BMC Oral Health最新文献

Background: Oral squamous cell carcinoma (OSCC) is one of the most prevalent oral cancers in the world. The major etiological factors are considered to be tobacco and alcohol. However, the etiological factors for non-habit associated oral squamous cell carcinoma (NHOSCC) remains an enigma. So we focused in assessing various etiological factors like genetic factor, microbial factor, dental factor and the biochemical factor of non-habit associated oral squamous cell carcinoma. The aim was to assess Harvey Rat Sarcoma Virus gene (HRAS) mutation, total bacterial count, Herpes Simplex Virus-1 (HSV-1), regressive changes of teeth, total antioxidant capacity and its association with NHOSCC.

Materials and methods: A total of 564 (n = 564) patients with OSCC were included in the study. Out of 564 patients, 282 patients had NHOSCC and 282 patients had habit associated oral squamous cell carcinoma (HOSCC). The isolated DNA from the tissue was subjected to Sanger's sequencing analysis for mutation analysis of the HRAS gene. The isolated serum was subjected to HSV-1 ELISA analysis and TAC ELISA analysis. The dental cast used to analyze the presence of sharp teeth/ any other form of regressive changes of teeth.

Results: Firstly, we found 3 novel pathogenic mutations c.16C > A/p.L6M (missense mutation), c.359 T > C/p.L120P (point mutation), c.382C > T/p.R128W (missense mutation) of HRAS gene in NHOSCC samples by genetic analysis. No significant difference was noted in the total bacterial count between the non-habit associated and habit associated oral squamous cell carcinoma (HOSCC). The binary logistic regression showed patients with HSV1 infection have 2.667 odds (2.667 OR, CI, 1.589- 4.484) of getting NHOSCC and it was found to be statistically significant (p < 0.001).The dental analysis revealed that patients with regressive changes have 4.432 odds (4.432 OR, CI, 2.807- 6.998) of getting NHOSCC and it was found to be statistically significant (p < 0.001). The biochemical analysis revealed patients with lower total antioxidant capacity have 0.671 odds (0.671 OR, CI, 0.621-0.725) of getting NHOSCC and was found to be statistically significant (p < 0.001). Our results suggest that the frequency of HRAS mutation in NHOSCC is high. HSV1, oxidative stress and regressive changes of teeth are associated with NHOSCC.

Conclusion: Our results suggest that the frequency of HRAS mutation in NHOSCC is high. HSV1, oxidative stress and regressive changes of teeth are associated with NHOSCC.

Background: There is a paucity of data on oral health problems among the residents of Fanteakwa districts (South and North) in the Eastern region of Ghana. Therefore, this study assessed the prevalence and factors associated with self-reported oral health problems in the Fanteakwa districts of Ghana.

Methods: This community-based cross-sectional study targeted residents of the towns of the Fanteakwa districts, who have not had any dental care visit in the past six months preceding the study. The participants were enrolled from July - October, 2023. Socio-demographic study variables collected were sex, age, educational level, income level, ethnicity, area of residence, household size and frequency of brushing teeth in a day. Whereas the self-reported oral health problems were tooth ache, swollen gum, bleeding gum, sensitive tooth/teeth, hole in tooth/teeth, discoloured tooth/teeth and mouth odour. The chi-square statistical test was used to test the association between the presence of oral health problem(s) and other independent variables. Whereas, Modified Poisson regression was used to test the relationships among the variables.

Results: In total, 400 community members were interviewed. The mean age of respondents was 31 years (SD ± 12.4, Min = 19, Max = 81). The majority were females (55.2%) and more than 96% had some form of formal education. The Akan ethnic group accounted for as much as 47% of the respondents. The overall prevalence of self-reported oral health problems was 58.5% (95% CI 53.5% - 63.4%). The commonly reported oral health problems were toothache (51.7%), swollen gum (38.5%), difficulty in chewing (33.3%), bleeding gum (32.1%), and mobile teeth (17.1%). About 98% (229/234) of the study participants who self-reported oral health problems, reported up to four different problems. Self-reported oral health problems associated with participants' age (χ² = 7.2, p = 0.027), income level (χ² = 19.3, p < 0.001), ethnicity (χ² = 21.2, p < 0.001), area of residence (χ² = 26.9, p < 0.001), religious affiliation (χ² = 15.7, p < 0.001) and frequency of brushing teeth in a day (χ² = 6.85, p < 0.032). Despite the observed relationships, Modified Poisson regression identified that compared to the rural dwellers, the urban dwellers had lower odds of self-reporting oral health problems (aOR = 0.718, p = 0.032, CI: 0.531-0.971), after controlling for age and frequency of teeth brushing in a day.

