Oral diseases最新文献

Objectives: Oral frailty, an intermediate stage between healthy and declined oral function, involves impairments such as tooth loss and chewing difficulty. Socioeconomic conditions may influence oral frailty risk. This study examined the socioeconomic inequalities in oral frailty and its components among older adults in Japan.

Methods: This cross-sectional study used 2022 questionnaire data from the Japan Gerontological Evaluation Study of adults aged ≥ 65 years. Dependent variables included oral frailty and its five components. Oral frailty was defined as having ≥ 2 of the following: fewer teeth, dry mouth, and difficulty in chewing, swallowing, or speaking. Independent variables were socioeconomic factors, comprising educational attainment, income, wealth, and pension type. Age and sex were adjusted as confounders. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were estimated after applying multiple imputation to address missing data.

Results: A total of 21,924 older adults were included. The prevalence of oral frailty was 33.6%. Significant inequalities were identified across all socioeconomic factors. Wealth showed the greatest inequality, with an adjusted SII of 0.17 (95% confidence interval (CI): 0.14-0.20) and RII of 1.66 (95% CI: 1.52-1.82).

Conclusions: Substantial socioeconomic inequalities in oral frailty were observed, with wealth being the most influential factor.

Objective: To assess the efficacy and safety of regenerative periodontal therapy (RPT) in recovery after impacted third molar extraction.

Methods: A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify eligible randomized controlled trials (RCTs) published from database inception to January 31, 2025. Pooled analyses were performed using a random-effects model. Effect estimates were reported as weighted mean difference (WMD) for continuous outcomes and odds ratio (OR) for categorical outcomes, both with 95% confidence intervals (CI).

Results: Thirty-two RCTs involving 1300 participants were included. Compared with conventional treatment, RPT significantly improved clinical outcomes, including greater clinical attachment level gain (WMD: 1.69; 95% CI: 1.13-2.25; p < 0.001), probing depth reduction (WMD: 1.13; 95% CI: 0.48-1.79; p = 0.001), and alveolar bone level gain (WMD: 1.31; 95% CI: 0.62-2.01; p < 0.001). The intervention demonstrated a comparable safety profile to the control group, with no statistically significant difference in adverse event risk (OR: 0.64; 95% CI: 0.34-1.19; p = 0.154). Subgroup analyses revealed significant heterogeneity in efficacy and safety across different regenerative protocols.

Conclusion: Current evidence indicates that RPT enhances periodontal tissue regeneration after third molar extraction, leading to improved clinical outcomes without increasing adverse events.

Trial registration: INPLASY: INPLASY202540109.

Objective: Botulinum toxin type A (BTXA) is widely used in oral and maxillofacial surgery to treat masseter hypertrophy and bruxism, inducing transient masseter atrophy, but the underlying mechanisms remain unclear. Mitophagy, essential for muscle fiber homeostasis, plays a critical role in muscle atrophy. This study aims to investigate whether mitophagy mediates BTXA-induced masseter muscle atrophy.

Methods: Rats received BTXA injections into masseter for 2 and 8 weeks. Muscle fiber composition was assessed via histology and immunofluorescence. Mitophagy markers (LC3-II, p62, beclin-1, Tomm20) were quantified by western blot. Mitochondrial function was evaluated via ATP content and mitochondrial DNA (mtDNA) copy number.

Results: BTXA injection led to transient masseter muscle atrophy. During this process, the proportion of type IIA muscle fibers significantly increased, while the proportion of type IIB fibers decreased. Additionally, at 2 weeks post-BTXA injection, the expression levels of LC3-II, p62, and beclin-1 were notably upregulated, whereas Tomm20 expression was downregulated. Furthermore, a significant reduction in ATP content and mtDNA copy number was observed at the same time point, indicating impaired mitochondrial function.

Conclusion: These findings suggest that mitophagy plays a crucial role in BTXA-induced masseter muscle atrophy, providing new insights into the mechanisms underlying BTXA treatment.

Objective: Periodontitis is the primary cause of tooth loss worldwide. This study aimed to identify herpes simplex virus (HSV) related biomarkers in periodontitis patients.

Methods: The present study used DIA-based liquid chromatography-tandem mass spectrometry to analyze the proteome of human gingival fibroblasts (HGFs) from one healthy donor across early and late stages (12-72 h) of HSV-1 infection.

