Frontiers in dental medicine最新文献

Background: Periodontitis is a growing public health concern worldwide. Salivary volatile metabolites have emerged as promising biomarkers for the diagnosis of periodontal disease. However, research on the collection and identification of these metabolites in periodontitis patients remains limited.

Objectives: To explore methods for collecting and identifying salivary volatile metabolites in periodontitis patients and investigate their potential as biomarkers for diagnosing periodontal disease.

Method: Oral exhaled breath and saliva samples were collected from 115 periodontitis patients and 35 healthy individuals, divided into four cohorts. The discovery cohort (Periodontitis: P = 55, Healthy: H = 23) and the test cohort (P = 48, H = 23) were screened and validated for potential biomarkers in volatile metabolites from oral exhaled breath by thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS). The validation cohort 1 (P = 12, H = 12) was tested for volatile metabolites in saliva by solid-phase microextraction-gas chromatography-mass spectrometry (SPME-GC-MS), while validation cohort 2 (P = 55, H = 23) was tested for metabolic pathways in saliva by liquid chromatography-mass spectrometry (LC-MS).

Result: A total of 78 Volatile organic compounds (VOCs) were detected by TD-GC-MS, with 14 differential VOCs identified. A diagnostic model was established using cyclohexanone, styrene, and ethanol, yielding a combined AUC of 0.8237. These metabolites were also detected in saliva by SPME-GC-MS, with cyclohexanone showing higher expression in the periodontitis group (P < 0.05). The caprolactam degradation pathway was a key source of volatile metabolites in the oral exhaled breath of periodontitis patients.

Conclusion: We developed a novel method for analyzing salivary volatile metabolites using TD-GC-MS, demonstrating potential for periodontitis diagnosis. Cyclohexanone is identified as a potential biomarker for periodontitis, and the caprolactam degradation pathway may play a significant role in future studies on oral microbiota dysbiosis in periodontitis patients.

Background: This study aimed to evaluate and compare demographic, periodontal, and cardiac parameters; Dickkopf-3 (DKK-3; rs11544817) and complement factor H (CFH; rs10737680) protein levels; and gene expression in patients with periodontitis with and without coronary artery disease (CAD) at baseline and following non-surgical periodontal therapy (NSPT).

Methods: A total of 140 participants were divided into the following four groups (n = 35 each): Group H, healthy individuals; Group P, periodontitis patients without systemic conditions; Group CAD, systemically compromised (CAD) but periodontally healthy individuals; and Group P + CAD, patients with both periodontitis and CAD. The baseline assessments included demographic details, periodontal and cardiac parameters, and protein/gene analysis from subgingival plaque and gingival tissue. NSPT was performed and assessments were conducted after 90 days.

Results: Group P + CAD had higher age, weight, and BMI, and lower socioeconomic status. Periodontal and cardiac parameters improved after NSPT. DKK-3 levels decreased and CFH levels increased post-treatment. Both proteins strongly correlated with gene expression, independent of confounders. The regression analysis confirmed their significant association with periodontitis and CAD risk.

Conclusion: The study found elevated DKK-3 (rs11544817) and reduced CFH (rs10737680) protein levels and gene expression in patients with periodontitis and CAD, suggesting that these genes regulate their respective proteins.

Background: Several meta-analyses of children and adolescents with Type 1 diabetes mellitus (T1DM) have shown that periodontal disease (PD) is linked to metabolic control. In South Africa, the prevalence of PD and its impact on T1DM children is however unknown. This study aimed to assess the prevalence of PD in T1DM children and adolescents attending the Paediatric Diabetic Clinic at Tygerberg Hospital and to assess the impact of metabolic control on the periodontal status.

Methods: A cross-sectional study was conducted to assess the periodontal status of T1DM patients. A basic periodontal examination (BPE) was performed and information on the HbA1c level, type and duration of T1DM, age, sex, BMI percentile, and pubertal status was gathered from patient records. A logistic regression model was used to identify associations between periodontal health status and risk factors.

