International Dental Journal[JOURNAL]
Sun
200 papers
Dentition Status and Denture Use in Relation to Later-Life Health Transitions in Older Chinese Adults.
Wang J, Su X, Yang Z … +5 more , Pei Y, Lu W, Mao Y, Xu K, Yuan Y
Int Dent J · 2026 Jul · PMID 42400988 · Publisher ↗
INTRODUCTION AND AIMS: We examined whether baseline dentition status was associated with transitions to activities of daily living (ADL) disability, dementia, both ADL disability and dementia, and death in older Chinese...
INTRODUCTION AND AIMS: We examined whether baseline dentition status was associated with transitions to activities of daily living (ADL) disability, dementia, both ADL disability and dementia, and death in older Chinese adults, and whether denture use further distinguished risk within low-dentition groups. METHODS: We analysed Chinese Longitudinal Healthy Longevity Survey data from 2008 to 2018. Participants were aged 65 years or older, had baseline natural tooth count data, and had no observed ADL disability or reported dementia at baseline. Dentition status was classified as at least 20 teeth, 1-19 teeth, and 0 teeth. Transition-specific discrete-time complementary log-log models were fitted within a cumulative five-state framework comprising Healthy, ADL disability only, dementia only, both ADL disability and dementia, and death. RESULTS: A total of 10,186 participants contributed 18,688 interval-level observations. The most frequent transitions were to death (n = 5,063) and ADL disability only (n = 2,048). Compared with participants with at least 20 teeth, those with 0 teeth had higher hazards of ADL disability only (HR: 1.20, 95% CI, 1.04-1.39) and death (HR: 1.18, 95% CI, 1.06-1.31). In joint analyses, those with 0 teeth and dentures had the highest hazard of ADL disability only (HR: 1.30, 95% CI, 1.10-1.53), whereas those with 0 teeth and no dentures had the highest hazard of death (HR: 1.33, 95% CI, 1.18-1.49). Dementia-related transitions were sparse. CONCLUSION: Among older Chinese adults without observed ADL disability or reported dementia at baseline, edentulism was associated with less favourable later-life transitions, most consistently to ADL disability and death. Baseline dentition status may serve as a simple marker of oral functional reserve and broader later-life vulnerability. CLINICAL RELEVANCE: Baseline dentition and denture status may help identify older adults who warrant broader assessment of function, nutrition, frailty, and oral rehabilitation needs.
Immunoglobulin Heavy Constant Mu as a Shared Gene in Periodontitis and Rheumatoid Arthritis: A Bioinformatic Analysis.
Yang H, Cheng T, Zhou B
Int Dent J · 2026 Jul · PMID 42400987 · Publisher ↗
INTRODUCTION AND AIMS: Rheumatoid arthritis (RA) and periodontitis (PD) are two inflammatory diseases sharing immunopathogenic features and a common inflammatory environment. This exploratory bioinformatic study aimed to...
INTRODUCTION AND AIMS: Rheumatoid arthritis (RA) and periodontitis (PD) are two inflammatory diseases sharing immunopathogenic features and a common inflammatory environment. This exploratory bioinformatic study aimed to generate hypotheses regarding shared genes between PD and RA. METHODS: Gene expression omnibus (GEO) datasets for PD and RA were utilized. Weighted gene coexpression network analysis (WGCNA) was conducted to identify modules associated with PD and RA. Differential gene expression analysis was performed to find DEGs, followed by functional enrichment analysis using 'clusterProfiler'. Machine learning models were applied to screen target genes. Immunoglobulin Heavy Constant Mu (IGHM) expression in clinical blood samples was validated using RT-qPCR and ELISA. RESULTS: By intersecting WGCNA module genes with upregulated DEGs, we identified 17 candidate genes for PD and 37 for RA. Three machine learning models (RF, SVM, and GLM) were further applied to screen these candidates. The intersection of the PD and RA candidate genes identified IGHM as a potential shared gene. Notably, both IGHM mRNA and protein exhibited high expression levels in clinical blood samples from patients diagnosed with PD and RA. ROC curve analysis demonstrated that IGHM had potential diagnostic value for PD and RA. GSEA revealed that IGHM was associated with B cell receptor, Th cell differentiation, and NF-kappa B signalling pathways in both diseases. Expression levels of two TFs IRF4 and BHLHE41 were significantly positively correlated with IGHM in both PD and RA. Immune infiltration analysis showed that the adaptive immunity level was significantly higher, innate immunity level lower, and T cell response level lower in high IGHM group compared to low IGHM expression group in both PD and RA. CONCLUSION: IGHM may serve as a potential shared gene of PD and RA and may have potential as a general surrogate plasma/B-cell marker reflecting immune responses in both diseases.
Multiteacher Knowledge Distillation for Canine Scoring Using Dental Panoramic Radiographs to Support Primary Care.
C H R, Mayya V, Sivakumar V … +2 more , Patil V, Singhal A
Int Dent J · 2026 Jul · PMID 42400986 · Publisher ↗
OBJECTIVES: Automated classification of radiographic findings remains challenging due to limited annotated datasets and interobserver variability. Artificial intelligence-assisted diagnostic technologies can improve acce...