Results: The study identified 890 differentially expressed proteins. At the early infection stage, there was a notable upregulation of proteins including interferon (IFN) regulatory factor 7, IFN-stimulated genes 15, interleukin 6 (IL6), toll-like receptor 2 (TLR2), and IFN-induced protein (IFI), alongside a downregulation of matrix metalloproteinase 2 (MMP2). We observed the activation of pathways, including the complement and coagulation cascades, lysosome, nucleotide-binding oligomerization domain-like receptors, retinoic acid-inducible gene I-like receptors, and TLR signaling pathways. Conversely, at the late stage, IFIs, IL1, and MMP3 were significantly upregulated, while complement proteins were downregulated. Biomarkers such as TLR2 may underscore the host's antiviral defense response to HSV-1 in the periodontal environment.

Conclusions: The present study identified several HGF proteins associated with periodontitis following HSV-1 infection, providing an analytical framework for determining the host's anti-viral defense response to antagonize HSV-1 infection in periodontal tissues.

Objective: This study aimed to explore the roles of Hedgehog (Hh) and platelet-derived growth factor receptor α (PDGFRα) pathways in regulating osteogenic differentiation of mesenchymal stem cells (MSCs).

Methods: An alveolar bone defect model was created by extracting the first upper molars of mice. Mouse alveolar bone-derived MSCs (mMSCs) were isolated to evaluate the effects of Hh/PDGFRα pathways on osteogenic differentiation. We constructed PDGFRα short hairpin RNA plasmids to knock down PDGFRα expression, and the effects of PDGFRα knockdown on the proliferation, migration, and osteogenic differentiation of mMSCs mediated by Hh were analyzed. Gelatin sponges were used as scaffolds to deliver mMSCs into tooth extraction wounds to study the effects of Hh/PDGFRα pathways on alveolar bone regeneration.

Results: The Hh pathway was activated during tooth extraction wounds healing. Hh upregulated PDGFRα expression in mMSCs (p < 0.05). PDGFRα knockdown weakened Hh signaling and its ability to enhance mMSCs' proliferation and migration (p < 0.05). Additionally, PDGFRα knockdown impaired the Hh pathway's effects on osteogenic differentiation (p < 0.01) and alveolar bone regeneration (p < 0.05).

Conclusions: The cross-talk of Hh/PDGFRα c regulates mMSCs' osteogenic differentiation to promote alveolar bone regeneration. Targeting Hh/PDGFRα signaling may provide intervention strategies for bone regeneration therapies.

Background: Actinic cheilitis (AC) is a sun-related oral potentially malignant disorder with no established optimal treatment. This systematic review aimed to evaluate the therapeutic efficacy of available treatments for AC.

Methods: Randomized Clinical Trials (RCTs) comparing AC treatments with placebo or other interventions were included. In February 2025, a literature search was conducted in PubMed, Cochrane Central, SciELO, ClinicalTrials.gov, Scopus, and Web of Science. Risk of bias was assessed using the RoB2 tool. A qualitative synthesis was performed for each clinical outcome.

Results: Eight RCTs, involving 230 participants, were included. Treatments assessed included daylight or conventional photodynamic therapy (PDT) with or without methyl aminolevulinate (MAL), imiquimod, and CO₂ laser, among others. The highest 3-month clearance rates were observed with MAL plus indoor daylight PDT, CO₂ laser, and electrodessication. At 6 months, the CO₂ laser remained most effective. Limitations include five trials with a high risk of bias and the inability to perform meta-analysis due to outcome measures heterogeneity and lack of standardized RCTs.

Conclusion: Due to limitations, the most effective AC treatment remains undetermined. Future research must improve methodology, assess standardized therapies, and include long-term follow-up to assess recurrences and malignant transformation.

Trial registration: PROSPERO: CRD42024561899.

Objectives: This scoping review aimed to evaluate the efficacy of different temporomandibular joint osteoarthritis (TMJOA) modeling methods in inducing condylar cartilage degeneration and subchondral bone loss in SD rats.

Materials and methods: PubMed, Embase, and Web of Science databases were searched for animal studies that established TMJOA models in SD rats and reported histological or micro-CT evaluation parameters. Two reviewers examined the methods and results sections of each selected study, performed methodological quality assessments, and extracted data.

Results: Fifty-seven studies met the eligibility criteria and were selected for analysis. The majority of these studies were rated as having a high risk of bias across the assessed domains. Three categories of TMJOA modeling methods (intra-articular injection, excessive mechanical loading, surgery) comprising fourteen specific techniques were identified and their data were analyzed.

