Oral health & preventive dentistry最新文献

Purpose: This randomized, double-blind, placebo-controlled trial evaluated the clinical efficacy of Lactobacillus reuteri in reducing gingival inflammation and alveolar bone loss in periodontitis by modulating endoplasmic reticulum (ER) stress.

Materials and methods: A total of 120 patients (aged 22-47 years) with periodontitis (n = 84) or gingivitis (n = 36) were allocated to receive either L. reuteri (1×10⁹ CFU/day, n = 60) or placebo (n = 60) for 8 weeks. Primary outcomes included ER stress markers (GRP78/CHOP), while secondary outcomes comprised probing depth (PD), clinical attachment level (CAL), inflammatory biomarkers (TNF-α, IL-6, CRP), and radiographic alveolar bone loss (Moffat grading). Statistical analyses utilized ANOVA, Welch's t-test, and ANCOVA, with significance at p 0.05.

Results: The L. reuteri group exhibited statistically significant reductions in TNF-α (30.01 ± 5.15 vs 16.57 ± 3.88 pg/ml, -45.3%, p 0.05), IL-6 (25.84 ± 3.11 vs 14.35 ± 2.16 pg/ml, -45.2%, p 0.05), and CRP (6.41 ± 1.18 vs 2.68 ± 1.04 mg/L, -57.8%, p 0.05) compared to placebo. Gingival pain (VAS) decreased by 48.5% (5.22 ± 0.51 to 2.69 ± 0.20, p 0.001). ER stress markers GRP78 and CHOP declined by 37.6% (p 0.01) and 35.2% (p 0.01), respectively. PD improved by 35.8% (4.92 ± 1.13 vs 3.12 ± 0.37 mm, p 0.05), with 68.3% of patients achieving ≥2 mm PD reduction (vs 13.3% in controls, p 0.001). Radiographic bone loss improved to mild Moffat grades in 66.7% of test patients (vs 33.3% in controls, p 0.001).

Conclusions: L. reuteri statistically significantly alleviates periodontitis by inhibiting ER stress and inflammatory pathways, demonstrating clinically meaningful reductions in PD, CAL, and alveolar bone loss. These findings underscore its therapeutic potential as an adjunctive intervention.

Purpose: This study investigates the effects of zinc-containing stents on gingival inflammation, bleeding, and plaque regrowth in patients with gingivitis.

Methods: A randomised, double-blind, placebo-controlled study was conducted at Çukurova University, enrolling 42 systemically healthy gingivitis patients aged 18-30. Participants were assigned to either a test group (Zn group) or a control group (placebo stents) and instructed to wear their stents for at least 12 h daily for 4 weeks after scaling. Clinical measurements, including gingival index (GI), plaque index (PI), and bleeding on probing (BOP), were assessed at baseline and at the 2nd, 4th, and 8th weeks. Statistical analysis was performed using IBM SPSS and RStudio.

Results: Both groups showed statistically significant improvements in gingival health over time, but the zinc-stent group exhibited statistically significantly lower GI scores at all time points, suggesting a greater reduction in gingival inflammation. PI and BOP scores also improved in both groups, though no statistically significant difference was observed between them.

Conclusion: The results indicate that zinc-containing stents may serve as a beneficial adjunct to mechanical plaque control in gingivitis management. Zinc's antimicrobial and anti-inflammatory properties likely contribute to improved gingival health. The findings suggest that zinc-containing stents provide additional benefits in reducing gingival inflammation beyond mechanical plaque removal alone. These stents may be a promising adjunctive approach in periodontal therapy, but further long-term studies are needed to confirm their broader clinical applications.

Trial registration: The study was conducted in accordance with the CONSORT guidelines and registered at clinicaltrials.gov (NCT06888440), 20 March 2025.

Purpose: Periodontitis is a common chronic inflammatory disease with a complex pathogenesis involving oral microbiota dysbiosis, systemic metabolic disturbances, and inflammatory responses. Although observational studies have suggested close associations between these biological factors and periodontitis, the causal relationships remain unclear. Elucidating the causal roles and interactions of these factors is crucial for effective prevention and treatment of the disease.