OBJECTIVES: Automated classification of radiographic findings remains challenging due to limited annotated datasets and interobserver variability. Artificial intelligence-assisted diagnostic technologies can improve accessibility to health care, especially in areas with limited radiologic expertise, while contributing to universal health care. This study examined whether a student model taught by multiteacher knowledge distillation (KD) outperformed individual teacher models in a 4-class radiographic grading task for impacted maxillary canines on panoramic radiographs. MATERIALS AND METHODS: Three teacher ResNet18 models were trained independently using different preprocessing versions from the identical dental panoramic radiograph (DPR) dataset: jaw region-of-interest crops, sharpness-enhanced crops, and original full DPR images. A student ResNet18 was then trained using KD, with averaged soft logits from all 3 frozen teachers. All models used ImageNet-pretrained weights and were tested on a hold-out test set (n = 92). RESULTS: Teacher models obtained test accuracies of 63.04%, 57.61%, and 59.78% (area under the curve [AUC], 0.73, 0.72, and 0.80). The student model surpassed all teachers, with 79.35% accuracy, weighted F1 = 0.77, macro F1 = 0.71, k = 0.58, Matthews correlation coefficient = 0.60, and AUC = 0.88 under equal teacher weighting; it further improved to 80.43% accuracy and AUC = 0.89 with differential teacher weighting. CONCLUSION: Multiteacher KD with complementing DPR preprocessing variants resulted in a student model that outperformed each teacher, demonstrating its suitability for automated radiographic scoring with minimal annotated data. Such approaches may support access to primary care by enabling reliable automated diagnostics in resource-constrained clinical environments.
Prior Periodontal Treatment Experience and Autonomy Preference in Stage III/IV Periodontitis: A Cross-Sectional, Questionnaire-Based Observational Study.
Oh SH, Lee JS, Ko KA … +3 more , Jung JY, Hong JY, Lee JH
Int Dent J · 2026 Jul · PMID 42400985 · Publisher ↗
INTRODUCTION AND AIMS: In this study, we aimed to evaluate whether prior periodontal treatment experience was associated with patients' autonomy preference (AP) in clinical decision-making among individuals with stage II...
INTRODUCTION AND AIMS: In this study, we aimed to evaluate whether prior periodontal treatment experience was associated with patients' autonomy preference (AP) in clinical decision-making among individuals with stage III/IV periodontitis. METHODS: This cross-sectional, questionnaire-based observational study included 146 patients with stage III/IV periodontitis who were categorised into treatment-naive and -experienced groups according to prior periodontal treatment history. Participants completed structured surveys assessing sociodemographic, medical, and oral health factors. AP was measured using a standardised scenario-based score featuring mild, moderate, and severe periodontal vignettes. Data were analysed using multivariable linear regression and propensity score weighting. RESULTS: In multivariable linear regression, prior periodontal treatment experience was significantly associated with a higher AP scenario score (P = .042), and this finding was supported by propensity score weighting. Higher AP in the treatment-experienced group was most evident in the mild scenarios, particularly for clinical scheduling (P = .026) and adjunctive care decisions (P = .002). However, as disease severity increased, AP diminished, with both groups universally relying on clinician-led decisions in severe cases. CONCLUSION: Prior periodontal treatment experience was independently associated with higher AP, with the association being most evident in mild periodontal scenarios. CLINICAL RELEVANCE: Prior periodontal treatment experience may enhance patient participation in periodontal decision-making, supporting more individualised shared decision-making in clinical practice.
Sidt2 Knockdown Aggravates Apical Periodontitis Via Autocrine Tumour Necrosis Factor-Alpha.
Li B, Zhang G, Du M … +1 more , He H
Int Dent J · 2026 Jul · PMID 42398448 · Publisher ↗
OBJECTIVE: Apical periodontitis (AP) is characterised by inflammatory infiltration and periapical bone loss, accompanied by high expression of tumour necrosis factor-alpha (TNF-α). SID1 transmembrane family member 2 (Sid...
OBJECTIVE: Apical periodontitis (AP) is characterised by inflammatory infiltration and periapical bone loss, accompanied by high expression of tumour necrosis factor-alpha (TNF-α). SID1 transmembrane family member 2 (Sidt2) is a lysosomal membrane protein associated with inflammation. However, the effect of Sidt2 on AP remains unknown. METHODS: We established an AP mouse model, and then the adenovirus-associated virus was used to inhibit Sidt2 expression in the AP model. Periapical lesions were detected using micro-computed tomography. Haematoxylin and eosin staining, tartrate-resistant acid phosphatase staining, and immunohistochemistry staining were conducted to explore the roles of Sidt2 in inflammation and osteoclast differentiation in AP; F-actin staining, quantitative real-time polymerase chain reaction, western blot, enzyme-linked immunosorbent assay and RNA sequencing analysis were used to detect osteoclast differentiation and TNF-α signalling pathway in RAW 264.7 cells. RESULTS: Sidt2 was suppressed, and TNF-α was increased in AP. Sidt2 knockdown aggravated inflammation and bone loss in AP. Besides, Sidt2 inhibition upregulated osteoclast differentiation both in AP and in RAW 264.7 cells. Mechanistically, RNA sequencing analysis revealed Sidt2 may regulate osteoclast differentiation via the TNF-α signalling pathway. Profoundly, knockdown Sidt2 enhanced TNF-α production and secretion, while neutralising TNF-α partially relieved Sidt2-knockdown-increased osteoclast differentiation in RAW 264.7 cells. CONCLUSION: Our data demonstrated that Sidt2 negatively regulates autocrine TNF-α signalling to participate in osteoclast differentiation in AP, supporting the notion that Sidt2 may serve as a therapeutic target for bone resorption.
