International dental journal最新文献

{"title":"Corrigendum to ‘Psychosocial Impact of Dental Aesthetics Among Aboriginal and Torres Strait Islander peoples: Mixed-Methods Study Using Psychosocial Impact of Dental Aesthetics Questionnaire’","authors":"Sonia Nath, Johanna Groundwater, Ria Aiyar, Joanne Hedges, Gina Guzzo, Kostas Kapellas, Alexander Pham, Lisa Jamieson","doi":"10.1016/j.identj.2025.109384","DOIUrl":"10.1016/j.identj.2025.109384","url":null,"abstract":"","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109384"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Fiber Type on Fatigue Performance of Fiber-Reinforced Inlay-Retained Dental Prostheses","authors":"Veronika T. Szabó ,&nbsp;Csongor Mészáros ,&nbsp;Balázs Szabó ,&nbsp;Balázs Szabó P ,&nbsp;Gábor Braunitzer ,&nbsp;Dániel Palkovics ,&nbsp;Zsolt Geretovszky ,&nbsp;Eija Säilynoja ,&nbsp;Lippo Lassila ,&nbsp;Sufyan Garoushi ,&nbsp;Márk Fráter","doi":"10.1016/j.identj.2025.109360","DOIUrl":"10.1016/j.identj.2025.109360","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effect of using only long- and short-glass fibers or their combination on the fatigue resistance of composite inlay-retained dental prostheses in dissected mandibular molars with different levels of periodontal support.</div></div><div><h3>Materials and Methods</h3><div>Seventy-two mandibular first molars and second premolars were included in our study. Distal halves of extracted molars were kept, and received endodontic treatment. Standardized occluso-distal and mesio-occlusal cavities were prepared, and premolar-molar units were assembled. The edentulous spans were restored by direct inlay-retained composite prostheses fabricated in 3 different ways (n = 12, 6 groups). In groups 1A and 1B, long fibers and a packable composite, in groups 3A and 3B, short fibers, while in groups 2A and 2B both short and long fibers were used. All units were embedded simulating either physiological periodontal support (1A-3A) or furcation involvement (1B-3B). Specimens were subjected to accelerated fatigue-testing through 40,000 cycles or until fracture. Kaplan–Meyer survival analysis and factorial ANOVA were conducted. Fracture mode was evaluated visually and by scanning electron microscopy.</div></div><div><h3>Results</h3><div>Group 2A (mean 39106.00 N, SD ± 2451, survival frequency 83.3%) and 2B (mean 38454.33 N, SD ± 3110, survival frequency 75%) had the highest load-bearing capacity. Factorial ANOVA revealed that the restorative material significantly affected load-bearing capacity (<em>P</em> &lt; .05) regardless of the periodontal support.</div></div><div><h3>Conclusion</h3><div>The combination of long and short fiber-reinforced systems significantly enhanced the fatigue resistance of direct inlay-retained composite prosthesis.</div></div><div><h3>Clinical relevance</h3><div>This approach may counterbalance the weakening effects of impaired periodontal support, thus improving treatment outcomes for patients with compromised molar support.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109360"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Quality in Resorbed Posterior Maxilla Affects Osteogenesis After Sinus Floor Augmentation: A Retrospective Analysis","authors":"Wenjie Zhou ,&nbsp;Shengchi Fan ,&nbsp;Emilio A. Cafferata ,&nbsp;Yihan Shen ,&nbsp;Yiqun Wu","doi":"10.1016/j.identj.2025.109397","DOIUrl":"10.1016/j.identj.2025.109397","url":null,"abstract":"<div><h3>Introduction and Aims</h3><div>Compromised bone quality and quantity in the posterior maxilla are widely recognised as significant risk factors for implant failures. This study aimed to (1) assess the bone quality of the resorbed posterior maxilla both radiographically and histologically and (2) evaluate the impact of native alveolar bone quality on osteogenesis following maxillary sinus floor augmentation (MSFA).</div></div><div><h3>Methods</h3><div>Patients presenting advanced posterior maxillary atrophy (residual bone height ≤ 4 mm) underwent MSFA via a lateral window approach using deproteinised bovine bone matrix (DBBM). Bone core biopsies were collected during second-stage implant placement for histological analyses. Preoperative cone-beam computer tomography (CBCT) images were used to classify bone quality based on cortical bone configuration. Multiple linear regression was employed to identify factors influencing osteogenesis.