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Search Results (613)

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Keywords = oral health statistics

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11 pages, 678 KiB  
Article
Evaluation of an Intraoral Camera with an AI-Based Application for the Detection of Gingivitis
by Cécile Ehrensperger, Philipp Körner, Leonardo Svellenti, Thomas Attin and Philipp Sahrmann
J. Clin. Med. 2025, 14(15), 5580; https://doi.org/10.3390/jcm14155580 - 7 Aug 2025
Abstract
Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a [...] Read more.
Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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17 pages, 241 KiB  
Article
Creating and Validating a Questionnaire on Dentists’ Perceptions Regarding Periodontics–Prosthodontics Interdisciplinary Clinical Practice
by Gabriel Rotundu, Dragos Ioan Virvescu, Zinovia Surlari, Dana Gabriela Budala, Florin Razvan Curca, Carina Balcos, Cristian Cojocaru, Vlad Constantin, Razvan Gradinariu and Ionut Luchian
Clin. Pract. 2025, 15(8), 149; https://doi.org/10.3390/clinpract15080149 - 7 Aug 2025
Abstract
Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire [...] Read more.
Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire designed to assess dentists’ perceptions regarding the influence of prosthetic restorations on the periodontium. Material and Methods: An observational cross-sectional study was conducted using a self-administered questionnaire distributed to licensed dentists across Romania. The questionnaire underwent expert review, pilot testing (n = 50), and statistical validation, including the Content Validity Index (CVI), Cronbach’s alpha for internal consistency, and Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with Varimax rotation. The final sample included 39 respondents. Data was analyzed using SPSS v26.0. Results: The questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.900; standardized alpha = 0.917). Most items had corrected item-total correlations > 0.40. EFA revealed eight coherent factors explaining 81.68% of total variance, with high communalities (0.549–0.966), strong Kaiser–Meyer–Olkin test (KMO) values, and significant Bartlett’s test values, confirming construct validity. Descriptive statistics showed predominantly positive attitudes among dentists regarding the periodontal considerations in prosthetic treatment. The highest-rated items emphasized oral hygiene, periodontal stability, and biological adaptation of restorations. Lower scores were associated with routine use of periodontal indices and recognition of failures due to insufficient evaluation. Conclusions: The validated instrument proved reliable and demonstrated strong psychometric properties in this exploratory validation, supporting its use in research and education. Romanian dentists demonstrated a favorable perception of the role of periodontal health in prosthetic success. This tool can inform curriculum development and interdisciplinary clinical protocols in prosthodontics and periodontology. Full article
16 pages, 257 KiB  
Article
Oral–Systemic Health Awareness Among Physicians and Dentists in Croatian Primary Healthcare: A Cross-Sectional Study
by Marija Badrov, Martin Miskovic, Ana Glavina and Antonija Tadin
Epidemiologia 2025, 6(3), 43; https://doi.org/10.3390/epidemiologia6030043 - 7 Aug 2025
Abstract
Objectives: This study aimed to assess the knowledge, attitudes, and self-confidence of physicians and dentists in Croatia regarding the relationship between oral and systemic health, focusing on periodontal disease and oral manifestations of systemic diseases. Methods: A cross-sectional, web-based survey was conducted among [...] Read more.