Effects of Abrasive Flow Finishing on the Surface Quality, Frictional Resistance, and Biological Performance of Brackets.
Yang F, Zhou C, Huang Z … +4 more , Chen M, Cao Y, Chen L, Wang W
Int Dent J · 2026 Jul · PMID 42398447 · Publisher ↗
OBJECTIVES: This study aims to investigate the effects of abrasive flow finishing (AFF) on the surface quality, frictional resistance, and biological performance of orthodontic brackets. METHODS: Stainless-steel brackets...
OBJECTIVES: This study aims to investigate the effects of abrasive flow finishing (AFF) on the surface quality, frictional resistance, and biological performance of orthodontic brackets. METHODS: Stainless-steel brackets were randomly allocated into blank, control, and AFF groups. The blank group was left untreated. The control group underwent conventional magnetic polishing, while the AFF group was treated with AFF. Surface morphology was observed using scanning electron microscopy. Surface roughness at the micro- and nanoscale was investigated via 3D optical profilometry and atomic force microscopy, respectively. The arithmetic average roughness (Ra) and root mean square roughness (Rq) were analysed. The changes in slot dimensions were evaluated. Frictional resistance was determined using a universal testing machine. Biological performance was evaluated via bacterial adhesion and in vitro calculus formation assays. RESULTS: The AFF group presented a mirror-like finish. Scanning electron microscopy micrographs exhibited the smooth and uniform surface in outer and slot areas in the AFF group, while the control group showed obvious defects and pits within slots. 3D optical profilometry and atomic force microscopy demonstrated the smooth and regular surface topography in the AFF group. Quantitative analysis showed that Ra and Rq values of the slot area in the AFF group were significantly lower than those of blank and control groups. There were no significant changes in slot dimensions following AFF treatment. The kinetic friction force was significantly reduced in the AFF group. Furthermore, AFF treatment inhibited bacterial adhesion and calculus-like mineral deposition on brackets. CONCLUSION: AFF treatment effectively reduced the surface roughness of orthodontic brackets, especially within slot area, outperforming conventional magnetic polishing. This improvement further minimized frictional resistance and inhibited bacterial adhesion and calculus-like mineral deposition. CLINICAL RELEVANCE: This study demonstrates that AFF is a superior post-processing technique for orthodontic brackets.
Pinocembrin Alleviates Gingival Fibroblast Senescence in a Mouse Model of Periodontitis Via CYP1B1 Downregulation.
Chen Z, Tang Q, Tang R … +5 more , Yang Y, Cai W, Guo R, Shao J, Fang F
Int Dent J · 2026 Jul · PMID 42398446 · Publisher ↗
INTRODUCTION AND AIMS: The severity of periodontitis, a chronic inflammatory disease, correlates with gingival tissue senescence. This study aimed to characterise the heterogeneous functions of these senescent cells and...
INTRODUCTION AND AIMS: The severity of periodontitis, a chronic inflammatory disease, correlates with gingival tissue senescence. This study aimed to characterise the heterogeneous functions of these senescent cells and to define the mechanisms driving gingival fibroblast (GF) senescence, thereby assessing cellular senescence as a potential therapeutic target. METHODS: We analysed cellular senescence changes in gingival tissues during periodontitis by integrating human gingival single-cell RNA sequencing (scRNA-seq) datasets. Biomarkers for a senescence-based diagnostic model for periodontitis were identified, and a potential drug targeting a key biomarker was screened. The effects of this drug on GF senescence were validated using an in vitro model induced by lipopolysaccharide (LPS) in primary human GFs (hGFs), alongside an in vivo experimental periodontitis mouse model induced by ligature. RESULTS: ScRNA-seq revealed an increase in senescence across various cell types in periodontitis-affected gingival tissues, with GFs being the predominant senescent cell population. Senescence levels in GFs were elevated in both human and mouse periodontitis tissues. A diagnostic model for periodontitis was developed based on a cellular senescence-associated 3-gene signature. Further mechanistic investigation showed that CYP1B1 drives LPS-induced hGF senescence by suppressing fatty acid metabolism. Ultimately, pinocembrin was found to attenuate senescence of GFs and ameliorate experimental periodontitis in mice, an effect mediated primarily through the downregulation of CYP1B1. CONCLUSION: Cellular senescence is increased in gingival tissues during periodontitis. Targeting senescent GFs presents a promising therapeutic strategy for the treatment of periodontitis. CLINICAL RELEVANCE: Periodontitis-related tissue destruction involves cellular senescence, yet the responsible gingival cell populations and molecular mechanisms remain undefined. CYP1B1-driven suppression of fatty acid metabolism underlies gingival fibroblast senescence, the predominant senescent process in periodontitis, and is attenuated by pinocembrin. CYP1B1 represents a novel therapeutic target for periodontitis. Pinocembrin warrants further preclinical evaluation as a promising adjunct to periodontal therapy.
Validity of a Combined General and Oral Health Indicator for Vulnerability.
