Frontiers in oral health最新文献

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.

Introduction: Orofacial clefts (OFCs) require complex care, which is further complicated by associated congenital anomalies and medical conditions. However, the specific patterns of these associated conditions across different OFC subtypes are not well-characterized in the Thai population. This study aimed to determine the prevalence of OFC subtypes and to analyze the distribution of associated congenital malformations, syndromes, and medical conditions specific to each cleft type.

Materials and methods: We conducted a retrospective analysis of 1,187 patients (0-3 years) treated at Tawanchai Cleft Center, Thailand, between 2011 and 2020. Cases were identified using ICD-10 codes and verified through medical records. Data were analyzed to determine OFC subtype prevalence and characterize the distribution of associated congenital malformations, syndromes, and medical conditions.

Results: Cleft lip and palate (CLP) was the most common subtype (49.2%), followed by isolated cleft palate (CP, 28.1%) and isolated cleft lip (CL, 22.7%). A significant portion of patients (45.4%) presented with at least one associated condition. Respiratory system malformations were most prevalent (35.3%), followed by circulatory (12.2%) and musculoskeletal system anomalies (11.1%). The prevalence of associated malformations was highest in the CP group, which was strongly associated with Pierre Robin Sequence (8.2%). Among the 7% of syndromic cases, 22q11.2 deletion syndrome was the most frequent diagnosis (9.6% of syndromic cases). Medically, otitis media (51.7%) and anemia (17.3%) were significant comorbidities across all groups.

Conclusion: Our findings demonstrate that the profile of associated anomalies differs significantly across OFC subtypes. This underscores the necessity for subtype-specific screening protocols and highlights the high burden of comorbidity in this population, directing a multidisciplinary approach for effective management.

Periodontal disease (PD) is an inflammatory condition affecting the supporting structures of teeth, initiated by bacterial biofilm formation. Porphyromonas gulae (P. gulae) and P. gingivalis are key pathogens in canine and human PD, respectively, producing biofilms, volatile sulfur compounds, and proinflammatory cytokines that contribute to halitosis and tissue destruction. Cyclodextran (CI), a cyclic oligosaccharide, has previously been shown to inhibit glucan synthesis in Streptococcus mutans, but its effects on periodontal bacteria remain unexplored. This study investigated the influence of CI on P. gulae and P. gingivalis in vitro. Bacterial cultures were co-incubated with varying concentrations of a CI-dextran mix (0.313%-5%) for up to 24 h. Biofilm formation and insoluble glucan production were assessed via fluorescence microscopy and biochemical assays. Hydrogen sulfide and methyl mercaptan levels were measured by gas chromatography, and cytokine production (IL-1β, IL-6) was quantified in murine and canine macrophage cell lines using ELISA. CI had limited bactericidal activity but significantly inhibited biofilm formation and glucan production in both bacterial species. Consequently, hydrogen sulfide and methyl mercaptan generation were markedly reduced, although CI did not directly neutralize these compounds. Furthermore, CI treatment significantly suppressed P. gulae and P. gingivalis-induced IL-1β and IL-6 secretion in macrophages in a dose-dependent manner without cytotoxicity. These findings demonstrate that cyclodextran prevents PD-related halitosis and inflammation primarily by inhibiting biofilm formation rather than bacterial killing or direct deodorization. CI represents a promising candidate for preventive oral care in humans and companion animals, with potential to reduce the onset and progression of PD.

Background/objectives: Periodontal diseases, which are highly inflammatory in nature, are very common throughout the world. In recent years, natural products have gained special attention as a complement to conventional therapy, and olive oil/ozonated olive oil (OLO/OzOLO), due to its anti-inflammatory and antimicrobial properties, has been proposed for these treatments. The aim of our study was to demonstrate its short-term clinical efficacy in periodontal treatment.

