Journal of Dental Research最新文献

{"title":"Randomized Clinical Trial on Caries Prevention of Silver Diamine Fluoride.","authors":"F M Zheng,I G Yan,D Duangthip,E C M Lo,S S Gao,C H Chu","doi":"10.1177/00220345251363837","DOIUrl":"https://doi.org/10.1177/00220345251363837","url":null,"abstract":"This 30-mo double-blind randomized clinical superiority trial aimed to assess the effectiveness of semiannual application of 38% silver diamine fluoride (SDF) solution in preventing early childhood caries in primary upper anterior teeth. The active comparator was 5% sodium fluoride varnish (FV). The primary outcome was the mean number of new carious tooth surfaces per child at the 30-mo follow-up. Children aged 3 to 4 y were block randomized to receive semiannual application of SDF or FV on their primary upper anterior teeth over a 30-mo period in kindergarten. Parents completed a validated questionnaire to collect information on child oral health-related behaviors and sociodemographic characteristics. In an intention-to-treat analysis, multilevel logistic regression with a generalized estimating equation (GEE) model was performed. At baseline, 730 children with 17,480 sound tooth surfaces were recruited (SDF group, n = 365 children with 8,732 sound tooth surfaces). At the 30-mo examination, 621 children remained (loss to follow-up, 15%; SDF group, n = 307 children with 7,368 tooth surfaces; FV group, n = 314 children with 7,536 tooth surfaces). At the child level, the distribution of new carious tooth surfaces for SDF (mean ± SD, 0.35 ± 1.09) was different from FV (0.54 ± 1.50; Mann-Whitney U test, P = 0.048). At the tooth surface level, GEE analysis showed that tooth surface type influenced new carious tooth surface development, and the caries risk of the SDF group was less than that of the FV group (adjusted odd ratio, 0.61; P = 0.029). In conclusion, semiannual application of SDF is more effective than FV in preventing caries in primary upper anterior teeth for proximal and smooth tooth surfaces (ClinicalTrials.gov NCT04075474).","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"32 1","pages":"220345251363837"},"PeriodicalIF":7.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Adversity Is Causally Linked to Multimorbidity Including Oral Conditions","authors":"A.O. Esemezie, D.J. Lizotte, G. Tsakos, N. Gomaa","doi":"10.1177/00220345251362201","DOIUrl":"https://doi.org/10.1177/00220345251362201","url":null,"abstract":"The fundamental cause theory posits social factors as causes of disease as they encompass access to important resources such as knowledge, wealth, and social networks. While these social factors have been consistently associated with oral and systemic diseases, causality remains unestablished. Here, we estimated the causal effect of social adversity, comprising low economic and social capital, on the development of (1) oral conditions (OC) and (2) multimorbidity including oral conditions (MIOC) in a cohort of middle-aged and older adults over a 7-y period and assessed whether effects varied by age or gender. We analyzed 2 waves from the Canadian Longitudinal Study on Aging (CLSA) (2011 and 2018). Social adversity comprised low economic (income) and social capital (community participation, social relationships). OC was defined as having 1 or more of poor self-reported oral health, lack of functional dentition (<20 natural teeth), or edentulism. Participants with an OC at baseline were excluded. MIOC was defined as having 2 or more chronic diseases and an OC. Logistic marginal structural models with inverse probability weighting estimated the causal odds ratio (OR) of developing both outcomes, controlling for sociodemographic and behavioral factors. In a total of 23,366 participants, 14% experienced social adversity at baseline, with a prevalence of 17% OC and 7% MIOC at follow-up. Social adversity significantly increased the odds of developing OC (OR = 1.9, 95% confidence interval [CI] 1.7, 2.2) and MIOC (OR = 1.7, 95% CI 1.5, 2.0) at follow-up. The observed effects were strongest in the middle-aged group, with similar odds observed in both men and women. Our findings indicate that social and economic capital are causally linked to the development of OC and MIOC over time. We suggest that policies for healthy aging should prioritize action on social and living conditions.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"16 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mandibular Advancement Device versus CPAP in Severe Obstructive Sleep Apnea","authors":"J.T. Colpani, Y.-H. Ou, A.M. Kosasih, F.K.F. Lee, S.-P. Chan, H.H. Tan, R.C.W. Wong, C.W. Chin, P.A. Cistulli, C.