Giacomo Begnoni, Guy Willems, Sonia Coman, Julie De Vlieger, Isa den Boer, Lies Dekoster, Anke Vandeberg, Emilie Willems, Maria Cadenas de Llano-Pérula
Aim: To compare standardised surface electromyography (ssEMG) data and patient perception between two EMG standardisation methods for clenching (cotton rolls vs. wax pads) and swallowing (with vs. without an air-filled bulb). The third aim was to analyse ssEMG data during saliva swallowing to detect differences among masseter (MM), temporalis (TM) and submental (SM) activity.
Methods: Electromyographic data were obtained from 45 participants after clenching tests with wax pads and cotton rolls, and swallowing tests with and without an air bulb. Participants rated comfort, quickness, and stress of each modality on a 10-point Likert scale. TM, MM and SM activities were recorded using ssEMG indices. Clenching and swallowing data were compared using the Student's t-test. A one-way ANOVA was used to assess muscle roles during saliva swallowing. Perception scores were compared with the Student's t-test.
Results: Forty-five participants (37 women, mean age 22.75 ± 1.27 years) were included. No differences emerged between ssEMG indices during clenching and swallowing, except for the IMPACT index of MM (p < 0.001) and TM (p < 0.01), both lower with wax. No perception differences were found between wax and cotton roll clenching. Swallowing with an air bulb was rated as more comfortable (p < 0.001) and less stressful (p < 0.05). During swallowing, SM showed significantly higher activity and longer duration (p < 0.001) than TM and MM.
Conclusion: Both cotton rolls and wax pads are suitable for clenching standardisation, though wax may reduce TM and MM activity. For swallowing, the air-filled bulb does not affect ssEMG indices but is perceived as more comfortable and less stressful.
{"title":"Standardised Surface Electromyography During Clenching and Swallowing: Patient Perception and Comparison of Two Protocols: An Observational Study on a Healthy Population.","authors":"Giacomo Begnoni, Guy Willems, Sonia Coman, Julie De Vlieger, Isa den Boer, Lies Dekoster, Anke Vandeberg, Emilie Willems, Maria Cadenas de Llano-Pérula","doi":"10.1111/joor.70145","DOIUrl":"https://doi.org/10.1111/joor.70145","url":null,"abstract":"<p><strong>Aim: </strong>To compare standardised surface electromyography (ssEMG) data and patient perception between two EMG standardisation methods for clenching (cotton rolls vs. wax pads) and swallowing (with vs. without an air-filled bulb). The third aim was to analyse ssEMG data during saliva swallowing to detect differences among masseter (MM), temporalis (TM) and submental (SM) activity.</p><p><strong>Methods: </strong>Electromyographic data were obtained from 45 participants after clenching tests with wax pads and cotton rolls, and swallowing tests with and without an air bulb. Participants rated comfort, quickness, and stress of each modality on a 10-point Likert scale. TM, MM and SM activities were recorded using ssEMG indices. Clenching and swallowing data were compared using the Student's t-test. A one-way ANOVA was used to assess muscle roles during saliva swallowing. Perception scores were compared with the Student's t-test.</p><p><strong>Results: </strong>Forty-five participants (37 women, mean age 22.75 ± 1.27 years) were included. No differences emerged between ssEMG indices during clenching and swallowing, except for the IMPACT index of MM (p < 0.001) and TM (p < 0.01), both lower with wax. No perception differences were found between wax and cotton roll clenching. Swallowing with an air bulb was rated as more comfortable (p < 0.001) and less stressful (p < 0.05). During swallowing, SM showed significantly higher activity and longer duration (p < 0.001) than TM and MM.</p><p><strong>Conclusion: </strong>Both cotton rolls and wax pads are suitable for clenching standardisation, though wax may reduce TM and MM activity. For swallowing, the air-filled bulb does not affect ssEMG indices but is perceived as more comfortable and less stressful.</p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charis Van der Straeten, Jolien Verbeke, Kim Bettens, Guy De Pauw, Kristiane Van Lierde
<p><strong>Objectives: </strong>This study aimed to assess the short- and long-term effectiveness of two intensive Orofacial Myofunctional Therapy (OMT) protocols on orofacial myofunctional status, orofacial strength and Oral Health Related Quality of Life (OHRQoL). One protocol focused exclusively on breathing patterns and orofacial posture (Breathing and Posture Only group; OMT<sub>BPO</sub>), while the other also incorporated orofacial muscle strengthening and swallowing patterns (Breathing, Posture, Strength and Swallowing group; OMT<sub>BPSS</sub>). Additionally, adherence to home-based exercises and satisfaction with OMT intervention were evaluated.</p><p><strong>Methods: </strong>A convenience sample of 14 young adults was recruited and randomly allocated to one of the two therapy groups in this longitudinal, multigroup, pre-test-post-test study. Evaluations were conducted pre-OMT, immediately post-OMT, and at a 6-month follow-up. Each group (OMT<sub>BPO</sub> and OMT<sub>BPSS</sub>) consisted of 7 participants (mean age: 19.1 years, SD: 0.69 years; and 18.8 years, SD: 0.55 years, respectively). Besides a clinical assessment, orofacial myofunctional status was evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES). Tongue and lip strength and endurance were measured with the Iowa Oral Performance Instrument (IOPI), and OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-NL14) questionnaire. Therapy satisfaction was evaluated using a custom questionnaire with visual analogue scales.