Naresuan University Hospital

Background/Objectives: This study aims to investigate the relationship between serum fatty acid-binding protein 4 (FABP4) levels and the severity of periodontitis in systemically healthy individuals. Additionally, the study examines whether non-surgical periodontal treatment can reduce FABP4 levels, establishing its potential as a biomarker linking periodontitis to systemic diseases. Methods: A total of 89 participants with stage I, II, or III periodontitis were recruited, excluding individuals with systemic diseases. Clinical parameters such as clinical attachment level (CAL), probing depth (PD), and gingival index (GI) were recorded. Serum FABP4 levels and Porphyromonas gingivalis (P. gingivalis) antibody titers were measured before and after periodontal treatment using ELISA kits. Statistical analysis included t-tests, correlation analysis, and multiple linear regression to assess changes in FABP4 levels and their association with clinical parameters. Results: FABP4 and P. gingivalis antibody titers significantly increased with the severity of periodontitis (p < 0.001). After non-surgical periodontal treatment, FABP4 levels significantly decreased across all stages of periodontitis. Moderate positive correlations were observed between FABP4 and CAL, PD, GI, and P. gingivalis antibody titers (p < 0.05). Multiple linear regression showed that FABP4 levels increased significantly with the progression of periodontitis, independent of age and sex. Conclusions: The study indicates that FABP4 is a potential biomarker for linking periodontitis to systemic conditions such as cardiovascular diseases and diabetes. Non-surgical periodontal treatment reduced FABP4 levels, potentially contributing to the improvement of systemic conditions associated with elevated FABP4. Further research should explore the role of FABP4 in patients with periodontitis and systemic diseases to strengthen its clinical relevance.

Background/Objectives: As non-thermal atmospheric pressure plasma (NTP) is known to have advantages in application in the medical field, we consider its applicability to periodontitis, a representative chronic inflammatory disease. The purpose of this study was to evaluate the effect of NTP in inhibiting the progression of periodontitis in a rat model when additionally used in scaling and root planing (SRP). Methods: To induce experimental periodontitis in 20 rats, ligatures were placed in the maxillary second molar and lipopolysaccharide from Porphyromonas gingivalis was injected around the teeth. Then, NTP treatment was performed for 2 or 5 min, together with scaling and root planing (SRP). To evaluate alveolar bone loss, micro-computed tomography (micro-CT) analysis and hematoxylin–eosin (H-E) staining were performed. Tartrate-resistant acid phosphatase (TRAP) analysis was performed to compare the number of osteoclasts, while immunohistochemistry (IHC) analysis was performed to determine the expression levels of receptor activator of nuclear factor-𝜅B ligand (RANKL) and osteoprotegerin (OPG). Enzyme-linked immunosorbent assay (ELISA) analysis was performed for the detection of cytokines (TNF-α, IL-1β, and IL-10) in tissues and sera. Results: When SRP was combined with NTP, alveolar bone loss was decreased, the number of osteoclasts and RANKL expression were decreased, OPG expression was increased, and pro-inflammatory cytokine (TNF-α and IL-1β) levels were significantly decreased. Compared with the NTP treatment for 2 min, when treated for 5 min, less alveolar bone loss, fewer osteoclasts, a lower RANKL expression level, and a higher OPG expression level were observed. Conclusions: This study evaluated the adjunctive treatment effect of NTP in periodontitis-induced rats. Based on the results of this study, we suggest that supplemental NTP treatment may be a good option for non-surgical periodontal treatment; however, further studies are needed to elucidate the mechanism through which NTP suppresses periodontal inflammation.

Background/Objectives: Tooth agenesis (TA) is a developmental anomaly prevalent in humans. It is particularly significant in children and adolescents because it is related to esthetic, physiological, and functional problems, including malocclusion, periodontal damage, and insufficient alveolar growth. WNT10A mutations have been identified as the main genetic alterations associated with tooth agenesis. Most previous studies have investigated WNT10A mutations in patients with tooth agenesis using single nucleotide polymorphism (SNP) arrays or exome sequencing. In this study, we conducted a comprehensive profiling of mutations within the exons and introns of WNT10A in Korean patients with non-syndromic tooth agenesis. Methods: Saliva samples were collected from Korean children and adolescents with non-syndromic tooth agenesis. Tagmentation-based sequencing was conducted to acquire mutation information for all exonic and intronic bases of the WNT10A gene. Results: Mutations were detected exclusively in the patient samples: 629C>G and 1100C>T in exon 1, 1977T>C in intron 1, 10256C>T and 10382G>A in exon 3, and 15953G>A in intron 4. Additional mutations were also observed at high ratios in the patient samples. Conclusions: The mutations identified in this study differ from previous findings. These results may provide useful information for understanding the pathogenicity of WNT10A mutations in Korean patients with tooth agenesis and support future diagnostic and therapeutic approaches.