Results: All 169 T1DM participants [median age 11.0 (9.0, 14) years] presented with PD. Based on BPE codes, 124 (73%) had gingivitis and 45 (27%) had periodontitis. The median HbA1c was significantly higher in the periodontitis group [12.6% (IQR: 10.4-13.6)] compared to the gingivitis group [8.9% (IQR: 8.1-9.9)] was statistically significant p = <0.001. Age was identified as risk factors (OR = 1.23, 95% CI: 1.1-1.4; p = 0.002), with children in the periodontitis group being older [13.0 (10, 15) years] than those with gingivitis [11.0 (8.0, 13.5) years; p < 0.001].Additionally, the periodontitis group had a lower median BMI percentile [59 (IQR: 29-78)] than the gingivitis group [74 (IQR: 42-92); p < 0.001].

Conclusions: Besides the limitations inherent to the study design, every child and adolescent with T1DM presented with periodontal disease. Older age and poorer metabolic control were significantly associated with increased odds of periodontal disease, highlighting a strong link between metabolic control and periodontal health in this population. Longitudinal studies or clinical trials with adequate sample sizes are recommended. These findings underscore the need to intensify both diabetes management and dental care through integrated, long-term approaches.

Background: Up to 20% of American adults experience dental anxiety, creating a psychological and physiological barrier to starting, completing, and/or finishing dental treatment. There is a clear need for novel approaches to mitigate chair-side anxiety, especially for endodontic treatment appointments. This study aimed to investigate two nonpharmacological dental anxiety management approaches: (1) A brief auditory-alone relaxation (ABR) period and a brief virtual reality relaxation (VRR) period, and their hypothesized effects on patients' perceived dental anxiety and physiological biometric scores.

Materials and methods: Fifty-eight participants who needed nonsurgical root canal treatment were assigned randomly to two groups: ABR or VRR. One group received earphones to listen to a guided, brief relaxation recording that incorporated conscious, diaphragmatic breathing and a guided body scan. The other group received Meta Quest 2 virtual reality headsets to listen and watch 360° inclusive and integrative experiences of ambient music, high-resolution graphic illustrations, and immersive scenery. The participants' self-reported levels of anxiety were assessed before and after treatment after they completed the State Trait Anxiety Indicator (STAI-State & Trait) and visual analog scale (VAS) scales. Additionally, biometric traits such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before (T0), during (T1), and after (T2) treatment.

Results: Both VRR and ABR significantly decreased anxiety, as reported by the STAI-State questionnaire (p = <0.001 for both) and the STAI-Trait questionnaire (p = 0.025 ABR; p = <0.001 VRR), throughout the appointment. The self-reported VAS scores also were reduced significantly from before to after treatment (p = <0.001 for both ABR and VRR). The heart rate also decreased from before to after treatment in both groups (p = 0.019 for the ABR group, p = 0.026 for the VRR group). Changes in blood pressure showed mixed results. No significant differences in the blood pressure outcomes were found between the two groups.

Conclusion: This is the first study to investigate the effects of ABR and VRR on dental anxiety. Both the ABR and VRR groups presented significant reductions in anxiety, pain, and heart rate after treatment. Our study demonstrated that nonpharmacological techniques, such as ABR and VRR, can be valid, noninvasive approaches to reduce anxiety before dental treatment, specifically endodontic therapy. However, given the small cohort in this study, it will be necessary to reproduce the methods with a larger cohort and different types of ABR and VRR applications to confirm the effects of nonpharmacological interventions on reducing endodontic dental anxiety.

Purpose: The aim of this study was to investigate the feasibility of using an electronic note template to evaluate and record caries arrest from the application of 38% Silver Diamine Fluoride (SDF) at the New York University College of Dentistry Pediatric Clinic (NYUCD-PD). The study evaluated adherence to its use and explored barriers and alternatives to document this procedure among the post-doctoral residents.

Methods: A template was designed to collect baseline characteristics of treated teeth, application methods, and caries arrest at subsequent visits. The template was implemented among 26 post-graduate students on October 31, 2023. A retrospective chart review was conducted in March 31, 2025 to evaluate utilization of the template and extracted data was analyzed using descriptive statistics. The residents' feedback was collected during two focus-group sessions and analyzed qualitatively to assess their understanding of the importance of documentation, identify barriers to utilization of the template, and explore other alternatives for documentation.