Objectives: This study aimed to assess the knowledge, attitudes, and self-confidence of physicians and dentists in Croatia regarding the relationship between oral and systemic health, focusing on periodontal disease and oral manifestations of systemic diseases. Methods: A cross-sectional, web-based survey was conducted among physicians and dentists in Croatian primary healthcare. The questionnaire addressed six thematic domains, including demographic information, knowledge, self-assessment, and clinical practice. Descriptive and comparative statistical analyses were performed. Results: A total of 529 respondents were included (291 physicians and 238 dentists). The mean knowledge score for the association between periodontitis and systemic diseases was 6.8 ± 3.6 out of 15, indicating limited knowledge. For oral manifestations of systemic diseases, the mean score was 10.0 ± 3.8 out of 16, reflecting moderate proficiency. Dentists scored higher than physicians in both domains, though not significantly (p > 0.05). Routine oral mucosal examinations were reported by 89.5% of dentists and 43.0% of physicians (p ≤ 0.001). Only 21.3% of physicians correctly identified the link between periodontitis and adverse pregnancy outcomes, compared to 58.8% of dentists. The primary barriers to effective clinical management were a lack of experience (52.7%) and inadequate education. While 68.3% of dentists felt adequately educated on oral–systemic links, only 22.7% of physicians reported the same. Conclusions: Significant gaps in knowledge and confidence were observed, particularly among physicians. These findings underscore the need to integrate oral–systemic health topics into medical education and to promote interprofessional collaboration to improve patient outcomes. Full article
13 pages, 248 KiB  
Article
The Prevalence and Impact of Dentinal Hypersensitivity on Adults’ Quality of Life in Saudi Arabia
by Haya Alayadi, Omar Alsadon, Maram Ali Alwadi, Alaa A. Alkhateeb, Deema Alroweilly, Zainab Alassmi and Wedad Alshehri
Dent. J. 2025, 13(8), 353; https://doi.org/10.3390/dj13080353 - 4 Aug 2025
Viewed by 143
Abstract
Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This [...] Read more.
Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article
(This article belongs to the Special Issue Dentinal Hypersensitivity)
14 pages, 1169 KiB  
Article
Putting DOAC Doubts to Bed(Side): Preliminary Evidence of Comparable Functional Outcomes in Anticoagulated and Non-Anticoagulated Stroke Patients Using Point-of-Care ClotPro® Testing
by Jessica Seetge, Balázs Cséke, Zsófia Nozomi Karádi, Edit Bosnyák, Eszter Johanna Jozifek and László Szapáry
J. Clin. Med. 2025, 14(15), 5476; https://doi.org/10.3390/jcm14155476 - 4 Aug 2025
Viewed by 166
Abstract
Background/Objectives: Direct oral anticoagulants (DOACs) are now the guideline-recommended alternative to vitamin K antagonists (VKAs) for long-term anticoagulation in patients with non-valvular atrial fibrillation. However, accurately assessing their impact on ischemic stroke outcomes remains challenging, primarily due to uncertainty regarding anticoagulation status at [...] Read more.
Background/Objectives: Direct oral anticoagulants (DOACs) are now the guideline-recommended alternative to vitamin K antagonists (VKAs) for long-term anticoagulation in patients with non-valvular atrial fibrillation. However, accurately assessing their impact on ischemic stroke outcomes remains challenging, primarily due to uncertainty regarding anticoagulation status at the time of hospital admission. This preliminary study addresses this gap by using point-of-care testing (POCT) to confirm DOAC activity at bedside, allowing for a more accurate comparison of 90-day functional outcomes between anticoagulated and non-anticoagulated stroke patients. Methods: We conducted a retrospective cohort study of 786 ischemic stroke patients admitted to the University of Pécs between February 2023 and February 2025. Active DOAC therapy was confirmed using the ClotPro® viscoelastic testing platform, with ecarin Clotting Time (ECT) employed for thrombin inhibitors and Russell’s Viper Venom (RVV) assays for factor Xa inhibitors. Patients were categorized as non-anticoagulated (n = 767) or DOAC-treated with confirmed activity (n = 19). Mahalanobis distance-based matching was applied to account for confounding variables including age, sex, pre-stroke modified Rankin Scale (mRS), and National Institutes of Health Stroke Scale (NIHSS) scores at admission and 72 h post-stroke. The primary outcome was the change in mRS from baseline to 90 