Journal of Dental Sciences最新文献

Background/purpose: Dysbiosis of oral microbiota has been reported in late stage of chronic hepatitis B (CHB) infection with cirrhosis. CHB is characterized by the constant virus-induced liver injury which may lead to liver cirrhosis and hepatocellular carcinoma (HCC). However, some patients show normal liver function without antiviral treatment, associating with favourable prognosis. The oral microbiota composition and oral health status in these patients is unidentified.

Materials and methods: The study focuses on the composition of oral microbiota and oral health status in individuals with CHB and HBV vaccinees as controls. The CHB patients were hepatitis B 'e' antigen (HBeAg)-negative, with or without elevated liver enzyme increase at time of sampling, The 16S rRNA high-throughput sequencing and bioinformatic analysis were applied to investigate oral bacterial diversity, and oral examination including decay-missing-filled teeth (DMFT) index, probing depth (PD) and mucosal status was performed, along with oral health questionnaire, to assess the oral health status in CHB patients and healthy controls.

Results: Our results indicate that their oral microbiome compositions are not significantly different though some have increased ALT/AST liver enzyme levels at the time of sampling, compared to the healthy control participants who are vaccinated e.g. protected from this viral disease. CHB patients here bore a good oral health status and life-style habits as comparing to healthy controls.

Conclusion: These findings suggest that a health-associated salivary microflora is present in CHB without severe liver injury. Continued regular dental health and lifestyle support in liver disease patients is therefore justified.

Background: /purposeSince 1995, Taiwan's National Health Insurance (NHI) has offered a comprehensive dental coverage to over 99 % of the population. This study mainly analyzed the dental service utilization and expenditure trends by the gender, age, and service type and evaluated the resource allocation across different demographics from 2000 to 2020.

Materials and methods: Nationwide NHI administrative data were used to assess the dental visit rates, average visits per user, and per capita expenditure by the gender, age, and 11 service categories for the years 2000, 2005, 2010, 2015, and 2020. The analysis accounted for the fluctuations in the point value within the global budget system and calculated the dental expenditure across the demographic groups and service types.

Results: The dental visit rates increased across all demographics, with the most substantial growth in the 0-14 age group (37.0 % in 2000 to 66.9 % in 2020). However, the visit rates for the older adults remained low at 39.5 % in 2020. Although the per capita expenditure rose significantly, the disparities persisted, with lower spending for the 65+ age group (58.5 USD) compared to the children (64.6 USD) in 2020. Operative dentistry and endodontic treatment expenditures showed declines in spending share, while preventive care and periodontal treatment expenditures increased.

Conclusion: While Taiwan has made progress in increasing the dental utilization, especially for the children, challenges remain in improving access for the older adults. Policy adjustments are needed to enhance the dental care according to the diverse oral health needs of the different age groups.

Background/purpose: The postgraduate year training program for dentists (PGYD) provides the comprehensive clinical training to bridge the gap between the academic education and the hands-on clinical practice. This study mainly explored the influence of training institutions on the future dental practice choices (in clinics or hospitals) after the completion of the PGYD program in Taiwan.

Materials and methods: A nationwide, register-based cohort analysis was conducted on all 3,966 PGYD trainees from July 2010 to April 2023. Data on the training time, institution type, and demographic characteristics were extracted from the PGYD and dentist registration systems. Chi-square tests and t-tests were used to assess the differences in the future dental practice choices and the PGYD training variables.

Results: For the PGYD training institutions, the dental clinics increased substantially, while the medical centers and teaching hospitals declined. The trainees who spent more time in the dental clinics were more likely to practice in the dental clinics, while those trained in the hospitals were more likely to choose the hospital-based practice (P < 0.001). The male dentists were more likely to practice in the dental clinics and the female dentists were prone to practice in the hospitals (P < 0.001).

Conclusion: The type and duration of the PGYD training significantly influence the future dental practice choices, with trainees who undergo more clinic-based training tending to choose dental clinic practice. However, the hospital-level training remains crucial for the specialty development, and further policy efforts are needed to improve the imbalance in the dentist distribution.

