Oral health & preventive dentistry最新文献

Purpose: With the increasing use of artificial intelligence (AI) in dentistry, it is feasible to self-monitor oral health using Oral Health AI Advisors (OHAI Advisors). This technological advancement offers the potential for early detection of oral diseases and facilitates early prevention. This systematic review aimed to evaluate the effectiveness of OHAI Advisors as a tool in preventive dentistry for the general population.

Materials and methods: Standardised searches were performed and screened across four electronic databases. The primary outcomes were changes in clinical and behavioural measures, and evidence was synthesised. The quality of the included studies was assessed.

Results: The initial search identified 1639 articles, 64 full texts were reviewed, and four studies were included in the analyses. Qualitative synthesis revealed that short-term use of OHAI Advisors, for up to 6 months, statistically significantly reduced plaque and gingival index scores. Combining OHAI Advisors with verbal counseling enhanced their effectiveness. No studies investigated effects on oral health awareness, behavioural changes, or adherence to regular practice. The risk of bias in the included studies was moderate to low.

Conclusion: OHAI Advisors appear to be effective for short-term oral hygiene maintenance. Further research is necessary to determine the preventive capability, focusing on assessing long-term outcomes on oral health and any changes in oral health behaviour.

Purpose: The aim of the present systematic review and meta-analysis was to assess the efficacy of non-surgical periodontal therapy (NSPT) with adjunct photodynamic therapy (aPDT) in reducing periodontal inflammation and haemoglobin A1c (HbA1c) levels in patients with diabetes mellitus (DM).

Materials and methods: The focused question was 'Does NSPT with adjunct aPDT help reduce periodontal inflammation and HbA1c levels in patients with DM?' The PICO (patient/population, intervention, comparison and outcomes) was formatted as follows: Patients (P): Participants diagnosed with DM; Intervention (I): NSPT with adjunct PDT for the treatment of periodontitis; Control (C): NSPT alone or NSPT with adjunct systemic antibiotic therapy; and Outcome (O): Changes in HbA1c levels. The inclusion criteria comprised RCTs specifically evaluating the impact of NSPT on HbA1c levels in diabetic patients, with a specific focus on interventions involving NSPT with and without adjunct aPDT. The literature search was performed in accordance with the Preferred reporting items for systematic reviews and meta-analysis. Indexed databases were searched without time and language restrictions using various keywords. Forest plots were created to illustrate the effects of the different studies and the global estimation.

Results: Five RCTs were included and processed for data extraction. The number of participants ranged from 12 to 45 patients with medically diagnosed type-2 DM. In all RCTs, aPDT was done using a diode laser with wavelengths ranging between 660 and 810 nm. Three and two RCTs had moderate and high RoB, respectively. In two RCTs, NSPT with adjunct aPDT reported no improvement in clinical periodontal parameters. Two studies reported that NSPT with adjunct aPDT significantly reduces periodontal probing depth compared to NSPT alone. Four of the five RCTs reported that NSPT+PDT does not influence HbA1c levels.

Conclusions: NSPT with or without adjunct aPDT does not affect HbA1c levels in patients with type-2 DM.

Purpose: Resins composites are widely used in modern dentistry because of their aesthetic and physical properties. However, discoloration of anterior tooth restorations is a common complaint. Understanding the factors affecting the colour stability of resin composites can lead to longer-lasting repairs. This study aimed to evaluate and compare the colour changes of nanocomposite-based bulk-fill and universal resin composites after immersion in coffee using various polishing systems.

Materials and methods: A total of 160 samples were prepared using four different composite groups, with 40 pieces for each combined group. Based on the finishing procedure, the samples were divided into four subgroups for each composite group. Three different polishing procedures were applied to the samples according to the manufacturer's instructions. The control group was not subjected to any treatment. Initial colour measurements were performed using a VITA Easyshade V spectrophotometer. After the initial measurements, the samples were immersed in a Nescafe coffee solution for seven days, followed by colour measurements. Data were analysed using the Kolmogorov-Smirnov test and two-way analysis of variance. Tukey's honest significant difference (HSD) test was used to determine differences between subgroups.

Results: The results indicate that bulk-fill resins exhibit more discolouration than universal composites; however, this difference was not statistically significant. The resin group with the smallest discolouration was Ceram X, and the most effective polishing method was Twist polishing.

Conclusion: Final surface polishing significantly reduced the composites' discolouration. These findings support the selection of appropriate materials and polishing techniques to achieve aesthetic outcomes and colour stability in dental restorations.

