Oral health & preventive dentistry最新文献

Purpose: To assess children's OHRQoL and associated factors among a sample of children with special needs in Riyadh, Saudi Arabia.

Materials and methods: A sample of 6- to 12-year-old children was obtained using convenience sampling from rehabilitation centers. Data were collected through a questionnaire and dental examination. The questionnaire included items related to the children's and their families' characteristics, oral health-related quality of life scales (Parental-Caregivers Perceptions Questionnaire [P-CPQ] and Family Impact Scale [FIS]), perceived health status, and dental care utilisation. Clinical examination was performed by a trained and calibrated dentist. The data were analysed using SPSS; descriptive and inferential data analyses were also performed using SPSS.

Results: The mean P-CPQ was 1.10 ± 0.74, and the mean FIS was 1.39 ± 0.88. There was a statistically significant correlation between P-CPQ and caries (r = 0.36, p = 0.02). After controlling for confounders, caries was associated with poor P-CPQ (B = 0.06, p = 0.024). Compared to low-income families, higher-income families had better P-CPQ (4000-8000 SAR: B = -1.36, p = 0.001).

Conclusion: Poor oral health-related quality of life in Saudi children is associated with caries and low income. Preventive measures addressing social determinants are vital to control caries and promote oral health in children with special health-care needs.

Purpose: This in-vitro study aimed to investigate the cleaning efficacy of 18 different manual children's toothbrushes applying horizontal, vertical, and rotational movements, as well as to evaluate the rounding of their filament ends.

Materials and methods: Models equipped with artificial teeth (coated with titanium dioxide) were brushed using a brushing machine with clamped manual children's toothbrushes. The machine carried out horizontal, vertical, and rotational movements for 1 min with a constant contact pressure of 100 g. The percentage of the area of titanium dioxide removed from the buccal, mesial, distal and total surfaces of the artificial teeth corresponded to the cleaning efficacy. To assess the filament design, a scanning electron microscope was used to check the morphology of the filaments which was scored with Silverstone and Featherstone scale. SPSS 22 was used for data analysis.

Results: The rotational and the vertical movements achieved the best cleaning efficacy with all tested toothbrushes. The vast majority of the tested toothbrushes had their poorest cleaning efficacy in the horizontal movement. Only a small part of the children's toothbrushes (3 out of 18) had a correct and acceptable proportion of rounded bristle ends.

Conclusions: Based on the present results, it could be concluded that the cleaning efficacy of different manual children's toothbrushes varied considerably. The best cleaning efficacy was almost always observed for rotational and vertical movements.

Purpose: Gingivitis and periodontitis are oral disorders characterised by chronic inflammation, impacting the supportive structures around teeth due to bacterial accumulation. While the role of inflammation in both periodontitis and dry eye disease (DED) has been established individually, their potential association remains unclear. This study aimed to investigate the association between periodontitis and the manifestation of signs and symptoms related to DED in patients aged 18-40.

Materials and methods: A cross-sectional study was conducted involving healthy controls, DED patients with or without periodontitis, and patients with periodontitis without DED. Ophthalmic and oral examinations were performed, and demographic, ocular, and systemic disease data were collected. Statistical analysis was conducted using ANOVA and chi-squared tests.

Results: A total of 684 participants were included in the study. Significant elevations in tear osmolarity levels, increased Ocular Surface Disease Index scores (OSDI), and decreased tear break-up time (TBUT) and Schirmer (ST-I) values were observed in DED patients with periodontitis compared to individuals with DED but without periodontitis, as well as control and periodontitis groups. Furthermore, higher neutrophil-to-lymphocyte ratios (NLR) were found in DED patients with periodontitis.

Conclusion: The findings suggest an association between periodontitis and the severity of signs and symptoms related to DED. The study highlights the importance of interdisciplinary approaches in understanding the systemic implications of periodontal disease and its potential impact on ocular health.

Purpose: To assess the prevalence and configuration of bifid (BMC) and trifid (TMC) mandibular canals using computed tomography (CT), describing the anatomical characteristics of the accessory canals, especially of the retromolar type.

Materials and methods: CT scans of 123 patients were analysed. BMCs were identified and the patterns of bifurcation were classified, including trifid canals. The width of accessory canals was measured. Retromolar canals were further classified according to their course and morphology, while their position and width were evaluated using linear measurements on CT images.

Results: The majority of patients (53.6%) presented at least one BMC or TMC. 36.2% of mandibular canals were bifid, while 4.5% were trifid. The forward canals (12.6%) and retromolar canals (10.2%) were the most common among BMCs. In relation to the retromolar canals, 60% were vertical and 40% curved, with a mean width of 1.03 ± 0.28mm.

Conclusion: BMCs and TMCs are common 3D radiographic findings, so that they should be considered as anatomical variations, not anomalies. Preoperative CT or CBCT evaluation should aid in identifying these variations and analysing their position and course in surgical planning.

Purpose: To compare the regenerative clinical and radiographic effects of cross-linked hyaluronic acid (xHyA) with enamel matrix proteins (EMD) at six months after regenerative treatment of periodontal intrabony defects.