Methods: In this study, we utilised large-scale genome-wide association study data and applied a two-sample Mendelian randomisation (MR) framework. We systematically evaluated the independent causal effects of 43 oral microbial taxa, 1,400 blood metabolites, and 91 inflammatory proteins on periodontitis risk. Direct effects were assessed using univariable MR (UVMR), while multivariable MR (MVMR) was used to analyse interactions. Mediation MR analysis was further performed to explore potential causal pathways.

Results: UVMR analysis found that family Pasteurellaceae (OR = 0.953) and genus Veillonella (OR = 0.943) were statistically significantly associated with a reduced risk of periodontitis. Further analyses revealed 45 blood metabolites and 4 inflammatory proteins with genetically supported causal relationships to periodontitis. Mediation analysis indicated that the protective effect of family Pasteurellaceae on periodontitis risk is partially mediated by the regulation of circulating 4-hydroxychlorothalonil, with a mediation proportion of 3.54%.

Conclusion: This study provides the first systematic genetic evidence for the causal roles and potential mediation mechanisms of oral microbiota, blood metabolites, and inflammatory proteins in the development of periodontitis. The findings offer new insights into the role of the oral microbiome-host metabolism-inflammation axis in periodontitis aetiology.

Purpose: This study aimed to evaluate the distribution of maxillary labial frenum (MLF) attachment types and their potential association with the development of early childhood caries (ECC) in children aged 2 to 5 years who presented to our clinic for routine check-ups or treatment.

Materials and methods: A total of 92 children aged 24-71 months (53 girls and 39 boys) were included in the study. Clinical oral examinations were performed, and MLF attachment types were recorded using Placek's classification. Standardised intraoral photographs were taken to document the anterior maxillary region and frenum attachments. Children were categorised into ECC and caries-free groups based on clinical findings. Statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) v26.

Results: The mean age of the participants was 52.7 ± 11.7 months. In the ECC group, the mean dmft score was 9.8 ± 4.3. Although no statistically significant relationship was found between overall frenum attachment types and caries formation in the anterior maxillary region, papillary and mucosal attachment types were more common in children with anterior caries, while the gingival type was more prevalent in the caries-free group (P 0.05).

Conclusion: A statistically significant association was observed between certain MLF attachment types and anterior caries; however, the presence of caries in mucosal-type attachments - typically considered low-risk - suggests that other aetiological factors play a more prominent role in ECC development. Therefore, clinicians should focus on comprehensive caries risk assessment before considering surgical interventions such as frenectomy.

Purpose: In recent years, advancements in technology have led to significant developments in the fields of dental implants and endodontic treatment. These technological improvements have resulted in better treatment outcomes and enhanced quality of life for patients undergoing these procedures. The objective of this study is to compare the quality of life related to oral health from the patients' perspective between single-tooth root canal treatment (RCT) and single-tooth dental implant (DI) treatment.

Methods: Patients in the RCT (n = 21) and DI (n = 19) groups, treated by experienced endodontists and prosthodontists, completed a two-part questionnaire after permanent restorations. The first part collected demographic and socioeconomic data, while the second part included a shortened version of the Oral Health Impact Profile (OHIP-14). Six focus group discussions were conducted for thematic analysis. For the comparison of OHIP-14 sub-dimension and total scores by groups, the independent samples t-test and the Mann-Whitney U test were used, while the Fisher Freeman-Halton test and Yates' continuity correction evaluated categorical data (α = 0.05).

Results: Statistically significant differences favoured DI in total OHIP scores (P = 0.041), social disability (P = 0.028), and psychological disability (P = 0.012). No statistically significant differences in mean total OHIP values were found between socioeconomic classes for either treatment (RCT; P = 0.892, DI; P = 0.572).

Conclusion: The results of this study indicate that the overall OHIP scores were comparable, with a high level of satisfaction observed for both treatment modalities. Content analysis of the discussion groups revealed several themes. These can be listed as: importance of preserving the tooth; dentist visits; treatment costs; physical pain; psychological discomfort; aesthetics; function; and treatment satisfaction. However, patients noted that both treatments improved their oral health and they valued the preservation of natural teeth.

Purpose: The aim of this study was to investigate the impact of oral health education on the hygiene awareness of preschoolers as well as their parents.

