Oral health & preventive dentistry最新文献

Purpose: To examine the effect of adding increasing amounts of green tea extract (GTE) to a soft drink (Rivella) on dentin wear in an erosion-only model.

Materials and methods: The study consists of two experiments: In the first experiment, a total of 60 bovine dentin samples from 4 groups (n=15) were immersed in four Rivella variants: red, blue, green, and yellow. The samples were subjected to 4 cycles (per cycle: 10 min in the specified solution followed by rinsing with deionised water for 5 sec then storage 60 min in artificial saliva). In the second experiment, a total of 120 bovine dentin samples from 8 groups (n=15) were immersed in Rivella red with modified GTE concentrations (0.0; 0.05, 0.2, 0.4, 0.8, 1.0 or 1.2%). The cycle procedure was the same as in the first experiment. The measured dentin loss corresponded to the vertical shift on the y-axis between the baseline and the final profile after the wear process in 2D. Erosive dentin wear was measured by a stylus profilometer (µm). Data were analyzed using ANOVA followed by post-hoc pairwise comparisons and the p-values were adjusted after Holm.

Results: In experiment 1 the following dentin wear (mean ± SD) was observed: Rivella red: 2.7 ± 0.4 µm; Rivella blue: 3.1 ± 0.4 µm; Rivella green: 2.1 ± 0.4 µm; Rivella yellow: 2.1 ± 0.3 µm. While the first two differed significantly, the last two did not. In experiment 2 dentin wear (mean ± SD) was: Rivella+0% GTE: 3.6 ± 0.6) µm; Rivella+0.05% GTE: 3.6 ± 0.2) µm; Rivella+0.2% GTE: 3.4 ± 0.6) µm; Rivella+0.4% GTE: 3.1 ± 0.4) µm; Rivella+0.6% GTE: 2.6 ± 0.3) µm; Rivella+0.8% GTE: 2.6 ± 0.4) µm; Rivella+1.0% GTE: 2.2 ± 0.2) µm; Rivella+1.2% GTE: 2.1 ± 0.3) µm. A significant decrease in erosive wear with increasing amount of GTE was observed.

Conclusion: When increasing the addition of green tea extract to the soft drink Rivella, an almost linearly increasing protection against erosion can be observed in vitro.

Purpose: Given the emerging potential of bioactive, cell-free regenerative therapies, integrating exosomes into dental practice may provide a biologically driven, minimally invasive method to improve soft tissue healing and root coverage outcomes. Hence, this first case series aimed to clinically assess the efficacy and safety of exosome-enriched solid platelet-rich fibrin (Exos-solid-PRF) to treat gingival recessions.

Materials and methods: Twenty-seven patients (125 teeth) treated between January 2023 and July 2024 using a minimally invasive vestibular access technique with Exos-solid-PRF and liquid-PRF were included. Autologous PRF was prepared via horizontal centrifugation and hydrated with exosomes before surgical application. Clinical parameters, such as attachment gain (AG), keratinized tissue (KT), recession depth (RD), and recession width (RW), were measured at baseline and at a 6-month follow-up.

Results: According to the Cairo classification system for recession, out of 125 teeth, 23 (18.4%) were recession type 1 (RT1) and 102 (81.6%) were RT2. Statistically significant improvements were observed in AG (+0.46 ± 0.84mm), RD (-1.93 ± 1.05 mm), and RW (-1.43 ± 1.43mm), with a mean root coverage of 68% and complete root coverage in 34 teeth. RT1 cases demonstrated 86% coverage, and RT2 cases achieved 64%, exhibiting the regenerative potential of this novel therapy in treating both isolated and multiple adjacent gingival recessions, particularly in the esthetic zone.

Conclusions: While the outcomes for RT1 defects are comparable to those of gold-standard CTG approaches, the modest improvements in RT2 defects reflect both the potential and the limitations of this novel method. Additional controlled studies, long-term follow-up, and mechanistic investigations are required to validate these outcomes and optimize the therapeutic application of exosomes in clinical periodontology.

Purpose: To examine the cross-sectional association between LC9 and periodontitis using NHANES 2009-2014 data, while also investigating the roles of systemic inflammation and oxidative stress in this relationship.

Materials and methods: LC9 was calculated based on the 8 components of LE8 and the depression score assessed by the Patient Health Questionnaire-9. Periodontitis was assessed according to the CDC-AAP definition. Multivariable logistic regression and restricted cubic spline (RCS) analyses were used to explore the relationship between LC9 and periodontitis. Exploratory mediation analyses were performed to examine the roles of systemic inflammation and oxidative stress markers.

Results: A total of 7191 participants were enrolled, and 3540 had periodontitis. In the fully adjusted model, LC9 was inversely associated with the odds of periodontitis (OR per 10-point increase 0.85, 95% CI 0.80-0.90, p 0.0001). Compared to Q1, participants with LC9 at Q2, Q3, and Q4 had statistically significantly lower periodontitis prevalence (OR 0.78, 0.64, and 0.62, respectively; p for trend = 0.0001). Most LC9 component scores were inversely associated with periodontitis. RCS analysis showed that LC9 was linearly associated with the odds of periodontitis. Exploratory mediation analyses suggested that white blood cell count, neutrophil count, systemic immune-inflammation index, serum albumin, and uric acid may explain 32.53%, 24.05%, 3.64%, 10.70%, and 6.64% of this association, respectively. Stratified analysis showed that age, race, and marital status moderate the relationship between LC9 and periodontitis.

