JDR Clinical & Translational Research最新文献

{"title":"A Call to Action: Advancing Interprofessional Primary Care through Research, Education, and Community.","authors":"L Rasubala, Y Ren, T Caprio","doi":"10.1177/23800844251345495","DOIUrl":"https://doi.org/10.1177/23800844251345495","url":null,"abstract":"<p><p>A shift toward integrated, interprofessional care models requires intentional action across multiple domains, most notably research, education, and community engagement. This commentary introduces the upcoming JDR CTR supplement titled \"Advancing Interprofessional Primary Care through Research, Education, and Community: A Call to Action.\" The supplement will include detailed information on the topics described in this commentary and highlight current strategies and opportunities to advance oral health integration across education, clinical care, and community-based models. This commentary emphasizes interprofessional education, faculty development, and community engagement as key drivers of systemic change. Integration must move beyond rhetoric to structural implementation, redefining oral health as essential to equitable, person-centered primary care.Knowledge Transfer Statement:This commentary highlights the JDR CTR special supplement (available in July 2025), featuring influential research and expert contributions that advance dentistry interprofessional health care. It is a valuable resource for exploring the progress, challenges, and opportunities at the intersection of research, education, and community practice, all aimed to advance oral health integration and improve equitable access to care.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251345495"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implicit Racial Bias in Oral Health: A Scoping Review of Students' and Providers' Perceptions.","authors":"P Martin, K Rafia, M Minter-Jordan, E P Tranby, P D Edouard, R Taylor, L J Heaton","doi":"10.1177/23800844251338167","DOIUrl":"https://doi.org/10.1177/23800844251338167","url":null,"abstract":"<p><strong>Introduction: </strong>Implicit bias is a form of unconscious bias that can affect judgment, decisions, and behaviors.</p><p><strong>Objectives: </strong>This scoping review examined what scientific literature exists about implicit bias demonstrated by dental/dental hygiene students and providers and, when possible, how these implicit biases are associated with patients' oral health outcomes.</p><p><strong>Methods: </strong>This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). This review included English-language PubMed peer-reviewed studies meeting inclusion criteria, published through October 2023, measuring the implicit bias of dental/dental hygiene students or professionals and how such bias can affect patient oral health outcomes.</p><p><strong>Results: </strong>A total of 363 records were found. After removing duplicates (<i>n</i> = 114) and title screening (<i>n</i> = 60), 54 abstracts were screened, 24 reports were assessed, and 10 were included in the final review. Implicit bias was assessed using the Implicit Association Test (IAT), Brief IAT (BIAT), and Color-Blind Racial Attitudes Scale (CoBRAS). BIAT scores revealed a pro-White unconscious racial bias in clinical decision-making among dental professionals, and additional IAT results suggested implicit racial preferences for European Americans over African Americans; non-White participants showed more positive implicit preferences toward African Americans in comparison with White participants. Studies using CoBRAS suggest moderate levels of color-blind racial attitudes among students and professionals, indicating an unawareness of racism and a need to further understand the implications of bias on patient outcomes.</p><p><strong>Conclusion: </strong>Despite small sample sizes and a lack of racial/ethnic diversity that limit their generalizability, the included studies provide evidence for implicit racial bias held by some dental/dental hygiene students and professionals that may affect the oral health outcomes of patients. Training to increase awareness of and reduce implicit bias among those providing oral health care is an important first step to providing a more equitable health care system for all patients.Knowledge Transfer Statement:Despite small sample sizes and a lack of racial/ethnic diversity that limit their generalizability, the included studies provide evidence for implicit racial bias held by some dental/dental hygiene students and professionals that may affect the oral health outcomes of patients. Training to increase awareness of and reduce implicit bias among those providing oral health care is an important first step to providing a more equitable health care system for all patients.