BACKGROUND:Interest in antimicrobial surfaces for dental devices, such as aligners and brackets, is growing. These surfaces are designed to retard biofilm formation. One approach is to load essential oils (EOs) into the material. The focus of this study was the antibacterial, anti-biofilm, and anti-inflammatory activities of an EO solution. METHODS:The EO solution contained cinnamaldehyde, methyl salicylate, eucalyptol, limonene, and trans-anethole dissolved in distilled water (dH2O) with polyglycerol-4-laurate/sabacate (basic solution). The positive control was 0.2% chlorhexidine digluconate (CHX). The antibacterial activity of the EO and the basic solution was tested against selected oral bacteria. Multispecies biofilms were formed on specimens of a cellulose-based (test) material loaded with the EO solution or the basic solution, and on a polyurethane-based (reference) material loaded with CHX. The level of IL-8 released from gingival fibroblasts (GF) exposed to the solutions was measured. RESULTS:The EO solution clearly inhibited bacterial growth. However, the basic solution also acted as a growth inhibitor at higher concentrations. The EO solution reduced the metabolic activity of the formed biofilm. In addition, the basic solution decreased biofilm mass and colony-forming unit counts. The basic solution was not inferior to CHX on the reference material. However, only the basic solution, not the EO solution, suppressed the release of IL-8 from GF when stimulated with bacteria. CONCLUSION:Applying essential oils (EOs) to surfaces may be an effective way to inhibit biofilm formation. The basic solution, which is polyglyceryl-laurate-based, exhibits anti-biofilm and anti-inflammatory properties. Further in vitro research should aim to gain a deeper understanding of the solubilizer's mechanisms and optimize the composition of the added essential oils before testing in clinical trials.
OBJECTIVES:To develop interpretable machine learning (ML) models for risk stratification of clinically meaningful anterior overbite decrease after stabilization splint therapy in temporomandibular disorder (TMD) patients, and to compare ML performance with conventional logistic regression. MATERIALS AND METHODS:This retrospective cohort included 87 TMD patients treated with stabilization splints, physical therapy, and pharmacologic therapy. Thirty-five pre-treatment cephalometric and demographic features were used. The primary outcome was overbite difference (OD = post-treatment minus pre-treatment overbite). For classification, patients were labeled as Decrease (OD < -0.5 mm; n = 37) versus Non-Decrease (OD ≥ -0.5 mm; n = 50), combining No Change and Increase due to severe imbalance in the Increase subgroup. Six classifiers (logistic regression, random forest, extreme gradient boosting (XGBoost), Light Gradient Boosting Machine, support vector machine, k-nearest neighbors) were evaluated using stratified fivefold cross-validation and leave-one-out cross-validation. Class imbalance was handled using class-weighting and the Synthetic Minority Over-sampling Technique (SMOTE) applied within the cross-validation loop. For regression, nine algorithms were tested to predict continuous OD. Model explainability was assessed using SHapley Additive exPlanations (SHAP). RESULTS:In fivefold cross-validation, XGBoost achieved the best discrimination (AUC = 0.734), outperforming logistic regression (AUC = 0.611). With SMOTE, the random forest achieved a comparable AUC (0.735) with improved sensitivity. Across regression models, cross-validated R2 values were near-zero or negative, indicating limited ability to predict the exact magnitude of overbite change from baseline variables alone. SHAP ranked pre-treatment overbite, ramus height, upper occlusal plane to SN angle, sella-to-condylion distance, and condylar positional indices among the most influential predictors for classification. CONCLUSION:Interpretable ML enables improved risk stratification for clinically meaningful anterior overbite decrease after stabilization splint therapy in TMD patients, whereas predicting the exact magnitude of overbite change remains limited using pre-treatment cephalometrics alone. These models may support individualized counseling and closer monitoring for patients at higher risk of open-bite development during splint therapy.
