Odontogenic infections in the antibiotic era: approach to diagnosis, management, and prevention.

PURPOSE: The prevalence of odontogenic infections remains one of the highest in the world. If untreated, odontogenic infections can break through the limitation, disseminate to other organs or spaces, and cause high mortality rates. However, it is still difficult to rapidly target limited or disseminated infections in clinical practice. The type of disseminated odontogenic infections and the responsible bacteria have not been described in detail. METHODS: Search databases (e.g., PubMed, MEDLINE, Web of Science, Embase) for reports published from 2018.1 to 2022.9. Use search strategies: ("odontogenic infections" OR "pulpitis" OR "periapical lesions" OR "periodontal diseases") AND ("disseminated infections" OR "complication"). RESULTS: Fourteen different types of disseminated odontogenic infections, most of which are polymicrobial infections, can spread through the body either direct or through hematogenous diffusion. Multiple microbial infections can be more invasive in the transmission of infection. Secondary infections are commonly associated with bacteria like Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Prevotella spp., and Staphylococcus spp. Antibiotics with broad-spectrum activity are fundamental as first-line antimicrobial agents based on the microorganisms isolated from disseminated infections. CONCLUSION: This review elaborates on the epidemiology, microorganisms, risk factors, and dissemination routes, and provides evidence-based opinions on the diagnosis, multidisciplinary management, and prevention of odontogenic infections for dentists and clinicians.

Clinical accuracy of partially guided implant placement in edentulous patients: A computed tomography-based retrospective study.

OBJECTIVES: This retrospective study was intended to evaluate the clinical accuracy of partially guided template in guiding implant placement in edentulous patients. METHODS: A total of 120 implants were placed in 24 patients with at least one completely edentulous arch with a partially guided system. Based on CBCT data, a repeatable method was used to measure linear and angular deviations of implants at 3D level in Mimics medical software. The influence of supporting tissue and implant region on the accuracy was assessed, followed by the evaluation of direction of linear deviations in biologically vital areas. RESULTS: Linear deviations of all implants were 1.91 ± 0.68 mm, 1.47 ± 0.68 mm, and 1.02 ± 0.69 mm at apical, apical lateral, and apical vertical levels. When at the cervical, cervical lateral, and cervical vertical levels, the linear deviations were 1.53 ± 0.65 mm, 0.98 ± 0.53 mm, and 1.01 ± 0.69 mm, respectively. Angular deviation of all implants was 7.14 ± 3.41°. Implants guided by mucosa + tooth-supported templates showed higher linear deviations at apical vertical level (1.21 ± 0.72 mm vs. 0.86 ± 0.63 mm, p < .05) and cervical vertical level (1.18 ± 0.72 mm vs. 0.87 ± 0.63 mm, p < .05) than mucosa-supported templates, and implants in maxilla were found higher angular deviation than mandible (7.89 ± 3.61° vs. 6.29 ± 2.97°, p < .05). CONCLUSIONS: The partially guided template served as clinically viable surgical assistance in implant placement in edentulous patients. When using mucosa + tooth-supported template or placing implants in maxilla, more caution was required, especially in biologically vital areas.

Developing a universal and reliable temporomandibular joint reference system for quantifying morphological and positional changes.

OBJECTIVES: This study aimed to provide a universal and reliable reference system quantifying temporomandibular joint (TMJ) morphological and positional changes. METHODS: Large field-of-view (FOV) cone-beam computed tomography (CBCT) images (20 TMJs) from 10 preorthognathic surgery patients and limited FOV CBCT images (40 TMJs) from 20 splint therapy-treated patients with temporomandibular disorders were collected. TMJ-specific reference system including a TMJ horizontal reference plane (TMJHP) and a local coordinate system (TMJCS) was constructed with landmarks on cranial base. Its application for TMJ measurements and its spatial relationship to common Frankfort horizontal plane (FHP) and maxillofacial coordinate system (MFCS) were evaluated. RESULTS: Five relevant landmarks were selected to optimally construct TMJ-specific reference system. General parallelism between TMJHP and FHP was demonstrated by minimal angular and constant distance deviation (1.714 ±â€…0.811º; 2.925 ±â€…0.817 mm). Additionally, tiny axial orientational deviations (0.181 ±â€…6.805º) suggested TMJCS rivaled MFCS. Moreover, small deviations in orientations and distances (1.232 ±â€…0.609º; 0.310 ±â€…0.202 mm) indicated considerable reliability for TMJCS construction, with intraclass correlation coefficients (ICCs) ranging from 0.999 to 1.000. Lastly, slight discrepancies in translations and rotations revealed high reliability for condylar positional and morphological measurements (ICC, 0.918-0.999). LIMITATIONS: TMJ-specific reference system was merely tested in two representative FOVs. CONCLUSIONS: This study provides a universal and reliable reference system for TMJ assessment that is applicable to both limited and large FOV CBCT. It would improve comparability among diverse studies and enable comprehensive evaluations of TMJ positional and morphological changes during TMJ-related treatment follow-up such as splint therapy and disease progression.

