Caries Research最新文献

Background and objective: Artificial Intelligence (AI) support is expected to increase accuracy and improve treatment plans in dentistry. Nevertheless, AI's ability to promote better oral health care is underexplored. This scoping review explores the influence of AI in supporting dental professionals with caries detection and decision-making regarding interventions.

Methods: Primary articles indexed on PubMed, Web of Science, Embase, Scopus, and Cochrane Library were searched until August 2025. Studies reporting the differences between participants' caries diagnosis process and decision-making with and without AI were included. Studies only reporting algorithm accuracy, in vitro studies, or studies without an outcome related to caries detection with AI support were excluded. No time and language limits were imposed. Outcomes regarding the influence of AI on the diagnostics process and decision-making were retrieved and narratively summarised.

Results: Thirteen publications were included. Number of participants ranged from 3 to 74, comprising dentists with varying experience and expertise, and dental students. Results showed that AI enhances sensitivity, though its impact on specificity varies (10 studies). AI can promote unnecessary interventions for early-stage caries lesions (1 study). AI increased assessment time in two out of three cases (3 studies). AI's cost-effectiveness is uncertain, as greater sensitivity did not lead to better economic outcomes (1 study).

Clinical significance: AI has the potential to improve diagnostics and influence treatment choices, but current evidence is limited and inconsistent regarding its impact on specificity, decision quality, and cost-effectiveness. Longitudinal studies in clinical settings with long-term follow-ups are needed to understand AI's impact on decision-making.

Background: Few health topics are as controversial as fluoride, and social media has become a powerful arena where health information and misinformation circulate and compete for attention. This study systematically examined fluoride-related posts across two major platforms (Instagram® and X™) in English and Spanish.

Methods: Using a standardized approach, we identified the first 200 publicly available posts related to fluoride and health on each platform and language (n=800 total). Posts were analyzed in duplicate, assessing perception (positive, negative, neutral), accuracy (accurate or non-accurate), format, account type, among others.

Results: Results revealed differences across language and platform. Spanish-language content was generally more accurate and conveyed a more positive tone, while English-language posts, particularly on X™, showed a higher prevalence of alarmist narratives. Engagement patterns varied by tone, post format and account type. Negative posts attracted more likes overall. Post wrtitten in Spanish generated lower engagement. Carousel and photo-video formats and professional accounts received substantially greater interaction.

Conclusion: These findings provide empirical evidence that language, source and format strongly influence the reach and resonance of fluoride posts. They also suggest that multilingual strategies using engaging formats and credible professional voices can enhance the impact of evidence-based fluoride communication and counter misinformation.

Objective: Dental caries, the most prevalent noncommunicable disease (NCD) in adolescence, may represent a hidden link to systemic inflammatory processes, a common underlying mechanism shared by all major NCDs. Accordingly, this study investigated whether dental caries was associated with systemic inflammatory burden in adolescents.

Methods: This population-based study utilized data from the RPS Brazilian Birth Cohort Consortium, specifically the 18-19-year follow-up conducted in São Luís, Brazil (n = 441). The main exposures included the visible plaque index (VPI), number of decayed teeth, DMFT index ( decayed, missing and filling) and PUFA index. The outcome was the allostatic inflammatory load, calculated as the sum of biomarkers-IL-6, IL-18, IL-1β, TNF-α, and C-reactive protein (CRP)-that fell within the high-risk range (≥75th percentile of the sample distribution). Each biomarker contributed one point, resulting in a total score ranging from 0 to 5. Crude and adjusted coefficients were estimated using regression models.

Results: The number of decayed teeth (β = 0.031, p = 0.015) and the visible plaque index (β = 0.006, p = 0.001) were positively associated with higher allostatic inflammatory load scores. Among individual biomarkers, both the number of decayed teeth (β=8.95, SE=4.09, p=0.02) and the visible plaque index (β=1.09, SE=0.50, p=0.03) were positively associated with IL-18 levels, whereas no significant associations were observed for the DMFT or PUFA indices (p>0,05).

Conclusion: Dental caries was associated with systemic inflammation in adolescence, possibly reflecting shared underlying risk factors and highlighting the relevance of integrating oral health into strategies addressing common risk factors for non-communicable diseases.