</div></div><div><h3>Results</h3><div>A total of 190 sinuses from 176 patients (96 males/80 females, mean age: 45.77 ± 4.13 years) underwent MSFA and biopsy. Radiographic analysis revealed the presence of bicortical bone in 42.21% of the maxillary ridges, unicortical bone in 25.97%, no cortical bone in 19.48% and sinus floor–crestal bone fusion in 12.34%. Histologically, native bone comprised 40.01% ± 14.85% of mineralised trabeculae while newly formed bone accounted for 18.77% ± 5.69% in the DBBM grafted areas. A significant positive correlation was observed between native bone trabecula percentage and new bone formation (r = 0.23, <em>P</em> = .04). No significant associations were found with age, sex, healing time or radiographic alveolar type (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Greater density of native trabecular bone may contribute to enhanced osteogenesis following MSFA.</div></div><div><h3>Clinical relevance</h3><div>This study enhances our understanding of the bone characteristics of the resorbed posterior maxilla. It emphasises the need to consider the bone quality of the recipient site before conducting a MSFA for determining the surgical procedure and predicting the prognosis.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109397"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Mandibular Distraction Osteogenesis Using Mixed Reality-based Dynamic Navigation: A Preclinical Study","authors":"Cheng Ma ,&nbsp;Shi-xi He ,&nbsp;Qian-yu Liu ,&nbsp;Yin-yu Shang ,&nbsp;Jian-gu Gong ,&nbsp;Xuan-ping Huang","doi":"10.1016/j.identj.2026.109426","DOIUrl":"10.1016/j.identj.2026.109426","url":null,"abstract":"<div><h3>Background</h3><div>Mandibular distraction osteogenesis (MDO) is critical for correcting mandibular hypoplasia. Mixed reality (MR) is an emerging surgical-navigation technology that can overcome the limitations of traditional methods. However, evidence regarding the benefits of MR navigation in MDO is limited. Herein, we developed a dynamic MR-based navigation system and compared its performance to techniques using surgical guides (SGs) as well as freehand (FH) and traditional navigation (TN) approaches.</div></div><div><h3>Methods</h3><div>An adjacent-display MR navigation system integrating optical tracking and a patient-specific registration device was developed for real-time dynamic guidance. Thirty mandibular three-dimensional (3D)-printed models were allocated to three groups (<em>n</em> = 10 each): MR, SG, and FH. Thirty-two Beagle dogs were randomised into four groups (<em>n</em> = 8 each): MR, SG, FH, and TN. The feasibility of the MR system was evaluated in 10 human cadaver heads. All procedures were performed by the same surgical team. The outcomes included osteotomy accuracy, distraction-vector deviation, distractor placement precision, intraoperative corrections, and operative time.</div></div><div><h3>Results</h3><div>In the model experiments, the MR group showed significantly higher distractor and osteotomy accuracy than the FH group and similar precision as the SG group. In animal studies, the MR approach reduced errors in distractor placement, distraction vector, and osteotomy in comparison with the FH approach, and outperformed the SG-based approach in terms of distractor positioning and osteotomy accuracy. In comparison with TN, the MR approach excelled in distractor positioning, osteotomy accuracy, and reduced operative time. Cadaver experiments revealed sagittal and transverse distractor errors of 1.99° ± 0.67° and 1.63° ± 0.88°, respectively, distraction-vector deviation of 2.62° ± 0.38°, and osteotomy angle deviation of 1.74° ± 0.50°. The average operative time was 85.23 ± 13.04 min; distractor positioning required 54.08 ± 15.71 min and the number of intraoperative corrections was 6.80 ± 1.87.</div></div><div><h3>Conclusions</h3><div>The dynamic MR navigation system achieved better accuracy than the FH approach and showed specific advantages over the TN and SG-based approaches, indicating its potential clinical applicability for precise MDO.