-H. Lee","doi":"10.1177/00220345251361796","DOIUrl":"https://doi.org/10.1177/00220345251361796","url":null,"abstract":"Severe obstructive sleep apnea (OSA) is linked to adverse cardiovascular outcomes. While continuous positive airway pressure (CPAP) is the standard treatment, mandibular advancement devices (MADs) offer an alternative. This substudy of a randomized trial compared the effectiveness of MADs versus CPAP on 24-h ambulatory blood pressure (BP), sleep-related quality of life, myocardial remodeling, ambulatory heart rhythm, and biomarkers in severe OSA. A total of 144 participants were randomized to MAD ( <jats:italic>n</jats:italic> = 73) or CPAP ( <jats:italic>n</jats:italic> = 71) for 12 mo. Median nightly usage was 5.4 (2.9–6.5) h for the MAD group (≥6 h/night: 56.1%) and 4.9 (4.0–6.0) h for the CPAP group (≥6 h/night: 28.3%). The apnea-hypopnea index at baseline and 6 mo was 44.0 (37.6–59.2) and 20.9 (11.7–31.9) events/h in the MAD group and 50.7 (40.7–59.8) and 2.1 (1.2–3.4) events/h in the CPAP group, respectively. MAD treatment reduced asleep mean BP (−4.7 mm Hg, 95% confidence interval [CI]: −8.3 to −4.0, <jats:italic>P</jats:italic> = 0.015), asleep systolic BP (−2.0 mm Hg, 95% CI: −10.0 to −4.0, <jats:italic>P</jats:italic> = 0.047), and asleep diastolic BP (−4.0 mm Hg, 95% CI: −9.0 to −3.0, <jats:italic>P</jats:italic> = 0.007), whereas CPAP showed no significant changes. The between-group differences favored MAD in asleep mean BP (−3.70 mm Hg, 95% CI: −7.40 to 0.00, <jats:italic>P</jats:italic> = 0.050) and asleep systolic BP (−4.78 mm Hg, 95% CI: −9.51 to 0.04, <jats:italic>P</jats:italic> = 0.048). Both improved sleep-related quality of life, although CPAP had a slightly greater effect on the Epworth Sleepiness Scale (Δ1.63, 95% CI: 0.45 to 2.81, <jats:italic>P</jats:italic> = 0.007). No significant changes were observed in cardiac magnetic resonance imaging parameters, ambulatory heart rhythm, or biomarkers. Adverse effects included jaw pain (14.8%) and teeth discomfort (8.2%) with MAD, whereas CPAP users reported dry mouth (50.8%), nasal congestion (23.0%), and air leakage (29.5%). In conclusion, these findings suggested MAD could be an acceptable and effective treatment for patients with severe OSA and hypertension. The study was registered at Clinicaltrials.gov (NCT04119999).","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"106 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanobiology of Collagen Synthesis, Assembly, and Mineralization","authors":"S. Wang, F. Song, S. Liang, C. Huang, H. Yang","doi":"10.1177/00220345251361795","DOIUrl":"https://doi.org/10.1177/00220345251361795","url":null,"abstract":"Mineralized collagen fibrils constitute the fundamental structural units within collagenous mineralized tissues (CMTs), particularly in bone and dentin, where they play a critical role in maintaining mechanical resilience and structural integrity. The mechanical microenvironment of CMTs is dynamically shaped by diverse physiologic loads from muscle contraction, body support, vascular system pressure, orthodontic movement, and mastication. While many reviews have covered cellular responses to mechanical stimuli, they often focus on cell differentiation at the generalized cellular level and lack a microscopic and dynamic perspective on mineralized collagen formation. There is an urgent need to review the behavior of collagen fibrils as primary effectors in response to mechanical stimuli. On the basis of compartmental changes and structural evolution, herein we analyze the effects of mechanical stimuli on mineralized collagen formation through 3 distinct stages: 1) intracellular collagen synthesis, where mechanical stimuli can regulate intracellular collagen synthesis at the gene level; 2) extracellular collagen assembly, where appropriate mechanical stimuli can induce orderly collagen fibril arrangement; and 3) intrafibrillar collagen mineralization, where mechanical stimuli can facilitate effective intrafibrillar mineralization. In this review, we trace the mechanobiological journey of mineralized collagen, showcase the latest research advancements in this field, and propose future perspectives. This review may aid in developing novel therapeutic strategies to improve CMT homeostasis and draw attention to the application of biomimetic mechanical microenvironments in tissue engineering.