Methods: This systematic review and meta-analysis was conducted in accordance with Cochrane guidelines, and searches were performed in PubMed, Embase, Cochrane Central, Scopus, and Web of Science (WOS) to identify eligible studies. Review Manager 5.4.1 and SPSS Statistics 30.0® were used to calculate standardized mean differences (SMD) and 95% confidence intervals (CI). The main outcomes assessed for periodontitis were probing depth (PPD), bleeding on probing (BoP), and clinical attachment level (CAL), and for gingivitis, plaque index (PI), gingival index (GI) and bleeding index (BI).

Results: Twelve randomized clinical trials (RCTs) involving 456 subjects were included. In periodontitis, compared with controls, OLO/OzOLO improved BoP reduction in the medium term (8-12 weeks) [-0.66; 95% CI (-1.07 to -0.26); p = 0.001], and no benefits were observed in terms of PPD reduction and CAL gain. In gingivitis, the effect of OLO/OzOLO, compared to controls, produced a significant reduction in all three indices (PI, GI, BI) after 2-8 weeks [-1.52, 95% CI (-2.60 to -0.44); p = 0.006].

Conclusions: Despite limitations, OLO/OzOLO treatments result in short-term CAL gain and improved gingival parameters.

Systematic review registration: doi: 10.37766/inplasy2025.10.0065, Identifier INPLASY 2025100065.

The adenomatoid odontogenic tumor is a rare benign epithelial odontogenic neoplasm that most frequently affects young women and typically occurs in the anterior maxilla. Its presentation in the posterior maxilla, especially in male patients, is uncommon and can create diagnostic challenges. This case describes a large posterior maxillary adenomatoid odontogenic tumor in a 16-year-old male who presented with a one-year history of progressive, painless swelling of the right cheek. Clinical examination revealed facial asymmetry, obliteration of the right nasolabial fold, and intraoral swelling extending from tooth 1.5 to the posterior maxilla. Panoramic radiography and computed tomography showed a multilocular radiolucent lesion with a "soap bubble" appearance, internal calcifications, and displacement of tooth 1.8 toward the floor of the right orbit, which remained intact. The lesion caused root resorption of adjacent teeth and extensive destruction of the maxillary bone. Surgical treatment consisted of enucleation and extraction of teeth 1.5-1.8, followed by histopathological confirmation of adenomatoid odontogenic tumor. Due to the degree of bone involvement, a subsequent wide resection of critical maxillofacial structures was necessary. Postoperative follow-up at five months showed no recurrence but significant residual anatomical changes. This case emphasizes the importance of including adenomatoid odontogenic tumor in the differential diagnosis of posterior maxillary lesions in male patients, and the need for careful surgical planning, histopathological confirmation, and long-term follow-up.

Background: Nasolabial cyst (NLC) is an extraosseous anterior maxillary cystic lesion located lateral to the midline. It is of epithelial, non-odontogenic origin and is considered a rare pathology. It has a controversial etiopathogenesis, which is still under debate. Commonly presenting as a slowly growing unilateral asymptomatic swelling of the alar region, it may obliterate both the nasolabial fold and maxillary labial sulcus, causing alar nasal elevation. Bilateral cases are rare. Facial asymmetry is the main complaint, prompting patients to seek treatment. Various imaging techniques, in addition to histopathological examination, can confirm the presence of the cyst. Surgical excision is the treatment of choice.

Case presentation: This case series outlines bilateral and unilateral NLC cases in which the patients sought medical care for painless facial swelling. Comprehensive diagnostic methods confirmed the diagnosis of an NLC. Surgical enucleation was performed, resulting in complete resolution of the lesions, with no signs of recurrence.

Conclusions: The represented cases illustrate a holistic description of the NLC features, diagnosis, and treatment, emphasizing the importance of understanding this cyst. Briefly reviewing the literature, they highlight the significance of reinvestigating the true prevalence of the NLC.

