Search Results (70)

Background: Regenerative endodontic procedures (REPs) are promising treatments for immature teeth with necrotic pulp. Artificial intelligence (AI) is increasingly used in dentistry; thus, this study evaluates the reliability of AI-generated information on REPs, comparing four AI models against clinical guidelines. Methods: ChatGPT-4o, Claude 3.5 Sonnet, Grok 2, and Gemini 2.0 Advanced were tested with 20 REP-related questions from the ESE/AAE guidelines and expert consensus. Questions were posed in Turkish and English, with or without prompts. Two specialists assessed 640 AI-generated answers via a four-point rubric. Inter-rater reliability and response accuracy were statistically analyzed. Results: Inter-rater reliability was high (0.85–0.97). ChatGPT-4o showed higher accuracy with English prompts (p < 0.05). Claude was more accurate than Grok in the Turkish (nonprompted) and English (prompted) conditions (p < 0.05). No model reached ≥80% accuracy. Claude (English, prompted) scored highest; Grok-Turkish (nonprompted) scored lowest. Conclusions: The performance of AI models varies significantly across languages. English queries yield higher accuracy. While AI shows potential for REPs information, current models lack sufficient accuracy for clinical reliance. Cautious interpretation and validation against guidelines are essential. Further research is needed to enhance AI performance in specialized dental fields. Full article

Staphylococcus aureus, an opportunistic bacterium found in the oral cavity, has been reported as a causative agent of infective endocarditis and pneumonia. Salt is an essential mineral for cell maintenance in the human body. This study was conducted to clarify how salt affects the formation of biofilms by S. aureus and Streptococcus mutans, pathogens implicated in dental caries. Bacteria were cultivated with various concentrations of NaCl on a 96-well microtiter plate in tryptic soy broth with 0.25% sucrose or 0.25% glucose (TSBs and TSBg, respectively) for 16 h. The effects of glucosyltransferase in S. mutans membrane vesicles (MVs) and extracellular DNA during biofilm formation were also analyzed. S. aureus biofilms were induced by 0.004–0.25 M NaCl but not by NaCl at concentrations greater than 0.25 M in TSBs. The mixed S. aureus and S. mutans biofilms gradually grew and were constructed by dead cells in a NaCl concentration-dependent manner in both TSBs and TSBg. Moreover, biofilms were slightly induced by glucan generation mediated by the glucosyltransferases in MVs under high-salinity conditions. The formation of mixed-species S. aureus and S. mutans biofilms increased in the presence of both extracellular DNA and MVs. Therefore, extracellular DNA, MVs, and dead cells are factors that promote S. aureus biofilm formation under harsh conditions containing NaCl. The sugar (sucrose and glucose) ingestion-induced S. mutans biofilm may be a risk factor for infection by opportunistic pathogens such as S. aureus in individuals who consume food and drinks containing high concentrations of salt. Full article

In pediatric dentistry, antibiotics are currently prescribed for both therapeutic and prophylactic purposes. Antibiotic therapy can be prescribed for the treatment of diffuse dental or oral cavity infections, always as a complement to the most suitable dental procedure for the specific case. The aim of this study was to investigate the knowledge regarding the use and prescribing practices of antibiotics in pediatric patients in a sample of Italian dentists by using an anonymous and telematic questionnaire. Methods: A specially prepared questionnaire was electronically transmitted to a cohort of Italian dentists. The questionnaire consisted of two parts: demographic information and general knowledge of antibiotic prescription in pediatric dentistry. The statistical analysis of the obtained data was performed. Results: The study sample consisted of 242 Italian dentists. Poor statistically significant differences emerged between specialists in Pediatric Dentistry and dentists without specialization or specialists in other branches, as well as between dentists who, in their clinical activity, mainly treat children/adolescents or adults. For the complementary treatment of dental or oral cavity infections, Amoxicillin was the antibiotic indicated as the first choice for pediatric patients with no allergy to penicillins by most of the sample, while more than 20% of dentists would prescribe Clindamycin in patients with an allergy to penicillin. The knowledge regarding the dosage of administration of the chosen antibiotic appeared not to be sufficient. Conclusions: An improvement in the knowledge of the Guidelines in Pediatric Dentistry appeared necessary regarding the posology of the antibiotic of choice. More information about the adverse effects of Clindamycin is needed. Full article