Abstract Objectives This study aimed to develop an automated method for generating clearer, well-aligned panoramic views by creating an optimized three-dimensional (3D) reconstruction zone centered on the teeth. The approach focused on achieving high contrast and clarity in key dental features, including tooth roots, morphology, and periapical lesions, by applying a 3D U-Net deep learning model to generate an arch surface and align the panoramic view. Methods This retrospective study analyzed anonymized cone-beam CT (CBCT) scans from 312 patients (mean age 40 years; range 10–78; 41.3% male, 58.7% female). A 3D U-Net deep learning model segmented the jaw and dentition, facilitating panoramic view generation. During preprocessing, CBCT scans were binarized, and a cylindrical reconstruction method aligned the arch along a straight coordinate system, reducing data size for efficient processing. The 3D U-Net segmented the jaw and dentition in two steps, after which the panoramic view was reconstructed using 3D spline curves fitted to the arch, defining the optimal 3D reconstruction zone. This ensured the panoramic view captured essential anatomical details with high contrast and clarity. To evaluate performance, we compared contrast between tooth roots and alveolar bone and assessed intersection over union (IoU) values for tooth shapes and periapical lesions (#42, #44, #46) relative to the conventional method, demonstrating enhanced clarity and improved visualization of critical dental structures. Results The proposed method outperformed the conventional approach, showing significant improvements in the contrast between tooth roots and alveolar bone, particularly for tooth #42. It also demonstrated higher IoU values in tooth morphology comparisons, indicating superior shape alignment. Additionally, when evaluating periapical lesions, our method achieved higher performance with thinner layers, resulting in several statistically significant outcomes. Specifically, average pixel values within lesions were higher for certain layer thicknesses, demonstrating enhanced visibility of lesion boundaries and better visualization. Conclusions The fully automated AI-based panoramic view generation method successfully created a 3D reconstruction zone centered on the teeth, enabling consistent observation of dental and surrounding tissue structures with high contrast across reconstruction widths. By accurately segmenting the dental arch and defining the optimal reconstruction zone, this method shows significant advantages in detecting pathological changes, potentially reducing clinician fatigue during interpretation while enhancing clinical decision-making accuracy. Future research will focus on further developing and testing this approach to ensure robust performance across diverse patient cases with varied dental and maxillofacial structures, thereby increasing the model's utility in clinical settings. Advances in knowledge This study introduces a novel method for achieving clearer, well-aligned panoramic views focused on the dentition, providing significant improvements over conventional methods.

Burning moouth syndrome (BMS) is a chronic pain condition similar to neuropathic pain. It is characterized by a persistent burning sensation in the oral cavity. Despite the lack of clarity regarding the etiology of BMS, recent studies have reported an association between the gut microbiome and neuropathic pain. However, few studies have investigated the association between the oral microbiome and orofacial pain, such as BMS. This study aimed to compare the oral microbial profiles of healthy controls (HC) and patients with BMS. The BMS group was further divided into BMS_low and BMS_high groups according to pain intensity. A total of 60 patients with BMS (BMS_low, n = 16; BMS_high, n = 44) and 30 HC provided saliva samples, which were sequenced and analyzed for the V1–V2 region of the 16S rRNA gene. The alpha diversity was similar among the three groups. However, a significant difference in the distribution of microbiome composition was observed between BMS_high and HC, as revealed by the Bray–Curtis distance analysis (P < 0.01). At the genus level, Prevotella and Alloprevotella were the most abundant genera in the BMS group. Compared to HC, BMS_high exhibited a relatively higher abundance of bacterial species. Some bacteria, including Prevotella spp., exhibit an increasing pattern with subjective pain intensity. These results suggest the potential involvement of oral microbiota in BMS pathogenesis. Additionally, variations in the microbiome may occur not only in the presence or absence of pain, but also with pain severity.

Chewing difficulty can contribute to psychological stress, which reduces the quality of life for older adults. The purpose of this study was to investigate and analyze the severity of masticatory discomfort, stress response, and sleep disturbance in older patients experiencing masticatory discomfort due to tooth loss or temporomandibular disorders (TMD), to find the further treatment direction for these patients. A total of 392 patients aged 50 years and older with mastication difficulties were analyzed. Two group of patients, those seeking prosthetic treatment due to tooth loss (n = 193) and those who were referred due to TMD-related pain discomfort (n = 199), were identified. Numeric rating scale (NRS), stress response inventory (SRI), and insomnia severity index (ISI) were used as tools to measure patients' subjective chewing discomfort, stress response, and sleep status. Chewing discomfort and age were found to be much higher in the prosthetic group than in the TMD group. The TMD group had significantly higher scores in five SRI parameters (tension, anger, depression, fatigue, and frustration) as well as total score and a higher percentage of clinical insomnia compared to prosthetic patients. Since the number of remaining teeth has a significant impact on the masticatory discomfort severity, restoring the occlusion through prosthodontic treatment is important to improve masticatory function. In patients with TMD, it is necessary to assess stress response and sleep quality, and a multidisciplinary treatment approach may be necessary to effectively address masticatory discomfort.

