搜索结果：Dental

Biological maturation varies substantially among children of the same chronological age, which may affect growth-based orthodontic decisions. In this cross-sectional study, 120 patients aged 8 to 16 years were evaluated using routine orthodontic diagnostic records. Chronological age was compared with dental age estimated using the Nolla and Demirjian methods, and skeletal maturation was assessed using cervical vertebral maturation stages (CVMS). Associations with sex, BMI, BMI-for-age z-score, and menarcheal status in females were examined. Both dental methods systematically overestimated chronological age. Mean discrepancies were +0.59 years for the Nolla method (95% CI: 0.39-0.79; Cohen's dz = 0.52) and +1.09 years for the Demirjian method (95% CI: 0.87-1.31; Cohen's dz = 0.89) (both P < 0.001). Female participants exhibited a higher proportion of pubertal and postpubertal CVMS than males (Cramer's V = 0.41; P < 0.001), although sex differences in dental age discrepancies were small (Cohen's d &#x2264; 0.14). BMI and BMI-for-age z-scores were positively correlated with dental age discrepancies (&#x3c1; = 0.27-0.31) and CVMS stage (&#x3c1; = 0.35-0.36) (all P &#x2264; 0.003), indicating small-to-moderate associations. Menarcheal status was not significantly associated with CVMS (P = 0.727) or dental age discrepancies (P > 0.05). Chronological age alone provides an incomplete estimate of biological maturation. Dental age estimation and CVM assessment offer complementary but nonequivalent information, and their interpretation should consider sex and basic anthropometric context.

Predoctoral dental education in temporomandibular disorders (TMD) remains inconsistent and highly variable despite CODA's mandate. This study examined how different TMD educational models (based on orofacial pain [OFP] postgraduate program affiliation, presence of OFP faculty offering TMD patient exposure, or absence of OFP faculty and clinical exposure) influence student confidence and perceived challenges. An anonymous survey was distributed to third- and fourth-year students at U.S. CODA-accredited dental schools through the Hispanic Student Dental Association and American Student Dental Association. Students rated confidence in TMD-related skills (1-5 scale, 5="most confident") and identified educational challenges. Data were analyzed using ANOVA, chi-square tests, and correlation analyses across four educational models. Among 136 respondents, overall confidence was low-to-moderate (2.4&#x2009;&#xb1;&#x2009;0.8), with only 26.3% reaching a sufficient threshold (&#x2265;3). Confidence was highest for screening and lowest for advanced procedures. Educational model type showed no significant effect on overall confidence (p&#x2009;=&#x2009;.099), whereas prior TMD patient exposure was associated with higher confidence (2.7&#x2009;&#xb1;&#x2009;0.7 vs. 2.1&#x2009;&#xb1;&#x2009;0.7, p&#x2009;<&#x2009;.001; r&#x2009;=&#x2009;.384, p&#x2009;<&#x2009;.001). Common challenges included limited patient availability (61.8%), insufficient faculty expertise (42.3%), and poor interdisciplinary integration (46.3%). Students without OFP faculty and clinical exposure reported significantly greater clinical challenges (p&#x2009;<&#x2009;.001). Lack of clinical exposure to TMD patients is strongly associated with low student confidence. Faculty calibration and integration of TMD screening and management into routine care are critical to improving competence and confidence in dental training.

