Abstract Dental pathology in professional singers can compromise the oral resonance chamber, jeopardizing their vocal performance and career longevity. Complex cases involving systemic diseases, psychological distress, and advanced oral deterioration require integrated multidisciplinary management. This report describes the interdisciplinary rehabilitation of a professional singer with severe oral structural compromise and significant systemic and psychological challenges. The management plan combined psychological counseling, medical optimization, surgical reconstruction, prosthetic rehabilitation, and targeted voice retraining. An 8-month program of structured psychological counseling reduced dental anxiety and restored treatment confidence in the patient. Medical optimization through coordinated endocrinology care achieved glycemic stability before the surgical intervention. Guided bone regeneration and staged implant placement ensured stable osseointegration, despite the presence of systemic risk factors. Prosthetic rehabilitation with a screw-retained metal–ceramic prosthesis restored gingival function and white and pink esthetics, while specialized vocal rehabilitation facilitated the recovery of resonance and projection. The integrated approach yielded complete restoration of oral function, resolution of psychological distress, stable implant integration, optimal prosthetic performance, and full return to professional vocal activity. This case demonstrates that with meticulous planning, interdisciplinary collaboration, and comprehensive psychological support, even high-risk patients with diabetes can achieve successful fixed prosthodontic rehabilitation, restoring both function and professional identity.
Abstract Objective: The study aimed to determine the distribution of congenital heart diseases (CHDs), associated congenital malformations, and syndromes among children with orofacial clefts (OFCs) at Tawanchai Cleft Center, Khon Kaen, Thailand from 2011 to 2020. Methods: The retrospective study reviewed medical records of 1187 children with OFCs at a tertiary cleft center from 2011 to 2020. A total of 95 eligible cases met the following inclusion criteria: diagnosis of cleft palate (CP), cleft lip (CL), or cleft lip and palate (CLP); age from birth to 3 years; confirmed CHD diagnosis by a cardiologist; confirmed diagnosis of congenital malformations or syndromes by a geneticist; and complete medical records. Distributions were described using frequencies and percentages. Fisher’s exact test and binary logistic regression (unadjusted and sex-adjusted) were used for inferential analysis. Results: Among 95 patients, CP was the most frequent OFC type (48.4%), followed by CLP (44.2%) and CL (7.4%). The sex distribution was 48.4% male and 51.6% female, and all patients were of Thai ethnicity. The observed proportion of CHDs (8.0%) fell in the mid-range of prior studies. The most common CHDs were atrial septal defect (ASD, 25.3%), patent ductus arteriosus (PDA, 20.0%), and ventricular septal defect (VSD, 18.9%). Pierre Robin sequence (PRS) was the most common associated congenital malformation (10.4%). Syndromic clefts occurred in 38 cases (40.0%), predominantly involving 22q11.2 deletion syndrome (18.4%), vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities association (13.1%), and Down syndrome (7.9%). Binary logistic regression revealed significantly lower odds of VSD in patients with unilateral CLP compared to those with CL (sex-adjusted odds ratio = 0.07, 95% confidence interval = 0.01–0.61, p = 0.02). Conclusion: ASD, PDA, and VSD are the most common CHDs among patients with OFCs. These CHDs frequently co-occur with PRS and 22q11.2 deletion syndrome. These findings underscore the importance of comprehensive cardiac screening in children with OFCs to support interdisciplinary cleft care management.
Abstract Objective: To evaluate and compare the surface elemental composition and cytotoxicity of round and rectangular nickel-titanium (NiTi) and stainless steel (SS) archwires before and after 4 and 8 weeks of intraoral exposure. Methods: Four groups of archwires (0.018 NiTi, 0.018 SS, 0.019 × 0.025 NiTi, and 0.019 × 0.025 SS), with five samples in each group, were used as as-received controls from the manufacturer. Each of the eight study groups included five samples, and the wires were retrieved after intraoral exposure of 4 weeks in four groups and 8 weeks in four other groups. The surface elemental composition and cytotoxicity of all samples were assessed using energy-dispersive X-ray analysis and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cytotoxicity test using human gingival fibroblasts. Two-way analysis of variance (ANOVA) was employed to evaluate the effects of wire shape (round vs. rectangular) and time (0, 4, and 8 weeks), as well as their interaction, separately for NiTi and SS wire types. Cell viability was analyzed using two-way ANOVA followed by post hoc tests. Results: All the rectangular wires showed greater alterations than the round wires. Wires exposed intraorally for 8 weeks exhibited greater changes than those exposed for 4 weeks. NiTi wires showed significant reductions in nickel and titanium, whereas SS wires showed significant reductions in nickel, chromium, and iron, particularly in rectangular wires at 8 weeks. Rectangular NiTi wires exhibited the highest cytotoxicity, followed by round NiTi, rectangular SS, and round SS wires. Conclusion: Prolonged intraoral exposure of various orthodontic archwires alters surface elements but has minimal impact on cytotoxicity.