Methods: One hundred preschool children who participated in the study were divided into two groups by a randomised numerical table method. The control group (n = 50) received conventional oral health education, while the observation group (n = 50) received simulation education on oral protection. Adverse oral behaviour, toothbrushing and dental health status of children before and after health education, and oral health knowledge acquisition after children's health education in the two groups are compared. Patients' hygiene awareness and satisfaction after parental health education were also compared.

Results: The children in the observation group had fewer pacifiers at bedtime, fewer sweet behaviours at bedtime, and fewer lip and finger biting after the health education. Correct brushing posture, use of fluoride toothpaste, brushing time, and number of daily brushing times increased in the observation group after the children's health education, and all of these were more significant in the observation group. Dental plaque index, gingival index, gingivitis rate, and caries rate were reduced in the observation group of children after health education. The rate of children's knowledge of oral health education after health education in the observation group was higher than that of the control group in terms of the correct way of brushing teeth, effective prevention of dental caries by correct brushing, bilateral chewing for daily eating, and rinsing the mouth after meals. Oral hygiene awareness and satisfaction with oral health education after parental health education were higher in the observation group than in the control group.

Conclusion: Simulation education on oral protection is beneficial for children to brush their teeth correctly, correct bad oral habits and improve dental health.

Funding: The work was not funded by any funding.

Conflicts of interest: The authors declared that they have no conflicts of interest regarding this work.

Purpose: To analyse the current status and emerging research trends in the field of dental hygienists using a bibliometric analysis.

Methods: Relevant literature on dental hygienists published up to 28 January 2025, was retrieved from the Web of Science Core Collection database. Bibliometric and visualisation analyses were conducted using Bibliometrix, VOSviewer, CiteSpace, Pajek, Tableau and Excel.

Results: A total of 1,835 publications related to dental hygienists were included. The annual number of publications showed a fluctuating upward trend, peaking at 167 articles in 2024. The research involved 94 countries and regions, as well as 209 institutions. The United States had the highest publication output, with the University of Michigan ranking as the most prolific institution. The top three high-frequency keywords were 'dental hygienists' (323 occurrences), 'oral health' (275), and 'dental hygiene' (260). Keyword clustering analysis identified 13 thematic clusters. The most prominent emerging keyword was 'allied dental education'. Notably, 'infection control' and 'health' started to gain prominence in 2022.

Conclusion: Global dental hygiene research centres in North America and Europe, led by US institutions, with evolving priorities from prevention to public health integration, particularly in infection control. These findings inform tailored strategies for developing countries to advance DH professionalisation and address oral health disparities.

Background: Gingivitis is a reversible, dental biofilm-induced inflammation which is characterised by bleeding on probing (BOP) and oxidative stress in the gingival tissues. Matcha tea, a type of green tea with high antioxidant content, has been reported to enhance periodontal health, but its exact beneficial efficacy remains to be investigated.

Objective: This pilot-controlled trial aimed to investigate the influence of daily consumption of matcha tea on gingival status and salivary 8-hydroxy-deoxyguanosine (8-OHdG) concentration in localised gingivitis patients, as well as to determine the bleeding on probing (BOP) threshold that predicts for gingival health after intervention.

Methods: Twenty-seven adults with localised gingivitis (BOP >10% but ≤30%) drank matcha tea twice a day for 30 days while maintaining oral hygiene habits. Clinical parameters, including plaque index (PI) and BOP, as well as salivary 8-OHdG, were evaluated at baseline and post-intervention. After treatment, patients with BO 10% were reassigned as healthy, and those with BOP ≥10% as gingivitis. Regression and correlation analyses, including the Wilcoxon and Mann-Whitney test, ANCOVA, and receiver operating characteristics (ROC) curve, were performed to determine a BOP cut-off value that would predict gingival health.

Results: PI, BOP, and 8-OHdG were statistically significantly decreased in the entire cohort after 1 month. Patients reassigned as healthy underwent a greater reduction in PI (from 28.3 ± 7.5 to 17.5 ± 5.3), BOP (from 16.4 ± 5.0 to 5.6 ± 2.5) and 8-OHdG (from 6.9 ± 1.6 to 5.6 ± 1.8 ng/ml). In contrast, patients with gingivitis had statistically significant reductions in PI and BOP, but not in 8-OHdG. The mean BOP reduction was statistically significantly higher in healthy subjects. A ROC calculation revealed a BOP cut-off 18% at baseline, indicating a high likelihood of achieving gingival health following ingestion of the matcha tea (sensitivity = 0.92, specificity = 0.70).

