BMC Oral Health最新文献

Objective: To study the biomechanical changes induced by differences in perioral force in patients with missing anterior maxillary teeth at rest via finite element analysis (FEA).

Methods: Using conical beam CT (CBCT) images of a healthy person, models of the complete maxillary anterior dental region (Model A) and maxillary anterior dental region with a missing left maxillary central incisor (Model B) were constructed. The labial and palatine alveolar bone and tooth surface of the bilateral incisor and cusp regions were selected as the application sites, the resting perioral force was applied perpendicular to the tissue surface, and the changes in maxillary stress and displacement after the perioral force was simulated were analyzed.

Results: Compared with Model A, the labial alveolar bone in the missing tooth area of Model B shows significant stress concentration under the action of perioral force. This adverse stress is distributed in an inverted V-shape, concentrated at the top of the labial alveolar ridge and gradually decreases toward the root.

Conclusion: In the resting state, labial soft tissue exerts adverse stress on the alveolar ridge in areas missing maxillary anterior teeth. This stress may affect alveolar bone healing, causing a reduction in alveolar bone width.

Background: Low-intensity pulsed ultrasound (LIPUS) has been used as an effective noninvasive method for treating fractures and osteoarthrosis, but the application in the field of oral implantation is in its infancy. This study aimed to clarify the effect and mechanism of LIPUS on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and implant osseointegration, and to provide an experimental basis for future clinical applications.

Methods: Dental implants were inserted into Wistar rat femurs, and LIPUS was performed for 4 weeks. Micro-CT and toluidine blue staining were used to assess implant osseointegration. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to identify enriched functional terms and signalling pathways for differentially expressed genes from LIPUS-treated rat BMSC RNAseq data obtained from the GEO database. The random forest method was used to identify key risk genes according to the mean decrease Gini (MDG) coefficient. Then, LIPUS was applied to treat rat BMSCs, and alkaline phosphatase (ALP) staining, alizarin red staining, RT-PCR and western blotting were used to determine whether LIPUS could promote BMSC osteogenic differentiation via integrin α11 (ITGA11) and the focal adhesion pathway.

Results: Our in vivo experimentations verified that LIPUS significantly increased new bone formation and osseointegration around the implant in rats. Bioinformatics analysis of RNA-seq data revealed that the upregulated genes in BMSCs after LIPUS treatment were significantly enriched in osteoblast differentiation-related functions and focal adhesion-related pathways. Random forest analysis revealed that ITGA11 was the most significant factor affecting BMSC osteogenic differentiation among the differentially expressed genes. In addition, LIPUS significantly increased ALP expression and mineralized nodule formation in rat BMSCs by upregulating ITGA11 and increasing the activity of FAK/PI3K/AKT/GSK3β/β-catenin pathway.

Conclusions: LIPUS can effectively promote implant osseointegration in rats and improve rat BMSC osteogenic differentiation by upregulating ITGA11 and increasing the activity of the downstream focal adhesion pathway.

Background: Maintenance of oral health, prevention, and health promotion stand as primary competencies for dental graduates. Consequently, it is necessary to promote such an approach in dental schools, which are traditionally focused on treatment, to improve the attitude and practice of students in the field of prevention, the final result of which is the reduction of oral and dental diseases in patients. The study aimed to design Integrated Oral Health Care Pathways (IOHCPs) for adults and children referred to Tehran University of Medical Sciences (TUMS), School of Dentistry.

Methods: The study was carried out in the clinical departments of the School of Dentistry during 2022-2023. The design process involved utilizing the NHS dental care pathway template and developing the initial model for the IOHCPs. Qualitative methods, including semi-structured interviews with adult patients, parents of pediatric patients, and selected members of the interdisciplinary team (including researchers, experts, and policymakers), were employed to assess existing conditions, needs, and available facilities. The Delphi method was utilized to finalize the care pathway.

Results: Four Integrated Oral Health Care Pathways were formulated, covering dental caries, periodontal diseases, pre-cancerous lesions, and TMJ problems for adults, along with one IOHCP addressing dental caries for children aged 6 years and older, referred to the School of Dentistry. The design of these integrated care pathways was based on the primary prevention of oral diseases. Details, including risk assessment, follow-up times, related home care, and preventive interventions that should be conducted by dental students, were included in the care pathways.

Conclusions: This study focused on designing care pathways based on primary prevention for child and adult patients in dental settings, aiming to enhance patients' oral health by integrating prevention with treatment. The care pathways, designed according to the needs and facilities of the School of Dentistry of Tehran University of Medical Sciences, allow for continuous monitoring of the patients' oral health status and can be considered as a suitable initial model for other educational centers.

Background: This study aimed to assess the histological and radiographic effects of sodium hexametaphosphate (SHMP) as a direct pulp capping (DPC) agent in immature permanent dog premolars.