Abstract Objective: Early marginal bone loss (MBL) influences the prognosis of dental implants. This study aimed to evaluate the extent of early MBL and its relationship with keratinized tissue width (KTW), bleeding on probing (BoP), and other clinical parameters to determine its prognostic significance. Methods: A prospective, longitudinal, observational study was conducted on 50 single dental implants placed in partially edentulous patients at Riyadh Elm University. Standardized intraoral periapical radiographs were obtained immediately after implant placement (T0) and 3 months later, before prosthetic loading (T1). Measurements of mesial and distal MBL were performed using Digimizer software (v6.4.0). Clinical parameters, such as KTW and BoP, were recorded, and the prognosis was classified as good, fair, poor, or hopeless. Paired t tests and Pearson’s correlation tests were applied with significance set at P < 0.05. Results: A significant difference in MBL was observed between T0 and T1 on both the mesial (−0.886 ± 0.944 mm, t = −6.632, df = 49, P < 0.001) and distal (−0.825 ± 0.923 mm, t = −6.315, df = 49, P < 0.001) surfaces. The mean and standard deviation values of KTW were 4.10 ± 1.09 mm, ranging from 2 to 6 mm. The prognosis distribution was as follows: good (2%), fair (74%), poor (22%), and hopeless (2%). The prognosis score showed a significant correlation with KTW and BoP. Conclusion: Significant early MBL occurred within 3 months of implant placement, representing physiological bone remodeling. Early MBL, KTW, and BoP may serve as early clinical markers. Regular radiographic monitoring during the healing period is essential for ensuring long-term stability.
Abstract Objective: Menopause-associated hypoestrogenism significantly alters oral homeostasis, often leading to xerostomia. Although salivary calcium and albumin are indicators of mineral turnover and mucosal permeability, their specific correlation with subjective and objective oral dryness in postmenopausal cohorts requires further elucidation. The aim was to evaluate salivary calcium and albumin levels in postmenopausal women with and without oral dryness and to compare these findings with the clinical symptoms. Methods: This case–control study included three groups ( n = 40 in each group): Group I (premenopausal), Group II (postmenopausal without oral dryness), and Group III (postmenopausal with oral dryness). An unstimulated flow rate of less than 0.1 mL/min was used to measure oral dryness. The estimation of salivary calcium via colorimetric spectrophotometry (612 nm), and albumin was quantified using standard biochemical assays. Statistical analysis was performed using analysis of variance, analysis of covariance, and Pearson’s correlation, with sample size justified by power analysis (80% power). Results: Group III (postmenopausal women with oral dryness) had significantly higher salivary calcium and albumin levels than both Group II and Group I ( P < 0.05). A moderate positive correlation was found between salivary albumin and calcium level. Multiple regression suggested that these biomarker elevations are associated with menopausal status, although age remains a potential confounding factor. Conclusion: Elevated salivary calcium and albumin levels serve as significant biochemical markers for oral dryness in postmenopausal women. These findings suggest that increased mucosal permeability and altered mineral transport are key physiological features of the menopausal oral cavity, necessitating targeted preventive dental care.
