Journal of Clinical and Experimental Dentistry最新文献

{"title":"Electromyography-guided percutaneous needle electrolysis for masticatory myofascial pain: A prospective clinical study.","authors":"Luis Miguel Gonzalez-Perez, Ramon Vera-Martin, Jose Francisco Montes-Carmona, Enrique Montes-Latorre, Pedro Infante-Cossio","doi":"10.4317/jced.64550","DOIUrl":"10.4317/jced.64550","url":null,"abstract":"<p><strong>Background: </strong>Masticatory myofascial pain syndrome (MMPS) is characterized by the presence of trigger points (TrPs) in the masticatory musculature. Percutaneous needle electrolysis (PNE) is a minimally invasive technique with proven efficacy in tendinopathies, although its application in the temporomandibular region is limited. The objective was to evaluate the clinical effectiveness of a single session of electromyography (EMG)-guided PNE on pain, function, and mandibular mobility in patients with MMPS.</p><p><strong>Materials and methods: </strong>A prospective clinical study was designed involving 26 patients diagnosed with MMPS with active TrPs (80.8% women). A single session of PNE was administered to the masticatory musculature under EMG monitoring. Pain intensity (visual analogue scale), mandibular mobility (maximum interincisal opening, lateral and protrusive excursions), and temporomandibular joint (TMJ) function were evaluated using a validated questionnaire. Measurements were obtained at baseline and at 7, 30, 90, and 180 days post-treatment. Non-parametric tests were performed for statistical analysis.</p><p><strong>Results: </strong>A statistically significant reduction in pain intensity was observed from the first week post-intervention (VAS score: 6.64 vs. 2.76; p<0.001), which remained sustained throughout the 6-month follow-up. The global functional assessment of the TMJ and all ranges of mandibular mobility showed significant early increases (day 7), which remained unaltered and clinically meaningful until the end of the study. Mild and self-limiting adverse effects were experienced by 11.5% of the patients.</p><p><strong>Conclusions: </strong>A single session of EMG-guided PNE constitutes a useful therapeutic alternative for the management of MMPS, as it provides early and sustained pain reduction, along with a significant restoration of mandibular dynamics and function. Controlled comparative studies are needed before its efficacy can be definitively established.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 9","pages":"e1148-e1155"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220482","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":"Intracanal adaptation and bond strength assessment of novel liquid/powder calcium silicate-based root canal sealer.","authors":"Reem Abdelgawad, Kawthar Bukhari","doi":"10.4317/jced.64109","DOIUrl":"10.4317/jced.64109","url":null,"abstract":"<p><strong>Background: </strong>Awareness about the vital role the root canal sealer plays in acquiring a three-dimensional seal necessitates continual work to develop a material that encompasses the intended physical, chemical, and biological properties. Therefore, the present study was designed to assess the sealing ability of MTApex powder/liquid and TotalFill ready-to-use calcium silicate-based formulas via measuring their adaptation and bond strength to the root canal wall. The potentiality of root canal sealer to adapt and bond with dentin wall is a suggestive caliber for obturation quality assessment. Calcium silicate-based root canal sealers gained broad acceptance due to their distinctive properties and clinical performance. MTApex is a novel calcium silicate-based root canal sealer in powder/water-based gel liquid component, which is claimed to show improved performance.</p><p><strong>Materials and methods: </strong>Thirty extracted teeth were assigned for the study. After chemomechanical preparation, the samples were separated into group I that used (TotalFill BC), and group II that utilized (MTApex) for obturation with F3 gutta-percha matching cone. Moreover, three sections of 2mm thickness were provided from each sample; and each section was assessed by Scanning Electron Microscope and Universal Testing Machine for sealer adaptation and push-out bond strength assessment, respectively. Inter-group statistically significant difference was detected via using Mann-Whitney U test, while intra-group statistical analysis was performed using Kruskal-Wallis test. Then, pairwise comparisons were done using Mann-Whitney U test with Bonferroni correction, which detected significant differences (P≤0.05).</p><p><strong>Results: </strong>Statistically, the lowest gap diameter and the highest push-out bond strength records were reported by TotalFill root canal sealer, compared to MTApex, concerning the three root sections. The coronal root section revealed lower gap diameters and higher push-out bond strength record; this is in comparison to the other sections (P≤0.05).