Frontiers in oral health最新文献

Introduction: The maturation of the midpalatal suture is a critical factor in determining the most appropriate maxillary expansion technique. Angelieri et al. introduced a CBCT-based staging system that shifted the focus from chronological age to individual anatomical assessment. However, inter-examiner variability and challenges in evaluating intermediate stages (C and D) have raised concerns about the diagnostic reliability of axial-only CBCT analysis. This study investigates whether the addition of standardized coronal CBCT sections to traditional axial assessment can improve diagnostic precision - particularly in borderline cases - by revealing morphological variations that may not be evident in axial views alone.

Materials and methods: 34 CBCT scans were retrospectively analyzed. Each midpalatal suture was assessed using both the conventional axial plane method proposed by Angelieri and a coronal view evaluation performed on three standardized slices (anterior, middle, posterior). The study focused on evaluating concordance between the two modalities, identifying regional discrepancies and analyzing ossification patterns, particularly in intermediate stages.

Results: Full concordance between axial and coronal assessments was observed in 23 out of 34 cases, supporting the overall consistency of the axial view method. However, discrepancies emerged primarily in stage C, where 8 of the 11 discordant cases were concentrated. In most of these cases, at least one coronal slice revealed a more advanced ossification stage than suggested by axial analysis. Additionally, atypical anterior-to-posterior ossification patterns were documented in a minority of cases.

Discussion: While our findings do not question the general validity of Angelieri's staging, they suggest that an exclusive reliance on axial views may, in some cases, underestimate the degree of suture maturation. The integration of coronal slices can improve diagnostic resolution in transitional stages, offering a more specific view of the suture's complexity. This multimodal approach may help reduce interpretive subjectivity and potentially limit inter-examiner variability.

Dental trauma in children is common and requires prompt diagnosis, which can be challenging in remote or isolated settings with limited access to emergency dental care. This exploratory case study investigates whether OpenAI's o3 can support dental trauma diagnostics in primary incisors, building on prior pretesting of GPT-4 on summative dental education exams (2023) and multimodal dental trauma analyses (2024), and focusing on o3's multimodal capability and reliability in 2025 with expert assessment ("human in the loop") prior to a supervisor seminar with students and supervisors (N = 84). Preliminary findings indicate that GPT-4 performed well on sample exams (2023), and that 7/10 multimodal analyses of dental injuries were accurate (2024); in the 2025 case, o3 correctly identified pulp necrosis in tooth 51 and uncomplicated enamel/dentin fractures in teeth 51 and 61, consistent with IADT guidance. Human expert involvement contributed essential validation, particularly for treatment decisions and ethical considerations. Overall, the study illustrates how symbiotic intelligence-purposeful collaboration between human and AI-may enhance learning outcomes in scenario-based simulations in remote areas, while requiring active human involvement and multiple validation communities.

Background: For dental care professionals to accurately diagnose and prevent dental conditions, radiographic imaging is essential. However, the variation in dental radiograph use across different populations remains unclear. We examined national data on dental x-ray utilization and explored how racial/ethnic and family income related factors were associated among children and adolescents in the U.S.

Methods: We conducted an observational cross-sectional analysis study of the National Survey of Children's Health (2016-2022) of children aged 1-17 years. The primary outcome variable indicates whether the child received a dental x-ray during the preventive dental visit in the past 12 months. We produced weighted estimates and fit survey-weighted adjusted logistic regression to estimate adjusted odds ratios (aORs) for dental x-ray receipt.

Results: Out of 279,546 children, 56% received x-rays. Non-Hispanic Black children (aOR 0.55; 95% CI, 0.51-0.60), Hispanic children (aOR 0.90; 95% CI, 0.83-0.98), and children from other races/ethnicities (aOR 0.75; 95% CI, 0.70-0.80) were less likely to receive x-rays than non-Hispanic White children. Children from families with incomes below 200% FPL (aOR: 0.81, 95% CI: 0.75-0.88), and those earning between 200%-400% of the FPL (aOR: 0.92, 95% CI: 0.86-0.98) had a lower likelihood of receiving x-rays compared to families with incomes above 400% FPL.

Conclusions: Dental radiography is commonly used during preventive visits, but its use in children depends on clinical need and age. In our study, we found significant disparities in dental radiograph utilization by race/ethnicity and family income.

