International dental journal最新文献

{"title":"The Use of a Respiratory Biofeedback Instrument in Managing Fear and Anxiety in Clinical Practice","authors":"Natalie Sui Miu Wong ,&nbsp;Andy Wai Kan Yeung ,&nbsp;Colman Patrick McGrath ,&nbsp;Yiu Yan Leung","doi":"10.1016/j.identj.2025.100882","DOIUrl":"10.1016/j.identj.2025.100882","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Fear and anxiety are commonly experienced across diverse healthcare settings globally, particularly in clinical practices where these emotions tend to be heightened due to the nature of the procedures. This single-blinded, randomized controlled trial aimed to investigate the effectiveness of a respiratory biofeedback instrument in reducing state and dental anxiety levels during dental extractions in adult patients.</div></div><div><h3>Methods</h3><div>The trial design and reporting adhered strictly to the CONSORT statement guidelines. Patients were randomly assigned to either the biofeedback group (n = 30) or the control group (n = 30). State anxiety levels were measured using pulse rate, respiratory rate, respiratory regularity, respiratory amplitude, Visual Analogue Scale (VAS) scores, and the State-Trait Anxiety Inventory (STAI). Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS), and Dental Fear Survey (DFS).</div></div><div><h3>Results</h3><div>Results demonstrated that the biofeedback group had a significantly lower state anxiety level during dental extraction, as evidenced by lower respiratory rate (mean difference = –2.75 bpm, <em>P = .</em>03), higher respiratory regularity (5.63%, <em>P = .</em>035) and higher respiratory amplitude (48.83 units, <em>P = .</em>005). The biofeedback group also had a significantly lower STAI-State score after dental extraction (–2.04, <em>P = .</em>015), and a larger reduction in pulse rate from the time of extraction to after extraction (–3.61 bpm, <em>P = .</em>030). However, biofeedback implementation did not significantly affect dental anxiety levels, as measured by the MDAS and DFS.</div></div><div><h3>Conclusions</h3><div>This study highlights the potential benefits of employing on-site biofeedback instruments to alleviate anxiety during dental extractions in adult patients without the need for multiple training sessions.</div></div><div><h3>Clinical relevance</h3><div>Further research is needed to explore its impact on dental anxiety levels and investigate its applicability to a broader range of dental procedures.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100882"},"PeriodicalIF":3.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535781","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":"Probiotics Enhance Bone Density and Reduce Inflammation Postalveolar Surgery","authors":"Dongjie Fu ,&nbsp;Xiaoxiang He ,&nbsp;Jian Lu ,&nbsp;Ting Du","doi":"10.1016/j.identj.2025.100881","DOIUrl":"10.1016/j.identj.2025.100881","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the clinical efficacy of probiotic-based interventions in modulating the inflammatory response of periapical tissues and maintaining alveolar bone homeostasis following oral alveolar surgery.</div></div><div><h3>Method</h3><div>In this open-label, nonblinded trial, 80 patients undergoing alveolar surgery were randomised into an experimental group (n = 40) receiving postoperative <em>Lactobacillus reuteri</em> DSM 17938 probiotics (10¹⁰ CFU/d) and a control group (n = 40) receiving standard care. Alveolar bone density was measured via cone-beam computed tomography (CBCT) at 1, 3, and 5 months postsurgery. Oral microbial diversity (16S rRNA sequencing) and inflammatory markers (IL-1β, TNF-α, IL-6) were analysed at 3 months.</div></div><div><h3>Result</h3><div>The experimental group demonstrated a 3.8% higher bone density than controls at all follow-ups (<em>P</em> &lt; .05), alongside a 15.2% increase in microbial diversity (Shannon index, <em>P</em> &lt; .05). Proinflammatory cytokines were significantly reduced (IL-1β: −18.5%; TNF-α: −22.1%; IL-6: −14.7%, <em>P</em> &lt; .05). While the bone density improvement was modest, its statistical significance suggests potential clinical relevance for osseointegration. Probiotic supplementation attenuated inflammation and enhanced alveolar bone stability postsurgery. However, the nonblinded design limits generalizability.</div></div><div><h3>Conclusion</h3><div>Probiotic-based interventions with <em>Lactobacillus reuteri</em> effectively modulated the inflammatory response and enhanced alveolar bone homeostasis postalveolar surgery in this cohort. While promising, future double-blind trials with larger cohorts are needed to confirm these findings and explore broader translational applications in bone regeneration strategies.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100881"},"PeriodicalIF":3.