To compare skeletodental and soft tissue changes in growing Class II patients treated with Herbst or Pendex appliances, followed by fixed edgewise appliances, using two-dimensional lateral cephalometric radiographs extracted from three-dimensional cone-beam computed tomography scans. Forty-six patients were examined: 23 treated with Herbst (12.07 ± 1.49years, 12 males/11 females) and 23 with Pendex (11.76 ± 1.18years, 10 males/13 females). CBCT-derived lateral cephalograms were analyzed at T1 (initial), T2 (6months post-Herbst removal or immediately post-Pendex removal), and T3 (final records after edgewise fixed appliance removal). Cephalometric analysis assessed skeletal, dental, and soft tissue changes. Repeated measures ANOVA analyzed within-group changes across the three time points, and t-tests were used to compare between-group differences at each time point and evaluate changes from T1 to T3. From T1 to T3, the Herbst group exhibited a significant decrease in the SNA angle, a non-significant increase in SNB, and significant increases in mandibular dimensions, including total length, body length, corpus length, and ramus height. In contrast, the Pendex group demonstrated stable SNA values, a significant increase in SNB, and mandibular dimensional changes comparable to those observed in the Herbst group. Vertically, both groups remained stable with no significant differences in skeletal vertical parameters. Overall, no significant between-group differences were observed in skeletal, dental, or soft tissue parameters between T1 and T3. We did not detect statistically significant differences in overall skeletal, dental, and soft tissue changes between the two groups.

To combine quantitative measures of gingival thickness (GT), keratinized tissue width (KTW), and alveolar buccal bone thickness (ABT) for developing a novel classification of periodontal phenotype through a clustering analysis, using two digital images. This cross-sectional study comprised 180 subjects with a total of 1080 maxillary anterior teeth. GT and ABT were assessed utilizing superimposed Cone Beam Computed Tomography (CBCT) and intraoral scan data, while KTW was obtained from intraoral images employing a correction factor. Hierarchical cluster analysis (HCA) was conducted to discern phenotypic categories. Cutoff values for GT, KTW, and ABT were derived from cluster boundaries to provide a clinically applicable scoring system. Cluster analysis identified four statistically significant phenotypic groupings (p < 0.001). Only 48.9% of instances accounted for conventional "thin" or "thick" phenotypes, while 51.1% exhibited mixed characteristics. Cutoff values were established as GT = 0.85mm, KTW = 3.0mm, and ABT = 1.0mm. Based on these cutoffs, a scoring system (0-3) was developed to classify individuals as fully thin, majority-thin (gingival thin/ bone thick)" and "majority-thick (gingival thick/ bone thin), or fully thick. This system demonstrated good internal consistency, with moderate to high coefficients of determination (R²) across parameters. This study presents a comprehensive, data-driven classification of periodontal phenotype using quantitative evaluations of GT, KTW, and ABT, providing an innovative viewpoint on phenotype-based diagnostics. The proposed system offers a clinically relevant framework for phenotype-based diagnostics, risk evaluation, and individualized treatment planning. By combining soft (GT, KTW) and hard (ABT) tissue parameters with 3D imaging and clustering analysis, this classification provides clinicians with a practical and quantitative tool for assessing periodontal phenotype, thereby supporting accurate diagnosis and evidence-based decision-making across multiple dental disciplines.

Malocclusion, particularly anterior crossbite and open bite, contributes to abnormal occlusal stress distribution, potentially leading to tooth loss. We examined the association between anterior malocclusions and tooth loss-related outcomes in a large-scale, community-based sample of Japanese adults. This cross-sectional study targeted 17,349 participants aged ≥ 40 years from the Tohoku Medical Megabank Cohort Study (2013-2017). Based on overjet and overbite, participants were classified into normal occlusion (n = 16,790), anterior open bite (n = 177), anterior crossbite (n = 348), and combined malocclusion (n = 34). Outcomes included ≤ 19 remaining natural teeth and posterior tooth loss. Adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using modified Poisson regression models. The crossbite group demonstrated a higher prevalence of ≤ 19 remaining teeth (PR, 1.48; 95% CI, 1.04-2.10) and posterior tooth loss (PR, 1.14; 95% CI, 1.07-1.20) than the normal group; the open bite group exhibited a lower prevalence of posterior tooth loss (PR, 0.79; 95% CI, 0.69-0.90). Heatmap analysis revealed lower molar tooth retention in the crossbite group and higher retention in the open bite group. Anterior crossbite is associated with increased posterior tooth loss, whereas open bite shows a weaker association. These findings suggest that specific anterior malocclusions may be linked to reduced tooth retention. Identification of anterior malocclusion types, particularly anterior crossbite, may help identify individuals at higher risk for tooth loss. Orthodontic management of anterior crossbite might support posterior dentition preservation and long-term oral function.