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251338167"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is the Normal Salivary Flow Rate in Healthy Adults? A Systematic Review with Meta-Analyses.","authors":"J R da Silva, R C R Marques, F P S Nunes, A A Lima, D Heller, C M Stefani, N Dame-Teixeira","doi":"10.1177/23800844251336205","DOIUrl":"https://doi.org/10.1177/23800844251336205","url":null,"abstract":"<p><strong>Objectives: </strong>Common reference values for defining healthy salivary flow rates were established decades ago. However, these parameters may no longer accurately reflect normal conditions in contemporary populations. This study aimed to establish average unstimulated (USF) and stimulated (SSF) salivary flow rates in adults as reference values for normality and to compare healthy individuals with those presenting hyposalivation-associated conditions (HACs).</p><p><strong>Methods: </strong>Searches were conducted across 8 databases and the gray literature. Included studies were those with a group of healthy adult individuals (>18 and <60 y old) who underwent a quantitative salivary profile assessment presented in milliliters per minute (mL/min). Studies were excluded if they lacked a healthy group or included children, adolescents, or elderly, among other criteria. The methodological quality of the included studies was assessed using a JBI instrument. An effect size meta-analysis was performed to estimate the average salivary flow in healthy individuals using the restricted maximum likelihood method. Pairwise meta-analyses comparing salivary flow between individuals with HACs and healthy controls were performed using a random effects model. Subgroup analyses and meta-regression were conducted to examine the influences of latitude, study year, and quality. Prospero: CRD42024449389.</p><p><strong>Results: </strong>A total of 63 studies, including 3,167 healthy individuals and 2,470 individuals with HAC (ages 18 to 60 y, 60% female), were included. The average USF in healthy individuals was 0.82 mL/min (95% confidence interval [CI] = 0.63-1.01), and the average SSF was 1.48 mL/min (95% CI = 1.31-1.65). The mean difference in salivary flow between individuals with HAC and healthy controls was 0.43 mL/min for SSF (95% CI = 0.04-0.76, <i>P</i> = 0.03) and 0.42 mL/min for USF (95% CI = 0.14-0.71, <i>P</i> = 0.004). Meta-regression and subgroup analysis revealed that latitude, study year, and methodological quality did not explain the heterogeneity.</p><p><strong>Conclusions: </strong>The average salivary flow in healthy individuals may be substantially higher than the current threshold values for USF but not for SSF. These values may represent the actual global salivary flow rates.Knowledge Transfer Statement:The limit of the confidence intervals could be adopted as the threshold for normality. Nearly 0.4 mL/min might be the clinically relevant salivary flow difference between healthy individuals and those with HAC.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251336205"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and Barriers to Prenatal Dental Care among Pregnant Women in 2 Regions of China.","authors":"Q Jing, H Yang, Y Chen, X Cao, L Shi, L Ma, K Wan, D Zhang","doi":"10.1177/23800844251338766","DOIUrl":"https://doi.org/10.1177/23800844251338766","url":null,"abstract":"<p><strong>Introduction: </strong>Maintaining oral health during pregnancy is essential for women's health, yet awareness of and access to dental care among pregnant women in China remain limited.</p><p><strong>Objectives: </strong>We aim to assess the knowledge, attitudes, and dental care-seeking behaviors of pregnant women in 2 regions of China and identify the key factors predicting prenatal dental care utilization.</p><p><strong>Methods: </strong>Data were collected via an online survey from pregnant women recruited through convenience sampling at 2 hospitals in Beijing municipality and Haikou city, Hainan province. The survey included knowledge, attitudes, and sociopsychological factors that may influence dental care utilization. Principal component analysis and multivariate logistic regression were applied to assess the roles of knowledge and attitudes in prenatal dental care utilization.</p><p><strong>Results: </strong>A total of 248 participants completed the survey. Among them, 39.92% consulted a dentist when experiencing dental issues, while 63.31% consulted any health care professional, including dentists and obstetricians. Participants from Hainan were significantly less likely to consult a dentist as compared with those from Beijing (odds ratio [OR], 0.01; 95% CI, 0.00 to 0.40). Regular dental care before pregnancy (principal component 1) was associated with lower odds of consulting a dentist (OR, 0.58; 95% CI, 0.37 to 0.92) and any health care professional (OR, 0.56; 95% CI, 0.35 to 0.92). Perceived severity of untreated dental issues (principal component 6) increased the odds of consulting a dentist (OR, 1.69; 95% CI, 1.22 to 2.33) and a health care professional (OR, 1.66; 95% CI, 1.21 to 2.30).