ABSTRACT Objectives Despite the growing number of studies assessing the performance of temporary restorative materials fabricated through CAD/CAM technologies, comparative analyses among 3D printed resins and milled PMMA blocks with differing compositions remain limited. This study compared mechanical and biofilm surface formation of 3D printed resins PMMA blocks with different compositions, using composite resin as control. Material and Methods Bar‑shaped (25 × 2 × 2 mm) and disc‑shaped (6 × 2 mm) specimens were fabricated. Flexural strength was evaluated by three‑point bending (ISO 4049), and Vickers microhardness was recorded. Multispecies biofilm formation was quantified using CFU/mL and examined morphologically via SEM. Statistical significance was set at α = 0.05. Results The 3D printed resins and milled hybrid PMMA showed the lowest flexural strength, with no significant differences between them, while the composite resin achieved the highest and statistically superior values (p < 0.001). 3D printed resin without inorganic fillers showed the lowest Vickers microhardness values (12.66 ± 0.83 HK) while 3D printed resin with inorganic fillers (15.20 ± 1.94 HK) and milled conventional PMMA (16.03 ± 1.35 HK) exhibited higher values. However, none of them differed statistically from the 3D printed resin without inorganic fillers (p = 0.064). Conversely, milled hybrid PMMA (16.67 ± 2.10 HK) demonstrated significantly higher Vickers microhardness than 3 d printed resin with inorganic fillers (p < 0.001). Biofilm formation ranged from 2.26 × 107 to 2.82 × 107 CFU/mL, with no significant differences among materials (p > 0.05). Conclusions Milled and 3D printed materials demonstrated comparable mechanical behavior while composite resin remained the performance benchmark. Material selection for provisional restorations should account for mechanical behavior and biological interactions, as surface treatment and clinical conditions may influence microbial colonization.
ABSTRACT Introduction This micro‐computed tomography (micro‐CT) study aimed to evaluate the shaping ability of two nickel–titanium (NiTi) rotary systems—XP4 and ProTaper Next (PTN)—in 3D‐printed replicas of C‐shaped canals. Methods Two extracted mandibular second molars with C‐shaped root canals—one continuous (Melton's Category I) and one discontinuous (Melton's Category II/III)—were selected and replicated via 3D printing. Replica accuracy was validated by best‑fit alignment. Sixteen resin replicas per specimen were randomly assigned to PTN or XP4 instrumentation (n = 8 per group) following the manufacturers' protocols. Pre‐ and post‐instrumentation micro‐CT scans were performed. Three‐dimensional registration and reconstruction enabled quantitative analysis of (1) volume/surface area changes and (2) unprepared canal surfaces. Results The replicas demonstrated high fabrication fidelity. In continuous C‐shaped canals, PTN removed significantly less resin (2.7 mm3, 7.4% of initial volume) than XP4 (4.3 mm3, 11.6%; p < 0.01). Conversely, in discontinuous C‐shaped configurations, PTN exhibited greater removal (13.0 mm3, 23.1%) versus XP4 (8.9 mm3, 15.8%; p < 0.01). Unprepared canal surface in continuous C replicas was higher with PTN (42.0%) than XP4 (25.5%; p < 0.01), whereas no significant difference was observed in discontinuous C replicas (PTN: 32.0%, XP4: 31.6%; p > 0.05). Procedural complications were observed exclusively in discontinuous C‐shaped canals, with PTN causing two cases of critical wall thinning and XP4 exhibiting two instrument separations. Conclusion In continuous C‐shaped canal replicas, XP4 showed superior shaping capability with significantly lower percentages of unprepared surface compared to PTN. In discontinuous C‐shaped configurations, both systems achieved comparable unprepared surface areas, although they differed markedly in resin removal patterns and iatrogenic risks. These results indicate that the relative performance and safety profiles of NiTi systems may vary depending on specific C‐shaped canal anatomy. Clinicians should consider canal configuration, curvature severity, and dentin thickness when selecting instruments for C‐shaped canal instrumentation.
ABSTRACT Objectives Autosomal dominant hypocalcified amelogenesis imperfecta (ADHCAI; OMIM#130900) is a hereditary enamel defect caused by truncation mutations in FAM83H, though the underlying pathogenic mechanisms remain incompletely understood. This study aimed to identify novel FAM83H mutations in a Chinese family with ADHCAI and to investigate their functional consequences on enamel formation. Materials and Methods A three‐generation ADHCAI family underwent clinical and genetic evaluation. Whole‐exome sequencing and Sanger sequencing were used for mutation identification. The proband's enamel was analyzed by scanning electron microscopy with energy‐dispersive X‐ray spectroscopy (SEM‐EDX). Structural impacts of the mutation were predicted bioinformatically (PSIPRED, SWISS‐MODEL). Patient‐derived periodontal ligament cells (PDLCs) were assessed by Western blot, immunofluorescence, and quantitative real‐time PCR for key enamel matrix proteins (AMELX, AMBN, ENAM) and osteogenic markers (RUNX2, ALP). Results A novel heterozygous nonsense mutation (c.1819G>T, p.(Glu607*)) in FAM83H was identified, resulting in a C‐terminally truncated protein lacking 573 residues that mislocalizes from the cytoplasm to the nucleus. SEM‐EDX revealed disorganized enamel ultrastructure, a reduced calcium‐to‐phosphorus ratio, and increased porosity. Functional analysis in PDLCs showed coordinated downregulation of enamel matrix proteins and osteogenic markers, indicating a dual regulatory role for FAM83H in biomineralization. Conclusions Our findings are consistent with the “presecretory pathogenesis” model for ADHCAI, wherein nuclear‐mislocalized truncated FAM83H may disrupt enamel mineralization partly through transcriptional suppression of matrix components. This expands the FAM83H mutational spectrum, offers preliminary mechanistic insight, and suggests potential targets for pre‐eruptive therapeutic strategies.
