BDJ Open最新文献

Introduction: Some recent studies have suggested that antioxidants, particularly lycopene, may improve periodontal treatment outcomes. However, conflicting past results regarding its effects highlight the need for further research. This study aimed to evaluate the clinical effects of oral lycopene supplementation as an adjunctive therapy in nonsurgical periodontal treatment for patients with periodontitis.

Methods: In this parallel clinical trial, 42 patients aged 25 to 55 with moderate to severe periodontitis and no recent history of periodontal treatment were randomly assigned to two groups after matching for mean age, sex, periodontal disease severity, and antioxidant capacity. One group received lycopene supplementation (15 mg/day) and phase I periodontal therapy. In contrast, the other group received a placebo (containing 1 g of corn starch) and phase I periodontal therapy. Periodontal parameters, including probing depth (PD), clinical attachment loss (CAL), and bleeding index (BI), as well as serum Malondialdehyde (MDA) levels, were assessed at baseline and after two months.

Results: Both groups showed significant improvements in periodontal parameters after two months. However, the lycopene group demonstrated greater reductions in probing depth (P = 0.009), clinical attachment loss (P = 0.015), bleeding index (P = 0.237), and MDA levels (P = 0.199) compared to the placebo group, confirming its positive effect in reducing oxidative stress and inflammation associated with periodontitis.

Conclusion: Oral lycopene supplementation was associated with better clinical outcomes than the placebo as an adjunct to nonsurgical periodontal therapy. It may be recommended as part of a periodontal treatment plan to enhance periodontitis management.

Objective: Dental caries is defined by the WHO as a multifactorial non-communicable disease. If left untreated, it can progress to abscesses and then head and neck odontogenic cellulitis. It requires immediate, appropriate, and interdisciplinary treatment. The aim of this study was to draw up an epidemiological profile of these children treated at the Lille University Hospital in northern France and to study the impact of self-medication of anti-inflammatory drugs.

Materials and methods: A single-centre retrospective, cross-sectional study was conducted on children with odontogenic cellulitis admitted to the paediatric emergency department of the Lille University Hospital between March 2013 and December 2021.

Results: 15.3% of the 636 children included had taken nonsteroidal anti-inflammatory drugs before going to the emergency department. The frequency of pain and trismus was higher in children who had taken nonsteroidal anti-inflammatory drugs than in those who had not. Frequency of hospitalisation was higher in children who had not taken nonsteroidal anti-inflammatory drugs than for those who had (70% vs. 57%, respectively; p < 0.05). Inversely, the mean length of stay was longer for children who had taken nonsteroidal anti-inflammatory drugs than in those who had not (1.1 vs. 0.8 days, respectively; p < 0.05).

Conclusion: This first French epidemiological study on odontogenic cellulitis in children underlines the need to develop multidisciplinary prevention and patient education.

Background: Occlusal loading refers to a modality in which an implant-supported prosthesis is subjected to functional loading, maintaining contact with the opposing dentition from the onset of prosthetic placement. In contrast, non-occlusal loading represents a non-functional approach, wherein a provisional implant prosthesis is initially placed in infra-occlusion or fully relieved of contact with the opposing dentition, which is subsequently (at a later stage) followed by functional (occlusal) loading with the definitive prosthesis.

Aim: To compare clinical outcomes in partially edentulous cases following an occlusal modality of loading versus non-occlusal modality of loading.

Method: A search on Pubmed, Scopus and Embase databases was conducted to identify randomised controlled trials (RCTs) comparing occlusal versus non-occlusal modalities of implant loading in partially edentulous patients receiving implants with single crowns or fixed bridges, between January 1 (2004) to June 12 (2024), examining implant survival, complications and marginal bone loss (MBL) of implants. The inclusion criteria involved RCTs of evidence level II (Oxford Centre for Evidence-Based Medicine Levels of Evidence). For assessing bias in the included studies, the Cochrane Risk of Bias tool was used.