Comparative evaluation of transverse width indices for diagnosing maxillary transverse deficiency.

OBJECTIVES: This study aimed to compare and evaluate different transverse width indices for diagnosing maxillary transverse deficiency (MTD), a common malocclusion characterized by uncoordinated dental arches, crossbites, and tooth crowding. MATERIALS AND METHODS: Sixty patients aged 7-12 years were included in the study, with 20 patients diagnosed with MTD and 40 normal controls. Transverse width indices, including maxillary width at the buccal alveolar crest and lingual midroot level, as well as at the jugal process width, were measured. Differences between these indices and their corresponding mandibular indices were used as standardized transverse width indices. The reference range of these indices was determined and evaluated. Receiver operating characteristic (ROC) analysis was performed to evaluate their diagnostic ability. RESULTS: The transverse width indices and standardized transverse width indices of the MTD group were significantly smaller than those of the control group, except for the jugal process width. The evaluation of the reference range and ROC analysis revealed that the difference of the maxillomandibular width at buccal alveolar crest was the most accurate diagnostic method. CONCLUSIONS: The jugal point analysis method may not be suitable for diagnosing MTD. Instead, measuring the difference in maxillomandibular width at the buccal alveolar crest proves to be a more reliable and accurate diagnostic method for MTD.

Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery. / çª¦ç®¡çš„è§£å‰–ä¸ŽåŠŸèƒ½åŠå ¶åœ¨ç§æ¤æœ¯ä¸­æŸä¼¤çš„é˜²æ²»ç­–ç•¥.

The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth, their corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, implantologists need to investigate strategies for preventing and treating canalis sinuosus injuries. Preoperatively, implantologists should use CBCT to identify the canalis sinuosus and virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, implantologists should assess bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT can be employed to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and its physiological functions in the anterior maxilla, and discusses strategies for effectively avoiding canalis sinuosus injuries during implant surgery, thereby enhancing implantologists' awareness and providing references for clinical decision-making.

Changes in bone graft height and influencing factors after sinus floor augmentation by using the lateral window approach: A clinical retrospective study of 1 to 2 years.

STATEMENT OF PROBLEM: Recent systematic reviews have reported resorption of bone grafts after augmentation, but the influencing factors are numerous and uncertain. Different brands of bone graft and other factors may affect the bone formation effect after sinus floor augmentation. PURPOSE: The purpose of this retrospective clinical study was to evaluate the graft material height changes after sinus floor augmentation with cone beam computed tomography (CBCT) and to investigate the potential influencing factors related to graft resorption. MATERIAL AND METHODS: Four midsagittal cut CBCT images of 157 posterior maxillary implants after maxillary sinus floor elevation by using the lateral window approach with bone grafts from 116 patients were obtained. Four CBCT scans had been performed immediately (T0), 6 months (T1) and 12 months after bone grafting (T2), and 1.5 to 2 years after treatment (T3), and the distance between the implant platform and the grafted mucosa of the maxillary sinus floor was measured at 3 locations. Correlation coefficients of these parameters were calculated. A linear mixed model was used to investigate potential factors influencing graft height reduction, including the patient's sex, age, smoking status, periodontal status, graft brand, implant site, implant level, placement time, and residual bone height. RESULTS: Mean ±standard deviation graft height at the mesial side of the implant (MeGH) was significantly decreased by 0.32 ±0.88 mm in the first 6 months, was gradually reduced after 6 months (0.26 ±0.43 mm), and then 1 to 2 years later increased to 0.39 ±0.97 mm. The changes in graft height at the center of the implant (CeGH) and graft height at the distal side (DiGH) groups were similar to those in the MeGH group. A significantly positive correlation was found among the height alterations in 3 locations (rs=0.954, P<.001). The linear mixed model showed that smoking was more likely to cause graft height reduction in MeGH (P=.034). CONCLUSIONS: Graft height significantly decreased after maxillary sinus augmentation over 1 to 2 years. Smoking had a negative effect on graft height changes, while the 2 brands of graft and other factors had no significant effect.