</p><p><strong>Conclusion: </strong>Geographic location and perceptions regarding dental care during pregnancy significantly influenced dental care-seeking behaviors among pregnant women. Women in less developed regions such as Hainan sought less dental care, while those aware of untreated dental risks were more likely to seek treatment. These findings highlight the importance of targeted interventions to address regional disparities and gaps in knowledge.Knowledge Transfer Statement:This study highlights key factors influencing prenatal dental care utilization among pregnant women in China, emphasizing regional disparities and the impact of knowledge and perceptions on care-seeking behaviors. Women in less developed regions, such as Hainan, were significantly less likely to consult a dentist or other health care professional as compared with women in Beijing. In addition, prior regular dental care was associated with lower odds of seeking treatment during pregnancy, and awareness of the severity of untreated dental issues increased the likelihood of seeking care. These findings underscore the need for targeted interventions to improve oral health education and access to prenatal dental care, particularly in underserved areas.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251338766"},"PeriodicalIF":2.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit-Cost Analysis of Noninvasive Early Childhood Caries Interventions among Latvian Children.","authors":"I Maldupa, S E Uribe, O Sļepcova, E Senakola, A Brinkmane, T M Nguyen, N Innes, R Mariño","doi":"10.1177/23800844251332888","DOIUrl":"https://doi.org/10.1177/23800844251332888","url":null,"abstract":"<p><strong>Objectives: </strong>Analyze the benefit-cost analysis of noninvasive early childhood caries (ECC) management in Latvian preschoolers versus placebo, from a health care perspective, over 12 mo.</p><p><strong>Methods: </strong>Randomized, blinded, placebo-controlled trial (September 2020-August 2022) at Riga Stradins University, Latvia. A factorial trial was conducted with 3 interventions (placebo, silver diamine fluoride [SDF], Tiefenfluorid) and 2 recall intervals (none: 1 and 6 mo: 2), all including behavioral modification. The 6 strategies were placebo (P1, P2), SDF (SDF1, SDF2), and Tiefenfluorid (TF1, TF2). Probabilistic sensitivity analysis was calculated from the health care perspective. Costs associated with each ECC management program and associated treatments were identified and measured. Incremental benefit-cost ratios (IBCRs) were calculated to determine the margin by which each program was more beneficial than P1 (comparator). The primary outcome measure used for economic evaluation was health care complications averted, defined as teeth with pulp involvement due to dental caries. The economic costs associated with health care complications averted were quantified in monetary terms as benefits.</p><p><strong>Results: </strong>All alternative strategies were more effective than the comparator in averting health care complications and dental caries lesions. Over 12 mo, SDF2, TF2, and P2 were dominant interventions, yielding an IBCR of -0.98, -0.80, and -0.70, respectively. SDF1 and TF1 had an IBCR of 2.95 and 10.67, respectively, rending these interventions economically beneficial but with lower return on investment.</p><p><strong>Conclusion: </strong>Biannual SDF applications (SDF2) were the most cost-effective for ECC, significantly outperforming Tiefenfluorid^® (TF2) and placebo (P2). TF2 and P2 slightly improved over placebo (P1) due to additional behavioral modification and counseling. Implementing SDF2 in Latvia would likely reduce health care complications and costs.Knowledge Transfer Statement:This study compared 5 noninvasive early childhood caries management strategies with a placebo \"no treatment\" group over a 12-mo period. The primary outcome measure was health care complications averted, quantified in monetary terms. The results showed that the 6-monthly applications of SDF and fluoride varnish demonstrated cost savings compared with the placebo group. The study recommends implementing SDF and fluoride varnish into routine clinical practice to reduce health care complications and associated costs.