</div></div><div><h3>Trial Registration</h3><div>This study was registered with the Chinese Clinical Trial Registry (ChiCTR2500098863).</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109426"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration Novel Therapeutic Targets for Periodontitis via Stress Granules Biomarkers","authors":"Yu Wang ,&nbsp;Xie Yang ,&nbsp;Bowei Shi ,&nbsp;Bowen Zhu ,&nbsp;Hai Zhuang ,&nbsp;Jialu Chen","doi":"10.1016/j.identj.2025.109390","DOIUrl":"10.1016/j.identj.2025.109390","url":null,"abstract":"<div><h3>Background</h3><div>Periodontitis (PD) is associated with stress granules (SGs), which are involved in cellular stress responses. Identifying biomarkers related to SGs in PD is key to grasping its pathogenesis and devising novel therapeutic approaches.</div></div><div><h3>Methods</h3><div>Microarray datasets GSE10334 and GSE106090 were downloaded from public databases, and experimental verification was conducted. Differentially expressed genes (DEGs) were determined via differential expression analysis and intersected with SGs-related genes (SGs-RGs). Machine learning methods and gene expression validation were used to further refine the biomarkers. Subsequently, a nomogram was constructed for disease prediction, and its accuracy was evaluated. Enrichment analysis was performed to investigate signalling pathways, and immune cell infiltration was analysed. Moreover, a transcription factor (TF) regulatory network and a disease-biomarker-drug interaction network were constructed.</div></div><div><h3>Results</h3><div>A total of 1618 DEGs, 95 candidate genes, and 4 biomarkers <em>(PECAM1, IL18, EGFR</em>, and <em>CCL5</em>) were identified. <em>PECAM1</em> and <em>CCL5</em> showed significant overexpression, while <em>IL18</em> and <em>EGFR</em> showed significant underexpression in PD patients. The nomogram based on these biomarkers showed high predictive accuracy. Enrichment analysis revealed that the biomarkers were primarily accumulated within translation pathways, like ribosome and rRNA processing. Besides, 14 differentially infiltrated immune cell types were identified, with significant positive correlations between <em>IL18</em>/<em>EGFR</em> and memory B cells, <em>PECAM1</em>/<em>CCL5</em> and plasma cells. Notably, TFs such as CEBPB, ELF1, and STAT3 were identified as important regulatory factors for the biomarkers. Potential drugs for the biomarkers included mycophenolate, afatinib, and fluticasone, and the biomarkers were associated with diseases such as gingivitis, diabetes, and cardiovascular diseases.</div></div><div><h3>Conclusions</h3><div>This study identified four SGs-related biomarkers in PD and proposed potential therapeutic targets, providing preliminary insights into its pathogenesis that warrant further experimental validation at the protein and functional levels.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109390"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Mechanism of Oral Cancer With Shikonin Based on the Network Pharmacology and Molecular Docking Technology","authors":"Lin Hou ,&nbsp;Kun Wang ,&nbsp;Yusheng Wang ,&nbsp;Jing Li ,&nbsp;Lin Guo ,&nbsp;Qingliang Zhao","doi":"10.1016/j.identj.2025.103954","DOIUrl":"10.1016/j.identj.2025.103954","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the underlying mechanisms of <em>shikonin</em> in treating oral cancer using network pharmacology and molecular docking methods.</div></div><div><h3>Materials and methods</h3><div>Targets of <em>shikonin</em> were obtained from the TCMSP, BATMAN, ChEMBL, PharmMapper and HERB databases. Targets of oral cancer were gathered from the OMIM, STITCH, GeneCards and Drugbank databases. The intersection targets of <em>shikonin</em> and oral cancer were obtained for subsequent analysis. The intersecting targets of <em>shikonin</em> and oral cancer were entered into the DAVID database and used its functions to perform Gene Ontology (GO) and Kyoto encyclopaedia of genes and genomes (KEGG) enrichment analysis on the intersection targets to obtain the relevant pathways and biological functions of <em>shikonin</em> in the treatment of oral cancer. The protein-protein interaction (PPI) network of <em>shikonin</em> and oral cancer targets was constructed in STRING platform. Subsequently, using Cytoscape 3.8.0 to obtain the key targets of <em>shikonin</em> and oral cancer. Finally, molecular docking and molecular dynamics simulations were used to evaluate the strength of binding between <em>shikonin</em> and key targets, as well as the hydrogen bonds involved.