Search Results (527)

Dental care is a well-established marker of both oral and systemic health, driven by behavioral, socioeconomic, and geographic factors. This study aimed to develop and evaluate machine learning models to classify the presence and severity of permanent tooth loss in U.S. adults using the 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset. We analyzed responses from 365,803 adults after recoding demographic, behavioral, socioeconomic, and access variables. Ten supervised classifiers were trained and evaluated using stratified 80/20 train–test splits, with ANOVA-based selection for the binary task and Pearson correlation plus engineered features for the multiclass task. Performance was assessed by accuracy, AUC, precision, recall, and specificity. For binary classification (any loss vs. none), XGBoost achieved the highest performance (AUC = 0.786; accuracy = 71.4%), with CatBoost close behind (AUC = 0.711). For multiclass severity (none, 1–5, 6+, all teeth removed), an ensemble of gradient-boosting models achieved strong discrimination (macro-AUC = 0.752). Key predictors included age, smoking, education, income, and general health. These findings demonstrate that large-scale survey–based ML models can support oral health surveillance by identifying high-risk groups and informing targeted prevention strategies. Full article

Background: The asymptomatic progression of initial gingival inflammation in children often remains unnoticed or undiagnosed. Although full-mouth periodontal examination is considered the gold standard in diagnosing periodontal diseases, it is usually time-consuming and expensive. Therefore, the aim of this study was to assess gingival status using partial-mouth examination with the Community Periodontal Index of Treatment Needs (CPITN) and full-mouth examination with Bleeding on Probing (BOP) in the periodontal diagnosis of adolescents. Methods: This cross-sectional study was conducted in a sample of 457 Bulgarian children aged 11 to 14 years. Full-mouth examination was performed with the BOP index on all fully erupted permanent teeth, probing four gingival sites—three buccal and one oral. Partial-mouth examination was performed with CPITN, probing six representative teeth at six sites. Statistical analysis was conducted using Pearson’s chi-square test (χ²) and t-tests to compare relative proportions. Results: The BOP index identified significantly more healthy children compared to the CPITN (t = 1.90, p < 0.05). The CPITN has limitations in distinguishing between initial (BOP 10–30%) and advanced (BOP 30–60%) gingival inflammation. The comparative evaluation of the two indices by sextant showed that a healthy periodontium is most commonly observed in the posterior segments of both jaws in children, while gingival inflammation is localized predominantly in frontal areas. Conclusions: The CPITN has the advantage of providing a quick and easy method for recording gingival status in children, but it does not allow for the determination of the severity of gingival inflammation. Clinical Significance: Full-mouth examination using the BOP index is a more appropriate method for periodontal diagnosis in children, as it provides a detailed and comprehensive picture of the condition of the gingival tissues, especially when a clinical diagnosis is required to guide further treatment planning. Full article

Background/Objectives: Impacted teeth are characterized by having more than three-quarters of root development completed, however failing to erupt or demonstrate imminent eruption, as evidenced both by clinical and radiographic evaluation. Canine impaction is an entity of clinical significance considering its potential to affect both oral function and facial aesthetics. If not appropriately managed, this condition may adversely impact functional occlusion and structural smile integrity. The purpose of the study was to investigate the prevalence of impacted and transmigrant canines in a Greek orthodontic cohort and identify potential sex-based differences. Methods: A total of 2594 panoramic radiographs and clinical records of consecutive patients in the mixed and permanent dentition stages, treated at the Department of Orthodontics of the Aristotle University of Thessaloniki, Greece, were retrospectively retrieved and analyzed to detect the presence of impacted and transmigrant canines. Patients lacking complete clinical records or panoramic radiograph, undergoing or had undergone orthodontic treatment, or presenting conditions affecting normal permanent dentition development, including pathological conditions, cleft lip and palate or hereditary disorders, were excluded. Results: At least one impacted canine was detected in 109 patients (67% females, 33% males), with a median age of 15 years (IQR: 13–18), documenting a 4.2% prevalence (6.97% females, 2.32% males). The frequency of maxillary canine impaction was 3.97%, while in the mandible a frequency of 0.46% was reported. The frequency of bilateral canine impaction was 1%, with it being present in 25.7% of patients with canine impaction. The prevalence of transmigrant canines was 0.11%, with detection solely in the mandible. A statistically significant sex difference was detected solely in the prevalence of impaction. Conclusions: Considering the implications of canine impaction, the epidemiological investigation of this entity may facilitate an early diagnosis and treatment. Full article

