BMC Oral Health最新文献

Background: Ossifying fibroma (OF) is a non-common benign fibrous-osseous lesion with highly aggressive behavior and tends to recur. Here, we report a case where Ossifying Fibroma (OF) was diagnosed in an adolescent female patient and was treated by marginal mandibular resection to avoid esthetic and functional defects in the future.

Case presentation: OF was diagnosed in a 13-year-old woman incidentally. Cone-Beam Computed Tomography (CBCT) examination showed a hypodense lesion compromising the vestibular table and 34 and 35 teeth. An incisional biopsy was performed to determine the histopathological diagnosis. After a multidisciplinary consensus, tooth extraction and surgical resection of the lesion were done. In the same way, bone reconstruction using the Khoury technique with an autologous graft of an external oblique line and with a mixture of autogenous and allogenic bone and fixation screws. Clinical and imaging follow-ups after 1, 4, 15, and 23 months were included, evidencing integration of the grafts in the treated zone.

Conclusions: OF early identification and treatment are essential to minimize risks of losing tissues in young people. Also, to avoid negative consequences in the people´s quality of life associated with bone and teeth loss. This highlights the importance of radiographic surveillance, analyses, and interdisciplinary collaboration to optimize clinical outcomes in patients with similar conditions.

Background: Several commercial programs incorporate artificial intelligence in diagnosis, but very few dental professionals have been surveyed regarding its acceptability and usability. Furthermore, few have explored how these advances might be incorporated into routine practice.

Methods: Our team developed and implemented a deep learning (DL) model employing semantic segmentation neural networks and object detection networks to precisely identify alveolar bone crestal levels (ABCLs) and cemento-enamel junctions (CEJs) to measure change in alveolar crestal height (ACH). The model was trained and validated using a 550 bitewing radiograph dataset curated by an oral radiologist, setting a gold standard for ACH measurements. A twenty-question survey was created to compare the accuracy and efficiency of manual X-ray examination versus the application and to assess the acceptability and usability of the application.

Results: In total, 56 different dental professionals classified severe (ACH > 5 mm) vs. non-severe (ACH ≤ 5 mm) periodontal bone loss on 35 calculable ACH measures. Dental professionals accurately identified between 35-87% of teeth with severe periodontal disease, whereas the artificial intelligence (AI) application achieved an 82-87% accuracy rate. Among the 65 participants who completed the acceptability and usability survey, more than half the participants (52%) were from an academic setting. Only 21% of participants reported that they already used automated or AI-based software in their practice to assist in reading of X-rays. The majority, 57%, stated that they only approximate when measuring bone levels and only 9% stated that they measure with a ruler. The survey indicated that 84% of participants agreed or strongly agreed with the AI application measurement of ACH. Furthermore, 56% of participants agreed that AI would be helpful in their professional setting.

Conclusion: Overall, the study demonstrates that an AI application for detecting alveolar bone has high acceptability among dental professionals and may provide benefits in time saving and increased clinical accuracy.

Background: Poor oral health, especially dental caries in early childhood is a major public health concern. Parental oral health knowledge, behavior, and perceptions are important elements in determining the child's oral health status. The aim of the study was to investigate the perceptions of mothers of preschool children in Qatar towards their children's oral health and their experiences with oral health services provided to children.

Methods: The study is based on qualitative methods using focus groups. Purposive sampling was used to recruit mothers of preschool children at two kindergartens in the city of Doha, Qatar. The focus group consisted of a series of open-ended questions about the oral health of children and the opinion of mothers towards the current oral health services provided in the country. An inductive thematic content analysis at the statement level approach was used to analyze the qualitative data.

Results: Twelve mothers between the ages of 20 and 41 years old from two kindergartens participated in two separate focus groups. The average number of children per mother was 5 with 45 months being the mean age of children. Several themes emerged from analyzing the data retrieved from the discussion with mothers. For oral health knowledge, mothers demonstrated a different level of oral health knowledge, from good to poor. As for experiences with health services, recognized the value of oral health services in Qatar but expressed difficulties in access to oral health services for their children with almost all having had some negative experiences. Regarding the anticipated role of mothers in the oral health of their children, mothers were very positive about their potential role in supporting their children's oral health. The mothers also gave recommendations to improve oral health services for young children.

