Frontiers in dental medicine最新文献

Aim: To assess the effect of minimal intervention on carious lesions in primary teeth through an umbrella review.

Material and methods: A comprehensive search was conducted in databases such as PubMed, Cochrane Library, Scopus, Web of Science, Embase, SciELO, Google Scholar, ProQuest Dissertations and Theses, and OpenGrey, covering literature up to September 2025. Systematic reviews, with or without meta-analyses, that assessed the effect of minimal intervention on carious lesions in primary teeth were included. Narrative reviews, rapid reviews, clinical trials, observational or experimental studies, case reports, editorials, letters, protocols, and posters were excluded. The methodological quality of the reviews was assessed using the AMSTAR-2 tool, and the risk of bias was assessed using the ROBIS tool.

Results: From an initial retrieval of 498 records, 49 systematic reviews met the inclusion criteria. The data showed an impact of minimally invasive interventions on carious lesions in primary teeth.

Conclusion: Based on high-confidence systematic reviews, among the minimally invasive interventions, the use of silver diamine fluoride, the Hall technique, and resin infiltration showed significant benefits for managing carious lesions in primary teeth.

Systematic review registration: https://doi.org/10.17605/OSF.IO/3T2GV, Open Science Framework (OSF): doi: 10.17605/OSF.IO/3T2GV.

Achieving precise, comfortable, and asymmetric maxillary expansion remains a clinical challenge in orthodontics. Conventional expanders, such as the Hyrax, depend on manual activation by caregivers, often leading to inaccurate screw turns, patient discomfort, mucosal injury, and inconsistent results. Moreover, their mechanical design limits controlled asymmetric expansion, reducing effectiveness in unilateral crossbites. This brief research report introduces a proof-of-concept electronic, key-controlled palatal expander designed to enhance precision, safety, and ease of use. The concept integrates an electronic activation system with a multi-keyhole design, allowing both symmetrical and asymmetrical expansion tailored to individual patient needs. To assess the device's mechanical behavior, a functional digital simulation was conducted using the finite element method (ANSYS 2024 R1, ANSYS Inc., USA). Activation of the center screw produced smooth, stable, and symmetric bilateral expansion, with a 1 mm screw advancement generating approximately 1.08 mm of lateral displacement. Selective activation of lateral keyholes yielded illustrative unilateral movement, with each 1 mm screw activation resulting in approximately 1.9 mm of displacement, demonstrating the device's potential for controlled asymmetric expansion under the modeled conditions. Currently at the conceptual and design stage, the device has not undergone bench or clinical testing. However, the mechanical simulation supports the feasibility of a digitally guided expander capable of delivering controlled and customizable expansion in theory while reducing reliance on caregiver-performed activations. This innovation may offer a safer and more precise alternative to conventional devices, although all proposed advantages remain preliminary and require experimental and clinical validation before clinical use.

Introduction: As obesity continues to escalate to pandemic levels worldwide, innovative approaches for early diagnosis, risk stratification, and disease monitoring are urgently needed. Saliva presents a promising non-invasive method for biomarker-based screening in obesity.

Objective: This study aimed to utilize a multi-biomarker approach to explore associations between salivary biomarkers and obesity. This was done by measuring a pre-selected panel of obesity-related salivary biomarkers and comparing their levels between individuals with and without obesity.

Methods: Unstimulated saliva was collected from 57 individuals, including 27 individuals diagnosed with obesity (BMI ≥ 30 kg/m²) and 30 non-obese controls (BMI < 30 kg/m²). Various biochemical techniques were used to quantify salivary total protein content, α-amylase activity (sAA), cortisol, interleukin 6 (IL-6), mucin 5B (MUC5B), albumin and calcium ions (Ca²⁺).

Results: The results indicated lower Ca²⁺, sAA, and MUC5B levels (P < 0.05) and higher IL-6 and cortisol levels (P < 0.05) in the obese group compared to non-obese controls. In the obese group, Ca²⁺ correlated positively with most biomarkers, with sAA (r = 0.632, P < 0.05) and IL-6 (r = 0.449, P < 0.05) showing the strongest associations.

Conclusions: In conclusion, this study highlights IL-6, Ca²⁺, sAA, and cortisol as a potential salivary biomarker-combination associated with obesity warranting further investigation. The observed changes in the salivary biomarker levels of the obese group may reflect underlying metabolic dysregulations, highlighting the advantage of a multi-biomarker approach to better capture early metabolic and inflammatory processes associated with obesity. To further validate these findings, large clinical studies with diverse, well-matched cohorts, as well as longitudinal studies, are needed.

Introduction: Periimplant mucositis and periimplantitis are inflammatory reactions occurring around endosseous dental implants. The objective of this scoping review was to examine diagnostic techniques used to assess periimplantitis in clinical studies on human subjects.

Methodology: The research question formulated was "What are the various diagnostic techniques used for detection of periimplantitis in patients who have received endosseous dental implants?" MEDLINE (PubMed), EMBASE, and SCOPUS were searched using a combined MeSH-based search strategy for studies published between 2015 to February 2025.