Background: Dental caries is a prevalent dental problem affecting primary and permanent teeth. Early demineralization of enamel lesions can be reversed through remineralization. Many studies have focused on caries prevention and disease progression arrest using silver diamine fluoride (SDF). No in vitro studies have compared the remineralization effects of different 38% SDF solutions on artificially demineralized enamel lesions. This study aimed to compare the remineralization potential of three commercial 38% silver diamine fluoride formulations on artificial enamel lesions in primary teeth using a pH cycling model. The hypothesis was as follows: different commercial SDF formulations would exhibit varying remineralization effects, as measured by surface microhardness, due to potential differences in their compositions. Materials and Methods: In this study, 75 primary molars were randomized into five groups (N = 15): I: baseline, II: SDF Riva Star Aqua^® 38%, III: Riva Star^® 38%, IV: SDF Advantage Arrest^® 38%, and V: control. Artificial caries were created by submerging teeth in 10 mL of demineralization solution (pH 4.5) for three days in a light-resistant container, ensuring distinct visual changes in the enamel as per the International Caries Detection and Assessment System (ICDAS level 2). After pH cycling, all samples underwent a standardized Vickers microhardness test (VMHT) with a 50 g load for 15 s. Data were analyzed using one-way ANOVA and Tukey’s post hoc test, with a significance level set at p ≤ 0.05. Results: The one-way ANOVA test indicated a significant difference in microhardness among the groups (SDF Riva Star Aqua, SDF Riva Star, and SDF Advantage Arrest), with an F-value of 167.73 and p < 0.001. The post hoc Scheffé test showed that SDF Riva Star Aqua and SDF Riva Star were not significantly different (p = 0.388). However, SDF Advantage Arrest had a significantly higher mean microhardness compared to both groups (p < 0.001). Overall, these results show that SDF Advantage Arrest leads to greater microhardness than SDF Riva Star Aqua or SDF Riva Star. Conclusions: SDF Advantage Arrest showed superior performance among the SDF-treated groups, significantly increasing microhardness compared to SDF Riva Star Aqua and SDF Riva Star. This suggests that SDF Advantage Arrest offers enhanced remineralization and structural strengthening, making it the most effective option for managing demineralized primary teeth. Future research should investigate the long-term performance and mechanisms of these treatments to optimize clinical protocols for preserving primary tooth integrity. Full article

Background/Objectives: Polymorphisms in metalloproteinases (MMPs) have the potential to be probable genetic biomarkers of dental caries. The aim of this study was to evaluate the distribution of the MMP13 A/G rs2252070 single nucleotide polymorphism (SNP) according to caries experience in Salvadoran children. Methods: A cross-sectional study was carried out on 185 Salvadorian school children between 7 and 12 years of age. Demographic data, frequency of toothbrushing, dental flossing and consumption of sugar-sweetened beverages were recorded. Caries data were collected by clinical examination. Genomic DNA was obtained from oral cells of the children. Polymorphism genotyping was performed by PCR-RFLP. Allele and genotypic frequencies were compared between the healthy and caries-experiencing groups. Data were analyzed with SPSS 26.0 using the chi-square test, the Kruskal–Wallis test and logistic regression analysis. Results: The allele frequencies of MMP13-77 A/G were 0.7 and 0.3 following the Hardy–Weinberg equilibrium (X² = 0.22, p = 0.63). 72% of subjects with caries experience were carriers of the A allele. Caries experience was higher for the GG genotype group for permanent and primary surfaces (DMFS = 2.11; dmfs = 5.64) and for permanent teeth (DMFT = 1.50). No significant differences were found in the allelic and/or genotypic frequencies of the SNP polymorphism between subjects with dental caries and healthy subjects (p > 0.05). Conclusions: The distribution of MMP13-77 A/G rs2252070 in the study population showed no association with caries experience. However, our findings highlight the importance of promoting oral hygiene habits from an early age. Full article