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"83 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing Dentin Multiscale Structures Using High-Resolution Transmission Electron Microscopy","authors":"M. Leclercq, M. Vallet, T. Reiss, A. Berdal, E. Vennat","doi":"10.1177/00220345251361912","DOIUrl":"https://doi.org/10.1177/00220345251361912","url":null,"abstract":"Like bone, dentin exhibits a complex multiscale hierarchical structure. Dentin microstructure has been widely studied at the microscale, using direct 2-dimensional observation techniques such as optical and scanning electron microscopy. Its porous network microstructure has been recently revealed in 3 dimensions using confocal laser scanning microscopy. However, at the nanoscale, the organization of collagen fibrils (CFs) and mineral crystals in the dentinal tissue remains unclear. This study uses high-resolution transmission electron microscopy (TEM) and selected area electron diffraction to analyze the dentin nanostructure. Two areas are discussed, one near the dentin–enamel junction (DEJ) and the other in the middle dentin. Special attention is paid to the TEM section orientation to the tubule axis for discussing the CF orientation and crystal shapes. The study concludes with the following outcomes: (1) the entanglement of CFs and hydroxyapatite minerals is revealed as a woven structure with various degrees of isotropy from the middle dentin to the sub-DEJ zone, (2) individual HAP crystals are elongated along their 3 crystal directions (a, b, and c axes) and assembled to create S-shaped structures around adjacent CFs, and (3) the yet-unknown transition zone between peritubular dentin and intertubular dentin (ITD) comprises CFs parallel to the tubule axis, which could explain the crack propagation from the tubules to the ITD. This study proposes a protocol for selecting and collecting a TEM dentin sample at a specific depth and orientation. This method enables the investigation of mineral/organic entanglement in dentin at various locations within the same tooth, paving the way for a better understanding of structural gradients and the structure–properties relationship of the dentinal tissue.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"35 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Frailty as a Predictor for Weight Loss in Older Japanese: A Cohort Study.","authors":"K Wang,Y Matsuyama,S Kiuchi,T Kusama,J Aida","doi":"10.1177/00220345251356437","DOIUrl":"https://doi.org/10.1177/00220345251356437","url":null,"abstract":"Oral frailty is a key factor in maintaining nutritional status, yet its impact on weight loss remains unclear. This study aimed to (1) evaluate the longitudinal association between oral frailty and the onset of weight loss among independent older adults and (2) explore how oral frailty components contribute to this association. Data were sourced from 2016 to 2022 of the Japan Gerontological Evaluation Study (JAGES). As a 6-y follow-up cohort study, the onset of >10% weight loss was used as the dependent variable, reflecting the significant threshold for older adults at ≥6-mo follow-up. Oral frailty was assessed as independent variables in 4 ways: (a) count score (sum of 5 components: fewer teeth, chewing difficulty, swallowing difficulty, dry mouth, and pronunciation difficulty), (b) individual 5 components, (c) a latent variable structured from 5 components, and (d) a refined latent variable incorporating additional paths from fewer teeth to chewing difficulty and pronunciation difficulty. Structural equation models (SEMs) were applied to examine the effect of oral frailty on weight loss, estimating standardized coefficients (SCs) and 95% confidence intervals (CIs). The construct validity of oral frailty was assessed using confirmatory factor analysis within the SEM framework. Model fit was evaluated using the standardized root mean squared residual (SRMR) and coefficient of determination (CD). Among 3,305 participants (47.4% women; mean age at baseline: 72.0 ± 4.9 y), 8.9% experienced >10% weight loss. Model d, which incorporated a refined latent structure of oral frailty, demonstrated the strongest association with weight loss (SC = 0.09; 95% confidence interval [CI] = 0.01; 0.16) among all models, with chewing difficulty showing the highest standardized factor loading (0.45; 95% CI = 0.35; 0.55). Model d also showed the best model fit (SRMR = 0.013; CD = 0.217), providing the high explanatory power and appropriateness of this model. Oral frailty significantly increases the risk of weight loss among independent older adults and its components have interrelationships.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"9 1","pages":"220345251356437"},"PeriodicalIF":7.