Methods: A split-mouth design was employed with three healthy 4-month-old Mongrel dogs, each having 36 premolars. The premolars were randomly assigned to either SHMP or MTA. The specimens were stained with hematoxylin and eosin (H&E) and Masson's trichrome, and histologically examined three months after the animals were sacrificed. To assess root maturity, radiographic changes in root length (RL), root surface area (RSA), and apical foramen width (AFW) were measured at baseline and after 3 months. Quantitative data were analyzed using the paired-sample t-test, while the qualitative data based on Stanley's histological scoring system were tested using the Monte Carlo exact test. The level of significance was set at 5%.

Results: Histological findings showed no significant differences between the two groups, except for the average thickness of the predentin and odontoblastic layers, which was significantly higher in the SHMP specimens (P < 0.0001). The frequencies of fully calcified dentin bridges and regularly arranged dentinal tubules were significantly higher in the SHMP specimens (P < 0.05). Both materials showed comparable radiographic measurements (P > 0.05), except for the change in RL, which was significantly longer in the SHMP group (P < 0.05).

Conclusions: There were no significant differences between SHMP and MTA in some respects. Histological evaluation showed that SHMP provided better bioinductive and biocompatible properties compared to MTA. Radiographically, both materials showed comparable root maturogenesis outcomes, except for the significant increase in RL in the SHMP group. SHMP may be a suitable alternative material for DPC in the treatment of immature permanent teeth.

Objectives: Pica is a non-nutritive eating behavior. The potential impact of pica on oral health and the association between pica and anemia are understudied. We examined the current evidence on the relationship between pica practices, anemia, and oral health outcomes.

Methods: We used Population, Intervention, Control, and Outcomes (PICO) terms to create MeSH terms to assess 1) the relationship between pica and iron deficiency anemia (IDA), 2) the relationship between IDA and oral health, and 3) the relationship between pica, anemia, and oral health outcomes. The review was registered on Prospero [CRD42022349022]. We searched databases including PubMed, Embase, Web of Science, Cochrane Library, and, clinicaltrials.gov in June 2022.

Results: From 4,159 searched articles, 89 met the inclusion criteria. Studies were published between 1959 and 2022 from 33 countries. Nearly half of these studies (55.1%, n = 49) were case reports. The most common picas included geophagia (soil/dirt) (44.9%, n = 40 papers), pagophagia (ice) (22.5%, n = 20), amylophagia (starch) (15.7%, n = 14), paint/metal (5.6%, n = 5), paper (5.6%, n = 5) and others such as pica for foam and hair. Fifteen case reports and one intervention study showed the effects of pica practice on oral health, such as tooth abrasion, dental caries, and de-papillated tongue. Furthermore, 81% of the papers reported the co-occurrence of pica with anemia and 15 papers reported a significant association (p < 0.05) between pica and low hemoglobin levels ranging from < 12.0 to 2.7g/dL among all age groups, including among pregnant and postpartum women. Pica practices were strongly associated with IDA (serum ferritin < 15.0 - 4.3 mcg/ml) but showed a non-statistically significant trend of association with oral health outcomes.

Conclusion: Pica was strongly associated with anemia and IDA. Tooth abrasion and dental caries were observed among pica users. Future studies could define the strength of the pica-oral health association, and the potential mediators, such as anemia.

Background: Different countries have varying dental specialities, shaped by diverse factors. The determinants influencing the development of these specialities differ between developed and developing countries. This study aimed to explore the factors contributing to the establishment of dental specialities in Iran, a developing country with a wide range of recognised dental specialities.

Methods: A qualitative case study was carried out, involving the review of 25 in-depth interviews and 47 documents. The data were organised using Atlas.ti (version 7.57) software and analysed through content analysis. This process included transcribing the interviews, identifying meaning units, abstracting content, categorising codes, and developing themes.

Results: The results identified three key factors influencing the development of dental specialities in Iran: stakeholders, contextual factors, and the specialisation process. Stakeholders encompass influential figures such as abroad-trained specialists, the government, the Ministry of Health and Medical Education, and scientific associations, along with their position, perceptions, and power. Contextual factors include cultural norms, sociopolitical relationships, political shifts, economic conditions, and academic disciplines. The process of establishing new dental specialities revealed several gaps, including the absence of formal needs assessments, advocacy plans, career planning, effective partnerships, and adequate evaluation mechanisms.

Conclusion: Contextual factors have played a crucial role in shaping dental specialisation in Iran, driving the formation of ideas in this field. Key players, including dentists trained abroad, have significantly influenced this process, often motivated by the desire to mirror practices in other countries. However, it did not address the specific oral health needs of the Iranian population. Due to limited awareness and the cost disparity between specialised and general services, there has been little public demand for dental specialisation. However, the process of establishing these specialities faces significant gaps that need to be addressed.

Introduction: Artificial intelligence (AI) applications have increased dramatically across a wide range of domains. Dental students will undoubtedly be impacted by the emergence of AI in dentistry.

Aim: This study aimed to evaluate the knowledge, attitudes, and perceptions of a group of Egyptian dental students toward artificial intelligence.

Materials and method: An online survey was conducted using a questionnaire sent to dental students via Google Forms. The questionnaire comprised 18 questions on participant's knowledge and perceptions regarding the future of AI in dentistry. The collected data was statistically analyzed.

