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Refugee populations face tremendous psychological, financial, and physical health challenges due to traumatic experiences and the stresses of resettlement. Access to oral healthcare represents a significant challenge due to language barriers, cost, and lack of familiarity with the healthcare system. Robust costing analyses are necessary to inform oral health programs tailored to newly landed refugees. The purpose of this study was to estimate the costs associated with delivering the Government Assisted Populations (GAP) oral health program for refugees settling in Nova Scotia, Canada. Using a bottom-up micro-costing method, we calculated the yearly direct and indirect costs associated with the delivery of oral health services via the GAP program between 2016 and 2024 from a healthcare system and societal perspectives. Direct costs consisted of the treatments rendered, and the salaries of a program coordinator and two language interpreters. Indirect costs were measured as opportunity costs. The valuation of costs was done according to published professional documents (i.e., Nova Scotia Dental Association suggested fee guide) and the current market values for goods and services. All costs were adjusted to the 2025 Canadian Dollars (CAD). Data from nine years of the GAP program data (2016-2024) were analyzed. The number of beneficiaries of the program/year rose from 67 patients in 2016 to 187 in 2024. The average annual treatment costs ranged from CAD 191 (SD 73) in 2016 to CAD 1,188 (SD 1,297) in 2024. The average annual productivity losses incurred by patients also rose from CAD 51 (SD 21) in 2016 to CAD 164 (SD 156) in 2024. Except for the first year, during which only hygiene services were administered, unmet needs were highest for restorative (19%-69%), preventive (13%-48%), and oral surgical (1%-10%). Total direct costs of the program ranged from CAD 53,589 in 2016 to CAD 267,622 in 2024. Over the same period, total indirect costs ranged from CAD 3,411 to CAD 30,561. The GAP oral health program addressed substantial oral healthcare needs among refugees, with costs increasing alongside service demand. These findings provide evidence to inform resource allocation and support equitable, culturally appropriate oral healthcare programs for newly resettled refugee populations.

Armed conflict disrupts health systems and daily self-care practices, yet quantitative evidence on its impact on oral health is scarce. This study compared self-reported oral health status, hygiene behaviours, and access to dental care among residents of the Gaza Strip before and during the 2023-2024 war. A comparative cross-sectional survey was conducted among 599 Gaza residents using a structured, self-developed 34-items online questionnaire. Participants reported oral health conditions and behaviours for two periods: before October 2023 and during the war. Paired categorical data were analysed using Bowker's test of symmetry for multi-category variables, and McNemar's test for binary variables, and subgroup associations were examined using chi-square tests. Significant deterioration was observed across all 12 assessed domains (p&#x2009;<&#x2009;0.001 for 11 variables; p&#x2009;=&#x2009;0.013 for the remaining variable). The proportion reporting severe oral pain increased from 6.5% pre-war to 73.8% during the war, while those reporting no pain decreased from 25.5% to 2.0%. Favourable self-rated dental status (excellent/good) declined from 85.3% to 9.7%, and the proportion reporting healthy gums decreased from 88.1% to 12.4%. Twice-daily tooth brushing fell from 77.5% to 9.5%, and complete cessation of brushing increased from 0.8% to 38.4%. Unmet dental care needs rose from 11.7% to 92.7%, with insecurity and lack of dental services as the main barriers. Stress-related oral habits increased markedly, and 86.0% of participants reported dependence on canned foods. Overall, 95.5% perceived their oral health to have worsened since the onset of the war. The Gaza war was associated with profound deterioration in self-reported oral health status, hygiene practices, and access to dental care. These findings highlight oral health as a neglected dimension of humanitarian crises and underscore the need to integrate essential dental services into emergency health responses and post-conflict reconstruction.