Conclusion: High rate of self-reported oral health problems was observed in the study site. Participants from rural residence were disproportionately affected. Therefore, local health authorities are encouraged to leverage on the identified risk groups for enhanced oral health education towards reduction in the reported oral health problems.

Introduction: The integration of artificial intelligence (AI) technologies in healthcare is revolutionizing the workflows of healthcare professionals, enabling faster and more accurate patient treatment. This study aims to evaluate the accuracy of responses provided by different AI chatbots to questions that dentists might ask regarding regenerative endodontic treatment (RET), a procedure that shows promising biological healing potential.

Methods: A total of 23 questions related to RET procedures were developed based on the American Association of Endodontists (AAE) 2022 guidelines. These questions were presented to three platforms: Google Bard (Gemini), ChatGPT-4o, and ChatGPT-4 with a PDF plugin. The questions were asked three times a day over the course of 10 days by two different researchers. The responses obtained were categorized as correct, incorrect, or insufficient according to the guidelines, and the results were statistically analyzed.

Results: A total of 1,380 responses were collected from the three platforms. Statistical analysis revealed significant relationships between the responses given by the platforms during morning, noon, and evening sessions (p < 0.05). ChatGPT-4 with the PDF plugin had the highest correct response rate (98.1%), while Gemini depicted the lowest (48%).

Conclusions: While ChatGPT-4o and Gemini offer promising results for regenerative endodontic clinical applications, they do not provide sufficient guidance. However, ChatGPT-4 with the PDF plugin could be a valuable tool for clinicians due to its high accuracy rate. Further research is needed to develop AI programs specifically designed for clinicians in the field of endodontics.

Background: This study aims to compare design, phase transformation behavior, and torsional resistance of the ProGlider (PG) and ProTaper ultimate slider (PUS) and to compare the performance of two files in the glide-path preparation of a double-curved artificial canal.

Methods: Scanning electron microscopy, micro-computed tomography, and differential scanning calorimetry were used to characterize the samples. A torsional resistance test was performed to obtain ultimate strength and distortion angle. Simulated glide-path preparation was conducted with a double-curved resin canal, and both PG and PUS were operated on by 300 and 400 rpms. Maximum screw-in force, torque generated during canal shaping, number of pecking strokes to reach the apex were compared between groups. After canal shaping centering ratio and alteration of files were assessed. Statistical analyses were performed using the Mann-Whitney U test, and the Kruskal-Wallis test with Bonferroni correction. A p value less than 0.05 was considered significant.

Results: While the PG had a square cross-section, the PUS had variable square and rhomboid cross-sections and alternating cutting-edge. PG and PUS have austenitic transformation starting and finishing temperatures of 24-25℃, and 57-59℃, respectively. Ultimate strength of PUS are superior to that of PG, whereas the distortion angle of PG is greater than that of PUS (p < 0.05). The maximum screw-in force and clockwise torque generated during glide-path preparation were highest in the PUS group rotated at 300 rpm (p < 0.05). Shaping with the PG at 300 rpm and shaping with the PUS at 400 rpm exhibited comparable maximum screw-in forces. There were no significant differences in the number of pecking strokes to reach the apex and centering ability among groups shaped with PG and PUS at both rotation speeds. PG shaped at 400 rpm demonstrated severe alteration on its surface, while PUS shaped at 300 and 400 rpms exhibited comparable surface alterations.

Conclusions: PG has a constant square cross-section, while PUS has a variable cross-section and alternating cutting-edge. Using PUS at recommended speed of 400 rpm ensures safe use with minimal screw-in force and surface alteration. At recommended speeds, both PG and PUS perform comparably and are safe for double-curved canals.

