Acta Odontologica Scandinavica最新文献

Background: Machine learning (ML) is transforming dentistry by setting new standards for precision and efficiency in clinical practice, while driving improvements in care delivery and quality.

Objectives: This review: (1) states the necessity to develop ML in dentistry for the purpose of breaking the limitations of traditional dental technologies; (2) discusses the principles of ML-based models utilised in dental clinical practice and care; (3) outlines the application respects of ML in dentistry; and (4) highlights the prospects and challenges to be addressed.

Data and sources: In this narrative review, a comprehensive search was conducted in PubMed/MEDLINE, Web of Science, ScienceDirect, and Institute of Electrical and Electronics Engineers (IEEE) Xplore databases.  Conclusions: Machine Learning has demonstrated significant potential in dentistry with its intelligently assistive function, promoting diagnostic efficiency, personalised treatment plans and related streamline workflows. However, challenges related to data privacy, security, interpretability, and ethical considerations were highly urgent to be addressed in the next review, with the objective of creating a backdrop for future research in this rapidly expanding arena.  Clinical significance: Development of ML brought transformative impact in the fields of dentistry, from diagnostic, personalised treatment plan to dental care workflows. Particularly, integrating ML-based models with diagnostic tools will significantly enhance the diagnostic efficiency and precision in dental surgeries and treatments.

Objective: This register-based follow-up study investigated periodontal status after periodontal treatment (PT) based on need following oral health examination (OHE).

Materials and methods: A total of 42,533 adults aged 18-89 years receiving OHE in the public oral health clinics of the City of Helsinki in 2009 were included. Dentists recorded periodontal status by the Community Periodontal Index (CPI), and determined the individual recall interval (IRI). Follow-up OHE between 2010 and 2015 was performed for 16,040 adults based on IRI or later. Outcome of interest was change of CPI during follow-up and was modelled with proportional odds model for each sextant separately. Results were reported as odds ratios (ORs).

Results: Signs of periodontal disease were present in 95% of the study population. Symptoms of periodontitis (CPI score 3 or 4) were observed in 24% of patients. In models, PT indicated better outcome in all six sextants and in sextant 5 after one treatment (OR 5.05, 95% confidence interval [CI] 4.53-5.63). A poorer outcome was observed in patients with diabetes or severe mental disorders and in men.

Conclusions: The study population had a high prevalence of periodontal diseases. Men and patients with diabetes or severe mental disorders should be specifically targeted by dentists.

Objectives: Recently, the Short-Form Fonseca Anamnestic Index (SFAI) was shown to have high diagnostic accuracy when compared to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in patient samples. This study investigated the dimensionality of the parent instrument (Fonseca Anamnestic Index [FAI]) and validated its main component using Rasch analysis in non-patient populations.

Methods: FAI data from a total of 901 participants from Singapore and Indonesia with a mean age 19.30 ± 1.48 years (65.0% women) were examined. Of these, 53.8% were FAI positive and 46.2% were FAI negative. Principal Component Analysis (PCA) was performed to extract the main component of the FAI using an eigenvalue > 1.0 and direct oblimin rotation with item loading of > 0.40. Rasch analysis was subsequently carried out on the items of the main component.

Results: The FAI was found to be multidimensional with the main component involving items F1, F2, F3, F6, and F7 which were the items of the SFAI. The SFAI had moderate internal consistency (Cronbach alpha = 0.63) and fitted the Rasch model with person and item infit/outfit mean square (MnSq) values of 0.98/0.96 and 1.00/0.96 logits respectively. The infit/outfit MnSq of the SFAI items ranged from 0.82 to 1.06 logits with Item F2 (side-movement difficulty) being the most difficult and item F3 (muscle pain) the easiest.

Conclusions: The FAI is multidimensional with the main component comprising the five items of the SFAI that fitted the Rasch model. With its good Rasch validity, separation, and reliability, the SFAI is a promising tool for TMD screening.