Background/Objectives: Children with special healthcare needs (SHCNs) face various physical, developmental, sensory, behavioral, or cognitive challenges affecting oral health and highlighting the need for specialized and more accessible oral and dental care. Mobile health (m-health) applications have emerged as a promising solution to bridge oral health education gaps and improve dental care access. This narrative review aimed to examine the available dental m-health applications designed for children with cognitive and physical impairments, exploring the perspectives of children, parents/caregivers, and dentists regarding their use and potential contribution to oral health. Based on these insights, a concept for a tailored dental m-health app is proposed, considering the interactions between children, caregivers, and dentists to support oral care. Methods: A literature search was conducted using MEDLINE/PubMed, Scopus, and Web of Science to identify studies on the use of m-health apps in pediatric dentistry for SHCN children. Results: Six studies were included in this review. M-health applications helped manage anxiety, behavioral issues, and compliance in children and were generally well received by parents and caregivers, thus improving oral hygiene practices and regular dental visits, and having the potential to reduce oral health disparities in children with cognitive and physical impairments and their families. However, current apps designed for children are limited and may not fully accommodate the diverse sensory needs of these SHCN children. Conclusions: The development of a tailored dental m-health app that adapts to the individual characteristics of SHCN children could enhance oral health awareness and support better compliance among children, parents/caregivers, and dentists. Full article

Objective: Access to dental care is critical for overall health, yet individuals with Down Syndrome (DS) face numerous barriers, including communication difficulties, insufficiently trained professionals, and financial constraints leading to poor oral health outcomes. These obstacles are compounded by a shortage of specialized services and geographic disparities that limit access to appropriate care. This scoping review aimed to explore the existing literature about these barriers and to identify strategies to enhance dental care for this vulnerable population. Methods: This scoping review followed the Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines. A comprehensive search was conducted across PubMed, Scopus, and Web of Science focusing on peer-reviewed studies published in English within the last 10 years that examined barriers and strategies related to patients with DS. To ensure methodological rigor, eligible studies were independently screened and reviewed by two reviewers. Any disagreements were resolved through discussion, and if consensus could not be reached, a third reviewer made the final decision. Data were extracted using a standardized form. The extracted data were analyzed and synthesized to identify and categorize barriers and strategies across different studies. Results: The initial search yielded 58 articles, with 42 remaining after duplicates were removed. Following titles and abstracts screening, 13 studies were considered for full-text review, and 6 studies met the inclusion criteria. These studies, published between 2015 and 2023, primarily employed cross-sectional designs and identified key barriers, including challenges in maintaining oral hygiene, limited access to specialized dental services, and behavioral and sensory difficulties affecting dental care for children with DS. Strategies to overcome these barriers included enhancing dental professional training, developing tailored care approaches, and integrating preventive dental programs into broader health initiatives. Conclusions: This review highlights significant, persistent barriers to dental care for children with DS. By emphasizing the need for enhanced dental professional training, personalized care approaches, and integrated preventive programs, this review provides a framework for improving dental care accessibility for this population. Addressing these barriers can lead to better oral health outcomes and improved overall well-being for children with DS. Full article

Background/Objectives: Oral health behaviors can be shaped by various factors, both global (such as the COVID-19 pandemic) and individual (e.g., gender, age). This retrospective study aims to assess the factors influencing the choice between conservative and surgical dental procedures among patients based on the example of the university specialized center in Poznan. Methods: We explored the patient dataset from the University Center of Dentistry and Specialized Medicine (Poznan, Poland), covering the period from 1 January 2017 to 31 December 2023. A total of 182,654 medical records were analyzed, focusing on procedures such as restorations, endodontic interventions, and extractions. Multivariate logistic regression and multidimensional correspondence analyses were employed to assess the impact of demographic factors (age and gender) and tooth-specific characteristics on clinical decisions. Results: Females, particularly younger, were more likely to choose restorative procedures, while males, especially those over 50, predominantly underwent surgical procedures. Endodontic treatments were most common in males aged 18–30, primarily for maxillary anterior teeth and premolars. Molar extractions, especially in the mandible, were the most frequent surgical procedure. Maxillary teeth, particularly canines and premolars, were more likely to be treated conservatively. Conclusions: Economic factors, limited treatment access, and variations in patient preference influenced the observed patterns. Despite a national trend toward increased conservative treatments, disparities persisted based on age, gender, and tooth type. These findings emphasize the need for targeted prevention strategies and equitable access to advanced dental care. Full article

