JDR Clinical & Translational Research最新文献

{"title":"Periodontitis Prediction Model Using Linked Electronic Health and Dental Records.","authors":"J S Patel, M Tellez, R Katiyar, N N Al-Hebshi, R Santana, R M Yucel, A Ismail","doi":"10.1177/23800844251408849","DOIUrl":"10.1177/23800844251408849","url":null,"abstract":"<p><strong>Introduction: </strong>Periodontal disease (PD) is closely linked to systemic health, with established associations with chronic conditions (eg, diabetes, cardiovascular disease). However, most predictive models rely solely on dental data, limiting the consideration of systemic factors such as medical conditions.</p><p><strong>Objectives: </strong>This study aimed to enhance PD risk prediction by using linked electronic dental records (EDRs) with electronic health records (EHRs) and machine learning (ML).</p><p><strong>Methods: </strong>We used EDR data from 20,946 adult patients at Temple University School of Dentistry's (2022-2023) axiUm®, linked with medical data (physician documented) from the Pennsylvania Health Share Exchange. The dataset includes demographics, dental diagnoses, medical history, medications, procedures, and social determinants of health. The target variable was PD. Because EHR data are not research ready, extensive preprocessing was required (eg, 1 patient may have 400+ medical codes, which ML/statistical models cannot process directly). To prepare for artificial intelligence/ML, we developed 5 automated feature reduction approaches to retain rich information while reducing variables. After preprocessing, 106 features were retained as independent variables. ML models (Gaussian Naive Bayes, Random Forest, LightGBM, XGBoost) were trained using cross-validation across 5 experimental strategies, including (1) features selected via chi-square test, (2) raw data (without extensive processing), (3) aggregated data, (4) systemic disease complexity system, and (5) EHR-only data. Model performance was assessed using sensitivity, specificity, and area under the curve (AUC).</p><p><strong>Results: </strong>The chi-square-selected features yielded the best performance: 85% specificity, 67% sensitivity, and 84% AUC. Although adding medical conditions did not significantly improve overall performance, key conditions (eg, cardiovascular diseases, endocrine/metabolic disorders, renal diseases, respiratory conditions, hematologic disorders, etc) contributed meaningfully to PD risk prediction. EDR factors (oral hygiene, periodontal treatment, brushing, flossing, smoking, and American Society of Anesthesiologists classification) dominated prediction.</p><p><strong>Conclusion: </strong>Although dental factors remained dominant predictors, strong systemic-oral health associations were observed. Future studies should validate these findings by integrating medical and dental records.Knowledge Transfer Statement:The results of this study can guide clinicians and policymakers in identifying patients at increased risk of periodontitis by integrating medical and dental records. This approach supports earlier interventions and highlights the importance of systemic health in oral disease management. It also demonstrates the potential of artificial intelligence-based prediction models to improve personalized care and promote interdisciplinary ","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"555-570"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Occlusal Caries Management over 2 Decades in France among General Dental Practitioners.","authors":"G Savard, S Léger, M Trébosc, B Grosgogeat, S Doméjean","doi":"10.1177/23800844251389843","DOIUrl":"10.1177/23800844251389843","url":null,"abstract":"<p><strong>Objectives: </strong>Despite being a central concept in dentistry, minimum intervention dentistry (MID) still faces a gap between evidence and practice. The aim of this study was to investigate the management decisions of French general dental practitioners (FrGDPs) for occlusal carious lesions (OCL) in 2023 and to compare the results to those obtained in 2002 and 2012 using the same questionnaire.</p><p><strong>Methods: </strong>An online, cross-sectional survey was conducted using a precoded questionnaire among the French dental practice-based research network (ReCOL). The structured questionnaire assessed the restorative threshold and management strategies for OCL. Three simulated clinical scenarios are presented: 1 illustrating a discrete progression of an OCL (assessing the intervention threshold) and 2 clinical cases (focusing on diagnosis and caries management). Descriptive and statistical analyses were performed to study the evolution over 2 decades.</p><p><strong>Results: </strong>The response rate was 45.4%. The 2023 sample included 56% female dentists and was younger and less experienced than the 2002 and 2012 population studies. In 2023, 68.5% of the respondents stated a restorative threshold when the OCL reached the outer third of dentine. Over the last 2 decades, this threshold has been significantly delayed to later stages of carious progression and so is shifting the cavity preparation to a more conservative approach. Over the 2 decades, for clinical cases 1 and 2, diagnosis, management strategies, and material selection have significantly evolved toward earlier grades of carious extension, a more micro- and non-invasive approach, and composite (P < 0.0001). Substantial variability persists among respondents.