Background/purpose: Selecting an appropriate coronal restoration after root canal treatment requires careful consideration, however, there is a lack of established web-based tool that is based on clear guidelines for suitable post-endodontic restorations. Hence, we aimed to design and determine the acceptability of an interactive application to aid the decision making process for post-endodontic restoration among the undergraduate dental students.

Materials and methods: A web-based post-endodontic restoration decision making interactive application, (RestoSmart) was developed after a detailed review of available literature. Seventy undergraduate dental students of IMU University were recruited in the study. A validated questionnaire was given to the participants before and after the use of RestoSmart to answer the provided mock clinical scenarios. Obtained data were statistically analyzed using IBM SPSS version 26 software package.

Results: The statistical analysis demonstrated that RestoSmart was acceptable among the undergraduate dental students (P < 0.05). Initially, participants recognized the potential benefits of designing an interactive application, 74% believing that it may enhance decision making and 76% emphasizing its user-friendliness. Additionally, close to half of the participants expressed the willingness to use interactive tools in future. Following the use of RestoSmart, there was a notable increase in favorability, with 94.2% finding it helpful in the decision making and 94.3% acknowledging its user-friendliness. Furthermore, 87.2% expressed intent to use RestoSmart in future.

Conclusion: RestoSmart was useful for decision making and user friendly. While overall response was positive, there exist some areas for improvement such as ease of use, updating evidence-based guidelines, and establishing its helpfulness in teaching and learning.

Background/purpose: Oral squamous cell carcinoma (OSCC) is notorious for its low survival rates, due to the advanced stage at which it is commonly diagnosed. To enhance early detection and improve prognostic assessments, our study harnesses the power of machine learning (ML) to dissect and interpret complex patterns within mRNA-sequencing (RNA-seq) data and clinical-histopathological features.

Materials and methods: 206 retrospective Vietnamese OSCC formalin-fixed paraffin-embedded (FFPE) tumor samples, of which 101 were subjected to RNA-seq for classification based on gene expression. Then, learning models were built based on clinical-histopathological data to predict OSCC subtypes and propose potential biomarkers for the remaining 105 samples.

Results: 2 distinct groups of OSCC with different clinical-histopathological characteristics and gene expression. Subgroup 1 was characterized by severe histopathologic features with immune response and apoptosis signatures while subgroup 2 was denoted by more clinical/pathological features, cell division and malignant signatures. XGBoost and SVM (Support Vector Machine) models showed the best performance in predicting subtype OSCC. The study also proposed 12 candidate genes as potential biomarkers for OSCC subtypes (6/group).

Conclusion: The study identified characteristics of Vietnamese OSCC patients through a combination of mRNA sequencing and clinical-histopathological analysis. It contributes to the insight into the tumor microenvironment of OSCC and provides accurate ML models for biomarker prediction using clinical-histopathological features.

Background/purpose: Titanium dioxide nanotube (TNT) structures have been shown to enhance the early osseointegration of dental implants. Nevertheless, the optimal nanotube diameter for promoting osteogenesis remains unclear due to variations in cell types and manufacture of nanotubes. This study aimed to evaluate the differences in MC3T3-E1 and Saos-2 cells behavior on nanotubes of varying diameters.

Materials and methods: TNT structures were fabricated by anodizing titanium foil at voltages ranging from 15V to 70V and annealed at 450 °C. Surface morphology and wettability were characterized using field emission scanning electron microscopy and water contact angle measurements, respectively. MC3T3-E1 and Saos-2 cells were cultured to evaluate biocompatibility. Early cell morphology and adhesion were visualized by scanning electron microscopy. Cell proliferation was quantified using CCK-8 assays, and differentiation was assessed through alkaline phosphatase assays. Osteogenesis-related gene expression was analyzed by real-time polymerase chain reaction (PCR), measuring runt-related transcription factor 2 (Runx-2), alkaline phosphatase (ALP), collagen type 1 (COL-1), osteocalcin (OCN), and Osteopontin (OPN) gene levels.

Results: Our results found that Saos-2 cells may be more suitable for TNT-related studies compared to MC3T3-E1 cells. Notably, the 65V nanotube group, with a diameter of 135.9 ± 15.83 nm, demonstrated the most significant osteogenic effect in our assays.