</p><p><strong>Conclusions: </strong>MTApex demonstrated adaptation and bond strength lower than that of TotalFill. Nevertheless, inconsistent adaptation and bond strength were reported regarding the different assessed sections, where a high level of adaptation and bond strength was detected in the coronal section, middle section, and apical section, respectively.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 9","pages":"e1046-e1051"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220441","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":"Osteocalcin and C-terminal telopeptide of type I collagen in serum and saliva: A cross-sectional pilot study on correlations and implications for MRONJ risk stratification in women on antiresorptive medications.","authors":"Chitsanupong Puntrakul, Nakarin Kitkumthorn, Puangwan Lapthanasupkul, Constantin Landes, Chakorn Vorakulpipat","doi":"10.4317/jced.64415","DOIUrl":"10.4317/jced.64415","url":null,"abstract":"<p><strong>Background: </strong>Medication-related osteonecrosis of the jaw (MRONJ) lacks reliable biomarkers for early detection in patients receiving antiresorptive therapy. The objective is to evaluate serum and salivary C-terminal telopeptide of type I collagen (CTX) and osteocalcin (OC) as tools to differentiate healthy controls, MRONJ at-risk patients, and those with MRONJ clinically present.</p><p><strong>Materials and methods: </strong>Cross-sectional pilot study of 30 females categorized into controls (n=10), MRONJ at-risk (n=9), and MRONJ clinically present (n=11). Serum and unstimulated saliva were analyzed by ELISA. Statistical analyses included ANCOVA with age as covariate, Dunn post-hoc test with Bonferroni correction, and bootstrapped ROC curves (1,000 iterations).</p><p><strong>Results: </strong>After age adjustment, serum OC was a significant independent predictor of group status (p=0.002), as was salivary OC (p=0.045). Post-hoc analysis showed serum OC was significantly higher in the MRONJ at-risk group versus controls (Bonferroni-adjusted p=0.030) and MRONJ clinically present (adj p=0.012). Serum CTX did not reach significance after Bonferroni correction (p=0.183). Serum OC achieved the highest discriminatory performance (AUC=0.88, 95% CI: 0.70-1.00; 100% sensitivity at <4,801 pg/mL). No significant associations were found between biomarkers and medication duration or trigger type.</p><p><strong>Conclusions: </strong>Serum OC is a promising adjunctive biomarker for MRONJ risk stratification, maintaining diagnostic significance after age adjustment. Serum-salivary correlations suggest noninvasive monitoring potential, though serum remains the more reliable measurement medium. While the proposed cutoff (<4,801 pg/mL) serves as a valuable preliminary reference, it remains exploratory and warrants external validation in larger prospective cohorts prior to clinical application.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 9","pages":"e1130-e1141"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220150","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":"Effect of different splinting configurations on the accuracy of complete-arch digital implant impressions: An in vitro study.","authors":"Simge Öner-Gedik, Helin Yolcu, Pınar Türkoğlu, Ali Murat Kökat","doi":"10.4317/jced.64318","DOIUrl":"10.4317/jced.64318","url":null,"abstract":"<p><strong>Background: </strong>This in vitro study aimed to investigate the effect of different splinting configurations on the accuracy of digital impressions in fully edentulous arches.</p><p><strong>Materials and methods: </strong>Five configurations were tested on an edentulous maxillary phantom model containing six parallel implant analogs: G1: Non-splinted control, G2: Bilateral posterior splint, G3: Anterior splinted/posterior unsplinted, G4: Segmental independent splinting, and G5: Cross-arch. Ten scans were obtained per group; reference data were acquired using a high-accuracy industrial scanner (Solutionix C500). Point-based RMS (Root Mean Square), surface RMS, and angular deviation (ΔAngle) were calculated using Geomagic Control X. ART ANOVA and one-way ANOVA with Bonferroni-corrected post-hoc tests were applied (α=0.05).</p><p><strong>Results: </strong>Significant differences among groups were detected for all parameters (p<0.001). In surface RMS, G5 exhibited the lowest deviation (0.62 ± 0.15 mm) and G2 the highest (1.27 ± 0.10 mm) (ηp²=0.793). In point-based RMS, G4 showed significantly higher deviation compared to G2, G3, and G5 (0.05 vs. 0.02-0.04mm). Regarding angular deviation, G2 showed the highest and G5 the lowest values (0.26° vs. 0.16°); the anterior and premolar regions demonstrated significantly higher angular deviation than the molar region (0.29-0.34° vs. 0.14°).</p><p><strong>Conclusions: </strong>The effect of splinting on scanning accuracy was found to be parameter-dependent; G5 was superior in surface RMS and angular deviation, yet no configuration achieved consistent superiority across all parameters. The anterior-premolar region was identified as the highest-risk area for accuracy across all configurations, exhibiting the greatest angular deviation values.