</div></div><div><h3>Results</h3><div>In total, 481 targets were screened for <em>shikonin</em>, and 10,058 targets were identified for oral cancer. By GO and KEGG analysis, the targets of <em>shikonin</em> and oral cancer may be involved in the mediation of apoptosis, inflammation and immune response. And the associated signalling pathways that targets may be involved in the treatment of oral cancer, including the FoxO signalling pathway, HIF-1 signalling pathway, TNF signalling pathway, and Th17 cell differentiation, etc. Cytoscape software screened the key genes including AKT1, MAPK1, CXCR4, CXCL8, CCL3, CCL4, CCL5, CYBB, BCL2, NOX1, HIF-1, TP53. The results of molecular docking and molecular dynamics simulations showed that <em>shikonin</em> exhibits good binding interactions with CCL3, AKT1 and NOX1.</div></div><div><h3>Conclusions</h3><div>Mulitple molecular mechanisms involved in oral cancer management with <em>shikonin</em> have been elucidated providing a glimpse og the underlying therapeutic targets for the disease..</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 103954"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Self-Medication Behaviour in Response to Dental Pain in Two Populations, France","authors":"Louise Le Texier ,&nbsp;Chantal Savanovitch ,&nbsp;Emmanuel Nicolas ,&nbsp;Pierre-Yves Cousson","doi":"10.1016/j.identj.2026.109418","DOIUrl":"10.1016/j.identj.2026.109418","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Self-medication appears to be a common practice for dental pain. However, in France, its prevalence and patterns in dentistry have never been studied. The primary objective was to assess the prevalence and self-medication behaviours in two at-risk populations: patients consulting for acute pulpal or periapical pain and patients with dental anxiety requiring treatment under general anaesthesia. The secondary objective was to examine the influence of socio-behavioural factors on these practices.</div></div><div><h3>Method</h3><div>Between April 2021 and May 2023, the behaviours of two at-risk population regarding self-medication were analysed in a cross-sectional observational study. The first population regrouped patients referred to an endodontic postemergency care unit after visiting the emergency service of a dental hospital. These patients were referred due to acute pulpal or periapical pain (Endodontic Group). The second population regrouped patients referred to a special care unit for dental treatment under general anaesthesia due to dental anxiety (Anxiety Group). Self-medication behaviours of the two at-risk populations were analysed with 5 self-administered questionnaires (self-medication, EPICES, IDAF-4C, Pain Catastrophizing Scale, Socio-demographic data). Comparisons between the two population were done using Pearson’s chi-square and Student’s <em>t</em> tests.</div></div><div><h3>Results</h3><div>During the study period, 43 patients were included in the endodontic group and 66 in the anxiety group. Socio-demographic and behavioural data differed between the two groups. However, self-medication prevalence was similar (51.2% in the Endodontic Group <em>vs</em> 45.5% in the Anxiety Group), as were self-medication behaviours (types and number of substances used, methods of acquisition, knowledge). No socio-demographic or behavioural factors explained these attitudes.</div></div><div><h3>Conclusion</h3><div>Self-medication in dentistry is often overlooked or poorly managed. Preventive measures and patient education on the proper use of medication are essential.</div></div><div><h3>Clinical relevance</h3><div>Standardized cooperation protocols should be developed involving dentists and community pharmacists to optimize the management of patients suffering from dental pain.