Results: This review identified seven RCTs investigating 273 implants over 1-3 years follow-up periods. seven studies reported 1-year MBL data and three reported 3-year data. Publication bias was noted at the 1-year follow-up (p < 0.01) but not at 3 years (p > 0.05). Differences in MBL were not statistically significant at both 1 year (Hedges' d = 0.01, p = 0.920, 95% CI: [-0.21, 0.24]) and 3 years (Hedges' d = 0.01, p = 0.952, 95% CI: [-0.28, 0.30]). Differences in complication occurrences were not statistically significant (RR = 0.882, p = 0.759, 95% CI: [0.397, 1.964]). The nature of data on implant survival rates prevented a meaningful meta-analysis.

Conclusion: For short-term periods of 1-3 years, no significant evidence supports clinical superiority in terms of complication rates and MBL between non-occlusal and occlusal modalities of implant loading. Future studies should explore functional and aesthetic aspects, as well as patient reported outcomes to determine any short-term differences or consider long-term follow-up with large sample sizes to detect significant clinical differences.

Introduction: Implementing artificial intelligence (AI) to use patient-provided intra-oral photos to detect possible pathologies represents a significant advancement in oral healthcare. AI algorithms can potentially use photographs to remotely detect issues, including caries, demineralisation, and mucosal abnormalities such as gingivitis.

Aim: This study aims to assess the effectiveness of a newly developed AI model in detecting common oral pathologies from intra-oral images.

Method: A unique AI machine-learning model was built using a convolutional neural network (CNN) model and trained using a dataset of over five thousand images. Ninety different unseen images were selected and presented to the AI model to test the accuracy of disease detection. The AI model's performance was compared with answers provided by fifty-one dentists who reviewed the same ninety images. Both groups identified plaque, calculus, gingivitis, and caries in the images.

Results: Among the 51 participating dentists, clinicians correctly diagnosed 82.09% of pathologies, while AI achieved 81.11%. Clinician diagnoses matched the AI's results 81.02% of the time. Statistical analysis using t-tests at 95% and 99% confidence levels yielded p-values of 0.63 and 0.79 for different comparisons, with mean agreement rates of 81.55% and 95.11%, respectively. The findings support the hypothesis that the average AI answers are the same as average answers by dentists, as all p-values exceeded significance thresholds (p > 0.05).

Conclusion: Despite current limitations, this study highlights the potential of machine learning AI models in the early detection and diagnosis of dental pathologies. AI integration has the scope to enhance clinicians' diagnostic workflows in dentistry, with advancements in neural networks and machine learning poised to solidify its role as a valuable diagnostic aid.

Introduction: Zygomatic implants represent a reliable treatment modality for patients with severe maxillary bone resorption, eliminating the need for bone grafting and enabling immediate loading. This study utilized cone beam computed tomography (CBCT) to identify optimal zygomatic bone regions for implant placement by assessing bone-implant contact (BIC) while minimizing intrusion risks into the infratemporal fossa (ITF). Additionally, differences in zygomatic characteristics between males and females were investigated to address the limited evidence regarding the influence of biological sex on BIC and implant stability.

Methods: This retrospective study analyzed CBCT scans from 20 fully edentulous patients (9 male and 11 female) with severe maxillary resorption. Zygomatic bone thickness, length, and BIC were measured at 12 anatomical points across the superior, middle, and inferior regions using standardized CBCT imaging and Nobel Clinician software. Virtual implants were placed to evaluate intrusion into the infratemporal fossa. Statistical analyses, including Kruskal-Wallis and Mann-Whitney U tests, were conducted to compare zygomatic measurements across regions and between genders.

Results: The greatest bone thicknesses in the superior, middle, and inferior regions were observed at Point A₁ (8.53 ± 1.63 mm), Point B₁ (6.97 ± 1.01 mm), and Point C₀ (6.36 ± 1.02 mm), respectively. Point A₃ (17.65 ± 2.24 mm) in the anterior region and Point B₁ (13.34 ± 2.35 mm) in the posterior region were identified as optimal implant sites, providing the highest BICs while minimizing intrusion risks. Zygomatic thickness and BIC at these optimal sites were significantly greater in males than females (p < 0.01).

