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16 pages, 475 KB

Open AccessArticle

Skeletal Characteristics and Clinical Treatment Patterns in Orthognathic Surgery: A Virtual Surgical Planning-Based Study

by Merve Berika Kadıoğlu, Mehmet Emre Yurttutan, Mehmet Alp Eriş, Meyra Durmaz and Ömer Faruk Kocamaz

Healthcare 2026, 14(6), 809; https://doi.org/10.3390/healthcare14060809 - 22 Mar 2026

Cited by 1 | Viewed by 557

Abstract

Background/Objectives: Virtual surgical planning (VSP) allows three-dimensional assessment of complex dentofacial deformities and has become integral to modern orthognathic surgery. However, evidence remains limited regarding how skeletal characteristics and malocclusion patterns translate into surgical movement selection. This study aimed to evaluate demographic features, [...] Read more.

Background/Objectives: Virtual surgical planning (VSP) allows three-dimensional assessment of complex dentofacial deformities and has become integral to modern orthognathic surgery. However, evidence remains limited regarding how skeletal characteristics and malocclusion patterns translate into surgical movement selection. This study aimed to evaluate demographic features, skeletal malocclusion patterns, and clinical treatment strategies in patients undergoing VSP-guided orthognathic surgery. Methods: This retrospective study included 158 patients who underwent VSP-assisted orthognathic surgery between 2019 and 2025. Sagittal skeletal classification, vertical growth pattern, facial asymmetry, and maxillary crossbite were evaluated together with planned maxillary and mandibular movements. Surgical procedures were analyzed according to skeletal malocclusion classes (Class I, II, and III). Group comparisons were performed using chi-square and Kruskal–Wallis tests. Multivariable logistic regression analysis was conducted to assess factors associated with bimaxillary surgery (p < 0.05). Results: Skeletal Class I malocclusion was most prevalent (46.8%), followed by Class III (29.7%) and Class II (23.4%). Hyperdivergent growth patterns were predominantly observed in Class II patients, whereas normodivergent patterns were most common in Class III cases (p < 0.05). Mandibular advancement and setback generally followed expected class-based trends but were also observed across non-corresponding skeletal classes. Maxillary impaction and mandibular autorotation were frequently incorporated. Bimaxillary surgery was performed in 84.2% of cases. Logistic regression analysis showed no independent predictors of bimaxillary surgery (p > 0.05). Conclusions: VSP-assisted orthognathic surgery demonstrates that surgical planning cannot be reduced to sagittal skeletal classification alone. Treatment decisions are shaped by combined sagittal, vertical, transverse, and patient-specific factors, supporting a multidimensional and individualized planning approach. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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19 pages, 430 KB

Open AccessArticle

Validity and Reliability of the Turkish Version of the Temporomandibular Joint Ankylosis Quality of Life Questionnaire (TMJAQoL-TR) in Patients with Severe Temporomandibular Disorders

by Manolya İlhanli, Mehmet Alptekin Karaçeşme, Kaan Gündüz, Mahmut Yaran and İlker İlhanli

Healthcare 2026, 14(5), 644; https://doi.org/10.3390/healthcare14050644 - 4 Mar 2026

Viewed by 439

Abstract

Background: The Temporomandibular Joint Ankylosis Quality of Life Questionnaire (TMJAQoL) is a disease-specific instrument designed to assess quality of life in patients with temporomandibular joint (TMJ) ankylosis. No validated Turkish version of this scale existed prior to this study. The aim of this [...] Read more.

Background: The Temporomandibular Joint Ankylosis Quality of Life Questionnaire (TMJAQoL) is a disease-specific instrument designed to assess quality of life in patients with temporomandibular joint (TMJ) ankylosis. No validated Turkish version of this scale existed prior to this study. The aim of this study was to translate, culturally adapt, and evaluate the Turkish version of the TMJAQoL (TMJAQoL-TR) in patients with severe temporomandibular disorders, including a predefined ankylosis subgroup. Materials and Methods: A total of 120 patients with temporomandibular complaints were included. Test–retest reliability was evaluated in a clinically stable subsample of 72 participants with a one-week interval. Following forward–backward translation and cultural adaptation procedures, the TMJAQoL-TR was administered together with the Oral Health Impact Profile Short Form-14 (OHIP-14), the Short Form-36 (SF-36), and Visual Analog Scale (VAS) pain scores. Reliability was assessed using Cronbach’s α, item-level Weighted Cohen’s Kappa, and test–retest Intraclass Correlation Coefficients (ICC), supported by measurement error indices (Standard Error of Measurement [SEM] and Minimal Detectable Change at 95% confidence [MDC₉₅]). Construct validity was examined using Spearman correlation coefficients. Structural validity was investigated through exploratory factor analysis, followed by a confirmatory structural model in AMOS to evaluate preliminary model consistency. Floor and ceiling effects were analyzed using the 15% criterion. Results: The TMJAQoL-TR demonstrated excellent internal consistency (Cronbach’s α = 0.879) and very high test–retest reliability (ICC = 0.995; 95% CI: 0.992–0.997). Strong correlations were observed with OHIP-14 (r = 0.772, p < 0.01), and moderate correlations with VAS pain scores (r = 0.312, p < 0.01). No significant floor or ceiling effects were detected. A weak but significant negative correlation with the SF-36 physical role subscale suggests that TMJ-related quality of life impairment is associated with role limitations in daily activities, although the magnitude of this association was modest. Exploratory factor analysis supported a clinically coherent two-factor structure, and the AMOS structural model demonstrated acceptable consistency with this framework. Conclusions: The TMJAQoL-TR appears to be a valid and reliable instrument for assessing quality of life in patients with severe TMJ-related functional limitations. Findings from the ankylosis subgroup support potential applicability within the instrument’s original target population; however, further validation in larger ankylosis-specific samples is warranted. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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10 pages, 220 KB