Conclusions: At the early time, disc perforation could effectively induce subchondral bone loss, while monosodium iodoacetate (MIA) injection, over mandibular advancement, mandibular deviation, occlusal elevation, and excessive mouth opening could effectively damage both condylar cartilage and subchondral bone. At the long time, partial discectomy could effectively promote condylar cartilage degeneration, while MIA injection, unilateral anterior crossbite, and posterior occlusal disorder could effectively induce condylar cartilage degradation and subchondral bone loss.

Objective: This study aimed to translate, culturally adapt, and validate the Thai versions of the Chronic Oral Mucosal Disease Questionnaire-15 (COMDQ-15) and Oral Lichen Planus Symptom Severity Measure (OLP-SSM), assessing quality of life and symptom severity in oral lichen planus (OLP).

Methods: Following COSMIN guidelines, both original instruments were translated and culturally adapted into Thai. Psychometric evaluation, including structural validity, convergent and discriminative validity, and internal consistency, involved 203 Thai adults with OLP. Participants also completed psychological assessments (GAD-7, PHQ-9, PSS-10, B-IPQ), while clinicians rated disease activity of OLP using the OLP-DAS and OLP-IGA.

Results: Structural validity supported the original four-factor COMDQ-15 and unidimensional OLP-SSM structures, consistent with international findings. Content validity was excellent (CVI ≥ 0.96). Convergent validity showed moderate-to-high correlations between COMDQ-15 scores and psychological measures, and between OLP-SSM scores and clinical disease activity. However, discriminative validity was limited in distinguishing symptom severity states, likely due to mild-to-moderate disease severity among participants. Internal consistency was robust (COMDQ-15 α = 0.922; OLP-SSM α = 0.778).

Conclusion: The Thai COMDQ-15 and OLP-SSM are valid, reliable, and culturally appropriate tools for assessing symptom severity and quality of life in Thai OLP patients, enhancing clinical care and facilitating holistic disease management.

Objectives: To develop an automated system for generating standardized reports for oral potentially malignant disorders (OPMDs) from white-light images, aiming to reduce documentation workload, facilitate early intervention, and enable longitudinal lesion monitoring.

Methods: We proposed the SegORG model using 441 oral mucosa images and 1323 corresponding reports. It employed SegFormer for lesion segmentation; a visual encoder extracted global and local visual embeddings, which were projected into a pre-trained large language model (LLM feature) space via a lightweight visual mapper. The Qwen2.5-7B model then generated structured diagnostic reports, enhanced by text augmentation techniques to improve diversity and professionalism.

Results: SegORG achieved BLEU-4, ROUGE-L, and CIDEr scores of 0.291, 0.517, and 0.578, respectively. Additionally, the model obtained a clinical diagnostic F1-score of 0.695 and a median expert rating of 4 on the Likert scale (p < 0.001). It significantly outperformed conventional baseline models (R2Gen, METransformer, and SwinB+BERT9k) and contemporary general-purpose multimodal LLMs (GPT-4, Gemini 2.5 Pro, and Qwen2.5-VL), despite its lean architecture (90.4 M trainable parameters).

Conclusions: By enhancing visual feature extraction and achieving efficient text alignment, SegORG offers an effective technical pathway for OPMDs reports automation. While single-center validation shows promise, multicenter trials are needed to assess generalizability.

Background: Psoriasis and periodontitis are chronic inflammatory diseases fueled by immune dysregulation. This study investigated their association by evaluating periodontal parameters and tumor necrosis factor-alpha (TNF-α), interleukin-17A (IL-17A), and YKL-40 levels in gingival crevicular fluid (GCF) and serum.

Methods: Sixty individuals were assigned into three groups: healthy controls (C), periodontitis (P), and psoriasis with periodontitis (PS + P). Periodontal indices, including plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded. TNF-α, IL-17A, and YKL-40 concentrations in GCF and serum were analyzed using enzyme-linked immunosorbent assay (ELISA).

Results: Periodontal parameters were markedly higher in both periodontitis groups than in controls (p < 0.05). Serum TNF-α and IL-17A levels were highest in the PS + P group. GCF TNF-α was increased in both P and PS + P groups, while GCF IL-17A was elevated only in the P group. GCF and serum YKL-40 were elevated in both periodontitis groups, without a significant intergroup difference. GCF TNF-α correlated with PD (p < 0.001), CAL (p < 0.001) and PI (p < 0.001), while GCF YKL-40 correlated with CAL (p < 0.001) and BOP (p < 0.001). In the PS + P group, GCF YKL-40 also correlated with GCF TNF-α (p = 0.001) and IL-17A (p = 0.003).

Conclusion: These findings suggest a possible influence of psoriasis on periodontal inflammatory responses.