Dongxin Da, Suyu Ge, Qingqing Weng, Hao Zhang, Xiaoli Zeng, Yiwei Jiang, Jin Yu, Huning Wang, Ying Zhang
Previous studies have indicated associations between the number of remaining teeth, oral health-related quality of life (OHRQoL), and frailty. We aimed to investigate the association between number of remaining natural teeth and frailty among Chinese community-dwelling older adults in Shanghai, and to explore whether OHRQoL mediates this association. In this cross-sectional study, 1,122 Chinese community-dwelling older adults in Huangpu District, Shanghai, underwent oral examinations and completed questionnaires. Oral examinations were conducted according to the World Health Organization's Basic Methods for Oral Health Surveys (5th edition). Frailty was assessed using the FRAIL scale, and OHRQoL was measured with the Chinese version of Oral Health Impact Profile-14 (OHIP-14). A counterfactual-based causal mediation analysis with 5,000 bootstrap resamples was performed, using the three-category frailty outcome (robust/pre-frail/frail), to evaluate the mediating role of OHRQoL in the association between number of remaining teeth and frailty. Among the 1,122 participants, 225 were diagnosed with frailty, accounting for 20.05% of the participants. Age, sex, education, body mass index, and number of remaining teeth significantly differed between participants with and without frailty (P < 0.01). After adjusting the covariates, logistic regression models showed that OHRQoL was significantly associated with frailty, with odds ratio (OR) = 1.140 [95% confidence interval (CI) 1.109–1.171]. In an exploratory analysis, OHRQoL was statistically consistent with a potential partial mediating role (proportion mediated = 19.3%, 95% CI 11.6%–31.2%). There is a potential association between number of remaining teeth and frailty, and OHRQoL may play a partial mediating role in this relationship. Given the cross-sectional design, causal inference requires longitudinal confirmation. Oral health—particularly, the number of remaining teeth—should be a key focus for both the elderly and healthcare providers.
Anna Turska-Szybka, Julia Sazonowa, Dorota Olczak-Kowalczyk, Elżbieta Wójcik-Gront, Giusy Rita Maria La Rosa
Enamel carious white spot lesions (WSLs) represent early-stage demineralization that may progress to cavitated lesions requiring invasive treatment. The self-assembling peptide P11-4 (SAP P11-4) is a biomimetic agent designed to promote enamel remineralization by forming a biomatrix that attracts calcium and phosphate ions and supports hydroxyapatite formation. Although evidence supports its efficacy, the optimal application protocol remains unclear, and no clinical trial has directly compared single vs. repeated SAP P11-4 application. To compare the remineralization efficacy of repeated vs. single SAP P11-4 application in adolescents with enamel carious WSLs at the prespecified 6-month primary time point, while also evaluating both SAP P11-4 regimens against fluoride varnish alone over 12 months. This three-arm, partially blinded, randomized controlled trial will enroll participants aged >10 and <18 years with at least two active enamel carious WSLs on smooth surfaces of permanent teeth. Participants will be randomly allocated 1:1:1 to Group A (single SAP P11-4 application + FV), Group B (SAP P11-4 applications at baseline and 3 months + FV), or Group C (FV alone). The planned sample size is 75 participants (25 per group). The primary outcome is the change in the QLF-derived lesion volume parameter (Δ Q) from baseline to 6 months at the lesion level, comparing repeated vs. single SAP P11-4 application. Secondary outcomes include longitudinal changes in QLF measures, fluorescence loss (Δ F), clinical lesion activity assessed using ICDAS II, ICDAS-LAA, and LAA criteria, periodontal parameters, and patient-reported tolerability assessed by visual analogue scale and adverse event recording. QLF assessments will be performed by a blinded investigator. Linear mixed-effects models will account for repeated measurements and multiple lesions nested within patients. The study was approved by the Bioethics Committee of the Medical University of Warsaw (KB/1/2026, 12 January 2026). Recruitment is planned to commence in February 2026, with study completion expected in July 2027. This trial will provide evidence on the comparative efficacy of single vs. repeated SAP P11-4 application and inform an evidence-based clinical protocol for managing enamel WSLs in adolescents. https://clinicaltrial.gov/, identifier NCT07664046.
