Frontiers in oral health最新文献

Periodontitis is a inflammatory disease characterized by progressive loss of periodontal attachment and alveolar bone, leading to tooth mobility and eventual tooth loss. Periodontal disease affects about half of U.S. adults. Epidemiologic evidence links periodontitis to increased incidence of cardiovascular disease (CVD). Peripheral artery disease (PAD) is common in adults aged ≥65 years and is associated with substantially increased cardiovascular risk. It is an atherosclerotic condition that shares major risk factors, diabetes, smoking, older age, hypertension, and chronic kidney disease. Although the link between periodontitis and CVD is well established, comparatively few studies have examined PAD specifically. This mini-review synthesizes recent studies on periodontitis and PAD. Across heterogeneous designs and populations, most reports support a modest association, which appears stronger in the presence of shared risk factors (e.g., diabetes, smoking) and with more severe periodontal involvement. Several studies have detected oral pathogens or pathogen-specific antibodies (e.g., Porphyromonas gingivalis, Treponema denticola) in patients with PAD and report higher circulating inflammatory mediators. Nonetheless, substantial heterogeneity in populations, exposure/outcome definitions, and confounding control, and the likelihood of residual confounding, limit causal inference. Large, well-designed prospective studies with standardized periodontal phenotyping and rigorous adjustment (including attention to temporal trends in dental extraction practices) are needed to define effect magnitude and clinical relevance.

Purpose: To evaluate the difference of a single posterior implant of the same length between planned and actual positions for two commonly used static implant planning software packages following a tooth-supported partially guided surgery protocol.

Materials and methods: There are 75 implant placement cases were included in this retrospective study. 40 were designed using the GuideMia Implant System, and 35 were designed using 3Shape Implant Studio. The implant position on the postoperative cone-beam computed tomography was superimposed on the planned implant position. Coronal, apical, and angular deviations in the 3D direction were measured for each group using an additional evaluation software program. Six risk factors that may influence the accuracy were evaluated separately: jaw, location, implant system, missing teeth at the free end, and implant length and diameter. Linear regression models were established to analyze the source of deviation.

Results: No statistically significant differences were observed between the two implant planning software programs no matter the implant length is 8 mm, 10 mm, or 12 mm (P > 0.05). Significant differences were observed at the entry point (P = 0.003), apex (P = 0.005), and angle (P = 0.002) between the free and non-free ends.

Conclusions: The implant planning programs showed similar results regarding the implant position accuracy of the same length. However, an implant located at the free end of a single missing posterior tooth has a significant influence on the accuracy.

Periodontitis is a chronic inflammatory disease driven by oral microbial dysbiosis, with Porphyromonas gingivalis playing as pathogenic roles and Fusobacterium nucleatum as a gram-negative bacterium is very relevant in the initiation and development of periodontal disease. Although local antibiotic therapy can help restore oral homeostasis, its effectiveness is often limited by bacterial resistance and poor accessibility to deep periodontal pockets. These limitations underscore the need for alternative therapies with proven antibacterial activity and biocompatibility. In this context, patchouli oil, derived from Pogostemon cablin Benth., offers promising antifungal, anti-inflammatory, and antibacterial properties. This study investigates the antibacterial potential of patchouli oil and its fractions, including crude, light and heavy, formulated into nanoemulsions and nanoemulgels for the adjuvant therapy of periodontitis. To achieve this, the formulation process begins by identifying which fraction meets the criteria for antibacterial efficacy. Antimicrobial characteristics are evaluated through phytochemical profiling, Fourier-transform infrared spectroscopy, and gas chromatography-mass spectrometry. The development of nanoemulsions and nanoemulgels is guided by nanomaterial formulation parameters, including physical characterization to ensure suitability for application as a mouthwash or topical paste aimed at restoring oral homeostasis. The results indicate that crude patchouli oil is a promising candidate for formulation, capable of being incorporated into nanoemulsions and nanoemulgels using surfactants and cosurfactants with appropriate hydrophilic-lipophilic balance. Furthermore, the concentration of the gelling agent significantly influences viscosity, which in turn affects the product's spreadability and retention in the oral cavity.

Introduction: Oral diseases such as caries and periodontitis are complex, multifactorial diseases and remain the most prevalent worldwide. Both diseases are associated with vitamin D deficiency (VDD) and its pathophysiological process. The prevalence of metabolic syndrome (MetS) is rising in developing countries, and studies have shown that oral diseases are more prevalent among the metabolic group. This study aims to assess and correlate the relationship between serum vitamin D levels, salivary antimicrobial peptides (AMPs), and their role in oral health.