Open AccessArticle

Association Between ASA Physical Status Classification and Postoperative Intensive Care Requirement in Pediatric Patients Undergoing Dental Treatment Under General Anesthesia: A Retrospective Study

by Enes Bardakci, Mehmet Sinan Dogan and Peris Celikel

Healthcare 2026, 14(5), 615; https://doi.org/10.3390/healthcare14050615 - 28 Feb 2026

Viewed by 746

Abstract

Background and aim: Accurate perioperative risk stratification is essential for patient safety in pediatric dental treatment under general anesthesia. We aim to evaluate the association between ASA (American Society of Anesthesiologists) Physical Status Classification and postoperative intensive care requirement in pediatric patients [...] Read more.

Background and aim: Accurate perioperative risk stratification is essential for patient safety in pediatric dental treatment under general anesthesia. We aim to evaluate the association between ASA (American Society of Anesthesiologists) Physical Status Classification and postoperative intensive care requirement in pediatric patients undergoing dental treatment under general anesthesia. Methods: In this retrospective study, the clinical records of 1003 children who underwent dental treatment under general anesthesia between June 2022 and June 2025 were evaluated. The patients’ age, gender, ASA classification, concomitant systemic diseases, and postoperative intensive care requirements were analyzed. The chi-square test and logistic regression analysis were used for statistical evaluation, and results are expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results: The mean age of the patients was 5.78 ± 2.87 years, and 58.3% were male. All patients requiring postoperative intensive care were in the ASA II (34.7%) and ASA III (65.3%) groups, while no intensive care need was observed in the ASA I group (p < 0.001). The need for intensive care significantly increased, particularly in the presence of cerebral palsy, epilepsy, autism, congenital heart disease, and intellectual disability (p < 0.001). In addition, the mean age of children requiring intensive care was significantly higher (p < 0.001). In multivariable logistic regression analysis, ASA classification was significantly associated with postoperative intensive care requirement (OR = 180.73, 95% CI: 9.40–1922.49, p < 0.001), whereas age and gender were not independently associated. Furthermore, the interaction term between ASA and age (ASA × Age) was not statistically significant (p = 0.59). Conclusions: ASA classification was significantly associated with postoperative intensive care unit admission in pediatric patients undergoing dental treatment under general anesthesia and may contribute to perioperative risk assessment. The findings emphasize the need for early identification of high-risk children and support the integration of ASA classification into multidisciplinary preoperative planning to enhance patient safety and optimize postoperative resource utilization. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

15 pages, 921 KB

Open AccessFeature PaperArticle

Dental Anxiety and Oral Health-Related Quality of Life Among Adults in the United Arab Emirates: A Cross-Sectional Study

by Nada Tawfig Hashim, Muhammed Mustahsen Rahman, Riham Mohammed, Md Sofiqul Islam, Vivek Padmanabhan, Sharifa Jameel Hossain, Nallan C. S. K. Chaitanya, Noran Osama Mohammed, Asawer Ahmed Saeed and Shahista Parveen Dasnadi

Healthcare 2026, 14(2), 219; https://doi.org/10.3390/healthcare14020219 - 15 Jan 2026

Viewed by 854

Abstract

Background: Dental anxiety is a common psychological condition that may influence patients’ perceptions of oral health and well-being. Although its association with oral health-related quality of life (OHRQoL) has been widely studied internationally, evidence from the United Arab Emirates (UAE) remains limited. [...] Read more.

