Acta Odontologica Scandinavica最新文献

Objective: To assess oral-health literacy and test a conceptual model of the relationships among oral health-related self-efficacy, social support, illness perception, and oral-health literacy in patients with periodontitis.

Materials and methods: This cross-sectional study recruited 230 eligible adult periodontitis patients by convenience sampling at the Department of Periodontology, Fourth Military Medical University (Xi'an) from March to July 2024. Participants completed validated Chinese versions of the short-form Health Literacy Dental Scale, the Self-efficacy Scale for Self-care, the Social Support Rating Scale, and the Brief Illness Perception Questionnaire. Data analysis included descriptive statistics, nonparametric tests, correlation analysis, and Hayes's PROCESS macro (Model 4 and Model 7) to test for social support's mediation and illness perception's moderation.

Results: The study included 230 participants (121 males, 52.6%; 109 females, 47.4%), with a mean age of 39.27 ± 11.85 years. The health literacy score for periodontitis patients was 42.00 (34.00, 52.00). The direct effect of oral health-related self-efficacy on oral-health literacy was significant (β = 0.2367, 95% CI [confidence interval] = [0.1176~0.3558]), and social support played a partial mediating role between oral health-related self-efficacy and oral-health literacy (β = 0.0526, 95% CI = [0.0153~0.0980]). Illness perception did not significantly moderate the relationship between oral health-related self-efficacy and social support (β = -0.0061, 95% CI = [-0.0133, 0.0010]).

Conclusions: This study assessed oral-health literacy at a moderate level in periodontitis patients. The tested model was partially supported: self-efficacy directly improved oral-health literacy, and social support partially mediated this relationship. Illness perception did not moderate the pathway. Therefore, self-efficacy and social support are primary targets for improving oral-health literacy.

Objective: Swedish smokeless tobacco, or 'snus', has a long history of use and has undergone significant transformations, including the introduction of portion-packed snus and tobacco-free nicotine pouches. This systematic review evaluates the impact of Swedish snus on oral health, focusing on gingivitis, gingival recession, periodontitis, caries, tooth wear, and oral cleft malformations.  Material and methods: The databases PubMed, Scopus, and EMBASE were used, terminating the searches on 11th June 2025. Original scientific articles written in the English or Scandinavian languages were screened by two independent researchers, finally including 26 out of 2,176 articles. The included articles were exported to the Elicit Pro library for quality assessment performed using the Joanna Briggs Institute's Critical Appraisal Tool for Systematic Reviews. Premalignant and malignant changes were excluded from the search.

Results and conclusion: The findings indicate that Swedish snus is associated with gingival recession, particularly among users of loose snus, with mechanical pressure and cytotoxic effects contributing to these lesions. Gingivitis was more prevalent among snus users, even after controlling for plaque levels, though no significant association with periodontitis was observed. Evidence regarding caries risk was inconsistent, with some studies reporting higher caries indices values among snus users, while others found no correlation. Additionally, maternal use during pregnancy was linked to a 48% increased risk of oral cleft malformations in offspring. Tooth wear and self-reported temporomandibular disorder (TMD) symptoms were also associated with snus use. These findings underscore the importance of public health measures to regulate snus use, particularly among populations such as pregnant women and adolescents, where they have increased in popularity.

Objective: This study aimed to evaluate the awareness levels of actively practicing dentists in Türkiye regarding artificial intelligence (AI)-related ethical issues, data security, anonymization, and legal regulations.

Materials and methods: A cross-sectional online survey (Google Forms) used a 12-item questionnaire (4 demographics; 8 awareness domains) rated on a five-point Likert scale. Participants were recruited via snowball sampling. Descriptive statistics, independent-samples t-tests, and one-way analysis of variance with Tukey post hoc tests were applied (p < 0.05).

Results: A total of 257 dentists participated. Mean domain scores ranged from 2.97 to 3.13; awareness of ethical issues was highest (3.13 ± 1.44) and perception of encryption lowest (2.97 ± 1.45). No significant gender differences were observed. University hospital dentists reported significantly higher awareness of ethical issues and a greater perceived need for anonymization than other institution types (p < 0.05). For awareness of Personal Data Protection Law (KVKK), scores were higher in university hospitals and private dental polyclinics than in private practices and public hospitals (p < 0.05). Professional experience was associated with differences in perception of encryption, awareness of personal data protection law, awareness of ethical issues, and perceived AI ethical risks (p < 0.05); perception of data security and awareness of big data security did not differ significantly (p > 0.05).