Conclusion: Mothers showed positive attitudes towards the oral health of their children and they recognized the importance of a good oral health care system.

Objective: Behçet's Disease (BD) may impair bone remodeling, increasing osteoporosis risk. This study evaluates mandibular trabecular bone fractal dimension (FD), mandibular cortical index (MCI), and temporomandibular joint (TMJ) degeneration in BD patients versus healthy controls.

Materials and methods: A total of 106 panoramic radiographs, comprising 53 from BD patients and 53 from healthy individuals, were examined. Fractal analysis was performed using ImageJ software, selecting 50 × 50 pixel regions of interest (ROIs) from the gonial, interdental, and condylar areas. Degenerative changes in the TMJ, including osteophytes, sclerosis, surface flattening, erosion, and subchondral cysts, were recorded. Statistical analysis was conducted with SPSS v.21 (IBM, Armonk, USA), using a significance level of p < 0.05.

Results: The BD group exhibited significantly lower FD values compared to the control group (p < 0.05). Similarly, MCI scores differed significantly between the groups (p < 0.05). BD patients showed more pronounced radiological evidence of mandibular cortical resorption than controls. Additionally, degenerative changes in the TMJ were more prevalent among BD patients (p < 0.05).

Conclusion: Comprehensive evaluation of the mandibular cortex, trabecular bone, and TMJ is crucial in BD patients to effectively detect and monitor osteoporotic alterations.

Clinical significance: BD patients may face considerable oral health challenges, such as jawbone deterioration and TMJ complications. Prompt diagnosis and treatment of these issues can enhance therapeutic outcomes and improve overall quality of life.

Background: The aim of our study was to develop and evaluate a deep learning model (BiStageNet) for automatic detection of dens evaginatus (DE) premolars on orthodontic intraoral photographs. Additionally, based on the training results, we developed a DE detection platform for orthodontic clinical applications.

Methods: We manually selected the premolar areas for automatic premolar recognition training using a dataset of 1,400 high-quality intraoral photographs. Next, we labeled each premolar for DE detection training using a dataset of 2,128 images. We introduced the Dice coefficient, accuracy, sensitivity, specificity, F1-score, ROC curve as well as areas under the ROC curve to evaluate the learning results of our model. Finally, we constructed an automatic DE detection platform based on our trained model (BiStageNet) using Pytorch.

Results: Our DE detection platform achieved a mean Dice coefficient of 0.961 in premolar recognition, with a diagnostic accuracy of 85.0%, sensitivity of 88.0%, specificity of 82.0%, F1 Score of 0.854, and AUC of 0.93. Experimental results revealed that dental interns, when manually identifying DE, showed low specificity. With the tool's assistance, specificity significantly improved for all interns, effectively reducing false positives without sacrificing sensitivity. This led to enhanced diagnostic precision, evidenced by improved PPV, NPV, and F1-Scores.

Conclusion: Our BiStageNet was capable of recognizing premolars and detecting DE with high accuracy on intraoral photographs. On top of that, our self-developed DE detection platform was promising for clinical application and promotion.

Objectives: To investigate the effectiveness of instrumentation using Protaper Next (PN; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) and Waveone Gold (WG; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) systems on the area of untouched surface (US), accumulated hard tissue debris (AHTD), and the filling ability of two obturation techniques on the volume percentage (vol%) of voids within C-shaped root canals of mandibular first premolars.

Methods: A total of 64 mandibular first premolars with C-shaped canals were scanned, matched, and subsequently assigned to two shaping groups (n = 32): PN and WG. After instrumentation, the specimens were randomly allocated into two obturation subgroups (n = 16): continuous wave compaction (CWC) and single-cone (SC) techniques. The US% and AHTD% post- instrumentation, as well as the vol% of voids after obturation, were calculated from micro-computed tomography. Data were analyzed using comparisons for two groups (PN vs. WG) or two subgroups (CWC vs. SC) at α = 0.05.