Multifocal epithelial hyperplasia confined to the interdental papilla of an adult Chinese man: a rare case report and literature review.

BACKGROUND: Multifocal epithelial hyperplasia (MEH), or focal epithelial hypertension (FEH), or Heck's disease, is an uncommon, benign oral mucosal disease associated with human papillomavirus infection. It is mostly observed in indigenous populations of the world, and has been rarely reported in China. However, previous research suggested there might be a greater prevalence of MEH in the Chinese population. While predominantly involves the lips, buccal mucosa and tongue, MEH was occasionally reported to affect the hard palate and gingiva as well. CASE PRESENTATION: This paper reports a case of extensive MEH lesions that confined to the interdental papilla of a Chinese male without detection of HPV, and summarizes the published gingiva-involved MEH reports from 1966 until present. The lesions were excised with an Er: YAG laser after scaling and root planning, no recurrence was observed after 6-month follow-up. CONCLUSIONS: The present report illustrates the need for clinicians to be aware of rare presentations of MEH to facilitate a prompt diagnosis and proper management. More reports are encouraged to determine a correct prevalence rate of MEH in China.

Application of WeChat-based flipped classroom on root canal filling teaching in a preclinical endodontic course.

BACKGROUND: This study was aimed to evaluate the application of WeChat-based flipped classroom in root canal filling teaching in a preclinical endodontic course. METHODS: A two-group comparative study was designed. The pre-class test, on-site quiz, and root canal filling on extracted premolars were performed by students from a lecture-based classroom group (LG, n = 30) and a WeChat-based flipped classroom group (WFG, n = 30). Results of the Pre-class test and on-site quiz were analyzed by independent samples t-test. Post-filling radiographs were taken and evaluated by a specialist in oral radiology who was blinded to grouping. Results of root canal fillings were analyzed by the Pearson chi-square test. Student responses in questionnaires were analyzed by Fisher's exact test. RESULTS: The students in WFG could get significantly higher scores in the on-site test and make better performances in root canal filling than those in LG. In terms of questionnaires, students from WFG were perceived to be more motivated to learn, better to understand the knowledge, better to improve communication and clinical skills, easier to perform root canal filling but spending more time. CONCLUSION: The WeChat-based flipped classroom teaching can have a better effect than lecture-based teaching on root canal filling learning for students with limited endodontic experiences.

EFFECTIVENESS OF INTRA-ARTICULAR INJECTIONS OF SODIUM HYALURONATE, CORTICOSTEROIDS, PLATELET-RICH PLASMA ON TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.

OBJECTIVE: To compare the efficacy of Intra-articular injections of corticosteroids (CCS), hyaluronic acid (HA), and platelet-rich plasma (PRP) on temporomandibular joint osteoarthritis. METHODS: Studies were identified from PubMed, Embase and Cochrane Central Register of Controlled Trials, ClinicalTrials.gov with date up to January 15, 2022. Randomized controlled trials included were the studies of patients with temporomandibular joint osteoarthritis who had intra-articular treatment with CCS, HA, PRP, placebo and follow-up assessing temporomandibular joint function in target outcome variables. The primary outcome was temporomandibular joint pain. The secondary outcomes were maximal mouth opening (mm), and lateral movement to the affected side (mm). This study is registered with PROSPERO, number CRD42021270914. RESULTS: Nine randomized controlled trials involving 316 patients were included. For primary pain outcome, no significance was detected when CCS, HA and PRP were compared with placebo by both short- (3-6 months) and long-term (>12 months) follow-up. Relatively, the top ranking of which was PRP in the long-term (Mean Difference, -0.23 [95% CI, -2.49 to 2.04]). In addition, these injectables did not significantly outperform placebo by evaluating secondary functional outcomes (maximal mouth opening and lateral movement) with the same follow-up. Subgroup analyses showed that the effect of CCS on subgroups with more than 70% women was statistically less effective compared with placebo (Mean Difference, 1.73 [95% CI, 0.37-3.09]). CONCLUSION: Evidence suggested that intra-articular pharmacological injections of CCS, HA, and PRP had no effect on improving temporomandibular joint pain and functional outcomes compared with placebo injection.