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109418"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Sodium Fluoride Safety Signals: Dual-Database Pharmacovigilance","authors":"Wanchen Ning ,&nbsp;Xiangyu Huang ,&nbsp;Simin Li ,&nbsp;Linxin Jiang ,&nbsp;Daniel R Reissmann ,&nbsp;Deborah Kreher ,&nbsp;Gerhard Schmalz ,&nbsp;Lei Chen ,&nbsp;Shaohong Huang","doi":"10.1016/j.identj.2026.109423","DOIUrl":"10.1016/j.identj.2026.109423","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Sodium fluoride is widely used in preventive dentistry, yet its global safety profile has not been comprehensively characterised using real-world data. This study aimed to characterise reporting patterns and safety signals associated with sodium fluoride through an integrated pharmacovigilance analysis of the FDA adverse event reporting system (FAERS) and the World Health Organization (WHO) VigiBase.</div></div><div><h3>Methods</h3><div>Adverse event (AE) reports related to sodium fluoride were extracted from FAERS (2004-2024) and VigiBase (1971-2024). Reporting characteristics, including demographic distributions, reporter type, and event seriousness, were summarised descriptively. AEs were coded using the medical dictionary for regulatory activities (MedDRA) at the preferred term (PT) and system organ class (SOC) levels. Disproportionality-based signal detection was performed using multiple algorithms, and cross-database validation was applied to evaluate signal consistency and database-specific reporting features.</div></div><div><h3>Results</h3><div>Reporting patterns differed between the two systems: FAERS reports were predominantly submitted from the United States and by consumers, whereas VigiBase reports were mainly from Europe, with a higher proportion of health care professionals reporting. Reports involving female individuals were more frequently observed in both databases. Safety signals were primarily concentrated in oral and dental conditions, including dental fluorosis and acute oral mucosal reactions. Overall, 122 shared safety signals were identified across the two databases, with 62% involving oral or dental tissues. Adult populations accounted for a substantial proportion of reported signals, and a high proportion of reports were classified as serious, with predominantly early reported onset intervals.</div></div><div><h3>Conclusion</h3><div>This dual-database pharmacovigilance analysis identified consistent sodium fluoride-associated safety signals with a predominant oral and dental focus, alongside notable geographic and demographic reporting differences. Cross-database validation highlighted complementary strengths of FAERS and VigiBase for global safety surveillance of fluoride-containing dental products.</div></div><div><h3>Clinical relevance</h3><div>These findings support enhanced awareness of sodium fluoride-related safety patterns and may inform targeted monitoring strategies in preventive dental practice.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109423"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classifying Delayed Dental Care Using Machine Learning: A National Health Interview Survey Analysis","authors":"Giang Vu,&nbsp;Atish Chandra,&nbsp;Sanket Salvi,&nbsp;Christian King,&nbsp;Varadraj Gurupur","doi":"10.1016/j.identj.2026.109407","DOIUrl":"10.1016/j.identj.2026.109407","url":null,"abstract":"<div><h3>Background</h3><div>Delays in dental care worsen oral disease and mirror broader inequities in health care access and use.</div></div><div><h3>Objective</h3><div>To estimate the 12-month prevalence of delayed dental care among US adults, to characterise disparities across demographic and socioeconomic groups and to evaluate the utility of machine learning models for identifying individuals at elevated risk of delay.</div></div><div><h3>Methods</h3><div>This study used cross-sectional analysis of the 2023 National Health Interview Survey (NHIS) Sample Adult file (<em>N</em> = 54,927). Survey weights were applied to obtain nationally representative estimates. Descriptive statistics were stratified by age, sex, education, dental insurance coverage and race/ethnicity. In parallel, supervised machine learning classifiers were developed to classify delayed dental care as a binary outcome. Class imbalance was addressed using oversampling applied to training data only. Model performance was evaluated using accuracy, precision, recall, F1-score and area under the receiver operating characteristic curve (AUC), and model interpretability was assessed using SHapley Additive exPlanations (SHAP).