Oral submucous fibrosis (OSF) is a chronic, potentially malignant disorder characterized by progressive stromal fibrosis and epithelial atrophy, leading to functional loss and an increased risk of malignant transformation. Areca nut consumption remains the principal etiological factor in South and Southeast Asia. Despite its distinct clinicopathological features, OSF assessment relies largely on clinical examination and invasive biopsy, underscoring the need for non-invasive approaches capable of interrogating tissue structure and composition. Optical imaging (OI) technologies, including confocal-based imaging, optical coherence tomography (OCT), narrow-band imaging (NBI), and Raman spectroscopy (RS), have been widely investigated in oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC). However, the applicability of OI to OSF remains undefined. The aims of this narrative review are to: 1) critically synthesize current OI evidence in oral mucosal disease, and 2) evaluates the biological plausibility and technical limitation of applying these modalities to OSF from a pathobiology point of view. Highlighted in this review are the cellular and extracellular matrix alterations that may generate measurable optical signals and the paucity of OSF-specific validation studies, in addition to discussing constraints related to imaging penetration depth and disease grading, and outlining future research directions, including extracellular-matrix-focus optical biomarkers and artificial intelligence-assisted analysis. Collectively, this work positions OI in OSF as a hypothesis-generating and exploratory domain requiring rigorous, pathology-correlated investigation before clinical translation.

The oral mucosa, the gingiva, and the salivary glands are effective reservoirs for HPV. Although HPV-related oral lesions (HPV-OL) have been described since ancient times, their diagnosis and management remain challenging, particularly in people living with HIV. In the oral mucosa, HPV can establish productive or latent infections in basal epithelial cells following microabrasion, resulting in four HPV-OL: squamous papilloma, verruca vulgaris, condyloma acuminatum, and multifocal epithelial hyperplasia, each with characteristic clinical and histological features, though overlapping patterns often complicate diagnosis. While there is strong evidence indicating that HPV can be transmitted through routes other than sexual, misconceptions about sexual transmission and the potential for malignancy continue to persist. Regarding treatment, topical drugs initially designed for the skin or anogenital mucosa lack evidence of safety for the oral mucosa; thus, conservative surgical excision remains the main option. HPV vaccination may contribute to reducing both low- and high-risk HPV infections, with potential impact on related diseases.

Objective: To clarify how fibula free flap (FFF) complications influence clinical and functional outcomes after implant-supported oral rehabilitation.

Materials and methods: A single-center retrospective cohort of 29 patients (56.41 ± 12.74 years; 31% female, 69% male) who underwent segmental jaw resection, FFF reconstruction and subsequent implant placement (2002-2010) was analyzed. Demographic, oncologic, flap, implant-related and patient-centered functional variables were extracted; associations were tested with exact, rank and regression statistics (⍺ = 0.05).

Result: Patients received 7.14 ± 3.06 implants each and 72% were restored with telescopic overdentures. Recipient-site wound-healing defects (WHD) occurred in 31% and were independently associated with multisegment osteotomies (p = 0.012) and longer operative time (p = 0.026); partial flap loss (PFL) was infrequent (6.9%). WHD reduced maximum inter-incisal opening (MIO) by 0.8 cm and PFL by 2.8 cm, both impairing contour ratings. Implant failure (0.59 ± 1.59) correlated with poorer speech intelligibility (p = 0.004) and lower aesthetic scores (p = 0.032). Nonetheless, 96% of patients spoke intelligibly (with or without concentration), 96% judged their dental aesthetic as good or excellent, and 75% consumed a normal diet. Ordinal regression confirmed the number of fibula segments as the sole predictor of contour (p = 0.001).

Conclusions: FFF reconstruction permits dependable, implant-supported rehabilitation, but multisegment osteotomies and prolonged surgery heighten soft-tissue morbidity, which in turn constrains both MIO and appearance. Failed implants further degrade speech intelligibility and aesthetics. Long-term success therefore hinges on balancing the contour gains of complex osteotomies with flap vascular resilience while safeguarding implant stability.

Background: Social media (SoMe) is increasingly used in dentistry for patient education, professional networking, and career development, yet formal curricula on its use and digital literacy remain limited in dental specialty programs.

Aim: This scoping review the existing literature on SoMe use in dentistry and identify gaps in curricular implementation and policy development for curricular integration in dental specialty training.

Methods: Following PRISMA- ScR guidelines, a systematic literature search of PubMed and Scopus for studies published between 2009 and 2024 were searched. Two reviewers identified 2,952 articles, of which 531 met inclusion criteria. Data were extracted and analyzed to identify publication trends, thematic areas, and key findings related to SoMe in dentistry.

Results: Research output grew substantially (412%) between 2015 and 2024. YouTube was the most studied platform (41%), followed by X/Twitter (27%), Instagram (19%), and Facebook (13%). Research involving dental professionals (54%) emphasized continuing education and networking, while patient-focused studies (43%) addressed oral health promotion, misinformation, and treatment decision-making. Only 7% evaluated formal SoMe curricula. Reported challenges, privacy breaches (38%), unprofessional conduct (32%), and misinformation (29%), highlights the need for structured educational content during dental specialty training.

Conclusion: SoMe changed the dynamics of clinical dental practice; however, concerns persist regarding digital literacy and professionalism. Evidence on the structured integration of SoMe into dental specialty curricula remains limited, highlighting the need for educational initiatives to promote ethical digital engagement and oral health communication.