Abstract Objective: This study aimed to assess the association between EI and stress coping strategies among dental professionals. Methods: This cross-sectional study was conducted among 588 dental professionals, including undergraduate and postgraduate students and qualified dentists, in Chennai, Tamil Nadu, from May to July 2024. Coping Inventory for Stressful Situations-21 and Schutte Self-Report EI Test questionnaires were administered to dental professionals using a convenience sampling method. Pearson’s correlation test and multivariable linear regression were carried out to evaluate the relationship between EI and stress coping strategies. Results: The overall mean EI score for undergraduate students (141.6 ± 38.49) was higher compared with that of qualified dentists (137.6 ± 40.96; P = 0.033). The mean task-oriented coping was found to be higher among qualified dental professionals (4.358 ± 1.963) compared with undergraduate students. EI showed a moderate positive correlation with task-oriented coping ( r = 0.319; P = 0.000) and a weak positive correlation with avoidance coping ( r = 0.198; P = 0.020), whereas a moderate negative correlation was observed with emotion-oriented coping ( r = −0.600; P = 0.000). Conclusion: EI demonstrated significant associations with specific coping domains among dental professionals. Higher EI was associated with greater task-oriented coping and lower emotion-oriented and avoidant coping after adjusting for gender and professional category.
Abstract Objective: The association between periodontal disease and atherosclerosis has gained significant attention, yet the intellectual structure and most influential works in this interdisciplinary field have not been systematically mapped. This study aimed to identify and analyze the characteristics, collaborative networks, and evolving research trends of the 100 most-cited articles concerning the relationship between periodontal disease and atherosclerosis. Methods: A comprehensive search was performed in the Web of Science Core Collection on January 24, 2025. Bibliometric analysis and visualization were conducted using VOSviewer, CiteSpace, and the “bibliometrix” R package. Metrics included total citations, h-index, and keyword burst detection. Results: The 100 articles garnered a total of 13,968 citations (average: 195.6 citations per article). The United States was the leading contributor ( n = 40), with the University of North Carolina identified as the most productive institution. The Journal of Periodontology and Circulation were the primary publication venues. Keyword clustering identified six research hotspots: risk factors, inflammatory responses, infection, confounding variables, Porphyromonas gingivalis , and related cardiovascular conditions. Burst analysis revealed a paradigm shift in research focus from mechanistic “infection” (2004–2005) to clinical “therapy” (2013–2020). Conclusion: This study delineates the foundational literature and thematic evolution of the periodontal–atherosclerosis link. The observed shift in the literature from mechanistic to interventional studies may correlate with an increase in publications on periodontal treatment for cardiovascular prevention. These findings provide a data-driven roadmap for future longitudinal trials and clinical guidelines.
Abstract Objective: To evaluate oral health, antibiotic prescriptions, and hospitalizations before and after dental follow-up among children assisted by the Home Care Service (HCS). Methods: This single-group quasi-experimental, nonrandomized study was conducted at the HCS of the Clinical Hospital, at a Federal University in Brazil. This study involved 29 children undergoing invasive mechanical ventilation and gastrostomy. Oral healthcare data were collected at two time points: T1 (December 2021) and T2 (December 2022). Dental interventions and oral health education activities were conducted between January and December 2022. Monthly data on hospitalizations and antibiotic prescriptions were collected for 2021 and 2022. Oral health assessment was based on the simplified oral hygiene index, gingival bleeding, and gingival hyperplasia. Statistical analysis was performed using the Wilcoxon paired test, with a 5% significance level. Results: There was a reduction in gingival bleeding (47.4%, P = 0.044) and the presence of dental plaque (50.0%, P = 0.011) and calculus (50.0%, P = 0.024). The number of antibiotic prescriptions decreased by 51.5% ( P = 0.043). No significant difference was observed in the hospitalization rates ( P > 0.050). Conclusion: Over the course of the dental follow-up, homebound pediatric patients showed a reduction in dental plaque, calculus, gingival bleeding, and antibiotic use. This is particularly relevant given that children with disabilities who are homebound often lack access to dental care. Regular dental checkups can reduce plaque accumulation, gingival bleeding, calculus formation, and the need for antibiotic prescriptions. Therefore, integrating dentists into home care teams may strengthen the relationship between improved oral health, reduced antibiotic use, and lower hospitalization rates in vulnerable pediatric populations.
