Oral health & preventive dentistry最新文献

Purpose: Pregnancy is a state particularly sensitive to oral pathologies (periodontal and decay). The oral health status of pregnant women can have an impact on the outcome of the pregnancy and the oral health of the child to come. As in the general population, the oral health of pregnant women is socially determined and dependent on psychosocial factors, including factors related to health behaviours. Research into the determinants of oral health in pregnant women will allow a better understanding of the mechanisms of action specific to this period of perinatality.

Materials and methods: The methodology of a scoping review was selected with the objective of investigating the contribution of knowledge, attitudes, practices (KAP) and oral health literacy on pregnant women's oral health.

Results: Of the 67 articles selected, 52 studied the 'knowledge' component, 27 the 'attitude' (including the perception and beliefs concerning health), and 54 the 'practice' component, while 6 articles examined literacy. The KAP components were studied in relation to socioeconomic determinants, oral health status, healthcare utilisation and oral health literacy. The level of oral health literacy of pregnant women is strongly related to their living environment and socioprofessional level which influences their attitudes and practices. Woman's oral health practices before pregnancy can be a predictor of her practices during pregnancy.

Conclusion: The complex nature of the attitude component (locus of control, sense of self-efficacy, perceived importance) is little discussed. The heterogeneity and exhaustiveness of topics related to KAP raises the question of how to more accurately assess KAP in pregnant women in a valid, reproducible, and transferable manner and the need to build a structured oral health consensus body of work. This review is a first step towards identifying the psychosocial factors that are essential for developing a model of educational intervention in oral health that combines the process of behavioural change and decision making while taking into account the concept of empowerment, and with the aim of reducing social inequalities in health.

Purpose: This study aimed to clarify the impact of the coronavirus disease 2019 (COVID-19) pandemic on individual dental-visit behaviour and examine the difference between elderly and other individuals regarding the impact on dental visits.

Materials and methods: An interrupted time-series analysis was performed to examine the change in data from the national database before and after the first declaration of a state of emergency.

Results: The number of patients visiting a dental clinic (NPVDC), number of dental treatment days (NDTD) and dental expenses (DE) during the first declaration of a state of emergency decreased by 22.1%, 17.9%, and 12.5% in the group under 64 years of age and 26.1%, 26.3%, and 20.1% in the group over 65 years of age, respectively, compared with those in the same month of the previous year. Between March and June 2020, the monthly NPVDC and NDTD were significantly reduced (p < 0.001, p = 0.013) in those over 65 years of age. The DE did not change statistically significantly in either the under 64 group or the over 65 group. There was no statistically significant change in the slope of the regression line in the NPVDC, NDTD, and DE before and after the first state-of-emergency declaration.

Conclusion: The first state of emergency greatly reduced the NPVDC, NDTD, and DE compared to those in the previous year. In people aged over 65 years, it might still be unresolved 2 years after the postponement of dental treatment owing to the first declaration of a state of emergency.

Purpose: To assess the root surface roughness and substance loss induced by chemical and chemomechanical challenges on root surfaces pretreated with ultrasonic instrumentation, a hand scaler, or erythritol airflow.

Materials and methods: One hundred twenty (120) bovine dentin specimens were used in this study. Specimens were divided into eight groups and treated as follows: groups 1 and 2: polished with 2000- and 4000-grit carborundum papers but not instrumented ('untreated'); groups 3 and 4: hand scaler; groups 5 and 6: ultrasonic instrumentation; groups 7 and 8: erythritol airflow. Samples from groups 1, 3, 5, and 7 then underwent a chemical challenge (5 x 2 min HCl [pH 2.7]), whereas samples from groups 2, 4, 6, and 8 were subjected to a chemomechanical challenge (5 x 2 min HCl [pH 2.7] + 2 min brushing). Surface roughness and substance loss were measured profilometrically.