Materials and methods: Sixty patients presenting one intrabony defect each were randomly assigned into control (EMD) and test (xHyA) groups. Clinical attachment level (CAL) gain was the primary outcome, while pocket probing depth (PPD), gingival recession (REC), bleeding on probing (BOP), full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and radiographic parameters such as defect depth (BC-BD), and defect width (DW) were considered secondary outcome variables. Parameters were recorded at baseline and after 6 months.

Results: At the 6-month follow-up, 54 patients were available for statistical analysis. In the control and test groups, the mean CAL gain was statistically significant in the intragroup comparison (p < 0.001). 48.1% of test sites showed a CAL gain ≤ 2 mm compared with 33.3% of control sites. The mean PPD reduction was statistically significant in the intragroup comparison in both groups (p < 0.001). The mean REC increase was similar in the two groups: 1.04 ± 1.29 mm vs 1.11 ± 1.22 mm (test vs control). The mean BC-BD, DW, FMPS, FMBS, and BOP changed statistically significantly only in the intragroup comparison, not in the intergroup comparison.

Conclusion: Both treatments, EMD and xHyA, produced similar statistically significant clinical and radiographical improvements after six months when compared with baseline.

Purpose: To study the clinical and pathological characteristics of oral lichen planus (OLP) in a large sample.

Materials and methods: A comprehensive analysis was conducted on 105 patients with oral lichen planus (OLP), considering various factors including sex, age, disease site, lesion type, lesion area, morphological characteristics, self-reported symptoms, and history of systemic diseases. Histopathological examination was performed for each patient, and the pathology results were analysed according to sex and age group.

Results: 70.5% of the OLP patients were female, and OLP was most likely to occur in the cheek, followed by the tongue, lips, gums and palate. The patients with moderate pain according to the VAS score accounted for 60%. Thirty-nine percent of the OLP patients had a systemic disease, and the most common clinical type of OLP was nonerosive. Most of the pathological results showed liquefaction degeneration of basal cells and infiltration of lamina propria lymphocytes. There was no statistically significant difference in pathological manifestations between male and female patients, and there were statistically significant differences in pathological manifestations among different ages patients.

Conclusion: This study analysed the sociodemographic data and clinical manifestations of 105 OLP patients to guide follow-up treatment planning and disease monitoring. Moreover, pathological manifestations should be analysed to avoid delayed treatment and to monitor for carcinogenesis. Furthermore, the correlation of pathological manifestations among OLP patients with different sexes and ages is conducive to further research on the specific differential manifestations and possible underlying mechanisms involved.

Purpose: This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders.

Materials and methods: One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups.

Results: TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months).

Conclusion: The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.

Purpose: To assess adherence to follow-up maintenance visits among patients who had previously undergone crown-lengthening surgery and investigate the different factors impacting their compliance.

Materials and methods: A total of 314 patients were identified for follow-up appointments. Based on their responses, participants were categorised into four groups: attendees, non-attendees, refusals, and unreachable. Furthermore, data on sociodemographic factors (age, sex, nationality, marital status, education, occupation, and residential area), medical history, dental history (including missing teeth, implants, or orthodontic treatment history), and past appointment attendance (average yearly appointments, missed appointment percentage, and last appointment date) were collected and analysed to understand their influence on patient compliance.

Results: In a sample of 314 patients, 102 (32.5%) attended the appointments successfully. Improved attendance rates were significantly associated with being female, Saudi Arabian, married, and employed (p < 0.05). Moreover, patients with a high frequency of annual appointments and a recent history of appointments exhibited better compliance. None of the analysed dental factors affected the attendance rates.

Conclusion: About one-third of patients who had undergone crown lengthening surgery were compliant with the follow-up visits. Different factors influenced this compliance pattern to varying extents, with more efforts needed to enhance patients' commitment to these visits.

Purpose: To investigate parental perceptions of comprehensive dental care under general anesthesia for their children.

Materials and methods: The study included parents of children who underwent comprehensive dental care under general anesthesia. Only parents who could communicate in English were included. They were invited to participate in a telephone interview within four weeks of their children's dental treatment under general anesthesia. The interviews were designed to gather information on three main domains: problems experienced before the operation, children's well-being after the operation, and satisfaction.

Results: A total of 45 parents participated in the study; 91.1% identified as women and 8.8% as men. Most parents resided in areas categorised as either more deprived (51%) or most deprived (24.4%), based on deprivation indices. Prior to surgery, 66.7% of children suffered from dental pain, 44.4% were affected by dental abscesses or facial swelling, 42.2% experienced difficulties with eating and drinking, while 37.8% experienced sleeping difficulties. Painkillers were used for a short duration to manage post-operative pain (48.9%). Four weeks after the operation, many parents reported improvements in their children's mouth comfort. They observed positive changes in their children's ability to eat (40%), sleep habits (33.3%), and overall health and well-being (82.2%). Overall, most parents expressed high levels of satisfaction with the care their children received (95.5%).

Conclusion: Parents observed improvements in their children's oral health and reported high level of satisfaction with the procedures.

Purpose: To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT).

Materials and methods: Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events.

Results: Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies.

Conclusion: There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO.