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Temporomandibular disorders (TMD) intelligent diagnosis promises to elevate clinical efficiency and facilitate timely TMD management for patients. However, development of TMD intelligent diagnostic tools with high accuracy and sensitivity presents challenges, particularly in sensing minute deformations and ensuring rapid self-recovery. Here we report a biocompatible hydrogel electronic sensor with instantaneous self-recovery (within 2.1 s) and ultra-low detection limit (0.005% strain). It could efficiently diagnose disc displacement with reduction (DDwR) with satisfactory accuracy of 90.00%, and also had a clear indication of the typical clinical manifestations of DDwR and the timing of temporomandibular joint (TMJ) clicking, with a sensitivity of up to 100% in human compared to the diagnostic criteria for TMD (DC/TMD). Furthermore, a predictive model based on waveform features achieved 84.4% accuracy and 86% sensitivity, reducing dependence on physicians. In summary, the hydrogel sensor is expected to become a radiation-free, non-invasive, practical and effective tool for future TMD diagnosis. Clinical diagnosis of temporomandibular joint (TMJ) disorders is complex and requires evaluation by a qualified physician. Here, Yan et al. develop a hydrogel electronic sensor to detect TMJ movement, able to accurately detect and classify disc displacement with reduction, a common TMJ disorder.

Oral cancer is a devastating disease and is commonly preceded by a range of oral premalignant disorders. We investigated the expression of PD-1 and PD-L1 in oral epithelial dysplasia (OED) that progressed to oral squamous cell carcinoma (OSCC) compared to non-progressing dysplasia. 49 oral biopsies were analyzed, including 19 progressing cases, 20 cases did not progress, and 10 OSCC. Samples were stained with monoclonal antibodies for PD-1 and PD-L1, followed by conventional peroxidase reaction immunohistochemistry (IHC) imaged under light microscopy or fluorescent immunohistochemistry (FIHC) imaged using a confocal microscope. Images were analyzed using a novel semi-automated analysis protocol. PD-1/PD-L1 expression was assessed at the epithelium/tumor cells (TC) and at inflammatory cells in lamina propria. Our results show a significant increase in PD-L1 expression in progressing compared to non-progressing dysplasia. Using FIHC, we showed increased PD-L1 expression, increased nuclear density in progressing dysplasia and a better interobserver agreement compared with IHC. We developed a new FIHC-based quantitative method to study PD-1/PD-L1 expression in FFPE samples and showed that PD-L1 is highly expressed in premalignant lesions progressing to cancer. Our results suggest that immunomodulation via PD-L1/PD-1 pathway occurs prior to malignant transformation.

Malnutrition-inflammation-atherosclerosis (MIA) syndrome is a significant risk factor for mortality in patients undergoing hemodialysis. This study aimed to investigate the association between MIA syndrome and oral health status in hemodialysis patients. A cross-sectional study was conducted on 254 hemodialysis patients. Comprehensive medical and dental examinations were performed. Three components were included to define MIA syndrome: Geriatric Nutritional Risk Index, serum high-sensitivity C-reactive protein, and history of cardiovascular events as indicators of malnutrition, inflammation, and atherosclerosis, respectively. The association of MIA syndrome components with periodontitis and occlusal support was examined by multiple-ordered logistic regression analysis. Of 254 participants, 188 (74.0%) had at least one component of MIA syndrome. After adjusting for possible confounding factors, severe periodontitis was significantly associated with presence of more components of MIA syndrome (odds ratio [OR]: 2.64, 95% confidence interval [CI], 1.44–4.84, p = 0.002) and inflammation and malnutrition components (OR: 2.47 and 3.46, 95% CI 1.16–5.28 and 1.70–7.05, p = 0.020 and 0.001). On the other hand, occlusal support, evaluated by Eichner index, was not significantly associated with MIA syndrome or any of its components. In conclusion, periodontitis is associated with MIA syndrome, particularly with inflammation and malnutrition in hemodialysis patients, independent of occlusal support.

Gene–environment interactions are believed to play a role in multifactorial phenotypes, although poorly described mechanistically. Cleft lip/palate (CLP), the most common craniofacial malformation, has been associated with both genetic and environmental factors, with little gene–environment interaction experimentally demonstrated. Here, we study CLP families harbouring CDH1 /E-Cadherin variants with incomplete penetrance and we explore the association of pro-inflammatory conditions to CLP. By studying neural crest (NC) from mouse, Xenopus and humans, we show that CLP can be explained by a 2-hit model, where NC migration is impaired by a combination of genetic ( CDH1 loss-of-function) and environmental (pro-inflammatory activation) factors, leading to CLP. Finally, using in vivo targeted methylation assays, we demonstrate that CDH1 hypermethylation is the major target of the pro-inflammatory response, and a direct regulator of E-cadherin levels and NC migration. These results unveil a gene–environment interaction during craniofacial development and provide a 2-hit mechanism to explain cleft lip/palate aetiology. Cleft lip and palate is a common birth defect thought to involve both genetic and environmental components in its etiology. Here they identify a mechanism involving inflammation and E-cadherin mutations that reduces neural crest migration, leading to craniofacial defects.