Oral lesions are frequent complications of Human Immunodeficiency Virus (HIV) infection, particularly among individuals with advanced immunosuppression. These lesions reduce quality of life and increase vulnerability to secondary infections. This study assessed knowledge, risk factors, and healthcare-seeking behavior related to oral lesions among HIV enrollees in Osun State, Nigeria. A descriptive cross-sectional study was conducted among 180 HIV-positive adults with clinically confirmed oral lesions attending selected Antiretroviral Therapy (ART) clinics in Osun State, Nigeria. Participants were recruited from three selected ART clinics using complete enumeration. Data were collected using a structured interviewer-administered questionnaire and analysed using SPSS version 20. Descriptive statistics and appropriate bivariate tests were used, with statistical significance set at p&#x2009;<&#x2009;0.05. Participants were mostly male (51.7%) and Yoruba (74.4%). Only 56.1% had good knowledge of oral lesions. Common risk factors included poor oral hygiene (56.1%), alcohol use (31.7%), and ART non-adherence. Healthcare-seeking within two weeks of symptoms was low (26.7%). Religion, education, and occupation were significantly associated with care-seeking. Poor oral hygiene and low CD4 counts were significant predictors of oral lesions. Knowledge and prompt care-seeking for oral lesions remain inadequate among HIV enrollees. Integrating oral health education, routine screening, and dental care into HIV treatment services is essential to improve outcomes in this population.

The February 6, 2023 Kahramanmara&#x15f; earthquake sequence was associated with widespread disruption across eleven provinces in Turkey. Studies examining earthquake exposure, psychological responses, oral health behaviors, and oral health-related quality of life (OHRQoL) in adult survivors remain scarce. This study aimed to evaluate these associations. A cross-sectional study was conducted among 284 adult patients attending Ad&#x131;yaman University Faculty of Dentistry. Data collected via online questionnaire assessed earthquake exposure (EEI), retrospectively assessed pre- and post-earthquake anxiety (EA), clinical safety concerns (CSCS-3), oral health behaviors (HU-DBI), and OHRQoL (OHIP-14). Retrospectively reported post-earthquake anxiety scores were significantly different from retrospectively reported pre-earthquake scores (17.70 vs. 14.92; p&#x2009;<&#x2009;0.001). EEI, pre-earthquake anxiety, post-earthquake anxiety, and CSCS-3 were positively correlated with OHIP-14 (r&#x2009;=&#x2009;0.283, 0.261, 0.159, and 0.276; all p&#x2009;&#x2264;&#x2009;0.007). The HU-DBI showed low internal consistency (&#x3b1;&#x2009;=&#x2009;0.544), limiting interpretability of oral health behavior findings. Chronic physical disease was associated with worse OHRQoL in both bivariate and multivariate analyses, whereas older age showed an association only in bivariate analyses. Although nominal sex differences were observed in post-earthquake anxiety and OHIP-14 scores, these differences did not retain statistical significance after false discovery rate correction. In bivariate analyses, earthquake exposure, anxiety measures, and clinical safety concerns were each significantly correlated with worse OHRQoL. However, in hierarchical regression analysis, only chronic physical disease (&#x3b2;&#x2009;=&#x2009;0.182, p&#x2009;=&#x2009;0.006) and clinical safety concerns (CSCS-3, &#x3b2;&#x2009;=&#x2009;0.165, p&#x2009;=&#x2009;0.018) remained significant independent predictors. Pre-earthquake anxiety (&#x3b2;&#x2009;=&#x2009;0.112, p&#x2009;=&#x2009;0.081), post-earthquake anxiety (&#x3b2;&#x2009;=&#x2009;0.045, p&#x2009;=&#x2009;0.512), and earthquake exposure (&#x3b2;&#x2009;=&#x2009;0.077, p&#x2009;=&#x2009;0.227) were not independently associated with OHRQoL. Psychiatric disorder alone was not associated with OHRQoL (&#x3b2;&#x2009;=&#x2009;0.034, p&#x2009;=&#x2009;0.572). These findings suggest that integrating dental care with psychological support may improve oral health-related quality of life among disaster survivors, particularly those with chronic physical diseases. Because participants were recruited from a single dental clinic, the findings are most applicable to individuals who had already sought dental care, and the potential influence of clinical safety concerns on dental attendance in the wider survivor population cannot be determined. Furthermore, the findings related to the newly developed CSCS-3 should be regarded as preliminary and hypothesis-generating until confirmed through external validation. Not applicable.