Background: This study aimed to establish a model for predicting the difficulty of mandibular third molar extraction based on a Bayesian network to meet following requirements: (1) analyse the interaction of the primary risk factors; (2) output quantitative difficulty-evaluation results based on the patient's personal situation; and (3) identify key surgical points and propose surgical protocols to decrease complications.

Methods: Relevant articles were searched to identify risk factors. Clinical knowledge and experience were used to analyse the risk factors to establish the Bayesian network. First, the qualitative mechanism knowledge, including the effect of risk factors on the extraction difficulty and the causal relationships between risk factors, was analysed to establish the framework of the Bayesian network. Then, the quantitative knowledge, including the occurrence probability of the parent nodes and the conditional probability table of the nodes with causal relationships, was given by the surgeon experience and calculated using the Dempster-Shafer evidence theory. According to the framework and likelihoods and relationships of risk factors, the Bayesian network model was established.

Results: This Bayesian network model analysed the weight by sensitivity of each risk factor and expressed the interaction relationship among risk factors as well as the effect of risk factors on extraction difficulty quantitatively. This Bayesian network model showed quantitative analysis results for extraction difficulty and key risk factors. The Bayesian network model revealed that the relationship to the inferior alveolar nerve, surgeon experience and patient anxiety were the most important risk factors for extraction difficulty. By integrating these patient-specific risk factors across the entire surgical process, this model could be used during preoperative planning to identify high-risk cases and to optimize resource allocation; during intraoperative management to tailor surgical techniques; and during postoperative follow-up to establish targeted follow-up protocols for high-risk patients. Moreover, this Bayesian network model can flexibly improve inclusion factors and conditional probabilities with the development of relevant research and expert opinions, as well as change states and probabilities of relevant nodes based on actual clinical conditions.

Conclusions: A model for predicting the difficulty of mandibular third molar extraction was established based on a Bayesian network.

Background: The purpose of this scoping review is to understand the etiological, clinical characteristics and treatment of chromogenic staining of teeth and the various management strategies reported in literature. This SR was performed in accordance with the PRISMA 2022 guidelines and was registered in the PROSPERO database (CRD42024565446).

Methods: A systematic electronic search on databases like Scopus, Medline, EMBASE, CINAHL, ProQuest and Web of Science from inception to July 2024 was performed. Two independent reviewers ran the search strategy in the mentioned databases.

Results: A total of 989 articles were obtained from various databases. 21 were included for data extraction of which 2 were case reports, 1 was case series and 18 were research articles. The prevalence of staining due to chromogenic bacteria reported from the included studies ranged from 3.1 to 18.5%. All these studies reported on the typical black color of staining of teeth.

Conclusion: This scoping review reveals sparsity in existing literature regarding the etiological, clinical characteristics and management of chromogenic staining of teeth. Though the role of peculiar oral microbiota is well established, evidence regarding the management strategies to combat these recalcitrant staining remains a strong research question.

Background: Previous studies have indicated that retinol and vitamin D may be associated with the oncogenesis of tongue cancer. Therefore, we aimed to assess the causal relationships of retinol and vitamin D with the risk of tongue cancer using the two-sample Mendelian randomization (MR) method.

Methods: Single nucleotide polymorphisms (SNPs) related to retinol, vitamin D and tongue cancer were obtained from the up-to-date genome-wide association study (GWAS) catalogue, which was screened for instrumental variables (IVs). We performed two-sample MR analyses and used inverse-variance weighted (IVW) as the primary method. Additionally, we used the MR-pleiotropy residual sum and outlier (MR-PRESSO) method, MR-Egger intercept analysis, Cochran's Q test and leave-one-out analysis to evaluate the sensitivity of MR.

Results: The IVW method revealed that retinol was not significantly correlated with the risk of tongue cancer (OR = 0.8602; 95% CI = 0.4453-1.6617; P = 0.654). However, the causal relationship between vitamin D and the risk of tongue cancer was significant according to IVW (OR = 0.4003; 95% CI = 0.1868-0.8577; P = 0.019). The sensitivity analysis did not detect any significant horizontal pleiotropy or heterogeneity.