Results: The untouched canal wall area was 18.75% and 22.69% in the PN and WG groups (p > 0.05), respectively. The apical third had higher US% than the coronal third (p < 0.05) in the two shaping groups. Instrumentation with WG left more debris (26.48%) than PN (8.36%) in the apical 1-3 mm (p < 0.05). In PN and WG group, the vol% of voids had no significant difference between the CWC and SC subgroups (p > 0.05). The apical region had significantly more voids than the coronal region of canal space in the two obturation subgroups regardless of which system was applied (p < 0.05).

Conclusions: Both PN and WG systems showed similar performance on US after instrumenting C-shaped canals of the mandibular first premolar. WG left significantly more AHTD compared with PN in the apical region. In PN or WG group, SC yielded similar obturation quality when compared with CWC. Both CWC and SC obturation techniques provided inferior filling quality in the apical region than that observed in the coronal region.

Background: Primary retention and progressive loss of retention of various attachment systems are critical elements in appropriate attachment selection; nevertheless, research on attachment retention reveals a broad spectrum of retention values for the same attachment system and between various systems. Accordingly, the aim of this study was to compare the retention of two different types of attachments (Ti Si snaps and locators) in two-implant-retained mandibular overdentures.

Methods: A completely edentulous mandibular educational cast was scanned. An STL file including the implant beds and mucosal space was designed. Two implant analogs were incorporated into each model in the canine area bilaterally, and conventional overdentures were fabricated over two types of implant attachments, the Ti Si snap attachments and the locator attachments, with the use of Retention sil in both groups at the fitting surface of the overdenture. Each group contained five 3D-printed edentulous mandibular models. Retention was measured by using a universal testing machine after the models were subjected to cyclic loading. This measurement was carried out at the time of insertion, after 75,000 cycles (simulating 6 months of clinical use) and 150,000 cycles (simulating 12 months of clinical use). The means and standard deviations of the recorded readings were collected, tabulated, and statistically analyzed.

Results: Student's t test revealed significant differences between the two groups. The Ti Si attachment group presented the highest retention rate at the time of insertion and after 6 months. However, there was no significant difference between the groups after 12 months. Both groups presented statistically significant changes in the mean retention value over time, as demonstrated by two-way ANOVA (time of insertion > six months > twelve months). Tukey's post hoc test revealed a nonsignificant difference between six months and twelve months.

Conclusion: Within the limitations of this study, the following conclusions can be drawn.

Objectives: To explore the bone regeneration effect of different forms of concentrated growth factor (CGF) when combined with deproteinized bovine bone mineral (DBBM) for simultaneous implant-guided bone regeneration (GBR) and its impact on postoperative adverse reactions.

Methods: Fifty-seven patients who underwent simultaneous implant GBR were selected for the study and divided into three groups. The study involved three groups: the gel phase concentrated growth factor (GPCGF) group, which used GPCGF-DBBM mixture; the liquid phase concentrated growth factor (LPCGF) group, which used LPCGF-DBBM mixture; and the control group, which used DBBM alone. The thickness of the buccal lateral bones was measured using cone beam computed tomography (CBCT), and patients were asked to complete questionnaires to assess primary adverse reactions during the first week after surgery. The data were analyzed using one-way ANOVA, Tukey test, and Kruskal-Wallis test.

Results: The buccal lateral bone thickness in the GPCGF, LPCGF, and control groups decreased significantly at 6 months post-surgery compared to immediately after surgery. The change of bone thickness in the GPCGF group was lower than that in the control group (p < 0.01), and that in the LPCGF group did not differ from that in the control group (p > 0.05). During the postoperative week, statistically significant differences could be observed in bleeding, mouth opening, chewing, sleeping, speaking, daily routine, and pain (p < 0.05).