Results: The least substance loss through chemomechanical challenge was noted after erythritol airflow treatment (4.65 ± 0.93 µm), followed by ultrasonic instrumentation (7.30 ± 1.42 µm) and the hand scaler (8.30 ± 1.38 µm); the last two (hand scaler and ultrasonic tip) did not differ statistically significantly. The highest roughness after chemomechanical challenge was observed on ultrasonically treated specimens (1.25 ± 0.85 µm), followed by hand-scaled specimens (0.24 ± 0.16 µm) and those subject to erythritol airflow (0.18 ± 0.09 µm); there was no statistically signficant difference between the latter two, but they both differed statistically significantly from the ultrasonically treated specimens. No statistically significant difference in substance loss through the chemical challenge was observed between specimens pretreated by the hand scaler (0.75 ± 0.15 µm), ultrasonic tip (0.65 ± 0.15 µm), and erythritol airflow (0.75 ± 0.15 µm). The chemical challenge smoothed the surfaces treated with the hand scaler, ultrasonic tip, and erythritol airflow.

Conclusion: Dentin pretreatment with erythritol powder airflow resulted in a higher resistance to chemomechanical challenge than did dentin treated ultrasonically or with the hand scaler.

Purpose: To analyse whether the stage of apical development affects the effectiveness of regenerative endodontic treatment by comparing the outcomes for necrotic mature and immature permanent teeth treated with regenerative endodontic procedures.

Materials and methods: Multiple databases (PubMed, Cochrane Library, Web of Science, EMBASE and OpenGrey databases) were searched through February 17th, 2022. Inclusion criteria were randomised controlled trials that included treatment of necrotic immature or mature permanent teeth using any regenerative endodontic procedures (REPs) that aimed to achieve pulp revascularisation or regeneration. The Cochrane Risk of Bias 2.0 tool was used to assess risk of bias. The included indicators were asymptomatic sign, success, pulp sensitivity, and discolouration. The extracted data were expressed by percentage for statistical analysis. The random effect model was used to explain the results. Comprehensive Meta-Analysis Version 2 was used to perform the statistical analyses.

Results: Twenty-seven RCTs were eligible for inclusion in the meta-analysis. The success rates of necrotic immature and mature permanent teeth were 95.6% (95% CI, 92.4%-97.5%; I2=34.9%) and 95.5% (95%CI, 87.9%-98.4%; I2=0%), respectively. The asymptomatic rates of necrotic immature and mature permanent teeth were 96.2% (95%CI, 93.5%-97.9%; I2=30.1%) and 97.0% (95%CI, 92.6%-98.8%; I2=0%), respectively. The treatment of immature and mature necrotic permanent teeth with REPs yields high success rates and low symptomatic rates. The incidence of positive sensitivity response for electric pulp testing in necrotic immature permanent teeth (25.2% [95% CI, 18.2%-33.8%; I2=0%]) was lower than that in necrotic mature permanent teeth (45.4% [95% CI, 27.2%-64.8%; I2=75.2%]), and this difference was statistically significant. The restoration of pulp sensitivity seems to be more evident in necrotic mature permanent teeth than in necrotic immature permanent teeth. The crown discolouration rate of immature permanent teeth was 62.5% (95% CI, 49.7%-73.8%; I2=76.1%). Necrotic immature permanent teeth have a considerable crown discolouration rate.

Conclusion: REPs for both immature and mature necrotic permanent teeth yield high success rates and promote root development. The vitality responses seem to be more evident in necrotic mature permanent teeth than in necrotic immature permanent teeth.

Purpose: To investigate the prevalence, clinical manifestations and related risk factors of malocclusion in schoolchildren of Jinzhou City, China.

Materials and methods: A total of 2162 children aged 6-12 years were randomly selected from various districts of Jinzhou. Conventional clinical examination was performed by stomatologists, and the results were described based on different clinical manifestations of malocclusion and individual normal occlusion. Further, a questionnaire survey completed by children's parents or guardians provided the demographic data, lifestyle, and oral habits. The distribution of individual normal occlusion and malocclusion was documented in percentage, and Pearson's Χ2 was used for two-factor analysis. The data were statistically analysed using SPSS software (version 25.0) with a significance level of α = 0.05.

Results: A total of 1129 boys and 1033 girls were included in this study, i.e. 52.2% and 47.8% of the total number of children, respectively. The prevalence of malocclusion in children aged 6-12 years old in Jinzhou was 67.9%, of which crowded dentition was the most common form, with a prevalence of 71.8%, followed by deep overbite, anterior crossbite, dental spacing, deep overjet, anterior edge-to-edge occlusion, and anterior open bite. In the logistic regression model, the results showed that BMI index had little effect on the occurrence of malocclusion (p > 0.05), while dental caries, bad oral habits, retained primary teeth, and a low labial frenum were all related to the occurrence of malocclusion (p < 0.05). Moreover, the higher frequency and duration of bad oral habits were associated with a higher likelihood of malocclusion.

