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Periodontal Health, Bite Force and Oral Health-Related Quality of Life of Obese Older Adults Using Removable Partial Dentures 使用可摘局部义齿的肥胖老年人牙周健康、咬合力和口腔健康相关生活质量
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-27 DOI: 10.1111/joor.70122
Guilherme Fantini Ferreira, Talita Malini Carletti, Lorena Tavares Gama, Thais Marques Simek Vega Gonçalves, Renata Cunha Matheus Rodrigues Garcia

Background

Obesity is associated with periodontal disease, which compromises chewing by reducing masticatory efficiency. However, little is known about periodontal health and the use of removable prostheses in obese older adults.

Objective

To evaluate the effects of removable partial denture (RPD) insertion on periodontal condition, maximum bite force (MBF), and oral health-related quality of life (OHRQoL) in obese and normal-weight older adults.

Material and Methods

Edentulous older adults in the maxilla and partially edentulous in the mandible were assigned to obese (71.9 ± 5.0 years; n = 12, 6 women and 6 men) and normal-weight (69.9 ± 6.7 years; n = 6 women and 6 men) groups. Periodontal parameters (probing depth, clinical attachment loss, gingival recession, bleeding on probing) were measured with William's probe, and plaque was assessed with the modified O'Leary index. MBF was recorded with pressure sensors, and OHRQoL was evaluated with the OHIP-14. Periodontal parameters and MBF were measured before and 3, 6, 9, and 12 months after RPD insertion, while OHRQoL was measured before, and after 6 and 12 months. Data were analysed by repeated-measures ANOVA with Bonferroni post hoc tests (α = 0.05).

Results

Obese individuals showed higher bleeding on probing (p = 0.02) and greater MBF (p = 0.002) at all time points. MBF increased in both groups after 3 months, while OHRQoL remained lower in obese individuals (p = 0.01). Both groups showed significant plaque reduction after RPD insertion (p < 0.05).

Conclusion

Obese older adults wearing RPDs exhibit greater periodontal impairment and poorer OHRQoL, despite similar improvements in MBF and plaque reduction. These findings underscore the need for closer periodontal monitoring and targeted oral health strategies for obese older adults receiving RPDs.

Trial Registration

Brazilian Registry of Clinical Trials: ReBEC #U1111-1228-7273

背景:肥胖与牙周病有关,牙周病通过降低咀嚼效率影响咀嚼。然而,对于肥胖老年人的牙周健康和可移动假体的使用知之甚少。目的:评价可摘局部义齿(RPD)对肥胖和正常体重老年人牙周状况、最大咬合力(MBF)和口腔健康相关生活质量(OHRQoL)的影响。材料与方法:将上颌无牙老年人和下颌骨部分无牙老年人分为肥胖组(71.9±5.0岁,女6人,男6人,n = 12)和正常体重组(69.9±6.7岁,女6人,男6人)。用威廉氏探针测量牙周参数(探诊深度、临床附着丧失、牙龈退缩、探诊出血),用改良的O'Leary指数评估牙菌斑。用压力传感器记录MBF,用OHIP-14评价OHRQoL。分别于RPD置入前、置入后3、6、9、12个月测定牙周参数和MBF,于置入后6、12个月测定OHRQoL。资料采用Bonferroni事后检验的重复测量方差分析(α = 0.05)。结果:肥胖个体在所有时间点均表现出较高的探查出血(p = 0.02)和较高的MBF (p = 0.002)。3个月后,两组MBF均增加,而肥胖个体的OHRQoL仍较低(p = 0.01)。结论:佩戴RPD的肥胖老年人牙周损伤更严重,OHRQoL更差,尽管MBF和菌斑减少的改善相似。这些发现强调了对接受RPDs的肥胖老年人进行更密切的牙周监测和有针对性的口腔健康策略的必要性。试验注册:巴西临床试验注册:ReBEC #U1111-1228-7273。
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引用次数: 0
Mandibular Atrophy and Its Impact on Overdenture Performance: Insights From a 5-Year Longitudinal Study 下颌萎缩及其对覆盖义齿性能的影响:来自5年纵向研究的见解。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-26 DOI: 10.1111/joor.70113
Fernanda Faot, Luciana Rezende Pinto, Lucas Jardim Da Silva, Laura Lourenço Morel, Otacílio Luiz Chagas-Júnior, Anna Paula Da Rosa Possebon

Background

The long-term influence of mandibular atrophy on masticatory function, patient-reported outcomes, and prosthetic maintenance in users of implant-retained overdentures remains unclear.

Objective

To assess the impact of mandibular bone atrophy on masticatory function, quality of life, patient satisfaction, and prosthetic maintenance over a five-year period.

Methods

Twenty-four fully edentulous patients were rehabilitated with mandibular overdentures retained by two narrow-diameter implants and divided into two groups according to mandibular bone height: atrophic mandible (AM) and non-atrophic mandible (NAM). Masticatory performance (MP) and swallowing threshold (ST) were assessed, while quality of life and satisfaction were evaluated using the Dental Impact on Daily Living (DIDL) questionnaire. Prosthetic maintenance events were recorded over 5 years. Multilevel mixed-effects regression evaluated temporal trends and group differences, and chi-square tests were used for prosthetic events.