Background: Advances in next-generation sequencing(NGS) and multi-omics approaches reinforced the concept of functional diversity within biofilm communities, revealing roles beyond bacterial taxonomy and highlighting metabolic and ecological mechanisms operating at the individual level rather than within isolated caries lesions. Moving toward new clinical solutions will require broader perspectives; to this end, we propose key directions to advance the translational potential of caries microbiome research. We present a perspective that connects ecological theory, molecular evidence, and clinical implications through three central topics: (I)microbial composition, (II)microbial function, and (III)individual-level characteristics.

Summary: From a compositional perspective, caries microbiome research should move beyond the search for bacterial culprits and instead consider the broader microbial ecosystem, including low-abundance and non-bacterial members (such as archaea). Within this framework, microbial taxa and functions should not be viewed as inherently "good" or "bad," but rather as context-dependent components of a dynamic ecosystem shaped by sustained environmental pressures. Functionally, the recurrent enrichment of pathways related to carbohydrate metabolism, sugar transport, and acid production likely reflects microbial adaptation to persistent sugar exposure rather than intrinsic virulence traits. This perspective suggests that progress in caries research depends on moving beyond disease-centered models toward understanding how microbial stability preserves oral health. At the individual level, individuals with previous caries experience may retain disease-associated microbial or functional signatures during remission, a phenomenon referred to here as a microbiological dysbiosis scar. This ecological memory may help explain why past caries experience remains one of the strongest predictors of future lesions and highlights the importance of incorporating individual history into the design and interpretation of caries microbiome studies. Integrating detailed clinical metadata with advanced bioinformatic approaches, including artificial intelligence, will be essential for establishing meaningful biological links.

Key messages: Progress in caries microbiome research depends on refining study design across microbial composition, functional, and individual levels. Strengthening the resilience of the oral microbiome rather than eliminating specific pathogens or the microbiome should be the central goal of caries microbiology. Moving from blame to balance is not merely semantic; it represents a fundamental shift in how we study, prevent, and manage dental caries.

Introduction: This study aimed to assess the sensitivity, specificity, and accuracy of a digital-based method for caries assessment in a rodent model, compared to a conventional modified-Keyes method.

Methods: One hundred and eight mandible molars of Sprague-Dawley rats were collected from a cariogenic caries rodent model, including both caries-free and carious teeth. Smooth surfaces were evaluated using digital photography, whereas sulcal lesions and volumetric quantification were assessed with micro-CT and the Amira software. In the conventional assessment, smooth surfaces were examined under a stereomicroscope with tactile probing, and sulcal surfaces were evaluated on stained, sectioned teeth. Sensitivity, specificity, and accuracy of the digital approaches were calculated, with the conventional method serving as the gold standard. Spearman correlation analysis was conducted between conventional enamel caries scores, combined digital (photography and micro-CT) enamel caries scores, and micro-CT quantified remaining enamel volume.

Results: A total of 107 m were available for smooth surfaces evaluation, and 98 m were included for sulcal surfaces, tooth-level caries detection and enamel lesion assessments. For smooth surfaces, the digital photographic method demonstrated an accuracy of 88.0%, with a sensitivity of 88.8% and a specificity of 85.7%. In the evaluation of sulcal caries, Micro-CT analysis achieved an accuracy of 96.9%, with 100% sensitivity and 87.0% specificity. For tooth-level caries detection, the combined digital approaches of smooth surface photography and sulcal micro-CT slicing achieved 96.9% accuracy, 97.6% sensitivity, and 92.9% specificity.

Conclusions: This study demonstrates the efficacy of digital photography and micro-CT in the caries assessment of rodent models. The findings support the establishment of a standardized, nondestructive imaging protocol to enhance consistency in caries research.

Introduction: The study objective was to assess and compare the use of diagnostic methods, clinical decision-making, treatment strategies, and attitudes of general dentists, pediatric dentists, and endodontists regarding deep carious lesions (DCL) in Egypt and Saudi Arabia.

Methods: A cross-sectional multinational study was conducted in Egypt and Saudi Arabia (January 2023-June 2024). A validated online questionnaire was distributed to 1,000 dentists (734 Egypt; 266 Saudi Arabia), including general practitioners, pediatric dentists, and endodontists. The survey covered demographics, diagnostics, clinical scenarios, treatment strategies, and influencing factors. Data were analyzed using SPSS v26 with descriptive statistics, chi-square tests, and logistic regression (p < 0.05).

