BDJ Open最新文献

Aim: To investigate the prevalence of dental caries and its association with Body Mass Index (BMI) among Syrian schoolchildren aged 6-9 years in Damascus.

Materials and methods: A cross-sectional study was conducted among 462 schoolchildren selected through multi-stage cluster sampling. Data were obtained using a structured questionnaire and clinical examinations based on WHO criteria. BMI was assessed according to standard protocols. Associations between dental caries and sociodemographic, dietary, oral hygiene factors, and BMI were analyzed using SPSS v25, with statistical significance set at P < 0.05.

Results: The prevalence of dental caries was 85.5%, with no significant differences by gender or age. Caries was significantly more frequent among children in public schools (87.7%; P = 0.042) and those from low socioeconomic backgrounds (95.7%; P < 0.001). Irregular fruit and vegetable intake and higher sugar consumption were associated with increased caries risk. BMI also showed a significant association with caries (P < 0.001), with overweight children exhibiting the highest prevalence (97.1%), although multivariable logistic regression confirmed BMI as an independent predictor with no difference between obese children and other classifications.

Conclusion: Dental caries is highly prevalent among Syrian children aged 6-9 years and shows significant associations with socioeconomic disadvantage, unhealthy dietary habits, poor oral hygiene, and increased BMI. Nevertheless, due to the cross-sectional design of the study, these associations do not establish a causal relationship between BMI and dental caries. Despite this limitation, the findings underscore the urgent need for integrated public health strategies to address both oral health and childhood obesity.

Objective: Emerging evidence suggests that oral squamous cell carcinoma (OSCC) harbors distinct microbial communities, yet their influence on tumor immunobiology remains unclear. This study investigated the prognostic value of intratumoral microbiota and their role in modulating CD8⁺ T-cell function.

Materials and methods: Using TCGA datasets, a 19-microorganism prognostic signature was constructed via Cox and LASSO regression and validated with Kaplan-Meier survival analysis. Comprehensive bioinformatics analyses, including GSEA/GSVA, CIBERSORT, ESTIMATE, pharmacogenomics, and mutational profiling, were performed to explore underlying mechanisms.

Results: The microbial signature demonstrated strong predictive performance, with higher risk scores significantly associated with reduced overall survival (p < 0.001). High-risk tumors exhibited enrichment of PI3K/AKT/mTOR signaling, metabolic reprogramming, and epithelial-mesenchymal transition, alongside an immunosuppressive microenvironment characterized by CD8⁺ T-cell depletion, M0 macrophage infiltration, and upregulation of immunosuppressive markers including CD276 and TGF-β1. Conversely, immune-activating checkpoints such as PD-1 and CTLA-4 were elevated in low-risk tumors. Notably, periodontal pathogens negatively correlated with immune effector activity, and TP53 mutations were more frequent in high-risk cases (82% vs. 67%).

Conclusions: This study identified intratumoral microbial signatures as independent prognostic biomarkers and validated their reproducibility in an external cohort. Our findings support a microbiota-immune axis contributing to immune evasion in OSCC, offering novel avenues for prognostic stratification and therapeutic intervention.

Background: In previous studies, immediate implant placement in molar regions has been widely applied.

Purpose: To study the clinical effect and feasibility of simultaneous implantation of implants combined with lateral maxillary sinus floor elevation in the maxillary molar region with severe bone defects.

Materials and methods: Patients requiring lateral maxillary sinus elevation (LMSE) surgery in the maxillary molar region were selected. The patients (residual bone height, RBH < 3 mm) were randomly divided into two groups: the experimental group underwent simultaneous implant placement combined with LMSE; the control group first received bone augmentation via LMSE, followed by delayed implant placement. The outcome indicators included implant success rate, surgical complications, and measurements of Cone Beam Computer Tomography (CBCT) data.