Conclusion: LC9 was linearly and negatively associated with the odds of periodontitis; systemic inflammation and oxidative stress markers may partially explain this association. These findings suggest that LC9 may serve as a valuable, comprehensive tool for assessing the likelihood of developing periodontitis, emphasizing that improving overall cardiovascular and mental health may be associated with lower prevalence of periodontitis.

Purpose: This study used data from the National Health and Nutrition Examination Survey (NHANES) to examine associations between the use of four illicit drugs (cocaine, heroin, marijuana, and methamphetamine) and the dental caries experience among adults in the US using the Decayed, Missing and Filled Teeth (DMFT) index.

Materials and methods: Data from NHANES 2017-2018, a cross-sectional study that included adults aged 18-69 years, was used in this study. A self-reported questionnaire was used to collect data related to drug use, and a calibrated dental examination was performed to diagnose caries. The associations among the illicit drug use, DMFT score, and score of each component were analyzed using zero-inflated negative binomial regression.

Results: Marijuana was the most commonly used drug among the participants (60.9%). In adjusted zero-inflated negative binomial models, current heroin was associated with fewer missing teeth (IRR= 0.50, 95% CI: 0.25 - 0.82) and former heroin use with fewer decayed teeth (IRR= 0.61, 95% CI: 0.41 - 0.97). The associations for marijuana and cocaine were not statistically significant after adjustment.

Conclusion: Illicit drug use shows heterogenous associations with the development of caries; however, the impact differs according to the type of drug. The findings of this study emphasize the requirement for comprehensive dental management and integration of substance-abuse screening within oral healthcare services.

Purpose: Persistent bacterial contamination of the root canal system, particularly by Enterococcus faecalis (E. faecalis) and Streptococcus mutans (S. mutans), remains a major obstacle in endodontic therapy. Sodium hypochlorite (NaOCl) is widely recognized as the gold-standard irrigant due to its broad-spectrum antimicrobial properties. However, its cytotoxicity has prompted the exploration of alternative or adjunctive disinfection methods, including ozone therapy, diode lasers, and photodynamic therapy (PDT). This study aimed to evaluate and compare the antimicrobial efficacy of NaOCl, ozone, diode laser, and PDT-used alone or in combination with NaOCl-against E. faecalis and S. mutans in vitro.

Materials and methods: Standard strains (E. faecalis ATCC 29212 and S. mutans ATCC 25175) were inoculated into 96-well microplates and exposed to the designated treatments following standardized protocols. In the combination groups, NaOCl was applied first, followed immediately by the secondary modality without rinsing. Colony-forming units (CFUs) were quantified by plating on Brain Heart Infusion agar and incubating under appropriate conditions. Statistical significance was assessed using the Kruskal-Wallis test with post-hoc pairwise comparisons (p 0.05).

Results: NaOCl, both alone and in combination, completely eradicated both bacterial species. Among the alternative methods, ozone gas and PDT statistically significantly reduced S. mutans counts but were less effective against E. faecalis. Diode laser and ozonated water exhibited minimal antimicrobial activity. No synergistic enhancement was observed in the combination groups.

Conclusions: NaOCl remains the most effective agent for root canal disinfection. Although ozone and PDT showed moderate efficacy-particularly against S. mutans-they may serve as adjunctive options when NaOCl use is limited. Further research is warranted to optimize these alternative approaches for clinical implementation.

Purpose: This study investigated the association between periodontitis and oral HPV infection, while exploring the role of oral bacterial microbiota diversity.

Methods and materials: Data from 4,685 adults in the NHANES 2009-2012 cycles were analysed. Periodontitis was defined based on clinical examination, and oral HPV infection was identified using PCR from oral rinse samples. Multivariable logistic regression models were employed to assess the relationship, adjusting for body mass index (BMI), age, sex, ethnicity, education, smoking, alcohol consumption, daily dental flossing, and history of systemic diseases. Subgroup analyses were stratified by age, sex, and education. Mediation analysis was performed to evaluate whether the oral microbiome acts as a mediator in the relationship between periodontitis and oral HPV infection.

Results: No statistically significant overall association was found between periodontitis and oral HPV infection (P > 0.05). However, females with moderate to severe periodontitis exhibited increased odds of oral HPV infection (P 0.05). Oral HPV infection was associated with greater microbial diversity (higher operational taxonomic units [OTUs]). No significant mediating effect of the oral microbiome was observed.

Conclusion: Moderate to severe periodontitis appears to be associated with higher odds of oral HPV infection in females. These findings highlight the potential relationship between oral health, microbial diversity, and oral HPV infection.