Results

Four participants were lost to follow-up, resulting in 10 individuals per group at 5 years. The AM group showed significant reductions in MP_X50 (–9.66%; p = 0.00) and ST_X50 (–1.9%; p = 0.01); and increase in ST_ME5.6 (+43.32%; p = 0.01). The eating/chewing domain of the DIDL was significantly lower in the AM group (0.35 ± 0.72) compared to the NAM group (0.73 ± 0.47). Although overall prosthetic maintenance did not differ significantly, the AM group exhibited a higher frequency of Equator dislodgement (9.24%; p = 0.00) and attachment replacement (6.02%; p = 0.00).

Conclusion

Mandibular atrophy adversely affected masticatory function, patient-reported chewing satisfaction, and the frequency of specific prosthetic complications over 5 years.

背景:下颌萎缩对种植覆盖义齿使用者咀嚼功能、患者报告的结果和义肢维护的长期影响尚不清楚。目的:评估下颌骨萎缩对咀嚼功能、生活质量、患者满意度和修复体维护的影响。方法:对24例全牙缺失患者采用两种窄径种植体保留下颌覆盖义齿进行修复,根据颌骨高度分为萎缩性下颌骨(AM)组和非萎缩性下颌骨(NAM)组。评估咀嚼功能(MP)和吞咽阈值(ST),同时使用牙齿对日常生活的影响(DIDL)问卷评估生活质量和满意度。假体维护事件记录超过5年。多水平混合效应回归评估时间趋势和组间差异,卡方检验用于修复事件。结果:4名参与者失去随访,5年时每组10人。AM组MP_X50 (-9.66%, p = 0.00)、ST_X50 (-1.9%, p = 0.01)显著降低;ST_ME5.6升高(+43.32%;p = 0.01)。AM组进食/咀嚼区DIDL(0.35±0.72)明显低于NAM组(0.73±0.47)。虽然整体假体维持没有显著差异,但AM组出现赤道移位(9.24%,p = 0.00)和附着体置换(6.02%,p = 0.00)的频率更高。结论:下颌萎缩在5年内对咀嚼功能、患者报告的咀嚼满意度和特定义肢并发症的频率产生不利影响。
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引用次数: 0
Oral Health Status and Sleep-Disordered Breathing in Post-Stroke Patients in Convalescent Rehabilitation Wards: A Cross-Sectional Study 康复病房卒中后患者口腔健康状况与睡眠呼吸障碍:一项横断面研究
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-24 DOI: 10.1111/joor.70109
Ryosuke Yanagida, Kohei Yamaguchi, Kazuharu Nakagawa, Kanako Yoshimi, Takami Hino, Ayumi Kisara, Haruka Tohara

Background

A bidirectional relationship exists between sleep-disordered breathing (SDB) and stroke. Post-stroke patients have worse oral health status.

Objectives

Post-stroke patients with worse SDB would also have worse oral health status.

Methods

Post-stroke patients in convalescent rehabilitation wards were enrolled in this study. An overnight sleep test using WatchPAT to measure the apnea-hypopnea index (AHI) was conducted. Each oral health assessment tool (OHAT) score between three groups divided by SDB severity was compared, and binary logistic regression analysis was used to assess the association between the total OHAT score and AHI. Also, a receiver operating characteristic curve analysis was performed using the total OHAT score for severe or non-severe SDB.

Results

Among the 196 participants enrolled, 140 participants (78 men and 62 women; mean age, 73.3 ± 12.4 years) underwent a sleep test, with 91 completing it. Significant differences were found between non- or mild SDB and severe SDB groups, as well as between moderate SDB and severe SDB groups in terms of natural teeth and total OHAT score. Binary logistic regression analysis revealed a significant association between AHI and total score of OHAT after adjusting for confounding factors. The cut-off value of the total OHAT score for severe or non-severe SDB was seven, with sensitivity and specificity of 0.524 and 0.735, respectively.

Conclusion

This study revealed that oral health status is associated with SDB severity, highlighting the need for dental professionals in convalescent rehabilitation wards to be involved with SDB.