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 9","pages":"e1095-e1102"},"PeriodicalIF":0.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220457","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":"Puberty-Associated Gingival Enlargement Exacerbated by Polycystic Ovary Syndrome: A Case Report.","authors":"Nipun Dhalla, Lipika Gopal, Garima Asthana, Vinanti Rekhan, Pragya Goyal, Ruchi Pandey","doi":"10.4317/jced.64044","DOIUrl":"10.4317/jced.64044","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting reproductive-aged women, characterised by metabolic abnormalities, polycystic ovaries, hyperandrogenism, and chronic anovulation. This pathology has been attributed to hormonal imbalances, including elevated levels of insulin, growth hormone (GH), ghrelin, LEAP-2, GnRH, LH/FSH ratio (>2:1), androgenic hormones, and estrogen. While puberty-associated gingival enlargement is primarily triggered by dental plaque, systemic hormonal fluctuations can significantly exacerbate the tissue response.</p><p><strong>Case presentation: </strong>A 17-year-old female presented with spontaneous gingival bleeding and generalized gingival overgrowth persisting for one year. Clinical examination revealed fair oral hygiene and extensive inflammatory swelling of the marginal, interdental, and attached gingiva with bleeding upon probing, but no evident bone loss. Medical evaluation confirmed PCOS based on irregular menses, weight gain, acne, elevated serum testosterone, an increased LH/FSH ratio, hyperinsulinemia, and polycystic ovarian morphology. Initial management consisted of non-surgical periodontal therapy, including scaling, root planing, and oral hygiene instructions combined with gynaecological care for PCOS, which successfully reduced acute inflammation. Residual fibrotic enlargement was subsequently treated via surgical gingivectomy and gingivoplasty. Postoperative healing was uneventful, yielding satisfactory functional, aesthetic, and periodontal outcomes.</p><p><strong>Conclusions: </strong>This case highlights that PCOS may contribute to or exacerbate gingival enlargement through hormonal and inflammatory alterations rather than being a direct etiological factor. Early interdisciplinary diagnosis and co-management between dental and medical professionals are crucial for optimizing both periodontal and systemic health outcomes in adolescent patients.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e968-e973"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654011","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":"Accuracy of the Emergence Profile of Dental Implant Restorations using different gingival mask techniques.","authors":"Firas Abdulameer Farhan, Ali Jameel Abdul Sahib, Mustafa Mahdi Jassim, Bayan Saleem Khalaf, Abdalbseet Ahmad Fatalla","doi":"10.4317/jced.64279","DOIUrl":"10.4317/jced.64279","url":null,"abstract":"<p><strong>Background: </strong>Accurate reproduction of peri-implant soft tissue contours is essential for the esthetics, phonetics, hygiene, and long-term success of implant-supported restorations. Gingival mask (GM) techniques play an important role in reproducing the emergence profile (EP) and peri-implant soft tissue contour. This study evaluated and compared the accuracy of crown adaptation using conventional, 3D-printed, and digital GM workflows.</p><p><strong>Materials and methods: </strong>Forty zirconia crowns were fabricated on implant standard abutments with a straight EP using a maxillary master model obtained from a patient missing left maxillary first molar. A single implant was placed using a guided surgical protocol and cone beam computed tomography. The crowns were divided into four groups (n=10) according to the GM technique: conventional, 3D-printed, adapted digital (DI-1), and non-adapted digital (DI-2). Crown adaptation and gap dimensions were evaluated using the digital subtraction method and a high-resolution desktop optical scanner. Scanning was performed for the abutment, internal crown surface, and the seated crown-abutment assembly. Measurements were obtained at buccal (B), palatal (P), mesial (M), and distal (D) points. Statistical analysis included Levene's test, one-way ANOVA, and Tukey's and Games-Howell post hoc tests (P 0.05).</p><p><strong>Results: </strong>The adapted digital GM group showed the lowest mean gap values at all measurement points, indicating superior adaptation accuracy, whereas the 3D-printed GM group showed the highest gap values. One-way ANOVA revealed significant differences among all GM groups at all measurement points (P=0.001). Post hoc analysis showed significant differences among most groups; however, no significant differences were found between the conventional and 3D-printed GM groups at point B or between the conventional and DI-2 groups at points P, M and D.</p><p><strong>Conclusions: </strong>GM techniques significantly influenced the accuracy of implant-supported restorations. The adapted digital GM workflow demonstrated superior adaptation and more accurate reproduction of peri-implant tissue contours and emergence profiles compared with the other techniques.