Conclusion: We propose that the use and screening of multiple cell lines prior to the evaluation of biomaterials can lead to more accurate in vitro experiments, thereby enhancing the reliability of biomaterial research.

Background/purpose: SimEx-Plus (EPED. Inc) was already a mature augmented reality (AR) dental training simulator that allowed students to have a high quality dental education practice. Now the EPCAD software has been further developed into a comprehensive computer-aided design software. It helps relevant professionals learn how to create digital fixed prosthesis in a virtual environment. This study used the newly developed EPCAD software that was integrated within the SimEx-Plus to design dental restorations then digital output milling restorations. We hope that the SimEx-Plus AR dental training simulator can achieve the multi-purpose function in one machine.

Materials and methods: A right maxillary central incisor was prepared in the standard dental model. The restorations were designed by EPCAD software integrated with the SimEx-Plus and milled by a 4-axis dental milling machine (N4+, vhf camfacture AG). The internal gap of the restoration was evaluated.

Results: The internal gaps of the crowns set on the right maxillary central incisor were among 68.27-89.80 μm. The different setting for digital output did not influence the internal gap (P 0.05, One-Way ANOVA). However, the internal gap on the palatal side was larger than that on the labial, mesial, distal, and incisal surfaces (P < 0.05, One-Way ANOVA).

Conclusion: The new software EPCAD that was integrated within the SimEx-Plus AR dental training simulator could design restorations, and the designed restorations had good internal gap for clinical use. The professionals can learn tooth preparation and digital restoration fabrication by the SimEx-Plus AR dental training system.

Background/purpose: The increasing importance of computer assisted implant surgery (CAIS) in the practice of implant dentistry calls for adequate education and training of clinicians. However, limited evidence exists to support optimal educational strategies and best practices. This study aimed to investigate the effectiveness of distributed training with dynamic CAIS (d-CAIS) on the precision of freehand implant placement by inexperienced operators.

Materials and methods: Six senior undergraduate dental students underwent simulation training in freehand implant surgery (5 implants) followed by distributed training in d-CAIS (6 implants). A final assessment of freehand implant placement (5 implants) was conducted thereafter. Outcomes were compared to a benchmark set by an experienced surgeon who repeated the same simulation exercises. Total surgical time and implant placement precision were recorded.

Results: The average precision of implant placement improved significantly after the d-CAIS training for novice operators. 3D platform deviation (1.63 ± 0.85 vs 0.92 ± 0.23; P < 0.001), 3D apical deviation (1.93 ± 0.88 vs 1.21 ± 0.19; P < 0.001), and angular deviation (5.27 ± 2.30 vs 2.74 ± 1.37; P < 0.001). The students achieved platform deviation comparable to this of the expert, but lagged in angle, apex precision, and total surgical time.

Conclusion: Short-term, distributed simulation training with d-CAIS can significantly enhance the precision of freehand implant placement by novice operators. However, novice operators still lagged at certain aspects of precision and surgical time when compared with the performance of an experienced surgeon in the same setup.

Integrating augmented reality (AR) and virtual reality (VR) into dental surgery education and practice has significantly advanced the precision and interactivity of dental training and patient care. This narrative review summarizes findings from extensive literature searches conducted in PubMed, Cochrane Library, and Embase, highlighting AR and VR technologies transformative impact and current applications. Research shows that AR improves surgical precision by offering real-time data overlays during procedures, leading to better outcomes in operations like dental implant placements. On the other hand, VR has revolutionized training environments by offering detailed, immersive simulations that significantly improve the retention of surgical skills. This was demonstrated through VR applications in orthognathic surgery in 2023. Despite their advantages, these technologies encounter adoption challenges, such as high implementation costs and the complexity of integrating advanced simulations into standard training curricula. The prospects for AR and VR in dental surgery are promising. Ongoing developments aim to enhance realism through improved haptic feedback and integrate artificial intelligence to tailor learning experiences. Continued innovation and research are crucial to overcome current limitations, expand applications, and fully realize the potential of AR and VR in improving dental education and clinical practice.