ABSTRACT Objectives The association between body roundness index (BRI) and periodontitis among US adults with hypertension remains unclear. This study aimed to investigate the relationship between BRI and periodontitis in this population. Material and Methods This cross‐sectional study included 4117 adults with hypertension from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. Multivariable logistic regression models were used to assess the association between BRI and periodontitis. Generalized additive models and two‐piecewise regression models were applied to explore potential nonlinearity and threshold effects. Stratified analyses across covariate‐defined subgroups and sensitivity analyses were conducted to evaluate the robustness of the findings. Results After adjustment for covariates, BRI was significantly associated with periodontitis. When BRI was analyzed by quartiles, participants in the highest quartile had significantly higher odds of periodontitis than those in the lowest quartile in both Model I (OR = 1.27, 95% CI: 1.05–1.54, p = 0.0122) and Model II (OR = 1.25, 95% CI: 1.03–1.53, p = 0.0258). A nonlinear association was observed between BRI and periodontitis. The log‐likelihood ratio test was statistically significant (p < 0.05), and the inflection point was estimated to be approximately 6. At or above this point, the OR for the association between BRI and periodontitis was 1.09 (95% CI: 1.04–1.15, p = 0.0006), whereas below this point, the corresponding OR was 0.94 (95% CI: 0.87–1.02, p = 0.1209). Sensitivity analyses yielded results that were broadly consistent with the primary findings. Conclusions Among US adults with hypertension, BRI was associated with periodontitis, and the association was nonlinear.
ABSTRACT Objective This study aimed to clarify the relationship between stromal cell‑derived factor 1 (SDF‑1) and osteoblast‐related responses in periodontal ligament (PDL) during orthodontic tooth movement (OTM) after tooth extraction, based on the hypothesis that local inhibition of SDF‑1/C‑X‑C chemokine receptor type 4 (CXCR4) signaling with the CXCR4 antagonist AMD3100 would attenuate osteoblast differentiation and alveolar bone remodeling during OTM. Methods Thirty‐six 6‐week‐old Wistar/Sprague–Dawley male rats were randomly divided into control and experimental groups. After the extraction of the maxillary left first molar, the maxillary left second molar (M2) was moved mesially with a 10‐gf force following the local injection of phosphate‐buffered saline or AMD3100 into the buccal and palatal gingiva adjacent to the M2 in the control and experimental group, respectively. Micro‐computed tomography was performed to assess tooth movement and alveolar bone changes. Histological and immunohistochemical analyses were performed to evaluate periodontal tissue morphology and the percentages of SDF‐1‐, CXCR4‐, RUNX2‐, and BGLAP‐positive cells on the tension side of the PDL. Quantitative reverse transcription PCR was used to assess expression levels of SDF‐1, CXCR4, RUNX2, and BGLAP. Results OTM distance and mesial tilt angle were significantly reduced in the experimental group. RT‐PCR showed that SDF‐1, CXCR4, and RUNX2 expression levels were significantly downregulated from Day 1 through Day 7, whereas BGLAP expression was significantly decreased only on Day 1. Immunohistochemical analysis of the tension side of the PDL demonstrated significantly reduced SDF‐1‐ and CXCR4‐positive cells on Day 3 and RUNX2‐positive cells on Day 7 in the experimental group. In contrast, the BGLAP‐positive cells did not differ significantly at any time point. Conclusion Local inhibition of SDF‐1/CXCR4 signaling reduced OTM and altered early alveolar bone remodeling after tooth extraction. The combined gene expression and immunohistochemical findings suggest that the SDF‐1/CXCR4 axis may contribute to osteoblast differentiation, particularly through RUNX2‐related responses during the early phase of OTM. Trial Registration Not applicable.