背景:睡眠呼吸障碍(SDB)与脑卒中存在双向关系。卒中后患者口腔健康状况较差。目的:脑卒中后SDB加重的患者口腔健康状况也较差。方法:选取在康复病房住院的脑卒中患者为研究对象。采用WatchPAT进行夜间睡眠测试,测量呼吸暂停低通气指数(AHI)。比较按SDB严重程度分组的三组患者各口腔健康评估工具(OHAT)评分,采用二元logistic回归分析评估OHAT总分与AHI的相关性。此外,使用严重或非严重SDB的OHAT总分进行受试者工作特征曲线分析。结果:在196名参与者中,140名参与者(78名男性和62名女性,平均年龄73.3±12.4岁)进行了睡眠测试,其中91人完成了测试。非、轻度SDB组与重度SDB组、中度SDB组与重度SDB组在天然牙和OHAT总分方面均存在显著差异。二元logistic回归分析显示,在调整混杂因素后,AHI与OHAT总分之间存在显著相关性。重度和非重度SDB的OHAT总分的临界值为7,敏感性为0.524,特异性为0.735。结论:本研究揭示口腔健康状况与SDB严重程度相关,强调了康复病房牙科专业人员参与SDB的必要性。
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引用次数: 0
Factors Influencing Oral Intake Restoration at Discharge in Patients Undergoing Fasting During Acute Care Hospitalisation 影响急性护理住院期间禁食患者出院时口腔摄入恢复的因素。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-21 DOI: 10.1111/joor.70107
Kohei Yoshikawa, Jun Kayashita, Takao Hamamoto, Masahiro Nakamori, Yukio Mikami, Sachio Takeno

Background

Dysphagia in older inpatients prolongs hospitalisation and increases pneumonia-related medical costs. In acute care hospitals, the prompt evaluation of oral intake potential is essential.

Objective

Early identification of patients with difficulty resuming oral intake and appropriate interventions, including alternative nutritional support, is crucial for preventing malnutrition and promoting functional recovery. This study aimed to identify the predictors of oral intake resumption at discharge in older inpatients by assessing swallowing function using the videoendoscopic Hyodo score and nutritional status using the Mini Nutritional Assessment–Short Form (MNA-SF) score.

Methods

This retrospective study included 114 older patients (mean age 77.9 ± 7.0 years) with a Functional Oral Intake Scale (FOIS) of 1 who underwent videoendoscopic evaluation between April 2020 and March 2022. Patients were classified into an oral intake group (FOIS ≥ 4 at discharge) or a non-oral intake group (FOIS < 4). Demographic, clinical, nutritional and swallowing-related variables were compared. Logistic regression was used to identify independent predictors, and receiver operating characteristic (ROC) analysis was used to assess predictive performance.

Results

In the logistic regression analysis, the MNA-SF score (odds ratio [OR] = 1.29, p = 0.003) and Hyodo score (OR = 0.84, p = 0.049) were independent predictors. Combined Hyodo and MNA-SF score, ROC analysis showed a sensitivity of 0.81, specificity of 0.61, and an area under the curve of 0.75 (95% confidence interval, 0.65–0.82).

Conclusion

Hyodo and MNA-SF scores can predict oral intake recovery at discharge in older inpatients, and a predictive model combining both is useful.

背景:老年住院患者吞咽困难延长住院时间并增加肺炎相关医疗费用。在急症护理医院,及时评估口服摄入潜力是必不可少的。目的:早期识别恢复口服进食困难的患者并采取适当的干预措施,包括替代营养支持,对于预防营养不良和促进功能恢复至关重要。本研究旨在通过视频内镜下Hyodo评分评估吞咽功能和Mini营养评估-简短形式(MNA-SF)评分评估营养状况,确定老年住院患者出院时口服摄入恢复的预测因素。方法:本回顾性研究纳入114例老年患者(平均年龄77.9±7.0岁),功能性口服摄入量表(FOIS)为1,于2020年4月至2022年3月期间接受了内镜检查。将患者分为口服摄入组(出院时FOIS≥4)和非口服摄入组(FOIS结果:logistic回归分析中,MNA-SF评分(优势比[or] = 1.29, p = 0.003)和Hyodo评分(or = 0.84, p = 0.049)为独立预测因子。综合Hyodo评分和MNA-SF评分,ROC分析显示敏感性为0.81,特异性为0.61,曲线下面积为0.75(95%可信区间为0.65 ~ 0.82)。结论:Hyodo评分和MNA-SF评分可以预测老年住院患者出院时的口服摄入恢复情况,两者结合的预测模型是有用的。
{"title":"Factors Influencing Oral Intake Restoration at Discharge in Patients Undergoing Fasting During Acute Care Hospitalisation","authors":"Kohei Yoshikawa,&nbsp;Jun Kayashita,&nbsp;Takao Hamamoto,&nbsp;Masahiro Nakamori,&nbsp;Yukio Mikami,&nbsp;Sachio Takeno","doi":"10.1111/joor.70107","DOIUrl":"10.1111/joor.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dysphagia in older inpatients prolongs hospitalisation and increases pneumonia-related medical costs. In acute care hospitals, the prompt evaluation of oral intake potential is essential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Early identification of patients with difficulty resuming oral intake and appropriate interventions, including alternative nutritional support, is crucial for preventing malnutrition and promoting functional recovery. This study aimed to identify the predictors of oral intake resumption at discharge in older inpatients by assessing swallowing function using the videoendoscopic Hyodo score and nutritional status using the Mini Nutritional Assessment–Short Form (MNA-SF) score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 114 older patients (mean age 77.9 ± 7.0 years) with a Functional Oral Intake Scale (FOIS) of 1 who underwent videoendoscopic evaluation between April 2020 and March 2022. Patients were classified into an oral intake group (FOIS ≥ 4 at discharge) or a non-oral intake group (FOIS &lt; 4). Demographic, clinical, nutritional and swallowing-related variables were compared. Logistic regression was used to identify independent predictors, and receiver operating characteristic (ROC) analysis was used to assess predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the logistic regression analysis, the MNA-SF score (odds ratio [OR] = 1.29, <i>p</i> = 0.003) and Hyodo score (OR = 0.84, <i>p</i> = 0.049) were independent predictors. Combined Hyodo and MNA-SF score, ROC analysis showed a sensitivity of 0.81, specificity of 0.61, and an area under the curve of 0.75 (95% confidence interval, 0.65–0.82).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hyodo and MNA-SF scores can predict oral intake recovery at discharge in older inpatients, and a predictive model combining both is useful.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 3","pages":"630-639"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573667","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}
引用次数: 0
Thermographic Behaviour of the Orbicularis Oris Muscle Under Different Provocative Tests 不同刺激试验下口轮匝肌的热成像行为。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-19 DOI: 10.1111/joor.70117
Patrícia Vieira Salles, Amanda Freitas Valentim, Maria Luiza Neves Caldeira, Denise Sabbagh Haddad, Renata Maria Moreira Moraes Furlan, Andréa Rodrigues Motta

