Frontiers in oral health最新文献

Introduction: Periodontitis is delineated by a dysbiotic microbiome at sites of lesions accompanied by a dysregulated persistent inflammatory response that undermines the integrity of the periodontium. The interplay of the altered microbial ecology and warning signals from host cells would be a critical feature for maintaining or re-establishing homeostasis in these tissues.

Methods: This study used a nonhuman primate model (Macaca mulatta) with naturally-occurring periodontitis (n = 34) and experimental ligature-induced periodontitis (n = 36) to describe the features of gene expression for an array of damage-associate molecular patterns (DAMPs) or alarmins within the gingival tissues. The animals were age stratified into: ≤3 years (Young), 7-12 years (Adolescent), 12-15 years (Adult) and 17-23 years (Aged). Gingival tissue biopsies were examined via microarray. The analysis focused on 51 genes representative of the DAMPs/alarmins family of host cell warning factors and 18 genes associated with tissue destructive processed in the gingival tissues. Bacterial plaque samples were collected by curette sampling and 16S rRNA gene sequences used to describe the oral microbiome.

Results: A subset of DAMPs/alarmins were expressed in healthy and naturally-occurring periodontitis tissues in the animals and suggested local effects on gingival tissues leading to altered levels of DAMPs/alarmins related to age and disease. Significant differences from adult healthy levels were most frequently observed in the young and adolescent animals with few representatives in this gene array altered in the healthy aged gingival tissues. Of the 51 target genes, only approximately ⅓ were altered by ≥1.5-fold in any of the age groups of animals during disease, with those increases observed during disease initiation. Distinctive positive and negative correlations were noted with the DAMP/alarmin gene levels and comparative expression changes of tissue destructive molecules during disease across the age groups. Finally, specific correlations of DAMP/alarmin genes and relative abundance of particular microbes were observed in health and resolution samples in younger animals, while increased correlations during disease in the older groups were noted.

Conclusions: Thus, using this human-like preclinical model of induced periodontitis, we demonstrated the dynamics of the activation of the DAMP/alarmin warning system in the gingival tissues that showed some specific differences based on age.

Inflammation of the gingiva is one of the most common and routine findings in dental practice. These routine appearances of inflammatory gingivae can show peculiarity when associated with an underlying systemic condition or because of reactive, benign, or malignant pathologies. This case highlights minute clinical signs of the gingiva that deviate from the routine presentation and warrant further investigations. A 63-year-old woman presented with a chief complaint of severe pain in relation to the lower front teeth region for 1 month. Intraoral examination revealed a gingival lesion on the labial aspect of 41, 42, and 43, and an intraoral periapical radiograph showed mild bone loss. The lesion persisted despite oral prophylaxis, and a biopsy was advised. The final diagnosis was stage 1 gingival squamous cell carcinoma (GSCC). It is important to note that the non-descript presentation of GSCC in early stages often mimics benign traumatic or inflammatory lesions of the gingiva. Peculiar clinical features of GSCC of note include the lack of traditionally associated risk factors and localized red or ulcerative lesions with increased bleeding tendencies that do not respond to routine periodontal treatment within 2 weeks.

Patients diagnosed with oral cancer frequently exhibit an increased likelihood of experiencing common dental conditions, lower dental health literacy, and a decline in their overall quality of life. However, there is limited understanding on the impact of oral health values on these patients. This study aims to explore the oral health status and their oral health determinants and reported outcomes in patients with oral squamous cell carcinoma (OSCC) at the Instituto Português de Oncologia de Lisboa Francisco Gentil. This cross-sectional study included patients who were diagnosed with OSCC for the first time. These individuals were administered a questionnaire that collected sociodemographic data, as well as their scores on the oral health value scale (OHVS) and the short-form oral health impact profile. In addition, participants self-reported their experiences with periodontitis and caries using the decayed, missing, filled index. The final sample consisted of 46 OSCC patients, consisting of 34 males and 12 females. The average age of the participants was 70.0 years (±13.2), with most of them being retired (65.2%). There were no differences found between sex regarding age (p = 0.531), employment status (p = 0.114), presence of systemic conditions, smoking habits (p = 0.423), or alcohol consumption (p = 0.404). In the OHVS, there was a statistically significant difference between men and women regarding the retention of natural teeth (p = 0.021). Patients with self-perceived periodontitis exhibited worse functional limitation (p = 0.039) and physical pain (p = 0.049). Regarding dental caries experience, it was observed that a majority of patients had a higher incidence of missing posterior teeth (59.2%). This sample presented a significant decline in oral health, in addition to the diagnosed OSCC. The oral health value and quality of life were severely declined. There is a concerning lack of oral care and health that, consequently, impacts the quality of life of these patients.

Providing dental care for children with neurological special health care needs, including Down syndrome, Cerebral palsy and Autism spectrum disorders, is challenging. They often require repeat exposure to sedation or general anaesthesia for routine dental care. 51 parents of children with special needs completed a questionnaire regarding the acceptance of Silver Fluoride as a treatment option.

Background: Silver Diamine Fluoride has become popular as a minimally invasive treatment option for providing oral health care to young or uncooperative children. Silver Fluoride (SF) is a newer development with similar but improved properties. The aim was to determine the acceptance of SDF/SF as treatment option for Children with Special Health Care Needs (CSHCN), including Down Syndrome, Autism Spectrum Disorder and Cerebral Palsy.

Methods: 51 Parents of CSHCN completed a questionnaire on the overall acceptance of SF; aesthetic concerns related to the location of application; the use of SDF as an alternative to general anesthesia; and the composition of SF.

Results: The use of SF on posterior teeth were more acceptable (70.59%) as opposed to its application to anterior teeth (50.98%). Parents generally agreed/ strongly agreed to the use of SF to reduce infection and pain (82%); to avoid treatment under GA (26.70%); and to avoid an injection (78%). 64% of parents indicated their agreement in using SF because it has a reduced cost when compared to a conventional restoration. Majority of parents were in agreement to use SF even if it contains Fluoride (84%) and Silver (78%).

Conclusion: The use of SF, as treatment option for caries, was well accepted by South African parents of CSHCN. Shared decision making should be applied when considering SF as treatment option for CSHCN.

This study describes social support of Hispanic parents and the correlation with dental caries in their children. A cross-sectional study design was utilized to assess the 157 parent-child triads recruited from the Children's Hospital Colorado Dental Clinic. The Basic Research Factors Questionnaire (BRFQ) survey was utilized to assess parents' oral health knowledge, attitudes, behavior, and other psychosocial measures with social support as the main predictor variable. Bivariate associations between the independent variables and dmfs were conducted. Independent variables with a bivariate association of p ≤ 0.2 for the outcome variable were included in the multivariable linear regression model. Dental caries in children was significantly associated with less overall parental social support (β = -10.10, p = 0.03). Overall social support was divided into four sub-categories: errand help, money help, childcare help, and transportation help. Dental caries decreased by 7.70 units for every 1-unit increase in transportation help (β = -7.70, p = 0.03). A significant association was observed between parental knowledge on dental utilization and dmfs (β = -2.70, p = 0.04). In the multivariable linear regression model, caries was significantly associated with social support (β = -11.18, p = 0.02) and knowledge on dental utilization (β = -3.84, p = 0.01). The study concludes that a higher level of social support and knowledge on dental utilization for Hispanic parents is correlated with lower rates of dental caries in their children.