Changes in the surface topography and element proportion of clinically failed SLA implants after in vitro debridement by different methods.

OBJECTIVE: To evaluate the surface topography and element proportion changes in clinically failed implants after different modalities in vitro debridement and to compare the cleaning effect of different method combinations. MATERIAL AND METHODS: Thirty clinical failed implants were treated by different debridement methods in vitro as follows: Group 1: physiologic saline irrigation; Group 2: glycine powder air polishing; Group 3: glycine powder air polishing + ethylenediaminetetraacetic acid (EDTA); Group 4: polyetheretherketone (PEEK) tip ultrasonic scaling; and Group 5: PEEK tip ultrasonic scaling + EDTA. The relative contaminated area reduction (RCAR), visual analogue scale (VAS, the higher value means, the better cleaning effect) and surface roughness were assessed using scanning electron microscopy (SEM), stereoscopic microscopy (SM) and white light interferometry (WLI). Surface chemistry was determined by energy dispersive spectroscopy (EDS). RESULTS: Group 4 and Group 5 showed higher RCARs (82.90%, 82.89%), VAS scores (2.61, 2.33) and roughness reductions (-0.85 µm, -1.80 µm). Group 3 attained the highest decrease of C% (carbon, -26.67%), O% (oxygen, -13.71%) and N% (nitrogen, -5.66%), and the highest increase of Ti% (titanium, 49.67%). PEEK remnants were detected on the implant surface of Groups 4 and 5. CONCLUSION: Within the limitation of the present in vitro design, PEEK tip ultrasonic scaling was more effective in eliminating visible contamination, while glycine powder air polishing combined with EDTA treatment was more conducive to expose the original surface element distribution. Both methods have their own advantages in decontamination, but none of them could reconstruct the surface as the pristine implant.

The association between low birth weight and dental caries among 11-to-13-year-old school age children in Ningbo, China.

BACKGROUND: The association between low birth weight (LBW) and dental caries is currently unclear. The aim of this study was to investigate the association of LBW with dental caries in permanent teeth in children of Ningbo city. METHODS: A total of 1975 children aged 11-to-13 years in Ningbo, China were enrolled in this cross-sectional study. LBW was defined as a birthweight< 2500 g. Ten dentists assessed the status of dental caries in permanent teeth in line with the World Health Organization (WHO) criteria and guidelines. Decayed, missing or filled teeth were considered to have dental caries. Parental questionnaires were used to collect child information. Non-conditional logistic regression analysis was used to estimate odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). RESULTS: Dental caries in permanent teeth was found in 610 children (30.9%), with a mean DMFS of 2.09 (SD = 1.2). The adjusted ORs for dental caries in permanent teeth was 1.46 (95% CI 1.00, 2.13) for LBW. CONCLUSIONS: LBW was not associated with dental caries in permanent teeth in the study population.

Skull Base Sphenoid Bone: A Potential Route of Brain Abscesses Induced by Odontogenic Infection.

ABSTRACT: Odontogenic foci are rarely linked with brain abscesses. The lack of an effective approach to match the causative origin with the infection can lead to late medical response of patients. Here we present a case of a 53-year-old man with brain abscesses that was probably caused by odontogenic foci. The imaging examinations clearly showed the periodontitis of mandibular left second molar and the destruction of greater sphenoid wing. Therefore, possible routes of extension through masticator space abscesses were indicated. For early infection of the maxillofacial space caused by potential odontogenic lesions, oral surgeons should eliminate the potentially odontogenic foci and use computerized tomography imaging to determine the existence of bone destruction around the oral cavity such as the skull to prevent further bone defect complications such as brain abscesses.