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251332888"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whose Responsibility Is It? A Community-Level Situational Analysis of Oral Health Care in Amsterdam.","authors":"S Begovic, M W van der Linden, K Rosing, L E de Almeida, M Lorenz, S Listl, M H van der Veen","doi":"10.1177/23800844251332227","DOIUrl":"https://doi.org/10.1177/23800844251332227","url":null,"abstract":"<p><strong>Background: </strong>DELIVER (DELiberative ImproVEment of oRal care quality) is a multinational project funded under the EU's Horizon Europe program that aims to improve the quality of oral health care at the practice, community, national, and international levels. It is important to understand the current situation of oral health care quality to make improvements possible. This study aimed to map oral health care priorities among stakeholders in Amsterdam, the Netherlands, and to describe how these stakeholders interacted to improve the quality of oral health care at the community level.</p><p><strong>Methods: </strong>A situational analysis approach was used to collate data from desk research and semi-structured interviews with key informants. Interview transcripts were analyzed and grouped into main themes and subthemes using inductive coding. A situational map, a social worlds/arenas map, and a positional map were constructed to represent the community-level situation of quality improvement of oral health care.</p><p><strong>Results: </strong>Interviews were conducted with 10 professional stakeholders (5 social/welfare workers, 3 health care professionals, 1 public health professional, and 1 municipality policy maker). Stakeholders described prioritizing at least basic oral health care and stated that it should be accessible for everyone. Other priorities included a need for simplified access to oral health care and strengthened social support. While stakeholders agreed that people should not rely on emergency funds and volunteers, they felt that it was unclear which organizations or individuals were responsible for determining access to oral health care. This led social/welfare organizations to feel a sense of responsibility and offer informal care solutions.</p><p><strong>Conclusion: </strong>There was consensus among stakeholders about the need for social support and simplified access to oral health care for citizens. Stakeholders also emphasized the lack of clarity about who was responsible for oral health care and quality improvement at the community level, which highlighted the urgent need for improved governance, allocating responsibilities for oral health care quality improvement to all parties operating at the community level.Knowledge Transfer Statement:This study mapped the current practice of oral health care quality in Amsterdam, the Netherlands, through a situational analysis as a crucial starting point for enhancing quality improvement of oral health care at the community level. It underscored the need for clarity about responsibilities and provided insights for oral health care providers, social and welfare workers, policy makers, and researchers that could support research and policy formulation targeted at underserved populations, involving multiple stakeholders.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251332227"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Autologous Concentrated Growth Factor in Regenerative Dentistry: A Systematic Review and Meta-Analysis.","authors":"A A Alshirah, M H Elnaem, Z Al-Ani, F Alzahrani, M Almasri, P A McCarron","doi":"10.1177/23800844251325532","DOIUrl":"https://doi.org/10.1177/23800844251325532","url":null,"abstract":"<p><strong>Introduction: </strong>Concentrated growth factor (CGF), a novel autologous platelet concentrate, has gained substantial interest for its potential role in managing oral diseases. The objective of this study is to evaluate the effectiveness of CGF in regenerative dentistry.</p><p><strong>Methods: </strong>A systematic search was performed across MEDLINE, OVID, Scopus, Cochrane Library, Google Scholar, Web of Science, and Elsevier for publications between July 1, 2013, and July 1, 2023. Only randomized clinical trials were included. The quality of the methodology was assessed using the Cochrane Risk of Bias Tool. Data were analyzed using RevMan 5.4 software.</p><p><strong>Results: </strong>In 3 trials treating periodontal intrabony defects, CGF combined with bone grafts showed significant superiority over bone grafts alone (<i>P</i> < .00001), with a mean reduction of 1.41 mm in intrabony defect depth and a mean gain of 0.55 mm in clinical attachment level (<i>P</i> = 0.002). For gingival recession in 5 trials, CGF combined with coronally advanced flap (CAF) was more effective than CAF alone, resulting in a mean increase in keratinized tissue width of 0.41 mm and a mean increase in gingival thickness of 0.26 mm (<i>P</i> < 0.00001). However, CGF combined with CAF was less effective than connective tissue graft (CTG) combined with CAF, showing a mean difference in root coverage of -15.09% and a mean difference in gingival thickness of -0.50 mm (<i>P</i> < 0.0001). In alveolar ridge preservation, sinus elevation, guided bone regeneration, dental implant procedures, and postextraction healing, CGF gave better values in clinical practice.