Background

Infrared thermography is an objective method for investigating muscle functioning, enabling inferences about physiology and therapeutics. This noninvasive and non-ionising imaging diagnostic method allows real-time visualisation of the vascular and musculoskeletal systems through skin microcirculation dynamics. It transforms information about the human body's thermal radiation, captured via infrared radiation, into an analysable image.

Objective

To describe the thermographic behaviour of the orbicularis oris muscle during sustained contraction and chewing tasks.

Methods

The study included 56 healthy women aged 18–52 years, who underwent thermographic evaluations before, during, and after performing sustained contraction and chewing tasks. The orbicularis oris muscle was analysed qualitatively and quantitatively using anatomical thermal areas and Student's t-test to compare mean temperature data.

Results

Qualitative analysis revealed temperature changes during the provocative tasks. A comparison of mean temperatures showed a significant temperature increase, corroborating the qualitative findings. The mean temperature variation per task was as follows: 0.57°C during lip compression, 0.20°C during lip protrusion, 0.57°C while chewing peanuts, 0.43°C while chewing crackers, and 0.37°C while chewing a bread roll. There was a decrease in mean temperature during the intervals between tasks, though insufficient to return to baseline levels, indicating a cumulative temperature effect between tasks.

Conclusion

The orbicularis oris muscle temperature increased during the provocative tasks. The 2-min interval between tasks was insufficient for the resting temperature to return to baseline levels. These findings confirm that thermography is an effective method for identifying such temperature changes.