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e1006-e1014"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653965","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":"Periodontal Involvement in Autoimmune Blistering Diseases: A Narrative Review.","authors":"Teresita Sarquis, Constanza Jiménez, Sven Niklander, Javier Fernández, Fernando Valenzuela, Alejandra Fernández","doi":"10.4317/jced.64082","DOIUrl":"10.4317/jced.64082","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune blistering diseases (AIBDs) are characterized by autoantibody-mediated epithelial damage affecting the skin and mucous membranes. Among them, pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) frequently involve the gingiva, most commonly presenting as desquamative gingivitis (DG). This chronic and painful gingival involvement may compromise oral hygiene and favor secondary inflammatory changes. Consequently, growing interest has focused on the periodontal status of patients with AIBDs and on associated oral microbiological findings.</p><p><strong>Materials and methods: </strong>A narrative review was conducted using PubMed and Scopus to identify primary studies evaluating periodontal status in patients with AIBDs. Periodontal conditions were mainly assessed using conventional clinical parameters, including probing depth and clinical attachment loss, along with additional periodontal and oral hygiene indices.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria. Most of them reported significantly worse periodontal status in AIBD compared to controls or DG-unaffected sites. In MMP, disease activity, duration, and DG involvement were associated with poorer periodontal parameters. Notably, adjusting for oral hygiene, as performed in only one study, rendered differences in PD and CAL non-significant, suggesting a potential confounding effect. However, the available evidence remains insufficient to support an independent link with clinically defined periodontitis. Only one study applied the 2017 World Workshop periodontitis classification, with similar conclusions. Microbiological data, limited to three MMP studies with heterogeneous methodologies, frequently detect periodontal pathogens associated with inflammatory tissue damage.</p><p><strong>Conclusions: </strong>Patients with AIBD tend to present worse periodontal status, likely due to pain limited oral hygiene and dysbiotic biofilms. These pathogens may amplify inflammation and perpetuate tissue destruction. Nevertheless, microbial profiles appear dynamic and influenced by disease activity and treatment. Recognizing this association is essential for early diagnosis and interdisciplinary management.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e940-e951"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653960","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":"In vitro evaluation of the microhardness of conventional and bulk-fill resins based on the depth of light-curing and the curing unit.","authors":"Vanessa Verónica Sara García-Mendoza, Rosa Josefina Roncal-Espinoza","doi":"10.4317/jced.64256","DOIUrl":"10.4317/jced.64256","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the microhardness of conventional and bulk-fill composite resins based on the depth of light-curing (2 mm and 4 mm) and the curing unit used (VALO Grand and BluePhase N G4 lamp).</p><p><strong>Material and methods: </strong>Discs were fabricated using two bulk-fill resins: Beautifil Bulk (BB) and Filtek Bulk Fill (ZB); and two conventional resins: Beautiful II (BC) and Filtek Z350 XT (ZC). For the preparation, the light-curing depth was set at 2 and 4 mm, and the curing units used were VALO Grand and BluePhase N G4. Microhardness was measured using the Vickers test on light-cured samples under standardized conditions. Statistical analysis was performed using ANOVA and the Tukey test (p < 0.05).</p><p><strong>Results: </strong>Significant differences were found between the groups, with the BB 4mm Valo group exhibiting the lowest microhardness values and significant differences compared to the others. Meanwhile, the 4 mm Bluephase ZC resin exhibited the highest microhardness values compared to the bulk-fill resin. At a thickness of 2 mm, the conventional resins showed similar values regardless of the polymerization source, except for BB, which performed better with the Valo unit. In addition, Valo demonstrated good performance with ZC at both thicknesses and results comparable to Beautifil II at 2 mm. Bluephase showed consistent values across all groups and depths, with superior performance when applied over ZC.</p><p><strong>Conclusions: </strong>The results showed that the final microhardness of the restorative material is influenced by a combination of resin type, depth, and light-curing unit; the conventional composite resin that exhibited the highest microhardness values was ZC, light-cured using a Bluephase light source at a thickness of 4 mm, compared to the bulk-fill resin.