Oral health & preventive dentistry最新文献

Purpose: To investigate the impact of manual toothbrush usage duration and associated wear on cleaning performance in a tooth model with fixed orthodontic appliances.

Materials and methods: Black resin teeth with attached brackets were coated with a white layer of titanium dioxide and subjected to brushing using a brushing machine. Two distinct brushing motions, horizontal and circular, were tested. Following each brushing session, the percentage of cleaned areas (total and adjacent to the bracket) was measured to determine the cleaning performance of the toothbrushes. Usage was simulated using a 3D-printed tooth relief with brackets and wire. Cleaning performance was re-evaluated after simulated 2, 4, 6, 12, 18 and 24 months of usage, and toothbrush wear was quantified respectively.

Results: Cleaning performance of all investigated brushing motions and tooth areas improved during the test period, although statistical significance was only reached for horizontal brushing. Furthermore, horizontal brushing proved more effective regarding total tooth area and the area adjacent to the bracket compared to circular brushing.

Conclusion: This in-vitro data shows that toothbrushes may feature sufficient or even improved cleaning performance on teeth with orthodontic appliances even after 24 months. However, direct transferability into the clinical setting is limited, as in-vivo toothbrush wear is complex and depends on individual patient habits, and other factors might necessitate an earlier toothbrush change. Nevertheless, this study suggests that cleaning performance and thus oral hygiene in patients with orthodontic appliances may not be critically dependent on usage duration and visual appearance of the toothbrush itself.

Purpose: Several studies have established a significant association between periodontal diseases and adverse pregnancy outcomes, such as preterm birth, low birth weight and preeclampsia. Despite this, awareness among pregnant women, particularly in developing countries, remains insufficient, potentially impeding the adoption of preventive measures. This study aimed to evaluate the knowledge of pregnant women in Ivory Coast regarding the association between periodontal diseases and adverse pregnancy outcomes.

Materials and methods: This cross-sectional study included pregnant women attending antenatal clinics in the gynecology-obstetrics department of the Cocody University Hospital in Ivory Coast. A questionnaire was distributed to assess sociodemographic characteristics and knowledge about the relationship between periodontal diseases and pregnancy complications. Data were analysed using the chi-squared test, with the level of significance set at p 0.05.

Results: The study sample included 338 pregnant women with an average age of 30.78 years (± 5.90). Of these, 24.26% were aware that periodontal disease could induce complications in pregnant women and newborns. The knowledge of pregnant women is correlated with their educational level (p = 0.023) and their profession (p = 0.009).

Conclusion: Knowledge among pregnant women about the association between periodontal diseases and adverse pregnancy outcomes remains insufficient in Ivory Coast. These results highlight the necessity for continuous improvement of educational programs targeting pregnant women and healthcare providers on this topic.

Purpose: To investigate the epidemiological profile of dental caries and periodontal disease, access to dental services, and perception of oral health in adolescents and adults from a rural community in Angola.

Materials and methods: This is an observational, analytical and cross-sectional study, performed with 575 individuals aged between 12 and 40 years. The prevalence of caries and periodontal disease was assessed using the DMFT index and the Community Periodontal Index. Data on access to dental services, health and oral hygiene habits, and perception of oral health were collected through interviews.

Results: 42.8% never had a dental appointment; 85.1% had their last consultation in a public health service; 60.2% considered the service to be average/poor; 32.5% had their last consultation due to pain; 57.4% considered their oral health to be good/very good; 51.0% brushed their teeth twice a day; and 36.9% did not use toothpaste. The prevalence of untreated caries was 72.9% and only 1.7% of teeth affected by tooth decay were restored. A mean of 0.88 ± 1.44 sextants showed gingival bleeding; 1.46 ± 1.74 showed dental calculus; and 0.16 ± 0.58 showed periodontal pockets. The prevalence of sextants with periodontal pockets of 6 mm or more was 1.7%.

Conclusion: The prevalence of untreated caries was high, while periodontal disease does not represent a severe problem in this population. Access to dental services is poor and limited to extractions.

Purpose: To establish the potential prognostic nutritional index (PNI) trajectory categories and examine the association between these PNI trajectory categories and severe radiotherapy-induced oral mucositis (RIOM).

Materials and methods: This was a longitudinal retrospective observational study on 470 head and neck cancer inpatients who were to undergo radiotherapy from a grade-A tertiary hospital in Hunan Province between July 2022 and October 2023. The latent class growth model and growth mixed model were used to identify PNI trajectory categories. Logistic regression analysis was used to examine the correlation between PNI trajectory categories and severe RIOM.