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535782","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":"Genetic Determinants of Leukocyte Count in Nonsyndromic Cleft Lip With or Without Cleft Palate Among Asians","authors":"Changyue Xing ,&nbsp;Shu Lou ,&nbsp;Yue Gao ,&nbsp;Xiaofeng Li ,&nbsp;Mulong Du ,&nbsp;Yongchu Pan","doi":"10.1016/j.identj.2025.100877","DOIUrl":"10.1016/j.identj.2025.100877","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies have shown that maternal proinflammatory status could increase the risk of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in offspring. This study aimed to assess the relationship between leukocyte counts and NSCL/P.</div></div><div><h3>Methods</h3><div>The NSCL/P genome-wide association study (GWAS) data with a total of 1069 cases and 1724 controls were included. Summary statistics for 6 leukocyte counts GWASs (white blood cell count (WBC), neutrophil count (NC), monocyte count (MONO), lymphocyte count (LYM), eosinophil count (EOS), and basophil count (BASO)) in large-scale East Asian populations were obtained from the IEU OpenGWAS database. Genetic association analyses include genetic correlations and genetic overlaps of traits. Multi-trait analysis was used to identify pleiotropic loci, followed by enrichment analysis for pleiotropic genes. Mendelian Randomization (MR) analysis was performed to infer causality between exposure factors and NSCL/P.</div></div><div><h3>Results</h3><div>We observed a significant global genetic correlation between WBC and NSCL/P (r_g = 0.14, <em>P =</em> 6.90E-03), as well as genetic overlap in 5 trait pairs of NSCL/P and WBC, NC, MONO, LYM, and BASO. Subsequently, we found 24 pleiotropic loci across these pairs, with the strongest pleiotropy in the genetic region 17q21.1 mapped to <em>GSDMA</em>. Notably, pleiotropic genes were enriched in the MHC protein complex, antigen processing and presentation, and bone cell development. In addition, MR analysis demonstrated that higher neutrophil counts significantly increased the risk of NSCL/P (odds ratio = 2.48, <em>P</em> = 5.41E-3), an effect that persisted in multivariable MR analyses (<em>P</em> = 1.33E-3) after adjusting for other inflammatory cell types.</div></div><div><h3>Conclusion</h3><div>Our study revealed genetic correlations and shared pleiotropic loci between leukocyte counts and NSCL/P, with further evidence suggesting a potential causal relationship between neutrophil counts and NSCL/P.</div></div><div><h3>Clinical Relevance</h3><div>High neutrophil cell counts showed a potential causal association with NSCL/P pathogenesis, suggesting an increased risk of disease development.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100877"},"PeriodicalIF":3.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535713","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":"Evaluating Dental Pain in Diverse Conditions: Findings From Short-Form McGill Pain Questionnaire Study","authors":"Jin Wang ,&nbsp;Yin-Fei Pu ,&nbsp;Hong-Tao Chen,&nbsp;Xiang-Song Bai,&nbsp;Xue Yang,&nbsp;Ai-Ping Ji,&nbsp;Jie Bai","doi":"10.1016/j.identj.2025.100864","DOIUrl":"10.1016/j.identj.2025.100864","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Making precise diagnoses of patients with dental pain is challenging. Thus, a screening system that can help accurately stratify patients depending on the severity of their condition is required. In this study, we compared the characteristics of dental pain in patients with different conditions using a Short-Form McGill Pain Questionnaire (SF-MPQ).</div></div><div><h3>Methods</h3><div>A total of 1541 patients admitted to the Peking University School of Stomatology between February 2022 and July 2023 were assessed. Demographic data and pain characteristics were collected. Pain was assessed using the SF-MPQ, which includes the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), and Pain Rating Index (PRI). Statistical analysis was performed using SPSS software, with variance analysis and Pearson's correlation coefficients, and a T-test was employed to assess the relationship between pain scores and various factors.</div></div><div><h3>Results</h3><div>A total of 11 conditions associated with dental pain were detected. Symptomatic irreversible pulpitis (SIP, 427, 27.7%) and symptomatic apical periodontitis (SAP, 429, 27.8%) were the most common conditions. Higher scores were seen in patients with SIP (5.5 ± 2.8 for PRI; 59.4 ± 24.4 for VAS; 2.9 ± 0.8 for PPI), SAP (5.6 ± 2.9 for PRI; 56.1 ± 32.0 for VAS; 2.8 ± 0.7 for PPI) and interappointment flare-up (IFU, 8.2 ± 0.5 for PRI; 56.2 ± 14.9 for VAS; 3.0 ± 0.0 for PPI). The location of pain in a tooth, spontaneous pain, sleep disturbance, duration of pain in a short time, taking painkillers was invalid, diagnosis with SIP and SAP, and IFU were significantly associated with higher pain scores (all <em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Patients with SIP and SAP present with higher pain scores. The SF-MPQ can aid in the effectiveness of dental emergency triage by identifying true acute symptomatic patients and ensuring appropriate management based on the severity of their conditions.