Conclusion: Dentists demonstrated varying levels of awareness across domains, with higher awareness reported in academic settings. Experience-related patterns differed by domain, indicating the need for focused educational strategies addressing legal and ethical aspects of AI-supported dental practice.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is an adverse condition in patients receiving antiresorptive or antiangiogenic therapies. Standard treatments, including surgical debridement, often yield suboptimal outcomes. In this context, bone morphogenetic proteins (BMPs), have been explored for their ability to stimulate osteogenesis and enhance bone repair.  Materials and methods: A systematic review of the literature was conducted, focusing on studies that applied rh-BMPs during surgeries to treat MRONJ. Databases were searched for relevant articles from inception to the present, using keywords such as 'MRONJ', 'BMP', and 'bone regeneration'. Inclusion criteria involved studies with human participants who had been treated with rh-BMPs, along with the surgical elimination of bone sequestrum, MRONJ stages 2 and 3 according to the AAOMS staging system and a minimum follow-up period of 6 months. Two independent reviewers (L.H.C. and C.C.V.) systematically selected the articles independently.

Results: The review included nine studies with a total of 217 patients treated with rh-BMP. Bone regeneration and osteonecrosis healing was reported in all the studies included using rh-BMP. However, the measurement methods were very different between the studies, using clinical examinations, different radiological tests and biomarkers and own scales. Moreover, there were inconsistencies in treatment protocols and follow-up periods, making it difficult to standardize conclusions.

Discussion: While rh-BMPs show promising results for bone regeneration in MRONJ patients, the variability in study methodologies limits definitive conclusions. The biological potential of BMPs could be beneficial, but standardized protocols and longer-term studies are needed to establish their effectiveness.

Conclusions: The application of rh-BMPs may promote bone regeneration in MRONJ patients, but further research with standardized methods is required to confirm these findings.

Objective: To investigate the level of burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS) among Norwegian oral health professionals who work with traumatized and vulnerable patients.

Material and methods: Professional Quality of Life-5 was used to assess BO, STS, and CS. Organizational and psychosocial work factors were measured with the Nordic Questionnaire for Psychological and Social Factors at Work.  Results: Participants (n = 114) reported moderate levels across all three dimensions, with 62.6% scoring in the moderate range for STS, 47.4% for BO, and 38.6% for CS. Poor work-life balance was associated with lower levels of CS and higher levels of STS and BO. Support was associated with positive outcomes of BO, STS, and CS.  Conclusions: Psychosocial factors within the work environment contribute more to occupational strain than the direct challenges of working with traumatized or vulnerable patients. Involving oral health professionals in wider conversations about supporting those who care for vulnerable populations is paramount. Addressing organizational conditions alongside individual support is important to promote well-being.

Objective: This study aimed to evaluate the periodontal and microbiological alterations in oral flora associated with using removable appliances and fixed orthodontic treatments.  Methods: The study materials consist of subgingival-supragingival plaque samples and periodontal measurements from 48 patients. The groups include fixed appliance users, removable appliance users, and a nontreatment control group. Periodontal measurements, including gingival index, plaque index, bleeding on probing, mobility, furcation, probing depth, and attachment level, were recorded at baseline (before treatment) and 6 months after treatment initiation. Plaque samples were collected at T0 and T1. Dental plaque samples were cultured on selective media for qualitative and quantitative microbial analysis, followed by qualitative evaluation using the VITEK 2 (Biomerieux) system. Data were analyzed using one-way one-way analysis of variance one-way analysis of variance (ANOVA), paired sample-T test, and Duncan's multiple range test to identify and compare statistically significant differences within and between groups, while intraobserver reliability was assessed using the Kappa statistic.  Results: Mobility or furcation involvement was not detected in any of the groups at either time point. At the T1 stage, a slight improvement in attachment level was observed in both the fixed and removable appliance groups compared with baseline measurements. However, during the same period, a significant increase in mean probing depth was detected only in the fixed appliance group (p = 0.003). Plaque index levels increased in both the removable appliance group (p = 0.019) and the fixed appliance group (p = 0.023). Furthermore, the bleeding on probing index also showed an increase in both groups, with p = 0.020 in the removable appliance group and p = 0.012 in the fixed appliance group. At the T1 stage, an increase in yeast counts was observed in the removable appliance group (p = 0.008), whereas decreases were detected in Lactobacillus (p = 0.004) and mutans streptococci (p = 0.026) levels. In contrast, the fixed appliance group demonstrated significant increases in Lactococcus (p = 0.042) and mutans streptococci (p = 0.037) counts. The identified microorganisms included a diverse range of bacterial species, such as Actinomyces spp., Fusobacterium spp., Lactobacillus spp., Streptococcus spp., Veillonella spp., and other clinically significant genera.  Conclusions: It may be inferred that fixed orthodontic treatments create a biological environment that is more susceptible to adverse periodontal alterations and increased colonization by specific microbial species. Conversely, the potential suppressive effects of removable appliances on certain microbial groups emphasize the need to consider patients' oral hygiene compliance, periodontal risk profile, and microbial sensitivity during treatment planning.

