Oral-health-related quality of life in adolescents: umbrella review

In-vitro simulation methods for mechanical plaque removal: a systematic scoping review of current techniques and future directions

BACKGROUND AND OBJECTIVES

Different methods to simulate plaque in order to test the efficacy of oral cleaning methods have been published. This scoping review aims to provide an overview of the existing models and to highlight their respective benefits and limitations.

MATERIAL AND METHODS

Following the recommended scoping review methodology the scientific literature was systematically searched electronically (PubMed and Scopus) and by hand search up to July 2024, using combinations of search items related to oral plaque simulation, periodontitis or peri-implantitis. Retrieved study titles and abstracts were screened for possible inclusion. Finally, data from included fulltexts was extracted by two independent reviewers. Nine different characteristics for proper plaque simulation method were defined and each existing method evaluated and rated accordingly, and an overall rating was calculated for each method.

RESULTS

Initially, 1787 records were identified. After abstract and title screening and fulltext revision, 25 fulltexts describing 7 different simulation methods, were included. The assessed methods of simulation were ink (12), varnish (5), calcium phosphate (1), calcium carbonate (1), occlusal spray (3), aluminum (1), commercially distributed and prepared artificial plaque (2). Even though some materials achieved good results in the assessment for individual criteria like water solubility, big differences could be found concerning practicability and production time, no simulation method was rated "very good" or even "good" in the overall evaluation. While ink and varnish were considered simulation materials of moderate quality for oral plaque simulation, all other techniques were assessed as weak simulation materials.

CONCLUSION

Among the different published methods for the simulation of mechanical plaque removal, none seems to sufficiently simulate the essential characteristics of oral plaque, while some simulation methods may be useful to feature single properties of plaque in in-vitro studies sufficiently. Nevertheless, advanced models reflecting the diverse features of dental plaque more comprehensively are needed.

Fixed Full-Arch Implant-Supported Restorations: Techniques Review and Proposal for Improvement

Full-arch zirconia restorations on implants have gained popularity due to zirconia's strength and aesthetics, yet they are still associated with challenges like structural fractures, peri-implant complications, and design misfits. Advances in CAD/CAM and digital workflows offer potential improvements, but a technique that consistently addresses these issues in fixed, full-arch, implant-supported prostheses is needed. This novel technique integrates a facially and prosthetically driven treatment approach, which is divided into three phases: data acquisition, restoration design, and manufacturing/delivery. Digital tools, including intraoral scanning and photogrammetry, facilitate accurate implant positioning, while 3D design software enables functional and aesthetic validation before final milling. A dual software approach is used to reverse engineer a titanium bar from the final restoration design, ensuring a superior outcome to other protocols. The restoration incorporates a zirconia-titanium hybrid structure, optimizing strength, flexibility, and weight. The proposed workflow enhances restoration precision and predictability through a prosthetically driven treatment plan, by ensuring passivity and aligning with biological and mechanical principles to promote long-term stability. By starting with the proposed restoration design and reverse engineering the bar, while also allowing for flexibility in material and component choices, this technique accommodates both patient needs and financial considerations. This approach demonstrates potential for improving patient outcomes in full-arch implant restorations by minimizing complications associated with traditional methods. Further research is recommended to validate the technique's efficacy and broaden its clinical applications.

Adverse Childhood Experiences and Oral Health of Children and Adolescents: A Systematic Review and Meta-Analysis

Adverse childhood experiences (ACEs) can be extremely traumatic, and their impact on health throughout the life course has been a public policy issue all around the world. Oral health conditions significantly influence quality of life, but its relationship with ACEs among children and adolescents is not well defined. This systematic review investigated the association between ACEs and oral health outcomes in children and adolescents. The search was conducted across six databases and the gray literature, with no restrictions. It included studies evaluating the association between ACEs and oral health outcomes (oral health condition, utilization of dental services, oral hygiene habits, or oral health related to quality of life) in individuals aged 0 to 19. Data of included studies were extracted and methodological quality was assessed. Meta-analysis was used for quantitative synthesis, and the Grading of Recommendations Assessment, Development and Evaluation approach assessed evidence certainty. From the 12 included studies, 11 had a cross-sectional design, and 1 was a cohort study. Seventeen types of ACEs were investigated, including neglect; violence between parents or caregivers; alcohol and substance abuse; and peer, community, and collective violence. The methodological quality compliance ranged between 38% and 100%. The meta-analysis revealed associations between ACEs and lower use of dental services, toothache, gingival bleeding, and dental cavities. Cumulative exposure to more than three ACEs was associated with poorer oral health. The certainty of the evidence varied from low to very low. These results highlight that children and adolescents with ACEs are more likely to present higher oral health problems, including decreased use of dental services.

