Frontiers in oral health最新文献

Background: Peptic ulcer disease (PUD) remains a significant public health issue, with established risk factors including Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs (NSAID) use, and lifestyle factors. Emerging evidence suggests a link between poor oral health and systemic diseases, yet its association with PUD is understudied, particularly in Central and Eastern Europe. This study aimed to investigate the relationship between oral health status and the presence of PUD in a nationally representative Hungarian population.

Methods: Using cross-sectional data from the 2,019 European Health Interview Survey in Hungary (EHIS), we analyzed oral health indicators (decayed teeth, bleeding gums, loose teeth, tooth extractions, dental restorations, and self-perceived oral health) and constructed a composite oral health status via exploratory factor analysis. Multivariable logistic regression assessed the association between oral health and self-reported PUD, adjusting for sociodemographic, lifestyle, mental health, and comorbidity factors.

Results: Active dental and periodontal disease (OR = 1.54, 95% CI: 1.07-2.20, p = 0.017) and a history of dental and periodontal disease (OR = 2.17, 95% CI: 1.01-4.67, p = 0.047) were significantly associated with higher odds of self-reported PUD. Older age, female sex, smoking, depression, and selected comorbidities were also associated with PUD.

Conclusions: Poor oral health, particularly indicators of active periodontal disease, was independently associated with PUD in this nationally representative cross-sectional sample. These findings suggest a potential connection between oral health status and gastrointestinal health, which warrants further investigation in longitudinal studies.

Introduction: Vertical facial growth patterns play a crucial role in craniofacial morphology and have significant implications for diagnosis, treatment planning, and long-term stability in orthodontics and maxillofacial surgery. This study sought to comprehensively study the macro- and microstructure of alveolar bone in different vertical facial patterns using cone beam computed tomography (CBCT).

Methods: A cross-sectional study involved 120 CBCT scans divided equally into normodivergent and hyperdivergent vertical facial patterns of both genders. Alveolar bone analyses were conducted for both the maxilla and mandible from central incisors to 2nd molars. Inter-radicular thickness (IRT) measurements were performed at 4 different vertical levels (4, 6, 8 and 11 mm). For the microstructural analysis, the extracted file of area of interest was obtained, and then ImageJ was used to assess trabecular bone thickness (Tb.Th), separation (Tb.SP), bone volume ratio (BV), and fractal dimension (FD). The independent t-test was used to assess the differences across all groups.

Results: Hyperdivergent males exhibited statistically significant thicker IRT, particularly in the posterior maxilla and mandible, with increased Tb.SP, and lower BV in most sites compared to normodivergent facial pattern. In contrast, hyperdivergent females had significantly thinner IRT, specifically in the anterior maxilla and mandible, associated with lower BV (notably between the lateral incisors and canines). Normodivergent males and females showed minimal differences, while the hyperdivergent group demonstrated more pronounced gender-related variation in both macrostructural and microstructural alveolar bone characteristics at different sites.

Conclusion: Hyperdivergent individuals exhibit distinct site- and gender-specific differences at the macrostructural level, accompanied by microarchitectural adaptations across both maxilla and mandible in comparison to normodivergent individuals.

Aim/purpose: Childhood dental caries and malnutrition share a bi-directional relationship and represent significant public health challenges. This study aimed to evaluate the effectiveness of a Common Risk Factor Strategy-based intervention in improving childhood oral health and nutrition among preschool and primary school tribal children in Kerala, India.

Methods: This pre-post quasi-experimental study was conducted among tribal children and their caregivers. Baseline assessments included knowledge of oral health, childhood dental caries, and nutrition, along with evaluations of oral health and nutritional status using validated questionnaires and indices. The intervention comprised oral hygiene awareness, dietary counseling, caries prevention through fluoride varnish application, arrest of cavitated lesions using silver diamine fluoride (SDF), curative dental treatment, and the regular provision of toothpaste and toothbrushes. The effectiveness of these interventions was assessed after one year.

Results: A total of 95 children (mean age: 4.47 ± 1.42 years) and their caregivers participated in the study. Post-intervention, there was a significant increase in mean KAP childhood caries assessed using 24 point scale [mean difference (MD): 14.52 ± 5.01] and nutrition knowledge assessed using 10 point scale (MD: 3.67 ± 3.42). The mean number of decayed teeth significantly decreased from 7.71 ± 3.59 to 1.43 ± 0.53, accompanied by notable improvements in oral hygiene and nutritional indicators. Among children under 5 years, weight-for-age and weight-for-length Z-scores improved significantly following the intervention (p < 0.05).

Conclusions: This study highlights the effectiveness of an integrated medical-dental approach in addressing childhood oral health and malnutrition. Strengthening early prevention strategies through the Common Risk Factor Approach can serve as a sustainable model to improve overall child health and well-being in vulnerable populations. Prioritizing such holistic interventions in public health policies can be a game-changer in reducing health inequities.

