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International Dental Journal Oct 2023Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous...
OBJECTIVES
Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs.
METHODS
Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement.
RESULTS
A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50.
CONCLUSIONS
Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.
Topics: Humans; Artificial Intelligence; Gingivitis; Dental Plaque
PubMed: 37117096
DOI: 10.1016/j.identj.2023.03.007 -
BMC Oral Health Nov 2023Oral care is important in preventing aspiration pneumonia in older adults. However, it is not clear what kind of oral care can reduce the number of bacteria in saliva.... (Randomized Controlled Trial)
Randomized Controlled Trial
Factors affecting the number of bacteria in saliva and oral care methods for the recovery of bacteria in contaminated saliva after brushing: a randomized controlled trial.
BACKGROUND
Oral care is important in preventing aspiration pneumonia in older adults. However, it is not clear what kind of oral care can reduce the number of bacteria in saliva. The purposes of this study are to clarify whether there is a relationship between plaque amounts and salivary bacterial counts, and how bacteria dispersed into the oral cavity by brushing can be reduced.
METHODS
First, saliva samples were collected from 10 healthy adult volunteers after 30 h of unbrushing and after thorough brushing, and the total bacterial count was determined by real-time PCR. Next, 40 older adults attending an outpatient dental clinic were randomly assigned into two groups: a wiping group (20 patients) and a mouthwashing group (20 patients). Saliva was collected before and after brushing, and after wiping in the wiping group and after mouthwashing in the mouthwashing group, and the total bacterial count was quantified by real-time PCR.
RESULTS
In a study of volunteers, there was no association between plaque amounts and salivary bacterial counts. In a study of older adult patients, salivary bacterial counts were significantly higher in patients with higher oral hygiene index and fewer remaining teeth. Brushing increased salivary bacterial counts. Wiping did not significantly reduce the number of bacteria, while mouthwash returned the increased number of bacteria after brushing to the pre-brushing level.
CONCLUSIONS
There is no direct relationship between the amount of plaque and the number of bacteria in saliva. Brushing disperses bacteria into the oral cavity, resulting in a marked increase in the number of bacteria in saliva. Wiping does not collect the dispersed bacteria, and it seems essential to rinse the mouth after brushing.
TRIAL REGISTRATION
UMIN000045854.
Topics: Humans; Aged; Saliva; Toothbrushing; Bacteria; Mouthwashes; Dental Plaque
PubMed: 38001433
DOI: 10.1186/s12903-023-03676-7 -
Materials (Basel, Switzerland) Nov 2023The aim of this study was to compare the potential of standard ion-releasing materials to repair demineralized lesions with recently introduced alkasite and glass hybrid...
The aim of this study was to compare the potential of standard ion-releasing materials to repair demineralized lesions with recently introduced alkasite and glass hybrid materials. Glass ionomer (GC Fuji TRIAGE), two glass hybrids (EQUIA Forte HT, Riva SC), calcium silicate cement (Biodentine) and an alkasite (Cention Forte) were tested. A total of 72 human third molars were used for sample preparation; on the dentine surface, a class-I cavity was prepared, and one half was covered with nail varnish. The teeth were subjected to a demineralization protocol, filled with the examined materials, and cut in half. The evaluation included a dentine microhardness assessment ( = 10) and SEM/EDS analysis ( = 2). The results were analyzed using SPSS 22.0 statistical software and compared using an analysis of variance and Scheffe post-hoc test. The statistical significance level was set to 0.05. Mean microhardness values (HV0.1) after 14 and 28 days were, respectively: EQUIA Forte HT (26.7 ± 1.45 and 37.74 ± 1.56), Riva Self Cure (19.66 ± 1.02 and 29.58 ± 1.18), Cention Forte (19.01 ± 1.24 and 27.93 ± 1.33), Biodentine (23.35 ± 1.23 and 29.92 ± 1.02), GC Fuji TRIAGE (25.94 ± 1.35 and 33.87 ± 5.57) and control group (15.57 ± 0.68 and 15.64 ± 0.82). The results were significantly different between most groups ( < 0.001). SEM/EDS revealed varying patterns, material deposits and distinct elemental variations. To conclude, all materials increased microhardness and affected the dentine surface appearance and chemical composition; EQUIA Forte HT demonstrated the most pronounced effects.