Results: The implant survival rate of both groups was 100%. One patient in each group experienced a maxillary sinus membrane perforation. From T1 (immediately after surgery) to T2 (9 months after surgery), both the bone height and bone width decreased in both the experimental group and the control group, and the bone resorption at the three sites (IBSH, MBH, DBH) in terms of bone height was greater than that in terms of bone width. The minimum bone resorption was observed at the IBSH site in both group. The amount of bone resorption in the experimental group at the above three sites was less than that in the control group, with statistical differences(p < 0.05). There was no statistical difference in the amount of bone width resorption between the two groups(p > 0.05).

Conclusion: In cases where the bone volume is less than 3 mm, the method of simultaneous implantation with LMSE is feasible.

Introduction: Oral squamous cell carcinoma (OSCC) ranks among the most prevalent cancers worldwide, typically arising from oral potentially malignant disorders (OPMDs). Early detection in high-risk individuals is critical for improving patient outcomes. This cross-sectional study assessed the diagnostic accuracy of sequential vital staining with 5% Methylene Blue (MB) and 3% Lugol's Iodine (LI) and explored its influence as a visual behavioural motivator to encourage tobacco cessation among Indian tobacco users.

Methods: Fifty adult tobacco users presenting with oral mucosal lesions underwent in vivo double vital staining. Each lesion was first stained with MB, followed by LI. Clinically retained MB and non-retained (negative) LI areas were recorded. Targeted biopsies were obtained from stained and unstained sites. Histopathological findings were correlated with staining patterns to determine sensitivity, specificity, and overall diagnostic accuracy.

Results: MB staining alone demonstrated high diagnostic yield, with sensitivity of 94.7%, specificity of 87.1%, and overall accuracy of 90.0%. Combining MB and LI increased sensitivity to 100%, ensuring no dysplastic lesions were missed, but reduced specificity to 67.7%, leading to more false positives. Clinically, the vivid contrast provided by double staining enhanced lesion delineation, and many participants reported that seeing the stained lesions heightened their awareness and spurred discussions on tobacco cessation.

Conclusion: The MB-LI sequential staining technique offers exceptional sensitivity for identifying dysplasia in tobacco-related oral mucosal lesions. Its bright visual feedback not only supports early diagnosis but also appears to function as a powerful motivational tool, prompting self-reflection and encouraging cessation behaviour among tobacco users. These findings suggest that vital staining has dual utility: as an effective diagnostic adjunct and as a behavioural intervention aligned with tobacco-cessation strategies recommended by dental professionals.

Objectives: The relationship between blood cadmium levels and the risk of periodontitis remains unclear. This study aimed to explore the association between blood cadmium concentrations and periodontitis in a large sample of the U.S. population from 2011 to 2014.

Methods: This cross-sectional study analyzed data from 5215 participants in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Blood cadmium levels were the exposure variable, and periodontitis was the outcome variable. Multivariate logistic regression and a two-piecewise linear regression model were used to examine the nonlinear relationship between blood cadmium levels and periodontitis. Stratified analyses were conducted to identify subgroups at higher risk.

Results: The study identified a nonlinear relationship between blood cadmium levels and periodontitis risk. The threshold effect was observed at 0.37 µg/L and 1.20 µg/L. When blood cadmium levels were below 0.37 µg/L, the odds ratio (OR) for periodontitis was 0.88 (95% CI: 0.31, 2.48; p = 0.81). For cadmium levels between 0.37 and 1.20 µg/L, the OR increased significantly to 12.40 (95% CI: 2.77, 55.57; p < 0.001). When cadmium levels exceeded 1.20 µg/L, the OR decreased to 0.45 (95% CI: 0.06, 3.39; p = 0.44).

Conclusions: The study found a nonlinear association between blood cadmium levels and periodontitis risk in U.S. adults. The risk of periodontitis increased significantly when blood cadmium levels were between 0.37 and 1.20 µg/L.

Aims: This study evaluated the influence of different root canal irrigants, 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), and a NaOCl-HEDP combination (Dual Rinse), on the mechanical behavior of nickel-titanium (NiTi) endodontic instruments with identical geometry but varying heat treatments.