Conclusions: The prevalence of malocclusion in children aged 6-12 years in Jinzhou is high. In addition, bad oral habits (such as lip biting, tongue thrusting, biting/gnawing objects, unilateral chin supporting, and unilateral mastication) and other related risk factors (such as dental caries, mouth breathing, retention of primary teeth, and low labial frenum, etc) were associated with malocclusion.

Purpose: This study investigated the effect of toothbrush bristle stiffness and brushing force on the cleaning efficacy in vitro.

Materials and methods: Eighty bovine dentin samples were allocated to eight groups (n=10). Two custom-made toothbrushes of different bristle stiffness (soft and medium) were tested at four different brushing forces (1, 2, 3 and 4 N). Dentin samples were stained in black tea and brushed (60 strokes/min) for a total of 25 min in a brushing machine with an abrasive solution (RDA 67). Photographs were taken after 2 and 25 min of brushing time. Cleaning efficacy was measured planimetrically.

Results: After 2 min of brushing, the soft-bristle toothbrush did not cause statistically significantly different cleaning efficacy at different brushing forces, while the medium-bristle toothbrush cleaned statistically significantly less efficaceously only at 1 N. Comparing the two different toothbrushes, higher cleaning efficacy was observed only at 1 N for the soft-bristle brush. At 25 min brushing time, the soft-bristle cleaned statistically significantly better at 4 N compared to 1 N and 2 N and at 3 N compared to 1 N. Using the medium-bristle, cleaning efficacy increased with increasing brushing force. After 25 min of brushing, no statistically significant difference was observed between the two different toothbrushes.

Conclusion: Irrespective the brushing force, the use of a soft or medium toothbrush results in comparable cleaning efficacy. At 2 min brushing time, increasing the brushing force does not increase the cleaning efficacy.

Purpose: The subgingival area is only reached to a limited extent during home oral hygiene with the aids available to date. The question was investigated whether a newly developed, flattened cross-sectional design of interdental brushes (IDBs) can extend their subgingival reach.

Materials and methods: In part I, the passage-hole diameters (PHD) of IDBs of different sizes and side-bristle lengths, with circular and flattened cross-sections, were compared according to the ISO standard 16409/2016. In part II, handling of flattened IDBs was described based on a case report of a patient with generalised stage 4, grade C periodontitis with locally persistent pockets.

Results: Depending on the brush's size, flattening of IDBs reduced the PHD by 1-18 intervals. IDBs with longer side bristles could thus be inserted into interdental spaces with equal force. This may increase the potential range of IDBs in the vertical dimension. Regular instruction and check-ups are necessary to enable correct handling, as the flattened brushes can only be used in two positions. The observations documented in the case report (duration: 1.5 years) showed that flattened IDBs were associated with reduced signs of inflammation (reduction of pocket depths from 6 to 3 mm, absence of bleeding on probing).

Conclusion: IDBs with a flattened cross-sectional design have not been previously described in the literature. It was shown that flattening of IDBs leads to a size-dependent decrease in PHD. Based on a case report, it was hypothesised that the design change of the IDBs could be clinically relevant in the case of persistent deep pockets in narrow interdental spaces. However, this can only be verified or falsified by clinical studies.

Purpose: To determine the self-perceived oral health and general health as well as the oral health-related quality of life (OHRQoL) among parents in Kuwait.

Materials and methods: This cross-sectional study was conducted among parents visiting the School Oral Health Programme (SOHP) clinics in all the governorates in Kuwait. Being a parent and able to read and understand the Arabic language was the inclusion criterion. A convenience sample of parents (n = 2357) were enrolled in this study, which was conducted using a self-administered questionnaire in Arabic. The questionnaire included previously validated questions and also questions designed for this study. The parents completed and returned the questionnaire while waiting for their children in the waiting area of the SOHP clinic.