Introduction: Recent advancements in diagnostic imaging technologies have significantly improved the field of dental medicine. This review examines these new imaging techniques and their impact on enhancing accuracy, enabling early detection, and facilitating effective treatment planning in dentistry. Methods: A bibliometric and content analysis was conducted on 61 peer-reviewed articles retrieved from the Scopus database, published between 2019 and 2024. The selection criteria focused on studies exploring advances in dental diagnosis through innovative imaging methods and personalized techniques for identifying oral pathologies. The bibliometric approach analyzed publication trends, while content analysis categorized emerging technologies and their clinical applications. Results: Our findings indicate a notable shift towards integrating cutting-edge technologies, including Cone Beam Computed Tomography (CBCT), artificial intelligence (AI), and biosensors. These advancements have significantly improved diagnostic accuracy, particularly in complex cases such as periodontal diseases, dental fractures, and oral infections. Studies demonstrate that molecular diagnostics and AI-driven algorithms enhance the personalization of treatment plans, optimizing patient outcomes. Conclusions: Emerging diagnostic technologies have the potential to enhance both the quality and efficiency of dental care. However, their implementation is challenged by high costs, the need for specialized training, and disparities in access. Future research should focus on refining AI-driven diagnostic models, addressing regulatory considerations, and expanding the clinical validation of novel imaging tools. As these technologies evolve, they are expected to increase diagnostic specificity, leading to more precise, patient-centered treatment approaches. Ultimately, these advancements offer substantial opportunities to transform dental practice by providing faster, less invasive, and more reliable diagnoses. Full article

Objectives: Cyclosporine A promotes gingival fibrosis by enhancing the proliferation of gingival fibroblasts, leading to gingival overgrowth. The population of gingival fibroblasts is regulated by cell cycle machinery, which balances cell growth and inhibition. Cells that detect DNA damage pause at the G1/S checkpoint to repair the damage instead of progressing to the S phase. Previous studies have linked drug-induced gingival overgrowth to the response of fibroblasts to lipopolysaccharide (LPS) and cyclosporine A. This research investigates the effects of cyclosporine A on the G1/S checkpoint and its mediators in LPS-treated gingival fibroblasts to clarify the mechanisms behind cyclosporine-A-induced gingival overgrowth. Methods: Semi-confluent human gingival fibroblasts were treated with LPS or cyclosporine A in DMEM. Cell proliferation was evaluated by counting the total number of cells. The distribution of the cell cycle phases was analyzed using flow cytometry. Additionally, the expression levels of mRNAs and proteins related to cell cycle regulators were quantified by reverse-transcription quantitative PCR and Western blotting, respectively. Results: Cyclosporine A treatment significantly enhanced cell proliferation and the G1-S cell cycle transition. It increased the mRNA levels of CDC25A and CYCLIN D while decreasing those of RB1, SMAD3, and SMAD4. Additionally, it upregulated the protein levels of CDC25A, CYCLIN D, CDK4, CDK6, and pRB and downregulated the protein levels of SMAD3 and SMAD4. Conclusions: Gingival overgrowth induced by cyclosporine A could be attributed to these alterations. Full article

Introduction: People with special care needs often face significant barriers in accessing dental care due to physical and cognitive limitations, leading to high rates of dental issues like caries. Despite the growing recognition of these challenges, unmet dental care needs remain prevalent. This review aims to explore the global landscape of special care dentistry to identify gaps and opportunities for improving dental services for this population. Methodology: A systematic search was conducted across three online databases—PubMed, Embase, and Scopus—to identify relevant articles from their inception through May 2024. Reference lists of the selected studies were also screened for additional sources. A thematic synthesis approach was applied to derive both descriptive and analytical themes. The scoping review was guided by the Arksey and O’Malley framework to examine the scope and nature of studies and documents related to dental care for individuals with special care needs. Furthermore, a Google search was performed to include accessible theses and official government documents from various countries. Results: A total of 49 studies from 11 countries were reviewed, all centered on providing dental care for people with special needs. The analysis revealed three main themes: Human resources, care delivery model, and management. Within these, nine subthemes emerged: Mid-level oral care providers, dentists, special care dentistry as a specialty, tele-dentistry, mobile dentistry, hospital care, levels of healthcare provision, financial support, and education. These themes and subthemes highlight essential areas for enhancing services for those people. Conclusions: A holistic approach is essential to enhance dental care for people with special needs. Critical strategies, including the involvement of mid-level oral care providers, the adoption of tele-dentistry and mobile units, and the availability of hospital-based services for complex cases, are crucial. To truly transform care for those people, each country must adapt these strategies to its specific context, aligning resources and policies to create an inclusive, accessible, and effective system. Full article