Materials and methods: A total of 80 individuals aged 35-75 years were recruited, including 40 patients in the metabolic syndrome group, following the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and 40 in the non-metabolic group. Serum vitamin D levels and salivary AMPs were estimated using enzyme-linked immunosorbent assay (ELISA). Oral health status was assessed using the Decayed, Missing, Filled Teeth (DMFT) index and by recording the presence or absence of periodontal pockets. The data obtained were subjected to statistical analysis to determine correlations between systemic status, biochemical markers, and oral health parameters.

Results: The Mann-Whitney U test was applied to compare continuous variables between the metabolic and non-metabolic groups, as well as between subgroups. The chi-squared test was applied to assess associations between categorical variables. Patients with metabolic syndrome exhibited reduced serum vitamin D levels, although differences were not statistically significant. Salivary β-defensin and cathelicidin levels were relatively higher in the metabolic group, but without significant intergroup variation. A higher DMFT score and greater prevalence of periodontal pockets were recorded among metabolic syndrome patients compared with non-metabolic individuals.

Conclusions: Within the study's limitations, a potential link between metabolic syndrome and compromised oral health was observed, as demonstrated by increased caries incidence and periodontal involvement. While variations in serum vitamin D and salivary AMPs did not achieve statistical significance, the findings suggest an altered host defense mechanism in metabolic syndrome patients. Larger, longitudinal studies are required to further elucidate these associations and emphasize the importance of routine oral screening in individuals with metabolic disorders, and the implementation of oral health polices is mandatory to maintain good oral health and well-being among both metabolic and non-metabolic populations.

Most severe presentation of medication-related osteonecrosis of the jaw (MRONJ) is classified as stage 3 for which there are still no standard surgical therapy guideline. Our aim was to describe "Five Times Three (FTT) Split" protocol as surgical treatment of stage 3 maxillary MRONJ. The present case series included a total of 14 patients diagnosed with stage 3 MRONJ of the upper jaw who were treated from February 2022 to September 2024 with mucoperiosteal flap and "FTT Split" protocol. The patients were followed up both clinically and radiologically for a period ranging from 9 months to 3 years. Primary wound closure was successfully achieved in all cases without any signs of oroantral or oronasal communication, and complete healing was observed during the postoperative follow-up period. The "FTT Split" surgical protocol demonstrated high success rates during a controlled postoperative period.

Background: Post-traumatic trigeminal neuropathy is conventionally treated with pharmacologic medications such as carbamazepine. Studies have reported that herbal medications (HM) exhibit antinociceptive properties and are helpful in managing painful post-traumatic trigeminal neuropathy (PPTTN).

Objective: The purpose is to systematically review preclinical studies that assessed the antinociceptive efficacy of HM in managing PPTTN.

Methods: The focused question was "Can HM reduce PPTTN-related nociception?" A comprehensive search of indexed literature was performed up to and including November 2025. Various keywords were used in different combinations using Boolean operators: Original studies that evaluated the effects of HM on PPTTN-related nociception were included. Study protocols, reviews, editorials, case reports/series, observational studies, and letters-to-the-editor were excluded. The risk of bias (RoB) and quality of evidence were assessed.

Results: Four studies on rodents were included. Three studies were performed in rats and one in mice. Protocols for experimental neuropathic pain induction, HM type and delivery and outcome variables were inconsistent in all studies. All studies reported that HM increase the induced pain thresholds in animals with induced PPTTN. Sample-size estimation was performed in none of the studies. The RoB and quality of evidence were graded as "high" and "very low", respectively.

Conclusion: The antinociceptive efficacy of HM in the management of experimentally induced PPTTN remains inconclusive, primarily due to methodological inconsistencies within the existing literature.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023486191.

Platelet-Rich Fibrin (PRF) is a second-generation autologous blood concentrate widely applied in regenerative medicine and dentistry for its wound-healing potential. Its clinical applications span dermatology, plastic surgery, periodontology, implantology, and oral maxillofacial surgery, with growing evidence supporting its effectiveness in tissue regeneration. Fibroblasts, as central regulators of extracellular matrix synthesis and remodeling, angiogenesis, and inflammation, are important targets of PRF's regenerative effects. This review summarizes the recent evidence of role of PRF in regulation of fibroblast functions important for wound healing and inflammation. It highlights PRF as a biologically active scaffold that accelerates soft tissue repair, primarily through modulation of fibroblasts, positioning it as a promising adjunct in regenerative therapies.

