BMC Oral Health最新文献

Background: Oral health, recognized as an essential component of overall health, quality of life, and a fundamental human right, is one of the most neglected aspects of refugee health. This study aimed to analyze the oral health status and dental care utilization patterns among newly arrived Ukrainian refugees in Poland during the first 100 days of the war.

Methods: This study utilized data from electronic health records (EHR) of all in-person dental visits by Ukrainian war refugees in Poland between February 24 and June 4, 2022. The data are presented using descriptive statistics.

Results: A total of 5,242 Ukrainian war refugees (mean age 28.8 ± 18.3 years [range: 1-95 years]; 1,792 [34.2%] minors; 3,954 [75.4%] female) were included in the analysis. During the first 100 days of the war, 8,811 dental visits were recorded, out of which 31.3% involved pediatric patients. The average number of appointments per patient was 1.7 overall (1.5 ± 0.9 [range: 1-8] for children; 1.8 ± 1.3 [range: 1-12] for adults). Dental caries (ICD-10: K02) was the most common diagnosis, affecting 63.1% of children and 65.4% of adults, followed by diseases of the pulp and periapical tissues (K04), which were significantly more prevalent in pediatric patients (44.5% vs. 37.5%, p < 0.001). Composite or protective restorations were received by 50.5% of children and 48.8% of adults. Tooth extractions occurred more frequently in pediatric patients (20.5% vs. 13.4%, p < 0.001), while endodontic therapy was provided to 12.5% of children and 11.2% of adults. About 27.1% of refugee children and 28.2% of adults required dental care across three or more service categories. Pediatric patients were statistically more likely than adults to have three or more teeth treated during the study period (11.4% vs. 6.5%, p < 0.001).

Conclusions: The data presented in this study provide important insights into the oral health needs of newly arrived Ukrainian refugees, particularly in terms of dental emergencies, during the early days of the conflict, and contribute to closing a research gap. This evidence can guide host countries in planning multisectoral interventions and delivering targeted dental care that meets the identified needs, promoting oral health and reducing inequalities among conflict-displaced populations.

Bracket debonding remains a clinical challenge in orthodontics, particularly when removing ceramic brackets, due to the potential risk of enamel cracks and surface damage. Recently, laser-assisted techniques have been investigated to facilitate safer and less traumatic bracket removal. This study aimed to evaluate the effect of 940 nm diode laser irradiation on the debonding process of metallic and ceramic orthodontic brackets by assessing shear bond strength (SBS) and enamel surface morphology using scanning electron microscopy (SEM).

Methods: Thirty two extracted human premolars were randomly divided into four experimental groups: Group A (Control-Metallic),Group B (Control-Ceramic),Group C (Laser-Metallic), and Group D (Laser-Ceramic).Brackets were bonded using a light-cured adhesive and subjected to diode laser irradiation at 940 nm, 1 W, for 5 seconds in the laser-treated groups. SBS was measured using a universal testing machine at a crosshead speed of 1 mm/min, and mean values were expressed in MPa. Enamel surface morphology was analyzed using SEM at 80× and 1000× magnifications. Statistical analysis was performed using one-way ANOVA and independent t-tests with a significance level of p < 0.05.

Results: Laser-assisted debonding significantly reduced SBS in metallic brackets (mean ± SD: 2.4 ± 0.3 MPa) compared with the control group (4.3 ± 0.4 MPa) (p < 0.05). In contrast, the difference between laser-treated and control ceramic brackets was not statistically significant. SEM observations revealed smoother enamel surfaces and fewer cracks in the laser-treated groups compared with controls.

Conclusions: Diode laser-assisted debonding (940 nm, 1 W) effectively decreases shear bond strength for metallic brackets and minimizes enamel surface alterations, suggesting it is a promising adjunct for safer bracket removal. However, the technique's effect on ceramic brackets appears limited at this power setting.