Conclusions: Given the limitations of this study, our MR study suggests that retinol is unlikely to influence the risk of tongue cancer, but vitamin D may decrease the risk of tongue cancer.

Background: Endodontic treatment aims in the preservation of extremely carious primary teeth. For root canal therapy to be successful, root canals must be properly prepared and effectively irrigated .Therefore, it is necessary to select the proper root canal disinfection method to preserve the primary tooth.

Objective: This research was carried out to compare non-thermal pressure plasma (NTPP), diode laser, propolis, and chlorhexidine (CHX) efficacy for disinfection of deciduous anterior root canals contaminated with Enterococcus Faecalis (E. faecalis) after sterilization by gamma radiation.

Methods: In this study, forty extracted single-rooted primary anterior teeth were used. All teeth were cleaned, disinfected, and stored till use. Gaining access was provided till reaching the orifices of canals, all pulp tissue debris was removed, and root canals of all teeth were prepared. Standardized 8 mm root length was obtained through crown decronation below the cemento-enamel junction. Samples were sterilized by gamma radiation then the bacterial suspension was inoculated inside root canals. Specimens divided into four main groups; ten samples each group. Group I: Samples irrigated with chlorhexidine. Group II: Samples treated with diode laser. Group III: Samples irrigated with Ethanolic extract of propolis. Group IV: Samples treated with NTPP.

Results: A significant difference was found between values measured before and after four irrigation types (p < 0.001) for CHX, Diode Laser, NTPP and (P = 0.035) for Propolis. The highest values of colony reduction measured before and after irrigation were for NTPP (4.06 ± 0.88). Maximum reduction in colony-forming units was recorded in the NTPP group (98.79%), while the lowest reduction in colony-forming units was recorded in Propolis group (81.99%).

Conclusion: All tested methods (CHX, NTPP, Diode laser and Propolis) decreased colony count, with the highest reduction noted in group treated by NTPP and the least reduction noticed in Propolis treated group.

Background: A large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene.

Methods: In this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses.

Results: In general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53-5.39) and poor oral hygiene (OR, 4.50; CI, 1.83-11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42-4.95), especially due to challenges eating (OR, 3.76; CI, 1.64-8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27-10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08-6.30).

Conclusion: Questions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene.

Background: Increasing demand for durable and aesthetically pleasing dental restorations, including laminates, inlays, onlays, and crowns, has led to advancements in all-ceramic systems, particularly with the development of advanced lithium disilicate materials. However, limited data on the fit accuracy and fracture resistance of these materials restricts their wider application in clinical restorative practices.

Aim of the study: This in vitro study aims to compare the marginal and internal fit, assess the fracture resistance, and evaluate the failure modes of crowns fabricated from advanced and conventional lithium disilicate materials.

Materials and methods: Thirty two (n = 32) crowns were fabricated and categorized into two groups based on the material used: Group (CT), where crowns were milled from CEREC Tessera (n = 16), and Group (EM), where crowns were milled from IPS e.max CAD (n = 16) using a CAD/CAM system. The marginal and internal fit were assessed digitally via a triple scan protocol. All samples were subjected to a fracture resistance test with a universal testing machine, followed by an analysis of failure modes under a stereomicroscope.

Results: In the evaluation of marginal, internal and total gaps, CEREC Tessera (CT) showed slightly better fit with lower gap values compared to e.max CAD (EM). However, an independent samples t-test indicated no statistically significant differences between the two groups (p = 0.141, p = 0.471). For fracture resistance (N), the CT group demonstrated higher values than the EM group; however, the independent samples t-test indicated no statistically significant difference (p = 0.053). Additionally, the Chi-squared test with Monte Carlo correction revealed no statistically significant differences in the modes of fracture between the two groups (p = 0.484).

Conclusion: Considering the limitations of this study, advanced lithium disilicate crowns demonstrated better results in terms of marginal fit, internal adaptation, and fracture resistance compared to traditional lithium disilicate crowns; however, the differences were not statistically significant. Both materials exhibited comparable fracture patterns.