Dimorphic Candida exist as commensal yeast carriages or infiltrate hyphae in the oral cavity. Here, we investigated the clinical relevance of Candida hyphae in non-pseudomembranous oral candidiasis (OC) by smears of tongue biofilms. We conducted a retrospective study of 2829 patients who had had tongue smears regardless of OC suspicion. Clinical characteristics were evaluated using a novel method of assessing hyphae. Clinical factors (moderate/severe stimulated pain, pain aggravated by stimulation, tongue dorsum appearance and initial topical antifungal use) were highly significant in the high-grade hyphae group but were statistically similar in the low-grade hyphae and non-observed hyphae group, suggesting low-grade hyphae infection as a subclinical OC state. In addition to erythematous candidiasis (EC), a new subtype named “morphologically normal symptomatic candidiasis” (MNSC) with specific pain patterns and normal tongue morphology was identified. MNSC had a significantly higher proportion of moderate and severe stimulated pain cases than EC. Low unstimulated salivary flow rate (<0.1 mL/min) was found to be a common risk factor in MNSC and EC. In non-pseudomembranous OC, pain patterns were dependent on Candida hyphae degree regardless of tongue dorsum morphology. Morphologic differences seen in high-grade hyphae infection were not associated with systemic diseases or nutritional deficiencies.
Early diagnosis of temporomandibular disorders is challenging. Particularly, intra-articular temporomandibular joint (TMJ) abnormalities can only be confirmed using magnetic resonance imaging (MRI). This study aimed to develop a comprehensive screening method for MRI-detectable TMJ pathologies. We developed an interpretable deep learning framework that leveraged paired open- and closed-mouth TMJ panoramic radiographs and structured clinical metadata. The architecture integrated anatomically guided attention, multimodal clinical features, and ensemble learning for enhanced diagnostic accuracy and interpretability. Across 1355 patients (2710 joints), the best-performing ensemble framework achieved an area under the curve of 0.86, with a balanced classification of MRI-negative and -positive cases. Gradient-weighted Class Activation Mapping visualizations confirmed a consistent focus on the condylar regions, and ablation studies demonstrated the added value of clinical metadata and spatial attention. In conclusion, our prototype workflow can be useful to triage TMJ patients for MRI referral, thus supporting early detection of TMJ abnormalities and timely interventions.
This study was designed to establish safe guidelines for pediatric dental practice regarding temporomandibular joint (TMJ) range of motion (ROM) and mouth area (MA). A total of 438 children aged 3–15 years old of homogenous ethnicity participated in the study; the distribution of participants was approximately equal (sex; n = 15; age, n = 30). Maximum mouth opening (MMO), body height, weight, and age of each participant were recorded, and the TMJ ROM including anterior and lateral movements, MA, and mouth width were documented. Males showed higher mouth width, MMO, and MA values than females. MMO and MA increased with age, height, and weight in a statistically significant manner. MMO of 40 mm is reached by the age of 5.2 years, at a height of 105.9 cm and a weight of 18.6 kg. MMO showed a moderate correlation with age, height, weight, and mouth width, and MA moderately correlated with mouth width. Anterior and lateral movements did not show any close relation to these aforementioned factors. The findings of this study suggest that forcible mouth opening over 40 mm should be more cautiously considered, especially in children shorter than 105 cm, lighter than 18 kg and in children under 5 years old.
Objectives: This study aimed to analyze the quantitative fat fraction (FF) of the parotid gland in menopausal females with xerostomia using the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method. Methods: A total 138 parotid glands of 69 menopausal females were enrolled in our study and participants were divided into normal group and xerostomia group. The xerostomia group was divided into those with or without Sjögren’s syndrome. Participants underwent IDEAL-IQ sequences of MRI and the stimulated salivary flow test (s-SFR). The unpaired t-test was used to compare the FFs between the normal and xerostomia groups and between the subgroups with and without Sjögren’s syndrome. The correlation between FF and s-SFR was analyzed by Pearson’s correlation. Results: Excellent intra- and interobserver agreement during the measurement of FFs by IDEAL-IQ method (ICC>0.99, respectively). FF value in the xerostomia group was statistically significantly higher than the value in the normal group (p < 0.05). Within the xerostomia group, the average FF value of females with Sjögren’s syndrome was higher than that of females without Sjögren’s syndrome. However, the difference was not statistically significant (p > 0.05). Within the xerostomia group, FF value correlated negatively with s-SFR (p < 0.05). Conclusions: The FF of the parotid gland was higher in the xerostomia group than in the normal group and FF value and s-SFR showed a negative correlation. Analyses of the FF using IDEAL-IQ in menopausal females can be helpful for the quantitative diagnosis of xerostomia.
Background: Masticatory muscle training by chewing gum can be performed easily and improve masticatory muscle function and strength. However, increased masticatory muscle activity and function may alter the mandibular shape.Objective: We aimed to investigate the effects of gum chewing training on the occlusal force, masseter muscle thickness (MMT) and mandibular shape in healthy adults.Methods: We conducted a prospective randomised controlled trial from January 2020 to September 2020 at the Yonsei University College of Dentistry. Fifty‐eight participants were randomly assigned to the training and control groups. The training group chewed gum three times a day for 6 months, while the control group received no training. Changes in the maximum occlusal force and MMT were evaluated at baseline and after 1, 3 and 6 months. Changes in the mandibular shape were evaluated at baseline and after 6 months.Results: The mean maximum occlusal force of the training group at 3 months was significantly higher than that at baseline, which was also significantly different from that in the control group (p < .001). As the maximum occlusal force increased, the occlusal contact area also increased (p = .020). There was no statistically significant difference in MMT or mandibular shape compared to the baseline.Conclusion: Mastication training using gum increases maximum occlusal force due to an increase in occlusal contact area but has no effect on MMT or mandibular shape.