</div></div><div><h3>Clinical Relevance</h3><div>SF-MPQ may help to increase effectiveness in dental emergency triage, diagnosis, and treatment.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100864"},"PeriodicalIF":3.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523421","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":"Ultrasound Microscopy-Based Identification of Enamel and Restorative Materials: An Ex Vivo Acoustic Impedance Study","authors":"Yukihiro Naganuma ,&nbsp;Masatoshi Takahashi ,&nbsp;Yoshifumi Saijo ,&nbsp;Masahiro Iikubo ,&nbsp;Atsushi Takahashi","doi":"10.1016/j.identj.2025.100880","DOIUrl":"10.1016/j.identj.2025.100880","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Differentiating restorative materials from enamel during dental examinations is challenging because of their similar appearances. Even with ultrasound microscopy, the acoustic properties of restorative materials remain unassessed. This study investigated the potential of ultrasound microscopy to differentiate between enamel, composite resin, and glass ionomer.</div></div><div><h3>Methods</h3><div>Extracted third molars served as the tooth model: a 1.2 mm-diameter cylindrical cavity drilled into the enamel and restored with either composite resin (flowable bulk-fill or paste) or glass-ionomer cement (conventional, high-filler, or multi-ion). To evaluate the restorative materials, a second model was prepared by milling a 2.0 mm-diameter, 3.0 mm-deep cavity into a PMMA block and filling it with the same materials. Both models were imaged with ultrasound microscopy to obtain acoustic-impedance maps, and the PMMA specimens subsequently underwent Vickers hardness testing to explore the correlation between hardness and acoustic impedance.</div></div><div><h3>Results</h3><div>Acoustic impedance was measured with an accuracy of 16 µm × 16 µm per pixel over an area of 4.8 mm × 4.8 mm, allowing for the construction of 2-dimensional colour images that effectively differentiated between enamel and restorative materials. The colour distribution for CR was homogeneous, while GIC exhibited a heterogeneous distribution across all samples. The mean acoustic impedance of enamel (15.6 ± 4.37 kg/m²s) was significantly greater than that of CR (Type Flow 5.36 ± 0.264 kg/m²s, Type Paste 5.49 ± 0.323 kg/m²s) and GIC (Type high-filler 4.80 ± 0.360 kg/m²s, Multiple ion 3.80 ± 0.360 kg/m²s, Conventional 3.74 ± 0.353 kg/m²s) (<em>P</em> &lt; .01). A distinct threshold was established based on the combined standard deviations (σ₁ + σ₂). Pairwise comparisons confirming the distinguishability of enamel, CR, and GIC.</div></div><div><h3>Conclusion</h3><div>Ultrasound microscopy effectively distinguishes between enamel and restorative materials, as well as between restorative materials (CR and GIC) through acoustic impedance measurement.</div></div><div><h3>Clinical relevance</h3><div>These findings suggest that ultrasound microscopy may assist in identifying restoration margins and assessing materials in clinical settings.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100880"},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513712","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":"Comprehensive Three-Dimensional Evaluation of Temporomandibular Joint Changes Following Stabilization Splint Therapy","authors":"Saba Ahmed Al-Hadad ,&nbsp;Pengyu Chen ,&nbsp;Yunshan Zhao ,&nbsp;Chushen Li ,&nbsp;Cui Zhang ,&nbsp;Lina Hassan Alshoaibi ,&nbsp;Mazen Musa ,&nbsp;Badr Sultan Saif ,&nbsp;Salma Izeldin ,&nbsp;Sarah AL-Qurmoti ,&nbsp;Xi Chen","doi":"10.1016/j.identj.2025.100845","DOIUrl":"10.1016/j.identj.2025.100845","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>While stabilization splints (SSs) have shown promising therapeutic effects for temporomandibular disorders (TMDs), comprehensive studies evaluating temporomandibular joint (TMJ) changes following SS therapy are necessary. This study aimed to assess TMJ structural, positional, and condylar remodelling changes in TMD patients by using advanced three-dimensional assessment and shape correspondence analysis.</div></div><div><h3>Methods</h3><div>This retrospective study included 80 adult TMD (arthralgia) patients treated with SS. Pre- and post-treatment cone beam computed tomography scans were analysed using three-dimensional Slicer software. The following measurements were evaluated: (1) volumetric condylar changes, (2) bone mineral density, (3) joint spaces, (4) condylar position, (5) condylar rotation, and (6) condylar remodelling (resorption or apposition). Statistical comparisons between time points and condylar sides were performed via paired <em>t</em> tests and Wilcoxon rank-sum tests.