Frontiers in oral health最新文献

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.

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.