Introduction: Oral leukoplakia (OL) is the most prevalent oral potentially malignant disorder worldwide. Its diagnosis is clinical and based on excluding all other white patches of the oral cavity, which can be challenging and time-consuming. In recent years, artificial intelligence (AI) has emerged as a promising tool to overcome these limitations, yet a comprehensive overview of the existing evidence is still lacking.

Objective: This scoping review surveys the current landscape of artificial intelligence applications for diagnosing oral leukoplakia, both clinically and histopathologically.

Materials and methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and OVID for studies on the use of artificial intelligence for the diagnosis of oral leukoplakia. No date/language restrictions were applied. Two reviewers screened articles and extracted data into predefined tables.

Results: Ten studies were included. Early research used spectroscopy-based models, while recent work employed deep learning for clinical and histopathological image analysis. Most models achieved moderate-to-high diagnostic performance, with sensitivity, specificity and accuracy values above 80%. Overall, models allowed differentiating oral leukoplakia from normal oral mucosa, oral squamous cell carcinoma, and proliferative verrucous leukoplakia, with stronger performance in advanced lesions. Furthermore, artificial intelligence showed promise in grading oral epithelial dysplasia severity in histological samples, occasionally outperforming oral pathologists.

Conclusions: While current evidence remains preliminary, artificial intelligence shows promise as an adjunct tool for oral leukoplakia diagnosis. However, standardized reporting, inclusion of lesions within datasets, and multicenter validation in large and diverse cohorts are still needed to ensure generalizability and further clinical validation.

Socket preservation, also known as alveolar ridge preservation, is a crucial dental procedure aiming to minimize the resorption of the alveolar ridge following tooth extraction. The use of bone substitutes has reduced the morbidity at the donor areas by decreasing the necessity of autogenous bone grafts and improved the patients' satisfaction and comfort. This case report aimed to evaluate the clinical and histological efficacy of deproteinized porcine bone mineral (DPBM) for socket preservation following molar extraction. A 48-year-old male patient underwent extraction of tooth #17 (maxillary left second molar), followed by socket preservation using DPBM. For comparative purposes, the patient's contralateral tooth #27 (maxillary right second molar) was extracted without socket preservation. After a 3-month follow-up, clinical evaluation revealed satisfactory dimensional stability of the alveolar ridge at the #17 site (bone height: 6.9 mm; bone width reduction: 7.4 mm), whereas the #27 site exhibited significant resorption (bone height: 6.4 mm; bone width: 6.9 mm). Histological analysis via Masson trichrome staining demonstrated new bone formation and tight integration between the DPBM particles and host bone at the #17 site. Subsequently, a dental implant was successfully placed at the preserved socket 4 months post-preservation, with stable osseointegration and functional restoration at the 1-year follow-up. This case confirms the effectiveness of DPBM in maintaining alveolar ridge dimensions and promoting new bone formation, providing a reliable foundation for subsequent implant therapy.

Objective: To investigate the association between the morphology of the articular eminence (AE) and mandibular fossa (MF) and the presence of temporomandibular joint (TMJ) disc displacement with reduction (DDwR) using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI).

Methods: This retrospective cross-sectional study analyzed 60 TMJs from 30 patients with intra-articular disorders treated at two Vietnamese centers (2022-2024). MRI classified joints as DDwR or normal disc position (No DD). CBCT provided morphometric measurements: AE inclination (top-roof line [TR] and best-fit line [BF] angles), AE height and width, and MF width. Intra-observer reliability was assessed using the intraclass correlation coefficient (ICC). Group differences were tested using t-tests or Mann-Whitney U tests (p < 0.05).

Results: MRI identified 50 DDwR joints (83.3%) and 10 No DD joints (16.7%). Measurement reliability was excellent (ICC = 0.86). AE inclination was significantly lower in DDwR joints (TR: 37.85 ± 7.13 ° vs. 46.44 ± 6.41 °, p = 0.001; BF: 53.80 ± 6.70 ° vs. 60.64 ± 7.16 °, p = 0.003). No significant differences were found for AE height (6.88 ± 1.51 mm vs. 6.91 ± 1.00 mm), AE width (9.37 ± 1.63 mm vs. 9.48 ± 1.54 mm), or MF width (15.24 ± 1.40 mm vs. 15.85 ± 1.00 mm) (all p > 0.05).

Conclusion: A flatter AE inclination is significantly associated with DDwR, challenging the traditional view that a steeper eminence predisposes to disc displacement. These findings suggest AE flattening may be a secondary change linked to degenerative remodeling. CBCT-based AE inclination assessment could aid in risk evaluation and early diagnosis of TMJ internal derangement.