High Correlation of the Decayed, Missing, and Filled Teeth (DMFT) Index With Caries Experience in First Permanent Molars: Perspectives and Implications in Oral Epidemiology From a Cross-Sectional Study

Background Dental caries is identified as one of the most prevalent chronic pathologies among the pediatric population on a global scale, constituting a public health problem. Within the permanent dentition, the first molars play a fundamental and critical role both in masticatory functionality and in the development of occlusion and the overall oral health of the patient. Previous research has shown that permanent molars tend to show significantly high levels of caries incidence, and a correlation has been detected between the status of the first permanent molars and the overall caries rate. Objective To investigate the correlation between the overall DMFT index (Decayed, Missing, and Filled Teeth Index in the permanent dentition) and the DMFT calculated from the status of the first permanent molars (FPMs) in a sample of Mexican school-aged children, and to discuss the implications for oral epidemiology. Material and methods A cross-sectional study was conducted on 107 children aged 5 to 12 years at a pediatric dentistry clinic of a public university in Mexico. All data were obtained from medical records. The DMFT index was calculated for the entire dentition, and a separate DMFT index was determined for the first permanent molars. Nonparametric tests were used in the analyses. Analyses were performed in Stata 14 (StataCorp, College Station, USA). Results The mean age was 8.52±1.36 years, and 50.5% were boys. The mean overall DMFT index was 1.90±2.01 and the DMFT-FPM index was 1.71±1.74, a difference of 0.19 (10%) (Wilcoxon: DMFT vs DMFT-FPM, p=0.0009). The correlation between caries indices was very strong (Spearman r=0.9803; p<0.0001). The overall caries prevalence was 58.9% for DMFT>0 and for the DMFT-FPM>0, 57.0%, a difference of 1.9 percentage points (3.2%). The results show an association of experience and caries prevalence by age (p<0.05), but not by sex (p>0.05). Conclusions There is a very strong correlation between the overall DMFT index and the DMFT calculated exclusively for the first permanent molars in this sample of Mexican schoolchildren. This suggests that the FPMs contribute significantly to the overall caries experience and could be a key indicator in the diagnosis and monitoring of oral health, taking into account the percentage of underestimation.

Oral health status, behavior, and practices among hearing impaired children attending a specialized school in Jordan

AIMS

To assess the oral health status and related factors among hearing impaired schoolchildren.

METHODS

A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen et al. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire.

RESULTS

The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls.

CONCLUSIONS

The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.

Activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults with dental caries: a systematic review and meta-analysis

BACKGROUND

Cytokines play an important role in the immunopathogenesis of dental caries. A systematic review and meta-analysis was carried out with the following three objectives: 1)To deepen and discuss through a comprehensive analysis of the literature the effects of dental caries on the activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults, 2)To compare the levels of this cytokines in saliva of the exposure group (moderate-severe dental caries) with the control group (caries-free or mild dental caries), and 3)To determine whether the levels of these cytokines could be used as a complementary clinical diagnostic tool to assess the severity of dental caries.

METHODS

The protocol followed PRISMA and Cochrane guidelines and was registered in the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/MF74V . A digital search was performed in PubMed/MEDLINE, Cochrane, Scopus, and Google Schoolar databases from February 15th, 2012, to January 13th, 2024. The methodological validity of the selected studies was assessed using Joanna Briggs Institute (JBI) tool. A meta-analysis was performed using a random-effects model to evaluate the association between dental caries/health, and the concentration of TNF-α, IL-6 and IL-8.

RESULTS

The search strategy provided a total of 126 articles, of which 15 investigations met the inclusion criteria. The total number of patients studied was 1,148, of which 743 represented the case/exposure group, and 405 represented the control group. The age of the patients ranged from 3 to 25 years. IL-6 was the most prevalent cytokine in the saliva of children and young adults with active dental caries. The meta-analysis revealed that there are significant differences between the levels of IL-6 and TNF-α in saliva of children with active dental caries compared to their control groups.

CONCLUSIONS

The findings suggest that IL-6 and TNF-α levels may have potential as complementary biomarkers for assessing dental caries severity. However, further research is needed to validate these findings in larger and more diverse populations before clinical application.

Influence of School Type and Class Level on Mean Caries Experience in 12-Year-Olds in Serial Cross-Sectional National Oral Health Survey in Germany-Proposal to Adjust for Selection Bias

The objective of this study is to analyse the effects of attended school type and class level on the reported caries experience (DMFT) obtained in the serial cross-sectional National Oral Health Study in Children in Germany (NOHSC) for the WHO reference group of 12-year-olds.

METHODS

Caries data from the 2016 NOHSC were adjusted for each federal state on the basis of two additional large-scale datasets for school type and class level.

RESULTS

Twelve-year-olds in all grades in Saxony-Anhalt (n = 96,842) exhibited significantly higher DMFT values than 12-year-olds in 6th grade (n = 76,456; +0.10 DMFT; ~14.2%, p < 0.001). Adjustments for school type had effects on DMFT on the level of federal states but almost balanced out on the national level (-0.01 DMFT; ~2%). Due to putatively similar structures of the federal states, the national mean DMFT for 12-year-olds in the latest NOHSC (2016; n = 55,002) was adjusted from 0.44 to 0.50 DMFT, correcting for selection bias.