Kim HN, Kino S, Kim NH
Int Dent J · 2026 Jul · PMID 42391889 · Publisher ↗
INTRODUCTION AND AIMS: Self-rated health (SRH) is widely used for population health monitoring but may miss oral health-related vulnerability. We examined whether combining SRH with self-rated oral health (SROH) improves...
INTRODUCTION AND AIMS: Self-rated health (SRH) is widely used for population health monitoring but may miss oral health-related vulnerability. We examined whether combining SRH with self-rated oral health (SROH) improves identification of multidimensional vulnerability among adults aged ≥45 years. METHODS: We used 2024 Korea Community Health Survey data to create a four-category SRH-SROH indicator: good both, poor oral only, poor general only, and poor both. Survey-weighted multinomial logistic regression assessed associations with sociodemographic, behavioural, health, oral healthcare access, and community-level factors. Chewing difficulty was excluded from regression models and used as an external functional validation outcome. Incremental validity was assessed by comparing Nagelkerke R² and AUC between SRH-only and combined-indicator models. Sensitivity analyses retained the full complete-case sample and reclassified 'fair' responses as poor/unhealthy or good/healthy. RESULTS: In the primary high-contrast sample, 32.6% reported poor health in both domains, 20.2% poor oral health only, 7.6% poor general health only, and 39.6% good health in both domains. The poor - both groups had higher prevalence of mobility limitation, chronic conditions, depressive symptoms, and unmet healthcare needs. Among participants with good SRH, poor SROH identified hidden vulnerability, including greater mobility limitation, unmet medical needs, and chewing difficulty. For chewing difficulty, the combined-indicator model increased Nagelkerke R² from 0.373 to 0.540 and AUC from 0.822 to 0.883. Findings were directionally robust across sensitivity analyses. CONCLUSION: Combining SRH and SROH better identified hidden functional and care-related vulnerability than SRH alone, particularly among individuals reporting good general health. Its main value is subgroup identification for population health monitoring, not stand-alone clinical screening. CLINICAL RELEVANCE: Adding a single SROH item may help identify vulnerability missed by SRH alone, but clinical screening use requires further validation.
Letter to the Editor on the e-SEM Programme: Methodological Considerations and Critical Perspectives on a Theory-Driven Digital Oral Health Intervention by Acosta and Pisarnturakit.
Koul A, Bhoomadevi A
Int Dent J · 2026 Jul · PMID 42391888 · Publisher ↗
Abstract loading — click title to view on PubMed.
Electric vs Manual Toothbrushing Effects on QLF-Assessed Plaque in Smokers and Non-Smokers: A 24-Week RCT.
Di Stefano A, Gangi D, La Rosa GRM … +10 more , Isola G, Fala V, Amaliya A, Kowalski J, Chapple I, Weglarz J, Del Giovane C, Pellegrino MN, Pacino SA, Polosa R
Int Dent J · 2026 Jul · PMID 42391887 · Publisher ↗
BACKGROUND: Electric toothbrushes are known to outperform manual devices in plaque removal, yet most comparative trials rely on conventional examiner-based indices and none have evaluated efficacy across smoking profiles...
BACKGROUND: Electric toothbrushes are known to outperform manual devices in plaque removal, yet most comparative trials rely on conventional examiner-based indices and none have evaluated efficacy across smoking profiles using objective fluorescence-based measurement. METHODS: This 24-week, 2-arm, parallel-group randomized controlled trial compared an oscillating-rotating electric toothbrush (Oral-B iO 6) with a manual toothbrush in 126 adults aged 18 to 50 years attending a dental clinic for routine scaling and polishing. Current smokers and never-smokers were enrolled to allow prespecified subgroup analysis by smoking status. Dental plaque accumulation was quantified using quantitative light-induced fluorescence (QLF) technology. The primary endpoint was ΔR30 (percentage of tooth surface with fluorescence increase ≥30%, reflecting total mature plaque); ΔR120 (fluorescence increase ≥120%, reflecting thick plaque and calculus-like deposits) was the secondary endpoint. The primary analysis used analysis of covariance adjusting for baseline plaque levels, treatment arm, smoking status, and their interaction. RESULTS: Use of the electric toothbrush was associated with significantly lower ΔR30 at 24 weeks compared with manual brushing (β = -1.84, 95% CI [-3.27, -0.41], p = .012), an effect that remained robust after adjustment for age, sex, and habitual oral hygiene behaviours. Baseline plaque level was the strongest predictor of follow-up values in both outcome models. No significant treatment effect was observed for ΔR120 (β = -0.77, 95% CI [-1.71, 0.18], p = .112). Subgroup analyses showed significant between-arm differences on both outcomes among never-smokers; among smokers, differences were directionally consistent but did not reach statistical significance, and the treatment-by-smoking interaction was not statistically significant. CONCLUSIONS: Oscillating-rotating electric toothbrushing produced significantly lower plaque accumulation than manual brushing over 24 weeks, as indexed by QLF-derived ΔR30. These findings support the potential advantage of oscillating-rotating powered toothbrushes for reducing plaque accumulation in adult patients and further support the utility of QLF as a precise and reproducible outcome measure for toothbrush efficacy trials. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT06358482.
CBCT-Based Clinico-Radiomic Nomogram Predicting Preoperative Mandibular Third Molar Difficulty: Development/Validation.