Background: For some children with autism spectrum disorder (ASD), over-responsivity to sensory stimuli in a dental office environment and communication barriers can result in uncooperative behavior, in extreme cases necessitating the use of general anesthesia. Tailored educational approaches are a promising tool to address these issues.

Objective: This study assesses the effectiveness of an existing educational approach, called the educational sensory-based approach (ESBA), which aims to improve cooperation during dental care treatment of children with ASD. The relevant research questions are whether children improve their levels of cooperation during the implementation of the phases of the ESBA and how such improvement depends on study variables. According to our definition, an initially uncooperative child (Frankl scale at first visit rated negative or definitely negative) is considered to have improved by the end of a certain phase if their Frankl scale rating at the end of the phase is positive or definitely positive, while an initially cooperative child (Frankl scale at first visit rated positive) is considered to have improved by the end of a certain phase if their Frankl scale rating at the end of the phase is definitely positive.

Methods: In this study, a retrospective repeated-measures design was used. The final sample comprised 45 initially uncooperative and 40 initially cooperative children with ASD who completed the ESBA program between 2013 and 2020. Data included demographic and clinical examination variables, medical history, and child behavior and cooperation. A statistical analysis was performed using 3,328 cumulative logit models to address the relevant research questions.

Results: A statistically significant improvement across the different phases of the ESBA program was observed, independent of the other explanatory variables in the study. The 95% confidence intervals for the predicted probability that an initially uncooperative child would improve by the end of the ESBA program were [0.71 and 0.88], whereas the probabilities for an initially cooperative child improving were lower at [0.04 and 0.20].

Conclusions: The ESBA represents a promising tool for managing dental care in children with ASD. It facilitates cooperation and limits reliance on general anesthesia. The findings from this study can inform clinical practice in pediatric dentistry, particularly in managing patients with ASD, and provide a starting point for other medical teams to implant and implement alternative educational approaches.

Introduction: The oral microbiota plays a fundamental role in maintaining both oral and systemic health, while dysbiosis contributes to diseases such as dental caries and periodontitis. Probiotics have gained attention as adjunctive strategies to restore microbial homeostasis. Heyndrickxia coagulans (formerly Bacillus coagulans) is a spore-forming, lactic acid-producing bacterium with documented antimicrobial, antioxidant, and immunomodulatory properties. Its resilience to environmental stressors and industrial processing makes it a promising probiotic candidate. This systematic review and meta-analysis aimed to evaluate the effects of H. coagulans on oral health outcomes.

Methods: A comprehensive search was performed across multiple databases up to September 2025 to identify randomized controlled trials (RCTs) and non-randomized studies assessing H. coagulans as a probiotic intervention for oral health. Data extraction followed PRISMA guidelines, and the risk of bias was evaluated using the RoB 2.0 and ROBINS-I tools. Meta-analysis was conducted using Stata SE® 18.5, with changes in salivary Streptococcus mutans levels as the primary outcome measure.

Results: Eight studies (seven RCTs and one NRSI) met the inclusion criteria. Most were conducted in India, Iran, and North Macedonia, with sample sizes ranging from 30 to 183 participants aged 5-73 years. Administration of H. coagulans, via chewable tablets, mouthwash, or food matrices, resulted in a significant reduction of salivary S. mutans counts in both children and adults compared with placebo or other probiotics. Meta-analysis of four studies demonstrated a pooled effect size of -0.99 (95%CI = -1.60/0.39; p < 0.01), although substantial heterogeneity was observed (I² = 98.2%). Additional studies reported improvements in Gingival Index, bleeding on probing, and clinical attachment levels among participants with gingivitis or periodontitis. No significant adverse events were reported.

Conclusion: H. coagulans appears to exert beneficial effects on oral health by reducing cariogenic bacterial load and improving periodontal parameters, supporting its potential use as an adjunct in caries prevention and gingival health maintenance. H. coagulans may favorably modulate the oral microbiota and contribute to overall oral health. However, further high-quality, large-scale clinical trials are needed to confirm these findings and define their therapeutic role in preventive oral care.