Results: Three PNI trajectory categories were identified: 'PNI high-level group' (20.9%), 'PNI medium-level group' (61.3%) and 'PNI low-level group' (17.9%). The risk of severe RIOM was statistically significantly higher in the 'PNI medium-level group' and 'PNI low-level group' with OR 2.174 (95%CI 0.980-4.822) and OR 3.45 (95%CI 1.212-9.815), respectively. PNI trajectory categories and cancer type were independent risk factors for severe RIOM.

Conclusion: PNI can be used as a biomarker to predict severe RIOM. Patients with head and neck cancer who have a lower PNI are at higher risk of severe RIOM.

Purpose: The prevalence of gingival recession in orthodontically treated patients and the relative impact of retainer type on its occurrence remain poorly understood. The objective of this study was to investigate the association between previous orthodontic treatment and retainer type on the long-term prevalence of gingival recession and to evaluate the role of other patient-related factors, such as gender, age, smoking and gingival phenotype.

Materials and methods: We included subjects both with and without a history of previous orthodontics (at least 5 years post-treatment). The periodontal status assessment and the presence of gingival recession were recorded. A generalised estimating equation (GEE) logistic regression model was used to examine the effect of the mode of retention and tooth type on recession adjusted for age, smoking, gender and gingival phenotype.

Results: A total of 251 individuals (mean age of 32 ± 9.43 years) were included. Ninety-nine (39.4%) had a history of orthodontics with an observation period of 15.7 years. Those undergoing orthodontics followed by fixed retention had the highest prevalence and magnitude of recession; a history of orthodontics was statistically associated with the occurrence of recession (odds ratio: 2.40; 95% CI: 1.52; 3.82; P 0.001). Both age and the presence of a thin gingival phenotype were significant predictors for recession (P 0.001). The adjusted probabilities of recession per tooth indicated that the mandibular central incisors had the highest probability for recession, with either a fixed or removable retainer.

Conclusions: Based on this observational study, the provision of orthodontic treatment followed by removable or fixed retention had a bearing on the occurrence of recession. The aetiology of gingival recession is multifactorial with a thin periodontal phenotype, age and smoking history being risk factors, while mandibular central incisors are particularly susceptible.

Purpose: To compare the clinical performance of the combination of enamel matrix derivatives and bone substitutes (EMD+BG) with bone substitutes (BG) alone in the surgical treatment of periodontal intrabony and furcation defects.

Materials and methods: Electronic databases (Medline, Embase and Web of Science) were searched for randomised controlled trials in humans that investigated the combination of EMD+BG vs BG alone in either intrabony or furcation defects with a minimal follow-up of 6 months. A random-effect meta-analysis was conducted according to the type of defect (intrabony or furcation defects) and the follow-up time (6 or ≥ 12 months).

Results: From a total of 1583 entries, 9 randomised controlled clinical trials (RCTs) were retrieved and included in the qualitative and quantitative synthesis. All of them were included in the meta-analysis. The meta-analysis detected an additional clinical attachment level (CAL) gain in intrabony defects treated with EMD+BG compared to BG alone in studies with ≥ 12-month follow-up (mean difference = 0.67 mm, 95% CI [0.44 ; 0.90], p 0.00001). No additional benefit was found in furcation defects in terms of CAL gain or probing depth (PD) reduction.

Conclusion: The addition of EMD may improve the clinical outcomes of intrabony defects treated with bone substitutes. These findings may support the use of this combined therapy, particularly in large and non-contained defects.

Purpose: The COVID-19 pandemic raised the question about the extent of microbial exposure encountered by dentists during dental therapy. The purpose of this study was to quantify microbial counts on surgical masks related to duration and type of dental therapy, as well as patient oral health variables.

Materials and methods: Sterile filter papers were fixed on surgical masks used during routine daily dental therapy. Thereafter, the filter papers were pressed onto blood agar plates for 1 min, before the agar plates were incubated with 10% CO2. After 48 h, the colony forming units (CFU) were counted and microorganisms were identified. The dependence of the CFU counts on treatment and patient-related variables was analysed using linear regression.

Results: Filter papers obtained from 322 dental treatments (429 masks) were included in the final analysis. On average, 5.41 ± 9.94 CFUs were counted. While mostly oral bacteria were detected, Staphylococcus aureus was also identified on 16 masks. Linear regression, incorporating patient-related and treatment characteristics through step-wise inclusion, revealed statistical significance (p 0.001) only with the variable 'assistance during therapy'. The type of dental treatment exhibited a trend, with fewer CFUs observed in caries treatment compared to periodontal or prosthodontic therapy. Furthermore, after analysing filter papers from masks used by dental assistants in 107 dental treatments, fewer CFUs were found on the masks compared to those used by dentists (p 0.001).