PubMed: 38068054
DOI: 10.3390/ma16237310 -
Dentistry Journal Jul 2023Dental plaque is a biofilm structured in an extracellular matrix of polymers of host and microbial origin; the microorganisms can coexist in harmony with the host, thus... (Review)
Review
Dental plaque is a biofilm structured in an extracellular matrix of polymers of host and microbial origin; the microorganisms can coexist in harmony with the host, thus guarantying oral health. Environmental modifications can lead to dysbiosis and onset of oral diseases; in fact, plaque is the etiological agent both of periodontal disease and dental decay. The use of an effective oral hygiene index should be considered as a relevant goal for the clinicians and the researchers, and consequently, numerous plaque indices have been proposed during the years. The present literature review aims primarily to obtain a complete summary of these scores to assess plaque deposits. It is useful because the clinician/researcher will select the right scoring method for the specific situation only if he knows the available options and if he is aware of both their strengths and weaknesses. This review applies a basic classification of plaque indices that distinguishes the ones that use non-quantitative methods from the ones that use quantitative methods. Non-quantitative methods are more subjective because they are based on the ability of the clinician to point out the presence or the entity of deposits, while quantitative methods introduce objectifiable means to measure plaque deposits.
PubMed: 37504238
DOI: 10.3390/dj11070172 -
Microbiology Spectrum Feb 2024Periodontitis has recently been defined as a dysbiotic disease caused by an imbalanced oral microbiota. The transition from commensal microbial communities to...
Periodontitis has recently been defined as a dysbiotic disease caused by an imbalanced oral microbiota. The transition from commensal microbial communities to periodontitis-associated ones requires colonization by specific pathogens, including . We previously reported an antagonistic relationship between and . To determine the role of in altering the interactions of with other oral bacteria in a complex context, we collected dental plaque samples from patients with periodontitis and assigned them to two groups based on the ratios of and . We then characterized the microbial profiles of the dental plaque samples using shotgun metagenomic sequencing and compared the oral microbial composition and functional capabilities of the group with high ratios with the low ratio group. Taxonomic annotation revealed significant differences in the microbial composition at both the genus and species levels between the low and high ratio groups. Notably, a higher microbial diversity was observed in the samples with low ratios. Furthermore, the antibiotic resistance gene profiles of the two groups were also distinct, with a significantly increased abundance of the genes in the dental plaque samples with low ratios. It, therefore, indicates that the ratios influenced the virulence potential of the oral microbiome. Our work shows that enhancing the ratio in oral microbial communities can be an attractive approach for revising the dysbiotic oral microbiome.IMPORTANCEPeriodontitis, one of the most common chronic diseases, is linked to several systemic diseases, such as cardiovascular disease and diabetes. Although is a keystone pathogen that causes periodontitis, its levels, interactions with accessory bacteria and pathobionts in the oral microbiome, and its association with the pathogenic potential of the microbial communities are still not well understood. In this study, we revealed the role of and the ratios of and in modulating the oral microbiome to facilitate a deeper understanding of periodontitis and its progression. The study has important clinical implications as it laid a foundation for developing novel non-antibiotic therapies against and improving the efficiency of periodontal treatments.
Topics: Humans; Porphyromonas gingivalis; Dental Plaque; Periodontitis; Microbiota; Streptococcus
PubMed: 38230927
DOI: 10.1128/spectrum.03482-23 -
Journal of Clinical Periodontology Jul 2023To investigate whether there is an association between subgingival microbial diversity and reduced respiratory function.
AIM
To investigate whether there is an association between subgingival microbial diversity and reduced respiratory function.
MATERIALS AND METHODS
A group of dentate 58-72-year-old men in Northern Ireland had a comprehensive periodontal examination including subgingival plaque sampling. DNA was extracted from plaque samples and the V1-V3 regions of the 16S rRNA gene were analysed by high-throughput sequencing and a microbial diversity index (MDI) was derived. Spirometry measurements were made using a wedge bellows spirometer. The primary outcome variable of interest was the percentage of predicted forced expiratory volume in 1 s (% predicted FEV ). Analysis included multiple linear regression with adjustment for various confounders.
