Australian dental journal最新文献

Aim: This project aims to systematically review and synthesise the data found in the literature regarding the survival of implants, complications, and gain in bone height using the hydraulic pressure technique to elevate the maxillary sinus floor.

Methods: A comprehensive literature search was conducted using databases including PubMed, Scopus, Embase, and Cochrane, covering studies from 2005 to July 2024. A total of 24 studies were included, comprising randomised control trials, cohort studies, and case series. The main outcomes evaluated were implant survival, complication rates, and endo-sinus bone gain.

Results: The review included 3053 implants placed in 2290 Sinuses of 2231 patients. The patients' ages ranged from 23 to 84, with a mean of 51.6 years. The included studies reported a pooled implant survival rate of 98.40% over follow-up periods ranging from 6 months to 8 years. The rate of sinus membrane perforation was relatively low (2.05%), and other complications, such as hematoma, sinusitis, nasal discharge, or oedema, occurred in 0.49% of cases. The average endo-sinus bone gain achieved using this technique was 6.72 mm.

Conclusion: The hydraulic pressure technique for sinus floor elevation is one of the many proposed solutions to provide predictable, safe, and efficient sinus floor elevation. The results from this review provide some cause for optimism, with high survival rates, low complication rates, and adequate gain in bone height. There is still a need for further long-term, high-quality research by independent third parties to confirm the effectiveness and safety of this technique.

Clinical relevance: There is limited information available for the hydraulic pressure technique for sinus floor elevation. It has only been briefly mentioned in a limited number of literary reviews, none of which quantify the available data. This study presents the first systematic review of the hydraulic pressure technique, synthesising the available data and suggesting that the hydraulic pressure technique demonstrates high success and safety.

Prospero: This review is registered in PROSPERO under ID: 1070614.

Background: The aims of this study were to assess and compare trends in microbial cultures and antibiotic resistance in individuals admitted with severe odontogenic infection in Auckland, New Zealand and South Australia, Australia.

Methods: A retrospective audit was completed on all adults ( $\ge$ 19 years of age) admitted with severe odontogenic infection in the Auckland and South Australia public oral and maxillofacial surgical teams, 2019-2023. Data was collected on demographic information, antibiotic prescribed at discharge, length of admission, number of procedures required, microbes isolated in cultures and antibiotic sensitivity, where completed by the laboratory.

Results: The total combined population of individuals admitted for severe odontogenic infection was 924. Auckland admitted more individuals for severe odontogenic infection (n = 542), compared to South Australia (n = 382) from a similar general population size. Moderate rates of resistance to penicillin (13.4% and 8.8%) and clindamycin (13.9% and 9.4%) in Auckland and South Australian cohorts, respectively were identified.

Conclusions: There was a higher presence of microbes that were resistant to antibiotics in the Auckland population compared to the South Australian population for individuals admitted for severe odontogenic infection. The presence of resistant microbe(s) was associated with an increasing trend of length of admission and likelihood of repeat surgical procedure(s).

Background: This study investigated the experiences and approach to practice of New Zealand (NZ) general dental practitioners (GDP) providing root canal treatment (RCT) for older adults.

Methods: A national online survey collected data from GDPs managing older adults including their approaches to pulpal diagnosis and RCT techniques. Questions also explored informed consent, specialist referrals, confidence, treatment outcomes and engagement with continuing education. Data were analysed descriptively and bivariate analysis of categorical variables used Chi-square and Fisher's exact tests.

Results: A total of 382 GDPs participated (response rate 23.6%). RCT for older adults was common, and most dentists felt confident and incorporated contemporary techniques, although they were less comfortable managing polypharmacy or complex medical conditions. Verbal consent was usual. Almost three-quarters had updated their endodontic knowledge and skills within the previous 2 years through continuing professional development. Around two-thirds found diagnosis challenging; however, RCT was viewed as successful. Females were less confident, and a proportion did not treat molars.

Conclusion: Older adults commonly require RCT, and enhancing GDPs' knowledge and skills to manage patients with a range of medical conditions is important. Written consent is advised for RCT when patient or tooth factors are complex, or where patients' capacity may be impaired.

