Search Results (648)

Background: Patients with hyperlipidemia are of interest because of the possible interplay between chronic local dental infections and hyperlipidemia. This interventional clinical study aimed to evaluate the oral health status of hyperlipidemic patients receiving lipid-lowering therapy for at least 6 months and the effects of non-surgical and surgical dental treatments on serum C-reactive protein (CRP) levels and lipid markers. Methods: Twenty-eight patients with controlled hyperlipidemia and 18 healthy controls were enrolled in the study. All participants underwent dental examinations (clinical evaluation, X-ray imaging, and microbial analysis of subgingival and supragingival plaque samples) at baseline. Hyperlipidemic patients received periodontal, endodontic, and dentoalveolar surgical treatments. Serum CRP and lipid parameters were assessed at baseline, 1 week, and 3 months, while subgingival and supragingival plaque samples were analyzed at baseline and 3 months after completing dental treatments. Results: At the 3-month follow-up, clinical periodontal characteristics, including the plaque index, gingival index, and periodontal probing depth, improved significantly (p < 0.05). A significant shift in microflora was observed in both subgingival and supragingival plaque samples (p < 0.05), alongside improvements in periodontal values and a significant reduction in serum CRP levels (p < 0.05). Serum cholesterol levels decreased significantly, while moderate improvements in serum triglycerides, low-density lipoprotein, and high-density lipoprotein levels were observed but were not statistically significant (p > 0.05). Conclusions: Treating local dental inflammation is associated with a significant decrease in CRP and cholesterol levels and may serve as beneficial adjunct therapy alongside lipid-lowering therapy in patients with hyperlipidemia. Full article

Background and Objective: This study aimed to examine the prevalence of dental fear among schoolchildren in Bosnia and Herzegovina, analyze the distribution of dental anxiety by gender, age, and place of residence in relation to perceived sources of fear, and evaluate its association with oral health status. Materials and Methods: The sample included 355 schoolchildren between the ages of 12 and 15. Data were gathered using a self-assessment questionnaire, a brief clinical oral examination, and the Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS). Results: Clinical examinations showed that 87.61% of the children had dental caries, with a mean DMFT score of 3.75 (SD = 2.93). The prevalence of dental caries was significantly higher in the older group compared to the younger group (p < 0.01). Dental fear was present in 21.7% of the children, with a mean total CFSS-DS score of 27.50 (SD = 13.85). The most feared aspect among the children was “Choking” (73.8%), followed by “Injections” (63.7%) and “The noise of the dentist drilling” (52.1%). Children with dental fear had a significantly greater number of decayed and missing teeth, higher DMFT scores, and poorer gingival health and oral hygiene compared to those without dental fear (p < 0.01), even after adjusting for sociodemographic factors. Conclusions: The study found a moderate level of dental fear among Bosnian schoolchildren, with younger children and those from urban areas showing more fear of injections. It also showed a consistent link between dental anxiety and clinical factors such as caries, gum disease, and oral hygiene, even after adjusting for sociodemographic factors. Full article

Background/Objectives: Mandibular fractures are among the most common facial injuries. Bilateral fractures of the mandibular body region (BBMFs), however, are rare. The aim of this retrospective study was to analyze the characteristics, surgical management, and outcomes of BBMFs in a third-level trauma center in northern Italy. Methods: Between 1 January 2001 and 31 December 2023, the following data were collected about patients hospitalized for BBMFs: age, sex, cause of fracture, dental status, degree of mandibular atrophy, surgical approach, number and thickness of plates used, concomitant maxillofacial fractures, length of hospital stay, and outcomes. Statistical analysis was performed using SPSS software. Results: During the study period, 26 patients (11 males and 15 females) presented with BBMFs, of which five were dentate (median age, 19 years) and 21 edentulous (median age, 80 years). The primary cause of trauma was road traffic accidents (RTAs) in dentate patients and falls in edentulous patients. In most dentate patients, fractures were treated using an intraoral approach with rigid or mixed fixation, using ≤1.4 mm thick plates. Edentulous patients were primarily treated using an extraoral approach and rigid fixation with ≥1.5 mm plates. The use of plates ≥ 1.5 mm was statistically associated with edentulous patients (p = 0.042) and with increasing degrees of atrophy (p = 0.020). Conclusions: This study shows that BBMFs are uncommon injuries, associated with high-impact trauma in dentate patients and medium- or low-impact trauma, such as falls, in edentulous patients. Internal fixation was predominantly rigid, with thicker plates used as the degree of mandibular atrophy increased. Full article