Clinical implication: In the general population, periodontitis does not appear to be a major risk factor for oral HPV; however, female with moderate to severe periodontitis and individuals with higher educati-on showed increased odds of oral HPV infection, suggesting that maintaining periodontal health may be particularly important for HPV related risk management in these subgroups.

Purpose: Vital pulp therapy (VPT) is a minimally invasive approach aimed at preserving pulp vitality in cases of caries or trauma. Despite advancements in diagnostic tools and bioactive materials, clinical practices vary significantly. This study explored the preoperative, intraoperative, and postoperative practices of dental professionals in Saudi Arabia regarding VPT, with a focus on diagnostic tools, rubber dam isolation, and material selection. The aim was to identify practice variability and evidence-based gaps and propose strategies to standardise care.

Methods and materials: A cross-sectional study was conducted among 302 dental professionals using a validated online questionnaire. Data collection spanned December 2024 to early March 2025. Descriptive statistics, non-parametric tests, including the Mann-Whitney U and Kruskal-Wallis tests, were employed to compare practices across groups, while binary logistic regression identified predictors of good knowledge (≥70%). A P value 0.05 was considered statistically significant.

Results: Preoperative practices highlighted frequent use of pulp sensibility testing (79.1%) and periapical radiographs (50%), with cold testing as the preferred method (52.6%). However, advanced tools like CBCT were underutilised. Intraoperatively, 67.2% consistently used rubber dam isolation, while calcium hydroxide (22.5%) was the most commonly used pulp capping material, despite increasing adoption of mineral trioxide aggregate (MTA) and biodentine. Postoperatively, 46% adhered to a 3-6 month follow-up interval, relying on cold testing and percussion for assessment. Logistic regression revealed postgraduate education, specialisation, and frequency of VPT procedures as significant predictors of evidence-based practices.

Conclusion: The findings highlight significant variability in VPT practices among dental professionals in Saudi Arabia, emphasising the need for targeted training programmes and standardised guidelines to bridge evidence-based gaps, improve clinical consistency, and optimise patient outcomes.

Purpose: This study aimed to evaluate antibiotic prescribing habits, guideline awareness, and allergy management practices among dentists performing oral surgical procedures in Turkey.

Materials and methods: A descriptive cross-sectional survey was conducted with 263 dentists between January and March 2025. A 25-item questionnaire collected data on demographics, prescribing criteria, prophylactic use, guideline adherence, allergy/hypersensitivity management, and educational needs. Ethical approval was obtained from the Ankara University Faculty of Dentistry Ethics Committee (Decision No: 7/1). The data were analysed via descriptive statistics and Chi-square tests (P 0.05).

Results: Penicillin-based antibiotics were most preferred (95.4%). Only 18.3% of the patients consistently followed clinical guidelines, and 16.0% referred patients for allergy testing. While 58.6% chose alternative antibiotics in suspected allergy cases, only 35.4% always informed patients about potential side effects. Awareness of national antibiotic guidelines was reported by 69.6%, but only 33.1% applied them. Statistically significant associations were found between professional title and both guideline adherence (P = 0.015) and monthly prescribing frequency (P = 0.018). Most dentists (77.9%) disagreed with stopping antibiotics when symptoms improved, preferring full courses.

Conclusion: Dentists in Türkiye frequently rely on empirical antibiotic prescribing in oral surgical procedures, with limited adherence to available clinical guidelines and insufficient attention to allergy management. Although awareness of antimicrobial resistance is relatively high, its translation into evidence-based practice remains inadequate. These findings emphasise the need for clearer national protocols, incorporation of antibiotic stewardship into dental education, and enhanced clinical training in allergy recognition to promote safer and more rational antibiotic use.

Purpose: To determine the frequency and factors associated with oral squamous cell carcinoma (OSCC) in the Peruvian population.

Materials and methods: This retrospective study (2013 to 2022) included data from clinical records of 416 patients from the Head-and-Neck and Oncology Services in two public hospitals in Lima. The primary variable included the presence, location, and degree of differentiation of OSCC with a confirmatory diagnosis from anatomy pathology. Secondary variables included demographic and health data. Comparisons were analyzed using prevalence ratios (PR) with 95% confidence intervals (CI) and statistical significance set at p 0.05.

Results: OSCC was identified in 169 cases (40.6%; 95% CI: 35.9‒45.4). Localization was frequently on the tongue (lateral border 34.5%, mobile 9.5% and base 7.1%), with a well- or moderately differentiated grade (97.4%). The presence of OSCC was similar in both sexes (1.2:1 ratio), was more prevalent in individuals aged 51 to 80 years (66.9%), retired (40.1%), born on the coast (66.7%) and diagnosed in 2018 and 2019 (30.8%). The PRs of OSCC were statistically significantly higher in men (palate: PR 2.77), patients >50 years (presence PR 1.54, lip: 5.28, moderately and well-differentiated: PR 1.11), retired persons (lip: PR 5.52), and those born in the highlands (lip: PR 2.4) (p ≤ 0.04).

Conclusion: OSCC was frequent in cases of suspected oral cancer, and more frequently affected the tongue, was well- or moderately differentiated, and associated with the demographic factors of sex, age, occupation, and region of birth.