Depression in older adults is a multifactorial condition influenced by demographic, behavioral, and health-related factors. Oral functional problems, such as chewing difficulty, have received relatively limited attention despite potential relevance to mental health. Machine-learning models were developed and temporally validated to predict depressive symptoms while assessing the importance of chewing difficulty alongside other health predictors. Although these approaches enable the evaluation of multiple competing variables, limitations remain in capturing complex interactions among demographic, behavioral, and clinical factors within large population datasets. This prediction modeling study used KNHANES data from Korean adults aged&#x2009;&#x2265;&#x2009;65 years who completed the PHQ-9 in 2020, 2022, and 2024. After excluding participants with missing PHQ-9 data and applying complete-case preprocessing across 24 predictors, 3,881 participants were included. The 2020 and 2022 cohorts were used as the development set, and the 2024 cohort was reserved as an independent temporal test set. Five machine-learning models were trained for PHQ-9&#x2009;&#x2265;&#x2009;10 and PHQ-9&#x2009;&#x2265;&#x2009;5 outcomes using stratified 5-fold cross-validation, with preprocessing, class imbalance handling, and hyperparameter tuning performed on the development set. Final tuned models were evaluated on the 2024 test set using area under the receiver operating characteristic curve (AUROC) as the primary metric, with area under the precision-recall curve (AUPRC), sensitivity, specificity, F1 Score, and Brier score also reported. CatBoost demonstrated the best discrimination for both outcomes. For PHQ-9&#x2009;&#x2265;&#x2009;10, CatBoost achieved AUROC 0.853 (95% CI 0.780-0.911), sensitivity 0.650, specificity 0.877, AUPRC 0.267, and Brier score 0.024. For PHQ-9&#x2009;&#x2265;&#x2009;5, AUROC was 0.751 (95% CI 0.707-0.789), sensitivity 0.620, specificity 0.764, AUPRC 0.300, and Brier score 0.088. Across models, perceived stress and activity limitation were the strongest predictors. Chewing difficulty ranked as the most important oral health predictor (6th and 5th among 24 variables for PHQ-9&#x2009;&#x2265;&#x2009;10 and &#x2265;&#x2009;5, respectively) and consistently higher model-predicted probability of depressive symptoms across SHAP analyses. Machine-learning models demonstrated robust temporal validity for predicting late-life depression. Chewing difficulty showed consistent predictive importance independent of general health factors, supporting the integration of oral functional assessment into multidomain depression risk screening strategies.

Oral cancer is among the ten most common malignancies worldwide and can be highly lethal if not diagnosed and treated promptly. Mapping the spatial and geographic distribution of this cancer can assist health authorities in planning effective prevention, control, and treatment strategies by identifying its geographic and demographic patterns. This study aimed to investigate the demographic characteristics and geographic distribution of oral cancer in Golestan Province, Iran, during the period 2014-2021. This trend study used data from the National Cancer Registry System of Golestan Province, Iran, covering the period from 2014 to 2021. Geographic mapping of the cities in Golestan Province was performed using ArcGIS software. The annual incidence of oral cancer was calculated for each city and expressed as the number of cases per 100,000 population per year. A total of 390 patients with oral cancer were identified in Golestan Province between 2014 and 2021. Of these, 200 (51.3%) were male and 190 (48.7%) were female. The mean age of the patients was 56.18&#x2009;&#xb1;&#x2009;17.37 years, ranging from 2 to 96 years. The standardized annual incidence rate of oral cancer in Golestan Province ranged from 4.25 to 6.75 cases per 100,000 population during the study period. Among the cities of the Province, Maraveh Tappeh showed the highest incidence rate, with an average incidence of 12.35 cases per 100,000 population. The incidence of oral cancer in Golestan Province demonstrated temporal fluctuations during the study period, with higher rates observed in several northern cities. Geographic mapping of the disease may provide valuable insights into the potential influence of environmental, cultural, and lifestyle factors on the distribution of oral cancer and can support more targeted prevention and control strategies.

