Oral health & preventive dentistry最新文献

Purpose: This study aimed to investigate the association between excessive daytime sleepiness and oral health-related quality of life (OHRQoL) in dental and dental-hygiene students using a cross-sectional design.

Materials and methods: Dental students and dental-hygiene students completed a sociodemographic and habits questionnaire. Oral health-related quality (OHRQoL) of life was assessed using the Oral Health Impact Profile (OHIP), and sleep quality was determined using the Epworth Sleepiness Scale. Student's t-tests and chi-squared tests were used to analyse the association between oral health-related quality of life with sleep and other variables. A linear regression model was constructed to adjust the effect of daytime sleepiness for oral health-related quality of life.

Results: The dimenstion of the OHIP that had the worst scores was physical pain (mean: 1.45; SD: 1.49). Excessive daytime sleepiness impaired the OHRQoL specifically because of physical pain, functional limitation, physical disability, and psychological disability. In the adjusted analysis, the presence of excessive daytime sleepiness increased the OHIP score to 2.54 points (95% CI: 1.09-3.99). To be female and to study at the technical-school level was also associated with a reduction of OHRQoL.

Conclusion: The presence of excessive daytime sleepiness impaired the OHRQoL of students. Excessive daytime sleepiness is a factor associated with lower OHRQoL. Integration of sleep monitoring in interventions aimed at improving the OHRQoL could have a relevant impact on young adult patients.

Purpose: To investigate the antibacterial and anti-biofilm effects of two Manuka honey toothpaste formulations containing propolis (Manuka prop) or fluoride (Manuka F), in comparison with the toothpaste base (TP con) and a commercial toothpaste (TP com), on oral bacteria and biofilm.

Materials and methods: The minimum inhibitory concentration (MIC) of the formulations and controls were tested against five oral bacterial species. Both the effect on a multispecies dental biofilm precultured for 3.5 days as well as the inhibition of de-novo biofilm formation up to 24 h were investigated. Test substances at concentrations of 20%, 10% and 5% were applied to preformed biofilm for 1 min. The reduction in colony-forming units (cfu), metabolic activity, and biofilm mass were determined. Similarly, the test substances were applied to surfaces for 30 min before bacteria and media were added. The reduction of a tetrazolium dye (MTT assay) was used to assess cytotoxicity on gingival fibroblasts.

Results: The MIC values of all toothpaste formulations including TP con were very low with the highest MIC of 0.04%. In precultured biofilms, both the number of colony forming units (cfu) and metabolic activity decreased following addition of any toothpaste. The greatest reductions of cfu were found after addition of 20% TP com (by about 6 log10) and after 20% Manuka prop (by about 2.3 log10). However, the biofilm mass was not reduced. Coating the surface with toothpaste formulation, the cfu in the newly formed biofilm decreased in a concentration-dependent manner, with TP com being most active. Both 20% of Manuka prop and Manuka F reduced the cfu counts more than the TP con at 24 h. The toothpaste formulations affected the viability of gingival fibroblasts in a concentration-dependent manner, with no differences observed among the formulations.

Conclusion: The Manuka-honey containing toothpastes might be an alternative to toothpaste containing conventional chemical agents. Further research is needed to clinically examine the effect on caries and gingivitis prevention.

Purpose: The oral-health impact of nicotine pouches, an emerging category of oral tobacco products, has not been well studied. We evaluated the effects of switching from cigarettes to on!® nicotine pouches (test product, TPs) on oral-health endpoints among adult smokers (AS) relative to those who just continued smoking (CS).

Materials and methods: In this randomised, open-label, parallel-group study, participants were randomly assigned to ad libitum use of 2, 4, or 8 mg nicotine TP or CS for 24 weeks. Oral-health endpoints, e.g., Modified Gingival Index (MGI), Gingival Bleeding Index (BI), and Lobene Stain Index (LSI)] were assessed at baseline and weeks 12 and 24, and compared between the TP and CS groups by using linear mixed model analysis for repeated measurements.

Results: n = 155 participants were randomised; 100 (TP = 48; CS = 52) completed week 12, and 85 (TP = 40; CS = 45) completed week 24 assessments. The TP group reduced their cigarette consumption by >90% by weeks 12 and 24 despite not intending to quit at baseline. Statistically significant reductions (p < 0.001) were observed for MGI and BI at weeks 12 (MGI = 20%; BI = 30%) and 24 (MGI = 28%; BI = 23%) in the TP group compared to the CS group, as well as compared to baseline. Statistically significant reductions (~60%, p < 0.001) were also observed for LSI in TP vs CS. No statistically significant changes were observed for LSI in the CS group at weeks 12 and 24 compared to baseline.

Discussion: The findings from this study suggest that TPs do not negatively impact users' oral health over 24 weeks of use. The reduction in oral health endpoints supports the harm reduction potential of TPs.

Purpose: The aim of this proof-of-principle study was to investigate the reproducibility of digital hard- and soft-tissue measurements obtained using an intraoral scanner.

