BMC Oral Health最新文献

Background: Osteoarthritis (OA) is a complicated autoimmune disease that often causes invasive inflammatory infiltration and serious articular destruction. The global prevalence of temporomandibular disorders (TMDs) is estimated to be around 30% of the population. Several clinical drugs have been reported to have adverse effects ranging from increased inflammation to liver cirrhosis. Even with the introduction of gene therapy, there is still a growing need for therapeutic alternatives for OA. This study aimed to evaluate the effect of dental follicle-derived stem cells (DFSCs) versus gold nanoparticles (AuNPs), on temporomandibular joint (TMJ) osteoarthritis induced by Complete Freund's Adjuvant (CFA).

Methods: In this study, for osteoarthritis induction, twice intra-articular injections of complete Freund's adjuvant (CFA) were performed, once at the beginning of the experiment and again after two weeks. After 4 weeks, the osteoarthritis animals were randomly allocated into three equal groups: osteoarthritis group, osteoarthritis group treated with Nanogold (AuNPs), and osteoarthritis group treated with Dental follicle stem cells (DFSCs). After one month, the TMJs were fixed and processed for staining with hematoxylin and eosin, and the disc thickness was assessed; results were statistically evaluated.

Results: The osteoarthritis group showed erosion of cartilage and subchondral bone and a thickened disc. Both DFSCs and AuNPs reduced the inflammatory signs. Though statistically non-significant, DFSCs showed a greater reduction in disc thickness.

Conclusion: This study's results highlighted the potential use of DFSCs and AuNPs as a promising treatment in TMJ osteoarthritis.

Objectives: This study aimed to evaluate the diagnostic accuracy of an artificial intelligence (AI)-assisted cone-beam computed tomography (CBCT) analysis system for predicting the spatial proximity of the inferior alveolar nerve (IAN) to impacted mandibular third molars (M3M), using expert radiologist assessment as the reference standard.

Methods: A retrospective diagnostic accuracy study was conducted on an internal institutional cohort of 312 patients (mean age 28.21 ± 6.62 years; January 2021-December 2024). A deep learning system employing a modified U-Net architecture automatically segmented the IAN canal and M3M on CBCT and classified the IAN-M3M spatial relationship into three categories: no contact (> 2 mm), proximity (0-2 mm), and contact/overlap. Diagnostic accuracy was evaluated on an independent hold-out test set of 486 M3 sites (283 patients). Two senior oral and maxillofacial radiologists provided the reference standard. Sensitivity, specificity, PPV, NPV, AUC, and Cohen's kappa were calculated; 95% CIs were derived by Wilson score method (proportions) and bootstrap resampling (AUC, kappa).

Results: The AI system achieved an overall accuracy of 90.1% (438/486; 95% CI: 87.1-92.5%), weighted AUC of 0.925 (95% CI: 0.904-0.944), and Cohen's κ of 0.851 (95% CI: 0.821-0.912), indicating almost perfect agreement with the expert reference standard. Per-category sensitivity ranged from 88.2% to 91.2% and specificity from 92.8% to 97.4%. Bland-Altman analysis revealed a mean difference of 0.06 mm (95% LoA: -0.63 to 0.75 mm). Mean DSC was 0.90 ± 0.04 for IAN canal and 0.93 ± 0.03 for M3M segmentation. AI processing time was 4.75 ± 1.12 s versus 189.12 ± 41.99 s for expert assessment (39.79-fold reduction; P < 0.001). Subgroup analysis showed highest accuracy for mesioangular (93.1%) and horizontal (91.6%) impaction.

Conclusions: The AI-assisted CBCT analysis system demonstrated high diagnostic accuracy and excellent agreement with expert radiological assessment in predicting IAN proximity to impacted mandibular third molars, while substantially reducing processing time. These results support the potential of AI-driven automated CBCT analysis as a preoperative decision-support tool; however, the reference standard was radiographic rather than intraoperative, and prospective multicenter validation incorporating surgical outcome data will be required before definitive clinical deployment recommendations can be made.