</p><p><strong>Conclusions: </strong>The results reveal a significant shift over the last 2 decades among FrGDPs toward MID. Initial and continuing education are key factors in the improved implementation of MID into practice. Resistance and variability act as barriers, and uncertainty proves to be a challenge, all of which require further investigation.Knowledge Transfer Statement:This 2-decade study on the diagnosis and management of dental caries provides valuable insights for dental practitioners, academic institutions, policy-makers, and health system stakeholders. The findings underscore the importance of education, consideration of barriers, and tolerance for uncertainty. These findings are important for raising awareness of, and helping to reduce, the gap between evidence and clinical practice.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"545-554"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633614","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 Place on Dental Use by Medicaid-Enrolled Adults in Massachusetts.","authors":"S Ticku, E Alpert, E Mo, J Barrow, H Wu","doi":"10.1177/23800844261425639","DOIUrl":"10.1177/23800844261425639","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Place-level factors influence oral health disparities, yet research predominantly focuses on individual-level determinants. This study examines how neighborhood characteristics influence dental service utilization among Medicaid-enrolled adults in Massachusetts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study analyzed data from adult Medicaid beneficiaries obtained from the 2015 Massachusetts All-Payer Claims Database, which includes dental, medical, and member eligibility information. ZIP Code Tabulation Area (ZCTA)-level Social Vulnerability Index (SVI) scores for 4 themes (socioeconomic status, household characteristics, minority status, housing/transportation) were calculated using American Community Survey 2015 data. Negative binomial regression analysis with multilevel modeling assessed the association between individual- and place-level factors on the utilization of preventive, restorative, and surgical dental care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The sample comprised 1,108,378 Medicaid beneficiaries across 511 ZCTAs and 13 counties in Massachusetts. ZCTA-level factors demonstrated several disparities. ZCTA with a low vulnerability for minority status SVI had up to 5-fold higher utilization across preventive (incidence rate ratio [RR]: 5.06, confidence interval [CI]: 3.67 to 6.97), restorative (RR: 5.28; CI: 3.88 to 7.17), and surgical (RR: 4.78; CI: 3.56 to 6.40) service types compared with high-vulnerability areas (predominantly minority ZCTAs). In addition, low-vulnerability neighborhoods for housing/transportation showed higher utilization for all preventive (RR: 2.67; CI: 1.98 to 3.59), restorative (RR: 2.44; CI: 1.84 to 3.24), and surgical (RR: 2.20; CI: 1.68 to 2.88) service types. Compared with ZCTA-level factors, individual factors such as age, gender, diabetes status, smoking status, and preventive medical care use contributed only marginally to explaining geographic variations in dental care use. Adding SVI themes reduced unexplained geographic variance by 38% for preventive services, 40% for restorative services, and 33% for surgical services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Place-based social vulnerabilities, particularly neighborhood racial composition and infrastructure, are stronger predictors of dental care utilization than are individual characteristics among Medicaid beneficiaries are. These findings reveal how structural inequities embedded in neighborhood environments create barriers to dental care access that persist even with insurance coverage.Knowledge Transfer Statement:This article examines the impact of place-related factors on dental service utilization among adult Medicaid beneficiaries in Massachusetts, focusing on ZIP Code Tabulation Area and county levels. It highlights the need to consider multilevel determinants in addressing disparities in access to dental care. By pinpointing predictors, this study supports interventions and policies to promote oral health ","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"571-582"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463412","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 Chewing Behavior Change on Cognition and Cerebral Hemodynamics.","authors":"M T Sta Maria, Y Hasegawa, S Yoshimura, T Suzuki, Y Ono, M Sakata, M Shiramizu, K Hori, K Yamamura, T Ono","doi":"10.1177/23800844251388317","DOIUrl":"10.1177/23800844251388317","url":null,"abstract":"<p><strong>Background: </strong>Impaired chewing ability is a recognized risk factor for cognitive decline in older adults, potentially due to reduced neural stimulation in cognition-related brain regions. While short-term studies have demonstrated transient increases in neural activity from chewing, the sustained cognitive and neurophysiological effects of encouraging thorough chewing habits in daily life remain unclear.