Research demonstrates associations between oral health and specific mental health conditions in the general population, yet these relationships remain understudied during pregnancy, despite pregnancy’s profound effects on both oral and psychological well-being. Our rapid review examines current evidence on associations between oral health conditions and psychological states (anxiety, depression, and stress) during pregnancy, aiming to inform and strengthen integrated prenatal care strategies. Following PRISMA-RR guidelines, we conducted a systematic search on OVID Medline, CINAHL, and PsycINFO (January 2000–November 2024) for studies examining relationships between oral health conditions (periodontal disease, dental caries) and psychological status during pregnancy and up to one year postpartum. Systematic screening of 1201 records yielded 22 eligible studies (13 cross-sectional studies, 3 longitudinal cohort studies, 3 comparative studies, 2 prospective studies, and 1 case–control study). Analysis confirmed significant associations between oral health and psychological well-being during pregnancy through three pathways: psychological (dental anxiety directly limits oral healthcare utilization), behavioral (maternal depression reduces oral health self-efficacy), and physiological (elevated stress biomarkers correlate with periodontal disease, and periodontal therapy is associated with reduced salivary cortisol). These interactions extend intergenerationally, with maternal psychological distress showing significant associations with children’s caries risk. Evidence suggests interactions between oral health conditions and psychological states during pregnancy, warranting integrated care approaches. We recommend: (1) implementing combined oral–mental health screening in prenatal care, (2) developing interventions targeting both domains, and (3) establishing care pathways that address these interconnections. This integrated approach could improve both maternal and child health outcomes. Full article

Background/Objectives: The aim of this cross-sectional study was to establish if there is a relationship between body mass index (BMI) and skeletodental development in young obese patients in comparison with normal-weight patients. Methods: The sample consisted of 178 individuals (115 normal weight, 37 overweight and 26 obese), aged 6 to 16 years, with a mean biological age of 11.96 ± 2.44 years. Dental maturation (dental age) was determined by using Demerjian’s method; craniofacial growth pattern, skeletal and dental class were determined by using cephalometric measurements; skeletal maturation was determined by using Baccetti’s method. Data were statistically analyzed. Results: According to Demirjian’s method, the mean dental age of the overweight and obese subjects was significantly higher than that of the normal-weight subjects (p = 0.001 and p = 0.02, respectively). A higher rate of dental class III was detected in the overweight group (p = 0.002). Concerning cephalometric records, statistically significant differences (p = 0.018) were observed in the distribution of SNA and SNB values, higher values being found in obese subjects. No difference was detected in the distribution of the ANB angle between the groups. As regards craniofacial growth pattern, no significant differences were found between the groups. Children with obesity presented more advanced skeletal maturation, reaching statistically significant differences (p = 0.02), in comparison with the normal-weight subjects. Conclusions: In conclusion, obese children showed increased tooth and skeletal development in comparison to the normal-weight subjects. These findings may be of interest for orthodontists, who should consider weight status when performing orthodontic treatment in children and adolescents. Full article