The images of the Quantitative Light induced Fluorescent (QLF) device, which provides both natural color images similar to those from intraoral cameras and fluorescent images using 405&nbsp;nm light in a single shot, were evaluated for the validity and inter examiner reliability in detecting tooth cracks. QLF images of 26 cracked teeth before and after removing crack lines were taken. Two examiners assessed the QLF images before removing the crack line with natural color images, fluorescent images, and combination images showing both images simultaneously, and recorded the crack’s location after observing images. The reference standard of the crack’s location was established by a trained dentist based on QLF images after removing the crack line. The agreement between examiners and the reference standard of the crack line was calculated by kappa value. Inter examiner agreement of natural color images showed at 0.394, while fluorescent and combination images showed at 0.449 and 0.493. Compared with the reference standard, the combination and fluorescent images showed higher agreement at 0.742 and 0.662, while the natural color images showed the lowest agreement, at 0.164. Determining crack location using only natural colored QLF images is challenging, but fluorescent and combination images improved agreement between examiners and the reference standard.

Peri-implantitis, a plaque-associated pathological condition, has been on the rise with the increasing prevalence of dental implants. Despite its similarities to periodontitis, peri-implantitis is difficult to control completely and has high relapse rates. This has sparked interest in exploring the pathogenic differences between the two conditions.

Park G., Lee J., Joo J., Sohn D.H., Kim H.

The aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)

Background/Objectives: It is well established that individuals with chronic temporomandibular disorder (TMD) exhibit differences in their physical and psychosocial characteristics from those with acute TMD. However, few studies have analyzed the physical and psychosocial characteristics of patients with acute TMD. The objective of this cross-sectional study is twofold: first, to ascertain whether there are differences in physical and psychosocial factors among patients with acute TMD based on the percent agreement between patient-reported pain sites and pain sites identified through standardized palpation and, second, to determine the potential of percent agreement as a diagnostic and prognostic factor. Methods: We analyzed physical and psychosocial factors in 309 patients diagnosed with acute TMD. Of these, 171 patients were selected for an analysis of their response to treatment. These patients were divided into three groups based on their percent agreement: Group A (agreement under 80%), Group B (agreement 80–89%), and Group C (agreement 90% or over) in the initial analysis and Group a (agreement under 80%), Group b (agreement 80–89%), and Group c (agreement 90% or over) in the subsequent analysis. This study was approved by the Ethics Committee of Pusan National University Dental Hospital (IRB No. 2023-05-011, 25 May 2023). Results: The lower the percent agreement, the greater the parafunctional oral habits, stress, chronicity, somatization, depression, anxiety, and number of painful sites. A lower percent agreement was associated with poorer treatment outcomes. The percent agreement demonstrated a 41.2% capacity to predict residual pain after treatment. Conclusions: Clinicians can utilize percentage agreement as an adjunctive diagnostic tool to provide more suitable treatments to patients.

The accuracy of intraoral scanning is critical for computer-aided design/computer-aided manufacturing workflows in dentistry. However, data regarding the scanning accuracy of various adjacent restorative materials and intraoral scanners are lacking. This in vitro study aimed to evaluate the effect of adjacent restorative material type and CEREC's intraoral scanners on the accuracy of intraoral digital impressions for inlay cavities. The artificial tooth was prepared with an occlusal cavity depth of 2&nbsp;mm, a proximal box width at the gingival floor of 1.5&nbsp;mm, and an equi-gingival margin extended disto-occlusally at the transition line angle on both the lingual and buccal sides for an inlay restoration. The adjacent teeth were veneered with crowns made of gold and zirconia, and an artificial tooth (resin) was utilized as the control group. The inlay cavity and adjacent teeth (Gold, Zirconia, and resin) were scanned 10 times using Chairside Economical Restoration of Esthetic Ceramics (CEREC) Primescan (PS), Omnicam (OC), and Bluecam (BC). A reference scan was obtained using a laboratory scanner (3-shape E3). Scanning was performed according to the manufacturer's instructions, including powder application for the BC group. Standard tesselation language files were analyzed using a three-dimensional analysis software program. Experimental data were analyzed using a two-way analysis of variance and the Tukey’s post-hoc comparison test. The restorative materials of the adjacent teeth significantly affected the accuracy of the intraoral digital impressions (p &lt; .05). The zirconia group exhibited the highest trueness deviation, followed by the resin and gold groups, with each demonstrating a statistically significant difference (p &lt; .05). The resin group demonstrated the highest maximum positive deviation and deviation in precision. Gold exhibited the lowest average deviation value for trueness compared with those of the other adjacent restorative materials. Intraoral scanner type significantly influenced the trueness and precision of the scan data (p &lt; .05). The average deviation of trueness according to the intraoral scanner type increased in the following order: BC &gt; PS &gt; OC. The average deviation in precision increased in the following order: PS&gt;OC&gt;BC (p &lt; .05). The restorative materials of the adjacent tooth and the type of intraoral scanner affect the accuracy of the intraoral digital impression. The trueness of the digital images of the BC group, obtained by spraying the powder, was comparable to that of the PS group. Among the adjacent restorative materials, zirconia exhibited the lowest trueness. In contrast, PS demonstrated the highest precision among the intraoral scanners, while resin displayed the lowest precision among the adjacent restorative materials.

Jeong S., Jeong C., Yoon M., Huh J., Lee S.