Background: Dental anxiety is a common psychological condition that may influence patients’ perceptions of oral health and well-being. Although its association with oral health-related quality of life (OHRQoL) has been widely studied internationally, evidence from the United Arab Emirates (UAE) remains limited. Objectives: This study aimed to examine the association between dental anxiety and OHRQoL among adult patients attending an academic dental clinic in the UAE. Methods: A cross-sectional study was conducted among adult dental patients using a non-probabilistic sampling approach. Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS), and OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14). Descriptive statistics and nonparametric tests were used for bivariate analyses. Multiple linear regression was applied as an exploratory approach to assess adjusted associations between dental anxiety and OHRQoL after accounting for age and gender. Results: Higher dental anxiety scores were independently associated with poorer OHRQoL after adjustment for age and gender. Bivariate analyses showed no statistically significant differences in dental anxiety or OHRQoL scores between men and women; however, subgroup comparisons should be interpreted cautiously given the sample size. The findings indicate a consistent association between higher anxiety levels and greater perceived oral health impact within the study population. Conclusions: Dental anxiety was associated with impaired oral health-related quality of life among adult dental clinic attendees in the UAE. These findings reflect associations observed within a modest, non-probabilistic, cross-sectional sample and should not be interpreted as causal or generalized to the wider population. Further longitudinal and population-based studies incorporating clinical and contextual variables are needed to clarify temporal relationships and strengthen external validity. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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9 pages, 320 KB

Open AccessArticle

Association of Early and Severe Early Childhood Caries with Oral Health-Related Quality of Life: A Cross-Sectional Survey

by Samaa K. Redwan, Najlaa M. Alamoudi, Osama M. Felemban, Amani A. Al Tuwirqi and Rana A. Alamoudi

Healthcare 2025, 13(23), 3153; https://doi.org/10.3390/healthcare13233153 - 3 Dec 2025

Viewed by 1039

Abstract

Background/Objectives: Early childhood caries (ECC) and severe early childhood caries (S-ECC) are oral health problems that affect many preschool children worldwide. ECC and S-ECC negatively impact the quality of life of preschool children, including functional, psychological, and social well-being, as well as [...] Read more.

Background/Objectives: Early childhood caries (ECC) and severe early childhood caries (S-ECC) are oral health problems that affect many preschool children worldwide. ECC and S-ECC negatively impact the quality of life of preschool children, including functional, psychological, and social well-being, as well as their families. There is no updated data regarding the prevalence of ECC and S-ECC in Jeddah, Saudi Arabia. Additionally, no study has been conducted on oral health-related quality of life (OHRQoL) with regard to ECC and S-ECC among preschool children in Jeddah. Thus, this investigation aimed to determine the prevalence of ECC and S-ECC in children 3 to 5 years old in Jeddah and its relation to OHRQoL. Methods: A cross-sectional survey was carried out on 322 children randomly selected from different preschools in Jeddah. The early childhood oral health impact scale (ECOHIS) questionnaires were distributed and completed by the parents followed by clinical examination. The dmft and dmfs index scores were determined by WHO diagnostic criteria. Results: A total of 322 preschool children were included in the final sample. The results indicated a caries prevalence rate of 74.2% with ECC and S-ECC prevalence rates of 34.2% and 40.1%, respectively. The mean ± SD dmft and dmfs scores were 4.6 ± 0.4 and 10.8 ± 0.9, respectively. The mean ± SD total score of the early childhood oral health impact scale (ECOHIS) was 6.1 ± 7.3. S-ECC was significantly associated with higher ECOHIS scores (p < 0.001) after controlling for age. Conclusions: ECC and S-ECC are highly prevalent in Jeddah, Saudi Arabia, and negatively impact OHRQoL. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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15 pages, 228 KB

Open AccessArticle

Validity and Applicability of Introducing a Healthcare-Associated Infection Surveillance System in Dental Hospitals in Korea Using the Delphi Technique

by Sun Young Jeong and So-Youn An

Healthcare 2025, 13(23), 3065; https://doi.org/10.3390/healthcare13233065 - 26 Nov 2025

Viewed by 768

Abstract

Background: This study determined the validity and applicability of introducing a healthcare-associated infection surveillance system in dental hospitals using the Delphi technique. Methods: The Delphi questionnaire was developed by conducting a systematic literature review and focus group interview involving five dentists and dental [...] Read more.