Retaining home care workers who are experiencing increasing job demands alongside deteriorating occupational health has become a growing concern. Previous research has found occupational self-efficacy, that is belief in one's own capabilities to successfully fulfil work-related responsibilities, associated with work wellbeing and meaningfulness. The aim of this study was to explore how home care workers who experience threatened occupational health perceive the importance of occupational self-efficacy for their occupational health and their sense of meaningfulness at work. Eight home care workers with threatened work ability, defined as having accumulated 30&#x2009;days or more of sick leave in the past year, were interviewed. The semi-structured interviews were analysed using Braun and Clarke's reflexive thematic analysis. Based on the analysis, an overarching theme-"Occupational self-efficacy, health and meaningfulness at work walking hand in hand"-was generated, together with two main themes. The main themes were "Holding on to myself through the balancing act of health, worth and work", and "Protecting the value of meaningfulness in the face of organisational challenges". The findings highlight a reciprocal relationship between occupational self-efficacy, health and meaningfulness at work, however, influenced by work environment. Supporting the inner health and sense of worth of home care workers experiencing ill health enhances sustainable occupational self-efficacy. A balanced sense of meaningfulness at work further contributes to this process. Although occupational self-efficacy is a personal resource, it is strongly influenced by the psychosocial and organisational work environment, underscoring the importance of developing a healthy work environment.

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An earlier study in Kampala, Uganda reported that a proportion of 0.9 children with dental caries remain untreated. A lack of comprehensive data about oral health in Uganda has been identified. However, the limited information available indicates an increasing prevalence of dental caries among adolescents. A recent survey conducted in Kampala revealed that over 75% of adolescents were affected by dental caries. There was limited data about the oral health status among children in Buhweju District of rural Southwestern Uganda. This study sought to establish the prevalence, predictors and treatment needs of dental caries among primary school children in Buhweju district. In a descriptive cross-sectional study design, 433 primary school children aged 5-17 years were enrolled from March to April 2025. Clinical oral examinations were performed in a private room at school under natural light. Every tooth visible in the mouth was examined by use of plain disposable mouth mirror and dental probe. Carious teeth and spaces (if a tooth was removed due to caries) were scored and reported as Decayed, Missing and Filled Teeth (DMFT) due to caries for permanent or Decayed and Filled teeth (dft) for primary dentition. The dental caries treatment needs were captured during clinical examination when there was decay or missing tooth. Overall, 274(63.3%) had dental caries with median DMFT of 0 (IQR=1) and median dft of 0 (IQR=2). Caries was more prevalent among females (64.7%) than males (62.1%). The prevalence of false teeth extraction among the permanent dentition was 72 (16.6%). Some 192 (44.3%) of the study participants needed Prompt treatment (including scaling, and fillings). At bivariate analysis, several variables met the inclusion criterion for multivariate analysis (p<0.25), including age 5-11 years, Bakiga ethnicity, belief that dental caries is not preventable, history of tooth removal, brushing after every meal, never eating cassava, previous dental clinic visits, and lack of oral health information through school career guidance. In the multivariate logistic regression model, two factors remained independently associated with dental caries. Children who had ever visited a dental clinic were twice as likely to have dental caries compared to those who had never visited a clinic (aOR=2.1, 95% CI: 1.2-3.4; p=0.005). Additionally, children who had never consumed cassava had 2.5 times higher odds of dental caries compared to those who consumed cassava monthly (aOR=2.5, 95% CI: 1.1-6.0; p=0.037). The study found a high prevalence of dental caries, mainly in permanent teeth, driven by limited dental health education, dietary factors, and unmet treatment needs. The study recommends strengthening school oral health programs through teacher training and three to six months oral health checkups as this ensures early detection of hygiene issues.