Artificial intelligence (AI), specifically Generative Pre-trained Transformer (GPT) technology, has revolutionized various fields, including medicine and dentistry. The AI model ChatGPT, developed by OpenAI, mimics human language on a large scale, generating coherent and contextually appropriate responses. ChatGPT serves as an auxiliary resource for diagnosis and decision-making across various medical disciplines. This comprehensive narrative review aims to explore how ChatGPT can assist the dental sector, highlighting its potential to enhance various aspects of the discipline. This review includes a literature search on the application of ChatGPT in dentistry, with a focus on the differences between the free version, ChatGPT 3.5, and the more advanced subscription-based version, ChatGPT 4. Specifically, ChatGPT has proven to be effective in enhancing user interaction, providing fast and accurate information and improving the accessibility of knowledge. However, despite these advantages, several limitations are identified, including concerns regarding the accuracy of responses in complex scenarios, ethical considerations surrounding its use, and the need for improved training to handle highly specialized queries. In conclusion, while ChatGPT offers numerous benefits in terms of efficiency and scalability, further research and development are needed to address these limitations, particularly in areas requiring greater precision, ethical oversight, and specialized expertise. Full article

Background/Objectives: Health management in workers in the taxi industry is particularly challenging due to irregular working hours and the need to prevent fatal accidents. In addition, drivers in Japan are aging, and the early prevention of age-related deterioration in oral health is an increasingly important issue. The aim of this cross-sectional study was to investigate the relationships between oral diadochokinesis (OD), tongue pressure, and lip-seal strength in Japanese male taxi workers. Methods: Measurements of tongue pressure and lip-seal strength were performed by dentists using specialized equipment. OD was measured using the number of consecutive “Pa”, “Ta”, and “Ka” vocalizations that could be produced in 5 s. We performed multiple regression analysis to examine the effects of lip-seal strength and tongue pressure on OD. Results: The study included 437 participants, excluding 17 who could not complete all oral cavity measurements. Tongue pressure showed a significant positive correlation with “Pa”, “Ta”, and “Ka” (correlation coefficients: 0.527–0.680). Lip-seal strength was not significantly correlated with OD. Tongue pressure showed a significant positive correlation with “Pa”, “Ta”, and “Ka”. In the results of multiple regression analyses without the elderly participants, tongue pressure was associated with “Pa” (β[95% confidence interval]: 0.574[0.304, 0.843]), “Ta” (0.436[0.231, 0.640]), and “Ka” (0.424[0.210, 0.639]), and lip-seal strength was associated with “Pa” (0.128[0.032, 0.224]) and “Ka” (0.083[0.006, 0.160]). Conclusions: OD may be associated with lip-seal strength and tongue pressure even without including elderly workers. Regardless of age, maintaining good OD may help maintain lip-seal strength and tongue pressure, which may play a role in reducing the risk of age-related oral disorders. Full article

Background: The goal is to analyze the need for reinterventions under deep sedation to treat oral pathologies in a population of children with special health care needs (SHCNs) and healthy children who followed a prevention program and to study the influence of parental motivation and child collaboration on the need for reinterventions under deep sedation. Methods: A retrospective study was carried out in a private clinic in Cartagena (Murcia, Spain), with patients treated under deep sedation from 2006 to 2018, both years included, following the Strobe statement. Results: In this study with 230 children who were treated under deep sedation, 23.92% underwent two or more sedations. The mean time elapsed between the first and the second sedations was 21.64 ± 15.87 months, and the main cause for reinterventions was the occurrence of new pathologies. Significantly more pulp treatments were performed in the first sedation than in the second (p = 0.013) and in the third (p = 0.007). Healthy children required fewer reinterventions under deep sedation than children with special needs (6.42% vs. 39.67%). Similarly, patients who followed the preventive program and required some type of dental treatment were reoperated fewer times than those who did not follow the preventive program (35.8 vs. 50%); than “cooperative” children as opposed to “non-cooperative” (12.12% vs. 60.93%) and than patients with “motivated” parents as opposed to those with “non-motivated” parents (20.83% vs. 46.34%). A total of 50% of the children who participated in the preventive program became “cooperative”, and 100% were able to receive some treatment in the dental chair. Conclusions: Prevention programs, including motivational interviewing, are essential to improve children’s behavior in the dental chair and reduce the need for reinterventions under general anesthesia or deep sedation. Although patients with special needs do require more sedation during their lifetime due to their inability to cooperate, these programs are necessary for the maintenance of oral health status and for the early diagnosis of caries lesions. Pediatric dentists should implement a quarterly preventive program because it improves patient collaboration. It is essential to achieve the motivation of parents in the oral care of their children. Full article