背景:红外热成像是一种客观的研究肌肉功能的方法,可以推断生理和治疗。这种非侵入性和非电离成像诊断方法允许通过皮肤微循环动力学对血管和肌肉骨骼系统进行实时可视化。它将通过红外辐射捕获的人体热辐射信息转换成可分析的图像。目的:描述口轮匝肌在持续收缩和咀嚼任务中的热成像行为。方法:研究纳入了56名年龄在18-52岁的健康女性,她们在进行持续收缩和咀嚼任务之前、期间和之后进行了热成像评估。采用解剖热区和学生t检验比较平均温度数据,对口轮匝肌进行定性和定量分析。结果:定性分析揭示了挑衅任务中温度的变化。对平均温度的比较表明温度显著升高,证实了定性的发现。每个任务的平均温度变化如下:嘴唇压缩时的温度变化为0.57°C,嘴唇突出时的温度变化为0.20°C,咀嚼花生时的温度变化为0.57°C,咀嚼饼干时的温度变化为0.43°C,咀嚼面包时的温度变化为0.37°C。在任务之间的间隔期间,平均温度有所下降,但不足以恢复到基线水平,这表明任务之间存在累积温度效应。结论:刺激时口轮匝肌温度升高。任务之间的2分钟间隔不足以使静息温度恢复到基线水平。这些发现证实了热成像是识别这种温度变化的有效方法。
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引用次数: 0
An Interpretable Machine Learning Model Based on MRI Features for Predicting Pain Severity in Temporomandibular Disorders 基于MRI特征预测颞下颌疾病疼痛严重程度的可解释机器学习模型。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-18 DOI: 10.1111/joor.70108
Chuanfang Xu, Xianyan Wu, Shibin Li, Qun Zhong, Chengbin Ye, Jiena Pan, Wenjie Yan
<div> <section> <h3> Background</h3> <p>Chronic pain around the temporomandibular joint (TMJ) and masticatory muscles is a primary symptom of temporomandibular disorders (TMD). However, the clinical significance of magnetic resonance imaging (MRI) features in predicting TMD-related pain remains unclear. This study aimed to develop and interpret machine learning (ML) models based on MRI characteristics for predicting pain severity in patients with TMD.</p> </section> <section> <h3> Methods</h3> <p>The present retrospective study included 584 patients with TMD between January 2022 and December 2024, yielding a total of 755 TMJ MRI data sets. Pain severity was classified using the visual analogue scale (VAS). Demographic variables (age, sex) and MRI features—including lesion side, disc position, disc morphology, disc signal, disc perforation, bilaminar zone tear, joint space, joint effusion, condylar movement, bony changes and morphology/signal of the lateral pterygoid muscle—were collected. Eleven ML models based on demographic and MRI features were developed: logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), adaptive boosting (AdaBoost), gradient boosting classifier (GBC), bagging classifier (BC), extremely randomised trees (ETC), decision tree classifier (DTC) and multilayer perceptron (MLP). Model performance was evaluated using multiple metrics, including the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity and F1 score. Precision–recall (PR) curves and calibration curves were plotted to assess discrimination and model calibration. Decision curve analysis (DCA) was conducted to evaluate the clinical net benefit across a range of threshold probabilities. Model interpretability was enhanced using Shapley Additive Explanations (SHAP), which quantified the contribution of each feature to individual predictions. Feature selection was conducted based on mean SHAP values, and separate LightGBM models were constructed using the Top 3, 5, and 9 most important features, as well as the full-feature set, for performance comparison.</p> </section> <section> <h3> Results</h3> <p>The data set was randomly divided into a training set (<i>n</i> = 604) and a test set (<i>n</i> = 151). Among the 11 ML models, the LightGBM model demonstrated the best predictive performance, with an AUC of 0.899, and was therefore identified as the optimal model. SHAP analysis identified age, disc position and condylar movement as the top three contributing features. Feature selection analysis indicated that selecting the top nine SHAP-ranked variables led to the highest diagnostic performance
背景:颞下颌关节(TMJ)和咀嚼肌周围的慢性疼痛是颞下颌关节疾病(TMD)的主要症状。然而,磁共振成像(MRI)特征在预测tmd相关疼痛方面的临床意义尚不清楚。本研究旨在开发和解释基于MRI特征的机器学习(ML)模型,以预测TMD患者的疼痛严重程度。方法:本回顾性研究纳入了2022年1月至2024年12月期间584例TMD患者,共获得755个TMJ MRI数据集。采用视觉模拟评分法(VAS)对疼痛程度进行分级。收集人口统计学变量(年龄、性别)和MRI特征,包括病变侧面、椎间盘位置、椎间盘形态、椎间盘信号、椎间盘穿孔、双层带撕裂、关节间隙、关节积液、髁突运动、骨骼变化和翼状外侧肌形态/信号。基于人口统计学和MRI特征开发了11个ML模型:逻辑回归(LR)、支持向量机(SVM)、随机森林(RF)、极端梯度增强(XGBoost)、轻梯度增强机(LightGBM)、自适应增强(AdaBoost)、梯度增强分类器(GBC)、袋装分类器(BC)、极端随机树(ETC)、决策树分类器(DTC)和多层感知器(MLP)。采用多种指标评估模型性能,包括受试者工作特征曲线下面积(AUC)、准确性、灵敏度、特异性和F1评分。绘制精确召回率曲线和校准曲线,以评估判别和模型校准。通过决策曲线分析(DCA)来评估阈值概率范围内的临床净收益。使用Shapley加性解释(SHAP)增强了模型的可解释性,该解释量化了每个特征对个体预测的贡献。基于平均SHAP值进行特征选择,并使用最重要的前3、5和9个特征以及完整的特征集构建单独的LightGBM模型进行性能比较。结果:数据集随机分为训练集(n = 604)和测试集(n = 151)。在11个ML模型中,LightGBM模型的预测效果最好,AUC为0.899,为最优模型。SHAP分析确定年龄、椎间盘位置和髁突运动是最重要的三个特征。特征选择分析表明,选择shap排名前9位的变量,诊断效果最高,AUC为0.829。结论:本研究建立了一种可解释的、高性能的基于mri的ML模型,结合SHAP分析,将影像学和临床特征结合起来,进行客观的疼痛评估,有助于识别高危TMD患者并指导个性化治疗策略。