Results: A total of 162 unique studies were included. Study designs, publication years, diagnostic domains, and methodological characteristics are summarized. Studies were categorized as belonging to the diagnostic domains of Imaging (n = 11), Microbial profiling (n = 57), Biomarkers in PICF/saliva (n = 28), Metabolic (n = 38), Genetic (n = 15) and Histopathology (n = 13). All studies used clinical and radiographic criteria to diagnose periimplantitis and then further assessed novel techniques and protocols for early diagnosis. Though standardized intraoral periapical (IOPA) radiograph remains the clinical standard of assessing peri implant bone loss, intraoral ultrasonography demonstrates potential utility to assess both peri implant hard and soft tissues. Microbial studies use Quantitative Polymerase Chain Reaction and Gene Sequencing techniques to identify bacterial community structures and microbial "shifts" that trigger inflammatory responses and measure therapeutic effects of treatments of established disease. Biomarkers of inflammation Interleukin-1β (IL-1β), collagen degradation enzymes active-Matrix Metalloproteinases-8 (aMMP-8) and bone turnover marker Receptor activator nuclear factor kappa b ligand (RANKL) in PICF demonstrate potential diagnostic and prognostic utility. Molecular signatures and study of small molecules were used for discovery of novel biomarkers while genetic studies assessed genetic polymorphisms increasing susceptibility to periimplantitis. Pathologic studies assessed changes in tissue architecture and correlation of shed implant particles and peri implantitis.

Conclusions: This scoping review identified major diagnostic domains and mapped various diagnostic tools to provide an overview of contemporary diagnostic approaches.

Introduction: Preclinical dental training requires students to master precise tooth preparation skills that directly influence clinical success. Traditional grading methods often lack objectivity and consistency. Analytic rubrics, by deconstructing complex procedures into measurable components, may improve reliability and feedback in preclinical assessment. This study evaluated the application of an analytic rubric system for assessing anterior metal-ceramic crown preparations performed by undergraduate dental students.

Methods: A cross-sectional, double-blind study was conducted among fourth-year Bachelor of Dental Surgery students at King Khalid University. Forty-five students prepared the maxillary right central incisor for a metal-ceramic crown under standardized conditions. Preparations were independently evaluated by four calibrated prosthodontists using an analytic rubric comprising eight criteria, each scored on a 0-1 scale. Descriptive statistics, one-way ANOVA, and post hoc Tukey's HSD were employed to analyze examiner variation. Inter-rater reliability was assessed using Cohen's kappa.

Results: The overall mean score across examiners was 3.436 ± 0.522. Among the parameters, incisal reduction (57.5%) and degree of taper (61.8%) recorded the lowest scores, while finish line form (76.9%) and gingival protection (76.4%) showed the highest. ANOVA indicated no significant differences among the four examiners across all parameters (p > 0.05). Tukey's HSD confirmed no pairwise examiner differences, demonstrating consistent grading. Inter-rater reliability yielded kappa values ranging from 0.67 to 0.85, indicating substantial to almost perfect agreement.

Conclusion: The analytic rubric proved to be a reliable and transparent tool for evaluating preclinical crown preparations, minimizing examiner subjectivity and enhancing feedback.

Introduction: The relationship between vertical facial dimensions and morphological-functional features of the masseter muscle in growing patients is of increasing interest in orthodontics. Understanding these correlations may enhance diagnostic accuracy and guide treatment planning, particularly in subjects with altered vertical skeletal patterns.

Materials and methods: Growing patients underwent two-dimensional cephalometric analysis and ultrasonographic evaluation of the masseter muscle. Cephalometric variables included SNA, SNB, ANB, SN-GoGn, FMA, AFH, and Go-Me, while ultrasonographic parameters comprised thickness, cross-sectional area (CSA), and volume of the masseter, both at rest and during contraction. Correlations were assessed using Pearson's coefficient, and multiple linear regression was applied to identify predictive associations. A p-value < 0.05 was considered statistically significant.

Results: A significant correlation was found between vertical growth pattern and ultrasonographic characteristics of the masseter. Subjects with increased vertical facial dimensions exhibited reduced muscle thickness and volume (p < 0.05). Regression analysis confirmed associations between vertical cephalometric indices (SN-GoGn, FMA) and ultrasonographic parameters, with R² values ranging from 0.30 to 0.45.

Discussion: Findings suggest that vertical skeletal pattern influences masseter morphology, highlighting the role of masticatory musculature in craniofacial development and vertical discrepancies.

Conclusions: Integrating ultrasonographic assessment of the masseter with cephalometric analysis may provide clinically relevant insights for orthodontic diagnosis and management in growing patients.

Background: Radiological reports are critical for accurate diagnosis and therapeutic decision-making. While narrative free-text reports remain the conventional standard in dental radiology, structured reporting has emerged as a promising approach to enhance report quality, consistency, and clinical relevance. This study aims to assess whether structured reporting provides measurable advantages over traditional narrative reports in the interpretation of dental radiographs.