Background: This study determined the validity and applicability of introducing a healthcare-associated infection surveillance system in dental hospitals using the Delphi technique. Methods: The Delphi questionnaire was developed by conducting a systematic literature review and focus group interview involving five dentists and dental hygienists with experience in performing infection control in dental hospitals and three infection control experts. The Delphi survey was administered to 16 experts, including 6 dentists and 5 dental hygienists with experience in infection control, 2 infection control nurses, and 3 infectious disease physicians. Results: The Delphi survey demonstrated a high level of agreement on the necessity of introducing a healthcare-associated infection surveillance system in dental hospitals and the need for dental hospitals to participate in the “Korean National Healthcare-associated Infections Surveillance System” that is currently operated on a national level. However, the level of agreement on the applicability was low given the lack of employees responsible for infection control. Conclusions: Surveillance criteria and a system for process indicators suitable for dental hospitals should be established. We suggest developing infection surveillance indicators and applying trials of the items with a high priority, as assessed in this study, to support dental hospitals’ participation in the “Korean National Healthcare-associated Infections Surveillance System”. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

14 pages, 237 KB

Open AccessArticle

Patients’ Awareness and Attitudes About the Importance of Sharing Medical History with Dentists in Riyadh, Saudi Arabia

by Khalid A. Abalkhail, Sanjeev B. Khanagar, Alanoud Alfawaz, Rand Alharbi, Deem Alsaykhan and Layan Alqahtani

Healthcare 2025, 13(21), 2774; https://doi.org/10.3390/healthcare13212774 - 31 Oct 2025

Cited by 1 | Viewed by 1003

Abstract

Background: A comprehensive medical history is fundamental to dental care, supporting accurate diagnosis, personalized treatment, and the prevention of adverse outcomes. Despite its importance, patients may underestimate its relevance or hesitate to disclose information to dental professionals. This study aimed to assess [...] Read more.

Background: A comprehensive medical history is fundamental to dental care, supporting accurate diagnosis, personalized treatment, and the prevention of adverse outcomes. Despite its importance, patients may underestimate its relevance or hesitate to disclose information to dental professionals. This study aimed to assess patients’ awareness and willingness to disclose medical histories to dental professionals, as well as the effect of an educational intervention on their knowledge. Methods: A descriptive cross-sectional study was conducted from 1 December 2023 to 30 September 2024 in Riyadh, Saudi Arabia. Data were collected through a structured bilingual questionnaire assessing demographics, awareness of the importance of medical history, willingness to disclose information, and post-intervention knowledge. The questionnaire’s validity and reliability were established through expert evaluation and test–retest reliability, yielding Aiken’s V values greater than 0.90. Internal consistency was confirmed with a Cronbach’s alpha coefficient of 0.8. A convenience sampling technique was used to recruit the study participants. Results: A total of 515 participants completed the survey, with 43.9% withholding medical information from their dentists. Chi-square analysis revealed that disclosure practices were significantly associated with demographic factors, particularly age (p ≤ 0.05). Although 90.7% acknowledged the importance of sharing their medical history, only 67.8% reported disclosing it to dental professionals. The regression analysis revealed that participants under 18 years of age (Odds Ratio (OR) 7.08, Confidence Interval (CI) 3.53–50.90) and those aged 18–29 years (OR 14.36, CI 3.45–25.26), as well as participants with elementary (OR 4.55, CI 2.72–20.57) and middle school education levels (OR 4.55, CI 2.72–20.57), were less likely to disclose any underlying medical condition to their dentist. The younger age group (under 18) respondents were significantly more likely to indicate that it was not essential to inform the dentist about their medical condition (OR 6.60, CI 1.05–41.42). Additionally, a significant number of these respondents (OR 5.77, CI 1.87–17.84) reported being unaware of the reasons why dentists request this information, compared to the older age groups. Conclusions: The findings reveal a significant knowledge gap concerning patient disclosure of medical history in dental care and highlight the importance of patient education. Implementing targeted educational initiatives is recommended to promote patient disclosure, foster interdisciplinary collaboration, and improve overall patient safety and treatment outcomes. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

17 pages, 750 KB

Open AccessArticle

Challenges and Recommendations for Oral Healthcare of Older Adults in a Long-Term Care Facility

by Haslina Rani, Amalina Alya Azizan, Nurul Izzah Abdul Walad, Siti Aisya Athirah Hassan, Tuti Ningseh Mohd Dom, Daphne Shu Huey Yeoh, Joyce Wuen Cheer Tay, Muhammad Syafiq Asyraf Rosli, Nur Saadah Mohamad Aun, Aznida Firzah Abdul Aziz, Kaung Myat Thwin and In Meei Tew

Healthcare 2025, 13(20), 2642; https://doi.org/10.3390/healthcare13202642 - 20 Oct 2025

Cited by 2 | Viewed by 2840

Abstract

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing [...] Read more.