Background/Objectives: The increasing prevalence of video gaming has raised concerns about its potential impact on musculoskeletal health, particularly temporomandibular disorders (TMDs). This study aims to compare TMD symptoms, mandibular function, and dental wear between gamers and non-gamers among university students. Methods: An observational study included 108 students aged 20 to 23 years, divided into gamers (n = 48) and non-gamers (n = 60). Participants completed questionnaires assessing TMD symptoms, gaming habits, and screen time. Clinical examinations measured mandibular movements, palpation-induced pain, and dental wear using the Smith and Knight Tooth Wear Index. Statistical analyses included independent t-tests, chi-square tests, Pearson’s correlations, and logistic regression. Seven comprehensive tables present the findings with p-values. Results: Gamers reported significantly higher screen time (Mean = 6.5 h/day) compared to non-gamers (Mean = 4.0 h/day; p < 0.001). Maximum unassisted mouth opening was greater in gamers (Mean = 48.31 mm) than in non-gamers (Mean = 46.33 mm; p = 0.04). Gamers exhibited a higher prevalence of pain on palpation of the masseter muscle (45.8% vs. 30.0%; p = 0.05). Dental wear scores were significantly higher in gamers for teeth 2.3 (upper left canine) and 3.3 (lower left canine) (p < 0.05). Positive correlations were found between hours spent gaming and maximum mouth opening (r = 0.25; p = 0.01) and dental wear (r = 0.30; p = 0.002). Logistic regression showed that gaming status significantly predicted the presence of TMD symptoms (Odds Ratio = 2.5; p = 0.03). Conclusions: Gamers exhibit greater mandibular opening, increased dental wear, and a higher prevalence of masticatory muscle pain compared to non-gamers. Prolonged gaming may contribute to altered mandibular function and increased risk of TMD symptoms. Further research is needed to explore underlying mechanisms and develop preventive strategies. Full article

Background: The World Health Organisation (WHO) included silver diamine fluoride (SDF) in the WHO Model List of Essential Medicines for the management of early childhood caries. SDF is typically available as a 38% aqueous solution, which is watery to apply. A 38% SDF gel has recently been developed, but its caries-arrest effectiveness remains unsubstantiated. The objective of this study is to determine whether the efficacy of a 38% SDF gel is non-inferior to a 38% SDF solution in arresting early childhood caries. Methods: This is a 30-month, randomised, active-controlled, parallel-group non-inferiority pragmatic clinical trial with two arms. The hypothesis is that the 38% SDF gel is not worse than the 38% SDF solution by a non-inferiority margin of 10% caries-arrest rate when applied semi-annually to preschool children. This trial will recruit 630 3-year-old kindergarten children through block randomisation to receive either an application of SDF gel or SDF solution on cavitated carious lesions in their primary teeth every 6 months. The primary outcome is the proportion of soft (active) carious tooth surfaces that turn hard (arrested) at the 30-month follow-up. The same calibrated dentist will conduct 6-monthly dental examinations in the kindergartens to assess the status of carious lesions over 30 months. The examiner, the children, and parents will be blinded to treatments. The parents will be surveyed on their child’s oral health-related behaviours and socioeconomic background to allow adjustment for effect modification. Results: If the anticipated results are obtained, clinicians can use the 38% SDF gel as an alternative of the 38% SDF solution in arresting early childhood caries. Conclusions: As SDF gel is cost-effective, non-invasive, and non-aerosol-generating, it can be widely recommended for caries control. Trial registration: ClinicalTrials.gov NCT06241261. Registered on 7 February 2024. Full article

Background: A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support. We have previously reported that low PNI is related to low FTUs. Objectives: The purpose of this study was to retrospectively examine whether the status of occlusal support relates to changes in PNI during neoadjuvant therapy in patients with esophageal cancer. Methods: This study included 34 patients who underwent neoadjuvant therapy before esophagectomy (32 men, 2 women; age, 36–82 years) in 2012 at Okayama University Hospital. Patients were divided into the good occlusal support group (FTUs ≥ 11, n = 18) or poor occlusal support group (FTUs < 11, n = 16), and changes in PNI during neoadjuvant therapy were investigated. Results: PNI decreased significantly after neoadjuvant therapy, particularly in the good occlusal support group, and became more dispersed after neoadjuvant therapy. Decreases in PNI after neoadjuvant therapy showed a significant positive correlation with good occlusal support by multiple regression analysis (p = 0.03). The proportions of patients provided with nutritional intervention (p = 0.02) or early dental intervention (p = 0.04) were lower in the good occlusal support group than in the poor occlusal support group. Conclusions: Even in patients with esophageal cancer with good occlusal support experienced significant declines in PNI during neoadjuvant therapy, potentially due to delayed nutritional and dental interventions. Early multidisciplinary interventions are thus recommended for all patients, regardless of preoperative dental or nutritional status. Full article