</p><p><strong>Conclusions: </strong>CGF enhances regenerative surgery outcomes for periodontal intrabony defects. Combined with CAF, CGF improves therapeutic efficacy for gingival recession, although less so than CTG with CAF. CGF shows promise in various regenerative dentistry areas. However, the absence of meta-analysis and low-quality assessments in many studies necessitates further high-quality research.Knowledge Transfer Statement:The use of concentrated growth factors (CGFs) in regenerative dentistry, within the limitation of low-quality studies, shows promising benefits in treating periodontitis infrabony defects, gingival recession, guided bone regeneration, dental implant alveolar ridge preservation, sinus elevation, and third molar extraction. Future research should focus on high-quality studies and explore combining CGF with grafting materials to enhance therapeutic outcomes in oral surgery.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251325532"},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Family Sociodemographics and Mother's Toothbrushing on Australian Preschool Children.","authors":"P Rajesh, D H Ha, L G Do, S K Tadakamadla","doi":"10.1177/23800844251326091","DOIUrl":"https://doi.org/10.1177/23800844251326091","url":null,"abstract":"<p><strong>Background: </strong>Understanding the predictors of toothbrushing at the 2 distinct preschool age time points will help develop and implement effective strategies specific to children's age.</p><p><strong>Aim: </strong>To examine the effect of a family's sociodemographic status and mothers' oral health behavior on children's toothbrushing frequency at 2 different time points: 2 and 5 y of age.</p><p><strong>Design: </strong>Secondary analysis (cross-sectional) of longitudinal data collected through a cohort study.</p><p><strong>Results: </strong>In children aged 2 y, the likelihood of toothbrushing twice or more per day was higher than their comparative counterparts if their mother's toothbrushing frequency was twice or more per day (odds ratio [OR]: 5.63; 95% confidence interval [CI]: 4.01-7.90), if they were girls (OR: 1.36; 95% CI: 1.04-1.79), if the mother had completed tertiary education (OR: 1.48; 95% CI: 1.01-2.19) or vocational training (OR: 1.54; 95% CI: 1.01-2.33), if the household had 2 adults (OR: 2.48; 95% CI: 1.12-5.50) or 3 or more adults (OR: 2.52; 95% CI: 1.06-5.97), if the total household income was >A$120,000/year (OR: 1.62; 95% CI: 1.03-2.56), if the household had both parents (OR: 2.11; 95 % CI: 1.11-4.02). At the age of 5 y, girls whose mothers brushed their teeth twice or more per day were 1.43 (95 % CI: 1.02-2.02) and 10.53 (95% CI: 7.01-15.80) times more likely to brush their teeth more than twice or more per day than boys whose mothers brushed less than twice per day, respectively.</p><p><strong>Conclusions: </strong>Child sex and mother's toothbrushing were the 2 main factors associated with children's toothbrushing frequency at both ages. In addition, several sociodemographic factors were associated with toothbrushing frequency at 2 y of age.Knowledge Transfer Statement:The results of this study can be used by parents, especially mothers and policy makers, as they can help promote consistent toothbrushing habits in children. This is crucial as it is a preventive measure against oral health issues and cavities. In addition, the research can play a vital role in shaping policies to improve toothbrushing practices among children between the ages of 2 and 5 y.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251326091"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocturnal Autonomic Nervous System Dynamics and Chronic Painful Temporomandibular Disorders.","authors":"J C Nickel, Y M Gonzalez, Y Wu, D Choi, H Liu, L R Iwasaki","doi":"10.1177/23800844251325226","DOIUrl":"https://doi.org/10.1177/23800844251325226","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain associated with temporomandibular disorders (TMDs) may reflect dynamic autonomic nervous system (ANS) effects. This pilot observational study tested the hypotheses that Characteristic Pain Intensity (CPI) scores correlated with 1) amplitude, 2) duration, and 3) power densities (amplitude/duration) of nocturnal ultradian cycling of the sympathetic and parasympathetic arms of the ANS.