Oral health & preventive dentistry最新文献

Purpose: The loss of interdental papilla (IDP) is a significant esthetic concern often associated with black triangles (BT). BT are potential consequences of periodontitis, orthodontic treatment, and anatomical variations due to their influence on the critical distance from the contact point to the bone crest. Various treatment options, both invasive and non-invasive, have been proposed to address this issue. Recently, the injection of hyaluronic acid (HA) has emerged as a promising minimally invasive alternative. This systematic review aims to evaluate the effectiveness of HA injections for IDP reconstruction in esthetic zones in humans.

Materials and methods: A comprehensive literature search was conducted using Cochrane library, PubMed/MEDLINE, and Embase databases with keywords like 'interdental papilla,' 'hyaluronic acid,' and 'human'. Change in BT mean height (mm) was considered as the primary outcome while percentage of change in BT area was considered as the secondary outcome.

Results: 177 articles were screened, and 15 eligible studies were included, focusing on the therapeutic effects of HA injections on interdental papilla dimensions in humans. Clinical trials have demonstrated varying degrees of success and patient satisfaction with HA injections for IDP reconstruction over a period of 4 weeks to 25 months. Several studies showed significant improvements related to BT height and width, although complete papilla fill remains unpredictable. Higher success rates were observed in the maxilla compared to the mandible, and patients with thicker gingival phenotype showed better outcomes. The initial size of the defect, the number of HA applications and the analysis method significantly influenced the results.

Conclusion: HA injections look promising for IDP reconstruction. However, the need for multiple injections and long-term efficacy remains to be fully understood. Further research is necessary to standardise treatment protocols and evaluate long-term outcomes and patient satisfaction comprehensively.

Purpose: The goal of this in-vitro study was to determine the impact of the antimicrobial disinfecting agents chlorhexidine (Peridex) and an herbal extract (StellaLife) on the wettability of four implant surfaces: titanium machined (TM), titanium-SLA (SLA), titanium alloy (TA), and zirconia.

Materials and methods: Each implant surface in the form of a disk was disinfected with 0.12% chlorhexidine (Peridex, group 1), peppermint-flavoured herbal extract (StellaLife, group 2), and saline solution as the control liquid (group 3). Using a calibrated micro-syringe, 7.5 µl of each liquid were dispensed on the center of each disk (n = 180). Then, a goniometer was used to measure contact angles between the droplet and the disk surface to evaluate the wettability (hydrophilicity) of each implant surface. The mean from 20 contact angle measurements per liquid and implant surface was calculated. Comparative statistical analysis was performed with ANOVA and Bonferroni correction at the p 0.05 level of significance.

Results: The Bonferroni post-hoc comparison revealed a statistically significant difference with improved wettability for group 2 compared to groups 1 and 3 for rough-surfaced titanium-SLA implant surfaces.

Conclusion: Overall, titanium implants may have improved hydrophilicity when rinsed with herbal extract antimicrobial agents compared to chlorhexidine.

Purpose: To examine the effect of applying different forms of remineralising agents during a pH-cyclinge on the bond strength of a universal adhesive applied in the etch-and-rinse mode and the types of fractures that occur after shear bond-strength testing.

Materials and methods: 84 human molars were divided into seven equal groups. Groups 1 (intact enamel) and 2 (artificially demineralised enamel) served as the positive and negative controls, respectively. In the experimental groups (3-7), the enamel was treated using remineralising agents during a 14-day pH-cycling protocol. Group 3: fluoride gel; group 4: fluoride varnish; group 5: Tooth Mousse; group 6: MI Paste Plus; group 7: MI Varnish. Afterwards, the molars' crowns were sectioned off, and a universal adhesive (G2-Bond Universal) was applied to the buccal surfaces of these samples using etch-and-rinse mode. Nanohybrid resin composite restorations (G-aenial Posterior) were then placed, and shear bond-strength testing was performed. The effects of remineralisation agents on artificial carious lesions were evaluated using scanning electron microscopy/energy-dispersive analysis.

Results: The fluoride varnish and MI varnish groups show statistically significantly lower shear bond strengths compared to the positive control group (p0.001). The bond strength to all remineralising agents was higher than that of the negative control group. All tested agents promoted remineralisation in demineralised areas of the enamel surface.

Conclusions: Remineralisation agents in forms other than varnish do not negatively affect the shear-bond strength to enamel surfaces.

Purpose: To evaluate the efficacy of photodynamic therapy (PDT) as an adjunct to resective and regenerative surgical peri-implantitis treatment (open flap debridement via scaling and smoothening of the implant surface [implantoplasty]) combined with guided bone regeneration (GBR) in a patient cohort of a university clinic.

Materials and methods: Seventy-two patients were treated with either conventional therapy (CON) or conventional therapy plus PDT. CON included mechanical debridement, implantoplasty, and GBR. Clinical parameters, including marginal bone level (MBL), probing pocket depth (PPD) and bleeding on probing (BOP) were assessed at baseline, 6, 12, and 18 months. The primary outcome was the resolution of the infection using a composite success criterion.