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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14 pages, 1198 KB

Open AccessArticle

Development and Validation of Oral Health-Related Quality of Life Scale for Patients Undergoing Endodontic Treatment (OHQE) for Irreversible Pulpitis

by Fadil Abdillah Arifin, Yuhei Matsuda and Takahiro Kanno

Healthcare 2023, 11(21), 2859; https://doi.org/10.3390/healthcare11212859 - 30 Oct 2023

Cited by 5 | Viewed by 3357

Abstract

An oral health-related quality of life measure specific to patients undergoing endodontic treatment has not been developed. This study aimed to validate the oral health-related quality of life scale for patients undergoing endodontic treatment (OHQE) for irreversible pulpitis, comprised of 42 questions. Sixty-two [...] Read more.

An oral health-related quality of life measure specific to patients undergoing endodontic treatment has not been developed. This study aimed to validate the oral health-related quality of life scale for patients undergoing endodontic treatment (OHQE) for irreversible pulpitis, comprised of 42 questions. Sixty-two patients with irreversible pulpitis, comprising 23 (37.1%) males and 39 (62.9%) females, were enrolled between August 2022 and February 2023. Data were collected at three time points: pretreatment, post-treatment, and at the second week post-treatment. Factor analysis revealed physical, psychological, and expectations as subscales of OHQE. Cronbach’s alpha coefficients ranged from 0.87 to 0.95 for each subscale. Each subscale of the General Oral Health Assessment Index (GOHAI) was moderately correlated with the OHQE subscales. Good–poor analysis revealed a significant difference between the high-scoring and low-scoring groups for each OHQE subscale. The intraclass correlation coefficients of the OHQE subscales ranged from 0.89 to 0.95. Multivariate linear regression analysis revealed a significant correlation between the pretreatment and post-treatment psychological factors (p < 0.05). Thus, OHQE will help researchers and policymakers understand the impact of oral health on the quality of life of patients with irreversible pulpitis undergoing endodontic treatment. OHQE could contribute to the appropriate planning, treatment decisions, and management of dental treatment. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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9 pages, 231 KB

Open AccessArticle

Nurses’ Awareness of and Current Approaches to Oral Care in a Community Hospital in Japan: A Longitudinal Study of Dental Specialists’ Interventions

by Takashi Koike, Ryuichi Ohta, Yuhei Matsuda, Chiaki Sano and Takahiro Kanno

Healthcare 2023, 11(17), 2425; https://doi.org/10.3390/healthcare11172425 - 30 Aug 2023

Cited by 2 | Viewed by 2229

Abstract

Objective: This study aimed to increase nurses’ interest and priority in oral care by implementing educational interventions, such as teaching oral care methods suitable for each patient in clinical settings, over a period of one year. Materials and Methods: This study included all [...] Read more.

Objective: This study aimed to increase nurses’ interest and priority in oral care by implementing educational interventions, such as teaching oral care methods suitable for each patient in clinical settings, over a period of one year. Materials and Methods: This study included all 150 nurses working in Unnan City Hospital in Japan who answered a questionnaire comprising 19 questions regarding awareness, actual implementation status of oral care provided, burden, and involvement with oral and maxillofacial surgery department of the hospital, along with participants’ characteristics. The rate of interest in learning, need for oral care, time spent in oral care, and oral health-related caregiver burden index (OHBI) score were compared between pre- and post-intervention groups. Results: The number and rate of valid questionnaires were 136 and 90.7%, respectively. The mean years of clinical experience were 19.3 ± 12.5 years; 93.4% of the nurses were women. After the interventions by dental specialists, the nurses’ level of interest in and priority to oral care were significantly higher than those before the interventions (p < 0.001), regardless of nurses’ background, such as age, gender, or years of experience. However, the “burden” did not statistically decrease. Conclusions: This study shows that dental specialists succeeded in significantly increasing nurses’ interest in and priority to oral care by intervening in clinical practice but failed in decreasing nurses’ burden of oral care. In the future, we would like to investigate the problems that hinder the reduction of the sense of burden, reduce the burden of nurses’ oral care, and improve oral care. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

12 pages, 1080 KB

Open AccessArticle

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

by Hiroto Tatsumi, Yuhei Matsuda, Erina Toda, Tatsuo Okui, Satoe Okuma and Takahiro Kanno

Healthcare 2023, 11(9), 1294; https://doi.org/10.3390/healthcare11091294 - 30 Apr 2023

Cited by 7 | Viewed by 4033

Abstract

The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and [...] Read more.