Despite the uncertainty of the sequence of events leading to appendicitis, the microbiome is presumed to play a central role in the pathogenesis. This preliminary cross-sectional study aimed to evaluate the intestinal microbes in distinct phases of acute appendicitis compared to the oral microbiota, considering the status of dental caries. Twenty children under 12 years were assigned into two groups: non-complicated appendicitis (NCA, n = 11) and complicated appendicitis (CA, n = 9). Biological material from the oral cavity (saliva) and appendix (mucosal scrapings) was submitted to microbial analysis to quantify Bacteroidetes, Firmicutes, and Fusobacterium nucleatum by qPCR. Data were assessed using ANOVA and Pearson's correlation (α = 5%). Considering CA, significant differences were found between the mouth and appendix for Bacteroidetes, Firmicutes, and Fusobacterium nucleatum levels (p < 0.05), with increased amounts in the intestinal niche. Conversely, there was no statistical difference (p > 0.05) regarding NCA. Bacteroidetes levels in the intestinal appendix significantly correlate to all of the studied bacteria in the mouth (p < 0.05, r = 0.66-0.89), while in the NCA pattern, this happened only with Bacteroidetes. Caries conditions were similar between the two groups. In conclusion, a relationship is suggested between the intestinal appendix and oral bacteria, in a comparable caries index, in distinct phases of acute appendicitis. The severity of the children's appendix condition seems to correlate with the magnitude of microbial changes.

Tobacco smoking remains the most consistent and preventable risk factor for oral cancer, driven by exposure to combustion-derived toxins that promote DNA damage, inflammation and microbiota dysregulation. Global data show substantial geographic variability in disease burden, with particularly high incidence and mortality especially in South and Southeast Asia, where culturally reinforced and deeply embedded forms of high-nitrosamine smokeless tobacco and areca nut continue to drive risk. In this evolving landscape, nicotine pouches have rapidly expanded as tobacco-free oral products manufactured to deliver nicotine without combustion. Toxicological analyses reveal significantly lower levels of harmful constituents relative to cigarettes and traditional smokeless tobacco, and short-term clinical studies report reductions in oral mucosal irritation and gingival inflammation among exclusive users. However, no long-term epidemiological evidence is currently available to assess their potential impact upon oral carcinogenesis, and existing human studies remain few, small and heterogeneous. This mini review highlights critical priorities for research, including the need for long-term prospective studies, standardized product testing, independent toxicological assessments and surveillance of patterns of use, dual use and youth uptake. The integration of harm reduction approaches with established prevention strategies may offer opportunities to mitigate oral cancer risk in adults who smoke and/or consume unregulated smokeless tobacco products with high risk profiles that are very common in Asia, the Middle East and Africa. However, this approach requires cautious interpretation of the current evidence and ongoing monitoring of emerging products.

Oral stem cells possess the capability to repair themselves and multipotent differentiation capacities, indicating that they have significant prospects in regenerative medicine. Nonetheless, due to the circulatory system's rapid clearance capability, they can only work consistently in certain areas for tissue healing. Thanks to their loose, porous architecture and high biocompatibility, hydrogels can act as transporters for oral stem cells, thereby delaying their release and enhancing their retention in specific regions. Oral stem cell-loaded hydrogels can be a valuable solution when specific areas require oral stem cells for optimal functioning, considering various types of hydrogels and the variables that affect their ability to transport and release oral stem cells. This review discusses the mechanistic processes underlying periodontitis, mentions current therapeutic techniques and their limitations, and explores oral stem cells and their regenerative capacities and design criteria of oral stem cells-laden hydrogels. Along with an assessment of the shortcomings in present investigations on the fundamental processes and innovative uses of oral stem cells in periodontal reconstruction, with the goal of offering fresh perspectives for upcoming research, the ongoing difficulties and disputes associated with oral stem cell-laden hydrogel personalized treatment options are also covered.

Introduction: Sagittal split ramus osteotomy (SSRO) is commonly used to in orthognathic surgery especially in the treatment of mandible laterognathism. But frequently, distal and proximal mandible segments can't be aligned passively to another, which will impair bone regeneration after surgery. Herein, we developed a novel ostectomy method, named as "triangular ostectomy", to remove bony interference fast and accurately, with the help of preoperative virtual planning and simulation.

Methods: A total of 12 patients were involved. The progress of orthognathic was simulated before surgery. "Triangle ostectomy", "posterior bending osteotomy" (PBO) technique and grinding method were applied. The patients' CT images were achieved 3 days and 4 months after surgery and the evaluation of alignment of proximal and distal segments was then carried out.

Results and discussion: After comparison, the "triangular ostectomy" was proved reliable to eliminate the bony interference quickly and accurately. The increased bone contact can accelerate postoperative bone regeneration. Furthermore, several tips during operation were also stated in this text to make this ostectomy easier and safer to operate.

Conclusion: This "triangular ostectomy" technique to remove mandible bony interference should be taken into consideration to achieve better bone regeneration after SSRO, especially treating patient with severe facial asymmetry.