Saido Gedi, Salma Ali Ossoble, Mohamoud M. Dahir, Nasra Abdulsamad Mohamud, Abubakar Ahmed, Jihaan Hassan, Maye Abu Omar
Oral diseases are among the most common noncommunicable conditions globally, yet oral health remains poorly integrated into primary health care (PHC) and universal health coverage, especially in fragile, low-limited settings. As Somalia rebuilds its health system through the Health Sector Strategic Plan III 2022–2026, the Essential Package of Health Services 2020, the Investment Case for the Somali Health Sector 2022–2027, and community health reforms, this study examined the place of oral health within national health policies. It identified barriers to integration and explored feasible pathways for strengthening PHC-based oral health. The study used a qualitative policy and health-systems analysis combining documentary review with 13 key-informant interviews. Participants represented national policymakers, health-system technical advisers, regulators, academics, professional associations, and providers at public hospital, and private dental settings. Data were analyzed thematically and mapped against the WHO health-system building blocks, PHC principles, and the WHO Global Strategy and Action Plan on Oral Health 2023–2030. Somalia's policy environment offers opportunities for oral health integration, but stakeholders highlighted a persistent gap between policy recognition and implementation within routine PHC. Seven interrelated themes were identified: (1) policy recognition without operationalization; (2) fragmented governance, weak regulation, and limited coordination; (3) reliance on out-of-pocket financing and private-sector; (4) workforce, education, and task-sharing constraints; (5) predominantly curative, urban, hospital-based service with weak linkage to maternal and child health (MCH) and PHC; (6) limited oral health data and evidence generation; and (7) opportunities for phased integration through PHC, MCH, school health, community health workers, and NCD platforms Policymakers emphasized the need for stronger policy implementation, financing, regulation, standards, and data systems, while service providers highlighted unaffordable care, delayed care-seeking, workforce and infrastructure shortages, and missed opportunities for prevention. Oral health integration in Somalia is a broader health system challenge rather than solely a dental-service issue. The most feasible approach is a phased, system-based model that prioritizes strengthened governance, a defined minimum oral health within PHC, workforce task-sharing, screening, counselling, referral pathways, private-sector regulation, essential commodities, and oral health indicators in District Health Information System 2 (DHIS2), followed by the gradual expansion of curative and rehabilitative services.
Huawei Liu, Qi Ning, Xiaodan Mu, Wenting Bi, Qingyan Sun, Zhigang Cai, Shijun Li, Xiaofeng Shan, Min Hu
To observe facial nerve function recovery from an autologous great auricular nerve (GAN) transplantation in repairing facial nerve defects. Thirty-six patients were included. Facial nerve functions were evaluated by using the House–Brackmann grading system. Abnormal sensations after the GAN sacrifice were recorded. The follow-up lasted for an average of 18.5 (12–60) months. Facial nerve defects were caused by parotid gland malignancies (n = 30) or trauma (n = 6), with an average length of 2.6 ± 1.1 (1.0–6.5) cm. One case showed tumor recurrence during the follow-up. Lack of feeling (78.1%) was the dominant postoperative abnormal sensation, followed by lack of sensitivity (53.1%) and abnormal sensation (40.6%). Long facial nerve defects (>3 cm) and preoperative facial paralysis combined with parotid gland malignancies retarded facial nerve function recovery. Autologous GAN transplantation is effective for repairing facial nerve defects and recovering facial nerve function during the 12-month follow-up period.
Periodontal disease is a chronic inflammatory condition that has been increasingly associated with systemic diseases such as diabetes mellitus, cardiovascular disorders, respiratory diseases, and adverse pregnancy outcomes. Medical professionals play a critical role in early identification and referral; however, awareness of periodontal–systemic interactions remains variable. To assess the knowledge, awareness, and attitudes of medical professionals regarding the relationship between periodontal disease and systemic health. A cross-sectional questionnaire-based study was conducted among 380 medical professionals across India, including interns, postgraduate students, practitioners, and faculty. A structured, pre-tested questionnaire was distributed electronically using Google Forms. Responses were scored using a Likert scale, and composite awareness scores were calculated. Data were analyzed using SPSS version 21. Descriptive statistics were used to summarize the data, associations between categorical variables were assessed using the chi-square test, and differences in mean awareness scores among groups were evaluated using one-way ANOVA followed by Tukey's post-hoc test. A p -value < 0.05 was considered statistically significant. Although 90.5% of participants reported referring patients to dentists, only 1.1% did so based on knowledge of periodontal–systemic associations. Awareness of clinical symptoms was high (86.6%), with gingival bleeding being the most commonly identified sign (33.4%). ANOVA revealed significant differences in awareness scores among professional groups (p < 0.05). Government practitioners demonstrated significantly higher awareness than interns regarding diabetes mellitus and adverse pregnancy outcomes, while medical faculty demonstrated significantly higher awareness than interns regarding PCOS. A significant knowledge gap exists among medical professionals regarding periodontal–systemic relationships. Integrating oral health education into medical curricula and promoting interdisciplinary collaboration may improve awareness, referral practices, and patient care outcomes.
