Oral health & preventive dentistry最新文献

Purpose: Periodontal disease is caused by periodontal invasion by pathogens such as Porphyromonas gingivalis. Although recent metagenomic analyses have shown that oral commensal bacteria are abundant in the mouth of healthy individuals, few studies have experimentally verified the benefits and functions of oral commensal bacteria in periodontal diseases. In this study, we focused on Neisseria among the oral commensal bacteria and aimed to experimentally verify its effects on P. gingivalis invasion.

Materials and methods: We evaluated the inhibitory effect of Neisseria spp. on P. gingivalis invasion using a flow cytometry-based invasion assay and analysed bacterial interactions by visualisation using scanning electron microscopy. Furthermore, we constructed a new experimental pre-mixed culture system that reproduced the interaction environment to evaluate the relevance of this interaction in invasion inhibition.

Results: Flow cytometry-based invasion assays showed that all Neisseria spp. inhibited P. gingivalis invasion, with Neisseria mucosa and Neisseria elongata being particularly effective. Interaction analysis using scanning electron microscopy showed that N. mucosa and N. elongata, which have strong inhibitory effects on P. gingivalis invasion, interacted with P. gingivalis at high frequencies.

Conclusion: Commensal Neisseria was found to exert a beneficial function by directly interacting with P. gingivalis and inhibiting its invasion of gingival epithelial cells. These results suggest that Neisseria, as a probiotic or synbiotic oral commensal, may represent an innovative approach to preventing periodontal disease.

Purpose: Silicone mouth swabs have emerged as a promising alternative to gauze, sponge brushes, and soft-bristled toothbrushes, offering a balance between gentle cleaning and effectiveness. The flexibility and softness of silicone make it a suitable material for safely cleaning the sensitive oral tissues of elderly patients. This study aims to determine the optimal hardness level of silicone that maximises cleaning effectiveness while minimising the risk of trauma to oral tissues.

Materials and methods: A pseudo-plaque was created by mixing 6.0 g of Thicken Up Clear food additive with 12.0 ml of water and food colouring, which was then spread onto a NISSIN dentoform silicone rubber sheet (simulated soft tissue) with a thickness of 2.0 mm. Silicone heads with different hardness levels - 20, 30, 40, 50, and 60 Shore A - were attached to a V.P.2000 tooth brushing machine, operating at 75 rounds per minute with a force of 1.96 N. Each swab was used to brush the surface 25 times (n = 16 for each group).

Results: A one-way analysis of variance (ANOVA) revealed a statistically significant difference in pseudo-plaque removal among the five hardness levels, with an F-value of 106.161 (degrees of freedom = 4, 75, p 0.001). The Games-Howell pairwise comparison test showed that all five silicone hardness levels differed significantly from each other in their effectiveness in removing pseudo-plaque (p 0.05). No visible simulated soft tissue damage was observed before and after brushing, as inspected with a stereomicroscope in all experiments.

Conclusion: The silicone oral swab with a hardness level of 60 Shore A was found to maximise pseudo-plaque removal in vitro. This finding is crucial for the development of specialised oral hygiene tools tailored to the needs of the elderly population, thereby enhancing oral health and overall well-being.

Purpose: There is a scarcity of data regarding the long-term follow-up of dental implants placed in grafted or non-grafted sites. The aim was to systematically review clinical studies which, compared the implant survival rate (ISR) after at least 10 years for dental implants placed in grafted and non-grafted sites.

Materials and methods: The focused question addressed was: 'Is there a difference in the ISR of dental implants placed in grafted and non-grafted sites for at least a decade?' The inclusion criteria were: (a) clinical studies, (b) studies on patients who had undergone dental implant therapy, (c) studies with at least 10 years follow-up, and (d) studies that compared the clinical and radiographic status around implants placed in grafted and non-grafted sites. Indexed databases (PubMed/Medline, Scopus, EMBASE, OVID, ISI Web of Knowledge, and Google Scholar) were searched without time and language restrictions up to and including December 2020 using different keywords. The literature search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed, and the pattern of the present systematic review was customised to summarise pertinent information.