Objectives: Cleaning splints (CSs) can facilitate interdental brush (IDB) insertion and guide IDBs during cleaning movement. Cleaning efficacy with and without CSs was to be assessed and compared for a fully dentate (FD) and a partially edentulous (PE) situation. Methods: For two maxillary typodont models simulating either an FD situation or a PE situation with every second tooth missing, suitable IDBs were selected and each cleaning splint was designed and fabricated by 3D-printing. Before and after standardized cleaning, model teeth were photographed at three timepoints: (T1) clean surface, (T2) surface coated with artificial plaque, and (T3) after IDB cleaning. For each of the four test groups differing in dental status (FD, PE) and CS use (without, with), n = 10 tests/group were completed. After aligning corresponding photographs, pixel-based color difference ratios (T2-T3)/(T2-T1) were calculated. Approximal cleaning efficacy was set as the mean value over predefined regions of interest. Effects of CS use and dental status were analyzed with two-way ANOVA (α = 0.05). Results: CS use significantly improved mean approximal cleaning efficacy for the PE model (p = 0.001), whereas no difference was found with the FD model (p = 0.381). Improved cleaning efficacy with the PE model was only found in combination with a CS (factor combination model × CS use: p = 0.003). Conclusions: Cleaning splints might have the potential to improve interproximal hygiene and can be recommended for clinical use. Clinical studies should validate the results of this in vitro study and clarify if CSs could be beneficial for patients with restricted manual skills. Full article

In 2020, the coronavirus disease 2019 (COVID-19) pandemic began worldwide. We examined the association between dental visit status and the incidence of COVID-19 and hospitalisation for it among older people based on medical claims data to help reduce COVID-19 severity. The study included 170,232 people who were 75–85 years old in fiscal 2019, with fiscal 2020 and 2021 serving as the follow-up period to ascertain the status of COVID-19. Using medical claims data, we investigated four types of dental visit (no visit, only periodontal treatment, periodontal and other treatment, and only other treatment) during fiscal 2019 and the incidence of COVID-19 and hospitalisation for COVID-19 during the follow-up period. Logistic regression analyses were performed with the incidence of COVID-19 and hospitalisation for COVID-19 as the dependent variables. Of the participants, 3206 (1.9%) developed COVID-19, of whom, 559 (17.4%) were hospitalised. There was not a significant association between the incidence of COVID-19 and type of dental visit. Participants with dental visits for periodontal treatment during the baseline year had a significantly lower odds ratio (OR) for hospitalisation due to COVID-19 compared to those without dental visits (OR: 0.71, 95% confidence interval: 0.58–0.78). The results suggest that dental visits for periodontal treatment including maintenance are important not only for maintaining oral health but also for preventing severe COVID-19. Full article

