Frontiers in oral health最新文献

Introduction: Artificial intelligence (AI), particularly large language models (LLMs), is transforming healthcare education and clinical decision-making. While models like ChatGPT and Claude have demonstrated utility in medical contexts, their performance in dental diagnostics remains underexplored; additionally, the potential of emerging platforms, like Manus, is yet to be evaluated.

Objective: To compare the diagnostic accuracy and consistency of the ChatGPT, Claude, and Manus-using authentic, case-based dental scenarios.

Methods: A set of 117 multiple-choice questions based on validated clinical dental vignettes spanning various specialities was administered to each model under standardised conditions at two separate time points. Responses were scored against expert-validated answer keys. Inter-rater reliability was assessed using Cohen's kappa, and statistical comparisons were made using the chi-square, McNemar, and t-tests.

Results: Claude and Manus consistently outperformed ChatGPT across both testing phases. In the second round, Claude and Manus achieved a diagnostic accuracy of 92.3%, compared to ChatGPT's 76.9%. Claude and Manus also demonstrated higher intra-model consistency (Cohen's kappa = 0.714 and 0.782, respectively) than ChatGPT (kappa = 0.560). Although the numerical trends favoured Claude and Manus, pairwise differences in accuracy did not reach statistical significance.

Conclusion: Claude and Manus demonstrated numerically higher diagnostic performance and greater response stability compared with ChatGPT; however, these differences did not reach statistical significance and should therefore be interpreted cautiously. This variability across models highlights the need for larger-scale evaluations. These findings underscore the importance of considering both accuracy and consistency when selecting AI tools for integration into dental practice and curricula.

Introduction: A previous culturally adapted oral health intervention was deemed ineffective in improving immigrant parents' oral health-related knowledge and attitudes. This qualitative study aimed to explore the perceived barriers to benefiting from the intervention and the perspectives of immigrant parents regarding their children's oral health behaviors, and use of dental health services.

Materials and methods: Forty-five immigrant parents who previously received the intervention were invited; 12 consented to participate and were interviewed using semi-structured individual interviews. The interviews were recorded and transcribed verbatim. Data was analyzed using thematic analysis.

Results: The participants were all women aged 28-44, from Africa, Asia, Eastern Europe and South America. Most were college or university-educated and were employed. Four main themes were identified: Intervention Implementation: Parents appreciated the use of pamphlets in their native languages, but highlighted the need to receive dental information from the public health nurses at the local health centers. Parental perspectives on children's oral hygiene habits: Parents demonstrated high oral health knowledge and highlighted the differences in oral hygiene habits between their home countries and Norway. Parental perspectives on children's feeding practices: Participants noted that sugar intake is deeply rooted in cultural and social practices, making it difficult for them to control their children's sugar intake. Dental Health Systems for Children: Parents expressed the need for more frequent follow-ups starting earlier than 3 years of age. They also emphasized the importance of cultural and linguistic competence and sensitivity during dental appointments.

Conclusions: This study highlights the influence of immigrant parents' cultural backgrounds, daily challenges, and interactions with the Norwegian dental health system on their children's oral health practices and perceptions of the oral health intervention. The findings suggest that oral health interventions should be comprehensive, easy to remember, and delivered by credible professionals. Furthermore, to promote positive behavioral change, it is advisable to provide continuous support, repeat oral health care guidance, provide clear communication, and utilize native languages.

Clinical trial registration: ClinicalTrials.gov Identifier: [NCT05758454].

Introduction: The global population is aging. Although aging populations experience a high burden of dental and systemic diseases, few studies have described the oral microbiota in aging population-based cohorts. This observational, registry-based study aimed to characterize the diversity and composition of the oral microbiota in 1,093 aging Swedes-aged 54-84 years at inclusion-and evaluate associations with host traits, as well as prospective measures of caries and periodontal status.

Methods: Saliva microbiota was characterized using complete 16S rRNA gene sequencing, and dental data were obtained from primary care dental records. Partial least squares regression was used to identify species associated with variation in age, number of teeth, total number of sequence reads, caries, and periodontal status. Follow-up analyses were conducted using two-part regression models with covariate adjustments.

Results: The oral microbiota remained highly diverse in the aging population without major shifts within this age frame. Carriage of hitherto unfamiliar yet well-documented disease-associated species was found to be associated with metrics of active disease but not lifelong measures, such as the common decayed, filled, and missing surfaces index.

Conclusion: These results underscore methodological considerations, including the importance of read number adjustments beyond using relative abundances, and the importance of carefully selecting metrics for oral disease in aging individuals.