Abstract Objective: Semaglutide, a glucagon-like peptide-1-receptor agonist, is widely used for the management of type-2 diabetes mellitus and obesity. Despite its increasing clinical use, the drug’s oral adverse effect profile remains inadequately characterized. This narrative review aimed to analyze the current evidence on semaglutide-associated oral adverse effects, with emphasis on mechanistic pathways, integration of pharmacovigilance and clinical data, and emerging implications for oral health and dental practice. Methods: A comprehensive literature search was conducted across PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar. Keywords related to semaglutide and oral adverse effects were used. Eligible studies included clinical trials, pharmacovigilance analyses, observational studies, case reports, and preclinical research reporting oral adverse effects or relevant mechanistic insights. Studies lacking oral health correlates were excluded. Findings were narratively reviewed in accordance with Scale for the Assessment of Narrative Review Articles guidelines. Results: Xerostomia or hyposalivation is the most consistently reported oral adverse effect, although its prevalence varies across studies. However, xerostomia often occurs secondarily to gastrointestinal symptoms including nausea, reduced oral intake, and delayed gastric emptying. Additional manifestations included dysgeusia, dry throat, oral paresthesia or hypoesthesia, halitosis, frothy saliva, and increased dental caries. Pharmacovigilance data show significant signals for dry mouth and altered taste. Case-series confirm semaglutide-associated hyposalivation. Limited evidence suggests increased susceptibility to oral candidiasis. Early experimental and observational data indicate potential modulatory effects on inflammation, tissue repair, and bone metabolism. Conclusion: Semaglutide therapy is associated with oral adverse effects, mainly xerostomia and sensory disturbances, which may compromise oral health. Awareness of these outcomes highlights the need for interdisciplinary oral health monitoring.
Abstract Objective: This longitudinal study aimed to assess the difference between normative, impact-related, and propensity-related needs (PRNs) for nonprogressive dental conditions among young adults in Chennai, India, and to evaluate the effect of dental health education (DHE) on behavioral propensity. Methods: A total of 195 post-graduate students aged 20–25 years from three randomly selected colleges in Chennai were examined. Normative needs (NNs) were assessed using the dental aesthetic index, community periodontal index for treatment needs, and WHO prosthetic needs index. Impact-related needs were evaluated with the oral impacts on daily performance questionnaire. PRNs were determined using four oral health behavior indicators. Participants with medium or low propensity received audiovisual DHE followed by reinforcement, and behavioral propensity was reassessed after 1 month. Data were analyzed using the chi-square and McNemar’s tests. Results: NNs were identified in 86.6% of participants, while 85.2% reported at least one oral impact. Only 2.7% of participants demonstrated high behavioral propensity and were classified as having sociodental needs at baseline. Following DHE, sociodental needs increased slightly to 3.7%. Behavioral propensity improved significantly, with high propensity increasing from 0% to 3.7% and medium propensity from 38.0% to 58.3% ( P = 0.001). Conclusion: The sociodental approach showed a considerable reduction in treatment needs compared with the normative method. DHE produced a significant improvement in behavioral propensity, indicating the importance of incorporating psychosocial and behavioral dimensions into oral health needs assessment.
Abstract Objective: Preeclampsia (PE) affects 2%–8% of pregnancies globally and represents a significant maternal health challenge, characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. Periodontal disease, defined as chronic inflammation affecting tooth-supporting structures, demonstrates a notably high prevalence among pregnant women. The objective of the present study was to compare serum inflammatory markers and periodontal status between preeclamptic and normotensive pregnant women in a cross-sectional design. Methods: Sixty pregnant women were recruited—30 preeclamptic and 30 normotensive—from the Department of Obstetrics and Gynecology, K.S. Hegde Hospital, Mangalore. Oral health evaluations were performed during hospital admission for delivery or 48 h before planned delivery to assess periodontal status. Following the examination of oral health status, the normotensive and preeclamptic pregnant women were grouped as preeclamptic women with healthy periodontium (PH), preeclamptic women with periodontitis (PP), normotensive women with healthy periodontium (NH), and normotensive women with periodontitis (NP) to compare the serum cytokine levels and periodontal status among the subgroups. Periodontitis was defined as a clinical attachment level ≥3 mm in ≥30% of examined sites, assessed by a single calibrated examiner. Serum levels of interleukin (IL)-10, IL-4, tumor necrosis factor-alpha (TNF-α), and IL-2 were quantified using enzyme-linked immunosorbent assay. Group comparisons were performed using the Kruskal–Wallis test with post hoc Bonferroni correction for cytokine data and one-way analysis of variance for periodontal parameters. Results: Periodontitis was significantly more prevalent in preeclamptic women (63.3%) compared to normotensive women (30%; P = 0.010). Serum IL-10 levels were significantly lower in the PP group (3.36 [3.06, 5.61] pg/mL) compared to the NH group (7.61 [3.52, 10.03] pg/mL) ( P = 0.010, post hoc Bonferroni correction). Serum levels of TNF-α, IL-2, and IL-4 showed no statistically significant differences across subgroups. Conclusion: In this cross-sectional study, periodontitis was associated with lower serum IL-10 levels in preeclamptic women, suggesting a possible immune dysregulation between periodontal disease and PE. A causal relationship cannot be established from the present observational data. These findings warrant further investigation through larger prospective longitudinal studies to establish temporality and causation.
