Frontiers in oral health最新文献

Objectives: Type 2 Diabetes (T2D) is recognized as a risk factor for periodontal disease (PD), with evidence supporting a bidirectional relationship. Food choices are thought to influence both conditions, but research on their impact specifically on PD remains limited. This study aimed to explore whether food choices were linked to higher prevalence of adverse periodontal parameters and poorly controlled glucose levels among Hispanic adults with T2D.

Methods: A cross-sectional study was conducted with 260 Puerto Rican adults aged 40-65 years, all diagnosed with T2D. Dietary habits were assessed by weekly frequencies of food choices deemed healthy or unhealthy over the past year. Periodontal health was evaluated by the percentage of sites with probing pocket depth (PPD) ≥4 mm and bleeding on probing (BOP) at corresponding teeth. Glucose control was measured by glycated hemoglobin (HbA1c) levels, with uncontrolled glucose defined as HbA1c ≥ 7%. Linear regression models adjusted for demographic and clinical variables estimated associations with PD. Logistic regression assessed associations with glucose control.

Results: The median Healthy Eating Score was 0.5 (Q1, Q3: -3.9, 4.5). A higher Healthy Eating Score was significantly associated with fewer sites exhibiting PPD ≥ 4 mm and BOP (adjusted β: -0.02; SE: 0.01; p = 0.035), and reduced odds of uncontrolled glucose (adjusted odds ratio: 0.94; 95% CI: 0.89-0.98; p = 0.007).

Conclusions: Adherence to a healthier dietary pattern appears to correlate with lower periodontal inflammation and greater glucose control among Hispanics with T2D. Prospective studies are needed to confirm causality and long-term effects.

Objective: This study aims to incorporate contact-killing quaternary ammonium into two root canal sealers, AH Plus (DentSply Sirona, New York City, NY, USA) and BC (FKG, Le Crêt-du-Locle Switzerland) sealers to improve their antibacterial properties.

Methods: Dimethylaminohexadecyl Methacrylates (DMAHDM) were synthesized and incorporated into AH Plus and BC sealers at 5 weight percent (wt.%). The physical properties were assessed via film thickness, flow, contact angle, and solubility. The antibacterial properties were assessed by determining the number of colony-forming units (CFUs) of Enterococcus faecalis and scanning electron microscopy (SEM). Two-way ANOVA and Tukey tests were used to analyze the data.

Results: Incorporating DMAHDM at 5 wt.% increased the film thickness and reduced the flow of the AH Plus and BC sealers (P < 0.05), but the values were within clinically acceptable limits. Simultaneously, DMAHDM incorporation increased the contact angle of the sealers (P < 0.001). DMAHDM incorporation significantly (P < 0.001) inhibited the E. faecalis biofilms and resulted in complete eradication. In contrast, the AH Plus and BC control sealers had approximately 10⁵ and 10⁴ CFUs of bacteria, respectively. The SEM images revealed no E. faecalis colonies over the AH Plus sealers containing 5 wt.% DMAHDM, while the AH Plus control sealers were covered with a thick layer of biofilms.

Conclusions: The results of this study suggest that DMAHDM, as a contact-killing agent, could be used as an approach to prevent endodontic reinfections.

Clinical relevance: Integrating DMAHDM into commercial sealers may enhance their antibacterial properties. These findings indicate a need for further investigation using more clinically relevant models to validate this approach.

This clinical report aimed to compare the scanning accuracy of SRA, and a novel extended scan body in edentulous patients. Through quantitative analysis, the study provided data support for oral prosthodontics and digital treatments. Edentulous patients with six Straumann bone-level implants were selected. The scan data was compared to the standard model derived from traditional impressions to evaluate scanning accuracy. The SRA scan bodies showed lower accuracy (46 ± 45 μm), while the Segma scan bodies with an extended structure achieved significantly higher accuracy (20 ± 2 μm). The extended structure effectively reduced image stitching errors in challenging intraoral regions, improving accuracy and speed. The Segma scan bodies with an extended structure accurately replicated spatial position information of implants in edentulous patients, providing insights for oral prosthodontics and digital treatments to enhance restoration quality.

Background: Hypovitaminosis, or vitamin deficiency, has been increasingly recognized as a potential contributing factor in the development of recurrent aphthous stomatitis (RAS), a condition characterized by the periodic formation of painful ulcers in the oral mucosa.

Materials and methods: This mini review includes a literature search on PubMed, Web of Science, and Scopus databases using keywords "hypovitaminosis AND aphthous ulcers."

Results: There is a growing body of evidence supporting the link between various vitamin deficiencies-particularly vitamins B12, C, and folate-and the prevalence of RAS, with implications for both diagnosis and management.

Conclusion: This review aims to outline the clinical and biochemical findings associated with hypovitaminosis in individuals presenting with RAS, emphasizing the diagnostic importance of recognizing vitamin deficiencies in these patients and exploring possible therapeutic approaches.