Results: 392 visit encounters on 250 patients were analyzed. Template utilization increased with time from graduated PGY-2 residents to current residents, but it was not universal or uniform. Qualitative analysis revealed that residents fully understand the importance of accurate record keeping, and the template's intended advantages. However, barriers for utilization like time constraints, difficulties when reporting multiple lesions in our complex patient population, and its accessibility within the system, limit their capabilities to comply.

Conclusion: Although a standardized electronic template can be an effective method of evaluating and documenting caries arrest in SDF-treated teeth, compliance with its use at every encounter is difficult in a hectic university clinic that treats very young children. Further investigation is required to overcome barriers for its use, and to test additional strategies that could be feasible in a dental educational setting.

Introduction: Exfoliated or extracted human teeth are increasingly used as accessible records of health history, biomarkers for predicting health risks, or analyzed for organic components to uncover the mechanisms of atypical development or disease. During formation, dental enamel incorporates and preserves biological information through mineralization, thereby creating a fossil-like record within the tooth structure as it reaches a mineral content of over 95% by weight. The key to unlocking this record depends not only on using appropriate analytical methodologies, but also on how storage conditions affect the original biogenic information.

Methods: To investigate the effect of storage conditions on enamel proteome, human third molars were collected upon extraction and stored for 4 months under four commonly used protocols in dental research: (1) at -80°C; (2) in 70% ethanol (EtOH) at room temperature (RT); (3) air-dried (Air) at RT; and (4) in phosphate-buffered saline with sodium azide at RT.

Results: Mass spectrometry-based proteomic analysis identified 454, 460, 232, and 221 proteins in the -80°C, EtOH, Air, and PBS groups, respectively. Enamel-specific proteins, such as amelogenin, ameloblastin, enamelin, kallikrein-related peptidase-4, and matrix metalloproteinase-20, were identified across all conditions, although their relative abundances varied depending on storage conditions. In addition, the preservation of specific protein families varied depending on the storage conditions.

Discussion: Although -80°C storage remains the gold standard for preserving organic material, storage in 70% EtOH at RT produced comparable proteomic results. This suggests that ethanol-based storage protocols may serve as a more practical alternative, easier to implement for sample collection, and help provide consistency in enamel research. Our findings underscore the importance of both storage methods and standardized protocols in enamel proteomics, as they help avoid bias in protein detection and facilitate comparisons of datasets between studies.

Socket preservation after tooth extraction is a critical procedure to maintain alveolar ridge dimensions for future prosthetic rehabilitation. Autogenous dentin has emerged as a promising graft material due to its biocompatibility, osteoconductivity, and similarity in composition to bone. A systematic search of MEDLINE (PubMed), Scopus, and Web of Science was conducted in January 2025 using a defined MeSH-based strategy. The search was limited to human clinical studies published in the past ten years. Only studies directly comparing groups with autogenous dentin grafts and spontaneous healing without augmentation were included. Six studies met the criteria and were included in the final review, all confirming the safety and biocompatibility of autogenous dentin. Histological evaluations showed active bone formation around dentin particles and high osteoblastic activity without inflammatory response. Cone beam Computed Tomography (CBCT) analysis, performed in most studies, revealed significantly better preservation of ridge dimensions in autogenous dentin matrix (ADM)-augmented sites, especially in the coronal third of the socket. One study highlighted successful outcomes even in periodontally compromised molar extractions. Despite the general agreement among studies, further research (ideally with standardized protocols) is needed to confirm long-term efficacy in diverse clinical scenarios.

Introduction: This cadaveric study evaluated the effect of a novel clockwise osseodensification (OD) technique on primary implant stability in low-density bone.

Materials and methods: Forty implants were placed in paired sites of nine formalin-fixed human tibiae, comparing OD (n = 20) with standard drilling (SD; n = 20). Primary stability was assessed by maximum insertion torque (IT) and implant stability quotient (ISQ). Postoperative bone-implant interface characteristics were examined using cone-beam computed tomography (CBCT), periapical radiography, and synchrotron-based x-ray tomographic microscopy (SR-µCT).