Background and Objectives: Caries development is associated with poor oral hygiene, inadequate dietary habits, quantitative and qualitative food content, and a high level of bacterial plaque. Physical and chemical changes in saliva composition and particularly changes in its buffering capability play a significant role in caries development. This study aimed to determine the predictors of poor oral health among a sample of second-year dental students. Materials and Methods: The oral health of students was estimated with clinical examination and the DMFT index. The interview included questions about demographics status (gender, age), a dietary habits questionnaire, questions about oral hygiene, and a demonstration of tooth brushing technique. Unstimulated saliva samples were collected to measure buffering capacity and pH. Results: Almost half of the students have a low level of caries experience (46.7%), followed by a slightly smaller number having a medium level (41.3%), while one in eight students (12.0%) demonstrates a high level of caries experience. Male students have a statistically higher DMFT index 5.7 ± 1.2 than female participants 4.5 ± 0.5 (p = 0.036). Significant predictors for the DMFT index score in students were milk [β-coefficient = −0.338, p = 0.011] and yoghurt [β-coefficient = 0.284, p = 0.040] consumption. All students brushed their teeth two or more times during the day, usually after waking up before breakfast and before bedtime. Most students (85.3%) apply the proper tooth brushing technique, with female students applying it more frequently (p = 0.038). The mean salivary pH was 6.9, while the mean buffer capacity was 5.8. Female respondents have a statistically lower buffer capacity (5.8 ± 0.5) than male respondents (6.1 ± 0.4) (p = 0.047). Conclusions: Dentistry students are introduced to good oral hygiene habits, especially female students, while dietary habits should be improved. However, one in eight dental students is at high caries risk. By assessing the level of caries experience, targeted strategies can be developed to promote, maintain, and enhance oral health among dental students. Full article

Background/Objectives: Dental malocclusions are highly prevalent worldwide, negatively impacting patients’ quality of life and leading to complex, often costly, orthodontic treatments. In Romania, the economic status of patients and the limited public funding for orthodontic care significantly influence treatment accessibility and choices. Advanced technologies, such as mini-implants (MIs), offer improved anchorage and treatment efficiency but are often underutilized due to financial constraints and variability in clinical training. In this context, there are limited data regarding the use and preferences of MI among orthodontists in Romania. This study aims to explore the characteristics, preferences, and challenges of Romanian orthodontists in their use of MI systems. Methods: A survey was conducted between June and September 2024, targeting orthodontists across Romania. The questionnaire, distributed via social media platforms, consisted of 24 items addressing professional experience, MI system preferences, insertion methods, and complications. Statistical analyses were conducted using IBM SPSS Statistics 25. Fisher’s Exact Test and Pearson’s Chi-Square Test were employed to evaluate relationships between categorical variables. When appropriate, logistic binomial univariable regression models were applied to predict key dependent variables (e.g., MI placement zones, MI experience, and MI complications) based on independent variables such as specific MI system usage and frequency of MI usage. A significance threshold of α = 0.05 was used for all tests. Results: Out of 105 participants, 85.7% reported using mini-implants (MIs) in their orthodontic practice, with the Dual Top and Benefit systems being the most frequently used (60% and 43.3%, respectively). The interradicular area was the most common placement site (60%), while the palatal and retromolar regions showed significant correlations with the Benefit system (p = 0.008). Practitioners with more than 10 years of experience reported a significantly higher frequency of MI use (p = 0.001), with frequent use being observed in 60.9% of these practitioners. Complications were common, with MI mobility reported by 92.2% and soft tissue damage by 57.8%. The midpalatal area was significantly associated with higher complication rates compared to other sites (p < 0.001). The success rates of MI usage ranged from 76% to 100% in 57.8% of respondents, with higher success rates being associated with infrazygomatic placements (p < 0.05). Conclusions: MI usage is prevalent among Romanian orthodontists, with experienced practitioners utilizing them more frequently. Despite high success rates, common complications highlight the need for improved insertion techniques and post-operative care. Further research and training are recommended to optimize MI application and reduce complication rates. Full article