Juvenile trabecular ossifying fibroma (JTOF) is a rare benign fibro-osseous tumor predominantly affecting the maxillofacial region in children and adolescents. This study represented a case of maxillary reconstruction using deep circumflex iliac artery (DCIA) flap for JTOF and systematically reviewed the clinical characteristics and management of JTOF. A systematic review of published studies was performed. Information including clinical features, management, and follow-up was collected. We reported a 15-year-old male with maxillary JTOF. The patient underwent maxillectomy followed by DCIA flap reconstruction guided by 3D-printed surgical guides. No recurrence during 24-month follow-up period. The systematic review included 43 articles and 86 cases. Tumors involved the maxilla and mandible equally, with an average diameter of 4.8 cm. The overall recurrence rate was 23.9%, with a mean follow-up period of 39.2 months. We systematically reviewed the clinical features of JTOF and reported a case managed with DCIA flap maxillary reconstruction. Larger cohorts and extended follow-up are needed to determine the optimal management strategy for this rare disease.

Objective: To compare the accuracy and consistency of five large language models (LLMs) in generating responses about dental trauma.

Materials and methods: Sixty dichotomous (true/false) questions were submitted daily to each LLM (ChatGPT, Google Gemini, Microsoft Copilot, DeepSeek, and Meta AI) for 30 days, totaling 18,000 responses. All interactions were performed under two prompting conditions (zero-shot and zero-shot with context). LLM responses were compared against the International Association of Dental Traumatology (IADT) guidelines. Statistical analysis was conducted using a generalized linear mixed model (GLMM) with a binomial distribution (α = 0.05), alongside calculation of sensitivity, specificity, accuracy, and area under the ROC curve (AUC) based on the 60-item set. Temporal stability was assessed using the intraclass correlation coefficient ICC.

Results: All LLMs achieved accuracy above 85%, with Microsoft Copilot (91.1%) and DeepSeek (90%) performing best; no significant difference was observed between them (p > 0.05), but both outperformed the other models (p < 0.05). DeepSeek and Microsoft Copilot also showed the highest consistency over 30 days (ICC > 0.90).

Conclusion: All evaluated LLMs, particularly Copilot and DeepSeek, demonstrated high accuracy in providing information on dental trauma, with stable performance over time. While the use of a context prompt did not significantly affect accuracy or stability.

Introduction: Virtual reality haptic simulator (VRHS)-training devices that integrate visual immersion with tactile feedback- are increasingly used in dental education, yet their application in periodontics remains limited. Sonic scaling requires high tactile precision and control, making it a suitable domain for evaluating VRHS efficacy. This study assessed faculty perceptions and performance using VRHS for preclinical periodontal training compared with conventional simulation.

Methods: A quasi-experimental, repeated-measures study was conducted with 30 calibrated faculty members (15 periodontists; 15 general dentists) from the European University of Valencia. Each participant performed standardized calculus removal tasks using both the Simodont® dental trainer and conventional mannequin-based models. Objective outcomes-treatment time, residual calculus, and tip angulation-were recorded, and perceptions were collected through a 14-item Likert questionnaire and open-ended questions adapted from Philip et al. (2023) and Bakr et al. (2016).

Results: Treatment time was significantly shorter in conventional training (26.7% completed <2 min) compared with VRHS (13.3%; p = 0.033). VRHS achieved higher residual calculus scores (3.00 ± 0.00 vs. 2.75 ± 0.21; p < 0.001) and improved tip angulation (2.68 ± 0.36 vs. 2.51 ± 0.44; p = 0.015). Within VRHS, periodontists outperformed general dentists in angulation (2.85 ± 0.18 vs. 2.52 ± 0.42; p = 0.010), though no other group differences were significant. Satisfaction scores were high (mean = 4.16 ± 0.45), and internal consistency was acceptable (Cronbach's α = 0.73). Faculty valued repetition, feedback, and confidence building but noted limited realism-particularly the absence of water, soft tissues, and subgingival calculus.

Conclusion: VRHS improved precision and consistency in preclinical scaling while requiring longer completion times. Faculty endorsed its educational value as a complementary tool to conventional training. Continued refinement in tactile realism and broader multicenter validation are needed to consolidate its integration into periodontal education.