Method: A total of 720 One Curve NiTi files (MicroMega, Besançon, France) with three heat treatments (none, C.Wire, S.Wire) were allocated into subgroups exposed to four irrigants (distilled water, NaOCl, NaOCl-HEDP, EDTA) at 21 °C and 35 °C for 1, 5, or 10 min. Mechanical tests were conducted in accordance with ISO 3630-1 to assess bending resistance, maximum torsional resistance, and angular deflection at fracture. Profilometric analysis was performed to identify potential signs of corrosion.

Results: No significant differences were found in maximum bending or torsional torque across irrigant groups. However, EDTA exposure resulted in increased angular deflection at fracture, followed by distilled water. NaOCl showed the lowest angular deflection, while NaOCl-HEDP exhibited intermediate behavior. Heat-treated instruments, particularly S.Wire, consistently showed superior mechanical performance across all test conditions.

Purpose: This study aimed to evaluate the influence of scan body geometry on the trueness of intraoral scanner (IOS) acquisitions.

Methods: An in vitro study was conducted using three groups of scan bodies with varying designs. Trueness was assessed by measuring deviations from a reference model obtained using a high-precision industrial scanner. Three model types were analyzed: a fully edentulous with six implants, a partially dentate with four implants, and a partially dentate with two implants.

Results: In all models, the reduced-length scan body (Group 2) showed the highest trueness, with the lowest mean deviations: 87 μm (6-implant model), 104 μm (4-implant model), and 10 μm (2-implant model). The standard design (Group 1) showed moderate deviations, while the more complex design with three flat surfaces (Group 3) consistently showed the highest deviations. Shorter, simpler designs performed best across all configurations.

Conclusions: Scan body geometry, particularly length and head design, plays a critical role in scanning accuracy. Simplified, shorter scan bodies enhance trueness, while greater height or geometric complexity may compromise it. These findings suggest that optimizing scan body geometry-particularly reducing height-can enhance the accuracy of digital implant impressions, with potential implications for improving reliability in implant-supported prosthetic workflows.

Objective: This systematic review and meta-analysis compare the diagnostic accuracy of intraoral scanners (IOS) and intraoral cameras (IOC) against traditional radiographic and histological methods for caries detection. Due to variation in sensitivity (SE) and specificity (SP) among diagnostic tools, this study evaluated their performance based on lesion type, lesion location, and examiner-dependent factors.

Methods: A comprehensive literature search was conducted using keyword-based search strings in Scopus, Web of Science, PubMed, Cochrane Library, and Dentistry & Oral Sciences Source, following PRISMA-DTA guidelines. Studies comparing IOS or IOC to radiographic or histological reference standards were included. Three independent reviewers assessed study quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, with disagreements resolved by discussion and Fleiss's kappa (κ) analysis. Meta-analysis was performed using a bivariate random-effects model to estimate pooled SE and SP. Subgroup analyses examined the impact of lesion type, lesion location, and examiner-dependent variabilities, using the Python programming language.

Results: Twenty-eight studies met the inclusion criteria, with 16 studies included in the meta-analysis. Pooled SE and SP of IOS and IOC were 50%, indicating moderate diagnostic accuracy. Radiographic methods had the highest SP, making them more effective at avoiding false positives. In contrast, IOSs and IOCs demonstrated higher SE for occlusal and dentin lesions, suggesting their utility in early caries detection. Lesion location significantly influenced diagnostic accuracy, with IOS and IOC showing superior SE for occlusal lesions but lower SE for supragingival lesions. Examiner-dependent differences in SE reached up to 32%, emphasizing the need for structured training and calibration protocols.

Conclusions: IOSs and IOCs showed promise for early caries detection due to their higher SE for occlusal and dentin lesions. However, their lower SP compared to radiographic methods raises concerns about false positives. Standardized examiner training and improved diagnostic protocols are essential to enhance the reliability of these digital imaging techniques.