Conclusions: Compared to the DBBM applied alone, the GPCGF-DBBM mixture has more positive implications for reducing bone resorption, promoting bone reconstruction and relieving certain postoperative adverse effects in dental implants with simultaneous GBR. The GPCGF-DBBM mixture was superior to the LPCGF-DBBM mixture in alleviating adverse effects in terms of bleeding and speaking after GBR.

Clinical trials registration number: The Chinese Clinical Trial Registry, NO. ChiCTR2300070107 (03/04/2023).

Domestic violence is a global public health issue with rising prevalence rates and varying risk factors. It is common for domestic violence victims to be seen by dental health care providers, therefore, dentists' ability to identify victims might help to address this problem. A cross-sectional study was conducted using the Domestic Violence Healthcare Providers Survey (DVHPS). This is a validated and structured questionnaire consists of 7 domains considered as potential facilitators and barriers for any health care provider to conduct domestic violence screening. The objective of this study was to evaluate the readiness of the practicing dentists to implement routine domestic violence screening in dental settings and to identify possible barriers to its implementation. Dentists included in this study were recruited from the western province in Saudi Arabia, which includes 3 major metropolitan cities. Out of 491 dentists were approached, a total of 400 dentists participated in this study with a response rate of 81.46%. All study subjects were enrolled through probability sampling using a disproportionate stratified random sampling technique to recruit an equal number of general and specialized dentists. The sex distribution was 53% and 47% for male and female dentists, respectively. The mean age of the study participants was 46.31 years, with an average dental work experience of 12.6 years. More than half of the study participants (58%) routinely screened their patients for domestic violence in their dental clinic. However, specialized and general dentists were comparable in terms of training in identifying domestic violence. Routine domestic violence screening was more common among general dentists than among specialized dentists. The current study suggested adequate readiness of general and specialized dentists to implement routine domestic violence screening for all patients. Specialized dentists showed less inclination to perform domestic violence screening on a routine basis due to several prominent barriers. These barriers were self-efficacy and professional role resistance. Education and reinforcement of the importance and high demand for domestic violence screening could encourage the dental community to embrace domestic violence screening as an integral part of routine dental examination.

Background: Periodontal diseases could cause halitosis and may impair taste and smell. While non-surgical periodontal therapy is known to reduce halitosis, its effects on taste and smell are less studied. This study aims to investigate the factors influencing self-perceived halitosis, taste, and smell, as well as the changes in these perceptions after periodontal therapy.

Methods: A total of 183 participants were divided into three groups: 61 patients with periodontitis, 61 with gingivitis, and 61 who were gingivally healthy. Periodontal parameters and self-perceived halitosis, taste, and smell were evaluated at baseline and four weeks after non-surgical periodontal treatment using a visual analog scale (VAS). Robust regression analysis was used to assess independent variables influencing baseline VAS ratings.

Results: The periodontitis group had the lowest taste perception and the highest self-perceived halitosis scores (p < 0.05). Taste perception was negatively associated with ≥ 4 mm pockets (p = 0.002). A positive relationship was also observed between the plaque index and self-perceived halitosis (p = 0.030). Post-treatment, taste perception improved significantly in all groups (p < 0.05), in parallel with improvements in periodontal parameters. Additionally, self-perceived halitosis showed a significant decrease (p < 0.05). The improvement in smell perception was statistically significant in the gingivally healthy and periodontitis groups (p < 0.05).

Conclusions: Periodontal disease may contribute to the development of chemosensory disorders. While the main goal of periodontal treatment is disease management, it can also improve taste and smell function. Oral hygiene practices play an essential role in the development of these improvements. However, further research is needed on the subject.

Trial registration: The study was registered as "Investigation of Halitosis, Taste, and Smell in Terms of Periodontal Condition Stated by Patients and Periodontal Diagnosis by Dentists, and Then Evaluation of Change Before and After Treatment" with the registration number NCT06063460 (13/09/2023) at https://www.

Clinicaltrials: gov Protocol Registration and Results System.

Clinical trial registration: This clinical trial was registered prior to participant recruitment on ClinicalTrials.gov (NCT06063460,13.09.2023).