Journal of the American Dental Association最新文献

{"title":"The association between parafunctional oral habits and temporomandibular disorders development in childhood and adolescence: A systematic review and meta-analysis.","authors":"Ana Luiza Peres Baldiotti, Patricia Santos-Silva, Fernanda Morais Ferreira, Izabella Barbosa Fernandes, Carolina Martins-Pfeifer","doi":"10.1016/j.adaj.2026.07.007","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.007","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorders (TMDs) encompass conditions affecting the temporomandibular joints or masticatory muscles, impairing oral health-related quality of life. Parafunctional oral habits have been suggested to be associated with TMDs in children and adolescents.</p><p><strong>Types of studies reviewed: </strong>Nine electronic databases were searched for observational studies evaluating parafunctional oral habits and TMDs in children and adolescents. Two reviewers independently selected studies, extracted data, and assessed risk of bias using Joanna Briggs Institute tools. Random-effects meta-analysis estimated odds ratios with 95% CIs, and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.</p><p><strong>Results: </strong>Thirty-five cross-sectional studies were included. Biting habits were associated with 45% higher odds of developing TMDs (odds ratio [OR], 1.45; 95% CI, 0.74 to 2.85; I² = 95.9%), sucking habits with 33% (OR, 1.33; 95% CI, 0.84 to 2.09; I² = 60.2%), and chewing habits with 84% (OR, 1.84; 95% CI, 1.09 to 3.11). Children with any parafunctional oral habit had a 2.16-fold higher odds of developing TMDs (OR, 2.16; 95% CI, 1.10 to 4.24; I² = 70.0%). Results of the sensitivity analysis, after removing studies that used invalid diagnostic tools for TMD, showed that the data were not robust to changes in the effect estimates. Sixteen studies were analyzed narratively. The certainty of evidence was very low for all estimates.</p><p><strong>Conclusions and practical implications: </strong>The evidence does not support an association between parafunctional oral habits and TMDs in youth. Given the cross-sectional design of the included studies, no causal inferences can be established. The very low certainty indicates that the findings are uncertain. There is a need for high-quality longitudinal studies and validated assessment tools. This systematic review was preregistered in the International Prospective Register of Systematic Reviews (CRD42022385606).</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of triple-headed and conventional toothbrushes for plaque control and gingival health in children and adolescents with autism spectrum disorder: A randomized controlled trial.","authors":"Biswadeep Roychowdhury, Sagar Jalihal, Anil V Ankola, Roopali M Sankeshwari, David Albert Coutinho, Karthiga Sakthi, Dorothy Dutta, Varkey Nadakkavukaran Santhosh","doi":"10.1016/j.adaj.2026.07.012","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.012","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents with autism spectrum disorder (ASD) are prone to poor oral hygiene due to motor and sensory challenges. This trial evaluated whether a triple-headed toothbrush (THT) improves gingival health and plaque control more effectively than a conventional toothbrush (CT).</p><p><strong>Methods: </strong>A multicenter, single-blind randomized controlled trial enrolled 102 children aged 7 through 18 years with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition level 1 or 2 ASD across 3 special schools in India, randomized 1:1 to THT or CT. All participants received standardized oral health education and caregiver-supervised twice-daily brushing for 3 months. Plaque and gingival index scores were recorded by a calibrated, blinded examiner at baseline and at 3 months.</p><p><strong>Results: </strong>At 3 months, THT use produced significantly greater reductions in plaque (Hodges-Lehmann estimator, -0.50; 95% CI, -0.63 to -0.31; P < .001; r = 0.60) and gingival (Hodges-Lehmann estimator, -0.25; 95% CI, -0.44 to -0.13; P < .001; r = 0.39) scores than CT, with pronounced improvements on the lingual surface. Both groups showed significant within-group reductions. THT acceptability improved significantly over the study period.</p><p><strong>Conclusions: </strong>A THT produced superior plaque and gingival improvements compared with a CT in children and adolescents with ASD, with pronounced lingual surface benefits and increasing acceptability over time.</p><p><strong>Practical implications: </strong>For families supporting children with ASD in resource-limited settings, a THT offers a cost-effective, technique-forgiving alternative to CTs, improving oral hygiene outcomes when used with caregiver supervision. This clinical trial was registered at Clinical Trials Registry-India. The registration number is CTRI/2024/12/078552.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center experience in the management of medication-related osteonecrosis of the jaw.","authors":"Reema Mahmoud, Leonid Groysman, Shlomi Kleinman, Gilad Wasserman, Clariel Ianculovici, Oren Peleg, Amir Shuster","doi":"10.1016/j.adaj.2026.06.015","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.06.015","url":null,"abstract":"<p><strong>Background: </strong>Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive therapy, yet optimal management remains controversial. The authors evaluated treatment outcomes, with an emphasis on the role of surgical intervention.