Frontiers in oral health最新文献

Background and aim: Despite the convergence of visual impairment and poor oral health among children, there is a scarcity of data on the common oral health disorders and their prevalence among children with visual impairments in South Asia. The purpose of this systematic review is to synthesize the existing literature on oral health diseases in visually impaired children in South Asia.

Methods: An exhaustive literature search was carried out in PubMed-MEDLINE, Scopus, Embase and Google Scholar from inception till 31st December, 2024. We included studies if they fulfilled the following criteria: visually impaired children (aged <18 years); assessment using dental examination; children with no other impairment from South Asian regions. Due to the high variability across age groups within the target population, we have synthesized and presented the data in a narrative format.

Results: The search across databases yielded a total of 1,681 studies, out of which 9 studies were included. The prevalence of dental caries was reported ranging from 40% to 98.5%, and dental trauma ranged from 4.62% to 44.28%. High prevalence of malocclusion and gingivitis has also been reported. Quality assessment showed that three studies had medium risk of bias and remaining had a low risk of bias.

Conclusion: In the South Asian region, it is crucial to make special needs dentistry widely accessible, provide caregivers with sufficient dental health information, and ensure dentists receive specialized training to enhance the effectiveness, comfort, and satisfaction of treatment.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=582083, PROSPERO (CRD42024582083).

Introduction: Mandibular distraction osteogenesis is globally accepted as the gold-standard surgical solution for various craniofacial deformities and syndromes. Stock device evolution has advanced into complex designs to achieve the most accurate three-dimensional distraction vector of elongation. Today's cutting-edge solution is patient-specific distractors designed by virtual surgical planning (VSP) to facilitate surgical performance and ensure the most predictable clinical results. However, tailoring patient-specific distractors comes with a significant price tag.

Methods: Using VSP technology, we developed an inexpensive stepwise method of precisely directing the distraction vector by adapting off-the-shelf distractors for the individual contour of the patients' mandibles based on the in-house designed and printed cutting guides.

Results: The virtual planning sequence and clinical application are described in detail. The final results are assessed by 3D analysis to confirm the method's precision and predictability.

Discussion: The final positions of the adapted off-the-shelf distractors were found to match the pre-operative virtual planning precisely, resulting in excellent clinical results. This method can be easily reproduced in similar clinical cases with reduced cost.

Intraductal papilloma is a rare benign neoplasm arising from the secretory ducts of the salivary glands. A 79-year-old man with an intraductal papilloma located in the minor salivary gland of sublingual mucosa was reported. The lesion, characterized by extensive internal papillomatous hyperplasia, was confirmed through histopathology and immunohistochemistry. We conducted a literature review to clarify intraductal papilloma and differences between inverted ductal papilloma, highlighting the significance of CK7 and MUC-1 immunohistochemical staining in diagnosing intraductal papilloma.

Objectives: Oral and maxillofacial diseases affect approximately 3.5 billion people worldwide. With the continuous advancement of Artificial Intelligence technologies, particularly the application of generative pre-trained transformers like ChatGPT-4, there is potential to enhance public awareness of the prevention and early detection of these diseases. This study evaluated the performance of ChatGPT-4 in addressing oral and maxillofacial disease questions using standard approaches and the Chain of Thought (CoT) method, aiming to gain a deeper understanding of its capabilities, potential, and limitations.

Materials and methods: Three experts, drawing from their extensive experience and the most common questions in clinical settings, selected 130 open-ended questions and 1,805 multiple-choice questions from the national dental licensing examination. These questions encompass 12 areas of oral and maxillofacial surgery, including Prosthodontics, Pediatric Dentistry, Maxillofacial Tumors and Salivary Gland Diseases, and maxillofacial Infections.

Results: Using CoT approach, ChatGPT-4 exhibited marked enhancements in accuracy, structure, completeness, professionalism, and overall impression for open-ended questions, revealing statistically significant differences compared to its performance on general oral and maxillofacial inquiries. In the realm of multiple-choice questions, the application of CoT method boosted ChatGPT-4's accuracy across all major subjects, achieving an overall accuracy increase of 3.1%.

Conclusions: When employing ChatGPT-4 to address questions in oral and maxillofacial surgery, incorporating CoT as a querying method can enhance its performance and help the public improve their understanding and awareness of such issues. However, it is not advisable to consider it a substitute for doctors.