Purpose: Traumatic dental occlusion (TDO) is a multifactorial and dynamic clinical condition that extends beyond localised tooth wear and has been reported to be associated with alterations in temporomandibular joint biomechanics, neuromuscular function and overall masticatory system performance. While acute dental trauma often receives greater clinical attention, chronic occlusal trauma may remain underrecognised in routine practice, despite its potential to influence mandibular movement patterns, modify joint loading and contribute to patient-reported functional complaints.

Basic procedures: This narrative review synthesises current concepts from the literature regarding the proposed etiologic factors, functional implications and long-term clinical consequences of traumatic dental occlusion. Particular emphasis is placed on the adaptive nature of the masticatory system and the variability of individual responses to occlusal disturbances. Contemporary digital diagnostic tools, occlusal analysis technologies and CAD/CAM-assisted restorative workflows are discussed as adjunctive modalities that may support clinical assessment and treatment planning rather than as definitive solutions.

Main findings: The review outlines commonly applied clinical approaches used in the management of TDO-related structural and occlusal changes, including tooth wear and variations in occlusal vertical dimension, with reference to provisional strategies, indirect restorations and minimally invasive interventions.

Principal conclusions: By providing an expert narrative synthesis and acknowledging ongoing controversies within occlusion and temporomandibular disorder research, this review aims to enhance clinician awareness, support cautious and patient-centred decision-making and encourage further research to clarify the clinical relevance of traumatic dental occlusion within contemporary dental practice.

Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder that may initially present with oral manifestations, posing diagnostic challenges, especially in adults. We report a rare case of a 27-year-old male who initially presented with painful ulcerative palatal lesions and advanced periodontal symptoms. Despite early biopsy-confirmed LCH diagnosis and haematology referral, the patient's noncompliance led to delayed treatment, resulting in progression from localised oral involvement to multisystem disease, including mandibular, iliac, and vertebral bone lesions. Treatment ultimately required systemic chemotherapy after repeated biopsies and positron emission tomography/computed tomography imaging confirmed disease dissemination. Dental extractions and soft tissue excision were performed to manage oral symptoms. This case highlights the critical role of dental professionals in early LCH detection and underscores the impact of delayed intervention. Interdisciplinary collaboration and patient compliance are essential to prevent disease progression and improve outcomes in LCH with oral involvement.

Background: Paediatric orbital abscesses represent true emergencies requiring immediate recognition and multidisciplinary management to prevent permanent vision loss and life-threatening complications.

Methods: We present three paediatric cases of orbital abscess (ages two, six, and eight years) presenting to emergency departments. Cases were analysed for emergency presentation patterns, imaging findings, and treatment outcomes.

Results: All patients presented with periorbital swelling and fever, and all three cases originated from odontogenic infections. Emergency CT imaging was crucial for diagnosis. Multidisciplinary management involving emergency medicine, ENT, and maxillofacial surgery achieved excellent outcomes with no visual or neurological complications.

Conclusions: Emergency physicians must maintain high clinical suspicion for orbital abscess in children with periorbital swelling and fever. Immediate CT imaging, broad-spectrum antibiotics, and emergency surgical interventions can prevent catastrophic complications.

Objective: To systematically evaluate and quantitatively compare, through pairwise and network meta-analysis, the effectiveness of probiotic supplementation in reducing cariogenic Streptococcus mutans levels in human subjects.

Methods: A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science and Cochrane Library up to October 2025. Randomised controlled trials assessing probiotic or synbiotic formulations with quantitative S. mutans outcomes were included. Data expressed as mean ± standard deviation were synthesised under a random-effects model using a frequentist network meta-analysis (netmeta, R). Effect sizes were reported as mean differences (MD, 95% CI). To strengthen analytical validity, all outputs were cross-validated through triangulation using the MetaInsight platform, confirming consistency between independent computational environments. Risk of bias was assessed with RoB 2, and evidence certainty was appraised via CINeMA.