</p><p><strong>Results: </strong>The linear mixed models analysis revealed no significant changes in OMES scores, orofacial strength and endurance or OHRQoL measures post-intervention or at follow-up. Generalised estimating equations analysis showed no immediate post-therapy improvements in tongue posture; however, both OMT<sub>BPO</sub> (p = 0.023) and OMT<sub>BPSS</sub> (p = 0.033) demonstrated significant improvements at follow-up. While descriptive analysis suggested improvements in swallowing patterns post-therapy and at follow-up, these changes were not statistically significant. The OMT<sub>BPSS</sub> group showed a significantly higher adherence rate than the OMT<sub>BPO</sub> group (p = 0.026). Although therapy satisfaction was higher in the OMT<sub>BPSS</sub> group, this difference was not statistically significant.</p><p><strong>Conclusions: </strong>Within the limitations of this study, including a small sample size of healthy young adults, the findings suggest that an intensive 5-week OMT intervention may be sufficient to train motor skills necessary for improving orofacial functions. As improvements in orofacial myofunctional behaviour were similar across both OMT interventions, the more extensive program as offered in the OMT<sub>BPSS</sub> group may not provide additional benefits regarding the orofacial myofunctional outcomes for this population. However, variation in therapy content may be important for promoting a
{"title":"The OMA-Project-Orofacial Myofunctional Behaviour in Adults: Effectiveness of Orofacial Myofunctional Therapy Protocols in Healthy Young Adults With Orofacial Myofunctional Disorders.","authors":"Charis Van der Straeten, Jolien Verbeke, Kim Bettens, Guy De Pauw, Kristiane Van Lierde","doi":"10.1111/joor.70150","DOIUrl":"https://doi.org/10.1111/joor.70150","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the short- and long-term effectiveness of two intensive Orofacial Myofunctional Therapy (OMT) protocols on orofacial myofunctional status, orofacial strength and Oral Health Related Quality of Life (OHRQoL). One protocol focused exclusively on breathing patterns and orofacial posture (Breathing and Posture Only group; OMT<sub>BPO</sub>), while the other also incorporated orofacial muscle strengthening and swallowing patterns (Breathing, Posture, Strength and Swallowing group; OMT<sub>BPSS</sub>). Additionally, adherence to home-based exercises and satisfaction with OMT intervention were evaluated.</p><p><strong>Methods: </strong>A convenience sample of 14 young adults was recruited and randomly allocated to one of the two therapy groups in this longitudinal, multigroup, pre-test-post-test study. Evaluations were conducted pre-OMT, immediately post-OMT, and at a 6-month follow-up. Each group (OMT<sub>BPO</sub> and OMT<sub>BPSS</sub>) consisted of 7 participants (mean age: 19.1 years, SD: 0.69 years; and 18.8 years, SD: 0.55 years, respectively). Besides a clinical assessment, orofacial myofunctional status was evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES). Tongue and lip strength and endurance were measured with the Iowa Oral Performance Instrument (IOPI), and OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-NL14) questionnaire. Therapy satisfaction was evaluated using a custom questionnaire with visual analogue scales.</p><p><strong>Results: </strong>The linear mixed models analysis revealed no significant changes in OMES scores, orofacial strength and endurance or OHRQoL measures post-intervention or at follow-up. Generalised estimating equations analysis showed no immediate post-therapy improvements in tongue posture; however, both OMT<sub>BPO</sub> (p = 0.023) and OMT<sub>BPSS</sub> (p = 0.033) demonstrated significant improvements at follow-up. While descriptive analysis suggested improvements in swallowing patterns post-therapy and at follow-up, these changes were not statistically significant. The OMT<sub>BPSS</sub> group showed a significantly higher adherence rate than the OMT<sub>BPO</sub> group (p = 0.026). Although therapy satisfaction was higher in the OMT<sub>BPSS</sub> group, this difference was not statistically significant.</p><p><strong>Conclusions: </strong>Within the limitations of this study, including a small sample size of healthy young adults, the findings suggest that an intensive 5-week OMT intervention may be sufficient to train motor skills necessary for improving orofacial functions. As improvements in orofacial myofunctional behaviour were similar across both OMT interventions, the more extensive program as offered in the OMT<sub>BPSS</sub> group may not provide additional benefits regarding the orofacial myofunctional outcomes for this population. However, variation in therapy content may be important for promoting a","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Age-related decline in swallowing function (dysphagia) increases the risk of aspiration pneumonia and reduces quality of life in older adults. However, the efficacy of swallowing-targeted interventions in aging remains unclear.