Objective: This systematic review and meta-analysis aimed to assess the prevalence of dental caries among 6–11-year-old children in Nigeria and its distribution by sex, socioeconomic status, and geopolitical zones. Method: A systematic search was conducted in MEDLINE (PubMed), Google Scholar, and Cochrane Library (CENTRAL) to identify relevant studies published between 2012 and 2022. Cohort, cross-sectional, and observational studies reporting dental caries prevalence data among 6–11-year-olds in Nigeria were included. Using the random effects model, prevalence was analysed based on sex, socioeconomic status, and the country’s six geopolitical zones. The primary outcome was the pooled prevalence of dental caries. Meta-analysis was performed using the random effects model, and study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The systematic review was registered with PROSPERO (CRD42023396948). Results: Data were pooled from 8 of 1237 screened articles. The pooled prevalence of dental caries was 1.5% (95% CI: −1.2–4.1). Prevalence was higher among males (1.5%, 95% CI: −1.4–4.3) compared to females (1.4%, 95% CI: −1.6–4.4). It was 0.1% (95% CI: −1.0–1.1) among those with high socioeconomic status, 0.2% (95% CI: −1.6 to 1.9) among those with middle socioeconomic status, and 0.6% (95% CI: −2.8 to 3.9) among those with low socioeconomic status. The prevalence also ranged from 1.1% (95% CI: −1.8 to 4.1) in southwest, 1.1% (95% CI: −5.4 to 7.6) in south-south, 2.3% (95% CI: −7.1 to 11.6) in southeast, and 2.3% (95% CI: −7.1 to 11.7) in northwest. Conclusions: Caries intervention among adolescents in Nigeria may need to be tailored to address the observed sex, socioeconomic status, and geopolitical zone disparities. Full article

Background: Hormonal, vascular, and behavioral changes during pregnancy can negatively impact a woman’s oral health, resulting in conditions such as gingivitis, dental sensitivity, and caries. Although oral health is critical during pregnancy, it remains frequently overlooked. In this study, the oral health status and hygiene practices of pregnant women attending two university hospitals in southern Italy were evaluated. Methods: A cross-sectional cohort study was conducted with 72 pregnant women. Data were collected through an anonymous questionnaire that evaluated oral hygiene habits, dental visits, and oral pathologies, followed by a clinical examination. The examination included the assessment of the Decayed, Missing, Filled Teeth (DMFT) index and the Oral Hygiene Index (OHI) scores. Results: Among the participants, 61% were in their 9th month of pregnancy. The mean DMFT score was 7.9, and the mean OHI score was 3.6. Only 19.4% of participants had visited a dentist in the past 6 months, while 97.2% reported brushing their teeth just once per day. Gingival bleeding was reported by 72.2% of the women, and 38.9% experienced dental sensitivity, with both conditions worsening during pregnancy. Conclusions: The need for greater oral hygiene education and regular dental care during pregnancy is highlighted in this study. Integrating oral health maintenance into prenatal care programs is essential for preventing pregnancy-related oral diseases and promoting maternal and fetal well-being. Full article

Background: Dental caries is a multifactorial disease that results from interactions of susceptible host, cariogenic microorganisms, and fermentable carbohydrate sources. Our study explored oral microbiome shifts in children before and after dental treatment. Methods: Initial saliva samples were collected from caries free, moderate caries, and severe caries children based on the decayed, missing, and filled teeth index (DMFT/dmft) index. After three months of dental treatment, second saliva samples were gathered from the moderate and severe caries groups. The microbiota was analyzed by 16S rRNA gene-based high-throughput sequencing. Results: Most children with caries were between seven and eight years of age (40%), from middle-income group families (61%), highly educated parents (18% secondary level and 75% tertiary level) with good oral hygiene practices. There was a significant increase in alpha-diversity post-dental intervention. Firmicutes, Bacteroidota, and Proteobacteria were abundant across all samples. Post-treatment, Actinobacteria, and Firmicutes significantly decreased (p < 0.05) while Fusobacteria, Proteobacteria, Spirochaetota, and Synergistota significantly increased (p < 0.05). At genus level, a decreased trend was seen in Streptococcus, Prevotella_7, and Rothia and an increased trend was seen in Fusobacterium, Neisseria, Haemophilus, and Leptotrichia, but was not statistically significant. Conclusions: This study on Malaysian children highlights that dental caries are influenced by factors like age, socioeconomic status, and diet, with oral microbiome diversity increasing post-treatment, though some harmful bacteria persist, indicating a need for targeted oral health education and further research on probiotics’ role in caries prevention. Full article