Background: Two-piece hybrid abutment crowns (HACs) are CAD/CAM-fabricated implant restorations adhesively bonded to prefabricated titanium bases (Ti-bases). Since adhesive bond represents a potential weakness, methods to enhance long-term durability are being investigated. The aim of this in vitro study was to evaluate the influence of additional macroretention, specifically a circumferential groove, incorporated into polymer-infiltrated ceramic network (PICN) and zirconia crowns, and two Ti-base sandblasting protocols on adhesive bond strength of HACs.

Methods: Ninety Ti-bases, 45 zirconia and 45 PICN crowns were divided into six groups (N = 15). Prior to conventional cementation (Panavia V5, Kuraray) of zirconia control group (Z1), Ti-bases and internal crown surfaces were sandblasted (Al₂O₃; 50 μm; 1.0 bar) and treated with MDP primer. In PICN control group (H1), Ti-bases were sandblasted identically and pretreated with Adiva M-Prime. Internal surfaces of PICN crowns were etched (5% hydrofluoric acid) and primed with Adiva C-Prime. In Z2 and H2, a circular groove in the internal crown surface was prepared as a macroretention in addition to conventional pretreatment as performed in Z1 and H1. Z3 and H3 were also conditioned conventionally, as in Z1 and H1, but Ti-bases were sandblasted with 250 μm at 2.0 bar. After sandblasting, surface roughness values (RV) of Ti-bases were measured. Following thermocycling, tensile shear test was performed, and failure mode was analysed. Mean values were compared using t-test.

Results: RV differed significantly between differently blasted Ti-bases (p < 0.001). Both crown materials achieved significantly higher mean pull-off forces (Z1: 1085 N ± 79; H1 = 664 N ± 68) in control groups than in groups with macroretention (Z2: 1017 N ± 65; H2 = 438 N ± 48) (Z: p = 0.024, H: p < 0.001), and significantly lower pull-off forces than in groups with rougher Ti-bases (Z3: 1298 N ± 98, H3: 744 N ± 64) (Z: p < 0.001, H: p = 0.0023).

Conclusions: Increasing pressure and grit size during corundum blasting of Ti-bases can achieve higher pull-off force for zirconia and PICN crowns. Additional macroretention, at least in the form used here, offers no advantage regarding bond strength.

Objective: This study evaluated the effect of application delays on the dentin bond strength of different adhesive systems used in composite restorations.

Methods: Forty-five extracted human molars were randomly assigned to Clearfil SE Bond, G-Premio Bond, and Single Bond Universal (n = 15). Each adhesive was subdivided according to application time: immediate use, 3-minute delay, and 5-minute delay (n = 5). Adhesives were applied to occlusal dentin surfaces according to manufacturers' instructions, followed by composite build-up procedures. Microtensile bond strength (µTBS) was evaluated using a universal testing machine, and failure modes were examined microscopically. Selected specimens were analyzed using scanning electron microscopy (SEM).

Results: Adhesive system (F = 48.32, p < 0.001) and application time (F = 22.72, p < 0.001) significantly influenced µTBS. The highest bond strength was observed in the immediate Clearfil SE Bond group (34.5 ± 4.8 MPa), whereas the lowest value was recorded in the 5-minute delayed G-Premio Bond group (13.4 ± 2.8 MPa). A 5-minute delay significantly reduced bond strength in all adhesive systems, whereas a 3-minute delay generally did not affect bonding performance. More than 85% adhesive failures were observed in the 5-minute delay groups. SEM analysis revealed porosity and crater-like surface defects in delayed universal adhesive groups.

Conclusions: A 5-minute application delay significantly compromised dentin bond strength and increased adhesive failures. Immediate adhesive application is recommended to preserve bonding effectiveness and optimize restoration longevity.

Background: Diabetes is of great interest globally, given the associated health and economic costs. It may impact long-term systemic and oral health with unfavourable outcomes when undetected or poorly controlled, leading to various oral manifestations, including premature tooth loss and reduced quality of life. Early detection can enable early diagnosis, intervention and improve treatment and health outcomes.