</p><p><strong>Objective: </strong>This randomized controlled trial investigated whether promoting thorough chewing during meals could improve cognitive function and cerebral hemodynamics in older adults.</p><p><strong>Methods: </strong>Fifty participants aged 65 y or older were randomly assigned to either a 1-mo intervention group, which used a wearable device to monitor and increase chewing strokes during meals, or a control group that maintained usual chewing habits. Chewing behavior, cognitive performance (including memory and executive function via the color Stroop test), and cerebral hemodynamics in the dorsolateral prefrontal cortex (DLPFC) were measured at baseline and after 1 mo. Statistical analyses included <i>t</i> tests, chi-square tests, 2-way analysis of variance with post hoc tests, Pearson correlations, and generalized linear models to evaluate group differences and associations between chewing and cognitive outcomes.</p><p><strong>Results: </strong>Significant time-by-group interactions were observed for memory, <i>F</i>(1, 48) = 6.24, <i>P</i> = 0.043, and hemodynamic responses in the left DLPFC, <i>F</i>(1, 48) = 6.19, <i>P</i> = 0.013. The intervention group showed increased chewing frequency (<i>P</i> = 0.017), improved memory performance, and reduced left DLPFC responses compared with controls. Chewing frequency was positively correlated with Stroop test scores (<i>r</i> = 0.53, <i>P</i> = 0.010) and negatively with hemodynamic changes in the left DLPFC (<i>r</i> = -0.30, <i>P</i> = 0.040). Although improvements in other cognitive outcomes and hemodynamic measures favored the intervention group, these differences did not reach statistical significance.</p><p><strong>Conclusions: </strong>Promoting intentional chewing habits for 1 mo may enhance memory-related cognitive performance and neural efficiency in the DLPFC during working memory tasks in older adults. This nonpharmacologic, low-burden strategy warrants further research with longer interventions to support cognitive health and dementia prevention.</p><p><strong>Trial registration id: </strong>UMIN000044280Knowledge Transfer Statement:This study demonstrates that promoting thorough chewing habits in older adults can improve memory and enhance neural efficiency in the brain. Encouraging intentional mastication is a simple, nonpharmacologic approach that may help maintain cognitive health and prevent dementia, providing a practical strategy for clinicians and policymakers to support healthy aging.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"593-604"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633619","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":"Exploring Dentists' Views on Professionalism and Identity Formation: A Template Analysis Study.","authors":"J H Kwon, H von Bergmann","doi":"10.1177/23800844251413578","DOIUrl":"10.1177/23800844251413578","url":null,"abstract":"<p><strong>Objective: </strong>Professionalism is essential in dental education, yet limited research has examined the barriers and challenges dentists face and how these affect their professional identity. This study addressed this gap by exploring dentists' perceptions of professionalism, identifying workplace challenges, analyzing contributors to their professional identity development, and gathering recommendations to enhance professionalism education within dental education.</p><p><strong>Methods: </strong>A purposive sample of practicing dentists was recruited in the Metro Vancouver area of Canada. Semi-structured interviews were conducted using a piloted interview guide. These interviews, held via Zoom, were analyzed using template analysis in NVivo (version 14) by QSR International.</p><p><strong>Results: </strong>Ten dentists participated in the study. They identified patient-centered care, effective communication, adherence to ethical standards, and maintaining boundaries as key aspects of professionalism. While work experience reinforced professional identity, findings suggest a possible disconnect between professional identity formation and ethical behavior, emphasizing the need for deliberate and guided self-reflection. Participants also reported insufficient training in ethics and interprofessional collaboration, highlighting gaps between their understanding of professionalism and the education they received. They recommended improved professionalism training, stricter institutional oversight, and better workplace dynamics to support ethical decision-making.</p><p><strong>Conclusions: </strong>This study emphasizes the need for a strategic approach to foster professionalism in dental education, including enhanced professionalism training, promoting professional behavior in dental practice, and potentially revising licensing and oversight frameworks. Future research could examine broader contextual effects, such as regional or cultural influence on professional identity, to develop a more holistic understanding of professionalism in dentistry. These insights can inform dental educators in refining curricula to ensure that dentists provide patient care that adheres to the highest ethical and caring standards.Knowledge Transfer Statement:This study explores how practicing dentists in Canada understand professionalism and form their professional identities, revealing gaps in ethics training, interprofessional collaboration, and workplace support. It highlights a gap in improved professionalism education and institutional oversight. Dental educators, regulators, and policymakers can use these insights to revise dental curricula, ensuring that future dentists are better equipped to navigate ethical challenges and deliver patient-centered care grounded in strong professional values.