Results: The mean age of the parents was 38.3 ± 7.3 years. The majority (75.2%) of the participants perceived their oral health 'excellent', 'very good' or 'good' and 76.4% also rated their general health as 'excellent', 'very good' or 'good'. Overall, higher levels of perceived oral health were reported more frequently by younger participants, females, Kuwaitis, and those who had higher levels of education (p < 0.001). Most of the participants (72.3%) were satisfied with their oral health, (91.0%) enjoyed eating their food and (79.0%) liked their smile. Perceived difficulty in chewing food was stated by only 21.0%, and very few (5.0%) had speech difficulties. Almost half (45.0%) mentioned that they had never had any dental and/or gum problems that affected their daily activities during the past 6 months, nor did such problems influence their social activities. Nearly two-thirds (61.0%) stated that they never had any difficulty in conversation, and half (49.0%) did not report any disturbance in their sleep. Cronbach's alpha (0.89) showed a high degree of internal consistency between different OHRQoL responses.

Conclusion: Most of the parents were satisfied with their oral health, which had an impact on their quality of life.

Purpose: Since NaOCl acts as a strong oxidizing agent and presents potential toxicity, this study was adressed to evaluate the in-vitro safety of NaOCl solutions at concentrations below the limit of patient tolerance, i.e. ≥ 0.5%.

Materials and methods: First, an in-silico evaluation was conducted to predict the potential toxicity of NaOCl in terms of mutagenic, tumorigenic, irritant, and reproductive risks, as well as some drug-like properties of the molecule. The in-vitro experiments were based on 2D and 3D models. For the 2D approach, two selected cell lines - HaCaT (human skin keratinocytes) and HGF (human gingival fibroblasts) - were exposed to NaOCl at five concentrations (0.05 - 0.5%) for 10, 30, and 60 s to simulate possible clinical administration. The irritative potential of NaOCl 0.05% and 0.25% was assessed in a 3D in-vitro model (EpiDerm, reconstructed human epidermis). Statistical significance was set at p < 0.05.

Results: The main findings suggest that NaOCl exerts cytotoxicity towards HaCaT immortalised keratinocytes and HGF primary gingival fibroblasts in a cell type-, dose- and time-dependent manner, with the most prominent effect being recorded in HaCaT cells after 60 s of treatment with NaOCl 0.5%. However, NaOCl was computationally predicted as free of mutagenic, tumorigenic, irritant, and reproductive toxicity, and showed no irritative potential in 3D reconstructed epidermis at concentrations of 0.05% and 0.25%.

Conclusion: Further clinical and histological studies are required to confirm these results, as well as elucidate the potential cytotoxic mechanism induced by NaOCl in HaCaT and HGF cells at the tested concentrations.

Purpose: Saudi children have poor oral health; however, little data are available on the effects of dental caries and its clinical complications on the oral health-related quality of life (OHRQoL) in school-aged children. This study evaluated the impact of caries and its clinical effects on the OHRQoL of a sample of 8- to 10-year-old children attending King Abdulaziz University Hospital.

Materials and methods: The following variables were assessed for each child: sociodemographic data, OHRQoL using an Arabic-validated Child Perception Questionnaire for 8- to 10-year-old children (CPQ8-10), and two global health rating questions. Caries and its clinical effects on oral health were also assessed using the decayed-missing-filled teeth (dmft/DMFT) and pulpal involvement, ulceration, fistula, and abscess (pufa/PUFA) indices. Descriptive statistics of the sociodemographic variables and responses to the CPQ8-10 questions are presented as absolute values and percentages. The CPQ8-10 scores between children with different dmft/DMFT and pufa/PUFA scores were compared.

Results: In total, 169 children participated in this study. The means ± SD of dmft and DMFT were 5.03 ± 2.5 and 2.35 ± 1.7, respectively. However, the pufa and PUFA scores were 1.03 ± 1.6 and 0.05 ± 0.2, respectively. The most common oral health complaint affecting OHRQoL was food stuck to the teeth. Participants with higher dmft and pufa/PUFA scores had statistically significantly higher CPQ8-10 scores than did their counterparts.

Conclusion: High dmft and pufa/PUFA scores have a statistically signifcantly negative effect on the OHRQoL among healthy 8- to 10-year-old children. Worse global health ratings correlate with lower OHRQoL.