Materials and methods: A total of 50 randomly selected narrative reports of intraoral dental radiographs were retrospectively analyzed. Using a standardized template, corresponding structured reports were created for each case. Two independent dentists evaluated the reports using a detailed questionnaire, comparing both formats across nine parameters: therapeutic decision-making, completeness, information extraction, level of detail, logical sequence, trustworthiness, linguistic quality, clarity, and overall assessment.

Results: Structured reports showed significantly higher ratings in terms of completeness, information extraction, detail, trust, linguistic quality, clarity, and overall evaluation (p < 0.001). No significant differences were observed between structured and narrative reports regarding therapeutic decision-making or the sufficiency of information for treatment planning.

Conclusion: Structured reporting in dental radiology demonstrates clear benefits in report clarity, quality, and interpretive utility. Although its impact on clinical decision-making may be equivalent to narrative reports, its consistent structure offers valuable advantages for communication, documentation, and future integration with clinical decision support systems.

The diagnosis of irreversible pulpitis relies on subjective clinical criteria and low-specific sensitivity tests, potentially leading to inappropriate treatment decisions. High-sensitivity C-reactive protein (hs-CRP) is locally expressed in inflamed pulp tissues and may provide objective diagnostic information. This pilot study evaluated the construct validity of rapid hs-CRP quantification using a point-of-care fluorescent immunoassay (FIA) in pulpal blood and its capacity to discriminate clinically relevant inflammatory phenotypes. Thirteen adult patients with a clinical diagnosis of symptomatic irreversible pulpitis were prospectively enrolled. No healthy or reversible control group included. Pulpal blood hs-CRP was quantified using point-of-care FIA (Finecare FIA Meter Plus) during endodontic access. Pain intensity was assessed using visual analog and categorical ordinal scales. Median hs-CRP was 2.9 mg/L (IQR 0.0-3.5). Very strong correlation was observed between hs-CRP and pain intensity (ρ = 0.918, p < 0.01, 95% CI 0.73-0.99). ROC analysis for severe pain yielded AUC = 0.944 (95% CI 0.82-1.00). The 3.4 mg/L threshold demonstrated 100% sensitivity, 89% specificity, a positive likelihood ratio of 9.33, and a negative likelihood ratio of 0.06. Monte Carlo sensitivity analysis correcting for imperfect clinical reference standards revealed robust specificity (median, 83%) and moderate sensitivity (median, 56%). Point-of-care hs-CRP quantification in pulpal blood represents an objective biomarker with excellent construct validity and discriminative capacity for identifying intense inflammatory phenotypes of irreversible pulpitis in this pilot study. These preliminary findings warrant validation in larger multicenter studies with composite reference standards before clinical implementation can be considered.

A profound understanding of dental students' use of artificial intelligence (AI) applications and their perceptions is essential for promoting responsible adoption and guiding integration into dental education.

Aim: This study evaluated dental students' perceptions, usage patterns, and trust in ChatGPT, Snapchat's My AI, and the Metaverse as educational tools.

Materials and methods: A cross-sectional online survey was administered to undergraduate dental students at RAK College of Dental Sciences, United Arab Emirates, between February and May 2024. The questionnaire comprised 29 questions organized into five sections. The questions were formulated as multiple-choice questions. Descriptive statistics were calculated. Pearson's chi-square tests with post-hoc adjusted standardized residuals (ASRs) and Bonferroni corrections examined categorical associations. Ordinal logistic regression assessed predictors of AI awareness, and paired-samples t-tests with Cohen's d compared trust in ChatGPT vs. Snapchat AI.

Results: The response rate was 57%, of which 70% were females. Self-rated awareness of AI increased across academic years, with fifth-year students rating their awareness score as 4 ± 0.9 out of 5, compared to 3 ± 1.4 in the first year. Ordinal regression showed no significant effects of year, gender, or their interaction (p > 0.19). ChatGPT was the most used tool (81.5%), followed by grammar correction tools (75%) and Snapchat AI (74.4%), while Metaverse use was limited (28.6%). Chi-square analyses confirmed significantly greater use of ChatGPT, Grammarly, and Snapchat AI compared with Metaverse (p < 0.001). Fourth-year students most often used AI for academic or clinical purposes (41.7%). Educational potential was endorsed by 78% of students, while privacy and data security were the predominant concerns (78%). Compared with Snapchat AI, ChatGPT was significantly more often used for education, preferred for quick responses, and more frequently associated with positive beliefs about future learning. Paired-samples t-tests demonstrated consistently higher trust in ChatGPT across all academic years, with moderate-to-large effect sizes (Cohen's d = 0.67-0.91; p < 0.01).

Conclusions: Dental students reported widespread adoption and higher trust in ChatGPT compared to other AI tools. While recognizing its educational potential, concerns about accuracy and privacy underscore the need for integrating AI literacy and evidence-based evaluation into dental curricula.