RESULTS
Five-hundred and seven men were included in the analysis. The mean age was 63.6 years (SD = 3.1). Of these, 304 (60.0%) men had no or mild periodontitis, 105 (20.7%) had moderate periodontitis and 98 (19.3%) had severe periodontitis. Multiple linear regression analysis showed that a one unit increase in MDI was associated with a 0.71% loss (95% confidence interval: 0.06%-1.35%; p = .03) in % predicted FEV after adjustment for all confounders.
CONCLUSIONS
In this group of dentate men from Northern Ireland, subgingival microbial diversity was associated with reduced respiratory function.
Topics: Male; Humans; Middle Aged; Aged; Female; Cross-Sectional Studies; RNA, Ribosomal, 16S; Periodontitis; Dental Plaque; High-Throughput Nucleotide Sequencing
PubMed: 37051866
DOI: 10.1111/jcpe.13819 -
Journal of Clinical Periodontology Sep 2023To investigate the differences between the subgingival microbiota of healthy subjects (HS) and periodontitis patients (PP) from four different countries through a...
AIM
To investigate the differences between the subgingival microbiota of healthy subjects (HS) and periodontitis patients (PP) from four different countries through a metagenomic approach.
MATERIALS AND METHODS
Subgingival samples were obtained from subjects from four different countries. Microbial composition was analysed through high-throughput sequencing of the V3-V4 region of the 16S rRNA gene. The country of origin, diagnosis and clinical and demographic variables of the subjects were used to analyse the microbial profiles.
RESULTS
In total, 506 subgingival samples were analysed: 196 from HS and 310 from patients with periodontitis. Differences in richness, diversity and microbial composition were observed when comparing samples pertaining to different countries of origin and different subject diagnoses. Clinical variables, such as bleeding on probing, did not significantly affect the bacterial composition of the samples. A highly conserved core of microbiota associated with periodontitis was detected, while the microbiota associated with periodontally HS was much more diverse.
CONCLUSIONS
Periodontal diagnosis of the subjects was the main variable explaining the composition of the microbiota in the subgingival niche. Nevertheless, the country of origin also had a significant impact on the microbiota and is therefore an important factor to consider when describing subgingival bacterial communities.
Topics: Humans; RNA, Ribosomal, 16S; Genes, rRNA; Healthy Volunteers; Dental Plaque; Periodontitis; Bacteria; Microbiota
PubMed: 37246304
DOI: 10.1111/jcpe.13827 -
BMC Oral Health Jul 2023Most people's tooth brushing performance is deficient, even when they are encouraged to brush to the best of their abilities. The aim of the present study was to explore... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Most people's tooth brushing performance is deficient, even when they are encouraged to brush to the best of their abilities. The aim of the present study was to explore the nature of this deficit by comparing best-possible vs. as-usual brushing.
METHODS
University students (N = 111) were randomly assigned to receive one of two instructions: "brush your teeth as usual" (AU-instruction) or "brush your teeth to the best of your abilities" (BP-instruction). Video analyses assessed brushing performance. The marginal plaque index (MPI) assessed after brushing was used as an indicator of brushing effectiveness. A questionnaire assessed subjectively perceived oral cleanliness (SPOC).
RESULTS
Participants in the BP group brushed their teeth longer (p = 0.008, d = 0.57) and used interdental devices more often (p < 0.001). No group differences emerged in the distribution of brushing time among surfaces, the percentage of brushing techniques used beyond horizontal scrubbing, or the appropriate use of interdental devices (all p > 0.16, all d < 0.30). Plaque persisted at the majority of the sections of the gingival margins, and the groups did not differ in this respect (p = 0.15; d = 0.22). SPOC values in the BP group were higher than those in the AU group (p = 0.006; d = 0.54). Both groups overestimated their actual oral cleanliness by approximately twofold.
CONCLUSIONS
Compared to their usual brushing effort, study participants increased their effort when asked to brush their teeth in the best possible manner. However, that increase in effort was ineffective in terms of oral cleanliness. The results indicate that people's concept of optimized brushing refers to quantitative aspects (e.g., longer duration, more interdental hygiene) rather than qualitative aspects (e.g., considering inner surfaces and gingival margins, appropriate use of dental floss).
TRIAL REGISTRATION
The study was registered in the appropriate national register ( www.drks.de ; ID: DRKS00017812; date of registration: 27/08/2019 - retrospectively registered).