days. Statistical analysis included ordinary least squares (OLS) regression and principal component analysis (PCA). Results: After matching, 90-day functional outcomes were comparable between groups (mean mRS-shift: 2.00 in DOAC-treated vs. 1.78 in non-anticoagulated; p = 0.745). OLS regression showed no significant association between DOAC status and recovery (p = 0.599). In contrast, NIHSS score at 72 h (p = 0.004) and age (p = 0.015) were significant predictors of outcome. PCA supported these findings, identifying stroke severity as the primary driver of outcome. Conclusions: This preliminary analysis suggests that ischemic stroke patients with confirmed active DOAC therapy at admission may achieve 90-day functional outcomes comparable to those of non-anticoagulated patients. The integration of bedside POCT enhances the reliability of anticoagulation assessment and underscores its clinical value for real-time management in acute stroke care. Larger prospective studies are needed to validate these findings and to further refine treatment strategies. Full article
(This article belongs to the Section Clinical Neurology)
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16 pages, 424 KiB  
Article
Evaluation of Clinical and Quality of Life Effects of Oral Semaglutide Use in Type 2 Diabetes from a Public Health View: A Prospective Study in Italy
by Paola Pantanetti, Vanessa Ronconi, Stefano Mancin, Cristina De Carolis, Sara Alberti, Orietta Pazzi, Sandra Di Marco, Grazia Michetti, Silvia Coacci, Veronica Mignini, Franco Gregorio, Giulia Baldoni, Sara Toderi, Sara Morales Palomares, Fabio Petrelli, Gabriele Caggianelli, Mauro Parozzi and Giovanni Cangelosi
Diabetology 2025, 6(8), 80; https://doi.org/10.3390/diabetology6080080 - 4 Aug 2025
Viewed by 135
Abstract
Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, [...] Read more.
Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, represents a modern strategy to improve patient adherence while supporting glucose and weight regulation. This study primarily investigated the effects of oral semaglutide on key metabolic indicators and secondary endpoints included cardiovascular risk markers (blood pressure and lipid profile) and patient-reported quality of life (QoL). Study Design and Methods: A longitudinal, prospective observational study was conducted involving patients with T2D across two Italian healthcare facilities. Participants were assessed at baseline (T0) and at three subsequent intervals—6 months (T1), 12 months (T2), and 18 months (T3)—following the initiation of oral semaglutide use. Key Findings: Out of 116 participants enrolled, 97 had complete and analyzable data. Across the 18-month follow-up, significant improvements were observed in glycemic parameters, with a notable reduction in HbA1c levels (T0 vs. T3, p = 0.0028; p ≤ 0.05, statistically significant). Self-reported outcomes showed enhanced quality of life, especially in treatment satisfaction and perceived flexibility (T0 vs. T3, p < 0.001). Conclusions: Daily administration of 14 mg oral semaglutide in individuals with T2D resulted in substantial benefits in glycemic regulation, weight reduction, cardiovascular risk management, and overall patient satisfaction. These findings reinforce its potential role as a sustainable and effective option in long-term diabetes care from both a clinical and public health perspective. Full article
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18 pages, 2511 KiB  
Article
Depression, Anxiety, and MSQOL-54 Outcomes in RRMS Patients Receiving Fingolimod or Cladribine: A Cross-Sectional Comparative Study
by Müttalip Özbek, Adalet Arıkanoğlu and Mehmet Ufuk Aluçlu
Medicina 2025, 61(8), 1409; https://doi.org/10.3390/medicina61081409 - 3 Aug 2025
Viewed by 210
Abstract
Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated [...] Read more.
Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article
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14 pages, 2030 KiB  
Article
In Vitro Assessment of the Antimicrobial and Antibiofilm Activities of Commercial Toothpastes Against Streptococcus mutans
by Yun Ju Lee and Jeong Nam Kim
Appl. Biosci. 2025, 4(3), 38; https://doi.org/10.3390/applbiosci4030038 - 2 Aug 2025
Viewed by 214
Abstract
Toothpaste is an essential oral hygiene product commonly used to sustain oral health due to its incorporation of antimicrobial agents. Numerous functional toothpastes enriched with antimicrobial agents have been developed and are available to consumers. This study evaluates the antimicrobial and antibiofilm efficacy [...] Read more.