Results: A total of 500 dentists responded (response rate of 46.0% for Egypt [338/734] and 60.9% for Saudi Arabia [162/266]). Most participants were general practitioners (60.4%) and female (57.8%), with an average of 9 years of clinical experience. Selective caries removal was preferred by 23.2% of general practitioners, 34.2% of pediatric dentists, and 21.8% of endodontists. Multivariable regression analysis showed that selective caries removal was more likely to be chosen by pediatric dentists (adjusted odds ratio [AOR] = 1.38, p = 0.04), dentists practicing in Egypt (AOR = 2.70, p < 0.001), and those who had attended MID courses (AOR = 1.75, p < 0.001). Endodontists demonstrated greater adherence to evidence-based guidelines (AOR = 3.35, p < 0.001), whereas practicing in Egypt (AOR = 0.43, p = 0.002), having more years of experience (AOR = 0.94, p = 0.001), and attending MID courses (AOR = 0.57, p = 0.03) were associated with lower odds of adherence.

Conclusions: Pediatric dentists, practitioners in Egypt, and those with training in minimally invasive dentistry were more likely to favor selective caries removal, whereas endodontists demonstrated the highest adherence to AAE guidelines and tended to prefer more invasive treatment strategies. Despite strong evidence supporting conservative approaches for managing DCLs in vital teeth, invasive strategies were still commonly reported among respondents. Greater implementation of evidence-based, patient-centered treatment strategies is needed among dentists in Egypt and Saudi Arabia.

Introduction: To simultaneously assess three alternative models to animal caries testing - an in situ remineralization model, an in vivo salivary fluoride clearance model, and a modified in vitro pH cycling model - for measuring the anticaries efficacy of dentifrices containing monofluorophosphate (MFP) up to 2800 ppm F.

Methods: A series of MFP dentifrices were prepared at 250, 1100 and 2800 ppm F as MFP in a silica abrasive base with a placebo toothpaste (fluoride-free). Model #1: In a randomized crossover trial, in situ remineralization (% surface microhardness recovery of partially demineralized enamel) and enamel fluoride uptake (microbiopsy) were assessed over 7, 14, and 21 days in 15 participants. Model #2: In vivo salivary fluoride clearance was evaluated in 26 participants using a randomized, crossover design by measuring salivary fluoride concentration over 30 minutes following 2 minutes of brushing. Model #3: A modified in vitro pH cycling model with pre-hydrolyzed (2N HCl) MFP dentifrice supernatants was used to evaluate lesion progression over 19 days with 6 hours demineralization and 17 hours remineralization daily (Monday-Friday with weekend remineralization) and twice daily morning and afternoon 2-minute dentifrice slurry treatments on 10 teeth per dentifrice.

Results: There was a statistically significant impact of dose (p<0.001) observed in all three models, and the three models are highly correlated with one another and with animal caries testing results (Spearman's ρ > 0.77, p < 0.0001). In situ hardening, fluoride uptake, and fluoride AUC clearance showed linear relationships with MFP dose. Acid hydrolysis successfully liberated ionic fluoride and lesion progression in pH cycling was exponentially suppressed with fluoride dose.

Conclusion: The in situ, in vivo, and modified in vitro models each provided dose-responsive and sensitive measures of MFP activity. Importantly, the modification of pH cycling for MFP hydrolysis enabled a well-developed laboratory protocol to be adapted to an important fluoride source. These approaches appear to offer viable alternatives to animal caries models for evaluating the efficacy of MFP-containing dentifrices and each could be chosen in different settings to understand the impact of monofluorophosphate-containing dentifrices on caries prevention.

Introduction: Automated methods for caries detection among children can help triage children with greater need for treatment and assist clinicians in achieving a more accurate diagnosis of caries lesions. Therefore, we aimed to develop artificial intelligence algorithms based on various object detectors for detecting and staging caries lesions in primary molars using bitewing radiographs.