Aims: To synthesise evidence on risk‑targeted screening and early case‑detection protocols for Type 2 Diabetes (T2D) that incorporate HbA1c or glucose point-of-care testing (POCT) using finger‑stick (FSB) or gingival crevicular blood (GCB) with a clinical risk assessment, to ascertain the value and potential impact of chair-side testing if implemented in primary care dental settings.

Methods: Electronic databases were searched using a pre-defined strategy, identifying 21 eligible studies; nine studies focused primarily on identifying at-risk individuals through finger-stick testing and twelve through gingival crevicular blood testing. Returned articles and grey literature were screened and used as supportive material for later discussion. A descriptive synthesis of 21 articles was undertaken, with focus of the review on multi-stage chair-side diabetes screening protocols incorporating risk questionnaires and periodontal examinations and HbA1c or glucose POCT testing.

Results: Chair-side HbA1c-or glucose POCT may identify potentially new T2D cases. Identification rates were shown to range between 20-66%.

Conclusion: When a POCT is added as part of a two-staged screening protocol, it enhances the ability to identify more cases correctly and is easily integrated into the dental appointment for chair-side screening. Gingival crevicular blood may be used as an alternative blood source; however, the screening method has limitations. Therefore, the most promising solution seems to be a multi-staged predictive model involving tandem risk questionnaires, periodontal examination, and capillary testing with a chair-side POCT.

Objectives: Accurate dental age (DA) estimation is essential in pediatric dentistry, orthodontic treatment planning, and forensic practice; however, the applicability of international reference standards varies across populations. This study aimed to evaluate the accuracy of a population-adapted Nolla method for dental age estimation in children from northwestern Romania and to compare its performance with the original approach.

Materials and methods: A retrospective analysis was performed on 860 digital panoramic radiographs of children aged 3-15 years. Dental development was assessed using the Nolla staging system, and a third-degree polynomial regression model was developed to estimate chronological age (CA) based on the total Nolla score. Model performance was evaluated using coefficient of determination (R²), five-fold cross-validation, and non-parametric statistical tests.

Results: The original Nolla method underestimated CA by approximately 1.5 years. The population-specific model showed strong predictive performance (R² = 0.846; cross-validated R² = 0.84) and close agreement between estimated DA and CA (mean difference 0.000 ± 0.976 years; p = 0.983). Accuracy was stable across most age groups, although larger deviations were observed after 12 years. Girls showed slightly more advanced dental maturation than boys, but differences were clinically small.

Conclusions: The proposed population-calibrated equation eliminates systematic bias and provides a reliable tool for dental age estimation in children from northwestern Romania, although external validation is recommended.

Background: To investigate whether taurodontism is associated with localized alterations in the surrounding trabecular bone microenvironment using quantitative radiomic analysis of panoramic radiographs in children.

Methods: Panoramic radiographs of 24 children (6 taurodontism cases; 18 age-matched controls) were retrospectively evaluated. Due to incomplete root development, severity was qualitatively assessed via Shaw's criteria. Trabecular bone was analyzed across four topographic regions (interradicular epicenter, mesial apex, distal apex, and gonial angle) using Image Biomarker Standardisation Initiative (IBSI)-compliant 3D Slicer. Diagnostic performance was preliminarily evaluated using receiver operating characteristic (ROC) curve analysis.

Results: Radiomic alterations demonstrated a distinct spatial gradient, with the most pronounced differences localized to the interradicular region and progressively diminishing toward the mesial, distal, and gonial regions. Four higher-order radiomic features showed significant discriminatory performance in the interradicular regions of interest (ROI) (all p < 0.05). GLSZM_ZoneVariance achieved the highest diagnostic accuracy (AUC = 0.824; 95% CI: 0.617-0.948), with 100.0% sensitivity and 72.2% specificity, followed by GLSZM_ZoneEntropy (AUC = 0.815).

Conclusion: This proof-of-concept study provides preliminary evidence that taurodontism is associated with localized radiomic alterations in the surrounding trabecular bone microenvironment, particularly within the interradicular region. These findings suggest that quantitative radiomic analysis of routinely acquired panoramic radiographs may provide complementary imaging features for investigating developmental dental phenotypes. Further prospective multicenter studies with external validation are required to confirm the biological and clinical significance of these observations.