Objective
This study aimed to systematically review the interventions for age-related dysphagia in aged rodent models and evaluate their effectiveness through a meta-analysis.
Methods
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched MEDLINE, Embase, and Cochrane Library (January 2024) for studies on interventions for swallowing decline in aged rodents. Seventeen studies were included, of which eight contributed to the meta-analysis.
Results
Interventions included progressive resistance tongue exercise, neuromuscular electrical stimulation (NMES), treadmill running, and pharmacological manipulation. The meta-analysis showed that tongue exercise significantly increased in both young (standardised mean difference [SMD] = 3.659; 95% confidence interval [CI]: 2.011–5.308) and aged rodents (SMD = 3.274; 95% CI: 2.682–3.867). Beyond force, tongue exercise improved endurance, induced region-specific myosin heavy chain shifts, and elicited neural and mitochondrial metabolic adaptations. NMES increased fatigue resistance, promoted a shift toward fatigue-resistant fibre isoforms, and partially restored neuromuscular junction integrity. Treadmill running improved endurance and fatigue resistance, with region-dependent effects on fibre composition. Pharmacological interventions had limited impact.
Conclusion
Robust evidence shows that progressive resistance tongue exercise can mitigate age-related decline in swallowing, whereas evidence for NMES, treadmill running, and pharmacological interventions remains limited. These findings underscore the translational potential of exercise-based therapies and highlight the need for age-tailored strategies.
{"title":"Effect of Tongue Exercise on Improving Age-Related Decline in Swallowing Function: A Systematic Review and Meta-Analysis of Animal Model–Based Interventions","authors":"Han-Na Kim, Ji-Youn Kim","doi":"10.1111/joor.70123","DOIUrl":"10.1111/joor.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Age-related decline in swallowing function (dysphagia) increases the risk of aspiration pneumonia and reduces quality of life in older adults. However, the efficacy of swallowing-targeted interventions in aging remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to systematically review the interventions for age-related dysphagia in aged rodent models and evaluate their effectiveness through a meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched MEDLINE, Embase, and Cochrane Library (January 2024) for studies on interventions for swallowing decline in aged rodents. Seventeen studies were included, of which eight contributed to the meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interventions included progressive resistance tongue exercise, neuromuscular electrical stimulation (NMES), treadmill running, and pharmacological manipulation. The meta-analysis showed that tongue exercise significantly increased in both young (standardised mean difference [SMD] = 3.659; 95% confidence interval [CI]: 2.011–5.308) and aged rodents (SMD = 3.274; 95% CI: 2.682–3.867). Beyond force, tongue exercise improved endurance, induced region-specific myosin heavy chain shifts, and elicited neural and mitochondrial metabolic adaptations. NMES increased fatigue resistance, promoted a shift toward fatigue-resistant fibre isoforms, and partially restored neuromuscular junction integrity. Treadmill running improved endurance and fatigue resistance, with region-dependent effects on fibre composition. Pharmacological interventions had limited impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Robust evidence shows that progressive resistance tongue exercise can mitigate age-related decline in swallowing, whereas evidence for NMES, treadmill running, and pharmacological interventions remains limited. These findings underscore the translational potential of exercise-based therapies and highlight the need for age-tailored strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"807-818"},"PeriodicalIF":4.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145863353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marlon Ferreira Dias, Amanda Costa Ferro, Juliana Homem Padilha Spavieri, Túlio Morandin Ferrisse, Daniela Aparecida de Godoi Gonçalves
Background
Migraine and temporomandibular disorders (TMD) are comorbid conditions that are highly frequent among patients.
Objective
This systematic review with meta-analysis (MA) aimed to evaluate the bidirectional association between migraine and TMD in adults.
Methods
The protocol was registered with the International Prospective Register of Systematic Reviews. The literature was searched in 5 main databases and 3 grey literature databases from inception until May 12, 2025. The review included observational cross-sectional studies that based TMD classification on the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD), and migraine was diagnosed according to any edition of the International Classification of Headache Disorders (ICHD). The risk of bias (Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools) and the certainty of evidence (GRADE) were assessed.