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e1015-e1020"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653941","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 Independent and Combined Associations of Multimorbidity and Polypharmacy on Periodontal Disease Severity and Progression in Older Adults.","authors":"Georgios S Chatzopoulos, Larry F Wolff","doi":"10.4317/jced.64297","DOIUrl":"10.4317/jced.64297","url":null,"abstract":"<p><strong>Background: </strong>The aging global population is characterized by a high prevalence of multimorbidity and polypharmacy. This study aimed to investigate the independent and combined associations of these factors on the severity and progression of periodontal disease in older adults and to develop a predictive machine learning model for clinically meaningful disease progression.</p><p><strong>Materials and methods: </strong>This retrospective cohort study utilized de-identified electronic health records from patients aged 65 and older with periodontitis. The primary independent variables were polypharmacy (categorized as 0-4, 5-9, or 10+ medications) and a multimorbidity index (a sum of self-reported systemic conditions). The outcome variables were baseline mean clinical attachment level (MEAN_CAL) and the annualized rate of MEAN_CAL progression. Multivariable linear regression models were used to assess associations, and a Random Forest Classifier was developed to predict clinically relevant disease progression (CAL 1mm).</p><p><strong>Results: </strong>The study included 5,645 patients for cross-sectional analysis and a sub-cohort of 2,130 for longitudinal analysis. Both polypharmacy (5-9 medications: 0.18 mm; 10+ medications: 0.29 mm) and each additional systemic disease (0.09 mm) were significantly associated with higher baseline MEAN_CAL (p < 0.001). Longitudinally, hyperpolypharmacy (10+ medications) and each additional comorbidity were associated with an annual CAL loss of 0.08 mm (p = 0.002) and 0.03 mm (p = 0.001), respectively. The machine learning model predicted disease progression with an AUC-ROC of 0.81, 94% specificity, and 61% recall. Baseline MEAN_CAL, smoking, age, bleeding on probing, diabetes, and the number of medications were the most important predictors.</p><p><strong>Conclusions: </strong>Multimorbidity and polypharmacy are significant and clinically relevant independent predictors of more severe periodontal disease and faster progression in older adults. Predictive modeling can help identify high-risk individuals, emphasizing the need for integrated medical-dental care for this population.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e982-e989"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653631","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":"Improvement in Quality of Life Using an Ethylene-Vinyl Acetate Palatal Obturator in a Patient with Self-Inflicted Nasal Defect and Palatal Perforation.","authors":"Naohiro Horie, Kaoru Kusano, Kenji Yokozeki, Kazumi Osada, Hiroki Nagayasu, Tsuyoshi Shimo, Masaru Murata","doi":"10.4317/jced.64151","DOIUrl":"10.4317/jced.64151","url":null,"abstract":"<p><p>A 67-year-old female patient with intellectual disability presented with a self-inflicted nasal defect and palatal perforation. In 2006, she was referred to our department by a nurse from her care facility with the chief complaint of food leakage into the nasal cavity due to the palatal perforation. Her medical history revealed a long-standing habit of scratching the nasal cavity, which had persisted for more than 30 years since approximately 27 years of age. Clinical and radiographic examinations, including three-dimensional computed tomography (3D-CT), demonstrated a nasal defect, crust formation around the nasal region, a perforation in the central palate (approximately 3 × 4 mm), and a palatal bone defect (approximately 28 × 24 mm). We selected a conservative approach using a soft palatal obturator made of ethylene-vinyl acetate (thickness: 3.0 mm) instead of surgical closure. In 2007, after several sessions of assisted feeding training with verbal encouragement, the patient accepted the use of the obturator. Although enlargement of the perforation (approximately 12 × 9 mm) was observed in 2018, her body weight increased by 4.0 kg and body mass index (BMI) improved by 3.1 compared with baseline values in 2006. In addition, no hospitalization due to aspiration pneumonia or other systemic complications occurred during the approximately 18-year follow-up period. The patient died at the age of 84 in 2024. The long-term use of a palatal obturator in a care facility setting may have contributed to improved nutritional status and reduced self-injurious behavior.</p>","PeriodicalId":15376,"journal":{"name":"Journal of Clinical and Experimental Dentistry","volume":"18 8","pages":"e934-e939"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653919","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}