CONCLUSION

Selection bias in this NOHSC leads to an underestimation of caries levels by about 15%. Due to very low caries experience in children in Germany, these precise adjustments (+0.06 DMFT) have only a minor effect on interpretations of the national epidemiologic situation. Consequently, other national caries studies worldwide using the robust marker of DMFT should also adjust for systematic selection bias related to socio-economic background rather than increasing efforts in examination strategy.

Psychometric Properties of the Iowa Fluoride Study Oral Health Questionnaire in Mexican Adolescents

BACKGROUND AND OBJECTIVE

The perception of quality of life about health status is subjective; assessment of the impact includes well-being while eating, speaking, smiling, interacting with others, and feeling good about the esthetic appearance of teeth and mouth. The objective of the present study was to cross-culturally adapt and determine the validity and reliability of the Mexican version of the Iowa Fluoride Study Oral Health for adolescents.

MATERIAL AND METHODS

A cross-sectional study was carried out in a sample of 240 Mexican adolescents aged 15 to 19 years. The questionnaire was translated, back-translated, and administered through the Google Forms platform. The cultural adaptation consisted of the evaluation of the grammatical, conceptual, and linguistic equivalences. The evaluation of the utility and acceptability was carried out through an analysis of semantic equivalence. The utility of the questionnaire was also evaluated by analyzing its grammatical readability. Reliability tests, Kaiser-Meyer-Olkin (KMO), factor analysis, and Pearson's correlation were performed.

RESULTS

The mean age of all participants was 16.4±1.4; 65.3% (n=158) were female. Face validity was considered adequate. The wording of the objective and instructions of the questionnaire were improved. The confidentiality assurances were highlighted. The questions were clear, understandable, and pertinent, and they showed adequate syntax. The INFLESZ index corresponds to a "fairly easy" level of readability. In the quantitative validation, the correlation of items was greater than 0.4. The KMO was 0.930 (p=0.001), and Bartlett sphericity was 2466.5 (p=0.001). Through the exploratory factorial analysis, we evaluated the emotional well-being (12 items), social welfare (five items), and oral symptoms (OS) (three items) dimensions. Internal consistency was high (Cronbach's α=0.942).

CONCLUSION

The culturally translated and adapted questionnaire is valid and reliable for use in research on Mexican adolescents.

Vitamin D and Periodontal Health: A Systematic Review

The role of vitamin D in maintaining gum well-being is crucial. However, scientific research reported that the connotations of cholecalciferol and periodontal health have been divested in the present literature. However, there is enormous heterogeneity in the data available. The current review aims to systematically review and appraise the available literature investigating the role of vitamin D in maintaining periodontal health. Studies included randomized controlled trials and clinical trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and cohort studies reporting associations between vitamin D and oral health in systemically healthy patients. Databases such as PubMed, Google Scholar, Scopus, Embase, and other sources, including hand search, were searched until May 2023 using together-equipped search sequences. Altogether, scientific articles that conform to the inclusion principles underwent a thorough eminence evaluation. All papers meeting inclusion criteria were subject to quality assessment, and the method used to assess the risk of bias was the Cochrane risk of bias tool. The search identified 1883 papers, among which 1435 were excluded after title evaluation. After abstract and title screening, 455 were excluded, and six full texts were assessed. After full-text evaluation, two articles were excluded, and only four were included. The data shows vitamin D's association with oral health maintenance. Along with its action on bone metabolism, it has extended function, which provides for its action as an anti-inflammatory agent and production of anti-microbial peptides, which help maintain oral health. Although the literature available is immense, there is enormous heterogenicity in the papers conducted to appraise the association between vitamin D and oral health. This systematic review has filtered all the data to review a few essential aspects of the role of vitamin D in maintaining oral physiology. Vitamin D has a linear relationship with periodontal health; however, the evidence is insufficient, and further studies must be done.

Social Anxiety and Orthognathic Surgery Effect on Oral Health-Related Quality of Life

OBJECTIVES

This study aimed to investigate the impact of patients' social anxiety on oral health-related quality of life (OHRQoL) in the context of orthognathic surgery.

METHODS

The study involved a cohort of 70 patients who were tasked with completing a comprehensive questionnaire aimed at assessing various facets of their OHRQoL at distinct stages of treatment: pre-surgery, within one month post surgery, and more than one month post surgery. Statistical analyses were conducted in the form of t-test.

RESULTS

Out of the 70 participants, 27 were male (38.57%) and 43 were female (61.43%). The sample distribution comprised 30 (43%) subjects in the pre-surgical stage, two (3%) at one month post surgery, and 38 (54%) more than one month post surgery. In relation to the t-test results, we found variations in the significance of the results for each question, with multiple results showing patients who reported experiencing discomfort significantly outnumbering those who did not (p < 0.05).

CONCLUSION

Social anxiety and orthognathic surgery both demonstrate significant influences on OHRQoL. Subsequent research should delve into specific areas where patients experience the greatest impact.