Toothpaste is an essential oral hygiene product commonly used to sustain oral health due to its incorporation of antimicrobial agents. Numerous functional toothpastes enriched with antimicrobial agents have been developed and are available to consumers. This study evaluates the antimicrobial and antibiofilm efficacy of 12 commercially available toothpaste products, including those with specialized functions. Statistical significance was assessed to validate the differences observed among the toothpaste samples. Their effects on Streptococcus mutans, the primary pathogen responsible for dental caries, were evaluated. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined, and bacterial growth was measured to compare antimicrobial activities. Toothpaste containing 1000 μg/mL fluoride and whitening toothpaste exhibited the strongest antimicrobial effects, effectively inhibiting S. mutans growth. Additionally, bamboo salt-enriched and tartar-control toothpaste demonstrated inhibitory effects on bacterial growth. Assays to evaluate the ability of cells to form biofilms and the expression of genes involved in biofilm formation revealed a partial correlation between biofilm formation and spaP, gtfB, gtfC, and gtfD expression, although some showed opposite trends. Collectively, this study provides valuable insights into the antimicrobial and biofilm inhibition capabilities of commercial toothpastes against S. mutans, offering a foundation for evaluating the efficacy of functional toothpaste products. Full article
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11 pages, 685 KiB  
Article
Fetal Pancreatic Circumference as a Predictor of Gestational Diabetes Mellitus During 75 g OGTT
by Mehmet Can Keven, Ece Aydoğdu, Banu Derim Yeğen, Ebru Yucel, Zafer Bütün and Atakan Tanaçan
J. Clin. Med. 2025, 14(15), 5414; https://doi.org/10.3390/jcm14155414 - 1 Aug 2025
Viewed by 132
Abstract
Objectives: The objective of this study was to investigate the relationship between the simultaneous 75 g Oral glucose tolerance test (OGTT), gestational diabetes mellitus (GDM), and fetal pancreatic circumference at 24–28 weeks of gestation. Methods: This prospective case–control study was conducted between September [...] Read more.
Objectives: The objective of this study was to investigate the relationship between the simultaneous 75 g Oral glucose tolerance test (OGTT), gestational diabetes mellitus (GDM), and fetal pancreatic circumference at 24–28 weeks of gestation. Methods: This prospective case–control study was conducted between September 2024 and February 2025 at our perinatology clinic, which provides tertiary health care services. The correlation between the 75 g OGTT, GDM, and pancreatic circumference was assessed by comparing fetal pancreatic circumference between the groups with and without GDM at the time of diagnosis. Results: A total of 130 pregnant patients were recruited for this` study, with 64 patients forming the GDM group and 66 patients forming the control group. Fetal pancreas circumference (7.0 cm vs. 6.4 cm, p < 0.001), fetal pancreas circumference percentile (88.5 vs. 52, p < 0.001), and the rate of fetal pancreas size >90th percentile (15.6% vs. 3%, p < 0.001) were significantly higher in the GDM group compared to the control group. Conclusions: Although our findings demonstrate a statistically significant correlation between fetal pancreatic circumference and GDM, diagnostic performance remains modest. Therefore, fetal pancreatic circumference should be interpreted as a supportive marker, such as family history, rather than a definitive marker for identifying individuals at risk for GDM. Full article
(This article belongs to the Special Issue Clinical Insights in Maternal–Fetal Medicine)
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21 pages, 1112 KiB  
Article
Associations Between Smoking, Stress, Quality of Life, and Oral Health Among Dental Students in Romania: A Cross-Sectional Study
by Adina Oana Armencia, Andrei Nicolau, Irina Bamboi, Bianca Toader, Anca Rapis, Tinela Panaite, Daniela Argatu and Carina Balcos
Medicina 2025, 61(8), 1394; https://doi.org/10.3390/medicina61081394 - 1 Aug 2025
Viewed by 242
Abstract
Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived [...] Read more.
Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived stress level, and self-assessed quality of life in a sample of dental students. Materials and Methods: The cross-sectional study included 338 students, who completed validated questionnaires and were clinically examined. Lifestyle was assessed using a smoking behavior questionnaire, stress levels were measured with the Student Stress Inventory (SSI), and quality of life was evaluated using the EQ-5D-5L instrument. The DMFT index was calculated to determine oral health status. Results: Among the 338 participating students, 53.8% were smokers. The lifestyle analysis revealed slightly higher average scores among non-smokers across all domains—social (3.26 vs. 3.09), attitudinal (2.75 vs. 2.97), and behavioral (3.82 vs. 3.49), but without statistically significant differences (p > 0.25). The mean DMFT score was 12.48, with no significant differences between smokers and non-smokers (p = 0.554). The SSI total score averaged 83.15, indicating a moderate level of perceived stress, again with no statistically significant differences between the groups (p > 0.05). However, slightly higher average stress scores among smokers may suggest the use of smoking as a coping mechanism. In contrast, quality of life as measured by EQ-5D-5L showed significantly worse outcomes for smokers across all five dimensions, including mobility (78.6% vs. 95.5%, p = 0.000) and self-care (93.4% vs. 100%, p = 0.001). Multivariable logistic regression identified smoking (OR = 1.935; p = 0.047) and moderate stress levels (OR = 0.258; p < 0.001) as independent predictors of oral health status. Conclusions: The results obtained suggest that smoking may function as a stress management strategy among students, supporting the relevance of integrating specific psychobehavioral interventions that address stress reduction and oral health promotion among student populations. Full article
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22 pages, 2677 KiB  
Article
Prevalence of Temporomandibular Disorder Symptoms Among Dental Students at the Faculty of Dental Medicine in Iași: A Self-Reported Study Based on DC/TMD Criteria
by Eugenia Larisa Tarevici, Oana Tanculescu, Alina Mihaela Apostu, Sorina Mihaela Solomon, Alice-Teodora Rotaru-Costin, Adrian Doloca, Petronela Bodnar, Vlad Stefan Proca, Alice-Arina Ciocan-Pendefunda, Monica Tatarciuc, Valeriu Fala and Marina Cristina Iuliana Iordache
Diagnostics 2025, 15(15), 1908; https://doi.org/10.3390/diagnostics15151908 - 30 Jul 2025
Viewed by 258
Abstract
Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms [...] Read more.
Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ2 tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article
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17 pages, 1908 KiB  
Article
BDE-47 Disrupts Gut Microbiota and Exacerbates Prediabetic Conditions in Mice: Therapeutic Potential of Grape Exosomes and Antioxidants
by Zaoling Liu, Fang Cao, Aerna Qiayimaerdan, Nilupaer Aisikaer, Zulipiya Zunong, Xiaodie Ma and Yale Yu
Toxics 2025, 13(8), 640; https://doi.org/10.3390/toxics13080640 - 29 Jul 2025
Viewed by 222
Abstract
Background: BDE-47, a pervasive environmental pollutant detected in >90% of human serum samples, is increasingly linked to metabolic disorders. This study investigates the specific impact of BDE-47 exposure on the gut microbiota in prediabetic mice and evaluates the efficacy of therapeutic interventions [...] Read more.