Conclusion: Point A₃ and Point B₁ are the most suitable sites for zygomatic implant placement. Quad zygomatic implants may achieve enhanced primary stability in males than in females due to greater zygomatic bone thickness and BIC.

Objective: This study investigates refusal rates of dentists in Damascus, Syria, to manage patients who disclose that they are carriers of tuberculosis, human immunodeficiency virus (HIV), hepatitis B and C (HBV/HCV), and patients with dental phobia, asthma, epilepsy, patients unable to afford dental care, and children. The aims are to identify to what extent dentists refuse patients who are diagnosed carriers of certain blood born viruses, require extra measures, take a lot of time, or do not pay.

Methods: A cross-sectional study was conducted in Damascus by distributing paper and electronic questionnaires to dental clinics based on the administrative divisions of the city.

Results: A total of 246 responses were collected. The average years of dental practice among respondents was 9.39 ± 9.8. Rates of refusal were as follows: children (n = 55, 22.4%), tuberculosis (n = 176, 71.5%), HIV (n = 192, 78.0%), HBV/HCV (n = 98, 39.8%), dental phobia (n = 58, 23.6%), asthma (n = 12, 4.9%), and epilepsy (n = 73, 29.7%). Acceptance of patients with tuberculosis, HIV, and HBV/HCV was positively associated with greater years of experience. Dentists who graduated outside of Syria were more likely to accept treating patients with HIV and HBV/HCV. A significant correlation was found between refusal rates for patients with tuberculosis, HIV and HBV/HCV.

Conclusions: The proportion of dentists in Damascus refusing to treat patients who disclose that they are carriers of tuberculosis, HIV/AIDS, and HBV/HCV was notably high. Managing patients who cannot afford treatment often involved reducing fees. The findings provide valuable insights into the systemic challenges in healthcare delivery and propose possible improvements in managing vulnerable population in resource-constrained settings.

Background: This study evaluates the use of large language models (LLMs) in generating Patient Education Materials (PEMs) for dental scenarios, focusing on their reliability, readability, understandability, and actionability. The study aimed to assess the performance of four LLMs-ChatGPT-4.0, Claude 3.5 Sonnet, Gemini 1.5 Flash, and Llama 3.1-405b-in generating PEMs for four common dental scenarios.

Methods: A comparative analysis was conducted where five independent dental professionals assessed the materials using the Patient Education Materials Assessment Tool (PEMAT) to evaluate understandability and actionability. Readability was measured with Flesch Reading Ease and Level scores, and inter-rater reliability was assessed using Fleiss' Kappa.

Results: Llama 3.1-405b demonstrated the highest inter-rater reliability (Fleiss' Kappa: 0.78-0.89). ChatGPT-4.0 excelled in understandability, surpassing the PEMAT threshold of 70% in three of the four scenarios. Claude 3.5 Sonnet performed well in understandability for two scenarios but did not consistently meet the 70% threshold for actionability. ChatGPT-4.0 generated the longest responses, while Claude 3.5 Sonnet produced the shortest.

Conclusions: ChatGPT-4.0 demonstrated superior understandability, while Llama 3.1-405b achieved the highest inter-rater reliability. The findings indicate that further refinement and human intervention is necessary for LLM-generated content to meet the standards of effective patient education.

Objective: This systematic review was conducted to evaluate the attachment of human gingival fibroblasts (HGFs) of the soft tissue, to titanium dioxide nanotubes (TNTs) compared to commercially pure titanium (cp-Ti) and its alloys, in in-vitro studies. It is postulated that the nanotopography of the TNTs provide cells with a biomimetic environment, allowing HGFs to form more focal adhesion (FA) attachment sites at the tubule edges.

Method: A comprehensive literature search was conducted on MEDLINE, DOSS, EMBASE and Google Scholar from January 2012 to January 2022. The identified studies were screened based on titles and abstracts for inclusion criteria. The relevant studies underwent data extraction. The risk of bias was assessed through the Office of Health Assessment and Translation (OHAT) tool.