Results
From 7329 studies, 17 were included in the qualitative assessment and 6 in the quantitative analysis. Seven studies were classified as low risk of bias, nine as moderate, and one as high. The qualitative assessment demonstrated an association between both conditions. MA revealed that patients with migraine were significantly more likely to have TMD (OR = 6.08; 95% CI: 4.80–7.68), and patients with TMD were more likely to have migraine (OR = 2.64; 95% CI: 2.19–3.18). The certainty of evidence was rated high.
Conclusion
The study identified a strong bidirectional association between migraine and TMD. Clinicians should systematically screen for both conditions, especially in the presence of one of them, to optimize treatment outcomes.
背景：偏头痛和颞下颌紊乱（TMD）是患者中非常常见的合并症。目的：本系统综述与荟萃分析（MA）旨在评估成人偏头痛和TMD之间的双向关联。方法：该方案已在国际前瞻性系统评价注册中注册。文献检索自建库至2025年5月12日的5个主要数据库和3个灰色文献数据库。本综述包括基于TMD研究诊断标准（RDC/TMD）或TMD诊断标准（DC/TMD）的观察性横断面研究，偏头痛根据国际头痛疾病分类（ICHD）的任何版本进行诊断。评估偏倚风险（Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument工具）和证据确定性（GRADE）。结果：7329项研究中，17项纳入定性评价，6项纳入定量分析。7项研究被归类为低偏倚风险，9项为中等偏倚风险，1项为高偏倚风险。定性评估表明这两种情况之间存在关联。MA显示偏头痛患者患TMD的可能性更大（OR = 6.08; 95% CI: 4.80-7.68）， TMD患者患偏头痛的可能性更大（OR = 2.64; 95% CI: 2.19-3.18）。证据的确定性评价很高。结论：研究发现偏头痛与TMD之间存在很强的双向关联。临床医生应系统地筛查这两种情况，特别是在其中一种情况下，以优化治疗结果。
{"title":"Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis","authors":"Marlon Ferreira Dias, Amanda Costa Ferro, Juliana Homem Padilha Spavieri, Túlio Morandin Ferrisse, Daniela Aparecida de Godoi Gonçalves","doi":"10.1111/joor.70110","DOIUrl":"10.1111/joor.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Migraine and temporomandibular disorders (TMD) are comorbid conditions that are highly frequent among patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review with meta-analysis (MA) aimed to evaluate the bidirectional association between migraine and TMD in adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The protocol was registered with the International Prospective Register of Systematic Reviews. The literature was searched in 5 main databases and 3 grey literature databases from inception until May 12, 2025. The review included observational cross-sectional studies that based TMD classification on the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD), and migraine was diagnosed according to any edition of the International Classification of Headache Disorders (ICHD). The risk of bias (Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools) and the certainty of evidence (GRADE) were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 7329 studies, 17 were included in the qualitative assessment and 6 in the quantitative analysis. Seven studies were classified as low risk of bias, nine as moderate, and one as high. The qualitative assessment demonstrated an association between both conditions. MA revealed that patients with migraine were significantly more likely to have TMD (OR = 6.08; 95% CI: 4.80–7.68), and patients with TMD were more likely to have migraine (OR = 2.64; 95% CI: 2.19–3.18). The certainty of evidence was rated high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study identified a strong bidirectional association between migraine and TMD. Clinicians should systematically screen for both conditions, especially in the presence of one of them, to optimize treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"794-806"},"PeriodicalIF":4.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic apical periodontitis (CAP) remains among the most challenging endodontic conditions due to persistent infection and inflammatory destruction in the periapical region. In contemporary endodontic terminology (AAE 2015), CAP typically corresponds to apical periodontitis with radiographic apical radiolucency, which may present with or without symptoms.
Objective
This study evaluates the effect of a novel bioceramic sealer, iRoot SP, on periodontal clinical parameters and masticatory function in patients with chronic apical periodontitis (CAP) compared with the traditional AH-Plus sealer.
Methods
In a single-center randomised controlled trial, 108 patients with single-tooth CAP were randomly allocated in a 1:1 ratio to the iRoot SP group or the AH-Plus group. Standardised root canal treatments were performed according to a strict protocol. Primary outcome measures included immediate obturation quality, clinical efficacy at one week, postoperative pain, periodontal parameters (probing depth, sulcular bleeding, gingival and plaque indices), and masticatory efficiency assessed preoperatively and at follow-up intervals of one week, three months, and six months.