The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and rigid internal fixation (OR-IF) of mandibular condylar fractures using the high perimandibular approach. Twenty consecutive patients undergoing OR-IF were included in this study. They included 11 male and 9 female patients, of an average age of 58.5 years, all of whom responded to a follow-up call at least 12 months after the surgery. All patients were evaluated for range of mouth opening, postoperative complications, and radiological findings. A statistical analysis of the relationship between range of mouth opening and related clinical parameters at 6 months postoperative evaluation was conducted. The fracture of the condylar neck was associated with a limited range of mouth opening and longer operation time. However, longer operation time was not associated with a limited range of mouth opening. The high perimandibular approach with OR-IF in mandibular condylar fractures is a feasible and safe technique; however, prolonged surgery and mandibular condylar neck fractures could affect the postoperative range of mouth opening. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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8 pages, 240 KB

Open AccessCommunication

Association between Clinical Periodontal Features and Glycated Hemoglobin in Patients with Diabetes and Controlled Periodontitis: A Cross-Sectional Study

by Masayuki Tooi, Yuhei Matsuda, Hui Zhong and Shinichi Arakawa

Healthcare 2023, 11(7), 1035; https://doi.org/10.3390/healthcare11071035 - 4 Apr 2023

Cited by 2 | Viewed by 3070

Abstract

Diabetes and periodontitis are the most prevalent chronic diseases, and they influence each other’s progression. Only a few studies have shown the association between diabetes and mild periodontitis. We aimed to investigate the relationship between well-controlled periodontitis and glycated hemoglobin (HbA1c) in patients [...] Read more.

Diabetes and periodontitis are the most prevalent chronic diseases, and they influence each other’s progression. Only a few studies have shown the association between diabetes and mild periodontitis. We aimed to investigate the relationship between well-controlled periodontitis and glycated hemoglobin (HbA1c) in patients with diabetes. This retrospective study investigated 150 Japanese patients with type 2 diabetes treated with supportive periodontal therapy (SPT). Medical histories of diabetes and periodontal therapy were collected, and a multiple linear regression analysis was performed to determine their association. The patients included 67 (44.7%) males and 83 (55.3%) females, with a mean age of 68.1 (standard deviation = 10.5) years. Forty-four (29.3%) patients were treated for diabetes, and the mean HbA1c was 6.7% (0.7). Oral status was 23.3 (5.1) for the number of teeth, 2.5 mm (0.4) for mean probing pocket depth (PPD), and 163.9 mm² (181.3) for the periodontal inflamed surface area (PISA). The multiple regression analysis showed a significant association between mean PPD (β = 0.38, p = 0.03) and HbA1c in patients with mild diabetes but not in severe cases. These results suggest that the diagnostic indices for periodontitis used to assess the association between periodontitis and HbA1c would be determined based on the severity of periodontitis and type 2 diabetes. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

9 pages, 448 KB

Open AccessArticle

Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions

by Ryo Miyazaki, Shintaro Sukegawa, Ken Nakagawa, Fumi Nakai, Yasuhiro Nakai, Takanori Ishihama and Minoru Miyake

Healthcare 2023, 11(6), 871; https://doi.org/10.3390/healthcare11060871 - 16 Mar 2023

Cited by 3 | Viewed by 8848

Abstract

Wisdom tooth extraction is one of the most commonly performed procedures by oral maxillofacial surgeons. Delayed-onset infection (DOI) is a rare complication of wisdom tooth extraction, and it occurs ~1–4 weeks after the extraction. In the present study, risk factors for DOI were [...] Read more.

Wisdom tooth extraction is one of the most commonly performed procedures by oral maxillofacial surgeons. Delayed-onset infection (DOI) is a rare complication of wisdom tooth extraction, and it occurs ~1–4 weeks after the extraction. In the present study, risk factors for DOI were investigated by retrospectively analyzing the cases of 1400 mandibular wisdom tooth extractions performed at Kagawa University Hospital from April 2015 to June 2022. Inclusion criteria were patients aged >15 years with a wisdom tooth extraction per our procedure. The exclusion criteria were patients with insufficient medical records, a >30-mm lesion around the wisdom tooth shown via X-ray, colonectomy, radiotherapy treatment of the mandible, the lack of panoramic images, and lesions other than a follicular cyst. The DOI incidence was 1.1% (16 cases), and univariate analyses revealed that the development of DOI was significantly associated with the Winter classification (p = 0.003), position (p = 0.003), hypertension (p = 0.011), and hemostatic agent use (p = 0.004). A multivariate logistic regression analysis demonstrated that position (OR = B for A, 7.75; p = 0.0163), hypertension (OR = 7.60, p = 0.013), and hemostatic agent use (OR = 6.87, p = 0.0022) were significantly associated with DOI development. Hypertension, hemostatic use, and position were found to be key factors for DOI; long-term observation may thus be necessary for patients with these risk factors. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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10 pages, 267 KB

Open AccessArticle

Fast Eating Speed Could Be Associated with HbA1c and Salt Intake Even after Adjusting for Oral Health Status: A Cross-Sectional Study

by Satsuki Watanabe, Yuhei Matsuda, Yui Nanba, Mayu Takeda, Takafumi Abe, Kazumichi Tominaga, Minoru Isomura and Takahiro Kanno

Healthcare 2023, 11(5), 646; https://doi.org/10.3390/healthcare11050646 - 23 Feb 2023

Cited by 3 | Viewed by 3230

Abstract

This study aimed to examine the relationship between eating speed and hemoglobin A1c (HbA1c), considering the number of teeth, using cross-sectional health examination data from community-dwelling older individuals in Japan. We used data from the Center for Community-Based Healthcare Research and Education Study [...] Read more.