Xu M, Wu Y
Int Dent J · 2026 Jul · PMID 42385346 · Publisher ↗
OBJECTIVE: This study aimed to develop and validate a clinico-radiomic nomogram, integrating Cone-Beam Computed Tomography (CBCT) radiomic features with clinical characteristics, to predict the difficulty of mandibular t...
OBJECTIVE: This study aimed to develop and validate a clinico-radiomic nomogram, integrating Cone-Beam Computed Tomography (CBCT) radiomic features with clinical characteristics, to predict the difficulty of mandibular third molar (MTM) extraction. METHODS: A retrospective cohort of 600 patients undergoing MTM extraction was divided into training and validation sets. Radiomic features were extracted from preoperative CBCT images. The Least Absolute Shrinkage and Selection Operator (LASSO) method was used to select key features and build a radiomic score (Rad-score). Multivariable logistic regression identified independent clinical predictors. A final nomogram was established by combining the Rad-score and clinical factors. The model's performance was assessed for discrimination (AUC), calibration (Hosmer-Lemeshow test), and clinical utility (Decision Curve Analysis - DCA). RESULTS: Eleven robust features were selected to construct a radiomic signature. The Rad-score was significantly higher in the high-difficulty group (P < .001). Five independent predictors were identified: Age, BMI, Pell & Gregory classification, Root Curvature, and the Rad-score. The combined clinico-radiomic nomogram demonstrated superior predictive performance in both training (AUC = 0.892) and validation (AUC = 0.865) cohorts, significantly outperforming models based solely on clinical or radiomic factors alone. The model showed excellent calibration between predicted and observed probabilities and demonstrated substantial clinical net benefit via DCA. CONCLUSION: The novel CBCT-based clinico-radiomic nomogram provides a noninvasive, accurate, and visual tool for the preoperative stratification of MTM extraction difficulty. This facilitates more informed surgical planning and personalised patient counselling.
Refusal of Hospital-Based Oral Cancer Treatment Driven by Health Beliefs in Pakistan: A Qualitative Study.
Amanat MU, Sriplung H, Wichaidit W … +2 more , Naorungroj S, Kerdpon D
Int Dent J · 2026 Jun · PMID 42365791 · Full text
OBJECTIVES: Hospital-based treatment refusal among oral cancer (OC) patients remains poorly understood. No qualitative studies have examined this phenomenon specifically in OC. This study aimed to explore the beliefs and...
OBJECTIVES: Hospital-based treatment refusal among oral cancer (OC) patients remains poorly understood. No qualitative studies have examined this phenomenon specifically in OC. This study aimed to explore the beliefs and attitudes underlying treatment refusal among OC patients in Pakistan. METHODS: We conducted a theory-informed qualitative case study guided by the Health Belief Model (HBM) using purposive criterion sampling. Semistructured interviews were conducted with eight OC patients who refused hospital-based treatment, eight family members involved in decision-making, and three oral surgeons. Interviews were audio-recorded, transcribed verbatim, translated into English, and analysed using inductive thematic analysis. Emergent themes were subsequently interpreted in relation to HBM constructs using abductive, theory-informed pattern matching. Methodological rigour was enhanced through data source triangulation and member checking. RESULTS: From the 19 in-depth interviews, we identified seven interconnected themes underlying treatment refusal: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, cues to action, and religious beliefs. Treatment refusal was shaped by fatalistic perceptions of cancer incurability, intense fears of treatment-related harm, and substantial financial, access, and role-related constraints. Strong family influence and trust in traditional and complementary medicine further reinforced these decisions. Religious interpretations functioned bidirectionally, reinforcing acceptance of divine destiny and legitimizing nonbiomedical healing pathways, while in some cases also supporting treatment-seeking through religious doctrine. CONCLUSION: Refusal of hospital-based OC treatment reflects a culturally embedded decision-making process shaped by interacting sociocultural, religious, and structural factors. The findings support the applicability of the HBM in this context and inform the development of culturally responsive, communication-focused interventions in oral oncology. CLINICAL RELEVANCE: Recognition of belief-driven treatment refusal can help clinicians tailor communication, address fears of treatment harm, and engage family and religious influences to improve acceptance of hospital-based OC care.
Pulpal Pressure Aggravates Pulpitis by Mechano-Inflammatory Signal Synergy.
Hu W, Cui H, Fu Y … +11 more , Luo X, Li L, Wang Z, Bao L, Gong S, Luo H, Liu S, Wang H, Yang X, Liu S, Ma D
Int Dent J · 2026 Jun · PMID 42364415 · Full text
INTRODUCTION AND AIMS: Pulpitis is a common oral disease characterized by severe pain and markedly impairs quality of life. A hallmark of its pathogenesis is a sharp increase in pulpal pressure due to vasodilation and oe...