Results
The iRoot SP group achieved a significantly higher adequate filling rate (96.3% vs. 85.2%, p < 0.05) and overall clinical effectiveness (98.2% vs. 83.3%, p < 0.01). Moreover, postoperative pain was markedly lower (3.7% vs. 18.5%, p < 0.05). Superior improvements in periodontal metrics and masticatory function were consistently observed at all follow-up points (all p < 0.001).
Conclusion
The innovative iRoot SP sealer enhances root canal obturation quality and clinical outcomes while reducing postoperative discomfort and promoting periodontal and functional recovery in CAP. These results underscore its potential as a superior alternative in endodontic therapy.
背景：慢性根尖牙周炎（CAP）仍然是最具挑战性的根管疾病之一，因为在根尖周围区域持续感染和炎症破坏。在当代牙髓学术语（AAE 2015）中，CAP通常对应于根尖放射率高的根尖牙周炎，可能有或没有症状。目的：研究新型生物陶瓷封口剂iRoot SP与传统AH-Plus封口剂对慢性根尖牙炎（CAP）患者牙周临床指标和咀嚼功能的影响。方法：采用单中心随机对照试验，将108例单牙CAP患者按1:1的比例随机分为iRoot SP组和AH-Plus组。标准化的根管治疗按照严格的方案进行。主要结局指标包括即刻封闭质量、一周临床疗效、术后疼痛、牙周参数（探诊深度、龈沟出血、牙龈和菌斑指数）以及术前和随访1周、3个月和6个月时评估的咀嚼效率。结果：iRoot SP组获得了明显更高的充足率（96.3% vs 85.2%）。结论：创新的iRoot SP密封器提高了根管封闭质量和临床结果，同时减少了CAP术后不适，促进了牙周和功能的恢复。这些结果强调了其作为根管治疗的优越替代方案的潜力。
{"title":"Impact of iRoot SP on Periodontal Clinical Parameters and Chewing Function in Patients With Chronic Apical Periodontitis","authors":"Jiaxu Li, Caixia Suo, Min Zhang, Lei Zhang","doi":"10.1111/joor.70137","DOIUrl":"10.1111/joor.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic apical periodontitis (CAP) remains among the most challenging endodontic conditions due to persistent infection and inflammatory destruction in the periapical region. In contemporary endodontic terminology (AAE 2015), CAP typically corresponds to apical periodontitis with radiographic apical radiolucency, which may present with or without symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluates the effect of a novel bioceramic sealer, iRoot SP, on periodontal clinical parameters and masticatory function in patients with chronic apical periodontitis (CAP) compared with the traditional AH-Plus sealer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a single-center randomised controlled trial, 108 patients with single-tooth CAP were randomly allocated in a 1:1 ratio to the iRoot SP group or the AH-Plus group. Standardised root canal treatments were performed according to a strict protocol. Primary outcome measures included immediate obturation quality, clinical efficacy at one week, postoperative pain, periodontal parameters (probing depth, sulcular bleeding, gingival and plaque indices), and masticatory efficiency assessed preoperatively and at follow-up intervals of one week, three months, and six months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The iRoot SP group achieved a significantly higher adequate filling rate (96.3% vs. 85.2%, <i>p</i> < 0.05) and overall clinical effectiveness (98.2% vs. 83.3%, <i>p</i> < 0.01). Moreover, postoperative pain was markedly lower (3.7% vs. 18.5%, <i>p</i> < 0.05). Superior improvements in periodontal metrics and masticatory function were consistently observed at all follow-up points (all <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The innovative iRoot SP sealer enhances root canal obturation quality and clinical outcomes while reducing postoperative discomfort and promoting periodontal and functional recovery in CAP. These results underscore its potential as a superior alternative in endodontic therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"786-793"},"PeriodicalIF":4.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danielle Soley Batista, Gabriela Aparecida Winkert Manfron, Diulia Pereira Bubna, Débora Marta Barbosa, José Stechman-Neto, Karinna Veríssimo Meira Taveira, Cristiano Miranda de Araujo, Flávio Magno Gonçalves, Thalita de Paris Matos Bronholo
Objective
To investigate whether implant-supported overdentures provide nutritional advantages compared with conventional complete dentures in older edentulous adults, through a systematic review and meta-analysis.
Methods
A comprehensive search was performed in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, EMBASE, LILACS, LIVIVO and grey literature sources. Eligible studies included completely edentulous patients aged ≥ 60 years rehabilitated with overdentures or conventional complete dentures, with nutritional intake assessed using validated methods. Data extraction and risk of bias assessments were conducted independently by calibrated reviewers. Random-effects meta-analyses were performed, and the certainty of evidence was rated using GRADE.