The acidic nature of gastric refluxate and the aciduric properties of cariogenic microorganisms may influence the oral microbial environment in children with gastroesophageal reflux disease (GERD). Streptococcus mutans and Streptococcus sobrinus are among the primary bacteria associated with dental caries and may proliferate under acidic conditions. This study aimed to investigate the association between dental caries indices and oral levels of cariogenic microorganisms in children with GERD symptoms compared with healthy controls. This case-control study included 32 children with GERD symptoms and 37 healthy children aged 5-11 years. GERD symptoms were assessed using the Gastroesophageal Reflux Disease Assessment in Pediatrics Questionnaire (GASP-Q). Dental status was evaluated using the decayed, missing, and filled teeth (dmft/DMFT) index according to WHO criteria. Oral microbial samples were collected from the tongue and buccal mucosa using sterile cotton swabs, and the levels of S. mutans and S. sobrinus were quantified using culture-based methods. Statistical analyses were performed using chi-square tests, independent t-tests, Pearson correlation coefficients, and linear regression analysis at a significance level of P < 0.05. The mean age of participants was 8.22 &#xb1; 1.92 years. No significant differences were observed between the GERD and control groups regarding age (P = 0.379), sex distribution (P = 0.126), or dmft/DMFT scores (P = 0.410). However, the mean bacterial count was significantly higher in children with GERD symptoms compared with healthy controls (P < 0.001). After adjustment for age, sex, and dmft + DMFT, multivariable linear regression analysis indicated that children in the case group tended to have higher log10 bacterial counts than those in the control group, although the association was not statistically significant (&#x3b2; = 1.009, 95% CI: -0.192 to 2.209, P = 0.098). Athough children with GERD showed higher salivary counts of Streptococcus mutans and Streptococcus sobrinus, this association was not significant after adjustment for confounding factors. GERD was not independently associated with cariogenic bacterial counts or dental caries experience.

Kerman is Iran's largest province, with a population exceeding three million and documented socioeconomic disparities in oral health outcomes. This systematic review and meta-analysis aimed to characterize temporal trends in dmft/DMFT indices across six age groups in Kerman province over nearly three decades. This study was conducted in accordance with the PRISMA 2020 guidelines. English and Persian databases, including PubMed, Scopus, Embase, Web of Science, and SID, were searched up to April 2026. This search was supplemented by a manual review of dental master's theses from Kerman Dental School and national oral health reports. Cross-sectional studies reporting dmft/DMFT indices in the general healthy population of Kerman province were included. Two reviewers independently performed study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Pooled estimates and 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using I2 and Q statistics. Subgroup analyses by time period (prior to 2015 versus 2015 to present) and univariable meta-regression with four pre-specified covariates were performed to explore sources of heterogeneity. The certainty of evidence was assessed using the GRADE framework. A total of 49 studies (comprising 26 peer-reviewed articles, 19 theses, and 4 national reports) were included. The pooled dmft was 3.55 (95% CI: 3.26-3.84) for children aged 3-6&#xa0;years, 5.12 (95% CI: 4.74-5.50) for 6-year-olds, and 4.09 (95% CI: 2.73-5.46) for 9-year-olds. Pooled DMFT values were 2.04 (95% CI: 1.70-2.39) for 12-year-olds and 2.61 (95% CI: 1.38-3.84) for the 12-15-year age group. In adults aged 35-44&#xa0;years, the pooled DMFT was 13.80 (95% CI: 10.80-16.78). Meta-regression and subgroup analysis revealed a significant increasing temporal trend in the 3-6-year group (+&#x2009;0.21 units per year; p&#x2009;<&#x2009;0.001), while geographic location significantly predicted caries levels in 6-year-olds (p&#x2009;<&#x2009;0.001). Heterogeneity was very high across all age groups (I2&#x2009;>&#x2009;94%, p&#x2009;<&#x2009;0.001). The certainty of evidence was rated as very low for all age groups using the GRADE framework. The dental caries burden in Kerman province remains high across all age groups, with a significant worsening trend in early childhood caries. Due to the very low certainty of current evidence, a standardized provincial oral health survey is needed. Future strategies should prioritize expanded water fluoridation and targeted community-based preschool interventions.