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a single tertiary referral center, including patients treated for MRONJ from 2009 through 2025. Lesions were defined as improved if clinical downstaging occurred and as resolved if complete mucosal coverage without infection or exposed necrotic bone was achieved. Treatment modalities and outcomes were compared between osteoporosis- and oncology-associated MRONJ.</p><p><strong>Results: </strong>A total of 222 patients with MRONJ were analyzed: 139 had oncology-associated MRONJ (62.6%) and 83 had osteoporosis-associated MRONJ (37.4%). Oncology-associated MRONJ was more frequently managed conservatively with systemic antibiotics (21.6% vs 6.0%; P = .002), whereas patients with osteoporosis-associated MRONJ more often underwent surgical treatment (94.0% vs 78.4%; P = .002). Overall, 84.6% of patients improved and 69.4% achieved clinical resolution. Resolution was significantly higher in osteoporosis-associated MRONJ (80.7% vs 62.6%; P = .005). Surgical intervention was associated with favorable outcomes, accounting for 87.8% of improved cases and 94.2% of resolved cases (P < .001). Marginal mandibulectomy and partial maxillectomy were most associated with complete resolution (50.0% vs 22.1% in nonhealed cases; P < .001).</p><p><strong>Conclusions: </strong>Surgical management was associated with improved outcomes in patients with MRONJ compared with conservative approaches. Prospective studies are required to confirm the optimal timing and extent of surgical intervention.</p><p><strong>Practical implications: </strong>A surgical approach may be considered an important option in the management of MRONJ in appropriately selected patients.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing the dental hygiene workforce crisis: Lessons from Maine with national policy implications.","authors":"Adam E Saltz, Natalie Saltz","doi":"10.1016/j.adaj.2026.07.026","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.026","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral intraosseous lesion with palatal swelling.","authors":"Hardeep Chehal, Nagamani Narayana","doi":"10.1016/j.adaj.2026.07.021","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.021","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submucosal swelling of the upper lip.","authors":"Victoria Scarpa, Joseph Marsallo, Hans Li, Simrit Dhindsa, Khanh Trinh, Daria Vasilyeva, Elizabeth Philipone","doi":"10.1016/j.adaj.2026.07.010","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.010","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the anesthesiologist goes to the dentist: A humbling reflection on vulnerability, empathy, and the shared history of our crafts.","authors":"Rafael Ortega","doi":"10.1016/j.adaj.2026.07.019","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.07.019","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microscopic evaluation of the dentin-pulp complex response in carious primary teeth after 38% silver diamine fluoride application: An ex vivo study.","authors":"Chanchal Kumari, Ruchi Singhal, Ritu Namdev, Mala Kamboj, Shiwani Chawla, Khusboo Chhanna","doi":"10.1016/j.adaj.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.06.011","url":null,"abstract":"<p><strong>Background: </strong>Silver diamine fluoride (SDF) is widely used for caries arrest in pediatric dentistry; however, histologic evidence with larger samples regarding its effects on the dentin-pulp complex in teeth remains limited.</p><p><strong>Methods: </strong>This ex vivo observational study included 35 carious primary teeth treated clinically with 38% SDF and extracted 6 months later. Histologic analysis was performed to assess silver penetration depth, dentinal tubule occlusion, tertiary dentin formation, pulpal response, and bacterial presence. Penetration depth was measured using digital image analysis software. Statistical analysis included descriptive statistics and nonparametric tests.</p><p><strong>Results: </strong>Silver deposition within dentinal tubules was observed in all specimens. Penetration depth ranged from 230 through 1,132 μm (mean [SD], 541 [221] μm). Tertiary dentin formation was present in 27 of 35 (77.1%) samples, with thickness ranging from 21 through 55 μm. Of 35 specimens, 31 had preserved pulp architecture without inflammation. No bacterial infiltration was detected. Specimens exhibiting tertiary dentin formation had significantly greater SDF penetration than those without tertiary dentin (P = .004).</p><p><strong>Conclusions: </strong>Within the limitations of this study, 38% SDF is considered a clinically suitable minimally invasive approach to the management of caries lesions in primary teeth to preserve tooth structure and maintain pulpal health.</p><p><strong>Practical implications: </strong>The study findings support the use of 38% SDF as a safe and effective minimally invasive option for arresting caries while maintaining pulpal health when an adequate minimum remaining dentin thickness is present.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How sweet it is!","authors":"J Timothy Wright","doi":"10.1016/j.adaj.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.adaj.2026.08.021","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Directory","authors":"","doi":"10.1016/S0002-8177(26)00580-5","DOIUrl":"10.1016/S0002-8177(26)00580-5","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"157 10","pages":"Page A14"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149094515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}