This study aimed to examine the relationship between eating speed and hemoglobin A1c (HbA1c), considering the number of teeth, using cross-sectional health examination data from community-dwelling older individuals in Japan. We used data from the Center for Community-Based Healthcare Research and Education Study in 2019. We collected data on gender, age, body mass index, blood test results, Salt intake, bone mineral density, body fat percentage, muscle mass, basal metabolic rate, number of teeth, and lifestyle information. Eating speed was evaluated subjectively as fast, normal, or slow. Overall, 702 participants were enrolled in the study and 481 participants were analyzed. Multivariate logistic regression analysis revealed a significant association between fast eating speed and being a male (odds ratio [95% confidence interval]: 2.15 [1.02–4.53]), HbA1c (1.60 [1.17–2.19]), salt intake (1.11 [1.01–1.22]), muscle mass (1.05 [1.00–1.09]), and enough sleep (1.60 [1.03–2.50]). Fast eating may be associated with overall health and lifestyle. The characteristics of fast eaters, after taking oral information into consideration, tended to increase the risk of type 2 diabetes, renal dysfunction, and hypertension. Dental professionals should provide dietary and lifestyle guidance to fast eaters. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

Review

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16 pages, 3480 KB

Open AccessReview

Dental Trauma and Quality of Life in a Paediatric Population (Up to 14 Years): A Bibliometric Analysis

by Bianca Núbia Souza-Silva, Danilo Cassiano Ferraz, Walbert de Andrade Vieira, João Marcos da Costa Ribeiro, Gabriel Phelipe de Paula Santos, Nathalia de Oliveira Domingos, Saul Martins Paiva, Carlos José Soares and Luiz Renato Paranhos

Healthcare 2026, 14(4), 475; https://doi.org/10.3390/healthcare14040475 - 13 Feb 2026

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Abstract

Background/Objectives: Dental trauma is common in childhood and may negatively affect oral health-related quality of life (OHRQoL). Given the growing volume and diversity of publications on this topic, a bibliometric approach is suitable for mapping scientific production, collaboration patterns, thematic evolution, and [...] Read more.

Background/Objectives: Dental trauma is common in childhood and may negatively affect oral health-related quality of life (OHRQoL). Given the growing volume and diversity of publications on this topic, a bibliometric approach is suitable for mapping scientific production, collaboration patterns, thematic evolution, and citation dynamics. This study aimed to perform a bibliometric analysis of the literature addressing the impact of dental trauma on OHRQoL in a paediatric population up to 14 years of age. Methods: A bibliometric study was conducted using Clarivate’s Web of Science Core Collection (WoS-CC), selected for its standardized citation indexing and suitability for bibliometric analyses. Publications retrieved up to August 2025, without restrictions on language or year, were analyzed using VOSviewer (version 1.6.20) and Biblioshiny (Bibliometrix package). Indicators included scientific output, collaboration networks, keyword co-occurrence, thematic evolution, and citation performance. Spearman’s correlation was used to explore relationships between citation counts, journal impact factor, and year of publication. Results: A total of 107 articles published between 2006 and 2025 were included. Scientific output increased steadily, with publications concentrated in specific countries, notably Brazil and India. The predominant research focus concerned the impact of dental trauma on children’s quality of life. Dental Traumatology was the most productive journal and showed high local citation impact. Citation analysis demonstrated a weak positive correlation between citation counts and journal impact factor (rho = 0.37, p < 0.001) and a strong negative correlation with year of publication (rho = −0.84, p < 0.001). Conclusions: This bibliometric analysis identifies research trends, thematic stability, and collaboration patterns in studies on dental trauma and OHRQoL in children, highlighting regional concentration and limited international collaboration. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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16 pages, 650 KB

Open AccessReview

Integrating Dentistry into Interprofessional Healthcare: A Scoping Review on Advancing Collaborative Practice and Patient Outcomes

by Man Hung, Wendy C. Birmingham, Madeleine Tucker, Connor Schwartz and Amir Mohajeri

Healthcare 2025, 13(21), 2780; https://doi.org/10.3390/healthcare13212780 - 1 Nov 2025

Cited by 8 | Viewed by 3287

Abstract

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, [...] Read more.