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Fluoride in Preventing Occlusal Caries in Children in a Fluoridated Area: A Randomized Clinical Trial.","authors":"S He,D Duangthip,C H Chu,E C M Lo","doi":"10.1177/00220345251355260","DOIUrl":"https://doi.org/10.1177/00220345251355260","url":null,"abstract":"This study aimed to investigate the effectiveness of the semi-annual application of 38% silver diamine fluoride (SDF) and that of 5% sodium fluoride (NaF) varnish in preventing occlusal cavitated caries in the primary molars of preschool children over a 30-mo period. This was a parallel 3-arm, double-blind, randomized controlled trial. Generally healthy children around 3 y old were randomly allocated to 1 of the 3 study groups: group 1: 38% SDF solution; group 2: 5% NaF varnish; and group 3: tonic water (placebo). The noncavitated occlusal surfaces of all primary molars received semi-annual topical application of the agent according to group assignment. The outcome was caries development at the cavitation level. An intention-to-treat analysis was adopted. A generalized estimating equation and a multilevel grouped proportional hazards model were used to evaluate the differences in caries development rates at the tooth level. A total of 791 children with 5,909 primary molars were included. At the 30-mo follow-up, the caries incidence rates were 25.5%, 24.4%, and 30.1% at the child level and 7.5%, 7.6%, and 9.1% at the tooth level in groups 1, 2, and 3, respectively. The odds of having cavitated caries in the study primary molars in both the SDF and NaF groups were significantly lower than that of the placebo group (aORSDF = 0.67, aORNaF = 0.58, P = 0.027). The effectiveness of SDF and NaF varnish in preventing occlusal cavitated caries was not significantly different (hazard ratio = 0.97, 95% credible interval = 0.57, 1.63). Baseline oral hygiene status, caries experience, occlusal surface status, tooth type and location, and snack-taking frequency significantly influenced the incidence of occlusal caries. Compared with placebo control, both semi-annual application of 38% SDF and semi-annual application of 5% NaF varnish are effective in preventing occlusal cavitated caries in primary molars, and their effectiveness is not significantly different.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"9 1","pages":"220345251355260"},"PeriodicalIF":7.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canonical and Noncanonical WNT-Loaded Hydrogel for Dentin-Pulp Regeneration.","authors":"I J de Souza Araújo,R S Perkins,W Zhang,S A Krum,G T-J Huang","doi":"10.1177/00220345251357588","DOIUrl":"https://doi.org/10.1177/00220345251357588","url":null,"abstract":"Canonical and noncanonical WNT signaling pathways are tissue specific and play roles in mineralized tissue development and repair. Here we characterize the activity of noncanonical WNT5B and canonical WNT10B in dental pulp stem cells (DPSCs) in osteo-/odontogenesis and target dentin-pulp complex regeneration using rWNT-loaded hydrogels. DPSCs in monolayers were treated with recombinant WNT10B (rWNT10B, 50 ng/mL), rWNT5B (50 ng/mL), or the canonical WNT pan-activator CHIR 99021 (10 nM). Gene expression of osteo-/odontogenic markers and Alizarin Red assay were performed. Collagen-based hydrogels were prepared from bovine type I collagen and loaded with rWNT10B, rWNT5B, or CHIR. A control group with no treatment was included. WNT release from hydrogels in phosphate-buffered saline was performed up to 14 d. The DPSC response to hydrogels was characterized by viability, morphology, gene expression, and alkaline phosphatase (ALP) activity. In vivo investigation was conducted using an ectopic model of pulp exposure in human tooth fragments implanted in mice for 4 wk. Hematoxylin and eosin, trichrome staining, and immunohistochemistry were performed. Statistical analysis was performed using analysis of variance and Tukey post hoc (α = 0.05). Our in vitro studies showed that rWNT5B significantly upregulated ALP, RUNX2, and DMP1 after 7 d. rWNTs and CHIR significantly enhanced mineralization. rWNTs were almost completely released from the hydrogels in 14 d, with 2 release peaks at 6 h and 4 d. rWNT-loaded hydrogels did not affect cell viability and morphology. rWNT10B-loaded hydrogels significantly increased the expression of ALP and RUNX2. The rWNT-loaded hydrogels significantly increased ALP activity. Our in vivo histological data indicate the presence of gel in the exposure area, the formation of pulp-like tissue in contact with the hydrogels, new blood vessels, and polarized cells adjacent to dentin tubules. Canonical WNT10B and noncanonical WNT5B appear to play specific roles in DPSC differentiation. WNT-loaded hydrogels are cytocompatible, increase the expression of osteo-/odontogenic markers and ALP activity, and induce pulp-like tissue formation.