Journal of Clinical and Experimental Dentistry最新文献

Background: While orthodontists determine the need for treatment, the demand for treatment is a patient's own decision, based on a questionnaire that addresses their self-perception of their dentition and facial aesthetics. The demand for professional treatment depends on a wide range of factors, such as socioeconomic status, culture, age, and self-perceived appearance, which is sometimes poorly correlated with the normative need for treatment. This study investigated the malocclusion prevalence and orthodontic treatment demand among 15-year-olds in Ho Chi Minh City, considering geographical disparities based on dentist-to-population ratios in three distinct areas: the urban center (6 dentists/10,000 population), para-center (1.6 dentists/10,000 population), and peri-urban areas (0.9 dentists/10,000 population).

Material and methods: Utilizing multi-stage cluster sampling, 673 children were selected, ensuring representation from each area. Participants completed questionnaires on treatment demand and underwent orthodontic examinations using the Index of Orthodontic Treatment Need (IOTN). Analysis involved conventional statistics and decision tree models.

Results: Results revealed a prevalence of 37% and 46.95% for severe malocclusion, with a noTable demand for treatment (51%), particularly prominent in the urban center area. Decision tree analysis achieved 0.67 accuracy in predicting treatment demand, identifying children from urban centers with DHC-IOTN scores ≥4 as most likely to demand treatment.

Conclusions: Our study reveals geographic disparities in orthodontic demand among 15-year-olds in Ho Chi Minh City, driven by differences in dentist-population ratios. A decision tree model could be effective for clinicians and strategists in determining the most appropriate way to meet the demand for early orthodontic treatment in adolescents across different neighborhoods. Key words:AC-IOTN, DHC-IOTN, malocclusion, orthodontic treatment need and demand, decision tree.

Background: Gingival keratinization is a critical physiological process that protects against mechanical stress and microbial invasion. Disruptions in this process contribute to periodontal diseases, affecting over 50% of adults worldwide. Despite its clinical significance, the molecular mechanisms of gingival keratinization remain poorly understood. This scoping review evaluates three predominant mathematical modeling paradigms-Gene Regulatory Networks (GRNs0, Ordinary Differential Equations (ODEs), and Agent-Based Models (ABMs)-to establish a framework for periodontal research.

Material and methods: A comprehensive literature search was conducted in PubMed, Web of Science, and IEEE Xplore, identifying 42 studies for analysis. Models were assessed across six dimensions: biological scale, spatial-temporal resolution, stochasticity, computational complexity, and perturbation response. Quantitative scoring was applied to compare capabilities in gene expression, temporal dynamics, and spatial modeling. Statistical analysis included one-way ANOVA and Tukey's HSD test.

Results: ABMs demonstrated superior versatility (total score: 75.0%) in simulating spatial organization and mechanical stress responses, while GRNs excelled in gene expression modeling (score: 9/10) and ODEs in temporal dynamics (score: 7/10). Perturbation coverage was highest for ABMs (87.5%), particularly for inflammation and mechanical stress. GRNs and ODEs scored 62.1% and 65.2%, respectively, with strengths in genetic and population-level dynamics.

Conclusions: ABMs are optimal for spatial and stochastic modeling, whereas GRNs and ODEs are better suited for molecular and temporal analyses. Integrating these approaches could provide a comprehensive understanding of gingival keratinization. This review offers guidelines for model selection based on research objectives and computational resources. Key words:Gingival keratinization, Periodontal diseases, Gene regulatory networks, Differential equations, Computational biology, Systems biology.

Toxic epidermal necrolysis (TEN) is a mucocutaneous hypersensitivity reaction to certain drugs and/or infections that can lead to multisystem involvement. The oral cavity is affected in almost all cases. The aim of this study was to report three clinical cases of TEN managed with photobiomodulation therapy (PBMT) and antimicrobial photodynamic therapy (aPDT) for the treatment of oral lesions. All patients presented with oral ulcers at various locations. Treatment consisted of oral hygiene with 0.12% chlorhexidine digluconate combined with PBMT applied to strategic sites and aPDT applied to areas of secondary infection. The proposed therapeutic approach resulted in significant clinical improvement of the oral lesions, even prior to improvement of skin manifestations, including pain relief and accelerated tissue healing. These findings suggest that PBMT and aPDT may be effective in improving the oral condition of patients with TEN. Key words:Toxic epidermal necrolysis, Photobiomodulation therapy, Antimicrobial photodynamic therapy.

Background: The long-term success of dental implants is often compromised in patients with a history of periodontitis. This study aimed to identify the specific pre-implant clinical, demographic, and systemic risk factors associated with implant failure in a large cohort of periodontally susceptible patients who had received prior non-surgical therapy.

Material and methods: This retrospective cohort study utilized electronic health records from the multi-center BigMouth network (2011-2022). A final cohort of 434 patients with a history of periodontitis was analyzed at the patient level. Patients were stratified into an implant failure group (n=32) and a survival group (n=402). A comprehensive range of pre-implant variables, including detailed periodontal measurements from the most recent exam before surgery, demographics, and systemic conditions, was compared using t-tests and Chi-squared tests. Binary logistic regression was used to calculate odds ratios (OR) for significant predictors.