</p><p><strong>Materials and methods: </strong>In accordance with institutional review board oversight and Strengthening the Reporting of Observational Studies in Epidemiology guidelines, adult subjects gave informed consent, completed Axis I and II components of Diagnostic Criteria for TMD (DC-TMD), and were trained in research protocols to record nocturnal heart rate data. Subjects were assigned to ± pain groups based on CPI scores (0 = no pain, >0 = pain). Nocturnal ultradian cycling of sympathetic and parasympathetic activities was characterized using heart rate variability measures of the percentage of the absolute value of the low-frequency power component (ms²) and normal-to-normal sinus node depolarizations >50 ms compared to total number (pNN50, %), respectively. Peaks and valleys of ultradian cycling were identified, where cycle amplitudes and durations were quantified, and sympathetic/parasympathetic power densities were calculated. The hypotheses were tested by nonparametric correlations and regression analyses, where significance was defined by <i>P</i> < 0.05.</p><p><strong>Results: </strong>Of 32 individuals screened and enrolled, 18 females and 11 males completed all study protocols. Subjects produced 87 nighttime electrocardiogram recordings with an average duration of 7.7 ± 1.0 h. CPI scores ranged from 0 to 70 and were significantly higher (<i>P</i> = 0.032) in females (30 ± 25) than in males (10 ± 17). Nocturnal ultradian sympathetic cycling in females compared to males showed significantly higher amplitudes (<i>P</i> = 0.011) and lower durations (<i>P</i> = 0.048). CPI scores were correlated with nocturnal cycling amplitude and duration (all |<i>R</i>| ≥ 0.80) and the log of sympathetic/parasympathetic power densities (<i>R</i>² = 0.89).</p><p><strong>Conclusion: </strong>Characteristic Pain Intensity scores were correlated with amplitudes, durations, and power densities of nocturnal ANS ultradian cycling.Knowledge Transfer Statement:Chronic myofascial pain may reflect autonomic nervous system (ANS) activity. Characteristic Pain Intensity scores of subjects were correlated with power densities of ANS ultradian cycling during sleep. Future research is needed to detect sex differences in ANS power densities in subjects with chronically painful temporomandibular disorders.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251325226"},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Vulnerability Index and Dental Caries in Children: An Exploratory Study.","authors":"J Pellegrom, K Pickett, G Kostbade, T Tiwari","doi":"10.1177/23800844241279566","DOIUrl":"10.1177/23800844241279566","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective cross-sectional study evaluated the association between caries outcomes in a pediatric population visiting a dental clinic and the social vulnerability index, an area-based measure capturing 4 main social determinants of health: socioeconomic status, household composition/disability, minority status/language, and housing/transportation.</p><p><strong>Methods: </strong>The Centers for Disease Control Social Vulnerability Index (SVI) and electronic dental record data of children (0 to 18 y) reporting a caries diagnosis at the Children's Hospital Colorado in 2020 were extracted for 9,201 children. Logistic regressions were used to test the association between SVI and the presence or absence of dental caries, adjusting for age, sex, ethnicity, and race.</p><p><strong>Results: </strong>Children with a caries diagnosis had a greater mean overall SVI percentile (62.0, standard deviation [SD] = 29.1) compared with patients without a caries diagnosis (59.1, SD = 29.8; P < 0.001). With each 10-point increase in the overall SVI percentile, having a caries diagnosis visit was 2.7% more likely compared with having a visit without a caries diagnosis (odds ratio [OR] 1.027, 95% confidence interval [CI] 1.012, 1.042; <i>P</i> = 0.0004). Those with an overall SVI percentile between 51 and 75 were 23% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.23, 95% CI 1.07, 1.42; <i>P</i> = 0.003), and those with a percentile >75 were 23.6% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.236, 95% CI 1.09, 1.40; <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Children (0 to 18 y) living in socially vulnerable environments or areas were more likely to have a caries diagnosis at their dental exam.Knowledge Transfer Statement:This study showed an association between social determinants of health demonstrating social vulnerability and dental caries in children. Ultimately, understanding upstream factors for children living in socially vulnerable areas could support policymakers in creating more effective policies to support socially vulnerable populations.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"190-197"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}