This study aimed to map the complex relationships among physiological, psychological, and social factors of oral frailty using network analysis. The primary goal was to identify the most central and influential elements within this network to guide future intervention strategies. A cross-sectional study included 991 community-dwelling older adults in Jiangsu Province, China. Data were collected on oral frailty (OFI-8), oral health self-efficacy (GSEOH), depressive symptoms (GDS-5), family support (APGAR), personal mastery (PMS), and nutritional appetite (SNAQ). A Gaussian Graphical Model network was constructed, and centrality indices were calculated to identify key nodes. The analysis revealed a stable network where personal mastery (PMS), nutritional appetite (SNAQ), and oral health self-efficacy (GSEOH) emerged as the most central nodes. The strongest connection was found between GSEOH and SNAQ, highlighting a key psycho-physiological link. Notably, oral frailty (OFI) exhibited lower centrality and was negatively associated with these core psychosocial resources. Oral frailty should be conceptualized as an outcome of dysregulation within a broader biopsychosocial system, rather than a central driver. Personal mastery, nutritional appetite, and oral health self-efficacy form a critical, interconnected core. A holistic approach strengthening these hubs may be more effective in managing oral frailty than focusing on oral symptoms alone. This study advocates for a clinical shift from reactive symptom management to proactively enhancing older adults' psychological resources, such as personal mastery. Interventions targeting the feedback loop between nutritional appetite and self-efficacy represent a promising strategy to prevent oral frailty and promote healthy aging.

This study aimed to develop, validate, and implement a novel wearable monitor to detect mouth breathing rates and analyze their correlation with malocclusion severity using craniofacial measurements obtained from CBCT and 3D photographs. The monitor was equipped with two sensors mounted in a 3D-printed holder for oral and nasal breathing detection respectively, which senses humidity changes by silk fibroin and interprets into capacitive values. After qualitatively and quantitatively validated by polysomnography and the infrared thermography, the monitor was employed to calculate mouth breathing rates. Malocclusion parameters were derived from CBCT and 3D photographs, and correlated to mouth breathing rates. The accuracy, precision and recall of this novel monitor were 101.07 ± 5.21%, 98.80 ± 3.70% and 99.85 ± 2.08% respectively. The temperature changes and normalised capacitance values showed strong negative correlation during both inhalation and exhalation, with the mean correlation coefficients K at -0.8985 and -0.9332 respectively in the same breathing process. Strong correlations were identified between mouth breathing rates and maxillary canine width, palatal operculum height, left and right mandibular angle, lower face height, lower lip protrusion, nasolabial angle, chin-lip angle and the volumes of adenoid, nose, total airway and nasopharynx airway. This novel wearable monitor can qualitatively and quantitatively monitor mouth and nasal breathing accurately and precisely, potentially establishing itself as gold standard for mouth breathing diagnose and severity assessment. The strong correlations observed between mouth breath rates and malocclusion emphasize the importance of early orthodontic intervention in addressing mouth breathing habits.

Bacteria and viruses are components of the oral microbiome and are linked to various oral diseases. Clinical observations indicate a higher prevalence of apical periodontitis (AP) during viral epidemics. However, research on this association is limited. This meta-analysis aimed to explore the relationship between viral infections and AP. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were identified through systematic database searches, and data were extracted for eligible studies. Three validated quality assessment tools were used to ensure rigor. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the strength of the association. Out of 427 screened records, 31 studies comprising 1,341,636 participants met the inclusion criteria. The meta-analysis revealed that the prevalence of AP was 2.78 times higher in patients with viral infections compared to controls (95% CI = 1.88-4.12, p < 0.001). Infected individuals demonstrated more severe clinical symptoms (OR = 3.49, 95% CI = 2.07-5.90, p < 0.001) and significantly larger periapical lesions (OR = 3.84, 95% CI = 1.08-13.67, p < 0.05). The evidence suggests a significant association between viral infections and AP, particularly in cases of viral co-infections. These findings suggest that evaluating viral infections, particularly herpesviruses, could inform the clinical management of AP. However, further research is required to establish causality.

To characterize restorative materials, including low-viscosity resin composites containing or not S-PRG fillers, under erosive challenge. Specimens of glass-ionomer (GC Gold Label 2-GL), resin composites without (Filtek Supreme Flowable Restorative-FSF; Filtek Bulk Fill Flowable Restorative-FBF) and with S-PRG fillers (Beautifil Flow Plus F00-F00 and Beautifil Bulk Flowable-BBF) were prepared. Materials were assessed for color stability (CIELab/CIEDE 2000), Knoop microhardness (KHN), flexural strength (FS), elastic modulus (E) and Energy Dispersive Spectroscopy (EDS) before and after cycling in orange juice (3 cycles/5min/5 days). Shrinkage stress (SS) was assessed to complement their characterization. Material, storage condition and their interaction were significant for most tests (p < 0.05). Under acidic conditions, GL was more vulnerable, with color change, reduced KHN, and elemental loss. Resin composites maintained both color stability and microhardness after erosive challenge. Among them, BBF and F00 exhibited higher KHN values than FBF. GL and BBF showed stable FS, while the elastic modulus increased for all materials except BBF. BBF also showed the lowest SS compared to FBF and GL. Low-viscosity resin composites, in particular containing S-PRG fillers were able to resist under erosive challenge. BBF presented the best balance of color stability, resistance and low SS among the tested materials. The bulk-fill resin composite containing S-PRG fillers represents a promising restorative strategy for cervical erosive lesions, combining resistance to surface degradation with reduced shrinkage stress that may help preserve the adhesive interface.