Objective: This study aims to investigate the effect of bruxism on the fracture resistance of maxillary zirconia fixed denture prostheses (FDP) with different inter-implant distances and different occlusion types.

Methods: We developed four finite element models that reflect maxillary fixed dental prostheses in patients with bruxism. The original version retains the prosthesis using six implants positioned at the canines, premolars, and first molars. The second one features implants positioned at the lateral incisors, canines, and second premolars. The development of two supplementary models, 3 and 4, included a reduction of the cusp height by 0.35 mm. Angle's classification, encompassing classes I, II, and III, directs the application of pressures to all models subjected to parafunctional habits, including bruxism.

Results: Model 1 exhibited the lowest values for FDP and bone deformation, measuring 77 μm and 27 μm, respectively. Model 3 followed with values ranging from 71 to 73 μm for FDP and 25 to 26 μm for bone deformation. In contrast, Models 2 and 4 demonstrated higher values, with Model 2 showing particularly elevated measurements of 104 μm for FDP and 43 μm for bone deformation. In Models 2 and 3, the Von Mises stress in the FDP was less than 500 MPa, suggesting a less risk of fatigue, whereas Models 1 and 4 surpassed this threshold. Models 1 and 3 exhibited physiological bone stress, whereas Models 2 and 4 demonstrated unsafe levels indicative of potential structural damage. Class I and II occlusions exhibited stable, low-stress profiles, while Class III occlusions resulted in increased shear and torque due to anterior occlusal displacement. This underscores the importance of occlusion-specific prosthetic design to mitigate peri-implant stress.

Conclusions: The distribution of implants in Models 1 and 3 may enhance stability and extend longevity. A 350-micron reduction in occlusal surface height was associated with reduced stress and deformation in the models, which may enhance the lifespan of the FDPs. Therefore, reducing the occlusal surface height of FDP is recommended for patients with bruxism.

Clinical significance: It is recommended that clinicians construct maxillary zirconia FDPs with a broader implant distribution and a cusp inclination of (≤ 15º) for better outcomes in patients with bruxism. This configuration enhances prosthetic stability and reduces stress, thereby increasing longevity. Clinical protocols may encompass strategic implant placement, reduction of cusp height, and individualized occlusal design.

Purpose: To evaluate the diagnostic accuracy of artificial intelligence (AI) based on convolutional neural network (CNN) in diagnosing oral squamous cell carcinoma (OSCC), we carried out this meta-analysis.

Methods: We searched PubMed, Embase, Web of Science, ProQuest, Cochrane Library, and Scopus to identify relevant articles from database inception to April 2025. Studies assessing the diagnostic accuracy of AI based on CNN to detect OSCC were included in this search. Statistical analyses were performed by using the Meta-Disc (version 1.4) and Stata 18.0 software.

Results: A total of 14 studies with 61,372 samples were included in the analysis. The pooled positive likelihood ratio (PLR) of 13.08 (95% CI 9.21-18.60) and negative likelihood ratio (NLR) of 0.06 (95% CI 0.03-0.10) were observed with a diagnostic odds ratio of 261.58 (95% CI 131.03-522.19) and the area under the curve being 0.98, respectively. The pooled sensitivity and specificity of CNN based AI in detecting OSCC were 0.94 (95% CI 0.89-0.98) and 0.94 (95% CI 0.92-0.97). Heterogeneity was observed (I² > 75%). Subgroup analyses revealed variations in diagnostic performance based on study design, cancer site, statistical method, external validation, and sample size. The Fagan nomogram indicated that when the pre-test probability was set at 20%, the post-test probability could increase to 81%.

Conclusion: In detecting OSCC, CNN-based AI demonstrates a high diagnostic performance. These findings suggest that CNN models, though not yet widely implemented in routine diagnostic workflows, hold strong potential for OSCC detection. However, the current evidence is largely based on retrospective studies with limited sample sizes and methodological variability, and only one study performed external validation. Therefore, larger prospective and multicenter studies are needed before clinical translation.