Enhanced osteogenesis of quasi-three-dimensional hierarchical topography.

Natural extracellular matrices (ECMs) are three-dimensional (3D) and multi-scale hierarchical structure. However, coatings used as ECM-mimicking structures for osteogenesis are typically two-dimensional or single-scaled. Here, we design a distinct quasi-three-dimensional hierarchical topography integrated of density-controlled titania nanodots and nanorods. We find cellular pseudopods preferred to anchor deeply across the distinct 3D topography, dependently of the relative density of nanorods, which promote the osteogenic differentiation of osteoblast but not the viability of fibroblast. The in vivo experimental results further indicate that the new bone formation, the relative bone-implant contact as well as the push-put strength, are significantly enhanced on the 3D hierarchical topography. We also show that the exposures of HFN7.1 and mAb1937 critical functional motifs of fibronectin for cellular anchorage are up-regulated on the 3D hierarchical topography, which might synergistically promote the osteogenesis. Our findings suggest the multi-dimensions and multi-scales as vital characteristic of cell-ECM interactions and as an important design parameter for bone implant coatings.

Citrate Improves Biomimetic Mineralization Induced by Polyelectrolyte-Cation Complexes Using PAsp-Ca&Mg Complexes.

Magnesium ions are highly enriched in early stage of biological mineralization of hard tissues. Paradoxically, hydroxyapatite (HAp) crystallization is inhibited significantly by high concentration of magnesium ions. The mechanism to regulate magnesium-doped biomimetic mineralization of collagen fibrils has never been fully elucidated. Herein, it is revealed that citrate can bioinspire the magnesium-stabilized mineral precursors to generate magnesium-doped biomimetic mineralization as follows: Citrate can enhance the electronegativity of collagen fibrils by its absorption to fibrils via hydrogen bonds. Afterward, electronegative collagen fibrils can attract highly concentrated electropositive polyaspartic acid-Ca&Mg (PAsp-Ca&Mg) complexes followed by phosphate solution via strong electrostatic attraction. Meanwhile, citrate adsorbed in/on fibrils can eliminate mineralization inhibitory effects of magnesium ions by breaking hydration layer surrounding magnesium ions and thus reduce dehydration energy barrier for rapid fulfillment of biomimetic mineralization. The remineralized demineralized dentin with magnesium-doped HAp possesses antibacterial ability, and the mineralization mediums possess excellent biocompatibility via cytotoxicity and oral mucosa irritation tests. This strategy shall shed light on cationic ions-doped biomimetic mineralization with antibacterial ability via modifying collagen fibrils and eliminating mineralization inhibitory effects of some cationic ions, as well as can excite attention to the neglected multiple regulations of small biomolecules, such as citrate, during biomineralization process.

Reversion of ACP Nanoparticles into Prenucleation Clusters via Surfactant for Promoting Biomimetic Mineralization: A Physicochemical Understanding of Biosurfactant Role in Biomineralization Process.

Amphiphilic biomolecules are abundant in mineralization front of biological hard tissues, which play a vital role in osteogenesis and dental hard tissue formation. Amphiphilic biomolecules function as biosurfactants, however, their biosurfactant role in biomineralization process has never been investigated. This study, for the first time, demonstrates that aggregated amorphous calcium phosphate (ACP) nanoparticles can be reversed into dispersed ultrasmall prenucleation clusters (PNCs) via breakdown and dispersion of the ACP nanoparticles by a surfactant. The reduced surface energy of ACP@TPGS and the electrostatic interaction between calcium ions and the pair electrons on oxygen atoms of C-O-C of D-α-tocopheryl polyethylene glycol succinate (TPGS) provide driving force for breakdown and dispersion of ACP nanoparticles into ultrasmall PNCs which promote in vitro and in vivo biomimetic mineralization. The ACP@TPGS possesses excellent biocompatibility without any irritations to oral mucosa and dental pulp. This study not only introduces surfactant into biomimetic mineralization field, but also excites attention to the neglected biosurfactant role during biomineralization process.