Abstract Objective: Kidney transplant recipients (KTRs) are particularly vulnerable to periodontal disease due to long-term immunosuppression, metabolic disturbances, and chronic inflammation. However, data in Southeast Asia remain scarce. The aim of the study was to determine the prevalence, stage distribution of periodontitis, and to examine systemic and behavioral factors associated with the disease among Vietnamese KTRs; as a secondary exploratory aim, we evaluated selected systemic biomarkers (C-reactive protein [CRP], serum urea, and platelet count [PLT]) and descriptively summarized their cross-sectional discrimination with respect to the periodontitis status using prespecified receiver operating characteristic (ROC) analyses. A cross-sectional analytical study among 300 KTRs at 103 Military Hospital, Vietnam Military University, Hanoi, Vietnam. Methods: A cross-sectional study was conducted among 300 KTRs at a teaching hospital in Hanoi, Vietnam, from June 2025 to October 2025. Periodontitis was defined and staged according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions (American Academy of Periodontology/European Federation of Periodontology). Descriptive statistics, chi-square/Fisher’s exact test, and logistic regression were used to examine associations. Crude and adjusted odds ratios (ORs and aORs) were calculated. An exploratory ROC analysis was performed to assess the discriminatory ability of selected clinical and biochemical variables. Chi-square, t test, analysis of variance, multivariate logistic regression, and ROC analysis using Statistical Package for the Social Sciences version 27.0 were used for statistical analyses. Results: Periodontitis was present in 77.7% of participants. Stage I disease was most prevalent (33.0%), followed by Stage II (27.0%) and Stage III (16.3%); only 1.3% of patients had Stage IV disease. In multivariable analysis, poor oral hygiene (OHI-S; aOR = 3.47), lower PLTs (aOR = 0.986), higher CRP levels (CRP; aOR = 1.32), and elevated serum urea (aOR = 2.09) were independently associated with periodontitis. Conclusion: Periodontitis is highly prevalent in Vietnamese KTRs, predominantly in moderate stages, underscoring the need for preventive strategies. Systemic inflammation, renal biomarkers, and poor oral hygiene were strongly associated with disease. Integrating periodontal assessment into routine post-transplant care may support preventive oral health strategies in this population.
Objective:Out-of-hospital cardiac arrest is a major public health concern in India, with survival rates below 10%. Dental professionals, interacting with patients in diverse settings, represent an underutilized segment of the health system for emergency preparedness. This study aimed to assess knowledge, perceived barriers, and opportunities related to basic and advanced cardiovascular life support (BLS/ACLS) among dental professionals in India through a mixed-methods approach. Methods:A convergent parallel mixed-method study was conducted between February and July 2025. Quantitative data were collected from 330 registered dental professionals using a validated questionnaire (Item-Content Validity Index = 0.82; Cronbach α = 0.86). The primary outcome was the mean knowledge score. Data were analyzed using descriptive statistics, t tests, analysis of variance, and multivariate linear regression with reporting of 95% confidence intervals (CIs). Multicollinearity was assessed using variance inflation factors. Qualitative data were obtained through two focus group discussions (n = 18) and analyzed using thematic analysis. Results:While 64.5% of participants had received BLS training, only 21.5% had ACLS exposure. The mean knowledge score was critically low at 35.59% (95% CI: 33.77-37.41). Multivariate regression (model fit: R 2 = 0.188) identified prior BLS training (B = 6.93, P < 0.001; CI: 3.10-10.76) and higher qualification (e.g., Doctor of Philosophy (PhD) vs. Bachelor of Dental Surgery: B = -14.72, P = 0.011; 95% CI: -26.01 to -3.43) as significant predictors of knowledge. An attitude-based regression (model fit: R 2 = 0.173) found that disagreement with mandatory automated external defibrillators (B = -19.37, P = 0.016; 95% CI: -35.08 to -3.65) and neutrality on the importance of compression-only life support (B = -10.20, P = 0.015; 95% CI: -18.33 to -2.06) were significantly associated with lower scores. Qualitative analysis yielded five major themes: training, medical emergencies, needs and role of dentists, barriers, and areas for improvement. These themes elucidated factors such as low confidence, significant infrastructure deficits, and systemic obstacles to training, especially in small towns. Conclusion:This study highlights critical deficiencies and quantitatively low knowledge scores in cardiovascular life support preparedness among dental professionals. The findings underscore a missed opportunity to expand India's emergency response capacity, pointing to an urgent need for mandatory, standardized training and systemic infrastructure improvements.