</div></div><div><h3>Results</h3><div>Treatment duration was 6 to 12 months (mean: 9.8 months). Study results indicated a slight increase in condylar volume and bone mineral density, but no statistically significant changes were observed. However, significant differences were noted in the anterior joint space on both sides. Condylar positional changes demonstrated inferior, lateral, and anterior translation, along with forward rotational movement on both sides. Localized condylar remodelling revealed bone formation predominantly in the posterior and superior regions, while slight bone resorption was mainly observed in the anteromedial and medial regions.</div></div><div><h3>Conclusions</h3><div>SS therapy promotes favourable condylar remodelling and TMJ realignment, as evidenced by reduced anterior joint space, anterior-inferior condylar displacement, and forward rotational changes, along with localized bone apposition. These findings highlight its role in facilitating adaptive changes in patients with TMD.</div></div><div><h3>Clinical relevance</h3><div>This study demonstrates that SS therapy improves TMJ function and condylar dynamics, offering a noninvasive treatment option that reduces mechanical stress and enhances patient outcomes. These insights provide clinicians with valuable evidence for incorporating SS therapy into TMD management strategies.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100845"},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513713","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":"Numb Chin Sign and the Role of Radiology","authors":"David MacDonald ,&nbsp;Thomas Ka Lun Li ,&nbsp;Vera Telyakova","doi":"10.1016/j.identj.2025.100862","DOIUrl":"10.1016/j.identj.2025.100862","url":null,"abstract":"<div><div>The numb chin sign is an important clinical sign that compels dentists to consider a serious disease that could be both local or distant. In addition to the clinical examination and history taking, appropriate radiology is required. Although today cone-beam computed tomography (CBCT), due to its widespread availability, as a valuable modality in dental practice, it still rests on appropriate lower-radiation-dose conventional radiography. The choice of the appropriate reconstruction of the CBCT dataset enhances the quality of the interpretation without adding further to the radiation dose, as illustrated in this rare case report.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100862"},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517798","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":"Successful Oral Health Interventions for Children Living in Vulnerable Circumstances – A Scoping Review","authors":"Awani Balasooriyan ,&nbsp;Christine Dedding ,&nbsp;Clarissa Calil Bonifácio ,&nbsp;Ruben R. Lacroix ,&nbsp;Kirsten A. van Gelderen – Ziesemer ,&nbsp;Rik Gerritsen ,&nbsp;Monique H. van der Veen","doi":"10.1016/j.identj.2025.100855","DOIUrl":"10.1016/j.identj.2025.100855","url":null,"abstract":"<div><div>Promoting equal opportunities for young children’s oral health is a global health priority. Several interventions have been developed to address persistent oral health inequalities. However, the understanding of how these interventions improve children’s oral health remains limited. This scoping review aims to explore researchers’ explanations for the success of interventions promoting oral health in young children (≤5 years) and their families living in vulnerable circumstances in Western countries to strengthen future interventions. A comprehensive search strategy was developed and applied to three electronic databases: PubMed, Embase.com, and Clarivate Analytics/Web of Science Core Collection. This yielded 21,415 articles, which were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The included articles were analysed thematically using a macro, meso, and micro system level framework. From a total of 21,415 references, 251 were assessed for eligibility; 39 articles were included, covering 37 interventions. In particular, interventions implemented at the macro level (n = 1), macro-meso levels (n = 4) and macro-meso-micro levels (n = 10) seem to be the most promising. The researchers argue that interventions with a personalised, educational and culturally sensitive approach, delivered through interdisciplinary collaboration between professionals within and outside the dental sector, supported by adequate resources (e.g., appropriate time, funding, location), are key to success. Future interventions require a careful account of families' complex daily realities by intensifying collaboration between parents, community workers, school staff, dental professionals, primary care providers and government, providing training and balanced workloads for professionals and ensuring sufficient resources. According to the researchers, engaging with actors from macro, meso, and micro system levels is essential in child oral health promotion. Government leadership is needed to address oral health inequalities as a societal responsibility <em>in partnership with</em> families, their social network, food shops, (pre-)schools, dental practices, community and primary care organisations.