Transcervical excision is the conventional treatment for submandibular gland pleomorphic adenomas (SMG PA), but it may result in visible cervical scarring and marginal mandibular nerve injury. This study aimed to establish a standardized endoscopic-assisted transoral surgical protocol and evaluate its feasibility and early outcomes. This study included 120 consecutive patients with cytologically diagnosed SMG PA who underwent standardized endoscopic-assisted transoral resection between February 2023 and May 2025. The primary outcome was procedural feasibility, defined as successful completion of gland and tumor resection through the transoral route without conversion to a transcervical approach. Secondary outcomes included operative time, length of hospital stay, postoperative complications, recurrence, cosmetic satisfaction, and the learning curve. Operative time was analyzed using cumulative sum analysis to evaluate procedural proficiency. All procedures were completed transorally without conversion to a transcervical approach. The mean operative time was 57.6&#x2009;&#xb1;&#x2009;28.1&#xa0;min, and cumulative sum analysis showed a learning-curve inflection point at case 34. The mean hospital stay was 4.5&#x2009;&#xb1;&#x2009;1.2 days, ranging from 2 to 7 days.During a mean follow-up of 17.9&#x2009;&#xb1;&#x2009;7.9 months, no recurrence was observed. Complications were transient and included lingual numbness in 112 patients(93.3%), temporary tongue movement limitation in 5 patients(4.2%), abscess in 9 patients(7.5%), and hematoma in 1 patient(0.8%).Cosmetic satisfaction was high. The standardized endoscopic-assisted transoral approach appears feasible and potentially safe in selected patients with SMG PA. Longer follow-up and comparative studies are required to confirm its long-term surgical reliability and relative clinical benefits. Chinese Clinical Trial Registry ChiCTR2500096609; Registration date: January 26, 2025; Retrospectively registered.

The incidence of dental caries among children in Dongying City is very high. In 2018, the city launched a regional policy that provided free pit and fissure sealants and school-based oral health education. This study aims to assess the five-year impact of a regional public oral health policy. This study adopted a census sampling method to include eligible research subjects. Through oral examinations and parent questionnaires, chi-square tests, variance analysis, and trend tests were used to evaluate the effectiveness of the intervention measures for second-grade students. The survey results showed that the overall tooth decay rate decreased from 86.4% in 2018 to 84.6% in 2022, and the difference was at the borderline significance level (P&#x2009;=&#x2009;0.05). Notably, the caries rate and Decayed, Missing due to caries, and Filled Teeth index (DMFT) for permanent teeth demonstrated a significant decline (P&#x2009;<&#x2009;0.05), whereas those for deciduous teeth showed minimal changes. Although the filling rate for dental caries increased in 2022, it remained relatively low. The key performance indicators all showed significant trends (P&#x2009;<&#x2009;0.05). The oral health intervention measures implemented in Dongying City effectively reduced the level of permanent tooth caries among second-grade students. However, the improvement of deciduous tooth caries was not significant, and the filling rate remained low. It is necessary to strengthen the long-term oral health behavior cultivation of both families and schools, enhance the supervision of the intervention projects, and improve the treatment work in key areas to enhance the effect of caries prevention.

Dental aesthetics plays a key role in children's social perception and psychosocial development. However, evidence on smile perception in children remains limited, highlighting the need for valid and reliable assessment tools. This study aimed to perform the cross-cultural adaptation and psychometric validation of the Smile Perception Questionnaire for Children Aged 8-10 Years (SPQ 8-10) for use in Turkish children. This observational methodological validity-reliability study included 300 healthy children aged 8-10 years who attended the Department of Pediatric Dentistry at Bursa Uludag University and met the predefined eligibility criteria. Eligible participants were healthy children aged 8-10 years whose parents provided informed consent; children with previous or ongoing orthodontic treatment, systemic diseases, or mental, physical, hearing, or visual impairments affecting communication or questionnaire completion were excluded. The SPQ (8-10) was translated into Turkish using forward-backward translation and expert review. Standardized perioral smile images were digitally generated to represent different dental conditions, and each participant evaluated one randomly assigned image using a five-point Likert scale. Exploratory factor analysis (principal axis factoring) and confirmatory factor analysis (DWLS estimation) were conducted to assess construct validity. Internal consistency (Cronbach's &#x3b1;, McDonald's &#x3c9;) and test-retest reliability (ICC) were evaluated. Cronbach's &#x3b1; coefficient for the scale was 0.844, while McDonald's &#x3c9; coefficient was 0.847. The analysis yielded ICC (3,1)&#x2009;=&#x2009;0.803, 95% CI [0.628, 0.901], indicating that the scale had good temporal stability. CFI and TLI values above 0.95 and an SRMR value below 0.06 suggest a good fit. RMSEA value was at the threshold (0.084). The final 10-item Turkish version of the SPQ (8-10) demonstrates adequate psychometric properties in terms of factorial structure, internal consistency, and temporal stability.