Introduction: Salivary mucin MUC5B has been suggested to support eubiosis in early oral biofilms by regulating the attachment of commensals, while downregulating dysbiotic activities related to dental caries development, such as microbial carbohydrate transport and metabolism.

Methods: To investigate how the metabolism of glucose, a potential driver for dental caries, in early mono- and dual-species biofilms of oral Actinomyces naeslundii and Streptococcus gordonii clinical isolates was affected by the presence of the complex salivary mucin MUC5B, this study employed nuclear magnetic resonance (NMR)-based metabolomics with the interpretation of network integration.

Results and discussion: MUC5B reduced early attachment in the presence of glucose compared with uncoated surfaces but maintained even species distribution. This suggests that MUC5B may represent an innate mechanism to regulate biofilm eubiosis by supporting early coadhesion while regulating total biomass. All annotated metabolites were intermediates in either carbohydrate metabolism, pyruvate conversion, or amino acid metabolism, which was not unexpected in biofilm glucose metabolomes from two saccharolytic species since pyruvate conversion represents a junction point between glycolysis and amino acid metabolic chains. The 10 metabolites present in all early biofilms represent a core metabolome shared by A. naeslundii and S. gordonii. Such core metabolomes can be used to detect deviations in future studies. Significant differences in metabolite abundance elicited by the presence of MUC5B were also detected. In early biofilms where they were each present, pyruvate, ethanol, and metabolite 134 were present in significantly higher abundance in the presence of 25% MUC5B with 20 mM glucose (MUC5B + G) compared with a physiologic buffer with 20 mM glucose (PBS + G), while metabolites 84, 97, and sarcosine were present at significantly lower abundance. Metabolite 72 was unique to biofilms grown in MUC5B + G, and eight unannotated metabolites were unique to biofilms grown in PBS + G. A pathway enrichment analysis of the metabolites that were differently expressed in early A. naeslundii, S. gordonii, and dual-species biofilms grown with 20 mM glucose with or without MUC5B showed that pyruvate metabolism was significantly over-represented. Studying the metabolic interactions between commensal members of oral biofilms and modulatory effects of host factors such as glycoproteins in saliva during the metabolism of substrates that are potential drivers of dysbiosis, such as glucose, is essential to understand the roles of oral microbial ecosystems in oral health and disease.

Aim: To investigate the effect of periodontal therapy on endothelial function of subjects with periodontitis in stages III or IV and established cardiovascular disease.

Materials and methods: A triple-blinded, parallel groups, randomized clinical trial of 6 months duration, on patients with history of coronary heart disease and periodontitis in stages III or IV was performed. Intervention consisted of steps 1 (oral hygiene instructions and professional mechanical plaque removal) and 2 (subgingival instrumentation) of periodontal therapy, including an antiseptic mouth rinse for 7 days. Patients in the control group received only step 1, with the adjunctive use of a fluoride-containing mouth rinse. Endothelial function (flow-mediated dilation [FMD]) and carotid intima-media thickness (cIMT) at baseline, 3 and 6 months, and serum markers of inflammation and cell adhesion at 3 days, 10 days, 3 and 6 months after therapy, were evaluated. Demographic characteristics, cardiovascular risk factors, history of cardiovascular diseases, medication intake, lipids profile, blood pressure, and periodontal outcomes were also evaluated. Student T, Mann-Whitney U, Chi-square and Fisher-exact tests were performed along with repeated measures ANOVA with post hoc Bonferroni's corrections.

Results: Thirty-five patients were included. In the test group, improvements in pocket depth, bleeding on probing and suppuration at 6 months were significantly better than in control patients. Reductions in mean FMD [test group -3.43%; 95% confidence interval-CI [-2.68; 9.54], p = 0.487; control group -6.75%; 95% CI [1.29; 12.22], p = 0.012] and cIMT (test group -0.05 mm; 95% CI [0.01; 0.10], p = 0.014; control group -0.01 mm; 95% CI [-0.03; 0.05], p = 1.000) were observed in both groups from baseline to 6 months, without significant intergroup differences at any time-point. Differences between groups in serum inflammatory markers were detected at baseline and 3 days for interleukin (IL)-18, and at 10 days for IL-8.

Conclusion: Preliminary results from the present pilot study showed that steps 1 and 2 of periodontal treatment in subjects with periodontitis in stages III-IV and established cardiovascular disease induced improvements in cIMT and periodontal outcomes, although changes in FMD were not observed.