Results: The initial search yielded 412 studies through electronic database searching. An additional 30 studies were identified through manual searching of full texts of studies. In total, three studies were included and processed for data extraction. In these studies, the number of participants ranged between 34 and 96 individuals. The mean age ranged between 47.2 and 67.6 years. The reported ISR ranged between 91.6% and 100%. All studies had a low risk of bias. Due to the high heterogeneity among the studies included, a meta-analysis could not be done. Prior sample-size estimation was done in none of the studies.

Conclusion: Dental implants placed in grafted and non-grafted sites demonstrate similar ISR for at least a decade. However, further well-designed and power-adjusted studies are needed.

Purpose: Multifocal motor neuropathy (MMN) is a rare immune-mediated neuropathy causing progressive, asymmetric weakness without sensory loss. Long-term administration of intravenous (IVIg) or subcutaneous (SCIg) immunoglobulins is the primary therapeutic approach. Despite this, therapy failure can result in a decline in strength, particularly in the hands, impacting daily activities. This review and case report presents the current literature on this complex dental and medical topic and explores the novel use of dental implants for full-mouth rehabilitation in MMN patients undergoing long-term IVIg therapy.

Materials and methods: A patient with MMN underwent 15 years of long-term treatment with intravenous immunoglobulin (IVIg), starting with an initial dose of 0.4 g/kg for 5 days every 4 months in 2008. The maintenance dosage of 0.2 g/kg as a single dose every 3 months was established as a long-term therapy. In 2017, the patient received a maxillary and mandibular complete-arch implant-supported prosthesis.

Results: MMN showed no progression until the IVIg interval was extended to every 4 months in 2022. Significant deterioration in dental health resulted from a loss of right-hand dexterity, which affected toothbrush use and interproximal brushing, resulting in poor oral hygiene. Dental hygiene and dental health, which were not optimal anyway, were considerably worsened by the loss of dexterity in the right hand, which impaired the use of the toothbrush and the cleaning of the interdental spaces.

Conclusion: Dental implants are a well-established treatment for edentulous patients, but their success in those with MMN requires careful consideration of oral health practices. Effective maintenance protocols and optimised prosthetic designs are crucial for long-term implant therapy success in MMN patients. Peri-implant diseases pose risks influenced by various factors. In the case of MMN and its neurological considerations, implications for dental implant provision warrant further exploration, considering clinical symptoms, therapy, and potential progression.

Purpose: Periodontal diseases, commonly linked to dental biofilm and affecting adults, were studied using Geographic Information Systems (GIS) and Kernel Analyses with epidemiological data. This paper presents a hybrid method for use in epidemiological studies by evaluating the spatiotemporal distribution of disease prevalence.

Materials and methods: This study analy ed 47,757 patients from the Department of Periodontology out of 662,351 visitors to University Faculty of Dentistry (2012 to July 2023). The central districts of Kayseri in Turkey were selected as the study areas. Periodontitis prevalence was assessed through radiographic evidence and clinical examination. Point-based location data, including gender, age, and disease type, matched household data, creating building-based spatial data. Kernel Density (KD) and Average Nearest Neighbor (ANN) analyses examined patient concentration and disease types in specific regions. Accordingly, standard deviation ellipses were prepared by year to assess the spatial changes in the regions where patients resided.

Results: The study found higher periodontitis prevalence in males, increasing with age, while gingivitis decreased. After 2017, periodontitis prevalence notably declined. Location-based data exhibited clustering in patient distribution. KD maps showed similar patient distributions over the years, with more applications from areas closer to the Faculty of Dentistry. The spatial distribution of the patients applying has remained consistent over the last 5 years.

Conclusions: Through GIS, KD maps reveal the spatial-temporal distribution of periodontitis patients. This aids in identifying high-prevalence regions and guiding strategic healthcare facility placement. Implementing preventive programs in high-demand areas, particularly in family health centers (local health facilities), can reduce community-wide periodontal disease prevalence.