Results: Twenty trials fulfilled inclusion criteria. Most interventions showed a short-term reduction in S. mutans counts, but differences versus placebo were small and not statistically significant across intervals. Forest-plot synthesis and triangulated results indicated that effects were transient and strain-dependent. SUCRA rankings suggested a high percentage of success, but those findings are only probabilistic, not conclusive superiority. Overall evidence certainty was low to moderate.

Conclusions: Probiotic supplementation exhibited a limited, time-dependent capacity to modulate S. mutans levels without a consistent advantage over placebo. Current findings support its role as a safe adjunctive rather than as a standalone preventive strategy.

Clinical significance: Within the available evidence, probiotics should be regarded as experimental adjuncts rather than as replacements for conventional caries-prevention measures. Any observed microbiological benefits were modest, transient and strain-specific, without consistent translation into clinical outcomes. Their recommendation should remain cautious until larger, long-term randomised trials confirm durable effects.

Trial registration: PROSPERO registration number: CRD420251180536.

Background: Globally, the number of migrants with limited language proficiency and low health literacy has been steadily increasing. In Australia, while most state governments have recognised these individuals as a priority population and provide free or subsidised access to oral healthcare services, their satisfaction levels regarding the received dental care remain uncertain. Studies suggest that patients with communication barriers often report greater dissatisfaction and anxiety in healthcare settings, with cultural insensitivity further worsening their experience. Therefore, feedback on oral healthcare services is crucial for improving service delivery and care quality.

Objective and methods: This study aims to compare and assess the satisfaction of migrant and Australian-born parents with the oral healthcare received by their children in Australia. Data from the 2012-2014 National Child Oral Health Survey (NCOHS) was utilised, which involved a cross-sectional survey of 24,664 representative school children aged 5-14 years and their parents in Australia. This study used the Child Oral Care Performance Assessment Scale (COPAS), which was originally developed to collect parental observation and assessment of dental care received by their child. In the present study, the COPAS was used as a proxy measure for gauging the parents' satisfaction. Data were analysed using the complex samples' general linear model regression analyses to confirm the association between the factors.

Results: In general, the satisfaction scores were significantly lower in migrants than non-migrant parents regarding the oral healthcare provided to their children in efficient, responsive, accessible and capable domains of COPAS. The overall satisfaction score, across all domains, revealed that migrant parents had lower satisfaction levels than non-migrants (B = -1.64; 95% CI, -3.11 to -0.17). Parental language and income were also linked to satisfaction levels, with migrant parents from countries where English is not the primary language having notably lower scores than migrant parents from countries where English is the primary language (B = -4.16; 95% CI, -5.98 to -2.34). Among the other factors studied, parents in lower-income (B = -7.55; 95% CI, -9.14 to -5.95) and middle-income (B = -4.31; 95% CI, -5.45 to -3.17) groups were less satisfied with oral healthcare compared to higher-income parents. Single-adult households also reported lower satisfaction (B = -5.01; 95% CI, -9.67 to -0.35). On the other hand, having fewer children was associated with higher parental satisfaction.

Conclusions: Notable differences in satisfaction levels with oral healthcare of their children were observed between migrant and non-migrant parents. These findings help guide policymakers in developing public health measures to improve satisfaction among migrant parents.

This scoping review mapped and critically appraised laboratory evidence on counterfeit and replica-like nickel-titanium endodontic files, evaluating design, metallurgical composition, surface finishing, and mechanical performance to clarify clinical and regulatory implications. Comprehensive searches of major databases and key endodontic journals identified 17 in vitro studies; no clinical studies were found. Counterfeit instruments consistently exhibited design irregularities, surface defects, and altered metallurgical properties that reduced cyclic fatigue resistance and produced unpredictable mechanical behaviour, posing significant patient-safety concerns. Replica-like instruments showed heterogeneous performance, with some matching or rarely exceeding original files in specific tests but others demonstrating inferior flexibility or torsional resistance. Quality-control standards were inconsistent or lacking. These findings demonstrate that deviations in alloy processing, phase transformation, and surface finishing compromise mechanical reliability and highlight the urgent need for stronger regulatory oversight and clinical validation to safeguard practitioners and patients.