Background: The developmental patterns of craniomaxillofacial structures and dental arch structure represent a central concern in the fields of orthodontics and craniofacial surgery. Understanding the associations between these anatomical features is crucial for accurate orthodontic diagnosis and effective treatment planning. This study aimed to explore the associations between craniomaxillofacial structures and dental arch structures, with the goal of enhancing diagnostic precision and facilitating the shift from experience-based to evidence-based clinical practice in orthodontics.

Methods: The study analyzed 77 craniomaxillofacial and dental arch variables collected from 500 patients using multivariate statistical methods, including descriptive statistics, correlation analysis, and canonical correlation analysis.

Results: Correlation analysis revealed significant associations between dental arch measurements and multiple craniomaxillofacial measurements, including facial height measurements (such as chin height), facial width measurements (such as minimum frontal width), and mandibular body length. Canonical correlation analysis identified five pairs of canonical variates, indicating a coordinated pattern of vertical development between craniomaxillofacial structures and dental arch structures. Facial width, mandibular plane angle, and mandibular measurements were found to influence both the maxillary and mandibular dental arches and basal arches.

Conclusions: Significant correlations were identified between craniomaxillofacial structure and dental arch structure. Facial width, facial height, and mandibular body length were found to have strong effects on dental arch structure, particularly in the maxillary region (notably at the first molar). The craniomaxillofacial-dental arch system constitutes a complex, multilevel interactive network, suggesting that comprehensive orthodontic assessment should consider the relationships among these anatomical systems.

Background: This study aimed to evaluate the effect of diode laser irradiation on the micro-tensile bond strength (µTBS) of hybrid ceramic restorations bonded to dentin using one-step and two-step self-etch adhesives.

Methods: An in vitro study was conducted using 20 freshly extracted human permanent molars. Standardized Class I inlay cavity preparations were performed, and hybrid ceramic inlays were fabricated using Shofu Block HC (Shofu Inc.). Specimens were randomly divided into four experimental groups (n = 5 per group) according to the adhesive strategy and laser treatment protocol. Two adhesive systems were evaluated: Clearfil S3 Bond Universal (Kurary Noritake Dental Inc.), applied in the self-etch mode (SE1), and Clearfil SE Bond 2 (Kurary Noritake Dental Inc.), a conventional two-step self-etch adhesive (SE2). Each adhesive group was further subdivided intolaser-irradiated (SE1-L, SE2-L) and non-irradiated control (SE1-NL, SE2-NL) subgroups. Laser irradiation was applied using a 940 nm diode laser after adhesive placement and before light polymerization in the SE1-L and SE2-L groups. The inlays were bonded using a light-cure flowable composite resin under static load. Following storage and accelerated aging by immersion in 10% sodium hypochlorite for one hour, specimens were sectioned into 0.9 mm microtensile beams. Microtensile bond strength (µTBS) was measured using a universal testing machine. Failure modes were analyzed using stereomicroscopy, and representative fractured specimens from each griuo were qualitatively examined by scanning electron microscopy (SEM). Data were analyzed using the Mann-Whitney U and Fisher's exact tests (α = 0.05). Randomization and assessor blinding were implemented.

Results: Laser irradiation significantly increased the µTBS of both one-step (SE-1) and two-step (SE-2) self-etch adhesives. For SE-1, laser-treated specimens showed a median µTBS of 13.7 MPa (mean ± SD: 16.3 ± 5.6) compared to 7.7 MPa (8.8 ± 5.6) without laser (P=.047). Similarly, SE-2 groups exhibited median µTBS values of 22 MPa (21.3 ± 3.1) with laser and 12 MPa (12.5 ± 5.4) without laser (P=.028). However, no statistically significant difference in µTBS was observed between the two adhesive types, regardless of laser application (P>.05). Failure mode analysis revealed no significant differences among groups (P=.167).

Conclusions: Diode laser irradiation enhanced the µTBS of both one-step and two-step self-etch adhesive strategies when bonding hybrid ceramic restorations to dentin. No statistically significant difference was observed between the two adhesive strategies following laser irradiation. Further studies are needed to evaluate the long-term durability and clinical relevance of this approach.