Clinical trial registration: clinicaltrials.gov, Identifier, database (NCT02716259).

Oral health in Africa is often overlooked despite its substantial impact on overall health and well-being. Currently, Africa has a very high prevalence of dental diseases, including untreated dental caries in permanent teeth, severe periodontal disease and oral cancer. Dental human resources are also very low, with dentists ranging from 1.77 to 0.03 per 10,000 population across the continent. The number of technicians also varies across the continent from 0.17 to.0.1 per 10,000 population. Southern Africa has the highest median dental assistants and therapists per 10,000 population ratio (0.2), whereas Northern Africa has no dental assistants or therapists. In addition, limited infrastructure and funding have resulted in significant oral health disparities, leaving large portions of the population without adequate access to oral health services. Only 57% of African countries have developed an oral health policy that sets targets and implementation strategies. African countries have also been shown to spend a fraction of their health budget on oral health care, albeit that dentistry is one of the most expensive medical services. Addressing these gaps requires addressing the oral health workforce needs, facilitating the development of oral health policies built on context-specific evidence, and guiding practice and policy. In addition, partnerships are needed to support innovation, sustainability and monitoring of the instituted oral health programs.

Childhood stunting, defined as impaired linear growth and development, remains a significant global health challenge with long-term consequences on cognitive and physical well-being. Emerging evidence highlights the pivotal role of the oral microbiome-a dynamic microbial ecosystem-in influencing nutritional status, immune response, and overall systemic health. This review explores the intricate interplay between the oral microbiome and stunting, emphasizing mechanisms such as microbial dysbiosis, its impact on nutrient absorption, and immune modulation. Disruptions in the oral microbiome can lead to nutrient malabsorption and systemic inflammation, further exacerbating growth impairments in children. Furthermore, the potential for microbiome-targeted diagnostics and interventions, including probiotics and prebiotics, offers novel strategies to address stunting. A deeper understanding of these interactions may inform innovative diagnostic tools and therapeutic interventions aimed at mitigating stunting through oral microbiome modulation. Integrating oral microbiome research into stunting prevention efforts could provide valuable insights for public health strategies to improve child growth and development, particularly in resource-limited settings. Future research should focus on elucidating the molecular pathways linking the oral microbiome to stunting and developing personalized interventions that optimize microbiome health in early life.

Background: Oral squamous cell carcinoma (OSCC) is a prevalent and devastating malignancy of the oral cavity that profoundly affects patient survival and quality of life (QOL). Cleavage Stimulation Factor Subunit 2 (CSTF2) is known to influence tumor development across multiple cancer types. However, its specific association with patient prognosis and immune cell infiltration in OSCC remains insufficiently understood.

Methods: To assess the expression levels and prognostic implications of CSTF2 in OSCC, comprehensive data were acquired from The Cancer Genome Atlas (TCGA) and subsequently normalized. Immunohistochemical staining of tissue microarrays was performed to analyze CSTF2 expression in the OSCC samples. Differences in CSTF2 expression between OSCC and adjacent non-cancerous samples were evaluated using the Wilcoxon rank-sum test. Functional enrichment analyses have been performed to identify biological pathways and functions associated with CSTF2. The relationship between the infiltration of various immune cells and CSTF2 expression levels was assessed using single-sample gene set enrichment analysis (ssGSEA). Ultimately, the prognostic significance of CSTF2 was evaluated through Kaplan-Meier survival analysis, in conjunction with univariate and multivariate Cox regression analyses, as well as receiver operating characteristic (ROC) curves.

Results: High CSTF2 expression was observed in OSCC and associated with unfavorable clinicopathological variables, including histological grade and lymphnode neck dissection. Functional enrichment analysis indicated that CSTF2 plays a role in epidermal development and differentiation, immunoglobulin complexes, peptidases and endopeptidase inhibitor activity, and cytochrome P450 metabolic processes. Additionally, the overexpression of CSTF2 exhibited a negative correlation with the infiltration of immature dendritic cells (iDCs), cytotoxic cells, and plasmacytoid dendritic cells (pDCs). Notably, elevated CSTF2 expression is significantly associated with reduced patient outcomes.

Conclusion: Elevated CSTF2 expression in OSCC is associated with poor prognostic outcomes, highlighting its capacity to function as an innovative prognostic biomarker and a target for therapeutic interventions.