Oral diseases最新文献

Background: Pediatric Sjögren's syndrome (pSS) diagnosis remains challenging due to its low prevalence, heterogeneous clinical presentation, and the lack of universally accepted pediatric-specific diagnostic criteria. This systematic review aims to clarify the diagnostic pathway in pSS, with emphasis on the utility of minor salivary gland biopsy.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched up to November 2025. Observational, retrospective, cohort, cross-sectional studies, case series, and case reports were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

Results: Thirty-nine studies met the inclusion criteria. Recurrent or persistent parotitis emerged as the most frequent glandular manifestation. The most common extra-glandular features included joint involvement and lymphadenopathy. Serological analysis revealed positivity for anti-SSA in 64% and anti-SSB in 51% of cases, with antinuclear antibodies and rheumatoid factor detected in 69% and 53% of patients, respectively. Minor salivary gland biopsy yielded positive findings in approximately 70% of cases.

Conclusions: Minor salivary gland biopsy appears to represent a key component of the diagnostic work-up, particularly in the absence of standardized pediatric criteria. When integrated with clinical and serological findings, it may facilitate earlier and more accurate diagnosis.

Objective: Periodontitis is a chronic inflammatory disease affecting tooth-supporting tissues, primarily due to bacterial plaque and host response. Traditional therapy relies on oral hygiene instruction (OHI) and risk factor control, though adherence is challenging. This randomized controlled trial aimed to evaluate the effectiveness of Medical Coaching on Oral Health (MCOH) in improving plaque control (PCR) and gingival bleeding index (GBI) after 1 month, compared to conventional OHI.

Materials and methods: Sixty-four patients with periodontitis at the University Hospital of Bari (Italy) were randomized into MCOH (n = 32) and control (n = 32) groups. Baseline assessments included periodontal status, PCR, GBI, and a lifestyle questionnaire (smoking, alcohol, nutrition, physical activity, sleep, stress). The MCOH group received personalized sessions, including goal-setting, emotional barrier assessment, and action planning, while the control group received standard OHI.

Results: After 4 weeks, the MCOH group showed greater improvements in GBI (-47.5 vs. -24.5, p < 0.001) and PCR (-44.0 vs. -32.0, p = 0.003). The composite clinical outcome was significantly higher in the MCOH group (75.0% vs. 34.4%, p = 0.001). Lifestyle improvement, particularly smoking cessation, alcohol reduction, and stress management, was greater in the MCOH group. MCOH improved periodontal outcomes and promoted healthier lifestyle behaviors compared to OHI.

Registration: NCT06887946.

Aims: The oral microbiome is at the frontline for environmental exposure and plays an important role in human metabolism. This study explores the relationship between PM_2.5 exposure, the oral microbiome, and metabolic biomarkers including ghrelin, resistin, and insulin.

Methods: Data from 473 adult participants (97.7% Black; median age: 53.6) were analyzed. PM_2.5 exposure was retrospectively assigned based on residential addresses, metabolic biomarkers were measured from blood samples, and oral microbiome profiles were obtained from saliva samples. Multivariate linear regression, weighted quantile sum regression, and high-dimensional mediation analysis were employed to estimate microbiome-biomarker associations, the association of the oral microbiome mixture, and mediation effects for PM_2.5 exposure.

Results: A total of 20 oral microbiome taxa were significantly associated with at least one biomarker, with genus Atopobium linked to all three. Insulin demonstrated the strongest sensitivity to the oral microbiome influence. Genera in phyla Actinomycetota and Bacillota played key roles in the relationship between the oral microbiome and metabolic biomarkers. Mediation analysis revealed that the oral microbiome mediated 16.5% and 11.1% of PM_2.5's associations with resistin and insulin, respectively.

Conclusion: This study suggests potential mechanisms regarding how the oral microbiome influences metabolic biomarkers and mediates the metabolic effects of PM_2.5 exposure.

Objective: To systematically evaluate rehabilitation interventions for oral cancer patients with trismus and clarify effects on trismus.

Materials and methods: A comprehensive search for randomized controlled trials and quasi-experimental studies published up to November 28, 2024, was conducted across PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang using the PICOS strategy. The primary outcome was mouth opening distance. Two authors independently assessed risk of bias and methodological quality using the Cochrane Handbook (version 5.1.0) and ROBINS-I. The study protocol was registered with PROSPERO (CRD42024613003).

Results: The review included 15 articles, including eight randomized controlled trials and seven quasi-experimental studies. There were variations in the timing and type of rehabilitation. Most interventions started 2-3 weeks post-surgery. Three types of interventions, including exercise training, physical therapy, and speech training, improved trismus.

Conclusion: Rehabilitation interventions are often used in combination, but the effectiveness of individual interventions remains unclear. Physical therapy has been shown to alleviate pain, while remote reminders can enhance adherence. Only a basic consensus on rehabilitation interventions can be summarized due to design differences. Future research should focus on conducting rigorous trials to provide more conclusive evidence.

Aim: To evaluate whether periodontal parameters and tooth loss are associated with lung cancer incidence and mortality among older adults.

Materials and methods: Data are from the Health, Aging and Body Composition (Health ABC) study, which included 1136 older adults who received a periodontal examination and were followed for up to 16 years. Pocket depth and clinical attachment level were assessed for all present teeth. Adjusted Cox regression models were used to examine the relationship between periodontal parameters and number of natural teeth with lung cancer incidence and mortality.

Results: Lung cancer incidence was 4.4% (n = 50) and was identified as cause of death in 3.3% (n = 38). Those presenting at least 10% of sites with probing depth ≥ 6 mm demonstrated a higher risk of lung cancer and death due to lung cancer (hazard ratio [HR]: 3.12, 95% confidence interval [CI]: 1.45-6.72 and HR: 3.08, 95% CI: 1.27-7.46), respectively. Tooth loss was associated with a reduced hazard of lung cancer incidence (HR: 0.96; 95% CI: 0.93-0.99) and related mortality (HR: 0.96; 95% CI: 0.92-0.99).

Conclusion: The association between severe periodontal disease parameters and tooth loss with lung cancer among older adults underscores the importance of oral health maintenance for cancer prevention strategies.