Dehydrated human-derived amnion–chorion membranes (ACM), known for their bioactive composition of growth factors and cytokines, have demonstrated potential as a bioactive scaffold in regenerative medicine; however, their clinical application in regenerative endodontic procedures (REPs) remains unexplored. This retrospective study aimed to evaluate the clinical and radiographic outcomes of REPs using ACM compared to collagen matrices (CM) in immature necrotic permanent teeth. Forty-one immature necrotic teeth from 38 patients (mean age: 14.68 ± 7.43 years) were treated with REPs using either ACM (n = 21) or CM (n = 20) scaffolds over a mean follow-up period of 23.23 months. Outcomes assessed included survival, success, root development measured by radiographic root area (RRA), and pulp sensibility. Independent t-tests compared outcomes between groups, while Cox regression and generalized linear models identified predictors of treatment outcomes. Overall survival and success rates were 87.8% and 82.9%, respectively. ACM-treated teeth achieved 90.5% survival and 85.7% success rates, while CM-treated teeth demonstrated 85.0% survival and 80.0% success rates, with no statistically significant differences between groups (p > 0.05). Root development occurred in 85.4% of cases overall, with significant RRA increases of 13.89 ± 13.95% for ACM and 11.24 ± 11.21% for CM (p < 0.05 within each group). Pulp sensibility recovery was observed in 51.2% of treated teeth overall, with 42.9% for ACM-treated teeth and 55.0% for CM-treated teeth (p > 0.05). Notably, ACM-treated teeth demonstrated earlier sensibility recovery compared to those of CM-treated teeth. Age was identified as a significant negative predictor of root development outcomes (p < 0.05). This clinical study demonstrates that both ACM and CM are clinically effective scaffolds for REPs, achieving high survival rates and promoting root development in immature necrotic teeth. While overall success rates were comparable, ACM showed faster sensibility recovery, suggesting potential biological advantages for enhanced tissue regeneration and earlier functional recovery. Full article

Background/Objectives: Official data on the oral health of young children in Romania are limited, especially concerning the societal shifts following the COVID-19 pandemic. This study aimed to compare the oral health status, hygiene habits, diet, and dental care patterns of 6-year-old children in a rural Romanian region before and after the pandemic. Methods: A cross-sectional survey studied two groups of 6-year-olds from rural Transylvania: Group 1 (n = 77), assessed 2018–2020 pre-pandemic, and Group 2 (n = 136), assessed in 2024 post-pandemic. Clinical data used the Decayed, Missing, and Filled Teeth (DMFT) index. Parents completed questionnaires on oral hygiene, diet, dental visits, and pandemic-related topics for Group 2. Chi-square, Student’s t-tests, and a multiple linear regression were used to analyze the data. Results: Post-pandemic, 70% of children brushed twice daily, up from 26%. Despite this, negative outcomes increased: the number of affected teeth rose from 6.8% to 29.6% (p < 0.001), sugar intake increased, and dental visits became more reactive, with pain being the main reason for 61% of post-pandemic visits, compared to 17% pre-pandemic. Conclusions: This study reveals a significant oral health paradox: despite a three-fold increase in recommended toothbrushing, caries experience in permanent teeth increased four-fold. This outcome was driven by a high-risk environment of more cariogenic diets and reduced preventive care, with lower maternal education also identified as a key independent risk factor. These findings show that promoting hygiene alone is insufficient, underscoring the urgent need for public health programs that integrate nutritional counseling, improve access to preventive care, and address underlying socioeconomic disparities. Full article

Molar incisor hypomineralization (MIH) is characterized by systemic hypomineralization affecting one to four first permanent molars (FPMs), often accompanied by lesions in incisors and potentially involving other primary or permanent teeth. MIH poses clinical challenges, including hypersensitivity, susceptibility to pulp involvement, and aesthetic concerns. Optical Coherence Tomography (OCT), an advanced, non-invasive imaging modality, has gained interest as a potential diagnostic tool in dentistry. This exploratory observational case-control study aims to compare the structural characteristics of MIH-affected and healthy teeth using in vivo OCT, focusing on identifying qualitative imaging patterns associated with enamel hypomineralization. This study included 50 mild MIH-affected permanent teeth from pediatric patients and 50 healthy permanent teeth as controls. Representative OCT scans were acquired, analyzed, and compared for both groups. In OCT imaging, healthy enamel and dentin appeared as two distinct superimposed layers defined by the dentin-enamel junction. Conversely, MIH-affected teeth exhibited characteristic subsurface hyper-reflective zones, indicative of hypomineralized enamel, with deeper hypo-reflective shadowing. This first in vivo study applying OCT to MIH-affected teeth demonstrates its potential as a non-invasive technique for the real-time assessment of enamel structural anomalies, supporting its future role in monitoring remineralization therapies and improving early detection strategies in pediatric dental care. Full article