ABSTRACT Objectives This case series reports on alveolar osteitis (AO) treatment outcomes after standard AO therapy combined with cross‐linked hyaluronic acid (xHyA) and a collagen sponge. Material and Methods Nine patients fulfilling the AO criteria after permanent tooth extraction were included. After standard AO treatment, that is, irrigation and curettage, a xHyA gel combined with an absorbable collagen sponge was applied into the socket and stabilized with a suture. Pain perception (visual analogue scale [VAS], pain killer consumption), soft tissue healing index (STHI), alveolar bone exposure, necessity of re‐treatment, occurrence of complications, and patients’ opinion were assessed up to 14 days post‐treatment. Results Eight patients completed the 14‐day follow‐up, while one patient dropped out after 1 day due to persisting pain. Initial mean pain perception (VAS) was 7.5 (1.4), which decreased after a single treatment to 4.4 (2.2) within 6 h and by 50% (3.8 [2.4]) within 24 h. In 5 out of 8 patients, complete pain resolution was achieved after 14 days, while 3 patients still experienced moderate pain. Pain reduction was accompanied by an improvement of STHI, reaching 4.0 (0.8) within 14 days; complete coverage of exposed alveolar bone walls was already observed within 3 days in all 8 patients. Only one patient required re‐treatment; 5 out of 8 patients expressed willingness to pay on top between 50 and 300€ for the material costs (xHyA+collagen sponge). Conclusions A single application of xHyA combined with a collagen sponge offered effective and fast pain relief combined with a favorable healing process in patients suffering from AO. Furthermore, the need for re‐treatment was infrequent, and favorable patient feedback was observed. However, randomized controlled trials with a sufficient sample size and a control group are essential to validate these findings.
ABSTRACT Objectives To describe the clinical characteristics and dental treatment for patients treated at a dental hospital in the United Kingdom. Material and Methods This descriptive study utilized anonymized routinely collected electronic health record data from dental patients who attended Leeds Dental Institute, collected from 2014 to 2023. Patient characteristics, comorbidities and completion of dental treatment were reported through descriptive statistics (mean and standard deviation [SD]; percentage) and by clinic attended. Results A total of 109,718 patients were included in this study, of whom 58,964 (54%) were female, and 43,828 (40%) lived in the most deprived areas in England. The most frequently recorded comorbidities were joint or bone problems (n = 4913, 5%), chest or breathing problems (n = 4619, 4%), and heart problems (n = 4455, 4%). Across clinic groups, the proportion of patients with at least one recorded comorbidity was highest among those attending periodontal/restorative clinics (24%) and acute dental care clinics (19%). Less than half of all patients (n = 52,655, 48%) completed their dental treatment. Oral surgery had the highest percentage of patients who completed their treatment (n = 10,459, 71%). Conclusions The sociodemographic and clinical characteristics reported in this study reflect a large population of dental patients from Leeds and the surrounding region. The findings of this study are consistent with literature showing sociodemographic trends in dental attendance. Future linkage of dental electronic health records with hospital records could improve understanding of the complexities of oral‐systemic associations further.
ABSTRACT Objective This cross‐sectional survey aimed to assess oral health in patients with inflammatory bowel diseases (IBD) living in Austria. Methods Data collection was conducted with an online questionnaire, including when possible validated tools, covering general medical history, socioeconomic factors, IBD‐related parameters, and various oral health parameters, that is, tooth loss rate, prevalence of severe periodontitis, oral health‐related quality of life (OHRQoL), and presence of oral lesions. The questionnaire was disseminated to the members of the Austrian Crohn's Disease/Ulcerative Colitis Association. Results The analysis included the responses of 327 patients (68% female; average age 46 years), 134 with ulcerative colitis (UC) or IBD unclassified, and 193 with Crohn's disease (CD). Based on self‐reported data, about 85% of the patients reported intake of an IBD‐related medication and about two thirds of the responders reported some IBD activity in the past 12 months. Approximately 24% of the patients had < 20 remaining teeth, 34% had severe periodontitis, and 7% reported poor OHRQoL. IBD diagnosis did not affect the odds for having < 20 teeth or self‐reported severe periodontitis, but patients with CD presented more frequently with poor OHRQoL. In addition, patients with CD received more frequently information from their physician on the possibility of oral lesions due to IBD; however, > 50% of all patients indicated not having any problems with oral lesions. Conclusions Oral health remains inadequately addressed in patients with IBD despite the significant need for dental care. Hence, treating physicians should motivate patients with IBD to inform their dentist about their diagnosis and to maintain regular dental checkups.