Conclusion: Daily intake of matcha tea for 1 month improved gingival health and decreased oxidative stress markers in the localised gingivitis patients. A 18% baseline BOP predicted successful transition to gingival health after intervention. These results corroborate the adjuvant therapy of matcha tea in the treatment of gingivitis, and further large-scale randomised trials are recommended.

Source of funding: No external funding was received.

Purpose: Epulis represents a group of reactive hyperplastic lesions occurring in the gingival area, distinct from true hypertrophy, as these lesions involve tissue proliferation rather than enlargement of existing cells. These lesions present significant clinical challenges in diagnosis and management.

Methods: This narrative review synthesises current literature on epulis, examining epidemiological patterns, clinical characteristics, pathogenic mechanisms, and treatment approaches across different subtypes.

Results: Epulis primarily affects young and middle-aged adults with female predilection. The molecular pathogenesis involves complex interactions between local irritants and signalling pathways, particularly aryl hydrocarbon receptor (AhR) and RAS-PI3K-AKT-NF-κB activation. Definitive diagnosis requires histopathological examination, with fibrous, vascular, and giant cell variants exhibiting distinctive features. Surgical excision remains the primary treatment, though emerging evidence supports laser therapy, sclerotherapy, and combination approaches. Preventing recurrence necessitates elimination of local irritants, regular periodontal maintenance, and awareness of patient-specific risk factors.

Conclusions: Clinicians should perform thorough clinical and radiographic examinations to differentiate epulis from malignancies, and consider subtype-specific management strategies, implement comprehensive prevention protocols, and conduct long-term follow-up, especially for high-risk cases. Future research should focus on developing targeted molecular therapies, standardised treatment guidelines, and personalised recurrence prevention strategies.

Purpose: The aim of the present study was to evaluate the association between periodontitis and SARS-CoV-2 infection severity in a Turkish population.

Methods: Adult patients attending hospital consultation and testing positive for SARS-CoV-2 infection were consecutively enrolled in this study. Demographic variables, smoking status, COVID-19 symptoms, SpO2 levels, and markers of inflammation (D-Dimer, lymphocytes and white blood cells count, CRP) were recorded. Patients suspected of periodontal disease were evaluated using self-reported questionnaires (OHIP-14, modified CDC/AAP questionnaire). Periodontal screening score (PESS) was calculated from the questionnaire. Univariate and multivariate logistic regression analyses were performed to evaluate the association between COVID-19-associated parameters and periodontitis.

Results: The study included 134 patients diagnosed with COVID-19. Nearly half of the participants were female (n = 68, 50.7%), and the mean age of the patients was 48.7 ± 18.2 years. A statistically significant majority of individuals (69.2%) were asymptomatic, while 22.3% experienced mild symptoms, and 8.5% reported moderate or severe symptoms. Oxygen saturation was found to be higher in asymptomatic patients (96.4 ± 2.8) compared to mild (90.4 ± 5.1) and moderate/severe patients (86.6 ± 8.9) (P 0.001). There was no statistically significant difference concerning OHIP-14 score (P = 0.316), periodontitis (PESS ≥ 5) (P = 0.130), brushing habits (P = 0.901), and frequency of dental visits (P = 0.975) when considering SARS-CoV-2 infection severity. In multivariate logistic regression analysis, it was concluded that male gender (OR = 2.90, 95% CI: 1.04-8.04, P = 0.040), age 55 and above (OR = 5.94, 95% CI: 1.22-28.76, P = 0.026), and smoking (OR = 0.14, 95% CI: 0.02-0.75, P = 0.022) were statistically significant predictors of SARS-CoV-2 infection severity.

Conclusions: Even the association between SARS-CoV-2 infection severity and periodontitis, evaluated through self-reported outcome measures, were weak: male gender, age, and smoking were independent risk factors for SARS-CoV-2 infection severity in this patient cohort. Further research is warranted to explore these associations comprehensively.