Objective: The aim was to assess the correlation between periodontal status, whole salivary interleukin-1 beta (IL-1β) levels and oral yeasts carriage (OYC) among individuals with varying ranges of body mass index (BMI).  Material and method: The weight, waist circumference (WC), and height of individuals were assessed. Participants were categorized into three groups: Group-1 - normal weight (18.5-24.9 Kg/m2); Group-2 - overweight (25-29.9 Kg/m2); and Group-3 - obese (≥ 30 Kg/m2). Plaque and gingival indices (PI and GI, respectively), probing depth (PD), clinical-attachment-loss (CAL), missing teeth (MT) and marginal-bone-loss (MBL) were assessed. Whole salivary IL-1β levels and OYC were assessed. Group-comparisons were done. P < 0.05 was considered statistically significant.  Findings: Twenty-two, 22 and 22 individuals with comparable mean ages were included in groups 1, 2 and 3, respectively. The mean WC and BMI were higher in Group 3 than Groups 1 (P < 0.05) and 2 (P < 0.05). The mean PI, CAL, PD, GI, MT and MBL were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was no difference in mean PI, CAL, PD, GI, MT and MBL in groups 1 and 2. The salivary flow rate was higher in groups 1 (P < 0.05) and 2 (P < 0.05) than Group-3. The OYC and IL-1β were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was a correlation between PD and OYC in Group-3 (P < 0.05).  Conclusion: Periodontal inflammation is worse, and whole salivary IL-1β levels are elevated in obese than overweight individuals and subjects with normal BMI. There seems to be no association between BMI and OYC.

Background: Skeletal Class III patients can be treated with bone anchored maxillary protraction (BAMP) treatment. The placement of miniplates is an invasive operation and needs to be carried out under general anesthesia.

Aim: The aim of this retrospective study was to determine the failure rate of miniplates.

Methods: All the patients who had miniplates placed for BAMP treatment between January 2010 and April 2020 in Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Finland were included in this study. The patient records were retrospectively screened. The success rate of the placement of orthodontic miniplates was evaluated between surgical residents (Group 1) and consultant surgeons (Group 2).

Materials: The study group consisted of 164 miniplates in 42 patients. The miniplates were divided into two groups, depending on the placement operator. Group 1 consisted of 86 miniplates placed by surgical residents. Group 2 consisted of 78 miniplates placed by consultant surgeons.

Results: In Group 1 (11 females, 14 males) and Group 2 (16 females, 9 males). The overall failure rate of miniplates was 23.8% (n = 39). The failure rate for surgical residents (Group 1) was 31.4% (n = 27) and for consultant surgeons (Group 2), 15.3% (n = 12) (p < 0.05). Out of all the failed miniplates 69.2% (n = 27) were placed by residents and 30.8% (n = 12) by consultants.

Limitations: This retrospective study consisted of a limited number of patients.

Conclusion: The failure rate of miniplates placed by consultant surgeons was lower compared to surgical residents (p < 0.05).

Objective: The aim was to compare the cost-effectiveness of root canal treatment and an indirect restoration (RCT + PC) versus an implant-supported single crown (ISSC) in the case of a decayed first mandibular molar with a necrotic pulp. The study was based on Swedish population and the reference prices for dental treatments in Sweden.

Materials and methods: The cost-effectiveness for RCT + PC and ISSC were calculated with the help of two decision trees. The initial costs were from the Swedish dental reference prices in 2024, and the probability values were from published articles based on Swedish data.

Results: In Decision tree I, the expected costs for RCT + PC and for ISSC were 17,400 and 18,800 SEK, respectively. In the Decision tree II, the respected expected costs were 19,500 SEK and 18,800 SEK. The threshold probability values were 83 and 93% for RCT survival.

Conclusions: Given the assumptions and limitations of this decision analysis, the probability of survival for RCT + PC needs to be in the range of 83-93% in order for it to be more cost-effective than ISSC, when deciding about treatment on a compromised first mandibular molar.