Materials and methods: Two consecutive digital scans of the maxilla and mandible of 20 subjects aged 18-58 years were captured with an intraoral scanner. Afterwards, the double scans of each subject were virtually matched by three different methods using a dental software program. Linear distances between defined hard- and soft-tissue points on the intraoral scans were measured for each individual. To assess the reproducibility of the measurements for each matching method, the corresponding linear distances of the first and second scans were compared using a paired t-test (p 0.05). ANOVA (p 0.05) was used for comparison of the three matching methods.

Results: For both hard and soft tissue, the measured linear distances between the first and second scans did not differ statistically significantly. Furthermore, there were no statistically significant differences between the three matching methods for soft (p = 0.196) and hard (p = 0.963) tissue.

Conclusion: Digital measurements of hard and soft tissue are reproducible using intraoral scans. Furthermore, all three matching methods are suitable for the superimposition of scans. However, possible inaccuracies may depend on the experience of the practitioner, the technical limitations of the systems used, and patient-related factors.

Purpose: To evaluate hereditary angioedema (HAE) attack frequency associated with dental procedures, determine whether patients with post-dental procedural attacks receive more appropriate treatment after their condition is diagnosed, and investigate the potential impact of perceived risk on patients seeking dental care and dental professionals providing it.

Materials and methods: The observational study included all the eligible adults from the Romanian Hereditary Angioedema Registry who provided informed consent. The impact of dental procedures on the HAE attacks was measured using a structured questionnaire including 20 questions administered via telephone.

Results: Patients experienced dental procedure-related symptoms suggestive of HAE both before (47.6%) and after their condition was diagnosed (51.9%). Before the HAE diagnosis, 86.2% of the patients received glucocorticoids and antihistamines for post-procedural swelling. After diagnosis, 85.3% of the patients were given Icatibant and C1-INH. More than half (55.3%) of the patients reported not seeking dental interventions because of fear of HAE attacks or anticipation of refusal, and 24.7% of them declared they had been denied dental care by dental health professionals at least once.

Conclusion: Swelling related to dental procedures was common among the studied HAE patients. Unwarranted medications used before HAE diagnosis for dental post-procedural symptoms were replaced by adequate HAE-specific medications in most patients with established HAE diagnosis. A statistically significant proportion of patients refrained from undergoing dental interventions, and some of them were refused dental care by oral health professionals due to fear of HAE attacks.

Aim: To evaluate the relationship between body mass index (BMI) and dental caries in children aged 4-12 years.

Materials and methods: 367 children referred to the pedodontics clinic were included in our study. In this two-stage study, firstly the decayed, missing, and filled teeth index (DMFT) or dental caries index (dft) scores of the children were recorded by oral examination, and their weight and height measured. Secondly, the children's parents or legal representatives were asked to complete a questionnaire assessing sociodemographic data and their children's nutritional habits. The data obtained were analysed statistically. In multiple comparisons of variables showing continuous variation with normal distribution, ANO-VA post-hoc analysis and Tukey's tests were used. For variables not showing normal distribution, Kruskal-Wallis post-hoc analysis and Mann-Whitney U tests were used.

Results: Considering their BMI, 34.1% children were underweight, 30.8% were of normal weight, 14.4% were overweight, and 20.7% were obese. A significant relationship was found between the children's BMI and age groups (P = 0.000) and BMI increased as age decreased. Both BMI and dental caries incidence increased as the consumption of carbohydrates and sugar products increased. The mean DMFT score was higher for children with overweight BMI. The mean dft score was higher among children in the obese BMI category.

Conclusion: High BMI and dental caries are multifactorial disorders with similar risk factors, and the relationship between both is still not fully clear in the literature. Although cross-sectional studies provide the infrastructure for future studies by revealing the prevalence of the disorder, risk factors, and possible consequences, they are inadequate to examine the cause-effect relationship. More detailed and longer-term studies are needed to establish the causal relationship between BMI and dental caries.

Purpose: To investigate the effects of patient-related factors such as age, sex, implant location, and history of periodontitis, on crestal bone loss in the posterior region throughout the surgical healing and functional periods.

Materials and methods: This study evaluated 311 implants from 163 patients, with an average follow-up of 27.10 months. Implants were assessed based on age, sex, implant location, and history of periodontitis. Crestal bone loss was quantified by measuring bone level changes using oral panoramic radiographs. Time T1 was defined as the period from implant placement to the healing phase, and T2 as the period from the second-stage surgery to the follow-up visit. Group comparisons were made using the Mann-Whitney U-test, with significance set at p 0.05.

Result: At T1, crestal bone loss averaged 0.27 ± 0.40 mm; at T2, it averaged 0.40 ± 0.50 mm. A statistically significant difference at T1 was observed between patients aged 20-39 and 40-59, and between these two age groups in female patients (p 0.05). During T2, within the 40-59 age group, bone resorption differed statistically significantly between males and females (p 0.05). Statistically significant differences were also noted between males aged 40-59 and those 60 years or older, and between females aged 20-39 and 40-59 (p 0.05). There were no differences between the other groups.