Results
Nine studies met the inclusion criteria, of which five were included in the quantitative synthesis. Overdenture users showed significantly higher vitamin B12 levels at 6-month follow-up (SMD = 0.60; 95% CI: 0.18–1.02; I2 = 54%), but no consistent differences were observed for albumin or folate. Overall certainty of the evidence was rated as moderate for vitamin B12 and albumin, and low for folate, due to methodological limitations, heterogeneity in outcome measures and small sample sizes.
Conclusion
While overdentures improve masticatory function and may transiently enhance vitamin B12 status, the current body of evidence does not support a consistent nutritional advantage over conventional dentures. High-quality, long-term trials are needed to clarify the systemic nutritional implications of prosthetic rehabilitation in older adults.
{"title":"Nutritional Outcomes of Overdentures vs. Complete Dentures in Older Edentulous Adults: A Systematic Review and Meta-Analysis","authors":"Danielle Soley Batista, Gabriela Aparecida Winkert Manfron, Diulia Pereira Bubna, Débora Marta Barbosa, José Stechman-Neto, Karinna Veríssimo Meira Taveira, Cristiano Miranda de Araujo, Flávio Magno Gonçalves, Thalita de Paris Matos Bronholo","doi":"10.1111/joor.70111","DOIUrl":"10.1111/joor.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate whether implant-supported overdentures provide nutritional advantages compared with conventional complete dentures in older edentulous adults, through a systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was performed in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, EMBASE, LILACS, LIVIVO and grey literature sources. Eligible studies included completely edentulous patients aged ≥ 60 years rehabilitated with overdentures or conventional complete dentures, with nutritional intake assessed using validated methods. Data extraction and risk of bias assessments were conducted independently by calibrated reviewers. Random-effects meta-analyses were performed, and the certainty of evidence was rated using GRADE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies met the inclusion criteria, of which five were included in the quantitative synthesis. Overdenture users showed significantly higher vitamin B12 levels at 6-month follow-up (SMD = 0.60; 95% CI: 0.18–1.02; I<sup>2</sup> = 54%), but no consistent differences were observed for albumin or folate. Overall certainty of the evidence was rated as moderate for vitamin B12 and albumin, and low for folate, due to methodological limitations, heterogeneity in outcome measures and small sample sizes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While overdentures improve masticatory function and may transiently enhance vitamin B12 status, the current body of evidence does not support a consistent nutritional advantage over conventional dentures. High-quality, long-term trials are needed to clarify the systemic nutritional implications of prosthetic rehabilitation in older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"592-602"},"PeriodicalIF":4.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Post-stroke dysphagia (PSD) significantly increases the risk of aspiration-related pneumonia. While prior studies have linked abnormal temporal coordination of swallowing motions to aspiration, limited efforts have been made to explore its individualised mechanisms. This study aims to identify the biomechanical mechanisms underlying aspiration in PSD by developing an interpretable machine learning model based on videofluoroscopic swallowing study (VFSS) data.
Methods
A retrospective analysis was conducted on 135 PSD patients with dysphagia, comprising 547 individual swallowing events. Ten VFSS-based temporal parameters were extracted, with aspiration and non-aspiration used as binary outcome variables. Five machine learning models and the Shapley Additive Explanations (SHAP) method were employed to evaluate variable importance and their non-linear contributions to aspiration risk.
Results
The support vector machine (SVM) demonstrated the best performance (Accuracy: 92.7%). SHAP analysis identified laryngeal vestibule closure reaction time (LCRT), oral transit time (OTT), laryngeal closure to upper oesophageal sphincter opening interval (LC-UES), upper oesophageal sphincter opening duration (UOD) and stage transition duration (STD) as the most predictive parameters. Further interpretation demonstrated that aspiration results from complex temporal dysregulation rather than delays in isolated actions. Key parameters exhibited nonlinear and interactive effects, highlighting diverse compensatory or maladaptive patterns in impaired swallows.
Conclusions
By integrating VFSS-derived temporal parameters with interpretable machine learning, this study elucidates aspiration mechanisms in PSD at both the population and individual swallow levels, thereby providing a mechanism-driven basis for precision-guided clinical interventions.