[This corrects the article DOI: 10.3389/froh.2025.1714875.].

Background: Nano α-tricalcium phosphate (nano α-TCP) and silver nanoparticles (AgNPs) both possess bioactive qualities needed for pulp-capping materials. AgNPs effectively combat microbial infections without sacrificing cell viability, while nano α-TCP releases calcium and phosphate ions necessary for dentin regeneration. To assess the connection between composite structure and function, a thorough characterization utilizing Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), ion-release analysis, and pH measurements is necessary.

Purpose: This study aimed to develop and evaluate a novel biocomposite composed of nano α-TCP and AgNPs for application in direct pulp capping. The investigation focused on the material's chemistry and physical properties, as well as its antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus.

Methods: We prepared combinations of nano α-TCP and AgNPs with varying concentrations of AgNPs. Subsequently, we analyzed the composites using XRD, FTIR, and SEM. The investigation also evaluated pH stability and the release of ions (Ca²⁺ and PO₄³⁺) at 1, 3, 72, and 504 h. Antibacterial assays were performed against Streptococcus mutans and Lactobacillus acidophilus.

Results: FTIR and XRD analyses confirmed that the functional groups and crystallinity in the nano α-TCP matrix remained unchanged following incorporation of AgNPs. SEM imaging demonstrated that the particles were uniformly distributed with minimal agglomeration. The 1% AgNPs concentration showed the best results, with a steady release of ions, a stable alkaline pH that helped with mineralization, good mechanical strength (according to ISO 9917-1), and strong antibacterial activity. The 1% AgNPs concentration also had the most potent antibacterial effect.

Conclusion: The nano α-TCP/AgNPs composites, particularly the 1% AgNPs formulation, exhibited sustained calcium and phosphate ion release, stable alkaline pH, adequate compressive strength, and strong in vitro antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus. These physicochemical and antibacterial properties highlight that this biocomposite is a promising candidate for future direct pulp-capping applications. However, its cellular responses and dentin regenerative potential must be confirmed through dedicated in vitro and in vivo studies.

Background: Severe early childhood caries (s-ECC) remains a highly prevalent condition among children worldwide, posing a considerable burden in both developed and developing regions. This systematic review seeks to comprehensively identify, synthesize, and critically evaluate available evidence on salivary proteomic and peptidomic biomarkers that may aid in the diagnosis or risk assessment of ECC.

Aim and objectives: This study aims to evaluate any difference in the level of proteomic salivary biomarkers in children with and without ECC.

Methods: A comprehensive search was conducted across four major electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, Scopus, and Google Scholar. From an initial yield of 1,253 records, 11 studies fulfilled the eligibility criteria and were included for data extraction. The risk of bias for the included studies was assessed using the QUADAS-2 tool for the Quality Assessment of Diagnostic Accuracy Studies.

Results: Of the 11 studies included, quality appraisal using the QUADAS-2 indicated that 3 out of 11 studies had low risk in all domains, while the remaining studies had unclear or high-risk domains.

Conclusion: The pooled evidence suggests that salivary biomarkers have significant potential for detecting ECC. Utilizing salivary diagnostics may enhance the prevention of new carious lesions. Future clinical trials with robust methodologies are recommended to generate further conclusive evidence.

Clinical significance: Salivary proteomic biomarkers, including MS protein, mucins, amylase, glycoproteins, proline, and glycine, may provide additional value in the early diagnosis of ECC in pediatric populations.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023468566, PROSPERO CRD42023468566.

Objective: To explore self-perceived oral health and general self-efficacy and relate this to dental plaque, gingival inflammation, and oral mucositis in head and neck cancer patients in Sweden, before, during, and three months after treatment.

Methods: Registration of clinical variables (dental plaque, gingival inflammation, and oral mucositis) was performed in 75 patients. The patients completed the self-perceived oral health (SPOH), and general self-efficacy (GSE) questionnaires at baseline, week 6 during treatment, and 3 months after treatment. Changes in clinical variables and answers to questionnaires between time-points were analyzed as well as differences between clinical variables and questionnaire data.

Results: The majority had low levels of plaque and gingival inflammation at all time-points, and oral mucositis occurred in 82%. Forty-three percent perceived their oral health as good at baseline, and the proportion decreased to 18% at week 6. At baseline, toothbrushing twice a day was reported by 95%, and daily interdental cleaning by 51%. The majority had high self-efficacy at all time-points. No statistically significant differences between self-perceived oral health and clinical variables were found.