Introduction: Regular use of mouthwash can disrupt nitrate reduction by oral bacteria and may affect systemic nitric oxide (NO) levels, which are important for inflammation and endothelial function. We aim to assess the association between over-the-counter (OTC) mouthwash use and nitrate/nitrite, markers of inflammation (IL-6, TNF-α, CRP) and endothelial function (sICAM-1, sVCAM-1) in serum and saliva, and to assess the relationship between nitrate/nitrite levels and these biomarkers, as well as how OTC mouthwash modulated this relationship. We hypothesize that nitrates/nitrites are associated with these biomarkers, and that their associations would vary with the frequency of mouthwash use.

Method: Our cross-sectional study used data and specimen from the baseline of the San Juan Overweight Adult Longitudinal Study (SOALS). Robust Gamma regression with log-link function, Spearman correlations and partial correlations adjusted for covariates were used for the analysis.

Results: Using OTC mouthwash twice a day or more was significantly associated with lower serum nitrite levels compared to less frequent use (β = -0.357, 95% CI: -0.650, -0.064), but not with other markers of inflammation and endothelial function. Mouthwash use differentially impacted the relationship between nitrate/nitrite and TNF-α, sICAM-1 and sVCAM-1. Specifically, in the participants who used mouthwash less than twice a day or no use, TNF-α (β = -0.35, 95% CI: -0.52, -0.18), and sICAM-1 (β = -0.21, 95% CI: -0.32, -0.09) were negatively associated with serum nitrite. In the participants who used mouthwash twice a day or more use, TNF-α was positively associated with serum nitrate (β = 3.36, 95% CI: 2.07, 4.65), salivary nitrite (β = 1.04, 95% CI: 0.39, 1.69) and salivary nitrate (β = 0.48, 95% CI: 0.25, 0.71); sICAM-1 was positively associated with serum nitrate (β = 1.58, 95% CI: 0.86, 2.29). In both subgroups of mouthwash users, sVCAM-1 was positively correlated with serum nitrate and salivary nitrate. In addition, sVCAM-1 was positively correlated with serum nitrite in participants who used mouthwash frequently (ρ__S = 0.18, p = 0.045).

Discussion: Regular use of OTC mouthwash was associated with systemic nitric oxide. This raises concerns about its potential effects on the levels of inflammatory and endothelial biomarkers associated with cardiometabolic diseases.

Introduction: Dental pain is a multifactorial and unpleasant experience that negatively affects daily activities. Previous studies have shown that adults living in socioeconomically disadvantaged areas showed higher dental pain prevalence. This study evaluated whether income inequalities are related to increased dental pain intensity among adults and identified differences between women and men.

Methods: A probabilistic sample of adults was investigated, and income inequality was evaluated using the Gini Index. Dental pain intensity was recorded on a scale from 1-10 for those who experienced dental pain in the 6 months preceding the survey. The covariates were contextual (related to cities) and individual (related to individuals). Associations were investigated for the entire sample and stratified by gender using multilevel Poisson regression models.

Results: Dental pain was reported by 41% of the included sample (n = 4,512 adults). Maximum pain intensity was reported more frequently for women than for men. Those living in municipalities with higher Gini Index values reported 1.26 times (95% CI: 1.01-1.56) greater dental pain intensity compared to adults living in cities with lower Gini Index values, even after adjustment by variables. The same pattern was observed when stratified by gender, but it was not statistically significant.

Conclusion: Thus, the contexts of income inequalities can contribute to more severe dental pain intensity among adults. Also, the findings suggest that income inequality does not modify the relationship between gender and dental pain intensity.

Introduction: Upper aerodigestive tract cancers are prevalent, with a global incidence surpassing 500,000 new cases in 2018. Among these, oral squamous cell carcinomas (OSCC) constitute the majority. OSCC has a low 5-year survival rate due to late-stage diagnosis. Risk factors include alcohol and tobacco use. However, non-smokers and non-drinkers are also affected, especially young patients with tongue cancer. The impact of tumor microenvironment (TME) and tumor-infiltrating lymphocytes (TILs) on OSCC prognosis remains debated. Remarkably, Tertiary Lymphoid Structures (TLS) identified in solid tumors have shown associations with favorable outcomes, yet their prognostic significance in OSCC remains understudied.

Objective: Thus, this systematic review aims to explore the value of TLS in OSCC reported in the literature.

Method: A scoping review was conducted and six retrospective cohort studies involving 1,203 patients met the inclusion criteria.

Results: Predominantly male patients, with an average age of 49.3 years were included. Immunohistochemistry was the primary method to identify TLS, present in 21% up to 100% of cases. TLS were predominantly located in the peri-tumoral area (75.4%-84.8%) compared to the intra-tumoral area (33.8%-33.9%). Our review shows that the presence of TLS is associated with improved survival in OSCC.