INTRODUCTION AND AIMS: Pulpitis is a common oral disease characterized by severe pain and markedly impairs quality of life. A hallmark of its pathogenesis is a sharp increase in pulpal pressure due to vasodilation and oedema. However, the specific role of the elevated pulpal pressure in pulpitis progression remains unknown. This study aimed to investigate how pulpal pressure influences pulpitis progression and its underlying mechanism. METHODS: Rat models of pulpitis were established, and changes in pulpal pressure were quantified by immunofluorescence for mechanosensitive markers. Double immunofluorescence and colocalization analysis were used to assess the ability of macrophages to respond to pulpal pressure during pulpitis at 0, 24, 72 hours (n = 6/group/timepoint). Furthermore, an in vitro pressure-culture model of inflamed teeth was established at 0 and 180 kPa (n = 6/group), and pulp inflammation was assessed. An in vitro cellular model was established in which lipopolysaccharide-prestimulated macrophages were exposed to hydrostatic pressure. Finally, pulp inflammation after infiltration of a Piezo1 inhibitor was assessed by H&E and immunofluorescence. RESULTS: Elevated pulpal pressure was positively correlated with pulpitis severity, and the capacity of macrophages to sense the pressure significantly increased with the progression of pulpitis (r = 0.672 ± 0.105 at 24 hours and 0.805 ± 0.077 at 72 hours, P < .001). Experimentally applied hydrostatic pressure significantly exacerbated both pulp inflammation and macrophage inflammatory responses (P < .05). Mechanistically, the synergistic interaction occur between signals induced by the inflammatory stimulus lipopolysaccharide and hydrostatic pressure in macrophages. CONCLUSIONS: Elevated pulpal pressure synergized with inflammatory signals to exacerbate pulpitis. This mechano-inflammatory transduction pathway potentiated the TRAF6-NF-κB pathway and synergistically activated TRAF6-YAP pathway in macrophages, thereby leading to hyper-inflammatory activation and increased pulpitis. CLINICAL SIGNIFICANCE: Our work highlights the synergistic interplay between pulpal pressure and inflammation in disease progression, supporting a therapeutic strategy that integrates the mechanical microenvironment for effective inflammatory control.
Global Burden of Lip and Oral Cavity Cancer Attributed to Different Tobacco Use From 1990 to 2021 and Projection to 2050.
Yu Z, Zhang M, Zheng Y … +7 more , Su J, Han S, Chen X, Fang Y, Liu H, Liu X, Wan G
Int Dent J · 2026 Jun · PMID 42364414 · Full text
INTRODUCTION AND AIMS: Lip and oral cavity cancer (LOCC) remains a significant global health challenge, with tobacco use being its primary modifiable risk factor. However, a comprehensive understanding of the LOCC burden...
INTRODUCTION AND AIMS: Lip and oral cavity cancer (LOCC) remains a significant global health challenge, with tobacco use being its primary modifiable risk factor. However, a comprehensive understanding of the LOCC burden attributable to different forms of tobacco use is lacking. This study aims to systematically quantify the global, regional, and national burden of LOCC attributable to smoking and chewing tobacco from 1990 to 2021 and to project trends to 2050, providing evidence for targeted tobacco control policies. METHODS: Using data from the Global Burden of Disease (GBD) 2021 study, we extracted mortality and disability-adjusted life years (DALYs) for LOCC attributable to tobacco smoking and chewing tobacco. Age-standardized mortality rates (ASMR) and DALY rates (ASDR) were analysed by sex, region, and Socio-demographic Index (SDI). Cross-country inequality was assessed using the Slope Index and Concentration Index. A Bayesian age-period-cohort (BAPC) model was employed to forecast the burden to 2050. RESULTS: Globally, between 1990 and 2021, absolute tobacco-attributable LOCC deaths nearly doubled, while the ASMR declined (from 1.07 to 0.94 per 100,000). This decline was driven entirely by smoking, whereas the burden from chewing tobacco increased slightly. Striking disparities emerged: the burden in females remained stable, driven primarily by chewing tobacco, while males saw a decline driven by reduced smoking. Regionally, South Asia bore the highest burden. Inequality analysis revealed narrowing disparities for smoking-attributable LOCC but persistent, unaddressed inequality for chewing tobacco. BAPC projections to 2050 forecast a continued decline in smoking-attributable burden but no improvement for chewing tobacco-attributable burden. CONCLUSION: While global tobacco control efforts have successfully reduced the smoking-attributable LOCC burden, the persistent and, in some populations, increasing burden from chewing tobacco - particularly among females and in low-SDI regions - demands urgent attention. Projections indicate that without targeted intervention, chewing tobacco will remain an unmitigated cause of LOCC for decades. CLINICAL RELEVANCE: Targeted tobacco control is urgently needed for the reduction of LOCC burden in specified populations.
Decoding the Dynamic Landscape of Sequential Disease Stages from Oral Submucous Fibrosis to Oral Squamous Cell Carcinoma.
Bin X, Cheng J, Wu J … +10 more , Tang Z, Sun Y, Su K, Li K, Hu Y, Quan H, Deng Z, Wang B, Tang Q, Liu O
Int Dent J · 2026 Jun · PMID 42364413 · Full text
Oral submucous fibrosis (OSF) is a chronic and progressive disease of the oral mucosa that is considered potentially malignant. However, the specific mechanism of OSF occurrence and malignant transformation into oral squ...
