Frontiers in oral health最新文献

Background: Probiotics have emerged as a promising adjunctive strategy for oral health, particularly in the prevention of dental caries, a multifactorial disease driven by ecological imbalances in the oral microbiome.

Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between January 2014 and January 2025, focusing on the use of probiotics for caries prevention in children and young adults. Clinical trials and observational studies were included, and a qualitative synthesis was performed based on the extracted outcomes.

Results: Twenty-one studies met the inclusion criteria. Most clinical trials reported a significant reduction in Streptococcus mutans levels following administration of probiotic strains, particularly Lactobacillus paracasei, Lactobacillus rhamnosus, and Bifidobacterium lactis. Several studies also demonstrated a decreased incidence of new carious lesions and an improvement in salivary immune markers. However, a minority of studies found no significant effect, highlighting potential variability due to strain type, dosage, delivery method, and population characteristics.

Conclusion: The current evidence supports the potential of specific probiotic strains to reduce cariogenic bacterial loads and contribute to caries prevention. Further standardized, long-term trials are needed to clarify the most effective formulations and regimens for clinical application.

Systematic review registration: PROSPERO CRD42025646287.

Background: Edentulism is a critical global health issue. It affects physical health and quality of life, and the associated healthcare costs pose a burden on individuals and society. Therefore, we analyzed the global burden of edentulism from 1990 to 2021 and projected trends from 2021 to 2041.

Methods: This study used publicly available data from the 2021 Global Burden of Disease, Injuries, and Risk Factors Study (GBD). The paper reports prevalence, incidence, and years lived with disability (YLDs) of edentulism per 100,000 population [with 95% uncertainty intervals (UI)] in 1990 vs. 2021, across all age groups (0-95 + years). It details changing trends from 1990 to 2021 by gender, age, and Socio-demographic Index (SDI). Trends were assessed using joinpoint regression. Nordpred and BAPC models projected incidence from 2021 to 2041.

Results: Globally, the age-standardized incidence rate (ASIR) decreased from 328.85 (95% UI: 268.72-396.35) per 100,000 in 1990 to 305.04 (95% UI: 261.19-356.58) in 2021, with an estimated annual percentage change (EAPC) of -0.23% (95% CI: -0.33% to -0.14%), indicating a long-term decline. However, joinpoint regression revealed a recent upward trend from 2015 to 2021. The age group with the highest incidence increased by 5 years; the 75-79 group had the highest rate in 2021. The ASIR for males (284.91, 95% UI: 284.74-285.07) was lower than for females (325.06, 95% UI: 324.90-325.23) in 2021. Middle-range SDI regions tend to have high ASIR. When SDI is between 0.5 and 0.7, ASIR peaks. Incidence increased from 2015 to 2021 in both sexes. Nordpred and BAPC models predict rising incidence and case numbers from 2021 to 2041.

Conclusions: Despite declining age-standardized rates, the absolute global burden of edentulism continues to rise due to population growth and aging, disproportionately affecting low-middle SDI regions, women, and older adults (≥75 years). Without intervention, incidence and burden will escalate.

Introduction: Modifying bacterial virulence could be an interesting alternative to antibiotics. The study aimed to examine the effects of an inhibitor targeting bacterial glutaminyl cyclase [which is selectively present in Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), and Prevotella intermedia (Pi)] on various multispecies biofilms.

Methods: Two multi-species biofilms-one containing four species (including Tf) and another with 12 species (including Tf, Pg, and Pi)-were cultured in the presence of 31.25-500 µM of a [4,5-c]pyridine-based inhibitor. After 24 h, bacterial counts, biofilm biomass, metabolic activity, and, when Pg was included, Arg-gingipain activity were measured. Additionally, the biofilms were exposed to monocytic cells; here, the release of interleukin (IL)-1β and IL-10 was analyzed. The data were analyzed using a one-way analysis of variance (ANOVA) with a post-hoc comparison performed using the Bonferroni correction.

Results and discussion: In all biofilms, total bacterial counts and those of Pg and Tf remained unaffected by the inhibitor. In the 12-species biofilm, both biomass and total metabolic activity decreased at high inhibitor concentrations (500 µM to 75.2 ± 6.5% and 87.2 ± 5.8%, respectively; each p < 0.001). The arginine-specific amidolytic activities of Rgp declined dose-dependently, down to 60.4 ± 10.2% (p < 0.001) at 500 µM of the inhibitor. Consequently, Pg colonies lost pigmentation as inhibitor concentrations increased. The inhibitor also reduced IL-1β release from monocytic cells stimulated by the 12-species biofilm. The studied [4,5-c]pyridine-based inhibitor is able to modify virulence of a multispecies biofilm. It might have the potential to be a promising approach in periodontal prevention and therapy.

Background: Dental aesthetic issues can negatively affect mental functioning and create barriers in social functioning in young individuals.

Objective: This study aimed to analyze the role of self-esteem in the relationship between dental self-confidence and well-being in young Romanian adults and to test whether self-esteem functions as a mediator in this association.

Methods: A cross-sectional study was employed, using a convenience sample of 775 respondents (Mean age = 21.74 years, SD = 3.40; 410 females) who were recruited to complete an online survey. This survey assessed dental self-confidence (scale from the Psychosocial Impact of Dental Aesthetics Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and subjective well-being via its cognitive and affective dimensions (Satisfaction with Life Scale and the Scale of Positive and Negative Experience). Partial least squares path modeling (PLS-SEM), a variance-based structural equation modeling method, was used to analyze the data.