Objective: This study aimed to evaluate the mean age of eruption of permanent teeth and their clinical emergence sequence in a longitudinal sample of children from a multi-ethnic urban population. Methods: A total of 854 children (413 females and 441 males), aged between 4 and 13 years, were examined annually for a minimum of 4 consecutive years, as part of their annual dental screening appointment. The presence of permanent teeth was recorded at each examination. Mean and median ages, with standard deviations, of individual tooth eruption were calculated, in addition to the eruption sequence, and the analysis of the data was performed using the lognormal distribution model. Regarding the error of the method, two examiners reviewed all relevant dental screening forms, and any discrepancies were resolved through consultation with the senior author. Results: The sequence of permanent tooth eruption followed a consistent pattern across sexes, with distinct differences between the maxillary and mandibular arches. In the maxilla, eruption began with the first molar, while in the mandible, it started with the central incisor. Mandibular teeth generally erupted earlier than maxillary teeth, with girls experiencing earlier eruption than boys, with some exceptions, and prolonged eruption periods. No statistically significant differences were found in the timing of eruption between contralateral homologous teeth. Conclusions: Based on the present data, the observed sequence of tooth eruption in a multi-ethnic urban population showed similar patterns across sexes. Mandibular teeth generally erupt earlier than maxillary teeth, with girls experiencing earlier eruption than boys. Full article

Primary teeth play a crucial role in a child’s development, particularly in maintaining space for permanent teeth. The premature loss of a primary tooth can lead to orthodontic issues, making the use of space maintainers essential to ensure proper growth and development of permanent teeth. To preserve space, the fabrication of a space maintainer is necessary. Since conventional space maintainers do not restore masticatory function, this study presents an innovative solution for space preservation following the extraction of the first primary molar through the design of the functional space maintainer KOS&MET (Key Orthodontic System and Materials Enhanced Therapy). The space maintainer was designed using the 3Shape Dental Designer 2023 version software tool and manufactured via additive 3D printing, utilizing a metal alloy with high resistance to masticatory forces. The crown is supported by the primary canine, while an intraoral window is created to monitor the eruption of the successor tooth. This design does not interfere with occlusion and enables bilateral chewing. Masticatory performance was assessed using two-color chewing gum, and the results showed improvement after cementing the space maintainer. This innovative approach not only preserves space for permanent teeth but also enhances masticatory function, contributing to the proper growth and development of the jaws and teeth. Full article

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

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article

Background: Although the prevalence of dental caries in children has been decreasing in recent years, many patients still visit tertiary dental institutions with dental caries as their chief complaint. In addition, the COVID-19 pandemic that occurred around the world in 2020 may have affected the lifestyle and oral condition of children. Methods: We investigated the oral condition of new patients whose chief complaint was dental caries, and compared the results for 3 fiscal years: 2013, 2018, and 2023. The caries status was evaluated using the dmft/DMFT index. Results: The number of subjects was 129 in 2013, 163 in 2018, and 127 in 2023. The number of preschoolers in 2023 was lower than in the other years, whereas the number of elementary school students was higher, showing a statistically significant difference (p < 0.05). For the 3 years investigated, there was no change in the incidence of dental caries in primary teeth in elementary school children; however, the incidence in permanent teeth increased over time. Additionally, in the age group, the df and DMF scores were higher in 2023 than in the other years. Conclusions: At this tertiary dental institution, the number of elementary school patients, especially females, increased over the 10-year period, and the amount of dental caries in their permanent teeth also increased. It is important for dental professionals to understand this trend and focus on providing oral hygiene education to this age group. Full article

This study presents an analysis of the electromagnetic noise and vibration in a surface-mounted permanent magnet synchronous machine (SPMSM), focusing on their excitation sources. To investigate this, the excitation sources were identified through an analytical approach, and their effects on electromagnetic noise and vibration were evaluated using a finite element method (FEM)-based analysis approach. Additionally, an equivalent curved-beam model based on three-dimensional shell theory was applied to determine the deflection forces on the stator yoke, accounting for the tooth-modulation effect. The stator’s natural frequencies were derived through the characteristic equation in free vibration analysis. Modal analysis was performed to validate the analytically derived natural frequencies and to investigate stator deformation under the tooth-modulation effect across various vibration modes. Furthermore, noise, vibration, and harshness (NVH) analysis via FEM reveals that major harmonic components align closely with the natural frequencies, identifying them as primary sources of elevated vibrations. A comparative study between 8-pole–9-slot and 8-pole–12-slot SPMSMs highlights the impact of force variations on the stator teeth in relation to vibration and noise characteristics, with FEM verification. The proposed method provides a valuable tool for early-stage motor design, enabling the rapid identification of resonance operating points that may induce severe vibrations. This facilitates proactive mitigation strategies to enhance motor performance and reliability. Full article