Results: The analysis revealed that the severity of pre-existing periodontal disease was the primary predictor of failure. The failure group had a significantly higher pre-implant Mean Probing Depth (3.34 mm vs. 3.07 mm, p=0.0311) and more sites with PPD ≥ 4mm (p=0.0488). Logistic regression showed that for every 1 mm increase in Mean PPD, the odds of implant failure increased by a factor of 2.45 (OR=2.45, 95% CI: 1.08-5.56). Other patient-level factors, including demographics, systemic conditions, and medication use, as well as implant-level characteristics, were not significantly associated with implant failure.

Conclusions: The severity of residual periodontal disease, specifically elevated pre-implant probing depths, is the most significant and powerful predictor of dental implant failure in patients with a history of non-surgically managed periodontitis. Achieving periodontal stability before surgery is paramount for long-term implant success in this high-risk population. Key words:Dental Implants, Implant Failure, Periodontitis, Risk Factors, Probing Depth.

Background: A novel measurement drill was fabricated to analyze bone density. We hypothesized that evaluating the correlation between primary stability and bone density-assessed using drilling torque values obtained with a novel drill-under various bone density conditions could aid in selecting appropriate implant placement protocols. This study aimed to determine whether drilling torque values measured using the novel drill could serve as a guide for implant placement protocol.

Material and methods: Experiments were conducted using solid rigid polyurethane bone blocks corresponding to Misch classifications D2-D4. After measuring the drilling torque, the implant sockets were prepared under two conditions: undersized and normal-sized drilling protocols. The implant was placed, and the insertion torque value was measured as the primary stability.

Results: A correlation was observed between the drilling and insertion torque values across different bone densities and surgical protocols.

Conclusions: Drilling torque measurements using the novel drill may be a useful method for selecting appropriate implant placement protocols. Key words:Drilling torque value, Implant, Primary stability, Undersized technique.

Background: Stylohyoid complex elongation represents significant anatomical variations with clinical implications, yet comprehensive morphometric analyses using advanced statistical modeling remain limited in establishing evidence-based diagnostic criteria.

Material and methods: This cross-sectional study analyzed 100 digital panoramic radiographs from a Colombian population. Advanced statistical methods included multivariate regression analysis, receiver operating characteristic (ROC) curve analysis, cluster analysis, and factor analysis. Morphometric measurements were validated using intraclass correlation coefficients and Bland-Altman analysis.

Results: Mean styloid process length was 36.79±10.15 mm. A 97% prevalence of elongation >25mm was observed. Multivariate logistic regression identified age (β=0.31, p<0.001) and female gender (β=4.23, p=0.030) as independent predictors. ROC analysis revealed optimal diagnostic cutoff at 32.5 mm with excellent performance (AUC=0.87, sensitivity=89.2%, specificity=78.6%). Factor analysis identified three principal components explaining 78.4% of total variance. K-means clustering revealed four distinct phenotypic groups.

Conclusions: This study establishes evidence-based diagnostic criteria for stylohyoid complex evaluation through advanced statistical modeling. The 32.5 mm cutoff demonstrates superior performance compared to traditional values, while predictive models provide reliable risk assessment capabilities for precision medicine applications. Key words:Eagle syndrome, styloid process, panoramic radiography, physiological calcification, temporal bone, predictive models.

Background: This study aimed to evaluate the cyclic fatigue resistance of WaveOne Gold (WOG) and R-Motion (RM) nickel-titanium instruments after multiple simulated clinical uses.

Material and methods: A total of 48 instruments (24 WOG and 24 RM) were tested. For each instrument system, files were divided into four subgroups (n=6 per subgroup) based on the number of prior simulated clinical uses: WOG0 and RM0 (new, no prior use), WOG1 and RM1 (single prior use), WOG2 and RM2 (two prior uses), and WOG3 and RM3 (three prior uses). Instrumentation was performed in 3D-printed resin teeths designed to simulate the mesial root canals of mandibular first molars. Subsequently, all instruments were subjected to a dynamic cyclic fatigue test in a stainless-steel artificial canal until fracture occurred. The number of cycles to fracture (NCF) was recorded. The groups had a normal distribution and were analyzed using the parametric ANOVA test, considering a 95% confidence interval, where the One-Way ANOVA, Bonferroni, Tukey, and Scheffe' tests were used.

Results: The time to fracture of the RM was higher when compared to the WOG (p < 0.05). There was no significant difference between the groups of the same instrument (p > 0.05). There was no significant difference between the length of the fractured instruments.

Conclusions: Although both instruments showed good resistance to cyclic fatigue after 3 uses, the RM had better cycle fatigue resistance than the WOG. Key words:Cyclic fatigue, Dental instruments, Endodontics, Root canal preparation.