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100855"},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517797","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":"Effects of Xylitol-laced Sweets on the Accumulation of Dental Plaque : A Systematic Review and Meta-Analysis","authors":"Mohammad Mostafazadehbakhtiyary ,&nbsp;Sara Majidinia ,&nbsp;MohammadHassan Sohouli ,&nbsp;Hossein Chalakinia ,&nbsp;Atefeh Sadat Langari ,&nbsp;Sara Ziaaddini ,&nbsp;Reza Shakiba ,&nbsp;Shayan Yousefi","doi":"10.1016/j.identj.2025.100842","DOIUrl":"10.1016/j.identj.2025.100842","url":null,"abstract":"<div><h3>Background</h3><div>This meta-analysis was carried out in order to assess the effects of xylitol-laced sweets on the accumulation of dental plaque biofilm.</div></div><div><h3>Methods</h3><div>Using predetermined keywords, a systematic search was conducted using the original databases published until July 2024 on randomized controlled trials that evaluated the effect of xylitol-laced sweets on the accumulation of dental plaque. The random-effects model was used to obtain the 95% confidence intervals and the pooled weighted mean difference.</div></div><div><h3>Results</h3><div>A quantitative meta-analysis of 13 treatment arms of the included studies showed that xylitol-laced sweetssignificantly decreased the plaque index (PI) (WMD: −0.41, 95% CI: −0.62, −0.20, <em>P</em> &lt; .001) and the quantity of plaque accumulation (WMD: −7.46 mg, 95% CI: −13.38, −1.53, <em>P</em> = .014) compared with thecontrol groups. The subgroup analysis showed that xylitol causes a greater decrease in plaque accumulation (PI and amount of plaque) in the dose of interventions ≤20 g compared to &gt;20 g and also during the intervention &lt;4 weeks compared to ≥4 weeks . In addition, the subgroup analysis shows a greater effect on PI reduction in those ≤ 18 years of age.</div></div><div><h3>Conclusions</h3><div>Our findings show the potentially beneficial and significant effects of xylitol-laced sweets either in gummy or candy forms, on reducing plaque accumulation.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 4","pages":"Article 100842"},"PeriodicalIF":3.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501594","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":"The Joint Impact of Heavy Metals and Polycyclic Aromatic Hydrocarbons on Periodontitis","authors":"Ziqiu Fan ,&nbsp;Guangna Yue ,&nbsp;Dongming Yu ,&nbsp;Min Zhang ,&nbsp;Hideki Kitaura","doi":"10.1016/j.identj.2025.100879","DOIUrl":"10.1016/j.identj.2025.100879","url":null,"abstract":"<div><h3>Objective</h3><div>Heavy metals (HMs) and polycyclic aromatic hydrocarbons (PAHs) are significant environmental pollutants, raising growing concerns about their potential impact on human health, particularly oral health. This study aimed to investigate the combined effects of these pollutants on periodontitis (PD) – a prevalent chronic inflammatory disease affecting tooth-supporting structures.</div></div><div><h3>Methods</h3><div>This study utilized the National Health and Nutrition Examination Survey data to examine interactions between HMs, PAHs, and PD. A comprehensive analytical approach included survey-weighted multivariate logistic regression to evaluate individual pollutant exposures, restricted cubic splines to assess dose-response relationships, and advanced models such as Weighted Quantile Sum regression, Quantile G-Computation (qgcomp), and Bayesian Kernel Machine Regression to analyse joint pollutant effects.</div></div><div><h3>Results</h3><div>Findings revealed significant associations between high levels of certain blood HMs – particularly cadmium (Cd) and lead (Pb) – and increased PD risk. Elevated urinary levels of PAH metabolites were similarly linked to higher risk. Importantly, the study highlights that risk is substantially amplified by the synergistic effects of combined HMs and PAHs exposure. Weighted Quantile Sum, qgcomp, and Bayesian Kernel Machine Regression consistently demonstrated that simultaneous exposures lead to a notably higher PD risk, suggesting that traditional single-pollutant assessments may underestimate health risks.</div></div><div><h3>Conclusion</h3><div>This study provides robust evidence that exposure to both individual and combined HMs and PAHs significantly elevates PD risk. These findings underscore the importance of considering cumulative and interactive pollutant effects in public health risk assessments.</div></div>","PeriodicalId":13785,"journal":{"name":"International dental journal","volume":"75 5","pages":"Article 100879"},"PeriodicalIF":3.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490326","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}