Background: BDE-47, a pervasive environmental pollutant detected in >90% of human serum samples, is increasingly linked to metabolic disorders. This study investigates the specific impact of BDE-47 exposure on the gut microbiota in prediabetic mice and evaluates the efficacy of therapeutic interventions in mitigating these effects. Objectives: To determine whether BDE-47 exposure induces diabetogenic dysbiosis in prediabetic mice and to assess whether dietary interventions, such as grape exosomes and an antioxidant cocktail, can restore a healthy microbiota composition and mitigate diabetes risk. Methods: In this study, a prediabetic mouse model was established in 54 male SPF-grade C57BL/6J mice through a combination of high-sugar and high-fat diet feeding with streptozotocin injection. Oral glucose tolerance tests (OGTT) were conducted on day 7 and day 21 post-modeling to assess the establishment of the model. The criteria for successful model induction were defined as fasting blood glucose levels below 7.8 mmol/L and 2 h postprandial glucose levels between 7.8 and 11.1 mmol/L. Following confirmation of model success, a 3 × 3 factorial design was applied to allocate the experimental animals into groups based on two independent factors: BDE-47 exposure and exosome intervention. The BDE-47 exposure factor consisted of three dose levels—none, high-dose, and medium-dose—while the exosome intervention factor included three modalities—none, Antioxidant Nutrients Intervention, and Grape Exosomes Intervention. Fresh fecal samples were collected from mice two days prior to sacrifice. Cecal contents and segments of the small intestine were collected and transferred into 1.5 mL cryotubes. All sequences were clustered into operational taxonomic units (OTUs) based on defined similarity thresholds. To compare means across multiple groups, a two-way analysis of variance (ANOVA) was employed. The significance level was predefined at α = 0.05, and p-values < 0.05 were considered statistically significant. Bar charts and line graphs were generated using GraphPad Prism version 9.0 software, while statistical analyses were performed using SPSS version 20.0 software. Results: The results of 16S rDNA sequencing analysis of the microbiome showed that there was no difference in the α diversity of the intestinal microbiota in each group of mice (p > 0.05), but there was a difference in the Beta diversity (p < 0.05). At the gate level, the abundances of Proteobacteria, Campylobacterota, Desulfobacterota, and Fusobacteriota in the medium-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Patellar bacteria was lower than that of the model control group (p < 0.05). The abundances of Proteobacteria and Campylobacterota in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Planctomycetota and Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Campylobacterota in the grape exosome group was higher than that of the model control group (p < 0.05). The abundance of Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Firmicutes and Fusobacteriota in the antioxidant nutrient group was higher than that of the model control group (p < 0.05). However, the abundance of Verrucomicrobiota and Patescibacteria was lower than that of the model control group (p < 0.05). At the genus level, the abundances of Bacteroides and unclassified Lachnospiraceae in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Lachnospiraceae NK4A136_group and Lactobacillus was lower than that of the model control group (p < 0.05). The abundance of Veillonella and Helicobacter in the medium-dose BDE-7 group was higher than that in the model control group (p < 0.05), while the abundance of Lactobacillus was lower (p < 0.05). The abundance of genera such as Lentilactobacillus and Faecalibacterium in the grape exosome group was higher than that in the model control group (p < 0.05). The abundance of Alloprevotella and Bacteroides was lower than that of the model control group (p < 0.05). In the antioxidant nutrient group, the abundance of Lachnospiraceae and Hydrogenophaga was higher than that in the model control group (p < 0.05). However, the abundance of Akkermansia and Coriobacteriaceae UCG-002 was significantly lower than that of the model control group (p < 0.05). Conclusions: BDE-47 induces diabetogenic dysbiosis in prediabetic mice, which is reversible by dietary interventions. These findings suggest that microbiota-targeted strategies may effectively mitigate the diabetes risk associated with environmental pollutant exposure. Future studies should further explore the mechanisms underlying these microbiota changes and the long-term health benefits of such interventions. Full article
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22 pages, 2239 KiB  
Article
10-Year Fracture Risk Assessment with Novel Adjustment (FRAXplus): Type 2 Diabetic Sample-Focused Analysis
by Oana-Claudia Sima, Ana Valea, Nina Ionovici, Mihai Costachescu, Alexandru-Florin Florescu, Mihai-Lucian Ciobica and Mara Carsote
Diagnostics 2025, 15(15), 1899; https://doi.org/10.3390/diagnostics15151899 - 29 Jul 2025
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Abstract
Background: Type 2 diabetes (T2D) has been placed among the risk factors for fragility (osteoporotic) fractures, particularly in menopausal women amid modern clinical practice. Objective: We aimed to analyze the bone status in terms of mineral metabolism assays, blood bone turnover [...] Read more.