Results: After 18 months, infection resolution rates were 75% for CON and 80% for PDT groups (p = 0.75). Kaplan-Meier survival analysis showed no statistically significant difference for the infection resolution between groups (log-rank test, p = 0.6221). Both groups demonstrated statistically significant MBL gain after 6 months (mean 2.59 mm ± 1.25), with no statistically significant differences between groups throughout the follow-up. PPD was statistically significantly lower in the PDT group (two-way ANOVA, p = 0.018). BOP scores decreased initially but showed an increasing trend in both groups over time (chi-squared test, p = 0.045), with no statistically significant differences between groups.

Conclusion: PDT as an adjunct to conventional peri-implantitis treatment with GBR resulted in statistically significantly lower PPD values. However, no additional benefits were observed for infection resolution, maintenance of infection-free status, MBL or BOP. Initial improvements in both groups followed by gradual recurrences in clinical parameters over 18 months.

Purpose: This study was initiated to assess the oral health status and identify factors associated with dental caries in children from Zhoushan.

Methods and materials: A total of 125 children aged 5-12 years old were selected for oral examinations at the paediatric dentistry department of our hospital. The dental caries status of the children was examined and recorded, and a questionnaire was administered to their caregivers. The questionnaire collected data on patients' awareness of oral health, supervision of children's toothbrushing, assessment of brushing effectiveness, as well as dietary habits, oral behaviours, and oral healthcare practices. Univariate and multivariate logistic regression analyses were employed to analyse the relationships between the prevalence of dental caries and the selected variables.

Results: The caries rate among the 125 children was 62.40%. Logistic regression analysis showed that the use of fluoride toothpaste, brushing ≥ 2 times per day, and brushing after eating were protective factors against dental caries in children (OR < 1, P < 0.05). In contrast, age at initiation of brushing > 3 years, consumption of sweets and beverages ≥ 2 times per week, and frequent bedtime eating were likely to increase dental caries risk in children (OR > 1, P < 0.05).

Conclusion: In view of the identified factors contributing to dental caries in children, it is important to strengthen oral hygiene education for both parents and children. Promoting standardised dental caries prevention and treatment practices and cultivating good oral hygiene habits among children are essential for improving their oral health.

Purpose: Oral health is an integral part of health and well-being. Through birth cohorts, it is possible to identify health conditions and pathways of exposure that occur earlier in life. The objective of this study was to identify the data collected by birth cohorts regarding the oral health of children aged 0 to 5 years and to determine the relationship between their dental health status and their environment.

Materials and methods: Five databases were queried: PubMed, Web of Science, Scopus, Embase, and Dentistry & Oral Sciences Source. Eligible articles presented data on children's oral health before their 6th birthday, based on birth cohorts. They could be based on clinical, epidemiological, or self-reported oral health data obtained during at least one follow-up between birth and the age of 6 years.

Results: 3083 articles were identified in biomedical literature databases. After exclusions for various reasons, 359 abstracts and finally 145 full-length articles were read. A total of 101 articles were included in the analysis. These 101 articles came from 43 cohorts on 5 continents. They were published between October 1980 and January 2022. The most frequently identified theme was early childhood caries and its associated factors. Other themes were also studied: quality of life in relation to oral health, children's use of dental care, eruption of primary teeth, enamel anomalies, dental trauma, occlusion, and parafunctions in childhood.

Conclusion: Preschool children's oral health has been widely studied in terms of caries and its risk factors. However, biopsychosocial determinants have to date been insufficiently studied in these birth cohorts.

Purpose: To evaluate the occurrence of previous mucosal dysplasia in patients with oral squamous cell carcinoma (OSCC) and to charaterise patient profile, types of previous oral mucosal lesions, and care-seeking in relation to earlier mucosal findings.

Materials and methods: Retrospective data of OSCC patients with a primary tumour were collected. The primary outcome variable was any history of oral mucosal findings; the secondary outcome variable was a history of previous oral mucosal dysplasia. The primary predictor variable was the mode of seeking treatment. Patient and tumour-related variables were compared between patients with and without anamnestic mucosal changes or findings.

Results: A total of 528 patients were included in the study. Of these patients, 169 (32.0%) had a history of an oral mucosal lesion. Oral mucosal dysplasia was detected in 34 patients (6.4%) before the OSCC diagnosis. Patients who had a history of heavy alcohol use were less likely to have a history of any mucosal lesions or dysplasia (adjusted odds ratio [aOR] 0.350, 95% confidence interval [CI] 0.215-0.571, p 0.001 and aOR 0.235, 95% CI 0.070-0.795, p = 0.020). Tumours were detected more often in conjunction with routine appointments in patients with a history of any mucosal lesions (aOR 2.671, 95% CI 1.704-4.187, p 0.001) and in those with previously detected dysplasia (aOR 6.195, 95% CI 3.004-12.774, p 0.001).