Purpose: Focusing on immigrant parents with children aged 0-6 months, this study assessed whether awareness of and attitudes towards restricting children's sugar consumption vary according to family sociodemographic background and parents' oral-health-related behaviours.

Materials and methods: A cross-sectional study was conducted including immigrant parents attending child public health centers for vaccination of their children. The study included parents born in Asia, Africa, South America, Central America and Eastern Europe. Parents from Western Europe and North America were included if they were partners of the above-mentioned participants. Cross-tabulation and multiple variable logistic regression were used to assess associations of parental knowledge and attitudes with their child's sugar intake and sociodemographic characteristics.

Results: Overall, response rate was 72.6%. A total of 345 parents completed personal, structured interviews during their visit to the health centers. Attitudes and knowledge, but not indulgence, related to children's sugar restriction were sociodemographically unequally distributed among immigrant parents. Employed mothers, mothers with immigrant background from North America or Western Europe as well as parents with less frequent own sugar intake were more likely to confirm positive attitudes towards restricting children's sugar snacking. The corresponding odds ratios were OR=1.8 (95% CI 1.1-3.1) and OR=6.6 (95% CI 2.3-18.9). Employed mothers and parents having received dental care information were more likely than their counterparts to possess good oral-health-related knowledge.

Conclusion: Parents from sociodemographically disadvantaged backgrounds were less inclined to express positive attitudes and demonstrate sufficient knowledge regarding the limitation of their children's sugar snacking. Culturally adapted oral health intervention programs should be implemented for immigrants, with special reference to children's dietary habits.

Purpose: To investigate the antimicrobial effects of a mouthrinse containing silver nanoparticles (AgNP) on polymicrobial biofilms in vitro.

Materials and methods: Polymicrobial biofilms were grown on glass cover slips following the method of Exterkate. Saliva collected from a healthy human was added to McBain medium (including 0.2% sucrose) to achieve a 50-fold dilution. Glass coverslips were attached to the lid of a 24-well culture plate and suspended in the medium of each well. After 24 h of cultivating, coverslips with biofilms were immersed in each of four treatment solutions or sterile deionized water for 5 min. The control and four treatment groups were as follows: 1) control: sterile deionized water; 2) nanosilver (NS): mouthrinse containing AgNP; 3) 0.05C: 0.05% chlorhexidine gluconate; 4) 0.2C: 0.2% chlorhexidine gluconate; 5) Xyl: 25% xylitol. The biofilms were further regrown for 48 h. After removing the biofilms ultrasonically, they were cultured on blood agar, viable cells were counted, and the amount of lactic acid in the biofilms was analysed using a colorimetric assay.

Results: Mouthrinse containing AgNP suppressed viable cells in the biofilm to the same degree or more than with chlorhexidine gluconate. Amounts of lactic acid after 72 h cultivation of biofilms treated with 0.2C and NS showed consistently low values.

Conclusion: The mouthrinse containing AgNP suppressed viable cells in polymicrobial biofilms to the same level as 0.2% chlorhexidine or higher.

Background and purpose: Despite substantial evidence supporting the role of resident bacterial communities in therapeutic fasting outcomes, research has primarily focused on gut microbiota, leaving changes in oral microbiota largely unexplored. The clinical significance of oral health changes during fasting is nonetheless underscored by the documented development of halitosis in fasting individuals. However, no scientific studies have comprehensively examined the interplay between salivary microbiota alterations, inflammatory changes in the gingival crevice, and the production of malodorous volatile compounds. We examined volatile sulphur compounds (VSC) in breath during fasting, cytokine levels in the gingival crevice, and oral microbiota composition of the saliva in a single-arm interventional study involving 36 subjects who fasted for 10 ± 3 days.