Background: Type 2 diabetes (T2D) has been placed among the risk factors for fragility (osteoporotic) fractures, particularly in menopausal women amid modern clinical practice. Objective: We aimed to analyze the bone status in terms of mineral metabolism assays, blood bone turnover markers (BTM), and bone mineral density (DXA-BMD), respectively, to assess the 10-year fracture probability of major osteoporotic fractures (MOF) and hip fracture (HF) upon using conventional FRAX without/with femoral neck BMD (MOF-FN/HF-FN and MOF+FN/HF+FN) and the novel model (FRAXplus) with adjustments for T2D (MOF+T2D/HF+T2D) and lumbar spine BMD (MOF+LS/HF+LS). Methods: This retrospective, cross-sectional, pilot study, from January 2023 until January 2024, in menopausal women (aged: 50–80 years) with/without T2D (group DM/nonDM). Inclusion criteria (group DM): prior T2D under diet ± oral medication or novel T2D (OGTT diagnostic). Exclusion criteria: previous anti-osteoporotic medication, prediabetes, insulin therapy, non-T2D. Results: The cohort (N = 136; mean age: 61.36 ± 8.2y) included T2D (22.06%). Groups DM vs. non-DM were age- and years since menopause (YSM)-matched; they had a similar osteoporosis rate (16.67% vs. 23.58%) and fracture prevalence (6.66% vs. 9.43%). In T2D, body mass index (BMI) was higher (31.80 ± 5.31 vs. 26.54 ± 4.87 kg/m2; p < 0.001), while osteocalcin and CrossLaps were lower (18.09 ± 8.35 vs. 25.62 ± 12.78 ng/mL, p = 0.002; 0.39 ± 0.18 vs. 0.48 ± 0.22 ng/mL, p = 0.048), as well as 25-hydroxyvitamin D (16.96 ± 6.76 vs. 21.29 ± 9.84, p = 0.013). FN-BMD and TH-BMD were increased in T2D (p = 0.007, p = 0.002). MOF+LS/HF+LS were statistically significant lower than MOF-FN/HF-FN, respectively, MOF+FN/HF+FN (N = 136). In T2D: MOF+T2D was higher (p < 0.05) than MOF-FN, respectively, MOF+FN [median(IQR) of 3.7(2.5, 5.6) vs. 3.4(2.1, 5.8), respectively, 3.1(2.3, 4.39)], but MOF+LS was lower [2.75(1.9, 3.25)]. HF+T2D was higher (p < 0.05) than HF-FN, respectively, HF+FN [0.8(0.2, 2.4) vs. 0.5(0.2, 1.5), respectively, 0.35(0.13, 0.8)] but HF+LS was lower [0.2(0.1, 0.45)]. Conclusion: Type 2 diabetic menopausal women when compared to age- and YSM-match controls had a lower 25OHD and BTM (osteocalcin, CrossLaps), increased TH-BMD and FN-BMD (with loss of significance upon BMI adjustment). When applying novel FRAX model, LS-BMD adjustment showed lower MOF and HF as estimated by the conventional FRAX (in either subgroup or entire cohort) or as found by T2D adjustment using FRAXplus (in diabetic subgroup). To date, all four types of 10-year fracture probabilities displayed a strong correlation, but taking into consideration the presence of T2D, statistically significant higher risks than calculated by the traditional FRAX were found, hence, the current model might underestimate the condition-related fracture risk. Addressing the practical aspects of fracture risk assessment in diabetic menopausal women might improve the bone health and further offers a prompt tailored strategy to reduce the fracture risk, thus, reducing the overall disease burden. Full article
(This article belongs to the Special Issue Diagnosis and Management of Metabolic Bone Diseases: 2nd Edition)
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16 pages, 3457 KiB  
Article
Association Between Genotoxic Effects of Ageing Dental Restorations and Micronuclei in Oral Mucosal Cells
by Csilla Benedek, Bernadette Kerekes-Máthé, Zsuzsanna Bardocz-Veres, Boglárka Szabó, Alina Iacob, Alexandra Stoica, Timea Dako, Mónika Kovács, Lóránd Dénes and Liana Bereșescu
Medicina 2025, 61(8), 1363; https://doi.org/10.3390/medicina61081363 - 28 Jul 2025
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Abstract
Background and Objectives: Dental restorations can be composed of various materials, including amalgams and methacrylate-based resins. The health risks associated with the components of the restorative materials have always been a concern, even more so with the ageing of the restorations. As [...] Read more.