Interprofessional service-learning (IPSL) combines community-based experiential learning with interprofessional education (IPE), fostering collaborative competencies and civic responsibility among students. Despite growing interest, the integration of service-learning and IPE in undergraduate dental curricula remains underexplored. This scoping review was conducted using the Arksey and O'Malley framework and refined by Levac et al., adhering to the PRISMA-ScR guidelines. Several electronic databases (PubMed, Scopus, Web of Science, EBSCO, and EMBASE) were searched from 1960 to March 2025 using a combination of controlled vocabulary and free-text terms. Manual searching of reference lists and grey literature through Google Scholar and institutional repositories supplemented the database searches. Screening and data extraction were conducted by two independent reviewers based on pre-defined inclusion and exclusion criteria. Thematic synthesis was used to analyse and categorise the findings qualitatively. From 1422 records, 11 eligible studies published between 2015 and 2023 were included. Most studies were conducted in the United States, with one from Canada. IPSL interventions occurred in diverse settings, including refugee shelters, rural clinics, prisons, and global health contexts. Dental students engaged with disciplines such as medicine, nursing, pharmacy, public health, social work, law and others. Key themes included 'Implementation Contexts and Interprofessional Partnerships', 'Oral Health Promotion and Prevention', 'Oral Health Literacy Outcomes', 'Reflective Learning', and 'Student Perceptions and Attitudes'. IPSL is an impactful educational strategy for dental students, promoting both clinical and interprofessional development. Future programmes should include structured preparatory training and longitudinal assessment to sustain learning outcomes and enhance the reach of IPSL globally.

Payment initiative in dental services is a key policy strategy to enhance access, affordability, and patient satisfaction. The Ghasedak project, a six-month pilot initiative at a university dental school in Iran, aimed to test a new payment model. This study analyzed the reasons for its suspension to draw lessons for future initiatives. A qualitative study was conducted using Walt and Gilson's policy triangle framework. Data were collected in 2024 through 19 semi-structured interviews with project stakeholders (founders, managers, providers, and philanthropists) and 28 patients, selected via purposive sampling at Alborz University of Medical Sciences, Karaj. Data were analyzed using the Elo and Kyng&#xe4;s inductive content analysis approach in MAXQDA, consisting of preparation, organization, and reporting phases. From 145 initial codes, 13 themes and 61 subthemes were identified. Mapped to the policy triangle, barriers included: Context (management instability, lack of institutionalized inter-sectoral cooperation, insufficient upstream support); Content (lack of an independent and transparent structure, unsustainable funding, non-adherence to social work principles, and lack of continuity in service delivery); Process (administrative bureaucracy, decreased financial transparency, lack of service support); Actors (low patient satisfaction stemming from mistrust, lack of motivation of stakeholders, and unrealistic patient expectations). Structural, managerial, and operational deficiencies undermined the pilot's sustainability and impact. Strengthening future payment initiatives requires secure financing, coherent management, streamlined implementation, and genuine stakeholder engagement. These findings provide actionable insights for policymakers seeking to design more resilient and effective dental payment initiative.

Typodont simulation is a key part of undergraduate dental training globally, allowing prospective dentists to repeatedly practice the necessary skills to safely and effectively care for their future patients. Anecdotally, and in previous small studies, typodonts fall short when compared to what they aim to replicate: human teeth. This study aimed to evaluate opinions on the effectiveness, use, advantages and disadvantages of typodonts. This study gathered quantitative and qualitative data from 338 dentists and dental students using an online questionnaire, evaluating their opinion on the effectiveness of typodont simulation. Likert scales to 32 questions collected opinions on effectiveness of various typodont attributes such as tactile feedback and appearance. Responses were analysed to examine differences in opinion across participant groups using the appropriate parametric and non-parametric tests; free-text responses were analysed thematically. Typodonts were used extensively in all surveyed institutions. They were considered to be moderately effective and readily available for repeated practice of direct and indirect preparations. Improvement is required in several key areas: caries simulation, anatomical layering and endodontic simulation, particularly in relation to material properties related to tactile realism. There were varying opinions on cost and environmental impact when comparing methods of manufacture. Standardisation and customisation of typodonts for education was valued by all. Anatomical layering, tactile realism and caries are important factors to students and dentists in simulation education. Traditionally manufactured typodont were used by the majority of those surveyed but lack key qualities such as realistic tactile feedback required for effective simulation of human teeth, simulation of caries and root canal anatomy. There is potential for more modern methods of manufacture such as 3D-printing to assist in this need for better representation of the complex anatomy and feel of teeth, positively impacting both patient safety and dental education, yet these still fall short in realistic haptic feel and caries simulations. Alongside these features, environmental, financial and availability should be considered.