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引用次数: 0
Mindfulness Level Influences the Frequency, Amplitude and Duration of Awake Bruxism Episodes During Standardised Mental Capacity Tasks 正念水平影响标准化心智能力任务中清醒磨牙发作的频率、幅度和持续时间。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-17 DOI: 10.1111/joor.70119
Rafael Chadud Matoso-Filho, Caio Sberni Pinheiro Souza, Nykolas Jorge Silva Castaldi, Melissa Oliveira Melchior, Fabiane Carneiro Lopes-Olhê, Simone Cecílio Hallak Regalo, Laís Valencise Magri, Jardel Francisco Mazzi-Chaves
<div> <section> <h3> Background</h3> <p>Awake bruxism (AB) is characterised by repetitive or sustained masticatory muscle activity during wakefulness, including clenching, grinding, or mandibular bracing. Recent consensus defines AB as a motor behaviour influenced by psychological and contextual factors. Among these, dispositional mindfulness may play a modulatory role in the frequency and intensity of AB episodes.</p> </section> <section> <h3> Objective</h3> <p>This study aimed to evaluate how standardised cognitive tasks of varying complexity modulate awake bruxism (AB) and to investigate whether dispositional mindfulness is associated with the frequency, duration, and amplitude of AB episodes measured by surface electromyography.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional study was conducted with 68 dental students (18–40 years) from the School of Dentistry of Ribeirão Preto, University of São Paulo. Participants were classified into AB and control groups based on self-report and Ecological Momentary Assessment (EMA). Surface electromyography (sEMG) of the masseter muscle was recorded during five conditions: rest, maximal voluntary clenching, self-report questionnaires, mathematical tasks of different complexity, and an electronic memory game (Genius). Episodes were analysed at thresholds of 10%, 20%, and 30% of maximal voluntary contraction (Ap10, Ap20, Ap30), extracting frequency, duration, and amplitude. Dispositional mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Statistical analyses included Friedman tests, Mann–Whitney <i>U</i> tests, Generalised Estimating Equations (GEE), and Spearman correlations.</p> </section> <section> <h3> Results</h3> <p>Controls showed increased episode frequency at lower thresholds (Ap10) as task complexity rose, whereas AB individuals maintained elevated frequencies across all tasks. Significant between-group differences were observed at higher thresholds (Ap20, Ap30). Duration and amplitude showed no significant differences, except for a trend of greater amplitude in controls during the Genius task. Within the AB group, higher dispositional mindfulness was associated with fewer and shorter contraction episodes, a pattern consistent with previous research indicating a potential protective association. (notably at Ap30) and shorter durations across tasks, while no associations were observed in controls.</p> </section> <section> <h3> Conclusion</h3> <p>AB indiv
背景:清醒磨牙症(AB)的特征是在清醒时反复或持续的咀嚼肌活动,包括咬牙、磨牙或下颌支撑。最近的共识将AB定义为受心理和环境因素影响的运动行为。其中,性格正念可能对AB发作的频率和强度起调节作用。目的:本研究旨在评估不同复杂性的标准化认知任务如何调节清醒磨牙症(AB),并探讨性格正念是否与表面肌电图测量的AB发作的频率、持续时间和幅度有关。方法:对巴西圣保罗大学 ribebereo Preto牙科学院的68名18-40岁的牙科学生进行横断面研究。参与者根据自我报告和生态瞬时评估(EMA)分为AB组和对照组。在五种情况下:休息、最大自主握紧、自我报告问卷、不同复杂程度的数学任务和电子记忆游戏(Genius),记录咬肌的表面肌电图(sEMG)。在最大自发性收缩(Ap10, Ap20, Ap30)的10%,20%和30%的阈值下分析发作,提取频率,持续时间和幅度。使用五面正念问卷(FFMQ)评估气质正念。统计分析包括Friedman检验、Mann-Whitney U检验、广义估计方程(GEE)和Spearman相关性。结果:对照组显示,随着任务复杂性的增加,在较低阈值(Ap10)时发作频率增加,而AB个体在所有任务中都保持较高的频率。在较高阈值(Ap20, Ap30)时,组间差异显著。持续时间和振幅没有显著差异,除了在天才任务中,控制组的振幅有更大的趋势。在AB组中,更高的性格正念与更少、更短的收缩发作有关,这一模式与先前的研究一致,表明了潜在的保护性关联。(特别是在Ap30)和更短的任务持续时间,而在对照组中没有观察到关联。结论:与对照组观察到的适应性调节相比,AB个体表现出稳定和持久的咀嚼肌活动模式。在AB组中,更高的性格正念与更少、更短的收缩发作有关,这表明它具有保护作用。这些发现强调了将心理特征(如正念)整合到AB的行为理解和管理中的相关性。
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引用次数: 0
Does Frequency of Temporomandibular Disorders Pain Influence on Physical and Emotional Function? 颞下颌疾患疼痛频率对身体和情绪功能有影响吗?
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-17 DOI: 10.1111/joor.70102
Goli Chamani, Nora Gourie, Zam-Zam Osman, Petra Lahdo, Golnaz Barjandi, Malin Ernberg