{"title":"Identification of Individualised Aspiration Mechanisms in Post-Stroke Dysphagia: A VFSS-Based Interpretable Machine Learning Approach","authors":"Tingting Jiang, Lian Wang, Jia Qiao, Xiangxiang Zhang, Zitong He, Chunqing Xie, Yiqiu Lin, Meng Dai, Zulin Dou","doi":"10.1111/joor.70124","DOIUrl":"10.1111/joor.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Post-stroke dysphagia (PSD) significantly increases the risk of aspiration-related pneumonia. While prior studies have linked abnormal temporal coordination of swallowing motions to aspiration, limited efforts have been made to explore its individualised mechanisms. This study aims to identify the biomechanical mechanisms underlying aspiration in PSD by developing an interpretable machine learning model based on videofluoroscopic swallowing study (VFSS) data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 135 PSD patients with dysphagia, comprising 547 individual swallowing events. Ten VFSS-based temporal parameters were extracted, with aspiration and non-aspiration used as binary outcome variables. Five machine learning models and the Shapley Additive Explanations (SHAP) method were employed to evaluate variable importance and their non-linear contributions to aspiration risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The support vector machine (SVM) demonstrated the best performance (Accuracy: 92.7%). SHAP analysis identified laryngeal vestibule closure reaction time (LCRT), oral transit time (OTT), laryngeal closure to upper oesophageal sphincter opening interval (LC-UES), upper oesophageal sphincter opening duration (UOD) and stage transition duration (STD) as the most predictive parameters. Further interpretation demonstrated that aspiration results from complex temporal dysregulation rather than delays in isolated actions. Key parameters exhibited nonlinear and interactive effects, highlighting diverse compensatory or maladaptive patterns in impaired swallows.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By integrating VFSS-derived temporal parameters with interpretable machine learning, this study elucidates aspiration mechanisms in PSD at both the population and individual swallow levels, thereby providing a mechanism-driven basis for precision-guided clinical interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"776-785"},"PeriodicalIF":4.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare clinical examination findings, functional limitations, and psychological profiles between patients with subclinical temporomandibular disorders (TMD) and those with self-reported painful TMD.
Materials and Methods
This cross-sectional study investigated 98 subclinical TMD patients and 262 self-reported painful TMD patients attending a specialised orofacial pain clinic. Subclinical TMD was defined as positive palpation findings without muscle or joint pain complaints. Self-reported painful TMD required both pain complaints and positive clinical findings. Validated questionnaires assessed jaw functional limitations (JFLS-20), depression (PHQ-9), stress (SPST-20), and oral behaviours (OBC). Statistical analysis used Mann–Whitney U tests and chi-square tests with Bonferroni correction.
Results
Self-reported painful TMD patients were significantly older (median age 39 vs. 31 years, p = 0.003), showed greater jaw functional limitations (JFLS global score: 1.88 vs. 0.75, p < 0.001), and higher depression scores (PHQ-9: 1.0 vs. 0.0, p < 0.001). Sleep bruxism frequency differed significantly between groups (p < 0.001), with subclinical patients more commonly reporting frequent sleep bruxism. No significant differences were found in stress levels, overall oral behaviours, or daytime clenching frequency.
Conclusions
Patients with self-reported painful TMD demonstrate distinct clinical profiles characterised by greater functional impairment and psychological distress compared to subclinical cases.
Clinical Relevance
These findings suggest different phenotypes within the TMD spectrum that may require tailored clinical approaches. Longitudinal studies are needed to determine whether subclinical TMD represents an early stage or a distinct entity.
{"title":"Clinical and Psychological Profiles of Patients With Subclinical Versus Self-Reported Painful Temporomandibular Disorders","authors":"Thiprawee Chattrattrai, Supawadee Jariyasakulroj, Somsak Mitrirattanakul","doi":"10.1111/joor.70136","DOIUrl":"10.1111/joor.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare clinical examination findings, functional limitations, and psychological profiles between patients with subclinical temporomandibular disorders (TMD) and those with self-reported painful TMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This cross-sectional study investigated 98 subclinical TMD patients and 262 self-reported painful TMD patients attending a specialised orofacial pain clinic. Subclinical TMD was defined as positive palpation findings without muscle or joint pain complaints. Self-reported painful TMD required both pain complaints and positive clinical findings. Validated questionnaires assessed jaw functional limitations (JFLS-20), depression (PHQ-9), stress (SPST-20), and oral behaviours (OBC). Statistical analysis used Mann–Whitney U tests and chi-square tests with Bonferroni correction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Self-reported painful TMD patients were significantly older (median age 39 vs. 31 years, <i>p</i> = 0.003), showed greater jaw functional limitations (JFLS global score: 1.88 vs. 0.75, <i>p</i> < 0.001), and higher depression scores (PHQ-9: 1.0 vs. 0.0, <i>p</i> < 0.001). Sleep bruxism frequency differed significantly between groups (<i>p</i> < 0.001), with subclinical patients more commonly reporting frequent sleep bruxism. No significant differences were found in stress levels, overall oral behaviours, or daytime clenching frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with self-reported painful TMD demonstrate distinct clinical profiles characterised by greater functional impairment and psychological distress compared to subclinical cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>These findings suggest different phenotypes within the TMD spectrum that may require tailored clinical approaches. Longitudinal studies are needed to determine whether subclinical TMD represents an early stage or a distinct entity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"770-775"},"PeriodicalIF":4.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical trials combining caffeine and 5-ALA for British Meditational Syndrome (BMS) have shown preliminary signs of short-term symptom relief. These substances, which are not traditional painkillers, act through unique, non-traditional mechanisms that are usefully understood through mechanism-based nomenclature.