Objective: This study aimed to clarify whether third molar extraction becomes more difficult as the patient ages. Previous research results on the topic are contradictory.

Materials and methods: All 12,649 third molar extractions in Helsinki's primary care during 2016 were retrieved from electronic records using treatment codes. The primary outcome was extraction difficulty, classified as simple (forceps) or surgical (raising a flap). The secondary outcome was an extraction labelled as demanding. Predictor variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ2 test and binomial logistic regression.

Results: Mean age of the patients was 32.2 years (range 12-97 years). Simple extractions in the maxilla (P < 0.001) and all surgical extractions (P < 0.001) were more likely to be demanding at a higher age. In the mandible, simple extractions were easier at a higher age (odds ratio [OR] 0.971; 95% confidence interval [CI] 0.964; 0.978). Surgical extraction was 1.4 times (95% CI 1.145; 1.766) more likely to be demanding in men and twice (95% CI 1.143; 3.462) as demanding in the mandible.

Conclusions: Surgical and maxillary simple extractions were more difficult at a higher age. Surprisingly, in the mandible, simple extractions were easier at a higher age.

Objectives: The Nordic welfare state aims for social security and equality. However, incarcerated people often face vulnerable situations impacting oral health. This study describes oral health and background characteristics of incarcerated people in Norway and explored differences between Nordic and non-Nordic origins.

Material and methods: This cross-sectional study included 326 participants from four prisons in Norway. Dental personnel conducted visual oral examinations and collected questionnaire data on sociodemographic, socioeconomic and health-related background, self-reported oral health and dental anxiety.

Results: The population mainly consisted of young (mean 36.9 ± 11.8) men (95.4%). Almost half had low education (46.4%), reported financial difficulties (37.8%), lacked labor market attachment (45%), and over half (54.8%) experienced physical pain. Dental services were irregularly used (56.2%), and dental anxiety was prominent (39%). Almost half reported poor oral health (46.5%) and clinical measures (mean decayed, missing and filled teeth [DMFT] 11.4 ± 7.4) revealed decayed teeth in four of 10 individuals (39.8%). Group differences showed that non-Nordic individuals had stronger labor market attachment, fewer health challenges, and less caries experience than Nordic individuals.

Conclusion: Diverse socioeconomic backgrounds, untreated caries, poor self-reported oral health, dental anxiety, and irregular dental attendance were common. The group disparities challenge the equity goals of the Nordic Welfare state.

Background: Chronic periodontitis is a prevalent inflammatory disease, and miR-125a-5p's role in its pathogenesis remains unclear.

Objective: We examined the clinical significance and mechanisms of miR-125a-5p in chronic periodontitis by testing two hypotheses: (1) miR-125a-5p expression is altered in chronic periodontitis and correlates with clinical indicators; (2) miR-125a-5p regulates periodontal ligament fibroblast (PDLF) functions by targeting specific genes, contributing to disease pathogenesis.

Method: Pearson correlation analysis assessed the association between miR-125a-5p expression and key clinical indicators. Receiver operating characteristic (ROC) curve analysis evaluated its diagnostic performance in chronic periodontitis. Periodontal ligament fibroblasts were treated with lipopolysaccharide (LPS) to establish an inflammatory model. miR-125a-5p and B-cell translocation gene 2 (BTG2) expression levels were measured by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Cell count kit-8 (CCK-8) assay and enzyme-linked immunosorbent assay (ELISA) assessed miR-125a-5p's effects on cell proliferation, oxidative stress, and inflammation. The direct interaction between miR-125a-5p and BTG2 was confirmed using a dual-luciferase reporter assay.

Results: The expression level of miR-125a-5p in the gingival crevicular fluid of patients with chronic periodontitis was significantly upregulated and positively correlated with the severity of periodontal tissue damage. In the LPS-induced PDLFs model, miR-125a-5p expression was upregulated, cell proliferation capacity was suppressed, oxidative stress was induced, and levels of inflammation-related factors were increased. Notably, transfection with a miR-125a-5p inhibitor effectively reversed these effects. Moreover, the study confirmed that BTG2 is a direct target gene of miR-125a-5p, and that miR-125a-5p exerts its regulatory effects on cellular functions through targeting BTG2.

Conclusion: miR-125a-5p is potentially associated with chronic periodontitis, and may serve as a therapeutic target.