This study evaluates changes in critical thinking among dental healthcare workers after anti-involution training (AIT) and identifies key predictors of training effectiveness. A pre-post quasi-experimental design was conducted with 91 participants. Critical thinking was assessed using the CTDI-CV scale. Spearman correlation, multiple linear regression, and LASSO regression were employed to identify predictors, with machine learning models (Random Forest) used for nonlinear exploration and validation. AIT significantly improved critical thinking disposition, with a mean total score increase of 11.813&#x2009;&#xb1;&#x2009;6.752 (P&#x2009;=&#x2009;0.001). Cognitive maturity showed the greatest improvement (3.978&#x2009;&#xb1;&#x2009;6.645, P&#x2009;=&#x2009;0.004). Multiple linear regression revealed that truth-seeking (&#x3b2;=-1.738, P&#x2009;=&#x2009;0.019) negatively predicted improvement, while cognitive maturity (&#x3b2;&#x2009;=&#x2009;1.467, P&#x2009;=&#x2009;0.016) positively predicted improvement. Random Forest validated these findings (AUC&#x2009;=&#x2009;0.889). AIT effectively enhances critical thinking among dental professionals. Baseline truth-seeking and cognitive maturity are key predictors of training outcomes, informing personalized educational strategies.

Poor oral health and oropharyngeal dysphagia are modifiable risk factors for aspiration pneumonia. Dental hygienists (DHs) and speech-language pathologists (SLP) provide specialized services to individuals with these issues and may benefit from interdisciplinary knowledge in these areas. The objective of this study was to assess how an interprofessional education (IPE) event influenced students' knowledge and competence in working with individuals at risk for aspiration pneumonia. The current study was a prospective, within-subjects cohort design. Participants included speech-language pathology and dental hygiene students (N = 52). The 3-hr IPE event provided didactic and hands-on training that focused on the modifiable risk factors for aspiration pneumonia. Outcomes were assessed with a content assessment, the Interprofessional Education Collaborative (IPEC) Competency Self-Assessment Tool (Version 3), the Interprofessional Attitudes Scale (IPAS), and written feedback. Students scored significantly higher on the content assessment following the IPE event than at baseline. Ratings on the IPEC Interprofessional Interaction and the Interprofessional Values domains significantly increased following the IPE event, but their IPAS scores did not differ. Three themes emerged in students' written feedback, including: appreciation for an interactive and hands-on educational experience, growth through interprofessional content exploration, and desire for expanded interprofessional opportunities. Students particularly appreciated the hands-on activities (e.g., providing oral care, observing an endoscopy of the upper airway). The IPE event enhanced the interprofessional knowledge and short-term perceived competence of the student clinicians. Long-term interprofessional competence may be best supported by integrating IPE programmatically into academic curricula and assessing outcomes with longitudinal, behavior-based evaluations.

Regenerative endodontic therapy offers a highly promising solution for functional dental pulp regeneration; however, reconstructing a functional vascular network remains the core bottleneck. This study investigated the synergistic effects of hypoxia and compressive stress on dental pulp cells angiogenic activity. This study established an in vitro model that combines hypoxic conditions and compressive loading conditions to simulate the complex microenvironment for DPCs. Cellular proliferation was quantified via Cell Counting Kit-8 assays, migration ability was assessed by scratch wound assays, and angiogenesis-related gene/protein expression was analyzed using real-time quantitative polymerase chain reaction and Western blotting. Functional vascularization potential was assessed through tube formation assays. Both hypoxia and compressive stress significantly induced angiogenic cytokine expression in DPCs. Sustained co-stimulation, however, attenuated hypoxia's regulatory efficacy. Temporal profiling revealed peak angiogenic factor expression occurred markedly earlier under mechanical loading (2&#x202f;h post-stimulation) versus hypoxia alone (16-24&#x202f;h). Both hypoxic conditions and short-duration compressive stress upregulated pro-angiogenic factor expression in DPCs. However, compressive stress exerted a more rapid regulatory effect, while hypoxia induced slower-developing but more sustained upregulation.