Conclusion: Crestal bone loss correlates with patient age and sex. Increased attention should be given to female patients within certain age ranges. Patients with history of periodontitis can maintain bone tissue stability around the implant.

Purpose: Periodontitis and heart failure (HF) impact millions of individuals globally with heavy social and economic burden. Prior research has indicated a connection between them. However, the conclusions have been somewhat inconsistent. Our objective is to confirm, through meta-analysis and Mendelian randomisation studies, whether patients with periodontitis have an increased risk of HF. Therefore, we conducted a comprehensive analysis to explore the causal association between periodontitis and the risk of HF.

Materials and methods: In this meta-analysis, we searched online to identify studies involving periodontitis on the risk of HF. The main endpoint assessed in this study was the risk of HF. We used R language to calculate the pooled results and create plots. A random-effects model was employed in the analyses. In the Mendelian randomisation (MR) analyses, we obtained data from public databases. MR analyses were conducted using genome-wide association data for acute and chronic periodontitis. Independent genetic variants associated significantly with each exposure (P 5*10-6) were considered as instruments. The primary analysis employed the inverse variance weighted (IVW) method, which was subsequently supplemented by a series of sensitivity analyses to ensure the robustness and reliability of the findings.

Results: Our meta-analysis included three publications, with a total of 21,997 participants. The pooled result demonstrated that periodontitis increased the risk of HF (OR = 1.62, 95% CI 1.29-2.03). Periodontitis increased the risk of heart failure with reduced ejection fraction (HFrEF) with a low level of heterogeneity (OR = 1.99, 95% CI 1.22-3.23) and heart failure with preserved ejection fraction (HFpEF) with little heterogeneity (OR = 1.36, 95% CI 1.00-1.86). In the MR study, acute or chronic periodontitis did not increase the risk of HF. Sensitivity analyses revealed that the causal association estimations were robust.

Conclusion: In summary, the meta-analysis results indicate that individuals with periodontitis are at a higher risk of HF. The findings from the MR study fail to establish a causal link between the two variables under investigation. To validate this assertion and elucidate the fundamental mechanism, additional research is imperative.

Clinical significance: Based on the current evidence, it cannot be concluded that there is a causal relationship between acute or chronic periodontitis and HF.

Purpose: A direct association exists between caries and high-sugar diets. The aim of this study was to test whether the cariogenicity of diet assessed and analysed through a new mobile app is associated with caries risk among children.

Materials and methods: A total of 247 children, 2-15 years old, were recruited from university and hospital daycare centers and dental clinics. Diet was assessed via a 24-h recall, and caries (dmft/DMFT- ICDAS criteria) was documented through clinical examination. A mobile app was designed to analyse dietary data and calculate the diet's cariogenicity. Demographics, daily meals, meal duration and type, and toothbrushing were entered. A diagram presenting an estimate of the oral pH was produced, showing the time interval during which caries may develop, and a calculated cariogenic dietary risk was generated. Multivariate logistic regression derived odds ratios estimating associations between the cariogenic diet and caries across three age groups.

Results: A cariogenic diet analysed by the app was positively associated with dfmt (r = 0.477, p 0.001) in 2- to 6-year-old children, with dmft (r = 0.376, p 0.05) and DMFT (r = 0.271, p 0.05) in 7- to 11-year-old children, and with DMFT (r = 0.383, p 0.001) in 12- to 15-year-old children. Parents' lower educational level was associated with a statistically significantly higher caries risk in younger children (p 0.05).

Conclusion: Cariogenic diet evaluated with the new app was associated with increased caries, providing evidence of an accurate assessment among children. This app could assist dentists in providing dietary assessment and advice related to caries risk at the dental office in a more structured, educational, and time-saving way.

Purpose: To determine oral health myths and associated factors in pregnant women.

Materials and methods: This was a cross-sectional analytical study carried out in an outpatient clinic of a public hospital in Lima, Peru, in a sample of 390 pregnant women (mean age = 30.02 ± 6.32 years) who answered a questionnaire of 61 items, comprising 39 oral health myths, 10 demographic/socioeconomic items, and 12 general health items. Multiple linear regression models were used with Jamovi v.17 at p 0.05.

Results: Oral health myths were prevalent (33.6‒77.6%) and numerous (10 [7‒13] per pregnant woman), with common gestational or maternal beliefs associated with the presence of weakening of enamel/increased risk of caries and gingivitis, infection, or calcium loss; gingival bleeding and dental caries; risks posed by spicy food, medication, radiography, or anesthesia; and intense toothbrushing. Positive predictors of oral health myths were birth in geographical districts outside Lima, previous sexually transmitted disease and pre-eclampsia. Negative predictors were having more children, a higher educational level, better employment status, minimum monthly income, and history of smoking (R2 = 13%; F = 2.37; p 0.001).

Conclusion: Pregnant women had a high prevalence of beliefs in a large number of oral health myths associated with birth in the geographical districts outside the capital city, less maternal experience, poorer educational, occupational and economic conditions, and obstetric-gynecological medical history.