Dental caries, one of the most prevalent diseases globally, affects individuals throughout their lifetimes. Recently, researchers have increasingly focused on postbiotics for caries prevention. Postbiotics, comprising inanimate microorganisms and/or their components, confer health benefits to the host. Growing evidence suggests postbiotics' potential anticaries effects. Specifically, numerous postbiotics have demonstrated the ability to inhibit dental caries onset and progression by modulating oral flora microecology and reducing human caries susceptibility. This review elaborates on the current research regarding postbiotics' anticaries effects, highlights some studies' shortcomings, and innovatively proposes that postbiotics could potentially influence tooth development and salivary characteristics through epigenetic modifications. Furthermore, it anticipates postbiotics' future application in personalised caries treatment, given their multifaceted anticaries potential.

Purpose: To evaluate the antimicrobial effect of a new active oxygen fluid (Blue®m) as a root canal irrigant against Enterococcus faecalis compared to sodium hypochlorite (NaOCl).

Material and methods: Forty-five extracted single-canaled human teeth were selected, received root canal preparation, autoclaved, and contaminated with Enterococcus faecalis. The specimens were randomly allocated into three groups: Group (A) served as the negative control, receiving irrigation with saline (n = 15); Group (B) was irrigated with 5.25% NaOCl (n = 15); and Group (C) was irrigated with 10 mL of Blue®m (n = 15). Microbial sampling from the root canals was performed before and after irrigation. The difference between the pre-irrigation and post-irrigation colony-forming units (CFU/mL) was calculated. The data was analysed using a one-way ANOVA followed by post-hoc Tukey tests. The significance level was set at 5%.

Results: Blue®m statistically significantly reduced the bacterial load compared to saline (p = 0.009), but NaOCl was most effective, outperforming both (p 0.0001).

Conclusion: Irrigation with Blue®m demonstrated antibacterial efficacy against Enterococcus faecalis, but it was not as effective as NaOCl.

Purpose: Nonsurgical root canal therapy (NSRCT) is indicated for management of permanent teeth diagnosed with symptomatic irreversible pulpitis. However, recent research has suggested that vital pulp therapy (VPT) may be a less invasive option in these cases. The purpose of this systematic review was to evaluate the outcomes of VPT, using hydraulic calcium silicate cements (HCSCs) including complete and partial pulpotomies in permanent posterior teeth with symptomatic irreversible pulpitis.

Materials and methods: The PRISMA recommendations were adhered to. The search approach used electronic databases from PubMed, EMBASE, the Cochrane Library, and grey literature. The Newcastle-Ottawa Scale, ROBINS-I, and Cochrane Collaboration Risk of Bias tools were used to evaluate the quality of the selected studies.

Results: The initial database search turned up 142 papers, of which 3 prospective cohort studies and 9 randomised controlled trials were selected for analysis. For three, seven, and two articles, the risk of bias was rated as 'high' or 'serious,' 'fair,' and 'low,' respectively. The success rates for VPT using HCSCs typically ranged from 78% to 90% one to five years following VPT. The results of the VPT and NSRCT were equivalent at one and five years, according to two articles. Although the intra-operative pulp assessment is essential for VPT treatments, most studies did not provide a thorough account of this process or the time required to achieve haemostasis. Three studies reported sample sizes that were 23 teeth. The 12 studies that were analysed revealed successful VPT procedures using HCSCs in permanent posterior teeth that had symptomatic irreversible pulpitis, with radiographic success rates ranging from 81% to 90%. Two articles claimed that the results of VPT and root canal therapy were equivalent.

Conclusion: When considering VPT as an alternative to NSRCT, appropriate case selection and outcome criteria must be created. This data highlights the need for additional studies contrasting the longer-term effects of different treatment regimens.

Purpose: To find an association between oral mucosal human papilloma- and/or Epstein-Barr (HPV, EBV) virus infection in patients with dry mouth and/or Sjögren's syndrome (SS) compared to healthy controls and to find connections with salivary gland histopathological alterations.

Materials and methods: Ninety-two participants were divided into four groups: 1. healthy controls (n = 32); 2. xerostomia (n = 28); 3. hyposalivation (n = 22); and 4. SS groups (n = 10). To detect virus infection brush biopsy was outlined in all groups. Detections of virus-specific sequences were achieved with polymerase chain reaction (PCR). Lip biopsy and histopathological assessment was performed in groups 2, 3 and 4.

Results: HPV positivity of oral mucosal cells was shown in group 1: 1 (3.12%); group 2: 3 (10.7%); group 3: 2 (8.26%); and in group 4: 0 of the samples. EBV was present in group 1: 14 (43.7%); group 2: 17 (60.7%); group 3: 6 (27.3%); and in group 4: 5 (50%) of the cases. There was no statistically significant difference between the attributes. Intact salivary gland in 28.2%, chronic sialadenitis in 28.2%, stromal fibrosis in 6.5%, lipomatous atrophy in 8.6%, fibrous atrophy in 6.5% and positive focus score (SS) in 26.1% were found in the subjects. Neither HPV nor EBV infection caused statistically significantly more histological abnormalities.