Background: A Special Health Care Need (SHCN) is characterized by any type of physical, mental, sensorial, cognitive, emotional, or developmental condition that requires medical treatment, specialized services, or healthcare interventions. These conditions can negatively impact oral health as SHCN children can hardly cooperate or communicate and experience higher levels of dental fear/anxiety, which interfere with regular appointments. The present narrative review aims to analyze the use of audiovisual (AV) tools in dental setting for the management of SHCN children during dental treatment and to evaluate their effectiveness in anxiety/behavior control from the child, dentist, and care-giver perspectives. This analysis leads to the proposal of a new multi-session model for the behavioral management of SHCN pediatric subjects. Methods: An electronic search on the MEDLINE/Pubmed, Scopus, and Web of Science databases was carried out and through this analysis, a new model was proposed, the “UNISA-Virtual Stepwise Distraction model”, a multi-session workflow combining traditional behavior management and the progressive introduction of AV media to familiarize the SHCN child with dental setting and manage behavior. Results: AV tools helped in most cases to manage SHCN behavior and decreased stress in both the dentist and child during dental treatments. Care-givers also welcomed AV distractors, reporting positive feedback in using them during future treatments. Conclusions: The present narrative review found increasing evidence of the use of AV media for SHCN pediatric subjects as distraction tools during dental treatment. In the majority of the studies, AV tools proved to be effective for the management of anxiety, dental fear, and behavior in dental setting. Full article

The rise of artificial intelligence has created and facilitated numerous everyday tasks in a variety of industries, including dentistry. Dentists have utilized X-rays for diagnosing patients’ ailments for many years. However, the procedure is typically performed manually, which can be challenging and time-consuming for non-specialized specialists and carries a significant risk of error. As a result, researchers have turned to machine and deep learning modeling approaches to precisely identify dental disorders using X-ray pictures. This review is motivated by the need to address these challenges and to explore the potential of AI to enhance diagnostic accuracy, efficiency, and reliability in dental practice. Although artificial intelligence is frequently employed in dentistry, the approaches’ outcomes are still influenced by aspects such as dataset availability and quantity, chapter balance, and data interpretation capability. Consequently, it is critical to work with the research community to address these issues in order to identify the most effective approaches for use in ongoing investigations. This article, which is based on a literature review, provides a concise summary of the diagnosis process using X-ray imaging systems, offers a thorough understanding of the difficulties that dental researchers face, and presents an amalgamative evaluation of the performances and methodologies assessed using publicly available benchmarks. Full article

The aim of this study was to explore periodontal health among intellectually disabled individuals living in an institutional rehabilitation centre in the Al-Baha Region of Saudi Arabia. A cross-sectional study was conducted from November 2023 to January 2024. Clinical oral examinations were carried out using the World Health Organization criteria for bleeding sites and the presence of periodontal pockets. Simplified oral hygiene and community periodontal indices were employed to evaluate participants’ oral health. A total of 89 participants, comprising both males and females with intellectual disabilities, were included in this study. Gender, severity of intellectual disability, type of additional physical disability, tooth brushing habits and oral hygiene status were significantly associated with the presence of periodontal disease. Additionally, poor oral hygiene, not brushing teeth and periodontal pockets of 4–5 mm and 6 mm or more were significantly more prevalent among individuals with severe and moderate intellectual disabilities (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The prevalence of periodontal disease among the studied population was 54%. The odds of having periodontal disease were significantly higher in the severe intellectual disability group compared to the mild intellectual disability group (OR = 2.328, 95% CI = 1.430–3.631, p = 0.03). It was also found that intellectually disabled participants with additional physical disabilities suffered more from periodontal disease than those without additional physical disabilities (OR = 0.971, 95% CI = 0.235–4.023, p = 0.025). Overall, individuals with intellectual disabilities had a significant demand for periodontal care. This study highlighted the need for more organised preventive programmes for individuals with intellectual disabilities. Dentists should be vigilant about improving periodontal health, focus on preventive programmes and provide comprehensive dental care with an emphasis on periodic recall and monitoring. Full article