The particular feature of this study is the investigation of effects of pure fluoride- or stannous ions based mouthrinses on the erosion protective properties and the ultrastructure of the in situ pellicle (12 volunteers). Experimental solutions were prepared either from 500 ppm NaF, SMFP, AmF or SnF 2 or 1563 ppm SnCl 2 , respectively. After 1 min of in situ pellicle formation on bovine enamel slabs, rinses with one of the preparations were performed for 1 min and intraoral specimens’ exposure was continued for 28 min. Native enamel slabs and rinses with bidestilled water served as controls. After oral exposure, slabs were incubated in HCl (pH 2; 2.3; 3) for 120 s and kinetics of calcium- and phosphate release were measured photometrically; representative samples were analysed by TEM and EDX. All mouthrinses reduced mineral loss compared to the native 30-min pellicle. The effect was pH-dependent and significant at all pH values only for the tin-containing mouthrinses. No significant differences were observed between the SnF 2 - and the SnCl 2 -containing solutions. TEM/EDX confirmed ultrastructural pellicle modifications. SnF 2 appears to be the most effective type of fluoride to prevent erosive enamel demineralisation. The observed effects primarily have to be attributed to the stannous ions’ content.

Effective treatment of oral homogeneous leukoplakia requires the use of an antioxidant with optimal properties to ensure a regression of the lesion with respect to size and colour, which is evaluated clinically and also with the help of salivary MDA levels. Despite the availability of various antioxidants, an improved standard evaluation system is needed for adjunct therapy of herbal antioxidants to widely systemically administered lycopene; a standardised evaluation system still needs to be improved. To develop a Comparative Cumulative Index (CCI) for assessment of regression of oral homogeneous leukoplakia that systematically evaluates and ranks adjunct herbal antioxidants to systemically administered lycopene based on their regression in size and colour of lesion and salivary MDA levels. CCI was developed through a structured process involving expert identification, panel discussions, and the establishment of scoring criteria. Two herbal antioxidants as an adjunct to systemically administered lycopene and lycopene alone (Groups A, B, C) were evaluated. Mean values for the core properties were calculated, and antioxidants were ranked accordingly. The total CCI for each antioxidant was computed based on the assigned scores for each property. Lesion size, lesion colour, and salivary MDA parameters all showed differences in CCI between the assessed treatment groups. Group C, with a 50% CCI. Group B’s performance, with a CCI of 41%, is highlighted by deficiencies in several properties, whereas Group A came in third with a CCI of 34%. CCI provides a comprehensive antioxidant evaluation approach to assist practitioners in making informed decisions. The significance of balancing regression in lesion size and colour as well as salivary MDA levels is highlighted by Group C’s high CCI. The results are in line with earlier studies that emphasized the significance of these traits in the treatment of oral homogeneous leukoplakia. The CCI makes it easier to compare adjunct antioxidant therapy based on empirical data and offers a reliable and equitable method of evaluating antioxidants. Future research should enhance the index and validate its use in a range of clinical contexts in order to improve treatment outcomes in oral homogeneous leukoplakia.

This study was undertaken to evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. A smiling photograph of a male and a female dental students were selected and digitally manipulated to create changes the amount of gingival display from 4 mm of gingival display to 4mm of gingival covered by the upper lip in 1 mm increments. Each photo was accompanied by a visual analog scale (VAS) for rating. Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score ± SE, 7.3 ± 3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7 ± 3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3 ± 3.18). The same rating was given by 48.3% of laypeople (6.1 ± 3.6) (p ≤ 0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient.

Conventional methods for assessing tongue bacterial biofilms have low inter-examiner reliability due to visualization challenges. This study aimed to develop and assess a novel Tongue Biofilm Fluorescence Index (TBFI) for the accurate detection and objective evaluation of the quantitative and qualitative characteristics of tongue biofilms at the chairside. Data were collected from 81 elderly individuals (n = 162 images). Qraycam captured white-light and fluorescence images of the dorsal tongue, and two examiners assessed tongue coating (TC) using the TBFI. The TBFI was calculated based on biofilm intensity and coverage (0–2 scale). Inter-examiner agreement (Kappa) was compared with the Winkel’s Tongue Coating Index (WTCI) and the Oho Index. Validity was evaluated through correlations with hydrogen sulfide (H₂S) and methyl mercaptan (CH₃SH) levels. TBFI demonstrated the highest inter-examiner reliability (TBFI, κ = 0.752; WTCI, κ = 0.317; Oho Index, κ = 0.496), particularly for thickness rating (agreement rate: TBFI, 96.3%; WTCI, 76.5%; Oho Index, 79.6%). H₂S and CH₃SH concentrations showed significant positive correlations with all three indices, with the highest correlation observed between H₂S and TBFI (TBFI, r = 0.369; WTCI, r = 0.304; Oho Index, r = 0.308; p < 0.01). Furthermore, H₂S levels increased significantly with higher TBFI scores (p < 0.0001). TBFI shows enhanced reliability and validity, supporting its clinical potential.

Lasers are being used for modifying the surfaces of biomaterials to make them resistant to microbial adhesion. However, the effect of such surface modification on physical and mechanical properties has not been widely reported. The aim of the study was to investigate the effect of surface modification using laser patterning on the physical and mechanical properties of denture base materials. Nd: YAG nanosecond laser was used to create different patterns on two commercial denture base materials. Surface characteristics of the patterned specimens such as surface roughness, contact angle and resistance to microbial adhesion were measured. Laser patterned specimens with lower microbial adhesion were subjected to evaluation of mechanical (flexural strength and surface hardness) and physical (water sorption and solubility) properties using standard methods. Laser patterning increased the surface roughness, contact angle and the resistance to microbial adhesion. Laser patterning did not have any detrimental effects on mechanical and physical properties. However, a significant increase in surface hardness was observed in all patterned specimens. By fine-tuning the laser patterning parameters, it is possible to create surfaces with enhanced resistance to microbial adhesion without compromising the physical and mechanical properties of the material, which can ultimately lead to better oral health outcomes for denture users.