ABSTRACT Objective This systematic review evaluated the diagnostic accuracy of CBCT for BMD assessment using DEXA as the reference standard and aimed to quantify its performance through meta‐analysis. Materials and Methods This review included prospective and retrospective observational studies assessing CBCT's diagnostic performance in detecting low BMD, with DEXA as the reference. Searches in PubMed, Embase, and Scopus identified 13 eligible studies involving adult participants (≥ 18 years). Two reviewers independently extracted data and assessed study quality using the QUADAS‐2 tool. Meta‐analysis was conducted using random‐effects models. Results Pooled sensitivity and specificity of CBCT for detecting low BMD were 0.58 (95% CI: 0.50–0.67) and 0.78 (95% CI: 0.69–0.86), respectively. The summary receiver operating characteristic (SROC) curve showed an area under the curve (AUC) of 0.73 (95% CI: 0.69–0.77), indicating moderate diagnostic accuracy. Subgroup analyses revealed heterogeneity influenced by sample size and anatomical site. Conclusion CBCT demonstrates moderate diagnostic accuracy in detecting low BMD, with better specificity than sensitivity. While promising, standardization of CBCT protocols and larger studies are needed to confirm its role in clinical assessment. PROSPERO Registration Number (CRD42024598958).
ABSTRACT Objectives Autologous platelet concentrates (APCs) have emerged as biologically active adjuncts in guided tissue regeneration (GTR), aiming to enhance the treatment of intrabony periodontal defects through the local release of growth factors. Despite growing interest, the clinical benefits of combining APCs with bovine‐derived bone grafts (BBG) in the treatment of intrabony periodontal defects remain uncertain. This systematic review aimed to evaluate the clinical efficacy of incorporating APCs alongside GTR and BBG in managing intrabony defects. Materials and Methods A comprehensive electronic literature search was conducted across PubMed, Ovid MEDLINE, Scopus, Cochrane, and Web of Science. Inclusion criteria included randomised control trials involving systemically healthy adults with periodontal intrabony defects > 3 mm. Studies were screened based on predefined inclusion and exclusion criteria, and the methodological quality and risk of bias were assessed using the Cochrane Risk of Bias 2.0 tool. Results The initial search identified 214 articles, from which eight full‐text studies were screened for eligibility. Five randomised controlled trials met the inclusion criteria. One study reported potential clinical benefits with adjunctive APC use, while the remaining trials showed no statistically significant improvements. All included studies demonstrated concerns regarding risk of bias, primarily due to the absence of predefined protocols, and only one study provided trial outcomes beyond 12 months. Overall, the APC groups exhibited slightly greater mean gains in clinical attachment level (0.1–1.0 mm) and probing pocket depth reduction (0.1–0.8 mm) at 12 months compared with controls. Conclusion The adjunctive use of APCs with bovine‐derived bone grafts and guided tissue regeneration did not result in statistically significant improvements in clinical attachment level gain or probing pocket depth reduction. Future studies with standardised methodologies, larger sample sizes, and extended follow‐up durations are needed to clarify the long‐term efficacy of APCs in periodontal regenerative therapy.
ABSTRACT Objectives Orthodontic treatment is performed between 6 and 20 years—a period in life carrying the highest risk for traumatic dental injuries. The presence of traumatic injuries leads to treatment modifications and may adversely impact orthodontic outcomes. Yet, the literature on the prevalence and characteristics of traumatic injuries among patients undergoing orthodontic treatment is sparse. This study aims to describe the burden and distributional patterns of traumatic injuries, and the quality of information provided by general dentists to specialists on them (i.e., referral practices) among children undergoing orthodontic treatment. Material and Methods We included in the study 1529 participants (46.1% males, aged 7–18 years) undergoing orthodontic treatment in Western Norway, 2001–2018. Demographic, clinical, and other relevant information related to orthodontic treatment, as well as referral practices on traumatic injuries, were obtained from journals. Results Overall, 16.5% of participants experienced traumatic injuries. The prevalence did not change over time or across age categories but was higher among males (OR = 1.81; 95% CI:1.38–2.39). Traumatic injuries were mostly mild (85%), involved often (79.8%) ≤ two teeth, typically maxillary central incisors, and occurred mostly at school (40%). Out of 201 participants with TDIs before commencement of orthodontic treatment, only 9% of them had adequate information on trauma in their electronic journals. This proportion was, however, higher (48.4%) when trauma was moderate or severe. The severity of trauma was strongly associated with the quality of referral routines (17.4 and 83.5 times more likely to have adequate referral, for moderate and severe injuries, respectively, compared to mild injuries). Conclusions TDIs are common among patients receiving orthodontic treatment, with males being at higher risk. The severity of TDIs was strongly associated with referral routines, highlighting the need for improved referral practices to optimize information and subsequent treatment in this subgroup of patients.