Conclusion: Orofacial mucosal HPV and/or EBV DNA rates did not differ statistically significantly in patients with xerostomia or hyposalivation or SS compared to healthy controls, therefore, it cannot prove the provocative role of these viruses in dry mouth and/or SS. Neither dry mouth nor SS were accompanied by statistically significantly more salivary gland alterations in HPV- and/or EBV-positive subjects; these alterations are frequent in the virus-negative cases too.

Periodontitis is associated with numerous systemic diseases, and it has been shown that these associations are partly causal in nature. It is assumed that such interactions between periodontal and systemic diseases are also medi- ated via adipokines. Apelin, an adipokine about which there is little research in the dental field, is also produced together with its receptor in periodontal cells. The aim of this review was to summarize the currently available literature on the apelin-APJ system to better understand the pathomechanistic relationship between periodontitis and obesity and to de- termine the potential clinical relevance of apelin for diagnostics and therapy. In vitro studies suggest that apelin can en- hance bacterial-induced synthesis of proinflammatory and proteolytic molecules, indicating a significant etiopathogenic role of this adipokine. Since serum levels of apelin are elevated in diabetes and/or obesity, it is possible that such sys- temic diseases promote the development and progression of periodontitis via apelin. On the other hand, it is also conceivable that apelin from the periodontium influences such systemic diseases. Further research is needed to better understand the role of apelin in the periodontium and the entire oral cavity, but also in the interactions between periodontal and sys- temic diseases. In particular, clinical intervention studies are needed to further decipher the etiopathogenic role of apelin in periodontitis.

Purpose: This study aimed to evaluate the relationship between depression and social appearance anxiety in young female patients who applied for aesthetic dental treatment.

Methodology: The study was conducted in a single centre and included 56 female patients aged 18-35 years. The mean age of the participants was 22.27 ± 5.62 years. Participants were informed before treatment, and the Beck Depression Inventory (BDI), Social Appearance Anxiety Scale (SAAS), and Visual Analogue Scale (VAS) were administered. Immediately after the treatment and 1 month later, the SAAS and VAS were administered again. The Kruskal-Wallis test was used for the comparison of the data obtained and the Friedman test was used for temporal comparison. Multiple comparisons were made with Dunn's test.

Results: After aesthetic dental treatment, all participants' satisfaction with the appearance of their teeth increased, and social appearance anxiety decreased (p 0.001). The group with the lowest pretreatment satisfaction level was the group with moderate/high-level depressive symptoms. There was no correlation between the severity of depression and the increase in satisfaction after treatment (r = 0.247; p = 0.066). Satisfaction levels were similar in all depression groups after treatment. The group with the highest level of social appearance anxiety before and after treatment was the group with moderate/high-severity depressive symptoms. A moderate positive correlation was found between depression severity and social appearance anxiety (r = 0.4; p = 0.002).

Conclusions: The severity of depressive symptoms seen before treatment does not affect the level of satisfaction after treatment. There is a decrease in social appearance anxiety after aesthetic dental treatment. There is a positive relationship between social appearance anxiety and depression severity.

Purpose: This study aimed to develop a systematic interdental brush set with size distribution based on the passage hole diameter (PHD), addressing existing gaps in size selection criteria for effective interdental cleaning.

Materials and methods: In the first step, an interdental brush set that ascends stepwise according to the PHD value was envisioned. The study was divided into three phases: (i) in-vitro determination of PHD values of a currently existing assortment on the market by 13 calibrated dental professionals, (ii) in-vitro assessment of forces during insertion, and (iii) creation and evaluation of new prototypes for missing or non-matching PHD sizes. Intra- and inter-rater reliability, assessed with the intraclass correlation coefficient (ICC), as well as insertion forces and PHD sizes at all stages were reported.

Results: In the existing range, three interdental brushes fitting the desired PHD sizes were initially identified. Mean insertion forces between 0.3 and 1.7 N were documented based on raters' PHD choices. Two additional rounds of measurements with prototypes adapted in diameter and shape were necessary, particularly for PHD values of 1.4, 2.3 and 2.6. High intra- and inter-rater reliability was observed throughout the study (ICC > 0.95), ensuring consistent evaluations. After three rounds of assessments, a prototype was successfully identified for each targeted PHD value in the systematised set, showcasing reliable sizing and insertion forces.

Conclusion: Using a structured approach, a comprehensive interdental brush set was developed with reliable PHD sizing and moderate insertion forces. The verification of size reliability through measurements by dentists represents a novelty in development and underlines the importance of accurate brush size selection for optimal biofilm control. Whether a systematic set based on the PHD value offers added value for clinical practice, and at what intervals, must be demonstrated in further studies.