Results: This systematic review included four studies evaluating cell proliferation, protein expression, gene expression and cell morphology of HGFs evocative of stronger and mature soft tissue attachment. A significant increase in the cell proliferation at TNTs compared to cp-Ti, at day 7 for three studies and at day 14, for one study was evident. In addition, a significant increase in the type 1 collagen protein expression at TNTs compared to cp-Ti, at day 6 for one study and day 7 for two studies. Enhanced cellular extensions from HGFs attached onto TNTs, compared to cp-Ti was observed in all four studies. All the primary effects evaluated suggest the formation of better interlaced fibers giving a stronger adhesion than the parallel ones which is the most relevant outcome of this research.

Conclusion: HGFs showed enhanced contact guidance onto TNTs but a true biological attachment was not confirmed. This review involved invitro studies which lack methodological rigor to compare among studies, lack information and have small sample sizes limiting effectiveness of parametric tests. The results may be unpredictable when translated to in-vivo studies mainly affected by confounding factors. Further research is needed to determine the precise mechanism of mechanical attachment between the soft tissue and the transmucosal surfaces.

Objective: Dental traumas are one of the most common reasons for children to visit the dentist. This study aimed to investigate the predictors of mothers' behavior based on the health belief model (HBM) for the prevention of dental trauma in 7-12-year-old children.

Methods: The current cross-sectional study was conducted on 700 mothers in Kashan city in 19 September 2023 to 2 March 2024 included in the study by multi-stage random cluster sampling method. The data collection tool was a valid and reliable researcher-made questionnaire consisting of demographic information, Knowledge, constructs of HBM, and preventive behavior for dental trauma. Data were analyzed using SPSS 21 and descriptive statistics (standard deviation, mean, median and range), inferential tests (Pearson correlation coefficient, regression) and path analysis to test the direct and indirect effect of model constructs on the dependent variable by AMOS software.

Results: Knowledge (r = 0.365, P < 0.001), perceived benefits (r = 0.166, P < 0.001), and self-efficacy (r = 0.425, P < 0.001) had a positive correlation and perceived barriers (r = -0.313, P < 0.001) had a negative correlation and a significant relationship with mothers' preventive behaviors. Knowledge, perceived barriers and self-efficacy explained and predicted a total of 33% of preventive behavior changes (R-Square=0.329). In the path analysis, self-efficacy (β = 0.327, P < 0.001), knowledge (β = 0.251, P < 0.001) and perceived barriers (β = -0.242, P < 0.001) had the most direct effect, and perceived severity (β = -0.017), perceived susceptibility (β = -0.004), and perceived benefits (β = 0.092) had an indirect effect on mothers' preventive behaviors (P < 0.05).

Conclusion: Knowledge, self-efficacy, and perceived barriers were key predictors of mothers' preventive behaviors. Interventions should target these factors to improve dental trauma prevention in children. The HBM effectively identified these predictors.

Objectives: The temporomandibular joint system and visual apparatus seem to be correlated. Our study aimed to examine the potential effects of occlusal splints on visual capacities (accommodation and ocular convergence) in individuals with temporomandibular disorders, followed for a period of 6 months and 1 year, assessing changes over this timeframe.

Materials and methods: Forty-two subjects were enrolled in a year-long study conducted at the Operative Unit of Odontostomatology of ASST Santi Paolo e Carlo, in collaboration with the University of Milan, Italy. A gnathological examination was followed by an orthoptic assessment using the stick of Duane and measuring convergence and accommodation at three jaw positions at different time points (T0, T1, T2, T3).

Results: After 6 months of occlusal splint therapy, an improvement in visual abilities at maximum intercuspation and resting positions was observed. In contrast, the open-mouth position did not yield statistically significant results. Further assessments at 1 year did not show significant changes. Occlusal splint therapy appears to positively influence visual capacities (in maximum intercuspation and resting positions). While the open-mouth position did not exhibit significant improvements.

Conclusion: Our study results highlight the importance of considering jaw positions in evaluating visual function, suggesting the possible integration of occlusal splints with an orthoptic assessment in comprehensive TMD management.