MicroRNA-146a-loaded magnesium silicate nanospheres promote bone regeneration in an inflammatory microenvironment.

Reconstruction of irregular oral-maxillofacial bone defects with an inflammatory microenvironment remains a challenge, as chronic local inflammation can largely impair bone healing. Here, we used magnesium silicate nanospheres (MSNs) to load microRNA-146a-5p (miR-146a) to fabricate a nanobiomaterial, MSN+miR-146a, which showed synergistic promoting effects on the osteogenic differentiation of human dental pulp stem cells (hDPSCs). In addition, miR-146a exhibited an anti-inflammatory effect on mouse bone marrow-derived macrophages (BMMs) under lipopolysaccharide (LPS) stimulation by inhibiting the NF-κB pathway via targeting tumor necrosis factor receptor-associated factor 6 (TRAF6), and MSNs could simultaneously promote M2 polarization of BMMs. MiR-146a was also found to inhibit osteoclast formation. Finally, the dual osteogenic-promoting and immunoregulatory effects of MSN+miR-146a were further validated in a stimulated infected mouse mandibular bone defect model via delivery by a photocuring hydrogel. Collectively, the MSN+miR-146a complex revealed good potential in treating inflammatory irregular oral-maxillofacial bone defects.

Adjacent tooth migration after maxillary first molar loss in patients with sinus augmentation: A retrospective research.

PURPOSE: The objectives of this study are to: (1) investigate the extent of antagonistic and distal neighboring tooth migration in the maxillary posterior single tooth-missing site during the healing period of bone augmentation and implant surgery; (2) identify factors associated with tooth migration. MATERIALS AND METHODS: One hundred and forty-three cases that lost the maxillary first molar were included, and their CBCT data during the edentulous period were obtained. Dentition models were reconstructed from CBCT, and superimpositions were performed, followed by measuring migration distances and calculating migration rates of antagonistic and distal neighboring teeth. Factors were analyzed using multivariate generalized estimating equations (GEE). RESULTS: The mean migration distances were 208 ± 137 µm and 403 ± 605 µm for antagonistic teeth and distal teeth, and the mean migration rates were 26.8 ± 21.2 µm/month and 48.5 ± 76.7 µm/month, respectively. One hundred and nineteen out of 143 distal neighboring teeth migrated toward the edentulous site, and all antagonistic teeth migrated occlusally. Occlusal contact loss and chronic apical periodontitis both significantly accelerated antagonistic tooth migration (p < 0.05), the latter also accelerated distal tooth migration (p < 0.05). Besides, the displacement of the distal teeth was somewhat accelerated by the impacted adjacent third molar and root protrusion into the sinus. CONCLUSIONS: The neighboring teeth tend to migrate toward the edentulous gap in the maxillary posterior region. Occlusal contact loss and chronic apical periodontitis are two significant risk factors for accelerating antagonistic tooth migration, and for distal teeth, chronic apical periodontitis is the risk factor. The impacted adjacent third molar and root protrusion into the sinus are also potential risk factors for accelerating the migration of the maxillary distal tooth. Thus, to prevent maxillary edentulous gap reduction, the factors mentioned above should be taken into consideration when planning treatment flow.

Public sense of dental implants on social media: A cross-sectional study based on text analysis of comments.

OBJECTIVES: To investigate the most discussed topics and possible new interests in dental implants among the public, as well as the public sentiments toward dental implants through topic and sentiment analysis of online comments. METHODS: Comments of the top 100 most viewed dental implant-related YouTube videos were studied. The comments were analyzed by topic analysis (LDA topic model, Word co-occurrence analysis) and sentiment analysis. The basic information of videos was collected and classified. Video quality was evaluated by GQS criteria and 9-point usefulness scoring system. Statistical analyses were performed using Kruskal-Wallis test, Mann-Whitney U-tests, and Spearman correlation analysis. RESULTS: 74 videos with 61,618 comments were considered eligible in this study. Most videos targeted the public with high viewing and comments, but the theme was single and the quality was low. From topic analysis, the most discussed topics in the comments were procedure, cost, feelings associated with prognosis, and expectations. Multidisciplinary approaches in implant dentistry were frequently discussed. From sentiment analysis, the public mainly expressed positive sentiment through comments. In detail, the public had positive feelings about aesthetics and health, negative feelings about pain, and neutral feelings about cost. CONCLUSION: The hot topics of public concern were procedure, cost, feelings associated with prognosis, and expectations. Intriguingly, multidisciplinary approaches in implant dentistry have emerged as a new hot subtopic within the topic "procedure". Based on the sentiment analysis of the comments, the general sentiment expressed by the public toward dental implants was predominantly positive. CLINICAL SIGNIFICANCE: Text mining can extract data from social media to explore public interest in dentistry. Clinicians should convey reasonable expectations and understanding about dental implants, especially addressing the most public-concerned topics (procedure, cost, feelings, and expectations), and provide patients with well-grounded multidisciplinary treatment plans to meet the growing public demand.