Results: The findings showed that the relationship between the influence of dental aesthetics and subjective well-being was partially mediated by self-esteem. Dental self-confidence positively impacted self-esteem (β=0.345), which in turn had a significant impact on well-being (β = 0.724). Together, self-esteem and dental self-confidence explained 59.9% of the variation in subjective well-being.

Conclusions: The study concludes that young people who perceive themselves more positively regarding dental aesthetics tend to experience higher levels of well-being. The findings suggest that oral health campaigns to raise awareness of the psychosocial relevance of dental health could be beneficial.

Implant-supported restorations are critical for rehabilitating jawbone defects and restoring patients' occlusal function. Achieving proper fit and occlusal relationship with opposing teeth, as well as establishing a healthy peri-implant soft tissue seal, is essential to prevent infection and promote maintainability. This article presents a case involving the precise management of a thick soft tissue flap and the placement of an implant-supported restoration following mandibular reconstruction with a fibula flap. It offers a comprehensive overview of the diagnostic approach, surgical procedures, and prognostic outcomes, with the aim of providing valuable insights for clinical practice. The review spans the entire treatment process-from the planning of Stage I implant surgery, including optimal implant positioning and type selection, to the intraoperative techniques for layered debulking and flap preconditioning. It further discusses the evaluation of soft tissue thickness and the application of a customized healing abutment during Stage II surgery, as well as strategies for long-term oral hygiene maintenance.

Introduction: Gingival melanosis is characterized by a change in the physiological color of the gingiva, that usually ranges from brown to black. It can be a source of discomfort for affected people, an attractive gingiva being associated with a pink color. The main objective of this study was to compare knowledge about gingival melanosis between fourth- and fifth-year dental students and dental professors at the European University of Valencia.

Methods: The conduct of this cross-sectional observational study was approved by the Research Ethics Committee of the European University of Valencia. The survey used was drafted by the authors of the study. Participants completed the questionnaire between February and March 2024. Statistical analysis was performed using IBM SPSS 23.0.

Results: Significant differences were found between the knowledge of both groups regarding monthly and annual detection frequency (p < 0.001), diagnostic with the DOPI index (p = 0.048), treatment options (p < 0.001), recurrence (p = 0.004) and impact on the patient's life (p = 0.012). Professional knowledge was higher, except regarding the impact. Conversely, there were no significant differences in the detection of gingival melanosis, etiologies, the ways to transmit information to the patient and diagnosis using the melanin and gingival pigmentation indices.

Conclusions: It can be concluded that teachers' knowledge is more important in terms of detection frequency, use of the DOPI index, treatment options and recurrence, except for the impact on the patient's life. However, in terms of detecting gingival melanosis in the oral cavity, possible etiologies and diagnostic methods such as the melanin and gingival pigmentation index, knowledge is the same between both groups.

Background and aim: Orthognathic surgeries often involve significant blood loss due to the high vascularity of the maxillofacial region. Conventional tools such as saws and burrs, while effective, can cause tissue damage and heat that may delay healing. Piezosurgery, a newer technique using ultrasonic vibrations, allows for precise bone cutting while protecting the soft tissues and nerves. This review aimed to compare intraoperative blood loss between piezosurgery and conventional osteotomy methods.

Materials and methods: A systematic search of PubMed, Scopus, and Web of Science was conducted up to 5 October 2025, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Studies involving patients who underwent orthognathic surgery using either piezosurgery or conventional tools, with reported blood loss data, were included. Six studies with 144 participants and 252 surgeries met the criteria. The data were analyzed using STATA 18 to calculate the weighted mean difference (WMD). Heterogeneity was assessed, and publication bias was evaluated with funnel plots.

Results: Piezosurgery significantly reduced blood loss compared to conventional methods, with a WMD of -81.73 mL (95% CI: -97.30 to -66.16, P < 0.001). The sensitivity analysis confirmed the reliability of these results, and formal statistical tests indicated no significant publication bias.

Conclusion: Piezosurgery significantly reduces intraoperative blood loss during orthognathic surgeries, likely due to its precision and minimal tissue damage. Although it is more costly and takes longer, it offers a safer alternative, particularly in complex cases. Further research with larger samples is needed to confirm these findings.

Systematic review registration: PROSPERO CRD420251232995.

Introduction: Tobacco smoking and the use of electronic cigarettes (e-cigarettes) are well known to harm oral health, but the dangers of e-cigarettes are still not fully acknowledged, especially in Saudi Arabia where their use is steadily increasing. This study explored awareness of the oral and dental health consequences of tobacco and e-cigarette use among residents of the Al-Madinah region and compared awareness levels across smokers, e-cigarette users, dual users, and non-smokers.

Methods: A cross-sectional online survey was carried out on 278 participants who are 16 years and over in 2025. A validated self-administered questionnaire was used in the collection of data on demographic characteristics, smoking habits, oral health habits, and awareness of smoking-related oral health risks. Chi-square and Fisher Exact tests were used to analyze the data at a statistical significance level of p ≤ 0.05.

Result: Of the respondents, 6.8% were traditional smokers, 6.5% were e-cigarette users, 2.2% were dual users and 84.5% were non-smokers. Although more than 80% identified smoking as a cause of oral health problems such as cancer, discoloration, halitosis, and impaired healing, only 17.6% considered e-cigarettes as harmful. The non-smokers and cigarette smokers were more aware than the e-cigarette and dual users who were more likely to underestimate the risks associated with e-cigarettes.

Conclusion: The results indicate that although the level of awareness on the negative effect of tobacco is high, the misconceptions on e-cigarettes are still present, thus suggesting the need for a public health campaign.