Immediate implant has been one of the solutions to decrease bone resorption after tooth extraction. Gap distance between the dental implant and adjacent bone has undergone much research to enhance bone formation in this area. This is small exploratory study that aimed to compare the efficacy of extended platelet rich fibrin (e-PRF) a regenerative biomaterial produced by heating platelet-poor plasma (PPP) to denature albumin, extending the resorption time of standard PRF from 2 to 3 weeks to 4-6 months, as well as allograft as a space filling material in immediate dental implant placement. Twenty-eight implants were placed for the prosthetic replacement of non-restorable single-rooted maxillary teeth using immediate implant placement. Patients were randomly allocated into two equal groups (n&#x2009;=&#x2009;14 each). In Group I, allograft was placed in the peri-implant gap, whereas in Group II, e-PRF was used. Implant stability was assessed using resonance frequency analysis (RFA). Buccal bone thickness and marginal bone loss were evaluated using CBCT throughout the follow-up period. Statistical analysis was performed on all clinical and radiographic data. A total of 28 patients received 28 immediate implants in the maxillary esthetic zone. During the 12-month follow-up period, all implants were successful with no complications. No statistically significant differences were observed between the groups regarding implant stability, marginal bone loss, or buccal bone thickness. Within this small exploratory trial, no statistically significant intergroup differences were detected between e-PRF and allograft as space-filling materials around immediate implants regarding stability, marginal bone loss, and buccal bone thickness. Clinical-Trials.gov PRS ( https://register. gov ) has this study registered under the identifier number. NCT07445776 on 03/02/2026.

Admission to dental programs in Italy has traditionally been regulated by a national entrance examination. However, a recent reform replaced this system with a merit-based assessment during a "filter semester." This study aimed to evaluate whether admission test scores predict academic success in the Dentistry programme at the University of Turin and to compare outcomes between students admitted through the standard process and those admitted via legal appeals. We conducted a retrospective cohort study of 431 students enrolled between 2009 and 2018. In this context, CFUs are fully equivalent to ECTS (European Credit Transfer and Accumulation System) credits. Performance indicators included the accumulation of Crediti Formativi Universitari (CFUs; university credits equivalent to ECTS credits) during the first and second years, degree completion, and on-time graduation. Receiver operating characteristic (ROC) analysis, expressed as area under the curve (AUC), and logistic regression were used to assess the predictive power of entrance test scores. Higher admission test scores were associated with a greater likelihood of completing coursework and graduating on time. The test showed almost good predictive ability, particularly for first-year performance (AUC&#x2009;=&#x2009;0.71; 95% CI: 0.65-0.75), total CFUs expected in Years I and II (AUC&#x2009;=&#x2009;0.74; 95% CI: 0.66-0.81), and degree attainment (AUC&#x2009;=&#x2009;0.70; 95% CI: 0.67-0.75). A score of 40 (out of 90) was identified as the optimal cut-off for classifying "low" (<&#x2009;40) and "good" (&#x2265;&#x2009;40) scores. Students below this threshold had an increased risk of not achieving the expected CFUs in Year I [OR&#x2009;=&#x2009;5.04; 95% CI: 3.18-7.98], not completing all expected CFUs in Years I and II within the established timeframe [OR&#x2009;=&#x2009;19.9; 95% CI: 2.72-146.0], and not graduating within six years [OR&#x2009;=&#x2009;2.27; 95% CI: 1.30-3.96]. The admission test showed almost good predictive value for academic success in dentistry. Its elimination may have implications that warrant further evaluation, particularly in relation to attrition rates and resource allocation. These findings provide evidence to inform the ongoing debate on university admissions in Italy.