Objective:Fluoride mouthwashes are essential tools for caries prevention; however, their efficacy and safety depend on accurate fluoride concentrations and non-erosive pH levels. Deviations from labeled specifications can compromise therapeutic outcomes or pose risks to dental enamel. The aim was to quantify the available fluoride concentration and evaluate the pH of commercially available mouthwashes in Morocco, benchmarking them against international ISO standards and clinical safety thresholds. Methods:Twenty commercially available mouthwashes were collected from Moroccan pharmacies and supermarkets. Fluoride concentration was determined using the Belcher-West colorimetric method with Alizarin complexone, based on spectrophotometric measurements at 618 nm following appropriate calibration and method validation. The pH of each product was measured using a calibrated digital pH meter. The accuracy of fluoride labeling was examined based on international quality standards. Statistical analysis included a 15% deviation benchmark (ISO 16408) and Pearson's correlation to assess the relationship between fluoride stability and acidity. Packaging materials (polyethylene terephthalate/high-density polyethylene) were assessed for their impact on physicochemical stability. Results:Among fluoridated mouthwashes, 80% (n = 8) complied with international quality standards, showing relative deviations between 0.71% and 5.76% from labeled values, while 20% (n = 2) were non-compliant due to significant under-labeling. Measured fluoride concentrations ranged from 95.50 ± 0.78 ppm to 475.90 ± 3.55 ppm, with sodium fluoride identified as the active ingredient in all fluoridated formulations. All non-fluoridated mouthwashes exhibited fluoride levels below the detection limit (<0.7 mg·L-1). The pH values varied widely across products, ranging from 3.9 to 8.0 in fluoridated mouthwashes and from 2.8 to 5.5 in non-fluoridated formulations. No statistically significant correlation was observed between fluoride concentration and pH among fluoridated products, indicating that fluoride presence was not restricted to neutral or alkaline formulations. Packaging analysis revealed a consistent absence of pH information on product labels. Conclusion:A substantial proportion of Moroccan mouthwashes fail to meet international standards for fluoride labeling accuracy. Furthermore, the presence of acidic formulations in the market necessitates stricter regulatory oversight to ensure enamel safety. Clinicians should be cautious when recommending specific low pH formulations to patients with high erosive risk.
Objective:To introduce a robust clustering model for the early prediction of autism spectrum disorder (ASD) in toddlers. Methods:Five parametric and five non-parametric clustering algorithms were employed using all available features of a dataset obtained from Kaggle.com. The performance of these algorithms was evaluated through a comparative analysis based on several metrics, including the Silhouette Score (SS), Davies-Bouldin Index (DBI), adjusted rand index (ARI), Fowlkes-Mallows index (FMI), normalized mutual information (NMI), standard deviation (SD), and processing time (PT). Results:The results demonstrate that the Gaussian Mixture Model (GMM) achieved superior performance compared with the other algorithms on this dataset. The best results were observed in terms of both clustering performance (SS = 0.1952, DBI = 1.8038, ARI = 0.9730, FMI = 0.9884, NMI = 0.9439) and time efficiency (an average of 4.1998 s over five runs) when training and testing were conducted on the entire dataset. When the dataset was split into training and testing sets, GMM achieved the following performance: SS = 0.2108, DBI = 1.6722, ARI = 1, FMI = 1, NMI = 1, and SD=0.0818. Conclusion:ASD is a long-term neurological condition that requires early, rapid, accurate, and effective diagnosis to ensure appropriate healthcare intervention. Traditional diagnostic methods are often time-consuming and costly. Consequently, machine learning approaches have emerged as faster and more cost-effective alternatives for ASD diagnosis. In this study, GMM showed superior performance among the algorithms compared within this dataset, but should not be interpreted as a diagnostic tool without further validation.