Topics: Humans; Toothbrushing; Gingivitis; Tooth; Dental Plaque; Dental Plaque Index
PubMed: 37415160
DOI: 10.1186/s12903-023-03127-3 -
BMC Oral Health Apr 2024The oral cavity is home to various ecological niches, each with its own unique microbial composition. Understanding the microbial communities and gene composition in...
BACKGROUND
The oral cavity is home to various ecological niches, each with its own unique microbial composition. Understanding the microbial communities and gene composition in different ecological niches within the oral cavity of oral cancer (OC) patients is crucial for determining how these microbial populations contribute to disease progression.
METHODS
In this study, saliva and dental plaque samples were collected from patients with OC. Metagenomic sequencing was employed to analyze the microbial community classification and functional composition of the different sample groups.
RESULTS
The results of the study revealed significant differences in both the function and classification of microbial communities between saliva and dental plaque samples. The diversity of microbial species in saliva was found to be higher compared to that in plaque samples. Notably, Actinobacteria were enriched in the dental plaque of OC patients. Furthermore, the study identified several inter-group differential marker species, including Prevotella intermedia, Haemophilus parahaemolyticus, Actinomyces radius, Corynebacterium matruchitii, and Veillonella atypica. Additionally, 1,353 differential genes were annotated into 23 functional pathways. Interestingly, a significant correlation was observed between differentially labeled species and Herpes simplex virus 1 (HSV-1) infection, which may be related to the occurrence and development of cancer.
CONCLUSIONS
Significant differences in the microbial and genetic composition of saliva and dental plaque samples were observed in OC patients. Furthermore, pathogenic bacteria associated with oral diseases were predominantly enriched in saliva. The identification of inter-group differential biomarkers and pathways provide insights into the relationship between oral microbiota and the occurrence and development of OC.
Topics: Humans; Saliva; Dental Plaque; Bacteria; Mouth Neoplasms; RNA, Ribosomal, 16S
PubMed: 38575895
DOI: 10.1186/s12903-024-04181-1 -
Cureus Dec 2023Background and aim Assessing the priority of the patient towards dental needs while considering the distance traveled by them is important to improve a dental...
Background and aim Assessing the priority of the patient towards dental needs while considering the distance traveled by them is important to improve a dental service. The purpose of this study was to rank the patients' felt needs for dental care in the private dental institution in order of importance. The objective is to count the number of patients with various major complaints and compare how far patients traveled for various treatment plans tailored to their individual needs in a private dental institution. Material and methods The sample consisted of all new patients who sought dental care at Saveetha Dental College and Hospital, Chennai, India, between January 1, 2022, and December 31, 2022. Retrospective data from the dental information archive system was gathered on their primary chief complaint and residential address. Frequency distribution of patients with different chief complaints was found. The mean and standard deviation of distance traveled by patients for different treatment plans was done using descriptive statistics using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). Results The priority order of the felt need by the patients was dental pain in which n=1299 (15.4%) > missing teeth with n=1224 (14.59%) > deposit/stains/halitosis n=1149 (13.6%) > shaking tooth n=936 (11.15%) > irregularly placed/proclined teeth n=852 (10.15%) > dislodged crown/restoration n=843 (10.05%) > tooth decay/discoloration n=759 (9%) > general checkup n=723 (8.6%) > swelling/ulcer/wound n=246 (2.93%) > painful jaw/facial pain/difficult mouth opening n=198 (2.26%). In 2022, most patients requiring caries preventive measure (0.8%) located at the mean distance of 10.75±2.2 km, while patients requiring scaling (16.9%), dental filling (10.9%), endodontic management (18.6%), extraction (23.7%), prosthetic replacement (13.9%), orthodontic management (10.9%), and facial pain management (2.2%) were located at the mean distance of 14.49±8.2 km, 10.28±6.25 km, 18.43±13.9 km, 14.29±6.6 km, 23.49±11.8 km, 11.76±8.13 km, and 45.32±17.35 km, respectively. Conclusion More number of patients traveled long distances even more than 50 km for painful tooth decay. Also, lots of patients were found to seek replacement of their missing teeth next to pain. Thus, dental pain and missing teeth form a major priority of the patient's felt dental need. Also, the patient had traveled a lot for facial pain management compared to other treatment needs which shows the lack of facial pain management practice by dental care centers near their local residence.
PubMed: 38249284
DOI: 10.7759/cureus.50806