Endoscope-assisted maxillary sinus floor augmentation with a mini-lateral window: A retrospective study.

OBJECTIVES: The aim of this study was to evaluate the efficacy of endoscope-controlled sinus floor augmentation through a mini-lateral window, compared with traditional lateral window approach. MATERIALS AND METHODS: This retrospective research included 19 patients and 20 augmented sinuses using lateral window approach with simultaneous implant placement (test group: a 3-4 mm round osteotomy; control group: a 10 × 8 mm rectangular osteotomy). Preoperatively (T0), immediately after surgery (T1), and 6 months postoperatively (T2), cone-beam computed tomography (CBCT) scans were obtained. Residual bone height (RBH), lateral window dimension (LWD), endo-sinus bone gain (ESBG), apical bone height (ABH), and bone density were measured. Intraoperative and postoperative complications were recorded. Patients' evaluation of pain first day after surgery and a week later was assessed by visual analog scale (VAS). RESULTS: No significant difference was found in ESBG, ABH between the two groups at T1, T2 or their changes from T1 to T2. However, the increase of bone density value in the test group was significantly higher than control group (356.28 ± 149.59 vs. 242.99 ± 129.54; p < 0.05). The sinus perforation rate of test and control group was 10% and 20%, respectively. The VAS score of the test group at the first day after surgery was significantly lower than control group (4.20 ± 1.03 vs. 5.60 ± 1.71; p < 0.05). CONCLUSIONS: Endoscope-controlled maxillary sinus floor augmentation through a mini-lateral window yield similar result with traditional approach in terms of bone height gain. The modified approach could facilitate new bone formation, reducing sinus perforation rate and postoperative pain.

Influence of edentulism on the structure and function of temporomandibular joint.

Background: With the acceleration of the aging process of the population, the number of edentulous patients continuously increased. Edentulism induces the loss of occlusal relationship and cause adverse effects on the stomatognathic system. Temporomandibular joint (TMJ), as a significant component of this system, may also be affected by edentulism in the process of supporting mandibular movement. Purpose: Provide a comprehensive review of the structure and function of TMJ in the edentulous population, as well as the prevalence of temporomandibular joint disorder (TMD) in edentulous group. Study selection: An electronic search was conducted on articles prior to December 2022 to filter all papers relevant to the structure and function of TMJ in edentulous population. The internet databases (PubMed, Cochrane Library, Embase) were searched using various combinations of keywords for "edentulism" or "edentulous" and "TMJ" or "TMD". Results: Firstly, 522 articles were selected from the internet database, and finally, a total of 44 articles met the inclusion and exclusion criteria. The research content of these articles mainly focuses on the structure and function of TMJ in edentulous patients, as well as the clinical signs and symptoms of TMD. Conclusions: Edentulous arch induces the loss of occlusal relationship, which may lead to degenerative changes of TMJ components consisting of changes in morphology and bone mass density of condyle, articular fossa, and articular eminence. In addition, the condyle could be shifted backward and upward, and displacement of the articular disc may occur after dentition loss. And the condyle and the articular disc may be guided back to the normal position after effective prosthodontic treatment. But the conclusions of the study on the function of TMJ and the prevalence of TMD in edentulous people are inconsistent. The condition of TMJ, especially the position of condyle-fossa and the symptoms and signs of TMD should not be ignored. If necessary, radiographic examinations should be performed.