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"691-702"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth in Children with a Cleft Lip and/or Palate in 8 US Hospitals: A Retrospective Cohort Study.","authors":"C M McKinney, W Howard, K Bijlani, S Kinter, C Crerand, R Dang, O Jackson, C Discolo, M Rosenman, E Mendonca, I Ormanidou, K Dickinson, C L Heike","doi":"10.1177/23800844261423910","DOIUrl":"10.1177/23800844261423910","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate growth patterns in US children with cleft overall and by cleft lip (CL), CL and palate (CLP), and cleft palate (CP) across US children's hospitals from 0 to 18 mo of age.</p><p><strong>Design: </strong>We conducted a retrospective cohort study leveraging medical records from 2009 to 2022 in children with a cleft seen at 8 US children's hospitals.</p><p><strong>Participants: </strong>Individuals with a cleft seen at a PEDSnet consortium hospital.</p><p><strong>Exposure: </strong>We examined growth over time, by cleft type, and across hospitals.</p><p><strong>Main outcomes: </strong>We used electronic health data to generate weight-for-age z scores (WAZ) and length-for-age z scores (LAZ), as well as underweight (WAZ <-2) and stunting (LAZ <-2). We tracked longitudinal growth using generalized linear mixed models to estimate mean WAZ and LAZ from 0 to 18 mo of age. We compared the prevalence of underweight and stunting against World Health Organization growth standards.</p><p><strong>Results: </strong>Our sample included 10,223 children: 19.1% with CL, 31.7% with CLP, and 49.2% with CP. WAZ and LAZ trajectories showed a fast rate of decline in the first 4 mo of life (P < 0.001). Between 6 and 12 mo and between 12 and 18 mo, WAZ showed a significant nonlinear increase in growth (P < 0.01) while LAZ remained unchanged (P > 0.05). All children had a higher prevalence of underweight and stunting relative to World Health Organization growth standards. Underweight and stunting were highest among those with CP, followed by CLP and then CL, and varied across hospitals.</p><p><strong>Conclusions: </strong>Growth trajectories were slower in the first 4 mo of life, followed by rapid catch-up in weight to 12 mo of age. Children with cleft had a high prevalence of underweight and stunting at all ages. Variability across hospitals suggests that care patterns may affect growth. Close growth monitoring in the first 4 mo in children with cleft may be warranted.Knowledge Transfer Statement:US children with a cleft of the lip and/or palate have substantial growth deficits that vary by cleft type, comorbidities, and across hospitals, particularly in the first 4 mo of life.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"638-649"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Dental Care for Children Accessing Early Childhood Intervention: A Qualitative Study.","authors":"T Kangutkar, A N Fernando, O Walsh, M Lim, K Milner, J Thorpe, M Silva","doi":"10.1177/23800844261427424","DOIUrl":"10.1177/23800844261427424","url":null,"abstract":"<p><strong>Introduction: </strong>Children accessing early childhood intervention due to developmental concerns or disability may be less likely to receive regular dental care compared with the general pediatric population. This qualitative study explores the perspectives of parents and carers regarding their children's experiences with dental services.</p><p><strong>Methods: </strong>A qualitative descriptive design was used to study families accessing early childhood intervention services at a community health service in Melbourne, Australia. Convenience and purposive sampling was used to recruit families of children aged 0 to 6 y. Semi-structured interviews were conducted, recorded, and analyzed using thematic analysis to explore perspectives on the oral health needs and experiences of families.</p><p><strong>Results: </strong>Participants included 11 parents of children aged 1.5 to 6.4 y. Parents were primarily mothers, with 1 interview including both parents and another including the father. Three themes were developed regarding child and family experiences, and 3 themes were developed relating to opportunities to improve dental care as part of early childhood intervention.</p><p><strong>Discussion: </strong>This study highlighted the anxiety and distress faced by children with complex needs and their families in the traditional dental environment setting. Sensory sensitivities led to avoidance of dental visits and compromise of oral health status. A holistic preventative approach emphasizing desensitization coupled with improved practitioner training in disability awareness could mitigate anxiety. Systemic barriers, including fragmented health care and inadequate support networks, further impeded access. Reforms prioritizing person-centered care are essential to address these unmet needs.