Conclusions: The results emphasise the importance of careful examination and close follow-up of findings in the oral mucosa.

Purpose: To evaluate the caries status and its associated factors among Iraqi schoolchildren.

Materials and methods: A cross-sectional study was conducted from October to December 2022 with 372 primary schoolchildren aged 8-10 years in Kut City, Iraq. The study participants were selected using a multi-stage random sampling technique. Information about the children was collected through a questionnaire that included demographic characteristics, oral health-related behaviours, and parental knowledge regarding oral health. Moreover, a clinical dental examination was performed, which included assessment of decayed, missing, and filled teeth (DMFT, dmft) based on the criteria of the World Health Organization (WHO). The statistical analysis included the chi-squared test, ANOVA, and simple and multiple logistic regressions.

Results: The children's mean age was 9.0 years (± 0.82). The overall caries prevalence among the children was 94%. In terms of caries experience, in the primary dentition, 84% of the children had a mean dmft = 4, and in the permanent dentition, 61% of the children had a mean DMFT = 1.5. Multiple logistic regression showed that lower maternal educational level (OR = 2.10, 95% CI: 0.43-10.07), no history of dental visits (OR = 10.99, 95% CI: 2.29-52.72), and poor parental knowledge (OR = 7.70, 95% CI: 1.74-34.12) were positively associated with the prevalence of untreated tooth decay in this group of schoolchildren.

Conclusion: Dental caries was found to be highly prevalent, while a favourable level of oral health behaviours was rare among schoolchildren in this study. The mother's educational level, parents' knowledge about oral health, and having a dental visit in the last year were found to be associated with caries.

Purpose: To investigate the function of the Systemic Inflammation Response Index (SIRI) in the association of Healthy Eating Index (HEI) 2020 in patients with periodontitis risk.

Materials and methods: This study utilised data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014, including participants's oral examination results, dietary records, and levels of inflammatory markers. The study employed HEI-2020 as the independent variable and periodontitis as the dependent variable, using weighted logistic regression analysis to examine the association between HEI-2020 and periodontitis. Additionally, restricted cubic splines (RCS) were employed to further explore the non-linear association between the two. Mediation analysis was conducted to investigate the role of SIRI in the association between HEI-2020 and periodontitis.

Results: 3829 (34.5%) of the 9569 patients were diagnosed with periodontitis. In the weighted logistics regression model, HEI-2020 and the risk of periodontitis showed a statistically significant negative association (OR: 0.99, 95% CI: 0.98-1.00, p 0.001). The findings of the RCS curve showed a linear correlation (pnon-linear=0.684) between the risk of periodontitis and HEI-2020. With a mediation proportion of 9.82% (p 0.001), the findings of the mediation study indicated that SIRI partially mediated the relationship between HEI-2020 and periodontitis.

Conclusion: HEI-2020 and periodontitis risk are statistically significantly negatively correlated, and SIRI is a major mediating factor in this relationship. The study results may help clinicians better understand how a healthy diet impacts the risk of periodontal disease and identify the mediating role of SIRI in this association. This knowledge can guide personalised dietary and inflammation management strategies, enhancing oral and overall health by preventing and managing periodontal issues effectively.

Purpose: To investigate the approximal abrasive enamel and dentine wear using interdental brushes (IDBs) with and without toothpaste in a novel standardised in-vitro set-up.

Materials and methods: Seventy-two bovine enamel and 72 dentine specimens were prepared and randomly allocated into 12 groups (odd group: dentine; even group: enamel). The specimens were brushed with three IDB types of ISO 2 (Curaprox (CPS09, groups 1-4), Elmex (size 2, groups 5-8) and Circum (Circum 2, groups 9-12)) with artificial saliva or toothpaste slurry (Colgate Total Original). A custom-made brushing device simulated interdental brushing for 1 h on dentine (7,200 strokes) and 6 h on enamel (43,200 strokes). Wear was assessed using a contact profilometer, and electron microscopy images were taken. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis.

Results: The combination of IDBs with artificial saliva resulted in enamel and dentine wear below the detection limit, similar to the enamel wear when toothpaste was used. Dentine specimens showed significant abrasive wear, which was influenced by the IDBs' design as follows: Curaprox (median ± interquartile range (IQR): 8.6 ± 1.0 µm), Circum (9.7 ± 2.9 µm), and Elmex (18.8 ± 9.1 µm). The difference in wear between Curaprox and Circum was not statistically significant (P = 1). However, the increase in the wear of Elmex compared with that of the other IDBs was significant (P 0 0.001).

Conclusion: The use of IDBs with toothpaste may cause statistically significant dentine wear and should not be recommended in combination. Appropriate instructions are essential.