Materials and methods: Participants fasted according to Buchinger fasting guidelines. VSC were evaluated every morning before any food or drink intake using the OralChroma gas chromatography device. Saliva and gingival crevicular fluid (GCF) samples were collected at the clinical site before fasting, at the end of fasting, and at the end of food reintroduction. Follow-up saliva samples were sent to the patients after 1 and 3 months. Saliva samples were processed and analysed by targeted sequencing of 16S rRNA gene amplicons, whereas the expression of 6 inflammatory markers in the GCF were analysed using a multiplex fluorescent bead-based immunoassay.

Results: The quantification of volatile compounds in the breath demonstrated a statistically significant increase in dimethylsulfide levels during fasting, which corroborates the occurrence of bad breath as a common side effect of fasting. Salivary microbiota profiling showed a shift in microbial composition, including reduction in the levels of Neisseria, Gemella and Porphyromonas spp., concomitant with an increase in the levels of Megasphaera, Dialister, Prevotella, Veillonella, Bifidobacteria, Leptotrichia, Selenomonas, Alloprevotella, and Atopobium. We further demonstrated a reduction in the levels of the pro-inflammatory cytokine interleukin-8 in the GCF.

Conclusion: Dimethylsulfide concentrations in the breath increased during fasting, and this was correlated to changes in the oral microbiota. Future studies are needed to illuminate the possible impact of these changes on oral and general health status.

Purpose: This study aimed to investigate the association between vitamin D levels and periodontitis according to sleep duration in a representative sample of Korean adults.

Materials and methods: A total of 3535 subjects who participated in the sixth (2013-2014) Korea National Health and Nutrition Examination Survey were examined. Vitamin D deficiency was defined as a 25-hydroxyvitamin D serum concentration of 20 ng/ml. Periodontal status was assessed with the community periodontal index (CPI). A high CPI was defined as a score ≥ 3. Multivariable logistic regression analyses were adjusted for sociodemographic variables, oral and general health behaviors, and systemic health status. All analyses used a complex sampling design, and a subgroup analysis was performed to determine estimates following stratification for sleep duration (≤ 5, 6, 7-8, and ≥ 9 h per day).

Results: Multivariable regression analysis indicated that among participants who slept for ≥ 9 h per day, those with vitamin D deficiency were 5.51 times (95% confidence interval = 2.04-14.89) more likely to have periodontitis than those with sufficient vitamin D levels. This association was not statistically significant in the other sleep duration groups.

Conclusion: The findings of this study indicate that people with vitamin D deficiency who sleep 9 h or longer may also be statistically significantly more likely to have periodontitis.

Purpose: The objective of the present observational study was to assess the inter-examiner agreement for the diagnosis of periodontitis using the 2018 CPD among fourth and fifth year undergraduate students. It is hypothesised that there is no difference in the inter-examiner relaibility between fourth- and fifth-year undergraduate students regarding staging and grading periodontal disease using the 2018 Classification of Periodontal Diseases (CPD).

Materials and methods: All participants received training on the 2018 CPD scheme through a mandatory periodontics course conducted by a periodontist. Documentation for seven deidentified periodontitis patients, comprising medical history, dental history including tooth loss, intra-oral photographs and radiographs, periodontal charts reporting probing depth, plaque and bleeding on probing scores, furcation involvement and clinical attachment loss, was sent via e-mail to undergraduate students. The cases consisted of one sextant, and the participants were instructed to assume the sextant to be a true representation of the entire dentition. Power analysis was done on pilot data, and the level of significance was set at p0.05.

Results: The percentage of undergraduate students in the fourth and fifth year that correctly identified the stage of periodontitis according to the 2018 CPD ranged between 28% and 72% and 18.5% and 77.8%, respectively. The percentage of undergraduate students in the fourth and fifth year that correctly identified the grade of periodontitis ranged between 40% and 88% and 51.8% and 92.5%, respectively. The overall staging and grading ranged between 22.8% and 74.1%, and 45.66% and 87.4%, respectively. There was no statistically significant difference between fourth- and fifth-year undergraduate students with regards to assigning the correct diagnoses to case documentation in terms of either stage or grade.

Conclusion: Fourth- and fifth-year undergraduate students demonstrated high inter-examiner agreement using the 2018 CPD.