Background: The main aim was to investigate the influence of incisal embrasure variation on the perception of smile attractive-ness among laypeople and dentists in three countries: Portugal, France and Italy, and between gender, age and specialty of the clinicians.

Material and methods: Two initial facial photographs were used to create 6: three of a male model and three of a female model with different incisal embrasures. Participants: Portuguese (204 laypeo-ple/195 doctors). French (214 laypeople/199 doctors) and Italian (204 laypeople/210 doctors). The attractiveness of the image was assessed by completing a questionnaire (visual analog scale VAS: 0-10).

Results: The results were analyzed with non-parametric comparisons (p<0. 05). Significant differences were found between physicians and laypersons in the three countries. The difference in perceived attractiveness was greatest in Portugal. The most attractive embrasure was round and the least attractive was rectangular. The perception of attractiveness did not differ according to medical specialty. Portuguese female doctors were more critical than male doctors; French laymen were more critical than others. Age had no effect on perceived attractiveness of the embrasure.

Conclusions: It was found that there are differences in aesthetic perception between physicians and laypeople in the three countries. In Portugal, dentists are stricter in their aesthetic perception of the embrasure than laypeo-ple. This was not observed in Italy, while France showed an intermediate result between the two countries. Gen-der had some influence on the rating in Portugal and France, in contrast to age. The area in which the doctor practiced had no influence. Key words:Smile aesthetics, Incisal embrasures, Aesthetic impact.

Background: Dentine hypersensitivity (DH) is a common condition with varying patient perceptions, making diagnosis and management challenging. Patient-reported outcome measures, such as the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15), provide valuable insights into its impact on daily life. This study aimed to adapt and validate the Spanish version of the DHEQ-15 for use in Spain, ensuring its reliability and relevance for Spanish-speaking patients.

Material and methods: A structured translation and cross-cultural adaptation process followed Beaton et al.'s (2000) methodology. Spanish-speaking participants aged 35-60 completed the DHEQ-15. Psychometric properties were assessed through factor analysis for construct validity, Cronbach's alpha for internal consistency, and the intraclass correlation coefficient (ICC) for test-retest reliability. Sociodemographic factors such as gender, age, and education level were also analyzed.

Results: The Spanish DHEQ-15 was well-received. It showed excellent internal consistency (Cronbach's alpha = 0.958) and high test-retest reliability (ICC = 0.932). Factor analysis identified three main dimensions: Restrictions-Coping, Psychosocial Impact, and Identity explaining 76% of score variance. The questionnaire was easy to complete, with an average completion time of 4 minutes. Women scored higher in 'Restrictions-Coping,' while age and education level showed no significant associations.

Conclusions: The Spanish DHEQ-15 has been successfully adapted and validated in Spain, demonstrating high reliability and validity. It is a viable and effective tool for assessing the impact of DH on the quality of life of Spanish-speaking populations. Key words:Dentine hypersensitivity, Validation, Quality of life, Questionnaire.

Background: This in vitro study evaluated the effect of adding two types of nanoparticles-nanodiamonds and calcium carbonate-to conventional glass ionomer cement (GIC) and resin-modified glass ionomer cement (RMGIC) on their flexural strength.

Material and methods: Using a precision digital scale, 0.2 wt.% nanodiamond particles or 4 wt.% calcium carbonate nanoparticles were added to the powders of CGIC (GC Fuji II LC Gold, GC Corp., Japan) and RMGIC (GC Fuji IX LC Gold; GC Corp., Japan). Six groups of materials were prepared (n=10 each): 1) GIC, 2) GIC with 0.2 wt.% nanodiamond, 3) GIC with 4 wt.% calcium carbonate, 4) RMGIC, 5) RMGIC with 0.2 wt.% nanodiamond, and 6) RMGIC with 4 wt.% calcium carbonate. The mixtures were placed into rectangular molds (25 mm × 2 mm × 2 mm), and flexural strength was measured using a universal testing machine. Data were analyzed using the Shapiro-Wilk test, two-way ANOVA, and Tukey's post hoc test (α = 0.05).

Results: Group 6 (RMGIC + 4% calcium carbonate) showed the highest flexural strength (31.90 MPa) among all groups (P < 0.001). The flexural strength of the CGIC group (7.96 MPa) was significantly lower than that of all other groups (P < 0.001), except for Group 2 (GIC + 0.2% nanodiamonds). The flexural strengths of Groups 2 and 3 (GIC + 4% calcium carbonate) were statistically similar. RMGIC groups exhibited significantly higher flexural strength compared to their corresponding CGIC groups (P < 0.05).

Conclusions: Adding 4 wt.% calcium carbonate to both GIC and RMGIC enhances their resistance and clinical performance in stress-bearing areas. The addition of 0.2 wt.% nanodiamonds improved the flexural strength of RMGIC, although to a lesser extent than calcium carbonate. Key words:Glass ionomer, Resin modified glass ionomer, Nanodiamonds, Calcium Carbonate, Flexural Strength.