ABSTRACT Introduction Oral Potentially Malignant Disorders (OPMDs), including Leukoplakia and Erythroplakia, carry significant risks of malignant transformation. Early differentiation from confounding inflammatory conditions like Oral Lichen Planus (OLP) and Candidiasis is critical yet challenging due to visual similarities. This study develops a robust, interpretable deep learning framework for automated multi‐class classification of pre‐localized oral lesions. Materials and Methods A curated dataset of 705 high‐resolution images across five categories (Leukoplakia, Erythroplakia, OLP, Candidiasis, and Normal) was utilized. We proposed a Multi‐Architecture Weighted Ensemble Framework integrating ResNet‐50, Xception, and EfficientNet‐B0. A stratified patient‐level splitting strategy prevented data leakage. Model interpretability and clinical utility were assessed via Gradient‐weighted Class Activation Mapping (Grad‐CAM) and Decision Curve Analysis (DCA). Results The ensemble model achieved 91.2% accuracy and a 90.8% macro‐averaged F1‐score, significantly outperforming individual baselines. The strategy improved OLP detection (F1‐score: 0.83), effectively distinguishing it from Leukoplakia. Grad‐CAM confirmed the model focuses on pathognomonic lesion features rather than confounding artifacts. DCA suggested a potential theoretical net clinical benefit over default strategies. Conclusion This weighted ensemble framework demonstrates high retrospective accuracy and provides transparent visual explanations for the classification of pre‐localized oral lesions. However, it must be interpreted strictly as a preliminary proof‐of‐concept investigation. While the current results suggest potential adjunctive value, extensive external validation, prospective testing, and clinician‐in‐the‐loop studies are strictly necessary to validate its true clinical utility and impact on patient outcomes in primary care settings.
ABSTRACT Objectives Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with few reliable early diagnostic markers. Bioinformatic screening identified hsa_circ_0100833 as a differentially expressed circRNA in OSCC. Its potential significance in OSCC was then examined experimentally. Material and Methods Differential circRNA expression was profiled using the GSE145608 dataset and Limma software. ROC curve analysis, circRNA–miRNA–mRNA interaction prediction, functional enrichment, and survival analysis were then used. Hsa_circ_0100833 expression was measured by qRT‐PCR in 20 paired OSCC and adjacent normal tissues. This analysis was also performed in CAL‐27 and FaDu cell lines (n = 3 each) and three normal human gingival fibroblast cultures. hsa‐miR‐607 and SORBS1 were quantified in parallel. Results Differential expression analysis of the GSE145608 dataset identified hsa_circ_0100833 as down‐regulated in OSCC. Bioinformatic analysis then predicted a binding interaction between this circRNA and hsa‐miR‐607. Hsa_circ_0100833 was significantly reduced in OSCC tissues and cell lines relative to normal controls; hsa‐miR‐607 was up‐regulated, and SORBS1 showed parallel downregulation. ROC analysis revealed AUC values of 0.799 in cell lines and 0.712 in tissue samples. The predicted ceRNA network was enriched for PI3K‐Akt signaling and focal adhesion pathways. Conclusion hsa_circ_0100833 was down‐regulated in OSCC and may act as a tumor suppressor through a hsa‐miR‐607/SORBS1‐dependent mechanism. Its diagnostic potential warrants further investigation.
