), no orthodontic treatment/intraperitoneal CE injection (4), orthodontic treatment/CE injection (5), no orthodontic treatment/saline injection (6), orthodontic treatment/saline injection (7), no orthodontic treatment/no medication under stressful conditions (8), orthodontic treatment/no medication under stressful conditions (9), no orthodontic treatment/CE injection under stressful conditions (10), orthodontic treatment/CE injection under stressful conditions (11), no orthodontic treatment/saline injection under stressful conditions. The rats in the chronic group were studied over a 40-day period in the following 11 subgroups with the same subgroups of the acute group. All rats were then sacrificed, their maxilla was resected, and OTM, the mean number of blood vessels, osteoclasts, and Howship's lacunae, bone volume/total volume (BV/TV) ratio, and bone mineral density (BMD) were assessed.

Results: OTM was significantly greater under chronic stress (0.23 ± 0.19 mm) than acute stress (0.21 ± 0.16 mm, p  < 0.001), and in rats receiving CE injection (0.29 ± 0.19 mm) compared with controls (0.20 ± 0.17 mm, p  < 0.001). The mean number of Howship's lacunae (10.74 ± 5.27 vs. 8.52 ± 6.31, p  < 0.001), osteoclasts (14.69 ± 7.53 vs. 11.06 ± 8.45, p  < 0.001), and blood vessels (12.45 ± 3.19 vs. 10.81 ± 2.69, p  < 0.001) were also significantly higher in stressed rats receiving CE. BV/TV and BMD were significantly lower in CE-treated stressed rats (BV/TV: 17.56% ± 2.20% vs. 27.79% ± 5.68%, p  < 0.001; BMD: 1.76 ± 0.39 vs. 2.54 ± 0.46 g/cm³, p  < 0.001) compared with controls. All parameters were further enhanced by orthodontic treatment.

Conclusion: Daily CE injection combined with acute and chronic stress significantly enhances OTM in rats, accompanied by increased osteoclastic activity, vascularization, and decreased bone density. Quantitative data and statistical significance provide robust evidence of these effects.

Aims: To evaluate marginal bone loss (MBL) around implants restored with platform-matched (PM) or platform-switched (PS) abutments after loading and to examine the influence of vertical soft tissue thickness (STT) and keratinized mucosa width (KMW) on MBL.

Materials and methods: In a split-mouth randomized controlled design of total 22 patients (44 implants), patients received one PM and one PS restoration in contralateral posterior mandibular sites. Standardized periapical radiographs were obtained immediately after restoration, at 3, 6, and 12 months to measure MBL. STT (thin, <2 mm vs thick, and ≥2 mm) and KMW (narrow, <2 mm vs wide, and ≥2 mm) were recorded. A linear multiple regression analysis was conducted with dependent variable (MBL) and independent variables (STT and KMW).

Results: MBL did not differ significantly between PM and PS across follow-up. In contrast, thin STT and narrow KMW were associated with greater bone loss over time. Multivariable analysis revealed that the soft tissue phenotype significantly influenced MBL, whereas the abutment design showed no significant effect (β = -0.43 for STT and β = -0.36 for KMW).

Conclusion: Establishing a STT and KMW of ≥2 mm may be beneficial for bone preservation around implants, although further long-term studies are needed for clinical practice.

Objective: The study aimed to assess occlusal force in patients with posterior crossbite using a dynamometer. Additionally, the discrepancies in force between the crossbite side and the opposite side of the arches were evaluated.

Methods: The occlusal force of 52 patients with posterior crossbite was measured and compared with that of 52 patients with normal occlusion. The Wilcoxon signed-rank test was performed to compare the force of each side. Because the data had a non-normal distribution, to compare the total occlusal force of the two groups, the Mann-Whitney test was performed. Finally, to compare the force between the two sides, using a symmetry index determined by the difference in force between the sides, the Mann-Whitney test was used.

Results: In the group of patients with crossbite, the crossbite side showed greater occlusal force than the opposite side. The total occlusal force was lower in the crossbite group than in the control group.

Conclusions: In patients with posterior crossbite, an alteration in occlusal force, characterised by a higher value on the crossbite side than on the opposite side, was observed. In addition, these patients showed lower total occlusal force compared to the control group.

Background: The temporomandibular disorder (TMD) treatment modalities range from noninvasive to surgical treatments. Diathermy is one of the noninvasive medical treatment options in which controlled high-frequency energy is applied to generate heat in body tissues to treat osteoarthritis and muscle pain. The aim of this pilot study was to evaluate diagnostic criteria for temporomandibular disorder (DC-TMD) Questionnaire based results of diathermy stimulation rehabilitation in patients with temporomandibular joint (TMJ) problems with no internal dislocation of the disc.

Methods: The DC-TMD questionnaire documents were uploaded to a special question evaluation software, and 47 questions (grouped in 8 categories) were automatically chosen to assess TMD-related pain, jaw mobility, and quality-of-life impact. All the patients received diathermy stimulations that were scheduled once a week for 5 weeks (T0: 1st diathermy simulation, T1: 2nd session, T2: 3rd session, T3: 4th session, Tf: 5th session). Pre and post-treatment results from 47 questions were collected at each session, and outcomes were assessed among them, using T0 as a baseline to evaluate improvements.

Results: 10 patients (8 women and 2 men) aged between 22 and 50 years were included. There was a tendency for improvement for each category, and mean scores decreased over time. However, no significant difference was found in overtime for any category except the Mandibular Functional Limitation Scale (LM), which showed significant improvement, and patients reported fewer limitations.

Conclusions: The outcomes obtained cannot be considered total recovery from problems, but according to the results, diathermy applications can be regarded as beneficial for improving TMJ-related disorders, which can increase the quality of life (QoL) of such patients.

Introduction: Periodontitis is a host-mediated inflammation associated with microbial dysbiosis which can result in loss or periodontal attachment. This is a common oral health complication in patients with kidney failure. Haemodialysis (HD) is the primary treatment modality for kidney failure. Given the increasing prevalence of kidney failure and periodontitis, understanding their associations and implications is crucial.

Objective: This scoping review explores the relationship between periodontitis and HD and examines the impact of periodontal health on clinical outcomes and oral health quality of life (QoL) in patients undergoing HD.

Methods: The review followed The Joanna Briggs Institute (JBI) Scoping Review Methodology and Preferred Reporting Items for Systemic and Meta-Analyses extension for Scoping Reviews((PRISMA-ScR). Medline, Embase, Scopus, and grey literature were searched for peer-reviewed English-language articles up to December 2023. Data were summarised using thematic analysis.

Results: Eighty-one articles were included, with most studies conducted in Europe and Asia. The prevalence of periodontitis in HD patients ranged from 36.27% to 99.06%. Findings highlighted associations between periodontitis and increased risks of comorbidities such as cardiovascular disease (CVD), metabolic syndrome, and other systemic illnesses.

Conclusion: Periodontitis is highly prevalent in patients on HD and associated with adverse systemic and oral health outcomes. Limitation in current evidence are heterogeneity in case definitions and lack of longitudinal studies to provide causal inference. The review recommends standardised diagnostic criteria and longitudinal studies to guide integrated care approaches.