Conclusion: Despite major challenges during cancer treatment, most patients had good oral hygiene, perceived their oral health as good, and had high self-efficacy.

Clinical relevance: This study contributes to increased knowledge about HNC patients' self-perceived oral health and ability to maintain good oral hygiene during cancer treatment. Such knowledge can be used in the development of customized oral care protocols, which in turn may have a positive impact on both oral health and quality of life.

Introduction: Oral health status (OH) seems to be relevant for the overall health status and common physical performance (PP). Aim: The aim was to explore the associations between OH, days of absence (due to illness and injury), parameters of on-ice and off-ice performance diagnostic, and the match performance (MP) over three seasons.

Methods: Twenty male players (age: 27.7 ± 3.6 years; range: 20-34 years; 2 goalies, 7 defenders, and 11 forwards) from a third league professional ice hockey team were investigated regarding several dental parameters (DMFT, PSI, API, and PBI) by a calibrated examiner. The PP diagnostic contains the ice hockey-specific complex test (IHCT), strength-endurance tests (bench press, plank), and endurance tests on bike (PWC 170, 30 min all-out test) as well as the measurement of postural stability and regulation using posturography. Furthermore, the number of sick days and the MP were collected and assessed over three seasons.

Results: We could not find any relevant (r > 0.5) correlations between days of absence and the above-mentioned independent variables. A relevant association was found between PSI and penalty times [r = 0.46; 95% CI = (-0.04; 0.78)]. The match performance score was associated with the IHCT total time [r = -0.55; 95% CI = (-0.82; -0.07)], especially with transition without puck [r = -0.62; 95% CI = (-0.85; -0.18)]. Only one player (5%) reported that oral health had ever had a negative impact on his physical performance. This player had 124 days of absence compared with an average of 58 days for all other players.

Discussion: In the framework of this study, dental health and injury prevention did not correlate with each other. Overall, the dental health of the German ice hockey sample examined could be rated above comparable averages. The test and match data once again prove the IHCT to be a suitable assessment tool.

Intraoral scanners generate accurate optical impressions for dentate areas, but wide edentulous spans remain challenging due to limited stable landmarks and mobile mucosa. This article describes a single-visit, chairside workflow that combines an intraoral scan with a digitized irreversible hydrocolloid impression to obtain an optimized three-dimensional model of a partially edentulous mandible suitable for computer aided design-based removable partial denture fabrication other prosthetically driven procedures. The workflow includes intraoral scanning, conventional alginate impression taking followed by chairside digitization with the same scanner, mesh trimming and inversion to generate a positive mucosal surface, and integration of both datasets through sectioned areas and targeted best-fit alignment. The resulting composite model preserves the dentate part from the impression scan. The composite model accuracy should be validated intraorally a three-dimensional printed try-in. This fully chairside protocol provides a practical approach to producing a working mandibular model for digital prosthodontic applications for patients who require a minimal clinical appointment.

Introduction: The increasing prevalence of dental implants has brought greater attention to the prevention and management of peri-implant diseases, which can compromise long-term implant success. This systematic review evaluated the current evidence on oral self-care practices for maintaining peri-implant health in healthy, non-smoking adults.

Methods: This systematic review was reported in accordance with the PRISMA 2020 statement and registered in the PROSPERO database (CRD420251028140). PICO methods and guidelines for the Center for Evidence-Based Medicine were used to develop the focus question, "What are the best practices for oral self-care for the prevention and management of peri-implant conditions and diseases?" Risk of bias was determined by applying the ROBIS Tool to assess risk of bias in systematic reviews and the revised Cochrane risk of bias tool for randomized trials (RoB2).

Results: Across 12 studies, interventions were categorized into five domains: toothbrushes, interdental aids, toothpaste, mouth rinses/topicals, and multi-modal self-care strategies. Powered toothbrushes, particularly oscillating-rotating models, demonstrated superior plaque and inflammation reduction compared to manual options. Triclosan-containing toothpastes consistently outperformed fluoride-only formulations in decreasing plaque, bleeding on probing, and pathogenic bacteria. Interdental aids such as interproximal brushes and oral irrigators were more effective than floss in reducing inflammatory markers. Stannous fluoride-based rinses showed potential anti-inflammatory benefits, while prolonged chlorhexidine use may elevate inflammatory cytokines.

Discussion: A multimodal approach combining mechanical and chemical adjuncts was most effective for peri-implant disease prevention. These findings emphasize the importance of individualized, evidence-based home care protocols in preserving implant longevity and reducing peri-implant disease burden.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251028140, PROSPERO CRD420251028140.