ABSTRACT Objectives To investigate how soluble byproducts derived from a four‐species endodontic biofilm model impact the viability, transcriptomic profile, and inflammatory response of human dental pulp stem cells (DPSCs). Methods A sterile‐filtered supernatant was extracted from an established interkingdom endodontic biofilm model comprising Streptococcus gordonii, Fusobacterium nucleatum, Porphyromonas gingivalis, and Candida albicans. DPSCs were exposed to the microbial biofilm supernatant (BSN) for 4 and 24 h. Cellular responses were evaluated via MTT, CCK‐8, LDH assays, and Annexin V/PI staining. Transcriptomic sequencing was performed to assess gene expression dynamics, with GO and KEGG pathway enrichment analyses. IL6 and IL8 expression was validated by qPCR and ELISA. Data were analyzed using t‐tests/ANOVA and RNA‐seq differential expression using DESeq. 2 with FDR adjustment. Results BSN significantly suppressed DPSC metabolic activity without inducing apoptosis or necrosis. RNA‐seq revealed 723 significantly differentially expressed genes at 4 h and 1667 at 24 h. Early responses were dominated by upregulation of inflammatory mediators, with enrichment of TNF, NF‐κB, and JAK‐STAT signaling pathways. At 24 h, the expression profile shifted toward redox regulation and metabolic suppression, including downregulation of glycolytic and purine metabolism pathways. IL6 and IL8 expression was markedly increased at both transcript and protein levels. Conclusions Soluble factors produced by a biofilm model representative of deep caries and carious pulp exposures induce a time‐dependent transcriptional response in DPSCs. This response is characterized by a biphasic pattern of early immune activation followed by later transcriptional metabolic adaptation. These findings highlight the capacity of soluble biofilm‐derived products associated with deep caries to modulate DPSC immune–metabolic signaling. They further emphasize the importance of vital pulp therapy strategies that not only target microorganisms but also account for their secreted byproducts.
ABSTRACT Objective This systematic review and meta‐analysis aimed to evaluate the association between obstructive sleep apnea and periodontitis and to quantify the magnitude of this relationship based on the available evidence. Methods A systematic literature search was conducted in PubMed, Scopus, and Web of Science up to November 2025, following PRISMA 2020 guidelines. Observational studies investigating the association between OSA and periodontitis in human adults were included. Study quality was assessed using the ROBINS‐I tool. A random‐effects meta‐analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Additionally, Spearman correlation coefficients were synthesized when available. Results Twenty‐three studies were included in the qualitative synthesis, and 18 studies were eligible for quantitative analysis. The pooled meta‐analysis demonstrated that OSA was significantly associated with an increased risk of periodontitis (OR = 2.22; 95% CI: 1.78–2.77), with moderate heterogeneity (I2 = 57.4%). Furthermore, a random‐effects meta‐analysis of correlation coefficients revealed a moderate positive association between OSA and periodontal disease severity (r = 0.39; 95% CI: 0.17–0.58). These findings were consistent across different populations and diagnostic approaches, particularly in studies using polysomnography for OSA assessment. Conclusions The present meta‐analysis provides evidence of a significant association between obstructive sleep apnea and periodontitis, with patients affected by OSA showing more than twice the risk of developing periodontal disease. Although causality cannot be established due to the observational nature of the included studies, shared inflammatory and microbiological pathways support a biologically plausible link. An interdisciplinary approach involving dental and sleep medicine professionals may be beneficial for early diagnosis and comprehensive management of both conditions.
ABSTRACT Objectives Traumatic dental injuries (TDIs) are frequent in clinical practice and require rapid, guideline‐based decisions, yet accessing accurate and reliable information may be challenging. Large language models (LLMs) such as ChatGPT, Gemini, DeepSeek, and Qwen are increasingly used as quick online information tools; however, evidence regarding their accuracy, consistency, and the influence of different user interfaces is limited. This study aimed to evaluate the performance of several LLMs in answering TDI‐related questions through both web‐based interfaces and mobile phone applications. Material and Methods Twenty questions were prepared according to the 2020 International Association of Dental Traumatology (IADT) guidelines, including 10 open‐ended and 10 yes–no items. Four LLMs (ChatGPT‐4o, DeepSeek‐V3, Gemini 2.0 Flash, Qwen2.5‐Max) were queried simultaneously via web and mobile interfaces over five consecutive days, generating 800 responses. Open‐ended answers were assessed using the Global Quality Score (GQS) and modified DISCERN (mDISCERN), while yes–no responses were compared with a predetermined answer key. Statistical analyses were performed using IBM SPSS v23.0, with significance set at p < 0.05. Results Qwen2.5‐Max demonstrated comparatively higher GQS and mDISCERN scores across both interfaces. Accuracy for yes–no questions ranged from 86% to 91% without significant differences among models. Interface comparisons showed that ChatGPT‐4o generated comparatively higher‐quality responses on the web, whereas Qwen2.5‐Max performed better on mobile. Over the 5‐day period, Qwen2.5‐Max showed relatively higher temporal consistency, while DeepSeek‐V3 exhibited notable day‐to‐day variation. Conclusions LLMs may serve as useful supplementary tools for providing guideline‐based information on TDIs, especially for straightforward, closed‐ended clinical questions. However, their performance varies by model, interface, and question type. Qwen2.5‐Max demonstrated comparatively higher performance across several evaluated measures. Despite these results, LLM‐generated information should be interpreted cautiously and verified by dental professionals before being used in clinical decision‐making.