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral–systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner–dentist partnerships and medical–dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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Other

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17 pages, 2504 KB

Open AccessSystematic Review

CBCT-Based Assessment of External Apical Root Resorption in Clear Aligner Versus Fixed Orthodontic Therapy: A Systematic Review and Meta-Analysis

by Ersin Yıldırım and Celalettin Topbas

Healthcare 2026, 14(11), 1547; https://doi.org/10.3390/healthcare14111547 - 2 Jun 2026

Viewed by 192

Abstract

Background/Objectives: External apical root resorption (EARR) is a recognized biological consequence of orthodontic tooth movement. Although clear aligner therapy has been hypothesized to reduce EARR due to staged and intermittent force delivery, existing evidence remains heterogeneous, particularly with respect to imaging modality. [...] Read more.

Background/Objectives: External apical root resorption (EARR) is a recognized biological consequence of orthodontic tooth movement. Although clear aligner therapy has been hypothesized to reduce EARR due to staged and intermittent force delivery, existing evidence remains heterogeneous, particularly with respect to imaging modality. This systematic review and meta-analysis aimed to compare EARR between clear aligners and fixed orthodontic appliances using exclusively quantitative cone-beam computed tomography (CBCT)-based linear root length measurements. Methods: A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, CENTRAL, ClinicalTrials.gov, WHO ICTRP, and Google Scholar (inception to January 2026). Comparative clinical studies reporting CBCT-based linear root length changes (mm) in clear aligner and fixed appliance groups were included. Random-effects meta-analysis (DerSimonian–Laird method) was performed to calculate pooled mean differences (MD = CA − FA). Heterogeneity was assessed using Cochran’s Q and I² statistics. Risk of bias was evaluated using the ROBINS-I tool, and certainty of evidence was assessed with GRADE. Results: Six studies involving 392 patients met the inclusion criteria and were included in the quantitative synthesis. Random-effects meta-analysis demonstrated significantly lower EARR in the clear aligner group compared with fixed appliances (MD = −0.50 mm; 95% CI −0.79 to −0.21; p < 0.001). Between-study heterogeneity was moderate (I² = 60.8%). Subgroup analysis suggested a larger reduction in extraction-based protocols, although data were limited. Sensitivity analyses confirmed the robustness of the overall effect. The certainty of evidence was rated as low. Conclusions: Clear aligner therapy was associated with lower CBCT-measured external apical root resorption compared with fixed orthodontic appliances; however, this finding should be interpreted with caution due to the limited number of studies, moderate heterogeneity, and potential residual confounding inherent to non-randomized designs. The results should be considered exploratory rather than definitive. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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26 pages, 617 KB

Open AccessSystematic Review

Distribution of Candida Species Causing Oral Candidiasis in High-Risk Populations: A Systematic Review

by João Pedro Carvalho, Jéssica Rodrigues, Célia Fortuna Rodrigues, José Carlos Andrade and António Rajão

Healthcare 2026, 14(2), 159; https://doi.org/10.3390/healthcare14020159 - 8 Jan 2026

Cited by 1 | Viewed by 1827

Abstract

Background: In the last decade, infections caused by Candida species have increased. Although C. albicans remains the most predominant species, fungal infections caused by non-albicans Candida (NAC) species have also been rising. This study aimed to determine which Candida spp. are most [...] Read more.

Background: In the last decade, infections caused by Candida species have increased. Although C. albicans remains the most predominant species, fungal infections caused by non-albicans Candida (NAC) species have also been rising. This study aimed to determine which Candida spp. are most frequently associated with oral candidiasis. Methods: In accordance with PRISMA guidelines, a literature search was conducted in the PubMed, Cochrane Library, and ScienceDirect databases. The search used the keyword combination “candida spp” AND “oral candidiasis” AND “oral isolates” and included articles published between 2013 and 31 October 2025. Results: A total of 658 articles were identified, of which 24 met the inclusion criteria. Across these studies, 12,750 isolates were reported. C. albicans was the most prevalent species, accounting for 81.7% of all isolates. NAC species were detected at lower frequencies, including C. tropicalis (7.2%), C. glabrata (4.5%), C. krusei (4.1%), C. parapsilosis (1.0%), C. dubliniensis (0.8%), C. kefyr (0.2%), C. guilliermondii (0.1%), C. lusitaniae (0.1%), and other rare or unidentified species (0.2%). The increasing prevalence of Candida infections is associated with a growing population of immunocompromised individuals, and treatment remains challenging due to rising antifungal resistance. Conclusions: Although C. albicans remains the most prevalent, the appearance of NAC species is gradually increasing. With the increase of Candida spp. resistant to conventional antifungal agents and with the competitive or synergistic interaction between Candida spp., it is necessary to develop new therapeutic approaches. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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