Discussion: However, variations in TLS detection and classification methods across studies introduce potential biases, hindering direct comparisons between findings. For instance, reports that are based solely on examining HES-stained slides for TLS identification may raise reliability concerns. Standardization of methodologies is imperative to ensure consistency in criteria utilization, thereby facilitating meaningful data comparisons.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428010, PROSPERO (CRD42023428010).

Background: The styloid process (SP), a bony projection from the temporal bone which can become elongated, resulting in cervical pain, throat discomfort, and headaches. Associated with Eagle syndrome, this elongation can compress nearby nerves and blood vessels, leading to potentially severe complications. Traditional imaging-based methods for classifying various types of elongated styloid processes (ESP) are challenging due to variations in image quality, patient positioning, and anatomical differences, which limit diagnostic accuracy. Recent advancements in artificial intelligence, particularly deep learning, provide more efficient classification of elongated styloid processes.

Objective: This study aims to develop an automated classification system for elongated styloid processes using deep learning models and to evaluate the performance of two distinct architectures, EfficientNetB5 and InceptionV3, in classifying elongated styloid processes.

Methods: This retrospective analysis classified elongated styloid processes using Ortho Pantomograms (OPG) sourced from our oral radiology archives. Styloid process lengths were measured using ImageJ software. A dataset of 330 elongated and 120 normal styloid images was curated for deep learning model training and testing. Pre-processing included median filtering and resizing, with data augmentation applied to improve generalization. EfficientNetB5 and InceptionV3 models, utilized as feature extractors, captured unique styloid characteristics. Model performance was evaluated based on accuracy, precision, recall, and F1-score, with a comparative analysis conducted to identify the most effective model and support advancements in patient care.

Results: The EfficientNetB5 model achieved an accuracy of 97.49%, a precision of 98.00%, a recall of 97.00%, and an F1-score of 97.00%, demonstrating strong overall performance. Additionally, the model achieved an AUC of 0.9825. By comparison, the InceptionV3 model achieved an accuracy of 84.11%, a precision of 85.00%, a recall of 84.00%, and an F1-score of 84.00%, with an AUC of 0.8943. This comparison indicates that EfficientNetB5 outperformed InceptionV3 across all key metrics.

Conclusion: In conclusion, our study presents a deep learning-based approach utilizing EfficientNetB5 and InceptionV3 to accurately categorize elongated styloid processes into distinct types based on their morphological characteristics from digital panoramic radiographs. Our results indicate that these models, particularly EfficientNetB5, can enhance diagnostic accuracy and streamline clinical workflows, contributing to improved patient care.

Introduction: This study synthesizes evidence on the impact of subgingival periodontal treatment combined with antibiotics on reducing systemic inflammation markers-C-reactive protein (CRP), interleukins, and tumor necrosis factor-alpha (TNF-α)-in patients with metabolic syndrome (MS) and periodontal disease (PD), compared to supragingival periodontal treatment with placebo.

Methods: Randomized clinical trials (RCTs) published in English, Spanish, or Portuguese that addressed the research question were included. A search was conducted in eight databases (PubMed, EMBASE, CINAHL, LILACS, Scopus, WoS Core Collection, Dentistry & Oral Science Source, and Cochrane Central) on June 20, 2023. Risk of bias was assessed using the Cochrane RoB 2 tool, and evidence certainty was evaluated following GRADE guidelines. A qualitative synthesis of the evidence was performed.

Results: Two RCTs with 228 participants (ages 35-65) were included. Montero et al. reported significant reductions in CRP levels favoring the treatment group at 3 months (2.7 mg/L ± SE: 0.4 vs. 3.9 mg/L ± SE: 0.6; p = 0.001) and 6 months (2.9 mg/L ± SE: 0.4 vs. 4.0 mg/L ± SE: 0.8; p = 0.004). Lopez et al., however, found no significant differences throughout follow-up. Only Montero et al. reported on interleukin 1β and TNF-α, observing significant reductions at 3 months for interleukin 1β (0.9 pg/dl ± SE: 0.1 vs. 2.3 pg/dl ± SE: 0.5; p = 0.046) and TNF-α (6.4 pg/dl ± SE: 0.8 vs. 10.0 pg/dl ± SE: 2.3; p = 0.037).

Discussion: The evidence is limited by the small number of comparative RCTs. One RCT with low risk of bias demonstrated significant reductions in CRP, interleukins, and TNF-α levels at 3 months and CRP at 6 months. The other, with unclear risk of bias, showed no differences in CRP up to 12 months. Findings suggest that subgingival periodontal treatment with antibiotics reduces systemic inflammation for up to 6 months in patients with MS and PD. However, larger RCTs with standardized methods and longer follow-up are needed to confirm these results.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022366056, PROSPERO (CRD42022366056).