ABSTRACT Objective Immune cells are the first to interact with implant surfaces, yet their contribution to osseointegration is often underestimated. Understanding how titanium‐based and zirconia‐enriched surface properties regulate macrophage polarization is essential for designing regenerative biomaterials. This study evaluates how these physicochemical characteristics modulate macrophage behavior and how macrophage‐derived signals affect osteoblast mineralization, a key determinant of successful clinical outcomes. Material and Methods Human monocytes were differentiated into pro‐inflammatory (M1) or anti‐inflammatory (M2) macrophages on hydrophobic and hydrophilic titanium (P, SLA/modSLA) or zirconia‐enriched titanium (R/modR) surfaces. Macrophage polarization was assessed by Real Time‐PCR, fluorescent immunoassays, and Luminex analysis of pro‐/anti‐inflammatory cytokines and bone‐related markers. Conditioned media from M1/M2 macrophages cultured on each surface were used to culture human osteoblast‐like cells, and their differentiation and mineralization were evaluated by gene expression analysis and Alizarin Red staining. Results The obtained results indicate that surface chemical composition, rather than hydrophilicity, is the main driver of early macrophage phenotype modulation. Zirconia incorporation induced effects comparable to titanium on macrophage activation while increasing transcription of pro‐ and anti‐inflammatory genes. Moreover, zirconia enhanced M1 activation and the release of angiogenic and osteogenic mediators, including VEGF and OPN. Although seemingly contradictory, these effects contribute to an immune microenvironment favorable to bone formation by promoting a balanced macrophage response. Consistently, zirconia‐enriched surfaces enhanced osteoblastic differentiation and mineralization, regardless of hydrophilic differences compared with conventional titanium surfaces. Conclusion Our findings indicate that zirconia‐supplemented titanium alloys may provide a useful model to elucidate the concept of osseointegration as an osteoimmune process rather than a conventional bone healing response. The data emphasize the critical role of early M1 macrophage activity controlling the release of specific cytokines, supporting the hypothesis that the use of titanium/zirconia alloys may provide an osteoiummunomodulatory advantage that may contrast peri‐implant bone loss.
ABSTRACT Background It has previously been demonstrated that the nuclear factor of activated T cells (NFAT) is crucial for the development of tumors. Given OSCC's drug resistance and poor outcomes, identifying NFAT‐associated prognostic genes is urgent for better treatment. Material and Methods The TCGA‐OSCC and GSE41613 datasets were utilized to identify differentially expressed genes (DEGs) between oral squamous cell carcinoma (OSCC) and controls. Specifically, differentially expressed genes related to NFAT (DEG‐NFATs) were further screened for NFAT scores in OSCC versus control. The intersection of DEGs and DEG‐NFATs was taken to identify differentially expressed NFAT‐related genes (DE‐NFATRGs). Univariate Cox and least absolute shrinkage and selection operator (LASSO) regression analyses were employed to identify prognostic genes. A risk score was developed based solely on the expression levels of the seven‐gene signature. Subsequently, independent prognostic analyses incorporating clinicopathological variables were performed using univariate and multivariate Cox regression to evaluate whether the risk score served as an independent predictor of survival. Lastly, targeted therapeutic agents for OSCC were predicted. In addition, prognostic gene expression was validated using reverse transcription‐quantitative polymerase chain reaction (RT‐qPCR). Results Totally 4463 DEGs obtained were intersected with 310 DEG‐NFATs to obtain 263 DE‐NFATRGs. A risk model can be built using the seven prognostic genes associated with NFAT (ALB, PDK4, SERPINA5, SPINK6, SERPINA9, CGNL1 and IL17F). The risk score accurately predicts survival in OSCC patients. Finally, a total of 31 drugs with significant differences were predicted between risk groups. The most significant of these were AG.014699, Midostaurin, Gefitinib, and LFM.A13. Besides, the expression levels of ALB, PDK4, and SERPINA5 were significantly higher in tumors, while the expression levels of CGNL1 and IL17F were significantly lower in tumors. Conclusion The identification of new prognostic genes (ALB, PDK4, SERPINA5, SPINK6, SERPINA9, CGNL1, and IL17F) was provided for the prognosis and treatment of OSCC.