Conclusion: The mean number of CFUs observed consistently remained low, highlighting the efficacy of the implemented hygiene measures. Consequently, it is clinically recommended to support dental treatment with precise suction of the generated aerosols.

Purpose: To evaluate the effect of a fresh-breath mild effervescent tablet on halitosis as an alternative to mouthwash.

Materials and methods: Halitosis is the unpleasant and offensive odour emanating from the oral cavity (bad breath), which is linked to the presence of volatile sulphur compounds (VSCs). A randomised, single-blind, controlled clinical trial was conducted with 102 volunteers who had oral complaints (range 18-60 years). Breath samples were taken and analysed for the level of hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide (CH3SCH3). Sixty-one volunteers who met the halitosis criteria were enrolled and completed the clinical trial. Two groups were formed according to the test employed: the Immediate Effect Test (IET) (n = 31) and the Effective Duration Test (EDT) (n = 30). In the IET, subjects were divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 11), the fresh-breath lozenge tablet (LT, n = 10), and fresh-breath mouthwash (MW, n = 10). Halitosis was measured immediately after completely consuming the test tablet or gargling. In the EDT, subjects were also divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 10), probiotic powder (PP, n = 10) and probiotic tablet (PT, n = 10). Halitosis was measured at 0 h, 1 h, and 2 h after consuming the test substances.

Results: In the IET group, a statistically significant reduction in VSCs was obtained in all three subgroups compared with baseline (VSCs of MT group, p 0.01, VSCs of LT subgroup, p 0.05, VSCs of MT group, p 0.01). The fresh-breath mild effervescent tablet subgroup showed a statistically significantly greater reduction in VSCs compared to the fresh-breath lozenge subgroup (p 0.01). No statistically significant differences in VSC reduction were found between the fresh-breath mild effervescent tablet subgroup and the mouthwash group (p = 0.38). In the EDT group, the VSC level of the fresh-breath mild effervescent tablet group was still statistically significantly lower than the baseline 2 h after consumption (p 0.01). The two control groups which used commercial fresh-breath probiotic products did not show any statistically significant difference compared to baseline. The VSC level of these two groups gradually returned to the baseline level 2 h after consumption.

Conclusion: Fresh-breath mild effervescent tablets have shown promising potential as an alternative, effective, and potentially safe choice for fresh breath in comparison to mouthwash.

Purpose: This study investigated oral diadochokinesis (ODK) and its associated factors, including age group differences, among Japanese older adult outpatients.

Materials and methods: A cross-sectional study was conducted with 127 outpatients (≥65 years) receiving dental check-ups (May 2022-February 2023). Oral function was assessed using ODK (pa/ta/ka/) (KENKOU-KUN®), tongue pressure (TPM-01), masticatory performance (gummy jelly), and swallowing function (RSST). Structured interviews measured social engagement (LSNS-16), depression (GDS-15), and cognitive function (MMSE). Statistical analyses included Chi-square tests, t-tests, and linear regression.

Results: Mean ODK values were 6.2 ± 0.7 (/pa/), 6.1 ± 0.8 (/ta/), and 5.6 ± 0.9 (/ka/). Age-grouped differences were found in tongue pressure and ODK /ta/, /ka/. Unadjusted analysis revealed associations between ODK /pa/ and sex, number of remaining teeth, and social engagement. ODK /ta/ was associated with tongue pressure (B: 0.022, 95%CI: 0.008, 0.036), masticatory performance, and swallowing difficulty. ODK /ta/ and /ka/ showed age and sex association. Adjusted regression analysis showed associations between ODK /pa/ and number of remaining teeth (B: 0.028, 95% CI: 0.004, 0.052), ODK /ta/ and tongue pressure (B: 0.021, 95% CI: 0.007, 0.035), masticatory performance (B: 0.095, 95% CI: 0.018, 0.161), and swallowing difficulty (B: -0.679, 95% CI: -1.192, -0.165).

Conclusions: This study reveals ODK's multifaceted nature, highlighting its relationships with various oral and psychosocial factors. Associations between ODK (pa and ta) and other oral functions suggest that improving ODK could maintain overall oral health and quality of life in older adults. Incorporating ODK assessments into routine dental check-ups should be further assessed.