Background: Periodontal disease affects 3.5 billion people globally, resulting in annual treatment costs exceeding $54 billion. Guided tissue regeneration (GTR) membranes are essential for periodontal therapy, but commercially available options often suffer from limitations, including high cost, limited accessibility in resource-limited settings, and suboptimal mechanical properties. This study aimed to develop and characterize a novel porcine cholecystic extracellular matrix (CECM)-based GTR membrane and comprehensively evaluate its physicochemical properties, cytocompatibility, and in vivo biocompatibility compared to the commercially available Healiguide® membrane.

Methods: CECM membranes were fabricated through systematic decellularization, lyophilization, and ethylene oxide (ETO) sterilization of porcine gallbladders. Surface characterization was performed using scanning electron microscopy (SEM) with quantitative pore analysis, and biochemical composition was assessed via Fourier Transform Infrared Spectroscopy (FTIR). MTT assays were performed on L929 fibroblast cells to evaluate cytocompatibility. Wound healing capacity was assessed using scratch assays monitored over 72 h. In vivo biocompatibility was evaluated through subcutaneous implantation in Sprague-Dawley rats, with histological analysis performed at 1, 2, 3, and 4 weeks post-implantation.

Results: SEM analysis revealed that CECM membranes exhibited a heterogeneous, multilayered structure with larger average pore sizes compared to Healiguide® (18.2 ± 4.6 µm vs. 12.5 ± 3.2 µm, p < 0.05), facilitating enhanced cellular infiltration. FTIR confirmed the preserved integrity of collagen in both membranes, with CECM showing an enhanced glycoprotein content indicative of retained bioactive components. Cytocompatibility assessment demonstrated excellent cell viability for CECM, showing 97.4 ± 1.6%, 94.2 ± 1.8%, and 90.8 ± 1.4% viability at 20, 50, and 100 µg/mL CECM extracts, respectively. The scratch assay demonstrated superior wound healing capacity for CECM, with significantly enhanced wound closure at 72 h compared to Healiguide® (89.7 ± 6.1% vs. 79.4 ± 5.8%, p < 0.05). Subcutaneous implantation studies confirmed excellent in vivo biocompatibility, with CECM showing lower initial inflammatory response (inflammation score: 2.3 ± 0.5 vs 2.8 ± 0.6 at week 1, p < 0.05), enhanced vascularization (12.3 ± 2.1 vs 9.7 ± 1.8 vessels/hpf at week 3, p < 0.05), and superior tissue integration compared to commercial controls.

Conclusion: The porcine CECM membrane demonstrated favorable physicochemical properties, excellent cytocompatibility, enhanced wound healing potential, and superior tissue integration characteristics compared to commercial GTR membranes. These preliminary findings provide a strong scientific foundation supporting the development of the GTR membrane for periodontal regenerative therapy.

Objective: The objective was to assess the effectiveness of the theory-based educational intervention tailored to the Theory of Planned Behavior (TPB) and behavior change techniques (BCTs) on oral hygiene behavior among university students through the oral hygiene behavior index and oral health outcomes.

Materials and methods: A randomized controlled trial involving university students was conducted from November 2022 to March 2023 (n = 71). Participants were randomly assigned to a control group (n = 38) or an intervention group (n = 33). The control group received conventional dental health education, whereas the intervention group underwent a 21-day TPB-based educational intervention delivered through a three-minute video. Oral hygiene behavior index (OHBI) and oral health outcomes, including caries activity, salivary hemoglobin level, and total bacterial count, were assessed at baseline and three-month post-intervention.

Results: Statistically significant improvements were seen in the OHBI score between groups and within the intervention group at three-month follow-up, with higher scores indicating better oral hygiene behavior. In addition, caries activity and salivary hemoglobin level were also improved. The total bacterial count in the intervention group did not show any statistically significant difference, even though it was lower than that of the control group.

Conclusion: This study indicates that theory-based educational intervention tailored to TPB and BCTs improves oral hygiene behavior and certain oral health outcomes. Future studies should examine the long-term effects and generalizability in diverse populations.

Trial registration: Thailand Clinical Trial TCTR20230105003.