Oral submucous fibrosis (OSF) is a chronic and progressive disease of the oral mucosa that is considered potentially malignant. However, the specific mechanism of OSF occurrence and malignant transformation into oral squamous cell carcinoma (OSCC) is still unclear. This study aimed to elucidate the spatiotemporal changes in cellular biological behaviour during the occurrence and malignant transformation of OSF, providing new insights for understanding the underlying mechanism and developing novel therapeutic strategies. Sets of normal, OSF, margin area, and OSCC tissue samples were collected, and 10 × Visium spatial transcriptomics technology was used for sequencing library construction. The spatial transcriptomic data were combined with single-cell transcriptomic data for analysis. Phenotypic shifts in fibroblasts drove the progression of diverse disease stages, and immune cell patterns revealed adaptive immune dominance in OSF and immunosuppression in OSCC. A distinctive transitional zone with low transcriptional activity and intermediate transcriptomic features between noncancerous and cancer cells was identified at the forefront of the cancer invasion margin. Moreover, cancer-side cells had increased cell-cell communication around the tumour margin, reprogramming the adjacent microenvironment to facilitate invasion. The differential end states of epithelial cells demonstrated that basal epithelial cells were the dominant cell source of cancer cells in OSCC. Dynamic changes occur in gene expression and cellular function during the transformation of OSF into OSCC. The malignant transformation of OSF is a complex process involving multiple cell populations, in which changes first occur in cellular biological behaviours instead of pathomorphology. These spatiotemporal insights provide important evidence for clarifying the mechanisms of OSF-OSCC transformation and offer potential targets for early intervention. The identified transitional zone presents potential targets for early intervention in OSF patients at high risk of malignant transformation, supporting the development of strategies for OSCC prevention and precise clinical management.
Comment on "Complete-Arch Implant Impression Precision: Digital vs Conventional Techniques".
Sati DM, Shinde VD, Agarwal C
Int Dent J · 2026 Jun · PMID 42364412 · Full text
Abstract loading — click title to view on PubMed.
Multiomics Reveals NDRG1-Driven Oral Squamous Cell Carcinoma Progression: Competitive Endogenous RNAs Regulation and Proangiogenic Microenvironment Remodelling.
Feng L, Ou Y, Tian L … +3 more , Jiang W, Zhang M, Sheng X
Int Dent J · 2026 Jun · PMID 42364411 · Full text
Oral squamous cell carcinoma (OSCC) is characterized by high aggressiveness. This study aims to elucidate the role of NDRG1 in the evolutionary heterogeneity and spatial microenvironmental remodelling of OSCC. By integra...
Oral squamous cell carcinoma (OSCC) is characterized by high aggressiveness. This study aims to elucidate the role of NDRG1 in the evolutionary heterogeneity and spatial microenvironmental remodelling of OSCC. By integrating bulk transcriptomics, single-cell RNA sequencing (scRNA-seq), and spatial transcriptomics (ST), complemented by in vivo and in vitro functional assays, we systematically explored the regulatory logic of the MSTRG.47889/miR-1299/NDRG1 axis. The MSTRG.47889/miR-1299/NDRG1 ceRNA regulatory axis was identified and validated, demonstrating its significant role in promoting OSCC proliferation and invasion while impairing cellular adhesion. Single-cell analysis revealed a significant expansion of the NDRG1-high subpopulation in tumour tissues, which drives cellular evolution along a pseudotime trajectory toward a partial epithelial-mesenchymal transition (p-EMT) and a high glycolytic state. Spatial transcriptomics analysis revealed that NDRG1 is highly expressed within 'hypoxia-metabolic' niches. Our integrative analysis suggests that these regions may coordinate with endothelial cells, highlighting a potential role for the ANGPTL4-CDH5 signalling axis in promoting a proangiogenic microenvironment. These findings provide preliminary insights into how NDRG1 serves as a pivotal regulator driving p-EMT and coordinating niche remodelling. NDRG1 serves as a pivotal regulator driving p-EMT and proangiogenic niche remodelling, representing a potential novel target for the diagnosis and treatment of OSCC.
Radiographic Analysis of Bone Graft Changes and Anatomical Factors Influencing Maxillary Sinus Floor Augmentation.
Wei X, Yang F, Zhou Q … +3 more , Li R, Sun Y, Yu Y
Int Dent J · 2026 Jun · PMID 42361537 · Full text
OBJECTIVES: This study aimed to investigate the role of anatomical factors on the outcomes of lateral sinus floor augmentation with simultaneous implant placement using cone-beam computed tomography (CBCT) images. METHOD...
OBJECTIVES: This study aimed to investigate the role of anatomical factors on the outcomes of lateral sinus floor augmentation with simultaneous implant placement using cone-beam computed tomography (CBCT) images. METHODS: This retrospective study evaluated 80 patients who underwent a sinus lift procedure with simultaneous implant placement and Bio-Oss particles using the lateral window approach. The patients underwent CBCT scans preoperatively, immediately, and 6 months after surgery. CBCT images were used to measure bone graft changes and anatomical features, including sinus width (SW), sinus angle, Schneiderian membrane thickness (Tm), and sinus floor morphology. Descriptive statistics and multiple linear regression models were used to investigate the correlations between these features. RESULTS: The linear changes in apical bone grafts are shown below: apical bone grafts height loss of the implant (aBGHL, median [interquartile range, IQR]: 1.00 [1.53] mm), bone and bone grafts height loss 2 mm away from the implant root horizontally (BGHL, median [IQR]: 1.14 [1.61] mm), apical bone grafts width loss of the implant (aBGWL, median [IQR]: 1.60 [4.15] mm), and bone grafts width loss 2 mm below the implant root (BGWL, median [IQR]: 0.80 [2.00] mm). Both aBGHL and BGHL were positively correlated with SW and Tm, while aBGWL and BGWL were primarily correlated with SW in a series of sequentially adjusted multivariable models. CONCLUSION: During the early bone remodelling phase, SW plays a pivotal role in the linear resorption of bone grafts, while Tm primarily influences the loss of bone graft height. CLINICAL RELEVANCE: The results suggest that sinuses with a wide bucco-palatal bony wall distance and a thick Schneiderian membrane are more likely to experience greater bone substitute loss after sinus floor augmentation. These findings will aid clinicians in the selection of implant sites, as well as determining the type and quantity of bone grafting materials.