Peri-implant diseases are among the most clinically significant biological complications of implant therapy, yet the relative contribution of patient- and implant-related factors to their development remains incompletely understood. This retrospective study examined the associations between demographic, clinical, and implant-related variables and peri-implant disease status in a large clinical cohort. A total of 199 patients with 968 dental implants placed between January 2015 and January 2023 were evaluated. Variables recorded included demographic characteristics, systemic conditions, smoking status, oral hygiene habits, implant-related parameters, clinical indices (plaque index, gingival index, probing depth, attached gingiva width, and gingival thickness), and radiographic marginal bone loss. Peri-implant disease status - classified as peri-implant health, peri-implant mucositis, or peri-implantitis according to the 2017 World Workshop criteria - was the primary outcome. Multivariable generalized estimating equations (GEE) models were applied to account for the clustering of multiple implants per patient. Of the 968 implants, 713 (73.6%) were classified as peri-implant health, 173 (17.9%) as peri-implant mucositis, and 82 (8.5%) as peri-implantitis. In multivariable GEE analysis, smoking&#x2009;&#x2265;&#x2009;10 cigarettes/day (OR&#x2009;=&#x2009;2.55, 95% CI: 1.07-6.10 for mucositis; OR&#x2009;=&#x2009;4.40, 95% CI: 1.60-12.08 for peri-implantitis), inadequate tooth brushing (OR&#x2009;=&#x2009;4.65, 95% CI: 1.99-10.86; OR&#x2009;=&#x2009;5.90, 95% CI: 2.21-15.77), and thin gingival phenotype (OR&#x2009;=&#x2009;4.22, 95% CI: 2.09-8.51; OR&#x2009;=&#x2009;15.64, 95% CI: 6.08-40.23) were independently associated with both conditions. Longer implant functional duration was additionally associated with peri-implantitis (OR&#x2009;=&#x2009;1.57, 95% CI: 1.30-1.90; p&#x2009;<&#x2009;0.001). Within the limitations of this retrospective study, smoking, inadequate oral hygiene, thin gingival phenotype, and longer implant functional duration were independently associated with peri-implant diseases. These findings suggest that peri-implant soft tissue assessment and patient-level risk assessment should be integral components of long-term implant maintenance protocols.

China is experiencing rapid population ageing and increasing demand for palliative care. However, development remains uneven because of fragmented policies, workforce shortages, limited public understanding, and sociocultural barriers. Existing studies have typically described these factors separately, offering limited insight into how they interact within complex health systems. This study aimed to examine the dynamic interactions among facilitators and barriers shaping palliative care development in China, informed by Wu-Xing theory. We conducted a multi-method qualitative study across hospitals, palliative care institutions, and community settings in multiple regions of China between January 2024 and November 2025. Purposive sampling was used to recruit 49 stakeholders. Focus group discussions involved 38 stakeholders, including healthcare professionals, policymakers, researchers, volunteers, and service-sector representatives, while field observations captured the experiences of 6 patients and 5 family members in palliative care settings. Data were analysed using reflexive thematic analysis, with Wu-Xing theory used as an interpretive framework to examine relationships among themes. Five interdependent factors shaped palliative care development in China: policy standards, professional development, promotion and outreach, public awareness, and ethical culture. Analysis suggested two linked cycles. The Generating Cycle described how policy standards supported professional development, professional development enabled promotion and outreach, promotion and outreach improved public awareness, public awareness nurtured ethical culture, and ethical culture in turn updated policy standards. The Controlling Cycle described how policy standards regulated promotion and outreach, promotion and outreach reshaped ethical culture, ethical culture rectified professional development, professional development recalibrated public awareness, and public awareness in turn updated policy standards, contributing to mutual adjustment across the system. Palliative care development in China may be better understood as a dynamic health-system process rather than as a linear effort to address isolated barriers. The Wu-Xing framework provides a culturally grounded lens for examining how policy, workforce capacity, communication, public attitudes, and ethical norms interact. These findings highlight the need for more integrated and context-sensitive strategies to strengthen palliative care in China. Not applicable.