Methods: We used a dataset of 1,023 bitewing radiographs of primary molars from children aged 3-10 years. The radiographs were annotated by two examiners using a dedicated annotation platform to draw bounding boxes corresponding to four different primary caries severity stages. Five popular deep learning object detection algorithms were trained to detect the annotated caries and evaluated with various performance metrics, considering three different thresholds: all lesions, dentine caries lesions, and dentine caries lesions requiring operative treatment.

Results: For staging caries lesions, the DINO model achieved higher concordance with a weighted kappa score of 0.713 on the test dataset, outperforming other object detectors. The DINO model achieved the highest sensitivity for detecting all caries lesions (0.509) while also attaining the highest sensitivity and accuracy in identifying dentine caries requiring operative treatment, at 0.659 and 0.980, respectively. However, YOLOv7 also achieved good performance, with specificity values exceeding 0.99 and accuracy values exceeding 0.92 across all thresholds.

Conclusions: The DINO and YOLOv7 algorithms perform well at detecting caries on primary molars in bitewings, highlighting their potential for clinical application at aiding clinicians in daily practice.

Introduction: Area-level socioeconomic factors are within the social determinants of health, encompassing conditions in which people are born, grow, live, work, and age, which influence health beyond individual characteristics. This review examined the association between area-level socioeconomic factors and dental caries and tooth loss. The hypothesis was that individuals residing in more socioeconomically deprived areas experience higher odds of dental caries and tooth loss, independent of individual socioeconomic status.

Methods: A systematic search was conducted in PubMed, Scopus, Embase, and Web of Science. Studies reporting clinical or self-reported dental caries or tooth loss and evaluating area-level socioeconomic deprivation or income (neighbourhood, municipality, or region) using multilevel models were included.

Results: Of 4,671 screened records, 44 studies (41 cross-sectional) published from 2006 to 2024 were included. The most common exposures were area socioeconomic deprivation indices (n = 24), area average income (n = 21), and the Human Development Index (HDI) (n = 13). Quantitative synthesis was precluded by heterogeneity of aggregation levels, outcomes (tooth loss, caries experience, and untreated caries), and outcome measurement (dichotomous/continuous). Most studies adjusted for individual-level socioeconomic factors (82%). The hypothesised association was most consistent for tooth loss (e.g., functional dentition or edentulism, 6/6 studies), at a medium level of aggregation (13/15), and for the HDI (10/13). Studies using ordered categories frequently demonstrated clear socioeconomic gradients.

Conclusion: The findings support the hypothesis that residing in more affluent areas is associated with better oral health outcomes, specifically lower levels of tooth loss and, to a lesser extent, dental caries, after adjusting for individual-level socioeconomic factors.

Introduction: The aim of this study was to determine the level of erosive tooth wear (ETW) in young, healthy Finnish men in relation to their sociodemographic background; the number of decayed, missing due to caries, and filled teeth in their permanent dentition (DMFT); and Community Periodontal Index (CPI). Studies on the association between ETW and periodontal health, as well as those related to sociodemographic factors, have so far been inconclusive, indicating a need for further research on these associations.

Methods: The data used in this study were collected from the database of the "Oral Health of Finnish Conscripts 2021" project, including clinical and survey data from healthy Finnish males (n = 1,712) in their early twenties. Basic Erosive Tooth Wear Examination (BEWE) scoring was used to evaluate the ETW level. Distributions and mean BEWE sum score values excluding wisdom teeth were calculated. Cross-tabulation together with a χ2 test and binary logistic regression analysis were used to evaluate increased risk (BEWE sum score ≥3) for ETW. A geomap was used to illustrate the prevalence and severity of ETW across various regions of Finland.

Results: ETW is common among young Finnish men as almost two-thirds (63.0%) of the subjects had signs of erosive lesions. Severe ETW (BEWE sum score ≥9) was rare (3.2%). More severe ETW was associated with poorer overall oral health as the DMFT and CPI values were both higher with an exacerbated level of erosion. Restorative treatment need (D >0) and periodontal treatment need (CPI ≥2) were also associated with ETW. Living in urban areas and older age were associated with a higher prevalence and severity of ETW. A distinct variation in the increased risk for ETW was observed between various regions of Finland.

Conclusion: Poorer dental and periodontal health, as well as place of residence, were associated with higher severity of ETW. The progressive and irreversible nature of the condition underscores the importance of early detection.