</p><p><strong>Conclusion: </strong>This study highlighted the need for tailored resources, integrated care models, accessible services, sensory-friendly environments, and flexible approaches to dental care to improve oral health outcomes for children accessing early childhood intervention. Future research should explore these issues from the perspective of health care providers and investigate co-designed interventions to address the identified barriers.Knowledge Transfer Statement:The results of this study can be used to inform patient-centered approaches to dental care for children with developmental concerns and/or disability who are accessing early childhood intervention services. The perspectives of families suggest that clinicians, health services, and policymakers all play an important role in improving dental experiences for children and their families.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"666-677"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Inflammatory Clusters in Gingivitis and Periodontitis.","authors":"Y-T Hsu, M Smith, D Daubert, R Koistinen, R P Darveau","doi":"10.1177/23800844251375468","DOIUrl":"10.1177/23800844251375468","url":null,"abstract":"<p><strong>Introduction: </strong>Individual variability determines host responses and disease progression. Inflammatory clusters (ICs) have been shown to influence host responses against bacterial challenges during the induction of human experimental gingivitis.</p><p><strong>Objectives: </strong>This study aimed to evaluate the role of ICs in naturally occurring gingivitis and periodontitis.</p><p><strong>Methods: </strong>Using a cross-sectional and split-mouth design, this study evaluated the immune regulation and tissue-remolding responses in sites with different disease severity of periodontal diseases to provide a comprehensive assessment of disease features on the basis of analyzing gingival crevicular fluids. Cluster analysis was performed based on the clinical indices, including gingival index, plaque index, and probing depth. Further comparisons of the host mediators and clinical indices among clusters based on the disease severity were also performed.</p><p><strong>Results: </strong>A total of 48 patients were recruited in this study, including 24 patients with gingivitis only and 24 patients with stage III grade B generalized periodontitis. Our results demonstrate that 2 distinct ICs were found in the sites with naturally occurring gingivitis: low-ICs had less expression of myeloperoxidase, intercellular adhesion molecule-1, and interleukin-12 as well as greater expression of angiopoietin-1 than high-ICs did. At the sites with generalized severe periodontitis, however, low-ICs had significantly elevated expression of angiopoietin-1, fractalkine, granulocyte-macrophage colony-stimulating factor, matrix metalloproteinase-2, osteopontin, and vascular endothelial growth factor versus high-ICs. Our results for the first time confirmed the influence of ICs in naturally occurring gingivitis, showing that low-ICs displayed minimal inflammation and less neutrophil involvement compared with high-ICs. The influence of ICs in periodontitis was site specific rather than patient specific.</p><p><strong>Conclusion: </strong>Our collective findings highlight the importance of ICs in disease progression, benefiting the modulation of immune responses and preventing further periodontal tissue destruction. By identifying specific ICs, clinicians can better predict disease progression and recurrence, ultimately improving patient outcomes through targeted interventions.Knowledge Transfer Statement:The present study discovered the role of inflammatory clusters (ICs) on the host responses in a cross-sectional setting, including immune regulation and tissue remodeling, during naturally occurring gingivitis, whereas the disease progression to periodontitis seems to be site specific. Low-ICs were more prevalent in the gingivitis-only group compared with the periodontitis group, suggesting that gingivitis sites in periodontitis patients may be at increased risk for disease progression compared with gingivitis sites in gingivitis-only patients.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"617-625"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633724","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":"Osteoporosis Modifies the Association between Breastfeeding and Remaining Teeth in Postmenopausal Women.","authors":"E M Choi","doi":"10.1177/23800844251401117","DOIUrl":"10.1177/23800844251401117","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the association between osteoporosis, cumulative breastfeeding duration, and remaining teeth in postmenopausal women and to investigate whether osteoporosis status modifies the relationship between breastfeeding duration and oral health outcomes.