Treatment-resistant depression (TRD) is associated with severe depression, low quality of life (QoL) and reduced work productivity, which may increase risk of relapse, suicide and suboptimal response to treatment. Esketamine nasal spray plus a newly-initiated oral antidepressant (esketamine&#xa0;+&#xa0;OAD) has been shown to improve depression symptoms, QoL and productivity in patients with TRD; however real-world evidence is limited. This was a descriptive, exploratory post-hoc subgroup analysis of patients with TRD who received esketamine&#xa0;+&#xa0;OAD treatment over 16 weeks through an Early Access Program in Australia and New Zealand. This analysis aimed to describe response to esketamine&#xa0;+&#xa0;OAD (&#x2265;50% decrease in Hamilton Depression Rating Scale Index [HAMD-17] score at Week 16), including changes in depression severity, QoL and work productivity. QoL was assessed using the Assessment of QoL-8D (AQoL-8D) questionnaire and work productivity was assessed using the Workplace Productivity and Activity Impairment: Specific Health Problem Questionnaire (WPAI:SHP). Overall, 28 (33.3%) participants were identified as responders. Responders experienced mean improvements in HAMD-17 (71.2%), AQoL-8D (29.5%) and WPAI:SHP (&#x2265;11.9%) from Baseline to Week 16. The greatest improvement among AQoL-8D domains was observed in mental health (32.9%). The largest improvement in WPAI:SHP was seen in overall work productivity loss (35.9%). These findings describe concurrent improvements in symptoms, QoL and self-reported functioning among responders. Results should be interpreted with caution due to limitations conferred by the post-hoc design, short follow-up, small population sizes and missing data.

This study aimed to evaluate the attitudes and perceptions of parents of pediatric patients in our sample towards the growing use of artificial intelligence in dental practices. The descriptive cross-sectional survey study was conducted with parents of pediatric patients who visited the K&#x131;r&#x131;kkale University School of Dentistry for routine dental examinations between 2024 and 2025. A 23-question survey was designed for participants to complete. The survey was evaluated as a scale consisting of three sub-dimensions. The data were analyzed using SPSS 27. A total of 74.4% of participants reported having an average level of self-reported knowledge about the digital world (internet/technology). The biggest advantage of AI identified by the participants was saving time (64.3%). The AI-Health Education Score differed significantly according to educational status (p = 0.003). The participants with a bachelor's degree had higher mean scores on AI-Health Education than high school graduates. The effect size was small (&#x3b7;&#xb2;=0.051). The mean Physician-AI Collaboration Score for men was significantly higher than that for women. The effect size was small (Cohen's d = -0.305). These findings suggest that, within this sample, parents generally view AI positively and may be receptive to its integration into dental practice. These results may support the appropriate integration of AI into dental practice. It is also necessary to assess the effects on patient satisfaction and the quality of healthcare services.

Early and intensive intervention is crucial for children with cerebral palsy (CP), particularly during the period when gross motor activities typically develop. Despite the prevalence of CP, robust evidence for effective early mobility interventions remains limited. Frame Running, which enables children with limited walking ability to engage in dynamic, high-intensity activities, has emerged as a promising approach, yet research on its effect in young children is currently lacking. The aim of this study is to implement and evaluate the effects of a mobility-focused training program combining Frame Running and goal-directed gross motor training, on mobility in every day life and cardiovascular health in children aged 2-5 years with CP. The study uses a prospective repeated-measures intervention design with assessments conducted during baseline, intervention, and post-intervention follow-up phases. At least 18 children meeting the inclusion criteria (CP diagnosis, age 2-5 years, GMFCS II-IV) will participate. The design consists of three baseline measurements, a 12-week intervention phase and three post-intervention measurements, across approximately 5-6 months. The program combines home-based training and hospital-based group training, with parents as active trainers and therapists providing coaching. Frame Running and goal-directed training are tailored to individual goals, set collaboratively with families. Outcome measures include the Gross Motor Function Measure (GMFM-66), Functional Mobility Scale (FMS), Paediatric Evaluation of Disability Inventory Computerised Assessment Test (PEDI-CAT), time-based mobility tests: ultrasound assessment of muscle size and morphology, gait analysis, accelerometry (7-day activity monitoring), heart rate monitoring during training, and Goal Attainment Scaling (GAS). Feasibility and fidelity will be investigated by questionnaires. By evaluating the Full Speed Ahead program, this study aims to improve understanding of how an early intensive family-centered mobility intervention may influence developmental trajectories and health in children with CP. If effective, the findings will have significant implications for planning both short- and long-term treatment and services for young children with CP. The prospective repeated-measures intervention design allows for both group-level and individual-level analysis of changes over time, thereby strengthening the evidence base for early, intensive, family-centered mobility interventions. ClinicalTrial.gov NCTO7374432, Registered November 18 2025.