Objective: To analyse the Oral Health-Related Quality of Life (OHRQoL) of 6-18-year-old children visiting the special needs and paediatric dental clinics of the University of the West Indies (UWI).  Material and methods: Parents/caregivers of all 6-18-year-old children (n = 201) attending the Special Needs Dental Clinic (SNDC) and Child Dental Health Clinic (CDHC) were recruited. The Oral Health Impact Profile (OHIP-14), shortened version, was employed. Outcomes calculated were severity, prevalence, and OHIP-14 domains. Chi-square and Mann-Whitney U tests, and logistic regression models served for statistical analyses.

Results: Parents/caregivers of children with disabilities (n = 101) and without (n = 100) participated. The mean age of the children was 10.6 (3.4 standard deviation [SD]) from the SNDC and 11.3 (2.8 SD) from the CDHC. The OHRQoL differed slightly between mean severity scores for children with disabilities (6.41 ± 9.09) and without (7.01 ± 6.87) (p = 0.020). When adjusted for confounders, OHIP-14 impacts perceived occasionally, daily or very often, children with disabilities had poorer OHRQoL.

Conclusions: The overall OHRQoL among the children visiting the UWI dental clinics was poor. The OHRQoL was poorer in children with disabilities in terms of oral impacts perceived occasionally, daily or very often. Children attending for 'pain and filling' had higher odds of having OHIP-14 impact than others.

N/A.

Objective: This study aimed to evaluate the effect of slice thickness (ST), plunger size (PS), shape and region of the root canal on push-out tests using standardized artificial root canals.

Materials and methods: Two teeth with round and oval root canal anatomy were selected using cone beam computed tomography. Teeth were prepared, scanned with micro computed tomography and stereolithography data were obtained. Seventy-two round and 72 long oval artificial root canals were produced using a 3D printer. Root canals were obturated, then divided into two main groups (oval-round) and further divided into six subgroups (n = 12) according to ST (1, 1.5, and 2-mm) and PS (0.5, 0.75, and 1-mm). Push-out tests were performed and dislocation resistance values were calculated. The data were analyzed using the ANOVA two-way test (p = 0.05).

Results: Different STs showed similar results in oval canals (p > 0.05). 1-mm ST showed higher results in round canals (p < 0.05). There was a significant difference between 0.75 and 1-mm PSs (p < 0.05). Middle and coronal regions showed similar results in oval canals (p > 0.05), and coronal region showed lower results in round canals (p < 0.05).

Conclusion: ST, PS, root canal shape and region variables affected the dislocation resistance of core material in standardized root-filled canals.

Objective: The aims were to describe the dental status and mental and somatic health profile of patients with severe dental anxiety requiring dental treatment under general anesthesia (GA) in Rogaland County, Norway (2018-2021), and to compare patients with and without reported abuse history.

Material and methods: Dental status was assessed by panoramic X-rays. General health variables were collected from patient records. Statistical comparisons of patients with and without abuse experience by tests of association (significance level p < 0.05).  Results: 38 women and 18 men (mean ± standard deviation [SD]: 37.9 ± 9.2 years) were included; 27 reported abuse experience. Dental assessment showed 4.6 ± 3.8 missing teeth, 4.8 ± 3.0 root remnants, 5.8 ± 3.7 teeth with caries and 2.6 ± 1.9 teeth with apical periodontitis, among patients with ≥1 of the respective findings. 57.1% used analgesics due to dental pain. 55.4% had comorbid psychiatric conditions; 35.7% used psychopharmaceuticals. There were no statistical differences in dental variables but the abuse experience group had higher frequencies of comorbid psychiatric disorders (p = 0.01) and mixed somatic conditions (p = 0.03).

Conclusions: Patients with severe dental anxiety requiring dental treatment under GA have complex health problems. They need access to treatment under GA, as treatment of serious odontogenic conditions is otherwise unmanageable.