Background: Topical application of 0.02% Mitomycin-C (MMC) has demonstrated efficacy in reducing fibrosis in ophthalmic and laryngeal procedures. This pilot study aimed to evaluate the potential role of MMC in enhancing healing outcomes in patients with Oral Submucous Fibrosis (OSMF) following surgical release of fibrous bands and reconstruction with the Buccal Fat Pad (BFP).

Methodology: A prospective, double-blinded, split-mouth feasibility pilot study was conducted on 10 patients diagnosed with OSMF. Each patient underwent surgical release of fibrous bands and/or coronoidectomy under general anaesthesia, followed by BFP reconstruction bilaterally. The right buccal mucosa (study side) received topical application of 0.02% MMC (0.2 mg/ml) twice, first, for 5 min over the raw surgical site before BFP placement, and again after 10 days for 3 min over the healing mucosa. The left side (control) received a placebo (normal saline) following the same protocol. Patients were assessed over three months for mucosal pliability, cheek flexibility, mucosal colouration and mouth opening.

Results: However, despite the theoretical antifibrotic potential of MMC, no statistically significant difference was observed between the MMC-treated and control sides with respect to mucosal pliability or cheek flexibility at any postoperative interval. Although preoperative cheek flexibility (4 ± 0.67 mm) demonstrated initial postoperative improvement, this was not sustained during follow-up, and the MMC application did not confer any measurable long-term advantage over placebo. Additionally, mucosal coloration remained stable and comparable on both sides, indicating no clinically discernible enhancement in mucosal healing attributable to MMC. Notably, no adverse tissue reactions or complications were associated with MMC use, supporting its local biocompatibility. Postoperative mouth opening showed significant improvement from a baseline of 16 ± 2.79 mm to 38.4 ± 1.58 mm at 1 week (T1), 36.1 ± 1.85 mm at 1 month (T2), and 33 ± 2.11 mm at 3 months (T3).

Conclusion: These findings suggest that while MMC is safe for intraoral application at this concentration, its therapeutic efficacy in mitigating fibrosis in the OSMF surgical site remains inconclusive, warranting further investigation through larger, controlled trials.

Trial registration: Clinical Trials Registry- India registration (CTRI/2022/04/041738) dated 08/04/2022).

Objective: Diagnostic and treatment errors are detrimental yet relatively common in primary healthcare settings. Crowdsourcing and collective intelligence (CI) in the form of peers' opinion and group decision-making can lead to modifications in diagnosis and treatment planning by dentists. In this review, it was explored their use in oral healthcare delivery, investigating specific applications and evaluating their merits and drawbacks in oral healthcare.

Methods: A scoping review approach was chosen as the optimal study design, due to the complexity of the topic. A literature search from 1980 to December 2024 using selected search terms and a search strategy was implemented across six databases: Medline, Scopus, Web of Science, SciELO, LILACS, and CINAHL. Inclusion criteria specified studies published in English, Spanish, and Portuguese, focusing on CI applications in oral healthcare settings.

Results: Of the 265 identified studies, 63 abstracts and 20 full-text studies were screened, and 7 studies were included in the qualitative synthesis. The findings suggest that CI may significantly enhance patient management in primary healthcare settings by employing various group decision-making models such as multidisciplinary teams (MDTs) and the Delphi method. MDTs, comprising professionals from different disciplines, can enhance patient care through collaborative problem-solving and holistic approaches. The Delphi method allows for reliable, expert-driven decisions through anonymous feedback rounds. CI not only addresses diagnosis and treatment planning challenges but also improves resource allocation. While these approaches can reduce individual biases and systematic errors, challenges such as conformity bias and groupthink were also acknowledged.

Conclusion: This review highlights the significance of diverse expert opinions and structured consensus-building in advancing collective intelligence in oral healthcare. It emphasizes CI's potential to improve patient management through collaborative decision-making models. However, further research is necessary to explore CI's specific applications and effectiveness in oral healthcare.