{"title":"A Pharmacological and Critical Review of Caffeine and Alpha-Lipoic Acid for Burning Mouth Syndrome","authors":"Takahiko Nagamine","doi":"10.1111/joor.70126","DOIUrl":"10.1111/joor.70126","url":null,"abstract":"<p>Clinical trials combining caffeine and 5-ALA for British Meditational Syndrome (BMS) have shown preliminary signs of short-term symptom relief. These substances, which are not traditional painkillers, act through unique, non-traditional mechanisms that are usefully understood through mechanism-based nomenclature.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"603-605"},"PeriodicalIF":4.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorena Tavares Gama, Mariana Marinho Davino de Medeiros, Yuri Wanderley Cavalcanti, Mario Augusto Brondani, Renata Cunha Matheus Rodrigues Garcia
Background
Although objective and subjective masticatory function measures may correlate, associated oral health–related factors may differ, highlighting the need for comprehensive assessment to support tailored care in long-term care facilities (LTCFs).
Objective
To investigate the association between objective and subjective masticatory function and the oral health status of older LTCF residents in Brazil.
Materials and Methods
This cross-sectional study included 187 residents (mean age = 78.7 ± 9.2 years) from nine LTCFs. Masticatory function was evaluated objectively (bi-coloured chewing gum) and subjectively (‘Do you have trouble biting or chewing any kind of food?’). Oral health status was assessed by self-perceived oral health, the number of natural teeth and posterior occluding pairs (POPs), xerostomia and dental prosthesis requirement. Data were analysed using multiple regression (α = 0.05).
Results
Objective and subjective masticatory function were associated (p < 0.001). Older age (p = 0.006), low number of natural teeth (p = 0.001) and POPs (p = 0.004) and the dental prosthesis requirement (p = 0.016) were associated with poorer objective masticatory function. Poor self-perceived oral health (p = 0.001), low number of POPs (p = 0.013), severe xerostomia symptoms (p = 0.001) and dental prosthesis requirement (p = 0.030) were associated with poor subjective masticatory function.
Conclusion
Objective and subjective masticatory functions were associated and shared some common factors, number of POPs and the need for dental prostheses. However, objective measures (e.g., number of teeth) were linked to objective masticatory function, whereas self-perceived factors (e.g., perceived oral health and xerostomia) were associated with subjective masticatory function.
{"title":"Masticatory Function in Elderly Individuals Living in Long-Term Care Facilities in Brazil: Associations Between Objective and Subjective Measurements","authors":"Lorena Tavares Gama, Mariana Marinho Davino de Medeiros, Yuri Wanderley Cavalcanti, Mario Augusto Brondani, Renata Cunha Matheus Rodrigues Garcia","doi":"10.1111/joor.70133","DOIUrl":"10.1111/joor.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although objective and subjective masticatory function measures may correlate, associated oral health–related factors may differ, highlighting the need for comprehensive assessment to support tailored care in long-term care facilities (LTCFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between objective and subjective masticatory function and the oral health status of older LTCF residents in Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 187 residents (mean age = 78.7 ± 9.2 years) from nine LTCFs. Masticatory function was evaluated objectively (bi-coloured chewing gum) and subjectively (‘Do you have trouble biting or chewing any kind of food?’). Oral health status was assessed by self-perceived oral health, the number of natural teeth and posterior occluding pairs (POPs), xerostomia and dental prosthesis requirement. Data were analysed using multiple regression (<i>α</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Objective and subjective masticatory function were associated (<i>p</i> < 0.001). Older age (<i>p</i> = 0.006), low number of natural teeth (<i>p</i> = 0.001) and POPs (<i>p</i> = 0.004) and the dental prosthesis requirement (<i>p</i> = 0.016) were associated with poorer objective masticatory function. Poor self-perceived oral health (<i>p</i> = 0.001), low number of POPs (<i>p</i> = 0.013), severe xerostomia symptoms (<i>p</i> = 0.001) and dental prosthesis requirement (<i>p</i> = 0.030) were associated with poor subjective masticatory function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Objective and subjective masticatory functions were associated and shared some common factors, number of POPs and the need for dental prostheses. However, objective measures (e.g., number of teeth) were linked to objective masticatory function, whereas self-perceived factors (e.g., perceived oral health and xerostomia) were associated with subjective masticatory function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"761-769"},"PeriodicalIF":4.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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