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from 1,788 Korean women aged ≥50 y who participated in the 2010 to 2011 Korea National Health and Nutrition Examination Survey. Complete data were available for participants on breastfeeding duration, bone mineral density, and oral health examinations. Multiple linear regression analysis was used to assess the association between breastfeeding duration and the number of remaining teeth, stratified by osteoporosis status. Interaction analysis was conducted to examine the combined effects of osteoporosis and breastfeeding duration on tooth retention. Analyses were adjusted for potential confounding variables including age, socioeconomic factors, health behaviors, reproductive history, and oral hygiene practices.</p><p><strong>Results: </strong>Among participants, 36.8% (n = 658) had osteoporosis and 63.2% (n = 1,130) had normal bone mineral density. Women with osteoporosis had a significantly longer duration of breastfeeding (6.42 vs 4.09 years) and fewer remaining teeth (20.16 vs 25.42) compared with those with normal bone density. Each additional year of breastfeeding was significantly associated with fewer remaining teeth in both the normal bone density group (β = -0.39, 95% confidence interval [CI]: -0.70 to -0.08, P = 0.015) and the osteoporosis group (β = -0.52, 95% CI: -0.85 to -0.20, P = 0.002). A significant interaction between osteoporosis status and breastfeeding duration was identified (β = -0.34, P < 0.05), indicating a stronger inverse association between breastfeeding duration and remaining teeth in women with osteoporosis.</p><p><strong>Conclusion: </strong>These findings suggest statistical associations between prolonged breastfeeding duration and fewer remaining teeth in postmenopausal women, with stronger associations in those with osteoporosis. The interaction effect indicates that osteoporosis status may modify this relationship, highlighting the potential need for targeted oral health monitoring in this population.Knowledge Transfer Statement:Osteoporosis modifies the association between breastfeeding and remaining teeth in postmenopausal women. Health care providers should monitor oral health in women with osteoporosis and very prolonged breastfeeding histories, although clinical relevance remains limited.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"650-657"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933559","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 the COVID-19 Pandemic on Intersectional Inequities in Unmet Oral Care Needs in Sweden.","authors":"C Anticona, A L Suominen, J L Bastos, P Lif Holgerson, P E Gustafsson","doi":"10.1177/23800844251403963","DOIUrl":"10.1177/23800844251403963","url":null,"abstract":"<p><strong>Introduction: </strong>There are concerns that the COVID-19 pandemic exacerbated oral care inequities globally. In Sweden, declines in oral care utilization, particularly among certain regions and public clinics, suggest disproportionate impacts across population groups. Yet, the effects of the pandemic on oral care equity in Sweden remain unexplored, highlighting a critical gap in evidence to guide ongoing equity initiatives and strengthen future pandemic preparedness.</p><p><strong>Objective: </strong>To examine changes in unmet oral care needs (UOCNs) inequities among Swedish adults before and during the pandemic, following an intersectional approach.</p><p><strong>Methods: </strong>Data came from the 2018 and 2021 waves of a national survey, including 31,493 adults. Single-indicator and intersectional inequities were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy across 48 groups defined by gender, age, education, income, and immigrant status.</p><p><strong>Results: </strong>The prevalence of UOCNs increased during the pandemic. Notable shifts in single-indicator inequities included a decrease among immigrants but an increase among older adults. Modest increases were observed among individuals with low education and low income, while inequities decreased slightly for men and younger adults. The intersectional analysis revealed that inequities increased primarily among socially advantaged older adults, whereas decreases were more evident among immigrants and younger individuals facing other forms of social disadvantage. The discriminatory accuracy of both the single-indicator and intersectional inequities decreased during the pandemic, although intersectional models consistently showed slightly better accuracy.</p><p><strong>Conclusions: </strong>Patterns of UOCNs inequities shifted during the pandemic, with increased intersectional inequities among socially privileged older adults and decreased inequities among immigrants. These findings may reflect Sweden's unique pandemic context, which emphasized individual responsibility over restrictive measures and may have influenced how people approached health-related behaviors, including seeking oral care.Knowledge transference statement:The reconfiguration of inequities in unmet oral care needs during the pandemic might be explained by the unique response in Sweden, which adopted less restrictive measures. These findings highlight the importance of tailoring future pandemic strategies to ensure equitable oral care access, that is, targeted interventions addressing the needs and challenges of both medically vulnerable populations, such as the elderly, and socially marginalized groups, such as immigrants facing structural disadvantages.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"583-592"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}