Background

Pain frequency is considered an important aspect of pain chronicity, linked to heightened pain and psychosocial distress. In the International Classification of Orofacial Pain (ICOP), temporomandibular disorders (TMD) are classified as frequent (FR, 1–14 days/month) and highly frequent (HF, ≥ 15 days/month), but whether this is clinically relevant is unknown.

Objectives

This retrospective study aimed to examine differences in FR and HF TMD patients regarding demographics, diagnostics, characteristic pain intensity (CPI) and disability (GCPS), jaw function (JFLS), psychosocial variables (depression, anxiety, pain catastrophizing (PCS) and somatic symptoms) and oral-health-related quality of life (OHIP-5).

Methods

Records of 208 patients with either FR or HF TMD pain (ICOP), were included. All patients had been examined according to the Diagnostic Criteria for TMD (DC/TMD) axis I and axis II. Univariate statistics were used to compare FR and HF TMD, and multivariate statistics to identify variables differentiating HF from FR TMD (p < 0.05).

Results

Arthralgia and degenerative joint disease were more common in HF TMD compared to FR (p = 0.004 and p = 0.010). HF TMD had higher CPI (p < 0.001), JFLS (p < 0.001), PCS (p < 0.001) and OHIP-5 (p < 0.001) scores. Higher CPI, GCPS, PCS, JFLS and OHIP-5 distinguished HF from FR TMD patients (p < 0.05).

Conclusion

HF TMD patients showed increased pain intensity, disability, catastrophizing jaw functional limitations, and reduced quality of life distinguishing them from FR TMD patients. This study is the first to demonstrate the clinical relevance of the ICOP frequency-based classification of TMD, highlighting its importance in the risk assessment and management of these patients.

背景:疼痛频率被认为是疼痛慢性的一个重要方面,与疼痛加剧和社会心理困扰有关。在国际口腔面部疼痛分类(ICOP)中,颞下颌疾病(TMD)分为频繁(FR, 1-14天/月)和高度频繁(HF,≥15天/月),但这是否与临床相关尚不清楚。目的:本回顾性研究旨在探讨FR和HF TMD患者在人口统计学、诊断、特征性疼痛强度(CPI)和残疾(GCPS)、颌骨功能(JFLS)、心理社会变量(抑郁、焦虑、疼痛灾难化(PCS)和躯体症状)和口腔健康相关生活质量(OHIP-5)方面的差异。方法:对208例FR或HF TMD疼痛(ICOP)患者进行回顾性分析。所有患者均按照TMD诊断标准(DC/TMD) I轴和II轴进行检查。单因素统计比较FR和HF TMD,多因素统计区分HF和FR TMD的变量(p)结果:与FR相比,HF TMD中关节痛和退行性关节疾病更常见(p = 0.004和p = 0.010)。结论:HF TMD患者与FR TMD患者相比,表现为疼痛强度增加、失能、颌骨功能严重受限、生活质量下降。这项研究首次证明了基于ICOP频率的TMD分类的临床相关性,强调了其在这些患者的风险评估和管理中的重要性。
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引用次数: 0
Methods for Assessing and Measuring Tooth Wear—Applications in Clinical Research and a Comparison of the Basic Erosive Wear Examination, Tooth Wear Index and Tooth Wear Evaluation System Version 2.0 牙齿磨损评估与测量方法——在临床研究中的应用及基本侵蚀磨损检查、牙齿磨损指数和牙齿磨损评价系统2.0版本的比较
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-17 DOI: 10.1111/joor.70104
Maria Lorens, Iwona Tomaszewska
<div> <section> <h3> Background</h3> <p>Tooth wear is an increasing concern, particularly among younger individuals, driven by lifestyle and dietary changes as well as by bruxism. This condition, including attrition, abrasion and erosion, can result in sensitivity, aesthetic decline and functional impairment. Although dental caries prevention has improved, tooth wear remains a complex, multifactorial problem requiring early detection and effective management.</p> </section> <section> <h3> Objectives</h3> <p>This paper is a literature survey that provides an overview and compares three diagnostic systems for tooth wear assessment—the Smith and Knight Index (TWI), Basic Erosive Wear Examination (BEWE) and Tooth Wear Evaluation System (TWES 2.0)—as recommended by the European Consensus Statement (2017). BEWE is primarily designed to assess erosive tooth wear, whereas TWI and TWES 2.0 provide a more comprehensive evaluation that also encompasses attrition and abrasion. This paper evaluates the suitability of all three indices for both population-level screening and individual patient assessment, focusing on efficiency, detail and ease of use. All three indices can be applied for screening purposes and for detailed evaluation of patients, although their primary applications may differ: BEWE is primarily used for screening populations, whereas TWI and TWES 2.0 are more often employed for assessing individual patients requiring treatment. It should be noted, however, that the TWI is not a screening tool but a diagnostic index intended for detailed clinical evaluation. The article also examines limitations, especially regarding the assessment of wear on restorative materials, and explores emerging technologies.</p> </section> <section> <h3> Methods</h3> <p>A literature review was conducted to assess the clinical relevance, diagnostic performance and practical application of the TWI, BEWE and TWES 2.0, based on a literature search performed using PubMed, Embase, ScienceDirect and Web of Science databases. Key outcome parameters compared for each index included scoring system, focus area, simplicity, level of detail, sensitivity to early wear, inclusion of restorations, ease of standardisation, application, advantages and limitations. Emerging diagnostic technologies were also considered.</p> </section> <section> <h3> Results</h3> <p>All three systems offer structured approaches to diagnosing tooth wear, but each has limitations. BEWE is efficient for population screening but lacks clinical detail. TWI is comprehensive but time-consuming. TWES 2.0 balances efficiency with detail. Importantly, TWES 2.0 is the first diagnostic tool designed t
背景:由于生活方式和饮食的改变以及磨牙症,牙齿磨损越来越受到关注,特别是在年轻人中。这种情况,包括磨损,磨损和侵蚀,可导致敏感性,审美下降和功能障碍。虽然龋齿的预防已经有所改善,但牙齿磨损仍然是一个复杂的多因素问题,需要早期发现和有效管理。目的:本文是一项文献调查,概述并比较了欧洲共识声明(2017)推荐的三种牙齿磨损评估诊断系统-史密斯和奈特指数(TWI),基本侵蚀磨损检查(BEWE)和牙齿磨损评估系统(TWES 2.0)。BEWE主要用于评估牙齿的侵蚀磨损,而TWI和TWES 2.0提供了更全面的评估,还包括磨损和磨损。本文评估了所有三个指标在人群水平筛查和个体患者评估中的适用性,重点是效率、细节和易用性。这三个指标都可以用于筛查目的和对患者的详细评估,尽管它们的主要应用可能有所不同:BEWE主要用于筛查人群,而TWI和TWES 2.0更常用于评估需要治疗的个体患者。然而,应该指出的是,TWI不是一种筛查工具,而是一种用于详细临床评估的诊断指标。文章还考察了局限性,特别是关于修复材料磨损的评估,并探讨了新兴技术。方法:通过PubMed、Embase、ScienceDirect和Web of Science数据库的文献检索,对TWI、BEWE和TWES 2.0的临床相关性、诊断性能和实际应用进行文献综述。各指标比较的主要结果参数包括评分体系、重点领域、简单性、细节水平、早期磨损敏感性、修复体纳入、标准化难易程度、应用、优势和局限性。还审议了新兴的诊断技术。结果:所有三种系统都提供了结构化的方法来诊断牙齿磨损,但每个系统都有局限性。BEWE对人群筛查是有效的,但缺乏临床细节。TWI是全面但耗时的。TWES 2.0平衡了效率和细节。重要的是,TWES 2.0是第一个用于识别与病理性牙齿磨损相关的其他体征的诊断工具。与BEWE和TWI不同,TWES 2.0包括评估修复材料磨损的功能,尽管冠和桥的完整功能仍在开发中。结论:没有一个单一的系统是普遍适用于所有临床或流行病学目的。BEWE对人群水平的筛查是有效的,但缺乏详细的表面特异性信息。TWI虽然提供了全面的诊断细节,但不是为筛查目的而设计的,最适合于个人临床评估。TWI提供了全面的评估,但对于大规模研究来说耗时且不太实用。TWES 2.0平衡了效率和细节,并包括评估修复材料磨损的功能,尽管完整的功能仍在开发中。建议根据研究或临床目标选择最合适的系统,以准确评估和监测牙齿磨损。
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引用次数: 0
Correction to “Neuroimaging Meta-Analysis of Brain Mechanisms of the Association Between Orofacial Pain and Mastication” 修正“口面部疼痛与咀嚼相关脑机制的神经影像学meta分析”。
IF 4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-14 DOI: 10.1111/joor.70116