Objective:Systematic reviews (SRs) and meta-analyses (MAs) provide the highest level of scientific evidence for clinical recommendations and policy drafting in preventive dentistry. As readers frequently rely on abstracts for rapid appraisal, complete and transparent reporting is critical. The aim was to assess the reporting quality of abstracts of SRs and MAs published in international preventive dentistry journals using the Preferred Reporting Items for SRs and Meta-Analyses (PRISMA) 2020 extension for abstracts and to identify predictors of better reporting.Methods:This quality-of-reporting study analyzed 157 structured abstracts from seven purposively selected journals (quartiles 1-3) published between 2020 and 2022. Two independent, calibrated reviewers scored each abstract against the 12-item PRISMA 2020 checklist (0 = not reported, 1 = partially reported, 2 = fully reported). Inter-rater reliability was assessed using Cohen's kappa. Descriptive statistics and multiple linear regression were used for analysis.Results:Only the identification of the report as an SR/MA achieved 100% compliance across all journals. Moderate compliance was found for objectives and eligibility criteria. However, reporting was markedly suboptimal for synthesis methods, risk of bias, funding, and registration. Regression analysis revealed that a higher journal impact factor, larger journal volume, and affiliation with a professional society were significantly associated with higher reporting scores (P < 0.01).Conclusion:Adherence to PRISMA 2020 abstract guidelines in preventive dentistry remains suboptimal. Enhanced editorial oversight and strict adherence to reporting checklists are essential to improve the transparency and reproducibility of evidence used to shape clinical and policy decisions.
Objective:Concentrated Growth Factor (CGF) is a third-generation autologous platelet concentrate utilized for its high density of bioactive molecules. However, the influence of chronic hyperglycemia on the specific growth factor composition of CGF remains underexplored. This study aimed to quantify and compare the concentrations of IGF-1, VEGF-A, and TGF-β1 in CGF derived from individuals with uncontrolled type 2 diabetes mellitus (T2DM) versus non-diabetic controls. Methods:A cross-sectional study was conducted involving 80 participants: 40 with uncontrolled T2DM (HbA1c > 7%) and 40 non-diabetic controls (HbA1c < 6%). CGF was isolated via a standardized variable-speed centrifugation protocol (Medifuge MF200). Growth factor levels were quantified using validated, high-sensitivity enzyme-linked immunosorbent assays (CV < 10%). Data were analyzed using independent t-tests and Pearson's correlation (P < 0.05), adjusting for age and BMI. Results:CGF from uncontrolled diabetics exhibited significantly lower mean concentrations of all measured factors compared to controls: IGF-1 (0.42 ± 0.15 vs. 1.58 ± 0.06 ng/mL; P< 0.001), VEGF-A (0.11 ± 0.02 vs. 0.21 ± 0.03 ng/mL; P< 0.001), and TGF-β1 (2.52 ± 0.36 vs. 2.76 ± 0.15 ng/mL;P < 0.001). The largest reduction was observed in IGF-1 (~72%), followed by VEGF-A (~46.7%) and TGF-β1 (~8.7%). Correlation analysis indicated that these reductions were significantly associated with hyperglycemic status (HbA1c) rather than demographic variables such as age or BMI. Conclusion:Uncontrolled hyperglycemia is associated with a significant quantitative depletion of key regenerative growth factors within CGF, particularly IGF-1 and VEGF-A. These findings suggest that the intrinsic regenerative potential of autologous CGF may be compromised in diabetic patients, indicating a need for optimized glycemic control or adjunctive strategies in clinical regenerative procedures.