Aquaporin 5 (AQP5) is crucial for salivary secretion, composition and enamel mineralization. Genetic variations in AQP5 may influence susceptibility to dental diseases such as caries. This study investigated the association between AQP5 single nucleotide polymorphisms (SNPs), AQP5 mRNA expression, and caries severity in a dental practice cohort. A total of 246 patients were enrolled. Caries experience was assessed using the decayed, missing, and filled (DMF) index, and salivary AQP5 mRNA expression was quantified by RT-qPCR. Genotyping included rs2878771, rs296763, rs3736309, and rs3759129. Statistical analyses comprised Chi-square testing, ROC analysis with Youden Index determination, and binary logistic regression adjusted for age and sex. The A allele of rs3736309 was associated with an increased risk of severe caries, particularly in patients over 60 years of age. AQP5 mRNA expression was higher in individuals with severe caries and in carriers of the C allele of rs2878771. ROC analysis identified an AQP5 expression cut-off (0.11274) that discriminated between severe and non-severe caries (AUC&#x2009;=&#x2009;0.578, p&#x2009;=&#x2009;0.048). Logistic regression confirmed AQP5 expression as an independent predictor of severe caries (p&#x2009;=&#x2009;0.005). AQP5 expression and genetic variation appear to contribute to caries susceptibility in an age-dependent manner with moderate effects. The intronic variant rs3736309 was associated with caries severity. The biological mechanisms underlying this association remain unclear and require functional investigation. These findings support a potential role of AQP5 as an exploratory biomarker candidate for caries risk, particularly in elderly individuals.Trial registration: German Clinical Trial Registry No. DRKS00032425, date of registration: 2023-08-16.

This study compared the sedative effects of intravenous etomidate/fentanyl/midazolam versus propofol/fentanyl/midazolam combination, with a primary focus on behavioral outcomes assessed by the Houpt scale and hemodynamic safety, for dental treatment of uncooperative children between 3 and 10 years. This patient- and assessor-blinded, crossover clinical trial was conducted on 40 children (27 females, 13 males; mean age, 4.67&#x2009;&#xb1;&#x2009;1.46 years; mean weight, 15.93&#x2009;&#xb1;&#x2009;4.2&#xa0;kg) with negative and very negative behavior, as assessed by the Frankl scale. The children were randomly assigned to 2 groups (n&#x2009;=&#x2009;20). Group 1 received etomidate (0.2&#xa0;mg/kg), fentanyl (1&#xa0;&#xb5;g/kg), and midazolam (0.2&#xa0;mg/kg) combination in the first treatment session, and propofol (1&#xa0;mg/kg), fentanyl (1&#xa0;&#xb5;g/kg), and midazolam (0.2&#xa0;mg/kg) in the second treatment session. This order was reversed in group 2. Hemodynamic indices, including the heart rate (HR) and arterial oxygen saturation (SPO2), were monitored during the procedure, and the behavior of children was recorded using the Houpt behavioral rating scale. Data were analyzed using the Mann-Whitney and t tests (&#x3b1;&#x2009;=&#x2009;0.05). The hemodynamic indices were within the safe range, with no significant difference between the two groups (P&#x2009;>&#x2009;0.05). At the time of injection, a statistically significant but clinically modest difference in SPO2 was observed favoring the etomidate group (99.75% vs. 98.85%, P&#x2009;=&#x2009;0.003); however, mean SPO2 remained above 97% in both groups throughout all procedures. The mean HR showed greater stability with less fluctuation from baseline in the etomidate group compared to propofol (e.g., smaller magnitude of change at injection in the second session, P&#x2009;<&#x2009;0.005 overall for key time points). The two groups were similar regarding the Houpt scale, except during recovery, where the etomidate group had a significantly higher behavior score (7.45 vs. 6.60, P&#x2009;=&#x2009;0.007). Both combinations are highly effective and safe for the intravenous sedation of uncooperative children, providing comparable intra-procedural sedation. However, the etomidate/fentanyl/midazolam combination demonstrated specific advantages regarding intra-procedural heart rate stability and more favorable behavioral scores during the recovery period.Trial registration IRCT20230515058193N1, registeredretrospectively on 22 November 2024 in the Iranian Registry of Clinical Trials (https://www.irct.ir/trial/77589).