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"184 1","pages":"220345251357588"},"PeriodicalIF":7.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Action Needed on Oral Diseases within the Global NCD Agenda.","authors":"M Charles-Ayinde,F Cieplik,G H Gilbert,K Moriyama,B Wu,C H Fox","doi":"10.1177/00220345251350154","DOIUrl":"https://doi.org/10.1177/00220345251350154","url":null,"abstract":"The historic 2021 World Health Organization Oral Health Resolution urged member states to address key risk factors of oral diseases shared with other noncommunicable diseases (NCDs) and embed oral health within the NCD and universal health coverage agendas. The subsequent 2022 Global Oral Health Strategy and 2023 Global Oral Health Action Plan advocated for an increase in resource allocation to oral health within the NCD agenda. Despite oral diseases being classified as an NCD and affecting ~3.7 billion persons, substantially more than other NCDs, oral diseases are not primarily included within the NCD Agenda and within their 5 × 5 framework. Oral diseases remain siloed, divorced from the primary health care systems, and significantly affect communities from lower- and middle-income countries as well as vulnerable populations in all countries. This position paper considers the similarities between the primarily discussed NCDs and oral diseases and provides evidence and rationale for the integration of oral diseases within the NCD agenda and framework toward the prevention and control of NCDs. The integration of oral diseases can thereby strengthen the response to the Global Oral Health Resolution and Action Plan to provide a reform of health care systems and national policies to be inclusive of and responsive to oral health.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"45 1","pages":"220345251350154"},"PeriodicalIF":7.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effect of Periodontal Therapy on HbA1c Changes in Type 2 Diabetes.","authors":"H K Chee,S H X Tan,G H E Tjakkes,Y C M de Waal,A Vissink,C J Seneviratne","doi":"10.1177/00220345251357875","DOIUrl":"https://doi.org/10.1177/00220345251357875","url":null,"abstract":"Although prior studies have assessed the effect of nonsurgical periodontal therapy (NSPT) on glycemic management, most are short term and do not account for changes in diabetes medication. This longitudinal cohort study assessed the effect of NSPT on HbA1c levels and clinical periodontal measures of type 2 diabetes (T2D) patients with periodontitis. Medication changes up to 1 y prior to and 1 y after commencing NSPT were considered. A total of 154 nonsmoking T2D patients with periodontitis received initial periodontal treatment (professional mechanical plaque removal, subgingival instrumentation, root surface debridement) and oral hygiene instructions at baseline. Supportive periodontal care with repeated subgingival instrumentation for residual pockets was provided at 3, 6, 9, and 12 mo. A full-mouth periodontal examination assessing plaque, bleeding on probing, gingival suppuration, clinical attachment loss, and periodontal inflamed surface area (PISA) was conducted at baseline and at the follow-up visits. Glycemic management was monitored via point-of-care HbA1c testing at each follow-up, with HbA1c records up to 12 mo before NSPT obtained from patients. Linear mixed-effects models were applied to assess the effect of NSPT on HbA1c over time, controlling for important confounding effects such as medical history and changes in diabetes medications. The mean HbA1c at baseline was 8.4% ± 1.6%. Compared with baseline, HbA1c was lower by 0.70%, 0.73%, 0.68%, and 0.77% at 3, 6, 9, and 12 mo, respectively. PISA was reduced by 352.7 mm2 after 12 mo. Moreover, other periodontal health parameters (clinical attachment loss, probing pocket depth, and full-mouth bleeding score) were significantly reduced at 3 mo and sustained at 6, 9, and 12 mo. Participants were stratified by baseline HbA1c into \"acceptable\" (≤8.0%, n = 77) and \"unacceptable\" (>8.0%, n = 77) groups. The \"unacceptable\" group showed an HbA1c reduction of 1.31% at 12-mo follow-up compared with 0.24% in the \"acceptable\" group. The present study demonstrated that NSPT including maintenance significantly improved glycemic outcomes in T2D patients, particularly those with baseline HbA1c >8.0%.","PeriodicalId":15596,"journal":{"name":"Journal of Dental Research","volume":"80 1","pages":"220345251357875"},"PeriodicalIF":7.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}