Results: A total of 384 students answered the questionnaire. Of the participants, (49%) had a basic knowledge of the principles of AI, and (48%) participants were aware of AI usage in dentistry. Social media was the most common information source for AI applications. Most of the participants agreed on the leading role of AI in the advancement of dentistry and disagreed on the ability of AI to replace dentists in the future, (53%) and (44%) respectively. Moreover, (49%) and (52%) respectively of students approved the incorporation of AI applications in undergraduate and postgraduate dental training.

Conclusion: Egyptian dental students are acquainted with AI and its possible applications in dentistry. They consider the use of AI diagnosis exciting and approve of its definitive role in disease prediction. There is a necessity to include, enhance, and increase AI training in dental schools.

Trial registration: This study has been registered in clinical trials. gov with an identifier: NCT06348758.

Background: Molar incisor hypomineralization (MIH) is estimated to affect more than 800 million people worldwide. The clinical management of MIH can be challenging. For dentists, to provide effective and high-quality dental care to people affected by MIH, it is essential that they improve their awareness, ability to describe the clinical situation, and knowledge of treatment modalities. Previous surveys conducted with students showed that only a limited number are confident in diagnosing MIH. The aim of the study was to assess the clinical knowledge and perceptions of 4th- and 5th-year dental students regarding the distribution, severity, etiology and treatment modalities of MIH.

Methods: In this cross-sectional study, a total of 194 students studying in the 4th- (85 students) and 5th- (109 students) years participated in the survey. The survey had 23 questions and two sections, the first of which was intended to gather demographic information about the students. The second part consisted of questions about the diagnosis, etiology, and treatment of MIH. The independent t test and the chi-square test was used to compare qualitative data.

Results: The majority of students (78.87%) stated that they had known about MIH. 5th-year students had known about MIH at a statistically significantly higher rate compared to 4th-year students (p = 0.0001). While only 19.69% of the participants stated that they could diagnose a patient with MIH, the proportion of 5th-year students who could make such a diagnosis was statistically significantly higher (p = 0.0001). The majority of the participants (96.39%) stated that they wanted MIH-related practices to be included more in their clinical education. The most desired topic to be included was diagnosis (91.98%).

Conclusions: The current study showed that students have some knowledge about MIH, but this knowledge is not sufficient, especially in terms of diagnosis and treatment. The students clearly wanted to develop their knowledge of MIH both theoretically and practically.

Background: Fibrous dysplasia (FD) is a self-limiting benign disease with slow progression in which the normal bone is replaced by dysplastic fibrous tissue. The craniofacial skeleton is one of the most commonly affected areas, and it can create unique challenges in dental implant therapy. This case aims to report an unusual presentation of FD localized in the alveolar crest bone of the edentulous site, causing special obstacles to implant placement, and provide a diagnostic and treatment process that may be referenced.

Case presentation: A 32-year-old female patient presented with an abnormal expansion of the alveolar crest on the edentulous site of the mandibular first molar, which caused insufficient inter-arch space and pseudo-pocket in the adjacent teeth, previous medical history of residual root that existed for many years before tooth extraction was identified retrospectively. FD was diagnosed by the clinical, radiographic, and pathological examination, and the curettage was performed to remove abnormal bone tissue and obtain adequate restorative space for further implant therapy. This intervention was followed by histologically confirmed healing and successfully integrated implant placement.

Conclusion: We described an unreported pathogenic site of FD that occurred at the alveolar ridge of the edentulous site, which ended up with satisfactory oral implant rehabilitation through 5-year sequential diagnosis and treatment.

Background: The use of ChatGPT in the field of health has recently gained popularity. In the field of dentistry, ChatGPT can provide services in areas such as, dental education and patient education. The aim of this study was to evaluate the quality, readability and originality of pediatric patient/parent information and academic content produced by ChatGPT in the field of pediatric dentistry.

Methods: A total of 60 questions were asked to ChatGPT for each topic (dental trauma, fluoride, and tooth eruption/oral health) consisting of pediatric patient/parent questions and academic questions. The modified Global Quality Scale (the scoring ranges from 1: poor quality to 5: excellent quality) was used to evaluate the quality of the answers and Flesch Reading Ease and Flesch-Kincaid Grade Level were used to evaluate the readability. A similarity index was used to compare the quantitative similarity of the answers given by the software with the guidelines and academic references in different databases.

Results: The evaluation of answers quality revealed an average score of 4.3 ± 0.7 for pediatric patient/parent questions and 3.7 ± 0.8 for academic questions, indicating a statistically significant difference (p < 0.05). Academic questions regarding dental trauma received the lowest scores (p < 0.05). However, no significant differences were observed in readability and similarity between ChatGPT answers for different question groups and topics (p > 0.05).

Conclusions: In pediatric dentistry, ChatGPT provides quality information to patients/parents. ChatGPT, which is difficult to readability for patients/parents and offers an acceptable similarity rate, needs to be improved in order to interact with people more efficiently and fluently.