Chen TC, Lin CS. “Neuroimaging Meta-Analysis of Brain Mechanisms of the Association Between Orofacial Pain and Mastication,” J Oral Rehabil. 2023;50(10):1070–81.

In the published article, the affiliation for Ta-chung Chen was incorrectly listed. In addition to the first affiliation (1Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan), a second affiliation should also have been included (2Department of Dentistry, National Yang Ming Chiao Tung University, Hsinchu, Taiwan). The final correct version of the affiliation is as follows:

1Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan

2Department of Dentistry, National Yang Ming Chiao Tung University, Hsinchu, Taiwan

We apologize for this error.

陈振聪,林春生。口腔颌面部疼痛与咀嚼相关脑机制的神经影像学meta分析[J] .口腔康复杂志,2013;50(10):1070-81。在发表的文章中,陈大忠的所属机构被错误地列出。除了第一所属单位(1台北荣民总医院口腔修复科,台湾台北),第二所属单位也应包括在内(2国立阳明交通大学口腔学系,台湾新竹)。最终正确的隶属关系如下:1台湾台北市台北荣民总医院口腔科口腔修复科2台湾新竹国立阳明交通大学牙科科我们为这个错误道歉。
{"title":"Correction to “Neuroimaging Meta-Analysis of Brain Mechanisms of the Association Between Orofacial Pain and Mastication”","authors":"","doi":"10.1111/joor.70116","DOIUrl":"10.1111/joor.70116","url":null,"abstract":"<p>Chen TC, Lin CS. “Neuroimaging Meta-Analysis of Brain Mechanisms of the Association Between Orofacial Pain and Mastication,” <i>J Oral Rehabil</i>. 2023;50(10):1070–81.</p><p>In the published article, the affiliation for <b>Ta-chung Chen</b> was incorrectly listed. In addition to the first affiliation (<sup>1</sup>Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan), a second affiliation should also have been included (<sup>2</sup>Department of Dentistry, National Yang Ming Chiao Tung University, Hsinchu, Taiwan). The final correct version of the affiliation is as follows:</p><p><sup>1</sup>Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan</p><p><sup>2</sup>Department of Dentistry, National Yang Ming Chiao Tung University, Hsinchu, Taiwan</p><p>We apologize for this error.</p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513233","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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Journal of oral rehabilitation
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