Results: The OD group showed higher mean ISQ (67.5 ± 6.5) and IT (34.0 ± 6.6 Ncm) values than the SD group (62.9 ± 9.3; 29.5 ± 7.6 Ncm, respectively), although these differences were not statistically significant (p > 0.05). The results indicate a trend toward improved primary stability with OD (ISQ: p = 0.077; IT: p = 0.052). A statistically significant moderate positive correlation between IT and ISQ was observed in the OD group (ρ = 0.577, p = 0.0077) but not in SD (ρ = 0.208, p = 0.3778), indicating greater predictability of stability outcomes with OD. Radiographic analysis revealed denser peri-implant bone and reduced radiolucency in OD sites, indicating a tendency toward improved bone compaction and closer implant contact. SR-µCT observations qualitatively demonstrated a more condensed trabecular architecture around OD implants compared with SD, consistent with enhanced local bone compaction.

Discussion: These findings indicate that OD produces more consistent stability values and a stronger IT-ISQ relationship than SD, potentially enhancing the reliability of resonance frequency analysis in low-density bone. Unlike conventional counterclockwise OD, Clockwise OD uses densifying burs in the cutting direction at moderate speeds (800 rpm), offering a simpler, less technique-sensitive alternative without sacrificing the benefits of bone condensation. Within the limitations of a cadaveric model, OD demonstrated consistent stability values and a trend toward improved primary mechanical outcomes compared with SD. Further in vivo studies are required to confirm these findings and evaluate long-term biological effects.

Objective: The reasons for second molar extraction include endodontics, periodontal disease, and impacted third molars. This retrospective study analyzed medical records and image examinations of patients who underwent second molar extraction to clarify the proportional distribution of different causes.

Materials and methods: Medical records and imaging data of patients who underwent second molar extraction between January 1, 2020 and December 31, 2022 were systematically collected. Two senior dentists analyzed and recorded patient demographics, clinical diagnoses, and extraction causes. Inter-rater consistency was verified using Kappa testing.

Results: A total of 1,818 valid cases were included with a mean age of 52.9 years (male: 864 cases; female: 954 cases). Endodontic factors accounted for 1,045 s molar extractions (57.43%) and periodontal factors contributed to 588 extractions (32.40%), both showing significant age-related correlations (p < 0.05). Impacted third molar factors led to 185 extractions (10.01%) with no significant age-dependent association (p > 0.05). Impacted third molars contributed to 13.97% of mandibular second molar extractions, while only 5.73% to maxillary second molar extractions.

Conclusions: The main reasons for extracting second molars were endodontic factors, followed by periodontal factors, and impacted third molars. Advanced age was significantly associated with increased extraction risks attributable to both endodontic and periodontal disease. Impacted third molar-related factors accounted for a larger proportion in cases of mandibular second molar extractions.

Background: The precise and consistent application of adhesive systems is essential for achieving reliable bonding in restorative dentistry. Microapplicators are commonly used for adhesive delivery; however, variations in their structural quality and performance may affect clinical outcomes.

Objective: This study evaluated four commercially available microapplicator brands-Angelus, FGM, KG Sorensen, and SDI-regarding the quality of their active tips (bristle configuration) and adhesive delivery capacity.

Methods: A total of 160 microapplicators (40 per brand) were analyzed. Optical microscopy (15 per brand) assessed bristle integrity before and after use. Scanning electron microscopy (SEM; 10 per brand) evaluated surface morphology (five unused and five used applicators per brand). Adhesive release capacity (15 per brand) was determined by weighing each microapplicator before adhesive loading, after loading, and following application to a standardized cavity. Data was analyzed using One-way analysis of variance (ANOVA).

Results: New microapplicators from Angelus, KG Sorensen, and SDI displayed uniform bristle arrangements without visible gaps. After use, SDI and Angelus maintained superior bristle cohesion, whereas FGM showed the greatest deformation and sparse bristle distribution. Despite morphological differences, all brands delivered adhesive with comparable efficiency, exceeding 96% release.

Conclusions: SDI microapplicators demonstrated the highest structural stability and resistance to deformation, followed by Angelus, KG Sorensen, and FGM. Although adhesive release capacity was consistent across all brands, differences in bristle quality may influence handling characteristics and clinical precision.