Objective:Oral squamous cell carcinoma (OSCC) continues to pose significant therapeutic challenges due to high recurrence rates and treatment-related toxicity. Drug repurposing offers an accelerated, cost-effective pathway to discover novel therapeutic indications for established medications. This narrative review evaluates the mechanistic rationale and clinical potential of repurposing antifungal agents, such as azoles and allylamines, as adjuvant therapies for OSCC. Methods:A comprehensive literature search was performed across PubMed and Scopus (up to November 14, 2025). Studies were selected based on their focus on antifungal-mediated inhibition of OSCC growth and metastasis. Methodological quality was assessed using the Scale for the Evaluation of Narrative Review Articles. Results:Antifungal agents, particularly itraconazole and terbinafine, exhibit potent antitumor activity by targeting key oncogenic pathways, including the Sonic Hedgehog (SHH) and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin signaling axes. Preclinical evidence indicates that these agents induce apoptosis, inhibit angiogenesis, and sensitize OSCC cells to standard chemotherapy and radiotherapy. Specifically, itraconazole shows promise in treating SHH-high tumors, while terbinafine reduces tumor proliferation through antiangiogenic mechanisms. Conclusion:Antifungal drugs represent a biologically viable and resource-efficient strategy for enhancing OSCC treatment outcomes. To maximize clinical translation, future research must prioritize the development of nanoformulations and liposomal azoles to overcome existing bioavailability limitations.
Objective:Early childhood caries (ECC) is a multifactorial disease driven by biological and psychosocial determinants. Identifying noninvasive biomarkers could improve risk stratification and personalized prevention. The aim of the study is to evaluate the association of salivary cortisol, total secretory immunoglobulin A (sIgA), and pro-inflammatory cytokines (interleukin-6 [IL-6], interleukin-1β [IL-1β], and tumor necrosis factor-alpha [TNF-α]) with ECC in preschool children.IL-1β. Mathods:This cross-sectional analytical study included 120 children aged 3-6 years (60 ECC; 60 caries-free). Unstimulated saliva was collected via passive drooling. Biomarkers were quantified using high-sensitivity enzyme-linked immunosorbent assay kits. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed, adjusting for age, sex, feeding practices, oral hygiene, and socioeconomic status (SES). Results:Children with ECC exhibited significantly higher levels of salivary cortisol (8.92 + -2.11 vs. 5.21 + -1.98 ng/mL, P < 0.001), IL-6 (42.81 + -10.29 vs. 26.44+ -9.87 pg/mL, P < 0.001), and TNF-α (P = 0.002) compared to controls. Conversely, sIgA levels were significantly lower in the ECC group (11.34 + -4.12 vs.18.25 + -5.03 mg/dL, P < 0.001). ROC analysis identified cortisol (area under the curve [AUC] = 0.89) and sIgA (AUC = 0.86) as excellent diagnostic indicators. In the final multivariable model, cortisol (OR 3.94, 95% confidence interval [CI] 2.11-7.35) and sIgA (OR 0.44, 95% CI 0.28-0.70) remained independently associated with ECC after adjusting for SES and behavioral covariates. Conclusion:Salivary cortisol, sIgA, and inflammatory cytokines are significantly associated with ECC, reflecting complex interactions between stress physiology, mucosal immunity, and oral dysbiosis. While these biomarkers show promise as early-warning indicators, longitudinal data are required to establish their discriminatory utility for caries onset.
Objective:Periodontitis is a chronic inflammatory disorder that gives rise to tissue damage and loss due to the complex interaction between pathogenic bacteria and the host's immune response. The aim of this study is to determine the lipid peroxidation, total antioxidant (AO) capacity (TAC), and superoxide dismutase (SOD) levels in patients diagnosed with chronic gingivitis and chronic periodontitis and in periodontally healthy control subjects. Methods:The subjects were divided into three groups. Blood sample and saliva were collected. TAC, MDA, and SOD levels were estimated by spectrophotometric methods. SOD in the saliva samples was analyzed by using the enzyme-linked immunosorbent assay (ELISA) kit method. Results:The mean age of the study population in the control group was 45.21 ± 13.12, which in the gingivitis group was 44.12 ± 9.10 and in the periodontitis group was 42.19 ± 12.11. TAC and SOD levels were significantly reduced in both serum and saliva in the periodontitis compared to control and the gingivitis group. MDA levels were significantly increased in the serum and the saliva of the periodontitis compared to control and the gingivitis group. Conclusion:Oxidative stress, or the imbalance between oxidants and AO, is a major factor in the development and course of periodontitis.