First permanent molars (FPMs) in children are frequently affected by extensive caries or molar-incisor hypomineralization, making their long-term restoration challenging. Stainless steel crowns (SSCs) have been the traditional full-coverage treatment for compromised FPMs, whereas CAD/CAM-based indirect restorations (IDRs) offer a more conservative, tooth-colored alternative. However, evidence comparing the real-world clinical performance and esthetic satisfaction of SSCs and IDRs in pediatric patients is limited. This retrospective, exposure-based cohort study included children aged 7-14 years treated in a university-based pediatric dentistry clinic who received either an SSC or a CAD/CAM-based IDR on at least one FPM and had a minimum clinical follow-up of 12 months. Restoration type was determined by routine clinical decision-making (extent of structural compromise, pulpal status, occlusion, patient cooperation, and parental esthetic preferences), not by randomization. The SSC comparison sample was selected from an eligible/reachable source pool with the aim of balancing sex and age category at the patient level; this was not a formal pair-matched design. Clinical performance was evaluated using modified United States Public Health Service (USPHS) criteria. Esthetic satisfaction was assessed using separate 10-point visual analogue scales for children and parents. Statistical analyses were exploratory and included generalized estimating equations (GEE) to account for clustering of multiple restorations within patients, chi-square/Fisher's exact tests, and Mann-Whitney U tests, as appropriate. Sixty children (30 boys, 30 girls; mean age 11.3 years, range 7-14 years) with 78 restored FPMs were included: 39 SSCs and 39 IDRs. The mean follow-up period was 14.2&#x2009;&#xb1;&#x2009;2.7 months. According to modified USPHS criteria, most parameters showed no statistically significant between-group differences (p&#x2009;>&#x2009;0.05); however, marginal adaptation and gingival health differed between groups (both p&#x2009;=&#x2009;0.01). One SSC and one IDR received a Charlie score for secondary caries or retention. Among IDRs, both resin nano-ceramic (n&#x2009;=&#x2009;25) and lithium disilicate (n&#x2009;=&#x2009;13) restorations showed favorable short-term outcomes; given the small subgroup sizes and design heterogeneity, material-specific comparisons were descriptive. Children reported high esthetic satisfaction with both SSCs and IDRs (mean scores 9.2&#x2009;&#xb1;&#x2009;1.4 and 9.9&#x2009;&#xb1;&#x2009;0.4, respectively; p&#x2009;=&#x2009;0.008). Parents showed higher esthetic satisfaction with IDRs compared with SSCs (10.0&#x2009;&#xb1;&#x2009;0.2 vs. 8.8&#x2009;&#xb1;&#x2009;2.1; p&#x2009;=&#x2009;0.003), although absolute scores for SSCs remained high. In this retrospective cohort, selected compromised first permanent molars restored with either SSCs or CAD/CAM-based IDRs showed favorable short-term outcomes after a minimum 12-month follow-up. IDRs were associated with higher esthetic satisfaction, particularly among parents. Given the non-randomized treatment allocation, baseline differences between groups, and heterogeneity within the IDR group, these findings should be interpreted as observational and hypothesis-generating rather than evidence of comparative effectiveness. Longer-term prospective studies with standardized baseline characterization are warranted.