Deep Learning Based on Swin-Transformer and 3D U-Net: Implant Three-Dimensional Position Planning.
Shen J, Yang X, Zhang J … +5 more , Lu X, Chen G, Liu Y, Ye B, Ma M
Int Dent J · 2026 Jun · PMID 42348991 · Full text
INTRODUCTION AND AIMS: This study aimed to devise a deep learning-based model for the automated identification of anatomical mandibular lingual concavities in the posterior mandible and the prediction of biologically gui...
INTRODUCTION AND AIMS: This study aimed to devise a deep learning-based model for the automated identification of anatomical mandibular lingual concavities in the posterior mandible and the prediction of biologically guided three-dimensional implant positions. METHODS: Cone-beam computed tomography (CBCT) images with single-tooth posterior mandibular edentulism were included. A deep learning framework was constructed utilizing 3D U-Net and Swin-Transformer. This framework was designed to perform automated segmentation of teeth, mandible, and the mandibular nerve canal; to classify morphological types of lingual concavities; and to identify implant key points with coordinate prediction. Model performance was assessed via five-fold cross-validation. RESULTS: The proposed model achieved Dice similarity coefficients ranging from 0.87 to 0.91 for dental segmentation. In the classification of mandibular lingual concavities, an accuracy of 0.92 to 0.97 was attained. Regarding the prediction of three-dimensional implant positions, the automatically generated plans maintained a safety margin of 3.20 to 3.89 mm from the mandibular nerve canal. Furthermore, sufficient bone volume was preserved at both cervical and apical implant levels, with buccal/lingual cervical bone widths averaging 4.94 to 5.78 mm. CONCLUSION: The deep learning model in this experiment performed well across different views and learning tasks in a retrospective internal validation setting. Furthermore, it demonstrated the ability to accurately identify relevant anatomical structures, and the predicted three-dimensional implant positions showed clinically acceptable safety margins in the internal validation cohort. CLINICAL RELEVANCE: This model provides a preliminary AI-assisted framework for identifying critical mandibular anatomical structures and generating biologically guided preliminary implant position suggestions, thereby helping to mitigate intraoperative complications and reduce the risk of postoperative mechanical and biological complications in preclinical evaluation.
Cranial Base Characteristics in Growing Patients With Class III Skeletal Pattern: A Systematic Review and Meta-Analysis.
Li Z, Liu J, Wei T … +3 more , Hung KF, Su Y, Shan Z
Int Dent J · 2026 Jun · PMID 42348990 · Full text
INTRODUCTION AND AIMS: The treatment of skeletal Class III malocclusion presents challenges due to heterogeneous craniofacial growth patterns. The cranial base is a craniofacial growth centre, while its role in skeletal...
INTRODUCTION AND AIMS: The treatment of skeletal Class III malocclusion presents challenges due to heterogeneous craniofacial growth patterns. The cranial base is a craniofacial growth centre, while its role in skeletal malocclusion remains unclear. This systematic review aimed to investigate the relationship between the cranial base characteristics and skeletal Class III malocclusion in growing patients. METHODS: Observational studies investigating cranial base characteristics among growing skeletal Class III patients were included. Six databases (PubMed, Web of Science, Cochrane Library, Embase, MEDLINE, and Scopus) were searched up to May 5, 2026. Risk of bias and evidence certainty were assessed using the AXIS tool, and the GRADE framework. Meta-analysis was performed using RevMan 5.4 software. Subgroup meta-analyses were conducted by growth stage and gender if applicable. RESULTS: Eleven studies were included, of which eight were eligible for meta-analysis. Compared to Class I patients, Class III patients exhibited a smaller NSBa angle (-1.84°, 95% CI: -2.80°, -0.89°, P < .001) and NSAr angle (-2.02°, 95% CI: -3.26°, -0.78°, P = .001). Subgroup analyses revealed shorter SN and SBa lengths among Class III patients before or during the growth spurt (SN: -1.59 mm, 95% CI: -2.69 mm, -0.50 mm, P = .004; SBa: -1.56 mm, 95% CI: -2.88, -0.24, P = .004). Additionally, SN length was significantly shorter in Class III males (-1.68 mm, 95% CI: -3.11mm, -0.25 mm, P = .020). CONCLUSIONS: Growing skeletal Class III patients presented significantly smaller cranial base angles. Moreover, those evaluated before or during the growth spurt showed shorter anterior and posterior cranial base lengths, with differences in anterior cranial base length demonstrating gender-specific variation. However, the preliminary findings necessitate cautious interpretation given the very low certainty of evidence. CLINICAL RELEVANCE: A better understanding of the etiology of skeletal malocclusion may inform individualized orthodontic diagnosis and treatment planning.
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