Background and Objectives: Dental restorations can be composed of various materials, including amalgams and methacrylate-based resins. The health risks associated with the components of the restorative materials have always been a concern, even more so with the ageing of the restorations. As the micronucleus (MN) test is a standard, accessible, and minimally invasive technique for studying the genotoxic effect of clastogenic chemicals on oral mucosal cells, the current study was conducted to determine the frequency and morphological properties of MN in the exfoliated oral mucosal cells. Materials and Methods: A total of 115 aged composite and amalgam restorations were included in this study. Epithelial cells were collected from the gingival tissue adjacent to the restorations of each patient and stained with a hematoxylin–eosin (HE) stain. After evaluation of the slides, the results were subjected to statistical analysis using Chi-square tests. The level of significance was set at 0.05. Results: The mean number of MN was significantly lower for composite restorations compared to amalgam restorations. There were no statistically significant differences between composite restorations aged 1–5 years, 5–10 years, over 10 years, and amalgam restorations aged over 10 years in the location (p = 0.11), staining (p = 0.11), or morphological characteristics (p = 0.18) of the MN. Conclusions: Despite the main limitation of this study, the lack of a control group, our results suggest that long-term exposure to restorative fillings and the ageing of these materials can cause DNA damage locally in the adjacent sites of oral cavity. Full article
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14 pages, 2636 KiB  
Article
Self-Perception and Assessment of Antibiotic Therapy Knowledge in Dental Students in Spain: A Cross-Sectional Observational Study
by Ángel-Orión Salgado-Peralvo, Naresh Kewalramani, Irene-Alexandra Boullosa-Bernárdez, Carlos Oteo-Morilla, Ana-Leticia Lenguas-Silva, María-Rosario Garcillán-Izquierdo and María-Victoria Mateos-Moreno
Antibiotics 2025, 14(8), 755; https://doi.org/10.3390/antibiotics14080755 - 27 Jul 2025
Viewed by 306
Abstract
Background: The development of antimicrobial resistance is a major public health issue, in which dentists play a significant role by prescribing 7–11% of worldwide antibiotics. The aim of this study is to evaluate the self-perception and knowledge of antibiotic therapy in fifth-year [...] Read more.
Background: The development of antimicrobial resistance is a major public health issue, in which dentists play a significant role by prescribing 7–11% of worldwide antibiotics. The aim of this study is to evaluate the self-perception and knowledge of antibiotic therapy in fifth-year undergraduate dental students. Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 18 questions was conducted with fifth-year students enrolled in the 2022/23 and 2023/24 academic years. The data were analyzed using descriptive and inferential statistical methods. Results: A total of 139 students (76.4%) completed the questionnaire. A total of 71.9% of students considered that they had received adequate education in antibiotic therapy, particularly in Oral Surgery (89.2%) and Periodontics (86.3%). The theoretical classes (3.50 ± 0.98) and practical sessions (3.18 ± 1.29) provided the knowledge that had the greatest influence on their education. They showed high self-confidence in diagnosing an infection (3.49 ± 0.73) and in choosing the appropriate antibiotic and dosage (3.26 ± 0.73). Over 76% of students answered correctly regarding the need for antibiotic prescriptions in various practical scenarios, except in the replantation of avulsed permanent teeth (54%). Conclusions: Dental students’ knowledge of antibiotics should be reinforced, as a high percentage answered correctly regarding the indications for antibiotics in pulpal and periapical diseases, but students performed less well regarding the choice of antibiotic and dosage in patients without sensitivity to β-lactams. Full article
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