</div></div><div><h3>Results</h3><div>Overall, 14.5% of adults reported delaying dental care in the prior year. Delay was higher among adults aged 35-50 (18.3%) and 51-64 (17.2%) and lower among those 65 or older (11.0%). Racial/ethnic differences were evident: Black/African American adults (19.1%) and individuals reporting multiple races (21.1%) had higher prevalence of delayed care than did White adults (14.2%). Adults without dental insurance were more likely to report delays, underscoring the role of coverage. An educational gradient was observed, with higher delays among those with lower attainment. Among the evaluated classifiers, the Light Gradient Boosting Machine (LightGBM) demonstrated the strongest overall performance (accuracy = 84.87%). The SHAP analysis identified education, income-to-poverty ratio and insurance status as the most influential predictors.</div></div><div><h3>Conclusions</h3><div>Delayed dental care affects a substantial share of US adults and disproportionately impacts groups defined by age, race/ethnicity, education and insurance status. Interpretable machine learning models can complement traditional survey analyses by supporting population-level risk stratification. Policies that expand dental coverage, reduce financial barriers and target outreach to high-risk populations may mitigate inequities. Given the cross-sectional design, findings should be interpreted as predictive rather than causal. Future research should incorporate contextual determinants (eg, geographic access and provider availability) and longitudinal data to refine population targeting and evaluate intervention impact.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109407"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LRP6 β-Propeller Destabilization: Novel Variant, Phenotype and Diagnostic Implications in Tooth Agenesis","authors":"Narin Intarak ,&nbsp;Tohid Ghasemnejad ,&nbsp;Kausar Sadia Fakhruddin ,&nbsp;Ayaana Kamal ,&nbsp;Sasiprapa Prommanee ,&nbsp;Khadijeh Hoda Jahanian ,&nbsp;Nigel H. Lovell ,&nbsp;Hamid Alinejad-Rokny ,&nbsp;Thantrira Porntaveetus","doi":"10.1016/j.identj.2025.109367","DOIUrl":"10.1016/j.identj.2025.109367","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Oligodontia, the congenital absence of multiple permanent teeth, is frequently linked to <em>LRP6</em> variants. However, the genotype–phenotype correlations remain unclear and non-European cohorts are underrepresented. The objectives of this study were to: (1) characterize the molecular and clinical features of <em>LRP6</em> variants identified in unrelated Thai individuals with tooth agenesis; (2) conduct a scoping review of previously published cases; and (3) refine the understanding of <em>LRP6</em> genotype–phenotype correlations.</div></div><div><h3>Materials and Methods</h3><div>A detailed case series analysis of Thai families with congenital tooth agenesis (through exome sequencing and 3D protein modelling) was conducted, and functional validation was performed using computational structural prediction. A reviewed published cases of <em>LRP6</em> variants was performed following a PRISMA-ScR-guided scoping review (2005-2025).</div></div><div><h3>Results</h3><div>p.Asp411Tyr, a novel heterozygous de novo missense change, destabilised the β-propeller domain. While Thai probands expanded the phenotype and genotype spectrum of <em>LRP6</em>-associated tooth agenesis, a review of 20 studies showed clustering of variants in β-propeller domains (62%), usually autosomal dominant (78%) but with variable penetrance. The phenotypes ranged from isolated oligodontia to syndromic forms. Thai probands displayed rare ectodermal-associated features (preauricular pits, dry skin) expanding the spectrum.</div></div><div><h3>Conclusions</h3><div><em>LRP6</em> is a mutational hotspot in tooth development, with variable phenotypical expressivity and penetrance.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"76 2","pages":"Article 109367"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}